Which one would we choose?
Our choice: Sonic toothbrushes
The vast majority of electric toothbrushes available today are considered ‘sonic’ electric toothbrushes.
They usually have dentist recommended features, clean the teeth well, are affordable and easy to source.
Sonic brushes were introduced by ‘Sonicare’, a company now owned by Philips. These have been popularised under the brand ‘Philips Sonicare’.
‘Ultrasonic’ toothbrushes sound similar but are technically different.
Unlike sonic toothbrushes, ultrasonic models don’t rely on a physical motion to clean the teeth.
Only a few truly ultrasonic brushes exist, and those that do tend to be very expensive.
There is limited evidence to support the use of ultrasonic toothbrushes instead of sonic toothbrushes.
Our in-house dentist Dr Gemma Wheeler does not recommend using them on a daily basis because they cannot remove all plaque from the teeth.
It’s common for the word ultrasonic to be used incorrectly to describe what is actually a sonic toothbrush. We have noticed this in the marketing language of various sonic toothbrushes.
We recommend sonic toothbrushes. Our top choices are listed in the table below.
If you want a truly ultrasonic brush or want to know how they differ, read on.
What’s the difference between a sonic and ultrasonic electric toothbrush?
The fundamental difference between these two types of brushes is that sonic toothbrushes rely on a physical motion to clean the teeth, whereas ultrasonic brushes do not. Ultrasonic toothbrushes clean using hydrodynamic forces. Some use a combination of ultrasonic and sonic technology to remove plaque.
Many of the brushes we review and cover here at Electric Teeth are sonic, such as those from Oral-B and Philips.
However, Ultrasonic is another type of brush you could consider.
These are rarer to come across, but they are still available on eBay.
In this article, we’ll be taking a look at the key differences between the two types of brush. We’ve included an infographic further down showing the two side by side.
If you are looking for an overview of the current range, you may like to see our best electric toothbrush post.
Sonic electric toothbrushes
To be classified as a sonic toothbrush, the motion or vibration from the brush has to be quick enough to produce a ‘humming’ sound that is within the audible range of the human ear (20 Hz to 20,000 Hz).
Sonic brushes typically offer 12,000-24,000 oscillations or 24,000-48,000 movements per minute.
Sonic brushes rely on a sweeping motion alone to clean the teeth, the movement that they provide is often high in amplitude which means they offer larger sweeping brush stroke motions.
It is the bristles on the brush head that move at this speed to essentially brush away food particles and bacteria that sit on the teeth and gum line.
As it does this, the sonic motor inside the brushes creates a sound that is audible to the human ear.
Examples of a sonic brush include Philips Sonicare, Colgate, Ordo, Spotlight Oral Care, Fairywill, SURI, Curaprox, Oclean and many more. We look at these brushes in detail in our electric toothbrush reviews.
The vibrations the bristles make do cause disruption of plaque beyond the tips of the bristles without the bristles actually touching that area.
It is thought that very high frequencies cause liquids to move and create “hydrodynamic forces” which damage the plaque layer in hard to reach areas (1).
The following diagram from the National Library of Medicine provides a visual representation of this:
This secondary effect is actually the ultrasonic effect. This happens in many sonic toothbrushes and is beneficial to your oral health.
Sonic toothbrushes (with ultrasonic effects) should not be confused with ultrasonic toothbrushes. They are different.
Ultrasonic toothbrushes use only the very high frequencies, which you cannot hear. Ultrasonic toothbrushes clean using only hydrodynamic forces, and do not have a mechanical cleaning effect.
That said, often unintentionally, the word ultrasonic is used to describe products which use sonic frequencies too. Rarely are brushes truly ultrasonic. Be wary if a toothbrush is labelled as such.
As we shall explain, ultrasonic brushes operate at a much higher frequency and use ultrasound rather than the motion of the brush head to remove debris and bacteria. They can be silent too.
Ultrasonic electric toothbrushes
Ultrasonic toothbrushes, unlike sonic ones, do not rely on a physical motion to clean the teeth.
An ultrasonic toothbrush is one that uses a very high frequency of vibration referred to as ultrasound to remove plaque and bacteria from the teeth.
To be classified as such, the brush has to emit a wave of at least 20,000Hz or 2,400,000 movements per minute, considerably more than the very popular sonic technology.
