Brushing & Flossing
For advice about how you can improve the way you clean your teeth
Which toothbrush, toothpaste, and between-teeth cleaning method is right for you
Your dentist or dental hygienist if your gums ever bleed
Brush your teeth twice a day
Clean between the teeth at least once a day
Use a brush with extremely tapered bristles
Select a toothbrush with a handle that enables you to achieve the correct brushing angle automatically
To change your brush at least every three months
Toothbrushing for two minutes, twice a day, and every day is a fundamental component of good dental health. Toothbrushing, when performed well with a well-designed brush and a fluoride toothpaste, removes dental plaque to protect against gum disease and dental decay, and delivers fluoride to strengthen the tooth surface and protect against dental decay, acid erosion, and tooth wear.
Different people will take different amounts of time to complete the thorough brushing process to clean away the dental plaque. Most dental professionals believe this should take about two minutes to do well, acknowledging that some people can achieve good cleanliness quicker, and others may need more time. The act of toothbrushing with fluoride toothpaste delivers fluoride to the teeth, where it binds to the tooth surface and strengthens the enamel. Strengthened enamel is more resistant to acid. Acid attacks occur when dental plaque feeds on sugar in the diet and releases acid as a by-product, and when acidic foods and beverages are consumed. Most formulations of fluoride toothpaste will deliver most of their fluoride in approximately two minutes. For these reasons, two minutes has become the standard recommendation of dental experts.
Toothbrushing should be carried out twice a day, morning and night. As toothbrushing cannot reach all the areas between the teeth, specially designed interdental brushes or dental floss should be used once a day to clean between all teeth.
The benefits of toothbrushing twice a day with fluoride toothpaste are:
- Dental plaque is kept to a minimum and cannot build up and become harmful
- Fluoride is applied to strengthen the tooth surfaces and protect against dental decay, and to protect against acids in foods and drinks
- You feel clean and fresh, similar to other personal hygiene and grooming activities
- Your breath is less likely to have an unpleasant odor
- Your risk of dental decay and gum disease is much reduced
Effective oral health starts with the gums. Gums are the pinkish tissue surrounding the teeth and cover the bone that holds the teeth in place. Gums form a barrier of protection against dental plaque.
Dental plaque stimulates inflammation of the gums, a condition known as periodontal disease (gingivitis and/or periodontitis). Researchers in medicine and dentistry have discovered that people who have inflammation of the gums are more likely to experience general ill health, especially conditions such as diabetes, heart disease, and stroke, as well as pregnancy complications. Inflammation is thought to play a role as the chemicals produced in the inflammatory process are carried around the body by the bloodstream. Further research into these associations is ongoing. However, keeping gums healthy is a good start to overall health.
Figure: A healthy mouth in a healthy body. The circulation spreads the effects of inflamed gums throughout the body.
Like any task, selecting the right tools will positively influence the outcome. Dental professionals recommend a soft-bristled toothbrush to remove dental plaque safely. On the other hand, a hard-bristled brush, coupled with vigorous brushing, can result in recession of the gums and the abrasion of tooth enamel and exposed root surfaces. Many of the GUM® brand toothbrushes have a Dome Trim® design so that when the toothbrush is positioned at a 45° angle to the teeth, the raised center bristles are able to clean below the gum line, an important factor in preventing gum disease. Other highly effective bristle designs include those that are tapered to very fine endings that can reach and clean under the gumline (GUM® Technique® Deep Clean Toothbrush is one example) or have micro-feathered bristle tips (GUM® Micro Tip® Toothbrush). The size of the toothbrush head is also important for effective brushing. Toothbrush head sizes are typically full, compact or sub-compact. The compact size is ideal for most adults. A toothbrush head that is too large will not easily reach between the cheeks and the sides of the upper back teeth.
Check the toothbrush package for soft or ultra-soft bristles and the head size (regular, compact, sub-compact, or small).
Over time, the bristles on the toothbrush exhibit signs of wear, which reduces their plaque-removing abilities. The rate of wear will depend on a number of factors and will be unique to each person. However, as a guideline, replace your toothbrush every three months. Additionally, the mouth harbors a lot of bacteria and it is possible for it to be transferred to your toothbrush during use. Therefore, not only is replacing your toothbrush every three months recommended, but also rinsing your brush thoroughly following each use to remove any remaining toothpaste and debris. When storing your toothbrush, it is recommended that it be in an upright position, off the countertop, with the ability to be air dried between uses. If more than one brush is stored in a holder, it is recommended that they be separated to avoid cross contamination. As a further point, at no time should toothbrushes be shared. This could result in the transference of bacteria from one individual to another.
