Brushing

How to brush your teeth effectively

Brush your teeth after every meal if possible, or at a minimum, two times per day—when you wake up, and before you go to bed. Studies have shown that mechanical toothbrushes are superior to manual toothbrushing at removal of plaque.

If you do use a manual brush, try and brush for at least two minutes whenever you brush. Many mechanical brushes have built in timers, that alert you when it’s time to switch areas of the mouth and when two minutes have passed. You may be surprised at how long two minutes is!

If you’re using a manual toothbrush, consider purchasing a low-cost two minute “sand” timer (the kind you flip and watch the grains run out).

The mouth is full of nooks and crannies that can be difficult to clean—including overlapped or crowded teeth; under dental restorations like dental bridges or orthodontic treatment; and the pits and fissures of the back teeth.

Also, be sure to brush the teeth at the gumline.

Brush your tongue

Volatile Sulfur Compounds (VSCs) accumulate on the corrugated surface of the tongue. They’re the ones that cause bad breath (halitosis). In order to remove them effectively, it’s important to brush your tongue every day—or use a tongue scraper.

Having trouble holding a toothbrush?

Some people have difficulty grasping a toothbrush, due to hand injuries, arthritis, or other afflictions, and may find it particularly difficult to clean their mouths effectively. For some of these people, enlarging the handle size may prove helpful. This can easily be done by making a hole in a tennis ball and positioning the toothbrush into the hole. The patient then holds the tennis ball, which in turn “grasps” the toothbrush, making it easier for the patient to manipulate.

Some people may also find it difficult to hold and manipulate dental floss in order to clean between their teeth effectively. Several manufacturers make flossing devices that hold the floss rigidly in a plastic framework. The device helps to insert and remove floss from between the “interproximal” contacts of the teeth, allowing the user to raise plaque and biofilm out of the gingival sulcus where it may be swept or rinsed away. Flossing devices often incorporate a tooth pick at the free end. They are intended for single use, and are typically discarded after flossing all of the teeth one time.

Electric toothbrushes

Although the exposed surfaces of teeth can be cleaned effectively with a manual toothbrush if care is taken, electric toothbrushes do offer certain advantages that cannot be duplicated in a regular brush.

Cleaning your teeth is important, and while manual toothbrushes can work well if used carefully, electric toothbrushes have some advantages. They use a motor to make more brush strokes, which helps remove more bacteria from your teeth. This can make it less likely for you to have tooth decay or gum disease.

Some electric toothbrushes also create sound waves that can kill bacteria, even in areas where the bristles might miss. They may also tell you when it’s time to switch areas of your mouth, and when you can stop brushing.

Electric toothbrushes are especially helpful for people with arthritis or other conditions that make it hard to use a manual toothbrush.

Ask your dentist if an electric toothbrush would be good for you. And remember, even if you brush well, you still need to floss every day to prevent gum disease and tooth decay between your teeth.

Interdental brushes

Interdental brushes are special cleaning tools that come in different sizes. They are cone-shaped and can help you clean areas that regular toothbrush bristles can’t reach. They’re also useful for cleaning bridges and dentures. It’s important to clean the margins of the tooth/bridge interface effectively because decay is most likely to occur there.

To use the interdental brush, clean along the margins with the tip of the brush. Be sure to clean under the connectors, which a regular toothbrush can’t reach. Dental floss can’t reach these areas, so it’s important to clean them properly to prevent tooth decay and gum problems.

If you have braces, interdental brushes can remove plaque from around the brackets and in the spaces between the wires and your teeth. For dentures, an interdental brush can be used to clean beneath the retainer bars. People with difficulty using their hands may need help from a caregiver to properly clean under the bar.

Oral hygiene for braces and dental bridges

Orthodontic braces and dental bridges can be especially difficult to clean, because there is no easy way to get between the teeth. Orthodontic arch wires and brackets create barriers that make it difficult to adapt a toothbrush to the exposed surfaces of the teeth, and to clean along the gum line. Likewise, the teeth of a bridge are fused together, so you can’t use floss to clean between them. There is a significant risk of developing tooth decay on the abutment teeth—on the side that faces the pontic—if you don’t clean effectively under the bridge every day. The above video, while directed at people who wear braces, is also very applicable to patients with bridges.

Fortunately, special brushes and floss tools are available to simplify the task, and can be a big help in preventing cavities and gum disease for patients with braces or bridges, and are typically available at a drug or convenience store. If you find these devices difficult to use, or if you have trouble finding them in a store, ask your dental professional for their recommendations.

• Floss threaders: A floss threader is a flexible, yet rigid plastic tool for passing dental floss under fixed bridgework, behind orthodontic wires, and beneath removable denture retainer bars.
• Interdental brushes: Interdental brushes are special cone-shaped cleaning devices which are available in many sizes.
• Toothpicks: Although they may not be as effective as floss threaders or interdental brushes, toothpicks are readily available, and are much better than neglecting to clean under your bridge or braces.
• Oral irrigators: Oral irrigators are good at removing bulk food debris, but are largely ineffective at removing the filmy plaque (biofilm) that adheres to teeth and is loaded with bacteria.