Dental Myths Demystified

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


Myth 01: “Brushing Hard Helps”

Good for Teeth, Not for Gums

Growing up, I was always told to brush my teeth every night. But how to do so? As an avid rule follower and extremely prudent child, I sought out any tips in preventing the dreaded sugar bugs. Unfortunately, the only advice that most adults had to give was to brush twice a day, and hard,in order to remove all of the plaque on my teeth. If I had any left-over gunk at the end of brushing, it must have been because I didn’t brush hard enough.Today, we know that brushing hard does more damage than good, but do you know why?

I do admit that harder pressures are better at mechanically removing plaque and debris than softer pressures. And a tooth is a very sturdy thing, able to withstand stiff bristles and manually applied forces. However, we must remember that the teeth are surrounded by pink soft stuffs, known as gums, which aren’t as resistant to pressures. Brushing really hard, especially in left-to-right motions as we were previously taught, can lead to gum loss, in a process called gingival recession.

What is Recession?

Gingival recession occurs when gums move away from your tooth. Your gums experience wear, and soft tissue is prone to the damaging effects of heavy brushing. Consider gum recession as your body’s way of protecting itself by retreating. Over time, gum tissue disappears, and less and less gums surround your teeth. Unfortunately, once gum recedes, it does not grow back without the help of surgical dental procedures.

How Does this Affect Teeth?

What does gum health have to do with teeth health? Well, they are all inter-related. The gums are part of the structure that holds your teeth in place and keep the teeth stable. As you experience gum loss, multiple things can happen. First, you are losing the protective barrier around your teeth. Severe gum loss leads to exposure of your tooth’s roots. Unlike the rest of your tooth, the roots are not covered by an enamel layer. Therefore, the outside of your roots are closer to the nerves, and experience more sensitivity to things such as sweets, hot and cold temperatures, and movement. You may find eating ice cream a suddenly unpleasurable experience!

What’s more, as gums recede, there is an increased chance of food getting stuck in between your teeth. The space that gums once occupied is now empty, allowing for more food to be trapped every time you eat. Difficulty in keeping the areas around your teeth clean can lead to constant inflammation, your body’s way of fighting off anything it deems foreign. This can lead to gum disease, otherwise known as periodontitis, thereby causing further bone loss and gum loss! And the cycle continues.

The Right Way to Brush

Knowing all of this, we need to switch up our brushing techniques. Here are a few tips on how to brush successfully, without doing any harm.

  • Use a soft or very soft bristled toothbrush. I would avoid medium and hard bristled toothbrushes entirely.
  • Hold the brush like a flute. You’ll soon realize that there is very little force that can be applied when you hold it in this manner.
  • Point the toothbrush at the gums at a 45-degree angle.
  • Brush in circles or in small, vibrational motions. You never want to brush left-to-right.
  • Spend 3-5 seconds per tooth, vibrating the toothbrush around the gum line. Do the same with each tooth, and don’t forget to swing around to the back of each tooth. A person who has all their teeth should take about 2 minutes to brush.
  • If you own an electric toothbrush that already does the vibrations for you, don’t push down. You can still hold it like a flute and you should still angle it at a 45-degree angle. You simply need to hover it in this way over each tooth for 5 seconds, and your brush will do all the work for you. The worst thing you can do with an electric toothbrush is to use it the same way you would a manual toothbrush. There is such a thing as too much.

With these helpful tips, hopefully you can enjoy eating ice cream and drinking hot tea for a very long time.

Habit Shift: Teeth Grinding

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


We all have habits and tendencies. I’d be the first to admit that some of them are not good – such as always needing to eat a sliver of dessert after dinner, or never drying our good knives after washing them. I have a history of even worse habits during my teen years, such as chewing my nails, or chewing on the caps of pens, neither of which are good for my teeth. But like most habits, these I have direct control over, and I can change them whenever I so please, like when chewing on your nails turned from cool to gross. Unfortunately, there are some habits that are subconscious, and therefore much more difficult to break. An example of such a habit is teeth grinding, otherwise known as bruxism.

I am a heavy bruxor, meaning that I have the tendency to grind my teeth at night. Like so many others, it was undiagnosed until I landed myself in a dental chair due to a painful ache on my lower left tooth. I was prepared for a root canal and a crown, convinced that something this painful must be caused by a severe infection involving hateful bacterial species. So I was surprised when my co-worker showed me the x-ray and there was an absence of any signs of decay. Wait, then was going on?

Bruxism!

Bruxism is the subconscious habit of grinding your teeth. It is also considered a sleep-movement disorder. It is not uncommon for people who have other sleep disorders (such as snoring or sleep apnea) to grind their teeth as well. While some people grind their teeth from side to side, others chomp and chew, and yet others, like myself, clench really, really hard. It has even been reported by loved ones that their partner’s grinding habits are so loud it keeps them up at night! However, most people who grind their teeth are undiagnosed until they start to experience pain. The pain can be anything from mild to severe, and can be persistent or transient. Sometimes, bruxism is so severe that it causes to the teeth to fracture! This can then cause you to lose your tooth, depending on how it breaks. In order to prevent this from happening to you, it’s important to be aware of the most common signs and symptoms, as well as to try and protect your teeth from the effects of heavy grinding.

Bruxism

Signs and Symptoms

There are many signs and symptoms for bruxism, and they are different for every person. The severity depends on the frequency, duration, and weight of your bruxing habits.

