"How to Actually Brush Your Teeth"
How
to Actually Brush Your Teeth
Introduction
A toothbrush is an oral hygiene instrument used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They should be used in conjunction with something to clean between the teeth where the bristles of the toothbrush cannot reach - for example floss, tape or interdental brushes.
As you reach for your toothbrush each morning, you may not realize what’s hanging out on its bristles.
“Toothbrushes can become
contaminated with oral microbial organisms whenever they are placed in the
mouth,” says Sharon Cooper, PhD.
Viruses
and bacteria from an infected person’s mouth can live for weeks on a toothbrush
surface, and continue to cause illness, says Cooper, a clinical associate
professor at the University of Florida College of Dentistry.
Even
normal, healthy microorganisms can cause infections, especially if they enter
your gum tissue due to an injury, a break, or an oral ulcer, she adds.
Toothbrushes
don’t have to be sold in sterile packaging, so they may have bacteria right out
of the box, says the American Dental Association’s official statement on
toothbrush care.
Keep It Clean
You
may not give much thought to cleaning your toothbrush, since you’re wetting it
every day to scrub your teeth. However, it’s important -- and easy -- to do.
Wash
it. Give your toothbrush a
thorough rinse with tap water to remove debris. If you have a systemic illness
or immune disorder, you may want to soak it in antibacterial mouthwash or run
it through the dishwasher, Cooper says.
Try
deep cleaning. There
are many types of toothbrush sanitizers on the market, Cooper says. Some use
ultraviolet light to kill microorganisms.
Store
it properly. After
use, don’t pop that wet toothbrush back into your medicine cabinet, drawer, or
bathroom cup and forget about it.
Store
it upright, in a rack or cup, where it can dry out. Look for a cover that lets
air circulate and prevents mold, but isn’t completely sealed. The lack of air
can foster bacteria.
When to Call It Quits
How
long should you keep a toothbrush to prevent the ick from building up? Here are
a few useful tips:
Know
when to let go. Replace
your toothbrush about every 3 to 4 months, or when it shows signs of wear.
“Frayed bristles will not clean the teeth and gums adequately,” Cooper says.
Yes,
that means all toothbrushes. Treat electric or power models the same way you handle
an old-fashioned one. Chuck the brush attachment when the bristles begin to
show signs of wear, Cooper says.
No Sharing
Tempted
to lend a toothbrush to a family member? Don’t.
Toothbrush
sharing can transfer saliva and bacteria -- even the kind that cause tooth
decay. “Tooth decay is considered an infectious disease ... one more reason not
to share or borrow a toothbrush," Cooper says.
n First
introduced in China in 600 A.D.
n Development of the first toothbrushes (hog bristles set
in oxbone) in 1498 AD in china [weinberger (1948), kinnery et al (1968)]
n Introduced
to the western world in the 16th century.
n William
Addis in 1780, England
n Handles
of Gold, Ivory or ebony were used
n Nylon
came into use in toothbrush construction
in 1938
Parts of a toothbrush
Head or working
end-
n contains the tufts or bristles
nylon
or natural bristles --- boars hair
n selected based on the clients mouth
n large enough to remove plaque efficiently, yet
small enough to facilitate access to all areas of the mouth.
Head should not be
n Longer than -
1-1 ¼ inches-adult brushes (25.4 to31.8mm)
5/16 to 3/8 inches - children (7.9 to
9.5mm)
and
n Wider
than
½” - adult
5/16"
- children brushes
Toothbrush head
modifications:
n Concave
Surface
n Deep
Grooved Design
n Conventional
Flat Multitufted
n Special Indicator Bands
n Hard & Soft
n Natural & Synthetic
n Multitufted & Space tufted
n 1-1.25
inches in length
n 5/16 to 3/8 inches in width
n 2 to 4 rows of bristles
n 5-12
tufts/row
End of Tooth Brush Filaments
Rounded
Blunted - causes gingival abrasions
Handle
n Portion
that is grasped by the hand during use
n Should
be easy to grasp and free from sharp projections, durable and light weight
regardless of the design.
n Various types of handles
Shank
n Segment
that connects the head and handle
n Frequently
constricted so that it is narrower than the rest.
Brushing plane
n Surface
of the brush used for cleaning the teeth and tissues.
n May
be flat or uneven planes.
