Despite the health risks of failing to clean our teeth properly, the majority of us don't do so.
We are incredibly awful at brushing our teeth, whether it's a habit that most of us have had since we were able to see into the bathroom mirror or a routine that we all have to do.
According to a Swedish survey, only one in ten people actually use the ideal brushing technique. In a poll of 2,000 people in the UK, the British health insurer Bupa discovered that over half of the participants had no idea how to properly wash their teeth.
Josefine Hirschfeld, a clinical academic lecturer in restorative dentistry at the University of Birmingham in the UK, argues that it is quite possible that anyone who has not received formal instructions from their dentist or hygienist brushes wrongly. This will constitute the vast majority of the people in any nation, in my experience.
Given the confusing range of information available on how to wash your teeth, perhaps that is not unexpected. At least 66 different, occasionally contradicting pieces of professional advice were discovered in one investigation.
Nigel Carter, CEO of the UK's Oral Health Foundation, believes that it is quite misleading for consumers. The dizzying variety of dental equipment that may be purchased, from tongue-scrapers to interdental waterjets, adds to this perplexity.
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What specifically are most of us doing incorrectly, and how can we alter our routine to ensure we efficiently brush our teeth? (In part one of this two-part piece, you may learn more about how this might lessen the risks of concealed deep gum disease.)
What methods is the best?
According to Hirschfeld, "a lot of patients understand that what they need to do is eliminate food leftovers." "That can only be said in part. Cleaning the teeth of germs is significantly more crucial."
Instead of brushing your teeth, consider brushing your gumline. After that, the teeth will be automatically brushed. Hirschfeld, Josefine
Everyone has bacteria and other germs in their mouths, which proliferate and combine to produce a claggy biofilm known as dental plaque. The second-highest diversity in the human body after the stomach, it contains about 700 distinct types of bacteria in addition to a wide variety of fungi and viruses. According to Hirschfeld, "they are living in the sticky coating adhering to the teeth and also to the soft tissues." "This sticky film definitely needs to be manually cleansed; it can't be simply rinsed off."
The gumline, not the teeth, is the most crucial area to remove it from. Microbes can most easily penetrate the gum tissue at this point, resulting in irritation and eventually diseases like periodontitis. In actuality, the term "brushing your teeth" is somewhat misleading. Instead of brushing your teeth, Hirschfeld advises, "think about brushing your gumline." The teeth will then be automatically brushed after that.
So what exactly is the best way to do this?
One of the most effective ways to clear the biofilm is known as "the modified Bass technique". As I quickly discover, this needs a lot more manual dexterity than the hazy put-the-brush-in-your-mouth-and-look-busy strategy that many of us use.
I get ready to try the modified Bass in my bathroom with my bamboo-handled, nylon-bristled manual toothbrush. Stuck to the mirror is my new miniature hourglass that times two minutes (more on that later). I turn it over, and begin.
The modified Bass technique entails angling the brush toward the tooth face by 45 degrees (tilted down for the lower jaw and upwards for the upper, as if you are trying almost to edge the bristles below the gums). Then, you move your gumline back and forth in little, vibrating movements. I try it out after carefully watching various videos.
A little while later, my brush is on the floor and my mirror is covered in white toothpaste particles. In my zeal, I must have mishandled the brush and scraped my gums with the hard bamboo head before dropping it.
Unfazed, I quickly wash my toothbrush and give it another go, this time going more slowly. Hirschfeld gave me a detailed description of his little, swift-yet-gentle movements, which I found to be quite challenging to imitate. It reminds me of trying to write nice cursive letters with my left hand as a right-hander. When I've laboriously attempted the modified Bass on my entire gumline, including the upper, lower, inner, and outside, I check my tiny green hourglass. Who knows how long ago my two minutes expired, and I still haven't started flossing.
Other methods besides the modified Bass are effective in removing the biofilm. On another occasion, I experiment with the modified Stillman technique, which is similar to the modified Bass but includes an occasional delightful sweeping action away from the gumline. I imagine a biofilm of microbial filth being swept into a frothy oblivion during this motion.
The greatest techniques for eliminating the bacterial biofilm from your teeth aren't often used.
My gums begin to feel a bit painful after a week of testing and diminishing toothpaste specks on the mirror as I feel like I'm getting the hang of it. It turns out that I've been putting too much strain because of my zeal.
