Toothbrush a

Dr. Ibrahim Shaikh
1st Year MDS Periodontology
Seminar No. 2

CONTENTS :
2
1. Introduction
2. History
3. Manual Toothbrushes
4. Toothbrushing Techniques
5. Power Toothbrushes
6. Toothbrushing for Special Conditions
7. Effects of Toothbrushing
8. Care of Toothbrushes
9. Modern toothbrushes

4
The toothbrush is the principal instrument in
general use for removal of dental biofilm and is
a necessary part of oral disease control.
Clinical Practice of The Dental Hygienist; Esther M. Wilkins

Toothpicks as Toothbrushes
6
 3000 B.C - Mesopotamia

History of Periodontology ; Fermin carranza, Vincenzo Guerini
7
Omar Khayyam
(1025 – 1123)
William
Shakespeare
(1564 – 1616)
Erasmus
(1466 – 1526)

Chewstick
8
 1600 B.C. – China
 Religious ritual

Middle ages
9
 Tang Dynasty (619 - 907)
 1223 – Dōgen Kigen
 1498
 1728 – Pierre Fauchard
(Le Chirurgien Dentiste)
History of Periodontology ; Fermin carranza, Vincenzo Guerini

William Addis – The Inventor(1780)
10

H. N. Wadsworth
11
 1857 – First person to patent the toothbrush

DuPont de Nemours
12
 24 FEB, 1938 – First nylon bristle toothbrush.

Electric Toothbrush
13
The first electric
toothbrush, the
Broxodent, was
invented in
Switzerland in 1954

Toothbrush :
15
 According to American Dental Association Council on Dental Therapeutics
‘The toothbrush is designed primarily to promote cleanliness of teeth & oral
cavity.’
 OBJECTIVES:
1. To clean teeth and interdental spaces of food remnants, debris & stains.
2. To prevent plaque formation.
3. To disturb and remove plaque.
4. To stimulate and massage gingival tissues.
5. To clean the tongue.
6. Halitosis control
7. Sanitation of oral cavity
Essentials of preventive & Community Dentistry; Soben Peter

Characteristics :
16
1. Conforms to individual patient requirements in size, shape &
texture.
2. Easily & efficiently manipulated.
3. Impervious to moisture ; readily cleaned & aerated.
4. Durable & Inexpensive.
5. Has prime functional properties of flexibility, softness, & of
strength, rigidity & lightness of the handle.
6. Is designed for utility, efficiency & cleanliness.

Parts :
17

ADA Specification :
18
Brushing Surface:-
1 to 1.25 inches in length (25.4 to 31.8 mm
long)
5/16 to 3/8 inches in width (7.9 to 9.5 mm
wide)
2 to 4 rows of bristles
5 to 12 tufts per row Essentials of preventive & Community Dentistry; Soben Peter

Manufacturing :
19
Handle
 Durability
 Moisture
 Appearance
 Cost
 Maneuverability

20
 Shape :
 Grasp
 Projections
 Weight
 Strength
† A Twist, curve, offset, or angle in the shank with or without thumb rests
may assist the patient in the adaptation of the brush to difficult-to-reach
areas.

Bristles & Filaments
21

Factors Influencing Stiffness :
22
1. Diameter
2. Length
3. Number
4. Angle

Brushing Plane
23

Toothbrush Selection :
24
 Ability of the patient
 Manual dexterity of the patient
 Age of the patient
 Size & Shape
 Professional personnel

Soft Nylon Brush
25
1. More effective in cleaning.
2. Less traumatic to the gingival tissue.
3. Can be directed into the sulcus & into interproximal areas.
4. Applicable around appliances.
5. Tooth abrasion &/or gingival recession can be prevented.
6. Effective use for sensitive gingiva.

Guidelines :
27
A. Grasp of Brush :
 Objectives –
1. Grasp & manipulate the brush for successful removal of
dental biofilm.
2. Control of brush during all movements.
3. Sensitivity to the amount of force applied.
4. Effective positioning.

 Procedure –
1. Grasp handle in the palm of the hand with thumb against the
shank.
2. Position filaments in the proper direction for placement on the
teeth.
3. Adapt grasp for various positions of the brush head.
4. Apply appropriate pressure for the removal of the dental biofilm.
28

29
B. Sequence :

30
C. Amount –
 The Count System :
1. Count 6 strokes in each area for modified Stillman or other
method in which a stroke is used.
2. Count slowly to 10 for each brush position while brush is
vibrated & filament ends are held in position for the Bass,
Charters, or other vibratory method.

31
 The Clock System
1. Some patients brush thoroughly while watching a
clock or a egg timer.
 Built-in timers
1. Signals may be set for 30seconds, one or two
minutes.

32
D. Frequency –
 Emphasis in patient education is placed on complete
biofilm removal daily rather than the number of
brushings.
 Atleast two brushings, are recommended for the control
of dental biofilm, oral sanitation & for halitosis control

Methods of Toothbrushing :
33
1. Sulcular (Bass) Method & Modified Bass Method
2. The Stillman Method & Modified Stillman Method
3. Charters Method
4. Roll : Rolling Stroke Method
5. Circular : Fones
6. Vertical : Leonard
7. Physiologic : Smith
8. Horizontal
9. Scrub – brush

Modified Bass & Bass Method :
34
 Indication
 Limitation

Modified Stillman & Stillman
method
35
 Indication
 Limitations

Charter’s Method :
36
 Indication
 Limitation

Rolling Method
37
 Indication
 Limitation

Circular : Fones Method
38
 Indication
 Limitation

Vertical : Leonard Method
39
 Given by Hirschfeld
 With teeth edge-to-edge, place the brush filaments against
the teeth at right angles to the long axes of the teeth.
 Brush vigorously with light pressure & mostly up and down
strokes with a slight rotation or circular motion after striking
the gingival margin with force.
 Use enough pressure to force the filaments into the
embrasures, but not enough to damage the brush.

