The Right Way To Brush!
From the time we can remember and acknowledge the presence of pearly white teeth in our mouths we have been subconsciously carrying on a procedure introduced and taught to us by our parents and have been disciplined such, that it has become a habit and in some ways, a tradition.
The use of such powerful words do not seem justified in describing a simple day to day task of – Tooth brushing, but it well deserves the spotlight. And it should. In the hectic life styles we lead – the only thing which hits the mind the next morning after a late night and few minutes of oversleep is the fear of being late and the thought of being on time to work; the least of all worries is a proper tooth brushing! Here we’re just talking about an average adult with a normal lifestyle. A child on the other hand, thinks less – his agenda for the day starts with having to wake up early in the morning to go to school, a quick nibble and the numerous last minute preparations before the school bus comes. No doubt, no matter what the excuse, certain things in life should follow strict discipline. But lets think practically for a minute, in either one of the situations the least importance one gives to are – the Teeth.
In my limited years of experience in private dental practice, I am frequently faced with the task of answering a particular set of queries from concerned parents as well as adults, and the questions being – how to brush properly, or, even after regular brushing twice or thrice a day why doesn’t it seem to work, or, is there a specific way to brush, and, Why is brushing so important?
Very trivial questions, as a few may wonder, because the answers to these certainly do not solve issues such as global warming or promote world peace, but it surely holds a fathom importance in our day to-day lives as tooth decay is the second most commonest disease encountered by man standing only next to the common cold. The most frequently encountered dental disorders are – Dental Caries (tooth decay), and Periodontal diseases (gum diseases). The disease process in both these are long and different from one another but the root causes are the same – Plaque and Negligence.
Dental Plaque is the primary culprit in the pathogenesis in these disorders. Plaque is a buildup of a yellowish film on the tooth surfaces, which harbor bacteria. The bacteria that are found in these ferment the sugar and starchy-food debris found there into acids that destroy the tooth's enamel and dentine causing decay. Plaque is also the principal causative factor for the frequently encountered inflammation of the gums, also known as gingivitis. This condition is reversible and if not intervened on time leads to calcification of the soft plaque deposits into calculus, which cause pockets in the gums (periodontal pockets), infection, recession of the gums resulting in bone loss and eventually tooth loss.
Scientific studies by various researchers have highlighted the deleterious role plaque plays in the disease processes, and conclude that the solution lies in the prevention of plaque formation and in its early removal. Researchers also have demonstrated the results achieved after an efficient oral hygiene program i.e. after the adoption of good tooth brushing techniques, diet regimes and sound home care with periodic check ups.
Plaque formation is inevitable; it forms every time there is an intake of food. But it can be removed before any significant harm can be done. Bacteria residing in the plaque generate acids from sugar or starchy foods with in half an- hour of intake and the disease process is underway, hence if the teeth are brushed with in half hour after eating it is most significant. Practically this does not seem feasible, I mean imagine carrying a toothbrush with you all the time. But it is effective. Numerous researchers, based on sound scientific evidence have formulated a number of the so-called ideal brushing techniques. Each with its own complicated approach and technique. No doubt all of them are very efficient and remove plaque to a greater degree but most of the techniques are just a bit too complicated and adhering to their exact technique is a problem to few. Each of them is a slight modification of the other. The brushing technique used must be practical, easy and efficient. A to and fro action is totally contraindicated as it abrades the enamel from the teeth leading to other complications. The brushing stroke must be firm but gentle, in a circular manner starting from the gum margins and extending over the tooth surface. The circular motion must be applied on all the teeth on all their surfaces i.e. on the insides, out sides and the biting surfaces. This circular method of brushing is efficient and very easy to master and is ideally taught to children. This is the current principle behind the technology of power toothbrushes available in the markets, which perform highly satisfactorily.
In conclusion, prevention is definitely better than cure. A complete prevention of plaque buildup is next to impossible but it can be limited and efficiently removed. All snacks in between meal are to be avoided completely. Make sure that the meals consumed have a lesser quantity of refined carbohydrate contents in them i.e. avoid the various forms of junk food. Also introduction of foods with increased fiber content in the meals i.e. foodstuffs that require a good amount of chewing help. Most importantly, brush after meals, and brushing before bedtime is mandatory. When it comes to the brushing approach, equip your self with a good toothbrush preferably a soft toothbrush with a small, angulated head with bristles placed in a crisscross manner or a power-toothbrush. These make sure that the difficult regions in the mouths are also made accessible and the brushing removes plaque. For the toothpaste, any leading fluoridated toothpaste of choice can be used, unless, your dentist prescribes you a specific toothpaste. To top it all up, flossing – has to be performed at least once a day preferably at bedtime. For those uncomfortable with flossing, an inter-proximal / inter-dental brush can also be used for the same. Finally, for the toddlers, never put them off to sleep with the bottle and after every feed, be sure to use a sterile moist cloth or cotton to wipe the surfaces of the newly erupted teeth clean. This ensures that they are out of harms way from an early age.
A home assessment of your brushing procedure and technique can be done very easily by the use of these Plaque detectors or Plaque Disclosing agents, which are available at the chemists or your local supermarkets. These visibly show you the results of your performance and allow you to be the judge and help you improve your brushing.
Dr. Murali Srinivasan, MDS.
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