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‘Brushing up’ on options for toothbrushes: Manual vs. powered

The Bottom Line

  • Plaque is a sticky and invisible film that develops on our teeth, and if left to accumulate, it can lead to oral health issues ranging from cavities to severe gum disease.
  • The most common strategy for plaque removal is...brushing our teeth at least two times a day for two to three minutes each time.
  • Both manual and powered toothbrushes are effective in removing plaque, but powered toothbrushes may be slightly more effective.
  • Your mouth health matters! Investigate the pros and cons of the wide variety of manual and powered toothbrushes available on the market to find one that meets your needs. Consult with an oral health professional, if possible.  

Brush your teeth for two to three minutes two times a day. Floss at least once a day. Don’t forget to scrape or brush your tongue. Use a mouthwash or rinse once a day, generally in the morning, and toothpastes that contain fluoride. Opt for water over sugary drinks. Consume a well-balanced and nutritious diet. Decrease your alcohol intake. Quit smoking or vaping. According to the Canadian Dental Association, these are all components of a good oral hygiene routine that will help us maintain the health of our teeth, mouths, and bodies (1).


When it comes to meeting some of these requirements, Canadians are falling short. In 2018, it was reported that around 78% of those aged 12 and older brush their teeth at least twice a day, while only 43% floss at least once a day. If we look at those who both brush and floss their teeth daily, this number decreases even further to about 38% (2).


Brushing and flossing are important practices that help with the removal of dental plaque. Have you ever run your tongue across your teeth and felt a ‘fuzzy’ sensation? That’s plaque—a sticky and invisible bacteria-filled film. If not removed daily and left to buildup, plaque can lead to cavities, tooth decay, and mild to severe gum diseases (3).


Although all aspects of oral hygiene are important, let’s zero in on the most common form of plaque removal, brushing our teeth (4). The market is currently flooded with manual and powered toothbrushes that help us engage in this activity. But is there a difference in how effective they are in removing plaque? A relatively recent systematic review looked at the evidence (5).


What the research tells us

The studies included in the review had participants—who were generally healthy adults with no periodontitis, treatments fixing the positioning of the teeth, dentures, or dental implants—brush their teeth with a single-headed manual toothbrush or a single-headed rechargeable powered toothbrush. The powered toothbrushes varied in how they moved or functioned, but the most commonly used types were oscillating‐rotating brushes and side-to-side brushes. With an oscillating-rotating mode of action, the head of the brush rotates in one direction and then another; but with a side-to-side mode of action, the head of the brush moves from side-to-side.


Ultimately, the review found that after a single brushing exercise, rechargeable powered toothbrushes may be slightly more effective at removing plaque than manual toothbrushes. A closer look at mode of action also demonstrates that both oscillating‐rotating and side-to-side powered toothbrushes are more effective than manual toothbrushes (5). While this review did not compare the two types of powered toothbrushes directly, another more recent review suggests that neither oscillating‐rotating powered toothbrushes nor side-to-side powered toothbrushes are better than one another at reducing plaque or gingivitis. This means their benefits may be comparable (4).


Do these results mean that we should replace our manual toothbrushes with powered ones? Not necessarily. The findings presented don't show that manual toothbrushes aren’t effective; they just demonstrate that powered ones may have slightly more benefits. So, take a pause before rushing to the bathroom to throw out your manual toothbrush. Instead, enjoy the fact that you have more oral health tools to choose from and a better chance of finding a product that meets your needs—such as those related to mobility, cost, assistance with brushing for the recommended amount of time, and more. Be it comparing the pros and cons of products online or seeking advice from an oral health professional, if possible, do your homework before committing to your next toothbrush. 


Don’t forget, your oral health matters!   


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References

  1. Canadian Dental Association. Your oral health. [Internet] 2021. [cited August 2021]. Available from https://www.cda-adc.ca/en/oral_health/index.asp#intro
  2. Statistics Canada. Dental Care, 2018. [Internet] 2019. [cited August 2021]. Available from https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00010-eng.htm
  3. Boyle P, Koechlin A, Autier P. Mouthwash use and the prevention of plaque, gingivitis and caries. Oral Dis. 2014; 20:1-68. doi: 10.1111/odi.12187.
  4. El-Chami H, Younis A, Brignardello-Petersen R. Efficacy of oscillating rotating versus side-to-side powered toothbrushes on plaque and gingival index reduction: A systematic review. Int J Dent Hyg. 2021; 152(2):115-126. doi: 10.1016/j.adaj.2020.10.002.
  5. Elkerbout T, Slot D, Rosema NA, et al. How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises. Int J Dent Hygiene. 2020; 18:17-26. doi: 10.1111/idh.12401. Epub 2019 Jul 23.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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