Superiority of the Philips Sonicare Toothbrush

Dental Revelations Blog-4586
Philips Sonicare forever!

I used to be brainwashed by one of the biggest electric toothbrush manufacturers and thought that there is no better toothbrush than these round-headed ones. I was so stuck in this illusion that I didn’t even give another toothbrush a chance to be better.

But then I moved to another country where two of the biggest toothbrush brands were almost equally popular compared to my country of origin where this manufacturer with round-headed toothbrush was and is dominating the markets.

In my new country of residence I was offered a free trial of the Philips Sonicare. I was amused by the looks of it (it was the old model) and thought it wouldn’t be a very good toothbrush. I almost declined the free trial because I was so convinced about the superiority of this round-headed toothbrush.

But then I gave it a go. It was ticklish as hell at first but thankfully my colleague dentist had warned me about it. I carried on using it for the full two minutes. Once I was done I got my moment of awakening.  My teeth had never felt better. So smooth, so clean.

Patient Case

I was treating a lady – lets call her Sue – at her early twenties for severe gum disease. She had already had periodontist treatment and understood the severity of the situation considering her young age. Sue was very motivated to look after her teeth and did everything she was advised to do.

Sue had a surface retained glass fibre reinforced periodontal splints (everStick®PERIO) on her lower and upper teeth. She was using Tepe interdental brushes of various sizes twice a day and an electric toothbrush – the round head one. She changed the brush heads every month (even though she was informed it was necessary every 3 months). Her brushing technique was checked many times and it was perfect.

But every time I saw Sue for the 4-monthly scale and polish she had supragingival (visible) calculus on her lower front teeth. Lots of it. And she started to be very distressed about it because she was doing all the right things to prevent it. I tried to ease her worry and told that the supragingival calculus was not a problem gum wise as long as it was removed regularly. And in her case the gum didn’t even get inflamed by the presence of supragingival calculus. But it did not calm her mind. She didn’t like the looks of it as it was clearly visible for anyone when she smiled.

I had no idea what to advice more than I already had. She had all the right tools – interdental brushes and a latest model of an electric toothbrush. She used them often enough and with a correct technique.

Then I thought about Philips Sonicare I was using. I suggested to Sue that she could change her toothbrush. I expressed my frustration over the fact that she had spent quite a lot of money for the current toothbrush but this was all I could think of that might help her. I showed her the correct technique of the Sonicare just in case she followed my advice.

Next time Sue came in she had a wide smile on her face when she entered my surgery. She said the calculus had not built up at all! Sue had gone straight to the shop after the last visit and bought the Philips Sonicare toothbrush. She was very happy and thankful for the advice I had given.

This was even more of an eye opener for me than my own first experience with Philips Sonicare.

Why Is It Better?

The name says it all. It’s because of the sonic vibration. When used correctly the sonic vibration can reach beyond the bristles as the sonic vibration travels through the liquids in mouth.

People who think Sonicare is not a good toothbrush have not used it with a correct technique.

Conclusion

In my country where I live and work now the Philips Sonicare toothbrush is not very widely used or recommended by the dental professionals. I am considered as odd one out when I tell I use one. And even stranger it seems that I recommend it to some of my patients. Almost as if I didn’t know my business.

In the dental show case I didn’t even find a representative of Philips Sonicare from any stands. And I cannot find any contact details for a rep to invite her to my practice or to express my views over their marketing strategy. You see the marketing is very poor compared to their competitor who has given trial models to my practise with disposable brush heads so that the patient can be shown the correct technique etc. They give out free electric toothbrushes to the professionals (I have written about it on my previous post) and visit practices regularly to promote their products.

But thankfully the Philips Sonicare toothbrush is available in the shops. And I am doing a small-scale marketing for them. My hope is that they would take more aggressive approach to the almost non-existing marketing. I could even go to the next show case as their representative just to annoy the rep of their competitor who told me that the Philips Sonicare is as effective as manual toothbrush (you can read about it here).

It would definitely make my work easier when convincing the patients about the superiority of the Philips Sonicare toothbrush. And perhaps my colleagues will start to recommend it too.

Here are couple of models of Philips Sonicare electric toothbrush:

Basic model with 31000 brushstrokes per minute (don’t buy anything lower than 31000)

The flagship model with 31000 brushstrokes per minute

 

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New Natural Remedy (Fluoride-Free) for Decay

Dental Revelations

Just kidding. Just wanted to have your attention.

