Welcome back to the DDS Dental blog, where Dallas dentist Dr. Juan Diaz discusses topics relating to oral health.

This post covers all the highlights on toothbrushes and offers advice from Dr. Diaz. 

With roughly 3.5 billion toothbrushes sold across the globe every year, it’s clear that people understand the importance of brushing their teeth. But there isn’t nearly as much awareness about how different types of toothbrushes compare. Whether you brush for the sake of your overall health or in the interest of making a dazzling impression when you smile, toothbrush selection matters, and for a number of reasons. Today’s electric toothbrushes come loaded with tons of features, from tooth whitening modes to timers and pressure sensors. But are they worth it?

In this blog article from our dental blog, Dr. Juan Diaz, a Dallas dentist passionate about helping patients avoid the day-to-day plaque build-up that results in cavities and early gum loss, weighs in on what ultimately causes the common oral health issues he and offers his opinion on what type of toothbrush is best.

Why We Need Toothbrushes

We have some fairly compelling evidence from authoritative sources, including the Centers for Disease Control, suggesting that improvements in dental care are being undone by rising incidences of cavities and other dental issues. Despite increasing access to dental care items and professional dental services, experts say that 80% of people will have had at least one cavity by the age of 34.

Recent events have also taken a toll on our teeth and gums. Not long into the pandemic, researchers predicted that one especially significant consequence of the pandemic would be a “serious, and potentially long-lasting, toll on our oral health” resulting from stress-related increases in teeth grinding, as well as diet and hygiene changes. 

Those predictions already appear to be coming true, with more than 40% of adults in the US reporting pain in their mouths over the last year and over half of the adults reporting oral health problems none-the-less opting not to seek care.

Dallas dentist weigh-in:

It’s understandable why people might be more reluctant to visit the dentist, considering anxieties about the cost of dental care and the array of fears and anxieties people have about visiting the dentist. But regardless of whether you get routine dental care or haven’t seen a dentist in years, your toothbrush is your first line of defense against tooth decay and oral diseases. At the very least, make sure that you are using a high-quality toothbrush at home.

What does a toothbrush do and why does regular toothbrushing still result in cavities for some people?

Our mouths are the entry point to our digestive system, and the entire reason we have teeth is to chew our food, allowing it to be broken down more easily into nutrients that our bodies can then absorb.

But that’s not the only digestive activity happening: oral bacteria get to work, too, eating away food particles as we chew, which it does by producing acids that help break food down into nutrients.

Dallas dentist weigh-in:

The issue is that when bacteria and acid linger for too long on our teeth, they form a thin film called “plaque” and a dense material called “tartar”. Over time, and especially if you’re not brushing adequately, these can build-up and damage our teeth and gums, eventually leading to the oral health conditions and diseases that dentists see every day. And the longer these issues persist, the more involved and expensive it will eventually be to treat them.

 Tooth Tartar vs Plaque

 So, what is plaque on teeth and how does it differ from tooth tartar?  

  • Plaque is a soft, thin yellow film of bacteria, and if it’s not removed with routine brushing, it erodes awayyour tooth enamel.
  • Tartar, a hardened tooth plaque, develops if plaque build-up is not successfully removed with regular brushing. Once tartar builds up, it can only be removed by a dental professional.

Unaddressed build-up of plaque and tartar will eventually lead to tooth decay and cavities. This build-up also irritates our gums, potentially leading to gingivitis and periodontitis.

Brushing regularly allows us to (hopefully) rid our mouths of plaque, minimizing its ability to remain on the teeth and harden into tartar. The reason experts recommend visiting the dentist every 6 months is because try as we might, perfect brushing is difficult to achieve and more difficult to maintain. And as we age, the natural changes in our mouth make the task even more difficult.

Dallas dentist weigh-in:

Coming in for regular cleanings is important, especially if you have hard tooth plaque buildup that really can’t be removed fully by brushing at home. But nothing makes up for your overall oral hygiene habits. Brushing is your best bet for removing tooth plaque at home.

What are the three types of toothbrushes?

 Toothbrushes are our first line of defense for tooth plaque removal. When it comes to picking a toothbrush, we have three main types of options distinguished from one another based on how they remove food particles and plaque from your teeth.

1.Manual toothbrush

 The most well-established toothbrush on this list, today’s iteration of the toothbrush wasn’t invented until 1938.  While shape and bristle hardness can vary, the classic toothbrush is made up of a plastic handle with bristles on the end.  They are a great start to developing good oral habits.

2.Sonic toothbrushes (side-to-side)

 Sonic toothbrushes are a type of electric toothbrushes that work by vibrating the brush head rapidly side-to-side. They can provide up to 50,000 strokes per minute making them effective at removing plaque.

3.Oscillating-rotating (O-R)

 Oscillating-Rotating toothbrushes are electric powered that contain circular brush heads that rotate to clean, meaning that the motions are more dynamic than the sonic electric toothbrush.

Manual and Electric Toothbrush Comparisons: What Type of Toothbrush is Best? 

Not all toothbrushes are created equal. Research shows that the type of toothbrush you use can be just as important, if not more important, than how you brush.

Manual toothbrushes are the most established type of toothbrush and it’s easy to see why. They have clear cut advantages.

  • Accessibility – there are a variety of models and can be easily found in stores.
  • Affordable – they are generally priced for under $5 each, cheaper than the electric models.
  • More control – users are able to adjust brushing methods and pressure.

