At the age of 24, Amanda sustained severe damage to her teeth in a domestic violence incident, and the Perth mother’s dental health never recovered.

Last year, in her late 50s, she decided to dip into her superannuation savings to fund the dental work she had delayed for so many years.Ìý

After shopping around and getting quotes from several dentists, Amanda paid $60,000 in late November 2024 to Perth Dental Rooms for a full set of dental implants.Ìý

Just over a month later, before her work had begun, the director of the company that owned the clinic, David Hurst, died by suicide leaving an estimated 130 patients including Amanda out of pocket with work either not started or incomplete.Ìý

According to lawyers from Slater and Gordan, who are assisting some of the affected patients, Hurst withdrew more than $7 million from the company prior to his death. The company was facing bankruptcy and was placed in liquidation, leaving limited options for patients to recoup lost money.Ìý

Advocates say cases like this have highlighted the urgent need for reforms to the way that dental work is paid for across the industry.Ìý

Patients left in the lurchÌý

Slater and Gordan’s medical law practice leader Sarah Marshman says many patients are in “physical, financial and emotional pain” following Hurst’s death.Ìý

“A lot of them had paid quite a lot of money either privately or through their superannuation for treatment that was either never completed, never started or completed not at standard,” she says.Ìý

Hurst was convicted of defrauding the National Health Service (NHS) in the United Kingdom of tens of thousands of dollars before later coming to Australia to practice.Ìý

Marshman says during Hurst’s time at the practice, many of Perth Dental Rooms’ patients were subjected to “aggressive” social media advertising on Meta-owned Facebook and Instagram encouraging them to withdraw their superannuation early to pay for dental work.Ìý

As ÌÇÐÄVlog reported last year, the number of early super withdrawals to pay for dental work is skyrocketing with social media marketing playing a major role in the rising number of applications.Ìý

Marshman says the process for affected patients to attempt to get their money back will be a “long road”.Ìý “Many of the patients feel ashamed, angry, and misled, and they’ve lost both money and trust,” Marshman says.Ìý

Meanwhile Amanda has no idea where her $60,000 is.Ìý

“I wanted a nice smile for 30 years and now that dream has been taken away from me,” Amanda says.

New owners take overÌý

Perth Dental Rooms has since been sold to new owners, who do not have any connection to the previous ownership. ÌÇÐÄVlog is not alleging any wrongdoing on the part of the new ownership.Ìý

“We are deeply sympathetic to the many people affected by Mr Hurst’s unethical and illegal conduct. While the new ownership is not legally or contractually responsible for treatments performed prior to our acquisition, we felt a moral duty to assist those impacted where possible,” the new owners tell ÌÇÐÄVlog in a statement.Ìý

They added that support included consultations and new dental records to replace inadequate documentation left behind and “in many cases offering heavily subsidised treatment of up to 30%–80% off regular fees”

“In some cases, completely free dental care has been paid for at our own cost. Noting that no pre-paid funds were transferred to us at sale and there has been no assistance from government,” they say.Ìý

Hurst’s not the only case in WAÌý

Unfortunately, this is not the only case in Western Australia of something going wrong in the dental industry in recent months.Ìý

In June, the Australian Health Practitioner Regulation Agency (Ahpra) issued its first ever public warning that named a specific dental practitioner, following new legislation intended to protect public health and safety that allows the agency to refer to problem practitioners by name.Ìý

Western Australian dentist and dental nurse Peter Terzi, also known as Peter Taylor, was suspended from both professions in February 2025, but Ahpra warned that he may be continuing to present himself as a registered dentist or nurse.Ìý

The industry regulator Ahpra said he was also facing criminal charges before the Western Australian courts for allegedly practicing without registration, adding that he has pleaded not guilty to those charges.Ìý

Health Consumers’ Council Western Australia executive director Clare Mullen says they have been contacted by several of Peter Terzi’s clients who had prepaid for work which can now no longer be completed.Ìý

She says that both Terzi’s and Hurst’s cases highlight major gaps in the consumer protections in the dental industry, where patients are often asked to prepay tens of thousands of dollars for work.

“There is little to no protection for when things go wrong. Professional indemnity insurance covers some work that might be faulty, but it doesn’t cover the non-delivery of services,” she says.Ìý

A dental bond scheme could offer a solution

Mullen says she would like to see the introduction of a bond system, in which a government body holds the dental fees and releases it to the dentist when the work is successfully completed. The system would be similar to the way residential tenancy bonds are held.Ìý

“The dentist can access the money once the work is completed, but if anything should prevent the work from being completed you can get it back, it essentially remains your money, until the work is done,” she says.Ìý

Amanda supports the idea and says it would have saved her from losing her money.Ìý

“People shouldn’t have to pay a lump sum like that, and if they do, it should be put somewhere that is completely independent from the practitioner until the work is complete,” she says.Ìý

Ahpra’s Dental Board says it doesn’t have the power to advocate on behalf of patients in financial matters and has no oversight of the setting of dental fees.Ìý

The Board says it recently released new guidance for the use of superannuation to fund dental work after “concerns” were raised within Ahpra as well as the Australian Taxation Office.Ìý

“The significant increase in applications for future dental treatments in recent years raises concerns that some practitioners may be placing profits over patient care,” the Board says.Ìý

It added that it would not be appropriate for the Board to comment on whether stronger consumer protections were needed.Ìý

The post Amanda waited 30 years for a new smile, then she lost $60,000 appeared first on ÌÇÐÄVlog.

On this page:

• Are electric toothbrushes worth it?
• Battery-powered or rechargeable?
• Rotary or lateral cleaning: Which is best?
• Features to look for
• Does my toothbrush need an app?
• Can kids use an electric toothbrush?
• How to recycle an old toothbrush

Bad teeth can cause a world of pain, both physically and financially, so you want to make sure that your daily brushing is getting the job done properly.

Here’s everything you need to know if you’re in the market for a new electric toothbrush.Ìý

Are electric toothbrushes worth it?

Electric toothbrushes are fairly mainstream nowadays, but just because a technology is commonly used, doesn’t necessarily mean it’s better than the old-fashioned alternative.Ìý

However, it seems that electric toothbrushes probably do live up to their hype.

A 2014 review of 51 trials of manual vs powered (electric) toothbrushes by the nonprofit Cochrane Collaboration showed electric toothbrushes “reduce plaque and gingivitis more than manual tooth brushing”.

Do you need an expensive toothbrush?

We test electric toothbrushes for how they feel to use, how easy they are to use and charge, and how many days of use you’ll get before needing to recharge (read how we test electric toothbrushes for more).

Though the absolute best performers in our test are among the most expensive, you don’t necessarily need to spend big to get a good electric toothbrush.Ìý

Only a few percentage points separate the top five models in our test, and yet the prices range from $80 all the way up to almost $579. Outside of the top five, there are plenty of good toothbrushes that cost $100 or less.

Aside from performance, the difference between models really come down to comfort and preferences. More expensive ones typically use materials that feel nicer, and they may have a larger range of brushing modes to choose from. But that’s about it.

Battery-powered or rechargeable?

Rechargeable toothbrushes have a built-in battery pack that you can recharge using the provided AC adaptor.

Battery-powered models look just like regular toothbrushes, but with room for the battery in the handle. This type is inexpensive to buy, but it’s worth considering the cost and environmental impact of throwing away alkaline batteries. (Using rechargeable batteries can help minimise this.)

Rotary or lateral cleaning: Which is best?

An electric toothbrush will use either a rotary or lateral cleaning mechanism.Ìý

Rotary electric toothbrushes clean with a rotating movement. They may either maintain a consistent spin, or the direction may change with every turn. Some models also add extra movements from side to side.Ìý

Lateral electric toothbrushes vibrate from side to side, and can rapidly move in various directions. This type includes “sonic” models, which use very fast-moving vibrations or movement. (These should not be confused with the less commonly found models that use “ultrasonic” technology – high-frequency sound waves that purportedly vibrate plaque and bacteria off your teeth.)

As for which type of electric toothbrush does the better job, a 2024 review published in the International Journal of Dental Hygiene found a small but significant difference in favour of rotary over lateral models.

Cleaning modes and speeds

Many brushes have a variety of cleaning modes and speeds that typically determine the intensity of the brush and how the head moves. They often use pretty nonspecific terms such as ‘daily’, ‘sensitive’, ‘deep clean’, ‘gums’ and ‘whiten’, which give you a broad idea of what’s going on.

Though you can use these terms as a general guide, it’s best to cycle through all the available modes to find one that feels right for your teeth and gums. Try to find a toothbrush with a number of settings as this allows plenty of room to hone in on one that works for you.

Replacement toothbrush heads

Most brands sell a range of different heads that may vary from the one or two that are included with the toothbrush. Choosing a brand with a good range of heads can help you get the best brush possible, with options including interdental (between individual teeth), tongue-cleaning and teeth-brightening styles. Some people find that a smaller circular head offers better access to back teeth.

Brush heads do eventually need to be replaced, though they’re not overly expensive. You can save money by buying in bulk and it’s probably worth stocking up on a few, in case the heads stop being manufactured for your otherwise still-functional toothbrush.

Avoid cheaper models that don’t have replaceable heads. You’ll need to throw away the entire unit once the brush wears down, which is wasteful and expensive over time.

Features to look for

Brush head container: Useful for families or couples who share one electric brush, each with their own brush heads.

Charge indicator light: This shows when you should recharge your toothbrush – useful if you take your brush away on holiday or regularly unplug your charger.Ìý

Cleaning intervals: Timed breaks, usually 30 seconds, that prompt you to move to a different part of your mouth (e.g. back left, top left, back right etc.) by turning off or sounding an alert.

Indicator bristles:ÌýThe bristles slowly fade to white over time to indicate when it’s time to replace the toothbrush head.

Pressure sensor:ÌýThis can help prevent gum damage by detecting when you’re brushing too hard and alerting you with an indicator light or by reducing the movement action of the toothbrush.

Speed: Different speeds easily accessed from the front of the brush can make it easier to choose your preference.

