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Comment by skookumchuck | Hacker News Reader

I stopped using a powered toothbrush because:

1. my hygienist said it made no difference in plaque formation on my teeth (I did A-B experiments)

2. I was concerned it was abrading the enamel.

I'm old, btw, and am mostly concerned about receding gums and bone loss. I brush, floss, use the pipe cleaners for between teeth, and run one of those pointy rubber things along the gum line, and still get gingivitis. My dentist says there's nothing more I can do about it.

I've also tried various mouthwashes, which made no difference.

Anything else I can try?

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1. the powered ones do more "swipes" per minute, so in general they tend to be more effective. If you're good with a manual brush, you will most likely get the same results

2. enamel is far too strong to be abraded by the brush, what does get abraded is the dentin (the yellowish part closer to your gums, that's why sometimes you can see small dent-like abrasions there) so try to focus on brushing softly in those areas. A good idea is to use soft bristles

All you do is good and you're probably already doing 95% of what can be done, the other risk factors are smoking, female hormones, stress and diet. If you are not stressed, don't smoke, are male and eat mostly plant-based whole foods you can't do much more than that

Can you point to the research on the “mostly plant-based” part?

https://nutritionfacts.org/video/how-to-treat-periodontitis-...

https://nutritionfacts.org/video/best-food-for-periodontal-d...

https://nutritionfacts.org/video/plant-based-diets-dental-he...

Click on "sources cited" to find plenty of research

Greger's site. About what I was expecting...

This has to be weighed against anecdotal evidence ( good anecdotal evidence is IMO better than your average study/research) from vegans. Vegans tend to have very high occurrence of cavities despite the best of oral hygiene. ( source ex-vegans on their blogs etc.) Eskimos when first discovered by western explorers had a complete absence of cavities despite bad oral hygiene and a diet of almost no plants (Source: A book written by an explorer, whose name I cannot remember)

You could try a dental probiotic. I got slightly better gum gap scores when I was using this one, though I stopped because I thought it was upsetting my stomach a bit. Probably going to try it again after that recent research on gingivitis and Alzheimer's. http://www.biogaia-prodentis.com/dental-professionals/

> I brush, floss, use the pipe cleaners for between teeth, and run one of those pointy rubber things along the gum line, and still get gingivitis. My dentist says there's nothing more I can do about it.

I am not a dentist but have similar issues:

Consider wearing a mouthguard at night? Grinding teeth during sleep can contribute hugely to bone loss.

Also make sure you're using the rubbertip correctly. It's supposed to massage the gum with the flat part, not poke with the pointy part.

> I was concerned it was abrading the enamel.

Teeth are pretty hard on the Moh's scale relative to bristles. If you're abrading enamel, it's from something in the toothpaste (which has all kinds of mineral abrasives), or tooth-tooth contact from chewing/grinding.

Have you tried SmartMouth "DDS strength" mouthwash and toothpaste by chance? It contains a zinc formulation that inhibits baterial growth. So far, it's the best I've come across.

I did try a prescription-only DDS mouthwash. No difference.

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