The document presents a seminar by Dr. Tanya Attre on toothbrushes and brushing techniques, aiming to educate on dental plaque, the history of toothbrushes, types, and brushing methods. It covers the objectives of tooth brushing, various techniques, including the Bass and Modified Bass methods, and advancements in toothbrush technology, such as sonic and ionic toothbrushes. The conclusion emphasizes that effective plaque control is best achieved through proper motivation and instruction in toothbrush usage.

1. PRESENTED BY-DR.TANYA ATTRE
( MDS 1ST
YR)
GUIDED BY -DR.VIDYA SEKHAR
SEMINAR ON –TOOTHBRUSH AND BRUsHING
TECHNIQUES
DEPARTMENT OF PERIODONTOLOGY
AND ORAL IMPLANTOLOGY

2. CONTENT
 INTRODUCTION
 HISTORY
 OBJECTIVES OF TOOTH BRUSHING
 PARTS OF TOOTH BRUSHES
 TYPES OF TOOTH BRUSHES
 METHODS OF TOOTH BRUSHING
 CARE OF TOOTHBRUSHES
 RECENT ADVANCEMENTS

3. INTRODUCTION
 Dental plaque is defined clinically as a structured , resilient yellow-
grayish substance that adhere tenaciously to the intraoral hard
surfaces, including removable and fixed restorations.
 Biofilm removal via daily self care that includes tooth brushing and
inter-dental cleaning is an effective way to treat and prevent gingivitis.
OBJECTIVE OF TOOTH-BRUSHING
1.To clean teeth and interdental
spaces of food remnants and
stains
2. To prevent plaque formation
3. To remove plaque deposition
4.To stimulate and massage
gingival tissues.
5.To clean tongue

4. DEVELOPMENT OF TOOTHBRUSH
HISTORY
 First toothbrush-In china(1600 century)-western
countries(1640 century)-In 1900 craftsmen
constructed handles of gold, ivory or ebony in which
replaceable brush head could be fitted.
 Nylon toothbrush -1938
 First electric toothbrush-1960
 1987-First Rotatory action electric toothbrushes

5. PARTS OF TOOTH BRUSH
T0oth brush consist of a head of
tightly clustered bristles mounted
on a handle, which facilitates the
cleansing of hard to reach areas
of the mouth

6. TOOTHBRUSH DESIGN
According to ADA-
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 bristles-80 to 85 per tufts

7. TYPES OF TOOTHBRUSHES
MANUAL POWERED
ULTRASONIC
IONIC

8. SHAPE OF TOOTH BRUSHING HEAD
1.There are variety of
shapes such as
rectangular ,oval and
diamond shape.
2.Every tooth surface
can be cleaned
effectively with the
conventional tooth
brush head design.
3.Diamond shape is
mostly
recommended for
posterior teeth.
4.Round shape is
recommended with
wire and brackets

9. SIZE OF TOOTH BRUSH HEAD

10. BRISTLE PATTERN
BLOCK PATTERN
Bristle are of same length and
are arranged neatly like a
block.
WAVY OR V-SHAPE PATTERN
The bristles form v- shape.
This is intended to give the
bristle a better contact with
the area around the adjacent
teeth.
MULTILEVEL TRIM PATTERN
It enables the brush to reach
difficult to clean areas.

11. BRISTLE PATTERN
CRISS-CROSS PATTERN
According to manufacturer ,
this design can lift up the
plaque effectively
POLISHING –CUP BRISTLE
It is claimed that the bristles
can clean the surface stains
effectively

12. BRISTLES
 Bristle hardness is proportional to
square of diameter and inversely
proportional to square of bristle length.
 Diameter of bristle
Soft brush=0.2mm
Medium brush=0.3mm
Hard brush =0.4mm
Ultra soft=0.075mm

13. HANDLE DESIGN
STRAIGHT HANDLE CONTRA-ANGLE HANDLE
FLEXIBLE HANDLE SLIP-PREVENTION HANDLE

14. SEQUENCE OF TOOTH BRUSHING

15. AMOUNT and frequency OF
BRUSHING
 1.THE COUNT SYSTEM
Count 6 strokes in each area
 2.THE CLOCK SYSTEM
Time procedure cannot guarantee thorough
coverage ,as the most accessible area may get
more time.
 3.COMBINATION
 4.BUILT-IN TIMER

16. CLASSIFICATION OF BRUSHING TECHNIQUES

17. HORIZONTAL SCRUB TECHNIQUE
1.The most commonly used
technique used by uninstructed
individuals.
2.Back -and –forth motion on the
occlusal and buccal surfaces.
3.Most common cause for cervical
abrasion in patients.

