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Medical Forum / General / Dentistry / October 2004power toothbrush and oral irrigator
Hi all, my dentist recommended me to get an oral irrigator to replace the floss. I did some searches on the Internet and I found contrasting opinions about the oral irrigator efficiency, some people even say that it is harmful. What is your opinion about it? I also noticed that some oral irrigators include a power toothbrush, e.g.: "Oral-B ProfessionalCare 7900 DLX OxyJet Center" <http://www.oral-b.com/products/product.asp?tid=products&sub=power&cid=power&pid= oxyjet> Is the electric toothbrush better than a manual one? What are the benefits and the drawbacks? Do you recommend any brand/model? Thanks a lot. >Hi all, >my dentist recommended me to get an oral irrigator to replace the floss. [quoted text clipped - 16 lines] > >Thanks a lot. WaterPik, the cheap one is fine ...... Joel It squirts water .. .that's it! Joel >>Is the electric toothbrush better than a manual one? What are the >>benefits and the drawbacks? [quoted text clipped - 10 lines] > >Joel Super Soaker ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>Is the electric toothbrush better than a manual one? What are the >>>benefits and the drawbacks? [quoted text clipped - 12 lines] >> >Super Soaker ? YUP > Hi all, > my dentist recommended me to get an oral irrigator to replace the floss. Howdy me: Plaque is a sticky substance on the hard surfaces of the mouth. Its removal must be by mechanical scrubbing (tooth brush, floss, prox-a- brush). Tarter is old and hardened plaqaue (calcified) and must be removed by the dentist or hygienist using their mechanical scrapers. Irrigators may be good for promoting gingival health by delivering medicaments to the gum tissue, but they DO NOT remove plaque, period. Get it into your head, man. Do you stand under the shower and let the water clean you, or do you soap up and scrub yourself? If oral irrigators could dislodge plaque, the pressure on the water jet would have to be so high that it would rip the gums apart. Get some new floss, if you want, and work on your technique. Tell your dentist that I, for one, think that what s/he said (if, indeed you understood it right) is BULLSHIT. There are no other words that are appropriate. Remember: plaque removal=mechanical scrubbing SP  SignatureNot a real Addy, yet I disagree with Stove Pipe. 1. Plaque is not what we thought it was. 2. Irrigation is not good for delivering medicments 3. What we thought of as plaque is a biofilm 4. Biofilms can be removed by hydrodynamic forces, such as is created by sonic brushes, and water jets. 5. The waterjet, has been found to creat ghost cells, the matrix may still be there, but the bacteria is not. Vacant cells are harmless 6. Sounds like you have a good dentist/hygienist combo and I would be very comfortable if you were my patient and moved to another area of the country to find this pair. Shirley Gutkowski, RDH, BSDH "Everbody wants to save the earth - nobody wants to help Mom to do the dishes." - P. J. O'Rourke ~~~~~~~~~ http://www.dentistry.com/poralhealth_02.asp > I disagree with Stove Pipe. > 1. Plaque is not what we thought it was. > 2. Irrigation is not good for delivering medicments http://tinyurl.com/5ml2w Steve > 3. What we thought of as plaque is a biofilm > 4. Biofilms can be removed by hydrodynamic forces, such as is created by sonic [quoted text clipped - 10 lines] > ~~~~~~~~~ > http://www.dentistry.com/poralhealth_02.asp >> I disagree with Stove Pipe. >> 1. Plaque is not what we thought it was. [quoted text clipped - 3 lines] > >Steve EXCELLENT. THANKS. However, rinsing (B) formed significantly more plaque than using the oral irrigator (D, E). Group E showed the least amount of plaque. Joel ** 1: J Clin Periodontol. 1981 Jun;8(3):177-88. Related Articles, Links Use of oral irrigators as vehicle for the application of antimicrobial agents in chemical plaque control. Lang NP, Raber K. The purpose of the present investigation was to study the topographical distribution of plaque formation using chlorhexidine digluconate (CH) as a mouthrinse and in oral irrigators during experimental gingivitis. Forty dental students (aged 22--26) with clean teeth and healthy gingivae abolished oral hygiene for a period of 3 weeks (Löe et al. 1965). During this period the participants were randomly assigned to one of five groups. Group A rinsed daily with 30 ml of a placebo and Group B with 30 ml 0.1% chlorhexidine digluconate. In Groups C and E a fractionated jet irrigator was used for the daily application of 600 ml placebo (C) or 0.05% CH (E); 600 ml of 0.05% CH was also used in a monojet irrigator (Group D). At the start, after 1, 2 and 3 weeks of no oral hygiene and 1 week following reinstituted oral hygiene, plaque was assessed using the Plaque