Hard toothbrushes are not indicated by dentists only some smokers patients like it ,considering it can remove the stain.

Used for cleaning dentures.

I think there is no need of hard tooth brush as for teeth cleaning only slight pressure and soft or ultra soft toothbrush with a mild dentifrice is sufficient.

Hard toothbrushes are not recommended by dental hygienist. Users of hard bristled brushes usually omit the areas which need brushing the most: near the margins of the gingiva. This omission is because the hard brush "hurts" the "gums" when the toothbrush touches the area. When these areas are not cleaned daily, the results are excessive growth of bacterial chains which produce gingivitis and can progress to periodontal disease. This in turn, is a major cause of tooth loss and contributes to foul breath odors.

People who are used to using hard toothbrushes are usually "hard" to convert to soft toothbrushes. To those patients, I ask: Do you bathe your body with a soft w cloth and does your skin feel clean thereafter? Then, why would you use a hard brush to "try" to clean one of the most sensitive areas of your body?

Hard brush users usually present with somewhat clean teeth on the facial areas of their front teeth. But when all surfaces are visually/radiographically examined beyond that point , the "norm" is calculus "build-up" accompanied by some degree of periodontal disease,.

The chief area of concern where dental clinicians are concerned are the marginal and submarginal areas where disease progresses if the areas are not cared for.

Even if, brushing technique is optimal, I don't encourage my patients to use the hard brushes because they can lacerate gingival tissues and my belief is that whereas specific bacteria is found in the body in specific areas, why through tissue laceration , introduce bacteria naturally found in the mouth--into the blood stream? that might be a controversial point; but, it's practical. Proper use of soft brushes reduce trauma to the gingiva and promote dental health.

I agree with all the above statements. The hard brush doesn't hug the tooth shape and misses plaque while traumatising gingiva. The difficulty is getting supermarkets to stock only soft brushes. When asked, they insist that their choices are consumer driven. When consumers are asked, they complain that the supermarket doesn't stock small headed, soft bristle toothbrushes at reasonable prices or at all. My investigations of random supermarkets confirms this.

Although the soft tooth brushes are best when used with dentifrices, the hard tooth brushes can be used without dentifrices (tooth paste) especially in between meals during outdoor activities or in offices. They can be a valuable cleaning tools at these places. It is not tooth brushes which are harmful but it is abrasive quality of dentifrices and brushing technique which are deteriorating to tooth structure and periodontium. It might be a good topic for research.

@Dr Sabir, Sir, Assalamalaikum. I do agree with you. It's brushing technique and the abrasiveness of toothpaste, which has maximum role in abrasion of tooth surface. However, hardness of bristles do play a role in causing gingival recession. I think everyone here will agree that gingival laceration is very likely to happen with hard toothbrushes, even if the brushing technique is correct.

Hard toothbrushes without dentrifice can be used in the way described above by Dr Sabir, but still it is difficult to avoid trauma to gingival tissue, that results initially in transient bacteremia and gradually in gingival recession. Soft brush is again a better option in these circumstances too. They can be used without dentrifices, without need of extra force to adapt bristles into embrasures. I really can't see any need to manufacture toothbrushes with hard bristles.

I'll be grateful if anyone can tell me, if any authority like WHO, FDA, ADA, or American Association of Periodontology has recommended use of hard toothbrushes?

I think soft brushers are the most indicated. Also warning to the toothpast with flor it, s very dangerous. Tgere are a lot of toothpast from plants very healthy.

During mechanical oral hygiene performance which means the use of a toothbrush and dentifrice plus dental flossing, frictional and abrasivel properties have two sources one is the toothbrush bristle and the other is the toothpaste abrasive ingredients , the former is much likely to produce gingival recession and the latter producing tooth wearing defects like abrasion, when used inappropriately. I strongly agree with the general use of soft or extra soft multi-tuft toothbrushes which are being used and advised worldwide but there seems to be one apparent indication for the hard toothbrush. Patients with idiopathic gingival enlargement or fibromatosis as well as the hereditary form of it, have characteristically thick, enlarged, and fibrotic gingiva are those who benefit from pressure applied by customized gingival stents in order to prevent or delay the recurrence of gingival mass, and also pressure applied by regular use of a hard toothbrush and the indication is not for the purpose of oral hygiene but the gingival overgrowth. These patients usually use a soft toothbrush for the purpose of plaque control and a hard bristle brush for the purpose of gingival compression and pressure.

Dr Radafshar, thanks for sharing your views. Have you any first hand experience of patients with above mentioned conditions getting benefit from using hard toothbrushes. If really working, then it will be very useful adjunct to customized gingival stents.

Dr. Abdul Ahad, yes I do have experience with treatment of gingival overgrowth. During my residency program I was treating a patient with idiopathic form of gingival fibromatosis to whom aside from resective surgeries and customized stents, we instructed using a hard toothbrush and how to apply lateral pressure with the side of bristles on the marginal and attached gingiva while giving rotational movements to the toothbrush head. Unfortunately, there is no long-term follow up document rather than six months for the above-mentioned case but the concept is to exert pressure on the tissues during the day when stents can not be used.

I think the soft tissue brush is the highly recommended one but some heavy smokers patients prefer using the hard brush to remove the stains and they feel better cleaning their teeth as they said when came to our hospital. So, i explain the harmful effect of these brushes on teeth and gingival tissues and try to convert them to soft brushes. that is why the hard brush being in markets until now as many customers thought it has a better cleaning effect!!!!!