Toothbrushing is the most effective way to remove food debris and plaque from the teeth, which helps prevent cavities, gingivitis, periodontitis, candidiasis and bad breath.
There are manual and electric toothbrushes. Within each type, there are a few options available. So, what kind of toothbrush is best?

Let’s look at manual toothbrushes first.

There are two major types of manual toothbrushes.

The first type is made of natural wood sticks from miswak, neem or babool trees. All three are traditional chewing sticks prepared from the roots or twigs. Studies have demonstrated that they all have an antibacterial effect against Streptococcus mutants, a cavity and gum disease-causing oral bacteria.

The sticks needed to be prepared by chewing the end to create the bristles. However, the strands tend to be hard. The filaments can be difficult to effectively brush the areas between molars and the backs of the front teeth because the filaments are in a straight line with the stick and cannot be bent to reach those areas. Despite its potential antibacterial and anti-inflammatory effects, the sticks can cause damage to the gums, which leads to gum recessions. It is also challenging to get the tips of the bristles to effectively scrape the plaque and food debris away from the tooth surfaces.

Photo courtesy from the article “A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health.” SaudiMed J.
Authors: Mohammad M. Haque, BDS, MPH and Saeed A. Alsareii, SB (Surg), JBGS

The other type is made with a plastic, wood or bamboo handle with nylon bristles at about 90 degrees to the long axis of the handles. That configuration allows better contact with the molars and other difficult-to-reach areas. Dentists only recommend using toothbrushes with soft bristles to prevent “brushing” the gums away. There are a few different shapes, sizes, arrangements of the toothbrushes for diverse needs and purposes.

There are two major types of electric toothbrushes too!

The first type is the oscillating rotary heads, which are circular heads that spin and move back and forth. The exemplifying one is by Oral-B. The newer one has a blue tooth connection to your smartphone that can monitor your brushing in terms of time spent, pressure on the teeth, power level, etc.
The second type is the sonic brush heads which vibrate back and forth extremely fast. Philip Sonicare is the best-known brand using this technology. It also has a blue tooth connection to an app on your phone to monitor the brushing like the Oral-B.

Courtesy of Oral-B and Philips Sonicare

Overall, electric toothbrushes are more effective and efficient in removing plaque and debris simply because they have much faster strokes/vibration per minute than manual toothbrushing. The brush heads of the electric toothbrush are usually smaller than the manual toothbrush heads, especially the Oral-B one; therefore, the bristles can effectively contact the hard-to-reach areas like the molars, the spaces between teeth and the back of the front teeth.

Using electric toothbrushes needs less hand movement and requires less hand dexterity. Hence elderlies with poor hand coordination, patients with muscular dystrophy, multiple sclerosis and parkinsonism can benefit from the do-it-for-you movements of electric toothbrushes.

Patients with braces may also find it easier to clean their teeth with electric toothbrushes.

Despite the superiority of electric toothbrushes in food debris and plaque removal, they do have some factors that some patients may find to be unacceptable. For example, the sound and vibration may be too uncomfortable for certain patients. The initial cost to purchase an electric toothbrush is higher than the manual one. So as the cost of the replacement heads for the electric one is more expensive.

01 Sep, 2022

Implant for Upper Front Teeth

I would like to present another case of a single implant for upper front teeth that I did recently. The patient was suffering from advanced gum disease with generalized excessive… Read More
09 Oct, 2019


As Thanksgiving rolls around, I am made aware of the many things that I can be thankful for. My family for their encouragement, my friends for their kindness + constant… Read More