As a dentist, it’s not unusual to find me browsing the dental aisle from time to time. I like to see what’s new. What I find particularly interesting, though, is watching people as they make their product choices.
My impression is that one area which seems to attract the most indecision relates to the subject of which toothbrush to buy. With manual toothbrushes people ponder over whether to get a soft bristle, a medium hardness, or an outright hard bristle. Then, the question becomes should it be angled or straight?
In my office, people also frequently ask: “How often should I replace my toothbrush?” (As often as once every other month. Don’t let it go beyond three months on average, however. Also, replace your brushes after being sick. The bristles retain germs.)
Then there is the question: is an electric toothbrush really better than a manual? If so, what kind of electric brush? Sonic, rotary, or oscillating?
It can get pretty confusing. So let me sum it up for you.
While I’m not sure every dentist will agree with me (only “three out of four” of us agree on anything anyway) 🙂 here is my opinion:
If you’re buying a manual brush, get a soft bristle. If you are deciding between a manual and electric – go for the electric. In my experience battery-powered brushes are fine, but rechargeable brushes are more convenient and eliminate the cost of frequent battery changes. Rotation-oscillation is usually preferred, but I have seen excellent results with the sonics as well.
Soft bristles are kinder to the gums, and since you should be paying attention to your gum-line when you brush, this is important. When I was in dental school I recall a lecture explaining that soft bristles were also “end-rounded,” which means that if you looked at the tips of the bristles under magnification, their ends are, well, rounded. This is in contrast to bristles that are cut off at sharp angles on the harder brushes. I guess the manufacturers figure if you’re going to buy the harder bristle, “What the heck. There is no point to rounding off these babies, let’s keep ’em really rough.” The trouble is this can be abrasive to your gums.
As for the electric brush, I think a consensus exists that — per time spent brushing — more plaque is removed. So this is worth the extra investment. If finances are tight, I believe that you still can achieve excellent results with a manual brush – if you use it correctly. This means brushing in the correct directions, with the right motions and with the appropriate amount of force. Have your dentist or hygienist demonstrate the recommended technique to you. Also, if you have all of your teeth, you should spend at least two minutes brushing them. In my observation, the trouble is that most people simply don’t brush long enough. So time your brushing. One study showed most people think they are brushing much longer than they actually are. Since human nature seems to be inclined to “rush the brush,” this is where electric brushes have an advantage over the manual variety. Many of the electrics have built-in timers. You can still cheat, but at least you will know you are doing it.
Here is an interesting exchange I had with a patient not too long ago. I’m getting ready to start a cleaning after completing my examination. His gums are red (he has gingivitis), there is plaque visible, and I just know those gums will bleed when I start to clean them. I’d like to help him get this under control, but I suspect he doesn’t floss, so I ask “Do you floss?”
His answer: “Whenever I need to.”
I’m thinking: “That would be, like, EVERY DAY.” But instead I ask: “How often is that?”
He replies: “Whenever food becomes noticeably stuck between my teeth.”
I’m actually detecting just a little annoyance now, and then he says: “Yeah, every dentist I have ever been to mentions the flossing thing.”
Well, I suppose I could talk about his favorite color, or maybe something equally inane, like the weather — but somehow the ‘flossing thing’ seemed appropriate. And then it occurred to me, maybe that IS “flossing” for this guy. And how many others, I wondered?
Therefore, in my quest to help rid the world of gingivitis and periodontal disease, (which just may be the shared goal of “every other dentist” who has recommended flossing) I’d like to clarify a few points about what it is and what it isn’t. While floss is unquestionably effective at removing food particles from between your teeth, just picking out the occasional chunk of steak from between your teeth doesn’t classify as “flossing.”
Flossing involves taking a piece of floss – say, about eighteen inches or so – grasping it between your thumb and index finger (just a few inches apart), then holding it in a “C” shape against the side of your tooth. Pre-threaded flossers are just fine in my opinion. Use whatever you are most comfortable with and whatever will get you to floss regularly. Rub the floss up and down the sides of every tooth. You actually want to slide the floss under the gum line. This cleans out areas your toothbrush cannot effectively reach.
Imagine not cleaning some parts of your teeth – ever. Or maybe, you just clean some teeth and not others. Do you think the unclean teeth might become more subject to tooth decay? If you answered “Yes!” then you would be right. This is exactly what occurs when you don’t floss. The parts of the teeth that are in contact with each other never get brushed. It’s not physically possible. So, a sizeable portion of all the fillings I end up having to place for patients are between the teeth. This is so easily helped . . . floss!
If you are just beginning to floss, you can expect your gums to bleed. Don’t let this ‘freak you out.’ A number of patients have said to me over the years “I tried flossing but it made my gums bleed, so I quit.” No. Bacteria, gingivitis, and nutritional deficiencies made your gums bleed. Flossing will help. You just need to stick with it until you notice less and less bleeding.
It is important to have your teeth and gums examined regularly. While gingivitis and periodontal disease are bad enough, there are a few even more serious conditions that could contribute to bleeding gums.
I actually could go on for quite a while about the many benefits to your overall health that flossing brings, but I’ll spare you for now. Or shall we just talk about the weather?
ScienceDaily (2011-08-23) — Researchers in the UK have discovered a pain-free way of tackling dental decay that reverses the damage of acid attack and rebuilds teeth as new. The pioneering treatment promises to transform the approach to filling teeth forever.
