Reports & Studies

Is a manual or an electric toothbrush better during orthodontic treatment?

PD Dr. Kristina Bertl, PhD MSc MBA

As mentioned in a previous article (article) one of the most important factors during orthodontic treatment is that the patient has a healthy, inflammation-free periodontium. This applies both to inherently periodontally healthy patients and to patients who have had successfully completed periodontal treatment.

But this raises the question: what recommendations should we give to our patients regarding home oral hygiene? What works better on average – a manual toothbrush or an electric toothbrush?

Al Makhmari et al. summarized the available literature on this topic in a systematic review. In total, they could find 9 randomized clinical studies that met their inclusion criteria. All studies compared the effectiveness of a manual toothbrush with that of an electric toothbrush among patients who were undergoing orthodontic treatment. After at least 4 weeks, periodontal parameters such as inflammation and bleeding parameters were recorded. In total, data for 434 patients were collected. Statistical analysis showed that – at least in relation to a short follow-up (up to 3 months) – the electric toothbrush had significant advantages over the manual one regarding inflammation and bleeding parameters. Only a few long-term studies (more than 3 months) were available at the time, and they confirmed the results of the short-term follow-up.

Overall, however, the scientific evidence for this conclusion is rather weak. In terms of the dental practice, detailed, individually tailored oral hygiene instructions in conjunction with regular check-ups should generally be regarded as essential elements during orthodontic treatment – with a manual or an electric toothbrush and appropriate interdental cleaning!


  1. Al Makhmari SA, Kaklamanos EG, Athanasiou AE. Short-term and long-term effectiveness of powered toothbrushes in promoting periodontal health during orthodontic treatment: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2017 Dec;152(6):753-766.e7. doi: 10.1016/j.ajodo.2017.09.003.