In the teeth of the evidence
Have had another quick look at the evidence about tooth-brushing. I was entirely on top of it about 15 years ago when I developed a course which had it as an example. It's not changed a lot.
The main message is still you should totally brush your teeth with fluoride toothpaste for two minutes twice a day, once just before bed and again at whatever time you can do reliably. Flossing or other interdental cleaning is also good. Mouthwashes not so much, unless you can't brush or floss, in which case they're substantially better than nothing.
Also, electric toothbrushes are significantly better than manual ones. It looks like this is for two reasons: they clean better, and also they usually come with a two-minute timer which really helps people brush their teeth for two actual minutes rather than "that must be two minutes by now".
The evidence for differences within types of electric toothbrushes is very murky and mixed. I was in the middle of ploughing through an exhaustive/ing list of studies sponsored by Oral-B trying to find any in even that rather biased source that compared, say, 2D brushing (rotating-oscillating, probably the gold standard electric toothbrush in terms of evidence) and 3D brushing (goes in-and-out as well). Then I suddenly realised: they charge waaaay more for 3D brushes than 2D. If they had good, solid evidence showing 3D was better, they would not make it so damn hard to find it: they'd be crowing about it on the packaging, or at least at the top of summaries of evidence. They would also be pretty keen to try to find this evidence, so would carry out the studies, but if they found nothing, they would probably bury the studies in the file drawer.
So my guess - rather than my view based on a thorough literature search - is that there is no strong evidence that the expensive electric toothbrushes are better, and that this is because they aren't (much) better.
Edit Oops, missed jotting down main new point: the advice is now to avoid rinsing your mouth with water after brushing, to maintain fluoride concentration. It didn't seem to be very strongly evidence-based but it has a strong rationale. So I'm trying to cut down on rinsing.
This entry crossposted to http://doug.dreamwidth.org/311458.html, where there are
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The main message is still you should totally brush your teeth with fluoride toothpaste for two minutes twice a day, once just before bed and again at whatever time you can do reliably. Flossing or other interdental cleaning is also good. Mouthwashes not so much, unless you can't brush or floss, in which case they're substantially better than nothing.
Also, electric toothbrushes are significantly better than manual ones. It looks like this is for two reasons: they clean better, and also they usually come with a two-minute timer which really helps people brush their teeth for two actual minutes rather than "that must be two minutes by now".
The evidence for differences within types of electric toothbrushes is very murky and mixed. I was in the middle of ploughing through an exhaustive/ing list of studies sponsored by Oral-B trying to find any in even that rather biased source that compared, say, 2D brushing (rotating-oscillating, probably the gold standard electric toothbrush in terms of evidence) and 3D brushing (goes in-and-out as well). Then I suddenly realised: they charge waaaay more for 3D brushes than 2D. If they had good, solid evidence showing 3D was better, they would not make it so damn hard to find it: they'd be crowing about it on the packaging, or at least at the top of summaries of evidence. They would also be pretty keen to try to find this evidence, so would carry out the studies, but if they found nothing, they would probably bury the studies in the file drawer.
So my guess - rather than my view based on a thorough literature search - is that there is no strong evidence that the expensive electric toothbrushes are better, and that this is because they aren't (much) better.
Edit Oops, missed jotting down main new point: the advice is now to avoid rinsing your mouth with water after brushing, to maintain fluoride concentration. It didn't seem to be very strongly evidence-based but it has a strong rationale. So I'm trying to cut down on rinsing.
This entry crossposted to http://doug.dreamwidth.org/311458.html, where there are
comment(s) not shown here.