Best way to brush? Even dentists disagree





Brushing our teeth — we all do it, once in the morning, once before bedtime. And we all think we know the best technique.

However, it would seem that after all we don't and, more worryingly, neither do our dentists nor do the people who make our toothbrushes.

A new study, by dental experts at University College London, has condemned "unacceptably inconsistent" advice from national dental associations, manufacturers and dentists themselves on the simple matter of brushing teeth.

Across 10 countries, researchers identified no fewer than six basic methods of brushing, and a variety of advice on the important aspects of dental hygiene: how often to brush, how long to brush for, technique and ways of rinsing.

The authors said there appeared to be "no consensus among professional bodies on the best method of toothbrushing for the general population or for people of different ages or with particular dental conditions. Such diversity in recommendations should be of serious concern to the dental profession".

Dr Nigel Carter of the British Dental Health Foundation admitted that experts "struggle" over toothbrushing recommendations. "When you actually look at the science there is no clear evidence around what method might be best, and the recommendations on toothbrushing intervals also vary hugely around the world," he said.

In the UK for instance, widely followed advice says to brush for two minutes twice a day. But many countries recommend three minutes, while most South American countries advise brushing for one minute, three times a day.

"I think the toothbrush manufacturers have been guilty of not doing as much research as they might," said Dr Carter. "Hopefully what [the UCL study] will do will focus some scientists on doing some more robust research on both the various techniques of brushing and the brushing intervals."

The most-commonly recommended method is known as the modified bass -which involves horizontal brush movements, accompanied by vertical and sweeping motions to create circles. However, no large studies have been carried out to determine whether it is really more effective than other simpler methods — including the most basic scrub technique taught to children.

Dr John Wainwright, the study's lead author and a practising dentist, said that he often encountered patients concerned that his recommendations differed to what previous dentists had told them.

"What I feel we need is better research into what the easiest to learn, most effective and safest way to brush is," he said.

"The current situation where not just individual dentists, but different dental organisations worldwide are all issuing different brushing guidelines isn't just confusing — it's undermining faith and trust in the profession as a whole. For something most people do twice a day, you would expect dentists to send a clearer, more unified message t o t h e i r p a t i e n t s o n how to brush their teeth."