{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:30:42Z","timestamp":1787070642288,"version":"build-2736575974"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01 (SMD: Standard Mean Difference) 95% confidence interval: \u22124.23 (\u22127.62, \u22120.85),\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/drj.drj_286_24","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T11:00:06Z","timestamp":1739962806000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of the effectiveness of novel oral hygiene aids in the prevention of gingival diseases in children and adolescents with special healthcare needs \u2013 A systematic review and meta-analysis"],"prefix":"10.4103","volume":"22","author":[{"given":"Varunika V.","family":"Sahai","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, KAHER\u2019S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivayogi M.","family":"Hugar","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, KAHER\u2019S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhuvanesh N.","family":"Bhusari","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, KAHER\u2019S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niraj","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, KAHER\u2019S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna R.","family":"Kajave","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, KAHER\u2019S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehal S.","family":"Kumthekar","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, KAHER\u2019S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2]]},"reference":[{"key":"R1-20250524","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/jisppd.jisppd_229_24","article-title":"For every child, every right!","volume":"42","author":"Asokan","year":"2024","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"R2-20250524","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1093\/pch\/18.1.37","article-title":"Canadian Paediatric Society Community Paediatrics Committee Oral health care for children \u2013A call for action","volume":"18","author":"Rowan-Legg","year":"2013","journal-title":"Paediatr Child Health"},{"key":"R3-20250524","first-page":"107","article-title":"Oral hygiene status of disabled children and adolescents attending special schools of South Canara, India","volume":"2","author":"Rao","year":"2005","journal-title":"Hong Kong Dent J"},{"key":"R5-20250524","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1080\/00016350410010054","article-title":"Clinical evaluation of the plaque-removing ability of three different toothbrushes in a mentally disabled group","volume":"62","author":"Do\u011fan","year":"2004","journal-title":"Acta Odontol Scand"},{"key":"R7-20250524","doi-asserted-by":"crossref","first-page":"23","DOI":"10.5005\/jcdp-5-4-23","article-title":"The comparison of various oral hygiene strategies in neuromuscularly disabled individuals","volume":"5","author":"Bozkurt","year":"2004","journal-title":"J Contemp Dent Pract"},{"key":"R9-20250524","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/jrsm.1090","article-title":"Assessing baseline imbalance in randomised trials:Implications for the Cochrane risk of bias tool","volume":"5","author":"Corbett","year":"2014","journal-title":"Res Synth Methods"},{"key":"R10-20250524","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5005\/jp-journals-10005-1949","article-title":"Comparison of plaque removal efficacy with powered and manual toothbrushes in 10-14-year-old visually and auditory impaired children:A randomized controlled study","volume":"14","author":"Patel","year":"2021","journal-title":"Int J Clin Pediatr Dent"},{"key":"R11-20250524","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4103\/jisp.jisp_356_20","article-title":"A prospective case-control study to evaluate oral health status before and after intervention using different dental aids in children with visual impairment","volume":"25","author":"Sinha","year":"2021","journal-title":"J Indian Soc Periodontol"},{"key":"R12-20250524","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/scd.12152","article-title":"Effect on plaque control in children patients with Down syndrome using digital brush with or without chlorhexidine:A randomized clinical trial","volume":"36","author":"Stefanini","year":"2016","journal-title":"Spec Care Dentist"},{"key":"R13-20250524","first-page":"222","article-title":"Clinical evaluation of chlorhexidine for the control of dental biofilm in children with special needs","volume":"28","author":"Chibinski","year":"2011","journal-title":"Community Dent Health"},{"key":"R14-20250524","first-page":"501","article-title":"Dental plaque removal with two special needs toothbrushes in patients with Down syndrome:A parallel-group randomised clinical trial of efficacy","volume":"20","author":"Fageeh","year":"2022","journal-title":"Oral Health Prev Dent"},{"key":"R15-20250524","first-page":"6","article-title":"Clinical and microbiological evaluation of manual toothbrush, electric toothbrush and Nano-b toothbrush on plaque removing efficacy among visually impaired children:A randomised clinical trial","volume":"16","author":"Jaya","year":"2022","journal-title":"J Clin Diagn Res"},{"key":"R16-20250524","first-page":"462","article-title":"Effectiveness of two different modifications of manual toothbrush on plaque control-a multiple baseline trial among 12-17 year old children with cerebral palsy","volume":"2","author":"Iyer","year":"2019","journal-title":"Int J