The document provides a comprehensive overview of toothbrushes, including their history, types, construction, and specifications as defined by the ADA. It details various tooth brushing techniques and their advantages and disadvantages, as well as the importance of interdental cleaning aids such as dental floss and interdental brushes for effective plaque removal. Additionally, it discusses the role of powered toothbrushes and oral irrigation devices in maintaining oral health.

2. THE TOOTHBRUSH
 The bristle tooth brush appeared
about the year of 1600 B.C. in
China and later was patented in
America in 1857.
 Nylon – 1938
 Originally, they are varied in size,
length, hardness of the bristle,
and even in the arrangement of
the bristle

3. THE TOOTHBRUSH
- Generally toothbrushes very in size, design as well as in
length and arrangements of bristles hardness to overcome
this variation ADA given specification of toothbrushes.
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› Length : 1 to 1.25 inches
› Width : 5/16 to 3/8 inches
› Surface area : 2.54 to 3.2 cm
› No. of rows : 2 to 4 rows of brushes
› No. of tufts : 5 to 12 per row
› No. of bristles : 80 to 85 per tuft

4. OBJECTIVES OF TOOTH BRUSHING
• To clean teeth and interdental spaces of food remnants,
debris and stain etc.
• To prevent plaque formation
• To disturb and remove plaque
• To stimulate and massage gingival tissue
• To clean the tongue.

5. TYPES OF TOOTH BRUSHES
• Manual
• Powered
• Sonic and ultrasonic
• ionic

6. PARTS OF TOOTHBRUSH
• Handle
• Head
• Shank
• Tufts
• Brushing plane
•

7. • Natural bristles – hair of hog or wild boar
• Synthetic – nylon, uniform in size and elasticity,
resistant to fracture and do not get contaminated

8. • Stiffness of bristles depends on-
• Diameter of bristles - .0035 – .0190 Inch
• Length of bristles
• Number of filaments in a tuft
• Curvature of filaments
• ADA specifications-
• 1 - 1.25 inches in length
• 5/16 to 3/8 inches in width
• 2 – 4 rows of bristles
• 5 – 12 tufts/row

9. HOW TO BRUSH?
 Patient is instructed to start with molar region of one arch
around the opposite side than continue back around the lingual
or facial surfaces of the same arch
 Last surface to be brush are occlusal.
 Patient instructed to stroke each area ten time of spend 10
seconds per area then move on to next area.
 Time : 2 minutes ( 30 sec per quadrent )

10. Method Bristle placement Motion Advantage/
disadvantage
Scrub Horizontal on gingival margin Scrub in anterior position
direction keeping brush horizontal
Easy to learn & best suited
fro children
BASS Apical towards gingival into sulcus
at 450
to tooth surface
Short back and forth vibratory
motion while bristles remain in
sulcus.
Cervical plaque removal
Easily learned
Good gingival stimulation
Charter's Coronally 45o,
sides of bristles half
on teeth and half of gingiva
Small circular motions with apical
movements towards gingival
margin
Hard to learn and
position brush
Clears inter proximal
Gingival stimulation
Fones Perpendicular to the tooth With teeth in occlusions, move
brush in rotary motion over both
arches and gingival margin
Easy to learn
Inter proximal areas not
cleaned
May cause trauma
Roll Apically, parallel to tooth and then
over tooth surface
On buccal and lingual inward
pressure, then rolling of head to
sweep bristle over gingiva & tooth
Doesn't clean sulcus area
Easy to learn
good gingival stimulation
Stillman's On buccal and lingual, aplically at
an ablique angle to long axis of
tooth. Ends rest on gingiva and
cervical part.
On buccal and lingual slight
rotary motions with bristle ends
stationary
Excellent gingival
stimulation
Moderate dexterity
required
Moderate cleaning of
interproximal area
Modified
stillman's
Pointing apically at and angle of
45o
to tooth surface
Apply pressure as in stillmans's
method but vibrate brush and
also move occlusally
Easy to master
Gingival stimulation

11. Method Bristle placement Motion Advantage/
disadvantage
Scrub Horizontal on gingival margin Scrub in anterior position direction
keeping brush horizontal
Easy to learn & best suited
fro children
BASS Apical towards gingival into sulcus
at 450
to tooth surface
Short back and forth vibratory
motion while bristles remain in
sulcus.
Cervical plaque removal
Easily learned
Good gingival stimulation
Charter's Coronally 45o,
sides of bristles half
on teeth and half of gingiva
Small circular motions with apical
movements towards gingival
margin
Hard to learn and
position brush
Clears inter proximal
Gingival stimulation
Fones Perpendicular to the tooth With teeth in occlusions, move
brush in rotary motion over both
arches and gingival margin
Easy to learn
Inter proximal areas not
cleaned
May cause trauma
Roll Apically, parallel to tooth and then
over tooth surface
On buccal and lingual inward
pressure, then rolling of head to
sweep bristle over gingiva & tooth
Doesn't clean sulcus area
Easy to learn
good gingival stimulation
Stillman's On buccal and lingual, aplically at an
ablique angle to long axis of tooth.
Ends rest on gingiva and cervical
part.
On buccal and lingual slight rotary
motions with bristle ends
stationary
Excellent gingival
stimulation
Moderate dexterity
required
Moderate cleaning of
interproximal area
Modified
stillman's
Pointing apically at and angle of
45o
to tooth surface
Apply pressure as in stillmans's
method but vibrate brush and
also move occlusally
Easy to master
Gingival stimulation

