Did you know that much of the treatment that dentists provide can be directly or indirectly related to your tooth brushing? Few dental awareness programmes ever give this information or explain the dangers of the toothbrush.
First off, let me say that the idea of using a toothbrush as part of a hygiene programme to keep the mouth clean and healthy is undoubtedly a good idea. Without reservation, I support and advocate the concept. There has been, however, a tendency to promote the toothbrush to the position of Supreme Dental Product. The notion of the toothbrush as a dental cure-all has been allowed to take root unchallenged in the minds of people. This has led to all manner of problems not least of which is the sense of let down and disappointment that committed and enthusiastic brushers feel when they are told that they need fillings.
The Toothbrush Does Not Prevent Decay, - Hello!
“How can I have cavities when I brush my teeth not once but at least three or four times daily?” is a question that I am often asked. When I tell people that brushing has little effect, if any, on tooth decay, the reaction is often shock and disbelief. They have genuinely believed that tooth brushing would keep them safe from all cavities and are devastated to be told of, perhaps, the presence of a very large cavity that may require root canal treatment or extraction.
Just in case you, the reader, are experiencing that same state of shock and disbelief at these words, let me explain the facts clearly. Tooth decay, for the most part happens in specific areas of the tooth anatomy. The most common site for decay is in the nooks and crannies of the biting surfaces of the back teeth. The second most common site is between the teeth at a point just below where a tooth touches its neighbour. What these sites have in common is their inaccessibility to the bristles of your toothbrush. These sites are known as stagnation areas by virtue of their inaccessibility and could be termed the major ‘at-risk’ sites for decay. This is very simply why tooth brushing has little or no effect on tooth decay. The bristles are simply too large to access the at-risk areas!!
But What Is This Toothbrush Damage?
I like to call toothbrush damage the condition of those who care too much. As always, to really understand, we must look first to the mind. This problem arises from the notion/belief that the ‘harder’ one works at brushing, the better the job will be done. We are motivated and eager to produce the best possible result. However, lurking behind this gung-ho outward show there is a nagging fear that we will not succeed at producing the ‘good job’ and we will lose our teeth. In fact, we are deeply afraid of not being good enough. This fear of not being good enough at the job is a manifestation of the broader fear of failure.
If Hard Is Good, Then Harder Must Be Better?
This is when the crazy logic takes over in the fearful mind. If one bottle of beer is good, then ten bottles of beer must be ten times better! So in order not to fail, - in order to make sure that we will be good enough, we pull out all the stops and go at it with hammer and tongs. We scrub like crazy with a ‘good’ hard bristled brush. By golly, we will get these teeth clean!! The harder we go at it, the better we will do. And we so want to do well!
Is it any wonder then that when I advise these people to change to a soft brush they will invariably tell me that they don’t feel that they could possibly do a good job with a soft brush. Often they will continue with the hard brush despite the advice. This is because changing your mind is much more difficult than changing your brush and is also the reason why being advised to change your toothbrush is simply not enough to change the behaviour. Behaviour is an outcome, - the effect of a belief. The belief is the cause, the behaviour the effect. No change can happen in behaviour (effect) without a change in belief (cause)
Crazy Logic Brings Crazy Results
The damage caused by this behaviour is very common and affects the hard tissues of the tooth and the soft tissue of the gum. It affects young and old and in between. The earliest signs of damage involve the loss of gum tissue at the neck of the tooth and this can cause the tooth/teeth affected to look longer than unaffected neighbouring teeth. At the same time there appears a wear mark in the shape of a tiny notch in the dentine, again at the neck of the tooth. Sometimes this notch will be discovered because of the fact that it can be extremely sensitive to touch. An exploring fingernail might inadvertently touch against the notch and trigger a sudden electric shock of pain through the tooth.
Not surprisingly, the damage increases with time. More and more soft tissue is destroyed and the wear mark widens and deepens into the structure of the tooth. Furthermore, because there is no enamel protection over this exposed root surface, there is now a greater risk of tooth decay at the site. More often than not these damaged areas require porcelain filling/restoration as treatment. This requirement may be a cosmetic one, where a person feels that appearance is compromised by the damage. The damaged areas are often the most visible areas at the sides and front of the mouth. Other times sensitivity in the damaged area dictates the need for restoration. Other times again, tooth decay sets in to the damaged dentine and again restoration is needed. The damage done in extreme cases may result in the need for a root canal treatment or even extraction. Remember, all of this can happen as a result of a seemingly perfectly genuine and honest desire to do the best job possible. How do we solve the problem?
Gentleness Is A Requirement, Not An Optional Extra
The solution is gentleness. And with the realisation that the forcefulness and aggressiveness brings about the very thing you sought to avoid, you lay it aside and choose gentleness instead. You have changed your mind because the outcomes that you were producing were not the ones you sought. Having changed your mind the behavioural change easily follows. The soft brush and gentle but thorough approach gets the results you want. Instead of following the frantic antics of fearing failure, the soft steady strokes of calm caring guide you to sure and certain success.
In a Nutshell
Brush Clever
Understanding toothbrush damage saves you trouble and saves you money. It is very common but seldom highlighted. The fear of failure is at the root of the problem. We think we can ‘motivate’ using fear and we teach our children that failure is fatal. We cultivate the notion that it is hard to succeed and so in order to succeed we must push ourselves harder. This promotes the aggressive approach the consequence of aggression is always damage (Ask George Bush). In this case the damage is to our own tissues. The intention or reason behind the behaviour is actually good (desire to do well) but the motivation is the fear of disease rather than the love of health.
The Easy Solution
Stand back and look carefully at the cause (fearful belief) and the effect (damaging behaviour). Seeing through the gentle light of understanding, we can change our minds and our behaviour.
Remember
Use a Soft Brush
Use a Gentle Technique
Use enough time to give Thorough Loving Care to all surfaces of all teeth.
My name is Philip Christie. I qualified as a Dental Surgeon at Trinity College, Dublin (Ireland) in 1980 and completed a Master’s Programme in Dental Science, again at Trinity College Dublin, by research in 1995. I have been working full time in dental care either in general or specialist practice since qualification. My main interest is and always has been prevention.
My real qualification is 23 years experience in dealing with real people and their problems face to face, as a clinical practitioner. I am the author of "Something To Chew On: A Mouth Map To Health." It is a Health Manual with a difference. Different because it is designed for the future and for success. Different because it gives the power back where it belongs, - to the person’s own self. Different because it demonstrates the Mouth as the Mirror of the body and by tackling problems at source saves huge expense!
philip.christie3@ntlworld.ie
http://www.peopleaspartnersinmedicine.com