Inclusive oral care, interview with Dr Maike Siemons

Nathalie Schüller, Dental Tribune International

Mon. 10. June 2024

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Following on Oral-B Big Rethink initiative,the brand, together with the International Association for Disability and Oral Health (iADH), recently introduced the Disability Champions Award Programme, aimed at fostering a more inclusive experience at dental practices for people with disabilities. At the launch on 16 May at Oral-B’s Championing the Perfect Clean for All event in Amsterdam in the Netherlands, Dental Tribune International spoke with Dr Maike Siemons, the director of oral care research and development (R&D) across Europe at Procter & Gamble which owns the Oral-B brand. In this interview, she explains the company’s goal of creating products that enhance oral hygiene for everyone, the types of issues that people with disabilities face regarding oral care and how this has informed product design.

Dr Siemons, could you tell us about past projects where you’ve incorporated inclusive design principles aimed at improving oral care for individuals with disabilities. How did you approach these projects from an R & D perspective?
In exploring various areas of possible difficulty for individuals with disabilities, we acknowledge the broad spectrum of individuals with special needs. Since there’s no one-size-fits-all solution, we explore multiple avenues. For instance, we collaborated with a visually impaired colleague in R & D to enhance toothpaste recognition. She shared her organisational challenges at home, prompting us to create an emotion sticker for toothpaste caps, aiding in easy identification. Additionally, we experimented with NaviLens, an app popular among visually impaired users, which features coloured QR codes for product navigation in stores.

Our toothbrush handle adapter prototype underwent rigorous testing with individuals who have the needs in using the product that we tried to address, and their feedback informed iterative improvements.

Another example is package accessibility, as opening packages can pose challenges for many. We continuously make adaptations in order to address various issues, such as product location on store shelves, package accessibility, and product recognition and handling difficulties. This iterative process emphasises the importance of accommodating diverse needs. The development journey requires time and ongoing refinement in order to ensure inclusivity across all aspects of oral care products.

What are some of the major challenges you’ve encountered in designing oral care products for people with disabilities? Could you provide an example of how you successfully addressed one of these challenges through innovation?
One of the biggest challenges lies in the diverse range of needs stemming from individuals’ disabilities. Addressing one issue may inadvertently overlook others. Take, for instance, the toothpaste cap solution. Although it greatly benefits some users, others may not perceive its significance. However, achieving success doesn’t necessarily mean satisfying everyone; it’s about providing meaningful solutions without alienating others.

Another challenge arises from differing preferences and needs among users. Some prefer a robust toothbrush feel for effectiveness, whereas others seek a gentler touch. Balancing these preferences is crucial in product design. For instance, deciding whether to include multiple brushing modes poses a dilemma. Although it offers versatility, it may complicate usage for some users. Prioritising key functionalities becomes essential in navigating these complexities and ensuring inclusivity.

How do you integrate feedback from individuals with disabilities into your product development process? Could you share an example where user feedback led to a significant outcome or modification in a product’s design?
Our product development process revolves around iterative feedback loops, ensuring active participation from end users. We start with prototype samples for tactile and visual assessment. Subsequently, individuals outside our organisation test these samples in real-life scenarios, providing feedback on usability and desirability. Crucially, we gauge whether users miss the prototype after its use, helping us identify unmet needs. This approach extends across all our product lines, including toothpaste, toothbrushes and brush heads. Additionally, we conduct clinical research involving dentists and consumers to assess the health impact of our products.

As a scientist, I recognise the importance of user feedback in refining ideas. If a prototype doesn’t meet expectations, I delve into discussions to uncover missing elements and necessary enhancements. This interaction with consumers, coupled with a focus on technological details, is immensely rewarding. Witnessing the final product on store shelves is a testament to our collaborative efforts and commitment to meeting user needs.

To what extent do you believe the partnership with the iADH is instrumental in achieving the goals of the Big Rethink campaign?
The partnership with iADH is pivotal in advancing the objectives of the Big Rethink campaign. Through this collaboration, we gain valuable insights into the challenges faced by individuals with disabilities, both in oral healthcare and in dental practices. IADH brings expertise in understanding these issues, guiding us in developing products that address specific needs and enhancing dental practices to accommodate patients with disabilities.

Dentists play a crucial role in the journey of individuals with disabilities, and our partnership ensures that they are equipped with the knowledge and resources to provide inclusive care. While we focus on product innovation, iADH’s expertise complements our efforts by identifying areas where intervention is needed.