Index (Silness & Löe 1964) and gingival health was scored according to the criteria of the Gingival Index (Löe & Silness 1963). The discoloration of the teeth was determined using a set of color photos. During the experiment all groups reached plaque levels that were significantly different from each other. The highest PlI were seen in the placebo rinsing group (A) following by placebo irrigation (C). Plaque was significantly reduced in the CH groups. However, rinsing group (A) followed by placebo irrigation (C). Plaque was significantly reduced in the CH groups. However, rinsing (B) formed significantly more plaque than using the oral irrigator (D, E). Group E showed the least amount of plaque. In addition, the interproximal PlI were equally low as the buccal and lingual. With CH (B, D, E), gingivitis did not develop except for some interproximals in Group B. A fractionated jet irrigator was more effective for the application of CH than rinsing. Publication Types: Clinical Trial Randomized Controlled Trial PMID: 6947984 [PubMed - indexed for MEDLINE] *** >> 3. What we thought of as plaque is a biofilm >> 4. Biofilms can be removed by hydrodynamic forces, such as is created by sonic [quoted text clipped - 10 lines] >> ~~~~~~~~~ >> http://www.dentistry.com/poralhealth_02.asp > > 2. Irrigation is not good for delivering medicments > > http://tinyurl.com/5ml2w Thou shalleth not mass-medicate brave bacteria. Signature-History of fluorine, fluoride and fluoridation-: --- http://PMeiers.bei.t-online.de/index.htm --- ---------------------------------------------------- > > > 2. Irrigation is not good for delivering medicments > > > > http://tinyurl.com/5ml2w > > Thou shalleth not mass-medicate brave bacteria. This is not irrigation using specific antibiotics inducing a mutationally based bacterial resistance. SP SignatureNot a real Addy, yet > I disagree with Stove Pipe. > 1. Plaque is not what we thought it was. [quoted text clipped - 7 lines] > comfortable if you were my patient and moved to another area of the country to > find this pair. I have seen no evidence that oral irrigation is a satisfactory substitute for mechanical interproximal cleaning, either floss or proxabrush. Since the bacterial development of plaque depends heavily on the matrix, the failure to completely remove the matrix is a serious drawback of irrigators when compared to flossing or proxabrushing. Furthermore, I've seen more than a few times where patients with active periodontal disease have presented with abcesses after beginning to use oral irrigators. Patients need to be counseled in the judicious use of these devices. Steve > Shirley Gutkowski, RDH, BSDH > "Everbody wants to save the earth - nobody wants to help Mom to do the dishes." > - P. J. O'Rourke > ~~~~~~~~~ > http://www.dentistry.com/poralhealth_02.asp >I have seen no evidence that oral irrigation is a satisfactory >substitute for mechanical interproximal cleaning, either floss or >proxabrush. YUP, next month the dental hygienists will be giving the patient the water hose and then they can go back to the lunchroom and read for another thirty minutes! Joel Biofilm? BAH Humbug! >Since the bacterial development of plaque depends heavily >on the matrix, the failure to completely remove the matrix is a serious >drawback of irrigators when compared to flossing or proxabrushing. > Furthermore, I've seen more than a few times where patients with active >periodontal disease have presented with abcesses after beginning to use >oral irrigators. Research showing them to be superior was done by the manufacturer. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> I disagree with Stove Pipe. 1. Plaque is not what we thought it was. 2. [quoted text clipped - 29 lines] >> ~~~~~~~~~ >> http://www.dentistry.com/poralhealth_02.asp >I disagree with Stove Pipe. >1. Plaque is not what we thought it was. Errrr, the hygienists? >2. Irrigation is not good for delivering medicments >3. What we thought of as plaque is a biofilm OK. >4. Biofilms can be removed by hydrodynamic forces, such as is created by sonic >brushes, and water jets. [quoted text clipped - 3 lines] >comfortable if you were my patient and moved to another area of the country to >find this pair. Hey! You girls still clean teeth? Just wondering. Joel >Shirley Gutkowski, RDH, BSDH >"Everbody wants to save the earth - nobody wants to help Mom to do the dishes." > - P. J. O'Rourke >~~~~~~~~~ >http://www.dentistry.com/poralhealth_02.asp > >5. The waterjet, has been found to creat ghost cells, the matrix may > >still be there, but the bacteria is not. Vacant cells are harmless 6. [quoted text clipped - 7 lines] > > Joel Now, just a rootin' tootin'... SG is not advocating the halting of oral hygiene. I, for one, would like to know just what is the norm in Hygienist therapy these days for all you