Types Of
Toothbrushes:
n Manual
toothbrushes
n Powered
toothbrushes
n Sonic
& ultrasonic toothbrushes
n Ionic
toothbrushes
MANUAL
TOOTHBRUSHES
Ideal requirements:
n It
should confirm to individual patient
requirement in size, shape and texture.
n Be
easily and effectively manipulated.
n Be
readily cleaned and aerated , impervious to moisture.
n Be
durable and inexpensive.
TOOTH BRUSH
STUDIES
n No
one superior design of manual toothbrush. (Claydon N et al 2002, McDaniel TF
et al 1997 )
n The curved bristle toothbrush was significantly more effective in removing plaque overall than the conventional toothbrush. (Chava VK 2000, Williams NJ et al 1988)
According to One Study Conducted in 2007 efficacy of Toothbrush with a flat-trim bristle arrangement, Toothbrush with bi-level bristles arrangement,Toothbrush with wavy bristle arrangement and Toothbrush with zigzag bristle arrangements in plaque removal was observed. Result showed equal plaque accumulation on all surfaces, although the posterior surfaces showed greater accumulation when compared to the other surfaces. This is in agreement with most of the previous studies. The plaque scores were similar during all the four test periods. The results of the study showed no statistically significant differences between the four brushes. (Sripriya N, Shaik Hyder Ali K H 2007)
'Concept 45 degrees' toothbrush
n removed
significantly more dental plaque when compared to a standard, conventional
toothbrush. (Kanchanakamol U et al 1992, 1993)
n The
3-month-old toothbrushes were as effective as new brushes in plaque removal. (Tan
E et al 2002)
POWERED TOOTHBRUSHES
n In
1885, Fredrick Tornberg, a Swedish Watchmaker designed the first mechanical
toothbrush
n First powered toothbrush in 1939
Heads - oscillate in a side-to-side motion or in a
rotary motion.
Indications for Use
n Handicapped
individuals.
n Hospitalized
Patients.
n Patients
undergoing Orthodontic treatment.
n Individuals
with limited manual dexterity.
n Patients
with prosthodontic or endosseous implants.
n Patients
on supportive Periodontal therapy.
Advantages
n Increases
patient motivation resulting in better patient compliance.
n Increased
accessibility in interproximal and lingual tooth surfaces.
n No
specific brushing technique required.
n Uses
less brushing force than manual toothbrushes.
n Brushing
timer is incorporated in some brushes.
SONIC AND ULTRASONIC TOOTHBRUSHES
Produces high frequency vibrations.(1.6 MHz)
Cavitation and acoustic micro streaming.
Stain removal and disruption of the Bacterial cell wall. (bactericidal)
IONIC
TOOTHBRUSHES:
Change the surface charge of a tooth by an influx of
positively charged ions.
STUDIES :
According to the American Dental Association (ADA), both electric and manual toothbrushes are effective at removing oral plaque that causes decay and disease.
- No evidence of a statistically significant difference between powered and manual brushes.
- However, rotation oscillation powered brushes significantly reduce plaque and gingivitis in both the short and long-term studies. The clinical significance of this reduction is not known. (C. Deery et al, Heanue M et al, Niederman R 2003)
- Plaque removal can be achieved easier and faster with powered toothbrushes. (Heintze SD 1996, Borutta A 2002)
TOOTH BRUSHING
OBJECTIVES
- To clean teeth and
interdental spaces of food remnants debris and stain etc
- To prevent plaque
formation
- To disturb and
remove plaque
- To stimulate and
massage gingival tissue
- To clean the tongue
TOOTH BRUSHING TECHNIQUES
The Roll technique:
Modified
Stillman / Rolling Stroke
The Vibratory technique:
Stillman,
Charters & Bass method
The Circular technique:
Fones
method
The Vertical technique:
Leonard's
method
The Horizontal technique:
"Scrub-
Brush" method
The Physiological technique:
Smiths
method
Modified Bass Technique
Indications
1. As a routine oral hygine measure
2. Intarsulcular cleansing
Advantages:
- Excellent sulcus cleaning
- Good interproximal and gingival cleaning
- Good gingival stimulation
Disadvantages:
1. Moderate dexterity of wrist is required.
- This technique has equal or better potential than Bass technique far plaque removal and prevention of gingivitis.
