In America, we tend to think that if it’s new, fast, and powerful, it’s got to be better that whatever came before.
Thus, the explosion of the electric toothbrush.
It’s fairly new. It’s powered by electricity. And the bristles move fast. Therefore, it’s got to do a better job of cleaning teeth, removing plaque, and protecting oral health. Right?
We decided to find out.
History of the Electric Toothbrush
Try to find where the electric toothbrush began and you get a number of different stories. Seems that the general consensus is that an early one was produced in Switzerland in 1939, but didn’t do well and was soon removed from the market. The model that served as the prototype for those we use today was first created in 1954 by Philippe G. Woog, a dental equipment inventor.
E.R. Squibb and Sons, an American hygiene company, purchased the rights from Woog and introduced the “Broxodent” toothbrush in 1959 at the American Dental Association’s centennial celebration. They began marketing it in 1960.
It wasn’t until 1961, however—when General Electric introduced a cordless version of the electric toothbrush—that sales started to take off. Interplak later introduced the first rotary action brush (replacing the back and forth movement of the older versions) in 1987. After that, a number of other companies jumped on the bandwagon, creating varieties that incorporated rotating heads, moving bristles, vibration and ultrasonic actions, as well as timers and even UV brush head sterilization.
Studies Examine the Question of Power Vs. Manual and Power vs. Power
Ask people what they think about using an electric toothbrush versus a manual one, and you’re likely to hear that electric ones work better at cleaning. But is that true?
- 1996—sonic brush better at removing plaque: Tritten and colleagues researched the question by comparing a Sonicare toothbrush with a manual toothbrush in a 12-week study on 60 subjects. Some used the Sonicare and some used a manual every morning and evening for two minutes. Researchers evaluated plaque and inflammation before and after the study period. Results showed both types of brushes were effective in removing plaque and in reducing inflammation, but the sonic brush was “statistically superior, on a percentage reduction basis, in removing supragingival plaque from the dentition taken as a whole,” and was also better in hard-to-reach areas. The sonic brush was also less likely to cause gum abrasion than the manual brush.
- 2001—no difference: Mantokoudis and colleagues compared two electrical toothbrushes (Braun Oral-B Plak Control Ultra and Braun Oral-B Plak Control 3D) with manual tooth brushing. The methods were similar as the previous study, with participants using one of the three methods for two minutes twice a day. Researchers found “no significant differences” in plaque reductions between manual brushing and the two electric brushes.
- 2004—rotating/oscillating brushes slightly better: The Cochrane Collaborations Oral Health Group conducts a systematic review examining the clinical effectiveness of power versus manual toothbrushes. They looked at clinical trials conducted up through 2001 and identified over 300, but chose only 29 that met the inclusion criteria—things like whether the scientists compared power versus manual toothbrushes, used a randomized research design, tested the products in the general population, provided data on plaque and gingivitis, and were at least 28 days in length. The trials chosen involved 2,547 participants. Results showed that for both plaque and gingivitis, all types of power toothbrushes worked as well as manual toothbrushes. Only rotating, oscillating toothbrushes, however, consistently provided a statistically significant, though modest, benefit over manual toothbrushes in reducing plaque (7%) and gingivitis (17%).
- 2009—rotating/oscillating better: Researchers decide to compare rotating/oscillating toothbrushes with sonic power toothbrushes. The study lasts 10 weeks, with subjects brushing twice daily at home. Results were similar to the 2004 study—those using the rotating/oscillating brush had statistically lower gingivitis scores and significantly fewer bleeding sites than the sonic group, and only the rotation/oscillation group showed a statistically significant improvement in gingivitis and bleeding. Both groups showed lower plaque scores.
- 2010—electric is better than manual in hard-to-reach areas: Researchers compare the oscillating/rotating toothbrush (Oral-B Professional Care 8500) with two manual toothbrushes (also Oral-B brands). The electric toothbrush was better in plaque removal, and was significantly more effective in hard-to-reach areas.
- 2013—rotating/oscillating better in hard-to-reach areas: Researchers compare oscillating-rotating power brushes with sonic power brushes and manual brushing through a review of six comparative clinical trials. Brushes used included the Oral-B Professional Care Series 4000, Oral-B Vitality with Floss Action or Precision Clean brush head, the Sonicare FlexCare with ProResults brush head, and the American Dental Association reference manual toothbrush. Results showed that all toothbrushes provided significant post-brushing plaque removal efficacy, but the oscillating/rotating brush was “consistently superior” compared to either the sonic or the manual brush in removing plaque and getting into all the hard-to-clean areas. More specifically, this type of brush removed up to 34 percent more plaque than the other options.
What Should You Choose?
As more features become available on electric toothbrushes, we’ll probably have more studies evaluating how well they work. For now, the consensus seems to be that all brushing is effective, but the rotating/oscillating electric toothbrush is likely better at getting into hard-to-reach areas for an overall cleaner mouth.
If you’re on the fence as to whether to invest in an electric toothbrush, here’s a quick comparison to help you choose. In the end, the important thing is to brush and floss every day with whatever tool works best for you.
Manual vs. Electric
Which kind of toothbrush do you use? Do you have a reason for your choice?
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Shelley Moore, “Who Invented the Electric Toothbrush?” eHow, http://www.ehow.com/about_4598206_who-invented-electric-toothbrush.html?ref=Track2&utm_source=ask.
“The History of the Electric Toothbrush,” CosmicSmile.com, August 10, 2011, http://www.cosmicsmile.com/blog/archives/14-The-history-of-the-electric-toothbrush.html.
Tritten, C.B., and Armitage, Gary C., “Comparison of a sonic and manual toothbrush for efficacy in supragingival plaque removal and reduction of gingivitis,” Journal of Clinical Periodontology, July 1996, 23(7):641-648, http://onlinelibrary.wiley.com/doi/10.1111/j.1600-051X.1996.tb00588.x/abstract.
Dimosthenis Mantokoudis, et al., “Comparison of the clinical effects and gingival abrasion aspects of manual and electric toothbrushes,” Journal of Clinical Periodontology, January 2001; 28(1):65-72, http://onlinelibrary.wiley.com/doi/10.1111/j.1600-051X.2001.280110.x/abstract.
Forrest JL, Miller SA, “Manual versus powered toothbrushes: a summary of the Cochrane Oral Health Group’s Systematic Review, Part II,” J Dent Hyg. 2004 Spring; 78(2):359-54, http://www.ncbi.nlm.nih.gov/pubmed/15190692.
Karen Williams, et al., “Comparison of rotation/oscillation and sonic power toothbrushes on plaque and gingivitis for 10 weeks,” American Journal of Dentistry, December 2009; 22(6):345-349.
Julie Grender, et al., “Plaque removal efficacy of oscillating-rotating power toothbrushes: Review of six comparative clinical trials,” American Journal of Dentistry, April 2013; 26(2):68-74, http://www.dentalcare.com/media/en-US/research_db/pdf/am-j-dent/2013/AJDApril2013-Grender.pdf.
Pizzo G, et al., “Plaque removal efficacy of power and manual toothbrushes: a comparative study,” Clin Oral Investig 2010 Aug;14(4):375-81, http://www.ncbi.nlm.nih.gov/pubmed/19548011.