For the management of oral hygiene, brushing is necessary. The effects of brushing on the effectiveness of bacterial eradication have been extensively examined (1). Most people agree that manual teeth brushing can remove enough plaque if done correctly, as directed, and for a long enough period of time (2). However, it appears that a lot of people clean their teeth ineffectively or infrequently (2). On the other hand, electric toothbrush's cleaning performance is observed to be superior compared to manual toothbrushing (2).

Evidence shows that LED electric toothbrush exhibits antimicrobial activity. It is effective in reducing harmful bacteria responsible for gingivitis and formation of plaque (3). It is possible that visible blue light irradiation is a promising method for eliminating periodontopathogenic bacteria from periodontal lesions since 405-nm light irradiation selectively inhibits P. gingivalis growth and other oral pathogens (4). The antibacterial impact of a recently developed toothbrush equipped with light-emitting diodes (LEDs) on Porphyromonas gingivalis adhered to titanium surfaces that had been sandblasted and acid-etched (5). Feuerstein et al. demonstrated that blue light sources, such as LEDs at 400–500 nm, have a phototoxic effect on P. gingivalis (6). Therefore, in the present study we aim to determine the significance of LED electric toothbrush in improving oral health status and teeth whitening.

• To determine the efficacy of LED electric toothbrush in reducing gingivitis and plaque accumulation on teeth surface

• To investigate the role of LED electric toothbrush in accelerating teeth whitening.

This study is a blind, parallel, interventional and non-randomized study. A quantitative survey was conducted among periodontal healthy young individuals.

• Individuals of age-group 18-65 years

• Good periodontal health

• Good general health

• Presence of maxillary and mandibular teeth (atleast 10 teeth in upper and lower arch)

• Individuals of age-group 18-65 years

• Good periodontal health

• Good general health

• Presence of maxillary and mandibular teeth (atleast 10 teeth in upper and lower arch)

A total of 30 individuals who fulfilled the inclusion criteria were selected. Written consent was obtained and objectives were clearly explained. The groups were categorized as:

Group A (15 ppl): PAP+ whitening toothpaste and manual toothbrush,

Group B (15ppl): PAP+ whitening toothpaste + LED electric toothbrush

• To determine the teeth color change (self-reported survey)

• To assess participants satisfaction with the LED electric toothbrush versus manual toothbrush

• To determine reduction in gingivitis

• To determine reduction in plaque accumulation

• To determine any adverse outcomes (sensitivity or bleeding)

A total of 30 subjects participated in the study. There were 15 participants in electric toothbrush study and 15 participants in Manual toothbrush group. A total of 14 (99.3%) subjects in electric tooth brush group were very satisfied with teeth whitening procedure while only 5 (33.3%) were very satisfied with teeth whitening procedure in manual tooth brush group. A highly significant difference was observed in responses of subjects between the two groups.

All the study subjects in both groups did not experience any tooth sensitivity after tooth brushing.

In electric toothbrush group, none of the participants experienced gingival problems after tooth brushing while 7 (46.7%) subjects in manual toothbrush group experienced gingival problems and 8 (53.3%) in the same manual toothbrush group did not experience gingival problems. A high significant difference was observed in the responses between the two groups.

All the study subjects in electric toothbrush opined toothbrush to be effective in removing plaque while in manual group only 4 (26.7%) were of this opinion. A maximum of 11 participants (73.3%) in manual group found toothbrushing as not effective in removing plaque and highly significant difference was observed in responses between both groups.

All the study subjects in both groups noticed improvement in teeth shade after toothbrushing.

A maximum of 11 (73.3%) in electric tooth brushing group noticed improvement in teeth shade after 2-4 days and 4 (26.7%) after 4-6 days, while in manual tooth brushing group, 10 (66.7%) noticed improvement after 4-6 days and 5 (33.7%) after 7 days. Highly significant difference was observed between the two groups.

Overall comparison of responses of subjects reveals electric tooth brush to be more effective compared to manual tooth brushing (Table 1).

There were 8 (53.3%) subjects each in Electric and Manual toothbrush groups in the range of 18-30 years. There were 6 (40%) and 5 (33.3%) in Electric and Manual group respectively belonging to 30-45 years age group. Only 1 (6.7%) subject in electric group and 2 (13.3%) in Manual group belong to 45-65 years age group. There were 2 (13.3%) males and 13 (86.7%) females in electric tooth brush group. In Manual group, there were 3 (20%) males and 12 (80%) females (Table 2).

The present study demonstrates that LED electric toothbrush is significantly better in reducing gingivitis, enhancing teeth whitening and removing dental plaque than manual toothbrush. Majority of the participants were satisfied with the electric toothbrush and did not experience any adverse effects (sensitivity).

