Peer-reviewed dental literature indicates that forceful or vigorous toothbrushing is linked to cervical tooth abrasion, loss of tooth structure, and soft tissue or gingival injury.
<h4>Background</h4>Toothbrushing might be associated with the development of soft tissue lesions. This systemic review aimed to examine soft tissue lesions caused by different bristle stiffnesses and bristle end-shapes in manual toothbrushes in adult individuals.<h4>Materials and methods</h4>Scopus, EMBASE and PubMed databases were searched to find controlled trials that evaluated manual toothbrush bristle stiffness and/or end-shape in regard to soft tissue safety. The grey literature was also included in the search strategy. Two reviewers independently performed the screening, final selection and data extraction. To be included, studies had to have been performed using at least two manual toothbrushes differing in bristle stiffness and/or end-shape, and had to report any adverse effects on oral soft tissues after at least 7 days of follow-up. A meta-ethnography strategy was used for qualitative data synthesis. The Cochrane Collaboration tool was assessed to evaluate the risk of bias.<h4>Results</h4>Thirteen studies were included from the 1,945 initially retrieved. Toothbrush bristle end-shape was investigated in six studies, bristle stiffness in two, and both features were investigated in five studies. Hard-bristle toothbrushes produced more gingival lesions than medium- and soft-bristle brushes. A slight gingival recession width increase was identified in the end-rounded group, compared with the tapered group. Only four studies presented adverse effects as the primary outcome.<h4>Conclusion</h4>Soft and extra-soft toothbrushes tend to be safer. Oral soft tissue injuries are similar for both tapered and end-rounded bristles. Further studies investigating adverse effects as a primary outcome are recommended.
<b>Background/Objectives</b>: Toothbrushing is a recommended daily practice that helps sustain oral health. However, if performed improperly, it can lead to loss of tooth structure and injury to soft tissues. We explored this topic with an extensive literature search. <b>Methods</b>: A literature search was performed across textbooks and journals for original research and review articles in Scopus, PubMed, PubMed Central, and Cochrane databases, published between 1967 and 2024. <b>Results</b>: The search result yielded 118 articles that were suitable to include in this review. Toothpaste abrasivity plays a major role in combination with toothbrush forces. Therefore, maintaining forces between 2 and 3 N may be gentler on the tissue. Electric toothbrushes are safer. Toothpastes with low RDA values are also less abrasive. Active ingredients in whitening and desensitizing toothpaste can induce tooth wear. Remineralizing agents have the potential to manage the associated lesions. <b>Conclusions</b>: Cervical abrasions and gingival recession occur frequently due to oral hygiene measures. Standards in oral hygiene aid to match patient needs can prevent hard and soft tissue loss.
Toothbrush abrasion at the cervical areas of teeth is generally thought to be a result of frequent or forceful toothbrushing, faulty or vigorous technique, filament stiffness or design, dominant hand dexterity, or abrasive dentifrices. However, a review of the evidence-based literature cannot conclusively establish any one factor as the primary etiology of cervical abrasions because of inherent methodological limitations and conflicting results. Rather, a variety of factors related to toothbrushing may act in concert with dental erosion and, possibly, occlusal loading in the creation of noncarious cervical lesions. Individual variation also may make some individuals more susceptible to development and may modify the progression of those lesions. Individual variations may involve oral and dental anatomy, periodontal status or phenotype, and periodontal disease history and treatment. Further research is needed to clearly assess the interaction of all those factors in the development of cervical lesions. Therefore, awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient.
Why pick on teeth?
In the evolution of oral hygiene practices, the toothpick is the progenitor device. Although modern variations are used interdentally, with the current emphasis on plaque control rather than gingival massage and stimulation, the toothpick has been largely superseded by floss, interproximal brushes, and other supplementary aids. The natural hard bristle toothbrush and vigorous scrub brushing popular a generation ago have been replaced by soft bristle nylon brushes and gentler, more defined brushing procedures for plaque removal in the crevicular areas. Quantitative studies support the superiority of the current techniques in maintaining periodontal health with less trauma to the oral tissues.
Published in Journal of the American Dental Association (1939) (1990)
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This check searched the claim as stated. It did not run a separate search for evidence against it.