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BRUSHING

BRUSHING TIPS

Most of us learned to brush our teeth when we were children. We have stuck with the same brushing technique into adulthood. Unfortunately, many of us learned how to brush the wrong way. And even if we learned the right way, we might not always stick to it. Brushing correctly involves removing plaque without brushing too hard and damaging your gums.

Young children can't brush their own teeth well. Parents and those caring for children should supervise and help with brushing until a child is 7 or 8 years old.

Here are a few general pointers about brushing.

  • Brush at least twice a day. One of those times should be just before you go to bed. When you sleep, your mouth gets drier. This makes it easier for acids from bacteria to attack your teeth. Also try to brush in the morning, either before or after breakfast. After breakfast is better. That way, bits of food are removed. But if you eat in your car or at work, or skip breakfast, brush first thing in the morning. This will get rid of the plaque that built up overnight. Although the advice is to brush after eating to remove food particles, it is better to wait at least 30 minutes if you had an acidic drink such as soda or orange juice. The reason for this is the acidic drink (low pH) demineralizes the tooth surface. If you brush right after drinking very acidic drinks you can experience more wear of your teeth and loss of enamel. This is called erosion. It is best to wait 30 minutes before brushing to give your saliva time to remineralize and harden the enamel surface and reduce the possibility of erosion.
  • Brush no more than three times a day. Brushing after lunch will give you a good midday cleaning. But brushing too often can damage your gums.
  • Brush lightly. Brushing too hard can damage your gums. It can cause them to recede (move away from the teeth). Plaque attaches to teeth like jam sticks to a spoon. It can't be totally removed by rinsing, but a light brushing will do the trick. Some electric toothbrushes have an indicator light that will turn on if you are pressing too hard. Once plaque has hardened into calculus (tartar), brushing can't remove it. If you think you might brush too hard, hold your toothbrush the same way you hold a pen. This encourages a lighter stroke. If you accumulate a lot of tartar on your teeth, it can be prevented by using an antitartar toothpaste. The antitartar toothpastes contain pyrophosphates that reduce the amount of tartar that deposits on your teeth.
  • Brush for at least two minutes. Set a timer if you have to, but don't skimp on brushing time. Two minutes is the minimum time you need to clean all of your teeth. 30 seconds for upper right, 30 seconds for upper left, and then 30 seconds for lower left, and finally 30 seconds for lower right. Many electronic toothbrushes have a built in timer that directs you on how to brush.
  • Have a standard routine for brushing. Try to brush your teeth in the same order every day. This can help you cover every area of your mouth. If you do this routinely, it will become second nature.
  • Always use a toothbrush with soft or extra-soft bristles. The harder the brush, the greater the risk of harming your gums.
  • Choose a brush that you can hold using a light grip. Toothbrush handles can be long or short, thick or thin, flexible or rigid, soft or firm, smooth or rough. It should fit your hand and feel good to use.
  • Consider the size of your mouth. People who have small mouths and teeth will not need the same brush size as people who have a larger mouth and teeth. Your brush should allow you to reach even the teeth at the very back of your mouth. It also should allow you to brush one or two teeth at a time. It is a good idea to have a few toothbrushes so that you can clean all areas of your mouth. For example, for many people it is difficult to brush the very back teeth on the side close to the cheek. For a tight area like that you can use a child’s toothbrush to reach that difficult spot.
  • Change your toothbrush regularly. Throw away your old toothbrush after three months or when the bristles start to flare, whichever comes first. If your bristles flare much sooner than every three months, you may be brushing too hard. Try easing up. Some toothbrushes have blue bristles in the middle of the brush head. These bristles are designed to fade in color over time and with regular use. If the bristles fade halfway from blue to white, then it is time to replace your toothbrush.
  • Electric is fine, but not always necessary. Electric or power-assisted toothbrushes are especially useful for people who don't always use proper brushing techniques. They tend to make brushing your teeth easier. Because of this, people who use them have been found to brush longer and more often than people using a manual toothbrush. Powered toothbrushes also are a good choice for people with physical limitations that make brushing difficult. Use a powered toothbrush for at least two minutes, and don't press too hard. Some studies have shown that use of an electric powered toothbrush was more effective in removing plaque than a manual toothbrush.

