Ordinary vs. Powered Toothbrushes

Stroke of Genius?

5 min read

Nine-year-old Nicholas Racobaldo doesn't remember what it's like to clean his teeth with an ordinary toothbrush. For two years, he's been using an electrically charged gadget with high-speed, rotating bristles.

"I like it because it tickles," he says, and imagines that now a regular toothbrush would feel "yucky" in his mouth.

Nicholas isn't the only kid who prefers the powered devices.

Eileen Hermiston, RDH, a pediatric dental hygienist at the University of Iowa College of Dentistry, says many of her patients think the high-tech brushes are fun.

"It can be a big power struggle getting children to brush their teeth," she notes. "If you can inspire enthusiasm in children with power toothbrushes, daily tooth brushing becomes easier."

If the increased amount of space taken up on store shelves is any indication, the electric brushes are growing in popularity. Some of them are kid-friendly: The toothbrush handle may take on the shape of a racing car or a mermaid or a cell phone, and its color may resemble army camouflage.

Many patients are now asking their dentists about these mechanical tools so much that the American Dental Association (ADA) has issued several news releases on the matter.

The organization says manual toothbrushes can be just as effective as powered ones. The key to preventing tooth decay, say experts, lies in the way a toothbrush -- electric or otherwise -- is used.

"If you are a wonderful brusher and a wonderful flosser ... then the manual toothbrushes are just great," says Kimberly Harms, DDS, an ADA consumer advisor who is also a dentist in Farmington, Minn. However, she says powered devices can help people who have trouble physically moving their brushes around their mouth to clean all teeth surfaces. These may include anyone with a motor disability or arthritis.

There was a time when toothbrushes were considered luxury items.

According to the ADA, wealthy Europeans in the Middle Ages used twigs made of sweet-smelling wood to clean their teeth. Then, in 1498, the emperor of China developed a device with hog bristles placed in a bone handle. This type of toothbrush became so popular that in Europe even the common folk used it. The price of hog bristles was so steep, however, that a whole family would share the same toothbrush to cut costs.

Today the cost of a powered toothbrush can be more than triple that of a manual one. Modern society's obsession with cleanliness, however, has generally made it unacceptable to share toothbrushes.

Thirty-year-old Kevin Wong doesn't even like the idea of his electronic toothbrush falling on the floor and getting dirty. He says he worries about that happening since he finds it difficult to find a slot in his regular toothbrush holder for the small brush head, which detaches from the more bulky handle.

Overall, though, Kevin is pleased with his battery-operated, spinning brush. He thinks it's better at cleaning his teeth than a regular toothbrush. Yet that's not enough to convince him to continue using it after the bristles have worn off. "It's a fun thing to have, but I don't know if it's worth the cost," he says.

At 6,000 to 30,000 strokes per minute, the mechanical brushes appear to provide more power per dollar compared to manual ones. As Harms notes, it takes less time to do a thorough job with the electrified version.

Some people don't like the power stroke action, however. "For some younger kids or kids that are a little bit more sensitive, the vibrations seem to bother them," Hermiston says.

Toothbrushes, whether manual or electric, are considered by the U.S. government to be medical devices. They fall within the Food and Drug Administration's class I category, meaning that they are generally considered to pose little harm and are subject to the least regulatory control.

A spokeswoman for FDA says she is not aware of any problems with the powered toothbrushes.

Researchers at the University of Iowa College of Dentistry are in the process of studying the responses of parents, children, and dental professionals to high-tech brushes. Arthur Nowak, DMD, and colleagues are expected to issue their report this spring in the journal Compendium.

Toothbrush maker Braun Oral-B has already come out with a report of its own on the effectiveness of the mechanical devices. In one study, more than 16,000 patients were asked by their dentists or hygienists to use a Braun Oral-B powered toothbrush.

When asked to monitor their patients' progress, the dental professionals said the powered brush had a positive effect on the oral health of more than 80% of the patients. Most participants reportedly said their oral health was better after using the device.

Results of this study appeared in the March 2000 issue of the Journal of the American Dental Association.

Dental health experts agree that regular tooth brushing (no matter how high tech or low tech the gadget) and flossing can help prevent tooth decay.

As a general rule, Hermiston recommends that children up to age 7 have adult supervision while brushing. This is to make sure kids completely clean all surfaces of their teeth, even hard-to-reach places where plaque often accumulates, such as the back molars or the lower bottom teeth next to the tongue.

The ADA has more suggestions for parents to help their kids develop good dental habits:

  • Take your child to see the dentist regularly. Schedule a visit to the dentist within six months of the eruption of the first tooth and no later than the child's first birthday.
  • Encourage children to drink from a cup by their first birthday.
  • Start brushing the child's teeth with water as soon as the first tooth appears. A pea-sized amount of toothpaste can be used after age 2, when the child can spit it out.
  • Watch how your child eats. It's better to eat regular meals and fewer sugary snacks.
  • Make certain your child gets the right amount of fluoride needed for decay-resistant teeth. Ask your dentist how this can be done.
  • Ask your dentist about dental sealant, a thin protective barrier that shields the chewing surface of back teeth from tooth decay.