How the Traditional Nylon Toothbrush May Be Contributing to Patients’ Gum Disease
Dentists and dental hygienists routinely give advice to patients on brushing techniques; brushing frequency and the type of toothpaste that will best prevent decay.
There is often little focus on a patient’s toothbrush. There might be a mention that a soft bristle toothbrush is best, or even that it is a good idea to switch toothbrushes every month or so. The questions we should be asking is how do we prevent the bristles on toothbrushes from brushing away tooth enamel and eroding the gum-line?
The Car Wash Connection
If you have been to a car wash lately, you have probably noticed that they have become “brushless” to preserve the glossy paint on vehicles. The idea behind this advancement is that dirt and grit can be cleaned off without any risk of scratching the finish. If brushes can damage a car’s paint job, what could a toothbrush do to teeth and gums?
It has long been the accepted recommendation to brush teeth at least twice per day. Diligent patients who actively try to incorporate proper dental hygiene into their daily lives follow these guidelines with the assumption that regular brushing will protect them from receding gums and tooth loss.
The reality is that most individuals brush too abrasively which can wear away the thin enamel of the teeth and erode the gums. Over time, the bone under the gums can also disappear, and roots become exposed. This causes sensitivity and ultimately can contribute to root decay.
Not All Toothbrushes Are Created Equal
While improper brushing is a contributing factor in the development of gum disease and tooth loss, there’s more to the story. We must also consider the type of toothbrush used. Low quality, nylon toothbrushes do little to keep teeth clean and can even harm tooth enamel and gum tissue.
Archaeologists have found that when they examine ancient skulls, the front sides of teeth show very little wear. It would be logical to assume that since they had no access to modern dentistry, there would be significant evidence of tooth decay on those surfaces. However, research has shown just the opposite. Why? For starters, our predecessors were not wearing away their tooth enamel and gums with abrasive toothbrushes!
The Result of Overaggressive Brushing
Brushing the teeth too often, for too long, or too aggressively can lead to toothbrush abrasion. Patients with this common condition often present with tooth sensitivity, receding gums and visible roots. It can be difficult to remove plaque from the teeth of those with toothbrush abrasion due to the teeth being sensitive. This plaque eventually leads to tartar buildup and gingivitis, which, of course, can cause gum disease.
Ironically, most dentists recommend increased brushing to patients who show early signs of gum disease. The reality is that no toothbrush can clean the areas between teeth where 90 percent of plaque builds up. Flossing, interdental cleaners, and toothpicks can help remove the plaque between the teeth, but they do nothing to address the problem of toothbrush abrasion. In fact, the recommendation of more brushing only perpetuates the problem.
We Are Creatures of Habit
From the time we are toddlers, we have been instructed to brush our teeth. Most of us never question the type of toothbrush we use. Many buy toothbrushes at the local grocery or drug store without giving it any thought. A much smaller number choose electric brushes, but even these have abrasive, nylon bristles.
The reality is that nylon bristle toothbrushes can damage enamel and gums. We should consider our gums to be the skin of our teeth. We would not want to scrub sensitive parts of our skin with a scouring pad, so why must we scrub our gums with a nylon bristle brush? And more importantly, why are we telling patients to do so? We can and must do better.