Ancient chewing or cleaning sticks probably represent the forerunners of today's toothbrushes. Descriptions of their use can be found in both the gospel of Buddha and ancient Egyptian writings. The concoctions used to clean the mouth, decrease malodor and treat the gums in early writings often were more detrimental than preventive. For example, in the writings of Pliny (23-79 C.E.) several remedies are mentioned: burnt nitre (potassium nitrate) to restore whiteness; goat's milk to sweeten the breath; burnt stag's horn and ashes of various animals for strengthening the gums, etc.1 Many different remedies have been proposed for improving the conditions found in the oral environment, and one may even go so far as to call these unpleasant concoctions the first dentifrices. Two basic components of oral hygiene have passed the test of time and, although modified and improved, have their roots in ancient times. These components are both the bristle toothbrush and the dentifrice used in conjunction with the brush. Primitive cleaning sticks of different types still exist today and are the brush of choice in some cultures; although the modern day brush has evolved into a skillfully designed multi-tufted product. The manual brush continues to be improved in ways that enhance both function and performance. Power brushes are also available that move the bristles in many directions. These include versions with either oscillating-rotating or sonic movements. Improved tooth cleaning, coupled with excellent safety profiles for these products, makes them important developments for efficiently delivering fluoride, as well as other key ingredients, to targeted tooth surfaces. Dentifrices have also changed dramatically from the predominantly acid concoctions of the past to more basic or neutral products. This was the result of the acceptance of Miller's acidogenic theory of caries formation which helped promote the change from acidic to basic formulations.2
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