Development of Tooth Brushing Recommendations Through Professional Consensus

Anne-Marie Glenny; Tanya Walsh; Makiko Iwasaki; Elham Kateeb; Mariana Minatel Braga; Philip Riley; Paulo Melo

doi:10.1016/j.identj.2023.10.018

Development of Tooth Brushing Recommendations Through Professional Consensus

Int Dent J. 2023 Dec 4:S0020-6539(23)00963-2. doi: 10.1016/j.identj.2023.10.018. Online ahead of print.

Authors

Anne-Marie Glenny¹, Tanya Walsh², Makiko Iwasaki³, Elham Kateeb⁴, Mariana Minatel Braga⁵, Philip Riley⁶, Paulo Melo⁷

Affiliations

¹ Division of Dentistry, School of Medical Sciences, University of Manchester, UK. Electronic address: a.glenny@manchester.ac.uk.
² Division of Dentistry, School of Medical Sciences, University of Manchester, UK. Electronic address: tanya.walsh@manchester.ac.uk.
³ Iwasaki Dental Clinic, Kyoto, Japan.
⁴ Oral Health Research and Promotion Unit, Al-Quds University, Jerusalem, State of Palestine.
⁵ School of Dentistry, University of São Paulo, Brazil.
⁶ Division of Dentistry, School of Medical Sciences, University of Manchester, UK.
⁷ Faculty of Dental Medicine, Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Portugal.

PMID: 38052700
DOI: 10.1016/j.identj.2023.10.018

Abstract

Introduction: Despite being a largely preventable disease, untreated caries of permanent teeth is estimated to affect almost 2 billion people worldwide, which is followed by severe periodontal disease. The aim of this work was to provide a professional consensus on tooth brushing methods and associated oral hygiene behaviours and develop evidence-informed recommendations.

Methods: An initial scoping search was undertaken to identify systematic reviews of relevance and key questions. This was followed by comprehensive evidence mapping of the literature focussing on systematic reviews and clinical guidelines. Electronic searches of several databases including MEDLINE (via Ovid), Embase (via Ovid), Epistemonikos, and The Cochrane Library were undertaken from 2000 to May 2022, alongside a guideline repository search. Considered Judgement Forms were developed detailing the underpinning evidence, balance between benefits and harms, potential impact on the population, and feasibility of implementation. An online survey comprising 22 draft recommendations was distributed to international members of all FDI committees, including the FDI Council. Participants were asked to indicate to what level they agreed or disagreed with for each recommendation and to provide feedback. The Considered Judgement Forms were provided for reference.

Results: Three hundred ten records were identified and mapped to different aspects of tooth brushing methods and associated behaviours. Research literature informed 7 Considered Judgement Forms comprising 12 questions with draft recommendations. Twenty-five participants from Asia, Europe, North and South America, Africa, and Australia provided feedback on the recommendations. More than 70% of respondents showed agreement with 21 of the 22 draft recommendations. Final recommendations were drafted with associated strength of recommendation.

Conclusion: Using a robust methodology and an international professional consensus, a set of evidence-informed recommendations was developed. These recommendations provide clinicians with practical guidance to facilitate communications with patients that may help to reinforce individual-level preventive strategies.

Keywords: Dental devices; Home care; Interdental cleaning; Mouth rinse; Oral hygiene; Tooth brushing.