Electric toothbrushes

[BigFKahuna]

Curious what your take is on the evidence for cleaning frequency.

Oral Health

Whether you're considering cosmetic dentistry, need answers to a dental problem, or just want to improve your daily dental care, you'll find the information you need to keep your smile in top shape.

www.webmd.com

Best is to know what we are trying to achieve, and why. Caries (cavities) are the result of acid attack on mineralized dental tissue....ie teeth. Typically the acids are the result of an undisturbed bacterial colony residing on a tooth for a period of time, in the presence of a fermentable carbohydrate. Technically, sugar alone does NOT cause cavities. Disturbing the bacterial colonies once every 24 hours is essentially enough to prevent the production of acids that result in demineralization, so the thinking is that brushing (and flossing) once daily will suffice. However, as most people don't get all the nooks and crannies, it is often recommended to brush after every meal in order to get the spots that one misses....problem is that most people tend to miss the same spots when brushing. The bacteria (and dental plaque) must be disturbed mechanically, this rinsing with water alone does not suffice. Rinsing with an anti-bacterial agent helps, sometimes more than brushing for some people. Chlorhexidene being the most effective. Xylitol is very effective at the prevention of cavities, its use in mouthwashes and toothpastes might be more effective than fluoride. To address what another poster said...there are no well designed double blind controlled studies to show the efficacy of fluoride (in drinking water or toothpaste or as an additive...I actually forgot which, might be all).

In general toothpastes are there for Crest and Colgate to make money, and that fleeting clean minty feeling. Lots of things work better, including brushing, flossing and eating aged cheese after a meal. I still use toothpaste all the time, but I try to buy my fav brand when it is on sale.

Gum disease, gingivitis and periodontitis are a little different, but essentially the once daily routine will do the trick here as well.

Oral-B, Sonicare and manual brushes are all good, but the powered brushes with soft bristles get you there faster and possibly with less harm. And that is the thing....you want to do good and cause as little harm as possible. There is such a thing as too much brushing.
Flossing gets spots a water flosser does not, and vice versa. A water flosser might be better for those that exhibit gingival recession and open contacts and embrasure spaces.

Of course, your mileage might vary. There are people more or less susceptible to disease, but the above is a starting point from which adjustments can be made.

As well, always have a companion that is willing to tell you if you have chicken or broccoli in your teeth. And, better to rinse that out with water, either at the table discretely or in a washroom. Toothpicks in general cause more harm than they are worth and only look good in a dive bar or pool hall.

 

[ahofer]

Best is to know what we are trying to achieve, and why. Caries (cavities) are the result of acid attack on mineralized dental tissue....ie teeth. Typically the acids are the result of an undisturbed bacterial colony residing on a tooth for a period of time, in the presence of a fermentable carbohydrate. Technically, sugar alone does NOT cause cavities. Disturbing the bacterial colonies once every 24 hours is essentially enough to prevent the production of acids that result in demineralization, so the thinking is that brushing (and flossing) once daily will suffice. However, as most people don't get all the nooks and crannies, it is often recommended to brush after every meal in order to get the spots that one misses....problem is that most people tend to miss the same spots when brushing. The bacteria (and dental plaque) must be disturbed mechanically, this rinsing with water alone does not suffice. Rinsing with an anti-bacterial agent helps, sometimes more than brushing for some people. Chlorhexidene being the most effective. Xylitol is very effective at the prevention of cavities, its use in mouthwashes and toothpastes might be more effective than fluoride. To address what another poster said...there are no well designed double blind controlled studies to show the efficacy of fluoride (in drinking water or toothpaste or as an additive...I actually forgot which, might be all).

In general toothpastes are there for Crest and Colgate to make money, and that fleeting clean minty feeling. Lots of things work better, including brushing, flossing and eating aged cheese after a meal. I still use toothpaste all the time, but I try to buy my fav brand when it is on sale.

Gum disease, gingivitis and periodontitis are a little different, but essentially the once daily routine will do the trick here as well.

Oral-B, Sonicare and manual brushes are all good, but the powered brushes with soft bristles get you there faster and possibly with less harm. And that is the thing....you want to do good and cause as little harm as possible. There is such a thing as too much brushing.
Flossing gets spots a water flosser does not, and vice versa. A water flosser might be better for those that exhibit gingival recession and open contacts and embrasure spaces.