The strength of our partnership lies in the synergy between product development and the insights provided by iADH. Together, we strive to bridge gaps in oral healthcare accessibility and to alleviate the challenges faced by individuals with disabilities, who often experience heightened anxieties about dental visits. Through collaboration, we aim to create a more inclusive and supportive environment within dental practices, ensuring that everyone receives the care they deserve.

What strategies do you believe are essential for making oral care products more accessible and practical for people with disabilities?
To enhance the accessibility and practicality of oral care products for people with disabilities, several strategies are crucial. Firstly, education plays a vital role at all levels, involving personalised guidance on proper cleaning techniques tailored to individual needs. Secondly, it’s imperative to offer a diverse range of products that cater for specific requirements, ensuring inclusivity in choice.

From a clinical standpoint, electric toothbrushes have demonstrated superior efficacy in achieving optimal oral health outcomes compared with manual brushes. The automation feature of electric brushes alleviates some of the physical challenges faced by individuals with disabilities, making them a preferred option for many. Leveraging clinical data supporting the effectiveness of electric brushes reinforces the importance of offering accessible solutions that maximise cleaning efficiency while minimising manual effort.

In summary, a combination of education, product diversity and evidence-based recommendations can significantly enhance the accessibility and practicality of oral care products for individuals with disabilities, empowering them to achieve optimal oral health outcomes with greater ease and effectiveness.

Would you say the focus of the R & D is on toothbrushes, or are there also issues with other products, such as toothpaste, when it comes to focusing on people with disabilities?
The focus of our R & D extends beyond toothbrushes to encompass various oral care products, including toothpaste. We’ve addressed accessibility concerns by implementing solutions such as stickers on caps for product recognition and optimising packaging designs to facilitate easier access.

For instance, in our work with denture adhesive targeted at older individuals with dexterity issues, we’ve identified challenges related to application precision and the readability of instructions. By simplifying instructions and enlarging font sizes within regulatory guidelines, we’ve improved usability. Additionally, incorporating visual aids and clear, concise language enhances user comprehension, aligning with our commitment to accessibility.

Packaging design is another area of focus, as demonstrated by our efforts to improve mouthwash bottle caps for easier opening, which is particularly beneficial for individuals with dexterity limitations.

By addressing these diverse challenges across multiple products, we aim to enhance accessibility and usability for individuals with disabilities, underscoring our commitment to inclusive oral care solutions.

Regarding the prototype of the adapter sleeve for the toothbrush handle, could you tell our readers what the problem was that you were trying to address and that led to this design?
The prototype of the adapter sleeve for the toothbrush handle was developed to address several key issues identified during our research. Primarily, we observed that the sleek surface of the toothbrush handle posed a significant challenge, as many users found it slippery, particularly when wet with foam or water. This slipperiness made it difficult for users to maintain a firm grip, especially when pressing the power button to start brushing.

To address these concerns, we consulted individuals with dexterity problems, including those with tremors, in order to understand their specific needs. For individuals with tremors, preventing the brush from slipping through their hands was paramount. Additionally, we considered the needs of individuals who could only use one hand, recognising the importance for them of a stable toothbrush that could be easily laid down while applying toothpaste.

Importantly, our approach to design was guided by a commitment to inclusivity. Rather than creating a product specifically tailored to individuals with disabilities, we aimed to develop a solution that could benefit a wide range of users. By addressing these challenges, we sought to enhance the overall user experience for everyone, regardless of their specific abilities or limitations.

What new technologies do you believe will play a pivotal role in the evolution of oral care products for those with disabilities?
New technologies are poised to revolutionise oral care products for individuals with disabilities. Artificial intelligence holds promise for enhancing product customisation and user experience. Additionally, 3D printing enables the rapid production of specialised solutions tailored to individual needs, facilitating greater accessibility and personalisation.

Emerging innovations, such as mouthpiece-based cleaning systems, offer potential alternatives to traditional toothbrushes, simplifying oral hygiene routines for users with mobility limitations. Although still in development, these technologies represent exciting prospects for improving oral care accessibility.

From a chemistry perspective, advancements in ingredient technology may lead to longer-lasting benefits, potentially reducing the frequency of brushing required. This innovation aligns with the goal of developing more-efficient oral care solutions to meet the diverse needs of users.

Ultimately, the greatest opportunity lies in the ability to customise existing products for specific individuals. By leveraging cutting-edge technologies, we can enhance inclusivity and empower individuals with disabilities to achieve optimal oral health outcomes.

Looking ahead, the rapid pace of innovation suggests that the possibilities for enhancing oral care products over the next decade are boundless. As we continue to push the boundaries of technology and scientific discovery, the future holds tremendous potential for transforming oral care for individuals with disabilities.