Food particles that stay in the mouth mix with saliva and build up a sticky substance on the teeth. The colorless film of bacteria that thus forms on the teeth along the gum line is called plaque. The hardened form of plaque, called tartar, is attached to the enamel of the teeth below the gum line. The bacteria contained in the plaque cause gum disease and tooth decay. If plaque is not treated, it destroys the tissues holding the teeth, decays the teeth, produces bad breath, and finally the tooth is lost. It is, therefore, important to brush properly and regularly to protect teeth.
Brushing should cover the inside surface, the outside surface, and the chewing surfaces of the teeth. Brushing twice a day for a 2 minute duration in each session is ideal.
Toothbrushes come in different sizes and shapes and we can choose one that is of ease to hold and comfortable to the mouth. Soft bristles are preferred as stiffer bristles can harm the gums. Due to regular usage, the bristles become less effective and so the ideal time to change the toothbrush is once in every three to four months, or whenever the bristles are damaged.
To remove the remaining paste and debris from the toothbrush, it should be rinsed thoroughly after each use, put in an upright position, and allowed to dry in the air to avoid microbial growth. Toothbrush sanitizer devices may be used if the brushes need to be sanitized. Toothbrushes should not be shared from a hygienic standpoint.
Unlike a manual toothbrush, electronic toothbrushes use a different type of head movement—side-to-side, counter oscillation, rotation oscillation, circular, and ultrasonic, to facilitate brushing. Electronic toothbrushes are useful for the elderly, children, people with disabilities, and individuals who use dental appliances such as braces.
Some of us brush too little while some others brush too long, which can hurt the gums and strain the teeth enamel. Due to this, it is all the more important to brush regularly and correctly.
In general, there are five types of brushing methods:
- Horizontal method
- Vibratory method
- Roll method
- Circular method
- Vertical method
In the horizontal method, the brush is moved back and forth in short horizontal strokes, which may damage the gums. Although it is widely used, it is not a very effective method in controlling dental plaque.
The vibratory method includes the Bass or modified bass, Stillman, and Charter’s techniques.
The Bass, or sulcular, method is mostly used and considered to be very effective in removing dental plaque. The bristles are placed at a 45° angle to the long axis of the tooth and moved back and forth horizontally, in small vibratory movements, covering three teeth at a time. Pressing the bristles firmly cleanses the occlusal surfaces.
The Stillman method is used to stimulate the gums. The bristles are positioned similar to the Bass method and the bristles rest partly on the gums and partly on the tooth. Using a vibratory motion a slight pressure is exerted to stimulate the gums.
Charter’s method is best suited for people who have undergone periodontal surgery and use orthodontic and fixed prosthetic appliances. The bristles are directed coronally and are placed at a 45° angle to the gingival.
Patients suffering from anatomically normal gingival tissues are best benefitted by the roll method. The bristles are placed on the gingival margin pointed toward the apices and brought to the occlusal surface by exerting light pressure. It uses a rolling stroke and brushes occlusally to clean the interproximal and tooth surface in a single stroke.
Brushing techniques in children
Parents can watch the appearance of the first tooth in their child and start cleaning daily by using a clean, damp cloth until more teeth appear.
When the child is 2 years old, using fluoride toothpaste is recommended as fluoride is important in protection against cavities. Young children may swallow too much of the fluoride and this may leave them with white spots on the permanent teeth. This can be prevented by using a small amount of toothpaste—about the size of a pea on a small soft toothbrush. Children need to be taught to spit out the toothpaste and to rinse well after brushing.
When children start to brush on their own, the circular method, or Fones method, can be taught. This method involves placing the brush on the teeth and pressing the teeth to activate the bristles. By following a circular motion with the toothbrush, the teeth and gums are covered in the brushing procedure.
For small children with primary teeth, the vertical method is most convenient. Vigorous brushing across the upper and lower teeth separately is the characteristic of this method. Since the teeth are held apart, each section is brushed separately.
It should be noted that kids and children need to be supervised until they can handle the toothbrush on their own.
Reviewed by Afsaneh Khetrapal BSc (Hons)