Dr Andrew Chang interviews Dr Teck Tang, of the Specialist Dental Centre, Sydney. He is a well regarded specialist gum dentist, an expert in the field of keeping clean teeth and healthy gums.
To access the audio version of this, please go to our podcast. What’s covered in Part 1 are:
The transcript is below:
Dr. Chang: Good day! Today, I’m very honored to have a specialist periodontist, Dr. Teck Tang. His area of expertise is exclusively in teeth and gum health and maintaining and managing healthy teeth and gums or bringing them back to normal health.
So why I got him in today is we see many orthodontic patients or patients with braces or clear removable aligners. And sometimes keeping the teeth clean can be a challenge. So I’m very privileged to have Dr. Tang here who is going to talk about the importance of teeth and gum health in orthodontic treatment.
So good day, Teck. How are you doing?
Dr. Tang: Hello, Andrew. Thanks for having me here today.
Dr. Chang: To start off with, Teck, I have a lot of patients who ask me, “Is there any difference between a manual toothbrush and an electric toothbrush?”
Dr. Tang: No. Normally, they should work the same. So everything comes down to the right technique. But for patients who can’t really brush properly, sometimes there might be advantage in using an electric toothbrush especially for patients with braces on. Plaque control can always be an issue or a challenge. So for that, I will recommend electric toothbrush over manual toothbrush.
But if you use a manual toothbrush properly, it should do the same job. Yeah.
Dr. Chang: What about the size of the electric or other brand of electric toothbrushes, if you can talk about that first? Is one brand work better than the other? What about battery versus rechargeable types?
Dr. Tang: Generally, they’re all quite similar. But personally, I prefer oscillating electric toothbrush such as Oral-B. Just get the basic model. You don’t have to buy the $200 electric toothbrush. Probably just $30 would do. And I prefer the round small head with sensitive bristles, soft bristles. It’s always better.
Dr. Chang: Teck, can you just explain, what do you mean by an oscillating electric toothbrush? I mean how can we as I mean people walk into let’s Coles or Woolworths or pharmacy identifying a toothbrush as have oscillating head?
Dr. Tang: I believe the oscillating ones are the ones that rotates. Oral-B, in fact, all the Oral-B electric toothbrushes got an oscillating brush head whereas Colgate has got the normal brush head which doesn’t oscillate but it kind of vibrates and with lateral motions. Yeah.
Dr. Chang: And what about with the manual toothbrushes? Are there any difference in sizes as having a smaller size work better than bigger size? And how do we as people walk in to buying toothbrush, how do we know what is suitable size head for a manual toothbrush?
Dr. Tang: OK. Once again, we always recommend a toothbrush with smaller head with softer bristles. And this is not always the popular ones. So in fact, a lot of my patients have problems getting the right toothbrush in the supermarket. So I normally give out Colgate Ultra Soft.
Dr. Chang: Like an extra special soft, right?
Dr. Tang: Yes, ultra soft with super fine bristles. And you can try to get online or you can get it through your orthodontist.
Dr. Chang: Most of my patients are actually teenagers or even younger children. So I think for these ones like a small head, I mean would you say perhaps a centimeter or centimeter and a half in size or less will be what you consider small in terms of the bristle head, the bristle length?
Dr. Tang: In terms of the head, I think it’s about 15 centimeters. That’s probably the right size.
Dr. Chang: 15 millimeters you mean.
Dr. Tang: Sorry, sorry, 15 millimeters. Sorry. I haven’t got the correct measurements but yeah. So generally, smaller head is better than bigger ones and the soft bristles is better than the hard bristles. It’s all about using with the right technique because plaque is actually very soft. You don’t really need to hard bristles. Sometimes it might be damaging for your gum tissues.
Dr. Chang: Right, right. OK. And how often should we change the toothbrushes? I mean I know – I remember my mom used to say many, many years ago, we change it every three months. Is that something that’s still the case or do we change more frequently?
Dr. Tang: As a general rule, three to six months. But generally, if you think the bristles are not as firm or are not doing the job properly is probably a right time to change them.
Dr. Chang: The next thing, Dr. Teck Tang, I’d like to ask is with the toothpastes, is there any difference between a whitening toothpaste, a sensitive toothpaste and a fluoride toothpaste? And I even had patients asked me, “What about using a charcoal toothpaste as well?” I mean, yeah.
Dr. Tang: For gum health, it doesn’t really matter what type of toothpaste you use as long as you manage the plaque control properly. So it’s all about mechanical brushing. So as long as the toothpaste has got fluoride, which is very important for teeth protection, that should be sufficient. But for specific patients with specific needs such as teeth sensitivity then the sensitive toothpaste is always preferred.
