The Science Behind Sonicare For Kids

The Science Behind Sonicare For Kids

The Science Behind Sonicare For Kids

Notes from Dr. Joerg Strate

Vice President, Philips Oral Healthcare,

Clinical & Scientific Affairs

Sonicare For Kids—The First Sonicare Power Toothbrush

Designed for Children

Sonicare power toothbrushes have been the benchmark of modern oral hygiene devices ever since their first introduction nearly two decades ago. The combination of the most sophisticated technology and a unique user experience has provided patients around the world with outstanding results. The improvement of oral hygiene and maintenance of oral health have been recognized as key components of a healthy lifestyle. Establishing such habits and behaviors in children presents a unique challenge and an oppor tunity.

Dental caries remains the most common chronic childhood disease despite the continued effor ts to raise awareness of this risk.

Developing a Sonicare power toothbrush specifically designed for the needs of children seemed overdue. As with any Sonicare power toothbrush, Sonicare For Kids had to be suppor ted by sound clinical research that validates its high performance compared to other available solutions. But this Sonicare toothbrush had to do a lot more than that. The various developmental steps of children, as well as their gradually increasing dexterity, needed to be reflected in the design of this par ticular Sonicare—a design that promotes correct brushing habits and helps a child brush independently, a design that excites children and parents alike and is clinically proven to improve the oral hygiene behavior of children in different age groups.

The clinical research included here is an impressive testimonial of these accomplishments.

Sonicare For Kids is the first of its kind, and it may change the way we look at prevention and oral hygiene in children.

Table of Contents

Plaque Removal

Compliance

1 – 6

7 – 9

Sonicare For Kids

Plaque Removal

in vivo study

Comparison of plaque removal by Sonicare For Kids and a manual toothbrush in children aged 7–10 years

Millleman J, Putt M, Olson M, Master A, Jenkins W, Schmitt P, Strate J. International J Pediatric Dent.

2009; 19:s1

Objective

Methodology

Results

Conclusion

To compare the plaque removal efficacy and safety of Sonicare For Kids at “high” setting and Oral-B Stages 4 manual toothbrush (MTB) in children aged 7–10 years

Fifty-eight healthy children enrolled in and four withdrew from an IRB approved singleblind, randomized, parallel design study (totaling 32 females, 22 males; mean age 8.3 years).

Informed consent/assent (with parent) was obtained. All subjects abstained from brushing for 26 ± 6 hours prior to examination visits. At visit 1, subjects were screened for eligibility

(Turesky modified Quigley-Hein Plaque Index (TPI) >1.8). Eligible subjects were enrolled and instructed on use of both devices (Sonicare For Kids and MTB) in alternating manner at home (twice daily for two minutes) for a one-week familiarization period. At visit 2, baseline TPI was performed followed by a randomization and supervised two-minute brushing session with the assigned device. Post-brushing TPI scores were then obtained.

Safety was assessed in oral soft tissue examinations at visit 2. ANOVA was used for the primary statistical analysis.

Sonicare For Kids removed significantly more plaque than a manual toothbrush from the dentition overall (p=0.0001) as well as in hard-to-reach areas, i.e., the posterior teeth (p=0.0005) and the interproximal spaces (p<0.0001) of children aged 7–10 years. Both toothbrushes were safe to use.

Sonicare For Kids was found to remove significantly more plaque than Oral-B Stages

4 manual toothbrush in children aged 7–10 years. It is also proven safe and gentle on oral tissues.

% of Plaque

Reduction

50%

40%

30%

20%

10%

0%

45%

27%

47%

28%

43%

25%

44%

24%

42%

24%

Overall

(p=0.0001)

Anterior

(p=0.0003)

Posterior

(p=0.0005)

Interproximal

(p<0.0001)

Posterior

Interproximal

(p=0.0003)

Sonicare For Kids

Manual Toothbrush

2

Sonicare For Kids

Plaque Removal

in vivo study

Comparison of plaque removal by

Sonicare For Kids and a Crest batterypowered SpinBrush for Kids in children aged 7–10 years

Millleman J, Putt M, Olson M, Master A, Jenkins W, Schmitt P, Strate J. International J Pediatric Dent.