USA-ians. And, of course, what are the studies that lead to those norms.... Here I advocate brushing (after a lag of about 20 min to equiliberate the mouth pH); floss FOUR times a day, knowing that they'll do it four times a WEEK; prox-a-brush ( I give them away ); Rota Points (plastic tooth pics that come from ProDenTec); Gum and Tooth Tonic (in place of ChlX every day); cleaning PRN: one, two three or four times per year. JMO SP SignatureNot a real Addy, yet >Now, just a rootin' tootin'... SG is not advocating the halting of oral >hygiene. I, for one, would like to know just what is the norm in >Hygienist therapy these days for all you USA-ians Hygienist educates ..... Dentist cleans the patient's teeth ..... Everybody is happy. >And, of course, what >are the studies that lead to those norms.... They are all in Woman's Home Journal and Redbook ........ > >And, of course, what > >are the studies that lead to those norms.... > > They are all in Woman's Home Journal and Redbook ........ Jeeezzzzuz... those JOURNALS are expensive as hell.... ;-) SP SignatureNot a real Addy, yet >Here I advocate brushing (after a lag of about 20 min to equiliberate >the mouth pH); floss FOUR times a day, knowing that they'll do it four [quoted text clipped - 3 lines] >JMO >SP Lucky DUDE! Over here, once or a twice a week is success ... for brushing. > >Here I advocate brushing (after a lag of about 20 min to equiliberate > >the mouth pH); floss FOUR times a day, knowing that they'll do it four [quoted text clipped - 7 lines] > > Over here, once or a twice a week is success ... for brushing. Oh, I don't know.... I have a lotta those too: EVERYTHING is MY fault. As, I said: the above is what I ADVOCATE.... what actually happens is oftimes quite pathetic... SP SP SignatureNot a real Addy, yet >Here I advocate brushing (after a lag of about 20 min to equiliberate >the mouth pH); floss FOUR times a day, knowing that they'll do it four [quoted text clipped - 3 lines] >JMO >SP Best excuse for non-brushing ........ This was during the Viet Nam war ,,,,,,,, one of my patients was over to see me and then was scheduled to return back for a second tour of duty ...... he loved hunting people in the jungle .... He said, "I cannot brush my teeth over there as I do not want the smell of toothpaste anywhere upwind from Charlie." I agreed. Joel >He said, > [quoted text clipped - 4 lines] > >Joel You can brush your teeth effectively without a dentifrice. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > >He said, > > [quoted text clipped - 9 lines] > -- > W_B But then Charley (more likely his name would've been Vinh Ngyuen) would've heard your USA-ian teeth being scraped by the brush... and BOOM... Best not to fart too loud either.... or wipe yourself after going to the john... or... <OK, I'll shut up now>... and go empty out the old Bazzoo (car) and take it to the scrap yard... SP SignatureNot a real Addy, yet >>He said, >> [quoted text clipped - 6 lines] > >You can brush your teeth effectively without a dentifrice. YUP but he wanted to have teeth to come home with to brush to ......... Hi Gang: I'm back after a break. Here's my little two bits worth: My understanding is that the research on irrigators is pretty poor and/or unconvincing. And I'd say that mechanical removal is best - for sure eh. But you know, I've had a couple patients who just refuse to floss, or go to 3 month intervals, or see the periodontist - and they are deteriorating before my eyes. So, what the heck, I recommended a water pik - and advised them that there was no guarantee or good research. But - you know, they really healed up quite nice. (6 & 7mm pockets bleeding, went to 4mm minimal bleeding) I was shocked. I don't expect this to happen with all, and normally don't recommend these things. But with the odd, last-ditch-effort patient - why not. Yeah - I think you could have perio abcesses form if the cervical tissues heal, and the deeper areas aren't cleaned out properly beforehand. And I suppose that could happen if a hygienist does a crappy job too - only cleaning near the tops of the pockets. Have a nice day all. Linda (BC Hygienist) > > >5. The waterjet, has been found to creat ghost cells, the matrix may > > >still be there, but the bacteria is not. Vacant cells are harmless 6. [quoted text clipped - 20 lines] > JMO > SP Also, patients have been known to turn the power up too high on the irrigator and blow the bacterial right into the tissues. