Oral-B launches world first Bluetooth connected power brush: The new Oral-B SmartSeries 7000

The new Oral-B SmartSeries 7000 powered brush with its unique Bluetooth feedback system is a revolution rather than an evolution in powered toothbrush technology. The Oral-B SmartSeries 7000 is the first powered brush to be wirelessly linked to a smartphone as well as to an external data display and to have two-way communication between a user software application and the brush. This interactivity means the modes and other characteristics can be personalized for the individual user, making it truly an iBrush!

Why a better brush?

Because changes in dental plaque maturity are linked to the development of gingivitis, periodontitis and dental caries, being able to disrupt these ecologically by effective mechanical removal of plaque remains the cornerstone of preventive dentistry. Even though the message of regular tooth cleaning is "preached from the pulpit" of every dental practice as well by the dental industry and in the mass media, effective mechanical oral hygiene remains a great challenge for the majority of individuals in the population. While most studies of contemporary Australian and New Zealand populations show that over 90% of individuals brush once or twice each day, the quality of the outcome achieved is inadequate. A 2005 systematic review of the effectiveness of a single tooth brushing procedure using a manual toothbrush showed that its efficacy is low. This review of 33 studies of adult patients with gingivitis of at least six months in duration concluded that the quality of self-performed mechanical plaque removal "is not sufficiently effective".¹ In keeping with this, a 2012 systematic review of 59 published studies of manual brushing found that the extent of plaque removal from a single manual brushing procedure was only 27% after 1 minute of brushing and only 41% after 2 minutes of brushing.² This means that in practical terms, most patients leave over half their plaque behind.

Despite many developments in manual toothbrush design, plaque removal in the posterior regions of the mouth and from approximal tooth surfaces remains inadequate, yet these are the very sites that often show a propensity to develop disease. Improved oral hygiene can be achieved by better brushing techniques and by increasing brushing time, but these changes in behaviour patterns are almost impossible to achieve for the majority of individuals.³ Thus, what is required is a smarter brush that maximizes plaque removal, and is less dependent on how the user brushes.

Design features to address known problems and challenges

In the simplest analysis, one can consider the so-called triple threat - the patient is not aware of the correct methods for effective mechanical disruption of dental plaque (they don't know); the patient understands what the correct methods are, but cannot apply these effectively (they can't do); or the patient understands what the correct methods are and how they can be applied, but lacks the motivation to perform them sufficiently in terms of frequency, duration and quality (they won't do). Bearing in mind the range of areas where mistakes can occur, the design features of a modern powered toothbrush such as the SmartSeries 7000 can help address all these elements (Table 1).

Table 1. The 10 common problems and their solutions

• Using excessive force: The data display and a red warning light on the handle indicate when too much pressure is applied, and the system automatically decelerates the pulsation and oscillation speeds of the brush head.
• Insufficient time: When patients reach the recommended 2 minute brushing time, indicators change and sound tones are generated. Likewise at 3 minutes.
• Forgetting to do certain areas: Quadrant display reminds patients to do each area for a minimum time. App records the last 20 sessions for later analysis.
• Lacking motivation: Brushing time is linked to the number of displayed "stars". Brushing programs are personalized. The app shows news, weather and oral care tips while the patient is brushing, thereby maintaining their interest.
• Wrong brush head size: Optimized small heads of various designs.
• Difficult to hold: Ergonomic handle is easy to hold.
• Difficult to position the bristles: Angled bristles.
• Limited dexterity: Oscillating-rotating brush heads give superior cleaning to manual brushes.
• Incorrect technique: 6 different modes, all of which can be personalized (Daily Cleaning for exceptional cleaning of teeth and gums; Deep Clean for a more focused level of cleaning; Whitening for removal of surface stains and polishing; Gum Care for gentle gum stimulation; Sensitive for gentle yet thorough cleaning of sensitive areas; and Tongue Cleaning for a cleaner tongue and fresher breath).
• Limited effectiveness: Powered brush can do a better job of cleaning, particularly for those who have difficulty brushing or have limited manual dexterity or lack motivation, with up to twice the plaque removal of a manual brush.

Coaching and feedback

Given the extensive use of modern smart phone systems such as the Apple iPhone™ and Android phones with their integral Bluetooth 4.0 technology, it is logical to combine the natural attraction that many younger as well as older patients have with their smart phone to provide dedicated information on their brushing routine with the SmartSeries 7000 powered brush using a dedicated application. The Oral-B app can be downloaded for free from the iTunes App Store or Google Play™. Recent consumer surveys indicate that almost 75% of those who own a smart phone keep it with them and switched on at all times, meaning that they may already be carrying their phones in their pockets into their bathrooms - and now they can use them for getting coaching and structured feedback for using their powered toothbrush.

