Electric Toothbrush vs Manual Brushing: Which Is Superior?
It’s a debate that has to begin with consideration of the basics.
Toothbrush design as we know it today been around since 1938 – very similar to the bone and pig bristle brush invented by the Chinese in the late 15th century. Boar bristle had been used for 500 years until DuPont™ pioneered nylon filaments. Texturising additives meant that bristles mimicked animal hair, yet had more durability. It’s a product the company has continued to develop over 80 years.
Worldwide, around 3.5 billion manual toothbrushes are sold every year, and 1.8 billion electric ones.
Already there’s a notable divide. And still, there is another.
In Anna Rosling-Rönnlund 2016 TED talk on understanding how people live, to the question, “what do you use to brush your teeth?” a Malawi woman answered by extending her index finger; a common response among the 1.2 billion people living on less than a $1 a day. For toothpaste, she pointed to the abrasive mud walls of her hut. Scraped mud, mixed with water in her hand, rubbed across her teeth and inside her mouth is manual brushing at is most basic. Not even a chew stick is used, where a twig or root is chewed until one end is frayed. Dating back to Babylonia in 3500 BC it’s considered the first device ever used for teeth cleaning.
A family of West African Burkina Faso, used what first appears to be an ordinary twig, but it’s cut in a way resembling a large toothpick. For a family that can’t afford a plastic toothbrush, a sharpened stick to pick between and scrape teeth is the alternative.
Whether you use a manual or electric toothbrush, the recommended routine is to brush for two minutes, twice a day. Ideally, using an interdental brushes or flossing once a day completes the fundamentals for maintaining oral health.
Both manual and powered toothbrushes now have a variety of head sizes and bristle configurations, including clustered, angled, or rippled.
Studies have shown that tapered or angled are slightly more effective than flat bristles for removing plaque, which can destroy tooth enamel and cause cavities and gingivitis. This sticky film of bacteria can also develop on teeth roots below the gum, and break down the supportive bone.
Consumer toothbrush trends are increasingly focused on aesthetics, plaque removal, interdental cleaning and gum comfort. The indicator that a toothbrush has been independently tested for quality and effectiveness is the Seal of Acceptance: in Australia by the Australian Dental Association, and in the US the American Dental Association.
Whether you choose manual or electric, always opt for soft bristles. The idea that stiff bristles clean better is a mistake that leads to gum and enamel damage.
Over 11 years – the longest study of its kind – comparing manual toothbrushes to electric, scientists established that electric toothbrushes result in healthier gums, less tooth decay and reduced tooth loss.
The Journal of Clinical Periodontology reported that over the length of the study, manual brushing resulted in 22% more gum recession and an 18% increase in tooth decay.
Electric toothbrushes also yield better results for certain groups. Arthritis sufferers may not have the dexterity to effectively manoeuvre a manual brush. Powered brushes not only counter this, but the design necessity of a larger handle is easier to hold. According to both Dental Associations, most people brush for an average of 45 seconds when a timer isn’t used – far short of their standard advice.
Children benefit for the same reasons, with some toothbrushes with deliberate character themes playing familiar tunes for the requisite 2-minutes.
The American Academy of Pediatric Dentistry and the ADA both recommend parents supervise kids’ brushing until they’re about 7 or 8. When they are able to routinely tie their own shoelaces is the marker that they can also brush their own teeth efficiently; either with an electric or manual brush.
For anyone with braces, brackets and wires are easier to clean with an electric toothbrush with some brands offering heads explicitly for this.
Along with timers, powered brushes can also come with a pressure sensor for those with a tendency to brush too hard. It responds by stopping until it registers a lighter touch. Another innovation is the quadrant timer that vibrates every 30 seconds to remind you to move onto another area of your mouth.
That the lengthy study findings conclude electric toothbrushes clean teeth and gums better than manual ones backs up what smaller studies have previously suggested, although this is the strongest and clearest evidence yet.
Electric toothbrushes with oscillating heads are particularly effective in the removal of plaque.
Originally designed in 1939 for orthodontic patients and those with limited dexterity, General Electric was one of the first to mass market to Americans in 1960. They were not compact and nor were they cheap.
With its evolving technology along with science establishing its advantages, investing in an electric toothbrush should be an easy decision, although a recent poll by the Oral Health Foundation found that only 49% of British adults use one despite its affordability.
Worldwide, for almost 63% electric toothbrush users, more efficient cleaning is the reason for the switch. 34% were persuaded by their dentist, and for others it was a gift.
However, it’s not all good news.
According to Friends of the Earth, the international network of environmental organisations spanning 73 countries, electric toothbrushes are one example of a terrible product. Separating the technology from the batteries and plastic casing is almost impossible, which means toxic materials end up as landfill, or incinerated.
So … Electric Toothbrush vs Manual Brushing: Which Is Truly Superior?
The British Dental Journal published a study that found that the potential of the electric toothbrush due to climate change was 11 times greater than bamboo-handled manual ones.
Ostensibly the bamboo toothbrush seems the most environmentally friendly. Despite this popular belief, it is not a sustainable product; the land required for it is not put to the better use of biodiversity, and forest growth to offset carbon emissions.
Most surprisingly, according to the study, a plastic, replaceable head manual toothbrush has the least environmental impact.
Certainly not less so than an index finger dipped in mud.
Whether you use an electric toothbrush or not, it’s the adherence to a good and disciplined oral health routine, and regular check-ups with your dentist that is the guarantee for best results.
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