Toothbrush Buying Guide from Consumer Reports

Getting started

Toothbrushes come in all sizes and colors--some spin and others pulsate. But a toothbrush is worthless if you're brushing incorrectly. Our ShopSmart editors consulted with Kimberly Harms, DDS, a dentist in Farmington, Minn., and a consumer adviser for the American Dental Association, on keeping your teeth healthy and when an electric toothbrush comes in handy.

Who should buy a power toothbrush? All you really need is a good soft-bristled manual toothbrush if you take the time and effort to really clean your teeth. But if you have arthritis, lack dexterity, or would like some extra power, the powered toothbrushes are wonderful.

What's the biggest brushing mistake people make? Just swishing the toothbrush around without making sure to reach all areas of the mouth. People tend to brush their teeth very quickly, and they end up missing spots, especially in the back of their mouth. And that's a real problem because plaque is full of bacteria and it can lead to gum disease and cavities.

Are there any steps you can skip if you're in a rush? I recommend that my patients brush at least twice a day and floss at least daily. I guess in a pinch you can occasionally skip one brushing. You won't suffer too much damage since it takes about 24 hours for plaque and bacteria to form on your teeth. But only occasionally!

Any products you recommend? I'm thrilled with the little Y-shaped floss picks. People don't like to floss, so I love anything that makes it easier. These floss aids help you get to those hard-to-reach spots in between teeth. I've even seen dinosaur-shaped flossers, which is very exciting because I'm seeing both kids and adults floss more. (Warning: We did the math, and floss picks cost about 4 cents apiece, about twice as much as regular dental floss costs per use.)

Manual vs. electric

Studies have shown that both manual and electric toothbrushes can be equally effective if used right. To brush manually: Put the brush at a 45-degree angle against gums; move it back and forth gently in toothwide strokes over all teeth; move the "toe" of the brush up and down to clean inside front teeth; and brush your tongue gently to remove bacteria and freshen breath. With an electric brush, be sure to cover all surfaces.

Electric toothbrushes

Electric toothbrushes don't just sit there; they do everything but shake, rattle, and roll. Brush heads tend to be either sonic (they vibrate side to side) or spinning (they rotate very fast in one direction, then the other, and bristles may pulsate in and out).

We tested 10 electric toothbrushes that cost from $15 to $140. Nine have rechargeable bases; one uses AA batteries. Most have built-in 2-minute timers that either signal or shut the toothbrush off after 2 minutes, plus "quadpacers" that signal every 30 seconds so that you spend an equal time on each quadrant of your mouth. A higher price is likely to get you settings such as sensitive (gentler cleaning) or massage (gum stimulation), a charge-level display, or a travel case.

How we tested

Fifteen staffers used each electric toothbrush for one week and evaluated its comfort, convenience, and ease of use. We hid brand names and asked panelists to follow any manufacturers' instructions for brushing technique and time (usually two minutes). At the end of each week, each panelist didn't brush for at least 24 hours; then a dentist used a dye to reveal plaque before and after they'd brushed once more for 2 minutes. Plaque removal is important in gum health.

What we found

The two priciest brushes removed 75 percent or more of plaque in our tests, on average. The top-rated toothbrush rotates in both directions and pulses, and a sensor stops pulsations when you brush too hard; the runner-up is the vibrating type. Despite its effectiveness, most users said it vibrated too much.

Some brushes are more comfortable to hold and manipulate than others. Two toothbrushes got relatively low ease-of-use scores because some panelists said their brush heads were too big.

Bottom line

Scan the Ratings (available to subscribers) for a type and price you like. And check for a return policy: Some brushes offer a money-back guarantee. Most makers suggest replacing brush heads every three months, which boosts the cost. Whatever you buy, brush thoroughly: With all brushes, panelists removed more plaque from the cheek side of their teeth than from the tongue side, and more from front teeth than back.

Tips for cleaner teeth

Whichever brand of toothbrush, toothpaste, or floss you choose, using proper brushing and flossing techniques is critical for adequately removing plaque, which causes cavities and gum disease.

Brush up on brushing

What to use: Choose a brush with soft or medium bristles, which are gentler on the gums and may clean better because they're more flexible. The brush design does not appear to influence effectiveness, so choose any one you like.

How often: Brush twice a day, 2 minutes each time. And rinse your mouth after sugary or starchy snacks.

How to brush: Hold the brush with the bristles angled 45 degrees toward the gum line, so one row of bristle tips can slip slightly under the gums. Jiggle the brush head with a short, vibrating motion, then move on to the next spot. Finally, scrub the chewing surfaces.

Brush gently to avoid harming the gums; removing plaque doesn't require much pressure. Brush both the outer and inner surfaces of your teeth and the tops of molars. Brush your tongue, too, to remove bacteria and freshen breath (or use a tongue scraper, sold at drugstores for about $1 each).

Flossing fundamentals

What to use: All flosses clean effectively. But if you find flossing uncomfortable, consider a slippery one like Glide.

How often: Floss once a day to remove plaque and food particles your brush can't reach.

How to floss: Break off about 18 inches of floss and wind most of it around a finger; wind the rest around the same finger on your other hand. Use a careful sawing motion to slide the floss between your teeth down or up to the gum line; then gently move the thread slightly under the gums. Next, curve it into a "C" shape against the side of one tooth and sweep it up and down. Repeat for both sides of each tooth, unwinding clean floss from the first hand.

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