Advice on how we should brush our teeth from dental associations and
toothpaste companies is 'unacceptably inconsistent', finds new UCL research
Advice on how we should brush our teeth from dental associations and
toothpaste companies is 'unacceptably inconsistent', finds new UCL (University
College London) research.
The study, published in the British Dental Journal, looked at
the brushing advice given by dental associations across ten countries,
toothpaste and toothbrush companies and in dental textbooks. They found a wide
range of recommendations on what brushing method to use, how often to brush and
for how long.
The researchers found no clear consensus between the various sources,
and a 'worrying' lack of agreement between advice from dental associations
compared with dental textbooks.
"The public needs to have sound information on the best method to
brush their teeth," says Aubrey Sheiham, Emeritus Professor of Dental
Public Health (UCL Epidemiology & Public Health), senior author of the
study. "If people hear one thing from a dental association, another from a
toothbrush company and something else from their dentist, no wonder they are
confused about how to brush. In this study we found an unacceptably
inconsistent array of advice from different sources.
"Dental associations need to be consistent about what method to
recommend, based on how effective the method is. Most worryingly, the methods
recommended by dental associations are not the same as the best ones mentioned
in dental textbooks. There is no evidence to suggest that complicated
techniques are any better than a simple gentle scrub."
The most commonly-recommended technique involves gently jiggling the
brush back and forth in small motions, with the intention of shaking loose any
food particles, plaque and bacteria. However, no large-scale studies have ever
shown this method to be any more effective than basic scrubbing.
"Brush gently with a simple horizontal scrubbing motion, with the
brush at a forty-five degree angle to get to the dental plaque," Professor
Sheiham advises. "To avoid brushing too hard, hold the brush with a pencil
grip rather than a fist. This simple method is perfectly effective at keeping
your gums healthy.
"There is little point in brushing after eating sweets or sugary
drinks to prevent tooth decay. It takes bacteria from food about two minutes to
start producing acid, so if you brush your teeth a few minutes after eating sugary
foods, the acid will have damaged the enamel."
The conflicting messages given by different organisations highlight
the need for research into how effective different brushing methods are. At
present, the expert advice in the guidelines, 'The scientific basis of dental
health education', recommend a simple scrubbing technique as it is easy to
learn and there is no evidence to justify a more complicated method.
"The wide range of recommendations we found is likely due to the
lack of strong evidence suggesting that one method is conclusively better than
another," says lead author Dr John Wainwright, who carried out the study
at UCL and is now a practising dentist. "I advise my patients to focus
their brushing on areas where plaque is most likely to collect – the biting
surfaces and where the teeth and gums meet – and to use a gentle scrubbing
motion. All too frequently I am asked why the method I am describing differs
from how previous dentists have taught them in the past.
"What
I feel we need is better research into what the easiest to learn, most
effective and safest way to brush is. The current situation where not just
individual dentists, but different dental organisations worldwide are all
issuing different brushing guidelines isn't just confusing – it's undermining
faith and trust in the profession as a whole. For something most people do
twice a day, you would expect dentists to send a clearer, more unified message
to their patients on how to brush their teeth."^
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