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An adequate oral hygiene is the most effective form of prevention of the most important diseases that affect the oral cavity, namely oral caries and periodontitis.
Oral biofilms formed over tooth structures are the main etiologic factors of caries and periodontitis. Mechanical disruption of these biofilms is the single most effective method to remove them. Chemical agents such as mouth rinses are not able to completely remove the biofilm, this is why they are only used as co-treatments and cannot substitute mechanical brushing.
Tooth brushing is recommended to last a minimum of 2 minutes and should be performed a minimum of two times a day although it is recommended to be performed three times a day. Reducing the time and frequency of tooth brushing will likely leave biofilm and bacterial deposits behind and therefore increase the possibilities of developing caries or some form of periodontal disease.
The best toothbrush is the one that is adequately used. There are mainly two types of toothbrushes; manual and electric toothbrushes. Toothbrushes must be replaced regularly since the bristles of the brush wear of and therefore loose effectiveness. The recommended time to change brushes is once every 2-3 months.
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Oral hygiene
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For manual tooth brushing:
1. Put the toothbrush at an angle of 45º with the tooth and gingiva and allows the toothbrush bristles to gently clean under the gingival line. Gently move the brush back and forth in short (tooth-wide) strokes.
2. Performing a circular or elliptical movement brush the inner and outer surfaces of your teeth. Avoid vigorous tooth brushing that may irritate the gums.
3. In order to clean the masticatory surfaces of the posterior teeth, put the toothbrush directly over them and perform back and forth strokes. Do not forget to also clean the dorsum of the tongue.
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You may decide to use an electric toothbrush. Electric toothbrushes make cleaning simpler and are more effective than manual toothbrushes although they are not mandatory since an adequate oral hygiene can also be achieved with a manual toothbrush. If you use an electric toothbrush you should not perform strokes over the tooth surfaces as recommended for the manual brush, simply gently place the brush over each tooth surface for a period of 10-15 seconds, the toothbrush will do the job for you!
Tooth brushing
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Dental floss is a very useful method to remove the plaque and bacterial deposits that get trapped between teeth. In order to utilize it:
1. Cut approximately 60-80 cm of dental floss and roll it over you middle fingers of both hands. Once rolled over your fingers you should have approximately 10-12cm of floss to work.
2. Use your index fingers and your thumbs to gently insert the floss between the teeth. It is recommended using the thumb on one hand and the index on the other for the maxillae while for the mandible it is recommended to use both indexes.
3. Use gentle vertical stokes to clean each tooth surface. Note that in every space there are two surfaces to clean.
Waxed and unwaxed floss have similar efficacy, however, if you have tight contacts and problems inserting the floss the dental tape may be a more appropriate option for you.
Dental floss
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These little toothbrushes that have a cylindrical or conical shape, they have different sizes and come with or without handlers. They are mainly recommended for patients that have interproximal spaces sufficiently large to insert them and they are a very effective way of cleaning the space between the teeth.
In order to use them, different sizes may be selected to fit into the different spaces. They are required to be used from the outside surfaces and also from the inside surfaces. Once inserted in the interproximal space, the patients should perform horizontal strokes (a minimum of ten) in each interproximal space. It is important to clean the interproximal toothbrush between spaces to remove the plaque attached to them. Interproximal toothbrushes are used without toothpaste.
Interproximal tooth brushes
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