Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Improving Oral Health Assisted by Smart Powered Toothbrushes and Exploring Their Role in Innovative Health Technology
Blekinge Institute of Technology, Faculty of Engineering, Department of Health. Blekinge Institute Of Technology.ORCID iD: 0000-0001-9148-9582
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Maintaining good oral health is critical to healthy aging, as cognitive decline often accelerates the deterioration of oral health. Conversely, poor oral health can exacerbate cognitive decline. The thesis examines if introducing a powered toothbrush could prevent the deterioration of oral health in older individuals with mild cognitive impairment (MCI) and maintain a good quality of life. Another aim was to evaluate the actual use and the possibility of using the powered toothbrush as a carrier for other health sensors. From an interdisciplinary perspective, it examines technology's direct and indirect impact on oral health, which aligns with the  World  Health  Organization's definition of  applied health  technology. Maintaining oral health is critical in a growing aging population and with the increased incidence of MCI. The thesis includes four sub-studies. A pilot study was conducted on healthy adults, where core body temperature was assessed with a sensor attached to the toothbrush. For study I-III, two hundred and thirteen participants who met specific criteria such as age, memory problems, and cognitive levels were initially recruited. Oral health data with medical, cognitive, and quality of life assessments were collected over two years, with visits scheduled every six months. Ethical considerations followed the Declaration of Helsinki, which emphasized informed consent, participant autonomy, and dignity protection, which are particularly important for vulnerable populations such as individuals with MCI. This thesis shows that it is possible to maintain and improve oral health measured by Plaque Index (PI), Bleeding on Probing (BOP), and Periodontal Pocket depth 4mm or deeper (PPD≥4 mm) in a group of older individuals with MCI for at least 24 months. The results underline the potential of smart toothbrushes as tools for improved oral health and as carriers of sensors for health monitoring.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2024.
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 2024:13
Keywords [en]
Mild Cognitive Impairment, Smart Powered Toothbrush, Oral Health, Health Monitoring Sensors
National Category
Dentistry
Research subject
Applied Health Technology
Identifiers
URN: urn:nbn:se:bth-26839ISBN: 978-91-7295-486-1 (print)OAI: oai:DiVA.org:bth-26839DiVA, id: diva2:1892133
Public defence
2024-11-07, J 1630, Blekinge Tekniska Högskola, Karlskrona, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2024-09-13 Created: 2024-08-26 Last updated: 2024-10-14Bibliographically approved
List of papers
1. Use of a powered toothbrush to improve oral health in individuals with mild cognitive impairment
Open this publication in new window or tab >>Use of a powered toothbrush to improve oral health in individuals with mild cognitive impairment
2023 (English)In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 40, no 1, p. 74-82Article in journal (Refereed) Published
Abstract [en]

Objectives

The aim of the study is to investigate whether the use of a powered toothbrush could maintain oral health by reducing the dental plaque (PI), bleeding on probing (BOP), and periodontal pocket depth (PPD) ≥4 mm in a group of individuals with MCI and also if changes in oral health affect various aspects of quality of life.

Background

People with cognitive impairment tend to have poor oral hygiene and poorer Quality of life. In the present study, the participants were asked to use a powered toothbrush for at least 2 min morning and evening and no restrictions were given against the use of other oral care products. The participant survey conducted at each examination demonstrated that 61.2% of participants at baseline claimed to have experience of using a powered toothbrush, 95.4% at 6 months and 95% after 12 months. At the same time, the use of manual toothbrushes dropped from 73.3% to 44.7% from baseline to the 12-month check-up. This shows that several participants continue to use the manual toothbrush in parallel with the powered toothbrush, but that there is a shift towards increased use of the powered toothbrush. Removal of dental biofilm is essential for maintaining good oral health. We investigated whether using a powered toothbrush reduces the presence of dental plaque, bleeding on probing and periodontal pockets ≥4 mm in a group of older individuals with mild cognitive impairment.

