Toothbrushes and Toothbrushing

:: HOME ::

The British Dental Association has various fact files on toothbrushes, toothbrushing, mouthrinses and numerous other topics, which are available to members.

Toothbrushing is such a familiar process that it is often easy to forget how crucial it is to oral health and how important it is for us to brush our teeth properly. Women brush their teeth at least twice a day compared with only 58% of men. Adults should brush at the neck of the tooth where it meets the gum and use very short horizontal movements, at a 45-degree angle to dislodge plaque.

Children may find it difficult to brush effectively until they are at least 6 or 7. One common method for adults to help children clean effectively is for the adult to stand behind the child and tilt the childs head upwards so that all tooth surfaces can be brushed using a gentle scrub method.

Toothbrushing should be introduced as soon as the first teeth appear. If a baby resists brushing, use a clean piece of moist gauze with a tiny spot of fluoride toothpaste to wipe the teeth. An infant toothbrush ought to be used by the age of 2 with twice daily brushing.

There is little evidence at presence to support any specific toothbrush shape or design but it is sensible to buy a toothbrush from one of the companies that are well known for oral healthcare products, as they are often carrying out research to constantly try to improve them. Soft to medium textured, round ended, synthetic bristles are advised.

Teeth can be damaged through toothbrush abrasion if there is a faulty brushing technique. It is not advisable to use a brush, which is too old or too hard, or to brush too aggressively. Strictly speaking, the abrasive agents in the toothpaste cause the damage. Low abrasivity toothpastes are desirable if the patient has any exposed root surfaces.

Toothbrushes should not be shared as studies have shown that bacteria and viruses can live on a toothbrush so there is a risk of infection moving from person to person.

The bathroom could be a germ-laden room, and toothbrushes left lying at the side of a washbasin maybe vulnerable to bacteria. Also, when a toilet is flushed, a fine mist of water spreads through the air, contaminating the toothbrush and other surfaces.

A recent study by Janina has indicated that a significant number of adults (82%) do not realise they risk infection from there own toothbrush. The focus of the study was on the cause of long-term gum disease and halitosis (bad breath). Janina researchers found that high levels of bacteria accumulate on the toothbrush overnight.

During the study the method of cleaning the toothbrush was simply rinsing the brush with tap water. No antibacterial agents were used to disinfect the toothbrush. When this brush was used the next morning the bacteria was then reintroduced to the areas of the gums already infected therefore prolonging the patients infection.

A questionnaire was given to a selection of adult patients asking which method they used to clean their teeth when on holiday. 76% indicated they used bottle water to clean their teeth and rinse the mouth but then proceeded to rinse the brush with tap water. The assumption was that the toothpaste being used for brushing the teeth was sufficient to disinfect the toothbrush. They were unaware that the use of tap water to rinse the brush introduced a secondary source of contamination causing infection and possible intestinal disorders (Holiday Belly).

The introduction of Janina ULTIMA BrushClean sprayed on the toothbrush at night after brushing and rinsing - dramatically reduced the levels of bacteria on the toothbrush therefore promoting the rapid recovery from gum disease and the possibility of contamination from tap water.

A toothbrush should be changed about every two months although patients with active gum disease should change their toothbrushes more often if Janina ULTIMA BrushClean is not used.

Sonic and electric toothbrushes - because these brushes are more effective at removing plaque than manual ones higher levels of bacteria can accumulate on the brush over night. However, with the use of Janina ULTIMA BrushClean no bacteria was detected on the brush head.

Professor Ender Kazazoglu Istanbul Turkey.

In this study a mouthrinse spray (Janina ULTIMA with BRUSHCLEAN Spray) is tested in vitro for its effects on toothbrush micro-organisms which are Candida albicans, Staphylococcus aureus and Streptococcus mutans. These micro-organisms were cultured and after 48 hours of incubation, a suspension was prepared according to the McFarland technique. Then 5ml of Janina Ultima was added to the prepared suspension. 3,5,10,15,30 and 60 minutes later all specimens were found to be sterile.

From this in vitro study it can be concluded that the use of Janina ULTIMA with BRUSHCLEAN is highly efficient for disinfecting manual and battery brushes.

With the introduction of Ultima BrushClean, a good brushing and flossing program we now have a complete solution to a fast recovery from gum disease and bad breath.

Janina Ultima With added BrushClean
There are a wide range of mouthrinses on the market from simple breath fresheners to products which make a real contribution to oral health. Mouthrinses that contain fluoride can help to prevent dental decay. Fluoride mouthrinses should be recommended for children having orthodontic treatment, especially fixed appliance treatment that makes it more difficult to clean teeth.

Erosive potential of various mouthrinses with low pH
It is evident from clinical publications that factors such as pH, acid concentration, temperature, exposure time and frequency of exposure can all contribute to enamel erosion (products that do not contain Fluoride). However studies by Lussi & Jaegg.Schweiz Monatsschr Zahnmed 111 (2001), 274-281. Fluoridated dental care products, mouthrinses do not exhibit erosive properties and can increase enamel hardness despite low pH levels.

Fluoride rinses should also be recommended for children identified at special decay risk.

For patients suffering from dry mouth, or who have undergone radiation therapy a broad-spectrum formulation mouthrinse should be used (Janina Optima and Ultima with BrushClean).

This type of Mouthrinse can also help manage inflammatory periodontal diseases and treat halitosis (bad breath). Most rinses normally advise use twice daily, sloshing the rinse around the mouth for one or two minutes.

Very small children should not use any mouthrinses because they are not able to spit out properly and there is therefore a risk of swallowing.

Some mouthrinses contain some pharmaceutical grade alcohol, as a preservative and as a semi-active ingredient. Child-resistant closures for mouthrinses containing a higher proportion of alcohol are very important to minimise the risk of accidental swallowing. It has sometimes been suggested that alcohol-containing mouthrinses might be a cause of oral cancer.

Oral cancer is known to be associated with tobacco use and excessive alcohol consumption. People who smoke and drink may also use mouthrinses to conceal the smell, so the epidemiological data can be difficult to interpret. However, the BDAs accreditation panel concluded that there is no evidence that if used as directed, mouthrinses can lead to oral cancer. A further review carried out by a working party of the U.S. Food and Drug Administration in 1996 came to a similar conclusion.

Janina Optima and Ultima Mouthrinse
Research carried out over the past year by Dr Martin Grootveld, assessed the new Janina Optima and Ultima with BrushClean mouthrinse. This product contains fluoride, zinc, xylitol, pyrophosphate, a series of oxidants, baking soda and enzymes.

Dr Grootvelds research has shown that this Janina mouthrinse contains active tooth whitening agents, which not only serve to reverse adverse tooth colourations but are also proven to protect against oral malodour (bad breath). Each of these oxidant components is present at a level approved by the European Community and the UK Health and Safety Executive.

Dr Newton Johnson has presented data that Janina Opale and Diamond toothpaste was the least abrasive of all the whitening toothpaste products tested in a study carried out in collaboration with the University of Indiana in Indianapolis, USA. In addition, Dr Kevin Seymour reported in the British Dental Journal. In a double blind clinical trial proved intrinsic whitening with Janina toothpaste.

This paper presents an overview on toothbrushes, toothbrushing and mouthrinses and discusses research carried out by Edward Lynch Professor of Restorative Denttistry and Gerodontology in Queens University Belfast. Dr Martin Grootveld, Reader in Chemistry, St Bartholomews and the Royal London School of Medicine and Dentistry, University of London and Professor Ender Kazazoglu Yeditepe Universitesi Istanbul Turkey, John Mehmet Head of research Janina International.