Perhaps your dentist has recommended a powered toothbrush, telling you that it does a better job of keeping your teeth and gums healthier than old-fashioned manual brushes.
But that's not necessarily true. A new study found only one type of powered toothbrush was more effective at removing plaque and decreasing the incidence of gum disease than regular brushes. The better-performing models feature heads that spin in two directions, according to British researchers who reviewed 37 years of international dental studies.
Four other types of powered brushes, grouped by how the brush heads move, proved no better than manual brushes. Even more disappointing for proponents of electric and battery-operated toothbrushes was the finding that the best-performing powered brush wasn't that much better than the manual kind. Brushes using "rotational oscillation" (the Braun Oral B Plaque Remover is one example) removed 11% more plaque and reduced gum bleeding by 6% compared to manual brushes when used for three months or less. When used longer, these brushes removed 7% more plaque and reduced bleeding by 17%, said Dr. William Shaw, an orthodontist at the University of Manchester in England, who helped coordinate the report of the Cochrane Collaboration's Oral Health Group.
That's a pretty modest advantage for power brushes that can cost anywhere from $7 for a battery-powered model to $80 for a rechargeable model, considerably more than the manual toothbrushes that many people get free from their dentists.
"It really doesn't come up to the level that the American Dental Assn. says is a big enough difference to justify any oral health product, or for one brand to claim superiority over another," said Shaw.
The other products reviewed included the Philips Sonicare and Sonicare brushes (side-to-side motion), Conair's Interplak (counter oscillation), the Teledyne Aqua Tech, Rowenta Dentiphant and Rowenta Plaque Dentacontrol Plus (circular action) and Salton-Maxim's Ultrasonex (ultrasound).
Dr. Kenneth Burrell, director of the ADA's Council on Scientific Affairs, said the findings could be useful to dentists but should be considered with regard to the needs of individual patients. "We already know that some patients do benefit from the powered toothbrushes cited in the study," he said. "We also know that many patients do just as well with manual or other types of powered toothbrushes."
The maker of Sonicare, the nation's No. 3 powered brush behind the Gillette's top-selling Braun Oral B and Crest's popular battery-operated SpinBrush, questioned the study's findings. Sharen R. Ross, a spokeswoman for Philips Oral Healthcare in Snoqualmie, Wash., said brush effectiveness involves more than just plaque studies, such as how well you brush and how long you brush. Because Sonicare brushes have a 2-minute timer, she said, they are "going to help increase motivation and increase the time spent brushing."
Although billed as comprehensive, the review didn't include devices tested for less than a month or those sold after 2001, such as the SpinBrush, an inexpensive model that accounts for nearly half of all powered brushes sold in the United States, and Colgate's Actibrush, which also uses rotational oscillation.
The report was part of an effort by the Cochrane Collaboration, a nonprofit research group, to subject long-standing medical and dental practices and procedures to rigorous scientific scrutiny.
Dr. Harold Slavkin, dean of the USC School of Dentistry in Los Angeles, welcomed the study for bringing some science into the choice of dental products. If consumers can use a manual brush and "get the same bang for a significantly reduced cost" then that is useful information for people to have, he said.