Patients' information - Oral hygiene aides, part one (toothbrushes)

Oral Hygiene Aids, (Part One)

Robert B. Stevenson, DDS, MS

Columbus Ohio
Fax (614) 451-2988
gold2ooth1@aol.comhorizontal line

Following are some oral hygiene aides for special conditions that may interfere with use of ordinary toothbrushes. Comments about products are the sole opinion of the author and not intended as endorsement or promotion, and there is no commercial relation with any company named. Contact the manufactureres for additional information about the products.


Most adult-size toothbrushes are a bit large for people of smaller stature and may cause gag reflex in sensitive mouths, especially when brushing the rearmost molars. People with hair-trigger gag reflex might shy away from brushing the rearmost teeth in order to avoid gagging, but this can lead to many other dental problems.

Smaller children-size brushes can be used by gag-prone adults to reduce gag reflex. The smaller brushes are just as effective as adult ones, but it takes a little longer to brush. An adult brush could be used for the front or forward teeth, and then switch to a child brush for the back molars. Also, try to breath through the nose while brushing.

Wide spaces around bridgework or exposed root surfaces, orthodontic braces, loss of teeth or gum tissue can result in areas between teeth that are difficult to reach with ordinary brushes or floss. Orthodontic treatment involving braces or attachements to teeth are difficult to clean around. Miniature brushes designed for cleaning hard to reach places include the Py-Co-Pay Twin brush (Block Drug Co., Inc. Jersey City, NJ 07302) and Butler Proxabrush (J.O. Butler Co. Chicago IL 60630).

The brushheads are either cone-shaped or round cylinders, range in length from one-half inch to an inch (10-25 mm) and a few millimeters in diameter. It's wise to request personal instruction in the use of proxy-type brushes from a dentist or dental hygienist, as incorrect brushing might damage the teeth or gums.

Toothroots that are exposed due to gum recession or surgery are not covered with enamel like the crown-portion of the tooth. Roots can be abraded or worn away quickly if brushed as vigorously as enamel, leading to tooth sensitivity. It's important to keep hard-to-reach areas clean, but it must be done carefully.

Weak hand strength or coordination

Powered (electric) toothbrushes permit more thorough cleaning than regular brushes when used by people with compromised hand strength or ability. The powered bristles move much faster than is possible with manual brushes.

Comparing manual and powered brushes is like the difference between bicycles and motorcycles. Most early powered brushes have bristles that rotate or spin. The Interplak (Bausch & Lomb, Tucker GA 30084) has two rows of rotating bristles. Rota-dent (Pro-Dentec, Batesville AR 72503) has a single, larger rotating tuft of bristles with different shapes available. Both operate on cordless rechargeable batteries and are similar in cost. Toothpaste can clog the gears, draining the battery, so it's best to use mouthrinse instead of toothpaste with rotating brushes.

Newer powered brushes do not rotate but vibrate at around 30,000 cycles per minute. The vigorous action creates cavitation, or foaming activity that results in cleaning beyond the bristles. Vibrating brushes are a little more expensive than rotating types.

Sonicare (Optiva Corp, Bellevue WA 98005), available since 1992 is larger and a little heavier than SenSonic (Teledyne Water Pik, Ft Collins CO 80553), released in 1994. SenSonic is less expensive than Sonicare, especially for replacement brushheads, which are slightly smaller than Sonicare brushheads.

SenSonic has a simple on/off switch. Sonicare comes with a two-minute timer. For an additional fee, Sonicare has a 'quad-timer' that beeps at 30-second intervals, to help ensure each quadrant of teeth (upper/lower, left&right) receive equal time brushing. Sonicare vibrations have a wider arc of motion, meaning more strength or action than SenSonic. At this time there is more published research documenting the effectiveness of rotating brushes than for vibrating brushes, but available reports on vibrating brushes to date are quite promising. Since there are no gears, any sort of toothpaste may be used with vibrating brushes without risk of damage to the brush. However, using an abrasive toothpaste (like those recommended for smokers) could result in excessive wear on teeth.

The preceding material is for information only.
Please consult your regular dentist before changing daily oral hygiene procedures.

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