This frequency is too high to be heard by the human ear. It is ultrasonic.
Within the USA, the Food and Drug Association (FDA) actually specify a minimum of 1.6MHz or 192,000,000 movements per minute.
These high frequency waves are also low in amplitude. They can damage the bonds between bacteria, without a bristle physically touching the area.
The overall effect is that the bacterial chains found in the mouth that make up plaque are broken up by the vibrations and can work as far as 5mm below the gumline.
Essentially speaking the brush can clean the teeth simply by resting the brush on it.
Based on how they operate and their classification, these ultrasonic brushes may also be referred to as ultrasound toothbrushes.
An ultrasonic brush compared to the more commonly seen and used sonic brushes does not need a physical motion to clean the teeth surfaces and gumline. It is also silent in operation, you won’t be able to hear it.
Many ultrasonic brushes also provide additional sonic vibration (ranging from 9,000 to 40,000 movements per minute). This provides additional physical or mechanical cleaning via a sweeping motion of the bristles, this removes food particles and bacterial chain remnants.
As weird as it sounds, the addition of the sonic vibration (which can be heard) helps overcome the strange sensation of not having to brush the teeth in the way you have to with a sonic toothbrush.
An example of an ultrasonic brush is the M8S produced by Megasonex or the Emmi-dent Platinum.
This video from YouTube gives a good explanation of what an ultrasonic toothbrush is and how it works:
Sonic vs oscillating-rotating
Sonic toothbrushes are very popular, but so are oscillating-rotating brushes.
Oscillating-rotating brushes function differently to sonic brushes.
The bristles move in a back and forth circular motion compared to the straighter back and forth sweeping motion of sonic brushes.
Whilst the 2 approaches are different, oscillating-rotating brushes do fall into the ‘sonic’ category. This is because the movement produces vibrations in the audible range.
It is Philips Sonicare that has made sonic toothbrushes popular and Oral-B who popularised oscillating-rotating brushes.
There is much debate as to which is better. Clinical reviews that assess all the studies have concluded that Oral-B’s cleaning action does remove more plaque. However, whether this has any real life obvious benefit is not actually known. More research is required.
The reality is that the cleaning results from either are comparable. Both approaches are backed by many dental professionals around the world. Both types of brush are more effective than manual toothbrushes when it comes to removing plaque and reducing levels of gum disease.
Our Sonicare vs Oral-B article discusses the differences between the cleaning actions and the supporting evidence in more detail.
Despite sonic brushes being very popular, it is an oscillating-rotating brush from Oral-B that is our top choice for an electric toothbrush as it delivers great cleaning results and features at a very competitive price.
Other technology – DentalRF, Ionic power & more
The electric toothbrush and choosing one is more complicated than it really needs to be.
Many companies will cite special technology and features that make their brushes better.
There are other brushes that use additional technology. Examples of those technologies are:
- Iconic power
Whilst there may well be scientific merit to each of these, as it stands none have yet proven themselves worthwhile alternatives to the conventional sonic toothbrush.
In fact, many of these products still offer a sonic cleaning action, but the technology gives an additional dimension, and improvement to the cleaning results.
These technologies are different to the ultrasonic technology which is the main focus of this article.
It is worth being aware of these though because it is very easy to get confused and misunderstand what exactly is on offer, with so many competing brands and products.
Who makes the best ultrasonic toothbrush?
Whilst ultrasonic toothbrushes have been shown on a limited scale to be effective (1 & 2) the reality is that few such toothbrushes are available to buy.
The market is dominated by sonic toothbrushes, notably those from the largest household brands.
Most ultrasonic toothbrushes still have an element of sonic cleaning. Likewise many toothbrushes marketed as sonic technology will have a small ultrasonic effect too.
There are several toothbrushes that suggest they are ultrasonic, using such words in the product title and description, but in fact, they are just standard sonic toothbrushes, operating at up to 48,000 movements per minute rather than using ultrasound to achieve the cleaning.
It is my understanding that at the time of writing, the brands who do make toothbrushes closest to being truly ultrasonic are Megasonex, Smilex and Emmi-Dent. These rely mostly or entirely on ultrasonic frequencies (with minimal sonic frequencies) so you’ll be best off choosing between these if ultrasonic is what you want.