Common sign and symptoms include:

  • Abfraction Lesions – These look like little chipping of your teeth around the gum line. Teeth are anchored in the jaw, and when we clench and grind, we are causing these teeth to flex in all sorts of directions. As they flex, the part of the tooth closest to the gumline (where it is most tightly anchored) experiences the most stress, causing these areas to be prone to chipping.
  • Flat Occlusion – As we grind our teeth, we are slowly grinding away at the top portion of the enamel. Eventually, heavy bruxism may lead to completely flat teeth.
  • Fractured Teeth – Under the stresses of grinding and clenching, part of the tooth itself can give way and fracture. Teeth with large existing fillings are more prone to fracturing than a complete tooth or a tooth with a crown. When we start to see the first signs of cracking or microfracture, we want to take precaution and monitor the tooth closely. Sometimes, it may be beneficial to remove the cracked portion and place a crown, to help prevent any unpredictable and unfavorable fractures in the future.
  • White Lines Inside the Cheeks – Look inside your cheek to see if there is a white striation. These are formed from the repetitive sucking motion related to teeth clenching and grinding.
  • Tight or Tired Jaw Muscles – It may be that you are spending the entire night working your jaw left and right. Your jaw joints may then get tired, or feel very tight. If you ever wake up in the morning with a soreness in your jaws, you may have just experienced a night of heavy grinding!
  • Tooth Pain or Sensitivity – Teeth can experience sensitivity to hot, cold, or pressure if they are continually experiencing trauma from bruxism. There are nerves running to each tooth, and repetitive trauma to the tooth can cause these nerves to become hypersensitive. If treated right away, the hypersensitivity can be reversible.
  • Migraines and earaches – The nerves that innervate your teeth run up along the sides of your head. If they are hypersensitive, they can also cause migraines and earaches.
  • Sleep Disruption – Some people wake up in the middle of the night due to the sounds of bruxism. Others awaken due to aches and pains. Untreated bruxism can definitely take away a good night’s rest!

Causes of Teeth Grinding

The exact cause of bruxism is difficult to pinpoint. It could be a myriad of factors, so it’s important to evaluate whether any of the following apply to you.

  • Stress or Anxiety – The most common cause of teeth grinding is stress. I will always ask my patients if they are experiencing any stressful events in their lives lately when they report bruxism. Most people identify a difficult time at home, or a job change, or a recent move. Identifying the cause of stress and trying to manage or decrease it is really helpful in treating bruxism!
  • Abnormal Bite – Children often time experience grinding when their teeth first erupt and again when their adult teeth start to erupt. Sometimes they outgrow it, and sometimes they don’t. I have also noticed that bruxism is more common when people are missing teeth. A theory would be that an abnormal bite or a bad occlusion can lead to grinding.
  • Side Effects of Medications – Some medications are known to cause grinding. If you have recently started taking a new medication, ask your doctor whether grinding could be a possible side effect. Antidepressants, for example, have been shown to cause grinding.
  • Weight Gain and Sleep Disorders – Recent weight gain can make breathing more difficult when one is sleeping. Soft tissues around the neck and throat tends to push downward when we are lying down, thus obstructing the airway. This can lead to a number of sleep disorders, including snoring, sleep apnea, and grinding!

How to Protect Your Teeth from Grinding

There are many ways to protect our teeth! Unfortunately, since grinding is subconscious, eliminating the habit can be very near impossible to do. Therefore, we must find other ways to help prevent further wear and tear on our pearly whites!

  • Wear a Night Guard

Getting a night-guard is the best way to protect your teeth from the effects of bruxism. Since bruxism is a subconscious habit, it can be difficult to catch yourself doing it, let alone to stop yourself from grinding or clenching. A night guard is a protective plastic piece that sits on either your upper teeth or on your lower teeth. The plastic piece acts as a barrier between upper and lower teeth while you are grinding, so that you are not placing as much forces on your teeth and you aren’t wearing them down. The upper night guard works really well, but can feel very bulky for some. The lower night guard is a much more comfortable fit for first time users. You have the option of either buying universal night guards over-the-counter or making a custom-fit night guard with your dentist. Off course, the custom-fit night guard will protect your teeth better, but I can understand if you don’t want to spend that much money until you’ve tried an over-the-counter one to see if you can tolerate sleeping with a night guard. It will take awhile for you to get used to! It took me about two weeks. One thing is for sure: Once I started wearing my night guard, the pain went away. And if I ever forget, the pain will come back, which shows me that the night guard is doing its job!

  • Reduce Stress

There are many ways to reduce stress. I was first diagnosed with bruxism during dental school, which no doubt was a very stressful time. I find that I clench my teeth while I work or concentrate on something. When I involve myself in stress-reducing practices, I find that I clench less. Below are some ways to alleviate stress or anxiety.

    • Avoid stressful activities an hour before bed.
    • Drink caffeine-free tea in the evening after dinner.
    • Avoid screens in the last hour before bed. Try reading a book instead, or listening to calming music.
    • Choose exercises such as yoga in the late evenings, rather than hitting the gym and working out.
    • Write positive events or affirmations down. Gratitude has been shown to decrease stress and anxiety levels greatly. Try a 5-minute journal.
    • Spend time with your family, friends, or pet.
    • Practice deep breathing, and letting thoughts go.
  • Lose Weight

If you’ve recently gained weight and have noticed that you started grinding your teeth, try to get back to your previous weight. As mentioned above, weight gain is a common cause of grinding. Many patients have found success in decreasing bruxism by simply losing weight.

  • Regular Dental Visits

Regular dental visits are important when you grind your teeth. Make sure your dentist knows of your bruxism. They will be able to detect early signs of tooth fracture. When you start to see a hairline fracture, it shows that your tooth is giving way underneath all those chewing forces. You want to treat a small fracture with caution. It may be that a crown will be needed in the near future to cover the tooth and help protect it. A small crack can grow into a big one, and there is never any telling when and how a tooth will break. Sometimes, a tooth breaks and we can save it with a filling, a crown, and/or a root canal. However, other times, it breaks in a completely unfavorable way, and you may end up losing your teeth. Speak with your dentist about the best preventative practices you can engage in to save your teeth!

A Parent’s Guide: The First Dental Visit

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


Child raising is no easy task, especially if you’re a first-time parent. Despite all the advice that friends, family, and well-wishers throw at you, it seems that none of them actually work in terms of making the job easier. I’m sure you’re frantically trying to find space in your hectic schedule to get a bathroom break in peace, let alone a wink of sleep! So of course, I understand the look you’re going to give me when I tell you that somewhere in between the baby bottle juggling and the diaper toss, you’ve got to schedule your child’s first dental visit, too. A look that’s mixed between, “Can you not see I’m busy drowning in to do lists?” and “Why don’t you try your hand at this?” As if you don’t already have enough advice being thrown at you left and right, a few words on a child’s first dental visit:

When:

A child’s first baby tooth appears around 6 months old. Typically, it will be one of the lower two front teeth. Look out for it, although I am sure your little one will let you know it’s coming as they’re gnawing away at all those teething toys, or in some cases, whatever they can get their mouths on. Some might wail as a precautionary measure to warn you that it’s teething time! If the tooth comes earlier or later than 6 months, don’t be alarmed! It is considered normal to be within 3 months of the scheduled timeline. It is important to remember that some babies have a head start, and others are late bloomers. The eruption of the first baby tooth is the first sign that your child should see their dentist. It is recommended that a child establishes their “dental home” no later than a year after their birth. The sooner, the better – here’s why!

