How should I brush my teeth?

July 29, 2011

Tooth brushing

How should I brush my teeth?

Carefully and thoroughly. The idea is to hit every surface to disturb the bacteria. Time on task is important. Studies have shown that time spent is more important than specific techniquesor toothbrushes, see toothbrush blog. If you spend two minutes brushing you probably can’t help but hit every surface. Two minutes is a long time brushing. Try it you will be amazed. Most people spend less than 30 seconds. Automatic toothbrushes with timers and other timing devices can help to keep you on task long enough.

Several techniques have been developed to help prevent damage done by overzealous brushing and to more efficiently clean your teeth in a shorter time. One of the most important areas is along the gum line where the tooth emerges out of the gum. In older patients this is where the action is because this is where gum disease begins. The most popular technique, the Bass technique emphasizes placing the toothbrush at a 45 degree angle and using small circular strokes click to view

Things not to do:

Push or exert excessive pressure on the toothbrush against the gums. This will simply wear away the teeth and gums.
Do not use a hard brush, see toothbrush blog
Do not brush rapidly and horizontally across the teeth and gums. This also will tear away the gums and abrade the teeth causing sensitive teeth.

Tips that we have found useful for our patients:

Develop a system and order in which you brush so that you brush every surface. Unfortunately most people start and spend too much time brushing the easiest place to brush; the corner of the mouth, by the cuspid or eye tooth. This area is the most common site of excessive wear and gum loss. Our recommendation is that you start on the inside of the lower teeth next to the tongue, one of the most difficult and most neglected areas.
Make sure you close your mouth and relax your cheeks. Many people open their mouth slightly when brushing and this prevents them from reaching the back surface of the molars. Other patients use their cheek muscles to force the toothbrush against the teeth causing excessive wear.
Use warm water to further soften the bristles of the toothbrush. This also helps with teeth that have become sensitive to cold because of overzealous brushing.
Use a smaller brush. The smaller head allows access to the back teeth more easily especially for those with small mouths.
The inside of the lower front teeth are difficult to reach because of the narrow space. We have found the best way to reach this area is by holding the toothbrush vertically, literally with your hand up by your nose and using small vertical strokes.
Do not use too much tooth paste it simply makes your mouth fill up with foam and makes you want to. spit This reduces the time actually spent brushing.

How often do I need to brush?

We recommend brushing twice a day. Once in the morning to get rid of that morning mouth and bacteria that have grown over night and once at night to remove the bacteria and food that have accumulated during the day. If you could brush perfectly and disturb all the bacteria completely you would only have to brush once a day. Unfortunately most of us are not perfect and we miss some bacteria here and there so that brushing twice a day gives us another chance to get to every surface. Besides if feels good to go to bed and start the day with a fresh mouth.
Some people get carried away and brush almost every chance they get, often because of concerns regarding bad breath or to try to make their teeth whiter. Suffice to say if you thoroughly clean your teeth and you still have bad breath brushing them again is not going to solve the problem. We will deal with the other causes of bad breath and how to deal with them in another blog. Over brushing your teeth in an attempt to whiten them is counter productive because you actually wear the enamel away which then lets the yellower/darker portion of the tooth show through. Brushing too frequently is just as destructive to teeth an gums as brushing too hard.
Some people think they can overcome the guilt of bad habits like soda drinking, coffee with sugar, sour candies and other decay causing substances by immediately brushing their teeth. Unfortunately studies have shown that the teeth are softened by the acid in these and more susceptible to being worn away if brushed immediately. A better idea is to rinse your mouth with water or a fluoride mouthwash.
We recommend the fluoride mouthwash because it will taste terrible and at least make you feel like you paid for your sins.
So it really is simple: clean your teeth carefully and thoroughly.

Wake yourself up

I have also found an additional benefit of brushing your teeth: It wakes you up. On long drives at night, like going to Mammoth, when I start to get drowsy I dry brush my teeth rather than drinking coffee. The gums have excitatory receptors that when you stimulate them with your toothbrush you wake up. As a dental student/student researcher/paid research subject at UCLA I experienced first hand electrical stimulation of these receptors and believe me they can light up your life.