We have been hands-on with the Megasonex M8S and plan to test more in the near future.
At the time of writing, I couldn’t find any of these brushes available with UK retailers.
Don’t expect to find these in your local pharmacy, dentist’s office or supermarket.
Most manufacturers ship to the UK, or you can find them on eBay.
If you’re not specifically looking for ultrasonic, but rather a ‘standard’ electric toothbrush, check out our post that looks at the best sonic toothbrushes.
To help summarise the key differences between sonic and ultrasonic toothbrushes, we’ve put together the following table.
|Cleaning action||A physical sweeping motion is used to clean the teeth.|
Typically 12,000-24,000 oscillations or 24,000-48,000 movements per minute.
Use high frequency waves.
|No physical motion is required to clean the teeth.|
(Some do come with bristles for added cleaning effectiveness)
20,000Hz or 2,400,000 movements per minute.
Use high frequency waves with low amplitude.
|Noise/sound||Moderate humming sound.||Silent (ultrasound only mode).|
|Supporting clinical evidence||A large amount.||A limited amount.|
|Popularity & availability||High||Low|
|Common brands||Philips Sonicare|
32 thoughts on “Sonic vs Ultrasonic Toothbrush Comparison”
Can this article be updated for 2022 ?
Many brands have come out (Ion- Sei, Silk’n, Ordo Sonic+, Whites Beaconsfield, Spotlight Oral Care, DOKODEMO etc) and it’s very confusing to navigate the market, especially when Phillips and Oral b lines both have the term ultrasonic in most of their descriptions and I’m unsure whether they have both sonic and ultrasonic going on or no ultrasonic whatsoever despite their use of the word…
There’s also use of UV lights in the toothbrushes too, which seems great both for the teeth and cleaning the brush but what passes for genuine UV light? Is it any blue led?
Please please edit an up to date piece with current real ultrasonic toothbrushes with additional UV and Sonic feature options!!!
Thanks for the comment. We will look at updating this post, but the simple fact is very few brushes are actually ultrasonic. Brands like Ordo, Whites Beaconsfield, Spotlight Oral Care and more are all sonic toothbrushes and do not fall into the ‘ultrasonic’ category.
UV is different entirely to sonic and ultrasonic and would be a separate article. In fact on our USA website, we have an article about UV light and santisers available here.
Can you point us to examples of where you have seen Oral-B and Philips Sonicare quoting ultrasonic within their descriptions?
Sorry for the delay.
My mistake!! Realised that all the ultrasonic descriptions I read of Oral-B and Philips Sonicare were in terms mistakenly included in review articles I had been reading.
I’ve used an Oral B Vitality for maybe 8-9 years now and with a battery lasting two days max and the rubber peeling off, I’m on a mission for an upgrade in this bewildering and exciting stage of advancing technology in home oral healthcare.
With podcasts here, snippets of shared articles there, over time and osmosis it’s began to sink into me how significant oral health really is and how health should be approached in balance in tandem. Not as separate body parts. If the eyes are the so-called window to the soul, perhaps our mouth is the window to our health, or at least; the primary highway for infection.
With that, and recurring oral issues in the family I’ve had enough of (tartar, candida overgrowth, halitosis…), I’ve began emailing the companies Ion-Sei, MegaSonex, Emmi-Dent and Silk’n for further information. I left out Smilex after being unable to find an officail site I could access (unfortunately the link on the article no longer works).
Will you releasing a new article soon on navigating between these promising toothbrushes with advanced tech? That includes the ultrasound brands, the Silk’n’s “DentalRF” and ION-Sei’s ionic + UV (that claims to work without toothpaste!)
If so, shall I post the responses from these companies here?
Lastly, my cheap shot: let me know if you need any volunteers to test them out 😀
Many thanks for the informative articles Jon, and to those who have helped share information on the thread
Thanks for coming back Amy.
Well as you have probably seen my top pick is the Oral-B Pro 3 3500 and I think this would make a good replacement for your ageing Vitality brush.
If and when we test them, they will likely get their own articles on the site. Feel free to share any useful responses you get here.
Happy to be proven wrong once we dig more into the science and testing, but if these brushes are so wonderful and great I have to wonder why the major brands don’t incorporate them into their devices. But, they might not be innovating and there is more likely not enough research going on to really conclude one way or another.
