New Developments in Oral Hygiene

Proper oral hygiene is the key to proper maintenance of the health of our teeth and gums. The threat in the form of bacterial plaque puts us at risk for caries, gingivitis, periodontitis, and even increases the risk of other general diseases. Oral B, the brand most recommended by dentists in Spain, began its work in the middle of the last century with the aim of providing patients with the best tools to achieve proper oral hygiene. In line with this effort and continuous progress, Oral B presented last February at the Mobile World Congress in Barcelona its latest innovation in electric toothbrushing; the first intelligent toothbrush that sees what the patient does not see: Oral B GENIUS. Dr. Nart, a nationally and internationally renowned dentist specializing in periodontics and dental implants, has had the opportunity to test Oral B GENIUS personally and on his patients:

There are many different types of brushes for brushing: manual, electric, hard, soft, etc. Can you give us your point of view on what would be the ideal tool to use at home?

Indeed, there are brushes on the market with a multitude of different designs, shapes, sizes and consistencies. While each one will try to meet the specific needs that some patients may have, broadly speaking, brushes should meet the following requirements: small brush head, to be able to clean the most difficult to reach areas; medium hardness, to achieve an optimal balance between effectiveness in plaque removal and potential damage to the gums. Within the different brush modalities, the current scientific publications of greater impact and prestige clearly show a higher cleaning efficacy of electric toothbrushes compared to manual ones. And among them, those with round brush heads and movement in the three directions of space (oscillation-rotation-pulsation) are the ones that provide the most evidence.

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Dr. Nart, to what extent does good oral hygiene affect the health of our mouths? Is it really so important to brush and use toothpaste 2-3 times a day?

More than 600 species of bacteria are continuously formed in the mouth. Some of these are the cause of caries, gingivitis, periodontitis, halitosis as well as mucositis and peri-implantitis around dental implants. I usually tell my patients not to invest time and money in a dental treatment if there is no good oral hygiene on their part, because we know that the treatment will largely fail over time. Brushing twice a day is necessary to control and eliminate bacteria located on the teeth, gums and back of the tongue. In addition, oral hygiene between the teeth should be completed with dental tape or interdental brushes.

Recently, initiatives such as the Alliance for Health, led by SEPA, have been published with the aim of raising awareness of the interrelationship between general diseases and oral diseases and vice versa. To what extent does this relationship affect our daily lives? Or is it just a more theoretical relationship?

In May 2016 the Spanish Society of Periodontology established a pioneering agreement of cooperation between different medical societies that has proven to be closely related to oral pathology.

Thus, for many years periodontitis has been related to diabetes, so that diabetic patients are more susceptible to develop periodontitis. And vice versa, the treatment of advanced periodontitis helps to better control blood sugar.

More recently, bacteria from the mouth have been isolated in the atheroma plaque responsible for ischemic heart disease; angina, infarction, thrombosis… Although their role in this pathology is not yet clear, it seems evident that those patients at risk of stroke or coronary artery obstruction (smokers, hypertensive, obese…) if they do not control their oral hygiene and periodontitis and inflammation in the mouth will increase the chances of the appearance of these serious and threatening diseases.

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Finally, there is evidence that poor hygiene control leading to gum disease (gingivitis, periodontitis) can increase the risk of premature birth or low birth weight babies, as well as aspiration pneumonia.

The most recent research demonstrates this relationship between gum disease and increased risk of other systemic diseases. The dental clinic can become a space for primary prevention, working together with cardiologists, endocrinologists, pulmonologists, gynecologists and primary care physicians.

So poor oral hygiene puts us at risk of problems in the mouth and could in other organs. What are the keys to good brushing?

As we have mentioned before, the first thing is to have an effective tool, as the oscilanterotacional-pulsatile electric toothbrush (Oral B Professional) has proven to be. With this tool in hand, the most critical point is to control the time and pressure with which we rest the brush on the teeth. Of course, some force is necessary, but beyond a certain threshold, force only translates into damage. For this reason, Oral B Professional toothbrushes incorporate a pressure control that visually, tactilely and audibly indicates to the patient that he or she is overdoing it. And finally, we have to make sure that we brush all the teeth and for a sufficient amount of time. For this, electric toothbrushes incorporate a timer, but Oral B goes further. In short, effective tools, proper technique and good compliance (time and access to all areas of the mouth) … the latter being something that sometimes even dental professionals do not achieve 100%.

Is Oral B GENIUS then the toothbrush that will make it easier for patients to brush as their dentist recommends?

Oral B GENIUS is the ultimate toothbrushing tool. In line with the mart and “connected” world we live in today that has invaded health sciences and patient care, Oral B has managed to combine the excellent capabilities of its electric toothbrushes with innovations in facial recognition. The brush incorporates a position recording system that transmits to the SmartPhone through a Bluetooth connection.

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Bluetooth connection. In turn, the phone through the Oral B App and the front camera will recognize the position of the patient’s mouth. By combining the information received about the position of the toothbrush and the position of the patient’s face, the app shows the patient in real time which areas have been brushed for long enough and which have not. In this way, the patient can be sure that he or she has brushed all areas of his or her mouth at the end of brushing.

Oral B GENIUS allows patients to brush as recommended by their dental professional Oral B, with its Oral B GENIUS toothbrush, is at the forefront of oral hygiene.

As an implant specialist and because implants are for life, hygiene will not be such an important concern. Is this true?

Hygiene is always fundamental, even if the patient no longer has any teeth. It is essential to prevent caries and gum disease (gingivitis and periodontitis), both of which are bacterial in origin. But since an implant is nothing more than an artificial substitute for a dental root, the hygiene of a patient with implants is essential to avoid peri-implantitis.

Peri-implantitis is a consequence of the invasion of the implant surface by bacteria from the mouth. As with caries and periodontitis, peri-implantitis can result in the loss of an implant. But unlike teeth, implants appear to be more susceptible to inflammation. Hence, the hygiene of patients with implants must be even more exquisite.

If the patient with implants has a good hygiene, is not a smoker, his periodontitis is treated and attends professional maintenance every six months, the implants will last with health in the vast majority of cases. Prevention and hygiene are fundamental to avoid dental implant infections.