When Technology Tackles Teeth

triple-headed toothbrushesA new toothbrush doesn’t guarantee better brushing habits or even that you’ll get a better cleaning. Technique matters. But what if you have movement challenges, say, that make it hard for you to brush effectively?

One technology developed for such folks is the triple-headed toothbrush. The idea is that the three heads together maintain contact with all surfaces of each tooth at the proper angle. So you also see it marketed for children who have trouble with proper brushing, as well.

Marketers insist that a triple-headed brush will get the job done faster, easier, and better than a standard brush. But recent research in the International Journal of Dental Hygiene suggests that may only be the case when caregivers are doing the brushing.

Evaluating 15 clinical trials including 18 relevant comparisons, the authors found that

Of the 14 comparisons with self-performed brushing by the participants, the majority showed no difference between triple-headed and single-headed toothbrushes, with a few favouring the triple-headed. In the comparisons in which a caregiver performed the brushing, three of the four showed that the triple-headed toothbrush performed significantly better on the reduction in plaque scores.

Less is known about the efficacy of some new toothbrush designs for the general public, most of which aim to make brushing so quick and effortless, it becomes a cinch to do it regularly.

As if two minutes each morning and night – the duration and frequency we recommend for toothbrushing – were such a terrible sacrifice to make for supporting your oral and overall health.

But we digress.

The latest entry in the speed-brushing category is Amabrush, which has raised over $2.3 million through its highly publicized Kickstarter campaign. The device fits in your mouth and automatically brushes all the surfaces of your teeth with tiny silicon bristles in just 10 seconds.

But speed doesn’t come cheap. Not only do you pay a bit over $90 for the unit and charger but $7 every three to six months for a replacement mouthpiece and roughly $3.50 a month for the special toothpaste the device requires.

BlizzidentIt seems a lot like an automated version of the Blizzident device that came onto the market a while back. The makers of that device claim it cleans all tooth surfaces in just six seconds as you bite on the bristled mouthpiece. They also say it flosses your teeth and cleans your tongue – all for an investment of a few hundred dollars every year.

Amabrush stops short of the flossing claim. And the company’s founder and CEO offers an important caveat:

“It’s really hard to compare it to regular toothbrushes, manual or electric, because a toothbrush is just a tool, and tools are only as good as the people using them,” he said. “If a person already uses his regular toothbrush in a professional way, then Amabrush will definitely be no better than a regular toothbrush.

And you still need to floss – the part of hygiene that most people are most irregular about. We’ve yet to see any gizmo addressing that.


Other than a Toothbrush

Pop quiz: What do you need in order to clean your teeth thoroughly and effectively?



If your answer included “toothpaste,” you might be a little bit wrong. Or at least not entirely right.

Believe it or don’t, but there’s actually some argument as to whether toothpaste helps clean teeth. Consider, for instance, a study published a few years back in the Indian Journal of Dental Research. Not only did its authors find that toothpaste didn’t help remove plaque but that it might actually interfere with the process. While toothpaste users reduced plaque by about 57%, non-toothpaste users reduced 9% more.

Yet toothpaste has other purposes. For one, the taste can be refreshing and actually provide a little extra incentive to brush. It can also provide a way of applying essential oils such as clove, thyme, tea tree and peppermint (to name but a few) that can keep oral pathogens – “bad” bacteria and other microbes – in check. Likewise, it can deliver compounds such as theobromine, which can help the teeth remineralize more effectively – more so than fluoride, and more safely, as well.

toothbrush and waterFor the simple sake of breaking up dental biofilm (plaque), though, it’s the mechanical action of brushing that really counts. At most, as we’ve noted before, toothpaste can provide a little extra grit to help in the process.

As for the other answers to the quiz? A toothbrush (natch), floss (or a proxy brush or oral irrigator to clean between the teeth), good technique, and making good hygiene a habit.

(And in case you’re wondering if there’s a best type of brush, see this and this.)

Image by Greg Foster

The Perfect Toothbrush?

brushing teethLooking for a $1,000,000 idea? How about the perfect toothbrush?

That’s exactly what entrepreneur Mike Davidson and dentist Mike Smith set out to do. Since 2007, this team has been working towards creating a toothbrush that scrubs and polishes better than any other toothbrush on the market. (Not that others haven’t tried before.)

What’s so special about this brush?

To remove the bacteria that cause gum disease, most dentists say you should hold the brush so the bristles are at a 45-degree angle to the gum line. Easy enough, but most people don’t. Davidson’s brush has an unusual handle that automatically puts the bristles at the correct angle.

