Using an Evidence-based Approach to Making Patient Recommendations for Power Toothbrushes
Oscillating-Rotating (O-R) Technology (Oral-B) Toothbrushes

Course Author(s): Lesley McGovern Kupiec, RDH, MSDH; Jane L. Forrest, EdD, BSDH

Oscillating-Rotating (O-R) Technology (Oral-B) Toothbrushes

Following extensive development, in 1978, Oral-B® (Procter & Gamble Company, Cincinnati, OH, USA) pioneered the first mass-produced electric toothbrush intended for general use. The “D-1” (Figure 1a) featured a manual-like brush head and a side-to-side motion. The following decade saw electric brushes with modes of action attempting to simulate the rotary, circular-like movements of professional cleaning instruments (e.g., Rotadent® [Zila, Fort Collins, CO, USA]) or utilizing varying brush head tufts rotating in a counter rotational fashion (e.g., Interplak® [Conair, East Winslow, NJ, USA]). As these were launched, the popularity of electric brushes for general use began to grow.

A major milestone occurred in 1991 with the introduction of the Oral-B Plaque Remover ‘D5’ and its novel, prophylaxis-inspired O-R mode of action (Figure 1b).5 With a cup-shaped brush head and end-rounded bristles providing robust plaque removal via 5600 oscillations per minute, this was the first electric toothbrush technology clinically proven to clean better than a manual toothbrush.6 It also featured new compliance-enhancing features, including a two-minute light timer to boost brushing frequency.

Oral-B Plaque Remover ‘D5’ - 1991
O-R mode of action.
First electric toothbrush clinically proven to clean better than a manual toothbrush.
Two-minute light timer.

Figure 1a.
Photo showing the Oral-B D1 power toothbrush
Oral-B ‘D1’.
Figure 1b.
Photo showing the Oral-B D5 with oscillating-rotating mode of action
Oral-B ‘D5’ and its novel, prophylaxis-inspired oscillating-rotating (O-R) mode of action.

The next few years brought additional technological advances in O-R technology. The Oral-B 3D Plaque Remover (later renamed the ‘D15’) debuted in 1998, incorporating high frequency pulsating movement to the oscillating-rotating technology (O/R/P) for three-dimensional brush head movement, providing enhanced plaque removal and penetration in the approximal regions (Figure 1c).7

Adding increased oscillations and pulsating frequencies later culminated in the Oral-B Professional Care Smart Series with SmartGuide™ power toothbrushes. The Oral-B Triumph with Smart Guide (Figure 1d), launched in 2007, was the first power toothbrush with clinically proven combined O/R/P technology, together with an innovative new wireless remote display feature (Smart Guide) for continuous visible brushing feedback.8

Oral-B Triumph with Smart Guide - 2007
First electric toothbrush with clinically proven combined O/R/P technology.
Wireless remote display feature (Smart Guide) for continuous visible brushing feedback.

Figure 1c.
Photo showing the Oral-B 3D (D15) Plaque Remover power toothbrush
Oral-B 3D Plaque Remover (later renamed the ‘D15’).
Figure 1d.
Photo showing Oral-B Triumph power toothbrush with wireless Smart Guide
Oral-B Triumph with wireless Smart Guide.

In 2014, Oral-B introduced The Oral-B PRO 5000 with Bluetooth 4.0 connectivity (Figure 1e). It was the world’s first Bluetooth connected power toothbrush, which allowed for two-way communication between the brush and the Oral-B app to enable real time feedback, motivation, and rewards as well as a more personalized brushing routine. The app feature allowed patients to work hand-in-hand with their dental professional, who could program a patient’s brushing routine to help improve brushing behaviors and focus on problem zones within the mouth. This technology gave patients greater control over their oral care practices.

The Oral-B PRO 5000 - 2014
World’s first Bluetooth connected power toothbrush.
Real time feedback, motivation, and rewards.
More personalized brushing routine.

Two years later, Oral-B unveiled its next innovation, the Oral-B GENIUS (Figure 1f). The Oral-B GENIUS featured groundbreaking Position Detection Technology that combined motion sensor technology and video recognition using a smartphone’s camera to track areas being brushed. Users received instant feedback on the brushing of each zone of the mouth so that no zone was missed. The Oral-B App also included guidance on whether too much pressure was applied and brushing duration.

Oral-B GENIUS - 2016
Position Detection Technology combines motion sensor technology and video recognition.
Receive instant feedback on the brushing of each zone.
Guidance on too much pressure and brushing duration.

Figure 1e.
Photo showing Oral-B PRO 5000 power toothbrush with Bluetooth connectivity
Oral-B PRO 5000 with Bluetooth 4.0 connectivity.
Figure 1f.
Photo showing Oral-B GENIUS power toothbrush

The next generation of O-R technology introduced by Oral-B in 2020 is the Oral-B iO electric toothbrush (Figure 2).9 This new O-R brush represents a comprehensive internal and external re-design. It has been developed with a linear magnetic drive resulting in oscillating-rotations with micro-vibrations from controlled energy being directed to the bristle tips. This also provides a smoother brushing experience. The brush heads have been redesigned with features such as new tuft-in-tuft bristle trims and high-density bristle fields to maximize tooth surface coverage and cleaning, allowing bristles to penetrate along the gingival margin and proximally. It also has a ‘smart’ pressure sensor which not only lets users know when they are applying too much pressure, but unlike other power toothbrushes, it lets the user know when the pressure is too little or in the optimal range for safe and effective plaque removal.10 Also, if too much pressure is applied, the electronically controlled linear magnetic drive automatically decreases the brush speed so that it operates in the Sensitive mode.

Oral-B iO Electric Toothbrush - 2020
Internal and external re-design.
Developed with a linear magnetic drive = O-R with micro-vibrations.
Smoother brushing experience.
‘Smart’ pressure sensor - indicates excessive pressure, insufficient pressure and optimal pressure range.

Figure 2.
Photo showing Oral-B iO electric toothbrush
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