Home dental care • Manual vs electric toothbrush

5 patient groups: Summary of studies (Tandlægebladet 2/2020)

1. Children

There are several electric toothbrushes for children on the market (e.g. Colgate Batman and Oral B Disney Cars). Studies show:

4-5-year-olds who brush their teeth themselves: Electric brushes are slightly more effective in reducing plaque and gingivitis than manual brushes. It must be strongly discouraged to let children of that age brush their teeth themselves.

8-12-year-olds and 13-17-year-olds: Electric removes 12.8% more plaque than manual, mostly on the inside of the molars, where the electric removes 74.9% more plaque.

2. Orthodontic patients

A special brush head is available for patients with fixed appliances, but clinical studies show varying results.

A single study finds that the orthodontic brush head removes more plaque than the conventional brush head, and both remove more plaque than a manual toothbrush. Two other studies find no benefit.

3. Periodontitis patients

The effect of electric and manual toothbrushes in periodontitis patients in the maintenance phase: After 6 months, greater plaque reduction, less gingivitis and less pocket depth were seen when using an electric toothbrush. The effect was greatest on the inside and in the lower jaw

4. Patients with implants

There are electric toothbrushes with brush heads for implants (Oral-B Interspace). After 1 month, plaque reduction is seen with both electric and manual toothbrushes. After 3 months, the situation is further improved with electric brushes, but slightly worsened with manual brushes.

Patients with poor toothbrushing technique with a manual brush benefit from the electric toothbrush. Patients with good technique do not benefit from switching to an electric toothbrush.

5. Patients with functional impairment

Adults with intellectual disabilities: Equal reduction of plaque and gingivitis with electric and manual toothbrushes.

Young people (12-16 years) with visual impairment: Greater reduction of plaque and gingivitis with an electric toothbrush.

Care-dependent elderly: Even after 20g and 12 months, clear plaque reduction is seen with both brush types. It is significantly easier for the care staff to brush the citizens’ teeth with an electric toothbrush.

Manual or Electric – 6 Conclusions

  1. It is scientifically proven that electric toothbrushes, especially rotating and oscillating ones, reduce plaque and gingivitis more effectively than manual toothbrushes.
  2. It is generally recommended to brush your teeth for two minutes; but most brush for a shorter time. Since many electric toothbrushes have built-in timers, this can mean that you brush your teeth for longer than you would otherwise have done, and thus get more plaque removed.
  3. It is not clear whether the additional reduction of plaque and gingivitis achieved with an electric toothbrush has any clinical relevance.
  4. For patients with periodontitis and patients with implants, where oral hygiene is essential to stop disease progression or prevent the development of peri-implantitis, the reduction can be of significant importance.
  5. Using an electric toothbrush may be appropriate for patients with motor impairment.
  6. For people who have to help others (e.g. children or people with disabilities) with oral hygiene, it is less technically sensitive to brush another person’s teeth with an electric toothbrush than with a manual toothbrush.