The following article was written by Elvin Pimentel, RDH, in completion of requirements to become an IABDM Certified Biological Office Manager. Congratulations, Elvin!
What kind of abrasive detergent do you use – toothpaste, that is? Some defend themselves saying they use organic forms of dentifrice. However, even if it is a natural paste in daily use, you could still be using a very abrasive tooth detergent. Being natural does not guarantee toothpaste is not capable of causing permanent damage and wear of your teeth layers like enamel, dentin, and cementum over an extensive period of time.
Unfortunately, toothpaste companies do not put their Relative Dentin Abrasion (RDA) information on the labels or packaging of these products. Therefore, a consumer has nothing that sparks thinking of possible abrasive values. If toothpaste abrasion is not discussed ever in their dental care visits, nobody else is going to mention the future permanent wear facets that occur from using a sanding-like substance to clean daily, at least twice a day for two minutes each time.
The best way to avoid any tooth structure damage, from any dentifrice, is to always a pea size amount or less of any kind. That includes low abrasion and natural pastes. It has been the recommendation by ADA, although for other reasons.
RDA ratings are divided into 4 categories. Those categories are low abrasion, medium abrasion, high abrasion, and very dangerous harmful levels. Terribly disappointing but not surprising: The FDA and ADA set the limits too high, 200 and 250 respectively.
As we know, we do not believe in fluoride, one of the main reasons toothpastes were popularly manufactured. Nevertheless, do not support the use of antibiotics and other unhealthy agents. My patients are always reminded that spending two minutes or more brushing with a soft or extra soft brush and flossing daily are the best line of defense for oral health. It is the mechanical action that is going to remove the plaque, food debris, bacteria, and scar tissue build-up from our teeth and gum pockets.
Over the course of 12 years, ever since I took my first toothpaste abrasiveness class, a great deal of my temperature- and touch-sensitive patients have been relieved of their many years of toothaches. They all vary, but they are all willing to do something about it. Patients believed that toothpastes are required and needed to maintain optimal oral health. They did not want to compromise nor risk getting decay by being stingy.
In reality, when plaque comes in contact with sugars and carbohydrates, it becomes acidic. Plaque tends to grow at least every 12 hours, so brushing twice has been the norm. Brushing and flossing only gets 70-80% of plaque.
Certainly, we need brushing more frequently for longer periods of time – very helpful to minimize the presence of this very thin biofilm.
My patients started using less or no paste. Some will skip it every other time or every other day. Some started using baking soda. Myth says that baking soda is abrasive, yet it only has a 7 RDA; a toothbrush with water, a 4 RDA.
At their next recall appointment, patients were coming back with great smiles and expressing happily how their sensitivity was finally gone. No more need for any sensitivity dentifrice – though, mind you, some of them have been on sensitive brands like Sensodyne for 20 to 25 years. Most of them affirmed that the sensitive sensations went away, and not months nor weeks after, but more like the very next day.
These shocking revelations give me the more courage to continue to suggest and recommend the use of less toothpaste. It makes sense since we have very many small dentine tubules being scratched open. When exposed to environmental and food temperature factors, thermal signals are carried to thru the nervous system in our teeth.
The best way to avoid any permanent tooth structure damage from any dentifrice is to always apply just a pea size amount or less of any kind. That includes low abrasion and natural pastes. In any event, it has been the recommendation by dentists across the board, although for other reasons. Polishing needs to continue to be selectively done using a finer grade
Education is key, especially at the caregiver level. Dental professionals are lacking this fascinating research. Also, oral hygiene instructions should teach our patients to be mindful of toothpastes and pay attention without having to adjust their dental care visits, daily routines and diets as the result of tooth sensitivity reasons.
Save your money,
And save your teeth,
Use less toothpaste,
To clean your teeth!