Why:

When it comes to teeth, we can get behind creating good dental habits early on. It is best if a child establishes a dental home at a young age for multiple reasons.

  • To check and maintain a healthy oral cavity: It’s obvious that there is tooth decay when a tooth has turned black. Anyone can diagnose that. Unfortunately, by that point, it may be too late! Most tooth decay detected by our eyes have already been present for a long time! We recommend seeing your child every six months as soon as the first tooth erupts, so that we can spot problems early on! Maybe our exams will be limited until your child is old enough to take radiographs, but an exam is still better than nothing at all! Let’s be proactive with our dental care!
  • To develop good oral hygiene habits: When your little one is six months old, the people dentists really want to talk to are the parents. As parents, you will have to guide your child toward good, daily oral hygiene habits. Sometimes, that means holding their hand and doing the brushing for them until they are five years old! We know that they will want to grow up fast but we want them to grow up WITH TEETH! So don’t let them go on their own too early. If your child insists, maybe give them time to brush on their own, and then immediately afterwards, follow up by re-brushing their teeth. Your dentist should be willing to go over some tips if you’re having difficulty with your child’s brushing tendencies. I am sure you have a lot of questions, so do not hesitate to ask your dentist on these visits. Plus, the more times your child gets their cleanings, the more opportunities the dentist has to inform them on ways they can improve, too!
  • To become familiar with the family dentist and dental procedures: Dental procedures can be seen as scary to kids, no thanks to the bright lights, loud sounds, and perception in the media. But they shouldn’t be! We want kids to be familiar with going to the dentist. We want appointments to be fun! And we want to make check-ups easy for them. You know the saying: practice makes perfect. The more times they see the dentist, the more comfortable they will be.
  • To avoid fear of the dentist: Humans, especially little ones, fear the unknown. By developing a dental home early on, a child can become more comfortable with the dentist and will start to see check-ups as part of a routine. When you start to brush your child’s teeth, at first they will resist. But after many practice runs, much resistance, and possibly battle scars, they will soon accept it as a part of life. That’s the same with the dental visit (minus the battle scars!).

Things to Expect:

The first dental visit is not going to be perfect. But it establishes the start of what will be a great relationship between your child and their dentist. Here are some things that you might need to prepare yourself for.

  • The first dental visit will be a visual exam. At six months old, we are not going to take radiographs, a fact you probably already knew. “So what’s the point?”, you may ask. The first visit is usually a visual exam. Meaning, we have your child open their mouth and take a peek at their brand new chompers. If we can get a dental instrument in there to feel the surfaces for any ‘holes’ or ‘soft spots’ that might indicate a cavity, then great! If not, then there is always the next visit. What we really want to accomplish is the familiarity of going to the dentist. Good habits are easier developed early on.
  • Your child may cry. Let’s face it. Everything at the dental office is completely alien to your little one. There’s a lot of stimulation going on and your child may not like it. So, they cry. Well, crying is actually good, because I can stick my head in their tiny mouths and peer at their teeth, mid-cry. Sometimes, that’s better than fighting with a child to open their mouth. If your child cries, do not immediately assume it’s related to trauma or pain. And please do not stop coming to the dentist. As mentioned before, the more they get used to coming in, the more cooperative they’ll be in future visits.
  • Nothing may get done. If the baby or child is not cooperative AND does not cry, then it’d be pretty difficult to take a look at their teeth. No worries! Let’s just call this an introductory visit! “Here’s the dentist, your new friend!” “Nice to meet you, little one! Next time, you are going to do so great, we just know it!”
  • We have to be patient: We don’t want your child to have a traumatic experience, because that can affect their perception of dental procedures and can keep them away from their six month check ups when they grow older. We want the experience to be positive, therefore, forcing a child to cooperate is not the best way to go. We can always try again next time. If there IS treatment that needs to be done, but your child stops cooperating, there are also other things we can do, such as refer to a pediatric dentist (also known as a pedodontist) who specializes in working with children!

So there you have it! Now you are equipped with the to-dos and the whys and the hows. If you can find time to establish a dental home for your child early on, you and your child will have an easier time as your child gets older. Hopefully this advice helps you sleep soundly at night too, knowing that their teeth are in good hands!

On Trends: Charcoal Toothpaste

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.


Charcoal sure is getting quite the attention these days. It seems that this granulated, activated, ashy celebrity has stolen the spotlight. Instagram posts are covered with picture-worthy activated charcoal-containing foods, such as black scoops of ice-cream atop waffle cones, and seeded black hamburger buns on either side of a beef patty. This ‘coconut ash’ has also been praised to bind toxic drugs and chemicals in the body due to its negative charge, thus pulling out toxins before the stomach can digest them. (Someone has yet to start an all-charcoal diet.) For similar reasons, bits of charcoal are also being integrated into beauty products in the effort to bind dirt and oils, and I’ve seen humans who look like panda bears, mid-exfoliation. Pretty cute. And don’t think I didn’t consider for a moment the use of charcoal sticks in lieu of a water filtration system. In a crazed effort to eliminate plastic use completely while not being open to drinking unfiltered water, I myself fell down a charcoal-obsessed rabbit hole internet search. Drop a stick of charcoal in a jug of water, wait a few hours, and voila! Perfectly delicious drinking water advertised. While I have nothing at all to say about any of these aforementioned things, except maybe to note that charcoal ice cream temporarily stains your teeth the same color as the pint, I do have a few things to say when it comes to this much celebrated charcoal entering our toothpaste.

