Author Archives: Dental Revelations

About Dental Revelations

A dental professional on a mission. Also loves photography and writing. Follow me to learn the secrets of dentistry.

The Best Electric Toothbrush

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I have known it. I have told you about it. Now there is evidence of it (again).

The Philips Sonicare is the ultimate electric toothbrush. There’s no way going around it. I have written a post about it before as well but I had to bring it up again because there is new evidence supporting my opinion.

The Journal of Clinical Dentistry has earlier this year published a study A Comparison of the Effect of Two Power Toothbrushes on the Reduction of Gingival Inflammation and Supragingival Plaque. You can find an abstract of the study here. If you read it through, you must by now wake up from the brainwashed illusion that any other toothbrush would be better. 

There is mainly two brands that can compete in the category of the best electric toothbrush – Philips and Braun Oral-b. That is why this study is significant. Of these two best manufacturers, Oral-b gets the short end of a stick I’m afraid.

Tried It, Didn’t Like It

So you gave the Philips Sonicare a go? Did it tickle like hell? Well that’s what it does in the beginning. There is an easy-start mode to reduce the tickling sensation in the beginning but I would advice to use it in full power as soon as possible. The tickling will diminish in 1-2 weeks. Just persevere.

Did you not get a clean feeling? There is certain technique to be used with the Sonicare toothbrush. Firstly, you should use a gel-like toothpaste and soak the brush head under running tap before you start brushing. This is because the sonic vibration needs liquids to travel to hard to reach places like in between the teeth and below the gum line. The gel-like toothpaste will dissolve quicker into water than pastes. If the mouth is too dry, the sonic vibration won’t work and this will result in poor cleaning result.

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Secondly, you need to stop brushing. Let the brush slide slowly over the gum line (where the tooth and gum meets) and point the bristles where you want the sonic vibration to reach. The gum line is the most important area to brush, but once you have done this you can point the bristles directly towards the surface of the tooth. This is a brilliant way of reducing staining. The brushing like this will take about 3 minutes.

Thirdly, do not press too hard. If you press too hard, you will loose the sonic vibration.

Fourthly, change your brush head every 4-6 months.

By following these advices, you should have a squeaky clean teeth.

For the dental professionals, who have seen poor results with their patients that are using Philips Sonicare – teach your patients to use it correctly.

Hard Evidence

I’ve seen the evidence with my patients that Philips Sonicare does it’s business. I use it myself and wouldn’t change to any other toothbrush. But to convince everyone else of the greatness of Philips Sonicare, I am happy that there is new evidence of it. Here’s a quote from the study:

Conclusions: The Philips Sonicare Diamond Clean Smart powered toothbrush reduced gingival inflammation, gingival bleeding, and supragingival plaque significantly more than the Oral-B Genius 8000 powered toothbrush following a 42-day home-use period.

How can you argue with that?

Read more:

Testing Oral-b Smart Phone Holder, Take 2

Testing Oral-b Smart Phone Holder, Take 1

Superiority of the Philips Sonicare Toothbrush

Recommendations, Advice, Tips You Can Rely on

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Climate Change and Dentistry

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The Climate Report in 2018 wasn’t much fun to read. In fact it was rather depressing and raised many worries over the future of our children and their children. We might even face a situation where many adults living today will face the consequences of polluting our Planet Earth. We’ve all seen the warning signs – natural disasters, unusual weather like long heatwaves in countries where it is normally mild weather, extreme dryness causing crops to die just to name few.

Despite the fact that the report was worrying and depressing, I hope that all of you have read it. Hiding your head in the sand will not make it go away or change the fact that it is going to affect you as well.

We should all participate in saving the Planet Earth. Participating in saving ourselves and our children. That can be done by thinking what changes you can do in your everyday life to help in this cause. There are plenty of choices we make every day that can make a difference to the world’s future.

You can choose a product in the food store that use minimum amount of packing. For example choose muesli which has simple paper bag packaging and which is locally produced (or in your home country). Choose fruits and vegetables that have simple packaging or no packaging at all (there are re-usable fruit bags available).

