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When using a Philips Sonicare toothbrush with pressure sensor, is it possible to cause gum damage when pushing too hard?

Some of their toothbrushes have a pressure sensor. When you push too hard, it buzzes to warn you, and reduce its power to protect your gums.

Let's say the toothbrush is angled poorly so that the pressure wasn't evenly distributed. Is it possible to cause gum recession? Does the pressure sensor take into account the possibility of aiming it poorly?

Let's assume that inflammation was taken into account because when the swelling reduces, the gum line is lower.

I noticed that my gums were a little raw when I didn't angle it properly for my upper molars on the buccal side. Is that a sign of gum damage? Since my gum line was uneven from recession, it was difficult to find the gum line of my teeth.

Update: After almost a year of using the toothbrush, my dental hygienist noted about 0.5mm of gum recession on some areas. We're supposed glide the toothbrush, letting it do the brushing rather than using our muscles to do the brushing.

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    When it comes to specific products I think the manufacturer would be the best source of information. – Carey Gregory Oct 2 '18 at 14:30
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Q: When using a Philips Sonicare toothbrush with pressure sensor, is it possible to cause gum damage when pushing too hard?

Yes, absolutely. That is the reason for the pressure sensor. It warns the user but the user may override this warning and continue. But see hte last quote on how influential pressure force is across the board.

Lets you know when you're pressing too hard You may not notice if you’re brushing too hard, but your toothbrush will. If you start taking it out on your gums, the toothbrush will make a pulsing sound as a reminder to ease off on the pressure.

Most products from this manufacturer seem to provide a special "sensitive" for, well sensitive teeth and gums. But they seem to not include the matching brush head?

Sensitive and Gum Care cleaning modes are provided, but no Sensitive brush head, this is an optional extra.

The producer itself says this:

Troubleshooting

My gums are tender after using my Sonicare toothbrush?

Sometimes your gums feel tender after brushing with an electric Philips Sonicare toothbrush. Find out what could be the cause and how to prevent it. Common causes and solutions

If you have a gum disease, if you haven't been using an electric toothbrush before or haven't maintained regular gum care, some tenderness may occur. Apply only light pressure on the Sonicare when brushing your teeth and gums. Your gums should become less tender within a few days of use. If you still have concerns, consult your dental professional.

And the company wants you to stay calm:

Can the speed of the Sonicare toothbrush harm my gums?

A Philips Sonicare electric toothbrush behaves differently than a manual one. Be sure it cannot do any harm. Philips Sonicare toothbrushes will not harm your gums

Sonicare toothbrushes have even been shown in studies to be gentler on dentin than a manual or an oscillating toothbrush. While gentle, Sonicare technology cleans effectively by:

Gently whipping toothpaste and saliva into an oxygen-rich foamy liquid Directing the liquid between and behind teeth, and along the gum line where plaque bacteria flourish Gently massaging the gums, stimulating blood circulation and helping to dislodge plaque

The Philips Sonicare DiamondClean, FlexCare+ and FlexCare toothbrushes come with special Gum Care and massage modes to assure even more comfort for sensitive gums. Gum Care mode provides two minutes of complete whole mouth cleaning, with one additional minute of gentle cleaning for problem areas and along the gum line. Massage mode uses our patented technology to drive fluids to stimulate gums, resulting in healthier gums.

Note that I searched for pressure at the manufacturers site and was presented with an overly specific search result talking about the speed!

The marketing phrases should not be taken at face value anyway. But on the other hand, following the 'advice' given out by that sensor is a great tool:

Contrary to some research that indicates the superiority of power toothbrushes to manual toothbrushes, a recently published analysis of selected studies by Heanue et al. found that only one type of power toothbrush was more effective at removing plaque and decreasing gum disease than manual brushes. The study, whose ®ndings were published in early 2003 in the Cochrane Library, was conducted by a British-based non-profit health research group called the Cochrane Collaboration.

Heanue et al. concluded that the only category of power toothbrushes that cleaned better than manual toothbrushes were those that worked with rotation±oscillation action, with brush heads

Gingival abrasion and safety
The safety of power toothbrushes has been clearly established, and research indicates that daily use of a power toothbrush is at least as safe as a manual toothbrush (15). It is widely believed that use of a powered toothbrush, which employs a mechanical action instead of a manual action, reduces brushing force and the incidence of gingival bleeding because of gum damage. In a study by Danser et al., it was observed that brushing force was not influenced by the speed of the brush head and had no correlation with the incidence of gingival abrasion. In another study by Boyd et al., it was determined that power toothbrushes were used with about one-third the force of a manual toothbrush.

In a Swiss study evaluating the clinical effects and gingival abrasion aspects of two power toothbrushes and one manual toothbrush, it was determined that in a group of dental students trained in manual brushing technique, where efficacy was similar with the three toothbrushes tested, there was no evidence of greater gingival abrasion with either powered toothbrush when compared with a manual brush.

The concerns of gingival abrasion associated with tooth brushing are influenced by the filament end-rounding of the brush on either manual or power toothbrushes. The results of the Danser et al. study concluded that end rounding has no effect on plaque removal, but does affect the incidence of gingival abrasion. They showed that gingival abrasion is not influenced by brushing force, but is affected by filament end rounding.

Catherine Penick: "Power toothbrushes: a critical review", Int J Dent Hygiene P, 2004; 40–44. DOI: 10.1111/j.1601-5037.2004.00048.x

Summary

It is possible to negatively influence gums by using powerbrushes. But the pressure with which they are used is usually already smaller than manual brushing with most people. Pressure is also a much smaller factor to consider, usually, than too bristles that are not well rounded. Still, gently does it.

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