Evaluation of the effectiveness of novel oral hygiene aids in the prevention of gingival diseases in children and adolescents with special healthcare needs – A systematic review and meta‑analysis

Abstract

Background: Due to a lack of manual dexterity, impaired cognitive and general development, and
awareness of caregivers, special children are not able to maintain good oral health. This leads to
the development of dental plaque, gingival inflammation, and further periodontal diseases. It is, thus,
necessary for dentists and caregivers to understand which of oral hygiene aids can be best suited
for a child with special healthcare needs. The aim of this review is to evaluate the most efficacious
oral healthcare aids in children and adolescents with special healthcare needs.
Materials and Methods: Systematic search was conducted in databases: PubMed, Cochrane,
Google Scholar, Scopus, and ProQuest for studies published from January 1, 2000, till December 31,
2023. Randomized trials conducted among children and adolescents with special healthcare needs
below 18 years using oral hygiene aids to reduce plaque were included in this review.
Results: A total of 23 articles satisfying eligibility criteria were included in the systematic review and
11 articles for meta‑analysis. Meta‑analysis was divided into two parts. Novel toothbrushes were more
effective than manual toothbrushes with P = 0.01 (SMD: Standard Mean Difference) 95% confidence
interval: −4.23 (−7.62, −0.85), I2 = 99.63%). In chemical oral hygiene aids, chlorhexidine (CHX) spray
at concentration of 0.12% was found to be more effective than placebo to control plaque and was
not statistically significant.
Conclusion: Current evidence suggests that novel mechanical oral hygiene aids used with CHX
spray as an adjunct can be best suited for children and adolescents with special healthcare needs
to control plaque.
Key Words: Adolescents, children, dental plaque, gingival inflammation, special healthcare
needs

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Shivayogi M. Hugar: Pubmed,Google Scholar