№ 48 · CARE
Soft, medium, ultra-soft: how to actually read toothbrush hardness
June 20, 2026 · QDRO
Walk into any pharmacy and you will find three options: soft, medium, hard. Most people reach for medium because soft "seems weak." Dentists recommend soft. This is not an opinion — it is the ADA position, backed by clinical data.
There is a genuine paradox here. The toothbrush that "feels like it is doing something" and gives you that scrubbed-clean sensation is often the one causing the most long-term damage. Let us look at why that gap exists and what it means in practice.
Why "harder = cleaner" is imprecise logic
Dental plaque is a biofilm. It is soft, moist, and comes off with gentle mechanical motion. Removing it does not require force — it requires the right contact.
Hard bristles do not penetrate the gingival sulcus — the groove between tooth and gum where plaque accumulates. They press against the surface and scrape. Soft bristles, when angled correctly (45° toward the gum line, as in the Bass technique), flex and slide under the gum margin — exactly where the plaque is.
A soft brush, used with correct technique, cleans just as well. That is not marketing — it is what the clinical literature says.
What happens to gums with a hard toothbrush
Gingival recession is irreversible. Tissue does not grow back. It retreats under cumulative mechanical load built up over years.
A 2019 systematic review by Ranzan et al. (PubMed 30152076) analyzed 13 clinical studies and found that hard toothbrushes caused significantly more soft-tissue damage than medium or soft. Soft and extra-soft bristles showed the fewest adverse effects across all studies reviewed.
The ADA states this plainly: soft bristles with rounded tips are the standard for daily use. Medium and hard are only appropriate in specific clinical contexts, under professional guidance.
Gums do not signal distress until the damage is already done. Recession is visible only in retrospect.
The core problem: "soft" means different things at different brands
ISO 22254 is the international standard that measures bristle bundle stiffness. But it does not specify at which value a brush is called "soft" versus "medium." Every manufacturer decides that independently.
The result: one brand's "medium" may be softer than another brand's "soft." A patient who follows their dentist's advice to "get a soft toothbrush" is entering a lottery.
Two honest approaches to labeling
The market has developed two ways to make toothbrush hardness more legible.
Approach 1: words. Soft / medium / hard / x-soft / sensitive / ultra-soft / mild. Intuitive, but without a shared scale. Oral-B, Colgate, TePe, and most mass-market brands use this logic. TePe's X-Soft gradation is more precise than a plain "soft" — but the boundary between one brand's X-Soft and another's Soft is still undefined.
Approach 2: numbers. The count of individual filaments is used as a proxy for density and load per unit area. More fine filaments under the same hand pressure means a softer contact and a gentler touch on each point of the gum.
Curaprox built its naming system on this: CS 1560 has 1,560 CUREN filaments at 0.15 mm diameter; CS 3960 has 3,960 at 0.12 mm; CS 5460 has 5,460 at 0.10 mm; CS 12460 has 12,460 at 0.08 mm. The higher the number, the thinner the filaments and the denser the pack — meaning softer and more delicate. Revyline (a Russian manufacturer) applies similar logic: fewer than 5,000 filaments means medium-soft, 5,000–10,000 is soft, more than 10,000 is extra-soft.
| Brand | Labeling principle | Levels |
|---|---|---|
| Curaprox | Filament count + diameter (CUREN) | CS 1560 / 3960 / 5460 / 12460 |
| TePe | Word | X-Soft / Soft / Medium |
| Oral-B / Colgate | Word | Soft / Medium / Hard |
| Revyline | Filament count | less than 5,000 / 5–10k / more than 10k |
| President | Word + scenario | Sensitive / Soft / Medium / Ortho |
The trend: softness is the new premium
A decade ago, ultra-soft meant "for elderly patients" or "post-surgery." Today it means conscious care and advanced materials.
Growing numbers of diagnosed gingival recessions, periodontitis cases, and dentinal hypersensitivity are driving real demand. Manufacturers are responding: ultra-fine filaments at 0.08–0.10 mm, tapered tips, synthetic polymers with controlled stiffness — this is where the toothbrush market is growing.
Softness has stopped being a concession. It has become a signal that the manufacturer understands physiology, not just bristles.
What this means in practice
The label on the pack is a starting point, not the final word. Things worth checking:
- If your dentist said "soft," ask what they mean specifically. Or look for filament diameter on the packaging: less than 0.12 mm is genuinely soft, regardless of the printed label.
- A filament count in the product name (as with Curaprox or Revyline) is a more reliable signal than the word alone.
- For sensitive gums, recession, or orthodontic treatment — ultra-soft (0.10 mm diameter or below) with no compromise.
- A hard toothbrush does not clean better. It traumatizes more.
Sources: ADA Oral Health Topics: Toothbrushes (ada.org) · Ranzan N et al., Int Dental J 2019 (PubMed 30152076) · Clarkson et al., J Clin Periodontol 2021 (PubMed 34391550) · ISO 22254:2005 Dentistry — Manual toothbrushes · Curaprox CS product line specifications (curaprox.com) · Grand View Research, Manual Toothbrush Market 2024