Brushing

Q   What is oral hygiene?

A   Oral hygiene is the practice of keeping the mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, and bad breath.

Teeth cleaning removes dental plaque and tartar from teeth to prevent cavities, gingivitis, and gum disease.
Teeth cleaning can be achieved by a combination of brushing and interdental cleaning and the adjunctive use of mouthwashes to reduce tooth decay and gum disease.

Tongue cleansing is also a quick and efficient way to help achieve and sustain a healthy, fresh mouth.

Recent scientific evidence supports the need to practise regular tongue cleansing to help reduce harmful bacteria in the mouth.

Q   Why is brushing important?

A   Daily brushing and cleaning between your teeth is important because it removes plaque. If the plaque isn’t removed, it continues to build up, feeding on the food debris left behind and causing tooth decay and gum disease.

Q   How can plaque cause decay?

A   When you eat food containing sugars and starches, the bacteria in plaque produce acids, which attack tooth enamel. The stickiness of the plaque keeps these acids in contact with teeth. After this happens many times, the tooth enamel can break down forming a hole or cavity.

Q   How can plaque cause gum disease?

A   Plaque can harden into something called calculus another name for it is ‘tartar’. As calculus forms near the gumline, the plaque underneath releases poisons causing the gums to become irritated and inflamed. The gums begin to pull away from the teeth and the gaps become infected.

If gum disease is not treated promptly, the bone supporting the teeth is destroyed and healthy teeth may be lost. Gum disease is the biggest cause of tooth loss in adults and can lead to dentures, bridges or implants.

Q   How can I prevent gum disease?

A   It is important to remove plaque and food debris from around your teeth, as this will stop your gums from swelling and becoming infected. If you leave plaque on your teeth it can develop into tartar, which can only be removed by the dentist or hygienist. It is important to keep up your regular appointments so that your teeth can have a thorough cleaning if they need it.

Q   How do I know if I have gum disease?

A   Gum disease (gingivitis) will show itself as red, swollen gums that bleed when brushed or flossed. Many people are alarmed when they notice this bleeding and will then brush more gently, if at all. It is important that you continue to clean regularly and firmly in order to fight the condition.

Q   Which type of toothbrush should I use?

A   Your dentist or dental hygienist will be able to recommend a toothbrush to you. However, adults should choose a small to medium size brush with soft to medium multi-tufted, round-ended nylon bristles or ‘filaments’. The head should be small enough to get into all parts of the mouth: especially the back of the mouth where cleaning can be difficult. Children need to use smaller brushes but with the same type of filaments.

You can now get more specialised toothbrushes.For instance, people with sensitive teeth can now use softer bristled brushes. There are also smaller headed toothbrushes for those people with crooked or irregular teeth. Some people find it difficult to hold a toothbrush, for example because they have Parkinson’s disease or a physical disability. There are now toothbrushes, which have large handles and angled heads to make them easier to use.

Q   How often should I change my toothbrush?

A   Worn-out toothbrushes cannot clean your teeth properly and may damage your gums. It is important to change your toothbrush every two to three months or sooner if the filaments become worn. When filaments become splayed, they do not clean properly.

Q   How should I brush?

A   Brushing removes plaque and food particles from the inner, outer and biting surfaces of your teeth.

Here is one method of removing plaque:

• Place the head of your toothbrush against your teeth and angle against the gumline. Move the brush in small circular movements, several times, on all the surfaces of each individual tooth.

• Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gumline.
• Use the same method on the inside surfaces of all your teeth.

• Brush the chewing surfaces of the teeth.

• To clean the inside surfaces of the front teeth, tilt the brush vertically and make several small circular strokes with the toe (the front part) of the brush.

• Brushing your tongue will help freshen your breath and will clean your mouth by removing bacteria.

Q   How often should I brush my teeth?

A   Be sure to brush thoroughly with a fluoride toothpaste at least twice a day, more often if your dentist recommends it. If you keep getting discomfort or bleeding after brushing go to see your dentist about it.

POWER BRUSHING

Q   How do electric toothbrushes work?

A   The brush of an electric toothbrush has rotating tufts or a vibrating head which provides a lot of the action needed for thorough cleaning.

Q   Do electric brushes clean better?

A   Tests and clinical trials have shown that certain electric toothbrushes are better than manual brushes at removing the primary cause of dental decay and gum disease, i.e. dental plaque.

Q   Why are electric toothbrushes better at removing dental plaque?

A   With very little movement from the user there is a great deal of active cleaning movement of the bristles against the teeth. They are particularly useful for people with limited movement, such as disabled or elderly people who often find that using a normal toothbrush does not allow them to clean thoroughly.

Q   How do they do this?

A   There are different ways that the design of the toothbrush provides the necessary action to the bristles. One way is to make the individual tufts rotate, or arrange the tufts around a circular head which rotates or even make the bristles vibrate.

Q   What is the benefit of having rotating or oscillating tufts?

A   When there are single tufts which are individually oscillating back and forth many times a minute the bristles are flexible enough to allow better penetration between teeth and so clean areas often missed with a manual toothbrush.

Alternatively a round head with a ring of tufts placed around the perimeter moving back and forth (like the Braun/Oral-B or Philips) works well doing the same thing in a slightly different way.

Laboratory tests have shown that sonic vibrations (as in the Sonicare) are also detrimental to plaque.

Q   Are electric toothbrushes suitable for children?

A   Electric toothbrushes can be better for children as they may be more inclined to brush regularly because of the novelty of using an electric toothbrush. Discuss the idea with your dentist or hygienist to find out if your child would benefit from using an electric toothbrush.