Choose local fruits and vegetables or the ones that are not shipped from the other side of the world.

Reduce the amount of red meat in your diet or become a vegetarian (I’m not vegetarian but I have almost stopped eating red meat) ‘cos plant-based diet it is far more environmentally friendly than meat-based diet. Think about how large area of fields are needed to herd livestock and to grow food for them when these areas could be used for growing plant based food for humans or for growing trees that help the Planet to get rid of the carbon dioxide – it is a gas that is the largest contributor to the climate change.

Also, once you’ve done your environmentally friendly food shopping, do not use plastic bags to pack your stuff. Instead take a re-usable bags with you when you go food shopping. And why not use them the with all your shopping? Do we really need to tell everyone that we’ve been shopping at Harrods or Louis Vuitton? When the climate change reaches the point that our lives are at risk, these status symbols have very little meaning. So have one re-usable bag always tucked inside your LV hand bag, car, rucksack or pocket.

There are plenty of things we can do differently as long as we think we can make a difference. If everyone would think that it makes no difference if you buy these passion fruits that are shipped from the other side of the world or that it makes no difference if you recycle or not, we are doomed.

Together we can make a difference and you can change the way you do things in every aspects of your life, including your professional life. Personally speaking, I have noticed that I feel more and more guilty over the fact that dentistry is so very environmentally unfriendly.

Single-use materials

We produce massive amounts of waste every day. We have many disposable materials that we throw away after each patient. Many of the disposable materials are made of plastic. There’s no way going around it as disposable, single-use materials are the best option when it comes to cross infection control.

Water

Also, have you ever thought about how much water we use everyday? We wash our hands many times a day. Our rotary instruments require water, our instrument maintenance cycle requires water, our aspiration system loooves water (this is how one maintenance guy for the dental units expressed it) so we suck water into it in the morning, between every patient and in the evening. Well, at least this is how it should be done to prevent the backflow.

Backflow means bacteria and viruses travel towards the patient inside the suction tube. When patients close their mouth and form a seal around the tip of the saliva ejector, a partial vacuum occurs. Blood, viruses, saliva, bacteria, debris might travel as far as into the patient’s mouth. If you don’t believe me, read this. This of course means the patients should not close their mouths around the suction.

I have tried to change my way of using water by closing the tap (with my elbow) while I rub my hands together with soap – you know this should last 15 seconds for the soap to kill e.g. norovirus that is causing Winter Vomiting Disease. In that 15 seconds lots of water is wasted if you keep the tap on. The surgery should have taps that are easily operated without using fingers – the tap should be long enough (medical tap) for you to be able also open it with you elbow. There are also sensor-operated taps that will stop the water flow when hands are moved away from the tap.

Chemicals

We use many different chemicals that are bad for the environment. There’s no way going around this one either. Unless the manufacturers are trying to develop chemicals for disinfection that are more environmentally friendly.

Oral Hygiene Recommendations

On top of everything else we recommend to our patients products that are made of plastic. That’s why the wooden triangle-shaped tooth pick has become a product I recommend more and more (I have written about it in one of my previous posts). Of course it’s not suitable for all the patients, but for those that it is, it will make a difference in the amount of plastic waste.

Conclusion

There are not many things we can change in practising dentistry. But even the smallest changes matter. So please everyone, think about what change you can make and challenge your colleagues and friends to participate in saving the Planet.

Lets make it a norm rather than an exception to re-cycle and to live sustainable life.

Lets do it for our children.

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Elmex Sensitive Professional Toothpaste Review

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Elmex Sensitive Professional toothpaste

Elmex is a very old brand by GABA International AG (Switzerland). Gaba International AG is owned by Golgate-Palmolive of the United States. They brought out Elmex Sensitive Professional toothpaste which has added benefits to their Elmex Sensitive toothpaste.

I am always sceptical about new oral health care products and I make my judgement by testing the product myself and asking experiences of my patients. Lets find out what my professional opinion is about Elmex Sensitive Professional toothpaste. There will be an ingredient list at the end of this post.

