Brushing

Tooth brushing is one of the most important aspects of good oral hygiene. Others include flossing, diet, visiting the dentist regularly, etc. Many people question their dentist as to which brand or type of brush is the best to use. Many have personal preferences, however, what is agreed on most, is that a soft brush is best. Medium or hard can cause damage and wear to the soft tissues surrounding the teeth, as well as unnecessary wear to the tooth outer surface called enamel. Brushes should be replaced often, usually after three to four months or after a bad cold or flu. Ideally, one should brush after each meal, but at least mornings and before bedtime should be made part of one's normal routine.

Other common questions are what types of bristles should a toothbrush have. The answer again depends on personal preference, however, studies have found that synthetic bristles are best due to their ability not to split as often as natural bristles. This splitting of the bristle ends can cause severe gum irritations and eventually recession of the gums and tooth sensitivity. If one uses a synthetic soft bristled toothbrush that is replaced often, it will not cause this irritation.

Sequence of Brushing

Each person has their own method of brushing, however, an easy technique is to divide the mouth into six sections. Depending if one is right or left handed, you can choose which side to start on in the upper arch. Assuming you start on the upper right, start brushing the posterior four teeth. Place the toothbrush slightly on the gums or gingivae at a 45 degree angle and partly on the tooth. Gently brush back and forth. After brushing in this fashion, move the brush further down away from the gums and onto the rest of the teeth. Go further anteriorly until you reach the next one third. You should now be on the anterior six teeth.

Repeat the procedure. Move on to the four back left teeth, repeating the back and forth motions. Once completed, brush the left four posterior teeth, on the biting or occlusal surfaces. Roll to the inside tongue or lingual side of the teeth. Again, place the brush at a 45 degree angle on the gums and tooth. Follow this procedure now going from left to anterior to right upper back teeth. This is now repeated by dropping down to the lower teeth. Follow the same instructions.

Many patients ask whether manual or electric toothbrushes are better?

Our experience has shown that electric toothbrushes do provide advantages over manual brushes. The reason is that most of us tend to rush while brushing manually, instead of spending the recommended two to five minutes of brushing. It seems that people will spend at least 2 minutes with the electric toothbrush.

Another reason is that power-brushes use the same consistent level of movement which allows for less tooth wear and gum irritation. Many times, we see excessive wear in certain areas due to a patient over-brushing. This is minimized with the electric toothbrush.

Recent studies performed by the University at Buffalo Dental School, have also shown that electric toothbrushes more effectively reduce the levels of two bacteria that have been associated with gum disease. They performed studies using manual and electric toothbrushes in a controlled study and the results favored electric brushes as a sound investment in aiding oral hygiene.

In another study performed by the British Dental Association at the Birmingham University School of Dentistry, research also showed a drastic reduction in plaque with the electric brush. Levels of plaque colonies were measured and a reduction was seen in those that used the electric toothbrush rather than a manual one.

In the United States, in a study published by the ADA, in children between the ages of 8 and 12 years, the electric toothbrush significantly decreased the plaque on the primary and permanent teeth of these children.

In conclusion, it appears that the electric toothbrush does indeed help to decrease dental plaque and allows for better oral hygiene. However, as with the manual brushes, changing the heads at least every 3 months and using a soft-bristled head is important to avoid excessive wear of the outer enamel.