The efficacy of powered toothbrushes: A systematic review and network meta‐analysis

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>This systematic review and network meta‐analysis synthesizes the available clinical evidence concerning efficacy with respect to plaque scores following a brushing action with oscillating‐rotating (OR) or high‐frequency sonic (HFS) powered toothbrushes (PTB) compared with a manual toothbrush (MTB) as control.</jats:p></jats:sec><jats:sec><jats:title>Material and methods</jats:title><jats:p>Databases were searched up to 1 August 2021, for clinical trials that evaluated the efficacy of a PTB with OR or HFS technology compared with an MTB on plaque removal after a single‐brushing action and conducted with healthy adult patients. Meta‐analysis (MA) and a network meta‐analysis (NMA) were performed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Twenty‐eight eligible publications, including 56 relevant comparisons, were retrieved. The overall NMA results for the mean post‐brushing score showed a statistically significant difference for the comparison between an OR PTB and an MTB (SMD = −0.43; 95% CI [−0.696;−0.171]). The change in plaque score data showed a significant effect of a PTB over an MTB and OR over HFS. Based on ranking, the OR PTB was highest, followed by the HFS PTB and the MTB.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Within the limitations of the present study design, based on the outcome following a single‐brushing action, it can be concluded that for dental plaque removal, there is a high certainty for a small effect of a PTB over an MTB. This supports the recommendation to use a powered toothbrush for daily plaque removal. There is moderate certainty for a very small benefit for the use of a powered toothbrush with an OR over an HFS mode of action.</jats:p></jats:sec>