Q   What sort of toothpaste should I use?

A   To have a clean and healthy mouth you need to use the correct dental care products. Ask your dentist or hygienist to tell you what is best for you. Some toothpastes come in a gel form and are ideal for electric brushes. Alternatively using a regular requires running the head under the tap for 15 seconds after use – to prevent the mechanism from becoming clogged with dried abrasive.

As well as regular family toothpastes, there are many specialist toothpastes. These include tartar control for people who are prone to tartar build-up and desensitising ingredients those with sensitive teeth. Total care toothpastes include substances to help fight gum disease, freshen breath and help reduce plaque build-up.

Q   Can I use a whitening toothpaste?

A   Whitening, baking soda or smokers’ toothpastes are not recommended for use with electric toothbrushes because of their additional abrasive ingredients.

Whitening toothpastes are good at removing stains but are not strong enough to change the natural shade of the teeth.

Q   Should I use a fluoride toothpaste?

A   Yes, fluoride helps to strengthen and protect teeth which can reduce tooth decay in adults and children.

Children’s toothpastes have about half the level of fluoride that adult toothpastes have. They still provide extra protection for the teeth but as children have a tendency to eat their toothpaste, there is less risk of them taking too much fluoride.

Q   How much toothpaste should I use?

A   You do not need to smother the head of your brush in toothpaste. Wet the brush head and apply only a pea-sized amount. This is quite enough. Children should use a small scraping of toothpaste.

Q   Can I use an electric toothbrush if I have had periodontal surgery?

A   Discuss with your dentist or hygienist who has examined your mouth. Usually an electric brush will improve your plaque control and so help restore your gums to a healthy condition.

Q   How do I use the electric toothbrush?

A   Apply the toothpaste as described above. Insert the brush into your mouth before switching it on. Place the brush head with the bristles on the surface of the teeth and angled about 45° towards the gum margin. Move slowly from tooth to tooth, being sure to brush especially in between, until all surfaces of teeth have been covered.

Q   Do I still have to scrub?

A   No. The brush head automatically provides the correct cleaning action.

Q   What damage will I cause if I press to hard?

A   If excessive pressure is applied the unit will slow down or even stop.

Q   How long should I brush for?

A   Most recommendations say two minutes but thoroughness is more important than time. Units often have a built-in timer which switches off after two minutes.

Remember to switch off before taking the brush from your mouth to avoid splashing.

Q   My gums bleed slightly after I use the electric brush.

A   If this is a new method of oral hygiene for you, the slight bleeding at first may be normal but should stop within a few days. If it continues for more than a couple of weeks then consult your dentist.

Q   How should I look after my electric toothbrush?

A   Always rinse the brush thoroughly after each use since toothpaste inside the mechanism may prevent the brush from working properly. Fifteen seconds under a running tap should be sufficient.

Q   How often should I completely recharge a unit with rechargeable batteries?

A   Follow the manufacturer’s instructions. Normally rechargeable batteries need a 24 hour charge before the first use, after which EITHER use the toothbrush normally until fully discharged, then recharge for 12 to 16 hours OR replace it on the charger base after each use.

The Unit should be run down completely and recharged for a full 24 hours once every three months.

Q   How often should I replace the brush head?

A   Every three months should be sufficient

COMPACT TUFT BRUSHING

Q   What is a compact tuft?

A   It is a single tufted toothbrush that that has short and extra soft
filaments that are designed to clean in and around difficult to clean areas such as implants and newly erupted teeth.

Q   Do I use this instead of my normal toothbrush?

A   No, it is designed to be used in conjunction with your normal oral hygiene regime. It just helps you access those areas that are difficult to clean effectively with a standard toothbrush.

Q   How do I use it?

A   The filaments of the brush are designed to be splayed under pressure to achieve gentle but effective plaque removal.

An effective cleaning technique for along the gum line can be achieved by gently rotating the splayed filaments a t a 45 degree angle onto the gum margin.

For new and partially erupted teeth, the exposed part of the tooth can be cleaned effectively and comfortably by splaying the filaments onto the tooth surface and agitating the head to disrupt and remover plaque on the tooth surface and form just under the gum.

Q   When should I use it.

A   At least once a day or as instructed by your dentist or dental hygienist.

SINGLE TUFT BRUSHING

Q   What is a single tufted brush?

A   A single tufted brush is a toothbrush that consists of a small collection of specially configured brush filaments mounted on a standard toothbrush handle.

Q   Where would I use a single tufted brush?

A   The angle and configuration of the head makes them ideal for cleaning around implants, orthodontic appliances, crown and bridgework as well as difficult to reach areas.

Q   Should I use a single tufted brush instead of my normal toothbrush?

A   No, these brushes should be used to compliment your normal oral hygiene routine.

Q   Why is my normal toothbrush not enough?

A   A standard toothbrush is not able to reach the small and often difficult to access areas in most mouths. Any additional surfaces such as implants and orthodontic appliances require meticulous plaque control, which is often more easily achieved with a single tufted brush.

Q   How do I use a single tufted brush?

A   Once the angle of the brush tip is established, the bristles should be placed against the surface to be cleaned and either: 

• Splayed and agitated as in the case for cleaning around an orthodontic appliance.

• Splayed and moved with a small circular action for cleaning implant abutments.

• Splayed and swept along the gum line in the case of difficult to access back teeth.

Q    How often should the single tufted brush be used?

A    You need to clean thoroughly around appliances and prosthetic work at least once a day or as directed by your Dentist or Hygienist.