The new generation of manual and powered toothbrushes that have been tested in recent years exhibit better plaque removal than do older brushes. Differences are most significant when individuals have been instructed in proper brushing technique. Comparisons of powered and manual brushes show the clear superiority of newer powered brushes, but there is no such effect with older powered brushes, which stop when force is applied. Newer powered brushes reduce gingivitis and gingival abrasions. In a limited 18-month trial, a powered oscillating toothbrush improved existing periodontal conditions, thus effecting a considerable savings in treatment costs. At present, under optimal conditions, improved designs of both manual and powered toothbrushes, which do not stop or break down in use, produce more significant plaque removal in critical sites. Long-term trials are needed to confirm these results.