Tooth brushing

Last updated

A man brushing his teeth while looking in a mirror. Man brushing teeth.jpg
A man brushing his teeth while looking in a mirror.

Tooth brushing is the act of scrubbing teeth with a toothbrush equipped with toothpaste. Interdental cleaning (with floss or an interdental brush) can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene. [1] The recommended amount of time for tooth brushing is two minutes each time for two times a day. [2]

Contents

History

A photo from 1899 showing the use of a toothbrush. Toothbrush1899Paris.jpg
A photo from 1899 showing the use of a toothbrush.

Teeth-cleaning twigs have long been used throughout human history. [3] As long ago as 3000 B.C., the ancient Egyptians constructed crude toothbrushes from twigs and leaves to clean their teeth. Similarly, other cultures such as the Greeks, Romans, Arabs and Indians also cleaned their teeth with twigs. Some would fray one end of the twig so that it could penetrate between the teeth more effectively.

In the Islamic prophetic tradition, Muhammad taught his disciples to brush their teeth using miswak five times per day, and this remains prevalent amongst many Muslims world wide since 610 A.D. [4]

The Indian method of using wood for brushing was presented by the Chinese Monk Yijing (635–713 A.D.) when he described the rules for monks in his book: [5]

Every day in the morning, a monk must chew a piece of tooth wood to brush his teeth and scrape his tongue, and this must be done in the proper way. Only after one has washed one's hands and mouth may one make salutations. Otherwise both the saluter and the saluted are at fault.
In Sanskrit, the tooth wood is known as the dantakasthadanta meaning tooth, and kastha, a piece of wood. It is twelve finger-widths in length. The shortest is not less than eight finger-widths long, resembling the little finger in size. Chew one end of the wood well for a long while and then brush the teeth with it.

Brushing teeth with chewing stick Brushing teeth with chewing stick.jpg
Brushing teeth with chewing stick

Modern-day tooth brushing as a regular habit became prevalent in Europe from the end of the 17th century. The first mass-produced toothbrush was developed in England in 1780 by William Addis. In the United States, although toothbrushes were available at the end of the 19th century, the practice did not become widespread until after the Second World War, when US soldiers continued the tooth brushing that had been required during their military service. [6]

Reasons

Brushing teeth properly helps prevent cavities, and periodontal, or gum disease, which causes at least one-third of adult tooth loss. [7] If teeth are not brushed correctly and frequently, it could lead to the calcification of saliva minerals, forming tartar. Tartar hardens (then referred to as 'calculus') if not removed every 48 hours. [8] Poor dental health has been associated with heart disease and shortened life expectancy. [9] [10] [11]

Many serious problems result from not maintaining proper oral hygiene. Not brushing teeth causes harmful bacteria to build up on teeth and gums. [12] Bacteria growing in the mouth can infect the gums and then can travel into blood vessels. When gingivitis and periodontitis bacteria move into the blood vessels, it can cause inflammation and damaged vessels. It clogs blood vessels, making it hard for blood to flow and can lead to blood clots, heart attacks, and strokes. Although the study at Harvard Medical School has observed "remnants of oral bacteria within atherosclerotic blood vessels far from the mouth", [13] there are other factors including gender, alcohol consumption, diabetes, exercise, smoking, and family history of heart problems that could increase the risk of coronary artery disease as well. [14] These factors make it hard to judge how much not brushing one's teeth elevates the risk of coronary heart disease, but there is a proven correlation between poor oral health and coronary heart disease. [15] [12]

Another negative side effect of not brushing one's teeth is halitosis or bad breath. According to the American Dental Association, not brushing properly allows remnants of food to collect on the teeth, gum line, and the surface of the tongue. [16] Tooth plaque leads to gingivitis and periodontitis bacteria build-up, which produces bad-smelling odors. [17] Having bad breath is very common, and most people experience it, but not brushing one's teeth particularly increases the risk. The ADA states that properly brushing teeth to remove bacteria that contribute to oral odors will improve oral hygiene and keep breath smelling as fresh as possible. [18] [19]

Tooth-brushing guidelines

Frequency

A 2008 review [20] cites studies from 1969–1973 [8] that gum and tooth health were maintained if brushing removed dental plaque more often than every 48 hours, and gum inflammation happened if brushing happened at intervals longer than 48 hours. The 2008 review noted that tooth brushing can remove plaque up to one millimeter below the gum line, and that each person has a habitual brushing method, so more frequent brushing does not cover additional parts of the teeth or mouth. [20]

