The Real Reason Doctors Can’t Pay Down Their Student Debt

I was sitting at work once (and many times after), talking to colleagues of mine who were all in their early thirties – fairly young by doctor standards. We were talking about student loans (what else?) and how steep the price has become to get an education (in this case dental, but it applies to education in general). We were going through our numbers and they were going through their excuses as to why it was impossible in their situation to pay down debt. Of course, me being me, I gently stated the obvious which was that the real reason doctors “can’t” pay down their student debt was because they thought they deserve more than everyone else.

This statement may hurt many doctors’ feelings, but actually, it’s true.

For example. I had one person complaining about drowning in student debt. He blamed it on the kids and the fact that he is a single income household. Fine. But he also just bought a brand new Tesla SUV. He gets a nanny to watch his kids so that it’s easier on his stay-at-home wife. He gets help (did he say $100k a year??) from his in-laws that is budgeted for the kids. His dining out bill is $800 a month. But he can’t afford his student debt.

Another person also bought a brand new car after graduation, enrolled his 6-month old in Montessori private school, took wild vacations (without travel hacking!), and bought a grand house for their family of three.

Yet another person owns two medical-grade massage chairs in his home, bought his girlfriend a Tesla, and drops $10k on trips around the world.

What if I told you that this story is repeated many times over? I have spoken with my fair share of indebted graduates, especially after releasing my own personal story with ChooseFI.

They all wish to banish their student debt. They also don’t wish to do the work.

Here’s the thing I see most often with doctors. They work very diligently to get through school. They do anything to get to their dream career, including taking out a huge sum of moolah (hell, I did too). They sacrifice the best of their young years. They put off buying a home, earning money, and settling down. Then graduation hits and they think, “I’ve made it.” For a brief second, they breathe a sigh of relief thinking it’s all going to be worth it.

So they buy a new car to celebrate. Then they buy a home or a practice. They go out every weekend for food. Sometimes they dine out a few times a week! They want to live in affluent communities. They want to go on vacation. They throw themselves a dream wedding. They buy nice clothes and expensive Figs scrubs. But more than all this are the little purchases. They want the daily coffee, the trinkets from the $5 section in Target, the happy hour events, the spin class – you know, the harmless stuff.

They become obsessed with the high-life and quite quickly, they refuse to give it up.

And if you think I’m being extreme, I’m not.

Because when I graduated, I wanted all these things, too!

The most excruciating part about facing my student debt, the part that nearly killed me, was realizing that after every sacrifice and sleepless night, after giving up the best of my youth, after working three jobs during school, after wracking my brain on ways to extend $40 for another week, after being a model student, the good daughter, the most loyal employee, the most valuable I could be to the community – the work was still not done.

And when I tell new grads coming to me for advice on making loans disappear that they have to use their beat-up high-school ride, possibly move-in with their parents or take on a roommate, cook dinner every night, manage a budget every week, wear their same scrubs from dental school for five more years, and try their darndest to travel for FREE – well, their faces fall and I can see the disappointment plain as day scrawled on their furrowed brows.

Only thing is, I can’t tell if the disappointment lies in the fact that they have to continue living like a college kid for ten more years or if the disappointment lies in me – because I wasn’t the magic genie they wanted that would grant them their wish.

I can tell you how to repay your loans. You just might not like it.

99% of graduates with more than $350k of debt choose to stay with loan forgiveness. Probably because it hurts the human psyche too much to know that everything you’ve done thus far is not enough.

Becoming a doctor does not end the day you graduate. Not for me. It ends the day everything you need to become a doctor is behind you. Loans included.

Not everyone thinks this way, though. Many people truly believe that the hardship stops the day you get the degree. Ahhh, time to sit back and enjoy the benefits of all our hard work. But how can that be when you don’t even know what a hard-earned dollar looks like?! What makes you better than the rest of ’em?

I know I’m making enemies here but I must pose the question. If not I, who will?

I don’t blame the docs. They were merely children when they signed their lives away for a chance at the American Dream. I blame our upbringing for creating the expectation that a doctor’s life is a rich and easy one. I blame the institutions that are set in place that allow universities to charge this much money to get educated. I also blame lending companies who are handing out loans this large. Child robbery, that’s what I call it.