Of course, your mileage might vary. There are people more or less susceptible to disease, but the above is a starting point from which adjustments can be made.

As well, always have a companion that is willing to tell you if you have chicken or broccoli in your teeth. And, better to rinse that out with water, either at the table discretely or in a washroom. Toothpicks in general cause more harm than they are worth and only look good in a dive bar or pool hall.

Thanks, the article I linked is about cleaning at the dentist, questioning (for some) the 6 months frequency all dentists seem to recommend.

 

[BigFKahuna]

Thanks, the article I linked is about cleaning at the dentist, questioning (for some) the 6 months frequency all dentists seem to recommend.

Oh shoot! I should have followed that link, sorry! I assumed number of times per day by toothbrush...and ya.....my bad!

For myself, I have had my teeth cleaned once in the pst five years, and the person doing the cleaning thought I must have had it done just a few months ago. So no, not everyone needs to go every 6 months or every year even. (Same goes for x-rays). History of no cavities, no gingivitis or other issues and good oral hygiene and you are good for a long time. In fact the best dental plan is the daily proper use of brush and floss.
For those that always seem to get cavities or have gums that persistently bleed or otherwise, sometimes every three months is not enough.

The worst is when the frequency of dental visits happens to coincide with exactly what a person's dental benefits will allow.

 

[Digby]

Toothpicks in general cause more harm than they are worth and only look good in a dive bar or pool hall.

Why is this, wood & plastic alike?

 

[BigFKahuna]

Why is this, wood & plastic alike?

Generally, yes. The physical trauma to the gingival tissues and wearing away of tooth structure is often worse than what you are trying to resolve. Gums get pushed down resulting in large spaces between the roots of teeth, and the teeth themselves get worn away so that the roots become thinner. There were some brands of soft, flexible picks that were better. As well there are inter proximal brushes that are designed to clean between teeth, but those are best if you already have a space or for under something like a dental bridge.
If you have teeth like mine where in a few spots food seems to collect, better to swish with water or tease out what you need to gently, rather than going between the teeth. When no one is looking, of course!

 

[digitalfrost]

That scares me, I've been using metal toothpicks for years.

 

[BigFKahuna]

That scares me, I've been using metal toothpicks for years.

If your dentist has not freaked out then no worries. But, good to ask about it next time you do go for an exam.

 

[Digby]

Generally, yes.

Thank you for reply. This is fascinating.

The reason I use picks is because many of my teeth (esp molars) are tight at the top and the floss just breaks. I don't much like the idea of forcing them apart from the top either. Should I try the flexible picks...what do you suggest?

 

[Glen20]

Thanks, the article I linked is about cleaning at the dentist, questioning (for some) the 6 months frequency all dentists seem to recommend.

I can say that is definitely not true for all dentists, for all patients all of the time

Study ….“showed that one yearly cleaning is likely to be enough for patients with no risk factors," he said. "Patients with one or more risk factors, which represent over half of the population, should visit at least twice a year and likely more in some cases.

This is for healthy patients with no gum disease only. If you have gum disease ( which you may not even know about. Usally Only painful when it is so advanced you are about to lose the tooth) the above does not apply

 

[Berwhale]

There might be compounds that are more effective and safe, such as Xylitol for caries prevention

Just make sure you keep it away from your dog...

Xylitol Toxicosis in Dogs: An Update - PubMed

Xylitol ingestions in dogs may result in severe hypoglycemia followed by acute hepatic failure and associated coagulopathies. Aggressive treatment may be needed, but the prognosis is generally expected to be good for dogs developing uncomplicated hypoglycemia. Because of increased availability...

pubmed.ncbi.nlm.nih.gov

Personally, I use Smint https://www.smint.co.uk/products/smint-mint-100-pieces

Although I find ingesting the 5g or 6g a day of Xylitol can sometimes lead to other undesirable effects.

 

[Glen20]

Thank you for reply. This is fascinating.

The reason I use picks is because many of my teeth (esp molars) are tight at the top and the floss just breaks. I don't much like the idea of forcing them apart from the top either. Should I try the flexible picks...what do you suggest?

