What Should I Use?


           Patients ask this question all the time. Whether it's asked about toothpaste or mouthwash or toothbrushes or floss, you want to know what will work best for you. This is only natural. In most cases, however, there is no one set answer or brand name that completely answers your question. Each individual patient has different needs and your situation will differ from that of others.

           The purpose of flossing is to remove food particles from between your teeth. The first thing to remember about floss is that you should be using waxed floss. Whatever makes it easier for you to floss will encourage you to floss and waxed floss passes more easily through the contact point, that area between neighboring teeth where they touch each other. Some brands of floss are impregnated with fluoride, a substance known to make tooth enamel harder and more resistant to decay. Studies have shown that fluoridated floss does, in fact, strengthen tooth enamel. This should make the adjacent surfaces of your teeth less decay prone, but there are currently no studies available that confirm this. If you have a significant history of decay between your teeth where they touch each other, using fluoridated floss that is waxed may help to protect you against this problem, but this is unproven. Using fluoridated floss that is waxed cannot hurt and if it is not considerably more expensive than regular waxed floss it is probably worth trying. Different manufacturers have marketed electric rotary interdental (between teeth) cleaners that their advertising suggests are substitutes for flossing. THIS IS NOT THE CASE AS THEIR IS NO OTHER METHOD FOR CLEANING THROUGH THE CONTACT POINTS BETWEEN YOUR TEETH WHERE THEY TOUCH EACH OTHER BESIDES FLOSSING! While these devices may help remove debris from beneath your contact points, Dr. McArdle has attended continuing education seminars where periodontists (gum specialists) have proposed that such appliances can contribute to abrasion between your teeth and he does not advise their use.

           There are many different sorts of mouthwashes or rinses used for many different problems in your mouth. Depending on the severity of your condition, Dr. McArdle may have you use a prescription or office-dispensed product. Most patients, however, use over-the-counter (OTC) items in this category. Dr. McArdle will advise you to use a fluoride rinse. You must be sure to use one labeled as a "fluoride" or "anti-cavity" rinse, not just "with fluoride" as these latter types do not contain sufficient fluoride for the purpose. If you suffer from halitosis (bad breath) you need to use an oxygen releasing mouthwash. Oxygenating mouthwashes address the cause of bad breath whereas many other OTC mouthwashes simply try to cover it up. There are also rinses and mouthwashes formulated to reduce tartar build-up, loosen plaque, lighten your teeth and combat dry mouth. What you use will be determined by your individual needs, but there are certain things that you want to avoid in any mouthwash. Number one is a high concentration of alcohol. High alcohol brands can cause xerostomia (dry mouth) and have been linked to an increased risk of oral cancer. You should avoid products that have double digit percentages of alcohol content. Another ingredient that you want to stay away from is sanguinaria extract. In the mid 90's, pathologists from across the country became aware of a possible link between this substance and oral cancer as well. Some flavorings (especially cinnamon) are associated with a greater than normal incidence of allergic reactions.


One of the many available fluoride rinses.

           The main thing to remember when you select a toothbrush is to make sure that it is a soft one. Hard or medium stiffness bristles on a toothbrush are known to foster abrasion of your teeth and recession of your gums. Tooth brushing with hard or medium bristles is counterproductive and does not remove plaque or food particles from your teeth and gums any better than a soft bristle brush does. Although there are many different variations of the basic manual toothbrush design on the market, none have been shown to have an appreciable effect on your ability to remove build-up from your teeth and gums. Electric toothbrushes, as long as they have soft bristles, are safe and effective. They are especially useful in cases of limited manual dexterity (if your hands are afflicted with arthritis, for example) or if you simply can't or won't take the time to brush thoroughly. However, if you take your time and are conscientious you can brush your teeth just as well with a manual toothbrush as with an electric one provided that you have no physical impairments. You should replace your toothbrush at least every three months since worn brushes do not remove plaque and food particles from your teeth and gums as efficiently as new ones do.

           Just like mouthwashes, there are many different kinds of toothpastes (and gels or powders) formulated for the different oral conditions that you may have. Again, depending on the degree of your problem, Dr. McArdle may advise you to use a prescription or office-dispensed dentifrice as they are technically known. In most cases, however, OTC products will be sufficient. Any toothpaste that you use must contain fluoride to help prevent tooth decay. Fluoride has been shown to be the most effective ingredient for preventing tooth decay contained in toothpastes. Newer research indicates that calcium and phosphate may serve this aim in toothpastes as well. Some toothpastes contain antibacterial agents (triclosan, for example) that may help curb periodontal (gum) disease. In our experience, Aquafresh Extreme Clean can help with gum disease very effectively. Baking soda toothpastes (or powders) are also particularly effective in the treatment of gum disease. The salt in baking soda has a powerful attraction for water and so leaches fluids from the cells of bacteria that cause gum disease killing them in the process. Arm & Hammer Baking Soda Tooth Powder consistently has had among the highest baking soda concentrations (75%) of any brand on the market. Some other brands may claim to be baking soda toothpastes or have "with baking soda" on their labels and yet contain as little as 1% of this ingredient. If you have a problem with halitosis (bad breath), you may need to use an oxygen releasing toothpaste. These toothpastes contain peroxides that are also used in whitening toothpastes. Desensitizing toothpastes contain ingredients that coat root surfaces that may be exposed if your gums recede causing sensitivity to temperature, brushing and sweets. Studies seem to show that potassium nitrate is the most effective among the desensitizing agents. There are tartar control toothpastes, fresh breath toothpastes, smoker's toothpastes and all natural toothpastes. The things that you want to avoid in toothpastes are, again, sanguinaria extract and any of the "polishing" toothpastes. The latter tend to remove stains from teeth using heavy abrasives that can actually wear away your teeth.

Prescription toothpastes, like Prevident, can aid in controlling rampant decay.




Related Pages

Join Our eMail List


Dr. Barry F. McArdle, D.M.D. ~ 118 Maplewood Avenue, The Captain Moses House, Suite B-7, Portsmouth, NH 03801

Questions or Request an Appointment: Contact Us     Phone: 603-430-1010     Email: drmcardle@mcardledmd.com     Website: http://mcardledmd.com