Smartphone App Added No Clinical Benefit to Powered Brushing During Periodontal Therapy

Edited by Hygienetown staff

Adding smartphone app guidance to a powered toothbrush did not improve clinical outcomes for patients undergoing nonsurgical periodontal therapy for advanced periodontitis, according to a secondary analysis of a randomized controlled trial published Sept. 28 in BMC Oral Health.

The analysis included 44 patients with generalized stage III–IV periodontitis from the powered-toothbrush arm of a four-arm trial at Christian Albrecht University of Kiel in Germany. Toothbrush type was assigned by habitual use and clinical indication. Within the powered-toothbrush group, 23 patients were randomized to an app-supported brush and 21 to an identical brush without app support. All received standardized nonsurgical periodontal therapy and were assessed at baseline and again after five to six months.

Both groups improved. Mean probing depth fell 0.59 mm in the group without the app and 0.67 mm in the app group (both P < .001). The between-group difference of 0.08 mm was not significant (95% CI, -0.45 to 0.29; P = .832).

The gingival bleeding index, the registered primary outcome of the overall trial, also did not differ between groups: it fell 7.12% without the app and 9.28% with it (P = .573). There were no significant between-group differences in clinical attachment level, plaque, or probing depth distribution.

Some within-group results diverged. Clinical attachment level improved significantly only in the group without the app, and gingival recession increased more in the app group (P = .011). Questionnaire measures of oral hygiene motivation showed no between-group differences after correction for multiple testing, although motivation for interdental cleaning improved significantly within the app group (P = .002).

The authors concluded that app support provided no additional clinical benefit over powered toothbrushing without app support during nonsurgical periodontal therapy. They wrote that nonsignificant trends toward more favorable post-treatment changes suggest a possible role in behavioral support and maintenance, potentially combined with professional guidance.

Ann-Christin Feige and Miriam Cyris, joint first authors, led the study with Christian Graetz and colleagues at University Hospital Schleswig-Holstein in Kiel. The trial was registered in the German Clinical Trials Register. It was financially supported by Sunstar Suisse SA, which also provided the toothbrushes and dentifrices. The authors reported that the funder had no role in the study design, analysis, or manuscript, and they declared no competing interests.

The findings come from a secondary analysis of two arms of the trial, with a modest sample. Seven patients dropped out, and their missing data were handled by carrying the last observation forward.

Sources:
BMC Oral Health, “App-supported powered toothbrushing during non-surgical periodontal therapy in stage III–IV periodontitis: a secondary analysis of a randomized controlled trial,” published online Sept. 28, 2026: link.springer.com/10.1186/s12903-026-10002-4