Powered toothbrushing more effective than manual for oral health

Clinical question: 
How effective are powered and manual toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, cost, reliability and side effects?
Bottom line: 
Rotation oscillation brushes showed statistically significant reductions in both plaque (11% at 1 to 3 months and 21% after 3 months) and gingivitis (6% at 1 to 3 months and 11% after 3 months). All other brushes, apart from side-to-side, showed some statistically significant findings, but not consistently across both outcomes and time points. Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.
Caveat: 
The clinical importance of these findings remains unclear. The longer term result was based only on 14 trials, compared with 40 trials for the short-term analysis.
Context: 
Good oral hygiene through the removal of plaque by effective toothbrushing has an important role in the prevention of gum disease and tooth decay. Dental plaque is the primary cause of gingivitis and is implicated in the progression to periodontitis. The build-up of plaque can also lead to tooth decay. Both gum disease and tooth decay are the primary reasons for tooth loss.
Review CD#: 
CD002281
PEARLS No: 
449
Date: 
December, 2014
Authored by: 
Brian R McAvoy