How You Brush Is More Important Than the Type of Brush
June 8, 2005

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - A review of current research says at least one type of powered toothbrush may be somewhat better than a manual toothbrush for reducing plaque and gingivitis, at least in the short term.

The review, done by the Cochrane Collaboration, included 42 studies involving 3,855 people. For up to three months of use, brushes with a rotation-oscillation action — in which the head of the brush moves in one direction, and then the other — removed more plaque and reduced gingivitis better than manual toothbrushes did. After three months of use, the powered toothbrush was still better at improving the symptoms of gingivitis, but it no longer showed an advantage in removing plaque.

The bottom line message: Good oral hygiene matters more than the type of brush you use. "Although one brush or another may appear better, the number of rigorous studies is very limited and I would not jump to conclusions based upon these findings," says David Albert, D.D.S., M.P.H., associate professor of clinical dentistry at the Columbia University School of Dental and Oral Surgery.

However, he notes, "For most people a mechanical toothbrush is a good tool and a motivating factor to better brushing. I find them to be a plus in any oral hygiene regimen, but they are particularly helpful for people who have limited manual dexterity."

While powered toothbrushes used to be relatively expensive, they can now be purchased for under $10.

The authors of the review caution that "the results do not indicate that toothbrushing is only worthwhile with a powered toothbrush." All types of brushing will reduce plaque and gingivitis, and using fluoridated toothpaste will help prevent decay.

Dr. Albert agrees. "Brush and floss regularly, and spend at least two or three minutes brushing," he says. "Less time than that is inadequate."

The Cochrane Collaboration, an international nonprofit group, provides critical reviews of health care studies and other information. To be included in the review, studies had to include people who were randomly assigned to use either a manual or a powered toothbrush for at least four weeks. Studies that allowed the use of mouth rinses were not included, but those allowing flossing were included.

The review was published in the second 2005 issue of the Cochrane Library, which compiles all of the reviews and updates done by the Cochrane Collaboration.