Detrimental Methods :
40
A. Horizontal –
1. An unlimited sweep with a horizontal scrubbing
motion.
2. Can produce tooth abrasion.
3. Interproximal areas not touched.

41
B. Scrub-brush –
1. Consists of vigorously combined horizontal, vertical &
circular strokes, with some vibratory motions for certain
areas.
2. Can encourage gingival recession & tooth abrasion

Power Toothbrushes :
43
The heads of these toothbrushes oscillate in a side to side motion or in
rotary motion. The frequency of the oscillations is around 40Hz in an
ordinary powered toothbrush.
 ADVANTAGES
1. It increases patient motivation resulting in better patient compliance.
2. Increased accessibility in interproximal and lingual tooth surface
3. No specific brushing technique required
4. Uses less brushing force than manual toothbrushes
5. Brushing timer is incorporated in some brushes to help the patient in
brushing for the required duration.

Power v/s Manual :
McKendrick, A.J.W., et al. : A Two-year Comparison of Hand & Electric Toothbrushes, J.Periodontol. Res.,
3,224,1968
44
 Biofilm removal & reduction of gingivitis¹
 Current power brushes move in speeds & motions
that cannot be duplicated by manual brushes.
 Safety of powerbrushes as compared to manual-brushes
has been well established.
 Self-included timers.

Indications :
45
1. Ineffective manual biofilm removal techniques
2. Reduce calculus & stain buildup
3. Undergoing orthodontic treatment
4. Aggressive brushers
5. Patients with disabilities or limited dexterity
6. Patients unable to brush

Power Source :
47
1. Direct
2. Replaceable Batteries
3. Rechargeable
4. Disposable

48 TOOTHBRUSHING…
…In Areas For Special Attention

Facially Displaced Teeth :
49

Overlapped Teeth or Wide
Embrasures:
51

Distal Surfaces of Posterior
Teeth :
52

Acute Oral Inflammatory/Traumatic
lesions :
54
 Brush all areas of mouth that are not affected
 Rinse with warm, mild saline solution to
encourage healing & debris removal.
 Resume regular biofilm control measures on the
affected area as soon as possible.

Following periodontal Surgery :
55
 Brush occlusal surfaces of the teeth & use light
strokes over the dressing.
 Avoid direct vigorous brushing.
 Brush over teeth & gingiva, not involved in
surgery.

ANUG :
56
 In acute stage oral tissues are sensitive to any
touch, toothbrushing is therefore neglected.
 Soft brush recommended along with careful
brush placement.

The Gingiva :
59
 Trauma
 Changes in the Gingival Contour
 Gingival Recession

Dental abrasion
60
 Abrasion is the varying away of tooth structure.
 Incorrect brushing especially with an abrasive
toothpaste is the most common cause.
 Primarily on facial surfaces – canines, premolars
or any tooth in buccoversion or labioversion
 Cervical areas – most abraded areas.

Brush Replacement :
62
 Frequent replacement recommended; every 3 months
 Brushes need to be replaced before filaments become
splayed or frayed or lose resiliency.
 Brush contamination occurs with use.
 Patients who are debiliated, immunosuppresed, have a
known infection can be advised to disinfect their brushes or
use disposable brushes.

Cleaning Toothbrushes :
63
 Clean thoroughly after each use.
 Hold brush under strong stream of warm water from faucet
to force particles, dentrifice and bacteria from between the
filaments.
 Tap the handle on the edge of sink.
 Use one toothbrush to clean another brush.
 Rinse completely & tap out excess water.

Brush Storage :
64
 Open air – upright position, apart from contact with other
brushes.
 Portable brush containers – with sufficient holes.
 At least 6 feet away from the toilet.

Sonic Toothbrushes :
66
These types of toothbrushes produce high frequency
vibrations (1.6MHz)which leads to the phenomenon of
cavitation and acoustic microstreaming. This
phenomenon aids in stain removal as well as disruption
of the bacterial cell wall (bactericidal).

Ionic Toothbrushes :
68
Ionic toothbrushes change the surface charge of a tooth by
an influx of positively charged ions.
The plaque with a similar charge is thus repelled from the
tooth surface & is attracted by the negatively charged
brush.

73
 C.G.Daly, C.C.Chapple et al. To investigate the effect of
progressive toothbrush wear on plaque control. J Clin
Periodontol – 1996; 23: 45-49
 Akshay Vibhute, K.L. Vandana. The effectiveness of
manual v/s powered tootthbrushes for plaque removal &
gingival health- A meta analysis. JISP – 2012, vol 16, issue
– 2
 M.F. Timmerman et al. Comparitive analysis of high & low
brushing force in relation to efficacy and gingival abrasion.
J Clin Periodontol 2004, 31 : 620 - 624

References :
74
 Clinical Practice of The Dental Hygienist;
Esther M. Wilkins
 History of Periodontology ; Fermin
carranza, Vincenzo Guerini
 Essentials of preventive & Community
Dentistry; Soben Peter
 McKendrick, A.J.W., et al. : A Two-year
Comparison of Hand & Electric
Toothbrushes, J.Periodontol. Res.,
3,224,1968

…For The Patience.
75 THANK YOU

Toothbrush a

Recomendados

Recomendados

Mais conteúdo relacionado

Mais procurados

Mais procurados (20)

Semelhante a Toothbrush a

Semelhante a Toothbrush a (20)

Mais de DrIbrahim Shaikh

Mais de DrIbrahim Shaikh (8)

Último

Último (20)

Toothbrush a

Notas do Editor