• Ian G Needleman, Nicholas P Hirsch, Michele Leemans, David R Moles, Michael Wilson, Derren R Ready, Salim Ismail, Lena Ciric, Michael J Shaw, Martin Smith, Anne Garner, and Sally Wilson.
• Unit of Periodontology, International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK. i.needleman@eastman.ucl.ac.uk
• J. Clin. Periodontol. 2011 Mar 1;38(3):246-52.

AimTo investigate the effect of a powered toothbrush on colonization of dental plaque by ventilator-associated pneumonia (VAP)-associated organisms and dental plaque removal.Materials And MethodsParallel-arm, single-centre, examiner- and analyst-masked randomized controlled trial. Forty-six adults were recruited within 48 h of admission. Test intervention: powered toothbrush, control intervention: sponge toothette, both used four times per day for 2 min. Groups received 20 ml, 0.2% chlorhexidine mouthwash at each time point.ResultsThe results showed a low prevalence of respiratory pathogens throughout with no statistically significant differences between groups. A highly statistically significantly greater reduction in dental plaque was produced by the powered toothbrush compared with the control treatment; mean plaque index at day 5, powered toothbrush 0.75 [95% confidence interval (CI) 0.53, 1.00], sponge toothette 1.35 (95% CI 0.95, 1.74), p=0.006. Total bacterial viable count was also highly statistically significantly lower in the test group at day 5; Log(10) mean total bacterial counts: powered toothbrush 5.12 (95% CI 4.60, 5.63), sponge toothette 6.61 (95% CI 5.93, 7.28), p=0.002.ConclusionsPowered toothbrushes are highly effective for plaque removal in intubated patients in a critical unit and should be tested for their potential to reduce VAP incidence and health complications.© 2011 John Wiley & Sons A/S.

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