Ever heard this from your dentist? You only need to brush the teeth you want to keep.
Joking aside, how often and how well we brush our teeth can make a significant impact on our oral health. Eastman Institute for Oral Health’s Dr. Michael Yunker says the best technique for one person may not be the best approach for another. What’s best for you depends upon your particular dental situation.
Most people think the purpose of brushing and cleaning between the teeth is to remove food particles. The real purpose is to remove dental plaque--the almost-invisible layer of saliva, cells, food debris, and microorganisms that collect on the surfaces of the teeth and gums—which, if left in place, leads to dental disease.
Because people are different, proper oral hygiene requires different approaches, depending on each person’s oral conditions. We used to think it was best to use the biggest, stiffest brush available and to brush hard. Now we know a smaller brush will contact difficult-to-reach areas and soft bristles are best for use against delicate gum tissues.
Additionally, if there are spaces between the teeth, bristles of the brush can extend to those areas and more of the tooth surface can be reached by the toothbrush. But, if the teeth are crowded or at least touching, the bristles are only able to contact the part of the teeth that is visible, no matter how well a person brushes.
Some people need an electric toothbrush because they have a disability or simply don't have the dexterity to use a regular toothbrush. And, in some cases, a person may need someone else to do the cleaning for them. You have to use whatever is easiest that still does the job. If the work becomes too hard or too time-consuming, a person's natural instinct is to not do it. That's just human nature.
The American Dental Association recommends the Bass technique, holding the brush at a 45-degree angle to the gum and making very short back-and-forth movements. I suggest a gentle scrubbing method similar to the Bass technique for brushing, with the bristles directed toward the gum and into the spaces between the teeth, trying to get the tips of the bristles to go into the areas between the teeth and between the teeth and gums. For the biting surfaces of the teeth, I suggest a back-and-forth scrubbing motion.
Cleaning between the teeth depends on the condition of the gum tissues and the size of the spaces between the teeth. If there are minimal spaces between the teeth, then flossing is best, making sure to wrap the floss around the tooth to keep from cutting into the gum tissue.
If you have larger spaces between your teeth, or bone loss from periodontal disease, Stimudents or other interdental picks or circular bristle brushes for interdental cleaning will likely work the best. They are easier to use than floss and cover more surface area.
Still, brushing is only part of an effective system of oral hygiene that will prevent and reduce dental problems. Also important are good nutritional habits, limiting snacks between meals, limiting sugar intake, cleaning between the teeth, getting enough fluoride and visiting a dentist regularly on a schedule recommended by your dental professional.
- Brush at least twice a day. One of those times should be just before you go to bed.
- Brush lightly. Brushing too hard can damage your gums. If you think you might brush too hard, hold your toothbrush the same way you hold a pen. This encourages a lighter stroke.
- Have a standard routine for brushing. Try to brush your teeth in the same order every day. This can help you cover every area of your mouth. If you do this routinely, it will become second nature.
- Always use a toothbrush with soft or extra-soft bristle. The harder the brush, the greater the risk of harming your gums.
- Change your toothbrush regularly. Throw away your old toothbrush after three months or when the bristles start to flare, whichever comes first. If your bristles flare much sooner than every three months, you may be brushing too hard. Try easing up.
- Choose a brush that has a seal of approval by the American Dental Association. The type of brush you use isn't nearly as important as brushing the right way and doing it twice a day. Any approved brush will be a good tool, but you have to know how to use it.
Michael Yunker, D.D.S., is an assistant professor and assistant program director for the Advanced Education in General Dentistry program at Eastman Institute for Oral Health.