12. Charters method
Bass method

13. ELECTRIC TOOTHBRUSH ( POWERED)
• In 1939 powered tooth brush invented to make plaque control easier.
• Its mainly recommended for
(a) Individual lacking motor skills
(b) Hospitalized patients whose teeth are cleaned by the caregivers.
(c) Special needs patient ( physical and mental disability)
(d) Patient with orthodontic appliances
(e) Whosoever wants to use
 There are many powered tooth brushes some with reciprocal of back
and forth motions and some with combination of both some are
circular and elliptical motion.
 Powered tooth cleaner resembles a dental prophylaxis and hand piece
with rotary rubber cap.
 Patient should be illustrated for proper use.

14. DENTRIFICES
• Substance used with a toothbrush for the purpose of
cleaning the accessible surfaces of teeth.
• Function
• Minimize plaque build up
• Anticaries action
• Removal of stains
• Mouth freshener

15. INTERDENTAL CLEANING AIDS
 Any tooth brush , regardless of the brushing method, does not
completely remove interdental plaque. Even for patients with
wide-open dental embrasures. ( Gjermo, 1970, Schmid 1976).
 The majority of dental and periodontal disease's originate in
interproximal area, interdental plaque removal is necessary
 Tissue destruction associated with PDL Disease often leave
large ,open spaces, between teeth and exposed roots with
anatomic concavities and furcations which are difficult to clean
and access with the toothbrush.
 The purpose of Interdental cleaning aids is to remove plaque,
not to dislodge food wedged between teeth.

16. DENTAL FLOSS:
 Dental floss is the most widely
recommended method for
removing proximal plaque.
 The floss is wrapped around
each proximal surface and is
activated with repeated up
and down stroke.
 Floss should pass gently
through the contact area. Do
not snap the floss pass the
contact area as it may injure
the interdental papilla.

17. DENTAL FLOSS
• Floss is available in many types:
unwaxed, waxed
• Waxed floss contained wax to facilitate
passing the floss the floss through the
contact and alleviate fraying.
• Tape floss contain criss-cross fiber and
eliminate fraying.
• PTFE floss (Glide floss) is the teflon floss
which allow passing through very tight
contact easily without fraying.
• Superfloss is the web-like material with
improved proximal cleaning efficiency.

18. FYI
• Flossing can be made easier by using a floss holder –
• Floss holder should have –
1. One or two fork that enough to keep the floss tent
even when its moved through tight contact area
2. An effective and simple mounting mechanisms

19. INTERDENTAL BRUSH (PROXA BRUSH):
 Interdental brush are conical
shape brushes made of bristles
mounted on a handle, single
tufted brushes, or small conical
brushes.
 They are suitable for cleaning
large, irregular, or concave tooth
surfaces adjacent to wide
interdental spaces.
 They are inserted interproximally
and are activated with short back
and forth strokes in between the
teeth.

21. TOOTHPICK
 Studies have been conducted to compare the efficacy of tooth pick, dental
floss, and multi-tufted brush.
 Dental floss removed more plaque at lingual interproximal surface than
toothpicks.
 Toothpicks combined with multi-tufted brush used on oral surfaces were as
effective in removing interproximal plaque as dental floss.
 The use of floss or tooth pick combined with single tufted brush may reduce
the amount of plaque adhering to the proximal surfaces by an average of
50%

22. ORAL IRRIGATION
• Oral irrigation device include the use of
water picks.
• The high pressure, pulsating stream of
water through a nozzle is directed to the
tooth surface and subgingivally, washing
away debris and plaque containing
bacteria.
• They are helpful surrounding orhtodontic
appliance, and when used as an adjucntive
treatment in shallow pocket depth.
• Patients reqiure antibiotic premidication
should not use oral irrigation.

23. • When used as adjuncts to
toothbrushing , irrigation devises,
can have a beneficial effect on
periodontal health by reducing the
accumulation of plaque and
calculus and decreasing
inflammation and pocket depth.
• ( Robinson and Hoover, 1971)

24. THE END
QUESTIONS ?