If there’s a First Law of Oral Health, it must be Brush Your Teeth. Everybody learns this at a very early age. Who doesn’t know that brushing teeth is a healthful and necessary habit? Everybody knows it, and yet 23% of us report going two or more days without brushing. Young adults are the most negligent. Around 37% of Americans aged 18-24 let it go for two or more days. This group seems to try to make up for that by brushing 16 seconds longer ( when they finally get around to it) than the average. As will be seen, that doesn’t work. It’s not brushing right. The health and quality of life benefits from brushing right are clear, not at all controversial. Moreover, it’s just not that difficult to reap these benefits. A tiny bit of effort goes a long, long way.
It’s pretty simple. Brushing right acts to prevent you from getting sick. A secondary but real benefit is cosmetic. Brushing right helps keep your smile looking good and smelling fresh. Wait, did that say “acts to prevent you from getting sick”? Yes, that’s right. Tooth decay is a disease. In fact, it’s the most common childhood chronic disease. It’s not a trivial thing, either. Unchecked, that snowball rolls downhill into cavities, gum disease, and loss of teeth. And those are just the local problems. In kids, runaway tooth decay promotes all kinds of developmental issues, some with lifetime effects. In adults, the range of potential complications is formidable and even deadly. These include coronary artery disease, diabetes, pneumonia, dementia, and complications of pregnancy.
This shouldn’t be too surprising if one thinks about it. Our mouths, after all, are openings in our bodies. The gums, inner cheeks, tongue, and other tissues there are rich in blood vessels. Those blood vessels are pipelines to all the rest of the body. In addition, the air we breathe passes through or partially through our mouths. On its way to the lungs.
WHAT BRUSHING DOES
The detailed story of health and disease in our mouths is long and complex. It’s a well-studied subject. It makes good reading if you’re interested. For practical purposes, we don’t need to know it all. The important thing to understand is that brushing is a counterattack on bacteria. Certain bacteria are very well suited to living in our mouths. Some of these are unfriendly to their hosts. They scavenge for nutrition in there, and output acids that erode tooth enamel. Not only that, but they form “shelters” for themselves, that secure them at their “buffet”. Plaque and tartar are built up by these bacteria and counter our natural defenses. Brushing, in turn, counters the buildup of plaque, by removing it along with the bacteria living in it.
Bottom line, then, is brushing removes food residues and the disease-causing bacteria that eat them. That’s why we brush our teeth.
As suggested by the title, there are right ways and wrong ways to embrace the practice of brushing teeth. More accurately, there are better ways and less effective ways. We can describe the best practices in terms of a recipe with four ingredients: hardware, software, technique, and schedule. Brushing right means not falling short in any of these areas.
BRUSHING RIGHT: HARDWARE
First thing you need to brush right is a good brush. The American Dental Association (ADA) provides some clear guidelines. The most important things to consider are bristle texture and the size of the brush head. In any case, look for the ADA seal of approval on any brush you buy.
The ADA strongly urges us to use brushes with soft bristles. The things brushing can remove, plaque and food residue, are themselves soft. Tartar, in contrast, is so hard no toothbrush can remove it. That’s a job for the dentist or hygienist with professional tools. All a brush with hard bristles does is risk damaging gums and enamel.
The brush head size that works best fits readily into the mouth and brushes 1-2 teeth at a time. Kids, obviously, need brushes with the smallest heads, but they also adapt better to big handles.
Electric toothbrushes first introduced 90 years ago are increasingly popular. There’s been a lot of debate over whether they actually work better than manual brushes. The evidence appears to be tilting toward a “yes” answer to that question. There’s another way, though, to look at the question. No study has ever found that electric toothbrushes are less effective than manual. Even if they’re equally effective, other things being equal, other things are not equal. Elderly and others with physical challenges often find an electric toothbrush is a great solution. Others simply find an electric brush more motivating, and so better stick to a schedule of regular brushing. This is a great subject to ask your Orlando dentist about.
BRUSHING RIGHT: SOFTWARE
By “software” we mean the dentifrice you apply with your toothbrush, that is, a toothpaste or powder. The truth of the matter is that brushing without any dentifrice is quite effective at removing food debris and plaque from teeth. There are, nevertheless, good reasons to use one.
The most important, for most people, is that toothpaste or powder can deliver fluoride. Fluoride is unquestionably effective in reinforcing tooth enamel to resist cavities. All ADA-approved toothpastes contain fluoride. In addition to fluoride, various toothpastes deliver additives that whiten, reduce sensitivity, inhibit tartar formation, and break up plaque. Thus, toothpaste (or powder) is really essential to get the most benefit possible from brushing.
Tooth powder? It used to be a lot more popular than it is today. In fact, it’s pretty hard to find in retail outlets, though easy to find online. Some people still prefer it. There’s some recent study evidence that tooth powder’s more effective than toothpaste at removing stains and plaque, and reducing gingivitis. The toothpaste vs. tooth powder question is another good topic to ask your dentist about.
This discussion of brushing software would be incomplete without mentioning the obvious cosmetic factor. Toothpaste and powder impart a fresh, pleasant scent to the mouth and breath. In fact, this is likely a more important motivator to brush than many people would admit! A lot of brushing happens for social rather than health reasons. A Delta Dental survey found that over 30% of Americans make their partners brush before…kissing! It’s all good though, as long as everybody’s brushing right.
BRUSHING RIGHT: TECHNIQUE
This now brings us to the “how” of brushing right. The “cosmetic” brushing just mentioned is a useful starting point. A person whose only interest is freshening breath can get that done in much less time than brushing right demands. The ADA ( and nearly all other authorities) recommends a target of 2 minutes for brushing teeth. Use a pea-sized glob of toothpaste. Aim the brush at the gum line at a 45-degree angle. On the chewing surfaces use a to-and-fro motion. Everywhere else, a circular motion. And above all be gentle. This is not scrubbing a dirty pan, it’s tooth enamel. Brushing too hard wears it down. And remember, rinsing afterward is not necessary. In fact, rinsing sloshes away the fluoride meant for your teeth. Spit, and finish.
BRUSHING RIGHT: SCHEDULE
We now come to the best schedule for brushing right. It certainly is not once every couple of days, as too many millennials seem to think. Nor is it just before a big date. The ADA recommends brushing twice a day. Less than that gives up too much ground to the bacteria and plaque, which are always on the march. Too much brushing is just another assault on the enamel.
If you follow these guidelines, you’ll be investing a grand total of 4 minutes per day brushing your teeth. Each week, 28 minutes. A very small investment for a very significant benefit.
One last schedule item – your toothbrush itself. They don’t last forever. In fact, on the ADA-recommended brushing schedule, the average useful life for a toothbrush is about 2-3 months. Be sure to replace in a timely way. This, too, is a part of brushing right.