Manual or Electric: What’s the Buzz?

Over the years, Chelsea Wells, a dental hygienist with The University of Vermont Medical Center’s Dental and Oral Health team since 2014, has answered her share of questions about teeth, dangerous fads and all. (No, you should not use a Mr. Clean Magic Eraser on your pearly whites.) Here she offers more (safe!) advice on popular tooth-whitening trends, eco-friendly oral care products and more.

1. Charcoal toothpaste

“Patients ask about charcoal toothpastes all the time,” says Wells. These are all made from activated charcoal, which is used in other areas of medicine to draw toxins out of the body. It’s commonly used to absorb swallowed poisons, for example. “The idea is that charcoal can also draw toxins out of your teeth, removing stains and making them look whiter,” she says.

Unfortunately, the American Dental Association has found no evidence that charcoal is effective in this way. And, according to Wells, there are also two significant drawbacks to using charcoal toothpaste as part of your daily routine.

One: It’s very abrasive, so it can wear down your enamel. If you’re looking for a whitening product, this can actually have the opposite effect, Wells explains. “Only the outer shell of our tooth enamel is white. The sub-layer, or dentin, is more of a yellow or a light brown color.” So if your enamel wears down – as a result of natural aging, or sped up by using abrasive cleaners such as charcoal – your teeth will end up looking more yellow.

Another major problem with charcoal toothpaste is that none of these products contain fluoride. “Fluoride is the number-one thing we look for in any toothpaste, for its ability to protect against cavities,” says Wells.

2. Oil pulling

Wells says patients have also recently asked her about a whitening trend called “oil pulling,” in which patients swish with various oils – “usually coconut oil, because it tastes the best” – to counteract the bacteria that cause yellowing of the teeth. “These bacteria are ‘pulled’ out from between your teeth,” Wells explains. “But the thing is, you have to swish for 15 to 20 minutes, which is a long time!”

While there are no known risks associated with the practice, neither is there much long-term research on its effectiveness. For this reason, it is not ADA-recommended. And, Wells notes, “I’d rather see people invest that time into flossing, which has a much bigger impact on good oral health.”

3. Baking soda

For patients looking for a natural whitening product, Wells is more apt to recommend a baking-soda slurry. Baking soda is not as abrasive as charcoal, making it safe to use a couple of times a week. As long as it’s not used every day, and always in conjunction with a fluoride-containing toothpaste, it can be a good add-on to your dental routine, and a reasonably effective whitener, Wells says.

Plus, she adds, baking soda is basic, which offers a good balance to our mouth’s usually-acidic environment. In fact, dentists originally recommended baking soda in order to counteract those natural acids, which occur as sugars are broken down, and put us at risk for cavities and tooth decay. “Then they discovered a fun side effect, which was its whitening ability.”

To make a baking-soda slurry, simply combine one teaspoon baking soda with two teaspoons of water, and use it like you would a toothpaste. 

4. Whitening products

Baking-soda slurries, baking-soda toothpastes and whitening toothpastes containing hydrogen peroxide are all safe and effective for whitening, Wells says. However, whitening strips, whitening retainers and whitening treatments you receive in a dental office will work more quickly than any of those, simply because they contain a higher concentration of chemicals. So if you’re looking for fast results, you may want to go with one of those.

5. Bamboo toothbrushes

Bamboo toothbrushes are eco-friendly, and some are recyclable and/or biodegradable. They’re also tooth-friendly, Wells says, as long as you choose one with a bristle texture that’s either “soft” or “extra soft.” Some also have official ADA approval, so patients may want to look for that seal as they shop.

6. Zero-waste toothpaste and floss

Zero-waste toothpastes, such as toothpaste tablets, reduce the amount of packaging involved in toothpaste. They also eliminate the product waste inside the package (you know, that annoying last bit of toothpaste you can’t squeeze out of the tube). Unfortunately, once again, these products don’t contain fluoride, so they’re not ADA-recommended. 

If you want to leave a smaller footprint, Wells suggests looking into zero-waste floss. It comes in a refillable plastic package, which is itself recyclable. “We’ve tried some of these in our office,” says Wells. “They work great, and they taste great. The only drawback is that they’re quite a bit more expensive than the regular flossing products we’re used to.”

7. Toothbrushes: manual or electric?

“I was taught in college that you can be just as effective with a manual toothbrush as with an electric one,” says Wells. “Unfortunately, we’re taught to brush our teeth when we’re little kids, when our technique isn’t the best.” She explains that proper brushing technique requires quite a bit more precision, dexterity and patience than most of us have, at any age.

“You need to angle your bristles at a 45-degree angle to your teeth and gums, and you have to brush for two full minutes. The average time a person spends brushing their teeth is way less than that. Last I checked, it was somewhere around 38 seconds,” she notes.

So she recommends electric toothbrushes simply because manual brushing introduces a lot of human error. “If you have the time, the mindfulness, and the dexterity to use good technique, then it’s absolutely true that you can be just as effective with a manual toothbrush,” she says. “But with an electric toothbrush, you can afford to be a little less intentional, as long as you hit every surface.”

8. Flossing products, ranked

Since Wells felt the electric toothbrush was a good fit for busy lifestyles, we wondered whether she felt the same about advanced flossing technologies, such as water flossers and mouth rinses. It turns out, when it comes to in-between cleaning, manual is better.

“We don’t discourage any flossing products, because something is always better than nothing,” Wells says. “But if someone has the ability to floss, manual flossing, either with string floss or the floss picks, is always better. A device will never do as good a job.”

Here, Wells offers a very local analogy. “If you go four-wheeling in the mud, you can take a power hose and hose out your wheel wells, and that will get the big chunks out. But there will still be a fine layer of dirt that can only be removed with a sponge and some elbow grease. It’s the same with your mouth. While you may see chunks of food in the sink after using a water flosser, it won’t get you that deep clean between your teeth that you’ll achieve with regular dental floss.”

As for mouth rinses, Wells says, “we put those at probably the lowest level when it comes to in-between cleaning. They can reduce some of the bacteria in the mouth, and lots of them also contain fluoride, which is a bonus. But they don’t do as good a job as even a water flosser of removing particles trapped between teeth. You can only put so much ‘oomph’ into your swishing,” she notes.