Travel case: Helps protect the brush from grit, fluff and general damage when you’re on the road. These may be included in the box or sold separately.

Does my toothbrush need an app?

Some toothbrushes can pair with a mobile app for iOS or Android. This isn’t essential to use and the manufacturers don’t force you to use the apps, but they can be a fun tool to help you develop good brushing habits.

Basic apps simply log your brush date, time and duration, which is a useful tool for parents.Ìý

The more advanced ones track movement throughout the zones in your mouth, highlight coverage and provide feedback on your technique. Some even generate a brush score when you’re done.

Can electric toothbrushes be used with orthodontic bands, dentures or implants?

Orthodontic bandsÌý

Brushing is very important if you have bands on, so an electric brush could help here, as long as you don’t dislodge the wires or brackets. The Australian Dental Association recommends discussing it with your orthodontist, as it’s usually decided on a case-by-case basis.Ìý

DenturesÌý

Electric brushes can be useful for cleaning dentures properly, particularly if you also have poor manual dexterity.

Implanted teethÌý

A recent survey found rotation oscillation brushes were good for cleaning implanted teeth, but you should still discuss your individual situation with your dentist.

Can kids use an electric toothbrush?

Most electric toothbrushes are recommended for ages three and up, based on manufacturer guidelines.Ìý

According to the Australian Dental Association (ADA), one study has shown that electric toothbrushes offer similar advantages for children as they do for adults when it comes to dental hygiene.Ìý

The found that although brushing with either electric or manual toothbrushes reduced plaque and gingivitis, children had significantly better results with the electric toothbrushes.

The test compared electric and manual toothbrushes across a four-week period for three- to six-year-olds whose teeth were brushed by parents, and seven to ten-year-olds who brushed independently.Ìý

At the end of the trial:

• In both age groups there was more plaque reduction with the electric toothbrush than with the manual toothbrush, and this was particularly so in the 7–10 age group once parents stop helping to brush.Ìý
• Gingivitis levels among children were not significantly different for the two types of brushes.

The ADA also noted that features such as timers, prompts and associated apps can help kids develop good brushing habits at a young age. These are not available with manual toothbrushes.

But ADA spokesperson Dr Mikaela Chinotti warns that electric toothbrushes are no substitute for a parent’s help when needed.

“As with the use of any toothbrush, it is important that a parent or carer continues to brush the child’s teeth or assist until the child has the capability to do so solo,” says Chinotti.Ìý

How to recycle an old toothbrush

Electric toothbrushes are an appliance so you can’t just toss them in the bin. Instead, you’ll have to take your old or broken brushes to an e-waste service in your area. The will show you where to go.

If not, most local councils are likely to take them during e-waste drop-off events that happen throughout the year. Check your local council website or give them a call to find out if electric toothbrushes can be dropped off in your area.

The post How to buy the best electric toothbrush appeared first on ÌÇÐÄVlog.

On this page:

• How much does the dentist cost?
• Teeth whitening, implants, wisdom teeth and specialists
• Why do dentist costs vary so much?
• Does Medicare cover dental treatment?
• Private health insurance and dental costs
• How often do you need to go to the dentist?

About 4 in 10 Australians delayed or avoided a trip to the dentist due to cost in 2017-18, and more recently a number of people were not able to visit a dentist due to COVID-19 says theÌý,Ìý

How much does the dentist cost?

The Australian Dental Association (ADA) surveys dental practitioners to provide average price data on more than 120 dental treatments. Overall the fees charged by general practitioners increased by 3.7% over the two-year period from 1 July 2020 to 1 July 2022, well below the CPI.

According to ADA data from 2022, the average cost of a periodic check-up including an examination, scale and clean and a fluoride treatment is around $219 (dental item numbers 012, 114 and 121).Ìý

But there’s a wide variation between different dentists – the cheapest will cost you $162 for those three items, and the most expensive will set you back $309.

Prices also depend on where you live

The ADA fee survey shows big price variations for the average cost of dental work depending on where you live across Australia. In general, people in SA and WA paid the cheapest prices.

Teeth whitening, implants, wisdom teeth and specialists

Why do dentist costs vary so much?

Dentists are free to set their own fees. Unlike medical services covered by Medicare, which have prescribed rebates and for which the AMA provides their members with recommended fees, there are no standard fees for services provided by dentists or other dental professionals in Australia.

Dentists’ prices depend on a range of factors – such as location, overheads and experience, as well as factors that affect the degree of difficulty and time involved in doing a procedure on a specific patient and differences in the method or materials that are appropriate to each case.

You ultimately have the right to choose whether to go ahead with a particular treatment plan or not, but most of us don’t have expertise in dentistry. This makes it hard to know whether a dental practitioner’s recommendation is the best course of action or if they’re trying to make a profit at your expense.

Does Medicare cover dental treatment?

Dentistry is still unaffordable for many Australians.ÌýUnfortunately, dental services are only covered by Medicare under certain circumstances.

Public dental care

Public dental care is available only to a limited segment of the Australian population and waitlists can be long. Eligibility requirements for public dental care vary across states and territories but it is usually available to those with a healthcare or pensioner concession card.

In case of a dental emergency such as a dental condition that causes difficulty with breathing, tooth fracture that exposes a nerve or bleeding that doesn’t stop, call your nearest community dental clinic or hospital emergency department.Ìý

Free dental care for children

Under the Child Dental Benefit Scheme, children aged between two and 17 are eligible for free basic dental care such as check-ups, fillings, seals, extractions and root canal (up to the value of $1052 over two calendar years) if their parent, carer or guardian receives the Family Tax Benefit Part A or a relevant Australian Government payment.Ìý For more information see .

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Private health insurance and dental costs

When it comes to dental costs and private health insurance, there are two elements you’ll want to understand in order to choose a provider that offers you the best value for money.

• Rebates: This may be a percentage such as 60% or fixed dollar benefit amount for each item number, and is probably where you’ll save the most money.
• Preferred provider networks: Some funds have ‘preferred providers’. Using these means you’ll pay less in fees and get higher rebates, but it locks you into using particular providers.

To get value for money on your extras insurance you’ll need to make sure you’re getting more back from the fund than what you’re paying them in premiums, which is where rebates come in.

RebatesÌý

The average rebate available from private health insurers for a regular check-up – periodic exam, scale and clean plus fluoride – is $124. Though how much you get back will depend on your policy – some policies offer as much as 100% of the cost of a check-up.

Dental rebates vary not only across funds, but also between policies within funds and for the service being claimed. Funds also don’t publish the rebates they offer for all items of dental treatment in all circumstances, so check if you need special treatment before you sign up.

Watch out for annual and lifetime limits

In addition to the rebates, you’ll also want to check the annual limits for each category (for example, there may be different upper limits for general and major dental work), as well as lifetime limits on particular services (such as orthodontic work). Compare your extras cover.

Expect to pay more to cover major dental work

While nearly all policies will provide rebates for preventative dental care such as check-ups (exam/scale and clean/fluoride), fewer policies are willing to fork out for more expensive work such as braces and crowns. For those policies that do cover major dental work, the premiums will generally be more expensive.

Preferred providers

Some dental practices sign up to be part of a private health insurer’s ‘preferred provider network’ to attract clients (and some dental clinics are even owned by a fund). In return for being listed as a fund’s preferred provider, the private health insurer will set the maximum price the dentist can charge the fund’s clients. Prices set by the insurance fund for its clients are generally a bit lower than prices charged to other consumers, but it locks you into using particular providers.

Using a fund’s preferred provider (not all funds have them) may save you some money in fees, but the flipside is you may have fewer dental practices to choose from, or may have to travel a considerable distance to find a preferred provider with your fund, particularly if you live outside the major cities.Ìý

The ADA has been taking aim at private health insurers for the market power they’re gaining through their preferred provider schemes.Ìý

Higher rebates for dental check-ups

In addition to lower negotiated costs at preferred providers, some funds may also offer a higher rebate if you choose a preferred provider.Ìý

While Australia’s five largest funds (Bupa, HBF, HCF, Medibank and NIB) all have an extensive network of preferred providers, smaller funds often pay the same benefits for all dentists, or only have a handful of preferred providers or dental centres.Ìý

Other funds with a network of providers include Australian Unity, GMHBA, Peoplecare and TUH.Ìý

How often do you need to go to the dentist?

Regular routine check-ups are importantÌý–Ìýnot just for the teeth but also the gums and the mouth as a whole. But how often you need to see the dentist depends on your personal risk level.

The 2011Ìý for dental check-up frequency is:Ìý

“Everyone has different oral health needs and risk levels which should be reflected in the frequency of check-ups. Talk with your oral health professional about yours and how frequently you need to visit for an oral health check.”

So why do many dental practices encourage six-monthly check-ups as standard?

The six-monthly recommendation is outdated, says Professor Hans Zoellner, head of oral pathology at the University of Sydney.Ìý

This recommendation was questioned as far back as 1977, and more recently, a 2013 Cochrane review found there was insufficient evidence either “to support or refute the practice of six-monthly recalls”.

And a review of evidence by the National Oral Health Promotion Clearing House found “no evidence that any particular interval between check-ups is more effective than another, or that six-monthly recalls are more appropriate than other longer intervals”.

The post How much does the dentist cost? appeared first on ÌÇÐÄVlog.

According to the World Wildlife Fund, around 3.5 billion throwaway plastic toothbrushes – usually made from polypropylene and nylon which can take up to 500 years to break down in landfill – are bought each year around the world. The vast majority will end up as plastic pollution.Ìý

But several more sustainable alternatives are emerging, particularly brushes made from bamboo and cornstarch, or others that have replaceable heads to minimise plastic waste. But how green are they, really?

Bamboo brushes

Brushes made with bamboo handles are everywhere these days. You can buy them at Coles ($4), Woolworths ($8 for four), or Kmart ($6 for two) as well as direct from specialist online subscription services like Bamkiki and Toothcrush. Bamboo is generally considered to be an eco-friendly alternative to plastic as it’s fast-growing and breaks down relatively easily in compost.

