What Is the History of the Toothbrush, and What Are Its Limitations?
The English word "toothbrush" was originally mentioned in Anthony Wood's autobiography in 1690. While various oral cleansing tools have been experimented with throughout the centuries, including chew sticks, bird feathers, horsehair, animal bones, tree twigs, and porcupine quills, none are as effective as the modern-day toothbrush in cleaning all accessible areas of the teeth. Toothbrushes have evolved from manual to powered brushes, providing even better cleaning capabilities. It is essential to understand that teeth have both accessible and inaccessible interdental contacts that require effective cleansing using the proper brushing technique, ideally recommended by a dental professional.
Despite using the correct brushing technique, individuals may still encounter issues such as dental plaque, calculus, or deposits in the mouth. This is due to the limited ability of toothbrushes, whether manual or powered, to reach the inaccessible areas of the teeth where food particles and bacteria tend to accumulate. Ineffective or incorrect brushing techniques not only increase the bacterial load but also put individuals at risk of oro-systemic infections.
What Are the Indications of Powered Toothbrushes?
Reflex epilepsy is a drawback associated with seizure or epileptic patients, as powered toothbrushes are generally contraindicated for them. Dental professionals typically recommend that patients with reflex epilepsy should avoid using powered brushes and instead choose a less vigorous manual brush with a shorter brushing method for effectiveness.
On the other hand, individuals who are taking medications like Sialogogues for the treatment of xerostomia or dry mouth are often advised by dental professionals to use powered toothbrushes instead of manual ones. This is because Sialogogues may cause undesirable side effects such as sweating and gastrointestinal discomfort. Therefore, powered toothbrushes can be a more effective tool for maintaining strict oral hygiene in these patients and naturally stimulating saliva, without relying solely on medications. Current research indicates the potential future applications of powered toothbrushes utilizing sonic or ultrasonic vibrations to effectively reduce the bacterial load in the oral cavity by promoting proper salivary stimulation, especially for patients suffering from dry mouth or xerostomia.
How Are Powered Toothbrushes Classified?
Powered toothbrushes can be classified primarily based on the speed of their movements, categorized as standard power toothbrushes, sonic toothbrushes, or ultrasonic toothbrushes. Sonic toothbrushes are capable of generating rapid movements that produce an audible hum, falling within the frequency range of 20 Hz (hertz) to 20,000 Hz (hertz), which is detectable by humans. Toothbrushes with motion speeds exceeding the audible frequency range are known as ultrasonic toothbrushes. Conversely, toothbrushes with motion speeds lower than 20 Hz (hertz) are referred to as standard-powered toothbrushes.
The development of sonic and ultrasonic toothbrushes in this age of advancing technology is primarily driven by the challenges individuals face in effectively removing interproximal and subgingival dental plaque. Sonic and ultrasonic toothbrushes represent an evolution in powered toothbrushes as they not only clean accessible tooth surfaces through mechanical polishing but also possess the capability to remove tooth enamel stains and bacteria. This is achieved by the high-frequency vibration of the bristles, which generates fluid pressure and shear forces. The bristle vibration operates on the principle of acoustic energy, which is transmitted through the oral saliva to target stains, bacterial organisms, and deposits.
Are Powered Toothbrushes More Effective Than Manual Toothbrush?
The ongoing debate in dental research centers around the effectiveness of powered toothbrushes, such as sonic, ultrasonic, and rotation oscillation brushes, compared to manual toothbrushes in maintaining oral hygiene. Current research indicates that toothbrushes, in general, may offer only partial effectiveness in eliminating dental plaque. While there is promising research, the superiority of sonic and ultrasonic toothbrushes over manual toothbrushes is still uncertain, contributing to the ongoing debate regarding their efficacy, particularly in plaque removal.
However, significant research studies have shed light on the effectiveness of powered toothbrushes, indicating an improvement in individuals' periodontal health. While sonic toothbrushes may not be considered clinically superior to manual toothbrushes, whereas, powered toothbrushes (including oscillation-rotation toothbrushes, sonic, and ultrasonic brushes) have shown a statistically higher impact in reducing markers of gingival disease. Recent research suggests that powered toothbrushes may lead to a reduction in gum inflammation and pocket depth compared to manual toothbrushes. However, more scientific evidence is required to support these findings further. It is important to note that when used correctly with proper brushing technique, a manual toothbrush replaced every three to six months can still produce similar effects as a powered toothbrush, as recommended by dental experts.
Regardless of the dental disease process being discussed, such as caries development, calculus formation, gum inflammation or gingivitis, or periodontitis (gum infection damaging gums and jawbone), all dental issues are ultimately consequences of dental plaque accumulation, which includes harmful oral pathogens and bacteria, according to dental research studies. Studies present conflicting conclusions regarding the cleaning efficacy of powered toothbrushes compared to manual toothbrushes in terms of plaque removal. While some dental professionals argue for the efficacy of powered toothbrushes in eliminating plaque, especially in hard-to-reach areas, others believe that both powered and manual toothbrushes have a similar efficacy of approximately 50 percent in plaque removal, as indicated in the dental literature.. This divergence in viewpoints among dental professionals highlights the ongoing need for regular dental follow-ups and professional scaling or dental prophylaxis, where dentists or dental operators can effectively eliminate both dental plaque and calculus using high-speed dental scalers.
Conclusion
To sum up, despite numerous disputes regarding the effectiveness of powered and manual toothbrushes, research shows that powered toothbrushes have promising potential going forward in this developing technological age to remove nearly 60 percent more plaque than manual toothbrushes (always in combination with professional dental scaling) and effectively aid in reducing gingival disease and inflammation.
