Our hand is undoubtedly one of the most refined perceptive motor devices in existence. Since the 1940s several companies throughout the world have tried to replace (it would be more correct to say “implement”) manual brushing with an electrical device: for many decades these attempts have not been successful.
At the beginning of the 90s, electric toothbrushes as we know them today were preparing to take on the Western market on a large scale.
They were followed by the first “Manual versus Electric ToothBrushing” comparative studies. Certainly the high efficiency of the new electric tools showed some advantages over the old manual toothbrush, but the results ended up confirming that, with a careful and meticulous brushing practice, both systems could maintain optimal plaque levels. Considering that these studies were (inevitably) supported by the manufacturers of the new electric models, these result could be considered an impartial draw.
However, in the following years, the advantages and limitations of the two techniques would be highlighted.
The currently available electric toothbrushes use two different technologies:
- Mechanical electric toothbrushes: these have mechanically generated oscillating (not rotating !!!) and pulsating movements
- Ultrasonic electric toothbrushes: more similar to the manual ones, they use ultrasonic microvibrations
Of these two categories of electric toothbrushes, the mechanical ones are by far the most common today. Therefore we will refer mainly to these devices.
Electric toothbrushes offer results comparable to those offered by manual toothbrushes, but in a significantly shorter time (Van der Weijden et al. 1993)!
In a hurried society like ours, this seems to translate into (Deacon et al 2014)lower plaque and gingivitis rates.
Anatomical difficulties and manual ability
There are problems related to the patient’s specific oral anatomy or his personal manual ability:
- Some patients have significant anatomical abnormalities: cluttered teeth, small lip closures, unsuitable implant gum emergencies, dento-skeletal anomalies, small vestibular spaces, macroglossia (large tongue).
- Other patients have motor, sensory or cognitive disabilities (Parkinson’s disease, alcoholism, sclerosis, etc.) or simply a strong gag reflex.
These conditions can make proper and complete manual brushing more difficult for some patients compared to others. In these cases, using an electric toothbrush seems to be very beneficial and offers more predictable results in the long term.
Lack of attention
Using an electric toothbrush requires the same level of attention as a manual toothbrush. However, often the patient thinks that it is enough to apply it to the teeth because the tool can do the cleaning all by itself. Nothing could be farther from the truth. The electric toothbrush must however be applied on all the dental surfaces and when this does not happen… The clinical result is often worse than manual brushing.
Except for the ultrasound oscillation models (still not widespread also due to their high costs), the most common electric toothbrushes have a mechanical movement, so they are rather noisy. Noise is not a problem to be underestimated when planning to share common spaces and different times with people who are resting (for example, I remember on-call doctors’ shared quarters in a hospital!)
Freedom of use in any situation… it never has an empty battery and never breaks.
Bringing an electric toothbrush with its charging base on vacation or on a business trip is not all that easy. First of all, the minimum weight is about 160 g, furthermore the absence of electricity makes it already less effective after a few hours and completely useless after a couple of days without charge.
Furthermore, obviously, like any electric tool, it could break suddenly: and I can assure you that trying to brush manually with a dead electric small-head toothbrush is one of the most frustrating experiences you can have.
Very small size
Manual toothbrushes are light, take up very little space, and simply need to be used correctly by the user.
Manual toothbrushes are not noisy, making them the best choice when sharing common spaces with other people who are resting.
There is only one situation where I would definitely recommend an electric toothbrush compared to a traditional one: in the case of patients with receding gums due to unsuitable brushing. Excessive brushing
These lesions also occur in rather young patients and are characterized by festooned gums, exposed and often eroded roots, very sensitive teeth, and an unusually elongated appearance.
Lately these gum recessions appear more and more often and are caused by an incorrect (horizontal movement) and excessive (with too much pressure) use of a manual toothbrush.
Almost always, patients, even when they are informed of the problem, seem unable to change the manual brushing technique over the long run. After short periods of correct and moderate brushing, the unhealthy habits that they’ve had for years almost always end up returning.
For this type of patient, the change of tool – from manual to electric – is the best choice since it does not allow in any way to return to the horizontal and excessive movement that had caused the injuries. The new electric models today even have a warning light that comes on to indicate “excess pressure”.
Both types of brushing can offer optimal results…. as long as you remember the most important thing: oral hygiene must be frequent and prolonged, but above all it requires attention.
Thinking that strong movements or technology can replace the quality of a gesture of care towards ourselves is a (sadly frequent) mistake to be avoided.