Dent Sci Innov Res"},{"key":"R17-20250524","first-page":"219","article-title":"Clinical evaluation of the plaque-removing ability of four different toothbrushes in visually impaired children","volume":"10","author":"Sharma","year":"2012","journal-title":"Oral Health Prev Dent"},{"key":"R18-20250524","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.3390\/healthcare9091130","article-title":"Does customized handle toothbrush influence dental plaque removal in children with Down syndrome?A randomized controlled trial","volume":"9","author":"Droubi","year":"2021","journal-title":"Healthcare (Basel)"},{"key":"R19-20250524","doi-asserted-by":"crossref","first-page":"e057","DOI":"10.1590\/1807-3107bor-2020.vol34.0057","article-title":"Electric toothbrush for biofilm control in individuals with Down syndrome:A crossover randomized clinical trial","volume":"34","author":"Silva","year":"2020","journal-title":"Braz Oral Res"},{"key":"R20-20250524","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/scd.12334","article-title":"Evaluation of the effectiveness of a custom-made toothbrush in maintaining oral hygiene and gingival health in cerebral palsy patients","volume":"38","author":"Rai","year":"2018","journal-title":"Spec Care Dentist"},{"key":"R21-20250524","first-page":"481","article-title":"Randomized clinical trial on the efficacy of electric and manual toothbrushes in plaque removal and gingivitis control in visually impaired school students","volume":"48","author":"Cui","year":"2017","journal-title":"Quintessence Int"},{"key":"R22-20250524","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/ipd.12132","article-title":"Mechanical control of biofilm in children with cerebral palsy:A randomized clinical trial","volume":"25","author":"Ferraz","year":"2015","journal-title":"Int J Paediatr Dent"},{"key":"R23-20250524","first-page":"42","article-title":"Comparison of powered toothbrush with or without parental assistance with manual toothbrush on plaque and gingivitis in mentally challenged children of 12-18 years in Pune, India","volume":"22","author":"Jamkhande","year":"2013","journal-title":"J Pak Dent Assoc"},{"key":"R24-20250524","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/scd.12069","article-title":"Chlorhexidine spray as an adjunct in the control of dental biofilm in children with special needs","volume":"34","author":"Viana","year":"2014","journal-title":"Spec Care Dentist"},{"key":"R25-20250524","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fpubh.2023.1036499","article-title":"Prevalence, pattern and determinants of disabilities in India:Insights from NFHS-5 (2019-21)","volume":"11","author":"Pattnaik","year":"2023","journal-title":"Front Public Health"},{"key":"R27-20250524","first-page":"1","article-title":"Efficacy of power versus manual toothbrushing for compromised patients in reducing plaque index and gingival index","volume":"4","author":"Vatsa","year":"2021","journal-title":"Int J Health Clin Res"},{"key":"R28-20250524","first-page":"475","article-title":"What's better for children;an electric or manual toothbrush?","volume":"5","author":"Karimi","year":"2021","journal-title":"Interv Pediatr Dent Open Access J"},{"key":"R29-20250524","doi-asserted-by":"crossref","first-page":"6","DOI":"10.20473\/ijdm.v4i1.2021.6-10","article-title":"Effectiveness of the use of manual and electric toothbrushes and the effect of educational brushing teeth with video animation on OHI-S children with Down syndrome","volume":"4","author":"Zahra","year":"2021","journal-title":"Indones J Dent Med"},{"key":"R30-20250524","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/jar.12561","article-title":"A systematic review and meta-analysis of dental plaque control among children and adolescents with intellectual disabilities","volume":"32","author":"McGrath","year":"2019","journal-title":"J Appl Res Intellect Disabil"},{"key":"R31-20250524","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/scd.12821","article-title":"Powered or manual toothbrushing for people with physical or intellectual disabilities \u2013A systematic review","volume":"43","author":"Kalf-Scholte","year":"2023","journal-title":"Spec Care Dentist"},{"key":"R33-20250524","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3390\/dj11020046","article-title":"Systematic review and meta analysis of the relative effect on plaque index among pediatric patients using powered (electric) versus manual toothbrushes","volume":"11","author":"Graves","year":"2023","journal-title":"Dent J (Basel)"},{"key":"R34-20250524","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/6874144","article-title":"Powered toothbrushes:An opportunity for biofilm and gingival inflammation control","author":"R\u00f6sing","year":"2022","journal-title":"Int J Dent"},{"key":"R35-20250524","first-page":"221","article-title":"Plaque removal efficacy with powered and manual toothbrushes in visually impaired children using three different sensory input methods in dental health education-a comparative evaluation","volume":"42","author":"Sree","year":"2023","journal-title":"Latin Am J Pharm Life Sci J"},{"key":"R36-20250524","doi-asserted-by":"crossref","first-page":"500","DOI":"10.4103\/0976-237X.169848","article-title":"A clinicomicrobiological study to evaluate the efficacy of manual and powered toothbrushes among autistic patients","volume":"6","author":"Vajawat","year":"2015","journal-title":"Contemp Clin Dent"},{"key":"R37-20250524","first-page":"09","article-title":"Utilization of special grip