Toothbrush, Dental Floss, and Water Flosser: What is the Correct Way to Maintain Oral Health? - Minority#
#Omnivore
Highlights#
Brush as needed, at least twice. ⤴️ ^9b766734
I need to brush my teeth twice now.
Recently, while browsing through my favorite food blogger Su Dongpo's "Dongpo Collection," I came across a passage: "After each meal, rinse with strong tea, and the annoyance will go away... Gradually, this leads to a firm and dense state, and decay is avoided." Isn't this a form of ancient oral health education? Ancient people summarized their experiences through observations of daily life, which, though simple, contained profound wisdom.
In contrast, nowadays, with the improvement of living standards, people's attention to health has also increased. However, there is also a trend of over-reliance on commercial products. The market is flooded with various oral health products, from ordinary toothbrushes to high-tech electric toothbrushes, from mouthwash to "cure-all" toothpaste. The advertisements for these products are everywhere, and their promotional effects are becoming stronger. It seems that as long as these products are used, one can stay away from oral diseases.
I have always adhered to a philosophy that moves from "principle" to "method." If you grasp the principles, the methods can be very flexible. You don't need to be entangled in the pros and cons of certain tools and methods; as long as you can achieve the same effect, you can choose what suits you best. Therefore, I want to write an article about oral health and hygiene to discuss its principles, methods, and misconceptions in detail.
In addressing oral health, we first need to understand what cleaning and protection really mean, and then explore what methods and tools to use.
In this article, I want to address three main questions:
- Who is our "enemy"?
- Where is our "battlefield"?
- How should we choose our "tactics and weapons"?
Our Enemy - Dental Plaque#
Structure of Teeth#
To better understand the following content, I will briefly introduce some terms related to teeth and periodontal tissues.
Teeth#
Our teeth are mainly divided into two parts: the crown and the root. The crown is located in the oral cavity, and generally, the part of the tooth we can see is the crown. The root is located within the gums and bone, serving to anchor and support the tooth. The crown is further divided into five surfaces: the surface closest to the lips and cheeks is called the labial/buccal surface (outer), the surface closest to the tongue is the lingual surface (inner), the surface that makes contact during biting is the occlusal surface (top), and the surfaces adjacent to other teeth are called proximal surfaces.
Periodontal Tissues#
Most of the root is located within the bone, which we refer to as the alveolar bone. The pink, fibrous tissue that wraps around the alveolar bone and part of the tooth surface is called the gums. There is a thin membrane between the alveolar bone, gums, and teeth that serves to connect, nourish, and buffer; this membrane is called the periodontal membrane. The alveolar bone, periodontal membrane, and gums are collectively referred to as periodontal tissues.
Diagram of Tooth Structure
Oral Defense System#
The oral cavity itself has a very complete defense system.
I wonder if anyone has observed that most areas inside our mouths are made up of very smooth mucosa (pink, moist tissue). It is similar to skin and serves as the first line of defense for our oral cavity. When intact, it can directly resist the invasion of pathogenic microorganisms (mainly bacteria). At the same time, its smooth surface minimizes the accumulation and adhesion of food debris, cutting off the supply for bacteria to survive.
In addition to the physical barrier, saliva also plays an important role. It contains various antibacterial components, such as immunoglobulin A (IgA), lysozyme, and lactoferrin, which can inhibit or destroy microorganisms. Saliva also has a buffering effect, helping to maintain the pH level in the oral cavity and preventing the formation of an acidic environment, which is a key factor in inhibiting bacterial growth. Furthermore, the flow of saliva helps to clean the mouth, washing away food debris and microorganisms.
Additionally, the normal bacteria in the mouth can inhibit the growth of pathogens through competitive exclusion. The submucosa of the oral cavity contains immune cells, which are part of the immune system and can respond quickly when pathogenic microorganisms invade.
Thus, for bacteria, the survival conditions in the oral cavity are very harsh, and they face two urgent problems:
- How can they survive?
- How can they cause destruction?
The second problem is essentially the same as the first.
As a result, these pathogenic bacteria gather together and brainstorm. Some clever bacteria suggest:
"Why don't we form an alliance?"
"Send out an advance team to establish a few outposts."
"Then mobilize the main forces."
"Everyone work together, each doing their part."
"Grow strong and create glory again."
Dental plaque was born.
