Toothbrush Buying Guide

Brushing your teeth for 2 minutes, twice a day, is the most effective step you can take for oral health. That's true whether you use a powered brush or a manual one—though you need to make sure to brush correctly, for long enough, applying the right amount of pressure.

Regular brushing helps eliminate the bacteria that cause plaque, the sticky, germy film that builds up on teeth and leads to cavities, tooth decay, and gum disease.

What We Found – An Oral History

Who Should Buy a Power Toothbrush?
You don’t necessarily need to switch from a manual toothbrush to an electric toothbrush if your dentist says you’re doing a fine job with your current setup. But an electric brush can help some people do a better job removing plaque, especially for those who don't have the dexterity to reach every surface of their teeth, as may be the case with young kids or older adults with arthritis.

What Are the Biggest Brushing Mistakes People Make?
Most people don’t brush their teeth for long enough, averaging about 45 seconds a session, instead of the full two minutes. And many press too hard while brushing, which can damage gums and tooth enamel over time.

Are There any Steps You can Skip if You're in a Rush?
It's OK to occasionally skip a brushing, since it takes about 24 hours for plaque and bacteria to form on your teeth. But you should try to brush twice a day, and floss once.

Manual vs. Electric

You can do a fine job brushing your teeth with either a manual or electric toothbrush, though there is some research that indicates powered brushes might do a slightly better job of cleaning away plaque and warding off gingivitis and gum disease. However, pushing too hard with a powered brush can wear away enamel—which can also happen with a manual brush. Either way, use a gentle touch, and purchase a brush with soft bristles. 

Replace your brush or brush head every three or four months, whenever your bristles start to splay. One key thing to look for when purchasing any brush, manual or electric, is the American Dental Association (ADA) seal of acceptance.

Electric Toothbrushes

Electric toothbrushes don't just sit there; they do everything but shake, rattle, and roll. Brush heads tend to be either sonic (they vibrate side to side) or spinning (they rotate very fast in one direction, then the other, and bristles may pulsate in and out).

CR tested eight electric toothbrushes that cost from $9 to $250. Most had rechargeable bases; one used AA batteries and another used AAA batteries. Most had built-in 2-minute timers, plus "quadpacers" that signaled every 30 seconds so that you spend an equal time on each quadrant of your mouth. A higher price is likely to get you settings such as a pressure sensor, alternate brushing modes, a charge-level display, or bluetooth connectivity.

How We Tested
We tested these brushes using a panel of 20 people between ages 18 and 65, all electric toothbrush users in good dental health. Each product received an overall score based on cleaning performance, ease of use, battery performance, perceived noise, and extra features. To see how well each brush cleaned, a dental hygienist measured plaque levels in volunteers after having them skip brushing and using other dental products for 24 hours. Each then brushed using one of the electric toothbrushes for 2 minutes. Before-and-after differences in plaque levels made up the cleaning performance score. If a toothbrush came with multiple brushing modes or brush heads, we scored it based on the mode and head combination that scored highest.

What We Found
The cheapest models didn't remove plaque as well as moderate-to-expensive models, but amongst the better performing brushes, spending more didn't necessarily improve cleaning performance. All the brushes we tested scored at least "Good" in ease-of-use, a measure of comfort and ease in charging devices and changing brush heads, indicating that none were particularly uncomfortable or hard to use. There was little noticeable difference in noise generated by moderate-to-expensive models. 

Bottom Line
While more manufacturers are moving into the powered brush market, our testers found that Oral-B and Philips Sonicare remained untouchable in terms of quality. Our panelists thought that Oral-B brushes produced less vibration and were more comfortable to use. But Philips’ batteries tended to last longer and charge faster. Whatever you buy, brush thoroughly.

Tooth Smarts – Tips for Cleaner Teeth

Whichever brand of toothbrush, toothpaste, or floss you choose, using proper brushing and flossing techniques is critical for adequately removing plaque, which causes cavities and gum disease.

Brush Up on Brushing
What to use: Choose a brush with soft bristles, which are gentler on the gums and may clean better because they're more flexible. The brush design does not appear to influence effectiveness, so choose any one you like.

How often: Brush twice a day, 2 minutes each time. And rinse your mouth after sugary or starchy snacks.

How to brush: Hold the brush with the bristles angled 45 degrees toward the gum line, so one row of bristle tips can slip slightly under the gums. Jiggle the brush head with a short, vibrating motion, then move on to the next spot. When using a powered brush, you can simply set it against two teeth at a time as you methodically move around your mouth. Finally, scrub the chewing surfaces.

Brush gently to avoid harming the gums; removing plaque doesn't require much pressure. Brush both the outer and inner surfaces of your teeth and the tops of molars. Brush your tongue, too, to remove bacteria and freshen breath (or use a tongue scraper, sold at drugstores for about $1 each).

Flossing Fundamentals
What to use: All flosses clean effectively. 

How often: Floss once a day to remove plaque and food particles your brush can't reach.

How to floss: Break off about 18 inches of floss and wind most of it around a finger; wind the rest around the same finger on your other hand. Use a careful sawing motion to slide the floss between your teeth down or up to the gum line; then gently move the thread slightly under the gums. Next, curve it into a "C" shape against the side of one tooth and sweep it up and down. Repeat for both sides of each tooth, unwinding clean floss from the first hand.

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