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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Can You Trust the Recommendations given to You by a Dental Professional?

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Too Many Options

Floss, tape or ribbon? Soft, medium or hard brush? Manual or electric? Fluoride or herbal toothpaste? Whitening, double-action, triple-action or all-in-one? Mouthwash or not?

These questions are endless in the mind of a common consumer. So no wonder they rely on the advice of a dental professional. Why wouldn’t they? Us professionals have the latest information and studies. We have tested the products ourselves. We have seen them in use amongst patients with good results before recommending them.

Not.

As some of us might have, most of us haven’t. Let me tell you how a product gets recommended.

Annual Dental Show Case

Every year dental professionals gather at dental show cases where manufacturers of dental equipments and oral health care products have set up impressive stands to lure dentists, hygienists and nurses to discuss about the new products.

A revelation:

Most of these professionals are not interested in what types of root canal files they have invented or the qualities of the new toothpaste.

What they are interested in (while acting as if they are listening the representative) is:

Are there any freebies?

Yes, I have seen highly paid dentists with their Louis Vuittons to run after freebies like they had no money to buy them. They sit in free 45 minute lecture sponsored by one of the leading oral hygiene product manufacturer to receive the latest model of an electric toothbrush which they already have. This new one they will either sell or give as a Christmas gift to a relative. They go from stand to stand to pick toothpaste, floss, chewing gum, sweets and reluctantly accept advertisement leaflets which will go straight into the bin when they reach home.

The most generous representatives are the ones whose product end up recommended the most.

Why?

Because they send boxes and boxes of free samples to the practices. Let’s say a dental practice receives 6 boxes of toothpaste samples, those handy travel sized ones, you know? Each box has 100 samples. So 600 tubes of toothpaste to give away. Will all of these be given to the patients? Nope.

300 of them will confiscated by the staff of the dental practice for personal use
200 of them the staff will give to the relatives and friends

And finally the rest will go to a small bowl on the side of the desk in the surgery and these samples are given one by one to a patient who has deserved it. Some might even hide them in a drawer to avoid being forced to give them to a patient that annoyed them (because it’s not good manners to say no if the patient asks for samples).

Salesmen of the Manufacturers

The leading oral hygiene manufacturers have salesmen who visit regularly the dental practices to promote their products. They are warmly welcomed to the practices but often only if they visit whilst the practice is having a lunch break. The reason for this is:

  • The practice does not want to lose any profitable surgery hours.
  • All dental professionals know they will bring something to go with a coffee. A cake, sweets, a swiss roll. They had better or the salesman will be faced with a grumpy audience.

When the dental professionals are happily sipping away their coffee or tea with the cake, the salesman goes through the new products. There might be a question or two but what everyone is thinking while the salesman talks is:

Are there any freebies?

We often meet quite aggressive salesmen who will defend their product to the death. Honestly, what happened to customer is always right? If you are actually listening to the salesman when he is telling you about all the impartial studies of how their pulsating electric toothbrush is better than a manual toothbrush and especially better than their competitor’s sonic toothbrush (their study actually says sonic toothbrush is as crap as the manual toothbrush – whaaaat?) you are urged to raise your hand to get a say.

You want to tell the salesman, that you are actually using the sonic toothbrush and that you have recommended it to the patients with poor oral hygiene and the results are great. If you are wise, you don’t say anything and carry on recommending the product you know is the best. But if you cannot keep quiet, you will soon learn to do so next time. The salesman starts to talk to you as if you are retarded or malpracticing when recommending something their study has shown to be ineffective.

Impartial study my arse (beg pardon my French).

Anyway, the salesman gives everyone toothpaste and promises to send samples later on. Boxes of samples. And they will. And you already know what happens then.

I must say that it amazes me how some of the dental professionals are stubbornly stuck on recommending the same electric toothbrush they are using themselves and have never tried another one. Or they might have tried it once (let’s say this leading sonic toothbrush) with incorrect technique and judge it by that. They refuse to see the good results that are clear with the patients who are using this sonic toothbrush. Where is professionalism in this?

Personalities and Professions Clash inside the Practice

The dentist is the ultimate Master of the Universe (by Universe I mean a dental practice) and if the Master has ordered certain toothbrushes, certain toothpaste, floss and interdental brushes to be sold in the practice, then the rest need to comply. Of course there will be some rebellion inside the closed surgery doors. But it needs to be done so that one does not get exposed as there will be consequences. So one must occasionally recommend the products the Master has chosen.

For some reason unknown to the writer the patients seem to consider the dentists as God. What the dentist says overwrites everything another dental professional has said, including oral hygiene recommendations. The hygienist cannot be right if the dentist said something else.

