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Baffled by brushes.

BAFFLED BY BRUSHES

Next time you're in afull-service drugstore, take a look at the oral-hygiene section. Chances are you'll find at least five or six different brands of manual toothbrushes, each with a choice between hard, medium, or soft bristles; child, junior, or adult sizes; three, four, or even five rows of bristle tufts; six to eight colors and at least as many shapes. Somewhere on the shelf you'll also find two or three electric or power brushes, oral irrigators (hydraulic pumps), and even two or three brands of toothpicks and gum stimulators. If your friendly druggist carried every product from every domestic manufacturer, you would have to choose from among several hundred cleaning devices.

Does it really matterwhich you choose?

If you're like many people,you won't choose. You'll wait until your semi-annual visit to the dentist and hope for a free toothbrush, trusting that he or she will pick the right brush for you. But waiting so long can be a costly mistake, because most toothbrushes lose effectiveness after a few weeks of use.

Attending to one's teeth may predateeven the bath as a way of cleaning up the body. In various times and cultures, people have used toothpicks made of wood, thorns, porcupine or feather quills, bones, and seashells. Metal picks emerged somewhere along the line, and ornate toothpicks made from gold and other precious metals were especially popular during the 18th and 19th centuries. People have rubbed clay, sand, leather, leaves, and ashes on their teeth to restore the pearly-white sheen.

The first "modern" toothbrushwas the invention of an English tanner and political dissident, William Addis. The rabble-rousing Addis found himself in prison in the late 1700s. Having little else to do, he whittled a piece of bone into the shape of a handle and bored holes in one end. He next stripped the hairs from a cowhide, wired them in the holes, and promptly used his creation to clean his teeth. His descendants are still manufacturing quality brushes in Hertford, England.

Toothpicks are used primarily fordislodging bits of food from between the teeth. Toothbrushes properly serve two purposes: to remove foodstuffs and bacteria-laden plaque from tooth surfaces and to clean and stimulate the gingival sulcus, the edge of the gum, which encircles each tooth.

Approximately 90 percentof all toothbrushes sold in the United States have nylon bristles; the remainder have natural (hog) bristles. Because natural bristle is usually imported, nylon is cheaper. Nylon bristles can also be made with a uniform diameter and stiffness and smooth, rounded ends. Researchers at the American Dental Association and at dental research centers around the country consistently recommend brushes with smooth, rounded-end bristles because sharp ends are more likely to irritate the gums and to abrade the enamel.

Most dentists, too, recommendnylon bristles because they believe that natural bristles "feather" at the ends more often, tend to lose their stiffness earlier, and harbor more bacteria from one brushing to the next. The argument is by no means settled, however: not all nylon bristles are polished to a smooth, rounded tip, and no toothbrush is completely bacteria free unless sterilized.

The choice of bristles goes beyondthe debate between natural and nylon. One must decide on stiffness and the number of rows of tufts. Dentists clearly favor soft or medium-soft brushes. A good children's brush has three rows of tufts, with six to eight tuffs per row. Adults' brushes have six to ten tufts in each of three to four rows.

Although most dentists recommendthat the tufts of bristles be of equal height, several newer brushes on the market depart from that standard. The Collis-Curve's bristles curve around the tooth like a claw; other brands present a V-shaped brushing surface. The Aim brush from Lever Brothers has slanted tufts on the sides and perpendicular tufts in the center of the brush. These different shapes and angles are meant to provide a more dynamic action on tooth surfaces and to clean and stimulate the gingival sulcus more efficiently. Although dentists' individual preferences vary, the consensus holds that even brushing surfaces are better.

The marketplace includes brusheswith heads of varying shapes and sizes and handles shaped like everything from shoehorns to dachshunds. The popular Reach toothbrush from Johnson & Johnson has a recognizable angle to its handle, and Colgate's Plus has a diamond-shaped head to help clean hard-to-reach places. Rule No. 1 is to select a soft-bristled brush that feels comfortable in your hand and not too large for your mouth. Many adults find a junior-size brush easier to use and more effective than the adult size.

Although standard manual toothbrushesare, and probably always will be, the most popular, several new electric toothbrushes are competing for your home health-care dollar. These new products, specifically Interplak and Rota-dent, are superior to earlier electric toothbrushes. Early studies of the Interplak brush suggest a greater effectiveness than that of conventional brushes. These and similar products under development may be particularly useful for handicapped persons and others who can't use a common toothbrush effectively.

Once you've found a brush thatreaches every tooth surface, including the back sides of your molars, you are ready to concentrate on technique--because what matters most is not the shape, or even the composition, of the brush, but how you use it.

Generally, short, horizontal, back-and-forthstrokes are best. Make certain that you brush the juncture of the teeth and gums, not just the flat chewing surfaces. Holding your brush with the bristles at a 45-degree angle to the gum line is strongly recommended. Take special care to brush both sides of your teeth: next to the tongue and next to the cheek. It's also important to brush the small, hard-to-reach surface of your rear molars, the edges farthest back in your mouth. These areas, prime candidats for periodontal disease and dental decay, are also the hardest areas for most people to reach properly.

Fluoridated toothpastes strengthentooth surfaces and thereby help reduce dental caries, but the mechanical action of brushing is significant in disrupting and removing the plaque that builds upon teeth. Bacteria in plaque cause tooth decay. The more frequently the plaque is removed, the less likely you are to be troubled by decay. Frequent brushing, by keeping the inner surfaces of the gums clean and healthy, reduces the risk of gingivitis and periodontal disease.

Developing effective brushing habitstakes practice. Clock-watching can improve your brushing: a thorough brushing should take between two and three minutes, each tooth surface receiving equal attention.

Claudette Tapocik, a dental hygienistwho manufactures Plak Smaker toothbrushes, recommends that people brush first without toothpaste. She argues that a dry brush removes plaque more effectively than one wet and saturated with toothpaste. She says using a fluoridated toothpaste after a dry brushing is "more effective because the fluoride cannot penetrate the plaque."

Dr. Myron Nevins, the co-editor ofthe International Journal of Periodontics and Restorative Dentistry and a Swampscott, Massachusetts, periodontist, has seen thousands of patients with gum-disease problems. His greatest concern about oral hygiene is that "many people are not aware of the shelf life of their toothbrush. Most toothbrushes will last only three to five weeks before the bristles lose their shape and their effectiveness to remove plaque. In addition, these deformed brushes also may damage the gum tissue and the tooth surface.

"It is important to realize thattoothbrushes are only designed to clean plaque from the inner and outer surface of the teeth and gum tissues," Dr. Nevins goes on to note. "It's necessary to select some tool to clean the plaque from between the teeth because most dental disease occurs between the teeth. The toothbrush is simply not designed to reach these areas."

Floss and other interdental cleaningdevices are available for this critical job. Your dentist can provide guidance on which product will do the best job of helping you protect your teeth and gums.
COPYRIGHT 1987 Saturday Evening Post Society
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1987 Gale, Cengage Learning. All rights reserved.

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Title Annotation:toothbrushes and toothpastes
Author:Born, David O.
Publication:Saturday Evening Post
Date:May 1, 1987
Words:1306
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