Addy M, Hunter M L
Division of Restorative Dentistry, Bristol, UK.
Int Dent J. 2003;53 Suppl 3:177-86. doi: 10.1111/j.1875-595x.2003.tb00768.x.
Circumstantial evidence based on anecdote, case reports, epidemiological data and studies in vitro and in situ implicate tooth brushing with toothpaste with tooth wear, gingival recession and dentine hypersensitivity. This review attempts to assess the clinical significance of the potential harm produced by this most common oral hygiene habit. The toothbrush alone appears to have no effect on enamel and very little on dentine. Most toothpaste also has very little effect on enamel and in normal use would not cause significant wear of dentine in a lifetime of use. Wear of enamel and dentine can be dramatically increased if tooth brushing follows an erosive challenge. Gingival recession has a multi-factorial aetiology and certain individuals and specific teeth may be predisposed to trauma from tooth brushing. Tooth brushing is known to cause gingival abrasions but how these relate to gingival recession is not known. The role of toothpaste in gingival abrasion and recession surprisingly has received little if any attention. Gingival recession most commonly exposes dentine and localises sites for dentine hypersensitivity. Some toothpaste products can expose dentinal tubules but erosion is probably the more dominant factor in dentine hypersensitivity. There is no evidence to indicate that electric and manual toothbrushes differ in effects on soft and hard tissues. It is only under, over or abusive use or when combined with erosion that significant harm may be thus caused. In normal use it must be concluded that the benefits of tooth brushing far out-way the potential harm.
基于轶事、病例报告、流行病学数据以及体外和原位研究的间接证据表明，使用牙膏刷牙与牙齿磨损、牙龈退缩和牙本质过敏有关。本综述旨在评估这种最常见的口腔卫生习惯所产生的潜在危害的临床意义。单独的牙刷似乎对牙釉质没有影响，对牙本质的影响也很小。大多数牙膏对牙釉质的影响也很小，在正常使用情况下，一生使用也不会导致牙本质明显磨损。如果在受到侵蚀性刺激后刷牙，牙釉质和牙本质的磨损会显著增加。牙龈退缩有多种病因，某些个体和特定牙齿可能易受刷牙创伤。众所周知，刷牙会导致牙龈擦伤，但这些与牙龈退缩的关系尚不清楚。令人惊讶的是，牙膏在牙龈擦伤和退缩中的作用很少受到关注，如果有的话。牙龈退缩最常见的情况是暴露牙本质，并使牙本质过敏的部位定位。一些牙膏产品会暴露牙本质小管，但侵蚀可能是牙本质过敏中更主要的因素。没有证据表明电动牙刷和手动牙刷对软硬组织的影响有所不同。只有在使用不足、过度或滥用，或与侵蚀结合时，才可能造成重大伤害。在正常使用情况下，可以得出结论，刷牙的好处远远超过潜在危害。
