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Paediatric dentistry

Mirror, mirror on the wall—is toothbrushing instruction via a three-dimensional motion-tracked system the fairest of them all?



To assess the efficacy of a smart toothbrush and mirror (STM) system which provided computer-assisted toothbrushing instruction versus conventional verbal toothbrushing instruction (TBI) amongst a group of 6–12-year-old children.


This randomised controlled trial comprised South Korean school children who were randomly allocated to one of two arms - the STM (n = 21) or the conventional TBI arm (n = 21). The STM system used identical brushes as the TBI group, but with the brush employing three-dimensional motion tracking systems alongside a mirror with an inbuilt computer to guide the user. Modified Quigley-Hein plaque indexes were taken at baseline, immediately after STM/TBI, and then at 1 week and 1 month.


Overall, there was a statistically significant reduction in the average whole-mouth plaque scores for both groups, 40.50% and 40.57% for the STM group and TBI group respectively. There was no statistical significance that either arm was more effective in reducing plaque scores than the other. Both groups demonstrated time to be a statistically significant factor in reducing plaque indices.


There is no conclusive evidence that the STM system offers any benefits in terms of plaque control over conventional TBI in this study.

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  1. Public Health England, Child oral health: applying all out health. 2022. Available at (Accessed 16 May 2023).

  2. SDCEP, Prevention and Management of Dental Caries in Children, Dundee: NES, 2018.

  3. Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, et al. Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews 2014, Available at (Accessed 16 May 2023).

  4. UK Government, National Dental Epidemiology Programme (NDEP) for England: oral health survey of 5-year-old children 2022, GOV.UK, London, 2023.

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Correspondence to Rosie Fletcher.

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Fletcher, R., Linden, J. Mirror, mirror on the wall—is toothbrushing instruction via a three-dimensional motion-tracked system the fairest of them all?. Evid Based Dent (2023).

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