Saturday, May 30, 2020

From the time we’re young, we’re taught that using a toothbrush regularly is one of the best ways to keep our teeth and gums healthy. We hear that echoing of our parents, and now many of us as parents to our children, “Don’t forget to brush your teeth.” Seems simple enough. But have you gone to the toothbrush aisle recently? I have. And I see people spending time staring at the wall of brushes, and don’t know which to chose. So, a common question I am asked in my office is “Which toothbrush is the best?”

So I will start off with, it depends... But before we jump into the details, you know I like a little history (always good to know where it all began).

Toothbrushing tools date back to 3500-3000 BC when the Babylonians and the Egyptians made a brush by fraying the end of a twig; these were called  toothsticks.” Around 1600 BC, the Chinese developed “chewing sticks,” which were made from aromatic tree twigs to freshen breath. The Chinese are believed to have invented the first natural-bristle toothbrush made from the bristles from pigs’ necks in the 15th century, with the bristles attached to a bone or bamboo handle. When it was brought to Europe, this design was adapted and they used softer horsehairs. The first toothbrush of a more modern design was made by William Addis in England, but the brush portion was still made from swine bristles. In 1844, the first three-row bristle brush was designed. Natural bristles were the only source of bristles until Dupont invented nylon. The invention of nylon started the development of the truly modern toothbrush in 1938. The first electric toothbrush was made in 1939. OK, history lesson over.

Today, both manual and electric toothbrushes come in many shapes and sizes and are typically made of plastic molded handles and nylon bristles. The most recent toothbrush models include handles that are straight, angled, curved and contoured with grips and soft rubber areas to make them easier to hold and use. Toothbrush heads range from very small for young children to larger sizes for older children and adults and come in a variety of shapes such as rectangular, oblong, oval and almost round. Toothbrush bristles are usually synthetic and range from very soft to soft in texture, although harder bristle versions are available. Some of my patients feel that if they use a firm bristle brush they can clean and “scrub” their teeth better. This idea is false. Using a very firm brush for many can lead to “tooth brush abrasion” (wearing away of enamel), and gum recession. Truly it’s not the “scrubbing” that’s important, it’s cleaning all surfaces of your teeth. I tell my patients that it’s important to focus more on being able to get to those hard-to-reach areas, and spend a little bit more time.

So, how do you decide between style, make, model etc...?

The basic fundamentals have not changed since the times of the Egyptians and Babylonians—a handle to grip, and a bristle-like feature with which to clean the teeth.

There are certain characteristics that you should look for in whatever toothbrush you choose, regardless of whether it is manual or powered.

Size: The best toothbrush head for you should allow you easy access to all surfaces of your teeth. For most adults, a toothbrush head a 1/2-inch wide and 1-inch tall will be the easiest to use and the most effective. The toothbrush should have a long enough handle so you can comfortably hold it in your hand.

Bristles: If you go to the drug store to purchase a brush you will be able to select soft, medium or hard nylon bristles. For the vast majority of people, a soft-bristled toothbrush will be the most comfortable and safest choice. If you are vigorous when you brush your teeth, medium- and hard-bristled brushes could actually damage the gums, root surface and protective tooth enamel. The way you can tell if you fall in this category is to look how “frayed” your bristles look after a few weeks of brushing.

Electric or Not: There are many cool electric brushes. The adult brushes that move with sonic motion, those that spin and others that time your brushing. There are also cool kids’ brushes that even sing songs. I have patients who swear by their electric brushes, and their mouths look great.  Also, many kids are more motivated to brush their teeth with a cool bathroom toy.

What I like about electric brushes is that it works for us when we are lazy, and sometimes gets you to brush longer.

I hope this didn’t confuse you more, it was meant to clarify what’s out there. Spending the time to brush properly and thoroughly is the message. As I tell all my patients, “I don’t care if you brush with the free brush I give you after your visit, or you buy a $200 one in the store, JUST BRUSH!”

Look forward to next month’s issue of “Ask the Dentist.” Please send your questions to This email address is being protected from spambots. You need JavaScript enabled to view it..

With Dr. Brian M. Kalb

Dr. Brian Kalb practices dentistry in New Rochelle and Long Island. He can be reached at 914-262-1399 or

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