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Do you ever wonder what dentists really think about which toothpaste, which floss, which mouthwash, which anti-cavity rinse, which toothbrush, is the best to use? Have you ever been given a tongue scraper in your goody bag at your dental appointment and sat wondering if anyone really uses such a thing? Have you ever wondered who that fifth dentist in the commercials really is?
In this article, I am going to attempt to clear up the myth, the mystery, the confusion about dental hygiene. Let’s begin with the pre-brush anti-cavity rinse. These rinses are to use before you brush and floss. They are meant to bathe the teeth in fluoride and therefore prevent decay. Do they work? Are they helpful? The short answer is, it depends. If you are immunosuppressed, you might want to consider avoiding fluoride. However, fluoride in the diets of children does seem to reduce their rate of dental decay. But then again, dental decay may have more to do with the refined sugars we love so much.
What about your toothbrush? Is it better to spend the extra coin for a sonic brush? Is battery operated just as good? What about a good old-fashioned manual style? And what bristles should you choose? Soft? Medium? Natural? Here’s this dentist’s take. If you like natural bristles, go for it. Medium and hard bristles are only for cleaning tile grout. They are never to be applied to human teeth and gum tissues. If a battery-operated brush gets you going and seems more fun, then, use that. But those bristles must be soft. The point here is not to scrape the muck off forcefully. The point is to gently disturb the plaque, which is soft, and clean that space where your teeth meet your gums. That’s why we’re always going on and on about small circles and such when you see us. And yes, you really should brush the chewing surfaces, too, as well as the back of the back teeth.
How often should we really be brushing? The recommendation of twice daily, and after meals is no joke. It takes just 12 hours for that soft plaque to attract minerals and harden into tartar. The tartar must be scraped off with a tool, not a brush, and really is for the dental hygienist. No, you should not use your safety pin, toothpick, or other small implement on it. All you’re going to do is create more surface texture to attract minerals, and possibly injure your gums. If you seriously cannot manage twice a day, then at least once per day is critical. However, this does nothing for the food that is still present in our mouths after we eat. We all know what is going on with that food as it sits there, let’s not kid ourselves. It’s the same thing that happens to food sitting on the counter.
Next, we need to consider our toothpaste. So many choices. Whitening, fluoride, anti-cavity, the list goes on ad infinitum. Here’s my answer, as shocking as it may seem. I don’t give a hoot which toothpaste you use. I don’t care if you even use toothpaste. I want that plaque disturbed. That is all. If you have a chronic, medically induced dry mouth, there are certain super-fluoride pastes that can cut down the rate of decay. If you have extremely sensitive teeth, you do benefit from a sensitive paste. The sensitive pastes have an active ingredient that really does help seal the tooth structure. But water on your brush will remove that plaque. The point is, the business end of that toothbrush must contact those teeth, and particularly the spot where the teeth meet the gums. That is all. That really is all.
This brings me to the issue of floss. Is a water-pik just as good? What about those commercials that say a certain brush or mouth rinse gets in between the teeth just as well? Well, here’s the short answer. There is no substitute for something going between that point where your teeth touch on the side. The teeth touch. You can’t rinse between them. You can’t brush between them. It doesn’t matter how talented you are with a toothpick. That spot is elusive. That’s where we look for decay in our x-rays. That’s where it’s going to be. And that’s because we’re not actually getting in there if we don’t use floss. It doesn’t matter one bit if you like the string type or the pre-loaded horseshoe type. Like the toothbrush, it’s whatever gets your juices going about flossing. I don’t care how you floss, but you must use floss, and you must floss. Yes, the recommendation is twice a day and after meals. Guess what’s happening with the food left in your mouth right where the teeth touch? Yep. Same thing as food sitting on a counter. I’m sorry for this paragraph. I know very few people enjoyed reading it. I’m just the messenger.
Finally, mouthwash. Should you use it? Does it make any difference? And again, which brand? Which type? Is it even possible to hold Listerine in your mouth for a full minute? Here’s my take. I like mouth rinse. I feel like it rinses away the stuff I’ve loosened up by brushing and flossing. It makes my mouth feel minty fresh. But good old-fashioned water does the same thing, just doesn’t leave the minty flavor. If you have a gum infection, I do believe an essential oil rinse, or an anti-microbial rinse will help you. But in the absence of gum disease, mouth rinse is a personal preference thing. It’s just a feel-good thing. Totally personal preference.
In conclusion, the take home message is this: There is no substitute for proper brushing and flossing. We have refined sugars in our diets. Even if you try to avoid them, they’re hiding out sometimes. The large companies can try and try to help you find a way to avoid flossing, they will bombard you with how wonderful their toothpaste is, they won’t stop. They want your money. As a dentist, I want you to brush and floss. I want you to do whatever it is that’s going to help you brush and floss. I want you to buy whatever you feel will motivate you to brush and floss. And in case I didn’t already say it, brush and floss. 😊
