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An increasing variety of toothbrush types is available in the market today. Aside from traditional manual tools implementing different bristle design solutions, popular options for consumers include oscillating-rotating (OR) electric toothbrushes and tools that generate ultrasound to improve plaque removal. Dental care recommendations related to toothbrush selection may need to be clarified to reflect the most recent research regarding the links between toothbrush type and specific conditions, such as gingivitis.
Clinical Scenario
From my professional practice, adult patients with gingivitis, which is an extremely common form of gum disease, report concerns when it comes to choosing toothbrushes. Particularly, based on my interactions with this healthcare consumer demographic, these patients are interested in learning about the best toothbrush type to prevent gingivitis progression and remove plaque effectively. Despite adhering to all recommendations, some patients continue to give preference to manual brushes just due to fearing that the use of newer electric toothbrush models might result in increased sensitivity and harm their enamel. In some other cases, patients with this condition might see purchasing electric toothbrushes as an overrated investment, which affects their choices. Toothpaste selection and the frequency of brushing teeth can also play a role in gingivitis reduction and prevention (Ccahuana-Vasquez et al., 2019). Nevertheless, it is important to find out whether OR electric toothbrushes are more beneficial for those with gingivitis compared to manual toothbrushes in terms of dental health outcomes. Answering this clinical question would support the improvement of patient education practices and help patients with the first stage of gum disease to make informed choices.
PICOT Question Based on the Scenario
Taking the aforementioned problem into account, it is possible to formulate a PICOT question of the type that deals with selecting the most effective intervention in a specific population. The PICOT statement: in adults with gingivitis (P), how does the use of OR electric toothbrushes (I) compared to manual toothbrushes (C) affect gingival health status and plaque status (O) within a four-week time frame? The answer is anticipated to support patient counseling by providing those with gingivitis with assistance when it comes to selecting the best toothbrush.
PICOT Question and Approaches to Research
The posed PICOT question could be answered using quantitative research designs, such as a quantitative systematic review of literature on the topic, especially randomized controlled trials. The main reason for giving preference to quantitative approaches is the nature of the anticipated outcomes. They are measurable and can be converted into numerical values and compared by using one and the same dental health assessment procedure in all subjects. Moreover, the selected intended outcomes do not deal with subjective experiences and perceptions that would require in-depth qualitative analytical efforts.
A systematic review of high-quality studies with randomization, such as RCTs, is preferable to conducting an actual experimental study due to two reasons. Firstly, in my current setting, it could be problematic to control participants adherence to the selected teeth brushing protocol to ensure equal conditions. Secondly, a single study with two groups of patients would be inevitably limited to testing one specific toothbrush model, which would affect the generalizability of results (Grender, Adam, & Zou, 2020). Instead, attempts to systematize the results of available studies would help to provide a more credible answer to the stated PICOT question and even make comparisons between different manufacturers products to provide recommendations for patients.
Conclusion
In summary, the emergence of new tools for dental care at home has promoted patients opportunities for implementing dental hygiene practices to the next level. The PICOT question proposed in this paper aims to translate this variety into better dental health outcomes for those with gingivitis. The question related to OR toothbrushes advantage over manual toothbrushes could be addressed in quantitative studies, such as the reviews of RCTs.
References
Ccahuana-Vasquez, R. A., Adam, R., Conde, E., Grender, J. M., Cunningham, P., Goyal, C. R., & Qaqish, J. (2019). A 5-week randomized clinical evaluation of a novel electric toothbrush head with regular and tapered bristles versus a manual toothbrush for reduction of gingivitis and plaque. International Journal of Dental Hygiene, 17(2), 153-160.
Grender, J., Adam, R., & Zou, Y. (2020). The effects of oscillating-rotating electric toothbrushes on plaque and gingival health: A meta-analysis. American Journal of Dentistry, 33(1), 3-11.
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