Best electric toothbrush: what actually matters

What the research says

The best summary is a Cochrane review of 56 trials comparing powered and manual brushes in everyday use. Powered brushes reduced plaque and gingivitis, or gum inflammation, more than manual ones. The benefit showed up both in the first few months and in longer trials.

The gain is real but modest. After more than three months, plaque was about 21 percent lower and gingivitis about 11 percent lower. The reviewers rated the evidence as moderate quality and said the long-term effect on dental health is unclear.

About half the trials tested brushes whose head rotates one way, then the other (called oscillating-rotating). That type reduced plaque and gingivitis in both the short and long term. Other types had fewer trials. Few trials reported side effects, and those reported were local and temporary.

The American Dental Association says manual and powered brushes can both clean well. A manual brush used for two full minutes, twice a day, does the job. An electric brush can make the job easier to do well. The ADA notes that people who have trouble using their hands, or who wear braces, may find one easier to use.

What actually matters

Skip the app, the long list of modes and the fancy charging case. These five things do the work.

1. A two-minute timer. The ADA recommends brushing for two minutes, twice a day. A timer that buzzes every 30 seconds also tells you when to move to the next quarter of your mouth.
2. A pressure sensor. The ADA recommends gentle pressure, which may help protect your gums. A sensor warns you when you’re pressing too hard, something a manual brush can’t do.
3. Soft bristles. The ADA recommends soft bristles on any brush, because they’re less likely to injure your gums.
4. Heads you’ll actually replace. The ADA says to replace a brush every three to four months, or sooner if the bristles look matted or frayed. Worn bristles clean less well. Before you buy a handle, check that its heads are easy to get.
5. Battery life you can live with. This matters most if you travel. Check the listing for how long a charge lasts.

Look for the ADA Seal of Acceptance on the box. It means an ADA panel reviewed evidence that the brush is safe and reduces plaque and gingivitis.

Picks by need

Any of these beats a frayed manual brush. Choose by what you’ll actually use every day.

Simple and cheap: quip Sonic

The quip Sonic Toothbrush is a lightweight battery brush with soft bristles, a two-minute timer and a buzz every 30 seconds. It has one gentle vibration mode and shuts off on its own. It runs on a AAA battery that quip says lasts up to three months, so you swap the battery when you swap the head.

quip calls the plastic version its most budget-friendly brush. quip doesn’t list a pressure sensor, so go gently. It’s a good first step up from a manual brush.

Best overall: Oral-B Pro 1000

A rechargeable brush whose head oscillates, rotates and pulsates, the type with the most research behind it. The pressure sensor stops the pulsing when you brush too hard. The timer pulses every 30 seconds to tell you when to move on. See the pick box below this article.

Sensitive gums: Philips Sonicare ProtectiveClean 6100

Philips markets the Sonicare ProtectiveClean 6100 as gentle on sensitive areas and dental work. Its pressure sensor alerts you when you press too hard. It has three intensities, so you can turn it down, and a Gum Care mode that adds an extra minute at lower power. With Philips’ BrushSync heads, the handle recognizes the head and reminds you when it’s time for a new one.

Philips lists up to two weeks per charge, and it comes with a travel case. If your gums are tender or bleed when you brush, mention it at your next checkup. A gentler brush isn’t a substitute for having them looked at.

What it costs to keep going

The handle is a one-time cost. The heads are the ongoing one, and they add up over the years.

• Count heads, not handles. At the ADA’s three-to-four-month interval, that’s three or four heads a year per person. Compare head prices before you choose a brush.
• Batteries or a charger. A battery brush needs fresh batteries; a rechargeable needs its charger and an outlet.
• Subscriptions can help. quip will auto-ship refills, which takes remembering out of it.
• Check the warranty. Know what it covers and how long it lasts before you buy a rechargeable.

How to get the most out of it

A good brush only helps if you use it well.

• Brush twice a day with a fluoride toothpaste, for the full two minutes.
• Aim the bristles at the gumline and go gently. Cover every surface: outside, inside and chewing.
• Clean between your teeth once a day with floss or a water flosser.
• Rinse the head after brushing, stand it upright to air dry, and don’t share it.
• See a dentist for a checkup, so small problems get fixed before they hurt.

If a tooth already hurts, start with what to do for a toothache right now. If cost is what’s keeping you from a checkup, see dental savings plans explained.