Used once tooth brushes are new. Waterpik Sonic-Fusion 2.0 Professional flossing toothbrush. It is an electric toothbrush with a built-in water flosser. It combines brushing and flossing into one step. It has two speeds and three modes: brush, floss, or brush and floss together. It is clinically proven to be twice as effective as traditional brushing and flossing. The Waterpik Sonic-Fusion 2.0 is accepted by the American Dental Association (ADA) for safetv and effectiveness. It comes with multiple brush heads, a travel case, and a timer. It has global voltage and a removable water reservoir. It is recommended by dental professionals.