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Comment by SAI_Peregrinus | Hacker News Reader

There are prescription-only high-fluoride toothpastes. Excessive fluoride (more than you can get from Act + normal fluoride toothpaste) can cause fluorosis, which ends up being bad for the teeth. Normal amounts of fluoride are good for the teeth. The prescription-only toothpastes have enough that you don't want to use them regularly for a long period. As with most things, the dose makes the poison. Some dentists prescribe them even when they're not needed, since it won't be harmful to use a tube of the stuff every year, or even every 6 months, and it's profitable to them.

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I got high fluoride toothpaste when I was a kid. Turns out, I just didn't know how to brush my teeth properly.

  1. Floss first (!!!)
  2. Use *any* electric brush
  3. Spit, but don't wash out with water
  4. Use fluoride mouthwash

Is there any research/literature on this? A couple years ago I read that the "correct" order was mouthwash -> floss -> brush.

Really good question.

I personally treat it like gym: it's most important that you do it, not so much in what order or even how well.

I think the most important thing is to make sure your process leaves a fluoridated product in your mouth at the end. You want the fluoride to stay on your teeth for 30 minutes.

I thought it was floss -> mouthwash -> brush, but either way brush was always last because the toothpaste fluoride is what you wanted left on your teeth at the end of the process with the mouthwash serving as a base layer.

I have heard of Step 3 too, but shouldn't we bit at least a little bit concerned about the fluoride calcifying our pineal gland? I know some people might take my last sentence and think it's woo-ey but if you search it up, basically it seems like there's nothing conclusive one way or another.

I’m 40, have virtually never flossed, and I’ve never had any cavities or other tooth problems. I honestly wonder about the whole flossing and cleaning ideas.

That sounds like decent sized gaps between the teeth, wide jaw, not eating a ton of (sweet) stuff that gets stuck, etc. Or just lucky genes in general. YMMV.

E.g. there are many examples of people chain-smoking until the ripe age of 90+ and never having lung problems, but that does not invalidate the other 95% of the bell curve.

You don't need to floss but parodontitis is unavoidable if you don't use dental bristles.

You probably have the mouth bacteria that doesn't cause cavities and don't consume litres of acidic drinks every day?

It really depends on your teeth layout.

If you are lucky enough to have very straight and packed teeth, there is very little room between your teeth for any food to be lodged in. I used to never floss then one day I tried it and it took me 3 weeks of flossing before the wire came out clean and odorless.

> Some dentists prescribe them even when they're not needed, since it won't be harmful to use a tube of the stuff every year, or even every 6 months, and it's profitable to them.

How is it profitable for them? If I get a prescription from my dentist and fill it at a pharmacy, how does my dentist make extra money from that transaction?

Once the sales rep is happy with your performance pushing product, you get invited to expenses paid conferences in the tropics.

1. That is something that has happened. However, it is highly illegal and it is regularly prosecuted.

2. You can go here and look up any payments (cash or otherwise) from pharmaceutical companies to your doctor. All payments over $13.82 are reported.

https://openpaymentsdata.cms.gov/

3. Even if the dentist’s drug rep was interested in committing a felony. Fluoride toothpaste doesn’t have enough profit margin to send dentists on expenses paid international vacations. We’re definitely not talking about enough money to risk jail time.

4. Most physician groups and hospitals prohibit taking money from pharmaceutical companies or at least low limits.

5. My wife is a physician and most of our friends are physicians. No one that either of us knows has ever gone on drug company sponsored conference trip.

6. I always check my physicians and dentists on the open payments site. I’ve never seen any of them taking more than a few bucks for meals.

I find it extremely hard to believe there's a sales rep for my generic-branded fluoride toothpaste, and even more hard to believe that there's one sending my dentist on vacations.

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