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > Hi Gang: > I'm back after a break. [quoted text clipped - 45 lines] >> JMO >> SP Eeew - Another reason to be cautious and skeptical with irrigators. Thanks for the info Dr. Steve. Linda. > Also, patients have been known to turn the power up too high on the > irrigator and blow the bacterial right into the tissues. [quoted text clipped - 48 lines] > >> JMO > >> SP >Also, patients have been known to turn the power up too high on the >irrigator and blow the bacterial right into the tissues. Or get toothpaste on the ceiling of the bathroom ...... >Hi Gang: >I'm back after a break. [quoted text clipped - 15 lines] >Have a nice day all. >Linda (BC Hygienist) THANKS! Nice report. Joel >> > >5. The waterjet, has been found to creat ghost cells, the matrix may >> > >still be there, but the bacteria is not. Vacant cells are harmless 6. [quoted text clipped - 20 lines] >> JMO >> SP > Yeah - I think you could have perio abcesses form if the cervical tissues > heal, and the deeper areas aren't cleaned out properly beforehand. And I > suppose that could happen if a hygienist does a crappy job too - only > cleaning near the tops of the pockets. > Have a nice day all. > Linda (BC Hygienist) .... like when you take an ultrasonic scaler into the top of a pocket w/o anesthesia and then go only as deep as until the patient winces... There are quite a few I know who do that. JME SP SignatureNot a real Addy, yet >> Yeah - I think you could have perio abcesses form if the cervical tissues >> heal, and the deeper areas aren't cleaned out properly beforehand. And I [quoted text clipped - 8 lines] >JME >SP There was one patient who we called, "Senor Winces ....." NAH! Humor! Joel > I disagree with Stove Pipe. 1. Plaque is not what we thought it was. 2. > Irrigation is not good for delivering medicments 3. What we thought of as > plaque is a biofilm 4. Biofilms can be removed by hydrodynamic forces, > such as is created by sonic brushes, and water jets. 5. The waterjet, has > been found to creat ghost cells, the matrix may still be there, but the > bacteria is not. Vacant cells are harmless OK, I follow the ProDenTec cont ed courses in Perio (that's what we use) and I haven't heard anything like this. In fact, it's completely new to me. Do you have any references? Further, I don't see why you would advocate a mechanical sweep of the smooth surfaces (sonic brush) yet no mechanical sweeping of interdental spaces (no floss, unless I'm completely out in left field here). Any rererences would be appreciated Thanks SP SignatureNot a real Addy, yet >> I disagree with Stove Pipe. 1. Plaque is not what we thought it was. 2. >> Irrigation is not good for delivering medicments 3. What we thought of as [quoted text clipped - 6 lines] >and I haven't heard anything like this. In fact, it's completely new to >me. Do you have any references? Nope, this is just Shirley ....... >Further, I don't see why you would advocate a mechanical sweep of the >smooth surfaces (sonic brush) yet no mechanical sweeping of interdental >spaces (no floss, unless I'm completely out in left field here). Can't do it while reading magazines ....... >Any rererences would be appreciated >Thanks >SP > I did some searches on the Internet and I found contrasting opinions > about the oral irrigator efficiency, some people even say that it is > harmful. > > What is your opinion about it? Hi, thanks all for your opinions. If I got it correctly, the oral irrigator cannot replace the floss. I wonder if I can still the oral irrigator along with the floss to help the cleaning or if I should avoit using it at all ... What do you think about it? Also, what about the power toothbrush? Is it anything good? Thanks. >> I did some searches on the Internet and I found contrasting opinions >> about the oral irrigator efficiency, some people even say that it is [quoted text clipped - 15 lines] > >Thanks. It's not the brush, it's what you do with it. Females tell males this quite often, only they aren't talking about 'toothbrushes'. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>> I did some searches on the Internet and I found contrasting opinions >>> about the oral irrigator efficiency, some people even say that it is [quoted text clipped - 17 lines] > >It's not the brush, it's what you do with it. The motion of the Ocean or something like that ...... >Females tell males this quite often, only they aren't >talking about 'toothbrushes'. >>It's not the brush, it's what you do with it. > >The motion of the Ocean or something like that ...... Size of the boat ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>It's not the brush, it's what you do with it. >> >>The motion of the Ocean or something like that ...... >> >Size of the boat ? Yeah those guys in the canoes are always coming along side and asking about tonnage. Joel How does the pitch of the propeller effect it? Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>>>It's not the brush, it's what you do with it. [quoted text clipped - 7 lines] > > Joel >How does the pitch of the propeller effect it? Angle of the Dangle -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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