The goal is to brush 36o degrees around each tooth. And yes this includes the difficult to reach corners of the molar teeth at the back of the mouth. It's always a bit tricky around the back molars. Your hygienist will show you how to use your brushes optimally.
Types of brushes
First of all you need the correct tools. We recommend interdental brushes to clean the 'in-between' areas; tuft brushes for the awkward areas like crowded teeth, tilted molars or partially erupted wisdom teeth; soft bristled brushes to conform to the various tooth shapes without causing trauma stripping the gums which can lead to gum recession. You can use either a manual toothbrush or an electric toothbrush. Take note that there are subtle but significant difference in techniques for the various toothbrush designs.
We suggest using the interdental brushes first, followed by the tuft brush and finally a toothbrush for general cleaning. Always start and keep moving forward in the same direction. Be systematic and make it a habitual routine. It is sufficient to do the full clean once a day but you need to do it really well. A well lit shaving or make up mirror with magnification is helpful. You should see what you are doing. Contact us if you require more brushes or try an online store.
Insert the interdental brush between two teeth, following the slope of the gum contours. Use the entire length of the brush. Push it in and out 5 times. Then wrap the interdental brush around one tooth, position it so that it also follows the curve of the gum margin at the same time. Now push the interdental brush in and out keeping it always in contact with the root surface. Count 5 strokes. You will need to bend the brush to accommodate various tooth contours. Make a note of the direction of the handle of the brush, it should change direction as you wrap the brush around the neck of the tooth. Repeat each step for the immediate adjacent tooth. Remember to use a finger rest and a gentle pressure.
For wider sized gaps the Tepe brand is the best with dense soft bristles and well designed brush wire. In some areas you may need a wide diameter brush to clean directly under the contact area, swap to a narrower diameter brush to clean the "corners" or line angles of the same gap. Use floss for teeth with tight contacts.
Park the bristles 45 degrees or so at the gum margin. Spot jiggle or vibrate on the spot to clean the tooth. Always start at the back, angle the tuft brush into the concavity often found right at the back of the last tooth. Park and jiggle. Count to 5. Move the tuft brush to the corner of the tooth whilst keeping direct contact with the tooth at all times. Repeat the park and jiggle motion. For most patients you will need to do this for all of the molars and any crowded areas with overlapping teeth.
Manual toothbrush versus electric tooth brush
If you are using a manual toothbrush, we teach the Bass technique using a park and jiggle motion. Angle the bristles 45 degrees into the gum margin. Park the brush against the tooth and then do a spot jiggle. Start at the back with the last molar first, then move it to the tooth in front and so forth. Remember to brush the " inside" surfaces facing the tongue and the palate. It should take 2 minutes to brush all of the upper and lower teeth.
The electric toothbrush is like a buffer. Do not jiggle the brush head. Park it against the side of the tooth again at the 45 degrees, then let the electric brush head buffs the tooth surface. Orientate the brush head so that you are " walking" the brush head along dental arch. Patients with limited jaw opening or petite anatomy may benefit from a power tip or a small round head design or a small tapered diamond head shape. We suggest the Oral B or Phillips sonic range.
For patients who have receding gums, it is still important to brush the gum/tooth interface. Remember to use a very soft toothbrush with a very light pressure. Use controlled small movements. These techniques will minimise traumatic injuries to the gums associated with a harsh brushing method.
We may recommend implant care brushes or special care brushes to clean around the implant prosthesis or for the first few weeks after a surgical procedure.
The learning curve
There is a learning curve and it takes practice to obtain the ideal techniques. There is no one method that fits all conditions and tooth anatomy. Your hygienist is highly qualified in providing a personalised one-on-one oral hygiene coaching service with many practical suggestions and recommendations.
Topically applied products
These pastes condition and strengthen the tooth surfaces protecting them from dental caries or sensitivity issues. For patients requiring extra protection, your dentist or hygienist can fabricate a reservoir tray so that you can dispense the paste into the tray to wear it for several hours a day for several days for a single course of care. For many patients seeking mainly maintenance, the paste can be smeared directly onto the tooth surfaces with a clean dry finger tip at bedtime and left overnight. The active ingredients are usually Fluoride and / or Calcium and Phosphate in a bio-available form.
To apply smear a pea size blob over all of the tooth surfaces. Leave for 1-2 minutes. Get rid of the excess saliva. Do not eat or drink or rinse or for 30min afterwards. If possible try to do this at bedtime for maximum benefit. Saliva protects the teeth and at night time the amount of saliva produced by the salivary gland is estimated to be less than 10% of what's produced during the day.
If you are already using sensodyne toothpaste, try smearing a thin layer of sensodyne tooth paste after toothbrushing. The problem with sensodyne is that often the re-mineralizing protection layer dissolves rapidly the moment you stop using the product. The fluoride and calcium phosphate methods are more durable and penetrate deeper below the surface of the tooth.
The re-mineralizing pastes are often prescribed as an aftercare product after surgical and non-surgical treatments.
Should you have persistent intense sensitivity to cold please make an appointment with your dentist or periodontist promptly. Particularly if the symptoms are becoming increasingly more uncomfortable or keeping you awake at night.You may have an underlying problem with the root canal system or a cracked tooth.
Chlorhexidine gel or rinse
These are mainly prescribed for aftercare for a short period of time for specific indications. We do not encourage patients to use this on a long term basis. Try the Curasept range, contact us for instructions for application.
Salt water rinses
Salt water rinses are very soothing and safe for areas of discomfort in the mouth. Please contact your dentist or periodontist for advice if you have persistent discomfort or just had a procedure done recently. Do not rinse if you had oral surgery in the previous 24 hours.
Other home care advice
Wearing a bitesplint
Always consult your dentist/prosthodontist if you have any queries regarding the splint. The purpose of this mechanical device is to protect the teeth and fixed prosthetics from destructive and unsettling occlusal forces by spreading the load on a point over a wider surface area.
The presence of orthodontic hardware increases the microbiological count dramatically. It is important to brush under the wire and around the brackets. Try the interdental brushes and the tuft brush.
For patients who had treatment for moderate to severe gum disease, if you experience a significant relapse in your gum infection we may ask your orthodontist to remove the wire and maybe even the brackets to facilitate proper toothbrushing and any gum treatment.
Karen Marshall, our hygienist, is highly qualified with many years of experience as a hygienist within specialist periodontal practices here in New Zealand and in the U.K. She is here to assist you with your oral health needs and lifestyle choices in terms of prevention of tooth decay and gum infections.