Dealing with “unacceptably inconsistent” advice on toothbrushing

This summary is based on the article published in the British Dental Journal:  An analysis of methods of toothbrushing recommended by dental associations, toothpaste and toothbrush companies and in dental texts (August 2014)

J. Wainwright and A. Sheiham

Context

Universally, dentists, dental associations  and government bodies recommend regular daily toothbrushing because it is  so important for preventing periodontal  disease and caries. One would expect some professional consensus on which methods of toothbrushing to recommend.

Evaluations on  the effectiveness of dental health education indicate that adherence to recommendations on toothbrushing are not good. This may be related to the fact that the methods of  toothbrushing recommended are either too difficult to perform or conflict with what  patients have learned from other authorities  or adverts for toothpastes.

Purpose of the Study

To assess the methods of toothbrushing recommended for both adults and children by dental associations, toothpaste and toothbrush companies and professional sources, such as in dental textbooks and by experts. Secondly, to compare the advice by source and whether recommendations differed for adults and for children.

The study:

• Brings attention to the unacceptably wide diversity in recommendations on toothbrushing methods.
• Highlights the methods recommended by toothpaste companies differed from those of dental associations, as did advice in dental textbooks and research-based sources.
• Stresses higher grades of evidence of effectiveness of toothbrushing techniques are required.

Key Findings

• There was a wide diversity between recommendations on toothbrushing techniques, how often people should brush their teeth and for how long.
• The most common method recommended was the Modified Bass technique, by 19. Eleven recommended the Bass technique, ten recommended the Fones technique and five recommended the Scrub technique.
• The methods recommended by companies, mainly toothpaste companies, differed from those of dental associations, as did advice in dental textbooks and research-based sources.
• There was a wide difference in the toothbrushing methods recommended for adults and for children.
• The unacceptably large diversity in recommendations on what toothbrushing method to use should concern the dental profession. Higher grades of evidence of effectiveness of toothbrushing techniques are required to inform professional bodies that develop guidelines on toothbrushing.

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