Proper brushing is essential for cleaning teeth and gums effectively. 

Brushing removes plaque from the surfaces of your teeth.

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Plaque develops into unhealthy calculus

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Toothbrushing and Flossing Animated Video Demonstration

Use a toothbrush with soft, nylon, round-ended bristles that will not scratch and irritate teeth or damage gums. 

Treat yourself to a new toothbrush every three to four months, or sooner if the bristles become worn or frayed. A hard, brittle brush can injure your gums. 

Children's brushes may need to be replaced more often, as they can wear them out more quickly. 

Remember don't share your toothbrush with others, it can spread germs.

Place bristles along the gumline at a 45-degree angle. Bristles should contact both the tooth surface and the gumline.
Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating circular rolling motion. Move brush to the next group of 2-3 teeth and repeat.
Maintain a 45-degree angle with bristles contacting the tooth surface and gumline. Gently brush using a up and down and rolling motion along all of the inner tooth surfaces and gumline.
Tilt brush vertically behind the front teeth. Make several up & down strokes using the front half of the brush.
Tilt brush vertically behind the front teeth. Make several up & down strokes using the front half of the brush.

--Illustrations adapted by and used courtesy of the John O. Butler Company--

Contaminated toothbrushes have been shown to harbor and
transmit viruses and bacteria

Contamination from brushes touching. Even between uses, toothbrush bacteria can be a problem, according to the Academy of General Dentistry (AGD). Because most families store their toothbrushes in a huddle in the bathroom cabinet or on a countertop, bacteria that can cause oral infections (like gingivitis and more serious gum diseases) can spread from one family member to another through toothbrush contact. Being stored unprotected on countertops or in toothbrush holders, toothbrushes are also vulnerable to contamination from airborne bacteria, such as from a flushing toilet. Scientists commonly find coliform bacteria (E. coli)
on toothbrushes. If it enters the bloodstream, E coli cause serious infection.

CDC Recommendations for Infection Control with Toothbrushes

Recommended Toothbrush Care

1. Do not share toothbrushes. The exchange of body fluids that such sharing would foster places toothbrush sharers at an increased risk for infections, a particularly important consideration for persons with compromised immune systems or infectious diseases.

2. After brushing, rinse your toothbrush thoroughly with tap water to ensure the removal of toothpaste and debris, allow it to air-dry, and store it in an upright position. If multiple brushes are stored in the same holder, do not allow them to contact each other.

3. It is not necessary to soak toothbrushes in disinfecting solutions or mouthwash. This practice actually may lead to cross-contamination of toothbrushes if the same disinfectant solution is used over a period of time or by multiple users.

4. It is also unnecessary to use dishwashers, microwaves, or ultraviolet devices to disinfect toothbrushes. These measures may damage the toothbrush.

5. Do not routinely cover toothbrushes or store them in closed containers. Such conditions (a humid environment) are more conducive to bacterial growth than the open air.

6. Replace your toothbrush every 3-4 months, or sooner if the bristles appear worn or splayed. This recommendation of the American Dental Association is based on the expected wear of the toothbrush and its subsequent loss of mechanical effectiveness, not on its bacterial contamination.

A decision to purchase or use products for toothbrush disinfection requires careful consideration, as the scientific literature does not support this practice at the present time.

See this link for infection control with toothbrushes.

Never to Late

Are you the type who doesn't brush before bed? You might want to consider:

Mutans streptococci, the bacteria involved in causing tooth decay, multiply 30 times overnight if you haven't brushed your teeth before going to bed!
Lion Oral Care Institute 7/04


How Do I Choose and Use A toothbrush:

No matter the color, shape, size or promises made there is no body of scientific evidence exists yet to show that any one type of toothbrush design if better than another at removing plaque.

The only thing that matters is that you brush your teeth.

In general, a toothbrush head should be small (1" by 1/2") for easy access. It should have a long, wide handle for a firm grasp. It should have soft, nylon bristles with round ends. 

Some brushes are too abrasive and can wear down teeth. A soft, rounded, multi-tufted brush can clean teeth effectively. Press just firmly enough to reach the spaces between the teeth as well as the surface. Medium and hard bristles are not recommended.

How long should I brush?
It might be a good idea to brush with the radio on, since dentists generally recommend brushing 3-4 minutes the length of an average song. Using an egg timer is another way to measure your brushing time. 

Most people spend less than a minute brushing. To make sure you're doing a thorough job brush the full 3-4 minutes twice a day instead of brushing quickly five or more times through the day.

Change your toothbrush every 3-4 months because they become ineffective and may harbor harmful bacterial. Sick people should change them at the beginning of an illness and after they feel better.

You only need a pea size of toothpaste when you brush

Should I brush at work?
Definitely, but most Americans don't brush during the workday. Dentists say it's a good idea to keep a toothbrush in your desk, which increases the chances that you'll brush during the day by 65 percent. 

Getting the debris off teeth right away stops sugary snacks from turning to damaging acids. 

