Electric toothbrush – is it cool to have one?

January 4, 2018by Mahesh Patel

Electric toothbrushes:

There is little evidence in the literature that electric toothbrushes outperform manual brushes.

Electric toothbrushes tend to wider and more bulky. As a result there is tendency for electric brushes to clean the more pronounced teeth and most prominent parts of the teeth s seen in the image below.

Recession due to over brushing

Additionally, bacteria can be pushed between under the gums and between the teeth causing swelling and inflammation as seen in the image below:

Bunching of gums between the teeth due to poor technique
Bunching of gums between the teeth due to poor technique

The use of electric brushes can be compared to sweeping or scrubbing a cobble stoned street with a rotating pad. The pad will clean and polished the top of the stones but debris will collect between in the joins! In the mouth this would be equivalent to bacteria left between the teeth and at gum level where gum disease is initiated.



If one was to have an electric toothbrush an ultrasonic type ( eg sonicare ) is the preferred option. Use a light touch with these brushes.

How does ultrasonic toothbrushes work?

High frequency oscillations causes cavitation of the water creating large and quick pressure pressure changes in very small areas. This causes bacteria and debris to lift off away the teeth. Most toothbrushes will have a cut-off or a sound warning if the toothbrushing is too hard. This setting can be variable and in our opinion can be too high for delicate gum margins. Delicate gums margins are often in front of the lower front teeth.

Only those patients with manual dexterity assistance will really benefit from a powered brush.

What we advise our patients:

Almost all of our patients can attain a high standard of dental health with manual tooth brushes, even with fixed braces in place. The key factor are:

  1. The duration of brushing. It normally takes 20 small, tight wiggles between the teeth with a soft brush to loosen the plaque.
  2. The pressure on the teeth and gums. Quick hard scrubbing is bad for gums. Be gentle and take your time.
  3. Size and type of brush. These MUST be small. We recommend a small headed baby brush
  4. Supplementary aids such as disclosing tablets and interdental brushes can also be an enormous help. We will advise depending on individual needs.

Getting the right balance:

With good care of the gums and excellent orthodontics the long term improvement can reap long term benefits. See before and after images below:

Evolution Orthodontics. Treatment by Mahesh Patel

The reference for the manual/electric toothbrush: Insufficient evidence to conclude that orthodontic patients derive benefits from using power toothbrushes. Greg.J Huang. Journal of the American Dental Association. July 2009.