What’s our Best Advice to your patients when it comes to ToothBrush:
Our patients rely on us to give them advice on their oral hygiene especially when it comes to prevention. And, sometimes we are caught unaware of what’s really true and correct ourselves. There are times that the basic things that we thought we know are the very things we actually don’t know as we take them for granted that we should already know. Thus, we never ask ourselves if they are true or correct.
So, allow DMD Center to delve into some of the basic questions when it comes to oral hygiene, the brushing of one’s teeth which also means we need to discuss its main tool, the toothbrush.
What do we recommend and its explanation:
There are different kinds of toothbrush bristles available in the market, there’s Soft, Medium and Hard Nylon Bristles. As we don’t know how our patients really brush their teeth, how vigorous they do it and memorize the current state of all their teeth, then, the best bet to advice them is to choose the soft bristle with rounded tips. For the vast majority of people, a soft-bristled toothbrush will be the most comfortable and safest choice not to damage the gums, root surface, and protective tooth enamel.
The main cause why tooth brushing fails is that majority of our patients don’t really brush all areas of their teeth. Why? Because besides being lazy to do it, one of the reasons is that their toothbrush is too big to access all areas of their teeth especially for hard-to-reach areas such as the sides and backs of their molars. Some sizes also cause them gag reflex, thus, they don’t try anymore to do it. For most adults, a toothbrush head a half-inch wide and one-inch tall will be the easiest to use and the most effective. Though there are larger toothbrush heads available and assumes it will cover faster all areas, they may find larger head cumbersome to maneuver. Moreover, the toothbrush should have a long enough handle so one can comfortably hold it in one’s hand.
MANUAL AND POWERED TOOTHBRUSH
We all know as professionals that it is the manner and how long we brush our teeth that matters, however, as per our discussion, the toothbrush must at least be ideal to do the deed.
For disposable toothbrush, bristles should have:
(a) safe tips
(b) the bristles should not fall out of the toothbrush under typical brushing conditions
(c) the handle should withstand normal use
For the powered toothbrush should have undergone safety testing in an independent lab and proven through clinical trials that the toothbrush is safe for use on the tissues of the mouth and teeth, as well as any dental hardware that may be in place.
Talking about research, a research was conducted by a team led by Munirah Yaacob, on behalf of the Cochrane Oral Health Group. Helen V. Worthington, Scott A. Deacon, Chris Deery, A. Damien Walmsley, Peter G. Robinson and Anne-Marie Glenny were also on the team. And, they found that powered toothbrush compared to a manual toothbrush had plaque reduced by 11% after one to three months of use, and by 21% after three months of use. For gum inflammation, there was a 6% reduction after one to three months of use, and an 11% reduction when assessed after three months of use. So, what are the implications for dentists and the general public? This review has found that compared with manual toothbrushes, powered toothbrushes are more effective in reducing plaque and gum inflammation. However, there were inconsistencies in the trials when it comes to cost, reliability and side effects.
Then, what should you advice to your patients? It’s basically per your assessment to your patient which is best to advice as we’ve mentioned above what’s critical in tooth brushing. On my part, I advice non-compliant patients the powered toothbrush while those who are compliant will be dependent on their choice of convenience and willingness to spend and invest more on the cost of a toothbrush.
The world is changing and people are aware now that we need to take care not only ourselves but also the environment we live in.
(a) Bamboo Handles - Regular toothbrushes are typically made from BPA or PVC based plastics. Both the handles and bristles can potentially leave toxic microplastics in your mouth and digestive system. As mentioned, as most toothbrushes are made of Nylon Bristles and BPA, this PVC plastics take around 400 years to degrade once they are thrown into the landfill. Once they do degrade, what will happen is they will break up into smaller microplastic pieces which are dangerous to humans and animals alike? These microplastics will end up leaching through the environment into the rivers and eventually oceans which current predictions estimate that over 100 million marine animals die each year due to marine debris. Thus, we must do our share in protecting our environment.
Recently, the use of Bamboo toothbrush is becoming popular. The original bamboo toothbrush was invented by a Brisbane Dentist who crafted the handle from natural cellulose fibre to minimise the environmental impact of dental care. Bamboo is a fast-growing grass, which eliminates the need for deforestation and quickly biodegrades when exposed to the natural environment. In comparison to plastic toothbrushes, bamboo as a material is antibacterial. This means it can last longer and minimise the number of microbes being transferred to your mouth.
So, as dentists if you want to partake in decreasing these plastic toothbrushes waste on their impact on the planet’s resources, make sure to opt for toothbrushes which are biodegradable and packaged in the same materials, such as cardboard. Bamboo toothbrushes are a quick and easy solution to allow people to live a greener life, while not skimping away on their oral health.
(b) Charcoal Bristles - Similar to regular toothbrush, a charcoal toothbrush has the same shapes and designs with the common bristles on the brush head. However, the difference is that those bristles are infused with charcoal rather than being standard nylon/synthetic bristles that simply sweep and capture bacteria and debris. It actually claims to absorb plaque better wherein it supposedly absorbs and binds bacteria together, thus, reducing and remove the bacteria from the mouth in comparison of just sweeping the debris away. It is also said that it reduces bad breath and odor wherein its carbon absorbing properties that removes plaque and tannins, can also remove the bacteria that causes one to suffer from bad breath. And, the most drawing advantage of these charcoal products is its claim to whiten teeth wherein the activated charcoal in the bristles of the brush absorbs the tannins that bind to one’s teeth that causes stains.
Charcoal is a natural ingredient and has been around for quite some time for addressing oral hygiene, but, only just became recently popular due to people’s search of using organic ingredients and materials. The benefits mentioned above are claims of all charcoal products use in toothpaste and toothbrushes.
It is worthy to take note that there is actually very little clinical evidence to prove these claims, although there has been a couple of studies by Kaur et al and Lee et al that do show charcoal containing toothbrushes attract fewer bacteria when compared to normal toothbrushes. Having said that, the lack of evidence does not mean the claims aren’t true, it just means they aren’t proven yet. So, when it comes to this, you just have to be upfront to your patients in giving your 2-cents on this issue
Between manual versus powered and bamboo made versus plastic made, price will be part of the considerations especially for financially-challenged patients. Thus, cost will really be a part of what we can recommend and be advisable to your patients. As cost boils down also to the percentage of demand in the market, us as dentists and your patients as consumers can do make a difference on the cost on the products we buy. The more demand means the more production means the more competition equals the cheaper it gets. Initially, it boils down to us influencing and changing the course of how our patients will buy their oral hygiene products, so, it’s up to us to decide if price is really that important now at any circumstances versus the cost of later in our environment. It’s up to you.
As the chosen tool is as important to implement and achieve proper toothbrushing, whichever you may go in your recommendations, nothing will replace your right advice for your patients to do the right way of achieving good oral hygiene:
- Brush your teeth twice a day with a soft bristle brush
- Replace your toothbrush every three to four months
- Use our recommended fluoride toothpaste.
And, advice on correct tooth brushing technique and method:
- Place your toothbrush at a 45-degree angle to the gums
- Move the brush back and forth in tooth wide strokes
- Brush the outer surfaces, inner surfaces, and carefully in the chewing surfaces
- Tilt the brush vertically and employ up and down strokes to get to the inside surfaces of your front teeth.
So, the key priority for us to emphasize on our patients is truly on how well and frequently they brush their teeth, along with ensuring regular dental check ups with us to ensure their oral health.
Dr. Jean Galindez - Writer