Oral hygiene products we recommend, or, The Empire Strikes Plaque

What do I really need to keep my teeth healthy? Or what oral hygiene products are actually important?

Any time we walk into a pharmacy, the dental care aisles are invariably a cornucopia of brush types and designs, flosses, rinses, appliances, gels, and who knows what else seemingly designed to confuse and complicate.  So which oral hygiene products are actually important, and what should be left behind?  Here is our guide on the best Oral hygiene products, with a surprise twist at the end.

Oral hygiene is basically an exercise in bacteria removal (plaque control).  Given that the mouth is one of the most bacteria-laden parts of our bodies, the best oral hygiene products are the ones that most effectively remove bacteria and strengthen teeth against decay. So what are the best oral hygiene aides?  The ones you use.  Keep in mind our overall approach: a risk-based model of care that individualizes our recommendations to your level of dental disease risk.  We do not recommend all of these things for all people – just  the things that are needed as assessed. At the most, we are talking a toothbrush with toothpaste, some floss, and maybe a rinse.  That is all.

Toothbrushes: go for rechargeable electric, not the ones just powered by AA (ron) batteries.  There is now evidence to support the use of electric brushes as superior, and in the electric brush marketplace, there are really only two big names that are relevant: Sonicare or Oral-B.  We can’t cite any data showing which one is actually better, so it boils down to personal preference.  They’re both good.

Toothpaste: we are firm believers in fluoride, for its anti-cavity effect.  Any toothpaste we recommend should contain fluoride (except for children and those individuals who are unable to spit – fluoride should not be swallowed in large quantities).

However, not all toothpastes are the same.  The principal factor in abrasion of teeth from toothbrushing is not actually the brush, it is actually the toothpaste!  There are different abrasivities to toothpastes, as assessed by a measure called Relative Dentin Abrasivity (RDA).  Think of this as the “grit” of a toothpaste.   While the different RDA values of toothpastes are not easy to find, it is our recommendation to stick with the least abrasive possible.  Typically, this means an RDA of less than 70.

If one is at a higher risk of tooth decay, for example because of oral hygiene problems, dry mouth, or acid reflux, it pays off to expose the teeth to higher levels of fluoride.  The toothpaste of choice for these individuals is 3M’s Clinpro 5000 (not available in stores, but read on).  It is a high concentration fluoride toothpaste with low abrasivity.

Floss: again, the best floss is the one you use.  That said, Dr. Wong pushes regular unwaxed floss because it doesn’t slip the fingers and squeaks when your teeth are clean (although there is no data to show the superiority of one floss over another).  We’ve written about between-the-teeth cleaning before, and the story has not changed – floss is the best, but if for some reason you can’t floss (for example if you need to floss a small child’s teeth), then flosspiks are OK as well.  Waterpiks are not a substitute for floss, but for some people, something is better than nothing.  For people with implant-supported bridges or bars, waterpiks are a great option.

An interesting newer appliance is Sonicare’s AirFloss, which sprays a high-pressure jet between the teeth to remove debris.  Again, not as good as floss, but great for areas or people who cannot be flossed easily.

Rinses: these are good adjuncts to oral hygiene, but there are two specific rinses that we advocate.  Both of these rinses are anti-cavity rinses: one to reduce decay risk by a two-week / twice a day use, and then a maintenance rinse.

The first rinse is CariFree CTx4 rinse, indicated for people at high risk of tooth decay.  We’ve written about this rinse before, and it is a two-week bacteria-killing fluoride-containing rinse.  The four ingredients that it contains?
1) sodium hydroxide (to raise the pH of the mouth and make it less hospitable to bacteria and help enamel demineralization)
2) sodium hypochlorite (good ol’ medical grade bleach, to kill off bacteria)
3) xylitol (to reduce bacterial populations.  The bacteria ingest this sugar but cannot metabolize it, effectively starving them)
4) fluoride (to help remineralization) – fluoride is picked up by tooth enamel and makes it harder to decay later.

This stuff is nasty, and tastes just like one would imagine bleach in the mouth would taste like.  Trust us, two weeks is just about as much as you’d want to use this for.

After using the CariFree CTx4 (if it was recommended due to caries risk), we recommend the use of a daily fluoride maintenance rinse.  The brand we recommend is OralScience’s OptiRinse 0.05% fluoride rinse. This is a quite mild, pleasant-tasting rinse that also contains xylitol.  Use it daily.

Now for the big reveal: all of these recommended Oral hygiene products are available for sale to our patients AT COST.  That’s right, for some reason in Ontario we are prohibited from making a profit off of items we sell, so all of these oral hygiene products?  Available at cost.  The Oral-B electric brushes, the Clinpro5000, the floss, the CariFree CTx4, and the OptiRinse; all available at 0% markup.  Why do we do it?  Some of this stuff is not available in stores, and some of it you’ll pay extra if you buy it in stores. The only catch?  You have to be a patient.

Contact us for a complete oral examination!  We’ll set you on a path where the only dentistry you’ll need is that which prevents any problems.  We’d love to be your dentist in Barrie.