The nylon bristled toothbrush has essentially existed in its current form since the early 20th century. While several advances and upgrades have been applied to the manual toothbrush, it has been a relatively unchanged oral hygiene tool. The power toothbrush has come along more recently as an alternative to the golden standard. Given the opportunity to choose between power and manual toothbrushes, many patients ask whether one is more effective than the other, and if one is favored by you as their caregiver.
So, what do you tell them? Here are the pros and cons:
To effectively clean the teeth and gingiva, a proper brushing technique is essential with a manual toothbrush. Patients should be instructed to place the bristles of their manual toothbrush along the gingival margin at a 45-degree angle, contacting both the tooth surfaces and the gumline.1 With a vibrating, back-and-forth rolling motion, the patient should gently brush the surfaces of two to three teeth at a time, manipulating the brush head toward the chewing surface before continuing to the other teeth. This same motion is used first on the labial surfaces and then the lingual and occlusal surfaces.
The ADA recommends brushing teeth for two minutes, twice daily.2 As opposed to power toothbrushes that may have automated timers, patients with manual toothbrushes need to keep track of how long they’re brushing.
Toothbrushes are a personal choice. Patients with different size mouths may opt for a full-sized or compact head for their brush. Some may even prefer a child-sized toothbrush because of the ease of accessing hard-to-reach areas. With many different styles and the ability to be tailored to an individual in the form of bristles, heads, and special prints, manual toothbrushes are never short of options for patients with sensitivities or other problems.
Manual toothbrushes are also very easy to travel with, and don’t require charging packs or batteries. It’s inexpensiveness and easy availability makes it a preference for many.
Power toothbrushes, including oscillating, vibrating, and ultrasonic options, provide patients with greater conveniences under the premise that less work = better results! Today, a growing body of research (including those with random trials, standardized brushing regimens, and independent evaluators) indicates that the current generation of power toothbrushes removes more plaque than do manual toothbrushes.3,4 While automated toothbrushes are effective in removing the dental biofilm, it is still important for patients to supply proper technique with their use. The bristles will do the work (and thus require less force by the user), but proper angle and compliance are still essential parts of the toothbrushing routine.
As many feature a built-in timer, patients using power toothbrushes don’t have to do guess work on time spent brushing. However, with all the good that a typical automated toothbrush does, there are some drawbacks. Charging and replacing batteries means that travel can be less convenient than with a manual brush, and they can be damaged in transit. Additionally, power toothbrushes are typically more expensive than their manual counterparts. Nevertheless, the effectiveness and conveniences of the automated toothbrushes make them a compelling choice for many patients.
So What’s the Right Choice?
Although power toothbrushes have been proven to more reliably remove plaque and improve gingival health better than manual brushes,1 the difference between the two options often comes down to personal taste. Some like to stick to their instincts with the manual toothbrush, making sure they personally are caring for their teeth. Still others prefer the pulse or pressure of power toothbrushes. It’s important for patients to choose a toothbrush that will encourage the most compliance, proper technique, and frequency of use. Both can be effective in their own way, and whichever they go with, they should be satisfied.
- Proper brushing. American Dental Hygienists' Association. https://www.adha.org/resources-docs/7221_proper_brushing.pdf. Accessed September 19, 2016.
- Learn more about toothbrushes. ADA Seal of Acceptance. http://www.ada.org/en/science-research/ada-seal-of-acceptance/product-category-information/toothbrushes. Accessed September 19, 2016.
- Barnes C. The bottom line on toothbrushes. Dimensions of Dental Hygiene 2003;1(1):32-33, 35, 37.
- Walters P, Campbell SL. Five common misconceptions about power toothbrushes. RDH 2005;25(10).