The electric toothbrush has become very popular in recent years — some even say it provides superior dental care. But how does it actually compare to manual brushing?

“The idea of a toothbrush is to remove plaque and to stimulate the gums,” explains John Ictech-Cassis, DDS, DMD, clinical associate professor at the Boston University Henry M. Goldman School of Dental Medicine. “Most toothbrushes will keep the teeth clean if you know how to use them.”

Manual Toothbrushes: A Classic Route to Good Dental Care

“There are many advantages to the manual toothbrush,” says Dr. Ictech-Cassis. “We’ve been using this toothbrush for many years. It has a good track record.” Advantages include:

• Cost and availability. “It’s inexpensive and accessible,” says Ictech-Cassis. “This is the toothbrush that the majority of dentists give away.” Electric toothbrushes may simply be too expensive for many people, so it’s nice to know that you can do a great job brushing with a manual toothbrush.
• Easy to travel with. “It’s easy to take a manual toothbrush with you when you travel. It’s not bulky like an electric toothbrush,” says Ictech-Cassis. You’ll be less likely to let your good dental care habits lapse on vacation with a toothbrush that you can easily bring along, he adds.
• Puts less pressure on teeth and gums. “You can feel [how much pressure you're using] as you grasp the toothbrush,” Ictech-Cassis notes. “This helps you to avoid putting too much pressure on your teeth. With an electrical model you can’t feel that as well.” Placing too much pressure on your teeth can wear away at the tooth enamel, causing pain, sensitivity, and an increased risk of tooth decay.
• Good for kids. Even young children can use manual brushes safely and effectively once they’ve learned how, Ictech-Cassis points out.

Electric Toothbrushes: Recommended in Some Cases

Nevertheless, Ictech-Cassis admits that there are some situations where an electric toothbrush has clear advantages. "We recommend it for people who can’t do a good job with a manual toothbrush,” he says. For older people or people who have less manual dexterity, like those who have arthritis, the electric toothbrush may clean more effectively, he says. According to the American Dental Association (AMA), people with limited ability to move their shoulders, arms, and hands can benefit from the larger handle and powered brush of an electric model.

How to Choose an Electric Toothbrush

Today, electric toothbrushes are outfitted with a variety of features. Though they make nice additions, pressure sensors that tell you if you’re brushing too hard or timers that indicate when you’ve brushed long enough don’t directly affect how well the toothbrush actually cleans your teeth.

Electric toothbrushes “try to stimulate the gums and teeth with different configurations of the bristles," Ictech-Cassis says. “Even the most inexpensive electric models will keep your teeth clean, but you may have to move them a little more to reach the difficult areas.”

Although almost any toothbrush can do an effective job, research suggests there is one electronic toothbrush bristle configuration that seems to be better at removing plaque and preventing gum disease. Electric toothbrushes with bristles that rotate together in one direction, and then switch and rotate in the opposite direction — a process known as rotating-oscillating — appear to be more effective than manual brushes and other electric brushes that spin in only one direction. If you do opt for an electronic toothbrush, a model with rotating-oscillating bristles is probably your best bet.

How Often Should You Get a New Toothbrush?

Whether you choose a manual or an electric toothbrush, choose one with soft bristles and be sure to change the bristles on the electric brush when they become worn down. “Bristles are very important,” Ictech-Cassis says. “Brushes need to be replaced every three months or when the bristles are no longer straight and firm. In that condition, they will not clean the teeth as well as they should.”