Toothbrushes Review - from a dentist perspective

Toothbrushing have become a daily routine in modern day life and yet most of us don’t give much thought about the toothbrush we buy.

For a long time, I been wanting to write a post about toothbrushes and oral hygiene products that I have personally tried and were effective. I got to admit the urge to write this is highly influenced by those Youtuber skincare review videos which I frequently binged on. After googling, I noticed not many dentists have ever shared about their honest opinions of toothbrushes and their designs. Ever since learning about oral hygiene maintenance back in 3^rd year of dental school, I always love to explore what are the new toothbrushes available in the local market. Personally, I do believe that the manual toothbrush is good enough when designed appropriately. By using it in the right technique, it can be our greatest weapon to keep those plaque at bay. An electric toothbrush is not any superior. I know some people are more motivate to brush with them thinking technology is helping them to do a better job at cleaning. However, I want to make it clear that spending large amount of money on a toothbrush doesn’t equate to improving your oral health. Any tool used in the wrong manner will not bring out the desired result.

Modified Bass Toothbrushing Technique (Pic taken from Pinterest)

I truly stand by the Modified Bass toothbrushing technique as it can really clean all surfaces IF your teeth are in the right alignment. However, the selection of toothbrush design itself is important and many dentists just overlook this aspect when giving their patient oral hygiene instructions. I know and have seen people are often confuse when they are at the oral hygiene section in supermarkets or pharmacies, trying to pick out the right toothbrush. You can almost read it on their faces; hard or soft bristled? Blue or red? Should I get that one with the rubbery tongue scraper at the back? – so here are my personal opinion of good toothbrush designs that one should look out for. 

1.       Only Bristle that are Soft or any softer than that.

Remember the aim of toothbrushing is to remove food debris or plaque are that loosely bound to the teeth surfaces. We are not trying to remove stubborn stains or tartar that certainly won’t budge even though you brush with all your might.  It is fairly common to hear patient saying they feel brushing with a soft bristle doesn’t feel like they are doing effective cleaning and that’s why they continue to use the hard bristle. It is also this same kind of patient that will present with many cervical abrasion lesions (the holes that you create on the neck of the teeth when you brush) in their mouth. Irony the patient is losing good teeth structure while they are making the effort to clean their teeth to prevent decay. There are 3 contributing factor to this: You are using too hard bristle; You are simply putting too much force when brushing; You are brushing with the wrong technique.

Colgate Slim Soft Flex Clean toothbrush

Recently I have discovered a new kind of soft toothbrush from Colgate (picture above) where the bristle made of silicon (usually the bristles are made of nylon). The toothbrush when used with a gentle force already feels like you are brushing with a hard toothbrush and therefore, I felt that it will be good for those who are really used to brushing hard. However, the down side of it is that the bristle are not thin, so if the patient wants to use this toothbrush, they must floss afterwards.

2.       Thin Plastic casing that holds the bristle.

The width of the plastic that encase the bristle makes a huge difference when cleaning the upper back teeth. I only notice the significance of this part on the toothbrush after my upper wisdom teeth were erupting. Using such toothbrush in combination with not opening your mouth too big, you can reach those narrow areas of the upper molars nicely without hurting your cheeks.

 

Systema Super Thin Charcoal Compact toothbrush boast of a 3mm plastic encasing

DentalPro Ultra Slim Compact C22 toothbrush also have similar thinner head

 

3.       Longer Bristles

Longer bristle can facilitate to clean the lingual surfaces of lower anteriors (inner surface / tongue surface of lower front teeth) better. It is also more effective for those who have gum recession (shrunken gums) where the teeth are slightly longer.

Oral B Pro-Dense Gum Care toothbrushes do have bristles are longer than the usual by roughly 0.5mm. The overall size of the toothbrush head is also small and compact with the only design downfall in my opinion is the thick plastic casing.

