Center for Cosmetic Dentistry

   Latest Dental News Breaks

Dental products flourish on health, cosmetic concerns
By Kristen Gerencher

March 2003

SAN FRANCISCO (CBS.MW) - Want a winning smile and refreshing breath? U.S. dental products makers are more than eager to oblige.

From inexpensive electric toothbrushes and teeth-whitening kits to plaque rinses and organic toothpastes, consumer dental products are claiming an ever-growing section of supermarket health-and-beauty aisles. New designs and technology are also making daily cleaning routines easier for people with everything from arthritis to short attention spans.

"Go into the toothbrush aisle and a patient can get lost," said Shirley Beyard, a dental hygienist who teaches at the University of Maryland- Baltimore Dental School.

Whether your toothbrush is timer-controlled and battery-powered or traditional with a fancy new grip, manufacturers are striving to expand sales beyond the present $3.4 billion U.S. oral care market, according to the Academy of General Dentistry (AGD.)

Brush blitz

Nine out of 10 toothbrushes sold these days are manual, but their electric and battery-operated counterparts, many of which are rechargeable, make up one of the industrys fastest-growing segments, according to the AGD.

So-called sonic or ultrasonic electric toothbrushes such as those from Sonicare (PHG) and Conairs Interplak electric toothbrush make sense for patients who have trouble reaching back teeth with the standard kind, Glazer said.

"There is some validity to some of the claims theyre making that they do a better job, in part because of the cycles they use," he said of power brushes. "Theyre able to dislodge a lot of debris."

Still, not all dentists agree that ultrasonic brushes are the way to go. Rotational oscillation brushes that spin in one direction and then the other are shown to be more effective, said Chris Kammer, a dentist in Madison, Wis.

Oscillating brushes can be simple, such as the Crest (PG) Spin Brush for $6, or more elaborate such as the (G) Oral-B Ultra Plak Control for about $50 and Oral-Bs 2-speed 3D Excel for $80, he said.

Patients who plunk down a lot of money for a brush still need to invest enough time to get the full value of the cleaning, a factor that can be controlled in higher-end models, Beyard, said. "More sophisticated power brushes have timers on them so it continues to work for four minutes."

Brushes from Butler and Sensodyne also come with the compact heads she recommends, and Butler makes one that adapts to varying hand comfort needs as well, she said.

Toothpaste and floss

Once youve selected a brush, the choice of toothpastes can be equally overwhelming with promotions boasting tartar control, whitening agents or both.

A non-negotiable ingredient should be fluoride as well as an American Dental Association seal, Kammer said.

Those looking for a paste that also whitens their teeth should seek some form of peroxide in the tube, the chemical responsible for making pearly whites whiter, he said.

Arm & Hammer Advanced White toothpaste may do the job for $4 as well as Rembrandt Plus, which sells for nearly twice as much, he said.

Still, some whitening toothpastes without peroxide only may work to remove stains, and those with low levels of the ingredient may be better suited for use after a whitening treatment, Kammer said.

"These toothpastes are best used after youve had whitening to maintain your whitening," he said.

When it comes to targeting bacteria between the teeth and gums, oral irrigators and old-fashioned dental floss are key, Kammer said.

On the high tech side, Panasonic makes a power-flossing tool with an ultrasonic tip that reaches between the teeth for about $50, he said.

Water Piks oral irrigator, (PIK) a fine spray that patients angle to remove food particles, also remains a good way to remove hard-to-reach plaque and keep gums healthy, especially for people with braces, Kammer said.

"They just fill it up and point and shoot," Kammer said. "Weve found thats far more effective than hanging out hope people will floss more."

Brushing and flossing can reach pockets of three millimeters while a Water Pik can work down twice that deep, he said.

As for floss, the waxed kind tends to work better for patients with tight contacts between their teeth, and dental tape may not be appropriate, Beyard said. "Dental tape is very thick so youre going to need more space between the teeth to get it in."

Glazer agreed that dental tape can be counterproductive. "Its too difficult to manipulate properly and more likely to cause gingival irritation."

Butler and Glide also make floss aids that string the floss across a bow-like device to spare those with hand problems the pain of wrapping it around their fingers, he said.

Patients whose water supply lacks fluoride or who drink bottled water frequently might consider adding a fluoride rinse such as Colgates (CL) Fluorigard or Johnson & Johnsons (JNJ) Act to finish off their oral care routine, Glazer said.

To whiten or not to whiten

Americans in pursuit of whiter choppers are splurging on products such as Colgates Simply White, a two-week paint-on product for $15, and Crest White Strips, a tape-like covering that fits over the teeth that sells for as much as $50 for a two-week supply, Kammer said.

But these do-it-yourself kits come with several caveats - theyre not regulated by the FDA or ADA, patients using them should be sure their teeth are disease-free, and the products may cause burning on the gums or cold sensitivity in teeth, dentists said.

A professional whitening job that a dentist performs in the office using custom-made trays typically runs $300 to $500, said Peter Jacobsen, a professor at the University of the Pacific School of Dentistry in San Francisco. Some parts of the country report prices closer to $700 to $1,200 for in-office bleaching techniques.

While the over the counter remedies tend to work over time, patients should make sure the cause of the darkening isnt related to something other than cigarettes, coffee or red wine consumption or normal aging, he said.

"If you have one individual tooth that seems darker then the rest, that could easily be a dead tooth," Jacobsen said. "If you see dark in between on a couple of teeth, that could be interproximal decay."

Another problem is that consumers may have trouble applying an even distribution of formula over their teeth, potentially causing a blotchy appearance, said Matt Messina, a dentist in Cleveland, Ohio.

"The better it fits on the teeth, the better it is," Messina said. "Thats one of the challenges with something like the White Strips. Taking something square with the consistency of Scotch tape and putting it on the arch of the tooth which is round - that can be difficult for people."

Consumers also need to know that federal watchdog agencies arent overseeing what goes into the over the counter kits, he said. An average whitening toothpaste has about 1.5 percent of the peroxide solution compared with 4 percent for home whitening supplies, Messina said.

A tray and gel solution at the dentists office is 15 percent and an in-office light-activated system is about 30 percent solution, he said. "It gets results. Thats why it has to be regulated."

Patients also would be wise to temper their expectations and anticipate a change of only one or two shades lighter from the do-it-yourself brands, he said. "If youre truly concerned that your teeth need to be eight to ten shades whiter, this is not the way thats going to get you there is spite of all the claims."

Another drawback is the potential for burning or cold sensitivity in the teeth as a result of a higher concentration of caustic material than what whitening toothpastes contain, Beyard said.

"You have to be careful with those strips," she said. "If they touch the gum or the lip, it will burn."

Said Messina: "Its all a matter of finding the right system that delivers the results the patients interested in based upon how yellow or gray their teeth are, how much they want to be involved in the process and how much they want to spend."