The core issue is often overlooked: real improvements in oral health come not from pricey gadgets, but from smarter daily habits. This is the takeaway from dentist and periodontist Tim Thomassen in his dissertation, Oral Disease Prevention, which he will defend on December 12 at the University of Amsterdam. His study explores how different toothbrush designs perform and how the duration of brushing affects oral health.
Globally, nearly 3.5 billion people battle oral diseases such as cavities and gum problems. Dental plaque is a key contributor in many of these cases, which is why the standard guidance emphasizes effective brushing. But what defines effective brushing?
Thomassen’s investigation spans multiple facets of tooth and gum disease prevention, including toothbrush effectiveness, brushing duration, and the quality of oral-hygiene guidance. He synthesized dozens of international clinical studies into systematic reviews and conducted several of his own experiments.
Contrary to common belief, expensive high-tech solutions play a smaller role in preventing cavities and gum disease than usually assumed. The practical differences between products are often minor, meaning that personal habits ultimately make the biggest impact.
Which toothbrush is best: powered or manual?
Should you choose an oscillating-rotating, a high-frequency sonic toothbrush, or a plain manual one? Price varies widely, but does that translate into better cleaning?
For plaque removal, a powered toothbrush generally outperforms a manual one, says Thomassen. However, the gap between the two main categories of powered brushes is small in everyday use. He suggests manufacturers would serve the public better by focusing on user education and designing affordable, sustainable options rather than releasing yet another costly model.
How long should brushing last?
Worldwide guidelines are straightforward: brush twice daily for two minutes to effectively reduce dental plaque. Thomassen’s findings confirm that two minutes clears more plaque than one minute. He also tested whether three minutes offers more benefits; the answer is not significantly better.
How long do people actually brush?
Users of manual toothbrushes—still the majority globally—tend to brush for just under 1.5 minutes. “Brushing works, and the average brushing time has crept upward in recent years, but many people still don’t brush long enough,” Thomassen notes. Those using powered brushes reach the two-minute mark more often, and often brush for about 2.5 minutes on average. Built-in timers can help people extend brushing time.
Improving information availability
Thomassen also evaluated the brushing guidance provided by dental organizations worldwide. Only about one-third offer clear, accessible online instructions. He emphasizes the need for better, practical information that people can apply right away.
He advocates for guidelines that are realistic for diverse lifestyles, abilities, and budgets, so good oral care becomes achievable for everyone. A national, evidence-based oral-care guideline adaptable to different needs could bridge the gap between research and daily practice, benefiting both patients and oral-health professionals.
Thomassen envisions his work contributing to this goal, with preparations for such guidelines already in motion—and he is ready to take on the next challenge.
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