The Selling Speech

The manufacturer promises scientifically proven immediate and long-lasting pain relief for sensitive teeth. It is quite bold promise, but the older Elmex toothpaste versions have always been relatively good toothpastes because they contain organic fluoride called amine fluoride. Amine fluoride has been considered to be superior to more commonly used inorganic fluorides in toothpastes – sodium fluoride and sodium monofluorophosphate. But having said that, it’s good to bear in mind that the type of fluoride makes very little or no difference to a relatively healthy mouth.

The suprising fact with the Elmex Sensitive Professional toothpaste is that it does not contain amine fluoride. It contains sodium monofluorophosphate 1450ppm which is the recommended level of fluoride for adults. Any less would be ineffective. I am not sure why they don’t use amine fluoride with this toothpaste. But I try not to get stuck to this detail because there is something else in this toothpaste that will make it a super star of the toothpastes.

That is Pro-Argin technology.

Pro-Argin Technology

Pro-Argin technology system contains arginine and calcium carbonate. Arginine is an amino acid naturally found in saliva.

Once the arginine and calcium carbonate bind to the surface of the tooth, they will start to attract calcium. Calcium is the mineral we loose from the surface of the tooth (demineralisation) when we eat something with carbohydrates or drink something with carbohydrates or drinks that are acidic. The saliva normally tries to fix the surface of the tooth by returning the calcium and neutralising the acids (remineralisation). But often our life style habits are too much for the saliva to handle and not enough calcium is returned to the surface of the tooth.

This will result in cavities, hypersensitivity and/or erosion. The hypersensitivity happens because the tiny channels (tubules) leading from the surface of the tooth to the nerve of the tooth, loose their mineral cap. Open tubules cause the nerve to react to the temperature changes and pressure. It reacts by pain. So using a toothpaste that comes to saliva’s aid in remineralisation process, is definitely a good thing. Together with saliva the Pro-Argin toothpaste can block the tubules again with a mineral cap.

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Pro-Argin technology in toothpastes blocks the open tubules and therefore reduces sensitivity.

The Design

Well, the design has not changed really and there is no need to. It is a trusted brand with quality toothpastes so no need for any hocus pocus to make it more appealing.

I love the environmental advice on the packaging. When people get these hints on the products they use regularly it will raise awareness. Maybe the environmentally-friendly habits will find their way into peoples everyday life. Let’s save the world by little deeds!

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The Testing

Over the years of being a dental professional I have noticed that people struggle sometimes when they run into toothpastes that have the same design for opening the tube as Elmex Sensitive Professional.

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How to open that tiny little lid that looks like a sprocket? The answer is in the cap.

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Just turn the cap upside down and it will fit on top of the tiny lid. By twisting the cap the tiny lid will come off effortlessly.

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The consistency of the toothpaste is more a gel than a paste which is perfect if you are using Philips Sonicare toothbrush. It’s not too runny which I appreciate (no toothpaste marks on the sink) but will very quickly transform into liquid when brushing.

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The closer look shows that it is rather smooth in texture. So to my mind this means two things. It’s not too abrasive and also it most likely does not contain microbeads. The RDA level which tells you how abrasive the toothpaste is, should be under 100 for safe use of toothpaste. Elmex Sensitive Professional toothpaste has RDA level of 65. Perfect!

To know if a toothpaste contains microbeads, the polyethylene is the ingredient to look for. No-one should buy a toothpaste that contains microbeads as those tiny little beads will pollute our oceans. Elmex Sensitive Professional toothpaste does not have polyethylene in the ingredient list (see at the end of this post).

The toothpaste stays on top of the toothbrush bristles without dripping but it slowly disperses between the bristles if you have time to wait for this. I emphasise that you don’t need to wait – I just wanted to see what happens.

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I brush my teeth for two minutes and I get slight burning feeling in my mouth. It’s not unpleasant though and most of the non-professionals would say that the feeling is fresh, not burning. I’m just very sensitive.

