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There are a variety of different electronic toothbrushes on the market. If you ignore features like a timer that tells you when you have brushed the planned time, is there a measurable difference in the ability of different electronic toothbrushes to brush teeth?

In particular, are claims that more expensive electronic toothbrushes remove so-and-so percent more plaque backed up by peer-review research or even realistic?

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    Christian, the question "are they worth the money?" is subjective. See here. In addition, there is no claim here for us to examine skeptically. If no-one is (notably) claiming that there is a significant difference, this is considered off-topic. (e.g. roses are more expensive than daffodils, but no-one is claiming that roses are objectively better.) Please fix or delete. – Oddthinking Jun 30 '11 at 4:50
  • Should the possibility of over-use be mentioned as well for a possible additional comparison with "manual toothbrushes" (meaning "not the electronic kind")? I've heard a few dentists mention concerns with over-use of electronic toothbrushes and the possibility of wearing down tooth enamel -- see also the "Easily controlled" heading for "... placing too much pressure on your teeth can wear away at the tooth enamel ..." on this web page about electric and manual toothbrushes: thyblackman.com/2011/05/09/… – Randolf Richardson Jun 30 '11 at 5:53
  • Not at all relevant, but it just feels right: theonion.com/articles/scientific-breakthroughs,16696/?slide=4 – erekalper Jun 30 '11 at 16:35
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    I think you mean "electric", not "electronic". Unless there is some way of cleaning teeth with microchips ;-) – vartec Jul 1 '11 at 12:49
  • "Is there a measurable difference in the ability" -- Yes there is. Expensive models usually come with built-in rechargeable lithium batteries and a charger, while you can get cheaper models running on standard AA batteries. If you or your kids don't keep up a proper re-charge regimen, the lithium battery will die on you sooner or later, requiring a full replacement of the unit, whereas you could just swap out the AA batteries. Plus, and personal experience disclaimer, I found that the AA batteries in my "cheap" far outlast the lithium battery in my "expensive", both per-charge and lifetime. – DevSolar Sep 7 '16 at 15:20
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The Cochrane Collaboration are a well-respected organisation that do meta-analysis reviews of other studies. That is, they systematically examine all of the studies related to an area, discard the ones that are not high-quality (according to a pre-determined system), and pool the results to produce a high-quality result.

So, the fact that there is a Cochrane Review of electric toothbrushes makes the skeptics' job much easier. Someone has done all the hard-lifting. That's the good news.

Source: Deacon SA, Glenny A-M, Deery C, Robinson PG, Heanue M, Walmsley AD, Shaw WC. Different powered toothbrushes for plaque control and gingival health. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD004971. DOI: 10.1002/14651858.CD004971.pub2

They concluded that some types of tooth-brush might be a little better than others at removing plaque and gingivitus.

The review included data from 17 trials with 1369 participants. There is evidence from seven trials of up to three months and at unclear/high risk of bias that rotation oscillation brushes reduce plaque (SMD 0.24; 95% CI 95% 0.02, 0.46) and gingivitis (SMD 0.35; 95% CI -0.04, 0.74) more than side to side brushes. Due to the dearth of trials, no other definitive conclusions can be stated regarding the superiority of one mode of powered toothbrush over any other. Only minor and transient side effects were reported.

The authors summarised this as:

This difference is small and it's clinical importance is unclear.

The bad news is that despite the fact they set out to look at other factors ("calculus and stain removal, cost, dependability and adverse effects"), they didn't find a conclusion ("Cost, dependability were not reported.")

In conclusion:

While some electric toothbrushes mechanisms might be a little better than others, there isn't much in it (and I can stop looking, because if Cochrane didn't find it, it isn't there on the available evidence in the literature.)

I can't answer whether the expensive ones correlate to the better ones. I can note, informally, that cost, when it comes to consumer goods, may be regional and more related to branding, colour, battery-life, dependability and other factors not related to the toothbrush's efficacy.

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