Bluetooth-Connected Intelligent Brushing
Mobile technologies bridge the home-office gap to improve oral care compliance
Mário Rui Araújo, M Psych, RDH
The growing enthusiasm for online health tools has now reached the dental office, paving the way for new interactions with patients and improved effectiveness in oral healthcare. Consumers are using “health apps” to track and monitor many aspects of their personal health and hygiene, including exercise, diet, sleep and even water intake. In this connected and virtual environment, tools that integrate popular interactive technology with patients’ oral healthcare, such as a power toothbrush with Bluetooth® wireless technology linked to a mobile application that provides feedback on brushing habits, can provide a bridge between the instructions we give in the office and our patients’ implementation of those instructions at home.
Furthermore, patients continue to welcome this connection. In a 2013 study, almost half of mobile phone users reported that they were interested in interacting with their health professionals through their phones for maintaining safety and responding to emergencies, and nearly a third supported mobile interactions for monitoring medication intake and vital health statistics.1 Mobile technologies present oral healthcare providers with new tools to address the ongoing issue of poor patient compliance with recommendations for proper oral self-care.2
Powerful Features Drive Compliance
For example, patients can use an oscillating-rotating power toothbrush with Bluetooth technology, which offers a suite of powerful features that are not only effective in improving oral care, but also help drive patient compliance. The benefits of oscillating-rotating power brush technologies for plaque and gingivitis reduction are well-established.3 Since their inception, various features such as pressure sensors and timers have been added to improve compliance. In 2014, Oral-B® introduced the first Bluetooth-connected, oscillating-rotating power toothbrush, which represented a breakthrough in intelligent power brushes. Key features incorporated into the first model included real-time feedback on brushing session length, pressure, brushing mode, and battery status. Additional features allow for the tracking of brushing sessions and provide “achievements” to reward good brushing habits. All together, these features promote better compliance with dentists’ instructions and help to position oral care as an important health-promoting behavior.
This new approach is easy to implement and does not complicate the toothbrushing ritual. Patients download a free application to their mobile device and sync their power brush to it. While the patient is brushing, the application receives brushing data through the Bluetooth wireless connectivity and instantly reports it back to the user on the mobile screen. Patients can see how long they’ve been brushing and if they’re using excessive force via a red light “alert.” In addition, the mobile screen displays the brushing mode and battery status of the toothbrush and provides a reminder to change the toothbrush head when necessary. If programmed accordingly, the mobile application also can send reminders about flossing, tongue cleaning, and use of a rinse. It can even incorporate news, weather, and oral healthcare tips.
Many features of this new device, such as “Focused Care,” are designed to improve patient habits. This application mode can be used in combination with the dental professional’s clinical assessment to help personalize a patient’s brushing routine. For example, the feature can be programmed to show areas of the mouth that need special attention and alert the patient to brush those areas again after the 2-minute brushing period has ended. Essentially, this unique personalization integrates the professional’s recommendations into the patient’s home care routine, which helps improve compliance. Use of the feature is strategic because it helps bridge the gap between what the patient does and what he or she needs to do.4 According to Hermsen and colleagues, this type of feedback helps the patient create strategies to reach health goals, overcome obstacles, and explore different options to achieve the desired result.5
Position Detection System
Recently, Oral-B® introduced the Genius Pro, which offers even more innovative features (Figure 1). The most forward-looking of these, “Position Detection,” is the first technology in the world that makes it possible for patients to actually see and know where they are brushing (eg, which sextant) and for how long. This feature not only enables patients to brush areas that are usually left unbrushed, but also helps them adjust their brushing technique so they become better brushers—and that can translate into healthier patients. Imagine the power of this technology for patients with implants or periodontal issues (Figure 2).
The results of a recent study support the use of the oscillating-rotating power toothbrush with Bluetooth technology as a means for improving oral care. In a 2-week study of adowapplication was clinically demonstrated to increase overall brushing time and provide superior plaque reduction when compared with use of a manual toothbrush.6 A separate clinical trial among orthodontic patients showed similar results: better plaque removal and longer brushing time associated with the brush plus application.7
The results reported by oral health professionals are equally convincing. Patients say they can feel the difference, and clinicians can see that their patients’ oral care has improved. In addition, the self-efficacy of patients improves as they feel the results of their actions (ie, more targeted and effective brushing), and they are motivated to maintain those actions. Such “maintenance self-efficacy” is important, particularly when dealing with chronic behaviors like oral care—behaviors that should be done correctly for a long period of time.
When combined with effective problem-solving and collaboration with a dental provider, the use of an intelligent, oscillating-rotating power toothbrush with Bluetooth technology can create a practice-changing system. Patients can use the tools to get immediate and personalized feedback on how they are doing, which helps them build new and better brushing habits and results in improved outcomes. Encouraging patients to use the system reinforces the fact that oral care is just as important to their health as diet, exercise, heart rate, and other issues for which online health tools are readily available and increasingly used.
1. Kendal H. Health-e-Apps: A project to encourage effective use of mobile health applications. BCMJ. 2013;55(10):458-460.
2. Abroms LC, Padmanabhan N, Evans WD. Using Mobile Phones for Health Promotion. In: Noar SM, Harrington NG, eds. eHealth Applications: Promising Strategies for Behavior Change. New York, NY: Routledge; 2012:147-66.
3. Yaacob M, Worthington HV, Deacon SA, et al. Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews. 2014;6. doi: 10.1002/14651858.CD002281.pub3.
4. Patrick K, Griswold WG, Raab F, Intille, S. Health and the mobile phone. Am J Prev Med. 2008;35(2):177-181.
5. Hermsen S, Frost J, Renes RJ, Kerkhof P. Using feedback through digital technology to disrupt and change habitual behavior: A critical review of current literature. Computers in Human Behavior. 2016;57:61-74.
6. Erbe C, Ccahuana-Vasquez R, Ferrari-Peron P, et al. Clinical evaluation of an interactive toothbrush among adolescents. J Dent Res. 95(Spec Iss A): Abstract 0464.
7. Erbe C, Braunbeck F, Ferrari-Peron P, et al. Superior dental plaque removal and compliance of an interactive toothbrush. J Dent Res. 95(Spec Iss B): Abstract 317.
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