Toothcrush has broken down its product’s environmental cred compared to plastic toothbrushes – taking into account CO2 emissions from transport and recyclability of packaging – and claims that an annual Toothcrush subscription is 18 times less damaging to the environment than someone who buys four plastic toothbrushes per year.

One word of caution: each of these brands’ toothbrushes have nylon bristles. They are still used on most brushes on the Australian market, and are still a form of plastic waste that takes centuries to decompose. See ‘recycling’ section below.

Cornstarch brushes

Another increasingly popular material is cornstarch, like the toothbrush from Swedish brand The Humble Co ($3.38 from Smile Boosters).Ìý

Like bamboo, it’s biodegradable, but it’s less porous and so less likely to become “smelly” like bamboo can, according to Bare by Bauer, who also sells a cornstarch toothbrush for $4.50 plus shipping.Ìý

Cornstarch brushes are also available at Kmart in a two-pack for $6.00. Their version comes with charcoal-infused bristles, said to act as an antibacterial agent to keep the brush cleaner.

Boar bristle toothbrushes

One for the hardcore eco warriors, boar bristle toothbrushes are a fully biodegradable alternative to nylon bristles.Ìý

However, they involve ‘harvesting’ the bristles from an animal, something that’s unlikely to sit well with anyone concerned for animal welfare (or who simply doesn’t love the idea of putting pig hair in their mouth).Ìý

They can be hard to find but there are a few on the market, mostly sold overseas. One manufacturer is Gaia Guy.

Replaceable headsÌý

Electric toothbrush fans have been replacing the plastic heads on their brushes since they were first invented, but now regular manual toothbrushes are getting in on the head-swap action.Ìý

The Colgate Infinity starter pack, which includes two replaceable plastic heads, sells for $30 at stores including Woolworths and Big W (replacement heads are $8.40 for a two-pack).Ìý

It has a sturdy aluminium handle; something that should please anyone who finds bamboo handles a bit flimsy, and Colgate says it means using 80% less plastic than fully-plastic alternatives when you stick with it over time.

Oral B’s version is called ‘Clic’ and also retails for $30 at Woolworths. It claims to waste 60% less plastic than a fully-disposable toothbrush when used over two years.

Bamboo electric toothbrush headsÌý

A Good Company in Sweden has even found a way to make electric toothbrushes more environmentally friendly, creating a line of bamboo heads that fit conventional electric toothbrushes including Oral B and Philips Sonicare. A pack of four starts at $32 plus shipping.

Sonicare-compatible bamboo electric toothbrush heads are also available from sites such as Booheads (two-pack from $14.91) and The Sustainable Tomorrow (two-pack from $13.92).

What about recycling?Ìý

Here’s the tricky bit. If you simply throw your bamboo or cornstarch toothbrushes into your regular bin, you’ve basically wasted their biodegradable properties.Ìý

“If they are disposed of in landfill they will degrade in an anaerobic environment and create the pollutant methane,” says Dr Peter Cass, Principal Research Scientist of Polymeric Biomaterials Chemistry at the CSIRO.

A much more earth-friendly option is to dispose of them in your home compost where they will break down into organic matter – eventually.Ìý

“They will also degrade in the environment… but this will take considerably longer and require a moist environment,” says Dr Cass says.

But what about those bristles?Ìý

Nylon is still a plastic and can’t be added to compost. Most bamboo toothbrush manufacturers suggest you snap the heads off your brushes or pull the bristles out with pliers before you add the handle to your compost bin.

Many also indicate their bristles are ‘recyclable’ – but not so fast. It’s virtually impossible to find somewhere in Australia that will happily recycle them, particularly because they’re so small.

“Nylon is Code 7 ‘other’ plastic, which can be recycled depending on the capabilities of local recyclers, but not always. More importantly, bristles are far too small for them to be captured in the right waste stream during the recycling process,” says Liam Taylor, communications manager of Planet Ark. “Best advice would be to remove bristles and put them in the waste bin.”Ìý

So you’re still creating plastic waste with bamboo toothbrushes, just not as much as with 100% plastic toothbrushes.

Repurpose your toothbrushÌý

Rather than throwing away your toothbrush – plastic, bamboo or cellulose – as soon as it gets shaggy, consider giving it a second life.Ìý

“Toothbrushes actually make great tools for cleaning a host of diverse items and small or hard-to-reach areas and crevices,” says Taylor.Ìý

Use them to clean jewellery, grout, shoe soles, faucets, computer keyboards and even cheese graters. Just make sure you’ve given them a good wash first – no one wants bits of left-behind food stuck in their laptop keys.

Still attached to plastic? This recycling service could help

Can’t give up the sturdiness and convenience of your plastic toothbrush but want a way to give it an earth-friendly end-of-life?Ìý

Terracycle offers anÌýÌýthat turns toothpaste tubes and caps, manual toothbrushes, electric toothbrush heads, toothbrush and toothpaste tube plastic packaging and floss containers into hard plastic that can be reused by manufacturers. There’s also a separate program forÌý.

The post Eco-friendly alternatives to plastic toothbrushes appeared first on ÌÇÐÄVlog.

A whopping two million Australians put off going to the dentist or orthodontist in the past year because of the cost. If you’re one of them, then going down the DIY path for things such as teeth whitening or teeth straightening may well appeal.

And if fixing your wonky teeth is a priority, you’ve probably spotted ads for teeth-straightening kits on social media or online from brands including Franksmile, Wondersmile and EZ Smile (who were fined in 2020 for ).

SmileDirectClub, which is relatively new in Australia, is a US company flooding Facebook feeds in particular with claims that it “can straighten most smiles in an average of six months” (and save you up to 60% of the cost of traditional braces).

But does SmileDirectClub’s teeth straightening work? And what are the risks? We ask the experts.

Do teeth-straightening kits work?

For those of us who covet a straighter smile, DIY dental kits certainly sound tempting (and cheaper than you’d expect to pay a professional).

But Australia’s peak dental bodies warn that it’s a case of .

“It’s about buying a dental impression kit over the internet, taking moulds of your own teeth, receiving a set of clear plastic aligners in the mail and then doing your own orthodontic treatment at home without any direct supervision from an orthodontist – and that opens the door to potential problems,” says Dr Howard Holmes, vice president of the Australian Society of Orthodontists.

“If you’re a young adult with healthy teeth, healthy gums, no wisdom teeth and a normal bite who only has very minor crowding or crooked teeth, it might work for you,” he adds.

“But that’s a big ‘might’. And although it may seem cost-effective, when you take on board the risks that come with it and the potential ongoing costs if you don’t get the results you’re after, or if you develop dental complications, it’s actually not going to work out that much cheaper than seeing a specialist in the first place.”

Dr Carmelo Bonanno, president at the Australian Dental Association, agrees: “With respect to orthodontic treatment, there are many dangers and limitations of consumers attempting to move their own teeth with at-home kits,” he says.

What is SmileDirectClub?

SmileDirectClub was founded in the US five years ago by two friends – Alex Fenkell and Jordan Katzman – who met as teens, both bearing a mouthful of braces. Their mission as adults, they say, was to make “it affordable and convenient to transform your smile”.

The result? A home-use teeth-straightening kit that customers can order on the internet.

Kay Oswald, president of International SmileDirectClub, claims the company has helped more than 700,000 people globally, and has started trading in Australia this year due to “a demand for a more affordable and convenient alternative to traditional braces”.

“We’re making it easier for the customer to transform their smile by eliminating the need for timely in-office visits,” he says.

“The average clear aligner therapy plan takes six months, whereas traditional braces take an average of 18 months. Mild to moderate cases [which can be treated by SmileDirectClub] include space between teeth, crowding, rotations and some minor bite correction.”

How does the service work?

After passing a basic dental history quiz, you buy an impression kit to make moulds of your smile at home (or visit a ‘SmileShop’ to have it done – there are a limited number of branches across Sydney, Brisbane, Melbourne, Adelaide and Perth).

Once SmileDirectClub receives the moulds, it has them “reviewed by an AHPRA [Australian Health Practitioner Regulation Agency]-reviewed dentist or orthodontist”. The company then custom-makes plastic aligners and posts them to you, instructing you to wear them continuously for 22 hours per day, except when eating, drinking, brushing and flossing.

Oswald says its web-based teledentistry platform enables customers to communicate with “dental techs and prescribing doctors” via text, email, chat or phone.

“Remote check-ins are required every 90 days to ensure the customer’s smile is progressing as planned,” adds Oswald.

What are the downsides?

The notion of “remote check-ins” begs the question: is it really safe to use such kits if a dentist or orthodontist is never looking in or probing around your mouth?

“The fact that there is no face-to-face contact is a concern,” says Dr Bonanno. “These sorts of treatments, if not undertaken correctly, can cause permanent damage to the teeth, gums, jaw or jaw joints. We are aware of reports overseas of inferior treatment results.”

Dr Holmes adds that no orthodontist would ever consider treating a patient without first reviewing an X-ray of their teeth and jaws.

“Because you’re moving teeth through the jaws, through the bone,” he says. “And if there are no X-rays and no clinical examination, the person supposedly overseeing that treatment won’t be able to diagnose or detect gum disease (with associated bone loss around teeth), cracks in teeth, tooth decay, extra teeth hiding in the jaw bone, or even more sinister things like tumours or cysts.”

By comparison, a specialist orthodontist will thoroughly assess and address all dental issues – and leave you with a good-looking smile, a stable bite and no muscle or jaw problems, adds Dr Holmes.

“These are all really important from a dental health point of view and it goes beyond a quick cosmetic fix … which is essentially what these direct-to-consumer companies offer,” he says.

“They can do treatment in six months because they’re not fully addressing all the tooth alignment and bite issues and, in some cases, [they’re] actually making them worse.”

How much does SmileDirectClub cost?

SmileDirectClub has two pricing options: a one-off payment of $2499, or $99 a month for 24 months on top of a $399 deposit ($2775 in total).

You may also need to pay $79 for a remote impression kit if you’re unable to visit a Smile Shop for a free imaging appointment.