There many different types. try:
. Thinner floss
. Waxed floss
. Teflon floss tape
. Reach daily flosser to bite on to floss through contact handle
. Nylon (what most floss is made of )thread from sewing shop

 

[digitalfrost]

I swish with Xylitol before brushing. I simply buy it in 1kg sacks and use about a teaspoon of it.

 

[Glen20]

Just make sure you keep it away from your dog...

Xylitol Toxicosis in Dogs: An Update - PubMed

Xylitol ingestions in dogs may result in severe hypoglycemia followed by acute hepatic failure and associated coagulopathies. Aggressive treatment may be needed, but the prognosis is generally expected to be good for dogs developing uncomplicated hypoglycemia. Because of increased availability...

pubmed.ncbi.nlm.nih.gov

Personally, I use Smint https://www.smint.co.uk/products/smint-mint-100-pieces

Although I find ingesting the 5g or 6g a day of Xylitol can sometimes lead to other undesirable effects.

Also need to use xylitol 5x a-day to be effective

 

[Glen20]

That scares me, I've been using metal toothpicks for years.

The risk to your overall health and health of teeth and gums from gum disease or caries is far greater than the risk of damage due to aggressive interproximal cleaning

 

[Berwhale]

Also need to use xylitol 5x a-day to be effective

Indeed and I find that's easier to achieve with mints or gum than with toothpaste.

 

[Glen20]

The frequency of daily complete plaque removal by the patient (brush/floss/rinse/ fluoride/xylitol waterjet etc) to maintain oral health is dependent on multiple factors which change over a person’s life. So a recommendation is only valid for that person, at that time depending on the current health of their body, mouth and diet.
The cleaning regime to eliminate disease is much stricter than that to prevent disease for a healthy patient with a healthy mouth and a healthy diet.
Once daily complete plaque removal (and for some ,even twice daily )is not sufficient to remove disease if /once present.

 

[BigFKahuna]

There many different types. try:
. Thinner floss
. Waxed floss
. Teflon floss tape
. Reach daily flosser to bite on to floss through contact handle
. Nylon (what most floss is made of )thread from sewing shop

I agree, try different brands of floss. Teeth are actually normally able to move, easing floss between the teeth does no harm at all.

 

[BigFKahuna]

Just make sure you keep it away from your dog...

Xylitol Toxicosis in Dogs: An Update - PubMed

Xylitol ingestions in dogs may result in severe hypoglycemia followed by acute hepatic failure and associated coagulopathies. Aggressive treatment may be needed, but the prognosis is generally expected to be good for dogs developing uncomplicated hypoglycemia. Because of increased availability...

pubmed.ncbi.nlm.nih.gov

Personally, I use Smint https://www.smint.co.uk/products/smint-mint-100-pieces

Although I find ingesting the 5g or 6g a day of Xylitol can sometimes lead to other undesirable effects.

I agree with the ingestion part! I do prefer to use xylitol only in pastes or rinses. For those that are very prone to getting cavities the product you linked would be a good adjunct. Or perhaps a paste with hydroxyapatite or even fluoride.

 

[BigFKahuna]

The frequency of daily complete plaque removal by the patient (brush/floss/rinse/ fluoride/xylitol waterjet etc) to maintain oral health is dependent on multiple factors which change over a person’s life. So a recommendation is only valid for that person, at that time depending on the current health of their body, mouth and diet.
The cleaning regime to eliminate disease is much stricter than that to prevent disease for a healthy patient with a healthy mouth and a healthy diet.
Once daily complete plaque removal (and for some ,even twice daily )is not sufficient to remove disease if /once present.

Of course every patient is different. The mouth is intimately connected to the rest of the body, and dental disease is certainly multifactorial. Once we start talking about exemptions to the norm then treatment plans and recommendations certainly become more involved. That is why one treats each individual individually.

 

[Longshan]

Better than manual, the same, worse? What do you use and is there any solid science on this?

Powered versus manual toothbrushing for oral health

Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously ...

www.ncbi.nlm.nih.gov

MAJOR CAVEAT: Most people use their electric toothbrushes like manual ones, and ∴ apply too much pressure. Don't do that, unless you hate having enamel covering your teeth.