The role of oral hygiene: does toothbrushing harm?
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing experimental and in vitro evidence without systematic review methodology
PubMed 24993269 · doi:10.1159/000360379
What was done
This narrative review synthesized experimental and in vitro evidence examining the role of toothbrushing in tooth wear and abrasion, particularly in the context of acid-softened, eroded tooth surfaces.
What was found
The abstract reports no numerical data. Qualitatively, toothbrushing abrasion is primarily driven by toothpaste abrasivity, while the toothbrush acts as a modifying carrier. Intensive brushing can remove demineralized enamel layers on eroded surfaces, whereas brushing after an acid challenge appears to cause less additional hard tissue loss in dentine than in enamel. Brushing frequency, brushing force, and bristle hardness act as co-factors in non-carious lesion development.
Why it matters
It highlights that while normal oral hygiene benefits far exceed wear risks, aggressive brushing—especially over acid-eroded enamel—can exacerbate tooth surface loss.
Limits
The abstract reports no quantitative measurements, sample sizes, or systematic review protocols. Much of the underlying evidence derives from in vitro models, and in vivo effects on eroded dentine remain insufficiently investigated.
Cited by
- supports Tooth enamel is too hard to be damaged or worn away by toothbrushing alone.