4.       The length of the brush head should cover 2-3 teeth at once, not any lesser or more than that

You are not brushing an elephant’s teeth; you don’t need such long or big toothbrush. As our teeth are arrange in a curvature and the toothbrushes head are usually straight, a longer toothbrush head won’t be able to cover all the surfaces and may even hinder you from reaching those deeper areas. However, the head of the toothbrush also should not be too small/compact that you can only brush a tooth per time.

5.       Wider Brush Head

Especially when brushing the buccal (tooth surface towards the cheeks and lips) or lingual (tooth surface towards the tongue) surfaces, not the entire tooth surface will be cleaned if the brush head is too narrow. A wider brush head will increase the area of coverage, hopefully able to simultaneously cleaning from the coronal 3^rd to cervical 3^rd of the tooth.

Darlie Wide Clean toothbrush is a good example of wider brush head toothbrushes. However, this good feature is somehow compromised by the center elevated bristle which hinders the adaptation of the side bristle to clean effectively when used in a 45 degrees angulation on the buccal or lingual surfaces.

PERIOE Wide Edge toothbrushes from Korea also had similar wider brush head design

The above 5 points are crucial for me when I judge whether the toothbrush will be effective. I’m aware that companies have been trying to upgrade and improve this close to 100-year-old oral hygiene tool. One of such attempts is to in cooperate some rubbery bristle which claims to help polish the teeth and massage the gums as you brush. Having tried those toothbrushes, I don’t find that they are as effective as those with just regular nylon bristle. Also, I find toothbrush with charcoal, green tea, gold or silver particle infused bristle a little gimmicky.

 Unbeknownst, people still tend to choose their toothbrushes mainly base on the look and the packaging. As we live in a social media driven world, I know many are attracted to trendy toothbrushes (e.g. One Morning, Curapox) seen on the Gram with various color combinations and quirky designs.

One morning toothbrush

 Size wise and bristle I think it’s good but I find the shank to be not rigid enough to help you adapt the toothbrush to the surface of the teeth. Probably would be useful to train those patients who apply heavy pressure when brushing as such force will certainly cause the shank to bend away from the tooth.

The popular Curapox 5460 claimed to have more bristle packed into your toothbrush helping you to cover more surfaces while brushing. However, I noticed they have used same length bristles which seems more ineffective to adapt nicely against the convex and concave surfaces on the tooth.

Jordan Clean Smile do share similar design to Curapox 5460 with slightly longer brush head

As majority of our toothbrushes sold here in Malaysia are still made of plastic, I do share the concern they are that not eco-friendly. (Imagine your toothbrush when you used as a kid is still lying somewhere in the landfills) There is an increase interest among the public to switch to bamboo toothbrushes but I have yet to try any of them to give my thoughts in this post. Not just the brush but the plastic that is used in the packaging is also a concern that oral hygiene product manufacturing companies should look into. So far, only Jordan Green Clean toothbrush is a good example of an eco-friendly toothbrush in Malaysia with even its packaging made fully with recycled cardboard.

Jordan Green Clean toothbrush claims to be made of 100% Recycled Plastic with 100% BioBase Bristle packaged in a 100% recycled cardboard box. That’s a lot of 100% promises but if they could just make the toothbrush head slightly thinner, then it would be 100% marks for me!

There are also special toothbrushes with thicker handles for people who have dexterity issues.

Ci 803s toothbrush (left) have thicker handles for patients with weak grips.

Before I wrap things up, I want to specially mention this toothbrush I bought during my last Korea trip. Initially I was attracted to the contra-angle shank and wonder will it work like our dental handpieces. Surprising, the kind of shank actually also do help you get about the back teeth. However, such design is not available at the moment in Malaysia stores.

Contra-angled shank toothbrush I found in Korea

So far, my top 3 manual toothbrushes available in Malaysia are:

1. Systema Super Thin Charcoal Compact toothbrush

2. Oral B Pro-Dense Gum Care toothbrushes

3.  DentalPro Ultra Slim Compact C22

I hope my observations and honest opinions shared here can not only help the general public, dental practitioners but also toothbrush designers.

If you have read till now, I would like to know what are your thought process when come to picking a toothbrush and what have been your favorite brush so far. Please feel free to leave me comment. I would love to hear from you.