There are many aids to oral hygiene on the market. New toothpaste, mouthwashes, flosses, oral irrigators, interdental cleansing aids, and toothbrushes appear almost weekly. Some of them are gimmicks which can do more harm than good. Others are good ideas but don't seem to work well in practice. Still others are very useful and should be considered by health conscious people.
For the last four years, I have been personally evaluating several different toothbrushes. Each of the ones I have tried have had some advantages, but in my opinion, one stands out from the rest as the best all around toothbrush.
First of all, I find that most patients lack the skill or the time to do an adequate job of brushing their teeth with a manual brush. Some of the newer brushes are easier to use and are designed for efficiency, however, few patients seem to be able to get their teeth clean with them. Several studies have shown that 75% of all adult American have some form of gum disease. If manual brushes were effective for most people, gum disease would be far less frequent.
This brings us to electric toothbrushes. Studies for the last ten years have show that the electric brushes that copy the back and forth, or up and down motion of manual brushing are ineffective. In my evaluations, I concentrated on the rotary action toothbrushes. Several brands exist. Braun (Oral-B), Interplak, Oralgiene, and Rotadent are all rotary brushes. Braun and Oralgiene only rotate for a partial arc and then move back the opposite direction. Braun had the advantage of being available very inexpensively from several sources including the big discount stores and warehouses. I found it to be adequate for plague removal, but difficult to use in the back part of the mouth or the inside of the lower front part of the mouth because of it's size.
The Interplak had been intensively studied and has been shown to be effective as manual brushing. Due the very large head size, however, it is difficult to use in any but the largest of mouths.
The Oralgiene is somewhat gimmicky, but is very effective for young children, or people wearing braces. It has two circular brushes that fit on either side of your teeth, and two linear brushes that scrub the tops of the teeth. It is difficult to find, but is effective in cleaning teeth above the gum line with little dexterity.
The Rotadent has a very small head and can reach every area of the mouth easily. The brushes are soft so as to not harm the gums. Three shapes of brushes come with each unit so that every cleaning situation can be met. Several studies have demonstrated that the Rotadent is superior to other forms of brushing including the other rotary brushes.
New "sonic" brushes such as the Sonicare and the Sensonic offered some hope of improving on the vibrating type of electric brushes. The do work better than manual brushes, but now as well as the rotary brushes. Rotadent has been tested against each of these brushes and was found to work better at reducing plague, bleeding, and other clinical signs of gum disease.
The Rotadent has two other advantages not covered in these studies. First of all, it can be used with liquid medications such as mouthwashes to get the medications under the gum line where they are most needed. Secondly, the Rotadent has the ability to tell the patient when the teeth are clean. I think that the main reason for failure of manual toothbrushes is the lack of any feedback on whether the teeth are clean. A few seconds of tasting the toothpaste makes the mouth feel clean. The Rotadent can be effectively used without toothpaste. The soft bristles emulsify the plaque which results in foam. When the area stops making new foam, it is clean. This allows the patient to determine when the teeth are clean. For these reasons, I highly recommend the Rotadent toothbrush.
©2003 Dr. James S. Eaves, DDS
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