Manual versus electric toothbrush
Either type can do the job well. If you're buying a powered brush, the timer and the pressure sensor are the most useful features.
| Consideration | Manual brush | Powered brush |
|---|---|---|
| Plaque removal | Effective when the technique is correct and the full two minutes are completed. | Reviews of the evidence favor powered brushes on average, oscillating-rotating heads in particular, though the margin is modest. |
| Who it suits | People with sound technique and good dexterity. | Anyone who tends to brush quickly or firmly, people with arthritic hands, teenagers, and anyone with braces or bridgework. |
| Pressure | The brush gives no signal when you're pressing too hard. | Better models warn you or reduce the motion. |
| Timing | No built-in timer, so a clock or a phone helps. | A two minute timer, often with quadrant prompts. |
| Running cost | Low, with replacement every three months. | A higher initial cost, plus replacement heads. |
Toothbrush bristles and toothpaste: what matters on the label
- Soft bristles
- Medium and hard bristles don't clean better, and combined with pressure and a sawing motion they can wear notches into the root at the gumline and push the gums back. That kind of wear is permanent. Bristles that splay within a month usually mean too much force.
- Fluoride is the active ingredient
- Fluoride hardens enamel against acid and helps softened enamel take minerals back up. A paste without fluoride does the cleaning job without the strengthening job, so check the label on anything sold as natural.
- Prescription-strength fluoride paste
- A high-fluoride paste used once a day in place of ordinary toothpaste, for people at genuinely high risk: several new cavities in a short period, a dry mouth, exposed roots, braces. We can tell you at an examination whether it would help you.
- Whitening toothpaste
- These pastes work by abrasion rather than by changing the color of the tooth, and some are considerably more abrasive than regular paste. Used twice a day for years on exposed root surface, which is softer than enamel, that abrasion adds up. To change the shade, see teeth whitening.
Floss, interdental brushes and water flossers
The surfaces where teeth touch each other are the ones a toothbrush never reaches. The right tool depends on the size of the spaces between your teeth.
- Floss
- The right tool where teeth are in tight contact. Waxed floss slides through more easily, tape suits broader gaps, and the flavor makes no difference to the result.
- Interdental brushes
- Small tapered brushes sized to the space. Where there's room between the teeth, whether from recession, bone loss, or their natural shape, these often clean better than floss and tend to get used more consistently. Ask us about sizing at your next visit.
- Water flossers
- Effective at flushing debris away and reducing bleeding, and useful around bridges, implants and braces. A jet of water isn't the same as direct contact where teeth touch tightly. For someone who has never gotten along with floss, a water flosser is still a real improvement.
Mouthwash: what the different rinses do
- Fluoride rinse. Additional fluoride for higher-risk patients, ideally used at a different time of day from brushing.
- Antiseptic rinses. Essential-oil and cetylpyridinium chloride rinses can reduce plaque and gingivitis modestly, alongside brushing rather than in place of it. No rinse removes the biofilm attached to a tooth.
- The alcohol question. Alcohol acts as a solvent in a rinse rather than as the active ingredient, and alcohol-free versions work. Alcohol rinses sting and can dry the mouth, which makes them a poor choice if your mouth is already dry.
- Chlorhexidine. A prescription antimicrobial used in short courses, often after periodontal treatment. It is effective, and it stains: brown staining on the teeth and tongue builds up with use.
Diet, acid, and how often you eat
What matters is not only the amount of sugar you eat but the number of separate times each day your teeth are exposed to acid. Each time sugar reaches the plaque, bacteria produce acid within minutes, and the pH can stay low for half an hour afterward. Sipping a soda across an afternoon produces a long series of acid exposures, while drinking the same can with lunch produces one.
Acidic drinks can cause damage with no sugar in them at all. Citrus, sports drinks and both regular and diet soda soften enamel directly. Keeping them to mealtimes helps, as does rinsing with water afterward. Hold off on brushing right afterward, because brushing softened enamel can remove some of it.
Home care questions
Is an electric toothbrush better than a manual one?
For many people, yes, mainly because of the timer and the pressure sensor. If you already brush for a full two minutes with light pressure and good technique, a manual brush is unlikely to be the limiting factor.
Do I still have to floss if I use a water flosser?
Where teeth touch tightly, a jet of water isn't the same as direct contact with the surface, so floss remains the better tool there. Around open spaces, bridges, implants or braces, a water flosser performs well.
Is charcoal toothpaste a good idea?
Many charcoal pastes are abrasive and a good number contain no fluoride, which trades the ingredient with the strongest evidence behind it for something that scrubs. Enamel and root surface worn away by abrasion don't grow back.
How do I know which of this applies to me?
That's what an examination is for. Decay risk, gum condition, spacing, medication and diet all vary from person to person, and we're glad to help you sort through it. Bring the products you use with you to your next visit. Request an appointment or call (559) 683-4694.