Materials and methods

Two hundred and thirteen individuals with the mean age of 75.3 years living without official home care and with a Mini-Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous six months were recruited from the Swedish site of a multicenter project, Support Monitoring And Reminder Technology for Mild Dementia (SMART4MD) and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations and MMSE tests were conducted at baseline, 6 and 12 months.

Results

One hundred seventy participants, 36.5% women and 63.5% men, completed a 12-month follow-up. The use of a powered toothbrush resulted, for the entire group, in a significant decrease in plaque index from 41% at baseline to 31.5% after 12 months (P < .000). Within the same time frame, the values for bleeding on probing changed from 15.1% to 9.9% (P < .000) and the percentage of probing pocket depths ≥4 mm from 11.5% to 8.2% (P < .004). The observed improvements in the Oral Health Impact Profile 14 correlate with the clinical improvements of oral health.

Conclusion

The use of a powered toothbrush was associated with a reduction of PI, BOP and PPD over 12 months even among individuals with low or declining MMSE score. An adequately used powered toothbrush maintain factors that affect oral health and oral health-related Quality of Life in people with mild cognitive impairment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
mild cognitive impairment, oral health, powered toothbrush, quality of life
National Category
Dentistry
Research subject
Applied Health Technology
Identifiers
urn:nbn:se:bth-22572 (URN)10.1111/ger.12619 (DOI)000745467500001 ()2-s2.0-85123501414 (Scopus ID)
Projects
SMART4MD
Funder
EU, Horizon 2020, 643399
Note

open access

Available from: 2022-01-22 Created: 2022-01-22 Last updated: 2024-08-26Bibliographically approved
2. The long-term effect on oral health and quality of life using a powered toothbrush in individuals with mild cognitive impairment. An intervention trial
Open this publication in new window or tab >>The long-term effect on oral health and quality of life using a powered toothbrush in individuals with mild cognitive impairment. An intervention trial
2024 (English)In: Special Care in Dentistry: managing special patients, settings, and situations, ISSN 0275-1879, E-ISSN 1754-4505, Vol. 44, no 6, p. 1700-1708Article in journal (Refereed) Published
Abstract [en]

Background: The number of older individuals with mild cognitive impairment and neurocognitive diseases is increasing, which may rapidly deteriorate oral health and Quality of life. Therefore, removing dental biofilm is essential for maintaining good oral health. The present study aimed to investigate whether introducing a powered toothbrush reduces the presence of dental plaque, bleeding on probing, and periodontal pockets ≥4 mm, leading to maintained or improved oral health and improved Quality of life in a group of older individuals with mild cognitive impairment. Methods: Two hundred and thirteen individuals aged 55 or older living without official home care with a Mini–Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous 6 months were recruited and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations, Quality of life examinations, and MMSE tests were conducted at baseline, 6, 12, and 24 months. The intervention group was compared to control groups at baseline and 24-month examination. It was divided into an MMSE high group with a score of more than 26 and an MMSE low group with a score of 26 and lower or decreasing two steps or more for 12 months. Results: PI, BOP, and PPD≥4 mm improved continuously in both MMSE groups during the 24 months of the study. The values for QoL-AD deteriorated over time, while the oral health-related Quality of life did not show any statistically significant changes. Conclusions: Introducing a powered toothbrush improved PI, BOP, and PPD≥4 mm over 24 months, even among individuals with low or declining MMSE scores. Improved oral health is associated with a preserved OHR-QoL. © 2024 The Author(s). Special Care in Dentistry published by Special Care Dentistry Association and Wiley Periodicals LLC.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
mild cognitive impairment, oral health, powered toothbrush, quality of life
National Category
Dentistry
Identifiers
urn:nbn:se:bth-26767 (URN)10.1111/scd.13040 (DOI)001269200200001 ()38994574 (PubMedID)2-s2.0-85198070408 (Scopus ID)
Available from: 2024-08-08 Created: 2024-08-08 Last updated: 2024-11-22Bibliographically approved
3. Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health
Open this publication in new window or tab >>Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health
Show others...
2024 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 28, no 1, article id 8Article in journal (Refereed) Published
Abstract [en]

Objectives: The study aimed to investigate how the objective use of a powered toothbrush in frequency and duration affects plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm in elderly individuals with MCI. A second aim was to compare the objective results with the participants’ self-estimated brush use.

