Plaque is a sticky, white substance that is comprised of oral bacteria and a substance the bacteria secrete. This bacterial substance will form on perfectly clean teeth within 24 hours and as such, it must be removed on a daily basis.
Manual toothbrushes scrape away this sticky, tenacious substance. It takes the right amount of pressure on the brush, the bristles angled correctly to reach the surfaces and the correct number of strokes over the plaque mass to remove it completely. While manual toothbrushes can work well in the correct hands, inexperienced brushes or those who do not exercise adequate care will leave plaque behind.
Many patients do not do an adequate job with plaque removal when using a manual toothbrush. Such patients can benefit from a more sophisticated plaque removal instruments.
One plaque removal device that our office recommends is the Sonicare toothbrush. This electric toothbrush removes plaque from teeth in a novel manner. It was found, many years ago, that when an object is moved very rapidly in fluid (about 30,000 times per minute,) a phenomenon known as cavitation waves develop in the fluid. These cavitation waves carry enough energy within them to break apart the plaque mass. In fact, research has shown that when the bristles of a Sonicare toothbrush are placed in saliva, the cavitation waves that develop have enough energy within them to remove plaque 3 to 4 millimeters beyond the bristle tip. As such, the Sonicare bristle do not even have to touch the plaque physically in order to remove it. One can imagine how this would benefit the patient in plaque removal.
Plaque bacteria fix themselves in the plaque mass by bacterial structures called fimbrae. These microscopic, hair-like projections from the cell wall were found to be torn off of bacterium when they are exposed to the cavitation waves from a Sonicare toothbrush. As such, the plaque mass just falls apart. This is what is believed to be the mechanism behind the toothbrush's effective plaque removal. No manual toothbrush can provide a patient with this enhanced method of plaque removal. Other power toothbrushes that do not achieve this high oscillation frequency, remove plaque by mechanical scraping, and while they may assist the patient in plaque removal to some extent, they do not clean beyond the bristle tips.
In addition, the Sonicare is much more effective at plaque removal between the teeth than a manual toothbrush. Its ability to clean without physical contact provides such inter-dental cleaning. While the Sonicare is NOT a replacement for flossing, non-flossers are well served by the Sonicare.
Sonicare toothbrushes retail, between $60 and $170 depending on the model. All models will provide the same type of cleaning and models vary primarily in features, like gum massage mode, an ultra-violet sterilization feature and a ramp up power feature. Recently, the manufacturer of Sonicare has introduced child and adolescent models that are AA battery powered and a lower priced rechargeable model.
All rechargeable Sonicare models will typically hold a charge for 2 or more weeks, allowing the Sonicare to accompany its owner on vacations without having to lug the charging base along. The brush head on the Sonicare is replaceable and as such, more than one user can take advantage of the Sonicare by purchasing addition brush head which are color coded for easy identification.
The Sonicare is not used in the same manner a manual toothbrush is. Instead of scrubbing with the moving bristles, the manufacturer recommends that the oscillating brush head be placed at the tooth/gum interface and that it be moved slowly in a single, horizontal motion from the back of the mouth to the centerline in a ten second sweep. Then the brush head is placed on the chewing surface and another 10 second sweep from the back of the mouth to the centerline is executed. Finally, the inner surfaces are cleaned in the same manner. After this 30 seconds of cleaning, the brush will make an audible sound and its moved to another quadrant of the mouth. The internal times causes the brush to run for a total of 2 minutes and then it will automatically shut down, signifying that the brushing session is complete.
Many patients who purchase a Sonicare toothbrush will find that the rapid oscillation "tickles" the gums. This is only a temporary problem as most users report that after 3 or 4 days of use, they get used to the sensation from the toothbrush.
Our office sees substantial improvement in most of the patients who purchase and use the Sonicare toothbrush on a daily basis. If your dentist or hygienist have mentioned concerns about effective plaque removal, Sonicare may be the dental care device you need.