Getting our patients to take responsibility for their home care between visits can sometimes be a frustrating battle. When patients arrive with the sweater coating of plaque and materia alba, it’s enough to make you want to hand them a toothbrush and march them into the bathroom to get the job done. Funny, though—these patients often tell us they just brushed! I sometimes wonder if they think I’m talking about their hair.
One tool we frequently recommend to our patients to help with more effective home care is a rechargeable toothbrush. Much research supports the use of electric toothbrushes for improved patient compliance, plaque and calculus reduction, and periodontal health.1 Patients often brush longer and with a better technique when using an electric brush.2
As a super curious dental hygienist, I like to try out as many products as possible. Taking advantage of professional pricing and friendly relationships with companies, I have lined up my bathroom counter with the latest and greatest in rechargeable toothbrushes. (My husband is considering a bathroom addition if I add any more to the collection.)
Narrowing down the best
Ask five hygienists what the best electric toothbrush is, and you’ll get five different answers. I’m a member of the Cellerant Best in Class Dental Hygiene board. When we started to talk about the best rechargeable toothbrush, there was a lively discussion with absolutely no consensus. We each had our favorites based on price, different features, and brush heads and would not be swayed by others’ opinions.
Looking at some of the most popular toothbrushes side by side should help sort out some features so you can confidently recommend a rechargeable brush to fit your patient’s needs.
The two most popular brushing actions in rechargeable brushes are sonic and oscillating. Both are effective at removing plaque. Sonic toothbrushes use a motor to move brush heads with pulses of vibration while oscillating brushes spin the brush head back and forth. Some patients find sonic brushes “too tickly,” while others find oscillating brushes too loud.
In general, there are two different-shaped brush heads, round and oblong. Some manufacturers offer a compact head and a kid-sized version for small mouths. Curaprox offers a unique single-tufted brush attachment designed for gumline cleaning, malpositioned teeth, and implant care. Another brush feature is varying softness and tapered bristles for increased access and patients with sensitive teeth.
I’m guilty of checking out people’s brush heads when I visit their houses. I’m amazed at how long people will use the same head. Philips, Burst, and Izzo offer a brush head replacement subscription to help patients remember it’s time to change that head. The Sonicare and Oral-B I evaluated will give lighted indications that it’s time to replace the brush head.
An important consideration in what to recommend is a patient’s budget. It’s not up to us to decide what they can afford, but finding out what they are willing to invest in a rechargeable toothbrush can help us narrow down our recommendation. To streamline the evaluation, I chose only one model from each brand. Note that a few of the manufacturers have models that are less expensive but with different features. Don’t just look at the price of the brush itself; be sure to weigh in the cost of replacement heads as well as the warranty of the product.
To level the playing field, I compared the prices of brushes and replacement heads on Amazon. But there are ways to find better pricing through bulk buying, professional discounts, ambassador codes, and subscriptions.
Battery and travel
Battery life varied from a manufacturer-reported two to four weeks. In practice, they were all a little shy of their purported battery life. But I might be an overeager brusher going beyond my two minutes. Most of the time, two weeks should be fine, but if you have a patient who travels frequently, that’s a consideration. It’s super frustrating to have a dead toothbrush and no charger halfway through your trip.
Speaking of travel, almost all the brushes came with a convenient travel case, or offered one for purchase. Some hold two brush heads, allowing you to share a handle with a travel companion, while others hold only one. The Sonicare 9900 Prestige travel case charges the brush with a USB cord, making it great for long trips.
Smart coaching tools
Both the Sonicare and Oral-B evaluated come with smart coaching tools and Bluetooth-enabled app connection. I admit I felt like these were gimmicky until I actually used them. Apparently, I am not the perfect brusher I thought I was! You can download an app and go through guided brushing cycles with both brushes. The app will let you know if you’re scrubbing or pressing too hard and when to move from buccal to lingual and sextant to sextant.
Both brushes come with indicator lights that let you know if you’re using too much pressure. The Sonicare will also flash if you’re scrubbing. If you continue to use too much pressure with the Sonicare, the brush will automatically lower the intensity one level. The Oral-B iO lights up red if brushing too hard, blue if too soft, and green if just right. I was shocked to find I was brushing too lightly. When you turn the Oral-B iO off, you will get a face reflecting how well you did. There’s nothing like getting the star-eyed smiley face to kick my day off right. But boy, do I feel judged by the sideways smirk if I run in for a quick freshen-up!
A few of the brushes had unique features. The Izzo toothbrush comes with a polishing head much like your prophy angle for that in-between-hygiene-visits slick-tooth feeling. It also includes a UVC-LED brush head sanitizer that could double for a travel case. I’m not sure how I feel about the safe plastic scaler. But when I tried to scale between 24 and 25, I couldn’t get it to remove anything.
The Waterpik Sonic Fusion allows you to use an electric toothbrush and water floss simultaneously. It takes a minute to get used to; I’m a “walk around the house while I brush my teeth” kinda gal, but once you have the technique down, it’s brushing and interdental cleaning all in one device. You also can disconnect it and just brush.
And the winner is …
As you can see from the chart, there are many factors to consider when recommending a rechargeable toothbrush, so the winner is definitely an individual decision. Just looking at the quotes from clinicians about why they love their brush shows you how varied the opinions are. Some patients will appreciate a smaller, softer brush head, while others will prefer the bells and whistles of a brushing app. The bottom line: the best rechargeable toothbrush is the one your patient will use!
1.Pitchika V, Pink C, Völzke H, Welk A, Kocher T, Holtfreter B. Long‐term impact of powered toothbrush on oral health: 11‐year cohort study. J Clin Periodontol. 2019;46(7):713-722. https://doi.org/10.1111/jcpe.13126
2. Hovliaras C, Gatzemeyer J, Jimenez E, Panagakos FS. Dental hygienists' evaluation of the usability research study of the Colgate ProClinical A1500 electric toothbrush. J Clin Dent. 2015;26(1):13-16. PMID: 26054186.