18. THE BASS METHOD OR SULCULAR CLEANING
METHOD
INTRODUCTION
It is most widely accepted method for removal of
dental plaque present adjacent to and directly
underneath the gingival margin.
INDICATIONS:
Open inter proximal areas ,cervical area beneath the
height of contour of the enamel and exposed root
surface.

19. TECHNIQUE

20. ADVANTAGES AND DISADVANTAGES
ADVANTAGES
1.Effective method of removing plaque.
2.Provide good gingival stimulation.
3.Easy to learn.
DISADVANTAGES
1.Overzealous brushing may convert the very short
strokes into scrub brushing technique and cause
injury to gingival margin.
2.Time consuming.

21. MODIFIED BASS TECHNIQUE
INDICATIONS
 1.As s routine oral hygiene measures
 2.Intrasulcular cleansing
TECHNIQUE

22. ADVANTAGES
1.Excellent sulcus cleaning.
2.Good inter proximal and gingival cleaning.
3.Good gingival stimulation.
DISADVANTAGES
1.Dexterity

24. MODIFIED STILLMAN
INDICATIONS
1.Dental plaque removal.
2.Cervical area below the height of contour , gingival recession
and exposed root surface.
TECHNIQUE 1.Bristles are positioned
apically with an oblique angle
to the long axis of the tooth.
2.Bristles are positioned on the
cervical aspect of the tooth.
3.Short back and forth motion
moved in the coronal direction.
DISADVANTAGES
1.Time consuming
2.Damage epithelial
attachment

25. CHARTER`S METHOD
INDICATIONS
1.Missing papilla and exposed root surface.
2.FPD and Ortho appliances.
3.Periodontal surgery
4. Inter proximal gingival recession
1.Charter described two brush positions, One at a right
angle to the long axis of tooth and other at 45 degree
angle with the tip of the bristle towards the occlusal
plane.
2.For either brush position, the instructions were to
force the tips into the inter proximal area.

26. PROCEDURE
 1.Apply the Rolling stroke procedure
 2.Position the brush –Bristle are placed at an angle of
45 degree to the gingiva with the bristle directed
coronally
 3.Strokes-Press lightly to flex filaments and force the
tips between the teeth. Later, give the vibratory
strokes
DISADVANTAGE
A. Brush ends don’t
engage the gingival
sulcus to remove
subgingival bacterial
accumulation.

27. ROLL METHOD
This method of tooth brushing is also called as Rolling
stroke method or ADA method or the sweep method.
INDICATIONS
1.Meant for children
2.useful for preparatory instruction for modified
stillman`s technique
In this method ,the bristles are
placed at an angle of 45 degree
and lightly rolled across the
tooth

28. CIRCULAR :THE FONES METHOD
 This method may be recommended as easy-
to learn first technique for young children.
1.With the teeth closed,
Place the brush inside the
cheek with the brush tips
lightly contacting the
gingiva over the last
maxillary molar.
2.Lingual and palatal tooth
surfaces require an in and
out stroke.

29. VERTICAL:LEONARD METHOD
1.Vertical strokes are used
2.Maxillary and mandibular teeth are brushed seperately.
3.Bristles are placed at an angle of 90 degree to the facial
surface of the teeth.
4 Up and down strokes are mainly used.
Advantage-Most
effective and
convenient method for
small children
Disadvantages-
Interdental space of
permanent teeth are
not properly cleaned

30. PHYSIOLOGIC:SMITH METHOD
Based on the principle that toothbrush should follow
the physiologic pathway that is followed by the food
when it traverses over the tissue during mastication.
ADVANTAGE-natural self cleansing mechanism
DISADVANTAGE-Inter dental spaces and sulcular areas
of teeth are not properly cleaned.