Note the phrase “most dentists.” But it turns out there’s actually little consensus on the matter.

This we know thanks to a paper that came out in the British Dental Journal not long before NPR’s feature on Davidson’s and Smith’s brush. (Talk about lousy timing!) A review of online materials and dental texts found that

There was a wide diversity between recommendations on toothbrushing techniques, how often people should brush their teeth and for how long. The most common method recommended was the Modified Bass technique, by 19. Eleven recommended the Bass technique, ten recommended the Fones technique and five recommended the Scrub technique. The methods recommended by companies, mainly toothpaste companies, differed from those of dental associations, as did advice in dental textbooks and research-based sources. There was a wide difference in the toothbrushing methods recommended for adults and for children.

So what to make of all this? As the study’s lead author told the New York Times, “a simple scrub” may be effective enough.

And truth be told, the kind of brush you use matters less than you may think. A toothbrush can’t make you brush your teeth effectively any more than a treadmill can make you exercise.

What matters is that you clean all of your teeth. By “all,” we mean every single surface where plaque and bacteria might lurk.

That means between the teeth, too. Bristles can’t reach these areas, making them the ideal breeding grounds for oral bacteria and other pathogens. This is where flossing comes into the picture. Not only does it help clean these surfaces, as well as remove any food debris that’s been caught, but it also helps lower your risk of gum disease – and the host of other inflammatory conditions that have been linked to it.

If flossing is a problem for you, you may find it easier to achieve the same result – a clean mouth – by using interproximal or “proxy” brushes, perio-aids or an oral irrigator such as Waterpik. (Another benefit of using an irrigator: It’s easy to add herbal medicaments such as Dental Herb Company’s Under the Gums that can enhance oral health.)

The main thing: Get every surface clean. It’s your best insurance against decay and disease, supporting both your oral and systemic health.

As for the best toothbrush? As we’ve said before, the best brush is the one you use regularly.

Image by Just Jefa

Reflecting on Our First Blogiversary…

It’s hard to believe we’ve been blogging for more than a year now! And in recognition of this first “blogiversary,” we thought we’d take a look back at our very first post – a post on an absolutely fundamental point of optimal oral health: practicing good cleaning habits at home. As the title reminded, it’s about more than just brushing…

Toothbrushing Isn’t Enough

The statistics are all over the map, but one thing is clear: for most Americans, flossing isn’t a high priority. Most brush their teeth – if not as often or as well as they should – but less than half floss regularly. Some “forget.” Some make excuses.



Is it any surprise that half of us have periodontal (gum) disease, according to data from the CDC? This inflammatory condition has been linked with a number of systemic health problems, including diabetes, heart disease, stroke and rheumatoid arthritis.

It’s as simple as this: When you brush, you clean only about 60% of the surface area of your teeth – even if you use a fancy, sonic brush. It’s like bathing by washing from your feet up to the middle of your torso, leaving everything else increasingly filthy.

Flossing is what cleans the rest of your teeth – their necks, between them and at the gumline. As periodontal disease progresses, pockets form between your gums and teeth, becoming safe harbors for oral pathogens (bacteria, viruses and the like). The deeper the pockets, the harder to clean and the more gum disease advances.

And the more advanced your gum disease, the more likely you are to eventually wind up with a mouth like this:


Yes, gum disease also contributes to tooth loss. The disease ravages both the bone and soft tissues that support your teeth. As you lose this structure, your teeth begin to loosen. Eventually, they fall out (or your dentist recommends extracting them).

Knowing this, flossing suddenly doesn’t seem so bad, does it?

But there’s another option for cleaning the parts of your teeth that toothbrushes can’t manage: interproximal, or interdental, brushes. These fit between your teeth, where they can be manipulated along the necks and at the gumline. Many people find them easier and more comfortable to use than floss.

In fact, some research suggests they may be even better than floss! A research review in Evidence-Based Dentistry, for instance, found them more effective at removing biofilm. Pocket reduction also was much more “pronounced” among “proxy” brush users. A similar paper published early last year in the Canadian Journal of Dental Hygiene found these brushes to be “an effective alternative to dental floss for reducing interproximal bleeding and plaque.”

Here’s a quick demonstration of how they’re properly used:



You should be able to find proxy brushes at Walgreens or any other good sized drugstore. If all else fails, they’re readily available online from numerous retailers.

Whether you floss or use a proxy brush or even both (some do, especially if their gum disease is advanced), the main thing is this: Do it. Make it part of your routine for a healthy mouth (and a healthy rest-of-you, too).

