Sonic tooth brushing reduces gingival overgrowth in renal transplant recipients

Abstract

Cyclosporine (CSA) is a commonly used immunosuppressive medication in pediatric transplantation. Drug-induced gingival overgrowth (DIGO) is a frequent side effect associated with CSA use and can impair the patient's ability to achieve good oral hygiene. This study tested the hypothesis that sonic tooth brushing and oral hygiene instruction can reduce the occurrence or severity of DIGO in CSA-treated pediatric renal transplant recipients. Twenty-three pediatric renal transplant patients with DIGO were randomly allocated to treatment or control groups. The treatment group received oral hygiene instruction and use of a sonic toothbrush, while the control group continued their usual home care with manual brushes. Dental impressions and photographs of all subjects were taken at baseline and every 3 months for a year. The casts and photographs were evaluated by a dental panel to compare the DIGO levels from baseline until the end of the study. After 12 months the control group had significantly more severe DIGO than did the sonic tooth brushing and oral hygiene instruction group (OR=4.5, 95%CI=1.2-16.0, P=0.03). Of the risk factors considered, only male gender was significantly associated with worse outcome (OR=6.1, 95%CI=2.3-16.1, P=0.03). The use of a powered toothbrush, together with oral hygiene instruction, may be an important component of health maintenance for pediatric transplant patients on CSA.

Manual versus sonic powered toothbrushing in patients with intellectual disability: a cluster‐randomized clinical trial

“…) have found better results for sonic toothbrushes versus manual, but with clear methodological differences with the present study: patients with gingival overgrowth by cyclosporine (Smith et al. ), shorter duration and fewer patients and measurements made on dental casts and photos.…”

Aspects of Renal Disease Affecting Dental Management — Surgery in Patients Receiving Hemodyalisis

“…Djemileva [30] and Gera [42] believe that shared responsibility in maintaining oral health in the long process of treatment of these patients is a crucial factor as well as the possible switch of immunosuppressants. The studies of Somacarrera et al [108], Ellis et al [34], and J. Smith et al [106] are taken as evidence corroborating the supposition that maintaining sufficient oral hygiene leads to a decrease of gingival hyperplasia.…”

Routine and emergency management guidelines for the dental patient with renal disease and kidney transplant part 2

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