Manufacturers are producing a greater variety of toothbrushes incorporating different designs for handles, heads and bristles.
Currently, the dental profession recommends the following:
- for children, a small toothbrush head, approximately 20 mm X 10 mm seems most suitable;
- for adults, the toothbrush head can be slightly larger, approximately 22-28 mm X 10-13 mm.
Small-headed toothbrushes give better access to the back of the mouth. Nylon filaments are recommended because of their better physical properties and standardisation; the recommended diameter is 0.15-0.20 mm to give a soft to medium texture. Multi-tufted brushes are best. A general guide is that the size of the brush should be selected to suit mouth size, with smaller brushes being more suited to smaller mouths. Whether straight handles or angled handles are used is a matter of personal preference. People who experience difficulty cleaning their back teeth may find it easier using an angled brush; in any case the best brush is the one that enables the user to clean their teeth thoroughly without causing trauma.
The frequency with which toothbrushes are replaced has yet to be correlated with oral health. The most helpful guide is to replace a toothbrush when the bristles begin to show signs of wear. Toothbrush handles can also be adapted to improve the grip by the user. Electrical or battery operated toothbrushes are useful for people who have difficulty holding and maneuvering an ordinary toothbrush, such as persons with poor motor control or a physical disability A systematic review of trials involving the use of powered toothbrushes found that only powered brushes with an oscillation rotation action (i.e., brush head rotates in one direction and then the other) are more effective at removing plaque than conventional brushes, and can reduce gingivitis if used for over 3 months.
- Toothbrushes should be replaced when bristles show signs of wear.
- Brushing is more effective with multi-tufted, small-headed toothbrushes with soft to medium nylon filaments and a comfortable handle.
- Powered brushes with brush heads that rotate first in one direction and then the other (oscillate/rotate) are more effective at removing plaque than manual toothbrushes and can reduce gingivitis if used for over 3 months.