Toothbrushing

The major dental conditions of decay and gum disease can both be reduced by regular toothbrushing with fluoride toothpaste. 

 

To control decay it is the fluoride in toothpaste which is the important element of toothbrushing, as fluoride serves to prevent, control and arrest caries. Higher concentration of fluoride in toothpaste leads to better caries control.  Flouride content is stated as "parts per million" or ppm.

To control gum disease the physical removal of plaque is the important element of toothbrushing as it reduces the inflammatory response of the gingivae and its sequelae.  Some toothpastes contain ingredients which also reduce plaque, gingivitis and bleeding gums.

Smear
Children under 3

Pea

Children between 3 and 6

There is evidence to suggest that the preventive action of toothbrushing can be maximised if the following principles are followed:

•brushing should start as soon as the first primary tooth erupts

•brushing should occur twice daily as a minimum – clean teeth last thing at night before bed and at least one other time each day

•children under three years should use a toothpaste containing no less than 1,000ppm fluoride

•children under three years should use no more than a smear of toothpaste (a thin film of paste covering less than three-quarters of the brush) and must not be permitted to eat or lick toothpaste from the tube

•family fluoride toothpaste (1,350-1,500 ppm) is indicated for maximum caries control for all children except those who cannot be prevented from eating toothpaste.  Advice about adult supervision and the small amounts to be used will be given by your dentist

•children between three and six years should use no more than a pea-sized amount of toothpaste

•children need to be helped or supervised by an adult when brushing until at least seven years of age and must not be permitted to eat or lick toothpaste from the tube

•rinsing with lots of water after brushing should be discouraged – spitting out excess toothpaste is preferable

•rinsing with water, mouthwashes or mouth rinses (including fluoride rinses) immediately after toothbrushing will wash away the concentrated fluoride in the remaining toothpaste, thus diluting it and reducing its preventive effects. For this reason rinsing after toothbrushing should be discouraged

•toothbrushing aims to maximise plaque removal, you should systematically clean all tooth surfaces. No particular technique has been shown to be better than another

•disclosing tablets can help to indicate areas that are being missed

•brushing is more effective with a small-headed toothbrush with medium-texture bristles

While there is evidence that some powered toothbrushes (with a rotation, oscillation action) can be more effective for plaque control than manual tooth brushes, probably more important is that the brush, manual or powered, is used effectively twice daily.  Thorough cleaning may take at least two minutes.