TOOTH BRUSHING

1. TOOTH BRUSHING Dr.Rai Tariq Masood

2. Tooth Brush • The toothbrush is an instrument consisting of a small brush on a handle used to clean teeth through tooth brushing • Act of cleaning your teeth with the tooth brush is called Tooth Brushing

3. Tooth paste • Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth

4. Functions • Used to promote oral hygiene • Aid in the removal of dental plaque and food from the teeth on all the surfaces • Elimination and/or masking of halitosis • Deliver active ingredients such as fluoride or xylitol to prevent tooth and gum disease (gingivitis) • To clean the tongue

5. Amount of paste applied?

6. Tooth brush design

7. Introduction • The bristle tooth brush appeared 1st in china in 1600 • They vary in size, design, length, hardness and arrangement of bristles • Hence recommending a particular tooth brush, the ease of use by a patient as well as the perception that the brush works well are important • Each brush has a Handle, a Shank and a Working end

8. Components of a Toothbrush Handle Working end Shank

9. Ideal Properties of a Tooth Brush • Should remove all the calculus and plaque • Should access all the surfaces of the tooth • Should not injure the Gingiva • The bristles should be soft • The bristles should not deteriorate/ or should have long working life

10. Tooth Brush Design • The bristles are grouped in Tufts • Usually 3 or 4 rows of tufts • Bristles are obtained from Hogs or artificially from the Nylon • Two major types : manual & Electric

11. Manual & Electric

12. Soft and Hard Bristles Which is the better one?

13. Force for Brushing • The amount of force used is not critical for effective • vigorous brushing can lead to -Gingival recession -Bacteremia -Wedge shaped defects in the cervical area of the root surface

14. Tooth brush Trauma

15. TOOTH BRUSHING TECHNIQUES

16. Techniques • Stillman , Charters & Bass • Modified Stillman & Bass technique • Fones technique • Leonard technique • Scrub technique

17. Stillman Method • A toothbrushing technique that incorporates gingival stimulation and dental cleansing, in which the toothbrush is held against both the gingival and the dental surfaces and manually vibrated

18. Continued…… • The bristles ends are placed at 45 degree with the bristles directed apically on the gingiva and partly on the cervical portion of the tooth • when the bristles are in position a gentle but firm vibratory motion is applied to the brush with the bristles remaining in the same position

19. Stillman’s

20. Modified Stillman’s Technique • A occlusal stroke is also added in the movements • The occlusal stroke is used after every vibratory movement. • For Cleaning areas with progressing gingival recession and root exposure to minimize abrasive tissue destruction.

21. Charter’s Method • A method of toothbrushing utilizing a restricted vibratory motion with the bristles inclined coronally at a 45 degree angle. • Used when the interdental gingiva does not fill the embrasure spaces

22. Continued…… • The bristles are placed at 45 degree towards the occlusal surface • The bristles are placed interproximally and then vibratory movement is used while keeping the bristles in the position

23. Charter’s

24. Bass Method (intrasulcular) • Toothbrushing technique for controlling plaque involving placement of the bristles in the sulcus at an angle of 45° to the tooth's long axis and vibrating the bristles in a quick manner from side to side • Most widely accepted method for removal of plaque

25. Continued…… • The head of the tooth brush is placed parallel with the occlusal surfaces of the teeth and the bristles are directed apically into the gingival sulcus at 45 degree angle along the long axis of the tooth • A firm pressure is applied in apical direction and by making short vibratory strokes. • The short back-and-forth motion is easy to master. • It concentrates the cleaning action on the cervical and inter-proximal portions of the teeth, where microbial plaque is most likely to have accumulated.

26. Bass Method

28. Modified Bass Method • The modification consists of sweeping the bristles downward over the tooth surface occlusally

29. Fone’s Technique (circular Method) • A toothbrushing technique in which, with the teeth occluded and with the brush at more or less right angles to the teeth, large sweeping, scrubbing circles are described. With the jaws parted, the palatal and lingual surfaces of the teeth are scrubbed using smaller circles. Occlusal surfaces are brushed in an anteroposterior direction.

30. Continued…… • Brush is placed perpendicular to the tooth • Teeth are clenched and large circular movements are given with the toothbrush • Not recommended now because injury to gingiva usually occurs

31. Leonard’s Technique • A method of teeth cleaning that advocates a vigorous drawing of the toothbrush up and down across the teeth. The teeth are held apart, so that each section is brushed separately. • Also known as vertical toothbrushing.

32. Roll Method • Brush is placed over the gingivawith the bristles placed apically • The jaws are separated • The bristles are pressed against the gingiva and with continued pressure the brush is slowly rolled down over the surface of gingiva and tooth by rotating the wrist

33. Continued…… • Most easy method • But the gingival sulcus may not be cleaned by this

34. Horizontal scrub Method • The bristles are placed 90⁰ to the tooth and move horizontally. • Most widely used method but not recommended. • Can cause gingival recession.

35. Brushing the Occlusal Surface • The bristles are placed at right angle on the occlusal surface with the ends of the bristles deep into the pits and fissures • Vibrate the brush while keeping in the same area • Next give it the circular movements

36. Occlusal Brushing

37. Brushing the Tongue • Place the bristles at a right angle to the tongue • Apply pressure on the tongue and give to and fro movements

38. Mouth Rinsing • Very important • Done to flush away the debris that was loosened but not removed • Water or Mouth wash

39. ADJUNCTS TO TOOTHBRUSHING

40. Introduction • Simple toothbrushing cannot clean all the surfaces • For ideal plaque removal certain aids must be supplemented which assist in cleaning the remaining portions • Dental floss • Interdental toothbrushes • Mouth washes • Disclosing tablets and solutions • Dentifrices

41. Dental Floss

42. Continued…… • Slowly push the floss interdentally, Don’t force it otherwise gingival trauma may occur • Start from the base of gingival sulcus • Move in up & down motion • Move along the tooth surface • Do it slowly to avoid trauma

43. Flossing technique

44. Interdental Brush

45. Usage

46. Disclosing tablets & Solutions

47. Disclosed plaque

49. Thank you