Old-fashioned toothbrushes are just as good as electric ones at reducing plaque and gum disease, a U.K. review has found.

Only one type of electric toothbrush was slightly better than a manual toothbrush but the researchers were not sure if this made much practical difference.

The analysis was a collaboration between the Cochrane Oral Health Group and a team of researchers led by Dr Chris Deery of the Edinburgh Dental Institute.

The researchers publish their findings in the current issue of the Journal of Dentistry.

The researchers compiled 40 years of research comparing manual and electric toothbrushes. This included 29 high-quality trials involving more than 2000 people.

The only electric toothbrushes better than manual toothbrushes at reducing both plaque and gum disease were rotational oscillation brushes, where the head of the toothbrush rotates first one way and then another.

These toothbrushes achieved a "modest reduction", the researchers said, reducing the amount of plaque by 11% and gingivitis by 6% in three-month trials.

Other electric toothbrushes, such as ultrasonic toothbrushes, which vibrate at ultrasonic frequencies, were no better than manual toothbrushes, the researchers said.

Nor were toothbrushes with heads that moved from side to side, counter oscillation brushes with sets of bristles that moved one way then the other, or circular-motion electric toothbrushes whose heads rotated in only one direction.

"Toothbrushing certainly prevents tooth decay if carried out in conjunction with fluoride toothpaste. These benefits occur whether the brush used is manual or powered," the researchers said.

"As no trial compared durability, reliability or cost of using manual versus powered brushes, it is not possible to make a clear recommendation on toothbrush superiority."

Dr David Houghton, president of the Australian Dental Association said that both toothbrushes worked and if used correctly would clean plaque off teeth.

"You can do it just as well with a manual brush as you can with an electric," Houghton told ABC Science Online. "There has been a lot of research and sometime electric toothbrushes come out on top and sometimes manual toothbrushes come out on top."

Houghton said the reduction of 11% in plaque with the rotational oscillation toothbrush would "be useful but is not such a major thing".

The only advantages in an electric toothbrush, according to Houghton, is for people with low mobility, such as small children or aged people, or as an incentive to kids not interested in cleaning their teeth who might find an electric toothbrush a novelty.

The Australian Dental Association does not recommend using a particular type of toothbrush, Houghton said.

"They are all variations of a theme where they rotary or whether they oscillate backwards and forwards. If you get those bristles to the tooth gum junction and clean around those areas properly whether the bristle oscillate or go round and round doesn't mater, just as long as you get those bristles to that part of the tooth."

The Australian Institute of Health and Welfare reported recently that although adult patients attending dental clinics had improved their gum health since 1995, the incidence of tooth decay was still rising.

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