Meta-Analysis of the Results of Studies Comparing the Effectiveness of Manual and Sonic Toothbrushes
Brushing teeth is a fundamental means of maintaining good oral hygiene. While many people still rely on using manual toothbrushes, brushing with electric toothbrushes has also gradually gained significant popularity. Several studies comparing the effectiveness and gentleness of these two approaches have been conducted in the past, followed by a meta-analysis of their results.
Introduction
Manual toothbrushing is highly effective and, when done properly, is a reliable method. However, it requires skill and the practice of proper brushing techniques. Electric toothbrushes have been adopted by consumers and approved by professionals in the fields of dentistry and dental hygiene as a more convenient and in some cases more effective way of brushing teeth, thanks to several features including automatic bristle movement, ergonomic handles, and integrated timers to achieve the recommended 2 minutes of brushing.
The aim of the cited meta-analysis of randomized controlled trials was to evaluate the short-term clinical effectiveness of high-frequency, high-amplitude sonic toothbrushes compared to manual brushes in removing plaque and reducing gingivitis with daily use.
Methodology and Evaluated Data
Relevant clinical studies comparing at least one manual toothbrush with one sonic toothbrush regarding their effect on plaque reduction or gingivitis reduction over 4 weeks to 3 months in subjects without impairments that could affect brushing were searched in databases such as Embase, MEDLINE, BIOSIS, Inspec, PQ SciTech, Compendex, SciSearch, and IADR. The data were processed using random-effect models, and differences in plaque or gingivitis reduction were quantified based on the calculation of standardized mean differences (SMD). Considerations included the risk of bias and sources of heterogeneity.
Findings
The analysis of 18 studies involving 1870 participants showed that sonic toothbrushes had a statistically significantly higher rate of plaque removal (SMD −0.89; 95% confidence interval [CI] −1.27 to −0.51) and gingivitis reduction (SMD −0.67; −1.01 to −0.32). The heterogeneity of the studies was assessed as high, but no apparent bias was detected.
For data regarding efficacy around implants, 3 studies with 149 participants were separately analyzed. Although sonic toothbrushes appeared to perform better on average, no statistically significant differences were found when comparing the efficacy of both methods in terms of plaque removal (SMD −0.36; 95% CI −1.02 to 0.30) or gingivitis reduction (SMD −0.32; 95% CI −0.76 to 0.12) around implants.
Conclusion
High-frequency, high-amplitude sonic toothbrushes significantly reduced plaque and gingivitis around teeth more effectively than manual toothbrushes with daily use in studies lasting up to 3 months. In the case of implants, no statistically significant differences were noted between the methods, likely due to the specifics of the area around implants.
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Source: de Jager M., Rmaile A., Darch O., Bikker J. W. The effectiveness of manual versus high-frequency, high-amplitude sonic powered toothbrushes for oral health: a meta-analysis. J Clin Dent 2017; 28 (1 Spec. No. A): A13−A28.
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