Panasonic Doltz EW-DJ52 Jet Washer Doltz Oral Irrigator Cordless "Jet Washer" removes dirt with a powerful water stream. The unique ultrasonic water stream technology powerfully removes dirt from areas that are difficult for a toothbrush to reach. Everything in the photos is included. Instruction manual is not included. (Please refer to the manufacturer's website for instructions.) Used a few times. Operation confirmed. I have cleaned it thoroughly, but it is a used item, so please consider this before purchasing. When replacing the nozzle, please purchase Panasonic EW0983-X [Ultrasonic Water Stream Nozzle].