MODIFIED BASS BRUSHING TECHNIQUE

There are different ways to brush correctly. Your dentist or dental hygienist can show you the method that might be best for you.

The modified Bass technique (below) is among the most popular for adults.

  • Hold the toothbrush sideways against your teeth with some of the bristles touching your gums
  • Tilt the brush so the bristles are pointing at your gum line
  • Move the brush back and forth, using short strokes. The tips of the bristles should stay in one place, but the head of the brush should wiggle back and forth. You also can make tiny circles with the brush. This allows the bristles to slide gently under the gum. Do this for about 20 strokes or 20 circles. In healthy gums, this type of brushing should cause no pain. If it hurts, brush more gently
  • Roll or flick the brush so that the bristles move out from under the gum toward the biting edge of the tooth. This helps move the plaque out from under the gum line
  • Repeat for every tooth, on the insides and outsides
  • On the insides of your front teeth, it can be hard to hold the brush sideways. So hold it vertically instead. Use the same gentle back-and-forth or circular brushing action. Finish with a roll or flick of the brush toward the biting edge
  • To clean the biting or chewing surfaces of the teeth, hold the brush so the bristles are straight down on those surfaces
  • Gently move the brush back and forth or in tiny circles to clean the entire surface. Move to a new tooth or area until all teeth are cleaned.
  • Rinse with water
  • You can clear even more bacteria out of your mouth by brushing your tongue. Brush firmly but gently from back to front. Do not go so far back in your mouth that you gag. Rinse again

TOOTHPASTE

Toothpastes don't just clean teeth anymore. They have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or helping sensitive teeth. Some toothpastes can even strengthen enamel, leaving it more resilient to future enamel challenges.

Most toothpastes contain fluoride, which has been proven to prevent cavities. Fluoride also can stop small cavities from getting worse. It can even reverse early tooth decay. The Food and Drug administration regulates toothpaste ingredients such as fluoride. Topical fluorides that approved for use in toothpaste include Sodium Fluoride, Stannous Fluoride and Sodium Monofluorophosphate (MFP). All of these are effective in preventing cavities in teeth. Stannous Fluoride can stain the teeth, however if it does it can be cleaned with a visit to the dental office. An advantage of Stannous Fluoride is that in addition to preventing cavities it can reduce gingivitis.

Tartar-control toothpastes are useful for people who tend to build up tartar quickly. Someone who gets tooth stains may want a whitening toothpaste. Whitening toothpastes will remove only surface stains, such as those caused by smoking, tea or coffee. To whiten teeth that are stained at a deeper level, talk with your dentist.

Another therapeutic benefit in some toothpastes is desensitizing or anti-hypersensitivity. Those toothpastes either work by reducing pain signals from the tooth or by blocking the pores in the tooth that are called tubules.

There are toothpastes that are advertised as all natural, without fluoride. There are some that contain charcoal as well. The American Dental Association recommends a fluoride containing toothpaste that has received it’s seal of acceptance. Your needs will likely change as you age, so don't be surprised if your hygienist or dentist recommends a type of toothpaste you haven't used before. Choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint: These work the same way, so pick the one you like. Some people find that some toothpaste ingredients irritate their gums, teeth, cheeks or lips. If your teeth have become more sensitive or your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.

 

Last updated June 30, 2021

 

References:

  • Elkerbout T, Slot D et al. How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises.Int J Dent Hyg. 2020 Feb;18(1):17-26. Doi: 10.1111/idh.12401. PMID 31050195
  • Poklepovic Pericic T, Worthington HV, Johnson TM, et al. WITHDRAWN: Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev. 2019;4(4):CD009857. Published 2019 Apr 24. doi:10.1002/14651858.CD009857.pub3
  • Hu ML, Zheng G, Lin H, Yang M, Zhang YD, Han JM. Network meta-analysis on the effect of desensitizing toothpastes on dentine hypersensitivity. J Dent. 2019 Sep;88:103170. doi: 10.1016/j.jdent.2019.07.008. Epub 2019 Jul 17. PMID: 31325467.
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  • Milosevic A. Abrasion: A Common Dental Problem Revisited. Prim Dent J. 2017 Feb 28;6(1):32-36. doi: 10.1177/205016841700600104. PMID: 28376961.