Study puts 2 types of powered toothbrushes to the test

2014 04 16 15 23 14 468 Electric Toothbrush 200

Stand-up comedians and consumers are known to gripe about the immense variety they are faced with in the toothbrush and toothpaste aisle. A new study may help clinicians guide the choices of their patients who wish to purchase a toothbrush that is more high-tech -- and effective -- than a manual, flat-head brush.

The researchers compared the Oral-B Professional Care 1000, an oscillating-rotating (O-R) brush, and a new sonic brush, the Colgate ProClinical C200 with Triple Clean brush head, in a randomized, examiner-blind, single-center, two-treatment parallel group design study (American Journal of Dentistry, February 2014, Vol. 27:1, pp. 56-60). It was the first such comparison study of the two types of powered toothbrushes, and it was done at the Procter & Gamble Health Care Research Center.

While both reduced plaque during the course of the four-week study, "the oscillating-rotating brush was statistically significantly more effective in reducing plaque (p < 0.001) than the sonic brush," the researchers wrote. "Compared to the sonic power brush, the adjusted mean plaque reduction scores for the oscillating-rotating power brush were more than five times greater for whole mouth and approximal areas."

“The study demonstrated superior plaque reductions with an advanced oscillating-rotating power brush compared to a novel sonic brush.”

According to Malgorzata Klukowska, DDS, PhD, of the Clinical Operations segment of Procter & Gamble, plenty of evidence establishes the superiority of one powered toothbrush technology over the other, something that is worth the consideration of clinicians recommending brushes for their patients. "Oscillation-rotation brushes have consistently been shown to have significantly greater plaque removal and gingivitis benefits than sonic, demonstrated in a Cochrane review, so O-R technology should be considered for patients who could benefit from greater plaque control," Dr. Klukowska explained in an email to

All the study participants were older than age 18 and were instructed to refrain from oral hygiene for 12 hours before baseline measurements were taken. They were also told not to eat, drink, or chew gum for four hours before participating. The researchers excluded those with severe and active caries, extensive restorations, fixed or removable appliances, or severe periodontitis, as well as those who had used oral chlorhexidine within the previous two weeks or who were pregnant.

A total of 131 individuals participated in the study, with 65 randomly assigned to the O-R group and 66 to the sonic group. Prior to the study, 63% and 58% were manual toothbrush users, respectively. Each participant brushed twice daily during the four-week period using their assigned powered toothbrush and a standard dentifrice. Their plaque was scored at their return appointment using the Turesky-Modified Quigley-Hein Plaque Index from 0 to 5. The researchers graded each tooth site, but did not include those with restorations. The grading duties were randomly assigned to researchers who were unaware of which group the participants were in.

While both groups had significantly reduced whole-mouth plaque scores, the oscillating-rotating group had an adjusted mean plaque reduction from baseline of 0.390 (p < 0.001), while the sonic group's was 0.075 (p < 0.001). In addition, 97% of the O-R group saw a reduction in whole-mouth plaque, compared with 64% of the sonic participants.

The researchers observed a significant reduction in approximal plaque in both groups, but it was better in the O-R group than in the sonic brush group: 0.347 (p < 0.001) versus 0.068 (p < 0.001).

While the study was performed by Procter & Gamble, Dr. Klukowska is confident in the structure of the study and the results it produced. "The subjects were not aware of the study sponsor and the investigators were blind to treatment," she explained.

"The current study demonstrated superior plaque reductions with an advanced oscillating-rotating power brush compared to a novel sonic brush, corroborating previous studies demonstrating the superiority of oscillating-rotating power brushes relative to sonic brushes," the researchers concluded.

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