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Are electric toothbrushes better than manual?
Electric (battery or rechargeable) toothbrushes with circular bristle heads that rotate in alternating directions (oscillating) are better at removing plaque and reducing the risk of gum disease than ordinary manual toothbrushes, according to recent research.
The review by Peter Robinson and colleagues from Sheffield University included 42 studies and 3,855 participants. The studies compared manual, electric and battery-powered toothbrushes with a variety of bristle arrangements and motions and newer "ionic" brushes that buzz the tooth surface with small electric charges. Ionic brushes and powered brushes that did not use a circular, alternating motion were no better than manual toothbrushes in removing plaque and preventing gingivitis over one to three months, Robinson and colleagues conclude.
However, it was found that the powered brushes reduced gingivitis by 17 percent over the manual brushes after more than three months' use. The researchers found no evidence that powered brushes of any kind caused more gum damage than manual brushes.
Despite the better performance by the rotating powered brushes, the benefits of regular brushing "occur whether the brush is manual or powered, and the results of this review do not indicate that tooth brushing is only worthwhile with a powered toothbrush," the researchers write. "We did not want to say that electric brushes are necessary, just that they can help. It is possible to clean one's teeth perfectly well without an electric brush," Robinson says.
The review appears a The Cochrane Library review, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
Although the oscillating electric toothbrush seems more effective than the manual toothbrush, Robinson acknowledges that there is no standard for measuring how much of a reduction in plaque and gum inflammation is necessary to cause clinically significant improvements in oral health.
"There are standards proposed but they are arbitrary," Robinson says. "We can be reasonably sure that plaque causes periodontitis, and even that more plaque causes more periodontitis. But we cannot be sure by how much we need to reduce plaque levels in order to have a long term effect on periodontitis."
"Most people clean their teeth not to ward off gum disease but to feel fresh and confident. Likewise, some people simply enjoy gadgets. It would be difficult to put a value on those things," Robinson says.
Fred Peterson, a spokesperson for the American Dental Association, says the association has no official recommendation regarding manual versus electric toothbrushes. "Both manual and powered toothbrushes can effectively clean your teeth. If you have arthritis or otherwise need assistance with movement, a powered brush may be easier to use," Peterson says.