Efficiency in Oral Care
The “toothbrush” has undergone quite the makeover since 1998, when Dr. Pfister was teaching local Blake Elementary students about proper brushing techniques.
“An ounce of prevention is worth a pound of cure!”
That’s what Benjamin Franklin said in 1736 when he was addressing the fire-threatened Philadelphians. This was a great summary statement that reflected his philosophy on life, in that better information means better ideas, which in turn leads one to being better-prepared.
Taking Ben’s philosophy into the dental arena, every August, the leading clinical research magazine for dentistry, Dentistry TODAY, comes out with their Top 100 products of the year.
These products, according to the judges, reflect the best ideas and best products in each of their chosen areas.
This week, I thought I would continue Ben’s “ounce of prevention” philosophy and look at the newest approaches to the most basic instrument of our oral hygiene regimen… the toothbrush!
And yes, toothbrushes have changed. These are not your parents’ toothbrushes.
If you’re into manual-style toothbrushes…
Coming out of Mesa Arizona, the Curaprox company continued to stay non-electric this year, as they introduced the new CS 12460 which is, according to them, a significant refinement over their classic CS 5460 model (which launched the entire company into the oral care industry). The name comes from the distinguishing feature of the toothbrush’s head - 12,460 ultra-soft Curen filaments that gently and efficiently, according to them, disrupt and remove plaque from the enamel surfaces of the teeth. Each Curen filament has a rounded head which reduces toothbrush abrasion and scratches to the enamel when used.
I must throw my two cents in at this point to inform readers that all toothbrush bristles produced in the last 20 years must be rounded, according to the American Dental Association. Long-term research on brushes made from pig hair and an endless array of polymers showed these bristles to be sharp and even serrated at the tips, when viewed under a microscope. It didn’t take researchers long to show the enamel wear and gum tissue wear that this type of bristle would produce with continual usage. So if you like the manual style toothbrush and would like to check out the CS 12460, it can be viewed here.
If electric is more your style, let’s look at the 2021 lineup…
There is so much similarity between brands, I have spared the readers volumes of reading by looking at the top two, time-honored companies and their brushes.
Water Pik is the grandfather of water irrigating systems for oral health. I had one in the 70s when I had braces! The Water Pik company started in 1962; and the company name has been synonymous with water propulsion for cleaning teeth and massaging gum tissue (just as the name Kleenex is synonymous with facial tissues), irrespective of the maker.
In 2018, they introduced the world’s first hydro-flossing toothbrush with the Sonic-Fusion 2.0. This was a revolutionary advancement in personal oral care. Time, or should I say finding the time, has always been the chief detriment to oral care. Now, for the first time, both brushing and flossing could be done at the same time. And the circular motion of these bristles, designed in the brush’s head, has been shown by many research groups to be better for the tissue and more efficient in the cleaning of the enamel than the old back-and-forth handsaw-style stroke.
The Sonic-Fusion’s addition of a water jet in the center of the brushing head allowed the plaque once loosened to be washed away, even between the teeth, hence the name hydro-flosser. This year’s brush head has been remodeled over the past head design and can now achieve, according to their brochure, 30% more efficiency in cleaning due to 2x the increase in bristle speed. (I do need to inject again, that the ability to totally clean the tight contact points between the teeth with a hydro-flosser, especially after eating fibrous protein, has been challenged in the literature. Personally, I have spots that can only be cleaned by hand flossing. Your experience may differ but your dentist or hygienist can point out these areas that may need extra attention.)
In 1992, the Optiva company introduced their Revolutionary Sonicare toothbrush that, for the first time ever, had a brushing head design that could generate 31,000 revolutions per minute of plaque-removing energy. In 2000, the Optiva company was purchased by the healthcare giant, the Phillips company. Subtle yearly changes in handle design, colors, and bristle numbers have occurred over the years, until this year…
In July 2021, Philips harnessed artificial intelligence to create, in their advertising words, the most efficient and personalized brushing experience the world has ever seen, with the introduction of the Philips Sonicare 9900 Prestige!
This unique toothbrush is designed around each patient’s individual brushing habits and can actually sense a person’s brushing style. In its development - data on file - it is shown to reduce 20 times more plaque than conventional brushing with 100% less enamel stains in fewer than two days and, at the same time, can be 15 times healthier on the gingiva!
How is this possible, you say? I sure was curious. You guessed it…Bluetooth Technology.
Philips SenseIQ technology, integrated into the brush’s head, uses sensors to detect pressure applied by the patient, their cleaning motion, and the coverage that they have achieved, up to 100 times per second. The brush will automatically adjust patients’ pressure at each surface to protect the tissue being cleaned. I must add, this is darn cool stuff for old dogs like me and, believe it or not, if you techies want to go one step further, you can add the Philips Sonicare app. The sky’s the limit on what you can do with that data!
Do I recommend this brush? If this technology is what you have been waiting for in order to brush properly, please be my guest to try one and send me your thoughts and opinions.
What if you would like the data tracking but you don’t want to purchase a Sonicare? I have had more than a few patients have tooth sensitivity with 31,000 rpms. Wait ‘til you see what I have for you…
The Truthbrush from Candibell out of Lowell, Massachusetts, is a small decorative tracker that easily fits on any electric or manual toothbrush, just like a Fitbit. It allows the dentist or patient to track all tooth brushing events and even monitors duration, efficiency, technique, and coverage. There is no start or stop button; rather, it passively collects data as it is being used and trends can be viewed over time. We are looking into these for our patients. Parents may not always be there when the patient said they were brushing… but Truthbrush can!
There you have it, the latest innovations in toothbrushes for the Class of 2021…
And you are correct, these are not your parents’ toothbrushes!
I need to comment at this point. When I am asked, “What is the best toothbrush?” I always say, “The one that you will use!”
Is the new Bluetooth technology making it a better brush? Professionally, not at all. Most of these add-ons are for tracking and archiving your brushing data. If that’s important to you, go for it. You need to be happy with your brush - proper size and all - so you aren’t gagging. It should be comfortable in your hand with just the right stiffness of bristle so that you’re cleaning the enamel… not removing the gum tissue!
And one final note… please don’t brush more than twice a day if you are over 50 (for a gentleman) or over 40 (for a woman). I see more adults, as they have decided to go into Invisalign, needing gum enhancement through grafting or re-contouring surgery due to over-brushing! Ladies have told me they don’t like the lingering taste of their recent meal and brush to remove the taste. Please use gum, lozenges, Crest strips - anything but brushing. Gum tissue does not regenerate, and once it’s gone, it is gone!
Now get out in this lovely weather and do some hiking.
And don’t forget the toothbrush!
- Dr. Pfister