Dentists consider the extra abrasion of dentin from brushing multiple times per day to be insignificant, [21] since modern toothpastes have relative dentin abrasivity below 250. [22] A 1997 study simulated six months of brushing with manual or sonic toothbrushes. Neither caused observable wear of tooth surface or fillings. Both caused a small loss of cement at the edge of gold inlays. [23] A 2017 study put composite fillings on both sides of extracted teeth. The study simulated seven years of brushing one side of each tooth with a sonic toothbrush, then measured microleakage around the fillings. No leakage was found at any bond between filling and enamel. At bonds between filling and cementum, there was sometimes leakage, and it happened to the same extent on the brushed sides of teeth and the unbrushed sides. [24]

When asked to brush "to the best of their abilities", young adults brushed longer, but did not cover any additional parts of their mouths. They brushed especially long on the grinding surfaces of back teeth (occlusal), which are the prime location for cavities in young children, but not in adults, where sides are more prone to cavities. [25]

A 2005 review of dental studies found consensus that a thorough tooth brushing once a day is sufficient for maintaining oral health, and that most dentists recommended patients brush twice a day in the hope that more frequent brushing would clean more areas of the mouth. [26]

A 2018 review noted that tooth brushing is the most common preventive healthcare activity, but tooth and gum disease remain high, since lay people clean at most 40% of their tooth margins at the gum line. Videos show that even when asked to brush their best, they do not know how to clean effectively. [25] Another 2018 study found that dental professionals did clean their teeth effectively. [27]

Contamination

A 2012 literature review found that bacteria survive on toothbrushes over 24 hours in moist conditions, less so when air-dried, though they can pick up contamination from the surrounding environment. Brushes can be decontaminated by soaking for 20 minutes in mouthwash. Harmful bacteria are present on brushes of healthy and sick people, and can add to their infectious load. [28]

Mouthwashes themselves reduce plaque by an average of 35% if they contain essential oils or chlorhexidine gluconate. The research does not report the extent of simultaneous tooth brushing by participants in mouthwash studies. Side effects of mouthwashes with essential oils and alcohol include poor taste and oral irritation. Side effects of those with chlorhexidine gluconate include tooth stains, calculus, taste disturbance and effects on the mouth lining. [29]

Rinsing a toothbrush Washingtoothbrush.jpg
Rinsing a toothbrush

Techniques

Gargle clean, fresh water a couple of times and rinse the toothbrush with water. [30] Standard advice is that the front and backs of teeth should be brushed with the toothbrush at a 45-degree angle towards the gum line, moving the brush in a back-and-forth rolling motion that makes contact with the gum line and tooth. [31] To brush the backs of the front teeth, the brush should be held vertically to the tooth and moved in an up-and-down motion. [31] The chewing surfaces of the teeth are brushed with a forward and back motion, with the toothbrush pointing straight at the tooth. [31]

Specialized advice for OralB rotating electric brushes is to follow the shape of each tooth and the gums, holding the brush against each tooth surface one at a time, [32] for 1–2 seconds per tooth. [33] Advice for Sonicare brushes is to use a slight angle, so longer bristles can reach between the teeth, [34] [35] making 3–5 small circles for 1–2 seconds on each tooth. [33] Bristles conform to tooth shapes. [36]

There are several other techniques: [37]

As far as technique recommendations, the simpler Scrub and Fones techniques are recommended for use by children as they are likely easier to master than the more complex techniques. For adults, the more complex Bass and Modified Bass techniques are recommended. However, brushing techniques learned in childhood often carry over into adulthood and it is then difficult for adults to change these learned behaviours. Of high importance to note, is that more complex techniques are not necessarily more effective. While there are many different tooth brushing techniques, there is no evidence that any of them is superior to the others. [37]

Tooth brushing before meals

One study found that brushing immediately after an acidic meal (such as diet soda or common breakfast foods like orange juice, coffee, citrus fruit, dried fruit, bread, or pastries [39] ) caused more damage to enamel and dentin compared to waiting 30 minutes. Flushing the acid away with water or dissolved baking soda could help reduce acid damage exacerbated by brushing. The same response was recommended for acid reflux and other acidic meals. [40] Researchers and dentists have concluded that brushing immediately after consuming acidic beverages should be avoided. It is better to brush before breakfast or dinner. [41]

