A comparative study of stain removal with two electric toothbrushes and a manual brush

Recent studies have suggested that a sonic electric toothbrush is more effective than a manual brush at removing extrinsic dental stain. There have been few studies of the comparative stain removal properties of different electric brushes. The study reported here was conducted to compare the efficacy of the sonic toothbrush (Sonicare) with an oscillating/rotating brush (Braun Oral-B Plaque Remover) and a conventional manual brush (Crest Complete). The study was a single-blind, randomized, cross-over design, balanced for residual effects and employing 24 subjects. Stain was enhanced over a 21-day period by twice-daily rinses with chlorhexidine and frequent intakes of tea and/or coffee. At the end of each period, tooth stain intensity and area, tongue stain intensity and area, lower lingual calculus and subjective tooth sensitivity were recorded together with preference for the brushes determined at the study's completion. Similar levels of tongue staining were recorded for the three periods, with no significant differences between the three groups. Tooth stain intensity, for most sites, was not significantly different between the three groups. For mean total stain area and for lingual and lingual interproximal sites, a significant reduction in stain was seen following use of the oscillating/rotating brush compared to the manual brush. The reductions in stain with the sonic brush were not significantly different from the manual brush. With the exception of maximum stain intensity, there were no significant differences between the oscillating/rotating and sonic brushes. Significantly less tooth sensitivity was found following use of the oscillating/rotating brush compared to both the manual and sonic brushes. All three brushes were found to be safe, but volunteer preference significantly and predominantly favored the oscillating/rotating brush. The results suggest that the oscillating/rotating brush is superior to a manual brush for stain removal.