Conclusions

Automated self-care devices play an important and growing role in maintaining oral health. While many practitioners conscientiously seek to recommend the best device, the evidence seems to indicate that this is not possible nor practical. Rather, the research indicates the expected potential from most products instead of the superiority of one particular brand. 12,13,19,20,23,56,57 Additionally, what stands out is the inability of any one product to “do it all.” Certainly, automatic toothbrushes have the greatest abundance of research to document their plaque removing abilities,
3,5,6,8-16 but home irrigation provides greater evidence in the reduction of bleeding and pathogens. 44-46,48-50,52-55,62

Most automated devices are evaluated on the standard of reduction of clinical parameters such PI, BI, GI, PD, or CAL. However, recent studies by O’Beirne, et al. and Cutler, et al. demonstrate that a new benchmark may be approaching for product efficacy; the reduction of inflammatory cytokines.24,62 IL-1ß and PGE2 have been identified not only as primary agents in alveolar bone destruction, but also for the possible role they may play in heart disease and preterm low birth weight babies.63-68 Because of this, in the future, the multifunctional role that practitioners seek for product recommendations may not be one which will remove plaque and reduce gingivitis, but rather one which benefits both oral and general health.

There are many excellent, evidence- based automated self-care devices available to help clients. Due to growing client acceptance and appeal, the market is likely to continue to grow, and new brands of products will be introduced. However, it is important to keep in mind that research on one brand of product does not apply to a different brand. Each device has its own unique mechanism of action. Automatic brushes, particularly, have varying brush head configurations and sizes and powered flossers utilize different types of filaments and vibrations. It is important to look at findings from clinical research before making any product recommendations.