31. SCRUB BRUSH METHOD
INTRO- Require vigorous horizontal ,vertical
and
Circular motion
DISADVANTAGES
Can cause tooth abrasion and gingival
recession
Not very effective at plaque control

32. POWER TOOTH BRUSH
Power toothbrush are also known as power-assisted,
automatic, mechanical or electric toothbrush
PURPOSE AND INDICATIONS
GENERAL
APPLICATIONS
1.To facilitate
mechanical removal
of dental biofilm .
2.Reduce calculus
and stains build up
SPECIAL
CIRCUMSTANCES
1.Those undergoing
orthodontic treatment ,
complex restorative and
prosthodontic
treatment

33. GENERATIONS OF TOOTHBRUSH
First generation: Resembling manual toothbrushes, and
moved back and forth to simulate manual brushing.
Second generation: had a uniquely rotating head and
was powered by long-life/rechargeable batteries. The
newer types incorporated the vibrating and reciprocal
motion and additional features like pressure sensor and
timer.
Third generation: Sonic-powered toothbrushes and
ultrasonic
International Journal of Health Sciences & Research (www.ijhsr.org) 305Vol.8; Issue: 5; May 2018rasonic-powered toothbrushes were
introduced.

34. CLASSIFICATION OF POWERED TOOTHBRUSH
Powered toothbrushes are divided into
six groups
1. Side to side action
2. Counter oscillation
3. Rotation oscillation
4. Circular
5. Ultrasonic
6. Ionic

35. DESCRIPTION
MOTION
 The entire brush head
moves as a unit in one
type of motion.
 The entire brush head
moves as a unit ,but in
different yet
simultaneous motions.
 Different shaped brush
head moves separately.
 Group of tufts may
move differently.

36. MOTION OF POWER HEAD
The head follow three basic patterns when the
motor is started:
- Reciprocating-a back and forth movement
-Arcuate -up and down movement
-Elliptical-combination of reciprocating and
arcuate.

37. POWER SOURCE
 Direct
 Replaceable batteries
 Rechargeable
 Disposable
 Switches

38. CARE OF TOOTH BRUSHES
BRUSH REPLACEMENT
1. Frequent replacement recommended-at least every2 to 3 month.
2 . Brushes should be replaced before filaments become frayed or
lose resiliency.
3. Patients who are debilitated, Immuno suppressed , have a known
infection ,or about to undergo surgery for any reason can be
advised to disinfect their brushes or use disposable brushes.

39. CLEANING THE TOOTH BRUSH
- Clean brush thoroughly after
each use.
- Hold brush head under strong
stream
of warm water from faucet to
force
the particle, dentrifices and
bacteria
-Tap the handle on the edge of the
sink
BRUSH STORAGE
- Brush should be kept in open air
with head in an upright position
- Portable brush container should
have sufficient hole to give air
temporarily until the brush can
be completely exposed for drying.

40. NEWER
ADVANCEMENTS
 SONIC TOOTH BRUSHES
- These types of toothbrushes produce high
frequency vibrations which leads to the
phenomenon of Cavitation and acoustic
Microstreaming . This phenomenon aids in
stain removal as well as disruption of
bacterial cell wall

42. RECENT ADVANCEMENTS
 IONIC TOOTHBRUSH
Ionic tooth brush change the surface charge of the
tooth by an influx of positively charged ions. The
plaque with a similar charge is thus repelled from the
tooth surface and attracted by the negatively
charged brush
 ORTHODONTIC TOOTH BRUSH
 DOUBLE AND TRIPLE HEADED TOOTH BRUSH

43. BIODEGRADABLE TOOTHBRUSH

46. CONCLUSION
 Tooth brushing is the most commonly
employed method of plaque removal.
 Advancements in toothbrush designs
combined with newer technology have
made plaque control easy , less time
consuming and effective.
 Regardless of the design , the best plaque
control is achieved when the patient is
well motivated and instructed in its proper
use.

47. REFRENCES
1.CARRANZA`S CLINICAL PERIODONTOLOGY,14TH
EDITION
2.CLINICAL PRACTICE OF THE DENTAL HYGIENIST,ESTHER M.
WILKINS
3.ESSENTIALS OF PREVENTIVE AND COMMUNITY
DENTISTRY,SOBEN PETER
4.LINDHE’S CLINICAL PERIODONTOLOGY AND IMPLANT
DENTISTRY
5.International Journal of Health Sciences & Research
(www.ijhsr.org) 305Vol.8; Issue: 5; May 2018rasonic-powered
toothbrushes were
introduced
https://www.researchgate.net/publication/266151588_Effectiven
ess_of_different_tooth_brushing_techniques_on_the_removal_of
_dental_plaque_in_6-8_year_old_children_of_Gulbarga