Why Put Charcoal in Toothpaste?

Have you seen videos of people brushing their teeth with black globs of sticky stuff and wondered to yourself, “Why put charcoal in toothpaste?” Especially after divulging the fact that a first date may be complicated by stained teeth as a result of trying charcoal ice cream with a potential future life partner. Along the same lines of the previous train of thought that activated charcoal can bind to things due to its micro-porous nature, it seems that some are of the mind that it can also bind plaque and bacteria and tartar. There is the added benefit of whiter teeth, as well. So, why don’t we dig deeper about these two topics?

Does Charcoal Like Bacteria?

Not any more than we do! Activated charcoal is porous in nature. The thinking behind removing bacteria with activated charcoal is that plaque and micro-organisms will be caught in the pores of the charcoal particles, and thus be removed. Possible, but it seems that it does this at a similar rate as regular old toothpaste would. So, no, there is no special binding relationship between the new celeb and our bacteria.

Does Charcoal Toothpaste Detoxify?

There isn’t much to say about the detoxifying nature of charcoal toothpaste that so many people claim. The gums and teeth are not at all similar to your liver and kidneys, which take on the job of clearing your body of toxins. Because of this, the charcoal is not exactly detoxifying your body of anything. Of the same token, for those who are using charcoal toothpaste and are concerned about the charcoal affecting your current medications, rest assured that the charcoal is not in contact with the medications in your digestive tract and therefore has no effect. Unless, off course, you are swallowing the toothpaste rather than spitting it out.

Does Charcoal Actually Make Teeth Whiter?

The simple answer is, “Yes it does”. Bizarre, that you can brush with black to make them white! Charcoal is effective in removing surface stains, which isn’t exactly equated to whitening teeth. Surface stains are extrinsic staining on the teeth due to a coffee drinking habit, or the occasional red wine indulgence. These stains reside on the enamel layer which happens to also be the outermost layer of your tooth. Typically, other ‘whitening’ toothpastes remove these stains as well.

However, your teeth can also have intrinsic stains, either caused by trauma, certain medications, weak enamel, or excess fluoride use. These intrinsic stains can not be removed by toothpaste, with or without charcoal, primarily because the toothpaste will never reach these stains. Whitening of intrinsic staining can only occur from bleaching treatments (whether that’s in-office or over-the-counter) that penetrate past the enamel. But if you wish to use charcoal toothpaste to help reduce stains due to a cold brew habit, then charcoal toothpaste will suffice.

Should We Be Wary of Charcoal Toothpaste?

Unfortunately, charcoal is abrasive. Part of what makes it so good at removing extrinsic stains is the fact that it is rough and can rub off discolorations that are stuck in the pores of your teeth (teeth are porous too!). However, the concern is that charcoal acts like sand paper. Anyone who has consumed or brushed with charcoal will know the grainy feeling it leaves in your mouth. Like sandpaper, repetitive use of the stuff can abrade parts of the outer enamel layer. The enamel is the strongest part of our bodies (stronger than bone!) and our teeth need it as protection. Removal of the enamel layer will weaken the tooth and cause hypersensitivity. You know those ‘Zings’ you feel after a tooth whitening session? Well imagine a permanent version of that, if the enamel is removed. Yikes! Ironically, too, the removal of enamel makes the teeth even more prone to staining for future years to come. Enamel is definitely something we want to protect. If you are planning on using charcoal toothpaste, then consider brushing lightly and gently.

Also, before you declutter your regular toothpaste, may I suggest alternating your charcoal toothpaste with the regular one? Who knows? Like all trends, charcoal coolness may fade, and you may be reaching for your trusty familiar toothpaste brand, once again. At the very least, the alternation will help reduce abrasion to your beautiful, pearly whites. Plus, most charcoal toothpastes do not have fluoride, a good protector of teeth. Fluoride is what helps fight dental decay, and as much as we want white teeth, I am sure you would agree that we want to KEEP our teeth even more. Since charcoal is a recent celebrity, it is too early to tell what charcoal is really about. Better to wait until the tabloids (and research) unearth its true qualities before we fall head over heels for this new star.

Cocofloss: Join the Party!

This post may contain affiliate links. Please see my disclosure to learn more.

Much to the bereavement of all of society, flossing is absolutely necessary and cannot be replaced by things such as water-flossers or, say, prayers. All at once now, *collective sigh*. I get it. But there is a new hero in town, one that’s got me (and soon enough, you, too) cheering. I would like to introduce you to a new best friend and awesome travel partner, Cocofloss!

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It would be difficult to argue against the fact that  the hardest part about flossing is the motivation to actually do it. Cocofloss is a creative solution to making flossing (dare we say it?) an inspiring act looked forward to by all. Imagined and brought to life by two sisters, Chrystle and Cat, Cocofloss is all the right sorts of trendy. Chrystle is a dentist and is a flossing-pro. Cat is an artist and a bit more lazier on the flossing front. But together, they make a dynamic duo, saving the world, one tooth at a time.

Cocofloss is not just string in a box. It’s an experience, and I challenge you not to become completely enamored and transformed into a flossing fanatic once you’ve tried it out. Does it sound like I’m a crazed dentist? Maybe a little. I still dare you to try it! Scented with different fruity aromas, flossing transports you elsewhere. A sandy beach at the Caribbean, perhaps? The four standard flavors include Fresh Coconut, Cara Cara Orange, Pure Strawberries, and Delicious Mint. Currently, there is the seasonal Summer Watermelon flavor for post-BBQ hangouts. Once you open the box, delicious scents waft to your nose. Try not to get addicted!

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Now it isn’t just all fun and games. There’s lot to love on the dental front too. Firstly, the string is blue. That isn’t just to make it engaging to look at. The blue string actually makes the plaque that you remove visible. There is a sort of satisfaction in seeing the plaque that you are actively prohibiting from staying in your mouth. Crazed dentist, indeed! Take THAT, plaque!