This leads me into temptation to step out of the subject for a little while as I remembered something that has puzzled me for ages and I think I might get an answer through this blog. Here it goes… Patients consider the dentists as God and bring gifts (wine, chocolate, flowers etc) to them when the treatment is done and the nurses, hygienists and the rest hardworking supportive staff get nothing. Gifts TO THE DENTIST who makes gazillion amount of money compared to the supporting staff! Why o why? Dear patients, please use comment box to enlighten me in this matter!

Back to the subject.

Later on in this blog I will be writing more about the personalities and how it affects dental practice and the treatment given to the patient. But having mentioned it on the heading already I will write shortly here as well.

When a dental professional has a big ego it sometimes runs over the best interest of the patient. Lets say a dental hygienist recommended you a yellow interdental brush and she spent time and effort to get you to learn the technique by showing how to use it and by checking that you understood how and why to use it. You leave the practice happy because you learned a new skill to improve your oral hygiene.

Then you see a dentist the next week and he thinks the interdental brush is rubbish (as you lost a filling made by him when using the interdental brush) and advices you to use floss on your heavily filled teeth with wide gaps. He just casually says this without showing the technique. You try the floss as you have many times previously and it gets stuck, breaks and is difficult to use between the back teeth. You give up and stick to the toothbrush only.

Who wins? Nobody. Especially not the patient. And to be honest, you would be wasting your money anyway as the floss is not the right tool for you.

A revelation:

The dentist is not in the area of the best knowledge when it comes to recommending the oral hygiene products. They are far better drilling and filling the teeth. And doing all sorts of other nasty (from patient’s perspective) things that requires higher and longer academic education than hygienist’s.

Old Habits Die Hard

“I have always recommended floss and it’s been fine”

Oh, dear. Lets start from the basics of oral hygiene.

Patients are all different, our teeth and bones are different shapes. They have teeth that have no fillings, some fillings or mouth full of fillings and other restorations (crowns, bridges, implants). Some restorations are well made, some not. Patients have different motoric skills.

So you cannot recommend something out of custom.

To find out the best product to recommend to the individual patient, we should always use disclosing liquid (the one that dyes the plaque red/blue). If not used, it is impossible to tell what works and what doesn’t. You would be surprised to find out how ineffective the common floss or tape is. I do recommend floss every once in a while but only 3 certain types of certain brands (you will find out from here which they are, plus correct technique for the sonic toothbrush).

How It Should Be Done

This chapter is especially useful for the dental professionals but the patients benefit of reading this as well. You know you are in good hands when a dentist or hygienist is as thorough as I describe.

This is a short version of upcoming post about what recommendations should be based on.  It is last on the list because there are not many dental professionals who are this thorough.

The most important thing is to interview the patients about their current oral hygiene habits and reasons behind them. E.g. if the patient is not cleaning between the teeth, ask why? without sounding or being judgemental. Laziness, ignorance, stress, depression, difficult life situation, too hard… there are as many reasons as there are patients.

The next you need to find out where the problem areas are in patient’s mouth and decide the right tool for the patient to use. Test it, show it to the patient and let the patient try. Remember to say, it won’t be an easy ride at first even if looks easy when I do it.

Tell the patient where she can find them and where they are the cheapest to buy (do your research).

Give leash and don’t be overenthusiastic. By this I mean you should encourage patient even if there has been only small improvement, but also same time encourage to do better next time. Change the tool if it’s not working. Small steps!

In my experience it takes 12-18 months on average until you get it right if the patient is responsive. So don’t give up after the first visit.

Also worth remembering

  • the products sold in the practices are not necessarily the best ones like electric toothbrushes of certain makes and models. They are normally just the owner’s way of making more money on the counter. Use the products recommended by an experienced hygienist.
  • some of the products might even be a health risk like mouthwash which contains alcohol (now this is an issue that divides dental professionals. Some agree with me, some don’t. I will be writing about this later on in this blog).
  • some of the products might not be suitable for you like toothpaste containing soap if your mouth is sensitive (sodium lauryl sulfate).
  • some dental professionals are not revising and open to a new information and studies about dental products. They stick to the old knowledge despite the fact that the new information is indisputable. This happens especially if the new information is delivered by the lower rank colleague in the practice.
  • fillings, when well-made, do not come out with any oral hygiene product. The fault is always in the filling and in it’s maker if the filling is relatively new.

Conclusion

It was a long post, hopefully you made through it. To sum up all 2000+ words, only two words come to my mind that defines us dental professionals these days. Greed and pride. Two out of seven of deadly sins.

But there is hope.


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