When discussing toothbrushing with our patients we find two consistent themes:
Not enough time is spent to adequately clean the teeth: the average adult brushes less than one minute two times a day; and
To try and compensate for this lack of time many people brush too aggressively. This type of brushing is not only ineffective but can destroy both soft and hard tissues. This can result in recession and tooth root abrasion.
We feel strongly that effective, non-destructive toothbrushing is the cornerstone of long-lasting periodontal and dental health.
It is recommended that you use a soft bristle brush. This type of brush, used properly, will clean more effectively with less chance of injury.
We recommend that you start with brushing the chewing surfaces of the teeth. This way you can scrub back and forth in a forceful manner without hitting your gum tissue. We have found that not only does this allow you to adequately clean these surfaces but it also allows you to use us some energy that otherwise would be directed at scrubbing of the gumline.
Following this, turn your attention to the junction of the tooth and gum. Position the brush at a 45 degree angle where your teeth and gums meet. To clean effectively use small circular motions over the area of only one tooth at a time. The normal toothbrush covers 3 teeth but your efforts should be directed to one tooth at a time. Each tooth is addressed one-at-a-time for a period of 3-5 seconds each. In this way it will take, depending on the number of teeth present, from 45-60 seconds to complete one side of each dental arch. This would expand to 3-4 minutes to complete the entire mouth.
On the inside of the front teeth, both upper and lower, it is more effective to stand the toothbrush straight up and down as it better conforms to the curvature of the dental arch.
This procedure should be repeated a minimum of 3 times per day. For most people, this means upon waking, directly following lunch or returning home, and prior to bed.
The investment of 9-12 minutes each and every day will pay the largest dividend of any oral hygiene time investment.
How to Floss
Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (waxed is easier) about 18″ long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it into place. Bring the floss to the gum line and curve it into a C-shape against one tooth. Then, move the floss in an up-and-down motion (not back-and-forth as this acts to cut the gum tissue) with pressure against the tooth. It is very important not to proceed below the gum tissue very far. It is not your goal to go under the gum until the floss stops, or the gum tissue hurts or bleeds. If you can see the floss just disappear from view under the point of gum tissue between the teeth that is far enough.
We can not stress enough to not proceed under the gum very far at all! We have found colored floss helpful in this regard. Red or green floss can be purchased: these are usually cinnamon or mint flavored, respectively. Their contrast against the white tooth can aid in visualizing when the floss goes beneath the gum.
Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.
To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.
Caring For Sensitive Teeth
Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive, consult with Brete D. Moran, D.M.D., L.L.C.. He may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.
Choosing Oral Hygiene Products
There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.
Automatic and “high-tech” electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes made by Oral-B and Sonicare. For your convenience we have these brushes available at our offices.
Some toothbrushes have a rubber tip on the handle, this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with Brete D. Moran, D.M.D., L.L.C..
If used in conjunction with brushing and flossing, fluoride toothpastes and mouth rinses can reduce tooth decay as much as 40 percent. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gum line so these products have not been proven to reduce the early stage of gum disease.
Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.
Your periodontist, Brete D. Moran, D.M.D., L.L.C., is the best person to help you select the right products that are best for you.
Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Visit your periodontist, as he or she is an important part of your program to prevent gum disease. Keep your teeth for your lifetime.