Smile, You’re in the Dental Care Isle

ONE thing I've been genetically blessed with is good teeth. Lousy eyes, but great pearly whites. So maybe that's why I was slow to catch on to the oral hygiene revolution overtaking this country.

Powered toothbrushes that sell for more than $100. Whiteners. Mouthwashes that do double duty by preventing cavities or controlling tartar or gingivitis. Toothpaste in every conceivable flavor. "People want teeth like Chiclets," said Katie L. Dawson, president of the American Dental Hygienists' Association and a clinical hygienist for the last 30 years. The makeover shows, she thinks, are a large part of the reason oral hygiene - especially whitening - has become so popular.

As dental care has started moving from being a necessary but boring chore to another way to be glamorous, more and more products are moving onto shelves.

A visit to the toothbrush aisle in the neighborhood drugstore has become a long, drawn-out affair. For consumers, confusion abounds about what to buy, and whether, in fact, most of these items are essential.

"It's mind-boggling - you need an advanced degree," said Carol Hall of Pelham, N.Y. "There's been a baffling product explosion. There's toothpaste with whitening, toothpaste with cavity prevention. And if you want to get me crazy, talk about toothbrushes. I stick with manual toothbrushes, and even that's confusing. I'll come home with what I think is a deal on toothbrushes, and then I open them and realize I bought extra-long medium, not extra-long soft."

No wonder consumers are bewildered. According to the Datamonitor Productscan Online database, which monitors the introduction of products, 112 new toothpastes were sold in 2004. Figures from Intelligent Resources Inc. show that Americans spent $1 billion worth on toothpaste over the last 52 weeks, $439.7 million on manual toothbrushes and $194.6 million on powered toothbrushes. That number includes drugstores and supermarkets, but excludes Wal-Mart.

Dr. Kimberly Harms, consumer adviser for the American Dental Association and a dentist in Farmington, Minn., knows that people are perplexed, saying, "We call it the dental aisle of confusion."

She suggests that patients ask their dentists during regular checkups what is essential for oral hygiene and what is unnecessary. Do they have a lot of tartar buildup? Do they have sensitive teeth? Pick the products that address specific needs.

The first thing is to make sure the toothbrush can be held comfortably, whether it is manual or powered.

Then brush longer - most dentists recommend two minutes - and well enough to do the job.

"All you really need is a manual toothbrush, a bit of floss and some time," Dr. Harms said.

So why do I feel I am missing something by not buying the IntelliClean System from Philips Sonicare and Crest, which retails for around $130? Introduced earlier this year, it is a toothbrush that pumps liquid toothpaste directly onto the bristles before and during brushing. It also has a signal every 30 seconds to move to another quadrant of the mouth, and a two-minute timer. It also, according to news releases, brushes three times faster than other leading power toothbrushes.

On the other hand, that much dental hygiene before bedtime might make it hard to get to sleep.

The fact is, although people may love their high-powered toothbrushes, there is no evidence that they do a better job than manual ones.

Earlier this year, the Cochrane Collaboration, a British-registered nonprofit organization focusing on health care, released a review of 42 trials comparing the two types of toothbrushes.

"In most cases, manual toothbrushes remove as much plaque as their expensive electronic counterparts, and protect just as well against inflamed gums," the researchers said in the report.

The only exceptions were electric toothbrushes with rotating-oscillating heads, which rotate in one direction and then another; these did prove to be more effective.

Experts say powered toothbrushes may be good for people who have arthritis or problems with manual dexterity, or for those who rush through their brushing.

"The results show that many people may be wasting money on toothbrushes they believe will clean their teeth better, when actually a much cheaper traditional brush would do the job just as well," the summary of the report states.

Dr. Harms, as it turns out, has a mixed marriage - she uses a manual toothbrush, while her husband swears by his expensive electric one.

No toothbrush, she said, can get between teeth, no matter what the advertisers say, and that is why flossing is necessary (and not just the day or two before a dental visit, which I've been known to do).

As dental care is moving from being a boring chore to another way to be glamorous, more and more products are moving onto shelves.

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Courtesy New York Times