After reading the posting dated November 21, 2018 that seemed to imply that ultrasonic toothbrushes are “the biggest scam in the world”, I decided to do some research and even contacted the MEGASONEX manufacturer to get clarification about the information that they have on their packaging, which references the 1999 Japanese Study and the Ultima® toothbrush. Here is roughly what they said to me…
The ultrasound technology (in a toothbrush) of generating a sound wave at a frequency of 1.6MHz with a power rating not to increase the surface temperature of the tooth or surrounding tissue by more than 1 degree C, has been approved by the FDA in the USA in 1992. This frequency of ultrasound has been proven to be very effective not only in fighting dental plaque but also in treating canker sores, reducing the time necessary for bones to heal, increasing the speed of healing of lacerations etc. As everybody knows, FDA does not approve technologies without proof.
Since the late 1990’s when the first ultrasonic toothbrush started to be sold in the USA and in Europe, both the manufacturers of ultrasonic toothbrush and toothbrush features have changed, but the basic ultrasonic technology used in these products has remained the same today. MEGASONEX, being a responsible producer of Oral Hygiene products, wanted to provide full disclosure and therefore informed its readers that, when describing the action of ultrasound on its packaging or on its site, it was referencing the same identical technology, even though the actual experiment was done on another model/manufacturer’s product. This information, on the packaging or on the site, has not been changed since 2010 and should be updated soon.
Since 2010, other studies looking at the benefits of ultrasound in a toothbrush have been conducted around the world and some of them did choose MEGASONEX for their control. In all fairness, whether the study was done using MEGASONEX or another brand which operates using the exact same technology, the result would probably be very similar, since it is the ultrasound, at this given frequency, that is responsible for the results.
In 2015, the same professor that was part of the team that did the Ultima® study in Japan in 1999 (referenced on the MEGASONEX® packaging), ran a new experiment to see what effect additional vibration would have on the ultrasonic cleaning action of an ultrasonic toothbrush. This study happened to use the MEGASONEX® toothbrush, presumably since the Ultima® brand no longer exists and MEGASONEX® uses the same technology. This study was published in the Journal of American Dentistry December 2015 issue. The study concluded that ultrasound, at the frequency of 1.6MHz, tears apart bacterial chains rendering them harmless (confirming the 1999 studies conclusion) and that the concurrent sonic vibration enhances the cleaning effect by sweeping out the debris resulting from the ultrasonic action….
In my limited research, I have come across at least a half a dozen studies done in the past 2 decades, both done in vivo and in vitro, that demonstrate the effectiveness of the ultrasonic toothbrush technology. Anyone that goes on the internet and searches for studies on ultrasonic toothbrushes can find the same. Now your audience can draw their own conclusions.
I’ve looked at both the Emmi dent and Emmi pet and can see no difference in the equipment except the toothpaste yet the pet one is over £100 in the UK than the ‘human’ one. How are they so different?
I have not been hands on with either of these to comment with absolute certainty.
There does however seem to be no clear obvious difference between the 2, bar the name/packaging, having had a quick look.
Information and product details are sparse and inconsistent to be able to say fully.
The Emmi-Pet is silent and with no vibration whereas the Emmi-dent vibrates and the motor still makes a noise. The extra cost is due to the cost of developing and creating the silent motor for the pet version. For humans, we like obvious evidence (sound and sensation) that something is turned on, whilst this can be very off putting for pets.
an ultrasonic toothbrush works without any motor at all. The Emmi one, as you correctly write, has a built-in motor only to reassure the user. With the Megasonex one the motor is used in addition to ultrasound and you can switch it off having ultrasound with no noise at all.
So the explanation saying that ‘a special motor’ had to be developed for pets’ is wrong!
Ultrasonic brushes are the biggest scam in the world.
Go on the official Megasonex website and see for yourself – they explicitly write that they have no proof whatsoever that their brush can even do anything through the ultrasonic waves:
“Study conducted at the Tokyo Medical and Dental University, Department of Preventative Dentistry. Streptococcus mutans, a species of bacteria typically making up human plaque, was exposed to ultrasound at a frequency of 1.6MHz or 96,000,000 pulsations per minute, damaging bacterial chains and severing their methods of attachment, rendering them harmless. The study was conducted on the original version of the Ultima™ toothbrush that had no additional sonic movement whatsoever. Correlation between the results obtained on the Ultima™ and MEGASONEX® has not yet been established”
In other words – “not only was the original study in-vitro (not in vivo) and only tested on one specific type of bacteria, but we also have no proof that our brush can do what the original Ultima brush could (again, only in vitro, and only on one specific bacteria type).”
