It’s time to take a fresh look at tooth brushing.

First, do these statements sound reasonably solid or familiar?

• Everybody brushes their teeth daily
• Dentists and dental hygienists agree on how to brush
• Certain toothbrushes are better than others
• Dental treatment reduces oral disease
• Teaching tooth brushing leads to tooth brushing
• Plaque is the cause of tooth decay and erosion
• Tooth brushing is a limited personal experience
• Tooth brushing techniques and technologies are continually improving
• As you probably guessed, we are going to challenge these assumptions.

Tooth brushing as an isolated activity

We view tooth brushing as an individual and linear process. Each one of us purchases our own preferred toothbrush; we habitually stand alone in front of the mirror and brush however we want, for as long as we want and as often as we want; and after a few months we throw the brush out.

Occasionally we are motivated by our dentist or hygienist. Mostly we feel satisfied with our effort – and rightly so. Apart from the clean feel (in no small measure due to various “freshening” ingredients in the toothpaste), tooth brushing is an extremely effective way of controlling the oral bio-film and oral disease. Not all oral disease. You still need to stop smoking to reduce periodontitis and prevent oral cancer. Eat sugars less frequently to avoid tooth decay. Drink less acidic beverages to minimize tooth erosion. Nevertheless, currently, tooth brushing is the most basic means we have to take personal responsibility for our oral health.

The bio-film (“plaque”) in our mouths is a tenacious mass of different types of microbes working together to proliferate and stay put. The longer the bio-film is left unhindered, the more pathogenic it becomes and the more damage it does to the tissues. Brushing forces a plaque-restart and that is why daily brushing is so effective at preventing a range of conditions from halitosis (bad breath) to gum disease and tooth loss.

To be even more effective at removing bio-film, we need professional guidance with accessories such as inter-dental brushes or tooth-picks, dental floss, tongue brushes, electric brushes etc. However, in terms of manual tooth brushing, technology and technique have gone about as far as they can go. As long as you brush for at least 2 minutes, cover all areas of teeth and gums, don’t forget the tongue, brush gently and use soft bristles – you’re doing a good job. No particular technique or brush has been shown scientifically to be more beneficial. It’s really whatever works for you.

Tooth brushing in a planetary context

So far I’ve said nothing new. Manual tooth brushing has been nailed as a routine activity, and not much has changed for a number of decades.

However, there is a bigger picture than the one we see in the bathroom mirror each time we brush. In recent times we have internalized the understanding that many simple daily choices have ramifications, and we have changed our habits accordingly. For example, many of us: separate trash; use products manufactured free of child labor; don’t wear fur; eat free range poultry; take canvas bags with us to the supermarket…

Consider the broader environmental and social contexts of tooth brushing, and you find two huge problems with toothbrushes:

1. They leave a footprint. 5 billion hard plastic toothbrushes are produced every year, and most of them end up in landfills or in the oceans. Forever. We dispose of our toothbrushes as if the planet is not our home.
2. Not everyone has one. Many people living in remote rural regions of the world don’t have a toothbrush, and they are also the ones who don’t have access to any form of dentistry. Their diet is becoming sweeter, thanks to infiltration of western food products, but they don’t have the knowledge or means to deal with the resulting tooth decay. The result is often pain, tooth loss, missing school or work, disability, and impaired psychological and physical development.

These are two problems that we, in the developed world, have generated, and until now, have not addressed or taken responsibility for.

The sustainable alternative

Humble Brush is a toothbrush with a vision. The company was founded by a core group of young dental professionals who understood that we must change the way we look at tooth brushing.

As a young dental student, Noel Abdayem joined a group of dental volunteers who were in Jamaica treating and alleviating the pain of kids afflicted with tooth decay. After the difficult experience of having to extract decayed permanent molar teeth in children, Noel returned to Sweden and founded Humble Brush, with the aim of providing everyone on the planet with the means to prevent suffering and disability caused by an oral disease.

The 3 beacons that continue to guide Humble Brush’s efforts are:

Oral Health Care

Humble Brush produces ergonomically Swedish designed toothbrushes with soft bristles that allow optimal bio-film control without damaging the tissues.

Environmental Sustainability

The brush handles are handcrafted from panda-friendly, anti-bacterial, and bio-degradable bamboo.

Social Impact

Humble Brush is the main sponsor of the Humble Smile Foundation, which administers oral health outreach projects targeting the most vulnerable children around the world. In order for the impact to be sustainable, the program entails much more than just handing out toothbrushes. Educating about oral health has also been shown to be of little value. Dental treatment too doesn’t impact dental disease – if anything it contributes to further disease.

What’s needed are preventive oral health interventions, that include changes to the daily routine such as monitored tooth brushing and modification of the amount of sugar in the diet. Healthy behaviors and lifestyles developed at a young age are more sustainable throughout life. Other interventions that aim to promote and facilitate long-term sustainable improvements include tackling upstream factors, and the environment, that causes poor oral health and create inequities. In particular, water fluoridation is one of the most cost-effective public health measures to improve dental health and reduce inequities, as is removal of taxes for oral health products. The Humble Smile Foundation is committed to developing and strengthening the capacities of local non-dental health personnel through education and training. The advantages of such a capacity-building model are that it integrates oral health within general health, has the potential to strengthen the existing local healthcare system and enables sustainability as the trainees become trainers etc.

In order to allow consumers real freedom of choice to be part of the Humble vision, the retail price for Humble Brush is comparable to plastic toothbrushes, so we can all choose to make a difference without paying more. One of the first questions I asked Noel was how does Humble Brush manage to offer hand-made bamboo toothbrushes at a competitive price? The answer was quite enlightening: their approach to spreading the Humble vision relies less on traditional (expensive and noisy) marketing strategies such as advertising, and more on giving credit to consumers’ environmental and social awareness.

So, now we can all humbly make a difference.