The Role of Oral Hygiene: Does Toothbrushing Cause Harm?

Toothbrushing is considered as a prerequisite for maintaining oral health, but might also impact the process of tooth wear, particularly with regard to erosive tooth wear. Principally, the eroded surface of enamel and dentin is more prone to abrasion by toothbrushing than sound tooth surfaces. Toothbrushing conditions, such as time point of brushing after an erosive attack, toothbrushing frequency per day, and brushing force, seem of minor importance, as long as performed under conditions reflecting the clinical situation. The kind of toothpaste seems to be relevant as potential erosion-protective ingredients can be delivered, while on the same time, abrasive particles and other ingredients might impact on the eroded surface and the interaction between active ingredients and the eroded surface. The toothbrush mainly acts as a carrier, modifying the effects of the toothpaste. Most information so far is coming from well-controlled laboratory and in situ studies, limiting the extrapolation in the clinical situation. Based on the current knowledge, toothbrushing to a certain extent can be considered a physiological wear mechanism.