- It is easy to learn.
- Shorter time.
- Physically and emotionally handicapped individuals.
- Patients who lack dexterity for more technical brushing method.
- Gingiva is provided with good stimulation.
- Possible trauma to gingiva.
- Interdental areas are not properly cleaned.
- Detrimental for adults especially who use the brush vigorously.
- Acute
Alterations (lacerations)
n Scuffled
epithelial surface with denuded underlying connective tissue
n Punctate
lesions that appear as red pinpoint spots
n Diffuse redness and denuded attached gingiva
Precipitating factors:
n Horizontal
or vertical scrubbing tooth brushing method with Pressure (either manual or
powered)
n Over
vigorous placement and application of toothbrush
n Penetration
of gingiva by filament ends
n Use
of toothbrush with frayed, broken bristles or filaments
n Application
of filaments beyond attached gingival
Chronic Alterations:
n Recession
n Changes
in gingival contour
Rolled, Bulbous, hard firm marginal gingiva in
'piled up‘ or festoon shape
n Gingival
cleft
Precipitating Factors:
n Repeated
use of vigorous rotary, vertical or horizontal tooth brushing techniques over a
long period of time
n Habitual
prolonged brushing in one area
n Excessive
pressure applied with worn out non-resilient brush
Abrasion of The
Teeth:
n Hard
toothbrush
n Horizontal
brushing
n Excessive
pressure during brushing
n Abrasive
agent in the dentifrice
n Prominence
of the tooth surface labially, or buccally
Appearance:
Saucer shaped or wedge shaped indentations with smooth shiny surfaces.
n Hardness
of the bristle
n Worn
bristles
n Pressure
applied by the client during brushing
n Improper
brushing techniques
n Abrasiveness
of dentifrices
All these can influence degree of trauma.
New Tooth Brush
Especially hard brush
n abrade
the epithelium
n leave
painful ulcerations on the gingiva
n thin
marginal gingiva that are abraded away can lead to gingival recession and
exposure of the root surface.
Frequency of Tooth Brushing
Atleast 2 times in a day.
2 different brushes to be used
Morning
Night
Disposal of the
tooth brushes
n First
sign of the bristles becoming worn, splayed or frayed
n Average
life of tooth brush- approx 3 – 4 months (ADA)
n Person
with oral infection
change
of brush every 2 weeks
Duration of
tooth brushing
n 2
to 3 minutes with proper brushing technique is sufficient enough to remove the
plaque.
MAINTENANCE OF TOOTHBRUSH
n Clean
with antiseptic mouthwash daily
n Keep
in dry area or open air with the head in an upright position with no contact
with other brushes
n Various
agents can be used to disinfect toothbrush like chlorhexidine, listerine,
hydrogen peroxide, sodium hypochlorite, UV radiations, boiling water
n Soaking
the tooth brush in house hold bleach and water(1 :10)
n Listerine
& chlorhexidine were effective in preventing microbial contamination of
toothbrush, when stored daily for 20 min (Caudry SD et al, 1995)
n Hydrogen
peroxide found to be most effective disinfectant (Grewal N et al 1996, Sogi SHP
et al 2002)
Evaluation of
Tooth Brushing
n Client
demonstrating the technique first
n Then
the dentist
Long term evaluation
Evaluating periodontal health not by the presence or
absence of plaque.
Special Tooth
Brushing Considerations
n Pain
n Acute
necrotizing ulcerative gingivitis
n Acute
injuries to the soft tissues
n Periodontal
and oral surgeries
n New
dental appliances in the mouth.
Conclusion
Brush your teeth with fluoride toothpaste twice a day for about 2 minutes to help keep your teeth and mouth healthy.
Plaque is a film of bacteria that coats your teeth if you don't brush them properly. It contributes to gum disease and tooth decay.
Tooth brushing stops plaque building up. Try to make sure you brush every surface of all your teeth.
Dr. Mayank Chandrakar is a writer also. My first book "Ayurveda Self Healing: How to Achieve Health and Happiness" is available on Kobo and Instamojo. You can buy and read.
For Kobo-
https://www.kobo.com/search?query=Ayurveda+Self+Healing
The second Book "Think Positive Live Positive: How Optimism and Gratitude can change your life" is available on Kobo and Instamojo.
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