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| Brushing
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| 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.
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| 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.
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| Sequence of Brushing
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| 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
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| 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.
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| Copyright © 1999 Photo Illustration by Glidewell Laboratories.
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| How long is long enough when brushing?
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| Many people question how long they should take when brushing their teeth. Answers can vary, but the Academy of General Dentistry suggests, in their website (www.agd.org), that the average person brush for 2 minutes per day or 14 minutes per week. Mathematically this would mean that one brush approximately 12 hours per year. The AGD suggests that the average person should brush 6 minutes per day or 46 minutes per week which would equal approximately 36.4 hours per year. If you brush 2 times per day, that would mean you should brush for at least 3 minutes each time.
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| Electric vs. Manual Brushing?
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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| Flossing
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| Flossing the teeth is a very important adjunct to tooth brushing for good oral hygiene. Studies have even demonstrated that those who floss regularly have a decrease in periodontal disease, bad breath, and cavity incidence. Unfortunately, many people do not floss, and so the increase in periodontal disease is seen. Flossing, as many people believe, is not used to remove food particles only. It is used to remove plaque under the gums, which is the invisible film of bacteria that constantly forms on teeth. Floss allows one to go in between the teeth, and scrape the surfaces clear of this plaque and bacteria.
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| Flossing Technique
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| A 12 to 18 inch piece of floss should be used first. By placing a few inches around the middle fingers on either hand, and then using the thumbs for control, one places the floss in between teeth. Again, you can divide the mouth into sections. The important thing to remember is that you should get sufficient pressure to get in between the teeth. Pressure should be placed on either side of the teeth once the floss is in correct position. One must get under the gumline to loosen the debris, plaque, and bacteria. This area is called the sulcus. A good way to remember how long to stay in this area and clean, is to count the up and down strokes on each tooth. Eight to ten strokes on each surface should be quite sufficient. The amount of time might seem excessive, but the rewards are great for your dental health.
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| Questions arise on how often one should floss? The answer is that, to be effective, one should floss each day. What kind of floss is best? There are many flosses to choose from on the market. Each one works. Personal preference is up to the patient. Thickness, waxed or unwaxed, etc. are for the difficult spaces that exist in teeth. Flavored, non-flavored flosses are available, again it is personal preference of the patient. The main thing to remember is to floss on a regular basis to maintain good oral health. What if one finds it difficult using floss due to dexterity problems or a handicap? There are commercial devices that can aid one in overcoming these problems. Recently, a company has developed an electric motor type flossing device.
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| Tongue Scraping & Bad Breath
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| Ninety percent of bad breath is caused by bacteria, and dead cells on the back of the tongue. The best way to remove odor is to remove build-up on tongue. Tongue scrapers were developed to remove these dead cells and bacteria.
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| Preventing Bad Breath
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| Brushing and flossing regularly, including tongue surface, decreases bad breath.
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| Fibrous vegetables, such as celery sticks and carrots, aid in keeping the tongue surface clean.
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| Foods rich in proteins can cause bad breath. Dairy products, meats, fish etc., cause this by breaking down the bacteria on the tongue. The proteins, in turn, cause sulfur to form which causes bad breath.
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| Keep mouth moist. Saliva flow keeps tongue surface clean.
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| If odor is noticed. more from the nose, respiratory infection may be the culprit. See your physician.
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| Sources: Floss.com; www.agd.org
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