Dental Plaque#
Formation#
Although teeth are the hardest organs in the human body, they are a weakness in the eyes of oral pathogenic bacteria.
Initially, some bacteria (such as early colonizers from the Streptococcus genus, particularly Streptococcus mutans) adhere to the surface of the teeth by utilizing some proteins in saliva and food debris. Once these "pioneer bacteria" establish themselves on the tooth surface, they begin to produce extracellular polysaccharides. These polysaccharides not only help more types of bacteria adhere to solid surfaces and other cells but also provide additional protection for microorganisms. In some cases, extracellular polysaccharides can even serve as a reserve of energy and carbon for microorganisms to use when nutrients are scarce.
Building on this, a second batch of bacteria (including Porphyromonas gingivalis, Actinomyces, and Fusobacterium) begins to form more complex structures on the tooth surface. Over time, this structure becomes more layered and complex. At this stage, different bacterial communities communicate through physical and chemical signals, adjusting their metabolism to adapt to the environment. Ultimately, a mature and stable structure is formed—dental plaque.
Diagram of Dental Plaque Structure - "Oral Biology" 5th Edition, People's Health Publishing House
Dental plaque acts like a pioneer camp; once formed, it is very difficult for our body to rely on its own strength to eliminate it.
Why does dental plaque mostly adhere to the surfaces of teeth and the junction with the gums, rather than accumulating on the mucosa?
- Different surface characteristics: The surface characteristics of the oral mucosa are very different from those of the tooth surface. Teeth provide a hard and relatively smooth surface, which facilitates the formation of dental plaque. In contrast, the mucosal surface is softer, making it less conducive to the tight adhesion of dental plaque.
- Continuous cell renewal: Oral mucosal cells continuously renew and shed, which helps prevent bacteria from establishing stable growth and forming dental plaque on its surface.
Harm#
If dental plaque is not removed in a timely manner, it will continue to develop and lead to various oral problems.
The Acid Production Vicious Cycle
First, under anaerobic conditions (for example, within tightly packed dental plaque), some bacteria can metabolize sugars from food debris to produce various acidic substances. These acids accumulate in the dental plaque, gradually lowering the pH of the tooth surface. When the pH drops below a critical point, the minerals in the teeth (such as calcium phosphate) begin to dissolve, a process known as demineralization. Continuous acidic attacks can damage the hard structure of the teeth, ultimately leading to cavities (tooth decay).
At the same time, acidic environments are usually unfavorable for certain beneficial bacteria, disrupting the balance of oral microbiota. This environment favors the growth of acid-producing bacteria (such as Streptococcus mutans), which are typically pathogenic. They can further produce acids and lower the pH of the oral environment, creating a vicious cycle.
Formation of Tartar Accumulation
When dental plaque remains on the tooth surface for an extended period, it begins to mineralize using free minerals from saliva, combining with bacteria, cellular debris, and other organic materials to form hard tartar. Tartar acts like a fortress built on the camp, making it even more difficult to remove, usually requiring professional techniques and equipment (scaling).
The presence of tartar makes daily oral hygiene more challenging, providing an ideal habitat for oral bacteria. Pathogenic bacteria will further release harmful substances, leading to inflammation of the periodontal tissues (including the gums and the bone supporting the teeth), commonly known as gingivitis and periodontitis.
The "Source of All Evil"
According to the latest epidemiological statistics, about 62% of adults suffer from periodontitis, with 23.6% of them having severe conditions. As for cavities, those who have never had a cavity are indeed rare. Cavities can further develop into pulpitis, which can then progress to periapical inflammation, interacting with periodontitis and causing various forms of tooth pain and looseness. If left untreated, it can lead to tooth loss, jaw cysts, and more severe diseases, sometimes requiring surgical intervention.
Excluding congenital, externally caused (such as fractures), and some maxillofacial surgical diseases (primarily tumors in the maxillofacial region), most oral diseases can ultimately be traced back to dental plaque. Essentially, dental plaque can be referred to as the "source of all evil" in oral diseases.
Therefore, our current oral health measures primarily aim to eliminate dental plaque.
Pathogenic Model of Dental Plaque - "Oral Biology" 5th Edition, People's Health Publishing House
Our Battlefield - Weaknesses of Teeth#
There are some natural gaps between the teeth themselves, between teeth, and between teeth and periodontal tissues, which are more prone to accumulate food debris and dental plaque.
