Toothbrush Bristle Designs: Types and Effectiveness

You may be wondering why is there so many types of toothbrush bristle designs in the market. Without understanding the toothbrush design, you may likely to end up choosing the most familiar toothbrush, the most attractive packaging, or the cheapest which are often the results of the companies’ successful marketing strategies.

As I received more similar queries from patients regarding which toothbrush is the best to use, I began to wonder about the purposes of different toothbrush bristle designs. I then compiled the uses of different toothbrush bristle designs and wrote this article. I believe that you will be able to make a smart choice in picking the right toothbrush after you understand their designs’ purposes and effectiveness.

Types of Toothbrush Bristle Design

1. Flat Bristle

This could be the earliest and simplest toothbrush bristle design. All the bristles are arranged evenly and equal in length.

It is labeled by American Dental Associated (ADA) as the standard reference toothbrush and used by many manufacturers for comparison with the new toothbrushes (click here to check out ADA specification).

Because of its flat brushing surface, research showed that it has a “blocking effect”, which means that the bristles cannot go into the area in between the teeth whenever other bristles touch the tooth surfaces [2]. This makes it less effective in cleaning the area between the teeth, where tooth decay and gum disease usually happen

Due to this problem, manufacturers have innovated their design afterward.

2. Multilevel Bristle

To overcome the “blocking effect”, this design has different lengths of groups (tufts) of bristles. This feature enables the bristles to work independently. During brushing, some shorter tufts can brush the tooth surface while some longer tufts can clean the area in between the teeth.

Research has proved that the users of this toothbrush had better gum health than the users of the flat toothbrush [3].

3. Rippled Bristle

Having the same purpose as a multilevel toothbrush, this design has a wave-like shape to fit the scalloping row of teeth. The longer bristles will be able to enter the area in between the teeth to clean it [2,3]. Being able to clean the interdental area, it could improve the overall gum health of the user.

4. Angled or Crisscrossed Bristle

This innovative design has different groups (tufts) of bristles arranged at different angles. During brushing, different angled tufts can work “independently” in such a way that some tufts can still brush the deeper areas while others are being blocked by teeth surfaces.

Same as multileveled and rippled bristles, angled bristles toothbrush was proven to be able to clean better than a flat toothbrush and maintain better gum health [3].

5. Spiral Filament

This is considered to be a more recent innovation. The bristles are made by twisting few filaments together in spiral shape. The companies are claiming that the spiral bristle can effectively remove plaque between the teeth and at the gum line [5].

However, there is not enough evidence to really show that it can clean better than other toothbrushes.

6. Tapered Filament

This type of bristle has a very fine tip (0.01mm, 0.02mm). Its purpose is to clean the dental plaque from the tiny groove on the biting surface of the teeth and the gum line.

The diameter shown on the package is referred to its tip and not the diameter of the bristle (usually ranging from 0.2mm to 0.4mm depending on the stiffness).

Because of its fine tip, research proved that it causes less tooth abrasion than the flat toothbrush. It is also recommended to people who have receding gum. However, because of its softness, it may not be as effective as other toothbrushes to remove the dental plaque that causes gum disease and tooth decay [6]

7. Bilevel-orthodontic or V-shaped Bristle

This toothbrush has a row of indentation or groove running across the bristles. This shape nicely fits on the braces wire.

Braces wearer may find it more convenient to use because it can brush both the teeth and the braces on them together [4]

However, just like any other toothbrush, it cannot clean the area in between the teeth with braces well. This area will need special attention by cleaning with threaded floss or stiff floss (Super Floss) or an interdental brush.

Does Toothbrush Bristle Matter?

With the right toothbrush bristle, does it mean that it can clean your teeth well to keep you away from tooth decay and gum disease? Unfortunately, this is not true.

Besides choosing the right toothbrush, it is also very important to do the right toothbrushing method.

All the toothbrush bristle designs are made to serve one main purpose: to clean the dental plaque on the teeth and gumline to keep them healthy. 

However, there are two main factors that can affect the cleanliness of your teeth:

• Toothbrush design
• Brushing habit: brushing technique, duration, frequency

For manual toothbrush (not powered toothbrush) users, brushing habit is very much different from one person to another. Because of this, the toothbrush bristle design becomes less important. For example, a person who simply brushes for half a minute using a multilevel toothbrush will not clean better than the person who carefully brushes for two minutes using a flat toothbrush. 

But for a powered toothbrush which has programmed settings to standardize the brushing techniques for the users, its design becomes more important to improve the effectiveness in cleaning the teeth [3].  

Flat, zigzag and crisscross bristles were proven to be effective for braces wearers in cleaning away the dental plaque [7].

Therefore, considering the two factors, the best recommendation for a manual toothbrush user is to emphasize more on toothbrushing habit. These include brushing with a suitable toothbrush for two to three minutes at least twice daily. Try to keep the mouth food-free for two to three hours after brushing at daytime. At night, no food should be taken after brushing until the next morning.

It is also helpful to read this article to check for yourself whether you have brushed your teeth properly.

Summary

Toothbrush bristle design has undergone dynamic changes through innovation. Many has called them “specialized” toothbrushes as they serve specific purposes. The toothbrushes effectiveness will depend on the bristles design. To choose the best toothbrush, you should know what the functions of those toothbrushes are. You can find out this simple guide on how to choose the right bristle design by clicking here.

If you are interested in the evolution of the designs of toothbrush, click here to check out this article.

Reference

1. Versteeg P, Piscaer M, Rosema N, Timmerman M, Van der Velden U, Van der Weijden G. Tapered toothbrush filaments in relation to gingival abrasion, removal of plaque and treatment of gingivitis. International Journal of Dental Hygiene. 2008;6(3):174-182.
2. Hayasaki H, Saitoh I, Nakakura-Ohshima K, Hanasaki M, Nogami Y, Nakajima T, et al. Tooth brushing for oral prophylaxis. Japanese Dental Science Review. 2014;50(3):69-77.
3. Saxer UP, Yankell SL. Impact of Improved Toothbrushes on Dental Diseases II. American Journal of Orthodontics and Dentofacial Orthopedics. 1999;115(1):A1.
4. Voelker MA, Bayne SC, Liu Y, Walker MP. Catalogue of tooth brush head designs. American Dental Hygienists’ Association. 2013;87(3):118-33.
5. Kang KT, Seong JK, Soo H. Spiral filament and toothbrush using thereof. South Korean Patent No. KR20170117258A.February 22, 2017.
6. Ren YF, Cacciato R, Whelehan MT, Ning L, Malmstrom HS. Effects of toothbrushes with tapered and cross angled soft bristle design on dental plaque and gingival inflammation: a randomized and controlled clinical trial. British Dental Journal. 2008;204(2):83-83.
7. Naik SP, Punathil S, Shetty P, Jayanti I, Jalaluddin M, Avijeeta A. Effectiveness of Different Bristle Designs of Toothbrushes and Periodontal Status among Fixed Orthodontic Patients: A Double-blind Crossover Design. J Contemp Dent Pract. 2018 Feb 1;19(2):150-155.