I implore to all the existing doctors that make it seem like being a doctor is easy. How will we ever change the trajectory if we keep implying to young ‘uns that pursuing this career path will mean they won’t have to work hard for the rest of their life. How will they realize and make an informed decision when the time comes?

I know the real truth.

That behind the facade of wealth is an increasingly long list of medical professionals patiently waiting 25 years for loan forgiveness to hit. Behind every confident thrust of the credit card is an avoidance technique that makes life a bit easier to live. Behind all our heroics and saving lives lies a coward afraid to face our social responsibility to pay back debt that we chose to take out. And behind every accomplishment lies a lifestyle creep that is avalanching too fast out of our reach, propelling doctors further forward towards an unsustainable way of living.

The real reason doctors “can’t” pay back student debt is because they won’t.

They choose not to work hard anymore. It isn’t burn-out, although that stuff is real too. It’s the social expectation that a doctor’s life is breezy. The mindset to pay back debt just isn’t there. Many cannot accept that graduation is not the end-game. They think they already won.

There will be excuses. I don’t buy any of it.

There will come a day when I will finish my loan repayment journey, and people will think it’s a miracle. They’ll think I was one of the lucky ones, rather than a penny-pinching maniac. Perhaps the stars aligned and the pandemic gave me this “unique” ability to pay back loans faster because I was not being charged interest for six months. My parents must have helped me out. An investment strategy probably worked out for me but not them. I can’t wait to see the excuses they make. But none of that will be true.

My current car is a high-school ride that I’ve had for 13 years. The passenger’s rear-view mirror doesn’t match, because when someone broke it (probably to re-sell it), I didn’t want to pay an extra $60 to get one that was white when the stock color was black. Mike even helped me put it on the car myself because I didn’t want to pay a service fee at the auto shop. My neighbor came out of his garage this past week and looked at me funny when he saw me physically hand-washing my car. He said, “That’s … nice…” and walked away slowly.

I sometimes have to wipe graffiti off my windows, because I chose to live in a lower income neighborhood so that I could buy a business storefront AND a dwelling at a very low price. Last Friday night, it was getting ratchet at the club next door since they moved the party outdoors due to COVID restrictions. I’ve had to run away from my own home before when the riots first started and they fired fireworks at the cops.

I spent a third of last year working midnight shifts. I still wear my USC scrubs that I was forced to buy upon entering dental school in 2012. I run with the Nike’s that my husband bought me as a gift when I was attending dental school so that I could “be cool”. They used to be orange but now they’re mostly black. I sell my de-cluttered stuff on Poshmark. I research heavily in order to travel the world for FREE. I come home from work to work. I still actively budget every week. I aim to spend only $200 a month in groceries for the two of us and $150 a month in dining out. I created a lifestyle where my job is three blocks away, to reduce the gas I have to buy. TO REDUCE THE GAS I HAVE TO BUY. I spent my last birthday repainting our bathroom. We spent Mike’s birthday picking up birthday freebies. Heck, even our cat was free.

Do you know the real reason THIS doctor can pay off student debt?

Hard work and a willingness to.

It’s not rocket science.

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A Minimalist Mouthwash

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.

When it comes to mouthwash, I am unabashedly not a big fan, for multiple reasons. One unfortunate thing about mouthwash is the packaging. Always packaged in plastic bottles, it’s enough to make any zero-plastic-user cringe at the sight. Secondly, some mouthwashes contain more than 20% alcohol. Think of the strong smell that you experience when you open a bottle of Listerine. How about the burning sensation you feel when you swish the solution around, waiting for the moment that you could spit it right back out? That’s the alcohol’s doing. Sometimes, the alcohol can be a bit strong for the gums, and I would typically suggest choosing a mouthwash that is labeled “alcohol-free” for a gentler rinse. Additionally, the health benefits of mouthwash are disputed in the dental community. Some claim that people who rinse with mouthwash more than three times a day increase their chances of oral cancer. Some say it slightly elevates blood pressure. While I am not sure whether I completely believe those two claims, when it comes to protecting your teeth from cavities, many dental professionals agree that mouthwash doesn’t come close to the effectiveness of a toothbrush or floss. While it gives people that false sense of confidence in their oral health, mouthwashes arguably only temporarily improve one’s breath. And lastly, they’re expensive! As a frugalist, a recurring cost for a mouth rinse with limited pros does not really jive with me. In general, I do not find that the pros of using mouthwash outweighs the cons.

