Brushing techniques for better oral hygiene

Brushing your teeth is a crucial part of maintaining good oral hygiene.  The main objective of brushing is to remove plaque and debris from interproximal spaces and to massage gum tissue. Many methods for brushing the teeth have been described and promoted as being effective and efficient. These methods are categorized according to the pattern of motion when brushing. Each method has been designed to achieve a definite goal. Using correct brushing technique is essential for effective oral hygiene.

Brushing Methods

1. Scrub technique

This is probably the simplest and most common method of brushing.

Position of brush: The bristles are placed on the teeth and the brush is moved horizontally to the posterior region and pulled back. Although this is the method practiced by most of the people, it is not effective in removing the plaque and in the long run it may cause gingival recession and cervical abrasion

2. Bass Technique

Indications: This method is more often recommended in patients with periodontal disease because it provide more access to gingival areas. 

Position the Brush: Place the head of the toothbrush parallel to the occlusal plane, with the brush head covering 3-4 teeth . Place the bristles of the toothbrush at the gingival margin at a 45-degree angle to the long axis of the teeth.

Motion: Exert gentle vibratory pressure, using short back and forth motions without dislodging the tips of the bristle. Strokes are repeated for 10 times 3-4 teeth at a time. Lift the brush and move to the adjacent teeth and continue around the arch. Brush the occlusal surfaces of teeth by pressing the bristles into the pit and fissures with several back and forth motions.

3. The Modified Bass technique

Indications: This technique is particularly indicated for patients with periodontal disease as it helps clean the gum line effectively. 

Position the brush: This technique is similar to Bass technique with slight modification. Place the toothbrush at a 45-degree angle to the gum line. The bristles should touch both the tooth surface and the gum line.

Motion: Gently vibrate the brush back and forth with short, small strokes. This vibration should be enough to dislodge plaque without causing damage to the gums. After the vibration, roll or sweep the brush away from the gum line and the tooth. For the top teeth, roll the brush downwards; for the bottom teeth, roll the brush upwards. Use the same 45-degree angle and short back-and-forth motions on the outer and inner surfaces of all teeth. Use a firm back-and-forth scrubbing motion on the chewing surfaces of the teeth. Tilt the brush vertically behind the front teeth and make several up-and-down strokes using the front half of the brush.

4. Stillman Technique

Indications: This technique is recommended for patients with gum recession and root exposure.

Position the Brush: Place the brush partly on the gums and partly on the teeth.

Motion: Short back and forth motions similar to bass technique and brush head is moved occlusally with light pressure.

3. Charter’s Technique:

Indications: This technique is often recommended for people with braces or after periodontal surgery.

Position the Brush: Hold the brush at a 45-degree angle with the bristles pointing towards the chewing surface of the teeth.

Motion: Use short back-and-forth strokes.

Advantages: Stimulate and massage marginal and interdental gingiva.

4. Circular (Fones) Technique:

Indications: This technique is recommended for children or individuals with limited manual dexterity. 

Position the Brush: Place the brush against the teeth at a 90-degree angle.

Motion: Use large, sweeping, circular motions covering both teeth and gums.

Advantages: Easy to learn and it is not time consuming.

Brushing with electric tooth brushes

It generally uses a small, battery-powered motor to move the brush head. These toothbrushes are often recommended by dentists for their effectiveness in removing plaque and reducing gingivitis compared to manual brushing.

They can be particularly useful for individuals with limited mobility or dexterity, as they require less manual effort than traditional toothbrushes

General Tips for All Techniques

People can follow any brushing techniques and can modify to their needs with the goal of brushing until the teeth is free of plaque.

• Brushing should be done for at least two minutes, twice a day and ensure that you brush all surfaces of your teeth outer, inner, and chewing surfaces.
• Apply gentle pressure to avoid damaging your gums. 
• Don’t forget to brush your tongue everytime to remove bacteria and freshen breath. You can use either tongue scraper or toothbrush itself.
• Consulting with your dentist can help you determine the best method for your oral health.

Choosing the right tooth brush

Toothbrushes vary in size, design, length, hardness, and arrangement of bristles. 

• Soft, nylon bristle toothbrushes clean effectively when it is used properly and tend not to traumatize the gum or root surfaces. 
• Tooth brush heads are available in different shapes such as oval, round, rectangle, diamond shape. Choose the right tooth brush head to ensure that toothbrush head feels comfortable in your mouth and doesn’t causes irritation.
• If all the bristles are flattened in few days, it indicates that brushing is too vigorous. If the bristles look new after 6 months, it indicates improper brushing. Toothbrushes need to be replaced about every 3 months.
• Brushing alone does not remove the debris present in interdental areas, therefore flossing and interdental brushing is also included in the oral hygiene practices. .

The effectiveness and potential injury to gums from different tooth brushes depend to a great degree on how the brushes are use. To reduce gingival recession and cervical abrasion

• Do not use hard toothbrushes
• Do not do vigorous horizontal brushing
• Do not use extremely abrasive toothpowder or toothpaste

Summary 

Choosing the right brushing technique depends on individual dental health needs, dexterity, and personal preferences. Here are some general guidelines:

• Brush at least twice a day for two minutes each time.
• Use a toothbrush with soft bristles to avoid damage to gums.
• Use a fluoride toothpaste to help prevent cavities.
• Proper technique is more important than the type of brush. Focus on gentle, thorough cleaning.
• Any toothbrush regardless of the brushing method used, does not completely remove interdental plaque. Many tools are available for interdental cleaning such as dental floss and interdental cleaners, such as wooden or plastic tips and interdental brushes. 

Regular dental check-ups and cleanings are essential to complement daily oral hygiene practices. If you have specific dental concerns or conditions, consult your dentist for personalized recommendations on the most suitable brushing technique for you.

FAQs

Which brushing technique is most effective?

The modified Bass technique is widely considered the most effective brushing technique for overall oral health. It is particularly effective in removing plaque and preventing gum disease.

What are 5 tips for proper brushing of your teeth?

Use right toothbrush and toothpaste, brush for the recommended time, use proper technique, be gentle and don’t forget to brush your tongue.

What is the 2 2 2 rule for brushing teeth?

The 2 2 2 rule can help establish and maintain a consistent and effective oral hygiene routine in children. Children should brush twice a day and should spend at least 2 minutes each time.

What is the 45 degree brushing technique?

The toothbrush should be positioned at a 45 degree angle to the gum line. The bristles should be positioned so that they are angled towards both the tooth surface and the gum line.

Which brush is best for braces teeth?

Orthodontic brushes are available where the bristles are designed specifically to remove plaque and debris around the brackets and wires.