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Why just using a normal toothbrush is not enough

Why just using a normal toothbrush is not enough Prof. Denis Bourgeois stresses the importance of regular use of interdental brushes, which can remove around 16 billion bacteria from each interdental space. (Photograph: DTI)
Prof. Denis Bourgeois stresses the importance of regular use of interdental brushes, which can remove around 16 billion bacteria from each interdental space. (Photograph: DTI)

Why just using a normal toothbrush is not enough

By Kasper Mussche, DTI
August 20, 2018

When we think about keeping our teeth and gingivae healthy, what comes to mind for many of us is a gentle toothbrush, a good brushing technique and some fluoride-containing toothpaste. True, these are the main ingredients in keeping the largest part of our teeth and gums healthy. However, as our understanding of the oral flora progresses, we have come to realise that conventional brushing methods still fail to access a neglected part of the mouth: the interdental space.

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The interdental space is the most inaccessible and vulnerable part of the mouth and as such the perfect place for disease-causing bacteria and plaque to accumulate and cause eventual damage to the teeth, periodontium and gingivae. Even more so than dental floss, mouthwash and the bristles of conventional toothbrushes, interdental brushes have proven to be the most effective tool in removing virulent bacteria from these spaces between our teeth.

“In a 2017 study, we managed to collect over 16 billion virulent bacteria from each interdental space in young, healthy adults using interdental brushes, proving them to be the most efficient tool for cleaning interdentally,” said Prof. Denis Bourgeois, dean of the University of Lyon’s dental faculty in France, and a pioneer in research on oral prophylaxis, interdental biofilm management and interdental brushing techniques. Unfortunately, the use of interdental brushes has not yet become commonplace.

Bourgeois continued, “Interdental brushes are relatively new. The same way dentists in the 1950s had to explain to their patients that brushing their teeth with a normal brush is necessary, people nowadays need to be informed that brushing interdentally is just as important. Both historically and traditionally, dental floss has been the tool of choice for cleaning narrow spaces, as it has been somewhat of a market leader, as well as the only way to access the interdental space for people with healthy gums. However, using dental floss is no longer preferred as, unlike using interdental brushes, its use is not supported by conclusive scientific evidence. And, with today’s fine interdental brushes, we have the most efficient means to access 98 per cent of all interdental spaces in healthy people!”

"The same way dentists in the 1950s had to explain to their patients that brushing their teeth with a normal brush is necessary, people nowadays need to be informed that brushing interdentally is just as important."

Cleaning interdentally should, of course, be accompanied by dentist instruction regarding technique and brush size. An interdental brush should have the most efficient cleaning potential, but it should not be so large as to cause trauma. “The reason we used CURAPROX interdental brushes for our study is the calibrating colorimetric probe that goes with the brushes,” said Bourgeois. “The probe makes it possible to easily determine the width of the interdental spaces as well as the right brush size.”

Still, many people are reluctant to use interdental brushes owing to bleeding upon first use. According to Bourgeois, this initial bleeding is entirely normal: “Interdental brushes themselves do not provoke bleeding. The bleeding is the result of inflammation of the interdental space due to bacteria. When disturbed, bleeding occurs. Similarly, if you were to stop brushing your teeth for a week, which I do not advise, and then start brushing them again, your gums would bleed as well. The reason here is the same: there would have been an increase in bacteria, inflammation as a result, and finally bleeding when you brush.”

“The biggest challenge is explaining the importance of using interdental brushes to people with supposedly healthy teeth and gums,” concluded Bourgeois. “Nonetheless, the disease-provoking bacteria in the interdental spaces are there.”

Under the motto of “Better health for you”, Swiss, family-owned oral health care manufacturer CURAPROX, focuses on research, education and collaboration with industry experts to develop innovative healthcare products that are both engaging and original. The CURAPROX prime series is available here.

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