Do electric toothbrushes work better than manual ones?

Do electric toothbrushes work better?

The ADA says both manual and powered toothbrushes are effective at removing plaque, that powered brushes can cost more, and that some people prefer them. The Oral Health Foundation, a UK charity, says electric brushes are widely recognized for effectiveness in reducing plaque compared with manual ones and that their rotating-oscillating action is particularly effective. It summarizes a 2014 Cochrane review: over more than three months, electric brushes achieved about 21 percent greater plaque reduction and 11 percent greater gingivitis reduction, with shorter-term benefits also seen, and the authors were uncertain about the clinical importance of the differences.

Which electric brushes have the best evidence?

The Oral Health Foundation says oscillating-rotating brushes had the most consistent supporting evidence in the Cochrane review. The ADA lists several head movements for powered brushes, including side-to-side, oscillation, rotation, circular and ultrasonic. Neither source ranks brands. A search summary of another review found that the benefit is modest, which fits the uncertainty above.

Who might benefit from an electric toothbrush?

The ADA says powered brushes may suit people with dexterity problems, such as older adults, people with disabilities or children, or people with braces or other dental appliances. The Oral Health Foundation says they are particularly beneficial for people at higher risk of periodontal disease. For others, good technique with a manual brush works, which is the ADA's implication and flagged.

What does the ADA Seal mean?

The ADA says the Seal indicates that a manual or powered brush has shown safety and efficacy for plaque removal and gingivitis reduction, based on evidence the manufacturer supplies and the ADA's Council on Scientific Affairs reviews. Powered brushes must also pass electrical, mechanical and chemical tests and a clinical safety study. The sources we read do not say whether Quip or any specific brand has the Seal, so check the ADA's product list.

How long and how hard should you brush?

The ADA recommends brushing twice a day for two minutes with fluoride toothpaste, children under 3 using a smear of toothpaste about the size of a grain of rice, and children 3 and older a pea-sized amount under adult supervision. Can you overbrush? The ADA does not use the term but advises gentle pressure and a soft-bristled brush to reduce the risk of gum injury. Our guide on how to choose a toothbrush covers more.

Can you use regular toothpaste with an electric toothbrush?

The sources we read do not address this. The ADA recommends fluoride toothpaste for brushing in general, and our page on toothpaste explains fluoride. Check your brush's manual, because some makers advise against abrasive or whitening toothpastes, which is general advice and flagged.

How do you clean and sterilize a toothbrush?

The ADA says not to share toothbrushes, to rinse thoroughly after each use, and to store upright and let it air dry, because storing a damp brush in a closed container promotes microbial growth. To sanitize, it says soaking in 3 percent hydrogen peroxide or a mouthrinse reduced bacteria by about 85 percent in one study, and warns against microwaving or dishwashing, which can damage the brush, and says to look for FDA clearance if using a sanitiser device.

How often should you replace the brush or head?

The ADA says to replace it about every three to four months, or sooner if the bristles are matted or frayed, since worn bristles reduce effectiveness. That applies to manual brushes; for powered brush heads, follow the maker's guidance, which the ADA page does not give and is flagged.

Questions to ask your dentist

Take these to your check-up.

• Would an electric toothbrush help me?
• Is my brushing technique good?
• Do I brush too hard?
• Which toothpaste should I use?
• How often should I replace my brush or head?

Frequently asked questions