Grooves and Fissures on the Occlusal Surface#
The surfaces of our teeth have some natural irregularities, which form cusps, ridges, and grooves. Most of these are located on the occlusal surface of the teeth, and this structure helps to cut food and increase chewing efficiency. However, these grooves also serve as natural shelters for food debris and dental plaque.
Friends with children may have heard of a preventive measure called "fissure sealing" in recent years. When children get their new teeth, some grooves are relatively deep, and with inadequate cleaning, dental plaque can easily accumulate, leading to cavities. This preventive measure involves filling these deeper grooves to reduce the chances of food debris and dental plaque accumulation, thereby preventing cavities. Therefore, if your teeth are already decayed, it is meaningless to perform fissure sealing.
Proximal Surfaces (Interdental Spaces)#
Interdental spaces refer to the gaps between the proximal surfaces of two adjacent teeth. Under normal circumstances, the proximal surfaces of teeth should be tightly connected, and the area where teeth contact each other is called the contact area, while the triangular area below the contact area is called the interdental triangle, which is usually covered by the gingival papilla. This natural structure helps maintain the stability of the dental arch but also provides an opportunity for dental plaque. Because this area (interdental space) is difficult to clean, even when the contact area is tightly connected, the space below it can easily accumulate food debris and dental plaque.
When we say "large gaps between teeth" or "easy to get food stuck," we are actually referring to the contact area no longer being tightly connected for various reasons, making it easy for food to get pressed and packed into the contact area and the interdental triangle below. If not cleaned in time, the packed food will press against the gingival papilla, leading to further widening of the gaps (in reality, the gum that originally grew in the interdental triangle has receded).
Junction of Gums and Teeth#
There is also a natural gap where the gums contact the teeth, which we call the gingival sulcus. Under normal circumstances, the gums are tightly connected to the teeth through the periodontal membrane, the depth of the gingival sulcus is shallow, and dental plaque accumulation is limited, making it relatively easy to clean. If we do not clean in time, the bacteria in the dental plaque can further damage the periodontal membrane, leading to the separation of the gums and tooth tissue, deepening the gingival sulcus.
A deep gingival sulcus is more prone to accumulate dental plaque and is harder to clean. Deep gingival sulci also create an anaerobic environment that favors the survival of harmful bacteria. Therefore, tartar usually accumulates at the junction of the gums. At the same time, as the periodontal membrane is damaged, the barrier against bacterial invasion is lost, and the pathway opens up, allowing further invasion of the alveolar bone, leading to more severe periodontal disease.
If you can ensure thorough cleaning in these key areas, you can basically stay away from most dental and periodontal problems.
Our Weapons - Oral Health Methods#
The previous sections have introduced that the main purpose of oral health is to eliminate dental plaque, and have discussed the three "disaster zones" where dental plaque accumulates. Next, we need to choose the appropriate tools and use the correct methods to "capture them all."
Broadly Defined Brushing#
Why Just Using a Toothbrush is Not Enough#
Brushing teeth is something most people are familiar with, generally referring to using a toothbrush and toothpaste to clean the teeth. However, I believe that broadly defined brushing should involve using the correct cleaning methods to thoroughly clean the oral cavity.
The distinction lies in "using a toothbrush and toothpaste." As mentioned earlier, there are three key cleaning areas in our mouths. The structure of a traditional toothbrush is very suitable for cleaning the occlusal surface and the junction with the gums, but it is ineffective for the proximal surfaces. Due to the obstruction of the gingival papilla, it cannot enter the interdental triangle and perform effective cleaning. Therefore, using just a toothbrush is not enough.
Dental floss, interdental brushes, and water flossers are designed to better clean interdental spaces. Dental floss is thin enough to pass directly through the contact area and clean the area below it. Interdental brushes are specially designed small-headed toothbrushes that can bend freely, making it easier to enter interdental spaces for cleaning. Water flossers use high-pressure streams of water to clean the interiors of these spaces.
How to Choose the Right Tools#
I categorize oral cleaning tools into Category A and Category B. Category A tools include toothbrush + toothpaste, electric toothbrush + toothpaste, orthodontic toothbrush + toothpaste, which mainly clean most areas in the oral cavity. Category B tools include dental floss, interdental brushes, and water flossers, which mainly clean areas that toothbrushes cannot reach.