toothbrushes for children with cerebral palsy","volume":"11","author":"Pasiga","year":"2020","journal-title":"Syst Rev Pharm"},{"key":"R38-20250524","first-page":"291","article-title":"The curved-bristle toothbrush:An aid for the handicapped population","volume":"55","author":"Williams","year":"1988","journal-title":"ASDC J Dent Child"},{"key":"R39-20250524","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1902\/jop.2000.71.5.785","article-title":"An evaluation of the efficacy of a curved bristle and conventional toothbrush. A comparative clinical study","volume":"71","author":"Chava","year":"2000","journal-title":"J Periodontol"},{"key":"R40-20250524","doi-asserted-by":"crossref","first-page":"122445","DOI":"10.1016\/j.jhazmat.2020.122445","article-title":"Nano-enabled, antimicrobial toothbrushes \u2013How physical and chemical properties relate to antibacterial capabilities","volume":"396","author":"Johnson","year":"2020","journal-title":"J Hazard Mater"},{"key":"R41-20250524","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/idh.12433","article-title":"Microbial contamination and plaque scores of nanogold-coated toothbrush","volume":"18","author":"Durgesh","year":"2020","journal-title":"Int J Dent Hyg"},{"key":"R42-20250524","first-page":"137","article-title":"Effectiveness of triple-headed toothbrushes and the influence of the person who performs the toothbrushing on biofilm removal","volume":"9","author":"Oliveira","year":"2011","journal-title":"Oral Health Prev Dent"},{"key":"R43-20250524","doi-asserted-by":"crossref","first-page":"546","DOI":"10.4103\/jispcd.JISPCD_93_21","article-title":"Plaque removal efficacy of triple-headed toothbrush in 4-6-year-old children:A randomized crossover study","volume":"11","author":"Youcharoen","year":"2021","journal-title":"J Int Soc Prev Community Dent"},{"key":"R44-20250524","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/idh.12283","article-title":"Plaque removal with triple-headed versus single-headed manual toothbrushes-a systematic review","volume":"16","author":"Kalf-Scholte","year":"2018","journal-title":"Int J Dent Hyg"},{"key":"R45-20250524","first-page":"115","article-title":"Comparison of the clinical effectiveness of a single and a triple-headed toothbrushes in a population of mentally retarded patients","volume":"38","author":"Sauvetre","year":"1995","journal-title":"Bull Group Int Rech Sci Stomatol Odontol"},{"key":"R46-20250524","doi-asserted-by":"crossref","first-page":"389","DOI":"10.5005\/jp-journals-10005-2404","article-title":"A randomized controlled trial for evaluation of the effectiveness of oral irrigator and interdental floss for plaque control in children with visual impairment","volume":"15","author":"Deepika","year":"2022","journal-title":"Int J Clin Pediatr Dent"},{"key":"R47-20250524","doi-asserted-by":"crossref","first-page":"e0158339","DOI":"10.1371\/journal.pone.0158339","article-title":"Prevention and periodontal treatment in Down syndrome patients:A systematic review","volume":"11","author":"Ferreira","year":"2016","journal-title":"PLoS One"},{"key":"R48-20250524","doi-asserted-by":"crossref","first-page":"S188","DOI":"10.4103\/0976-237X.166811","article-title":"Evaluation and comparison of the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism","volume":"6","author":"Awasthi","year":"2015","journal-title":"Contemp Clin Dent"},{"key":"R49-20250524","first-page":"554","article-title":"Comparative assessment of herbal, saturated saline and chlorhexidine mouthrinse on oral hygiene status of visually compromised children:A randomised parallel arm clinical study","volume":"11","author":"Disha","year":"2023","journal-title":"J Coast Life Med"},{"key":"R50-20250524","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/scd.12597","article-title":"Evaluation of antibacterial efficacy of Triphala toothwipes on oral Streptococcus mutans count in intellectually disabled children","volume":"41","author":"Deshpande","year":"2021","journal-title":"Spec Care Dentist"},{"key":"R51-20250524","first-page":"e26874","article-title":"Effectiveness of Apple Cider Vinegar and Mechanical Removal on Dental Plaque and Gingival Inflammation of Children With Cerebral Palsy","volume":"14","author":"Asaad","year":"2022","journal-title":"Cureus"},{"key":"R52-20250524","first-page":"140","article-title":"Clinical and microbiological evaluation of the use of toothpaste containing 1% chlorhexidine and the influence of motivation on oral hygiene in patients with motor deficiency","volume":"30","author":"de Andrade Meyer","year":"2010","journal-title":"Spec Care Dentist"},{"key":"R53-20250524","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/j.1600-0528.2009.00488.x","article-title":"Evaluation of the mechanical and chemical control of dental biofilm in patients with Down syndrome","volume":"37","author":"Teitelbaum","year":"2009","journal-title":"Community Dent Oral Epidemiol"}],"container-title":["Dental Research Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/drj.drj_286_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:34:00Z","timestamp":1787067240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/drj.drj_286_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":48,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/drj.drj_286_24","relation":{},"ISSN":["1735-3327","2008-0255"],"issn-type":[{"value":"1735-3327","type":"print"},{"value":"2008-0255","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-06-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}