Helpful Oral Hygiene Instructions

Brushing

Amongst the profession, the gold standard brushing system is known as the modified bass technique. Studies have shown that this particular method of tooth brushing is significantly superior to standard tooth brushing. Disappointingly, few people are taught to brush their teeth using this method as part of a dental check-up.

The modified bass technique is divided into four stages:

Possibly the most important part of the technique is adopting the appropriate angle for optimum effect. Place the toothbrush on the cheek side of the lower teeth and tilt the head at 45 degrees so the bristles are angled into the gum. Using small circular movements, clean the outside surfaces of the teeth, being sure that the bristles cover both the tooth and the gum margin. This is most effective at removing the plaque that sits at the top of the gum, which is prone to causing gingivitis. Clean the outer surface of both the upper and lower teeth this way before performing a similar action on the inside surface, making sure the bristles are again touching the gum margin.

Once you reach the front teeth, angle the toothbrush vertically so you can access the gum margin. Behind the lower front teeth is the most common place to have tartar/calculus build up because of its close proximity to major salivary glands, so cleaning efficiently here (especially at the gum margin) is very important.

The last stage of the technique involves cleaning the chewing surfaces of the teeth. This surface can withstand slightly more force than that outside surfaces (which are vulnerable to gum recession if brushed too rigorously), so they can be scrubbed with small circular motions to remove all plaque from the fissures.

Flossing

Many people floss incorrectly, potentially damaging the gums. See-sawing, scrubbing or anything with too much force are all both harmful and ineffective at removing interdental plaque.

Flossing effectively can be time consuming at first, but with practice most people can clean every tooth in less than a minute. It is also likely that the gums will bleed if it is your first time flossing but with continued cleaning the bleeding should stop occurring within a week or so.

There are two main ways to hold the floss. The first way involves taking a generous length out of the box and wrapping the ends around the middle fingers so only a few inches are slack between them. This way you can use the thumb and first finger to pinch the floss for control. The second way suggests taking a smaller amount of floss from the box and tying it in a loop. The thumbs and first fingers can then be used to manipulate the loop through the teeth.

Regardless of which method you prefer, the technique for cleaning remains the same: slide the active length of floss down through two teeth (do this gently so if the floss meets some resistance you won’t power through and hit the gum – in these situations it is best to slowly move the floss backwards and forwards until you have passed the contact point). Take the floss down to the gum and slide it gently beneath the free tissue on one side of the chosen tooth. The floss should disappear a couple of millimetres under the gum without any discomfort. Pull the floss (using both hands) into a ‘C’ shape around the tooth and scoop upwards and out of the gum, pulling free the plaque that was hiding there. Complete the action for the tooth on the other side and either pull the floss back up between the teeth or let go with one hand and pull it horizontally through the gap (if not using the loop method).

It is recommended to have a rinse with mouthwash or water after flossing to flush free any loosened debris.

Interdental brushes (vision/TePe)

An alternative to floss, interdental brushes are really simple to use and effective. They come in a variety of sizes (each colour coded) so it is useful to buy a multipack initially to determine the suitable sizes for you. You may find you need multiple sizes for different teeth.

Holding the handle of the brush with your thumb and first finger, gently slide the bristles in between the gap. Don’t force the brush as it may bend or stab the gum; if it doesn’t fit, go down a size. You may find when you first start using interdental brushes that even the smallest size won’t fit: this is often due to a certain degree of gum inflammation which will subside with continued interdental cleaning.

Once the brush is through, pull it back and forth a couple of times. Be sure to manipulate the brush both up (to the contact point) and down (to the gum level) to clean the full area.

Hold the brush under running water to clean it after use.

Helpful Oral Hygiene Instructions