Costs for traditional metal braces can vary, but are roughly in the range of $5000 to $9000 for a standard 18-month plan.

Invisalign claim their treatment costs are similar to those for traditional braces, and while they don’t advertise specific costs, they do recommend speaking to an Invisalign-trained doctor for precise costs based on the complexity of your treatment.

“That said, a budget- or time-conscious patient who doesn’t want 18 months of braces or aligners and just wants slightly straighter teeth may be surprised at quicker, more limited treatment options orthodontists can also offer,” says Dr Holmes.

“And they can do it safely and in the same time and for roughly the same cost as if you order an impression kit or visit a retail scan shop and then try to do it yourself.”

Whichever path you choose, if you’re considering DIY straightening kits, experts say it’s critical to ask questions and do your research.

“We recommend consumers at least seek a face-to-face consultation with a dentist or orthodontist beforehand,” says Dr Bonanno.Ìý

Invisalign vs SmileDirectClub

Although SmileDirectClub and Invisalign are both based on the same principle – teeth straightening with the use of clear aligners – an Invisalign-trained dentist or orthodontist is involved in the Invisalign process every step of the way, says Dr Holmes.

He adds that the other difference with Invisalign is that in some cases orthodontists will attach little resin “dots” or “buttons” onto some teeth as part of the Invisalign teeth-straightening process.

“Without those small attachments, the teeth are not going to move in the way they’re supposed to, and anything you order online won’t have those put on your teeth because you’re not physically seeing an orthodontist,” he says.

“So a lot of the movement you’re after just won’t work by just having the plastic aligners. You need these sort of adjuncts plus regular supervision and adjustments along the treatment journey to ensure you get a successful result with clear aligner therapy.”

What to do if something goes wrong

If you have an issue with treatment by a registered orthodontist, there are avenues open to you.

“There’s a complaints process, there are regulators, that particular orthodontist is going to be accountable,” explains Dr Holmes.

By contrast, with more than 1000 customer complaints about SmileDirectClub on the Better Business Bureau’s website in the US, dental bodies here are concerned about Australian consumers hopping on the DIY trend.

“Governments should protect the public by legislating to control the provision of do-it-yourself dentistry,” says Dr Bonanno.

Oswald tells ÌÇÐÄVlog that “liability for clinical care issues with treatment is no different than it would be in a traditional dentist or orthodontist setting”.

But the terms on SmileDirectClub’s Australian site say that users must agree to release the company, its affiliates and third-party service providers “from all claims, demands and damages” arising from or connected to their “use of this site and its services”.

According to Sarah Agar, ÌÇÐÄVlog’s head of campaigns and policy, if SmileDirectClub uses these terms and conditions to try to prevent customers from claiming a refund if the product doesn’t work, this would probably break the Australian Consumer Law.Ìý

“It’s not possible to contract out of consumer guarantee rights,” she says.

Greater complexity, more complications

A spokesperson for AHPRA and the Dental Board of Australia did not directly respond to questions about whether there should be tighter laws to protect consumers.Ìý

But the spokesperson did say they are aware of the increase in DIY dental offerings and that it’s important for consumer health regulators to monitor any complaints from consumers.

“The more complex a patient’s dental concerns, the greater the risk that a DIY product will not be fit for purpose and may lead to other complications,” says the spokesperson.

“Any consumer considering a DIY dentistry option should make sure they understand how the treatment will work, what are the risks, what are the intended outcomes and what are the costs.

“If this information is not clear, AHPRA would recommend you seek advice from a registered dental practitioner before proceeding with a DIY offering.”

The post Do SmileDirectClub’s home teeth straightening kits work? appeared first on ÌÇÐÄVlog.

On this page:

• What's in HiSmile teeth whitening kits?
• Does HiSmile work?
• Is HiSmile safe or will it damage your teeth?

That’s the hard sell from HiSmile, an at-home teeth-whitening product that once boasted of a $10 million advertising budget for social media marketing alone, with celebrities and influencers including Kylie Jenner, Kim Kardashian and mixed martial artist Conor McGregor spreading the good word to their millions of followers.Ìý

But does HiSmile really work and, more importantly, is it safe?

ÌÇÐÄVlog tip: If you’re concerned about surface stains on your teeth, visit the dentist for a clean. If you have private health insurance with extras cover, you may not have to pay a gap.

What’s in HiSmile teeth whitening kits?

Each HiSmile teeth whitening kit comes with enough gel for six applications, an LED light, a mouth tray, a shade guide and an instruction manual.Ìý

You attach the LED light to the mouth tray, apply the gel to the tray, put it in your mouth and switch on the light. The light switches off automatically after 10 minutes, whereupon you take out the tray, spit, and rinse your mouth out.

The ingredients in the gel include:

• Phthalimidoperoxycaproic Acid (PAP)
• Potassium NitrateÌý
• HydroxyapatiteÌý
• Sodium Bicarbonate
• Sorbitol, Water, Propylene Glycol, Glycerin, PEG-8, Cellulose Gum, Hydroxyethylcellulose, Xanthan Gum, Flavour, Sodium Saccharin, Methylparaben, Aloe Barbadensis (Aloe Vera) Leaf Extract, Chamomilla Recutita Flower (Chamomile) Extract, Punica Granatum Seed (Pomegranate) Extract, Propylparaben

HiSmile’s new formula

The ingredients listed above are a new formula which HiSmile released in 2019.Ìý

The original HiSmile formula contained citric acid, sodium chlorite and sodium bicarbonate as the active ingredients. Citric acid can erode tooth surfaces and cause sensitivity, while sodium chlorite can be toxic in high amounts. Sodium bicarbonate was included for its ‘mildly abrasive action’ – it’s included in toothpastes for this purpose, but if it’s just sitting on your teeth it won’t have this effect.

Does HiSmile work?

Whether HiSmile works or not will largely depend on why your teeth are stained, says Professor Laurence Walsh AO, spokesperson for the Australian Dental Association.

“If the stains on your teeth are difficult or ingrained, it’s unlikely to work,” he says.

“But if your issue is with surface stains, such as those from coffee, tea, red wine, berries or sauces, products like HiSmile may reduce their colour, leaving you with less staining on your teeth.”Ìý

HiSmile commissioned a test on 24 people aged 19–55, and reports teeth were on average 3.5 shades whiter after a single 10-minute session.Ìý

HiSmile also reported on the results of a test conducted on human tooth enamel samples, although didn’t provide us with details about the test. This test found that the results after a single session were similar to the test on the 24 people, and after six sessions reported an improvement of over seven shades whiter.

However, explains Professor Walsh, the significance of this depends on several factors.

“How the shade change was measured and from what baseline shade influences the interpretation,” he says. “Some shades such as mid-range yellows are easier to lighten than others (such as browns and greys for instance).Ìý

“A change of 3.5 shades is not especially impressive, given that some toothpastes with improved polishing particles achieve 2 or more shades improvement or more just by removing some external stain or by repelling stains.Ìý

“Professional dental whitening products dispensed by a dentist or treatments provided in a dental office show gains of 6–8 shades typically or more.”

Is HiSmile safe or will it damage your teeth?

HiSmile says its kit is “designed to whiten and brighten teeth without pain or sensitivity”. The test on 24 people for whitening – which is limited by its small size and being short-term – reported no increased sensitivity after a single session, and some people with pre-existing sensitivity reported less sensitivity.

One of the ingredients, potassium nitrate, makes nerves in the dental pulp less likely to fire off and is found in toothpastes for sensitive teeth. It generally needs to be used regularly over a period of time – twice daily for two weeks or more – to have an effect.Ìý

Another key ingredient in HiSmile is hydroxyapatite – also known as calcium phosphate – which is the main component of tooth enamel. While not widely available, it’s found in some toothpastes to help strengthen teeth.Ìý

HiSmile commissioned a study on human tooth enamel samples which found that the hardness of tooth enamel increased after six consecutive sessions, while a hydrogen peroxide treatment weakened tooth enamel.Ìý

Professor Walsh says, “There is no independent evidence that the form of hydroxyapatite used in HiSmile or the formulation of their particular gel will allow remineralisation to occur, or promote it.Ìý

“Hydroxyapatite is highly insoluble and chemically very stable, so simply adding some into a product does not necessarily mean there will be any benefit to teeth,” he says.Ìý

“Remineralisation needs the correct chemical balance of calcium ions, phosphate ions and fluoride ions – in a bio-available form. Hydroxyapatite is the least bioavailable form because of its low solubility.”

Other concerns

Mouth trayÌý

Because the mouth tray is one-size-fits-all and not specially fitted, you may need to use a lot more gel to coat your teeth. That’s problematic because it could hurt your teeth and gums, and you could end up swallowing more of the gel.

OveruseÌý

Consumers who buy HiSmile but are disappointed in the results could be tempted to use more of it or keep the tray in for longer to get the results they’re after. Without a professional monitoring progress and tooth condition, they may end up damaging their teeth.Ìý

HiSmile encourages regular use of its products – it says the results will last three to four weeks, and recommends you do a single treatment every two weeks. You can sign up to a gel refill subscription service, saving money and ensuring a regular supply of whitening gel.Ìý

Other products

Teeth whitening pen

HiSmile also sells a tooth-whitening pen with the same formula as the gel for regular one-minute touch-ups.

“The one-minute application time is effective at clearing up light everyday stains and will help maintain a brighter smile for longer,” says HiSmile spokesperson, Koban Jones. However, he points out, it’s no replacement for the kit.

Toothpastes

HiSmile sells a set of Day & Night Toothpaste, and Pink Toothpaste for sensitive teeth.

None contain fluoride.

Jones says: “Our community has always been vocal about preferring a fluoride-free toothpaste, but due to the massive benefits fluoride provides your teeth, we needed to find an effective substitution.

“We found a specific combination of key ingredients (Xylitol, L’arginine, Potassium Nitrate, Sodium Hexametaphosphate and Hydroxyapatite) would serve as an effective substitute. These ingredients have the ability to inhibit the growth of harmful oral bacteria, prevent the growth of plaque and tartar, and reduce dentinalÌýhypersensitivity.

