What's in a Brush?

     The first toothbrushes were most likely branches with small, sturdy foliage. Brushes sure have changed over the years but the concept remains the same: when sticky plaque builds up on teeth you need some kind of mechanical scrubbing action to get it off. When you combine a brush with something abrasive (enter toothpaste) then you really have an efficient combination for removing the gunk and junk that is left after meals.

     As a dentist, I get asked about toothbrushes all the time. As any trip to your local pharmacy will prove there are a dizzying array of choices available, from the tried-and-true manual brush to battery-operated spinning brushes as well as the high-end rechargeable power brushes. Many of these (especially the more expensive models) claim to be the best brush out there for keeping dental problems away. Is there a best brush? Despite all the ads, research doesn't give us a clear cut answer. What we do know is this: any brush out there can effectively remove decay-causing plaque from your teeth if it's used correctly. That means that with the right technique, the $2 model can be just as good as the $200 one.

     So what's the right technique? The dental profession has given names to all sorts of techniques over the years, and the current one that stands out right now is called the modified Bass technique: small, circular motions with the brush held at about a 45 degree angle so it's touching both tooth and gum at the same time. Move from tooth to tooth slowly, taking 2-3 minutes to do your whole mouth. Be sure to get the backs of all your molars, where food often collects after a meal.

     Is it really that simple? It can be. Where people run into problems is by speeding up the process (three minutes is actually a really long time when you're watching the clock) or by using too much force. While taking shortcuts will leave plaque on your teeth that can harden into tartar, using too much force gets your teeth too clean. Clean, smooth teeth are definitely what you want, but brushing too hard will wear away enamel and even gum tissue over time, creating large defects that can tarnish your smile and require fillings, crowns, or gum grafting to correct. The ideal pressure is just enough to remove food and no more. Realize that toothpaste is mostly pumice, so it doesn't take much force at all to scrub your teeth clean.

    So is there a place for electric brushes? While they aren't necessarily better, they can be more convenient. They take the guesswork out of the small circles, so they difference is sort of like a push lawnmower versus a walk-behind model. Also, the spinning action works well enough that little-to-no pressure is needed, so if you're prone to recession these brushes can be better for you. If you're concerned about the price tag, the $8-10 models that run on AA batteries or are disposable can be a great 'test-run' before you decide if you want to commit to one with more bells and whistles.

   A more expensive brush is not a guarantee of less dental problems, but it might be for you. If you're keeping problems at bay with the $2 model though, there might not be any advantage to switching. If you're wondering if what you're hearing is hype or not, your dental team can guide you in the right direction.