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Advertised as a loofah for your smile, there is another feature that I absolutely love. The floss is made of multiple, soft, polyester filaments and is coated in vegan wax. The waxy material is easy to glide in between tight contacts. Once you pass the floss through the contact, the fibers seem to spread. In other words, they poof out ever so slightly, filling that gap underneath the contact and covering more surface area while massaging the gums. At the same time, the fibers are very gentle which protects the gums from trauma. Plus, we all know there is strength in numbers! The fibers are even strong enough to remove chunks of calculus and tartar! Off course, there’s a technique for that. For the non-queasy, here’s a video. Viewer discretion advised.

Also, remember how you floss vigorously before your six-month cleaning because you suddenly remembered that flossing was important? Don’t you deny it! Heaven forbid the dentist ever notice. As much as I love holding you accountable for flossing, Cocofloss can do that for you too. Each container has an indicator for how long the floss should last you. The regular packages are a two month’s supply. Once two months are up, you should be finished with your flossing container. If the indicator is not motivation enough, sign up for the six month plan on their website to make sure you are on track between dental visits. Under the six month plan, Cocofloss will ship you a new flavor of your choice every two months, for a total of three flavors, over the course of six months. If you receive your new Cocofloss before you have finished the old one, then maybe that’s an indication that you’ve skipped a day or two (or three or four).

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Lastly, the floss is infused with coconut oil. Which I think is a cool concept, especially considering all the rave about the benefits of oil pulling. However, I would not necessarily say that the coconut oil does much of anything, considering the amount of time it’s in contact with the teeth. Remember that oil pulling requires you to swish coconut oil around your mouth for 20 – 30 minutes! You only floss for a few minutes. The floss itself does a majority of the heavy lifting, but if coconut oil grooves with you, and it gets you to floss, then there you go!

Two things worth noting that could be improved. The floss is housed in a plastic container, although I would like to note that it is advertised as vegan, animal cruelty-free, and is a completely recyclable product. But still, more plastic being circulated around the world. I’m as crazy about plastic packaging as I am about teeth (maybe even more) so for that, I apologize. And secondly, it does come at a bit higher price than other floss. You can find these babies at $8 a piece, although if you buy a package of 3 or more, you will receive a discount. Regardless, if it is the only thing that’ll get you to want to floss every day, I say it’s worth it. Preventative care is the number one most important thing for oral health, and the fact exists that, for most people, flossing just ain’t fun. Cocofloss tries to bridge that gap. We need to make preventative oral health care cool, just like we made smoking cigarettes uncool. Consider it a changing of times, if you will.

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If you’d like to give Cocofloss a try, ordering is easy! This product lines the shelves of Sephora, Nordstrom, and Urban Outfitters, but you can also order here, from the comforts of your home. I have personally tried all five flavors, and I’ve got to tell you that Pure Strawberries is my absolute favorite. Reminds me of farmers markets and strawberry shortcakes! I recommend this product to all my patients, especially kids and younger teens who have yet to develop a flossing habit. Challenge them (or yourself) to floss for 21 days straight (the number of days it takes to form a habit). Let’s introduce a new flossophy to younger generations by teaching them that flossing is actually cool.

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Battle of the Brushes: Manual VS Electric

This post may contain affiliate links. Please see my disclosure to learn more.

We all know that prevention is better than treatment when it comes to your teeth. Wanting the finest for our teeth, we search for the best gadgets to aid us in making sure our pearly whites are nice and healthy. The most often used tool, and thus your tooth’s best friend, is the handy dandy toothbrush. But when it comes time to select your toothbrush of choice, the wide array of choices sitting on the shelf or available on the net can be very, very overwhelming. Looking at the dilemma from the macro-level, I think the most common fork in the road occurs where we have to choose between a manual toothbrush and an electric toothbrush. Here, I will review the pros and cons of both options, and then talk about which one I myself choose to use, and why.

WHO COULD BENEFIT FROM AN ELECTRIC TOOTHBRUSH?

When patients come to me and ask if they need an electric toothbrush, many of them are surprised when I tell them that the answer is no. There are a few groups of people who could benefit from an electric toothbrush, but it is not necessary for everyone to have in order to maintain good oral health. Electric toothbrushes greatly benefit people with Parkinson’s Disease, Rheumatoid Arthritis, or other such conditions that could impair one’s ability to hold and maneuver a toothbrush. Spinning and vibrating (and whirling and twirling) bristles are really great at restoring one’s manual dexterity when it has been lost. However, if you do not have any existing conditions that impair movement, then there is likely no need for an electric toothbrush at all.

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AN ELECTRIC TOOTHBRUSH DOES HAVE ITS LIMITATIONS

An electric toothbrush is useful because you’ve got this machine that moves in certain directions to remove the sticky plaque building up on your teeth, but it does have its limitations. Usually, the direction that a toothbrush head spins or vibrates is singular. With manual toothbrushes, you can vary the direction of your brushing at any time, which can be more effective. For example, if your teeth are slightly crooked, an electric toothbrush that only spins in a clockwise direction may miss a particular spot that a manual toothbrush can reach by moving side to side, or up and down. Depending on where the tight corners in your particular dentition are, you can alter the same toothbrush to move different ways in order to reach very difficult areas. Also, the electric brushes are very strong, which some people are not aware of. Using them requires an even softer hand than using a manual brush. Even though the intentions are good, pushing down on an electric toothbrush can cause too much trauma on the gums, causing gum recession. We like gums as much as teeth, so this is no good. Therefore, using an electric toothbrush may seem easier, but easier does not always mean better.

THE TRUTH: MOST PEOPLE WOULD DO JUST FINE WITH A MANUAL TOOTHBRUSH

The truth of the matter is, most people would do just fine with a manual toothbrush. I understand that it takes some time (and practice) to learn how to use a manual toothbrush, but the same is true of anything else in your life. Once mastered, the chore becomes a habit, and habits are subconscious and therefore become easy. If you can put in the time and effort to learn how to use a toothbrush effectively, then a manual toothbrush would work equally as well as an electric toothbrush! But, if you do not want to put in the effort to learn how to properly yield a manual toothbrush, then yes, you can buy a gadget and it can do the work for you. It makes sense that the results of inefficient manual toothbrush techniques will be subpar with the results of a vibrating electric device. However, what most people do not understand is that learning how to brush really well can yield results that are as good, and sometimes even better, than your new gadget.