Materials and methods: Objective brush usage data was extracted from the participants’ powered toothbrushes and related to the oral health variables plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm. Furthermore, the objective usage data was compared with the participants’ self-reported brush usage reported in a questionnaire at baseline and 6- and 12-month examination.

Results: Out of a screened sample of 213 individuals, 170 fulfilled the 12-month visit. The principal findings are that despite the objective values registered for frequency and duration being lower than the recommended and less than the instructed, using powered toothbrushes after instruction and information led to improved values for PI, BOP, and PPD ≥ 4 mm in the group of elderly with MIC.

Conclusions: Despite lower brush frequency and duration than the generally recommended, using a powered toothbrush improved oral health. The objective brush data recorded from the powered toothbrush correlates poorly with the self-estimated brush use. Clinical relevance: Using objective brush data can become one of the factors in the collaboration to preserve and improve oral health in older people with mild cognitive impairment.

Trial registration: ClinicalTrials.gov Identifier: NCT05941611, retrospectively registered 11/07/2023. © 2023, The Author(s).

Place, publisher, year, edition, pages
Springer Science+Business Media B.V., 2024
Keywords
Elderly individuals, Mild cognitive impairment, Oral health, Powered toothbrush
National Category
Dentistry
Identifiers
urn:nbn:se:bth-25835 (URN)10.1007/s00784-023-05407-2 (DOI)001132641500001 ()2-s2.0-85180240432 (Scopus ID)
Available from: 2023-12-30 Created: 2023-12-30 Last updated: 2025-01-02Bibliographically approved
4. Measurement of body temperature in the oral cavity with a temperature sensor integrated with a powered toothbrush
Open this publication in new window or tab >>Measurement of body temperature in the oral cavity with a temperature sensor integrated with a powered toothbrush
Show others...
2023 (English)In: SN Applied Sciences, ISSN 2523-3963, E-ISSN 2523-3971, Vol. 5, no 1, article id 22Article in journal (Refereed) Published
Abstract [en]

This paper presents a method for collecting core body temperature data via a temperature sensor integrated into a powered toothbrush. The purpose is to facilitate the collection of temperature data without any extended effort from the user. Twelve participants use a powered toothbrush with a temperature sensor mounted on the brush head twice daily for two months. The obtained values are compared with those from a conventional fever thermometer approved for intraoral use. The results show that the temperature sensor–integrated powered toothbrush can measure the core body temperature and provide values comparable to those provided by a traditional oral thermometer. The use of the device can facilitate disease monitoring, fertility control, and security solutions for the elderly. © 2022, The Author(s).

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Core body temperature, Powered toothbrush, Thermometer, Data acquisition, Disease control, Physiology, Thermometers, Body temperature, Control solutions, Core body, Disease monitoring, Measurements of, Oral cavity, Security solutions, Temperature data, Temperature sensors
National Category
Dentistry
Identifiers
urn:nbn:se:bth-24175 (URN)10.1007/s42452-022-05250-2 (DOI)000898780700001 ()2-s2.0-85144436915 (Scopus ID)
Note

open access

Available from: 2023-01-12 Created: 2023-01-12 Last updated: 2024-08-26Bibliographically approved

Open Access in DiVA

fulltext(4114 kB)528 downloads
File information
File name FULLTEXT01.pdfFile size 4114 kBChecksum SHA-512
8808f52dd1dfe80d4652b885cb77c15fa8dd8b4229616e352f9ff6a3a5144804ba0b71b64f6aad8e4bb8ba2b4da1bb4511167732c76283351130f58fc941d43b
Type fulltextMimetype application/pdf

Search in DiVA

By author/editor
Flyborg, Johan
By organisation
Department of Health
Dentistry

Search outside of DiVA

GoogleGoogle Scholar
Total: 531 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 1309 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf