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 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.20181104_152933.jpg

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.

I have noticed in the past 15 years of using the Sonicare that I and my patients who us it, get less stains. Hardly any even though I drink coffee and tea.

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

 

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.

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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 or pastille, slice of cheese or fluoride tablet once you are finished.dental-revelations-blog2
  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.

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

Dental Revelations Blog-4039

I have noticed it is very easy for a health care professional to get annoyed about different things by just browsing through dental forums and discussion sections of dental news.

This time it was the toothpaste.

Especially the toothpastes of certain big brand that promise all sorts of things but have side effects the representatives sweep under the carpet by saying casually

It’s perfectly safe to use

It’s normal

Yeah, peeling off the mucosa in your mouth is normal. I wouldn’t be so sure. Especially with the patients who have a sensitive mouth.

The salesmen of the manufacturers of oral hygiene products would sell their granny to promote their products. They can tell a fib or even lie to your face without loosing a good night’s sleep. All they want to achieve is that you will start to recommend their products. This is enhanced by giving the practices boxes and boxes of free samples which I have written about in my previous post Can you trust the recommendations given to you by a dental professional?

Are We Fooled by the Representatives and Adverts?

I remember an occasion when a representative of this big company came to my practice to introduce new products. These new all-in-one toothpastes. There were many different toothpastes in the same product family. One for everyone even though the first all-in-one toothpaste introduced not so long before these new ones was supposed to be the one to deal with e-v-e-r-y problem one could have. Slightly confusing I think.

Anyway, the rep went through these new toothpastes and recommended the sensitive version also for the sufferers of dry mouth. Then on the next sentence she mentioned that this sensitive toothpaste contains zinc…

Rather boring session got my interest immediately. Dry mouth and zinc? You got to be kidding me?

We dental professionals know our business. Every detail of it. Well at least I hope most of us do. Despite this I have noticed that many dental professionals are fooled by these selling speeches representatives give and do not notice that the things coming out of their mouths are simply bogus.

So I looked around to see if anyone else was looking puzzled? If anyone was about to say something? No, not a chance. They were just leaning back on their chairs with empty eyes staring at the products. But I couldn’t keep quiet. I never really have learned to keep my thoughts to myself especially if somebody is talking nonsense.

So I raised my hand to get a say (and I swear I could see my colleague roll her eyes meaning here we go again). The rep looked surprised.

Me: Did you say this toothpaste is for people with dry mouth?
Rep: Yes I did.
Me: And it has zinc in it?
Rep: Yes it has.
Me: But the zinc associated with dry mouth, isn’t it? It can make the dry mouth worse.
Rep: Err, I must say I do not have an answer for you now. But let me get back to you on that. What’s your e-mail address? I’ll find out and send you an e-mail as soon as possible.

A typical diversion from the subject. About month later I received an e-mail which said:

Hello,

I remember you asked something about the sensitive toothpaste. Care to clarify what was you specific question? All the toothpastes are well researched and tested. They are widely recommended by the dentists. Bla-bla-bla…

Yours truly,

Representative-that-will-not-come-to-my-practice-again-if-it’s-up-to-me.

Knowing Your Business in Depth

Now I must tell you that I did not know that zinc in toothpaste can be a culprit to dry mouth until another rep of another big oral hygiene product manufacturer (wouldn’t it be easier if I just told you which company?!) told me so couple of years ago.

I had recently tested their toothpaste for halitosis and got extremely dry mouth (honestly, I thought I will die of thirst between brushing my teeth and reaching the office in the morning). When I asked the rep about it she said that it could be due to the zinc in the toothpaste and asked me to file an adverse event report. She even gave me the document to fill in.

I was impressed. Not about the Sahara-Desert-in-mouth toothpaste but about the honest rep who could tell me something I didn’t know.

Since then it’s not been just once or twice that I have found out that my patient who is suffering from a dry mouth is using a toothpaste containing zinc.

The dentistry is constantly evolving. It is hard to keep up to it but we must. It is the only way we can give the correct advice to the patients.

Conclusion

It just occurred to me that I might be taking the visits of the representatives of oral hygiene products the wrong way. Perhaps it is accustomed way to let the reps babble away without questioning what they are saying. Am I considered to be rude to interrupt them when they are just trying to do their job? Should I just sit in silence when they are clearly not on the right path?

Perhaps, but I’m afraid it won’t happen in the near future. Or never. You see, isn’t it so that the annoying sides of one’s personality is only enhanced when one gets older?

Anyway. Be cautious of the advertising speeches of the reps. Read scientific studies about the ingredients and then make up your own mind if you will recommend certain products. Try them yourself and pay attention to how your mouth responds.

My advice for the patients is to use a toothpaste that feels good in their mouth. If the toothpaste burns, stings, makes your mouth numb or if you experience any other uncomfortable feeling STOP USING IT.


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