■ DEVELOPMENT OF TOOTHBRUSHES
I Early Toothbrushes
II. Early Brushing Methods
■ MANUAL TOOTHBRUSHES
I. Characteristics of an Effective
Toothbrush
Ii. General Description
III. Handle
IV. Brush Head
V. Bristles and Filaments
METHODS FOR MANUAL TOOTH BRUSHING
■ POWER TOOTHBRUSHES
• DEVELOPMENT OF TOOTHBRUSHES:
• 1600 B.C “CHEWSTICK” IS PRIMITIVE TOOTHBRUSH
ACCORDING TO CHINESE LITERATURE
:
I) EARLY TOOTHBRUSHES
III. HANDLE:
A. Composition
Most current brush handles are manufactured from a single
type of plastic, or a combination of polymers that combine
durability, Imperviousness to moisture pleasing appearance,
low cost, and sufficient maneuverability.
B. Shape
1. Preferred Characteristics
a. Easy to grasp.
b. Does not slip or rotate during use.
c. No sharp corners or projections.
d. Light weight, consistent with strength.
2. Variations
• 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.
A handle of larger diameter may be useful for patients with
limited dexterity, such as children, aging patients, and
those of any age with a disability.
B. End-Rounding
• Process of End-Rounding. Each filament is sealed and
rounded by heat treatment. The quality of
end-rounding varies depending on manufacturers.
Natural bristles cannot be end-rounded, but
nylon filaments can be.
.
METHODS FOR MANUAL
TOOTHBRUSHING
II. PROCEDURE
A. Position the Brush
1. Filaments. Direct the filaments apically (upfor
maxillary, down for mandibular teeth). Even though
brush placement calls for directing the filaments at a 45° angle, it
is usually easier and safer for the patient to first place the sides of
the filaments parallel
with the long axis of the tooth (Figure 25-6A). From that position
the brush can be turned slightly and brought to the gingival
margin to the 45° angle (Figure 25-6B).
III. PROBLEMS:
A. An overeager brusher may convert the previously mentioned
“very short strokes” into a vigorous scrub that
causes injury to the gingival margin.
II. PROCEDURE
A. Position the Brush
1. Filaments. Direct filaments apically (up for maxillary,
down for mandibular teeth).
2. Place Side of Brush on the Attached Gingiva. The filaments
are directed
apically. When the plastic portion of the brush head is
level with the occlusal or incisal plane,
generally the brush is at the proper height, as shown in
Figure 25-6A.
B. Strokes
1. Press to Flex the Filaments. The sides of the filaments
are pressed lightly against the gingiva. The gingiva will
blanch.
III. PROBLEMS
A. Brushing too high during initial placement can lacerate
the alveolar mucosa.
B. Tendency to use quick, sweeping strokes results in no
brushing for the cervical third of the tooth because the brush
tips pass over
rather than into the area; likewise for the interproximal
areas.
C. Replacing brush with filament tips directed into the gingiva
can produce punctate lesions.
■ THE MODIFIED STILLMAN
B. Strokes
1. Press to Flex the Filaments. The
sides of the filaments are pressed lightly against the
gingiva. The gingiva will blanch.
III. PROBLEMS:
A. Improper brushing can damage epethelial
attachments.
B. Patient may try to move the brush into the rolling stroke
too quickly, and the vibratory aspect may be ineffective for
biofilm removal at
the gingival margin.
II. PROCEDURE
A. Apply Rolling Stroke Procedure
Instruct in a basic rolling stroke for general cleaning to be
accomplished first.
B. Position the Brush
1. Filaments. Hold brush (outside the oral cavity) with
filaments directed toward the occlusal or
incisal plane of the teeth that will be brushed. The tips
are pointed down for application to the maxillary
and pointed up for application to the mandibular arch.
Insert the brush held in the
direction it will be used.
C. Strokes
1. Press Lightly. Press lightly to flex the filaments and force
the tips between the teeth. The sides of
the filaments are pressed against the gingival margin.
2. Vibrate the Brush. Vibrate gently but firmly, keeping the
tips of the filaments in contact. Count to 10 slowly
as the brush is vibrated by a rotary motion of
the handle.
E. Overlap Strokes
When moving the brush to an adjacent position,
overlap the brush position, as shown in Figure
25-4.
F. Position Brush for Anterior Lingual and Palatal
Surfaces
1. with brush handle parallel with long axis of tooth,
place side of toe-end filaments over
interproximal embrassure.
■ OTHER TOOTHBRUSHING
METHODS
ADVANTAGES:
1) Easy to learn.
2) Shorter time.
3) Physically or emotionally handicapped
individuals.
4) Pt who lacks dexterity.
5) Gingiva is provided with good stimulation.
6) Has equal or better potential than bass technique for
plaque removal.
DISADVANTAGES:
1) Possible trauma to gingiva.
2) Interdental areas are not properly cleaned.
DISADVANTAGES:
1) Interdental spaces of permanent Teeth of adults are
not properly Cleaned.
III. HORIZONTAL
Horizontal or crosswise brushing is generally recognized as
detrimental. An unlimited sweep with a horizontal
scrubbing motion bears pressure on teeth
that are most facially inclined or prominent.
DISADVANTAGES
1) With the use of an abrasive
dentifrice, such brushing may produce tooth abrasion.
I) PROCEDURE
a) A soft brush with small tufts of fine bristles arranged
in four parallel rows and trimmed to an even
length is used.
b) Bristles are pointed incisally or
occlusally and then along and over tooth surface and
gingiva.
c) the motion is gentle sweeping from incisal or occlusal
surface over to facial surface and progressing towards
and over the gingiva.
II) ADVANTAGES
1) Natural self cleansing mechanism.
2) Supragingival cleansing is good.
III) DISADVANTAGES
1) Interdental spaces and sulcus areas are not properly
cleaned.
V. SCRUB-BRUSH
DISADVATAGES
1) Vigorous scrubbing can encourage gingival recession.
A. General Application
MOTION DESCRIPTION
Rotational Moves in a 360 circular motion
Counter- Each tuft of filaments moves in a rotational motion;
rotational each tuft moves counter-directional to the tuft
adjacent to it (if one tuft rotates to the left, the
adjacent tuft rotates to the right)
Oscillating Rotates from center to the left, and then to the right;
degree of rotation from center varies from 25–55
Cradle or twist Side to side with an arc