Brush up on dental care

Honestly, how hard can it be? We’ve been doing it twice a day since kindergarten. But still we can’t get it right.

“Odd as it sounds, most people are no good at brushing their teeth,” said Dr. Paul Warren, a dentist and a vice president of scientific relations for Procter & Gamble Oral Care.

All you have to do is go tooth by tooth, bristles to the gumline, for at least two minutes, according to the American Dental Association.

But most adults fail miserably. We brush haphazardly, concentrating on the front-and-center teeth and making short work of our molars. For many, the cardinal sin is scouring their gum lines as if plaque were bathtub grout.

Patience is also no virtue among tooth-brushers. “They spend an average of 47 seconds doing it,” Warren said.

All of that incompetence is good news for toothbrush makers. The toothbrush is a mature product, one that designers and industry analysts say has reached far limits of amelioration. But thanks to our ineptitude, toothbrush designers have a raison d’etre.

Lately, toothbrush makers have feverishly reworked one of the most worked-over devices known to man. Colgate has presented 14 manual brushes in the last five years. Oral-B typically introduces one electronic brush a year, the fruition of the work of more than 300 designers and engineers over three to five years.

Never mind that the device we know — bristles mounted on a 6-inch-long handle — has been around for more than 5,000 years. Or that its job, removing remnants of your last meal, be it a bowl of Wheaties or a slab of roasted boar, has remained unchanged. The toothbrush has had more makeovers than Michael Jackson.

Some changes are merely cosmetic, but the majority are intended to make the simple task of brushing even simpler. “Consumers aren’t good at brushing, so we’re taking them out of the equation,” said Graham Mott, a research and development executive for Philips Sonicare. “We’re making the toothbrush idiot-proof.”

How to explain our ineptness when it comes to oral hygiene? “Most people don’t really understand the process or don’t want to spend the time and effort they should,” said Dr. Howard S. Glazer, a former president of the Academy of General Dentistry, an organization devoted to advocacy and continuing education. “They think it’s OK to go once around the park and then home.”

People don’t follow their dentists’ instructions, either.

“Lots of patients brush way too hard, no matter what we tell them,” said Dr. Susan Karabin, a periodontist in Manhattan and the president of the American Academy of Periodontology. “They think they’re not doing a good job unless they’re spraying toothpaste all over the vanity.”

Fret not, the oral care industry is here to help. Can’t be bothered to move the brush on your own? The new Ultreo brush ($169.99) adds ultrasound to sonic bristle action to make things even easier. Just hold the handsome orange-tinged gadget in one spot until you get the signal to relocate it. This hint occurs every 30 seconds.

Too tough on your teeth? The Colgate 360 (about $3.99) has a NASA-worthy bristle configuration, with extra rubber bits that squeegee plaque away with almost no pressure at all.

For the truly brutish (or brainless), there’s the Oral-B Triumph ($149.99) with SmartGuide, which features a remote digital display that delivers an audible and visual warning when you’re brushing too hard. Or the Sonicare FlexCare ($179.99), with its two different routines, the speedy GoCare setting and the MaxCare mode, a two-minute cleaning and one-minute massage.

Gizmos like these are designed to beat heavy-handed brushers at their own game. “These brushes provide their own motion, so they do the work for you,” explained Mott of Philips Sonicare. “Even if you’re doing everything totally wrong, you get the job done —and you can’t hurt yourself.”

Damage by toothbrushing is more common than you might think. After $5,000 worth of gum surgery, Stephanie Mascott, 32, a recovering aggressive brusher, bought an Ultreo and now hopes to have kissed her receding gums goodbye. “With a manual brush, it’s too easy to get carried away,” said Mascott, a brand director in San Diego.

Alli Noland, 38, a public relations executive in Jackson, Wyo., was also a bruiser of a brusher. “I always brushed really hard, so I thought I had special cavity-fighting powers when I was a kid,” she said.

After six fillings, Noland reassessed her methods and bought a Sonicare, which she says better helps her clean her nooks and crannies. “Now I’ve got no cavities, my teeth are actually cleaner and I’m not scrubbing my mouth off.”

Others see catering to the lackluster brusher as just marketing. “This rush for innovation is all madness,” said Timothy Dowd, a senior analyst with the research firm Packaged Facts and author of its Oral Care 2007 market report. “If you didn’t have product innovation, the market would rise or fall with the population because everybody brushes his or her teeth.”

Stephen Wilcox, a principal at Design Science Consulting in Philadelphia, who has designed a few in his day, is of the same mind. “The toothbrush has been around forever,” he said. “We’ve quit improving it. Now we’re just competing for the consumer’s attention, so we’re seeing a lot of mindless tweaking.”

But don’t tell that to brushing sloths. “I love my Sonicare because it does all the work,” said Barb Obergfell, 54, an outreach librarian in Indianapolis. “I can space out because I barely have to move it. It’s ironic because I advocate reading and distribute books all day, then come home and surrender to my electric toothbrush.”

Despite makers’ claims that their toothbrushes offer superior cleaning, “there are relatively few large, well-controlled studies demonstrating a clear advantage of one brush over another,” said Marjolijn Hovius, editor of the International Journal of Dental Hygiene.

How methodically a person brushes is far more important than the brush, most experts agree. A meticulous brusher can remove plaque with a bit of wood as well as with a state-of-the-art toothbrush, Karabin said.

There is one advantage to buying a $180 toothbrush. “If you spend a lot of money on a toothbrush, that’s a great motivational tool,” Glazer said. “You’ll probably use it more than the one I give to you for free.

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