Today I am going to write about fluoride. And the reason for doing this is that I keep on running into articles and websites promoting fluoride-free toothpastes (and water). Not only they recommend non-fluoride toothpastes but also they tell that the fluoride is toxic or poison when entering body.

It is rather entertaining to read these articles but sooner or later the amusement turns into annoyance. Especially after comments like this

I love the look on dental hygienist’s faces when I refuse the fluoride treatments or toothpaste for me and my kids

When the adults practice their anti-fluoride beliefs on their kids it is simply heart breaking. I have seen kids whose milk teeth were so badly decayed that most of them had to be removed. I have seen kids in pain because of the decay. Why would you want to put your kid through such experiences? They wouldn’t thank you if they knew what caused their bad teeth as an adult. But they will never find out the truth because they have been told that it runs in the family to have weak teeth… yeah right. There is no such thing as weak teeth that are hereditary. It’s all about oral hygiene habits and lifestyle habits. What could be called hereditary is the bacteria in mouth that you might get from your parents as a baby. If the parents neglect their teeth (poor oral hygiene and lifestyle habits) there is great amount of cavity causing bacteria in the mouth and if that bacteria is transferred to the baby there are big chances the child will struggle with decaying. And this means this child needs fluoride. And if the parents do not offer it… pain, screaming in fear at the dentist, sedation/general anaesthesia, fillings, extractions, malposition of the permanent teeth because of the loss of the milk teeth… So unnecessary!

To be honest, I can understand the worry over the fluoridated water to some extent. After all it goes into your body.

But the fluoride toothpaste! You are not meant to swallow it, are you? With young kids you can’t prevent them swallowing the toothpaste but that’s why you use only very tiny amount of it.

But you adults, come on! The local effect of the fluoride is important in prevention of decay. You brush for 2 minutes (hopefully) and that’s the time the fluoride stays in your mouth. Then you spit it out and rinse with water (I don’t but that’s why I glow in the dark…ha-ha). No fluoride has entered your body.

But still some people mix all sorts of things with “healing properties” to be used as a toothpaste. Herbs, clay, coconut oil etc. I just read an article about coconut oil that was recommended by Dr. Somebody to be used instead of fluoride toothpaste. And as if the article wasn’t full of baloney but the comments at the end of the article were even more so.

…I laugh when dentists tell their patients not to brush for an hour….. why leave the acidity on your teeth to do damage for an hour – five times a day – seven days a week etc…. it adds up!

This person refers to a previous comment where somebody said he vigorously rinses his mouth with water after eating anything (which is fine). I’m sure all the professionals know what will happen to the teeth if one brushes every day after every meal – five times a day – seven days a week etc.

Erosion or to be precise it is abrasion that will happen to the teeth and that is irreversible damage which will lead to hypersensitivity of the teeth and make the teeth more prone to decaying.

Facts Simplified

There are minerals in the enamel of the tooth (hydroxyapatite). Minerals like calcium are lost everyday from the enamel because of the acids the bacteria produce from the carbohydrates in the diet.

The saliva tries to minimise the loss of minerals by neutralising the acids (remineralisation) but saliva can’t do magic if the host’s lifestyle is giving it too much to handle. Snacking (eating more frequently than 5-6 times a day), drinking acidic or sugary drinks in daily basis between the meals, eating sweets the wrong way (yes, there is a right way of eating them), adding sugar to the tea/coffee (even milk contains sugar) and consuming them between the meals. All these habits produce too much acid for the saliva to handle and it is not able to return all the lost minerals back to the enamel.

Loosing too much minerals from the enamel means decaying.

So to prevent that you need to find a way to compensate the lost minerals. The most important one is the calcium. And when combined with fluoride it repairs the enamel with very strong fluorapatite that is hard for the acids to break. It is much stronger material than hydroxyapatite that the enamel is originally made of. Some professionals even say that area of the enamel that has been replaced by fluorapatite won’t ever get decay.

But even if you do use fluoride in some form you will get decay if you have poor oral hygiene and your eating habits are harmful to the teeth. The fluoride will only slow down the decaying process.

There are exceptions of course. There are individuals who neglect their teeth and never get a decay. They might not use fluoride toothpaste or they might not brush at all. I will emphasise that they are exceptions. Average Joe will get decay I’m afraid. I have already written about this on my previous post. I wrote that it is very rare for people to have good enough oral hygiene habits. It is about one in thousand patients who do not need my interference in looking after their teeth. So most of us need minerals (calcium and fluoride) to protect the teeth from our laziness and unhealthy lifestyle.

