HOW TO BRUSH AND FLOSS

Brush angles under the gum	Brushing lower molars	Brushing upper molars

Electric brushes have been shown to be more efficient than manual brushes. For most people they are easier to use. However, they also must be properly placed around the teeth to remove plaque. They do NOT replace the need for floss.

How To Brush

The object of brushing is to remove plaque from the tooth surface and from under the edge of the gum, on the inside and outside of the tooth. It is important to remember that periodontal disease starts under the gum edge, and placing the bristles in the sulcus is important when brushing. Also, remember that brushing cannot access plaque that forms under the gum's edge between the teeth, and flossing is needed to complete that important step of oral hygiene.

Toothbrush at 45 degree angle to tooth, allowing bristles to slide between the tooth and gum, to clean plaque hidden in the sulcus.

To brush, angle the bristles of the brush at 45 degrees to the side of the tooth. This allows the bristles to slide under the edge of the gum, reaching the hidden plaque. Think of sliding broom bristles under the edge of a refrigerator to remove dirt. The brush should not be scrubbed back and forth, but rather shimmied or rotated in small circular motions. This allows the bristles to remain under the gum's edge, and also prevents wearing the gum.

When all the teeth have been brushed under the edge of the gum, the top surfaces can be brushed. Brush the cheeks and tongue as well, for plaque forms throughout the mouth. Remember that brushing does not clean between the teeth, and flossing is needed to complete your daily oral hygiene

We generally recommend the usage of an electric toothbrush such as the Sonicare, Braun or Oral-B. These toothbrushes have been scientically proven to be superior at plaque removal than manual or regular toothbrushes. The angle that these brushes should be directed is similar to a manual toothbrush, however the toothbrush will perform the brushing action required. We recommend you spend 2 minutes brushing the top teeth, 2 minutes brushing the bottom teeth and spend 1 minute for flossing every morning and evening.

Flossing
is the only way to remove plaque from under the gum, between the teeth. Because most periodontal disease starts between the teeth, flossing is even more important than brushing. MOUTHWASHES DO NOT REPLACE THE NEED FOR FLOSSING. Good flossing is a skill that takes practice, but nothing can replace it in preventing periodontal disease. When learned, it should only take 2-3 minutes a day. When flossing it is important to slide the floss slightly under the gum, wrapping around the tooth as far as possible. A clean surface will elicit a "squeaky clean" sound.

How To Floss

Brushing removes the bacterial plaque from the sides of the teeth, but no brush is able to go between the teeth AND under the gums. Unfortunately, this is where most periodontal disease starts, so it is critical to remove plaque from these critical areas. Flossing is the most important contribution you can make to your own oral health. Learning how to floss properly takes time and patience, and most patients feel awkward flossing at first. However, once learned, it is an easy task that you will enjoy because your mouth will feel cleaner than ever before. It is not important when you floss, only that you do it at least once a day. Because it is not necessary to rinse when flossing, many patients find that after learning the technique, they can floss while watching television.

First, break off an 18-inch length of floss (any kind you like). Wrap the floss around your middle fingers, allowing enough room to control the floss with your index fingers and thumbs.

Floss wrapped around middle fingers leaving 4 - 5 inches between hands	Floss crosses over top of index fingers, which act to guide floss between teeth
Using index fingers allows easy placement of floss in back regions of the mouth	Floss may also be used by crossing over an index finger and opposite thumb
	Using thumb and index finger for flossing front teeth

 

 

 

 

 

 

 

 

 

 

 

 

 

Gently slide the floss between two teeth, allowing it to pass through the contact of the two teeth. Many people think this is the stopping point , but it is only the preliminary step.

Flossing going past the contact point of the front two teeth. The gum has not yet been cleaned.

 

 

 

Once the floss "breaks the contact", slide it between the gum and one of the teeth as far as it will go, without causing discomfort. The floss is moved up and down several times, until the plaque is dislodged. When you hear the floss "squeak", the tooth surface is clean. Don't remove the floss, but rather slide the floss against the other tooth, and repeat the procedure. Each time the floss goes between two teeth there are two places that must be flossed: the side of one tooth and the side of the other tooth. These are two separate steps.

Flossing the back of the canine, pulling the floss forward to wrap around the tooth.

Flossing the front of the adjacent tooth by pushing the floss backward to wrap around the tooth

 

 

 

 

 

At first it may take 10-15 minutes to complete the mouth, but when you become proficient, flossing should take a total of less than 5 minutes. This is the best investment of time you can make toward your oral health.

There are many other aids that are available to help with oral hygiene. These include small brushes that can clean spaces between the teeth (proxibrush), and threaders to guide floss under bridges (floss threaders). Toothpicks may be recommended to help clean furcations. Each patient is individually assessed to see what may help optimize their cleaning efforts.

Proxibrush entering space between teeth

Proxibrush cleaning between teeth