In daily oral hygiene, we should use a combination of Category A and Category B tools for cleaning. A combination of regular toothbrush + toothpaste + dental floss is suitable for the vast majority of ordinary people.
Category A tools should preferably be soft-bristled products, as we need to clean not only the tooth surfaces but also the junction between the teeth and gums. Bristles that are too hard can irritate the gums and may cause varying degrees of wear on the teeth.
In Category B tools, dental floss should preferably be flat floss, as it has a larger cleaning area compared to thin floss. This is because we need to remove food debris from the interdental spaces and also clean the dental plaque adhering to the proximal surfaces of the teeth through mechanical friction (specific usage methods can be found in the next section).
Above is flat floss, below is thin floss.
Interdental brushes are more suitable for the elderly or patients with periodontitis. These individuals often have larger interdental spaces due to physiological or pathological changes, making it easier for interdental brushes to enter. Water flossers are more flexible than the first two and can even clean areas that dental floss may not reach (such as crowded or misaligned teeth, or for some patients wearing dentures and orthodontic appliances). However, lower water pressure may not effectively clean dental plaque, while higher water pressure can easily damage the gums, requiring a certain level of skill to use.
Correct Brushing Method#
According to the popular science content from the Chinese Stomatological Association (the official organization for Chinese dentists):
- Adults are recommended to use the horizontal vibratory brushing method.
- Children are recommended to use the circular brushing method.
- Use dental floss, interdental brushes, and water flossers to clean interdental spaces.
Adults: Horizontal Vibratory Brushing Method
- Brush the labial, buccal surfaces, and the lingual surfaces of the back teeth: The bristles of the toothbrush should be angled towards the root, at a 45° angle to the side of the teeth. When brushing the upper teeth, the toothbrush points upwards; when brushing the lower teeth, it points downwards. Apply gentle pressure to allow the bristles to enter the gaps between the teeth and gums, performing horizontal short vibratory motions at least 5 times over a range of 2 to 3 teeth, then gently brush the labial and lingual surfaces of the teeth.
- Brush the lingual surfaces of the front teeth: Hold the toothbrush vertically, using the back of the brush head to contact the gums. Brush the lower teeth from bottom to top and the upper teeth from top to bottom.
- Brush the occlusal surfaces: Point the bristles towards the occlusal surfaces of the teeth and brush back and forth with slight pressure.
- Brush the proximal surface of the last tooth: Open your mouth wide, hold the toothbrush vertically, and use the brush head from the lingual surface of the last lower tooth, along the gum line, to the proximal surface of that tooth, until reaching the labial surface.
For specifics, see the "VCR" — Chinese Stomatological Association Popular Science Video
Children: Circular Brushing Method
- Brush the buccal surfaces of the back teeth: Bite down, and move the toothbrush in circles on the buccal surfaces of the back teeth, dragging the bristles from the upper gum to the lower gum.
- Brush the labial surfaces of the front teeth: Align the incisors, then continue to move the toothbrush in a circular motion over the teeth.
- Brush the lingual surfaces of the back teeth: Point the bristles towards the lingual surfaces and brush back and forth repeatedly.
- Brush the lingual surfaces of the front teeth: Hold the toothbrush vertically and brush up and down repeatedly.
- Brush the occlusal surfaces: Place the bristles on the occlusal surfaces and brush back and forth repeatedly.
- Brush the proximal surface of the last tooth: Open your mouth wide, hold the toothbrush vertically, and use the brush head from the lingual surface of the last lower tooth, along the gum line, to the proximal surface of that tooth, until reaching the labial surface.
For specifics, see the "VCR" — Chinese Stomatological Association Popular Science Video
Usage Methods for Dental Floss, Interdental Brushes, and Water Flossers
- Dental Floss: Insert the dental floss from the occlusal surface down, passing through the contact area, and perform an up-and-down motion against the proximal surface to remove dental plaque.
- Interdental Brush: Choose different sizes of interdental brushes according to the size of the interdental space. Insert the interdental brush into the space and perform a sawing motion to clean.
- Water Flosser: Aim the water stream at the area that needs cleaning.
"VCR": How to Use Dental Floss, How to Use Interdental Brushes, How to Use Water Flossers.