In addition, brushing before breakfast eliminates overnight bacteria buildup, preventing them from thriving on sugary breakfast foods and producing enamel-damaging acids, while stimulating saliva production to neutralize acidity and reinforce teeth with essential minerals. This practice secures dental hygiene within the morning routine, crucial for avoiding neglect due to the morning rush, particularly for families with children or those eating breakfast outside the home. [42]

Toothbrush

Head of a toothbrush Toothbrush 20050716 004.jpg
Head of a toothbrush

A toothbrush is an instrument used to clean teeth, consisting of a small brush on a handle. Toothpaste, often containing fluoride, is commonly added to a toothbrush to aid in cleaning. Toothbrushes come in manual and electric varieties. Although there is conflicting evidence as to which is more effective, most evidence points to electric toothbrushes with an oscillatory motion being more effective than manual toothbrushes, with toothbrushes lacking an oscillatory motion being equivalent. [43] A 2014 Cochrane review found moderate evidence that electric toothbrushes reduce plaque and gingivitis more than manual ones. [43] Overall, both manual and electric toothbrushes are effective, however, and it is often recommended that people use whichever they feel comfortable with, determine is affordable for them, and will be more likely to regularly brush with. [44]

Toothpaste

Modern toothpaste gel Toothpaste.jpg
Modern toothpaste gel

Toothpaste is a paste or gel dentifrice used to clean and improve the aesthetic appearance and health of teeth. It is almost always used in conjunction with a toothbrush. Toothpaste use can promote good oral hygiene: it can aid in the removal of dental plaque and food from the teeth, it can aid in the elimination and/or masking of halitosis when tonsil stones are not the cause, and it can deliver active ingredients such as fluoride to prevent tooth and gum (gingiva) disease.

There is evidence that the addition of xylitol to fluoride-containing toothpastes reduces incidence of tooth decay by about 13%. [45]

Tooth powder (or 'toothpaste powder') is an alternative to toothpaste. It may be recommended for people with sensitive teeth. Tooth powder typically does not contain the chemical sodium lauryl sulphate, commonly used in toothpaste, which can be a skin irritant. [46] The function of sodium lauryl sulphate is to form suds when teeth are brushed. Those with dentures may also use denture cleaner which can also come in powder form.

Fluoride toothpaste use in young children

When brushing teeth, using toothpaste that contains fluoride is recommended. There are different recommendations for the amount of toothpaste used based on age:

Toothbrushing should begin as soon as teeth begin to erupt into the mouth and should be done twice daily (morning and night). It is very important that caregivers supervise children's brushing to minimize swallowing of toothpaste. (ADA) For children at high risk of developing cavities, a dietary fluoride supplement (ADA) or professionally-applied fluoride varnish can be considered. [47] Fluoride is a safe and effective way to prevent and control cavities. [47]

See also

Related Research Articles

<span class="mw-page-title-main">Mouthwash</span> Liquid rinse for oral hygiene

Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swirled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.

<span class="mw-page-title-main">Human tooth</span> Calcified whitish structure in humans mouths used to break down food

Human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.

<span class="mw-page-title-main">Toothbrush</span> Oral hygiene tool

A toothbrush is a special type of brush used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They should be used in conjunction with something to clean between the teeth where the bristles of the toothbrush cannot reach - for example floss, tape or interdental brushes.

<span class="mw-page-title-main">Toothpaste</span> Substance to clean and maintain teeth

Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it is an abrasive that aids in removing dental plaque and food from the teeth, assists in suppressing halitosis, and delivers active ingredients to help prevent tooth decay and gum disease (gingivitis). Owing to differences in composition and fluoride content, not all toothpastes are equally effective in maintaining oral health. The decline of tooth decay during the 20th century has been attributed to the introduction and regular use of fluoride-containing toothpastes worldwide. Large amounts of swallowed toothpaste can be poisonous. Common colors for toothpaste include white and blue.

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

<span class="mw-page-title-main">Tooth decay</span> Deformation of teeth due to acids produced by bacteria

Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors, from yellow to black. Symptoms may include pain and difficulty eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation. Tooth regeneration is an ongoing stem cell–based field of study that aims to find methods to reverse the effects of decay; current methods are based on easing symptoms.

