Of all the things considered matinal essentials—reading the paper, guzzling caffeinated beverages, consuming a balanced breakfast—few tasks have more effect on long-term health and wealth than brushing one’s teeth. I grew up in a community where dentures were considered a convenient inevitability and most people underwent a full-mouth extraction as a mid-20s rite of passage. It will therefore come as little surprise to hear that, having grown up without being initiated into this essential morning ritual by my false-teeth-wearing parents, as an adult I spent hundreds of hours in various dentists’ chairs and have paid more than $60,000 to fix my messed-up choppers.
Please learn from my experience, readers. Toothache is world-stoppingly painful; seeing a dentist can be extraordinarily expensive; and if you happen to fall on hard times, very few states cover dental care for adults on Medicaid, and Medicare doesn’t cover dentistry at all. So, like Patti Smith says, take care of your teeth. Forget last year’s flap over flossing, the most essential ingredient to good oral health is a regular regime of brushing.
To answer the most controversial question first, the ideal brushing moment, in the morning slot, is right after breakfast. (Bedtime remains obvious.) But timing is just the beginning!
The bristles of a toothbrush do the heavy lifting of removing the food debris that can accumulate around the surface of the teeth, helping to prevent plaque from building up at the gum line, which can eventually turn your mouth into a tiny version of the Somme. A toothbrush is a toothbrush is a toothbrush—though an instrument with a small head is best for reaching into the tight quarters at the back of the mouth. The most important thing is that it be clean, so rinse your brush with hot water after it’s been in your dirty, filthy mouth. You should unwrap a new one every three months or so—more frequently if you’ve had a viral infection like the flu.
Toothpaste is a mere adjunct to the hard-working bristles, but its mild abrasives and surfactants make the toothbrush’s work more efficient. One thing: When it comes to loading up your brush, forget the generous swirls of dentifrice shown in toothpaste commercials—all that’s needed is a dab the size of a couple of grains of rice. Using more does no one, except the toothpaste manufacturers, any good.
A scouting trip to the toothpaste section of a supermarket or drugstore reveals boxes making five broad promises about their contents: that they’ll prevent cavities, fight gingivitis, combat sensitivity, whiten teeth, and freshen breath.
Fluoride found in toothpastes, gels, and rinses has been proved to fight tooth decay—and while many of us benefit from fluoridated water, topical applications keep the fluoride up against the surface layer of the teeth, where it can counteract the cavity-causing effects of acid from the sugars and carbohydrates we consume. This is a very good thing.
Products that promise tartar control can be effective in preventing plaque from hardening on teeth and gums. This tartar, or calculus, collects above the gum line and causes the soft tissues to swell or bleed, a condition known as gingivitis—tartar is what dental hygienists scrape and hack at when you get your teeth cleaned. If your hygienist swears under her breath when she looks inside your mouth, or the sink is as bloody as a Game of Thrones battleground scene after you’ve brushed, you might want to use an anti-gingivitis toothpaste to hinder the attachment and hardening of plaque and tartar.
When tooth enamel is worn down by gum disease, excessive brushing, acidic fruits or drinks, or tooth grinding, teeth can become sensitive, making brushing painful and turning treats like ice cream into instruments of torture. Desensitizing toothpastes don’t rebuild that damaged dentin, but they contain chemicals that block pain signals to the nerves of the teeth, effectively creating a numbing effect. If hot or cold drinks sometimes make you scream, it’s a good idea to use a dentifrice that promises to tone down sensitivity, but only a dental professional can fix the underlying problem.
Over-the-counter toothpastes can’t really be said to whiten teeth—higher concentrations of peroxide are needed for that, and the bleaching agents must be held against the teeth—but brushing can remove some superficial stains, for example from tea and coffee. They won’t have any effect on caps, crowns, veneers, or fillings, nor can they counter discoloration that results from injury or medications, but if your daily caffeine is robbing your smile of its sparkle, by all means try a whitening paste or gel.
Those promises to freshen breath are absolutely, totally, 100-percent true—except in the eventuality of an accidental purchase of wintergreen-flavored toothpaste, in which case one’s breath is curdled, soured, and utterly enstaled.
Do consumers need to worry about interactions between the various ingredients that provide these cavity-fighting, gum-disease-preventing, sensitivity-battling, stain-removing, breath-brightening benefits? The answer is a resounding no—active ingredients make up a tiny portion of the contents of the toothpaste tube, and they can all get along just fine. The apparently endless permutation of benefits promised by the products in the toothpaste aisle exist for the same reason there are an infinite variety of breakfast cereals or soft drinks. As Michael Moss explained in his book Salt Sugar Fat, “The main point of generating product line extensions is to win more space on the [supermarket] shelf. Store managers will only give so much room to any one product, no matter how briskly it is selling. Adding new flavors and colors creates new products that get their own space, and the more likely shoppers are to see the brand, the more likely they are to buy it.” As it is with Doritos, so it is with dentifrice.