Beyond Brushing#
Toothpicks#
Toothpicks are not recommended. First, toothpicks can only clean food debris and cannot remove dental plaque. Secondly, the sharp tip of a toothpick can easily injure the gums. Toothpicks are equivalent to having only half the effectiveness of dental floss, but with a higher risk. If possible, use dental floss for cleaning (I generally carry a portable dental floss pack with me).
Mouthwash#
If you have related oral diseases or have undergone oral treatment or surgery, please use mouthwash as directed by your doctor. Other than one specific situation, I do not recommend healthy individuals use any form of mouthwash.
Whether medicinal or commercial mouthwash, their main function is to inhibit bacteria. However, the oral cavity itself is a bacterial environment, and using mouthwash to forcibly inhibit bacteria is akin to destroying the entire normal ecological environment of the mouth. If using a toothbrush, dental floss, etc., for oral cleaning is like weeding and trimming a garden, using mouthwash is like indiscriminately applying pesticides. Some mouthwashes also contain irritating ingredients that can even irritate the mucosa, leading to mucosal diseases. Additionally, the principle of "you get what you give" is well understood. Relying on mouthwash for a long time may weaken the oral cavity's own defense system, as it no longer needs to resist bacteria itself.
However, if you've just eaten garlic and your girlfriend happens to call you to come over, or your boss asks you to report to the office, then you can use mouthwash as an emergency measure to improve your breath. Be sure to choose a mouthwash without irritating ingredients, and antibacterial action should be non-essential.
Chewing Gum#
Chewing sugar-free gum actually has several benefits, but it cannot replace brushing.
Chewing gum can adhere to some food debris and dental plaque, providing a certain level of cleaning. Additionally, chewing stimulates saliva secretion, assisting in oral cleaning. However, the cleaning ability of chewing gum is limited and cannot provide uniform and comprehensive cleaning for every tooth, so it cannot replace brushing. If there are no suitable conditions for brushing or rinsing after eating, chewing gum can be considered. Just be sure to choose sugar-free gum; otherwise, it would be counterproductive.
Common Questions and Answers#
Does using dental floss cause gaps between teeth to widen?#
No.
The wear caused by using dental floss is negligible and will not lead to wider gaps between teeth; rather, not using dental floss may actually cause gaps to widen.
The subjective feeling of wider gaps between teeth is usually due to food getting stuck. As mentioned earlier, food getting stuck is caused by the destruction of the contact area between the proximal surfaces of the teeth, leading to a loose connection. The primary cause of contact area destruction is cavities. Another major cause of widening gaps is periodontitis. Periodontitis can cause gum recession or damage the supporting structures of the teeth, exposing areas that were originally covered by the gums, resulting in larger gaps. Additionally, both cavities and periodontitis can lead to tooth loss. Once a tooth is lost, the overall stability of the dental arch is compromised, causing surrounding teeth to gradually tilt, and the relationship of the contact areas will no longer be tight.
How many times a day should I brush my teeth?#
==Brush as needed, at least twice.==
If your oral condition is good, brushing in the morning and evening is generally sufficient. The time bacteria take to form dental plaque is an important factor; regular brushing in the morning and evening is enough to prevent further accumulation and damage from dental plaque.
Additionally, since sugar is the main source of acid production from bacterial metabolism, it is necessary to clean the mouth after consuming high-sugar foods. If brushing is not possible, at least rinsing or chewing sugar-free gum should be done. If you frequently have food getting stuck, it is best to use dental floss after eating to remove the trapped food.
If you have oral diseases or are wearing orthodontic appliances, please follow your doctor's advice regarding brushing.
Is using toothpaste a capitalist conspiracy?#
No, but there are indeed some "capitalist conspiracies" involved with toothpaste.
Amount of Toothpaste#
In fact, using a pea-sized amount of toothpaste is generally sufficient for each brushing. However, many advertisements and promotional materials depict a long strip of toothpaste covering the toothbrush head. Such images create a psychological suggestion that leads you to unconsciously increase the amount of toothpaste used. Additionally, manufacturers may slightly enlarge the diameter of the toothpaste tube opening to encourage you to use more toothpaste.
A full squeeze of toothpaste.
Function of Toothpaste#
The main function of toothpaste is to assist in cleaning. Additionally, fluoride toothpaste can reduce the incidence of cavities and repair early tooth damage. Anti-sensitivity toothpaste can alleviate tooth sensitivity by reducing the teeth's sensitivity to external stimuli. These are all clear and effective functions of toothpaste.
