Tooth Brushing

TOOTH BRUSHINGDr.Rai Tariq MasoodTooth BrushThe toothbrush is an instrument consisting of a small brush on a handle used to clean teeth through tooth brushingAct of cleaning your teeth with the tooth brush is called Tooth Brushing

Tooth pasteToothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth

Dentifrice..aid in polishing and cleaning of tooth surfaces.3FunctionsUsed to promote oral hygieneAid in the removal of dental plaque and food from the teeth on all the surfacesElimination and/or masking of halitosisDeliver active ingredients such as fluoride or xylitol to prevent tooth and gum disease (gingivitis)To clean the tongue

Amount of paste applied?

Tooth brush designIntroductionThe bristle tooth brush appeared 1st in china in 1600 They vary in size, design, length, hardness and arrangement of bristlesHence recommending a particular tooth brush, the ease of use by a patient as well as the perception that the brush works well are importantEach brush has a Handle, a Shank and a Working end

Components of a Toothbrush

ShankHandleWorking endIdeal Properties of a Tooth BrushShould remove all the calculus and plaqueShould access all the surfaces of the toothShould not injure the GingivaThe bristles should be softThe bristles should not deteriorate/ or should have long working life

Tooth Brush DesignThe bristles are grouped in TuftsUsually 3 or 4 rows of tuftsBristles are obtained from Hogs or artificially from the NylonTwo major types : manual & Electric

Hog is pig10Manual & Electric

Soft and Hard BristlesWhich is the better one?Force for BrushingThe amount of force used is not critical for effective vigorous brushing can lead to -Gingival recession -Bacteremia -Wedge shaped defects in the cervical area of the root surfacePresence of bacteria in blood13Tooth brush Trauma

TOOTH BRUSHING TECHNIQUES

TechniquesStillman , Charters & BassModified Stillman & Bass techniqueFones techniqueLeonard techniqueScrub technique

Stillman MethodA toothbrushing technique that incorporates gingival stimulation and dental cleansing, in which the toothbrush is held against both the gingival and the dental surfaces and manually vibrated

ContinuedThe bristles ends are placed at 45 degree with the bristles directed apically on the gingiva and partly on the cervical portion of the toothwhen the bristles are in position a gentle but firm vibratory motion is applied to the brush with the bristles remaining in the same positionStillmans

Modified Stillmans TechniqueA occlusal stroke is also added in the movementsThe occlusal stroke is used after every vibratory movement.For Cleaning areas with progressing gingival recession and root exposure to minimize abrasive tissue destruction.

Charters MethodA method of toothbrushing utilizing a restricted vibratory motion with the bristles inclined coronally at a 45 degree angle.Used when the interdental gingiva does not fill the embrasure spaces

ContinuedThe bristles are placed at 45 degree towards the occlusal surfaceThe bristles are placed interproximally and then vibratory movement is used while keeping the bristles in the positionCharters

Bass Method (intrasulcular) Toothbrushing technique for controlling plaque involving placement of the bristles in the sulcus at an angle of 45 to the tooth's long axis and vibrating the bristles in a quick manner from side to sideMost widely accepted method for removal of plaque

ContinuedThe head of the tooth brush is placed parallel with the occlusal surfaces of the teeth and the bristles are directed apically into the gingival sulcus at 45 degree angle along the long axis of the toothA firm pressure is applied in apical direction and by making short vibratory strokes.The short back-and-forth motion is easy to master.It concentrates the cleaning action on the cervical and inter-proximal portions of the teeth, where microbial plaque is most likely to have accumulated.

Bass Method

Modified Bass MethodThe modification consists of sweeping the bristles downward over the tooth surface occlusallyFones Technique (circular Method)A toothbrushing technique in which, with the teeth occluded and with the brush at more or less right angles to the teeth, large sweeping, scrubbing circles are described. With the jaws parted, the palatal and lingual surfaces of the teeth are scrubbed using smaller circles. Occlusal surfaces are brushed in an anteroposterior direction.ContinuedBrush is placed perpendicular to the tooth Teeth are clenched and large circular movements are given with the toothbrushNot recommended now because injury to gingiva usually occurs

Leonards TechniqueA method of teeth cleaning that advocates a vigorous drawing of the toothbrush up and down across the teeth. The teeth are held apart, so that each section is brushed separately. Also known as vertical toothbrushing.Roll MethodBrush is placed over the gingiva with the bristles placed apicallyThe jaws are separatedThe bristles are pressed against the gingiva and with continued pressure the brush is slowly rolled down over the surface of gingiva and tooth by rotating the wrist

ContinuedMost easy methodBut the gingival sulcus may not be cleaned by this

Horizontal scrub MethodThe bristles are placed 90 to the tooth and move horizontally.Most widely used method but not recommended.Can cause gingival recession.Brushing the Occlusal SurfaceThe bristles are placed at right angle on the occlusal surface with the ends of the bristles deep into the pits and fissures Vibrate the brush while keeping in the same areaNext give it the circular movements

Occlusal Brushing

Brushing the TonguePlace the bristles at a right angle to the tongueApply pressure on the tongue and give to and fro movements

Mouth RinsingVery importantDone to flush away the debris that was loosened but not removedWater or Mouth wash

ADJUNCTS TO TOOTHBRUSHINGIntroductionSimple toothbrushing cannot clean all the surfacesFor ideal plaque removal certain aids must be supplemented which assist in cleaning the remaining portionsDental flossInterdental toothbrushesMouth washesDisclosing tablets and solutionsDentifricesDental Floss

ContinuedSlowly push the floss interdentally, Dont force it otherwise gingival trauma may occurStart from the base of gingival sulcusMove in up & down motionMove along the tooth surfaceDo it slowly to avoid traumaFlossing technique

Interdental Brush

Usage

Disclosing tablets & Solutions

Disclosed plaque

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