Artificial intelligence toothbrushes may not be worth the hype

Colleen Rex admits she is “oral care obsessed.”

In 2017, she began two years of oral surgery that involved harvesting tissue from the roof of her mouth to patch her receding gum line. She never wants to go through that again.

“I’d like to keep my teeth as long as possible,” said Rex, 51, a nurse who lives in Pennsport.

Rex has been using an electric toothbrush, which her dentist recommended because of her medical history, for more than 15 years. Last November, she made a major upgrade that she hopes will keep her teeth even cleaner: The Sonicare Prestige 9900, an electric toothbrush with artificial intelligence (AI) that gives real-time data on how well she’s brushing. At $300, she got it for a steal. These souped-up “smart” toothbrushes retail for as much as $400.

The oral care business is booming, with increasingly powerful and stylish electric brushes, toothpastes that promise gleaming white enamel, and reusable dental floss. Global electric toothbrush sales were just under $3 billion in 2020 and are expected to top $4 billion by 2028, according to Fortune Business Insights.

But as is often the case in health care, more expensive doesn’t necessarily mean better. Dental professionals insist that a traditional manual toothbrush, fluoride toothpaste, and floss will get the job done just as well — so long as they are used properly and paired with healthy eating and routine check-ups.

“Periodontal disease doesn’t happen overnight, and it can’t be reversed overnight,” said Mark Wolff, the dean of the University of Pennsylvania School of Dental Medicine and a practicing dentist for 38 years. “You can’t have a sudden burst of cleaning your teeth really well and expect your mouth to go backward all of a sudden.”

» READ MORE: From teeth cleanings to X-rays, Pa. dentists struggle to see glut of patients as pandemic wanes

The key to getting a good clean with a manual toothbrush is using it the right way — and not everyone can do that.

Electric toothbrushes may be especially helpful for people with dexterity problems, who can’t grip the narrow handle of a manual toothbrush and brush in circular motions for the recommended two minutes twice a day. And if a fancy toothbrush encourages you to brush more often — that’s great, too, Wolff said.

The latest AI toothbrushes, such as Rex’s, use Bluetooth to report your tooth-brushing stats to your phone. Rex’s toothbrush app tells her how often and for how long she brushes, and whether she has missed any crevasses. The brush automatically adjusts its intensity when it senses that the user is brushing too hard, according to Sonicare’s website.

“I put in that I’m interested in gum care and that I don’t want to brush too hard,” said Rex, who clicks on the app and sets the phone on the sink when she gets out her toothbrush. “It tells me how long to brush each quadrant and asks things like the intensity, duration and pressure I want.”

Sonicare claims its AI brush removes up to 20 times more plaque than a manual toothbrush and can give users “up to 15 times healthier gums in just two weeks,” according to the company’s website.

An array of pricey toothpastes similarly make promises that may sound too good to be true. Some guarantee whiter or brighter teeth, while others specify that they are especially formulated for sensitive teeth or people with gum disease.

“All the toothpastes that say they whiten do have the effect of whitening,” said Wolff. They will lift surface stains and whiten the enamel to some level, but they won’t make your teeth “toilet bowl white,” he said.

Whitening toothpaste is quickly watered down by saliva and rinsing, said Bryan Katz, co-owner and dentist at Corner Dentistry in Bella Vista. If you really want whiter teeth, consider a fitted bleaching tray that holds the bleach in place, he said.

Can’t afford the latest and greatest in oral care? That’s OK. Good oral hygiene habits are far more important.

The American Dental Association recommends brushing your teeth with a soft-bristled brush for at least two minutes twice a day. Replace your toothbrush at least every four months, or sooner if the bristles are frayed, because a worn toothbrush won’t do a good job of cleaning your teeth.

As for toothpaste, choose one that contains fluoride and is ADA-approved. Fluoride is the most important ingredient in toothpaste because it protects teeth against decay by strengthening developing enamel and slowing acid production of bacteria caused by plaque.

If you suddenly become addicted to gummy bears, there is no toothpaste in the world that’s going to protect you.

Mark Wolff, dean of the University of Pennsylvania School of Dental Medicine

Flossing, Katz said, is underrated.

“Bacteria can get between your gums and if you aren’t stimulating those gums and removing that bacteria at least once a day, it can lead to inflammation,” he said.

There are lots of flossing products on the market — traditional floss, floss sticks, electric water flossers, biodegradable bamboo floss, even reusable silicone floss — and any of them will do the trick, he said.

Another overlooked way to improve your dental health: Cut back on the sugar. Regular brushing and flossing can make up for small amounts of sugar, but eating too much of it will harm your teeth.

“If you suddenly become addicted to gummy bears, there is no toothpaste in the world that’s going to protect you,” Wolff said.

And don’t skip routine dental cleanings. Once a year is sufficient for people with healthy teeth, Wolff said. People with bleeding gums or tooth decay may need to see the dentist every three months.

Rex, who sees her dentist four times a year, thinks her gum problems stemmed from the back-and-forth sawing motion and hard-bristled brush she used as a child.

Her electric toothbrush has made a big difference. Rex’s dentist measures her gums at each visit and hasn’t noticed any negative changes in years.

“If I didn’t have my Sonicare, I don’t think I would know how to brush my teeth with a manual toothbrush anymore,” Rex said.

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