September 10, 2018

Complete Guide to Toothpastes and Tooth Brushing

Brushing and flossing at least twice a day is crucial to preventing cavities, and preserving the health of your teeth and gums. You can read more about how cavities form here, and learn more about gum disease here. You probably learned how to brush your teeth back when you were a small child, and may not have thought much about your technique since then! Here are some of the basics to making sure you’re doing your best brushing, as well as tips on choosing a toothpaste.

Toothbrushes and brushing technique

  • Always use a soft-bristled toothbrush.
  • Hold your brush at a 45-degree angle to your teeth. Move the brush back and forth in short strokes over each surface of each tooth several times. Be gentle – enamel erosion may occur as a result of over-vigorous brushing.
  • Brush for at least two minutes – less just doesn’t cut it!
  • To get the most plaque-removing mileage out of those bristles, replace your toothbrush every three months.

Electric toothbrushes vs manual toothbrushes

An electric toothbrush can clean more effectively than a manual brush. The rotating head applies equal, even pressure on all areas of a tooth quickly, meaning you are less likely to miss plaque and tartar as you brush. Many people apply too much pressure when using a manual brush; an electric toothbrush applies the right amount of pressure and avoids damage to the teeth and gums.

Along with pressure, efficiency is another benefit of using an electric toothbrush. When brushing with a manual toothbrush, you make about 300 strokes per minute, while an electric toothbrush makes thousands or even tens of thousands of strokes per minute, depending on the model. 

Many electric toothbrushes come with additional features like timers that let you know how much time to spend on each quadrant of your mouth.

Choosing the right toothpaste

The first consideration in choosing a toothpaste is to be sure that it contains fluoride and has the Canadian Dental Association (CDA) Seal of Approval. All CDA-approved toothpastes have met safety and effectiveness standards, and contain a mild, enamel-safe abrasive that works with your toothbrush to remove plaque.   

Here’s a closer look at common toothpaste ingredients and claims:

Fluoride
When used properly, fluoride has been proven to be effective at significantly reducing dental decay in patients of all ages, and twice-daily brushing with fluoridated toothpaste is recommended by the Canadian and American Dental Associations. Learn more about safe fluoride use here.

Different manufacturers use different formulations of fluoride in their toothpastes. The most commonly used and most effective form is sodium fluoride (NaF). Until children are able to effectively spit out all of the toothpaste used while brushing, non-fluoride toothpastes are recommended. See more information about children’s dental health in our Guide here.

For adults with high rates of caries (cavities) or reduced salivary flow, products with increased fluoride concentrations are available, and your dentist can recommend an appropriate product.

Tartar control
Tartar control toothpastes contain an ingredient that can help reduce the rate of tartar (the hardened plaque than can lead to gum disease) building up on teeth. It is important to note that these toothpastes only remove tartar above the gumline, and only a professional dental cleaning can remove tartar that builds up below the gumline.

The most common ingredient used in tartar control products is pyrophosphate. Pyrophosphate can also cause side effects such as increased tooth sensitivity, especially in patients with gum recession, and sores on the gums and inner borders of the lips. If you experience any of these side effects, you should talk to your dentist about whether this type of toothpaste is right for you.

Stain Removal and Whitening
Whitening toothpastes often have abrasive ingredients added to help strip away stains. These can be effective for people who build up heavy stains from habits such as smoking; however, most people do not build up a level of staining that requires the use of a potentially damaging abrasive. It is also important to note that abrasives do not change the underlying core color of your teeth – they simply remove deposits on the outside surfaces.

Since most people use whitening products in hopes of changing the underlying color of their teeth and not just for stain removal, many manufacturers have added hydrogen peroxide and related products to toothpastes, in an attempt to “bleach” teeth while brushing. Unfortunately the low concentration of the active ingredient combined with the short exposure time of brushing has been shown to be ineffective for whitening teeth. On top of this, daily exposure to peroxide products can cause soft tissue sores.

For information about safe and effective whitening, see here.

Baking Soda
Baking soda is a mild abrasive, and has been used in toothpaste to remove stains from teeth. However, some studies have indicated that once mixed with the saliva in your mouth, the abrasive action of baking soda is lost. In fact, some studies show that higher baking soda content toothpastes actually lead to lower overall cleaning scores. While not being harmful, baking soda toothpastes appear to not provide any additional benefit to your overall oral health.

Desensitizing
These toothpastes can be very effective for treating tooth sensitivity to hot or cold drinks and food by reducing the tube-like channels that pass through the teeth and connect to nerves, or reducing the ability of the nerves to transmit pain. For people who have gum recession, these products work by providing extra protection on the sensitive, exposed root surfaces. The active ingredient in desensitizing toothpastes is most often 5% potassium nitrate.

It will take about four to six weeks of twice-daily use before you notice any sensitivity improvement, and these toothpastes are not effective when used only periodically. Keep in mind that if your teeth are experiencing sensitivity, it’s important to come in to see your dentist to make sure there isn’t a more serious problem.

Antibacterial, Anti-Plaque, and Gingivitis Control
Some toothpastes claim to help control mild superficial inflammation of the gums (gingivitis) by reducing levels of bacterial plaque. Some are marginally effective, while others are not effective at all. If you suffer from chronic gingivitis, please ask your dentist which toothpaste product is best for you.

It is very important to note that these products will not reverse or treat more severe gum disease (periodontal disease) – this must be managed by your dentist.

Flossing
Flossing is just as important as brushing when it comes to fighting tooth decay and gum disease! If you haven’t flossed in awhile, your gums may bleed slightly when you do – this means that your gums are inflamed and bacteria are present. When you start flossing, you’ve taken the first step toward cleaning out the built-up plaque and strengthening your gums, and the bleeding will cease after the first time or two that you floss. Make sure you see your dentist if your gums continue to bleed.

Remember that toothpicks and oral irrigators like Waterpics are effective at removing food debris, but are not a substitute for flossing. Get more tips on flossing and how to make it a habit right here.

The importance of regular professional cleanings

While the importance of proper twice-daily brushing and flossing can’t be overstated, regular professional hygiene appointments are crucial as well! A professional cleaning will removing tartar that has built up on the tooth surface as well as below the gum line, where it is most harmful. After your cleaning, we use a powerful but safe polish that will get your teeth as white as they’ll ever be from brushing. Your hygiene appointment will also include a thorough examination and oral cancer screening by your dentist, to make sure no problems are present.

Book a hygiene appointment here.