WHY I CHOOSE TO USE A MANUAL TOOTHBRUSH

On that note, most patients are surprised to learn that I myself choose to use solely manual toothbrushes. There are many reasons why I opt for the manual brushes. As an advocate of slower-living, a lover of nature and sustainable products, and a fan-girl of the lost art of doing things for ourselves, I am partial towards tooth brushing by hand. Manual toothbrushes give us sustainable product options that are more eco-friendly than their plastic vibrating counterparts. We have manual brushes on the market that are biodegradable, recyclable, or recycled themselves. It allows me to pick a product that is in line with my values and my intention of creating less waste. Additionally, I have more control with a manual toothbrush. I can move the bristles in directions that are good for my particular dentition and I can alter the pressures that I place on my gums a bit easier. And lastly, I find them to be much more cost-effective. My persona as the Debtist easily explains why cost-efficiency is important for me. From a dentist’s perspective, I understand that we can do just as well with a manual as we can with an electric one.

While electric toothbrushes do have their uses and are a huge help to those who need it, I believe we have gotten to a point where they may be a bit over-hyped (and possibly over-sold) for the sake of convenience. It’s an easy answer to the question, “How do I brush my teeth well?” Instead of teaching people to be better brushers, we are making them dependent on a tool to do the work for them, and the cost is more plastic being introduced into our environment at ever-increasing price as less and less people learn how to effectively brush. I tell patients all the time that we are responsible for our oral health, and we shouldn’t depend solely on spinning brush wheels. We need to take our oral health back into our own hands. Quite literally. And with that, the battle of the brushes continue.

Tooth Brushing Techniques With Bogobrush

This post is sponsored by Bogobrush, a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program for low-income communities. 

We all know that prevention is better than treatment when it comes to the dental office. There are many ways to prevent caries formation and periodontal disease, the most common of which are proper oral hygiene at home and consistent visits to the dentist for dental check-ups and cleanings. Off course, there are many tools one can use to implement oral hygiene at home. However, the tools are not as important as the methods with which we carry out our everyday oral hygiene. Hence, this short discussion on tooth brushing techniques.

People always see me at the dental office and ask me, “Hey Doc, do I need an electric toothbrush?” Well, that depends. Are you physically capable of brushing your teeth? If you are without Parkinson’s or Rheumatoid Arthritis, or other such conditions that could impair your ability to hold and maneuver a toothbrush, then I would venture that you do not need an electric toothbrush. Now, if the question you meant to ask was, “Could I benefit from an electric toothbrush?”, well, that depends too. If you put in the minimal time and effort to learn how to use a toothbrush effectively, then a manual toothbrush would work equally as well as an electric toothbrush. If you do not want to put in the effort to learn how to properly yield a manual toothbrush, then yes, you can buy a gadget that can do the work for you. It makes sense that the results of inefficient manual toothbrush techniques will be subpar with the results of a vibrating electric toothbrush. However, what most people do not understand is that the results of an efficient manual toothbrush can be as good, and sometimes even better, than your new gadget.

So, in an effort to save you some money, and to save the planet from unnecessary plastic devices, I am going to discuss tooth brushing techniques using my favorite, eco-friendly, socially-conscious Bogobrush.

How to hold your toothbrush.

Most people brush too hard. The point is not to be vigorous with brushing. I know that your intentions are good, and you are making all efforts to remove the plaque from your teeth as best as you can, but excessive forces while brushing can lead to recession of the gums, which can then unleash another set of problems such as teeth sensitivity. Dentists love gums as much as teeth, so we definitely do not want to do that! The root of the problem is usually in the way a person holds their toothbrush. Usually, I see people enclosing their entire fists around the handle, which increases the pressure they can exert on the gum tissue. Unfortunately, this is WAY too much pressure. You want to hold your toothbrush like a flute. Four fingers on the top and the thumb on the bottom. You will notice the vast difference in pressure, and your gums will be all the more happier about it.

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Tooth Brushing Techniques

There are multiple tooth brushing techniques! Some are good, some not so good, and some are entirely bad. The methods that I will discuss today are the Bass Method, Stillman Method, and Charter’s Method, the names of which are completely unimportant, but the techniques of which are instrumental. All three methods can be modified, which will also be discussed here. Lastly, there are a few subpar methods called the Fones Method and the Roll-Stroke Brushing technique, which could be useful in teaching children elementary brushing techniques, however, they are not entirely effective in plaque removal and require graduation from once the individual is capable. But first…

How NOT to Brush Your Teeth: The Horizontal Method

A lot of people brush their teeth in horizontal fashion. Meaning they move the toothbrush left to right, from the posterior teeth to the anterior teeth, back and forth over and over again. Typically the toothbrush is pointed directly at the teeth, without ever touching the gums, which is the first negative part about this technique. Plaque will tend to accumulate near the gum line, so we definitely want to focus in this area. However, it’s just as bad if the horizontal method was carried out while pointing the toothbrush at the gums. This method is one of the leading causes of abrasion lesions. This means that the back and forth motion scrapes away at the gums and causes recession of the gum tissue. And as we said earlier, we want nice healthy gums to be covering the roots of our teeth. In the past, this is the tooth brushing method that was taught, so I hardly blame anyone who still believes that this is the optimal technique. But my dear friends, times have changed. Hand in hand with the idea of brushing your teeth as hard as you can, we now know that this is not the ideal way to brush teeth.

Good Brushing Techniques:

So how DO we want to brush our teeth? Below are three methods of teeth brushing. The three methods may seem very similar, and a mixture of these techniques may be used. The one unifying link between these brushing techniques that I think is an important take-away is the fact that the toothbrush is angled towards the gum line at a 45 degree angle, always!

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  1. The Bass Technique

This is my favorite brushing technique and it is actually one of the most effective because of its ability to remove plaque underneath your gum line, which then helps prevent periodontal infection.

