Toothbrush

The toothbrush is an indispensable instrument for the removal of plaque and food debris from dental surfaces.
There are many types of toothbrushes that differ in size, form, stiffness of bristles, and length and array of tufts.
The ideal toothbrush doesn’t exist (Bergenholtz et al. 1984), but various studies have shown that a short-headed manual toothbrush and synthetic bristles with rounded tips are more effective.

The SHORT HEAD has fewer tufts and is very functional because it can easily reach all areas of the mouth.
In fact, the fewer tufts present on the head of the toothbrush, the more effective it will be in removing plaque.

SYNTHETIC BRISTLES (e.g. nylon, tynes) are the best choice because they do not absorb water and therefore remain stiff, whereas natural ones tend to lose their original consistency and become very soft, and, therefore, ineffective in removing plaque (Bay et al. 1967).
Natural bristles have hollows in which bacteria can colonize and furthermore, they do not have rounded tips, which are, instead, indispensable because they reduce lesions of the gingiva.
The longer a toothbrush is used, the more its signs of wear increase, and its cleaning potential diminishes.
Due consideration should also be given to other factors that determine the wear of the toothbrush, such as the length and frequency of brushing, the brushing force applied, and the quality of the toothpaste. These factors vary a great deal according to the individual, and any variations will determine the rapidity with which the toothbrush begins to show signs of wear.
The toothbrush must be replaced when it loses its initial form and becomes matted.
As a general rule, even if the toothbrush is not deformed, it is advisable to change it every two and a half to three months, because in this lapse of time, variations in the form of the bristle tips can occur and this alteration reduces the effectiveness of the toothbrush in removing plaque (Kreifeldt et al. 1980, Massassati - Frank 1982).

Electric Toothbrush

The electric toothbrush (es. Interplak®) may be a valuable alternative to the manual toothbrush.
Some electric toothbrushes remove plaque more effectively than conventional toothbrushes especially on interproximal tooth surfaces.
In fact, as compared to the manual toothbrush, the electric toothbrush removes a larger quantity of plaque in an equal length of time (Van der Weijden et al. 1993).
It is particularly suitable for patients with limited manual dexterity, those who are lazy, patients with disabilities, and those with a fixed orthodontic appliance, for whom it is an indispensable aid (Mantovani et al. 1996). I always choose electric toothbrushes that clean delicately and I use them at a low speed.
Furthermore, I prefer to recommend electric toothbrushes with a very small head that permit adequate access to all areas of the mouth making the use of the manual single tufted toothbrush, superfluous.
The Interplak® electric toothbrush has instead six independent tufts of bristles, that perform rotary and counter-rotary movements.
This electric toothbrush executes a movement that is sufficiently reduced.
Glavind - Zeuner (1986) e Baab - Johnson (1989) assessed, respectively, the efficacy of the Interplak, concluding that the potential of these single-tufted electric toothbrushes to reduce plaque on the tooth surfaces is equal to that of a complete hygiene kit.

Toothpaste

it is advisable to use toothpaste to polish teeth and to clean, refresh, and deodorize the oral cavity.
Toothpastes make it possible to deliver some active agents to the tooth surfaces for preventive and therapeutic purposes.
Toothpastes contain various ingredients, and each of these components has its own function:
• Abrasive substances (e.g. Silica, Alumina, Calcium Phosphate, Calcium Carbonate) polish the tooth surfaces, but they can also scratch them to the extent that it is possible to find lesions on the teeth caused by an excessively abrasive toothpaste.
The abrasive effect of toothpastes should clean adequately without scratching.
Some toothpastes, among them Eburdent®, Elmex ®, declare their degree of abrasiveness, that is, the relative dentin abrasion (RDA=Relative Dentin Abrasion).
• Detergents give the product its foaminess and reinforce the action of the abrasives. The detergent most commonly used is Sodium Lauryl Sulphate.
• Thickeners and emollients, such as glycerin and silicates, prevent the toothpaste from drying out.
• Sweeteners, such as Xylitol and Sorbitol, sweeten the toothpaste.
• Flavorings, such as menthol or aromatic substances with a fruit flavor, make toothpaste more refreshing and pleasant to use. • Active ingredients, such as antiseptics, fluoride, desensitizers and other substances are delivered to the tooth surfaces by means of toothpastes, which are an excellent vehicle.