The key to oral health

Many dentists recommend a rectangular-shaped soft nylon brush without fancy curves and tufts. But actually, this is too vague for most people. The best toothbrush is one with a small head and soft bristles.These bristles should be all of the same height and that have round ends. The advantages of a soft brush are that it can be used on the gum as well as the teeth and tongue with less risk of abrasion. In any event plaque is like jelly and does not require a hard brush to remove it.

You may be wondering why then do manufacturers make hard toothbrushes. The answer is hard bristle toothbrushes are for dentures and bridges, not natural teeth. One way for you to evaluate which brush is the best for you and whether or not you require a prophylactic cleaning from your dentist, is to run your tongue over your teeth after brushing. If the teeth do not feel smooth and clean, you may want to see your dentist.

Another thing, people often ask me, “Doc when do I change my tooth brush, after 3 months, or what?” The answer is that the condition of the toothbrush decides. Toothbrushes are no longer effective if the ends of some of the bristles do not point straight up. As soon as the bristles start to curve outwards its time to get rid of that brush.

Plaque disclosing tablets, available in my clinic, contain a vegetable dye that stains red any plaque that remains on the teeth after brushing and flossing. This is essentially a teaching device to tell you if you are brushing properly. The tablet is chewed and mixed with saliva and then swished to bathe all the teeth with the solution.

By disclosing the residual plaque to view, you can learn where better brushing and flossing are needed. Disclosing tablets are not recommended for daily use but only as an occasional checkup on the brushing efficiency. Since most brushing is deficient anyway, the best advice is to take little more time and work conscientiously at being more thorough.

If you brush more than once a day, it is a good idea to have two brushes. By alternating, the bristles have a time to dry out and become firm again for reuse. Rechargeable battery operated toothbrushes are recommended for handicapped persons who lack the manual dexterity required for hand brushing.
Electric toothbrushes, though relatively expensive, remove plaque effectively from exposed tooth surfaces, though the same results can be obtained from a hand brush if you brush long enough. I personally use an electric toothbrush. Individuals who are too impatient for thorough manual brushing would benefit from one of the newer electric toothbrushes with programmed timers that tell you when to shift from one side of the mouth to another over a period of two minutes.

Following treatment for moderate to advanced periodontal disease, an electric toothbrush, with its high speed oscillation, may be nearly as effective as brushing with both a conventional toothbrush and a small interproximal brush. However, the electric brush cannot completely remove plaque from the proximal surfaces, especially if the spaces between the teeth are filled with gum tissue. Interproximal plaque can be removed from these surfaces only by use of dental floss.

For a person with the average dexterity and no special dental problems, an electric brush may be just one more superfluous gadget. Brushing with toothpaste that combines a very mild abrasive and a safe detergent is the most effective way to clean teeth. However, the best toothpaste is the one that contains fluoride and anticariogenic material. You should not use so much paste that you foam at the mouth when you brush. A half-inch dollop of paste is more than sufficient. The addition of fluorides reduces dental decay and gum line sensitivity. The fluoride can also repair early caries by promoting remineralization of enamel.

Some toothpastes, described as tooth whiteners, may contain harsher abrasives to remove tobacco stains. They are not intended for daily use since the abrasive may wear away the tooth surface, especially at the gum line, and produce areas of hypersensitivity. Do not brush with table salt, which is excessively abrasive. Baking soda, a popular fad in the past, is not as effective as modern toothpastes.

Unless one forms a great deal of tartar, tartar-reducing toothpastes have little advantage over regular pastes. The best guide is to choose fluoride toothpaste that has the approval of the American Dental Association and suits your personal taste (and I am not saying this because I am a member of that Association but because it has been proven in numerous studies).
The function of dental floss is to clean the side surfaces of incisors and cuspids( “eye teeth”) and the front and back surfaces of the bicuspids and molars that cannot be reached by the toothbrush. Dentists call these the proximal surfaces, meaning the sides next to each other. The floss is stretched taut between the fingers, which were placed inside and outside of the teeth. The floss is then gently slipped between hew teeth.

Excessive pressure that snaps the floss through the contact points of the teeth can injure the gum tissue, so it is important to ease rather than force the floss through. The floss should then be worked three or four times up and down in a scraping, motion against the front and back tooth surfaces without rubbing against the gum as it passes from side to side. The floss should not be pulled back and forth like a shoeshine cloth. This “sawing” action can wear grooves into the roots. Flossing helps to prevent bad breath.

Flossing is a skill that does not come easily. It must be practiced until one’s fingers get a “feel” for where they are and what they are doing. Floss holders can be purchased to make it easier, but they are not necessary for anyone with normal dexterity. As long as you can hold a string taut between two fingers you can learn to floss. But even a skilled flosser has difficulty where contacts between the teeth are very tight or they are rough or sharp edges on fillings and tartar deposits that tear or fray the nylon. A trip to the dentist will be necessary to eliminate these problems by smoothing or replacing defective fillings and scaling the teeth.

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