Removing plaque through effective toothbrushing has an important role in the prevention of gum disease and tooth decay. Dental plaque is the primary cause of gum inflammation, and this can lead to more serious oral conditions. The build up of plaque can also lead to tooth decay. There are different kinds of powered or electric toothbrushes available to the public, at a range of prices. Powered toothbrushes work in different ways – some move from side to side, and some in a circular motion. Are these kind of toothbrushes better to use than a manual toothbrush? Does their use lead to less inflammation in the gums?
What was the research?
A systematic review of the evidence, considering whether a powered or electric toothbrush is better than a manual toothbrush at maintaining oral health by reducing plaque and gum inflammation.
Who conducted the research?
The research was conducted by a team led by Munirah Yaacob, on behalf of the Cochrane Oral Health Group. Helen V. Worthington, Scott A. Deacon, Chris Deery, A. Damien Walmsley, Peter G. Robinson and Anne-Marie Glenny were also on the team.
What evidence was included in the review?
Data was extracted from 56 randomised controlled trials. A total of 5,068 people participated in the trials, and were randomly assigned to either a powered toothbrush or a manual toothbrush.
What did the evidence say?
There was evidence that there is a benefit in using a powered toothbrush compared to a manual toothbrush. Plaque was reduced by 11% after one to three months of use, and by 21% after three months of use. For gum inflammation, there was a 6% reduction after one to three months of use, and an 11% reduction when assessed after three months of use.
How good was the evidence?
The evidence presented in this review is of moderate quality, only 5 trials out of 56 were at low risk of bias.
What are the implications for dentists and the general public?
This review has found that compared with manual toothbrushes, powered toothbrushes are more effective in reducing plaque and gum inflammation. However, there were inconsistencies in the trials when reporting cost, reliability and side effects.
What should researchers look at in the future?
Trials of a longer duration are required to evaluate the effects of powered toothbrushes. There are few trials reporting data over more than 3 months. The research team also found some issues with trial design, researchers in this area are advised to follow the CONSORT guidance on the reporting of clinical trials.
Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM. Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD002281. DOI: 10.1002/14651858.CD002281.pub3.