By Angela Ward, R.D.H., M.A.
Columbia University College of Dental Medicine

Stores offer row upon row of toothbrushes, with a multitude of shapes, sizes, features and colors. Some are electric- or battery-powered. Others rely on your own effort. With so many different toothbrushes available, it's difficult to decide which one to buy.

Some of the more high-tech brushes can bend and flex. They have bristles of varying lengths and different colors. They certainly look impressive, but are they better than the more basic brushes? Not necessarily. In fact, toothbrushes are usually not subjected to rigorous clinical trials. So there is no actual proof that one is better than another.

What should you consider when deciding which toothbrush to buy?

The most important things you should consider are comfort and how well the toothbrush allows you to reach the teeth at the very back of your mouth.

Overall, your toothbrush should:

• Feel comfortable to hold — Toothbrush handles can be long or short, thick or thin, flexible or rigid, soft or firm, smooth or rough. Choose one that you can hold using a light grip. It should fit your hand and feel good to use.



• Fit the size of your mouth — Like our bodies, our mouths and teeth come in different shapes and sizes. People who have small mouths and teeth will not need the same brush size as people who have a larger mouth and teeth. Your brush should allow you to reach even the teeth at the very back of your mouth. It also should allow you to brush one or two teeth at a time.



• Have "soft" or "extra soft" bristles — Hard bristles increase the risk of harming gums when you brush. Make sure that you always use brushes that have soft or extra soft bristles.



• Have a seal of acceptance from the American Dental Association (ADA) — Dental products that carry the ADA seal have been tested by the ADA . They have been found safe and effective. This doesn't mean that dental products without the ADA seal are inferior. However, the ADA seal allows consumers to know that the product has been tested and has met certain ADA standards.

It is also a good idea to consider your current brushing practices when you buy a toothbrush. Do you give your teeth only a quick brush before you rush off to work or school, or before bed? Dental professionals recommend that you brush for at least two minutes.

If you are less than diligent about thorough brushing, then you might consider buying a powered toothbrush. Powered toothbrushes tend to make brushing your teeth easier. Because of this, people who use them have been found to brush longer and more often than people using a manual toothbrush. This means that more dental plaque is removed.

Careful and complete removal of dental plaque from all the surfaces of your teeth is one of the most important things you can do for your oral health. To remove plaque, remember that the type of brush you use isn't nearly as important as your brushing technique. Brush thoroughly, twice a day, for two minutes each time. With proper technique, almost any type of toothbrush will do the job.

Angela Ward, R.D.H., M.A., is a dental health educator at the Columbia University College of Dental Medicine. Ms. Ward has been involved in projects that have focused on providing tobacco cessation training and information to dental health care professionals and promoting the concept of tobacco cessation intervention in a dental office setting. Ms. Ward is a registered dental hygienist who practices within the ambulatory care network in the community of Washington Heights/Inwood in Northern Manhattan.