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
Dentifrice……..aid in polishing and cleaning of tooth surfaces.

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
Hog is pig

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
Presence of bacteria in blood

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 gingiva with 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