“Specifically, Xylitol has been proven by numerous studies to affect the ability of certain strains to adhere to the tooth surface, decreasing caries and reducing plaque formation.”

However, Professor Walsh points out, “Fluoride is the major active ingredient for dental caries prevention using toothpastes, and omitting that means that very little benefit will be achieved.

“Many dental products include xylitol. The research on xylitol shows that a large and frequent intake in the diet is needed to have any benefit. Recent large scale clinical research does not show any meaningful impact on dental caries risk in real world applications.”Ìý

The Night toothpaste contains activated charcoal which HiSmile says is an “effective and progressive whitening agent that removes surface stains from teeth”.Ìý

The ADA warns against charcoal toothpastes, because they may be overly abrasive. There are also concerns that charcoal and bentonite clay (which is also found in the night toothpaste) are carcinogenic.

How do the costs compare to other treatments?

Whitening kits

The HiSmile Teeth Whitening Kit, containing three tubes of gel (which the company says is enough for six uses), an LED light, a mouth tray and a shade guide, costs $99.99. A set of three gel refills costs $34.99, which will last 12 weeks if used as directed. Buying the gels on a subscription is a little cheaper, at $29.74 for three refills. HiSmile’s tooth-whitening pen is also available for ($39.99)

Other whitening kits that make very similar claims about their effectiveness and contain gel, a mouth tray and light are available at the supermarket or pharmacy for less than half the price of HiSmile.

Toothpastes

HiSmile also markets a range of other products, such as Day & Night toothpastes ($16.99 for two tubes) and Pink Toothpaste for sensitive teeth ($14.99).

Other toothpastes with micro-polishing particles, which can help reduce superficial stains, cost around $5.

Professional whitening

Going to a dentist for teeth whitening will cost from around $300 to $1000, depending on the technology used and level of treatment required.

Verdict

It’s relatively early days for the new HiSmile formula, and there’s a lack of long-term, independent testing for safety and effectiveness on large numbers of people.Ìý

While the small tests commissioned by HiSmile show some promise, the bulk of evidence for it comes from celebrity endorsements and positive customer reviews on the HiSmile website.

As Professor Walsh says, “The key issue I feel is that the onus of proof on the belief that PAP is safe and is also effective, rests with the manufacturers who choose it – after all there is high level evidence from systematic reviews and meta-analyses of randomised controlled clinical trials to support professional level home bleaching gels with carbamide peroxide and hydrogen peroxide, so that is the level that should be aimed for.

“I believe most people would want to know if a new and unproven ingredient was safe and also effective. To answer that question needs proper studies with the right design (e.g. suitable controls as well as comparison products).”

HiSmile has told us that more testing is on the way, and we look forward to seeing the results.

The post HiSmile teeth whitening kits – do they work? appeared first on ÌÇÐÄVlog.

On this page:

• Salon and kiosk whitening
• Dentist whitening
• DIY teeth-whitening kits
• Teeth-whitening toothpaste
• Causes of stained teeth

Teeth-whitening products are everywhere, from whitening toothpastes, bleaching kits and adhesive strips to salons and kiosks in shopping centres – all promising lighter, brighter teeth at a fraction of the cost you’d expect to pay for a full dental-clinic treatment.

ButÌýhow safe and effective are they? AndÌýwhat do you need to know before you jump into any of these teeth-whitening treatments?Ìý

Salon and kiosk whitening

Teeth-whitening salons offer in-chair treatments that claim to brighten smiles up to nine shades.Ìý

With little or no training and an outlay of a few thousand dollars for an activating light and bleaching equipment, pretty much anyone who has the money can establish a lucrative little earner in hair and beauty salons, shopping-centre kiosks, and even mobile home-based teeth-whitening parties.

Typically costing less than $200, it’s much cheaper than the similar teeth-whitening services that dentists offer.

To whiten teeth, salons typically use a bleaching gel and then expose your teeth to an activating light. But after an increase in injuries associated with teeth-whitening products, teeth-whitening preparations containing more than six percent hydrogen peroxide (18% carbamide peroxide) are now prohibited from sale, supply or use, except by registered dentists in a clinical setting.

To get around this restriction, some salons simply do more applications of the bleaching gel in one session to achieve a whiter shade, instead of using a strong ‘power-bleaching’ solution.

An unregulated industry

The teeth-whitening industry is largely unregulated and the practitioners in salons don’t necessarily have any dental training.Ìý

Practitioners can’t advise on whether the process is appropriate for you (some kinds of discolourationÌýdon’t respond to certain treatments), nor are they qualified to check for problems such as cracked enamel, cavities, restorations and exposed root surfaces that need special care.Ìý

Potential problems include lack of proper infection control, careless application and ill-fitting bleaching trays, causing irritation to gums and lips. But in most cases, the worst outcome will be temporarily sore gums and sensitive teeth.

Dentist whitening

The main advantage of dentists over cosmeticians is that they’re qualified to assess the overall state of your teeth, including taking a dental history, which may have a bearing on the treatment they’re prepared to give you. They can also assess and redress any underlying problems that could be causing discolouration.

But they’re also likely to be a lot more expensive – anything from about $300 to more than $1000, depending on the complexity and sophistication of the technology they’ll need to use, and the chairside time required.

Unlike in a salon, dentists are also allowed to do what’s called ‘power bleaching’ with strong hydrogen peroxide bleach (up to 38% hydrogen peroxide). After placing a special protective material on your gums, the dentist puts the gel on your teeth, and may enhance the bleaching effect by using a light or heat source, such as a laser, LED or halogen lamps.

Whiter but more sensitive teeth

In general, the stronger the product and the longer the contact, the whiter the teeth will be. But the teeth are also likely to be more sensitive afterwards. The use of light or heat to enhance the effect of the bleach appears to have a greater whitening effect than bleach alone. But some of this extra effect appears to result from dehydration of the tooth, and the colour will darken slightly as the tooth rehydrates.

You may need more than one treatment

The effects of power bleaching are immediate, but you may need more than one treatment to get the result you want. It’s not uncommon for an initial treatment at the dental surgery to be followed up with further treatment or maintenance at home.

Dentist-supplied home bleaching kits

Your dentist can also give you an at-home bleaching kit, either as a standalone treatment or to supplement in-clinic power bleaching. These kits are likely to be more expensive because the dentist will have to make custom-fitted trays. Customised trays mean that less gel is needed and gum sensitivity is reduced. But the dentist will still make sure the strength of the bleach is right for you.Ìý

DIY teeth-whitening kits

Most whitening products (except toothpastes) contain peroxides, such as urea peroxide or carbamide peroxide. This breaks down to hydrogen peroxide (10% carbamide peroxide releases 3.5% hydrogen peroxide in the presence of water), which chemically bleaches both surface stains and the tooth itself. At a high enough concentration, peroxides can whiten teeth so that they’re lighter than your natural colour.

DIY home tooth-bleaching kits can be easily bought on the internet. The kits generally contain:Ìý

• bleach trays, which may be mouldable (you dip them in boiling water and fit them to your teeth – so-called ‘boil and bite’)
• the bleaching chemical
• a light to accelerate the process (some kits)
• remineralising gel or paste to reduce sensitivity (some kits).Ìý

They may also come as a tooth-whitening pen or adhesive strips.ÌýAlthough whitening pens may seem low-mess and convenient, using them without trays may not be very effective.

“Brush-on gels are the least controlled and are typically poorly performing because of concerns around irritation of gum (gingival) tissues,” says Professor Laurie Walsh from the Australian Dental Association (ADA).Ìý

“They are more likely to be inactivated by normal saliva, which has enzyme systems that break down peroxides to harmless water and oxygen.”

Peroxide levels

When DIY teeth-whitening kits first hit the market, ÌÇÐÄVlog found products with hydrogen peroxide levels as high as 16% (carbamide peroxide 44%). This finding came in spite of recommendations from the ADA that home teeth-whitening products not exceed six percent hydrogen peroxide.Ìý

Regulations now limit the strength of DIY kits to six percent hydrogen (18% carbamide peroxide). Nevertheless, one of the kits recommended by several Australian magazines contains 35% carbamide peroxide and can be readily ordered online from the US.

Peroxide safety

Try to avoid bleach contact with gums as much as possible, and avoid swallowing the bleach.ÌýThere is some concern, though no conclusive evidence, that peroxides may cause oral cancer, although it’s more likely in people already at risk – smokers and those who abuse alcohol.

Excessive bleaching attempts can damage enamel, as can poorly formulated or over-acidic products. You may end up with more porous enamel, a bluish tinge and/or brittle teeth.

Some people can also experience temporary tooth or gum sensitivity when using home bleaching products.

A better fitting tray

The fit of the bleaching trays is an important aspect of this sort of teeth whitening. If you’re leaving them on for a long time (30 minutes or so), they need to be comfortable, and not cause gagging or excessive salivation.Ìý

The closer they fit, the less bleaching product you need to use. Excessive bleach can ooze out, and while not toxic in small amounts, it can taste unpleasant and may damage soft tissues.

Custom-made trays

Rather than giving you a boil-and-bite tray, some DIY kits get you to make impressions of your teeth, and send them back to the distributor. The distributor then makes and posts out a set of custom-fitted trays for you – much like those a dentist would make. They’re a little more expensive, but you can use them for many years.

Pre-filled traysÌý

These promise the convenience of not having to muck around with tubes of bleaching gel and so on. But because they’re one-size-fits-most, there needs to be a lot of gel in them to make sure all teeth have contact with the active ingredient. This means that excess gel oozes out and irritates the gums.

Do desensitisers help?

Some home whitening gels include ingredients that can help prevent sensitivity, including potassium nitrate, arginine compounds and calcium phosphate compounds. These are also found in toothpaste for sensitive teeth.

How effective they are very much depends on how it’s applied.

“Including it in the gel only makes sense for products with low levels of peroxide that are worn overnight in trays, because there is enough contact time,” says Professor Walsh.

