What's The Best Toothbrush?
Almost everyday patients ask us about the best type of toothbrush. We are asked about the difference between powered and manual brushes, hard vs soft bristles, brand X vs brand Y. The hope of this brief article is be to provide some answers.
Rather than relying solely on what we see in our patients, or our opinions as healthcare providers, we look at what the research says. When it comes to research there are various levels of strength of particular evidence. This is called a Hierarchy of Evidence. Without delving too much into this, the highest level of evidence is known as a Systematic review. What this consists of is a search through various databases, in order to gather all relevant studies on a specific question, and then pool these results in order to formulate an answer. Yes! Researchers really do go through all this to help you decide on the best toothbrush!
What is better Powered or Manual or Powered toothbrushes?
A Cochrane review (1) is the strongest type of systematic review, and therefor the gold standard for answering a question like this. And luckily there is a review on difference between powered and manual toothbrushes. The evidence produced showed benefits in using a powered toothbrush when compared with a manual toothbrush. There was an 11% reduction in plaque at one to three months of use, and a 21% reduction in plaque when assessed after three months of use. For gingivitis, there was a 6% reduction at one to three months of use and an 11% reduction when assessed after three months of use. The benefits of this for long-term dental health are unclear. We at Valley Arts Dental like several things about powered toothbrushes. Many powered toothbrushes have timers so you can ensure you are brushing the recommended 2 minutes. Many of these powered toothbrushes also have sensors to alert you if you are brushing too hard. With that said, choosing the appropriate toothbrush is and individualized decision. Powered toothbrushes have a higher cost, are less portable, and some patients with sensory issues or very sensitive gums do not tolerate powered toothbrushes.
What is better a rotating powered toothbrush or a side-to-side motion toothbrush?
Again, we go to a Cochrane review (considered one of the highest levels of evidence) to answer this question. A 2020 review (2) found that there is some evidence that rotation oscillation brushes reduce plaque and gingivitis more than side to side brushes in the short term. This difference is small and its clinical importance is unclear. In short, the rotating powered toothbrushes may be slightly better, but we really don’t know.
What is better a Soft, Medium, or Hard bristled brush?
And you guessed it… we go to a systematic review for some understanding of this question. A 2019 review concluded that soft and extra-soft toothbrushes tended to be safer because hard-bristle toothbrushes produced more gingival lesions than medium- and soft-bristle brushes. The basic thought is that for most people, a soft bristled toothbrush is the best type of toothbrush to use, because the harder bristled brushes do not provide the benefit of more plaque removal and are instead rough on the gums.
At Valley Arts Dental our philosophy is that every patient has individual circumstances which dictate their appropriate oral healthcare needs. While evidence may show that particular oral hygiene aid works better than another, in your case things may be different. This is why we typically discuss and reinforce your appropriate home care, making changes and modifications to your dental hygiene plans as needed.