Many patients are not fully aware of the correct method of applying the toothbrush onto the oral hard and soft tissues, which is where technology which provides information back to the patient on the use of force is important. One wants to block patients from applying excessive force and thereby reduce the possibility of trauma to the gingival soft tissues (which can promote recession) and abrasion of tooth surfaces. In the SmartSeries 7000, the data display indicates when too much pressure is applied and the internal electronics automatically decelerate the pulsation and oscillation speeds of the brush head. At the same time, a red warning light illuminates on the handle.

Commonly, patients forget to brush certain areas of the mouth, or to brush for sufficient time in one region or another. Very often, patients forget to brush the lingual surfaces of the mandibular teeth often enough or for long enough. This is where having systems which track the completion of different regions of the mouth are so useful.

Personalized care

We are now at the stage where records of brushing activity from these devices can be used by dental practitioners as we work in partnership with our patients to finesse their personalized brushing routines. The obvious problem here is what happens if the patient forgets to have their smartphone in the bathroom while brushing. The clever solution to this is that the brush can store data from up to 20 brushing sessions. This data is then transferred to the phone the next time the app is connected to the toothbrush, automatically updating the brushing records.

A further use of the communication between the smart phone and the brush is to reverse the flow of data so that the app can change the way the brush behaves. In other words, not only does the app on the phone receive brushing data and display this, but now both patients or dental practitioners can program the app so it communicates with the brush, to alter the settings for modes and brushing times and so achieve personalized brushing. This helps to drive patient compliance, since what is being done is truly personalized to the patient.

Proven effectiveness

The fundamental design of the new Oral-B SmartSeries 7000 powered brush follows on from the preceding Oral-B Triumph 5000, maximising the advantages of the specific movement pattern of the brush head. There is an extensive report from Cochrane reviews regarding the improved plaque removal performance of powered brushes over manual toothbrushes and in more recent times, the Cochrane collaboration has identified that the particular action used in Oral-B powered brushes gives better plaque removal than other systems. Taking this advantage to the next level, the Oral-B SmartSeries 7000 powered brush uses multiple brush heads (Cross Action™, Precision Clean, 3D White, Sensitive, Floss Action, and TriZone). The Cross Action brush heads have a number of important features including changes in bristle density which make them more gentle to the oral soft tissues, a 30% greater sweep and a 16° bristle angulation for better plaque removal interdentally and from gingival crevices.

There is extensive support in the literature for the greater effects of power brushes which use an oscillating-rotating action over both conventional manual toothbrushes and sonic tooth brushes, with a series of Cochrane systematic reviews commencing over 10 years ago.^4-6 A recurring theme across the studies was the ability of powered brushes which used a rotation-oscillation action to achieve significant reductions in plaque and gingivitis compared with manual toothbrushes. The new SmartSeries7000 powered brush from Oral-B takes a proven cleaning technology to the next level by incorporating advanced feedback methods for patients so that they are aware of how well they are completing the toothbrushing procedure.

Safety

Powered brushes such as the SmartSeries 7000 can be used by patients every day, without concerns as to gingival recession or abrasion of tooth surfaces. A 2011 review of all clinical and laboratory investigations on the safety of powered versus manual toothbrushes found no difference in gingival recession, nor evidence of other clinically relevant concerns for the oral hard and soft tissues.⁷ On this basis, they can be recommended with confidence around both effectiveness and safety.

References

• van der Weijden GA, Hioe KP. A systematic review of the effectiveness of self-performed mechanical plaque removal in adults with gingivitis using a manual toothbrush. J Clin Periodontol. 2005;32 Suppl 6:214-28.
• Slot DE, Wiggelinkhuizen L, Rosema NA, Van der Weijden GA. The efficacy of manual toothbrushes following a brushing exercise: a systematic review. Int J Dent Hyg. 2012;10(3):187-97.
• Beals D, Ngo T, Feng Y, Cook D, Grau DG, Weber DA. Development and laboratory evaluation of a new toothbrush with a novel brush head design. Am J Dent. 2000;13(Spec No):5A-14A.
• Niederman R. Manual versus powered toothbrushes: the Cochrane review. J Am Dent Assoc. 2003;134(9):1240-4.
• Deery C, Heanue M, Deacon S, Robinson PG, Walmsley AD, Worthington H, Shaw W, Glenny AM. The effectiveness of manual versus powered toothbrushes for dental health: a systematic review. J Dent. 2004;32(3):197-211.
• van der Weijden FA, Campbell SL, Dörfer CE, González-Cabezas C, Slot DE. Safety of oscillating-rotating powered brushes compared to manual toothbrushes: a systematic review. J Periodontol. 2011;82(1):5-24.
• Deacon SA, Glenny AM, Deery C, Robinson PG, Heanue M, Walmsley AD, Shaw WC. Different powered toothbrushes for plaque control and gingival health. Cochrane Database Syst Rev. 2010;(12):CD004971.