“Putting a desensitiser into a product applied for only 20 to 30 minutes or so will not give much effect, as the exposure time is far too short. Often people undergoing bleaching find that using a separate desensitising product is easier and more effective.”

But Professor Walsh also warns: “No desensitising product can totally prevent the reaction of the dental pulp of teeth to a bleaching treatment, so people should not expect that. Also, the reaction of teeth to bleaching is not reduced or alleviated by taking painkillers, such as paracetamol.”

Do the blue LED lights in over-the-counter teeth whitening kits really work?

These items of techno whizz-bangery may look the business, but how helpful are they? Some studies find they increase the whitening effect of the gels, while other studies find they don’t.

Professor Walsh says, “Generally these small blue LED lights do not provide much benefit because the gels lack the absorbers (chromophores) for photothermal actions, or the photosensitizers for photochemical or photodynamic activation from visible blue light.Ìý

“In other words, you need the right chemical ingredients to get a benefit from using light. This is why some studies find benefits but others don’t. It’s all about having the correct light absorbing compounds present in the gel.

“Teeth may look whiter initially, but this is often due to a dehydrating effect. As water is taken back up by the teeth, relapse occurs. Clinical studies have shown this relapse occurs with various systems, including those using blue light.”

DIY bleaching tips

If you’re going to go down the DIY home bleaching path:

Talk to your dentist firstÌý

Before you buy any whitening product, we’d recommend talking to your dentist about the particular type of stain that affects your teeth. Doing so will help you avoid wasting money – and effort – on a product that may not work for you.

Be prepared for increased sensitivityÌý

Greater sensitivity is highly likely, but using the product less often will help, although the whole process will take longer. Ask your dentist about toothpaste or other products that may help reduce sensitivity.Ìý

Don’t over-bleach

Don’t use more product (it won’t help), leave it on too long or do it too often. And you only really need to bleach the front surface of your teeth.

Choose products only from reputable Australian suppliersÌý

Don’t be tempted to save a few dollars buying unreliable products subject to poor hygiene and quality control. And be aware that products from overseas may exceed the permitted levels of peroxides.

ADA raises concerns with the ACCC

When we asked the ADA for comment on teeth-whitening products, it told us it had raised a number of concerns in a submission to the Australian Competition and Consumer Commission (ACCC) – in particular with regard to DIY home kits, which the ADA found to be the most popular non-dentist route to whiter teeth.Ìý

Issues included:

• the availability of products that exceed the allowable limits of hydrogen peroxide – mainly from overseas but readily available onlineÌý
• false and misleading statements about the degree of whitening people could expect
• certain sales and marketing strategies that encourage excessive and potentially hazardous use of whitening products.

Exaggerated whitening effects (“up to 12 shades”) are not only misleading, but they could also lead somebody who is disappointed by the initial result to overuse the products unsafely. For example, they mightÌý overfill the trays with gel, and/or apply whitening agents more frequently and for longer than is recommended.

The ADA is also concerned that some kit suppliers encourage excessive use of the products, such as recommending daily use until you’re happy with the results, and then fortnightly or weekly for ‘maintenance’. Many also sell whitening pens for daily use, marketed as “perfect for touch-ups and on the go teeth whitening”.Ìý

Potential dangers of over-using whitening products

Overusing teeth-whitening products can weaken tooth enamel, leading to a higher risk of cavities. It can also cause other oral and general-health issues.

There have also been no long-term studies of the effects of DIY teeth whitening. Studies that have attempted to simulate the long-term effects of bleaching use dentist formulas and exclude people with certain dental issues for whom whitening may not be safe. Although (legal) DIY kits are not as strong as the products dentists use, they’re often more acidic, which can increase the damage. They’re also used by people with dental issues that dentists wouldn’t do teeth whitening on.

The ADA sent the submission in May 2019 and have not yet received a response.

Teeth-whitening toothpaste

Most tooth-whitening products will use some sort of abrasive to remove stains, but some also use other ingredients.

Abrasive agentsÌý

Abrasives (such as alumina, silica/hydrated silica and dicalcium phosphate) remove surface stains by physically rubbing them off the surface of the teeth. Charcoal has become a popular ingredient in whitening toothpastes, but there’s no evidence that it’s effective and it’s been linked with greater enamel wear and cavities.

Bleaching agents

Hydrogen peroxide is found in some toothpastes but is unlikely to have much effect when in contact with teeth for a short time. As Professor Walsh explains, “stimulation of saliva by brushing will hasten the breakdown of peroxides. This is why such products have limited effects, mostly on dietary stains, but do not change the internal colours of tooth structure”.

Detergents (such as sodium lauryl sulphate)Ìý

These act as foaming agents and help to clean the tooth surface.

Enzymes (such as papain, derived from papaya)Ìý

These slow down the build-up of ‘pellicle’ — the protein-containing layer of saliva that forms on your teeth within a minute of brushing. Surface stains stick to the pellicle layer.

Polyvinylpyrrolidone (PVP)Ìý

This stops stains accumulating on the tooth surface. Interestingly, it was also the main ingredient in the first really successful hairsprays in the 1950s!

Sodium hexametaphosphateÌý

This acts as a repellent for stains and also displaces them from the surface of teeth.

Other ingredientsÌý

Ingredients such as tetrasodium pyrophosphate, pentasodium triphosphate, citric acid, sodium tripolyphosphate (Triclene) chemically alter the electrical charge on the stains so that they’re less able to stick to your teeth.

Causes of stained teeth

The natural colour of people’s teeth varies from white to yellow, with every shade in between. All teeth contain red and grey colours, and the grey colours increase with age.

Teeth are made up of three layers: tough outer enamel, softer dentine, and the inner pulp. As you get older, the enamel thins through wear and tear, and the darker dentine layer can begin to show through. The dentine structure also changes as it takes up more minerals from the pulp. These two processes can make older teeth look yellow.

As well as genes and aging, tooth colour depends on many other factors, of which general health (when your teeth are forming) and diet and lifestyle (once your teeth have fully formed) are key.

Health

Your health – particularly during your early years when your teeth are still developing – can be the cause of intrinsic stains, which affect the colour of the tooth itself. For instance, certain antibiotic drugs, such as some forms of tetracycline, can affect tooth colour during development, as can severe fevers.Ìý

Damage to the forming tooth can also cause internal discolouration, as can damage to the pulp of a permanent tooth (as a result of receiving a blow during contact sport, for example).

Diet and lifestyle

Lifestyle and diet can cause surface stains. Tea, coffee and smoking are three of the biggest culprits, followed by red wine, coloured berries and soy sauce, and coloured drinks such as colas.

Stain removal

Surface stains

Many whitening products specifically refer to surface-stain removal as one of their methods of whitening. A professional clean at the dentist can also remove surface stains (including those between the teeth), often producing a fresher, whiter appearance.

Deeper stains

Although removing surface stains can restore teeth to their natural colour, this doesn’t necessarily mean your teeth will be whiter. Deeper stains are more difficult to remove and may not respond well to home-bleaching treatments, or even to the special bleaches and whitening treatments that dentists use. If the tooth is very badly stained, some type of veneer might be needed to disguise the area.

So before you spend money on DIY whitening, speak to your dentist about treatment options for the particular type of stain affecting your teeth.

Five tips for teeth-whitening servicesÌý

• Avoid staining your teeth with tea, coffee, red wine, cola and smoking for a couple of days after whitening (which may mean giving them up for a few weeks for longer-term treatments).Ìý
• If you don’t want to give up certain drinks, you could try drinking them through a straw to reduce staining.
• Bleach won’t whiten caps, crowns or fillings, so these may need to be replaced if they no longer match the rest of your teeth.
• Your teeth may need re-whitening after a couple of years or so.
• Have realistic expectations – keep in mind that many photos of models and celebrities have been digitally manipulated to make their teeth look whiter, or they may have had veneers fitted in real life. Your teeth shouldn’t be whiter than the whites of your eyes – if they are, they can look unnatural.ÌýÌý

The post Teeth whitening treatments appeared first on ÌÇÐÄVlog.

On this page:

• How much do braces cost?
• Types of braces
• Dentist vs orthodontist

Your orthodontist is best placed to determine what will and won’t work for you, but in this article we explain the difference between the traditional bracket and wire braces and clear aligners, and also the pros and cons of dentist vs orthodontist for treatment.

How much do braces cost?

It depends on which type of braces you decide are best for you. Here’s the range of prices you could be looking at.

We explain more about the different style of braces in the article below.

Types of braces

Brackets and wire

Conventional braces have come a long way since the metal ‘train tracks’ of old. For one, the brackets (the bits that stick on your teeth) are smaller, can be made from stainless steel, titanium or ceramic, and can be silver, gold, clear or tooth-coloured. Stainless steel brackets are the most economical option.

The wires that ultimately pull the teeth into alignment are usually made from titanium alloy or stainless steel. Like the brackets, they also can be tooth-coloured, making them less visible (and more expensive).

There are different systems for holding the wire. The most common, the so-called ‘fixed edgewise appliance’, involves wire ties or small elastic bands – available in a rainbow of colour choices – which secure the wire within a slot on each bracket.

Self-ligating brace

An alternative is a self-ligating brace, where the brackets have a channel accessed via a spring-loaded door – the wire travels through these channels. The brackets themselves are smaller and their appearance less obvious than the elastic band system, and they come in silver-coloured or clear versions. Fans say the lower friction on the wire makes it work faster with fewer visits to the orthodontist, though these claims aren’t backed up by scientific evidence.