<span class="mw-page-title-main">Dental floss</span> Cord of thin filaments used in interdental cleaning

Dental floss is a cord of thin filaments, typically made of nylon or silk, used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use as part of oral cleaning is intended to maintain oral health.

Crest is an American brand of toothpaste and other oral hygiene products made by American multinational Procter & Gamble (P&G) and sold worldwide. In many countries in Europe, such as Germany, Bulgaria, Serbia, Ukraine, Belarus, Russia, Poland, Hungary, Latvia, Romania, Estonia and Lithuania, it is sold as Blend-A-Med, the name of an established German toothpaste acquired by P&G in 1987. In France, Spain, Italy, Israel, Sweden, Finland, Colombia, Belgium, the Netherlands, Brazil, the United Kingdom, the Republic of Ireland, Australia, Nigeria, Greece, Uruguay and Argentina, P&G markets similar toothpaste formulations under the Oral-B brand.

<span class="mw-page-title-main">Dental abrasion</span> Medical condition

Abrasion is the non-carious, mechanical wear of tooth from interaction with objects other than tooth-tooth contact. It most commonly affects the premolars and canines, usually along the cervical margins. Based on clinical surveys, studies have shown that abrasion is the most common but not the sole aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.

<span class="mw-page-title-main">Miswak</span> Teeth cleaning twig

The miswak is a teeth-cleaning twig made from the Salvadora persica tree. The miswak's properties have been described thus: "Apart from their antibacterial activity which may help control the formation and activity of dental plaque, they can be used effectively as a natural toothbrush for teeth cleaning. Such sticks are effective, inexpensive, common, available, and contain many medical properties".

Dentin hypersensitivity is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmotic, chemical or electrical; and which cannot be ascribed to any other dental disease.

<span class="mw-page-title-main">Scaling and root planing</span> Dental procedure

Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning, is a procedure involving removal of dental plaque and calculus and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms, the agents that cause inflammation. It is a part of non-surgical periodontal therapy. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.

<span class="mw-page-title-main">Oral hygiene</span> Cleaning the mouth by brushing the teeth and cleaning in between the teeth

Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

<span class="mw-page-title-main">Tongue cleaner</span> Oral hygiene device

A tongue cleaner is an oral hygiene device designed to clean the coating on the upper surface of the tongue. While there is tentative benefit from the use of a tongue cleaner it is insufficient to draw clear conclusions regarding bad breath.

<span class="mw-page-title-main">Remineralisation of teeth</span>

Tooth remineralization is the natural repair process for non-cavitated tooth lesions, in which calcium, phosphate and sometimes fluoride ions are deposited into crystal voids in demineralised enamel. Remineralization can contribute towards restoring strength and function within tooth structure.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

Gingival disease is a term used to group the diseases that affect the gingiva(gums). The most common gingival disease is gingivitis, the earliest stage of gingival-related diseases. Gingival disease encompasses all the conditions that surround the gums, this includes plaque-induced gingivitis, non-dental biofilm plaque-induced gingivitis, and periodontal diseases.

Interdental cleaning or interproximal cleaning is part of oral hygiene where the aim is to clean the areas in between the teeth, otherwise known as the proximal surfaces of teeth. This is to remove the dental plaque in areas a toothbrush cannot reach. The ultimate goal of interproximal cleaning is to prevent the development of interproximal caries and periodontal disease. The combined use of tooth brushing, and mechanical and manual interdental cleaning devices has been proven to reduce the prevalence of caries and periodontal diseases.

