3D-printed mouth guard helps remove dental plaque in older and disabled patients

Anisha Hall Hoppe, Dental Tribune International

Mon. 5. June 2023

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HONG KONG: Researchers from the University of Hong Kong have developed a personalised 3D-printed mouth guard that they say has plaque removal results between those of a manual toothbrush and a mouthrinse. They cited Hong Kong’s rapidly ageing population as a catalyst for the search for ways to improve oral health for elderly and disabled people and said that the newly designed mouth guard could prove a valuable tool in preserving oral health in these groups.

Older adults and disabled persons may lack the required arm and wrist dexterity to use toothbrushes, oral irrigators and dental floss. By next year, Hong Kong will have more than 21% of people over the age of 65, according to the researchers, compounding the need for improved oral health solutions when resources for oral healthcare may be more difficult to come by. Recent analysis of information from the World Health Organization indicates older adults are at the highest risk of periodontitis. A number of other dental conditions also increase in incidence with age and comorbid conditions, leaving those individuals with additional health impairments more vulnerable to dental disease. Creating an easier way to clean teeth for these populations is vital to oral health.

Building on prior research using micro-mist technology as an effective method of cleaning teeth, the researchers developed a brand-new mouth guard device easy for older adults and disabled individuals to handle safely on their own. The custom mouth guard has specifically designed outlets for micro-mist targeted at the gingival margins of each tooth. The micro-mist is generated at the outlets by mixing the air and water routed through two individual channels from a machine that pumps both into the mouth guard.

To test plaque removal effectiveness, the researchers tested the mouth guard in 55 patients 60 years of age or older. For each patient, a digital impression was taken with a standard intra-oral scanner, and the shape and outlet locations of the mouth guard design were customised in CAD software. It was then printed using stereolithography and elastomeric resin.

The overall findings indicated that the micro-mist technique was able to remove plaque while also mitigating risks of pain, injury, dental hyperaesthesia, gingival recession and tooth wear that can arise through toothbrushing. The mouth guard system was shown to have an efficacy between that of mouthrinses and manual toothbrushing. The researchers also found no association between tooth number and plaque removal effectiveness, and they suggested that this could be related to the even distribution of the water and air outlets, enabling thorough cleaning. Because it does not require much manual dexterity, the system could be suitable for both elderly and disabled people unable to brush their teeth.

The study, titled “A personalised 3D-printed dental plaque removal mouthguard for older adults”, was published online on 16 May 2023 in the International Dental Journal, ahead of inclusion in an issue.