I treat people in a low-income community, mostly, and when they come to me looking for mouthwash advice, I give them a recipe for a minimalist one. No surprise here. What IS a surprise is when I tell them that I do not buy mouthwash myself, and that my rinse of choice is nothing more than warm salt water, twice a day, swished for thirty seconds. Salt water rinses are great especially for the gums. It is my first line of defense whenever I see gum inflammation. I liken it to how salt water at the beach can heal the skin. So what makes it so great?

HEALTH BENEFITS OF A SALT WATER RINSE

It works by increasing the pH balance of your mouth. Bacteria likes to multiply in acidic environments, so by making the oral cavity more alkaline, we are making it more difficult for the bacteria to survive. This includes the bacteria that make our breath smell bad in the first place!
It is not irritating to mucous membranes, because it has a similar concentration of salts and minerals as our bodies do.
It is affordable and accessible to ANYONE.
It’s simple to make (see recipe below).
It is more widely embraced, especially when treating people who prefer holistic, natural methods. Not everyone wants a prescription for an anti-microbial rinse when they come to you looking for advice regarding puffy gums. Some are just searching for better oral hygiene practices, and maybe a rinse recommendation.

FAQs

“Doesn’t the salt abrade the teeth?”

Well, this is why warm water is important! Once salt is added to warm water, it dissolves immediately and we don’t have to worry about the grittiness of it. Our enamel stays safe.

“But how does it improve my breath?”

It works by reducing the bacteria that causes bad breath in the first place. Some patients complain that they don’t feel as if they’re breath is “as fresh” as when they use Listerine. I think that’s what makes people return to these mouthwash companies. But “fresh smelling breath” does not necessarily equate to a healthy mouth. It’s an illusion. When I ask people what fresh breath smells like, they say “minty”. When I ask them what fresh breath feels like, they say “cool” or “cold”. Neither of these are natural. They are socially taught. They are also very strong habit-forming experiences. Mouthwash companies want you to keep returning to their product. So they essentially make a product that, when it is missing from your life, is blatantly missing. Getting used to being without store-bought mouthwash takes time but once we’ve gotten that expectation of cool, minty freshness out of our minds, it becomes a simple matter of moving our point of reference. I have had people return and say that once they’ve gotten used to warm salt water rinses, they now view Listerine as “excessively strong and pungent”. Which it is. I remember the first time I ever tried mouthwash. I had that burning tingling sensation, and watering eyes. I was probably in my late teens. Over time, I’ve gotten immune to that feeling, expecting it even. It’s what makes people feel like they have a clean mouth, when in reality, they may not.

“Do I need to rinse my mouth at all?”

If you were using store-bought mouthwash, I would say it’s debatable, because I am not sure of its efficacy. But I do recommend salt water rinses twice a day for EVERYONE, to keep up with your gum health. Brushing and flossing will ultimately, still, be the best for your teeth.

A MINIMALIST MOUTH RINSE

Dissolve 1 tsp. of salt in 8 ounces of warm salt water. Swish for 30 seconds, twice a day, morning and night. Voila!

OVER -THE-COUNTER MOUTHWASH

There are two types of mouthwashes, generally speaking, which can be bought over the counter: Cosmetic and Therapeutic. If you wish to buy a therapeutic mouthwash, check the ADA’s site for a list of mouthwashes that have been granted an ADA seal. Look for this seal when perusing your store’s shelves. If you wish, you may seek out mouthwashes with the following ingredients:

Cetylpyridinium Chloride;
Chlorhexidine;
Essential oils;
Fluoride;
Peroxide.

These ingredients are found in therapeutic mouthwashes. Additionally, I would opt for mouthwashes that contain no alcohol. It is also important to note that mouthwash is not recommended for children under 6 years of age.

So there you have it. My quick, holistic, minimalist, zero-plastic, frugal, professional two-cents on mouthwash.

Getting to Know: Cat and Chrystle Cu of Cocofloss!

