A toothbrush includes a handle, and a head at an end of the handle having a thickness, a first surface, and an opposed second surface. Tooth cleaning elements extend outwardly from the first surface and have a length. A tissue cleanser is positioned on the second surface and has a plurality of tissue engaging elements and a height. A head height includes the thickness of the head, the length of the tooth cleaning elements, and the height of the tissue cleanser, and is less than 17.7 mm.
