Customized toothbrush handle for patients with limited manual dexterity

Abstract

Elderly people may have difficulty in grasping and holding tooth brush due to limited hand and finger movement. This article describes a technique of increasing the volume of toothbrush handle with acrylic device that is custom molded to the patient's unique hand. The customized handle will make holding the brush easier and more comfortable thereby contributing to the maintenance of oral hygiene.

Elderly people with chronic diseases such as arthritis, have difficulty holding toothbrush, which hampers cleaning of their teeth and dentures. A customized handle with increased volume improves hand grip on toothbrush making it easier to hold. It is also more effective in reducing biofilm on dentures when compared with conventional toothbrushes(Kammers and et al., 2015; Pasiga and Dewi, 2019) .^1,2 Various techniques have been reported in literature to customize the toothbrush handles but most of these techniques are either expensive or need to be repeated for each new brush design(Reeson and Jepson, 2002 Jun; De Mattos et al., 1998; Dickinson and Millwood, 1999; Arblaster et al., 1985) .^{3, 4, 5, 6} This article describes a simple low-cost technique to customize a toothbrush handle.

1. Procedure

• 1.Select a toothbrush of patient's choice, and lubricate the handle with Vaseline to prevent impression material from sticking to the toothbrush.
• 2.Mold a dense silicone putty impression material (Photosil Soft Putty, Dental products of India, Mumbai, India) around the toothbrush handle from the point at which the handle tapers toward the head to end of the handle. Instruct the patient to hold the toothbrush in hand, and to squeeze the material gently as if he/she were going to brush their teeth. Fig. 1
• 3.Make lateral cuts with a scalpel to divide the mold into halves after polymerization. Fig. 2
• 4.Process each half of handle using heat polymerized acrylic resin (DPI Heat Cure, Dental Products of India Ltd.) with a conventional compression molding technique according to manufacturer's instructions.
• 5.Finish and polish the handle and check for alignment on to the toothbrush.
• 6.Join the two halves with the help of a Press buttons (Snap Fasteners, K.S. Exports, Delhi, India) and Stainless-steel encased iron-neodymium-boron button magnets (Rare Earth Magnet, Permag Products Pvt. Ltd., Pune, India) of a 5-mm circumference.
• 7.Make Hollow cavities on the horizontal intaglio cut surface of two sections. Place magnetic press button in upper end of handle and magnets in remaining cavities using auto polymerized acrylic resin (DPI RR Cold Cure, Dental Products of India Ltd, Mumbai, India), so that each half could be exactly reassembled. Finish and polish the handle to complete the procedure. Fig. 3
• 8.Instruct the patient about handling of the toothbrush and maintenance of oral hygiene. Fig. 4

Fig. 1.

Patient molding condensation silicone around toothbrush handle.

Fig. 2.

Toothbrush handle made with condensation silicone sectioned.

Fig. 3.

Sectioned acrylic handle with magnets and press button aligned with toothbrush.

Fig. 4.

Patient holding customized toothbrush.

2. Discussion

Healthy oral environment is considered is an important factor for the quality of life.⁷ Good oral hygiene would be accomplished only if there was an adequate plaque control. Although different methods of plaque control are mentioned in the literature, mechanical plaque control by using a manual toothbrush is the most effective and reliable method.⁸ Various modification of handle design such as straight, angle curved and contoured grips with soft rubber areas to make handles easier to hold, use and control are being suggested.⁹

Elderly people with limited finger and hand movement need extra help to maintain good oral health. Although caregivers can help in such situation, maintaining their own oral hygiene by self-brushing can increase their self-esteem.¹⁰ It is very much necessary to have a design and length that properly fits in their hand to improve quality of toothbrushing. Using a manual brush with customized handle can have them good joint and muscle stimulation thus allowing better plaque control as compared to conventional toothbrush. Various techniques have been mentioned in literature to modify the toothbrush handle. Most of the techniques are costly or need to be repeated for new brush design.⁷

Various materials such as acrylic resins,⁴ light‐cured composite material³ and silicone putty⁵ have been used to fabricate customized handles. Light‐polymerized composite material although can simplify the procedure interns of time, it's very costly.³ Silicone putty has the ability to rupture and have to be replaced with every toothbrush design.⁵

This article describes a technique for fabrication of acrylic device with materials that are readily available in dental office. The handle is designed in two halves and then correctly realigned with the help of press buttons and magnets. The dentist can easily carry out procedure without the help of a dental technician. The same handle with little modification can be used with different toothbrush design minimizing the time and cost to make a new one in future.

3. Summary

This article describes a simple and cheap technique to customize a tooth brush handle which is Individually adapted for use by elderly patient with limited manual dexterity. The handle is made in two sections and attached with magnets. This allows future replacement of new brush design without making a new one thus saving additional time and cost.

Prior publication/Presentation

None.

Financial support

None.

Declaration of competing interest

None.