Fluoride we cannot get through our diet unless you eat fish with the bones but even then there is no localised effect on teeth. So we need it from somewhere else. And the fluoridated water is simply not enough as it passes through the mouth and does not provide long enough localised effect (so don’t use that as an excuse). That’s why we use the toothpaste.

Right Way of Eating Sweets (Thought You Might Want to Know)

You can eat sweets without getting decay. Us dental professionals are a living proof of that. You see we looooove to eat sweets but rarely get decay. I will tell you how we do it.

  1. If you buy pack of sweets eat them in one go and have xylitol chewing gum, slice of cheese or fluoride tablet once you are finished. If you eat one sweet every 10 minutes for the next two hours you will have an acid attack in you mouth for approx. 2 hours and 30 minutes. Or even worse example. If you take one sweet every 30 minutes for the full working day it means you have had an acid attack the whole time you were working. Acid attack means losing minerals. And I have already told you earlier what happens if you loose too much minerals which you certainly will do if you have 7-8 hour-long constant acid attack.
  2. Eat sweets as dessert. You get acid attack already because of eating and you can avoid getting an extra acid attack by eating the sweet in one go after a meal. Have xylitol chewing gum, slice of cheese or fluoride tablet once you are finished
  3. Whenever possible and if you stomach can take it, buy sweets that are sweetened by xylitol. Now people often blame the xylitol for the laxative effect of sugar-free sweets. But it is often not the xylitol that causes the upset stomach. It is the maltitol syrup. So seek products that are sweetened 100% by xylitol.

 

Please note: This post is directed to healthy adults. People whose saliva flow is impaired through illness or medication need more intensive fluoride treatment on their teeth.

Part III: I’m Sorry but I Did Not Get Qualified So That I Can Make Coffee for You

Dental Revelations Blog-

It is (finally!) time for the final part of the series of posts. This time it is of course the nurse’s role in the dental practice which probably is the most difficult one. Here’s why.

Experience Brings Wisdom

The dentist may know dentistry but he does not necessarily have any people skills. Or respect for others. Or ability to feel empathy. This kind of dentist is not fun to work with. Not even close to pleasant.

The nurse needs to put up with the dentist’s whimsy ways and misuse of a power. Some nurses might tolerate this for a long time but some do find another job quite quickly. Especially those who are experienced ones.

But having said that, sometimes experienced nurses are allocated purposely to assist difficult dentists. To kind of bring them in the line. And oh boy if the dentist resists the change. He will have miserable time as the nurse tells him off about everything. The dentist’s whining is quickly silenced by the quick-witted nurse who do not tolerate any nonsense.

So the wisest dentists will comply very quickly as it is crucial for the congenial atmosphere of the work place. Plus the wisest dentists understand that the experienced nurses are worth their weight in gold no matter how they seem to disrespect the outdated hierarchical structure of dental practice.

Experience Brings Knowledge

In the Part I of this series of posts I wrote that sometimes the hygienists can have better knowledge on how to treat the gum disease. It is the same with the nurses – especially the nurses with 20+ years of experience. They have stared at people’s mouths for such a long time that they know a cavity when they see one. They can tell if the soft tissues look suspicious or if the filling has sharp edges that would bother the patient’s tongue.

If the dentist is lucky to have this kind of nurse assisting him he should be grateful to have extra pair of eyes looking out for problems in the patient’s mouth. But too many let their ego come in the way of team work (please read Part II for more on this subject). They ignore the fact that the nurse is looking at the mouth from another angle and can see things that are on dentist’s blind side.

Nurse Aka the Barista

One thing I have never understood is that why is it the nurse’s duty to make a cup of coffee/tea for the dentist? Please tell me one good reason why the person behind the title nurse should be considered as a servant? If anything, it should be the dentist making the coffee for the nurses as once they are finished with the patient they can enjoy their lunch in peace whilst the nurse disinfects the surgery’s surfaces and deals with the sterilisation of the instruments.

Another thing I have never understood – which I have already written about on my second post – is the fact that the patients bring gifts to the dentists but not to the nurse. Wine, chocolate, sweets, books you name it. I guess they don’t realise that dentist would not be able to do any treatment without the nurse (well without compromising good quality of treatment).

