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* Manual vs.


Amanda Jackman
Ashlee Iezzi
Brittany Hope

Brushing with an electric toothbrush allows for

superior plaque removal compared again manual
tooth brushing
Brushing and flossing at home as a daily part of an oral hygiene routine is
essential to ensure adequate health in the oral cavity
Applying the correct brushing technique and using it twice daily for a total
of two minutes, without missing a tooth is imperative to maintaining a
plaque-free environment
Brushing with an electric toothbrush allows for superior plaque removal
when compared against manual tooth brushing

Benefits of an Electric
* Automatic timers
* Pressure sensors
* Easy tooth-by-tooth technique
* Variations in oscillations/rotations per minute
* Variation is type of toothbrush heads, sizes,
shapes, and softness
* Limited dexterity needed
* Superior plaque removal
* Perfect for all ages

P- For patients with dental plaque

I-Will an electric toothbrush provide superior
plaque removal in comparison to using a manual
C- Electric toothbrush versus manual toothbrush
O- Electric toothbrushes provide superior plaque
removal in comparison to using manual

Counter Argument
*Some studies argue that manual toothbrushes are

equally effective as an electric toothbrush

*In a study by Forrest and Miller (2004) it was concluded
that only toothbrushes equipped with rotating and
oscillating head motions were proven to be more
superior than using a manual toothbrush
*Study did not take good technique into consideration, or
duration spent brushing
*Effectiveness of a manual toothbrush is dependent on
the user both guiding the head to all accessible surfaces
of the teeth and providing the appropriate mechanical
action to enable filaments to remove surface deposits
*In an electric toothbrush, the use only needs to guide to
head around the dentition, the mechanical cleaning
action being provided electrically (Renton-Harper et al.

Plaque Removal
* A common problem with a manual toothbrush is

having to correct our clients on the proper

toothbrush method- something that can be easily
eliminated with an electric toothbrush
* A study found that oscillating-rotating toothbrush
removed significantly more plaque after a single
brushing than any other manual toothbrush (Kurtz.
Et al 2016.)
* The two competing electric toothbrushes, Oral-B and
Phillips Sonicare offer 300% more plaque removal
and offer 48,000 movements/minute
* Round headed brushed are perfect for hard to reach
areas, when enhanced with oscillating/rotating
movements the vibrations can easily break apart
heavy plaque and bacteria

Oral-B 7000
* Visible pressure sensor
* 6 different modes
* Tracks progress
* Tracks progress via mobile app
* Timer available on mobile app
* Vibrations indicating time
* Round head
* Oscillating/rotating
* 61,000/minute
* $191.99

Phillips Sonicare
* 2 brush heads
* 3 modes, 3 intensities
* UV brush head sanitizer
* Pressure sensor
* Timer
* 31,000 strokes/minute
* 3 week battery life
* $199.99

*Clients with Orthodontic


*Orthodontic patients are at a greater risk for developing gingivitis

due to appliances with hard to reach areas where plaque

accumulates, and it tough to get
*A study found that there was a reduced plaque accumulation and
gingival inflammation was found in over 58% of orthodontic study
patients using an electric toothbrush twice daily, compared to
participants undergoing ortho who were using a manual toothbrush
twice daily (Heintze et al. 2006)
*Oscillating/rotating roughly 20,000-70,000 movements/minute
ensures plaque is being removed adequately with each brushing

* Another study completed in 2010 came to a conclusion that

electric toothbrushes are far more superior in clients

undergoing orthodontic treatment in comparison to manual
toothbrushes (Schatzle 2010)
* Schatzle also stated that oval and v-shaped toothbrush heads
are even more effective in removing plaque from fixed

* Electric toothbrushes allow all populations, whether children

or elderly patients to brush with no necessary dexterity

* Manual toothbrushes require a steady hand and focused
motions to properly apply the correct brushing method for
two minutes, which can be tiring for a large population of
* When comparing both toothbrushes, yes manual toothbrushes
can be AS effective but not every patient is using the correct
manual toothbrush method for 2 minutes twice daily 100% of
the time.
* Electric toothbrushes take away a large portion of technique
and grip as the thousands of rotations per minute do almost
100% of the work for the patient

* A study fone by Das & Singhal (2009) found that children

from ages 3-5 were brushing for a mean time of 45 seconds

when brushing by themselves
* Children between 6-11 years old were brushing for a mean
time of 61 seconds, only half of the required time
* This conclusion states that there is a unlikelihood that
these patients are spending 2 minutes getting all areas in
the mouth, twice daily
* On top of inadequate brushing time, children and even
some adults lack the dexterity to reach areas in their
mouth such as the linguals, and posterior teeth, areas
where we see the most build up of deposits in our patients
* A study has shown that the use of an electric toothbrush
versus a manual toothbrush has been seen to effectively
decrease gingival inflammation and decrease pockets
(Ikeda, et al 2016).

