Making Sense of All Those Tooth-Cleaning Tools
Would you believe there’s a New Year’s resolution you can make that takes less than 10 minutes a day, yet could not only extend your life but your quality of life for years to come?
If you guessed “brushing and cleaning between your teeth,” a gold star for you!
It’s not much: just two minutes of brushing and a couple more to floss or otherwise clean between your teeth and along the gumline. Even so, it’s all too easy to forget supporting a healthy mouth/body connection when you’re late for work or exhausted before bedtime. Those few minutes of oral hygiene can seem downright overwhelming.
Also overwhelming is how that tiny portion of your self-care routine can be riddled with tricky questions. Power or manual toothbrush? To rinse or not to rinse? Are there options other than floss?
First of all, don’t panic. Help is here!
The choice between a power or manual brush is actually a pretty simple one, especially when you consider how much longer you have to brush manually to get your teeth clean. As our own hygienist Barbara notes,
It takes about 10 to 15 minutes to get all the plaque biofilm and gunk off with a manual toothbrush. Yes, I have timed it.
A power toothbrush does the job much more quickly and effectively. (Barbara recommends the lightweight, angled brush from Kyoui.)
If you choose to use a rinse after brushing, the best thing is actually your very own healthy saliva, which not only helps wash away debris but delivers minerals back to your tooth enamel.
If you do opt for a mouthwash, though, check the pH (Barbara offers a partial list of rinses with their pH values) and consider your timing. If your mouthwash has a pH below 5.5, it could damage your tooth enamel, especially if you use the rinse right before bed.
Where confusion can really reign, though, is with all the options for interdental cleaning. Floss? Interproximal brushes? Waterpik? Rubber tips? It can be tough to take, especially when you’re standing there in the store, looking at dozens of products, all with marketing ploys promising ridiculously stellar results.
Luckily, science has stepped up to identify which interdental tools are most effective for keeping your teeth clean and your gums healthy.
The most recent review from Cochrane set out to evaluate the effectiveness of various tools in combination with toothbrushing versus toothbrushing alone: floss, interdental brushes, wooden sticks, rubber/elastomer sticks, and oral irrigators.
Analyzing 35 random controlled trials involving nearly 4000 individuals, the research team found that
Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque, or both, more than toothbrushing alone. Interdental brushes may be more effective than floss. Available evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent.
However, they also noted that most of the studies only looked at short term results, with the overall evidence being of “low certainty.”
Some of this is echoed in another recent review, one that looked at a much larger batch of studies. Among its findings:
- Effective flossing is hard for a lot of people to manage. Ineffective flossing may be no better than not flossing at all.
- Interdental brushes are more effective than just toothbrushing alone and better than floss at reducing plaque and gingivitis. They’re especially helpful for people with gum disease. Soft-picks are also effective.
- Wooden sticks may help reduce gingival (gum) bleeding but otherwise seem to offer no advantage over brushing.
- Oral irrigators appear to be effective for reducing gingival inflammation but not so much for reducing plaque.
- For cleaning around dental implants, oral irrigators and interdental brushes seem to do a better job than floss.
While we find that interdental brushes and oral irrigators are a particularly good combo for keeping both teeth and gums at their healthiest, ultimately, the best interdental tools are those you use both regularly and well. Your dentist or hygienist can let you know how you’re doing and, most importantly, offer specific advice if you still need to improve your home care – whether that’s using different tools or simply getting better with your technique.
We want you to keep your smile healthy and whole for a lifetime. Helping you out with your home hygiene is a big part of our job.