Dr Robbie Schwartz, specialist orthodontist and spokesperson, says there’s little evidence that any one brand or system of fixed brace is better than another, nor that computer-assisted braces technology is better than other methods.Ìý

“There will likely never be one ‘type’ of treatment that is better than another, because there are so many factors that dictate which will be best for each patient,” he says.Ìý

Cost:ÌýMetal braces (traditional braces): $5500–$8000; ceramic braces: $6000–$9000

Clear aligners (Invisalign, ClearCorrect, ClearPath)

There are a few brands of clear aligners competing for market share in Australia, but Invisalign is probably the best known.Ìý

Invisalign hit the market in 1999, targeting adults with the promise of teeth straightening without braces. According to the company, more than six million people around the world have used Invisalign treatment. It consists of a series of clear plastic moulds – think slimline mouthguards – which are worn for about 22 hours a day.Ìý

The technique involves taking 3D images of your teeth at the start of treatment and computing which steps are needed to move your teeth gradually towards the final position you want.Ìý Special moulds are then made for each step. The number of steps depends on how much movement is needed.Ìý

You wear a set for about two weeks, then change to the next set. Each set moves your teeth slowly towards their desired position. Attachment points – tooth-coloured plastic bumps on your teeth – may be added to help the aligners get a better grip, and ‘buttons’ to hold elastic bands may also be needed.

Pros and cons of clear aligners

This system offers a couple of key advantages over traditional wire and brackets braces. First, they’re almost unnoticeable to others. Second, you can take them out before eating and cleaning your teeth, or even for a special occasion.Ìý

Invisalign is best for mild-to-moderate problems with crowding and alignment, and for people who have previously worn braces but have suffered a relapse because they haven’t worn their retainer.Ìý

The company claims its product can treat most orthodontic problems, but the results are unpredictable, especially for certain presentations such as tooth rotation or vertical movement of teeth. More research is needed to see if the effects last as long as those of conventional braces.

Before going down the clear-aligner route, ask yourself if you have the stamina for them. Remember, you’ll have to wear them for at least 22 hours a day – every day. You’ll have to take them out for meals and drinks, then brush and floss your teeth and clean the trays before putting them back in – possibly while you’re out and about. You’ll also need to look after them when you take them out – replacing a lost or damaged set is expensive.

Cost: $4500–$9500

Mail-order aligners

You may also be tempted to save time and money with so-called mail-order aligners. SmileDirectClub has been one of the most heavily advertised. These clear aligners are sold directly to consumers, meaning there is no in-person consultation or review by an orthodontist. You can read more about them in our article Do SmileDirectClub’s home teeth straightening kits work?

Schwartz warns that although the lower cost and apparent convenience may seem appealing compared with traditional orthodontic treatment, these kinds of DIY plans can lead to significant dental problems. They include permanent damage to the teeth, gums, jaw joints or jaws, which can lead to costly treatment.

“Companies providing direct-to-consumer orthodontic products are relatively new to Australia but have been operating in the United States for several years, where they have been heavily criticised by consumers and industry groups for over-promising and under-delivering on treatment results,” says Schwartz.Ìý

“We’re now seeing orthodontists begin to report cases like this, and we only expect this to increase if consumers do not heed the warnings about these products.”

Lingual braces (Incognito, Harmony)

Marketed as the ultimate in non-obtrusive braces, lingual braces attach to the inside surfaces of the teeth. They’re generally more expensive than braces on the outside of the tooth, and appointments with orthodontists tend to take longer because adjustments are more fiddly. The main drawbacks are that they’re a little less efficient than external braces, they make teeth cleaning harder, they can irritate the tongue, and they can also affect speech (although that is usually temporary until wearers get used to them).

Cost: $9000–$12,000

Fast fix (short-term orthodontics, FastBraces, Smilefast, Six Month Smiles)

There are brace systems that are claimed to work faster – and cost less – than conventional braces, perhaps because of their “special” wires or brackets. These systems can be offered by general dentists as well as by orthodontists.

Schwartz points out that they can help straighten the six front teeth – the so-called ‘social six’ – but can’t be used to fix problems with bite. That’s fine if you only want straight teeth, but in the hands of a skilled practitioner you could get similar and faster results with other products.Ìý

“There is also potential for long-term dental problems, such as an unstable and uncomfortable bite, excessively protrusive front teeth, muscular and jaw-joint imbalances, uneven tooth wear and gum recession,” warns Schwartz.

Other means of speeding up treatment are to use devices that vibrate or use low-level light therapy to accelerate bone breakdown and reformation. Experts say they may work, but there’s no good evidence yet.

Cost: $3500–$6000 for ‘social six’

Maintenance after orthodontic treatment

Once the braces are off, you’ll probably need to wear a retainer to maintain the results. It might be a fixed retainer, with a wire attached to the back of your teeth, or a removable retainer. If it’s removable, you’ll need to wear it full-time at first, then at night only, perhaps dropping back to every other night or once a week.

Dentist vs orthodontist

Orthodontists are specialist dentists who’ve done a further three-year university degree in orthodontics on top of their degree in dentistry, learning how to diagnose, prevent and treat facial irregularities to align teeth and jaws.Ìý

But that doesn’t necessarily mean you should automatically choose an orthodontist for your treatment – you have to choose the professional that’s right for you.

Advantages of going to a dentist

These days, more and more general dentists are offering orthodontic treatment. One reason is that systems such as clear aligners or some of the ‘social six’ fast treatments don’t seem to call for such specialist orthodontic knowledge.Ìý

Also, patients can go to their trusted family dentist, have their regular dental needs attended to during the same visit, and perhaps save some money – as long as everything goes well.

Advantages of going to an orthodontist

Whatever the benefits of seeing a dentist for orthodontic braces, it’s fair to say that goingÌý to an orthodontist offers several key advantages:

• They are the experts in straightening teeth and correcting bite. This is what they’ve been specially trained in, and what they do day in, day out. Most general dentists can’t offer that depth of knowledge and experience.
• Successful treatment depends on an accurate diagnosis and assessment of your teeth and jaw problems, which you’re more likely to get from an orthodontist.
• An orthodontist has many more tools – systems of braces – at their disposal than a general dentist does. They can choose the best one for you, which may change during treatment, depending on how your teeth respond.

The example of clear aligners is a case in point. Figures from Dental Protection Limited, the professional indemnity insurer that covers most dental practitioners in Australia, show that 80–90% of malpractice claims due to clear aligners involved dentists rather than orthodontists.

Perth orthodontist and academic, Dr Mithran Goonewardene, says, “If we have 100 patients with exactly the same problem, there will be an incredible variation in the way they respond. Orthodontists can adapt the treatment to the response, and revise the treatment as it goes. This is impossible to teach in the general dental curriculum, or in a weekend orthodontics course.”

Top tips for choosing braces

1. Check the practitioner’s credentials – ask about their qualifications, experience and treatment results. You can look up a dental practitioner on the website – it will tell you if they’re an orthodontist or a general dentist.
2. Ask for personal recommendations for a practitioner from friends, family and parents at your child’s school. You don’t need a referral for an orthodontist.
3. Keep in mind that costs and treatment times vary depending on the complexity of the case.Ìý
4. Get a second or third opinion if you have doubts about the diagnosis or treatment plan. The consultation may cost you $100 or more, but if you’re spending thousands, it’s important to feel reassured.
5. Remember, that quick, cheap fix might cause more problems later, requiring expensive undoing and more time in braces.
6. Don’t worry if you need to discontinue treatment, the practice closes down, or you move to a new city. Members of the Australian Society of Orthodontists are bound to a formula whereby payments are proportioned between the orthodontist who began the treatment and a new orthodontist, so you won’t bear the full cost twice.
7. Check your health insurance rebate – you’ll probably be surprised at how little is reimbursed.
8. Look after your teeth. Follow instructions for brushing and flossing, and cleaning appliances. Avoid sweet, sticky, hard foods and sugary drinks. Keep up your regular periodontal appointments.
9. Wear a mouthguard over your braces when playing contact sports and sports where you might inadvertently cop a blow to the face from a fall or an object.
10. Wear your retainer. Your teeth will continue to move throughout your life. Without a retainer, all the hard work from braces will come undone over time.

The post Guide to buying orthodontic braces and aligners appeared first on ÌÇÐÄVlog.

On this page:

• What's in toothpaste?
• Brushing-up on the different kinds of toothpaste
• Toothpaste investigation 2012
• ÌÇÐÄVlog oral health checklist
• What's on the tube

But all hype aside, what is the difference between the many types of toothpaste …if any?

What’s in toothpaste?

From pulverised bones and crushed oyster shells to the modern-day pearly white paste, the role of toothpaste has always been to remove plaque and prevent cavities. Professor Mike Morgan, Head of Population Oral Health and Periodontics atÌý, says most toothpastes contain essentially the same ingredients and believes very few in the marketplace would actually fail to perform these two tasks.

Toothpaste has two key ingredients, fluoride and a mild abrasive, bound together with thickeners, sweeteners, stabilisers and flavours.Ìý

While the abrasives can vary – such as calcium carbonate and hydrated silica – they fulfill the same purpose: to polish your teeth and dislodge particles of food caught between them. The experts we spoke to say the amount of abrasive in any given tube of toothpaste is limited to protect tooth enamel from erosion.

Since most toothpastes contain pretty much the same key ingredients, does that mean you might as well just opt for the cheapest brand? Morgan argues that you should stick with reputable brands – it’s recently been found that some cheaper toothpastes in the UK don’t actually contain bio-available (absorbable) fluoride, which are much better for your teeth.

Find out how to decipher what ingredients are in your toothpaste.

Brushing-up on the different kinds of toothpaste

Although just two companies,ÌýÌýandÌý, control most of the Australian toothpaste market, there are certainly more than two products on the shelves. As if regular toothpaste wasn’t cleaning teeth sufficiently, we now have whitening, tartar control, sensitive and enamel-lock toothpastes as well as products tailored to children.

“As a dentist, I’m quite amazed when I go through the supermarket aisle and look at just how many toothpastes are on the shelf,” says Dr Peter Alldritt, chairman of the Oral Health Committee at the (ADA). “How do people choose?”

Here’s an overview of some of the toothpaste segments:

Teeth-whitening toothpasteÌý

Teeth-whiteningÌýproducts are the largest segment in the oral care market. When we examined ingredients in a selection of whitening toothpastes in 2012, however, we found none contain a bleaching agent – required to physically alter the colour of teeth. The fine print often qualifies this by promising whiter teeth as a result of stain removal, not an overall whitening treatment.

