The Effectiveness of Manual versus High-Frequency, High-Amplitude Sonic Powered Toothbrushes for Oral Health: A Meta-Analysis

J Clin Dent. 2017 Mar;28(1 Spec No A):A13-28.


Objectives: Evaluate the short-term clinical efficacy of high-frequency, high-amplitude sonic powered toothbrushes compared to manual toothbrushes on plaque removal and gingivitis reduction in everyday use through a meta-analysis of randomized controlled trials.

Methods: Embase, MEDLINE, BIOSIS, Inspec, PQ SciTech, Compendex, SciSearch and IADR abstracts databases were searched. Eligible were clinical trials comparing at least one manual to one sonic powered toothbrush on plaque or gingivitis reduction over four weeks to three months in subjects without disability that could affect tooth brushing. Two authors selected and extracted data from eligible studies. When insufficient information was available, researchers were contacted. Data were pooled using random-effects models to compute standardized mean differences (SMD) and 95% confidence intervals (95% CI) quantifying differences in plaque or gingivitis reduction. Risk for bias and sources of heterogeneity were assessed.

Results: The combined results of 18 studies comprising 1,870 subjects showed that sonic powered toothbrushes had statistically significantly greater plaque removal (SMD = -0.89, 95%CI = [-1.27, -0.51]) and gingivitis reduction (-0.67, [-1.01, -0.32]). Heterogeneity was large and bias was not apparent.

Conclusions: High-frequency, high-amplitude sonic powered toothbrushes decreased plaque and gingivitis significantly more effectively than manual toothbrushes in everyday use in studies lasting up to three months.

Keywords: dental plaque; gingivitis; manual toothbrush; meta-analysis; oral health; powered toothbrush; randomized controlled trials; sonic powered toothbrush.

Publication types

  • Meta-Analysis

MeSH terms

  • Dental Plaque / therapy*
  • Dental Plaque Index
  • Equipment Design
  • Gingivitis / therapy*
  • Humans
  • Oral Health*
  • Randomized Controlled Trials as Topic
  • Toothbrushing*