The representative of Elmex Sensitive Professional toothpaste advised to spit the toothpaste out after brushing but not to rinse. So I follow this advice. The teeth feel very clean despite the low RDA level. That always makes me satisfied with the toothpaste.

I carried on using the whole tube of toothpaste twice a day and I must simply say Wow! I have been suffering hypersensitivity for example if I eat ice cream. The hypersensitivity does not happen while I eat it but as soon as I have stopped I get this excruciating pain, nerve pain that lingers way too long. There’s been no way to relieve it other than by avoiding the ice cream.

But after using one tube of Elmex Sensitive Professional, the hypersensitivity is gone! So I guess the Pro-Argin technology really works.

There is also an advice on the tube to rub the toothpaste over the most sensitive areas with a finger. The rubbing should continue for 1 minute. The toothpaste can be left in place without rinsing. Remember that this advice is only applicable from the age 12.

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Would I Recommend

I would definitely recommend this toothpaste to anyone suffering from sensitive teeth or dental erosion. Or anyone who wants to prevent these two things. I have not had this good results with sensitive teeth than with Elmex Sensitive Professional. Also the Pro-Argin technology has tendency to resist acids from a diet that contain food of low pH which is why it helps to prevent dental erosion.

I’m just wondering why manufacturers want to add soap (sodium lauryl sulfate) to their toothpastes as for some individuals it can work as an irritant. Sodium lauryl sulfate is the foaming agent in the toothpaste. It may cause dry mouth and aphthous ulcers. Mind you, nothing is scientifically proven but it is widely recommended amongst dental professional that people suffering from aphthous ulcers should change their toothpaste to non-foaming toothpaste.

Always remember to check from the ingredients if a toothpaste contains soap. There are other ingredients that may produce foam so not all the foaming toothpastes contain soap.

This toothpaste can be used for children as well (if they accept the taste), but remember to use only pea-size amount for children under 6 years and to very young children who cannot spit out yet, use only smear of toothpaste.

The Ingredients

  1. Calcium Carbonate – a mild abrasive. Combined with arginine the alkaline conditions are created to the surface of the tooth which will encourage phosphate ions and calcium to deposit on to the dentin
  2. Aqua – a main carrier for all ingredients. Helps dissolve other soluble ingredients. Helps the mechanical process of cleaning teeth in mouthwashes
  3. Sorbitol – a sweetener, humectant and texturising agent
  4. Arginine – an amino acid, the good in the toothpaste
  5. Sodium Lauryl Sulfate – a soap and therefore the foaming agent. Can work as an irritant
  6. Sodium monofluorophosphate – the good in the toothpaste
  7. Aroma – a chemical compound which adds odours to dental products. The specific aroma is not specified by the manufacturer
  8. Cellulose gum – a thickening agent
  9. Sodium bicarbonate aka baking soda – a mild abrasive as an ingredient of a toothpaste. Do not use your own baking soda to brush your teeth as it will be very abrasive.
  10. Tetrasodium Pyrophosphate – an agent to remove calcium from saliva. Used normally in tartar control toothpastes but with Elmex Sensitive Professional toothpaste I believe it is used for attracting the calcium from the saliva to the surface of the teeth
  11. Titanium Dioxide – a colorant and thickening agent
  12. Benzyl Alcohol – a solvent and preservative. In rare cases, this ingredient can cause contact allergy.
  13. Sodium Saccharin – an artificial sweetener
  14. Xantham Gum – a thickening agent
  15. Limonene – a natural solvent that cleans. Also it flavours the product.

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GC Tooth Mousse Review and Advice for Use

Oral-B Gum & Enamel Repair Original Toothpaste Review

RDA Value in Toothpastes – Any Relevance?

Hands up Who Knew That Zinc in Toothpaste Can Cause Dry Mouth?

Testing Oral-b Smart Phone Holder, Take 1
Testing Oral-b Smart Phone Holder, Take 2

Dental Erosion and Tea