Effectiveness of Toothbrush Containing Solar Cells and Titanium Dioxide Rod on Plaque Reduction During Caregiver‐Performed Toothbrushing—Randomised Crossover Clinical Trial

ABSTRACT Objectives This study was conducted to assess the effectiveness of a toothbrush containing solar cells and a titanium dioxide electrode (TiO 2 toothbrush) compared with a normal toothbrush for removing plaque during caregiver‐performed oral hygiene care for elderly residents in nursing homes who require care. Methods A randomised, double‐blind, placebo‐controlled crossover trial was conducted, which consisted of two 2‐week intervention periods separated by a 2‐week washout period. Participants were residents of a nursing home in Japan and met the eligibility criteria of at least one remaining tooth and not using an internal electronic device. Each underwent toothbrushing with either a TiO 2 or a placebo toothbrush. The study aimed to assess the effectiveness of caregiver‐performed toothbrushing, with the Rustogi Modification Navy Plaque Index (RMNPI) as the primary outcome measure. Toothbrushes were randomly assigned to the participants. The allocation process was double‐blinded, with the findings not revealed to the participants, intervention implementers or outcome assessors until after the trial. Results The randomised sample included 40 participants and analysis was conducted using a linear mixed‐effects model. The average plaque index with use of a TiO 2 toothbrush was 5.9% (95% CI: 3.9–8.0) and with a placebo was 10.4% (95% CI: 6.1–14.8), a statistically significant difference ( p = 0.032). No significant adverse events or side effects in either group were reported. Conclusions Caregiver‐performed toothbrushing with a toothbrush designed to exhibit photocatalytic effects and chemical reactions demonstrated superior plaque removal efficacy compared to a normal toothbrush. These findings suggest potential benefits for elderly individuals requiring care and may reduce the burden of oral hygiene care in nursing facilities.