Toothless mouth image via doctorspiller.com.

Are Electric Toothbrushes Better than Manual?

antique_toothbrushIt’s believed that the bristle toothbrush was invented in 1498 in China. You can bet that its first users would never have thought that centuries later, we’d have toothbrushes powered by batteries.

While some may see the use of a power toothbrush as lazy, research to date suggests that it may actually be more effective than brushing manually. A 2009 report published by the Cochrane Collaboration reviewed 42 studies and found that, at least in the short term, oscillating toothbrushes were better.

Most powered toothbrushes are of this sort. When combined with the normal back and forth motion of brushing, powered toothbrushes buff and clean away more plaque than just brushing with a manual toothbrush and are no more likely to damage gum tissue.

More recently, a study published in Clinical, Cosmetic and Investigational Dentistry reached a broader conclusion:

The subject group using the powered toothbrush demonstrated clinical and statistical improvement in overall plaque scores. Powered toothbrushes offer an individual the ability to brush the teeth in a way that is optimal in terms of removing plaque and improving gingival health, conferring good brushing technique on all who use them, irrespective of manual dexterity or training.

Is the additional cost of a power toothbrush worth it then?

brushesNot necessarily. Any dentist will tell you that picking the right toothbrush is only one factor when it comes to keeping your teeth healthy. Routine and proper technique matter even more. (Here are 10 mistakes you don’t want to make.) Ultimately, the best brush is the one you use regularly.


Brushing Tips

  1. Brush your teeth for about two minutes. Sing a jingle in your head if it helps.
  2. Brush your teeth twice a day.
  3. Make a special effort to reach all of your teeth, including your back molars.
  4. Pay close attention to the areas where you teeth meet the gums.
  5. Brush your tongue to eliminate bacteria and food debris that are still in your mouth.
  6. Rinse your toothbrush once you are done.

Above all else, make sure you floss as well as brush, and rinse afterward. After all, brushing only cleans 60% of your teeth. Flossing helps you reach the rest of those in-between places and at the gumline.

You wouldn’t wash a little more than half your body while you shower and still consider yourself clean, right?

Top image via Rae’s Ming Dynasty Blog; bottom image by K J Payne, via Flickr

Brushing with Chocolate?

There are those who insist that fluoride is the safest and best way to protect our teeth. We’re not the only ones who beg to differ. In the words of one study published late last year in Environmental Health Perspectives,

[our] results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment.

Such concern is just one of the reasons why the citizens of Portland, Oregon recently voted against fluoridation of their water supply – along with environmental and ethical concerns, not to mention the fact that there is just no evidence that swallowing fluoride helps your teeth at all. As scientist Kathleen Thiessen, formally of the EPA, has said, “The CDC and others say whatever beneficial effect there is from fluoride is from topical use. It’s not from swallowing it. It never has been from swallowing it.” [emphasis added]

Moreover, scientists now aren’t even all that sure how fluoride works. Just a couple years ago, a study published in Langmuir, the journal of the American Chemical Society, showed that the “protective layer” fluoride is said to provide is actually “at least 10 times thinner” than believed and not apt to do much protecting at all.

Hence, the search for alternatives – such as the xylitol lozenges we talked about last time or, if you’re the type of person who doesn’t always read below the headline, chocolate.


Actually, it’s not chocolate itself but a compound in cocoa called theobromine. Several studies have now suggested that this alkaloid may encourage remineralization of the teeth – the process by which minerals are restored to a tooth’s structure. The newest research says it flat out: theobromine may be more effective than fluoride in restoring minerals.

And unlike fluoride, theobromine is safe for humans to digest in large doses. (Keep it away from pets, though. Theobromine is pretty much the reason why we don’t feed dogs chocolate).

toothpasteSo should you just eat a hunk of dark chocolate after each meal and floss? Of course not! The chocolate you buy as candy is usually laden with sugars, and sugars are the favorite food of the bacteria involved in tooth decay.

But there are now toothpastes available that contain this compound. The one we like best is Theodent. The product website includes much more than just info about the product but also the scientific research backing it up. Just click the “Science” tab.

And, of course, there are other things you can do to support remineralization of your teeth, which we’ve known since Weston Price began publishing the results of his nutritional research. What it comes down to is this: Eat nutrient dense whole foods that benefit the whole body, including your teeth, and take care of your teeth.

Yes, it really can be just that simple.

Updated 10 February 2014

Chocolate by Annedore’s Fine Chocolates