When it comes to toothbrushes, the vast array of choices present in every store is enough to overwhelm and confuse the best of us.

First, there are the manual and powered toothbrushes that come in a vast array of colors, sizes, brush head types and technology modes.

Then there are the toothbrushes with tapered, angled, round or boxy heads. Some have neon, padded or gel handles that bend, others boast of 3D brushing action or bristles that fade when its time to replace your brush. Some have tapered or outer angled bristles, yet others flaunt their microfilament brush tips designed to reach underneath the gum line and in-between the teeth.

Some cost as little as a $2, yet others can burn a hole in your pocket costing upwards of $100, with their fancy ultrasound waveguided sonic technologies and multiple cleaning controls.

For kids, the options are even more endless with toothbrushes that sing a song while you brush and those that light up or come with cartoon characters on their handles.

When faced with so much choice, what should we be looking at when its time to buy a toothbrush? How do we pick the right one for us?

"It's like choosing tennis shoes," laughs Christopher Hughes, DMD, an implant, cosmetic and reconstructive dentist at Hughes Dental Arts in Herrin. "Should you pick the $20 one or the $120 shoe? The cheap toothbrush is going to be plainer; the bristles may wear out faster. My advice? Pick the best one you can afford."

When asked what kind of toothbrush he uses personally, Hughes says he uses the Philips Sonic Care. "It seems to be producing results," Hughes says. "It gets into nooks and crannies a lot more effectively than a power toothbrush and goes beyond simple brushing. Its more efficient and my mouth feels cleaner."

Angie Gobel, a dental hygienist at University Place Dental in Carbondale agrees. "I like using the Sonic Care myself. It's a sophisticated toothbrush with a timer and various modes like massage and sensitive teeth. It offers superior plaque removal and keeps your teeth whiter."

Priced at anywhere between $90-150, the toothbrush which comes in various models, does seem a bit pricey. But Hughes points out that if good oral health is a priority the investment is minimal for getting good results.

Backed by more than 140 abstracts representing clinical and laboratory studies at over 40 universities and research institutions worldwide, the Philips Sonicare is considered by some to be the Cadillac of toothbrushes. Available at dental offices throughout Southern Illinois for a slightly lower cost, the super deluxe model even comes with its own miniature decontaminating chamber. A UV light cleans the bacteria on the toothbrush after you are done brushing!

Of course experts say if you own a fancy toothbrush but don't use it as intended it can hurt you more than it can help you. When in doubt ask your dental hygienist to demonstrate. There is no shame in it.

For those who don't want to invest big bucks on a toothbrush, it's a good idea to choose a vibrating toothbrush rather than a manual one.

"The average adult brushes for less than 40 seconds," Gobel says. "The recommendation is 2-3 minutes at least. That's why I like electric toothbrushes because their built in timers encourage you to brush for the proper length of time. Also, they help remove plaque better than conventional toothbrushes."

Studies published in both the American Journal of Dentistry and the British Dental Journal agree that electric toothbrushes are more effective at removing plaque and reducing gingivitis than manual ones.

The American Dental Association currently recommends electric toothbrushes, particularly for people with manual dexterity problems or other physical limitations (such as arthritis) that might make it difficult to use manual toothbrushes.

However this doesn't mean that a manual toothbrush is ineffective. If you are buying a manual toothbrush, Gobel says you need to look for a small, rounded head, which will effectively reach all areas of your mouth. Beware of toothbrushes with acute curves as they can hurt you.

"Look for an angled toothbrush with a medium soft bristle," Hughes days. "The size and shape of the brush should fit your mouth comfortably, allowing you to reach all areas easily."

According to Hughes, a very coarse bristle can damage your teeth and gums, so a medium soft bristle is best.

For children, look for small headed toothbrushes with big textured or contoured handles for easy gripping. The singing toothbrushes can be fun motivators to brush fist thing in the morning.

The songs are usually timed for a little over two minutes so that the child brushes for the right period of time. The bristles should be soft enough to brush a soft tomato without hurting it.

No matter what type of toothbrush you choose, the ADA recommends that you brush twice a day, with a fluoride toothpaste to clean your teeth thoroughly and to provide fluoride protection against decay.

If plaque, an invisible sticky layer of germs and bacteria that forms naturally on the teeth and gums, is not removed regularly, it turns into tartar and eventually causes gum disease, which is also known as periodontal disease.

"That's why it's really important to floss in addition to brushing your teeth everyday," Hughes says. "Decay-causing bacteria still linger between teeth where toothbrush bristles can't reach."

For those with a huge gag reflex or conditions such as arthritis that make it difficult to floss the traditional way, a floss holder can work very well, by holding the floss in place for you.

"Good dental hygiene is important for oral and systemic health," Hughes says. "This is something we have to follow and also teach our children."

Change your brush every 3-4 months at a minimum. If you notice the bristles getting out of shape sooner, its time to change your brush.

"When you pay so much for dental work, a little bit of prevention goes a long way," Gobel says. "In addition to brushing and flossing your teeth regularly, make sure you visit your dental office regularly for professional cleanings and oral exams. In the end, the best toothbrush is the one that gets used."

Did you know?

Before the Chinese invented the toothbrush using the stiff hairs from a hog's neck, attached to a bamboo stick, people used everything from toothpicks, to chew sticks, tree twigs, strips of linen, bird feathers, animal bones and porcupine quills to clean their teeth with.

Toothbrushes have come a long way indeed from those days. The nylon-bristled toothbrush, as we know it today, was invented in 1938.