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Mouth Health: Are Sonic Toothbrushes Really Better?

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In my long career as a NYC Cosmetic Dentist, I get asked a lot about Sonic toothbrushes, and if they are really better than standard toothbrushes. Certainly the advertising would make you think so, as would the price tag (most "sonic" toothbrushes run $80-$150 plus). But are they really better? Let's find out:

To start, let's look at toothbrush technology, or I should really say, the lack of such. While I won't get into the entire history (which is a full blog post in and of itself), it's pretty safe to say that the basic design of toothbrushes have been around for a long time. And the toothbrushes we use today are very similar to the ones used decades ago. Shapes have changed a bit, bristle length varies, but the overall concept is the same.

There are really three kinds of toothbrushes: there are your standard "non-powered" brushes which most people use; there are "electric toothbrushes" that first came around in the 1950's; and there are high-powered electric models (also called "sonic" toothbrushes) that were first developed in the 1980's. Here are your basic differences between the three "types" of toothbrushes:

Standard "non-powered" toothbrushes - These come in many shapes and sizes, and are powered by your hand/wrist. The effect of using the brush is to scrape away plaque and other particles. These brushes are very effective at cleaning the surface of the teeth, and are getting better at getting "in between" teeth due to bristle design. But in the end, they can only clean what the bristles actually touch.

Electric Toothbrushes - First introduced 60 years ago or so, these toothbrushes move/vibrate the brush head, somewhere to the tune of 2,500 and 7,000 strokes per minute. This eliminates the user having to move the head in a "brushing" motion, and instead just move the vibrating brush head along the teeth. Personally, I would call these types of toothbrushes "gimmicky," because like a conventional toothbrush, they only clean what they touch. Thus, the only advantage is not moving your hand in a "brushing" manner, which isn't much of an advantage.

Sonic Toothbrushes - These are the above-mentioned "electric toothbrushes" on steroids. Sonic Toothbrushes generally vibrate at 30,000 to 40,000 strokes per minute. The advertising says that this gives you a better cleaning, because they clean even areas where the bristles don't touch. So, is that true? And if it's true, is it indeed better than a standard toothbrush? In my opinion, the answer is "it depends." It depends on you, and how in-depth your oral hygiene practices are.

I will say that the evidence does suggest that a sonic toothbrush will indeed clean areas that a conventional brush cannot. This is because the extreme vibration creates a substantial amount of energy and motion, powering mouth fluids (saliva, water, toothpaste) into the areas between teeth and below the gum line. The result is these areas are given an amount of attention that otherwise would not happen with a standard (or electric) toothbrush. So in that sense, a sonic brush is definitely superior to a standard brush. In addition, studies have shown that people brush longer with a sonic toothbrush. All else being equal, brushing longer is usually a good thing, so score another point for sonic toothbrushes. And lastly, many sonic toothbrush users report that their teeth "feel" better with a sonic toothbrush. That's worth something.

However, that doesn't mean they are truly "better." I said earlier that it depends on you and your oral hygiene routine. If your daily routine includes using a standard toothbrush for two minutes, and also floss, you are getting everything (and more) than a sonic toothbrush can give. Flossing scrapes/cleans the areas where a normal toothbrush cannot reach, and it does so better than any sonic toothbrush can (please don't think a sonic toothbrush is a substitute for flossing, despite what any advertising claims.) Also, some people use a water flosser (like a water pik®) -- again, this goes beyond what a sonic toothbrush can do.

So in the end, it really depends on you. If you don't floss (and I'm a realist -- I know most people don't), a sonic toothbrush will certainly serve you better than a regular toothbrush, and is probably worth looking into. But if you do brush diligently and floss regularly (and/or use a water flosser), a sonic toothbrush probably isn't totally necessary -- you are likely covering all the bases with your current oral hygiene routine (and congratulations on doing well in this area.)

But if you REALLY want to be sure, a sonic toothbrush AND flossing AND water flossing is an unbeatable combination. At least until technology gives us laser-powered nuclear fusion space-age super toothbrushes J

Until next time, keep smiling!

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