The antibacterial properties of 405 nm violet-blue light, which may be applied at exposure levels safe for people, make it potentially useful for decontaminating biological fluids (4). Microbial endogenous porphyrin molecules have been identified in published research as the primary photosensitive targets that start the deadly oxidative damage induced by 405 nm and other violet light wavelengths (4). Bacterial contamination in biological fluids, such as blood plasma, can be inactivated by 405 nm light. Microbial contaminants were significantly inactivated in plasma samples of various quantities kept in various containers, including prebagged plasma. This antibacterial approach has special advantages due to the penetration of 405 nm light and the lack of photosensitizing chemicals, which may promote its continued development as a potential replacement for UV light-based systems (4).

The oral bacteria Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, and Prevotella melaninogenica are all destroyed by blue light. In a study, the in vitro photosensitivity of the four Fusobacteria species (Fusobacterium nucleatum ss. nucleatum, F. nucleatum ss. vincentii, F. nucleatum ss. polymorphum, and Fusobacterium periodonticum) and the aforementioned black-pigmented microorganisms was examined in pure cultures and suspensions of human dental plaque. Additionally, suspensions of the bacteria found in human dental plaque were given a single exposure to blue light at 455 nm with a power density of 50 mW/cm2 and an energy flux of 12 J/cm2. All eight species displayed a significant development slowdown in cultures (p 0.05). In vitro biofilm growth was inhibited by the cumulative blue light treatment. This could open up a new path for the prevention of periodontal diseases (4). Lago et al. reported a clinical instance where they used a violet LED to bleach a young patient's teeth over the course of three 30-minute sessions separated by seven days (corresponding to 9 units on VITA Shade Guide) (7). These are in accordance with the present study where participants noticed whiter teeth as early as 2-4 days after using LED electric toothbrush.

Numerous studies have been conducted to determine which light-based technologies are most effective for bleaching teeth. Due to the disparity in technique and evaluations for irradiation parameters, it is impossible to compare these results (8). The literature that explains the adjuvant effect of light on enhancing dental bleaching efficacy, however, seems to at least support our findings. A recent study found that when utilizing the evaluated available market peroxide products on human teeth, blue light greatly increases both the rate of bleaching and the final whiteness degree that may be attained (9). Chromophores that are somewhat distinct from those bleached by the hydrogen peroxide products employed can be directly bleached by blue light alone by photobleaching. Recently, a novel LED device using violet wavelength (405-410 nm) has been introduced as an alternative to the traditional bleaching therapy with hydrogen peroxide (HP)-based compounds (10). The pigmented molecules in the dentin have the same absorption peak at this wavelength. Zanin et al., claims that at this wavelength, the pigmented molecules are highly responsive and reactive (11). As a result, the interaction between the light and the pigment is selective, and the light from the device can split larger molecules into smaller ones. Because the pigment molecules are structurally disrupted, the conventional method's harmful side effects from the chemical agents utilized are avoided. Furthermore, Photo dynamic therapy (PDT), which has been used to treat peri-implantitis, is employed by the LED toothbrush to destroy more bacteria. Habiboallah et al. (12) investigated P. gingivalis's response to bright blue light in the presence of the photosensitizer erythrosine. Erythrosine combined with visible blue LED light (440–480 nm, 570 mW) dramatically decreased the viability of the bacteria.

By encouraging saliva flow, the ultrasonically stimulated water stream can eliminate tooth biofilm from even non-contact surfaces. An ultrasound whitening device works using hydrogen peroxide and carbamide peroxide in contrast to the traditional whitening approach, which employs LED light. Reactive oxygen species are in-situ released as a result of the ultrasound-driven breakdown of these substances as they are exposed to a resonant frequency (1.6–1.8 MHz) in the oral cavity, which bleaches (and therefore sterilizes) the surface of the teeth. The bacterial biomass is harmed by the pressure and temperature gradients that are present (12).

When properly executed, manual toothbrushing is effective, but ultrasonic cleaning can surpass it if mechanical movement is paired with the acoustic action and LED. Powered toothbrushes can help patients who struggle with manual dexterity and make self-care for oral hygiene easier (13). Similarly, in a four-week experimental period, Takenouchi et al. found that ultrasonic toothbrushes were more successful in reducing dental microbial load and improving the flow rate of the dental fluid (14).

Overall comparison of responses of subjects reveals electric tooth brush to be more effective compared to manual tooth brushing. LED electric toothbrush has the capacity to reduce oral bacterial load, diminish gingival problems, and enhance teeth whiteness after regular use. With much less downtime and harmful side effects, the electric whitening process stands apart. An LED toothbrush can be utilized as a tool for patient-administered mechanical plaque control because brushing the teeth is done somewhere between one and three times each day. Further large sample size randomized controlled trials should be conducted to concentrate on improving the bleaching chemicals in toothpaste in order to magnify the efficacy of LED electric toothbrush.

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