Dentist.Com®

The most important instrument in healthcare.

Submitted by Darrell Pruitt DDS

While one can easily find popular literature including specialty magazines about healthy diets and exercise, when was the last time you went out of your way to look for a story about tooth-brushing technique? Look no further. I brought it to you right here – perhaps uncomfortably close for some.

Increasingly, medical research is linking poor oral health to serious chronic diseases such as diabetes, heart disease and kidney disease. In fact, for people who suffer from diabetes, the disease increases one’s susceptibility to gum disease, while at the same time, gum disease worsens the diabetes. If you know someone with bad breath, risk a little embarrassment. Tactfully let the person know that their mouth smells unhealthy – especially if the friend or family member is frail. Love is courage.

Very few people give much thought to brushing technique, yet a simple toothbrush in the hands of someone who is paying attention is the most valuable invention there is for maintaining whole-body health.

I find it interesting that some people who exercise for an hour or so every day in order to keep fit spend only seconds brushing their teeth. Even though many patients are truthful when they volunteer that they brush twice a day, their inattention to the effort does not go unnoticed by dentists and hygienists. We see the results that tolerant friends and family only smell.

I know that for a professional to write this frankly about oral health issues perhaps makes some readers uncomfortable. I am quite sure that it makes a few of my colleagues uncomfortable as well, but because of traditional reasons. Nevertheless, I plow on because it is my opinion that around the turn of the century, we all grew up a little bit. Modern Internet communication tools such as this USN&W forum cause stilted conversation in a flat world to appear top-heavy and foolish. Today, I wish to offer a few common sense tips about techniques of cleaning one’s teeth that may make a difference in someone’s life. Maybe even someone you know.
…..
From what I have witnessed, I must assume that many people often find themselves already running late only a few minutes into each brand new day. The last thing they hurriedly do before leaving home is to clean a few favored teeth – neglecting several habitually.

Patterns offer predictability. For example, a dentist or hygienist might see three or four clean teeth, interrupted by a segment of dirty teeth, and followed by a few more clean teeth. No matter what though, no one misses the fronts of the upper front four.  Understandably, the very last upper and lower molars are neglected most often, as well as between the teeth. It stands to reason that these are also the areas where decay and gum problems are most likely to start.

Here is some obscure dental knowledge for you: A patient’s handedness is often revealed by teeth that are commonly missed. For example, the fronts of upper and lower cuspids on the right side are often missed by right handers – completely skipped when some of them alter the position of their hand while moving from the back teeth to the front. Take that to Vegas.

It makes sense that a habit of following an organized path should be developed – eliminating the possibility of haphazardly missing certain teeth repeatedly. Here is what my staff and I recommend to our patients: Begin brushing behind the very last tooth on the upper right – angling the bristles in a forward and upward direction so that you can massage the gums at the neck of the tooth. It is the hardest place in the mouth to reach, so you may have to move your chin to the right to make room for the toothbrush. Take
your time and make sure you feel the bristles rub against your gums as you follow the edge of the gums around to the cheek side of the teeth and on towards the front of the mouth. A picking and probing motion is best. Rapidly brushing back and forth not only misses between the teeth, but slowly cause grooves to wear at the necks of the teeth that can eventually become so deep as to cause them to break off at the gums. As you come to the canine, make sure you don’t skip this area when you change positions for the front four favorites. Don’t become a statistic.

As you come to the last tooth on the upper left, shift your chin to the left to allow room for the head of the toothbrush. After cleaning the hard to reach spot from the cheek side, position the toothbrush bristles against the tongue side of the last tooth and continue picking and probing along the inside of the teeth – all the way around to where you started about a minute and a half earlier at the back of the last molar on the right. Then repeat the organized path of brushing for the lower teeth for another 90 seconds or so.

Electric toothbrushes are wonderful because they eliminate the fine wrist movements that are necessary to adequately stimulate the gums. However, one must still pick and probe, but for not as long.

Here is some bonus information for those who cannot force themselves to floss – no matter what. What if I told you that you don’t have to? Be aware that the following is my personal opinion and is not advice that I can support with any research. I back my claims with 25 years of knowing dental patients.

If one can attentively push the bristles of a soft toothbrush, preferably electric, half-way through the space between the teeth from the cheek side, wriggle them a bit, and then push them half-way through from the tongue side, one can save time and effort without increased risk of gum disease or cavities. That’s right. A licensed dentist, and proud member of the American Dental Association, has just suggested that even though flossing one’s teeth is a wonderful way to thoroughly clean between most (but not all) teeth, it is an intricate two-handed and messy routine that a majority of the population simply does not want to do. Let us face it. Most people will never floss. It is my opinion that all-or-nothing flossing doctrines actually discourage many from trying anything at all. How good is that?

Wait. There is more. I also claim that toothpicks are excellent tools for oral health. Once again, if one attentively manipulates a toothpick form both sides of the teeth once or twice a day, it will keep the gums very healthy, even if one does not floss. Just don’t do it at the table, please.

One last thing. Visit a dentist of your choice a couple of times a year. We care!