Tooth Brushing

Maintaining Healthy Teeth

Brushing after every meal and flossing at least once a day are important in order to remove plaque deposits around the teeth.

Objectives
remove plaque clean teeth of food debris and stains stimulate the gingival tissues

History
Early times,toothpicks were chewed to clean their teeth Toothpicks then matured into chewsticks 2 ends : Brush like-end and pointed The twigs from aromatic trees that had the ability to clean and freshen the mouth.

 Natural bristles
Synthetic bristles replaced the natural bristles

Nylon was first applied to the toothbrush at around 1938

Electric toothbrushes

 Tooth brushing efficiency depends on three factors:

brushing technique brushing frequency and duration brush design *The first two factors are the most important since good technique combined with increased time spent brushing will improve plaque removal.*

Brushing Procedures
Bristles along the gumline at a 45-degree angle. Contact between tooth surface and gumline

 Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating back & forth rolling motion. Move brush to the next group of 2-3 teeth and repeat.

 Maintain a 45-degree angle with bristles contacting the tooth surface and gumline. Brush back, forth, and rolling motion along all of the inner tooth surfaces.

Tilt brush vertically behind the front teeth. Up & down strokes using the front half of the brush.

 Occlusally: use a gentle back & forth scrubbing motion. Brush the tongue from back to front to remove odorproducing bacteria.

Tooth brushing Techniques

Each involves different combinations of horizontal, vertical, rotary, and vibratory motions.

Technique
Horizontal Scrub

Bristle Replacement
90 to tooth

Motion
Horizontal strokes

Effect
Supragingival Cleaning Gingival Stimulation Supragingival Cleaning Gingival Stimulation Supragingival Cleaning Gingival Stimulation Supragingival Cleaning

Fones

90 to tooth

Large circles over tooth and gingiva

Leonard

90 to tooth

Vertical strokes

Smith - Bell

At occlusal surface

Sweep gingiva

Rolling Stroke

Apically at attached gingiva

Sweep in arc occlusally

Supragingival Cleaning Gingival Stimulation

Stillman

45 to apex, part on gingival margin, part on crevix of tooth 90 to tooth

Vibratory pulsing

Gingival Stimulation

Modified Charters

Sweep occlusally ; Circular vibratory

Gingival Stimulation Interproximal Cleaning Supragingival Cleaning Gingival Stimulation

Modified Bass

45 to apex, in sulcus

Sweep occlusally; Vibratory, horizontal jiggle

 All the techniques can be used to clean facial, lingual and occlusal surfaces, but are less effective for interproximal areas.

Modified Bass - effectively cleans the sulcus.

Modified Charters - cleaning fixed orthodontic appliances. Horizontal scrubbing technique, excessive pressure and abrasive toothpaste will lead to gingival recession and tooth damage.

Brush Design
softer bristle texture and a smaller brush head have been related to interproximal efficacy, and longer handles are more comfortable and may improve compliance.

 Powered toothbrushes are consistently superior to manual toothbrushes for removing plaque, and reducing gingivitis, gingival abrasions, bacterial adherence and viability, and staining Particularly useful for removing interproximal plaque, which accumulates quickly and is difficult to remove with a manual brush

Caring for Your Toothbrush

Be sure to rinse the toothbrush after each use. Toothbrushes should be placed in a dry area as wet and moist toothbrushes may allow bacteria proliferation.

Cleaning the toothbrush daily in antiseptic mouthwash would be able to fight bacterial growth that can flourish into the toothbrush

Replacing Your Toothbrush

When : At least every three months When bristles begins to wear-off After an illness such as a cold or flu

Reasons for Changing:

Toothbrushes just simply wear out Bristles breakdown and lose their effectiveness Worn and fractured bristles are a breeding ground for germs, fungus and bacteria Worn toothbrushes can damage gum tissue

Tooth Paste
Fluoride
Fluoride prevents tooth decay by strengthening the enamel which covers the teeth. Childrens toothpaste has less fluoride in it as at high levels fluoride may interfere with the formation of the adult teeth which are still growing inside the gums. The technical name for this is fluorosis.

Strontium chloride Dentine hypersensitivity may be reduced using a toothpaste which contains strontium or potassium chloride. These act by blocking up the open dentine tubules which have acted as communication channels with the nerve chamber. Triclosan This is an antibacterial agent which is added to some toothpastes. This agent may reduce the levels of gum inflammation.

Flossing

The importance of flossing:

remove debris that adheres to teeth and gums inbetween teeth polish tooth surfaces control bad breath

 Dental floss allows the patient to access those areas which are missed by the toothbrush.

types of floss
waxed and unwaxed flavored and unflavored wide and regular

Flossing Methods
Spool Method (also called the finger-wrap method)
Measure and cut an arm's length of floss. Wrap the floss three times around one middle finger and the remaining floss around the opposite middle finger.

 Pinch the floss between the thumbs and index fingers. Use the index fingers to floss the teeth.

Use the thumbs to floss the molars.

 Gently insert floss between the teeth by moving back and forth in a see-saw fashion. Do not force the floss

Wrap the tooth with floss in a "C" shape. Move the floss up and down the side of the tooth two to three times. Repeat on next tooth.

 Loop method (also called the circle method) Cut off a piece of floss that is approximately 18 inches long, and tie it securely in a circle. Next, place all of the fingers, except the thumb, within the loop. Then, use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, making sure to go below the gumline, forming a "C" on the side of each tooth.

Other flossing techniques:

Flossing tools, such as a prethreaded flosser or floss holder