Test of toothbrush heads - the original against the copies


How well do the copies compare to the original from Oral-B? Testfakta Research has tested and compared ten compatible brush heads on the Nordic market. All are more or less identical in appearance, but the test shows big differences in quality, feel and performance.

Published: 26 Aug, 2022

How well do the copies compare to the original from Oral-B? Testfakta Research has tested and compared ten compatible brush heads on the Nordic market. All are more or less identical in appearance, but the test shows big differences in quality, feel and performance.
Ink cartridges, vacuum cleaner bags and now brush heads for electric toothbrushes. If you have an Oral-B electric toothbrush, you can today choose between several brands of compatible brush heads - all with the same rotating brush technology as the original head.

Is there any difference between the different makes? Do they brush as clean and last as long? To find out, Testfakta Research, on behalf of Procter & Gamble, tested ten different brush heads for Oral-B electric toothbrushes on the Nordic market.
The tests have been carried out in three different laboratories and include everything from the ability to brush away plaque to technical tests of the endurance of the bristles and the angle of rotation of the brush head.


The most important part, of course, is how good they are at removing plaque. To find out, 40 subjects were recruited who together completed 200 test brushings in the laboratory. The amount of plaque before and after brushing was documented with high-resolution images that were then assessed by the laboratory's dentist. The level of plaque was assessed individually for each tooth and tooth side, before and after brushing.

— This was a very extensive and demanding test where we took more than 3,600 images which were then sent on for analysis by our specialists in France, says Dr. Ines Sellami at SGS Institut Fresenius who conducted the clinical study. The result for each brush head is based on an assessment of nearly 1,800 teeth and tooth sides. What conclusions can be drawn from the results – was there any difference in plaque removal?

— The differences between the different variants were smaller than expected, perhaps due to the fact that they all use the same rotating brush technology. But you can still see a significant difference between the best and worst heads in the test, says Dr. Ines Sellami. Oral-B has the best plaque removal, which removes more than twice as much plaque on the inside of the teeth compared to the worst in the test - Danish Budget. On the outside, the differences are smaller with 32 percent for Oral-B compared to 23 percent for the worst - Danish Budget and Pepsodent. According to the manufacturers, you should change the brush head every three months, which is equivalent to six hours of brushing, if you brush four minutes a day. At RISE laboratories in Mölndal, they tested how the brushes were affected after a period of use. All brush heads had to move with a certain pressure against a tooth profile, both straight from above and at a 45° angle.
Pepsodent and Jordan were visibly affected after 360 minutes of brushing, but the hardness changed more or less for all brush heads.
The rotating movement of the brush head is important for cleaning the teeth. At the PZT laboratory in Germany, the so-called rotation angle was measured - how many degrees to the right and left the head rotates. Since it makes close to 8,000 movements per minute, a high-speed camera was used to measure the angle.

— For Pirkka, ICA and Jordan, you could see a big difference in rotation angle after a period of use, which indicates a lower quality and endurance in the mechanism, says Thorsten Kutzner, responsible test operator at PZT. Perhaps most important of all is how it feels to brush with the different variants. To find out, 200 people (20 per brand) used the different brush heads for four weeks and then answered questions about comfort, any discomfort, pain or bleeding in the gums, hardness of the brush head, technical problems, cleaning ability and access to all teeth.

— How one experiences the brush head is highly individual and this is also noticeable in the users' assessment. However, some brush heads broke or detached from the handle which is quite remarkable, says Dr. Ines Sellami.

— Two brush heads stand out in the user assessment. On the positive side Oral-B which got good reviews from most of the users and on the negative Dentalux which both broke and got low reviews from the panel. Overall, the best result in the test goes to the original head from Oral-B. Then there are considerably cheaper alternatives, but based on the test results, you should probably avoid the cheapest ones.

Testfakta Research August 2022

About the test

Testfakta Research has, on behalf of Procter & Gamble, conducted a comparative laboratory test of replacement brush heads for Oral-B electric toothbrushes. The purpose of the test is to compare the quality and performance of Oral-B Cross Action and nine compatible brush heads on the Nordic market. The tests have been carried out by three independent laboratories where the German laboratory SGS Fresenius stands for clinical testing and panel examination, Swedish RISE for tests of endurance and durability and German PZT for tests of technical properties and performance. The following brush heads have been tested:

  • Oral B Cross Action
  • ICA Refill
  • Coop Replaceable brushes
  • Pirkka Vaihtoharja
  • Jordan Clean
  • Pepsodent Complete Care
  • Prego Sanigum
  • Budget Protect & Care
  • Plackers Perfect Angle
  • Dentalux Active Cross

