How to Know If You’re Brushing Your Teeth Too Much

My mother’s dental story reads like a horror novel: multiple fillings, root canals, implants, jaw surgeries, gum grafts, and full veneers. Emotional costs aside, the financial investment was huge. As a result, she taught me from a young age to brush and floss my teeth twice a day. It clearly paid off: I never even had tooth decay.

Imagine my surprise when my gums began to drop a few years ago. Gum recession is what it sounds like: the pink, spongy tissue (known as gums) that covers and protects the roots of our teeth shrinks, exposing them more and more to harmful bacteria. Gum recession is not only cosmetic – it is the root of the “long in the tooth” idiom used to mean someone looks old, but it can also increase plaque build-up, tooth erosion and increased sensitivity.

According to a 2003 study , nearly half of the world’s adults aged 18–64 suffer from some degree of gum recession (this number rises to 88 percent for adults aged 65 and over). In the United States, 47 percent of adults age 30 and older have some form of gum disease (also called periodontitis), which causes not only gum recession, but also swollen and painful gum tissue, bleeding in the mouth, chewing pain, and abscesses.

But how can gum recession happen to a class A + toothbrush and floss like me that rarely skips brushing? When I asked my dentist, I got an unexpected answer: “Do you really brush your teeth hard?”

I’ve never thought about this before. When I Googled “brushing too hard,” however, dozens of research studies , individual dental practice sites, and the company’s name-brand toothbrush and toothpaste blog posts popped up, warning me about the dangers of brushing too hard. Many offered the same advice my dentist gave me: Use a soft bristled brush and hold it with either two or three fingers or my non-dominant hand. However, after a couple of weeks, I began to worry if I had swung to the other side of the pendulum: brushing my teeth too softly to brush my teeth properly.

To determine if my gums have led to grit blasting over the years of over-brushing my teeth, I spoke with Dr. James Wilson, president of the American Academy of Periodontology (AAP) – periodontics – the branch of dentistry that treats the structures around our teeth. , oral inflammation and implantation – and found that the response could be short. However, as Dr. Wilson emphasized, “There is a fine line between brushing your teeth too harshly and not removing bacteria that need to be removed, making you more susceptible to cavities [and] gum disease.” In other words, your goal is to brush your teeth smarter, not necessarily softer.

Brushing your teeth too hard is just one of the many causes of tooth and gum problems.

In addition to over-brushing your teeth, many factors contribute to tooth and gum wear: genetics , diet , access to healthcare, and even orthodontic treatment . When I shared my mother’s dental story, Dr. Wilson mentioned that my gum recession may be primarily due to the inheritance of weaker gum tissue (called the gum ), a smaller jaw, and even my thinner jawbone – all of which can increase the likelihood of gum recession. … and cavity. What’s more, my teenage braces, straightening my smile, could also push some of my teeth out of the bone.

As Dr. Wilson told me, “Brushing your teeth overly aggressively can certainly do some damage, [but] I personally think that’s too much of a charge.” If you or your parents have had many dental problems, you can ask your dentist if your X-rays and examinations show thinner bones and weaker gum tissue. If they do, you should definitely get serious about over-brushing your teeth as it is one of the few things you can control when it comes to preventing gum recession, gum disease, and tooth decay.

Soft-bristled toothbrushes remove most plaque, but can also do more damage.

Soft-bristled toothbrushes are not the best because they are gentle on the teeth and gums; they are recommended because their great flexibility allows them to cover more surface area and hold more toothpaste. From the point of view of periodontist Dr. Wilson, this flexibility also means that they are better at penetrating bacteria under the gum line than the stiffer bristles.

However, their ability to hold more toothpaste is one of the reasons you might want to pay attention to the abrasiveness of your brand at home. Some researchers warn that more abrasive toothpastes can erode enamel and underlying tissue (called dentin ), leading to increased sensitivity when exposed. Other experts insist that all available toothpastes are safe. (Look for the ADA Seal of Conformity if you want to be sure your brand has been thoroughly tested.) You need at least some of the abrasiveness of a toothpaste to remove plaque, unless your teeth are already showing significant wear and tear. Whitening toothpastes usually have the highest levels of abrasiveness (on a safety scale from 0 to 250); you can find out how your current brand is abrasive here .

