Manual toothbrushes are still the most frequently used device for dental biofilm (plaque) removal and overall for oral hygiene. However, as dentists, we know that the effectiveness of a manual toothbrush depends on several factors, such as brushing time, frequency, technique, and suitability of a specific toothbrush for a given patient. In this article, we share our top ten tips for helping your patients maximize the effectiveness of their manual toothbrushing.
Good brushing habits are of course essential, regardless of the brush being used. Patients with poor oral hygiene may be surprised to see just how much biofilm is hiding in plain sight! Using a dye-based or light fluorescence plaque indicator lets them see it. Simply gently running a probe over an area with dental biofilm and removing it with the probe to show it to them can help too. Repeating this at recall visits to show patients the positive results of their renewed oral hygiene efforts can motivate them further and any areas they are still missing.
For each patient, recommend a manual toothbrush with a brush head that suits their needs. A brush head size that is too large could make it difficult for patients to reach all areas of the mouth. For certain patients, a more compact brush head can help them to clean more comfortably and thoroughly.
Perhaps a plain bristle field might suffice, however your patient may benefit from a brush head with tapered, angled, multi-level or another bristle configuration. A brush with a soft-textured cheek and tongue cleaner helps to remove bacteria from the tongue and cheeks. The Colgate 360° Toothbrush has this feature as well as tapered bristles, and a raised cleaning tip area and soft rubber polishing cups incorporated into the brush head. Together, these provide for a whole mouth clean. For patients with fixed orthodontic appliances, a brush with u-shaped bristles or v-trimmed bristles like the Colgate® Ortho Toothbrush helps to clean around these.
Soft bristles are recommended by the American Dental Association (ADA) to minimize the chance of gingival abrasion. For patients with sensitive teeth, choose an ultra-soft toothbrush. Whatever your recommendation, the bristles should have rounded ends.
For younger patients, or those with limited manual dexterity, recommend a toothbrush with a chunkier handle and an anti-slip grip. Anti-slip grips can be helpful for other patients too. In addition to providing a more effective clean, this will make it easier for patients to brush without the brush slipping out of their hand. That could solve any frustration with toothbrushing that your patient may have experienced and encourage patients to stick to their oral hygiene routine.
The best brushing technique for your patient will ultimately depend on their individual oral health status and needs and on the brush. For example, you might recommend the Bass technique for most adults, the Fones for children, and the Charter for those with orthodontic appliances. For some patients, you may need to modify the techniques to suit their needs or abilities. Whichever you recommend, be sure to coach your patients on the correct pressure – strong enough to achieve a thorough clean, but not so strong that they damage the soft tissues or the bristles on the brush.
Empower your patients to care for their oral health with engaging, hands-on activities. You could demonstrate proper brushing technique with a dentition mock-up, or have the patient show you how they would brush their teeth at home. For parents of younger children, you could also recommend a training toothbrush. This special brushes feature an additional space on the handle for the parent’s hand, allowing the adult to guide the child as they brush.
Offer patients take-home resources to refer back to later, or point them towards online resources.
Brushes with bright colors, colorful designs on the brush handle and popular figures are appealing to children and can help motivate them to brush.
Timing and frequency are critical for effective biofilm removal. Remind your patient that for best results, they need to brush for two minutes, twice a day.
The Centers for Disease Control and Prevention (CDC) notes that toothbrushes become contaminated with bacteria, oral debris, blood and saliva from brushing. They recommend thoroughly rinsing the toothbrush with tap water after use, and advise against soaking the toothbrush in mouthwash or other cleaning solutions.
To prevent microbial growth, the ADA states that toothbrushes should be left to air-dry and should not be covered. They should be stored in an upright position, rather than a closed container, and they should not touch other toothbrushes.
As the bristles on a manual toothbrush become worn, the cleaning power of the brush drops significantly. For maximum effectiveness, encourage your patients to replace their manual toothbrush every 3-4 months in line with recommendations from the CDC, ADA and other dental organizations.
Let your patients know that this is a guide; soft-bristled toothbrushes wear faster, so if their toothbrush is showing signs of wear before the three-month mark, they should replace it sooner. Quick wear might also indicate that the patient is brushing too vigorously, so be sure to enquire about this possibility and address the issue if necessary.
Finally, make sure your patients know the number-one rule of toothbrushing: never share your toothbrush! Partners, or parents and kids, often think nothing of using each other’s brushes in a pinch, but this is a habit you should advise against. Recommend color-coded brushes to avoid any mix-ups.
We only get a short time with our patients in the chair, so it’s important to make sure that what they do at home really counts. With these simple tips for maximizing manual toothbrushing, you can empower your patients to take charge of their oral hygiene and achieve better health outcomes.