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

Cocofloss is a product created by the sister duo, Cat Cu and Chrystle Cu. Cocofloss is a fun (and highly effective!) floss that is bridging the gap between a socially perceived arduous task, and a walk on the beach. Their vision imagines a future where everyone can keep their teeth for the entirety of their lives! Their reach is on the global scale, helping those at home develop good preventative oral hygiene habits, as well as those outside our borders, who may not have access to the tools and education needed to maintain a healthy smile. The truth of the matter is, flossing is not exactly exciting stuff… until NOW!

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Who are the imaginary minds behind Cocofloss?

I’m Cat, and I started Cocofloss with my sister, Dr. Chrystle Cu! My sister is a tooth geek, philanthropist, and preventative dentist who graduated from Wellesley College and the Arthur A. Dugoni School of Dentistry. I’m an entrepreneur, yoga-addict, and art-lover. I studied engineering at Stanford and worked in finance, art, and tech before joining forces with Chrystle to start Cocofloss.

What was the inspiration behind creating Cocofloss?

Chrystle is very prevention oriented – she’s that dentist who spends an hour educating each patient about their teeth and gums – and Cocofloss embodies her dream to make taking care of your smile more effective and fun. Chrystle’s dream is for everyone to be able to keep their teeth for life.

I love how Cocofloss is geared towards making flossing a fun experience! What are some of your favorite aspects of the product?

I love the Caribbean-blue floss color. It evokes freshness and blue oceans full of possibility. And of course, it’s functional! Folks can see their progress flossing as plaque contrasts against the blue threads.

Which one is your favorite flavor? Are there any limited editions to try?

Watermelon! Just launched this summer as a limited run.

What are ways that Cocofloss can incentivize people to develop good flossing habits?

Cocofloss delivers a flossing experience that’s both rewarding and fun!

When I ask a lot of young patients if they have been flossing, their main excuse is, “We ran out of floss in the house”. Tell us more about your 6 month floss plan!

Would you floss tonight if you knew more floss would be arriving tomorrow? Customer behavior suggests so!

If you guys have ONE piece of pro tip for people who can’t get into flossing, what would it be?

Flossing is an acquired taste. Floss daily for 21 days (the number of days it takes to create a habit) with Cocofloss and soon enough you’ll begin to crave it.

Would you care to share some of your favorite flossophies?

Our flossophy:

Bliss is a life lived in balance – take an adventure and enjoy the familiarity of home, take something and give back something, set big dreams for the future and enjoy improvisation also, eat your cake and don’t forget to floss too!

I notice that you guys love to travel, just like me! I think it’s especially important that you’ve linked travel with having floss with you, all the time, when you’re on the go. Any tips on how to remember to floss during times when we are busiest and most on the go?

Keep floss in your bag so that you can floss whenever you feel like it and don’t be embarrassed to floss on-the-go! I’m often that awkward human flossing in public or on-the-go.

How is Cocofloss making an impact on a global scale?

We’d like to inspire folks to keep their teeth for life around all corners of the globe. To name a few, we’ve donated Cocofloss to communities in the Caribbean, the Philippines, and Mexico. The worldwide floss party is just getting started.

—————

I was born in the Philippines, so I share a connection with your mission. I, myself, personally returned home to Manila to give free dental care for a week. Can you share any insight as to how your experience was?

Chrystle:

The global tooth decay epidemic is so painfully real. What people need most is prevention and nutrition education. Unfortunately, sugar is used as a universal rewards across all cultures. We need to shift the way people think about rewards, and instead educate and reward with preventive tools like Cocofloss.

More on Philippines mission trip here (happy to discuss more also): https://cocofloss.com/blogs/cocofloss-life/a-note-to-the-kids-in-bohol-philippines

How do you envision making preventative dental care attainable to all groups of people?

We’re using the internet and social media as vehicles for prevention education. Our Cocofloss website has free education for all, and we’re on a mission to make flossing something everyone looks forward to daily.

Where will Cocofloss go next?

We have big plans to help folks find their smile wherever they go. Stay tuned!

A sincere thank you to Cat and Chrystle, who took the time to talk about what Cocofloss has to offer. If you’d like to read more about my personal experience with Cocofloss, check out my review here!

On Trends: Charcoal Toothpaste

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!

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!

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!

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).

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.

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.

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.

The Debtist

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.

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!

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.

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!

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.

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

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!

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.

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.

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