Method: Point the toothbrush towards your gum line (where your tooth and your gums meet) at a 45 degree angle.  Gently put enough pressure so that the bristles of the toothbrush enter the gingival sulcus, otherwise known as the space between the tooth and the gums. Create a vibrational movement using very very short back and forth strokes. You need to do 10-15 strokes per tooth (which is essentially what you pay an electric toothbrush to do for you). The important part is to do this vibrational motion without removing the bristles from the sulcus. After 10-15 strokes, you can move to the next tooth.

  1. The Stillman Technique

Method: This is very similar to bass technique with a slight modification. You will still point the bristles at a 45 degree angle towards the gum and place similar pressure. As you vibrate the toothbrush using short strokes, you move the toothbrush towards the occlusal surface (otherwise known as the top of the tooth). So in essence, you start at the gum line and move towards the tops of your teeth, while moving in this vibrating motion!

  1. The Charter’s Technique

Lastly, the Charter’s technique is used when there is an appliance in the mouth, such as braces!

Method: Think of the Charter’s technique as an inverted version of the Bass Technique. Instead of the toothbrush pointing at the gums, we want the toothbrush bristles to be pointing towards the occlusal surface of the tooth (or top of the tooth). The sides of the bristles should then be pushed up alongside the gums. The toothbrush should still be at a 45 degree angle. Vibrational movements are still used to remove the plaque.

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  1. Modified Versions of Techniques 1-3

The modified versions of all three techniques can be made, wherein one rolls the toothbrush towards the occlusal surface (or tops of the teeth) at the end of each vibrational sequence (Remember, 10-15 vibrational strokes per tooth!).

Brushing Techniques for the Young Learner

  1. Fones Technique

This technique is one of the subpar techniques that can be used to LEARN how to brush, in a very elementary sense, but is not extremely efficient in removing plaque. We teach this technique to children who are just learning how to brush their teeth.

Method: This technique is known as the circular brushing method. A toothbrush is placed on a set of teeth and is moved in a circular fashion a few times, before moving to the next set of teeth. It is important to understand that this method is only meant to be used to introduce people to brushing techniques.

2. Roll Stroke Brushing Technique

Similar to the Fones Technique, this technique is also subpar, but is simple and requires little practice, so it is usually used as an introduction to tooth brushing.

Method: Place the toothbrush towards the gums and swipe towards the occlusal surface of the tooth (the top of the tooth). Continue this movement until all teeth have been brushed.

Common spots you don’t want to miss!

It’s easy to forget about the backs of your teeth, but those are equally important as well. The back of your front teeth are where plaque and calculus tend to accumulate for most people, mostly because this area is so easily forgotten. Brushing the backs of anterior teeth can be very difficult, so here are some images to show how you can achieve the 45 degree angle in such a funky spot. Uncomfortable at first, but like everything else, it’ll fall right into “normal” after a few practice runs. Disclaimer: you have to brush the backs of anterior teeth with an electric toothbrush too!

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So there we have it! Tooth brushing techniques that will save you from needing an electric toothbrush, and the planet from unnecessary plastic.

To learn more about Bogobrush, check out a previous post here.

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Fun Fact: On average, a person should be replacing their toothbrush every 3-4 months. Once the bristles are splayed out, they are less efficient at removing plaque. Conveniently, Bogobrush has a subscription option that will automatically send your next toothbrush at a monthly interval of your choosing. Bogobrush is currently offering TheDebtist readers their first subscription for free.

As always, thank you for supporting those that support TheDebtist.

Bogobrush: Raising social and environmental awareness, one toothbrush at a time.

This post is sponsored by Bogobrush, a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program towards low-income communities, wherein a toothbrush is considered a commodity for the privileged.

In case I can convince you of the importance of choosing the right toothbrush for you and your loved ones, Bogobrush is offering The Debtist readers a special offer (full details below).

There are many folks out there who believe that a dentist’s main purpose is to sell treatment. Numerous patients have voiced to me some past experience or other with dentists who tried to sell them whiter teeth and nicer smiles for the sake of esthetics. So while this may be true for some, it isn’t how I operate or how I practice my work. I would say I fall heavily towards the more conservative side of practicing dentistry. A majority of my time is spent trying to teach patients how to prevent the need for dental treatment, via proper oral hygiene techniques at home and frequent follow ups and dental visits. I like seeing my patients twice a year, if not only to hear how their children are doing at school or how their holidays went. I prefer to think that they enjoy doing the same with me. In general, I am pretty hesitant on agreeing to cosmetic treatment, especially so with treatments such as veneers. When patient’s come to me wanting such treatment, I kindly voice the truth, which is the fact that nothing will ever be as strong (or beautiful) as your natural dentition. Removing tooth structure will always weaken the tooth. Enamel is the hardest part of your body, stronger even than bone. A veneer will possibly pop-off, since it is only bonded to your tooth on the facial aspect, and preparing the teeth for a veneer could cause sensitivity. If the patient is young, in their twenties or thirties, they must consider the likelihood that they will have to replace these veneers 3-4 times throughout the rest of their life. Quite a costly price for a cosmetic fix. Off course, if the patient insists, then autonomy prevails, and I will succumb to what will make them happy, but only after failing to convince them otherwise. To each their own. Some would consider my method a bad business move (because it is), but I didn’t enter the profession for money, so I don’t really have a motive to promote such options.

A majority of my time is spent trying to achieve a patient’s goal via the most conservative path possible. My favorite word during diagnosis is to “observe”. More often than not, the patient will be happiest to. My focus at work revolves around prevention. I would rather teach prevention of caries and other dental problems so that my patients return every six months needing nothing but a cleaning. Easier for me, easier for them. It saves them money, and saves me time, which could be used teaching even more patients the power of prevention. And so the cycle continues.

When I first entered dentistry, I knew that my model would revolve around teaching. I tutored for ten years prior to dental school, and it has undoubtedly shaped my world view about learning. I paid a lot of money going to dental school to learn about dental health care, so that others wouldn’t have to pay a lot of money to care for their teeth. As I volunteered in multiple third world countries, and farming communities within our own state, I learned that empowering is more important than giving. That equipping with knowledge is more important than aiding. It is the idea that it is better to teach a child at an early age how to brush their teeth properly thus empowering them with a life-long skill to improve their health, rather than aid an adult in extracting all their decayed teeth and replacing them with a denture. This is what it means to have TRUE impact that will change communities, even after you are gone and no longer around. I refuse to be a part of cycle that creates further dependency, but rather, prefer to create groups of people who are self-sufficient and independent.