* Patients with disabilities such as cerebral palsy may not

have the dexterity to hold a small handled manual

toothbrush, whereas a large diameter electric
toothbrush can easily be help with limited dexterity
* In another study done by Ikeda in 2016, he acknowledged
that in patients with neuromuscular disorders plaque was
more effectively removed, and dexterity was much less
of an oral issue with the electric toothbrush

Sonics Smile Bright Childrens

Musical Toothbrush
* A great motivator for children to be interested
in brushing their teeth
* Provides a musical timer for children to know
when to stop brushing after 2 completed
* Gets children excited about oral health
* Upbeat, happy songs can help make
toothbrush more fun and not a chore

*Gum Disease
* Electric toothbrushes provide superior plaque removal as the thousands
of oscillations/rotations are able to adequately remove heavy plaque
* Pressure sensors provided by electric toothbrushes help remind clients
not to brush too aggressively, which will help to stop any further
progression of recession
* Aggressive brushing is seen more often in clients who use manual
toothbrushes in conjunction with the scrub toothbrush method
(Cifcibasi et al 2014)
* Comparing the conditions of the tissue in both users of manual
toothbrushes and electric toothbrushes, there was a lesser incidence of
recession found when the patient correctly used an electrical
toothbrush. (McCracken et al, 2010)
* For patients that have previously been diagnosed with gum disease,
using an electric toothbrush is a great way to adequately remove
plaque and bacteria above and below the gum surface to prevent their
disease from worsening

* Electric toothbrushes have many variations between products and

brands that make a toothbrush perfect for every type of client

* Electric toothbrushes have many features to help focus and
motivate clients to stay on top of their oral hygiene behaviours
such as timers, pressure sensors and mobile apps
* Oscillating/roatating movements in electric toothbrush have
proved to be much superior than manual toothbrushes
* For manual toothbrushes to be as effective as electric
toothbrushes our patients would have to be performing the
correct brushing technique for two minutes twice daily
* Pressure sensors notifying patients when they are brushing too
aggressively can decrease severity of gum disease and recession as
we may see in our patients who brush too hard in specific areas of
their mouth

* Abyss Design. (2009, March 21). Electric toothbrush. Retrieved from
* Toothbrushes.htm
* Das, U. M., & Singhal, P. (2009). Tooth brushing skills for the children aged 3-11 years. Journal of Indian

society of Pedodontics and Preventive Dentistry, 27(2), 104-107. doi:10.4103/0970-4388.55335

* Cifcibasi, E., Koyuncuoglu, C. Z., Baser, U., Bozacioglu, B., Kasali, K., & Cintan, S. (2014). Comparison of
* manual toothbrushes with different bristle designs in terms of cleaning efficacy and potential role on gingival
recession. European Journal of Dentistry, 8(3), 395.
* Forrest, J. L., & Miller, S. A. (2004). Manual versus powered toothbrushes: A summary of the cochrane
* oral health group's systematic review. part II. Journal of Dental Hygiene : JDH / American Dental Hygienists'
Association, 78(2), 349-354.
* Heintze, S. D., Jost-Brinkmann, P., & Loundos, J. (2006). Effectiveness of three different types of electric
* toothbrushes compared with a manual technique in orthodontic patients. American Journal of Orthodontics &
Dentofacial Orthopedics, 110(6), 630-638. doi:10.1016/S0889-5406(96)80040-0
* Ikeda, T., Yoshizawa, K., Takahashi, K., Ishida, C., Komai, K., Kobayashi, K., & Sugiura, S. (2016).
* Effectiveness of electric toothbrushing in patients with neuromuscular disability: A randomized observer-blind
crossover trial. Special Care in Dentistry, 36(1), 13-17. doi:10.1111/scd.12141

Kurtz, B., Reise, M., Klukowska, M., Grender, J. M., Timm, H., & Sigusch, B. W. (2016). A randomized
* clinical trial comparing plaque removal efficacy of an oscillating-rotating power toothbrush to a manual toothbrush
by multiple examiners. International Journal of Dental Hygiene, doi:10.1111/idh.12225