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Q. Which is the right brushing method?

Answered by
Dr. Bharat Joshi
and medically reviewed by Dr.P.C.Pavithra Pattu
This is a premium question & answer published on Jan 01, 2022

Hello doctor,

There are several videos on how to brush your teeth correctly on the internet. But I am not sure which one is the best method. I am 51 years old and had some fillings for my teeth. But I think brushing in a circular motion may be the right way instead of a back and forth motion. Here is my current oral care routine.

1. I floss once a day before I go to bed late at night.

2. Use a Waterpik after flossing only at night before bedtime. Brush using toothpaste.

3. Then, I use an antibacterial mouth wash for twenty to thirty seconds in the mouth.

4. I also use another antibacterial mouth wash once a day after brushing in the morning.

My question is, what improvements or adjustments should I make over my current oral routine, and would you please explain the correct way I should brush my upper and lower teeth to prevent cavities? Is it necessary to brush your gums also? But I do not have aching gums? I will be having gum grafting first month of early next year. This was advised due to using a medium or harsher bristle toothbrush over the years. My dentist suggests a soft toothbrush, and my mother suggests an extra soft. Although it is more expensive, I only try to use an extra-soft toothbrush that I replace every three months.

Thank you.

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Hello,

Welcome to icliniq.com.

Thanks for writing in, and I understand your concern. First of all, I am glad to know you have 80% knowledge about oral hygiene methods. Yes, you are right; the circular motion could be practiced, but the force used should be significantly less. One stroke is sufficient to clean your teeth. Brushing twice a day is recommended. Once in the morning and at night. For the upper cusp of the tooth, you can go straight to clear debris. Also, simple water rinsing is enough. You can also brush the buccal and lingual surfaces gently. There is no need for a regular mouthwash. Since you are going for a gum graft procedure, please do not brush after surgery for at least a month. You can use Chlorhexidine mouthwash 0.2 percent for two weeks.

Regards.

Hello doctor,

Are you saying one complete circular motion for each tooth is sufficient enough to clean each tooth? I am thinking of adding another brushing to my day, making it three times: morning, afternoon, and late evening as that extra brushing may keep cavities at bay. I am worried that if I brush just day and night, the time gap between subsequent brushing sessions would be too long, and cavities may form. You mentioned previously to brush the upper cusp by going straight to clear debris, which sounds like a back and forth sawing motion. I assume you are referring to the teeth that do the job of biting food. Would you please correct me if I am wrong?

You also mentioned brushing the buccal and lingual surfaces gently. What do you mean by a gentle way? Is it how I should hold the toothbrush and move it? Do you not suggest that I use mouth rinse every day? My hygenist said that after I brush my upper and lower teeth, I can brush my gums in the last. Also, can I use water flosser?

Thank you.

#

Hello,

Welcome back to icliniq.com.

Firstly, brushing techniques are part of our curriculum as a periodontist, so I regularly teach patients and students. Our purpose is to prevent plaque accumulation controlled by simple atraumatic circular motion for one tooth. Gentle movement means less force - theoretically twenty grams. So that trauma is not caused to the gums. You are right, follow a vibratory motion for the cusp but not the same technique on the buccal and lingual surface since that can cause recession or abrasion. You can use water flosser, but regular rinsing as per my knowledge with mouth rinse is not recommended. Flossing regularly is advised too. Lastly, avoid the vertical or horizontal way of brushing.

I hope this helps.

Thank you.

Hello doctor,

Thanks for your response.

There was an article I read last night. That water flosser helps remove food debris and massages your gums, so you get two in one action. I have practiced and corrected the steps on using the water flosser by watching the videos. I must have been using the water flosser wrong, as I have been having the tip touch my gums and in between teeth, which may not be correct, as you mentioned earlier, to massage my gums regularly, at least once a day. I also have another two questions: Is using a water flosser sufficient to do regular massage my gums by providing a two in one action? Or do you only recommend using a manual toothbrush with soft or extra-soft bristles to massage my gums at least once a day regularly? If using a water flosser twice a day is too much on my gums or teeth, please let me know. Or if you suggest using only a water flosser once a day, are the correct methods to use water flosser provided on the online platforms?

Thank you.

#

Hello,

Welcome back to icliniq.com

In my opinion, a water flosser serves two purposes. Firstly, it irrigates your teeth and gums, thereby providing a gentle massage. Massage can also be done with fingers, but a manual force of the hand can aggravate bleeding. Secondly, it includes the removal of plaque which is the foremost principle. And I am delighted that you corrected the technique. Also, water flosser once a day is sufficient because controlled irrigation would be best during the morning. So please use a water flosser once a day to serve the dual purpose of irrigation and gum massage.

Happy to know about your keen interest in maintaining oral hygiene.

Regards.

Hello doctor,

Thank you for your response.

I researched some more and found another article and would like to have your opinion on this matter. First, I would like to share what the article has mentioned. It is said that antibacterial mouthwashes and other commercial mouthwashes are acidic and contain potential cancer-causing chemicals. However, simple gentler homemade rinses can soothe your mouth and balance your pH, among other benefits. For example, they help prevent cavities too.

The two products I have in my home for oral care other than the water flosser are traditional flossing. Another product I use at night after brushing before bedtime is a commercial mouthwash that claims to fight plaque along the gumline, help prevent gingivitis, and kill 99% germs on contact.

My question from all this is whether you recommend any therapeutic mouthwashes that can reduce plaque or contain fluoride for cavity protection for occasional use? Or should I stick with only simple, gentle homemade rinses that soothe the mouth? I never heard of simple gentler homemade rinses.

Thank you.

#

Hello,

Welcome back to icliniq.com.

I agree that there are therapeutic mouthwashes that enhance and provide a positive impact on the oral cavity. But there is one concept, that if we keep on using mouthwashes for everyday purposes, we will make our body completely dependent on mouthwashes. Let me cite an example for you. The best mouthwash, as per the latest studies, is Chlorhexidine with a 0.2 percent concentration. It has maximum efficacy for plaque control. But it is not recommended for more than two weeks because it promotes cancer and causes staining.

Similarly, as you said, commercial mouthwashes does not contain alcohol, but regular use does affect normal microflora. Among them, some are beneficial. They even create an effect on immune levels at a later stage. I suggest you please stick to your paste regarding caries control. And I think you may be having a systemic water fluoridation system that reduces caries to 65 to 85%, which I think is sufficient to control the formation of caries. You have been using commercial mouthwashes for a long time, but as per my knowledge and experience, it will affect your microflora at later stages.

Regards.


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