With all of this in mind, there is one thing I sell on the daily. Toothbrushes. And with this came multiple considerations that I felt did not align with my truest of values. Specifically, toothbrushes are created from plastic (most times), which are carelessly disposed of without a thought in the world.

Did you know that 450 million toothbrushes end up in US landfills every year?

Additionally, toothbrushes are usually packaged in clear plastic, but don’t ask me why. And then there is the issue of having multiple toothbrush companies, claiming that they can outdo all other toothbrushes. There are toothbrushes with hard bristles, medium bristles, soft bristles, even extra-soft bristles. There are toothbrushes with different handles, with grips claiming to improve ergonomics, with handles that are bent, handles that are straight. There are electric toothbrushes that move in circular motions, toothbrushes that vibrate left and right, toothbrushes that light up when you’ve brushed for the appropriate amount of time. Worse, there are advertisements, companies, and, let’s face it, some dentists, who sell these different types. I am here to say that while these toothbrushes could aid some groups of people, particularly those with arthritis, or Parkinson’s disease, or anyone else who has difficulty with holding and maneuvering a regular toothbrush, the efficiency of brushing teeth lies mostly in your technique, rather than the toothbrush itself. Sure, a change in toothbrush can get you closer towards increased plaque removal, but so could improving your brushing habits and methods. What if one increases plaque removal by practicing the proper technique? Then we could focus on buying a toothbrush based on other characteristics. Such as sustainability. Such as responsible and local manufacturing. Such as toothbrushes that give back to low-income communities.

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Enter Bogobrush! A toothbrush that is in harmony with many of my values, and one I would be happy to sell. Bogobrush was created with two things in mind: a product that was good for the planet, and for the people who live on it. The masterminds behind bogobrush are a brother sister duo from a small town in North Dakota, whose father was a dentist. The name BOGObrush comes from the idea of Buy One, Give One, a pillar of what Bogobrush is about. With each toothbrush you buy, another is given to someone in need through their partners. Created was a simple way to protect the planet, buy ethically-made, and give back.

Sustainable:

There are two toothbrush options:

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Recycled Plastic: A toothbrush that can be recycled repeatedly, forever. We are taking plastics destined for the landfill and giving them a second chance at life. The toothbrushes are made from recycled plastic number 5, and can be placed in your recycle bin. To facilitate the process, please remove the non-recyclable bristles with small pliers.

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Biodegradable: A composite material made from biodegradable plants, which can be composted at the end of its life. The current design is made from flax, but a new design is in the works for a plant-based material made from hemp! Recycling options include curbside or backyard. If you have a curbside compost bin, simply discard there. If not, you can toss the handle into your backyard compost pile. As organic matter, it will degrade into carbon monoxide, water, and humus (a soil nutrient). As with anything, it may take a few months or a few years to decompose, since the time of degradation depends on the health of the compost pile and is affected by factors such as humidity, temperature, and biodiversity. The bristles are not compostable so please pull them out using small pliers. However, if bristles do end up in the compost stream, they will break down into little pieces with time. Not the best solution, but a step towards the right direction.

Ethically Made:

Despite the higher cost of producing in the United States, these brushes are manufactured here, a sacrifice worth making. It allows for easier communication with the developers, facilitates site visits, and creates more personal relationships with those who source Bogobrush materials. The focus is to have transparency regarding the supply chain, with the knowledge of the who, what, where, and when of each part of the product, down to the bristles!

Giving back:

More than 80 million Americans lack access to adequate oral care.

This statistic can affect aspects in daily living that we take for granted, including education, work, and overall health. Imagine how much less access there is, to something as simple as a toothbrush, throughout the rest of the world. A toothbrush is a privilege, something I’ve learned throughout my journey volunteering in under-privileged communities. This is something we can change. The hope of creating a more balanced world was so important, that the name itself comes from the idea of buy one, give one.

Currently supporting:

  • Covenant Community Care: Detroit, MI. Serving the people of Metro Detroit through six health clinics across the city. They provide medical, dental, and behavioral health care to everyone regardless of their ability to pay.
  • Apple Tree Dental: Twin Cities, MN. Dedicated to providing complete dental care to people throughout Minnesota through its clinics and innovative mobile dental unites. They give away 20,000 toothbrushes annually.
  • Family Healthcare: Fargo, ND. Providing personal, high quality medical and dental care to anyone in the Fargo region, regardless of ability to pay. They also offer significant tools to aide healthful lifestyles.

Minimalist Design:

Admittedly, part of what initially grabbed my attention was the minimalist design. Here they are selling a toothbrush without the frills. Without the batteries, without the lights. A simple design that can be just as effective is always appreciated, in my book.

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Option to purchase a stand, also in a minimalist form.

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Subscription:

Most of my patients are surprised when I tell them that, ideally, we want the toothbrush to be replaced every 3-4 months. A frayed toothbrush has decreased efficiency with plaque removal, and depending on the method of use, a toothbrush can easily fray within a few months. Some tell me that they’ve had their toothbrush for over a year! With Bogobrush, you could subscribe so that a toothbrush is delivered to you every 2, 3, or 4 months. So you’ll never forget. You can also mediate how many shipments you receive. As incentive, the price of each toothbrush decreases with a subscription, in case all the other incentives above were not enough.

As even further incentive, Bogobrush is offering The Debtist readers their first subscription for free. Cancellation is allowed at any time, if you are not satisfied with the product. A link is placed on the sidebar, in case you are interested in making a change. You must subscribe via my personal link below or in the sidebar in order to receive the promotion. I hope you join me in the movement. If I am to support a product, I want it to be a product that will bring both social and environmental awareness into people’s everyday lives. A toothbrush is a product many of us use every day. And we have a choice.

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Thank you for supporting the brands that harmonize with The Debtist’s internal values and external intentions. And thanks to Bogobrush for inspiring me to be a better dentist and a better teacher. Starting today, there will be a series on my blog regarding all things dental, to promote dental education, without the student loans.