Children’s toothpaste

From milk teeth to big teeth, sparkling gel to Spider-Man, children’s toothpastes haven’t been left behind in the rush to segment the oral health care market. There are sparkles, coloured stripes and even Wiggles-endorsed products. They’re sugar-free and include fluoride and abrasives just like toothpastes for adults.

But as children are prone to swallow toothpaste, the ADA recommends parents avoid giving toothpaste to babies and toddlers up to 18 months and use only low-fluoride formulas for children 18 months to six years old to prevent fluorosis (caused by ingesting too much fluoride).

Colgate markets its low-fluoride toothpaste as ‘My First’ for children up to six, while Macleans offers ‘Milk Teeth’ for children up to three years of age and ‘Big Teeth’ for children over seven. Colgate also offers a big kids’ paste – for those six and up – with some clever Spider-Man marketing. The ADA’s policy on fluoride does not require a specialised toothpaste for children aged over six, so Alldritt argues those “big kid” products are a case of an intermediate market being created. “It is not a problem for the teeth, but it is confusing for parents with so many choices,” he says.

Products for sensitive teeth

When enamel thins or gums recede, porous dentine – the home of many nerve endings – can become exposed. Sensitive toothpaste is designed to block the dentine tubules and minimise sensitivity when brushing.

Of all the spin-off segments in the oral care market, toothpaste designed for sensitive teeth is the most legitimate, according to both Alldritt and Morgan. While Alldritt is happy to recommend it to patients who need it, he warns it is not a cure for everything and shouldn’t be used to cover up more serious problems, such as decay.

Tartar control and enamel protection

Tartar is the build-up of hardened plaque that can lead to gum disease. Although regular brushing can minimise its build-up, tartar can only be properly removed by a dentist. Of the toothpastes we looked at, almost all contain a tartar suspension agent – the most common being pyrophosphates and xanthan gum – designed to suspend tartar particles in saliva and prevent them from clinging to teeth. Although only three mention tartar control on their packaging, Morgan says most toothpastes will reduce the amount of tartar build-up if used in conjunction with a good toothbrush and regular brushing. Enamel is the outer coating of the tooth. Although generally much harder than the inner dentine, it can be worn down by excessive scrubbing or acidic foods. There are various products that claim to protect teeth enamel such as Colgate Sensitive Enamel Protect and Macleans Advanced with Enamelock formula – but, according to Alldritt, these claims may be a classic example of market trickery. “The best protection for enamel is fluoride,” he says. “Enamel is a fluoride, and when exposed to the fluoride in toothpaste, it is like putting a coat of armour on it.” The ADAÌýÌýa certain level of fluoride in regular adult toothpaste – and when we examined fluoride levels in toothpastes in 2012, neither of the “enamel-protecting” products contained any more fluoride than Colgate’s regular toothpaste.

Natural toothpaste

Another segment in the toothpaste market is natural, or herbal, toothpastes. Many of the so-called “natural” or “herbal” products ÌÇÐÄVlog looked at back in 2009 were made up of very similar ingredients to their mainstream counterparts, but most were made without fluoride.

Most experts say that fluoride is the one vital ingredient toothpaste should contain. Morgan advises against fluoride-free toothpastes and believes there are just two things to consider in your purchasing decision. “Look for toothpaste that has fluoride in it; after that the decision should really just be driven by price.”

Toothpaste investigation 2012

To test whether different toothpastes were in fact spin-offs of essentially the same thing, in 2012 we investigated the toothpaste market, comparing ingredients in 17 toothpastes from brands such as Coles, Colgate, Macleans, Sensodyne, White Glo and Woolworths. We found that of the 13 adult toothpastes we looked at, there was indeed little difference in the active ingredients.

Although many products have since altered their formulations or names slightly, the same principles apply. The following are the results of our 2012 investigation.

• Colgate Advanced Whitening and Woolworths Homebrand Freshmint Toothpaste (now has a different formulation), contained many of the same ingredients. Both used hydrated silica as the abrasive and the same suspension agent to prevent tartar from clinging to teeth. While exact ingredient proportions weren’t given, both include fluoride, a stabilising agent and titanium dioxide to give the paste an opaque, white appearance. The Woolworths product also had a naturally occurring preservative – and was less than half the price of the Colgate “whitening” toothpaste.

• White Glo Extra Strength Coffee and Tea Drinkers Formula was three times more expensive than the Coles Smart Buy regular toothpaste (no longer on the market), with very little difference in ingredients. Our analysis of ingredients found both used a calcium carbonate abrasive and fluoride, the same sweetener, humectant and a similar stabilising agent. The main difference being that White Glo also had carnauba wax – derived from a Brazilian palm tree – and rosehip oil. Alldritt, who says teeth can only be properly whitened by applying a bleaching agent over a number of hours, strongly doubts the wax would make any real difference when it comes to preventing stains.

The bold claims of these three toothpastes also stood out.

• Colgate Advanced Whitening

“Micro-cleansing crystals for clinically proven whiter teeth”.

Comparing the ingredients with that of regular Colgate, we believe the micro-cleansing crystals must be hydrated silica, which is the abrasive used in many other toothpastes.

• Macleans Extreme Clean Whitening

“Extreme clean with micro-active foam for deep-action whitening”.

No toothpaste without hydrogen peroxide is capable of physically whitening teeth, with or without “deep action”.

• White Glo Coffee and Tea formula

“Micro-wax to prevent staining on teeth enamel.”

The micro-wax is carnauba wax, derived from a Brazilian palm tree. Alldritt doubts a coating of wax would remain on the teeth throughout the day to repel stains from food and drinks.

ÌÇÐÄVlog oral health checklist

According to Alldritt, the most important considerations for maintaining good oral health should be:

• Fluoride: The most important ingredient in toothpaste.
• Regular care: Brushing in the morning and at night with a good toothbrush and soft brushing motion.
• Flossing: Cleaning in between your teeth to prevent small pieces of food from becoming trapped.
• Diet:ÌýBe mindful that the breakdown of sugars and carbohydrates by the bacteria in your mouth produces acid, which can attack enamel and begin the decaying process.

What’s on the tube

Here’s how to translate the ingredients you’ll find on the toothpaste tube.

• Abrasives might be called calcium carbonate, calcium hydrogen phosphate, sodium bicarbonate, dicalcium phosphate dehydrate, silica or hydrated silica and sodium chloride. For efficient tooth cleaning, toothpaste needs to be mildly abrasive.
• HumectantsÌýstop toothpaste hardening when it’s exposed to air. Common humectants are sorbitol, polyethylene glycols and glycerol.
• Binders disperse or swell in the presence of water and are used to stabilise the toothpaste by preventing separation of the solid and liquid phases. Binding agents in natural toothpaste include natural gums such as arabic, tragacanth, xanthan and carrageenan. Other products such as corn starch extract, CMC (sodium carboxymethyl cellulose) and cellulose may be used.
• Detergents lower the surface tension and therefore help loosen plaque deposits and emulsify or suspend the debris removed from the tooth surface during cleaning. Commonly used detergent sodium lauryl sulphate (not actually a detergent, more of a foam creator to help distribute the toothpaste abrasive agents into nooks and crannies), along with sodium lauryl sarcosinate, can irritate the skin. Lauryl polyglucose and lauryl glucoside are milder detergents.
• Flavours will often be labelled as such.
• Preservatives such as hydroxyl-benzoates or methyl-paraben helps restrict microbial contamination. Antibacterial agents can be added to help prevent gingivitis.
• Colour such as titanium oxide for white, chlorophyll for green and CI42090, an artificial blue colour.
• Sweeteners include sorbitol (which is also a humectant), glycerol, xylitol (which can help prevent decay), stevia and sodium saccharin.
• Desensitisers include sodium citrate, casein phosphopeptise, and potassium nitrate can relieve sensitivity, but this really depends on the person using the toothpaste.

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On this page:

• How we choose what we test
• How we test electric toothbrushes
• Test criteria explained

We put rotary and lateral toothbrushes through a series of technical tests and an ease of use trial. This is how we do it.

How we choose what we test

With a range of products on the market, what makes us choose one electric toothbrush to test over another?Ìý

As with most of our product testing, our aim is to test the most popular models on the market and what you’re most likely to see in the retailers.

We survey manufacturers to find out about their range of models, we check market sales information and we also check for any member requests to test specific models. From this information we put together a final list that goes to our buyers.Ìý

They then head out to the retailers and buy each product, just as a regular consumer would. We do this so we can be sure the products are the same as any consumer would find them, and not ‘tweaked’ in any way for better performance.

We also aim to test a range of rotary and lateral brush heads to cover all personal brushing preferences. That way you can use our results to find a model that truly suits your needs.

How we test electric toothbrushes

Our test looks at the following criteria.

Feel (volunteer trialists)

A panel of volunteers are given rotary or lateral toothbrushes, depending on what they’re used to using at home. They use the brush for 30–60 seconds and answer the following questions:

• How does the toothbrush feel in hand? Consider weight, balance, vibration in hand etc.
• How well does the brush comfortably reach all necessary areas?
• How does the toothbrush feel against your teeth, gums and tongue while in use?

They also have the option to leave additional comments of note.

Ease of use (volunteer trialists)

We ask the trialists to rate how easy it is to remove and attach the heads, adjust modes and turn each brush on and off.

Ease of charging

We assess the charging method, clarity of charge notifications such as LED lights, and how easy it is to plug and unplug each toothbrush to charge.

Operating time in days

We fully charge each brush, then cycle through two minutes on, then two minutes off until either the battery runs flat or we reach 56 cycles. Two cycles represents one day of normal brushing, 56 cycles represents four weeks of normal brushing. So if a brush still has charge after our test, it has enough power to brush your teeth morning and night for four weeks straight without recharging.

Test criteria explained

The ÌÇÐÄVlog Expert Rating, our overall score that determines which products we recommend, is made up of:

• ease of use (volunteer trialists) 45%
• feel (volunteer trialists) 45%
• ease of charging (10%).

We recommend electric toothbrushes with a ÌÇÐÄVlog Expert Rating of 80% or more.

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