Question

My son (23) has obviously been brushing his teeth incorrectly and now has gum problems. I advised him to use an electric toothbrush as I have had good experiences with it. However, the dental hygienist advised him against it. What are the pros and cons of an electric toothbrush? M. M. IN L. 

Short answer

Proper tooth cleaning is essential for good oral hygiene. If too much pressure and incorrect movements are used for cleaning, the gums can recede. If, on the other hand, it is not cleaned efficiently enough, tooth decay or gingivitis could develop.

Based on your brief information, I assume that your son's gums have already receded considerably on individual teeth. The affected teeth appear longer and the "softer" root surface is probably visible. The question of how such an area should be cleaned is justified: If too much pressure, too abrasive paste and incorrect movements are used for cleaning, the gums could recede further. If, on the other hand, it is cleaned too inefficiently, caries or gingivitis could develop. 

Learn the right technique 

Using soft (soft) toothbrushes with less abrasive pastes (RDA value less than 50) is an option with the correct technique (Stillmann technique). You should have this technique professionally demonstrated to you by your dentist. It involves brushing away from the gums in a vertical sweeping motion. The method involves a slightly rotating movement with little pressure. To improve the cleaning performance, abrasive or polishing agents are added to the toothpaste. The so-called RDA value (Radioactive Dentin Abrasion) is the measure for the abrasive effect (abrasiveness) of the cleaning agents on the dentin. RDA values of less than 30 are considered to be slightly abrasive, values of over 100 are considered to be highly abrasive. 

Sonic toothbrushes 

However, modern electric sonic toothbrushes with a hydrodynamic effect now represent a new dimension in prevention. In addition to mechanical cleaning, they generate hydrodynamic turbulence, which also removes bacteria from areas of the teeth that are not mechanically touched by the bristles. These sonic toothbrushes are superior to manual and other electric toothbrushes. Sonic toothbrushes are particularly recommended for patients with exposed tooth necks (gum recession), gum injuries, as in your case, periodontitis (inflammation of the tooth bed) and a high risk of caries formation, but also for implants and extensive reconstructions. According to a study by the University of Zurich, only the following sonic toothbrushes have a hydrodynamic effect: SenSonic SR 1000E (Water-pik), Sonicare FlexCare (Philips), Sonic Complete (Braun Oral-B), Panasonic EW-DL40 (Panasonic); for children: Sonicare Flexcare for Kids (Philips). Children can use the sonic toothbrush from the age of 4. 

Correct handling 

However, the quality of tooth cleaning also depends on correct handling. Ideally, you should ask your dentist to show you how to use it correctly. The cleaning time is about four minutes, which is quite long when using a slightly abrasive paste with an RDA value of less than 40 and minimal contact pressure. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on October 04, 2010