Karthiga Sakthi, Roopali M Sankeshwari, Anil V Ankola, David Coutinho, Biswadeep Roychowdhury, Varkey Nadakkavukuran Santhosh, Dorothy Dutta
Powered and manual toothbrushes demonstrated comparable overall effectiveness under supervised toothbrushing in people with IDs. Irrespective of powered toothbrushes and manual toothbrushes, supervision and the role of caregivers played a significant role in improving the oral hygiene of people with ID. However, the limited number of studies available for pooled analysis (n = 3) constrains the statistical power and certainty of these estimates.
BACKGROUND: Individuals with intellectual disabilities (IDs) often face significant oral health challenges due to limited motor skills, behavioural difficulties and dependence on caregivers for daily oral hygiene maintenance. The effectiveness of the types of toothbrushes, powered versus manual toothbrushes, under supervised brushing in this population remains unclear.
OBJECTIVES: This study aimed to assess the effectiveness of powered versus manual toothbrushes under supervised toothbrushing among individuals with intellectual and cognitive disabilities using clinical parameters.
METHODS: A comprehensive search was conducted across four databases (PubMed, Scopus, Cochrane Library and ProQuest) and Google Scholar from inception to November 2025. Studies assessing the effectiveness of powered vs. manual toothbrushes among individuals with mild to moderate ID and comorbidities were included. Data extraction followed a standardised protocol, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Meta-analysis was performed using a random-effects model.
RESULTS: Eleven studies from seven countries were included. Three studies (n = 3) were suitable for meta-analysis of plaque reduction using the Quigley-Hein plaque index. The pooled effect size, calculated using Hedges' g, showed moderate heterogeneity (I2 = 45.5%, p = 0.159). Three studies have reported that powered is equal to manual toothbrush, whereas five studies reported that powered is superior to manual toothbrush.
CONCLUSION: Powered and manual toothbrushes demonstrated comparable overall effectiveness under supervised toothbrushing in people with IDs. Irrespective of powered toothbrushes and manual toothbrushes, supervision and the role of caregivers played a significant role in improving the oral hygiene of people with ID. However, the limited number of studies available for pooled analysis (n = 3) constrains the statistical power and certainty of these estimates.