Every dentist I have ever heard speak on the subject, and every dental organization with something to say, says that soft is the best toothbrush. So, I used to get the obvious question from patients. If soft is clearly recommended by dentists, why do stores sell hard toothbrushes? The answer is simple: because people buy them.

There are some companies that as a matter of principle do not make any medium or hard toothbrushes-just soft ones. I commend them for their integrity. Butler and Oral B are two such companies, and they both make excellent brushes.

There are a lot of brushing techniques taught by dentists, hygienists, and dental assistants, and all of them are taught with the utmost zeal. One tells you to brush in little circles. Another tells you to go down to the gum and brush up. Others tell you to start at the top and brush down to the gums. Instead of going fanatical on a technique, what I'd like to teach you are the basic principles.

What you're trying to do is clean in the cracks and crevices. You see, your mouth has natural cleaning mechanisms. Your tongue, lips, and cheeks rub against the teeth and tend to clean the broad surfaces quite well. Think back to the tooth decay you've had. Has it ever been on broad flat smooth surfaces of your teeth? No. I wasn't there, but I can tell you that over 99 chances out of 100, they weren't. They were in the cracks, pits, crevices, and between your teeth. And gum disease is caused by plaque that nestles at the base of the tooth, right in the sulcus between your teeth and gums. So, my advice is not to get too excited about circles or up-and-down motions. There are various motions you can use to clean your teeth, and I don't think the direction you brush really makes a difference. Just be sure that you work the bristles into the cracks and crevices. Beyond that, I urge that you brush systematically so that you clean every surface of every tooth. Pay special attention to the inside of the lower molars-that's the place people miss the most.

Reach toothbrush
The original Reach toothbrush design-with the angled head and contoured bristles. Notice that the bristles on the sides are longer than those in the middle. This helps guide the toothbrush into the sulcus between the teeth and the gums.

Around 1980, the Reach toothbrush was invented. It broke new ground by featuring an angle to the head and contoured bristles that made it easy for the brush to reach into the crevice between the gum and the tooth. Now, nearly every manufacturer has copied that basic design, and I feel this is the best toothbrush design.

Oral B toothbrush
A new Oral B toothbrush, with the longer bristles on the sides.

Studies done in the 1980s showed that the Reach toothbrush, in the hands of the average brusher, removed more plaque than brushes with the conventional straight design. Since then, most major manufacturers have incorporated this contoured design into their line.

And soft. You've got to have soft. The bristles need to be able to flex easily so they will get into those cracks and crevices. If they're stiff, they won't go into those places. Or, if you do force them into the crevices, they will damage your gums. Soft, only soft.

Also, it is surprising to many people to hear that chewing gum is actually an excellent second choice for cleaning your teeth when you aren't able to brush. But it's true. Chewing gum gets your saliva flowing, and saliva has great cleaning properties. But use sugarless gum, of course.

By Dr. David Hall

Written by a cosmetic dentist!

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