Does a hard toothbrush destroy enamel?

Is an electric toothbrush the best choice? Many dentists recommend them, but consistency in your dental hygiene routine is the real key to healthy teeth.
Is an electric toothbrush the best choice? Many dentists recommend them, but consistency in your dental hygiene routine is the real key to healthy teeth.
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We all know -- or should know -- that good oral hygiene habits include both brushing and flossing at least twice a day to keep cavities at bay. But you may not realize that the benefits of these good habits go beyond preventing tooth decay. Good oral hygiene also helps to keep teeth white, and reduces the risk of gum disease and cardiovascular disease. But even the most dedicated brushers and flossers may find weaknesses in their routine: their tools and their technique. Before we talk tools, though, let's learn a few basics about our teeth.

Our teeth are made up of four parts: the root (periodontal ligament and the cementum), which holds the tooth in the jaw, the pulp, which is the nerve inside each tooth, the dentin, which is the hard layer that surrounds and protects the pulp, and the enamel, which is the outermost layer of the tooth. The enamel is the part of the tooth that we brush, polish and whiten. And it's the enamel that bears the impact of daily wear and tear, taking damage from common things such as the foods we eat (especially acidic, sugary and starchy foods), acid reflux, tooth grinding, nail biting, medications and dry mouth.

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This wear and tear on tooth enamel, a problem known as tooth abrasion, can cause enamel to become soft and begin to erode. Symptoms of weakened enamel include tooth sensitivity, usually to cold or sweet, teeth with a yellow hue, which can happen when dentin becomes exposed, teeth with cracks or chips and indentations on the tooth surface.

What you might not have considered, though, is that your toothbrush -- the tool with which you're trying to keep your teeth clean and healthy -- may be contributing to wear and tear on your tooth enamel. Let's go deeper into how tooth brushing and your choice of toothbrush can put you at risk for weakened enamel.

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Brushing Away Plaque ... and Enamel?

You may think your regular brushing and flossing habits are keeping your smile healthy, but if you're using the wrong tools for the job, or if your technique is not quite right, you may actually be harming those pearly whites despite your best efforts.

We've come a long way from the ancient chew-sticks and boar-bristled brushes used before nylon bristles came on the market, but if you're using a medium or hard-bristled brush to scrub away plaque and debris you could also be scrubbing away your tooth enamel (as well as damaging your gums), depending on how heavy handed you are when you brush and how strong your teeth are (or aren't).

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Because hard-bristled toothbrushes may damage tooth enamel, dentists recommend soft-bristled brushes. When it comes to brush head size, choose one that fits comfortably in your mouth and allows you to clean those hard-to-reach spots.

Once you've got the right tool for the job, you'll also want to assess your technique. Are you a vigorous scrubber? If so, it's time to lighten up. Proper tooth brushing takes two minutes -- think of it as 30 seconds dedicated to each quadrant of your mouth (upper right, upper left, lower right, lower left). While you may want to scrub away plaque, the best technique is to brush gently, holding your toothbrush at a 45-degree angle at the gum line where plaque likes to hide. Plaque is sticky, but it's easy to remove, so no scrubbing is necessary -- even with a soft-bristled brush. Use short strokes, and when you're cleaning the back surfaces of your teeth, use short up-and-down strokes. To avoid brushing too hard, try holding your toothbrush with your fingertips instead of gripping it in the palm of your hand -- this will give you a lighter touch. And pay attention while you clean: If you notice the bristles are bending as you brush, you're brushing too hard.

Weakened tooth enamel puts teeth at risk for staining, sensitivity and decay, and once enamel is gone, it's gone. The remaining enamel can be repaired, though, through a process called remineralization. Enamel is primarily made up of calcium and phosphate, and remineralization helps to make enamel stronger and reduces tooth sensitivity and decay by providing calcium and phosphate minerals right to the tooth surface. Products that contain calcium phosphate or casein phosphopeptide amorphous calcium phosphate nanocomplexes (CPP-ACP) such as Recaldent or MI Paste have been found to help remineralize enamel, and in addition, your own saliva helps with the process, too.

So, opt for a soft-bristle brush, ease up on the pressure and be consistent with your oral hygiene to ensure your healthiest smile.

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Lots More Information

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More Great Links

  • American Dental Association. "Cleaning Your Teeth & Gums." (Sept. 2, 2011) http://www.ada.org/2624.aspx
  • American Dental Association. "Saliva." (Sept. 2, 2011) http://www.ada.org/3005.aspx?currentTab=1
  • Children's Hospital Boston. "Mouth and teeth - In-Depth." (Sept. 2, 2011) http://www.childrenshospital.org/az/Site566/mainpageS566P1.html
  • Cleveland Clinic. "Choosing Dental Care Products." (Sept. 2, 2011) http://my.clevelandclinic.org/services/dental_care/hic_choosing_dental_care_products.aspx
  • Doheny, Kathleen. "10 Toothbrushing Mistakes." WebMD. 2010. (Sept. 2, 2011) http://www.webmd.com/oral-health/healthy-teeth-10/brushing-teeth-mistakes
  • Griffin, R. Morgan. "Periodontal Disease and Heart Health." WebMD. 2005. (Sept. 2, 2011) http://www.webmd.com/heart-disease/features/periodontal-disease-heart-health
  • Kam, Katherine. "Tooth Enamel Erosion." WebMD. 2010. (Sept. 2, 2011) http://www.webmd.com/oral-health/healthy-teeth-10/tooth-enamel-protection
  • MI Paste and MI Paste Plus. "Frequently Asked Questions." (Sept. 2, 2011) http://www.mi-paste.com/faq.php
  • Recaldent. "Frequently Asked Questions." (Sept. 2, 2011) http://www.recaldent.com/c_faq.asp
  • The Library of Congress. "Who invented the toothbrush and when was it invented?" 2010. (Sept. 2, 2011) http://www.loc.gov/rr/scitech/mysteries/tooth.html
  • WebMD. "Choosing the Right Toothbrush." 2011. (Sept. 2, 2011) http://www.webmd.com/oral-health/choosing-a-toothbrush-the-pros-and-cons-of-electric-and-disposable
  • WebMD. "Tooth Enamel Erosion and Restoration." 2009. (Sept. 2, 2011) http://www.webmd.com/oral-health/tooth-enamel-erosion-restoration

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