Some toothpaste claims to have anti-inflammatory effects, usually achieved by adding herbal or plant extracts, but the specific effects are debatable. If any toothpaste claims to treat any oral disease other than "dentin hypersensitivity," it is false advertising and should be reported.
The good news is that the State Council has issued the “Toothpaste Supervision and Management Measures”, which will officially take effect on December 1, 2023.
Do I need to get my teeth cleaned every year?#
Not necessarily, but the promotion of annual cleanings is more beneficial than harmful.
As mentioned earlier, tartar is formed from the mineralization of dental plaque. Ideally, if you can promptly and completely remove dental plaque, you will naturally eliminate the source of tartar formation and will not need cleanings. However, in reality, it is impossible to completely remove dental plaque. For example, if you have never used dental floss or other tools to clean the proximal surfaces, it is likely that some tartar has formed in your interdental spaces.
Therefore, my suggestion is that if you have never had your teeth cleaned before, you can first go to a reputable hospital for an examination, allowing the doctor to determine whether you need a cleaning. If a cleaning is necessary, you can note the areas where you have more tartar; these are also places you have not cleaned adequately. After that, as long as you maintain good oral hygiene habits, the amount of tartar formed each year will be very minimal, and there will be no need to get your teeth cleaned every year. Moreover, cleanings can cause some degree of damage to the gums and teeth.
Cleaning teeth is a dirty and tiring job, and the fees are low, so not many doctors are willing to do it. For dental clinics, if viewed from a sales perspective, cleanings are low-ticket items primarily used to attract customers. During the process, they can introduce high-ticket products to earn higher profits. For top-tier hospitals and medical science communicators, the cleaning process serves as a comprehensive oral examination, allowing for the detection of various potential oral problems, which can indeed promote the early diagnosis and treatment of oral diseases (secondary prevention). Furthermore, given the current high incidence of periodontitis and cavities, most people cannot achieve good oral cleaning. Therefore, promoting annual cleanings is certainly more beneficial than harmful at this stage.
How can I determine if I have cleaned adequately?#
The first method is to go to a reputable hospital for a comprehensive oral examination, using the feedback from the doctor to determine which areas have been cleaned adequately and which have not.
Additionally, a feasible method is to purchase a dental plaque disclosing solution and use it after brushing. This will show you which areas still have dental plaque that has not been cleaned.
Quite shocking; you can click to open the larger image.
Can a water flosser replace brushing and dental cleanings?#
No.
A water flosser can only assist in cleaning areas that a toothbrush cannot reach, but it cannot replace brushing.
The main purpose of dental cleanings is to remove tartar, and a water flosser is generally ineffective at removing tartar.
Conclusion#
Consumerism, as a cultural phenomenon, seems to drive us to pursue material satisfaction and superficial perfection. It induces us to purchase various oral health products, which may each have their benefits, but when we overly focus on surface-level, diverse products, we may neglect the most fundamental principles.
Using more advanced, refined, and expensive electric toothbrushes, water flossers, etc., does not guarantee good oral health. There are no fixed methods; the essence remains unchanged. Regardless of the tools and methods used, the ultimate goal is to achieve better cleaning of dental plaque.
Therefore, we need to cultivate a balanced perspective, appreciating the convenience brought by technology and products while maintaining a focus on basic life principles. Through this balance, we can choose a lifestyle that suits us better, avoiding being swayed by unnecessary material pursuits, thus achieving a genuine improvement in quality of life.
References#
- "Oral Biology" 5th Edition, People's Health Publishing House
- Almubarak, Abdulrahman et al. "Disruption of Monocyte and Macrophage Homeostasis in Periodontitis." Frontiers in Immunology vol. 11 330. 26 Feb. 2020, doi:10.3389/fimmu.2020.00330
- "Domestic authoritative oral experts jointly point out: Using fluoride toothpaste to prevent cavities is a safe, effective, and economical method" - National Health and Family Planning Commission of the People's Republic of China
- Expert Group on Dentin Hypersensitivity of the Oral Preventive Medicine Committee of the Chinese Stomatological Association. Guidelines for the Diagnosis and Treatment of Dentin Hypersensitivity (2019 Revised Edition) [J]. Chinese Journal of Stomatology, 2019, 54(4):223-227. DOI:10.3760/cma.j.issn.1002-0098.2019.04.002.
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