Angled heads, raised bristles, oscillating tufts and handles that change colors with use: you name it, toothbrushes come in all shapes, colors and sizes, promising to perform better than the rest. But no body of scientific evidence exists yet to show that any one type of toothbrush design is better at removing plaque than another. The only thing that matters is that you brush your teeth. Many just don’t brush long enough. Most people brush less than a minute, but to effectively reach all areas and scrub off cavity-causing bacteria, it is recommended to brush for two to three minutes.

Which toothbrush is best?

In general, a toothbrush head should be small (1″ by 1/2″) for easy access. Find a brush that has a long, wide handle for a firm grasp with  soft nylon bristles with rounded ends so you won’t hurt your gums.

When should I change my toothbrush?

Be sure to change your toothbrush, or brush head (if you’re using an electric one) before the bristles become splayed and frayed. Not only are old brushes ineffective, but they may harbor harmful bacteria that can cause infection such as gingivitis and periodontitis. Toothbrushes should be changed every three to four months. Sick people should change their toothbrush at the beginning of an illness and after they feel better.

How do I brush?

Place the toothbrush beside your teeth at a 45-degree angle and rub back-and-forth gently. Brush outside the teeth, inside the tooth, your tongue, and especially brush on chewing surfaces and between teeth. Be sure to brush at least twice a day, especially after meals.

Electric vs. manual

Electric toothbrushes don’t work that much better than manual toothbrushes, but they do motivate some reluctant brushers to clean their teeth more often. The whizzing sounds of an electric toothbrush and the tingle of the rotary tufts swirling across teeth and gums often captivates people who own electric brushes. They are advantageous because they can cover more area faster. We suggest electric brushes for people who have limited manual dexterity, such as a disabled or elderly person and those who wear braces. Sometimes, it takes more time and effort to use an electric brush because batteries must be recharged. Secondly, they must be cleaned after every use. Additionally, most electric brushes have rechargeable batteries that can take 10 to 45 minutes to recharge. The gearing in an electric brush occasionally must be lubricated with water. Prices range from $30 to $99.

How do electrics work?

Electric toothbrushes generally work by using tufts of nylon bristles to stimulate gums and clean teeth in an oscillating or rotary motion. Some tufts are arranged in a circular pattern, while others have the traditional shape of several bristles lined up on a row. When first using an electric toothbrush, expect some bleeding from your gums. The bleeding will stop when you learn to control the brush and your gums become healthier. Children under 10 should be supervised when using an electric brush. Avoid mashing the tufts against your teeth in an effort to clean them. Use light force and slow movements, and allow the electric bristle action to do its job.

How long have toothbrushes been used?

The first toothbrush was invented in China in 1000 A.D. It was an ivory-handled toothbrush with bristles made from a horse’s mane. Toothbrushes became popular in the 19th century among the Victorian affluent. Mass marketing and the advent of nylon bristles in the 20th century made toothbrushes inexpensive and available to everyone.

Don’t forget . . .
Visit your dentist regularly because toothbrushing and flossing is most effective with periodic checkups and cleanings.

Sources: “The Plaque Fighters: Choosing a Weapon,” Journal of the American Dental Association; April 1993; “Basic brushing,” American Dental Association, 1991; “Oral Hygiene Homecare,” Clinical Research Associates Newsletter, August 1986; “Update of Oral Hygiene Aids: Toothbrushes,” Dental Health, 1992/3; “Oral Inflammatory Disease and the Toothbrush,” Journal of the Alabama Dental Association, Fall 1993; “Toothbrush Age and Wear as it Relates to Plaque Control,” Journal of Clinical Periodontology; Jan. 1986; “A Guide to Good Dental Care,” Consumer Reports, September 1992; “The End-tuft Brush for the Partially Edentulous Patient,” Journal of Prosthetic Dentistry, August 1984; Howard S. Glazer, DDS, FAGD; general practitioner, The Bronx, New York.