Tooth Brush

Oscillating heads, raised bristles, handles that change colors, you name it, they've made it. But it’s not so much the brush that matters as how you use it! Dentists recommend that you use a soft-bristled brush with a small to medium head size (1" by 1/2").

You might also consider a brush with soft synthetic nylon bristles; the greater porosity of natural bristles harbors more bacteria. Bristles with rounded ends are generally less abrasive to the gums.  But, the choice of which brush to buy remains highly individual and is often decided on the basis of look and feel.

	How long should I brush?
	When should I change my toothbrush?
	Powered vs. Manual

You should brush your teeth at least 2-3 minutes twice a day. Unfortunately, most only brush for 30-45 seconds once a day.

Be sure to change your toothbrush, or toothbrush head (if you're using an electric toothbrush) before the bristles become frayed. Old toothbrushes are ineffective and harbor harmful bacteria that can cause gingivitis and periodontitis. A good rule of thumb is to change your brush once every three months. If you get sick, change your brush at the beginning of the illness and again after you recover. Children's toothbrushes may need to be replaced more often due to greater wear. The first toothbrush was invented in China in 1000 A.D. It had an ivory handle and bristles made from a horse's mane

A recent article in the Journal of Clinical Periodontology reviewed more than 30 studies comparing manual and powered brushes. The conclusion was that the powered brushes showed greater plaque removal efficiency than the manual brushes. However, their clinical superiority was not demonstrated. The articles reviewed did not show any significant statistical superiority of sonic brushes over motorized brushes. In general, powered brushes offer the most benefit to patients who have who have very crowded teeth, who have difficulty in manual dexterity, and/or who simply prefer the latest technology. When considering powered brushes, compare the head size of the different brands. Smaller head sizes allow you to access hard to reach areas. Children under 10 should be supervised when using an electric toothbrush. Make sure they’re not putting too much pressure on their gums with the bristles. Have them used light force and slow movements; this is much more effective and less damaging to the gums.

A note on sonic toothbrushes.

With this new technology, sonic waves are used to remove plaque and bacteria. Through the motion of sound waves, these toothbrushes are able to sweep away plaque in hard to reach places, between teeth, and to some degree below the gumline. Though they tend to be a little on the expensive side, they’re more effective at removing stains than other toothbrush alternatives.  

Don't forget to visit your dentist regularly; brushing and flossing are most effective with combined with periodic checkups and cleanings.

Brushing is not enough, if you don't do it the right way.

Brushing Technique

Place the bristles at the gum margin, establishing an angle of 45 degrees to the long axis of the teeth. Exert gentle vibratory pressure, using short back-and-forth motions without dislodging the tip of the bristles. Complete approximately 20 strokes in the same position.

Continue around the arch, brushing around three teeth at a time, and then use the same method to brush the inner surfaces of the teeth. To help reach the inner surfaces of the front teeth, insert the brush vertically.

Press the bristles firmly into the chewing surfaces of the teeth and brush with about 20 back-and-forth strokes
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FLOSSING

Dental floss is the best way to clean the tooth surfaces between the teeth. Different types of floss are available, such as regular floss, dental tape and superfloss. Floss is also available on a plastic holder, in the shape of a bow. It forms "the string of the bow" and it makes flossing very manageable.

Start with apiece of floss long enough to grasp securely; 12 to 18 inches is usually sufficient. Stretch the floss tightly between the thumb and forefingers.

Pass the floss gently through each contact area of the tooth with a firm back-and-forth motion.

Once the floss is below the contact area between the teeth,wrap the floss around the proximal surface of one tooth, and slip it under the gum margin. Move the floss firmly along the tooth up to the contact area and gently down into the gum margin again, repeating this up and down stroke several times.

Interdental Hygiene Aid

Interdental  (interproximal) brushes

These are triangular shaped small brushes. They are very useful for cleaning between the teeth. They fit onto a plastic handle, and are available in varying sizes. Select the size of brush that is best suited to you. Gently push the brush back and forth into the spaces between the teeth.

This Interdental brush is best suited to teeth that have spaces between them, caused by gum recession, or following gum treatment. Some degree of gum recession is seen in most mouths by middle age, and in those with gum disease, at any age.

End or single tuft toothbrushes

These are toothbrushes with only one tuft of bristles. They are used where the normal, multi-tufted toothbrushes cannot reach. These brushes are designed for brushing around crowns, bridges, displaced and rotated teeth. Gum recession creates spaces between the teeth that need to be kept free of food and plaque.

Interdental rubber tip stimulators

These are pointed rubber tips that are fitted to a handle. They are used to stimulate and toughen up the triangular soft gum between teeth. Your dentist or periodontist will tell you if you need them.

Mouth Washes

Daily oral hygiene practice should include brushing with toothpaste, flossing, and rinsing with a mouthwash. The mouthwash reaches between the teeth, where the toothbrush cannot get to.

It also disinfects all the oral tissues, including the tongue.

Function of the mouthwash are as follows - 

	They freshen the mouth and protect the teeth from decay.
	Breath freshening is a feature of all mouthwash.
	Most mouthwash contain fluoride to prevent decay.
	Some mouthwash claim to have antibacterial and antiseptic properties.
	Treatment for sensitive teeth is included in many mouthwash.
	The instructions and age restrictions listed on the container should be strictly adhered.

Peroxide : This is an antiseptic, which is used to treat mouth ulcers and gingivitis with bleeding gums. It should only be used for a limited time. Chlorohexidine : This is an antibacterial and antiviral medication. It is used to treat gingivitis. Chlorohexidine may leave stains on the teeth, but the dentist can remove them (see Staining of Teeth). Chlorohexidine is safe to use for a short time. It should only be used for a limited time. Fluoride : Fluoride mouthwash can reduce and prevent tooth decay. Triclosan: Triclosan is an antibacterial ingredient, and is also used in many types of toothpaste.

Mouthwash are not to be swallowed. However, it doesn't matter if you swallow some by mistake. Peroxide and Chlorohexidine are not safe to swallow. They are safe for rinsing only. Prolonged use of Chlorohexidine mouthwash can lead to discolouration of tongue, staining of teeth and leads to metallic taste in the mouth. The regular use and spitting out of a fluoride mouthwash is perfectly safe. Excessive doses of fluoride can cause fluorosis or can even be toxic.

Herbs, essential oils and other natural products are the main ingredients of alternative products. The ingredients are claimed to have many beneficial effects : Aloe Vera has a soothing effect. Vitamin K strengthens teeth. Grapefruit seed extract has antiseptic and antibacterial properties. Echinacea is anti-inflammatory and antiviral. Goldenseal claims to be anti-inflammatory and antiviral. It is also an antibiotic. –Peppermint oil and menthol are added for fresh, natural flavors.