Toothbrushing

Introduction

Tooth brushing is the most commonly recommended oral hygiene behaviour.

  • It is the primary mechanical means for removing dental plaque, thereby assisting in the prevention of oral diseases including gingivitis and dental caries.

Healthy Tooth to Gingivitis



Duration and Frequency

It is widely recommended that patients brush their teeth with a fluoride toothpaste for a duration of 2 minutes twice daily.

NOTE: Fluoride is anticariogenic, meaning it prevents tooth decay.



Toothbrushing Technique

Multiple toothbrushing techniques have been recommended by dental associations, toothpaste and toothbrush companies and in dental texts (e.g. Bass technique, Fones technique, Scrub technique), but studies have not reliably demonstrated one method to be superior for all patients.

In general, the toothbrush should be placed at the gumline at a 45° angle to remove plaque optimally at the gingival margin.

  • Patients should apply gentle force to insert the toothbrush into the sulcus.
  • The toothbrush should be moved in a vibrating motion in short strokes while remaining in contact with the sulcus.
  • All surfaces of the teeth (inner, outer, and chewing surfaces) should be brushed during each session.

Once finished brushing, patients should spit out any excess toothpaste but do not rinse out the mouth immediately with water.

  • By not rinsing, this leaves a thin layer of toothpaste on the surface of teeth, helping to protect them for longer.



Choice of Toothbrush

In general, look to use a toothbrush with a small head and soft bristles.

Patients can be assured that electric toothbrushes are at least as effective as manual toothbrushes.


Overall, patients should be encouraged to choose the toothbrush they prefer and will be able to use most consistently to promote adequate brushing practices.

NOTE: Toothbrushes should be replaced every 3 to 4 months, replacing more frequently if bristles are visibly frayed or matted.



Summary

Tooth brushing is primarily aimed at removing plaque, not just food debris.

  • Therefore, it is essential to brush your teeth regularly, even when you have not eaten.

Hardbrushing and using a toothbrush with stiff, coarse bristles can wear down teeth and gums, leading to problems like gum recession and enamel wear, both of which are linked to tooth sensitivity.

Tooth Anatomy



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