Many dentists and dental hygienists recommend replacing your toothbrush after illnesses such as coughs, colds, or influenza.
Figure: Note the difference between a new brush and one that is worn, with the bristles splayed out, which should be replaced.
The bristles are one of the most important components of a good toothbrush – it is the bristles that actually come in contact with the teeth and gums, physically dislodging dental plaque and stimulating the gums. Bristles in nearly all toothbrushes today are made of nylon – it makes soft, flexible, and hygienic bristles.
Not all nylon bristles are the same! The diameter of the bristle determines how flexible it is. The greater flexibility of narrow bristles enables them to reach into the hard-to-reach areas under the gums and between the teeth. Most toothbrushes have nylon bristles that are parallel-sided and have rounded ends. The end rounding is gentler than simply cut-off bristle ends that can be sharp.
Innovation in bristle technology and design has created the extremely tapered bristle. The tapering allows even greater flexibility and slenderness to reach deeper under the gumline and further between the teeth, in effect cleaning where other bristles cannot reach. Extremely tapered bristles provide more effective cleaning. GUM® Technique® Deep Clean and GUM® Summit®+ are toothbrushes manufactured with extremely tapered bristles.
Figure: The extremely tapered bristle on the left can reach much further under the gums and between the teeth than standard ‘end-rounded’ bristles.
The Modified Bass Technique is a time honored and highly effective method of toothbrushing. Dr. Charles C. Bass was a physician and microbiologist who had been diagnosed with advanced gum disease and advised to have all his teeth removed. Knowing about germs and parasites, he chose to keep his teeth and developed a technique of toothbrushing that would ‘disrupt and disorganize’ the colonies of bacteria (today, known as dental plaque or biofilm) around and under the gums. Dr. Bass died an old man with his natural teeth.
The Modified Bass Technique, as it is now known, involves these key elements:
- Holding the brush so that the brush head and bristles point toward the tooth at a 45 degree angle
- Gently pressing the bristles against the teeth and gums, at the gumline
- Moving the bristles in small, vibratory back and forth or circular movements, enabling the bristles to reach under the gumline and between the teeth, finishing each tooth with a sweeping or rolling movement away from the gums and toward the biting surfaces of the teeth.
It is important to work around the whole mouth moving from one tooth to the next, making sure that both outer and inner surfaces, as well as the biting surfaces, are all cleaned. To reach behind the front teeth, turn the brush lengthwise, end-on, so the narrower aspect can fit more easily.
Dr. Bass is regarded as not only a pioneer in preventive dentistry, but also as the father of personal oral hygiene.
Figure: Dr. Charles C. Bass (1875-1975) developed one of the most popular and effective techniques of toothbrushing.
Figure: A key feature of the Bass Technique is placing the bristles at a 45-degree angle to the tooth.
The ideal handle of a toothbrush will naturally create the 45-degree angle required in the recommended modified Bass Technique of tooth cleaning. The handle should be long enough to provide an adequate and comfortable grip, giving precise control and movement, and allow enough distance between the grip area and the brush-head to enable easy access to the teeth right at the back of the mouth.
The Quad-Grip® handle is a patented design that meets those criteria for the ideal brush handle. The Quad-Grip® handle is available on GUM® Technique® Deep Clean, GUM® Technique® Complete Care and GUM® Technique® Classic toothbrushes.
Figure: The patented Quad-Grip® handle is designed to guide the hand to hold the brush at the 45-degree angle so that the bristles are correctly positioned for optimal cleaning under the gum line
Sensitive toothbrushes are designed to be gentle on the teeth and gums. They generally have finer and more flexible bristles than regular brushes. The bristle texture may be described as soft or ultra-soft.
Sensitive brushes are ideal for people with tooth sensitivity, mouth sores, or during the initial healing after an oral surgical procedure. Due to their soft and gentle nature, they may need to be replaced more frequently than regular brushes. Seek advice from your dentist or dental hygienist about which brush type is right for your situation.
First, you should use a toothpaste that’s right for you. The right toothpaste for you makes for a pleasant and enjoyable experience, leaving your mouth feeling clean and fresh. If you do not like using a particular toothpaste because of its flavor or ‘mouth feel,’ you will never give your mouth the care and attention it needs with regular and thorough brushing.
Other factors to consider are that the toothpaste should contain fluoride to help prevent cavities and that it should not be too abrasive to avoid wearing your teeth. Secondary benefits of toothpaste include anti-gingivitis, whitening, anti-tartar, and anti-sensitivity. If in doubt, ask your dentist or dental hygienist which toothpaste may be right for you.