But over recent years, electric toothbrush usage has increased substantially, and for good reason:

  • Improved Effectiveness. According to several studies, researchers have demonstrated that electric toothbrushes are better equipped to remove plaque than manual counterparts. One longitudinal study even tracked manual and electric toothbrush users over the course of 11 years and found that by the end of the research period, the electric toothbrush users had managed to retain 19.5% more of their teeth than manual toothbrush users.
  • Ease of use – Especially for older people, children, and individuals with special needs, electric toothbrushes reduce the amount of effort required for adequate brushing and offset the impact of dexterity issues that might otherwise result in added build-up.
  • Added Features – This may not sound so important – what else can you possibly add to a toothbrush besides bristles and a motor, right? Well, not quite. As an example, our gums naturally recede as we age, leaving us more prone to abrasion issues while brushing. As gums recede and the weaker parts of our teeth become exposed, they can be damaged by excessive force while brushing. To alleviate that problem, some electric toothbrushes are now being manufactured to include pressure sensors, which help alert users to excessive force while brushing. Other helpful add-ons include features include timers and app tracking, which are known to promote improved oral health.

Oral B Toothbrush Comparisons: Why This Dallas Dentist Recommends the Oscillating-Rotating Toothbrush

Maybe you use an electric toothbrush already and are interested to know what type of electric toothbrush is best. While both sonic and oscillating-rotating (O-R) toothbrushes offer significantly better performance than manual toothbrushes, researchers have still identified differences in their overall effectiveness.

One randomized clinical trial conducted by Oral B, which specifically compared the effectiveness the two types of its electric toothbrushes in terms of plaque removal and gingivitis, found that O-R users were 1.8 times more likely to go from having gingivitis to “healthy” gums than participants using sonic toothbrushes. They also experienced greater reductions in bleeding gums throughout the course of the study.

Dallas dentist weigh-in:

Oral B toothbrush comparisons show that the O-R toothbrush is better than the sonic electric toothbrush. These findings make sense to me, considering that one of the most significant barriers to sufficient brushing involves trouble brushing all tooth surfaces evenly. The O-R toothbrush’s movement is designed to move back and forth at various angles, allowing for better surface coverage while brushing.

Diaz Dental Studio is a Dallas-Based Practice that Cares About Its Patients 

Dr. Diaz is the best family dentist in Dallas because he is committed to the health and wellness of patients at all ages, and he also takes time to understand the underlying factors and circumstances affecting the community members he serves.  

When you become a patient at Diaz Dental Studio, a local Dallas dentist office, you receive more than regular dental cleanings and treatments—you gain a dental home where the team is genuinely committed to your wellbeing.

We understand that cost is often a factor in seeking out dental care. Know that Diaz Dental Studio does what it can to assist patients facing cost barriers, and we are always available over the phone to discuss insurance coverage and pricing estimates for care.

Along this same vein, Dr. Diaz understands that electric toothbrushes, while highly beneficial for patients, are also expensive.  To help offset that cost, Diaz Dental Studio purchases Oral-B iO Series 9 electric toothbrushes directly from the manufacturer, passing cost savings onto you. These battery-powered toothbrushes come complete with real-time coaching micro-vibrations, 3d teeth tracking and AI technology, and a smart pressure sensor, and more. If interested, be sure to ask about this toothbrush at your next visit.

One final Dallas dentist weigh-in:

While preventative dental care requires effort to make and keep appointments, it’s incredibly important in preventing the potential high costs and demands of more involved dental treatments that result from plaque and tooth tartar buildup. We understand common fears our patients have about coming in for care. We offer quieter equipment and a number of accommodations for sensitive patients or those with special needs. As a patient, you will never be pressured into dental treatment, and our office will listen and work collaboratively with you to make sure you get the care you need.

To schedule an appointment or learn more about our practice, visit our website and give us a call today!



 Elkerbout TA, Slot DE, Rosema NAM, Van der Weijden GA. How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises. Int J Dent Hyg. 2020 Feb;18(1):17-26. https://pubmed.ncbi.nlm.nih.gov/31050195/.

 Tingley, Kim. “The Pandemic Was Bad for Our Teeth. Will it Change Oral Health Forever?” New York Times. https://www.nytimes.com/2021/05/19/magazine/the-pandemic-was-bad-for-our-teeth-will-it-change-oral-health-forever.html.

 Van der Sluijs E, Slot DE, Hennequin-Hoenderdos NL, Valkenburg C, van der Weijden F. Dental plaque score reduction with an oscillating-rotating power toothbrush and a high-frequency sonic power toothbrush: a systematic review and meta-analysis of single-brushing exercises. Int J Dent Hyg. 2021 Feb;19(1):78-92. https://pubmed.ncbi.nlm.nih.gov/32940391/.

 Van der Sluijs E, Slot DE, Hennequin-Hoenderdos NL, Valkenburg C, van der Weijden FGA. The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis. Int J Dent Hyg. https://pubmed.ncbi.nlm.nih.gov/35535635/.

 “Americans Are Still Not Getting the Dental Care They Need.” CareQuest Institute for Oral Health. https://www.carequest.org/resource-library/americans-are-still-not-getting-dental-care-they-need.

 “How Many Toothbrushes are Sold Annually?” Reference. https://www.reference.com/world-view/many-toothbrushes-sold-annually-31d26f6fdc981cf4.

 “Oral Health Conditions.” Centers for Disease Control and Prevention. https://www.cdc.gov/oralhealth/conditions/index.html.

 “Who Invented the toothbrush and when was it invented?” Library of Congress. https://www.loc.gov/everyday-mysteries/technology/item/who-invented-the-toothbrush-and-when-was-it-invented/.

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