Following is a reprinted article that outlines a real, but ultimately preventable, tragedy. As you will see from the attached video, some people scarcely believe that a tooth infection can produce such severe consequences.
September 9, 2011 — An unemployed man died last week because he couldn’t afford treatment for his infected third molar, according to news reports.
Citing physicians and family remembers, Cincinnati’s WLWT television station said the infection killed 24-year-old Kyle Willis when it spread from his tooth to his brain.
Dentists advised Willis, the nephew of funk bass player Bootsy Collins, to have the tooth extracted 2 weeks earlier, but Willis had no insurance and decided to wait, according to the report.
“He should have gone to the dentist to take care of the toothache, and it wouldn’t have escalated to this. It’s a lesson learned by all,” said Willis’ aunt, Patti Collins.
Suffering from headaches and swelling, Willis later visited an emergency department, where he got prescriptions for antibiotics and analgesics.
He could only afford 1 of the prescriptions and chose the pain medicine. Willis felt better, but swelling in his brain killed him.
Willis’ fate recalls the widely publicized 2007 death of 12-year-old Maryland boy Deamonte Driver, whose tooth infection also spread to his brain. Driver’s mother had trouble finding a dentist who would treat him for what she could pay. Physicians estimated that they had spent $250,000 trying to save him from an infection that could have been prevented by a simple extraction.
The Patient Protection and Affordable Care Act of 2010 expanded dental care subsidies for children of indigent families but has no provisions to pay for adult dental care. Many states have never offered adult dental benefits for Medicaid patients, and others have eliminated these benefits in recent years as revenues have shrunk in the recession.
Although Ohio does offer such benefits, Willis’ family had recently lost its benefits, according to ABC News.
In April, the Kaiser Family Foundation reported that 33% of people surveyed skipped dental care or dental checkups because they could not afford them.
Dentists who operate free clinics for the underserved say they are often overwhelmed by the demand.
Willis leaves behind a 6-year-old daughter. Family members are organizing funds for Willis’ funeral expenses and for his daughter’s college education. Donations may be made to: Kyle Willis Memorial Fund, 604 Ohio Pike, Cincinnati, Ohio 45245-2141.
I’m in the smile business. I can take an ugly smile and, in most cases, make it a very attractive one. Sometimes it’s something simple. At other times it’s not. Often, it depends upon how much I have to change to get there, as well as what people, themselves, are willing to do toward an end.
But the smiles I really care about the most are those that start on the inside.
Sure, I treat diseases. I also repair things that are broken down, replace things that are missing, prevent things that shouldn’t happen from happening, and more. It’s all part of the job. But at the end of the day, the thing I value the most are the smiles.
In today’s day and age, it seems that people are so focused upon the problems around them; they find it harder and harder to find the smile within them. After all, the media works hard to put our attention on earthquakes, hurricanes, flooding, unemployment, inflation, recession, terrorist attacks, famine, wars – and that’s just before breakfast. Who the heck wants to smile after that?
It’s really enough to make someone want to give up, to lose hope, or maybe even feel sorry for themselves. I sometimes think that’s actually the point: to beat us down. If we are all depressed, maybe they can sell us happiness in the form of something material thing, or package it in a pill. Maybe Madonna was right when she sang “Material World” after all.
So what can we do about it?
Start with a smile.
If it doesn’t feel natural, go ahead and force yourself. It actually takes courage to smile in the face of adversity, but that resolve is one thing no one can take away from you. It is also the gift you can give to another that costs you nothing – yet it will be cherished long after you have given it.
A smile is powerful because it emanates from you and when given genuinely, is truly valued.
Over the years I have accomplished many things both within my immediate profession and outside of it. People have paid me good money to help them with their problems but, when the time comes to hang up my dental handpiece, I know that it won’t be the dollars that mattered most or that I am even likely to remember. It will be the six year-old who came back and gave me a hug after I finished her filling, or drew me a picture. It will be the young man who made a special trip back to my office one evening, just to take me aside and say “Thank you. You don’t know how much fixing my smile has helped my self-esteem.” It will be the young lady who gasped, and finally took her hand away from her mouth (after always covering it up), when I showed her her new smile. Okay, she cried, but she was really happy. That made me happy too. And so I smiled. In fact, when I think about those moments I still smile.
Smiling and kindness are the two “secret” weapons we have to battle the insanity surrounding us. I say, let’s use them as weapons of mass destruction. If destruction is to be the order of the day, then let’s destroy the pessimism, the fear, the cynicism, and the hatred. Think of it as a form of biological warfare. Wouldn’t it be great if smiling and kindness went viral?
If you are starting to think, “Oh, that sounds great, but it’s a little naïve,” then maybe the “Dark Side” is winning. I don’t think happiness is at all sentimental or corny. It is the pay we get for living.
People search for happiness their entire lives. Yet, someone much wiser than I once stated that all the happiness you will ever find lies within you. So why not start with a smile?
I hope you enjoy the following video. May it make you smile. 🙂 If it does, why not send it to a few friends?
Smile
Smile though your heart is aching Smile even though it’s breaking When there are clouds in the sky, you’ll get by If you smile through your fear and sorrow Smile and maybe tomorrow You’ll see the sun come shining through for you
Light up your face with gladness Hide every trace of sadness Although a tear may be ever so near That’s the time you must keep on trying Smile, what’s the use of crying? You’ll find that life is still worthwhile If you just smile
That’s the time you must keep on trying Smile, what’s the use of crying? You’ll find that life is still worthwhile If you just smile
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.
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