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Interspace/interdental brushes for oral hygiene in orthodontic patients with fixed appliances

  • Review
  • Intervention




Accumulation of plaque on tooth surfaces that have fixed orthodontic appliances is increased. Effective removal is essential to maintain oral health but it is unclear whether the use of interdental or interspace brushes is useful.


To compare the effectiveness of standard toothbrushes with combined standard toothbrushes and interdental/interspace brushes used by patients during fixed orthodontic appliances therapy in relation to plaque removal, the health of dental and supporting tissues, dependability, cost and adverse effects.

Search methods

We searched the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, EMBASE and CINAHL. Schools of dental hygiene were contacted for additional data. No language restrictions were applied. Handsearching of the relevant journals was carried out. Most recent search: January 2006.

Selection criteria

Randomised controlled trials (RCTs) including the following criteria: participants - patients with fixed orthodontic appliances and uncompromised manual dexterity; intervention - unsupervised toothbrushing with standard toothbrush alone versus standard toothbrush and interdental/interspace brush. Primary outcomes were differences in plaque control, gingival health and decalcification.

Data collection and analysis

Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were to be conducted in duplicate and independently. Trials were to be grouped in terms of their interventions and outcome measures. Results were to be expressed as random-effects models using standardised mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated.

Main results

No studies were identified to support or contest the null hypothesis.

Authors' conclusions

The present practice of recommending the use of interdental/interspace brushes in addition to standard toothbrushes is not supported by clinical investigations. Interdental brushes and normal toothbrushes wear is increased during orthodontic treatment and brushes need to be replaced more frequently. This increases the economic burden of oral hygiene products for the patient.
Well designed RCTs are required to provide evidence for determining clinical practice in this area.






在裝置固定式矯正器治療的患者身上,比較使用標準牙刷與標準牙刷和牙縫 /牙間刷來清潔牙菌斑的效果、牙齒及支持組織的健康、可靠性、成本和副作用。




需為隨機對照試驗(RCT),包括下列條件:參加者  雙手靈巧裝有固定矯正器之病患;介入  單獨用標準牙刷刷牙或用標準牙刷和牙縫 /牙間刷。主要有差異的結果是在控制牙菌斑、牙齦健康和脫鈣的項目。









此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


裝置固定式矯正器的病患以牙間刷來維持口腔健康: 裝置固定矯正器的病患需要更努力來維持口腔清潔。牙醫師及口腔保健專家都建議以特別的牙間刷來維持牙齒清潔。固定矯正器及牙間刷需要更換較頻繁導致花費相對增加。目前並沒有臨床證據證實這一項建議是有用的

Plain language summary

Interspace/interdental brushes for oral hygiene in orthodontic patients with fixed appliances

Patients with fixed orthodontic braces need to make extra efforts to keep their teeth clean. It has been recommended by dentists and hygienists that special interdental or interspace brushes are required to maintain clean teeth. These special brushes and the braces mean that toothbrushes need replacing more frequently and therefore mean an increase in cost.

There is no evidence to show that this recommendation is supported by clinical investigations.