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is there a toothbrush in the market that is better than everything else? Should people with gum disease be using electric toothbrushes? Does it even make a difference? All these questions and more answered in this article.

Why is brushing important to prevent gum disease?

Gum disease originates in the mouth because of the presence of plaque on the teeth. Plaque is composed of bacteria that are found naturally in the mouth, and it stars to form a few seconds after the completion of brushing [1]. This does not mean that brushing is useless because the plaque is going to form anyway. To the contrary, it makes regular plaque removal more important. The nature of plaque keeps on changing with time. In the initial stages, it is composed of mainly harmless bacteria that do not damage the teeth. If, however, left undisturbed for around a period of 48 hours, the plaque stars to evolve [2].

More and more disease-causing micro-organisms which are very effective at producing enamel destroying acid start to inhabit the plaque the longer it's left unchecked. The growth of these micro-organisms is also accompanied by bacteria that cause inflammation in the gums and begin the process of gum disease [3].

Thus, better brushing directly equates to a better chance of preventing gum disease. There is no vaccine that can be given to prevent gum disease and neither are there any medicines which can do the job of treating gum disease once it has set in. Plaque removal and the prevention of its build-up remains the cornerstone of the prevention and treatment of gum disease [4].

Bleeding gums treatment is provided by scaling which should also be done periodically to keep the gums healthy.

Which brush is the best to prevent gum disease?

This is a very common question, and the answer is pretty simple. A brush that allows you to remove plaque most effectively is the best one. It does not matter if the bristles are straight, curved, or any other pattern manufacturers can think of. It does not matter if the brush vibrates electrically or its user provides manual movement by using a simple conventional brush [5]. All that matters is that the plaque is removed. 

There have been studies on the different characteristics of toothbrushes, comparing them and trying to evaluate what works the best. Some things can be agreed upon.

The bristles of the brush, whatever kind it may be, should ideally be ‘soft’. No mediums or hards are recommended anymore. Studies have conclusively proven that the bristles just need to sweep the teeth lightly to remove plaque and that over-exuberant force will only harm the teeth [6].

The brush should have a neck long enough to allow easy maneuverability and reach all surfaces of all the teeth in the mouth. The handle of the brush should be wide enough for the user to grip comfortably [7].

A lot of the other gimmicks that tootbrush manufacturers promote are just to distinguish their own product from the competition.

Are electric toothbrushes better than conventional ones?

In certain situations, electric toothbrushes are certainly better at plaque removal and are more convenient as well. Take for example young kids who are learning how to brush. It is easier for them to use an electric toothbrush — the bristles rotate in the correct direction, and the brush just needs to reach the teeth [8]. 

Similarly, elder people that are under the care of health care providers, hospitalized, or no longer have the dexterity to be able to brush their teeth satisfactorily will benefit from having an electric toothbrush [9].

Electric toothbrushes don't do anything revolutionary here. They just make the process of plaque removal easier, and that is exactly what needs to be done to prevent most dental diseases.

Is an electric toothbrush better for people with gum disease?

The answer to this question is very similar. If you are struggling with gum disease and find it easier to effectively remove plaque from your teeth using an electric toothbrush, then yes, it is better. If you are able to achieve the same result using a regular toothbrush then there is no difference.

A couple of studies have indicated that brushing with an electric toothbrush is equivalent to brushing conventionally, flossing, and using an anti-bacterial mouthwash [10]. This sounds positive, although we would take these studies with a pinch of salt because there can be many confounding factors that skew the results in such studies.

Conclusion

Electric brushes are bigger, heavier, and more expensive than conventional toothbrushes. They offer some fantastic benefits and convenience in certain situations but do not do anything radically different than their non-battery powered counterparts.

Buying and using a battery powered toothbrush can be a motivating factor for children to brush. It can help healthcare providers brush their patient’s teeth more effectively. In the end, there is nothing that would cause a dentist to not recommend not using an electric toothbrush. There is no harm in it, so if you think you can brush more effectively with them, then go for it.    

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