Find out the buzz on electric toothbrushes.

A simple manual toothbrush, a little toothpaste, and a couple of minutes are really all you need to brush your teeth well. That's assuming you follow proper brushing technique. But some people can benefit from using an electric toothbrush, or just prefer one.

The choices seem endless.

• Some have heads that rotate in one direction and then the other (rotation-oscillation action) or move from side to side.
• Others have adjacent tufts of bristles that rotate in opposite directions independently, or heads that turn in a circular motion.
• Still, others vibrate at very high frequencies (called a sonic or ultrasonic toothbrush).
• You can even find ones that signal you every 30 seconds to switch to another part of the mouth, or that tells you when you can quit.
• One massages your gums or beeps if you brush too hard.

You can find devices with all these bells and whistles (and more) in a wide range of prices for rechargeable models that you plug into a base. Battery-operated electric toothbrushes are also available.

How they compare

It’s hard to say which features and models are best. Research has yielded some conflicting findings. And most products have not even been put to competing tests. Many of the studies are affiliated with the manufacturers. They have also tended to be small and have design problems. Moreover, the effectiveness of electric toothbrushes depends, at least in part, on how you use them. But that hasn’t stopped companies from making all kinds of claims, some of which have been retracted for lack of evidence.

Here’s a look at some of the findings.

• A review¹ of studies found that rotation-oscillation brushes reduce plaque and gingivitis more than ones with side-to-side motion, at least in the short term (4 to 12 weeks).
  • But the difference was small and its clinical importance unclear.
  • The findings “do not support the use of any particular mode of action for powered brushes,” the authors concluded.
• An Italian study² found that an electric toothbrush that oscillated and rotated with additional pulsing bristles was better at removing plaque than manual brushes.
• A sonic toothbrush was also found to be better at reducing gingivitis than a manual brush, in one study³.
• Other studies⁴ have not found electric toothbrushes to be that much better at controlling plaque than regular ones, especially if you spend enough time cleaning your teeth manually.
• A study⁵ found that brushing with a manual toothbrush was associated with higher forces on the tooth compared with sonic toothbrushes.
  • The authors recommend the sonic brushes for people with severe tooth wear and exposed (eroded) dentin.

Should you plug in?

If any of the following sound like you, you might want to use an electric toothbrush:

• You have a disability such as arthritis that limits your dexterity.
• You like gadgets and think an electric toothbrush will motivate you to brush longer. Models designed for kids can make brushing fun and encourage them to keep at it.
• You scrub too hard or have dental erosion and would benefit from a model that reminds you not to apply too much force.
• You have braces and need the extra cleaning help.
• Your dentist or hygienist has recommended one for you, perhaps because you’re not doing a good enough job removing plaque with a manual toothbrush.

Bottom line

The debate about which type of toothbrush is better—manual or electric—continues. Even more heated is the debate over which electric toothbrush features are best. Just find what works for you. If you’re a lazy brusher (okay, admit it) or could otherwise benefit from an electric toothbrush, as noted above, go for it. On the other hand, if you are meticulous in your brushing habits, you probably don’t need one, though you may still like one. You might also want to get your dentist’s opinion on what’s best for you. More expensive electric toothbrushes typically have more features, but lower-priced ones can be good, too. Whatever brush you choose, what’s most important is to brush thoroughly, regularly, and use proper technique.

 

References:

1. Scott Deacon. Cochrane Collaboration, December, 2010.
2. Giuseppe Pizzo. Clinical Oral Investigations, August, 2010.
3. N. Sharma. American Journal of Dentistry, December, 2010.
4. M. Parizi. International Dental Journal, June, 2011.
5. Annette Wiegand. Clinical Oral Investigations, July, 2012.