Also keep in mind that abrasion caused by foreign materials such as brushes and toothpaste is just one of three ways to lose enamel. Abrasion occurs when our teeth rub against each other, mainly due to squeezing and grinding, and erosion is caused by dietary and environmental factors such as eating acidic foods and drinks, exposure to our saliva and stomach acid, and pollution from contaminated jobs (for example, mines). ). If you enjoy citrus fruits and juices, or drink sodas on a daily basis, consider shortening, or at least timing, brushing your teeth to limit potential erosion.

Also, remember to replace your brushes every three to four months, as old and worn brushes remove less plaque and may harbor bacteria and viruses .

Electric toothbrushes have pressure sensors that tell you if you’re brushing your teeth too much.

“I’m a big proponent of electric toothbrushes,” Dr. Wilson told me, “[because] if you use an electric toothbrush correctly, you won’t be using it with the brushing strokes.” All you have to do is keep the brush straight and guide it along the line of your teeth and gums, letting the brush do the rest of the work.

Even if you’re brushing, many electric brushes are now equipped with pressure sensors that light up or make a noise if you press too hard. (You can find this feature in all price points, from the $ 50 Oral-B and Sonicare brushes to the $ 250 Sonicare DiamondClean brush with fancy chargers and multiple settings.) The more expensive Oral-B 7000 ($ 130 on sale) and 8,000 ($ 140). on sale), as well as the $ 95 Quip smart brush that even connects to apps that show areas you missed and track your brushing habits.

While these brushes are more expensive than manual brushes, they also remove more plaque . As Dr. Wilson said, “An electric toothbrush is probably a very small investment when compared to the cost of some dental services.” Make sure you choose soft bristled brush heads and, as with hand brushes, replace them every three or four months.

Bring your toothbrush to your next brushing

Since 2013, the ADA ‘s position has been that the number of annual visits should be tailored to individual patient needs and risk factors. However, “361 days a year is your responsibility,” said Dr. Wilson. (His patients often suffer from gum disease and need to be cleaned quarterly.) “We should be your mentors on how to do these 361 days well.”

To get effective coaching, we need to show our business. (This is the difference between watching a champion weightlifter perform a snatch and then trying to replicate it alone at home, rather than showing the weightlifter your technique and asking for his advice.) Next time you go to clean, bring yours. toothbrush, brush your teeth in front of a hygienist and dentist and ask them for their opinion. Dr. Wilson emphasized this last part, as many dentists and hygienists hesitate to speak out at the risk of being overbearing or intrusive. “As soon as you ask,” he said, “you allowed [us] to criticize you.”

While they’ll start by looking at your brush – for example, if the bristles are frayed and tousled, you probably brush so hard and with such a tired brush that you actually remove less plaque – the best tip comes along. showing them my brushing techniques in action.

Don’t delay routine dental visits

In August 2020, five months after the beginning of the pandemic, the World Health Organization (WHO) issued a statement in which people were encouraged to postpone routine preventive dental care, such as brushing your teeth to reduce the spread of infection in the population. (The ADA “respectfully but emphatically” disagreed, insisting that ” dentistry is an important medical care .”)

In fact, dental surgeries in the United States and elsewhere revolutionized PPE in the mid-1980s in response to HIV / AIDS. While Dr. Wilson remembers a time when his dentists didn’t even wear gloves to examine his mouth, those days are long gone. “Going to the dentist is a very safe thing to do,” he said, and the available evidence – albeit scanty – seems to support it.

In addition, postponing preventive measures leads to the formation of holes in the teeth and, ultimately, in the pockets. After seeing my mom go through so many costly and painful procedures, I became convinced that one of my few excursions into the world after isolation was a cleanse, even though I have a weakened immune system and therefore an increased risk of serious illness and death from COVID. -nineteen.

However, many Americans often skipped preventive dental visits even before the pandemic, perhaps due to a lack of access to affordable medical care, relying instead onfluoridated water and school sealants to prevent tooth decay. But rates of untreated tooth decay and gum disease are two to three times higher among blacks, browns, and children and adults from disadvantaged backgrounds. While advocating the best dental insurance for all Americans is the ultimate solution, the cost of both routine and urgent dental care makes effective dental cleaning at home all the more important. Having good tools and techniques can help, even if some factors, such as genetics and the dental complex, are currently outside our control.

For example, I can’t wait to take my new soft bristled electric toothbrush with a pressure sensor to my next brushing to ask for feedback on my technique. I want my oral card to have a zero value and to massage my gums with perfect pressure.