|
Brushing
and
flossing
"good
oral hygiene"
are the two mainstays of oral hygiene. Most people
brush, but few have been shown to remove the plaque
from under the edge of the gum. The bristles of
the brush must slide into the cuff of the gum,
like a broom may slide under the edge of the refrigerator.
The brush should be positioned at a 45 degree
angle to the tooth, and move in a small circular
motion, or shimmy. Scrubbing is not recommended,
in that it may lead to gum recession. (See How
to Brush below) We recommend the use of an electric
toothbrush and would be happy to discuss which
one would be best for you.
|

Brush angles under the gum
Brushing lower molars
Brushing upper molars
|
|
How
To Brush The object of brushing is
to remove plaque from the tooth surface and from
under the edge of the gum, on the inside and outside
of the tooth. It is important to remember that
periodontal disease starts under the gum edge,
and placing the bristles in the sulcus is important
when brushing. Also, remember that brushing cannot
access plaque that forms under the gum's edge
between the teeth, and flossing is needed to complete
that important step of oral hygiene.
 |
Toothbrush
at 45 degree angle to tooth, allowing bristles
to slide between the tooth and gum, to clean
plaque hidden in the sulcus.
|
To brush, angle the bristles of the brush at 45
degrees to the side of the tooth. This allows
the bristles to slide under the edge of the gum,
reaching the hidden plaque. Think of sliding broom
bristles under the edge of a refrigerator to remove
dirt. The brush should not be scrubbed back and
forth, but rather shimmied or rotated in small
circular motions. This allows the bristles to
remain under the gum's edge, and also prevents
wearing the gum.
Brushing
the inside of the upper back teeth. Angle
the bristles at 45 degrees and make a jiggling
motion.
|
Brushing
the outside of the upper back teeth. Do
not scrub.
|
Brushing
the inside of the lower back teeth.
|
Brushing
the outside of the lower back teeth.
|
Brushing
the outside of the upper front teeth.
|
Brushing
the outside of the lower front teeth.
|
When
all the teeth have been brushed under the edge
of the gum, the top surfaces can be brushed. Brush
the cheeks and tongue as well, for plaque forms
throughout the mouth. Remember that brushing does
not clean between the teeth, and flossing is needed
to complete your daily oral hygiene
We generally recommend the usage of an electric
toothbrush such as the Sonicare, Braun or Oral-B.
These toothbrushes have been scientically proven
to be superior at plaque removal than manual or
regular toothbrushes. The angle that these brushes
should be directed is similar to a manual toothbrush,
however the toothbrush will perform the brushing
action required. We recommend you spend 2 minutes
brushing the top teeth, 2 minutes brushing the
bottom teeth and spend 1 minute for flossing every
morning and evening.
Flossing
is the only way to remove plaque from under the
gum, between the teeth. Because most periodontal
disease starts between the teeth, flossing is
even more important than brushing. MOUTHWASHES
DO NOT REPLACE THE NEED FOR FLOSSING.
Good flossing is a skill that takes practice,
but nothing can replace it in preventing periodontal
disease. When learned, it should only take 2-3
minutes a day. When flossing it is important to
slide the floss slightly under the gum, wrapping
around the tooth as far as possible. A clean surface
will elicit a "squeaky clean" sound.
How
To Floss
Brushing
removes the bacterial plaque from the sides of
the teeth, but no brush is able to go between
the teeth AND under the gums. Unfortunately, this
is where most periodontal disease starts, so it
is critical to remove plaque from these critical
areas. Flossing is the most important contribution
you can make to your own oral health. Learning
how to floss properly takes time and patience,
and most patients feel awkward flossing at first.
However, once learned, it is an easy task that
you will enjoy because your mouth will feel cleaner
than ever before. It is not important when you
floss, only that you do it at least once a day.
Because it is not necessary to rinse when flossing,
many patients find that after learning the technique,
they can floss while watching television.
First,
break off an 18-inch length of floss (any kind
you like). Wrap the floss around your middle fingers,
allowing enough room to control the floss with
your index fingers and thumbs.
 |
Using
thumb and index finger for flossing front
teeth
|
Gently
slide the floss between two teeth, allowing it
to pass through the contact of the two teeth.
Many people think this is the stopping point ,
but it is only the preliminary step.
 |
Flossing
going past the contact point of the front
two teeth. The gum has not yet been cleaned. |
Once
the floss "breaks the contact", slide it between
the gum and one of the teeth as far as it will go,
without causing discomfort. The floss is moved up
and down several times, until the plaque is dislodged.
When you hear the floss "squeak", the tooth surface
is clean. Don't remove the floss, but rather slide
the floss against the other tooth, and repeat the
procedure. Each time the floss goes between two
teeth there are two places that must be flossed:
the side of one tooth and the side of the other
tooth. These are two separate steps.
Slide
the floss under the edge of the gum of one
tooth, wrapping around the tooth. Gently
move the floss up and down.
|
Next
guide the floss under the gum of the adjacent
tooth, wrapping the floss and guiding it
up and down.
|
Once
the floss has cleaned between the two teeth, move
to the next contact and repeat the procedure until
all the teeth have been flossed, front and back.
Flossing
the back of the canine, pulling the floss
forward to wrap around the tooth.
|
Flossing
the front of the adjacent tooth by pushing
the floss backward to wrap around the tooth
|
At
first it may take 10-15 minutes to complete the
mouth, but when you become proficient, flossing
should take a total of less than 5 minutes. This
is the best investment of time you can make toward
your oral health.
There are many
other aids that are available to help with oral
hygiene. These include small brushes
that can clean spaces between the teeth (proxibrush),
and threaders to guide floss under bridges (floss
threaders). Toothpicks may be recommended to help
clean furcations. Each patient is individually assessed
to see what may help optimize their cleaning efforts.
Proxibrush
entering space between teeth
|
Proxibrush
cleaning between teeth
|
|