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The Perfectly Clean Mouth

woman holding up toothbrush with toothpasteBrush and floss. That’s all there is to it. Your mother told you to brush and floss, and so does your dentist and hygienist. It’s simple.

Well, there is a little more to it than that. I’d like to get into the details of how to brush your teeth exceptionally well.

I often hear, “I brush and floss everyday. I don’t understand how I got a cavity.”

Instead of thinking of brushing and flossing as an on-off thing, as an I-did-it or I-didn’t, think of it as a range. There is a difference between a full two minutes of brushing and I’m-so-tired-I-can-barely-keep-my-eyes-open, 10-second, there-I-did-it brushing before your head hits the pillow. Let’s talk about ideal brushing.

The American Dental Association recommends brushing for two minutes at least twice a day, and flossing at least once a day. It makes sense for these two brushings to be in the morning after breakfast, and at bedtime after the last food for the day has been eaten. Then you’ll get the benefit of a clean mouth all morning and while you sleep. Ideally, you should also brush after lunch, and avoid snacking in between meals.

Ideal brushing is going to be gentle and thorough. The goal is to remove plaque from the teeth. Plaque is soft and creamy. It doesn’t take much effort to remove it, so be gentle and thorough. A toothbrush with a soft or ultra-soft bristle is recommended.

Is there such a thing as brushing TOO well?  Believe it or not, there is. It’s possible to brush so hard that the gums are rubbed away. Recession of the gums exposes the root surface. If aggressive scrubbing continues, the root surfaces can wear away. This damage can only be repaired by fillings or surgical gingival tissue grafts. I estimate that one in five of my patients show signs of toothbrush abrasion. Please, please be gentle and thorough. Don’t use a hard or medium bristle toothbrush. Don’t scrub your stress away into your teeth.

Do you have specific problem areas that are difficult to clean (exposed furcations, under bridges, etc.)? Does your dentist or hygienist point out these areas and have useful suggestions on how to keep them clean? Do they provide special tools like Proxabrush or floss threader?

A Sonicare electric toothbrush is more effective at cleaning the mouth than a manual toothbrush. It automatically runs two minutes. Hit the button to start and brush your teeth until it turns off. The vibrating brushhead does the work for you – more brushing than you could possibly do with a manual toothbrush. Don’t push too hard against the teeth with a Sonicare, or its vibration is cushioned and less effective. It’s most effective with a light touch. A Sonicare toothbrush lowers the chance of recession. If you’d like to hear this explained in a nice, British accent, then watch below:

Flossing

Flossing is the most effective way to clean between the teeth where the toothbrush bristles cannot reach. Curve the floss around each tooth and move it up and down five or six times, as if you’re scrubbing between the teeth with a single toothbrush bristle.

Here’s an idea that shows promise: a full-mouth toothbrush that can clean all the teeth in six seconds. Rather than brush teeth individually for two minutes, this custom-fit toothbrush brushes all the teeth simultaneously. Where will the future of dentistry take us next?



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