Electric toothbrushes / Are electrics really better than manual brushes?

You might be surprised to learn that the design of some electric brushes is little changed from those first introduced over 50 years ago. Others, however, most notably the sonic (Sonicare) and oscillating / pulsating (Braun Oral B) brushes, utilize technology and designs whose application to dentistry is relatively recent.

So to help people make an informed decision, our pages cover topics such as:

  1. Are electric toothbrushes really superior to manual ones?
  2. Are there any safety concerns with using them?
  3. Reasons / applications where the use of an electric brush makes good sense.

We also review several Sonicare models and explain the use of the features found on them.

Philips and Sonicare are registered trademarks of Koninklijke Philips Electronics N.V. / Braun Oral B is a registered trademark of The Gillette Company.

Are electric toothbrushes really better than manual ones?

Effective tooth brushing takes time and diligence. And if the features of an electric toothbrush can help you meet these demands, then getting one can make a great choice.

But don't buy an electric just because you think that it can provide something that you can't do on your own, because that's not necessarily what dental research has shown.

Actually, the research that has compared the two is somewhat inconclusive.

Bowen (2003) evaluated the superiority of electric toothbrushes over manual ones by reviewing 46 clinical studies published between 1989 and 2002. The findings of this evaluation were:

  • 33 studies supported the superiority of electric toothbrushes over manual brushes.
  • Two of the studies found that manual tooth brushing gave better results.
  • The remainder either found equal effectiveness for both methods, or determined that the results of their study were inconclusive.

Sometimes it's difficult to trust the findings reported.

Actually, the quality of a great deal of the research that you no doubt have been exposed to (via TV commercials, printed advertising, etc...) that has compared the benefits of powered toothbrushes over manual ones is an issue open to debate.

This really shouldn't come as much of a surprise to anyone considering the amount of money involved with electric-toothbrush sales.

Another landmark study (Heanue 2003) also investigated the issue of powered vs. manual toothbrushes by way of reviewing the findings of other researchers.

This study created a set of guidelines for what they considered appropriate methodology for clinical trials. Of the 354 published and unpublished trials they found to evaluate, only 29 met their inclusion criteria (Niederman 2003).

Using an electric toothbrush may be more efficient than brushing by hand.

An electric toothbrush.

A study (van der Weijden 1993) compared the plaque removing efficiency of three different electric toothbrushes vs. brushing by hand over various time periods ranging from 30 seconds up to 6 minutes.

This study found that the use of all three electrics was more effective than brushing manually, for all of the time periods evaluated.

They also determined that more dental plaque was dislodged by an electric toothbrush in 2 minutes than a manual one used for 6.

That suggests that although you may be able to reach the same cleanliness end point with either method, when using an electric toothbrush you'll get their sooner.

Certainly, if a person has a set habit regarding how long they will brush, they will probably get more cleaning accomplished during this set time limit when using an electric toothbrush rather than a manual one.

Brushing by hand takes more skill.

In general, it seems that the superiority of electric toothbrushes over manual ones usually becomes more apparent as the time frame of a study increases. This is especially true in those cases where the study extends for 6 months or longer.

A manual toothbrush.

This may be related to the fact that an electric brush is generally easier to use. And therefore may be able to provide more consistent results over a prolonged time frame.

Electric brushes do a lot of the work for you.

You can think of an electric toothbrush as being a tool, which, on its own, creates an effective brushing action.

In a sense, all that's required from the user is the ability to move the brush around to various locations in their mouth (an activity that takes very little dexterity). Since the skill level that's needed to brush properly is minimal, all a person must do is focus on brushing long enough.

In comparison, using a manual toothbrush requires a fair amount of dexterity and some diligence. And if either are in short supply, the person's results will be lacking.

How long does a person need to brush?

As you might guess, many humans simply aren't self-disciplined enough to brush properly when they use a manual toothbrush. As a general rule, most people should brush their teeth at least twice a day with each brushing period lasting at least two to three minutes. The fact of the matter is that most of us fail to routinely meet these guidelines.

You may not be brushing for as long as you think.

Actually, the statement that most people aren't self-disciplined enough to brush properly when they use a manual toothbrush is probably a little bit harsh. Research has found that there can be a major discrepancy between the amount of time that a person actually does brush, as compared to the amount of time that they perceive they have brushed.

One study (our Saxer et al reference) found that their test subjects, on average, brushed their teeth for 78 seconds (a little longer than a minute) when they actually thought they were brushing for 141 seconds (over two minutes, an adequate amount of time). So, the intention of these people was appropriate but in reality their actions (actual brushing time) were lacking. (To help with this problem some electric toothbrushes have built in timers that allow you to measure the length of time you have been brushing.)

Powered Toothbrushes

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