Which toothbrush is the best?

One popular question asked of the dentist is “which toothbrush is the best?”  This question stems from the fact that there are many different brands of toothbrushes out there, all claiming to be superior.  However, when it comes down to it, most toothbrushes use the same basic design.  As far as rating the effectiveness of the toothbrush, there is obviously much greater variance due to technique and frequency of use than to size and placement of bristles.

Studies that compare the effectiveness of one toothbrush versus another often find that one design is not significantly better than another design.  Usually, when toothbrushes are compared in these trials, it is found that the device of interest shows slightly improved plaque removal for the short-term, but a distinct overall advantage for any one particular product is not demonstrated.  Claims made by toothbrush companies are many times based on a single variable, and do not investigate differences in the comprehensive health of teeth and gums.  However, there are some points that should be considered when choosing a toothbrush:

  • Hard vs. soft bristles: softer bristles are more flexible, clean slightly below the gums, and reach farther in between teeth.  Hard-bristled toothbrushes are associated with more gum recession.  But again, the manner in which the brush is used has a greater effect than the bristle hardness itself.
  • Bristle Wear: toothbrushes should be replaced periodically (every 3-6 months) because wear on the bristles decreases the toothbrush’s effectiveness.
  • Electric Toothbrushes vs. Manual Toothbrushes: For people who brush regularly and correctly with a manual toothbrush, it has been shown that they are just as effective as using an electric toothbrush.  However, electric toothbrushes do have several advantages.  Probably the most important of these is that electric toothbrushes provide better motivation to brush through both ease of use and through the internal timer function.  This has been shown to improve oral health especially for children and adolescents, those with physical or mental disabilities, hospitalized patients (including those who need to have their teeth cleaned by caregivers), and patients with orthodontic appliances.  Electric toothbrushes with low-frequency acoustic energy generate fluid movement and provide cleaning slightly away from the bristle tips.  The vibration has been shown to interfere with bacterial attachment.  One study of 157 people showed that powered brushes with oscillating, rotating motions demonstrated modestly greater reductions in plaque and gingivitis than manual toothbrushes.

So your choice in toothbrush all comes down to what you like and what you are going to use regularly and effectively.  If you are one who does a good job brushing with a manual toothbrush, then if it ain’t broke, don’t fix it!  If you are a reluctant brusher, or one that does not brush for a full 2 minutes, twice a day, then an electric toothbrush with a timer function might provide the motivation and effective brushing power that you need.  In the near future, we may get even more motivation to brush, as there are talks of creating a toothbrush that can access the internet and provide incentives for good brushing!

Many people are reluctant to try an electric toothbrush because some of them are so expensive.  Do you need to pay over 100 dollars to get a good electric toothbrush?  Well, a recent study published in the Journal of Contemporary Dental Practice reviewed many of the less expensive electric toothbrush models, and showed that they were to be just as effective as the higher-priced models.  No matter which type of toothbrush you use, it’s all about getting into the habit of brushing regularly and remembering to use a light, circular motion, being sure to spend enough time on all the surfaces.

Dr. James B Burley is listed at DentistDig.com

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