And personally, I prefer Colgate Pro Relief Sensitive or Sensodyne. They’re really good for patient with sensitivity. And in terms of having charcoal in a toothpaste, I know that’s probably one of upcoming trends in the toothpaste industry. But as long as it does the job, it has got fluoride, I’m not too fuss about it.
Dr. Chang: And I think is it still correct that Sensodyne that have fluoride in Sensodyne toothpaste or has that changed now?
Dr. Tang: In fact, most of the toothpastes, the normal toothpaste or the major brands that has got fluoride in them, you’ll probably find those herbal toothpastes that haven’t got fluoride in them. So I’m worried about them because if you got braces on and plaque control is not hundred percent, sometimes you’re more likely to get cavities in your teeth. So really I think fluoride is one of the major most important ingredients.
But for the gum health once again, it comes down to mechanical tooth brushing and plaque control rather than the ingredients in a toothpaste. Yeah.
Dr. Chang: We have some children which are 12 years old or younger and sometimes I know some of the labels of the toothpaste are saying, “Should be used with caution in children younger than 12 years old.” These are over-the-counter toothpastes. For example, I know this is not Colgate Total. For example, Colgate Sensitive Pro I think they have a label like that. Is there any popular brands that you recommend for the younger children, 12 years and younger?
Dr. Tang: Generally, they have children toothpaste whether it’s Oral-B or Colgate. So that’s purely because we need to have the right amount of fluoride in a toothpaste for children’s teeth and also for adult teeth. So before 12 years old, they will have some deciduous or baby teeth in place so it’s always better to have – to use children toothpaste rather than adult toothpaste.
Dr. Chang: Yeah. Thank you so much, Dr. Tang. Now, if we can sort of relate this now for someone who is undertaking orthodontic treatment, we talked about toothbrush and toothpaste. Is that sufficient? I mean are there other tools or I mean appliances that should be used as well?
Dr. Tang: So I generally recommend proper brushing at least twice a day focusing on the gum lines. And generally, you need to spend at least about 2 minutes when brushing all the teeth. If it’s less than 2 minutes, it’s probably not sufficient. If it’s more than 2 minutes, it’s probably overkill. It doesn’t help you that much more.
Dr. Chang: That is without braces, your 2 minutes, because I would imagine when you have braces on, it will be probably double the time.
Dr. Tang: Slightly longer. So it all depends on basically just brushing every single tooth thoroughly in a systematic manner. Now, for cleaning in between the teeth, you should at least consider using interdental brushes or super floss. So any other gadgets, I know there’s AirFloss or there’s WaterPik. That’s more of additional gadgets that you can try on top of your normal brushing and on top of the use of interdental brushes and dental floss.
Dr. Chang: So just so we can just explain about this interdental brushes, these brushes are ones that clean in between the teeth. Is that what you mean by interdental brushes? And what other common brands that our customers or patients can look for in the supermarket?
Dr. Tang: Yeah. The interdental brushes, it’s basically a brush that cleans in between your teeth. And obviously, they come in different sizes because patients always have different size gaps. So the common brands are TePe or Piksters. You can easily buy them from the supermarket or pharmacy. And most of my patients, they really love it. They find it so much easier than using dental floss.
Dr. Chang: I agree. I mean my patients too, find Piksters much easier to use than silver floss. So does that mean – I mean for patients that Piksters can replace the floss or what do you recommend?
Dr. Tang: I recommend both. The more cleaning my patients do, the better the gum health, the better the dental health. So the more, the better. So I always recommend the use interdental brushes and using the dental floss as well. But for patients who really struggle then I would at least recommend the use of Piksters or interdental brushes.
Dr. Chang: We also have some patients who lead very busy lifestyles or they have braces which are attached behind their teeth or sometimes with teenagers, it’s quite a battle. I mean it can be quite hard as parents trying to encourage them to brush their teeth. So I know there are like gadgets that would save time like Waterpiks. Can this be perhaps an alternative to these cleaning in between their teeth with perhaps they are struggling with using Piksters or flossing?
Dr. Tang: For Waterpik or AirFloss, they are great. They are probably to get food debris out. But plaque can be very, very sticky. So I’m worried that the water pressure from those gadgets may not be strong enough to remove the plaque. So I will still recommend them to do mechanical brushing properly and using these as additional gadgets. It helps but I don’t think it can replace the use of interdental brushes or dental floss.
Dr. Chang: So mechanical brushing as in you mean physically getting you to brush or the brush as in the Piksters and just getting there and just cleaning the plaque out.
Dr. Tang: That’s right, rather than relying on the water pressure from AirFloss or WaterPik. It’s fantastic but it’s not ideal.