Hirschfeld states that the applied pressure shouldn't be greater than 150-400g, while experts disagree on the ideal pressure. Too-vigorous brushing, especially when using a brush with a stronger bristle, might harm the gums. Overzealous brushing can cause tiny tears in the soft tissue that allow bacteria to enter the bloodstream. The bristles of the brush can also grate the enamel, leaving tiny grooves that over time result in considerable erosion of the tooth. When using a manual toothbrush, people frequently apply more pressure than when using an electric toothbrush, which frequently has sensors to alert the user when the pressure is excessive.
I experiment with a different method for a few days that is designed for kids and persons with less physical dexterity. In the Fones technique, the toothbrush is held at a 90-degree angle while being moved in circular motions over the teeth, skimming the gumline. While I experiment with getting the pressure about right, it is unquestionably simpler to do. But once my gums have healed from my enthusiasm, I'm determined to learn the modified bass.
"One of the best methods is the modified Bass method. It thoroughly cleans teeth while minimising damage to the gums and teeth "Hirschfeld says.
Nigel Carter of the Oral Health Foundation reassures us by pointing out that accuracy in the textbook version isn't necessarily what counts. In order to improve, "dental professionals and hygienists often advise patients to observe what they are doing and make adjustments to their existing approach," he explains.
Before or after food?
Does brushing your teeth before or after breakfast make more sense? Many people, from toothpaste producers to dental clinics, support the idea that brushing your teeth before breakfast is preferable to doing it later. But there is still discussion over this.
Hirschfeld argues there isn't a single, solid recommendation. However, many dentists advise brushing right away since it will remove both plaque and breakfast-related food particles.
Depending on what you eat and when, it may be better for you to exercise before or after breakfast. This is so that a biofilm can form, which necessitates the presence of both microbes and food for them to consume.
You cannot get cavities without food or bacteria, claims Hirschfeld. "It shouldn't matter how much sugar you consume if you completely wipe the bacteria off before breakfast. It's okay if there are no microorganisms that can ferment it." However, it's far from guaranteed that one brushing session before breakfast can completely remove the biofilm, especially considering the dubious brushing practises of the majority of people.
Brushing after breakfast also has its benefits. It should be equally OK, according to Hirschfeld, whether you have the sugars on top of the microorganisms already there.
The American Dental Association advises waiting 60 minutes between eating and brushing, which is one of the biggest disadvantages of brushing after breakfast. The cause is because dietary acids and the byproducts of bacteria' carbohydrate breakdown temporarily weaken the teeth.
According to Hirschfeld, "acids target the enamel layer of the teeth and temporarily soften it." The calcium and phosphate that are two of the enamel's essential building blocks are removed in this process, but they are restored over the course of many hours by minerals in the saliva. "As a result, the process is self-healing. The degraded surface will become very easy to just brush off if you don't wait for that self-repair to take place."
Depending on the items you are eating and how long you can wait before brushing again after breakfast, you should decide whether it is best to brush before or after breakfast.
Carter concurs that the answer to whether to exercise before or after breakfast depends on what you've eaten. Brush before rather than after breakfast if you plan to consume acidic foods and beverages, such as citrus fruit, fruit juice, or coffee, to avoid interfering with the remineralization process.
The evening brush is more crucial than breakfast and has an easier solution: it should always be done right before bed.
According to Carter, your saliva is a natural defence system that prevents tooth decay and bacterial growth. It's crucial to remove all of the plaque before going to bed because overnight, saliva flow decreases.
What should you use to brush your teeth?
She claims that the process takes years or decades to complete. But when the teeth wear down over time, they become more vulnerable to cavities and extreme temperatures.
Adults should use toothpaste without tiny abrasive particles and medium-bristled brushes. According to Hirschfeld, using a smaller brush head that is easier to manoeuvre around individual teeth is also better. You should also replace a worn brush before the bristles get too deformed.
Plaque can also be removed and cavities avoided with conventional toothbrushes or chewing sticks like the miswak from the toothbrush tree, which are popular throughout Africa, the Middle East, and South Asia. They do, however, carry a larger risk of damaging gums if improperly administered. (View the toothbrush packaging from Nature.
The electric toothbrush is more expensive and even more efficient than manual choices. The effectiveness of electric toothbrushes in eliminating plaque has been moderately supported by a number of meta-analyses after years of research that indicated no statistically significant difference between the two. (The authors of these meta-analyses indicate that they have previously been funded by electric toothbrush producers.)
The automatic vibratory motion, which requires less manual dexterity, is a contributing element, but the size of the heads is also a consideration. Many also feature pressure sensors that illuminate when a user applies too much pressure, thereby damaging the user's enamel. Hirschfeld claims that using a manual toothbrush and using it exactly right in terms of brushing technique, pressure, and other factors will yield an equivalently satisfactory outcome.
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