For something we do twice a day, advice on how we should brush our teeth is “unacceptably inconsistent”, finds a new study comparing recommended methods in Britain, Australia and elsewhere.
It found a “worrying” lack of agreement between dental associations and even the textbooks used to train dentists on how we should brush our teeth or even for how long.
Lead author John Wainwright said the wide range of recommendations – six methods with many variations – was because of a lack of strong evidence showing one method was conclusively better than another.
Should you use a gentle circular motion or scrub? Should children be taught the same method as adults? And how long and how often should you brush your teeth?
The answers depend on your country, even your dentist’s preferred style.
The British dentist Dr Wainwright said he advises his patients to use a gentle scrubbing motion, concentrating on the biting surfaces and where the gums and teeth meet. Yet his method differed from other British dentists, causing his patients to ask why different dentists make different recommendations.
“What … we need is better research into what the easiest to learn, most effective and safest way to brush is,” he said.
The present situation, where not just individual dentists but different dental associations worldwide were recommending different techniques, was not only confusing but it was undermining faith and trust in the profession.
The most common technique, used in Australia and many other countries, is the ”modifed bass” technique. It involves jiggling the brush back and forth near the gum line, and a gentle back and forwards cleaning of two or three teeth at a time. The secret is using a soft brush and having bristles at a 45 degree angle to the gums, Derek Lewis, a member of the Australian Dental Association’s oral health committee, said.
This method should take about two minutes twice a day, something only 40 per cent of Australians manage, he said.
Unlike Dr Wainwright, Dr Lewis said just scrubbing “10 teeth in a row like a pair of army boots” caused more harm than good.
But the report said no large-scale studies had shown Australia’s method to be more effective than scrubbing.
Dr Lewis, who is a dentist in Springwood, Queensland, said any technique would work, provided it was done with ”sufficient application and diligence, but not too vigorously”.
To compare one technique with another would be unethical, he said. “It is not easy research to conduct. You need big numbers, and it is not ethical for one of the experimental groups to use a technique that may cause damage like a scrubbing technique,” he said.