Discussion
ABI, gingivitis, disability, cognitive disability
GINGIVITIS, DENTAL PLAQUE, PLAQUE
This study was performed to evaluate the efficacy of a new double-headed toothbrush with rotating handle (Balene®) in removing dental plaque in patients with ABI. Although technological advances have helped improve the autonomy of individuals with disability and have facilitated their caregivers’ workload and that of health practitioners in providing dental care, attention to the oral health of patients with ABI is still very low [This study showed that the Balene® toothbrush significantly removes dental plaque, a result confirmed by other authors who have indicated that toothbrushes with multiple heads reduce the accumulation of plaque, promoting the resolution of gingivitis and reaching difficult-to-access intraoral locations in healthy adults [No significant differences between the Balene® toothbrush and the conventional toothbrush in terms of plaque removal were observed in this trial, as has already been demonstrated in a group of systemically healthy volunteers [When using the Balene® toothbrush, there were no significant differences in plaque removal efficacy when comparing the modality of autonomous versus assisted toothbrushing. Although this study did not compare the efficacy of the Balene® toothbrush with that of the conventional toothbrush when considering the toothbrushing modality (due to sample size limitations), it has been suggested that, for patients with physical and/or cognitive disability, multi-head toothbrushes are especially indicated when total assistance is required to perform the toothbrushing [In systemically healthy individuals, the Balene® toothbrush was safer, and users rated its efficiency and efficacy as satisfactory [This pilot study is not exempt from certain limitations that require the results to be interpreted with caution. The sample size corresponds to that of a study group of advisability. Recruiting all participants of the same center has advantages in terms of supervision, diet, and routine but requires the assumption that the study’s conclusions cannot be extrapolated to other groups. Moreover, there is the possibility of a carry-over effect regarding the order in which the two toothbrushes were applied, given that this study did not analyze the carry-over effect, as well as the lack of attendance by certain participants to one of the appointments. With the oral hygiene index employed in this study [