2009; 19:s1

Objective

Methodology Fifty-nine healthy children (mean age 8.5 years) participated in an IRB approved single-blind, randomized, parallel design study. Informed consent/assent (with parent) was obtained. Subjects abstained from brushing for 26 ± 6 hours prior to examination visits. At visit 1, subjects were screened for eligibility (Turesky modified

Quigley-Hein Plaque Index (TPI) >1.8). They were instructed on use of both devices

(Sonicare For Kids and Crest SpinBrush for Kids) in alternating manner at home

(twice daily for two minutes) for a one-week familiarization period. At visit 2, baseline

TPI was scored followed by randomization and a supervised two-minute brushing session with the assigned device. Post-brushing TPI scores were then obtained. Safety was assessed in oral soft tissue examinations at visit 2. ANOVA was used for the primary statistical analysis.

Results

To compare the plaque removal efficacy of Sonicare For Kids at “high” setting and

Crest battery-powered SpinBrush for Kids (“dolphin” and “ice cream cone” handle shapes) in children aged 7–10 years

Conclusion

Sonicare For Kids removed significantly more plaque than Crest SpinBrush for

Kids (“dolphin” and “ice cream cone” handle shapes) from the dentition overall

(p<0.0001) as well as in hard-to-reach areas, i.e., the posterior teeth (p=0.0001) and the interproximal spaces (p<0.0001) of children aged 7–10 years. Both toothbrushes were safe to use.

Sonicare For Kids was found to remove significantly more plaque than Crest

SpinBrush for Kids in children aged 7–10 years. It is also proven safe and gentle on oral tissues.

Sonicare For Kids

% of Plaque

Reduction

30%

25%

20%

15%

10%

5%

0%

50%

45%

40%

35%

46%

24%

23%

Overall

46%

24%

22%

Anterior

46%

25% 25%

45%

22%

21%

45%

24%

23%

Posterior Interproximal Posterior

Interproximal

Sonicare For Kids

Crest SpinBrush

- Ice Cream

Crest SpinBrush

- Dolphin

% of Plaque

Reduction

30%

25%

20%

15%

10%

5%

0%

50%

45%

40%

35%

46%

24%

46%

23%

46%

25%

45%

22%

45%

23%

Overall

(p<0.0001)

Anterior

(p<0.0001)

Posterior

(p<0.0001)

Interproximal

(p<0.0001)

Posterior

Interproximal

(p<0.0001)

Sonicare For Kids

Crest SpinBrush

3

4

Sonicare For Kids

Plaque Removal

in vivo study

Comparison of plaque removal by Sonicare

For Kids and a manual toothbrush in children aged 4–7 years in a professionally applied toothbrushing study

Pelka M, DeLaurenti M, Master A, Jenkins W, Strate J, Wei J, Schmitt P. International J Pediatric Dent.

2009; 19:s1

Objective

Methodology

Results

Conclusion

To compare the plaque removal efficacy of Philips Sonicare For Kids at high and low settings and Oral-B Stages 3 manual toothbrushes in a professionally applied brushing session simulating one and two minutes of brushing time in children aged

4–7 years

Sixty-eight healthy children (38 females, 30 males; mean age 5.3 years) participated in an IRB approved single-blind, randomized, split-mouth design study. Informed consent/assent (with parent) was obtained. Subjects were screened for eligibility

(Turesky modified Quigley-Hein Plaque Index (TPI) >1.8). Eligible subjects were randomized to Sonicare For Kids high, Sonicare For Kids low and a manual toothbrush by quadrant and were brushed accordingly by clinical hygienists. TPI was scored at one- and two-minute interval equivalents by quadrant by a blinded examiner. Safety was assessed in oral soft tissue examinations. For statistical analysis,

MANOVA for a split-mouth design was applied and P-values were adjusted using the Dunnett-Hsu adjustment.