I am absolutely convinced that the only reason both Megasonex and Smilex even work at all is that they have the additional sweeping (“sonic”) motion on top of the ultrasonic waves. As for Emmi-Dent, to insinuate that all you need to do to brush your teeth is HOLD THE TOOTHBRUSH ABOVE THE SURFACE OF THE TOOTH without sweeping at all is not only misleading but incredibly irresponsible.
EVEN IF the brush could somehow break up the bacterial chains (which I highly doubt it can), the plaque wouldn’t just disappear. It’s still necessary to remove it through mechanical brushing.
Both oscillating-rotating and sonic are great compared to a manual brush. I am personally a fan of Oral-B, I have the Genius and it works wonders on my teeth. Sonic is not for me, I hate the high-pitch sound, but at least I know the brush is doing something unlike this ultrasonic stuff.
Thanks for the detailed comment.
Indeed Ultra Sonic brushes are not really proven and it is for this reason we recommend brushes like Oral-B and Sonicare over such models.
Hi can anyone help ?
Do these ultrasound tooth brushes work in U.K. plugs are do I need a adapter?
These brushes should work in the UK just fine. However, it may depend slightly on which brush and where you are buying it from.
It may come with a 2 pin EU plug that may require an adapter to work here in the UK. In that case, you are probably worth buying a 2 pin EU to 3 pin UK plug adapter as you wont see a 2 pin EU to 2 pin UK bathroom plug adapter normally.
Did you have any problems with ulcers (afta) in mouth and if anyone did , did an ultrasonic brush help to fasten the healing process of the ulcers ?
Yes actually! I used to get them regularly and now in the rare cases that I do, they heal much faster. It lends Credence to the idea that it really is destroying bacteria on contact, since the harmful ones are known to prolong the duration of these mouth ulcers. Of course I also worry a little bit about what it might be doing to the good bacteria as well… But I’ve had no negative results so far. I also use Weleda calendula toothpaste, or activated charcoal or homemade salt/clay based toothpastes without synthetic chemical cleaners like SLS. I’ve had no cavities since starting this regimen except for one that was “forming” according to x-Ray’s, which reversed and healed by the time of my next visit. This is kinda crazy stuff but I love it!
I have a Megasonex toothbrush and can say that the build quality and ‘feel’ is excellent. Furthermore, the brush runs on a full charge for almost a month, and takes roughly 8 hrs for a full recharge from dead flat. It has a timer that gives you three minutes to clean all surfaces of the teeth, with momentary interruptions to the sonic vibration every 30s helping to ensure equal coverage by dividing and focusing equally on areas of the mouth – e.g. upper left, centre, right teeth, and the same for the lower teeth.
I’ve read much about the many rechargeable high-street brands that fail anywhere between 6 months up to typically 18 months, some with exhorbitant prices due to Bluetooth, dedicated apps, and all such modern tech marketing rubbish. On balance, I considered going with the Megasonex at an all-in cost (UK) of £160 from Germany via eBay. This means investment in technology that reportedly does the job more effectively, rather than your mobile app serving little more than as a regular brand ad’ in my opinion.
Don’t pay more for a full kit that includes their special toothpaste – It’s not worth it, particularly as it can’t be sourced separately. I mistakenly paid a bit extra for the paste-inclusive kit at the above price, but in true eBay style the seller had the gall to stick a… “free gratis :)” paper label on the toothaste box! I personally use a toothpaste with neem bark from Amazon, relatively expensive but in combination a very powerful and effective combination with the Megasonex.
Do ensure that you buy authentic branded brush heads as they contain the high-frequency resonators encapsulated just behind the brushes and can just be seen/confirmed with a powerful torch. Typically around £20 for a pair of replacement brushes, with recommended replacement at 3-month intervals.
I’ve had the Megasonex for just over a month now and it does appear to be significantly more effective when compared to my Braun Oral-B which, incidentally, also has expensive genuine replacement heads that do nothing more than brush in the more conventional manner.