All brush heads fit Oral-B toothbrushes in the Pro, Genius and Smart series. The test includes the following parts:

  1. Ability to brush away plaque (clinical test)
  2. Assessment of quality and feel (user panel)
  3. Endurance of the brush (technical test)
  4. Drop test (technical test)
  5. Brush pressure for the sensor to react (technical test)
  6. Rotation angle (technical test)

1. Ability to brush away plaque (clinical test)

The test was performed on a test panel consisting of 40 people. The panel was recruited based on specific criteria regarding plaque level, plaque build-up over 24 hours and general oral health. The ability to brush away plaque was tested 20 times per brush head. The panelists were randomly assigned to the ten different brush heads and each individual had to visit the laboratory five times to test the different brush heads. Before each visit, panelists were asked not to brush their teeth for 12 hours to allow for sufficient plaque build-up.

Photo documentation of plaque status. Photo: Tobias Meyer

Each visit began with staining of the teeth (plaque staining) followed by examination of the plaque level. After that, the panelist had to brush his/her teeth for a set time and according to careful instructions (the brushing was done under the laboratory's control). The teeth were then stained again and the plaque level after brushing was examined. Assessment of plaque was done on the inside and outside of the eight front teeth in the upper and lower jaw and the four inner cheek teeth. The level of plaque before and after brushing was documented with high-resolution photographs that were evaluated by the laboratory's dentist. Plaque status was assessed individually for each tooth on a five-point scale (Quigley Hines scale). The result per brush head is the average value of approximately 900 assessed teeth and tooth sides before and after brushing.

The dentist assesses the level of plaque based on high-resolution images. Photo: Tobias Meyer

2. Assessment of quality and feel (user panel)

For the user panel test, a total of 200 individuals were recruited and divided into groups of 20 per brush head.

laboratory prepares for testing the effectiveness of the brush heads. Photo: Tobias Meyer

Each subject was assigned an electric toothbrush (Oral-B Pro 2) equipped with one of the brush heads. During and after four weeks of home use, the panel members were asked to assess, among other things:

  • How well the brush head cleaned the teeth
  • If discomfort or pain was felt
  • The hardness of the brush
  • Technical problems or if the brush head broke
  • Durability
  • General assessment of quality and feel

3. The durability of the brush (technical test)

Before the test the properties of the brush heads were documented (weight, length, diameter, brush height and angle of the bristles).

The brush heads in the test rig during the endurance test for 360 minutes. Photo: Anna Sigge

The endurance of the brush head was tested for a total of 360 minutes, corresponding to three months of brushing (2 + 2 minutes per day). Brushing was done against a tooth profile and the angle of the head was changed between straight up, tilted 45° to the left and tilted 45° to the right. The brush head was pressed against the profile with a load of 400 grams on the handle (below the limit of the pressure sensor). A mixture of toothpaste and water was continuously dripped onto the brush head during the test. After completing the endurance test, the brush heads were thoroughly rinsed, examined under a microscope, and any change in brush hardness was measured.

Assessment of wear on the bristles after endurance test. Photo: Anna Sigge

4. Drop Test (Technical Test)

The electric toothbrush with an attached brush head was dropped in a controlled manner from 70 cm, from different angles onto a concrete floor. After each test, the function of the brush head and any damage was checked.

5. Brush Pressure for Sensor to Respond (Technical Test)

To measure the pressure required for the toothbrush's pressure sensor to respond, weights of 50 g were applied to the handle until the sensor lit up. During the test, the brush ran with the brush head against a 3D tooth profile.

6. Rotation angle (technical test)

Brush heads for Oral-B toothbrushes rotate at high speed left and right. The angle of rotation, from 0° to the left and right, was measured with the brush head rotating against a tooth profile. The rotation angle was recorded with a high-speed camera.

The laboratory measures the rotation angle with a high-speed camera. Photo: PZT

Measurements were made on new brush heads and heads subjected to endurance tests, both unloaded and with a pressure of 2N. Changes in rotation angle when the head is loaded and after a period of use were assessed in the test. Interpretation and grading of the laboratories' test results All test results have been graded in consultation with the performing laboratories. The grade is set on a scale from 1 to 10, where 10 is the best. Grades below 6.0 have only been given for results that are considered bad or significantly worse than other products in the selection. In the overall rating, the various test results have been given the following weight:

  1. Ability to brush away plaque (clinical test) 60%
  2. Assessment of quality and feel (user panel) 20%
  3. Brush endurance (technical test) 7%
  4. Drop test (technical test) 7%
  5. Brush pressure to the sensor should react (technical test) 0%
  6. Rotation angle (technical test) 7%

Brush pressure for the sensor to react has not been rated because the bristles on the different brush heads have different hardness.