So the super geeky, jet propulsion lab, MIT wanna be, engineering side of my personality (isn’t there an engineer in all of us?) was fascinated by this video produced by google engineer Ben Krasnow, which in illuminating, exhaustive detail shows the effects of brushing on the bristles of a toothbrush. Google is famous for it’s search engine, but a little known fact is that Google engineers are encouraged to spend 20% of their time to work on things that personally interest them (and which may have an application for Google). Apparently, engineer Krasnow has a fascination with microscopes and toothbrushes. And so do the 280,000 who have viewed the video.
It is common knowledge that one should change a toothbrush every 3 months. Ben’s project showed that after 3 months when viewed through a scanning electronic microscope, the bristles on the end of your toothbrush are worn smooth. In order for brushing to be effective, the tips of the bristles need to be ‘microscopically’ rough which not only aids in abrading away plaque but increases the surface area of the bristle contacting the tooth.
Ben also scans toothpaste, specifically looking at the coarse grains of di-calcium phosphate di-hydrate which is in toothpaste, and which acts as an abrasion agent to aid in the cleaning of teeth. Think baking soda or sand. These grains are 20 microns in diameter, similar to 600 grit sandpaper which is actually surprisingly coarse. He does reveal that in a pinch, one can use toothpaste to clean dirty car headlamps.
The video which is over 8 minutes in length is a nerdy scientist’s dream and is appropriate for anybody who enjoys watching detailed explanations of how things work. It is full of words like zoom ratio, vacuum desiccation, aspect ratios and silver vaporization. I give it a strong 2 thumbs up.
If you need a good excuse to change your toothbrush after 3 months, I highly recommend this video!
As pediatric dentists, we are referred patients who are unable to tolerate procedures at their family dentist. Patients come to us for a variety of reasons – chief among them are anxiety, apprehension, inability to comprehend, fear of the ‘needle’, combativeness, shyness and stubbornness. With the vast majority of patients simple behavior management which involves a lot of talking on our part, and clear, child-friendly explanation of procedures enables us to transform a previously uncooperative patient into one who comes to the practice with a smile!
Patients on the autism spectrum experience all of the behavioral issues previously discussed and more. Autism Spectrum Disorder is an extremely complex disorder of brain development. Symptoms vary in severity but are characterized by difficulties in social interaction, communication and repetitive disorders. Autism can be associated with intellectual disabilities, difficulties in motor coordination, and sensory disorders.
The key to treating our patients with autism is understanding, patience and parental involvement. Parents help guide our understanding of their child’s ability to tolerate treatment and are invaluable in discussing tactics that may be effective in gaining their child’s trust. Mostly, it’s about understanding that one needs to be flexible in determining what qualifies as a successful visit. For some of our patients, the ability to sit in a chair for a short period of time may be enough for a first visit. On the second visit, introducing them to the high speed suction or other tools that we use in dentistry may be the next step to gaining their trust. Usually, what is needed is patience and the willingness to spend multiple visits to achieve what may typically be done in one visit.
Other things that we do that have been successful in the past include:
- Treating patients in the operatory alone – less noise and distraction is essential and gives the patients the chance to acclimate to their environment
- Having the same dentist/hygienist see the patient every time. This eliminates the chance of there being any surprises for the patient
- Doing procedures in smaller chunks ie. only clean the teeth in 10 second increments, taking only one x-ray, doing only one filling
- Discussing with parents beforehand what the plan for the day is
- Placing a heavy lead apron over the top of the patient which can be soothing for some patients
- Use of a picture chart with images that patient can point at to communicate
- Instead of using a loud handpiece for cleaning teeth, brush with a toothbrush only. Loud noises can be quite disturbing
- Having the parent bring an iPad/tablet with the patient’s favorite music, movie or show playing
This list is by no means exhaustive nor do these techniques work with every patient. But these techniques can help.
One of the joys of pediatric dentistry is seeing our patients grow up before our very eyes. Treating patients on the autism spectrum is no different. The only difference is that it may take a little longer to gain their trust. But the reward is always a High Five and a smile.
Click here for a New York Times article on children with autism and dentistry
Take a walk down the aisle of any supermarket or pharmacy and you will be shocked by the number of toothbrushes available. From different shapes, sizes, bristle type (soft, extra soft, medium), brand names, store brand, electric or manual, what’s a consumer to do? Well, to further add to one’s toothbrush confusion, one now has the choice of purchasing an eco-friendly, recyclable and compost friendly, design chic toothbrush.
If one considers that you should be changing your toothbrush every 3 months, that is a lot of toothbrushes in one’s lifetime (rule of thumb is if the bristles on your toothbrush are no longer standing upright, it’s time to change your toothbrush; furthermore, waiting to get a new free toothbrush from your dentist at your regular 6 month check-up should not be the only way you obtain a new toothbrush). Imagine throwing away 500 toothbrushes over your lifetime, multiply that by the global population, and that is a lot of trash.
This new toothbrush made by the folks from a small Portland based company called Goodwell aims to solve this problem by creating a toothbrush that is biodegradable. The handle is made from harvested renewable bamboo, and the bristles are made from binchotan. Binchotan is made in the Kishu region of Japan.. It is a charcoal activated by burning oak branches at extremely high temperatures for several days and then rapidly cooling them. This charcoal is incorporated into biodegradable bristles. Aside from being environmentally friendly, proponents of this product state that it prevents bad breath, deodorizes and removes plaque. Supposedly, this activated charcoal also gives off negative ions and prevents bacterial growth within the brush. However, this has not been independently verified or studied.
Clearly, this is a toothbrush designed with those who care greatly about both the environment and chic design. Priced at $14.99 for a 3 pack, it is reasonably priced considering it is not manufactured by one of the ‘big boy’ companies that have the advantage of scale and distribution. There is also a subscription based model which will ensure that one never runs out of toothbrushes.
It will be interesting to see if this model of direct to consumer sale will be successful in the long run or if the Crests and Colgates of the World will jump in once they see there is a market for internet distribution of toothbrushes. They may even determine that an eco-friendly toothbrush makes sense. In a way, they are lucky to have the benefit of waiting to see if this small crowd sourced company achieves some measure of profitability before spending any money of there own. Best of luck to Goodwell for trying to shake things up in the toothbrush world.