Sonicare For Kids (in high and low settings) removed significantly more plaque than a manual toothbrush from the dentition overall (p<0.0001) as well as in hardto-reach areas, i.e., the posterior teeth (p<0.0001) and the interproximal spaces

(p<0.0001) at one- and two-minute brushing intervals in children aged 4–7 years with professionally applied brushing sessions. Both toothbrushes were safe to use.

Sonicare For Kids was found to remove significantly more plaque than Oral-B Stages

3 manual toothbrush in children aged 4–7 years with professionally applied brushing.

It is also proven safe and gentle on oral tissues.

Sonicare For Kids

Adjusted Mean Percent Plaque Reduction, Squirt Prototype

7 and 9 Degrees vs. Manual Toothbrush, 1-Minute Equivalent

% of Plaque

Reduction

30%

25%

20%

15%

10%

5%

0%

50%

45%

40%

35%

41%

42%

29%

43% 42%

30%

Overall

(p<0.0001)

Anterior

(p<0.0001)

38%

41%

27%

39%

40%

28%

36%

39%

25%

Posterior

(p<0.0001)

Interproximal

(p<0.0001)

Posterior

Interproximal

(p<0.0001)

Adjusted Mean Percent Plaque Reduction, Squirt Prototype

7 and 9 Degrees vs. Manual Toothbrush, 2-Minute Equivalent

Sonicare For Kids

- 9 Degrees

Sonicare For Kids

- 7 Degrees

Manual Toothbrush

70%

60%

50%

% of Plaque

Reduction

40%

30%

20%

10%

0%

68%

66%

49%

68%

66%

49%

Overall

(p<0.0001)

Anterior

(p<0.0001)

67%

64%

49%

65%

63%

47%

64%

62%

47%

Posterior

(p<0.0001)

Interproximal

(p<0.0001)

Posterior

Interproximal

(p<0.0001)

Sonicare For Kids

- 9 Degrees

Sonicare For Kids

- 7 Degrees

Manual Toothbrush

5

6

Sonicare For Kids

Plaque Removal

in vivo study

Comparison of plaque removal by

Sonicare For Kids and a Colgate children’s battery-powered toothbrush in children aged 7–10 years

Payne D, Rimmer P, Olson M, Master A, Jenkins W, Schmitt P, Strate J. International J Pediatric Dent.

2009; 19:s1

Objective

Methodology

Results

Conclusion

To compare the plaque removal efficacy and safety of Philips Sonicare For Kids at

“high” setting and Colgate children’s battery-powered toothbrushes (Shrek handle design) in children aged 7–10 years

Sixty-nine healthy children (mean age 8.4 years) participated in an EC approved single-blind, randomized, parallel design study. Informed consent/assent (with parent) was obtained. Subjects abstained from brushing for 26 ± 6 hours prior to examination visits. At visit 2, subjects were screened for eligibility (Turesky modified

Quigley-Hein Plaque Index (TPI) >1.8). Eligible subjects were instructed on use of both devices (Sonicare For Kids and Colgate children’s battery-powered toothbrush) in alternating manner at home (twice daily for two minutes) for a one-week familiarization period. At visit 3, baseline TPI was scored followed by randomization and a supervised two-minute brushing session with the assigned device. Postbrushing scores were obtained by scoring TPI. Safety was assessed in oral soft tissue examinations at visit 3. ANOVA was used for the primary statistical analysis.

66%

Sonicare For Kids removed significantly more plaque than a Colgate children’s battery-powered toothbrush from the dentition overall (p=0.0003) as well as in hard-to-reach areas, i.e., the posterior teeth (p=0.0037) and the interproximal spaces (p=0.0002) of children aged 7–10 years. Both toothbrushes were safe to use.

Sonicare For Kids was found to remove significantly more plaque than Colgate children’s battery-powered toothbrush in children aged 7–10 years. It is also proven safe and gentle on oral tissues.

