Oral vibration or manual stimulation?

One of the most common questions I get asked is electric toothbrush versus manual toothbrush.   Studies are massively varied, some showing a significant difference in reducing the infamous, acid-defecating bacteria and others showing no significant difference whatsoever.  Nothing unusual there then.

Other problems with these studies are that there is such a huge selection of electric toothbrushes and manual toothbrushes that which ones do you trial together?  The basic electric toothbrush with the boring, round head or the electric toothbrush with 1400 buttons that not only vibrates the bacteria into another dimension and but also increases the size of your bicep by 27% due to the strength needed to keep it from vibrating out your hand and destroying the bathroom?  Do you use a little manual toothbrush with bristles all perfectly in line like a military haircut, or a bristle brush that has bits of coloured plastic jetting off in every direction like a festival goer’s hairdo?  Too many choices.

A small study with children aged 4-5, using four different types of manual and electric toothbrushes “showed there were no clinically meaningful differences found between any of the toothbrushes tested during either of the trials with regard to plaque removal or improvement in gingival health. ”

Another study with children aged 5-8, using three different kinds of manual toothbrushes, showed there were no significant differences in the cleaning efficiency between the three toothbrushes. “Significant improvements in plaque removal in children can be achieved following good brushing instructions regardless of the toothbrush design used.”

However, in usual contrast, a study in adults, one group using a battery toothbrush and the other using a manual toothbrush, showed a significant difference between the effectiveness of plaque removal.  That might be because adult biofilm is a little more complicated than child biofilm.  I have no evidence of that.  Just speculating because it makes me sound intelligent.  And I like the word biofilm.

So before I bore you too much, I’ll skip straight onto the advice I give – some based on teachings at dental school, and other advice based on looking in several thousand mouths over the last 9 years:

Taken from a funny comic blog http://kaktimes.wordpress.com/
Taken from a funny comic blog http://kaktimes.wordpress.com/
  • It’s, in a nutshell, down to personal preference.  A manual toothbrush used well is just as effective as an electric brush.  It’s what you do with it that counts.  A toothbrush used badly, whatever it is, will be as effective as trying to access your mouth via your anus.  The bacteria will be the same though (not quite, but smell the same).
  • Only bother with battery-operated brushes if you’re unsure whether you’ll like the gummy stimulation of a vibrating brush.  This way you get to try it out cheaply before making up your mind.
  • Don’t bother with expensive sonic brushes.  Some dental professions swear by them.  Some patients swear by them.  They require such a specific technique, that in my opinion, do not improve gum health because they are rarely used correctly.  Plus, they splatter the bathroom mirror with mouth debris with such vigour, it’s like a bloody scene from a Tarrantino film by the time you’ve finished.
  • Regardless of how new-fangled your toothbrush claims to be, along with your mouth exploding mouthwash and miracle, enamel growing toothpaste, you will only be cleaning 60% of the tooth surfaces, so if you do not get in between the teeth, you could end up with breath like death.

Tips for electric toothbrushes:

  • Always get one with a two-minute timer as a basic feature
  • Always get a round-headed brush as opposed to rectangular
  • Always stick to the basic head it comes with – forget the heads with plastic gum massagers and polishers.  Pointless and expensive
  • Always get a rechargeable as opposed to battery
  • Spend at least £30 (unless you see one half price but the original price was more than £30!)
  • DO NOT use it like a manual toothbrush.  You will need to tilt the bristles towards the gums and hold it for a couple of seconds on each tooth.  If you move it too quickly, you’ll just skim past the proudest parts of the teeth and miss the nooks and crannies
  • DO NOT be tempted to use it when it has lost it’s charge.  Please refer back to my shoving toothbrush up arse comment earlier
  • Change the heads as soon as the blue bristles start to fade or start to splay
  • Do not rinse with water after you have finished brushing as you will wash away to antibacterial agents of the toothpaste

Tips for manual toothbrushes:

  • Keep it small and simple – no more than 2cm in length
  • Keep bristles fairly uniform and boring
  • Medium textured bristles
  • Brush for at least two minutes
  • Point the bristles towards the gums and use small, jigging movements
  • Use a bathroom mirror so you can actually see where you’re brushing and if any areas bleed.  If they do, call an ambulance.  Not really, just brush the bleedy area again.  Gums are like the soles of your feet; the more you walk around without socks on, the harder the skin gets.  The more effectively you brush your teeth, the tougher the gums get.
  • Change the toothbrush at least three-monthly or when the bristles start the splay and feel soft
  • Again, do not rinse with water after you have finished brushing as you will wash away to antibacterial agents of the toothpaste

So, the next time you find yourself standing in front of the sea of toothbrushes at the local supermarket, hopefully you’ll feel less like stabbing yourself in the head with an organic parsnip and be more equipped to picking the right brush. Just keep it simple.

I’ll leave you now with Charlie Brown – he will make you so knowledgeable about toothbrushing, that you can put it on your CV when applying for my job.

One thought on “Oral vibration or manual stimulation?

  1. Bravo! That may have been the funniest dental advice I’ve received. Maybe I should print this out and show my dentist. I think the illustrations are exceptionally helpful.

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