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Toothbrushing methods to use in children: a systematic review.

PURPOSE
To identify the most effective methods of toothbrushing in children, assessed according to their ability to remove dental plaque.


MATERIALS AND METHODS
After electronic research, randomised clinical studies in children which compared different toothbrushing techniques or different frequencies with the same technique were included. The evaluation criterion was plaque index.


RESULTS
Six of 534 identified articles were included. Because the protocols differed, regrouping of data was not possible. The level of evidence was moderate due to imprecise methods. The horizontal technique was found to be the most effective up to 6 to 7 years of age. For older children, there was no statistical difference between the techniques. No randomised clinical trial assessed different frequencies of toothbrushing.


CONCLUSION
Based on current knowledge, it would appear prudent to propose that, at the stage of the late mixed dentition, the technique adopted by the child be modified to improve brushing quality without favouring a particular technique. In younger children, the horizontal technique should be advised. The recommendations published via the Internet by national and international associations should be reconsidered.