70%

56%

62%

65%

62%

Sonicare For Kids

Colgate Battery Toothbrush

53% 53%

51%

51%

% of Plaque

Reduction

70%

60%

50%

40%

30%

20%

10%

0%

Overall

(p=0.0003)

Anterior

(p=0.0002)

Posterior

(p=0.0037)

Interproximal

(p=0.0002)

Posterior

Interproximal

(p=0.0028)

Sonicare For Kids

Compliance

in vivo study

Brushing duration and use interaction patterns of manual versus sonic toothbrushes in children aged 7–10 years

Defenbaugh J, Schmitt P, Master A, Jenkins W, Schmitt P, Strate J. International J Pediatric Dent

2009; 19:s1

Objective

Methodology

Results

To compare the brushing duration and use interaction patterns in children aged

7–10 years using a Sonicare For Kids power toothbrush versus Oral-B Stages 4 manual toothbrush

Sixty healthy subjects (31 females, 29 males) were enrolled in an IRB approved randomized, parallel design two-week study. Informed consent/assent was obtained.

At visit 1, eligible subjects were randomized and provided brushing instructions. They performed an on-site brushing session immediately thereafter. It was timed and video recorded for duration and use interaction data collection. A home-use period of two weeks commenced with the assigned product in order for subjects to familiarize with the device. At visit 2, the brushing and recording procedure was repeated and subjects were dismissed. Longitudinal and between-group comparisons were assessed for duration and ergonomic use interaction events. Statistical analysis was performed using the Wilcoxon Test.

Thirty-one subjects were randomized to Sonicare For Kids and twenty-nine to a manual toothbrush. A longer median brushing duration was observed for Sonicare

For Kids users at both time points. Sonicare For Kids (122 seconds) compared to manual toothbrush (83 seconds) at visit 1 (p=0.012). Sonicare For Kids (120 seconds) compared to manual toothbrush (73 seconds) at visit 2 (p=0.0001).

Brushing Duration

Median Brushing

Time (Seconds)

130

110

90

70

50

30

10

0

122

83

120

73

Sonicare For Kids

Manual Toothbrush

Visit 1

(p=0.012)

Visit 2

(p=0.0001)

7

Sonicare For Kids

In video analysis review by an ergonomic expert, use interaction brush artifacts occurred more frequently with a manual toothbrush than with Sonicare For Kids,

1.56 compared to 0.80.

Use Interaction Brush Artifacts

Vertical Brushing Shoulder Abduction Wrist Extension /

Hyperextension

Obvious Loose Grip Obvious Over Grip

Use Interaction Comparison

# of Artifacts per Brush Cycle

2

1.8

1.6

1.4

1.2

1

0.8

0.6

0.4

0.2

0

0.797

1.558

0.938

1.808

0.656

1.308

Net Artifacts Artifacts @ Visit 1 Artifacts @ Visit 2

Finger Extension

Sonicare For Kids

Manual Toothbrush

8

Sonicare For Kids

It was also observed that Sonicare For Kids toothbrush users prefer to grip with their fi ngertips, while manual toothbrush users prefer a power grip.

Grip Types

Power Grip Preferred for Manual Toothbrush

Fingertip Grip Preferred for Sonicare For Kids

# of

Occurrences

120

100

80

60

40

20

0

27

37

63

57

Power Grip

Grip Type Comparison

101

87

37

43

Fingertip Grip

Sonicare For Kids: Visit 1

Sonicare For Kids: Visit 2

Manual Toothbrush: Visit 1

Manual Toothbrush: Visit 2

Conclusion

For both types of brush, users prefer to grip in the center of the brush handle.

Users did not typically switch between grips or hand location during brushing cycles or between brushing cycles.

Children aged 7–10 years brushed signifi cantly longer with Sonicare For Kids than with a manual toothbrush following immediate product introduction and after a period of home use. Use interaction comparison suggests that form factor may infl uence the frequency of artifact occurrence.

9

10

Notes

© 2009 Philips Oral Healthcare, Inc. All rights reserved. PHILIPS and the Philips shield are trademarks of KPENV. Elite, Sonicare, and the Sonicare logo are trademarks of Philips Oral Healthcare and/or KPENV. www.sonicare.com

7005054 05/09

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