About Qualification Requirements

You may not need any qualifications to start as a trainee dental nurse.

This is a quote from National Careers Service’s website. It amazes me that in the UK you are still able to begin working as a dental nurse trainee without any qualifications and train yourself on the job. When I began working in the UK over a decade ago the dental nurse did not need to be qualified. Anyone could work as a dental nurse. Any random gal from the street. Seriously.

Somebody who has no clue about cross infection control or how to use all the equipment and materials safely would seriously compromise the patient’s, the dentist’s and the nurse’s own health.

In my current country that I work in the trainee nurses need to have certain modules accomplished before they can work as a trainee nurse. In my opinion this is far better system.

Hard Work Does Not Pay Off

The amount of work the nurses do does not show in the salary. They are very poorly paid and are expected to work on their lunch breaks if the dentist runs late and they are even expected to open the surgery in the morning on their own time.

I will tell you about one of my workplaces I used to work at. In this rather big company the nurses working hours were from 9am to 5pm. This was the time they got paid for. The problem with these working hours were that the patient came in at 9am and the surgery needed to be opened prior to that. All the nurses and the dental hygienists know that if you open your surgery properly it will take at least 30 minutes. Who would want to work 30 minutes for free? No-one apart from the charity volunteers but dentistry is no charity.

This meant that the nurses came in around 8.45am to open the surgery and they cut corners where ever they could. The same happened in the afternoon when the last patient had left. Closing the surgery also should take around 30 minutes but it was often done in less than 15 minutes. Needless to say that something important is left undone.

Pay Enough to the One You Want to Keep

Now on this final chapter I will give an advice to all the dentists who have nurses as employees. It is an advice that will make your practice a success story.

If you think your nurse is doing magnificent job

  • pay her enough money for that. Even more than what would be current going rate of the nurse
  • be flexible and take her personal life into consideration. Show that you care if she struggles with the demands of bringing family life and work life together
  • give her gifts every once in a while. Perfume, chocolate, her favourite music… anything
  • make sure you apologise if you run late before the lunch break. Let her go for an extra break later to compensate the lost time
  • buy her a lunch every now and then – after all you make gazillion times more money
  • make sure you both work in an ergonomic position
  • respect her

These are the only ways to stop your nurse looking for another job. You see every nurse know eventually that there are dentist’s who do value them more. Believe me, I know many nurses who have been rewarded generously by their employer – they have been paid more than an average nurse, they have been taken on board to a course trip overseas (even to Mauritius!), they get extra time off…

You see the dental practice who’s supportive staff keeps on changing all the time is not giving a very good impression to the patients. And that alone can be a reason for them to change dentist.

About Me, Myself and I

Dental Revelations Blog-1389

Before I will release the Part III of the series of posts I will tell you something about myself.

I have not written a lot about myself in this blog but this post will be an exception. And the reason for doing this is that you – my dear reader – would understand why I haven’t been and won’t be writing new posts as often as before.

Let me first tell you about the time when I decided to start writing this blog. This was in March this year. I had finished writing a novel in December last year which left a void in my life. More time in my hands. Thoughts that I wanted to put on paper (so to speak). Endless ideas for books.

But.

I have a family. Small children who need my time. I have a spouse who needs my time. I couldn’t begin another massive project of writing a novel. So I decided to put all my creative energy on this blog. But little did I know how time-consuming it would be. All the researching, writing, editing and advertising. It consumes as much time as writing a novel.

But I am not a person who gives up something that I have started. I will see things through until the (bitter?) end. So I made time for blogging and it went well up until now. You see my littlest one is about to begin nursery and I am about to return to practice my dental profession. And to be honest I am not looking forward to it. If you have read my posts you might have a pretty good idea why I feel this way.

As if all those things I have written about in my blog weren’t enough to make me wish I didn’t have to go back to my profession. On top of all those things I also work in a dental practice that have been dysfunctional for decades and even though people have come (including me) and gone it has made a very little difference to the atmosphere. But as a thoughtful and problem solving person that I am I have started to see this fast approaching and unwelcome life change as an opportunity. You see I won’t be out of post topics whilst working in there. Nope, it will be a horn of plenty!

So bear with me whilst I go through this hectic time in my life. Keep reading, sharing and commenting my posts. I have reached readers in every continent which I believe proves that people in dentistry go through the same problems all over the world. Let’s keep on changing the problems by discussing about them.