If you brush with fluoride toothpaste in the morning and before going to bed, you don't even need to use toothpaste at work. You can just brush and rinse before heading back to the desk. If you don't have a toothbrush, rinsing your mouth with water for 30 seconds after lunch also helps.

The following tips may improve your work-time brushing habits:

• Post a sticky note on your desk or computer at work as a reminder to brush teeth after lunch.

• Brush teeth right after lunch, before you become absorbed in work.

• Store your toothbrush and toothpaste at work in a convenient and handy place.

• Make brushing your teeth part of your freshening up routine at work.

• Dry brush inside bottom teeth first. 

Brushing After Meals Up 

A new US survey has outlined the different oral hygiene habits of men and women. Conducted for the American Dental Association's (ADA) 2003. 1,014 nationally representative adults were interviewed for the survey. It was found that women take better care of their teeth than men. However, overall American adults recorded a slight increase among those brushing twice a day or after each meal to 78 percent in 2003, compared with 1997's 75.4 percent. The most dramatic jump in brushing frequency occurred in the number of respondents saying they brushed after every meal, reaching 24.8 percent in 2003 compared with 11.5 percent in the 1997 survey. The daily use of dental floss or an interdental cleaner rose slightly to 50.5 percent in 2003 compared with 1997's 48.2 percent. Being thorough in your daily oral hygiene lays the groundwork for a healthy smile. A daily routine of brushing and flossing, in addition to regular dental checkups, can be enough in most cases to help prevent tooth decay and gum disease. 06/04

Brushing and Toothpaste

The importance of brushing:
The single best way to remove harmful plaque -- a thin, sticky film of bacteria -- from teeth and gums is to brush teeth regularly and properly.

What is the proper technique for teeth brushing?
Because every mouth is different, there is more than one technique of brushing that has proven to be effective. Deciding which technique is most appropriate for you depends largely on your teeth position and gum condition. Consult your physician and/or dentist to determine which brushing technique is most appropriate for your mouth.

Generally, most dentists recommend a circular technique for brushing. This includes brushing only a small group of teeth at a time -- gradually covering the entire mouth. The importance of maintaining a circular or elliptical motion is emphasized as using a back and forth motion may cause the following:

• a receded gum surface
• an exposed and tender root surface
• a wearing down of the gum line

Instead, dentists recommend the following method:

Step 1: Place the toothbrush beside your teeth at a 45-degree angle.

Step 2: Gently brush teeth only a small group of teeth at a time (in a circular or elliptical motion) until the entire mouth is covered.

Step 3: Brush the outside of the teeth, inside of the teeth, the chewing surfaces, and in between each tooth.

Step 4: Gently brush the tongue to remove bacteria and freshen breath.

Step 5: Repeat steps 1 through 4 at least twice daily, especially after meals and snacks.

What type of toothbrush should be used?
A toothbrush head should be small -- about 1 inch by 1/2 inch -- and should have a handle suitable for firm grasping. The bristles of the brush should be soft, nylon, and rounded at the ends. This helps ensure that the brush bristles are reaching the spaces between the teeth as well as the surface. Some brushes are too abrasive and can wear down the enamel on teeth. Thus, in most cases, medium and hard bristles are not recommended.

How often is brushing necessary?
Generally, brushing is recommended twice a day for at least three to four minutes each time. Patients generally think they are brushing long enough, when, in fact, most people spend less than one minute brushing. In addition, it is generally better to brush 3 to 4 minutes twice a day instead of brushing quickly five or more times throughout the day.

Dentists advise brushing your teeth during the day while at work, school, or play. Keeping a toothbrush handy -- in your desk or backpack -- increases the chances that you will brush during the day.

What is toothpaste?
Also called dentifrice, toothpaste is comprised of the following cleaning ingredients (stated in approximate percentages):

• humectant and water - 75 percent
  
• abrasive - 20 percent
  
• foaming and flavoring agents - 2 percent
  
• pH buffers - 2 percent
  
• coloring agents, binders, and opacifiers - 1.5 percent
  
• fluoride - .24 percent

Facts about toothpaste:
Brushing with toothpaste (particularly toothpaste with fluoride) helps to accomplish the following:

• remove plaque
• resist decay
• promote remineralization
• clean and polish teeth
• remove teeth stains
• freshen breath

Which type of toothpaste is best?
Fluoride is the most crucial ingredient in toothpaste. As long as the toothpaste contains fluoride, the brand, nor type (paste, gel, or powder) generally does not matter. All fluoride toothpastes work effectively to fight plaque and cavities, and clean and polish tooth enamel. The brand you choose should bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled, clinical trials.

Some toothpastes offer tartar control pyrophosphates to prevent the build-up of soft calculus deposits on teeth, while others offer whitening formulas to safely remove stains making teeth brighter and shinier. But, contrary to clever advertising and popular belief, fluoride is the true active ingredient that works the hardest to protect your teeth.