Tooth Brushing and Cervical Abrasion in Full-Mouth Rehabilitation Patients

Objectives: Cervical abrasion is commonly linked to improper brushing and full-mouth rehabilitation (FMR) patients may be particularly vulnerable. This study evaluated the association between brushing practices and cervical abrasion progression in FMR patients, and compared a novel beat sound-guided toothbrush with a conventional soft-bristle manual toothbrush. Methods: Prospective, two-arm, controlled clinical trial with 80 participants (40 per group) recruited from the Department of Prosthodontics, Saveetha Dental College. Objectives are stated explicitly in the Methods (see below). Group A used a conventional manual toothbrush; Group B used an institutional prototype beat sound-guided toothbrush designed to promote vertical brushing (details and limitations of the prototype are described in Methods). Cervical abrasion severity was measured using the Smith & Knight Index at baseline and 6 months. Brushing behaviour was assessed using a validated multi-method approach (baseline questionnaire, clinician-observed demonstration, and monthly verification). Between-group comparisons used independent t-tests; within-group changes were assessed with paired t-tests. Statistical significance was set at p < 0.05. With n=40 per group the study had 80% power to detect an effect size (Cohen’s d) of ~0.63 at alpha = 0.05. Results: At 6 months Group A (conventional) showed a mean increase in Smith & Knight score of 0.7 ± 0.30 (mean ± SD), while Group B (beat sound-guided) showed an increase of 0.2 ± 0.11. The between-group difference in change scores was statistically significant (independent t-test, p = 0.012, mean difference = 0.50, 95% CI 0.11–0.89). Horizontal brushing behaviour (clinician-observed and self-reported) correlated with larger abrasion progression (Spearman rho = 0.42, p = 0.003). Conclusion: The beat sound-guided toothbrush was associated with reduced short-term progression of cervical abrasion compared with conventional manual brushing in this cohort of FMR patients. Given design limitations (sample size, 6-month follow-up, and potential measurement limitations) conclusions are tentative and should be confirmed in larger, blinded, and longer trials.