On the strength of early ownership and reasonable personal experience, I would personally recommend Megasonex – also available as a twin-toothbrush kit for about £250 to the UK, again from Germany. A pity they’re not on general sale over here, though the UK does appear to be the worlds 5th richest nation with ‘no money’ in the public pocket so no surprises there, but I would say the investment is well-worth considering for perceptively-improved oral hygiene and personal health.
Thanks for the detailed comment and feedback on the Megasonex, great to hear such positive things.
Is an ultrasonic dangerous for implants?
Hi Mimi. No, all is fine to use with implants.
Hello,which brush do you recmoned better for dental implants-sonic or ultrasound?
Typically Sonic are the most popular.
Hello, Do you know if the ultrasonic brushes can have an impact on resine tooth, glue,… Basically, I would not lose one sealing by using high frequency vibrations…
Olivier, I don’t believe they would have any impact, given that your teeth essentially undergo more stress through eating etc. If you want complete peace of mind getting your dentists advice is advised, but from my knowledge and experience it should not be an issue.
Thank you for all the comments, this was confirmed by the pacemaker team at Wolverhampton New Cross Hospital.
Will ANY toothpaste work with an Ultrasonic toothbrush or does it HAVE to be a special one that produces nano-bubbles – what ever they may be?
You can use any toothpaste.
Do you know what these nano-bubbles that Emmi-pet rave about are? Could you please explain? Thank you for your time.
Emmi-Pet/Emmi-Dent are not a brand I am all that familiar with but is seems like they focus on Ultrasonic products, so I will be doing more research.
The Nano bubble are according to them: Specially formulated nano-bubbles are up to 1000x smaller and are able to reach between the teeth, into the smallest crevices, supporting and enhancing the cleaning effect of ultrasound. Nano-bubble cleaning removes plaque, tartar, food scraps and impurities.
So it would seem that these smaller bubbles are supposed to get into the gaps and clean better. Whilst there may well be some truth in this, it is not clear who or what they are comparing their bubble size too.
From all the pastes I have tested I have not come across the ‘nano bubbles’ before, but many brands come up with inventive marketing words/phrases.
There is a requirement too for brush bristles to sweep away the plaque and bacteria, to the small bubbles getting into a gap is only part of the solution. Yes, it may deposit bacteria killing fresh paste under the gum line for example, but ideally you want bacteria to be removed too.
The reality is that for a human a basic fluoride based toothpaste is fine in most instances.
I see you o dog grooming. Despite being a dog owner myself I am not all that familiar with what is essential to a paste for dogs. Nano-bubbles I do believe will be the least of the worries in brushing a dogs teeth!
I hope this shines a bit more light on things for you.
I called a pacemaker manufacturer and asked them. They said that the ultrasonic toothbrush does NOT interfere with its functions, based on the toothbrushes that they are aware of. So, no problems using it.
By the way, the info you have on Megasonex is incorrect (in the blue picture). It does not work on 20,000MHz, which does not translate to 2,400,00 movements per minute. The brush gives off ultrasound at a frequency of 1.6MHz (which translates to 96,000,000 pressure waves per minute or 192,000,000 movements per minute) and at the same time it vibrates at a sonic frequency of 18,000 movements per minute. 2 types of action at the same time.
Walter, Good to see the pacemaker manufacturer has confirmed it does not interfer with it.
The information on the graphic is aimed at a more general classification of Ultrasonic toothbrushes, but we do specify the 1.6MHz frequency for ADA approval.
Will the Ultrasonic toothbrush affect my pacemaker? I bought an Ultrasonic massager for £212 but the instructiond say I cannot use it if I have a Pacemaker. A very expensive doorstop.
It is our understanding that an ultrasonic toothbrush should not affect pacemakers as modern pacemakers are designed to be protected against such. Please refer to this post.
That said it is always worth checking with professionals given that the instructions say so. It may be that the toothbrush manufacturer is just being very careful to protect themselves against liabilities.
We are not medical professionals and are not in a position to give the final word on this. We are not aware of any issues but strongly advise speaking to your Doctor or the team that carried out your surgery.
Please do let us know what they say as we would like for you to get some use from your current expensive doorstop!