References

  1. Worthington HV, MacDonald L, Poklepovic Pericic T, Sambunjak D, Johnson TM, Imai P, Clarkson JE (April 2019). "Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries". The Cochrane Database of Systematic Reviews. 2020 (4): CD012018. doi:10.1002/14651858.cd012018.pub2. PMC   6953268 . PMID   30968949.
  2. "Toothbrushes". www.ada.org. Retrieved 16 August 2023.
  3. Wu, C. D.; Darout, I. A.; Skaug, N. (2001). "Chewing sticks: timeless natural toothbrushes for oral cleansing". Journal of Periodontal Research. 36 (5): 275–284. doi:10.1034/j.1600-0765.2001.360502.x. ISSN   1600-0765. PMID   11585114.
  4. The miswãk, an aspect of dental care in Islam
  5. Li, R., 2000. Buddhist Monastic Traditions of Southern Asia: A Record of the Inner Law Sent Home from the South Seas (p. 198). Numata Center for Buddhist Translation and Research.
  6. "Cosmetics and Personal Care Products in the Medicine and Science Collections: Oral Care". Smithsonian Institution. 20 March 2022.
  7. Dental, Levantine. "How to brush your teeth properly". Levantine Dental Clinic in Dubai. Levantine Dental Clinic.
  8. 1 2 Brushing at least every 48 hours:
    • Lang NP, Cumming BR, Löe H (July 1973). "Toothbrushing frequency as it relates to plaque development and gingival health". Journal of Periodontology. 44 (7): 396–405. doi:10.1902/jop.1973.44.7.396. hdl: 2027.42/141632 . PMID   4514570.
    • Löe H (1967). "The Gingival Index, the Plaque Index and the Retention Index Systems". Journal of Periodontology. 38 (6): Suppl:610–6. doi:10.1902/jop.1967.38.6.610. PMID   5237684.
    • Loe H (1970). "A review of the prevention and control of plaque.". In McHugh WD (ed.). Dental plaque. Edinburgh and London: E&S Livingstone. pp. 259–270.
  9. Li X, Kolltveit KM, Tronstad L, Olsen I (October 2000). "Systemic diseases caused by oral infection". Clinical Microbiology Reviews. 13 (4): 547–58. doi:10.1128/cmr.13.4.547-558.2000. PMC   88948 . PMID   11023956.
  10. Lai YL (August 2004). "Osteoporosis and periodontal disease" (PDF). Journal of the Chinese Medical Association. 67 (8): 387–8. PMID   15553796. Archived from the original (PDF) on 4 March 2016.
  11. Demmer RT, Desvarieux M (October 2006). "Periodontal infections and cardiovascular disease: the heart of the matter" (PDF). Journal of the American Dental Association. 137 (Suppl): 14S–20S, quiz 38S. doi:10.14219/jada.archive.2006.0402. PMID   17012731. Archived from the original (PDF) on 18 November 2012.
  12. 1 2 Batty GD, Jung KJ, Mok Y, Lee SJ, Back JH, Lee S, Jee SH (April 2018). "Oral health and later coronary heart disease: Cohort study of one million people". European Journal of Preventive Cardiology. 25 (6): 598–605. doi:10.1177/2047487318759112. PMC   5946673 . PMID   29461088.
  13. "Gum disease and the connection to heart disease". Harvard Health. 13 April 2018. Retrieved 8 July 2021.
  14. "MedlinePlus". vsearch.nlm.nih.gov. Retrieved 31 October 2022.
  15. "Licensing". Harvard Health. Harvard Publishing Health. Retrieved 4 March 2021.
  16. "Bad breath (halitosis): Causes, diagnosis, and treatment". www.medicalnewstoday.com. 10 January 2018. Retrieved 8 July 2021.
  17. "Periodontitis: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 6 November 2022.
  18. "Bad breath - Symptoms and causes". Mayo Clinic. Retrieved 4 March 2021.
  19. "Home - American Dental Association". www.ada.org. Retrieved 4 March 2021.
  20. 1 2 Claydon NC (2008). "Current concepts in toothbrushing and interdental cleaning". Periodontology 2000. 48: 10–22. doi:10.1111/j.1600-0757.2008.00273.x. PMID   18715352.
  21. "Toothpastes, Relative Dentin Abrasivity (RDA)". www.ada.org. Retrieved 13 January 2021.
  22. "Toothpaste Abrasiveness Ranked by RDA (Relative Dentin Abrasion) Value" (PDF). 16 July 2014. Retrieved 12 January 2021.
  23. Donly, K. J.; Vargas, M.; Meckes, M.; Sharma, A.; Kugel, G.; Hurley, E. (1997). "In vitro comparison of restoration wear and tensile strength following extended brushing with Sonicare and a manual toothbrush". The Journal of Clinical Dentistry. 8 (1 Spec No): 30–35. ISSN   0895-8831. PMID   9487843.
  24. Goldstein, Ronald E.; Lamba, Suruchi; Lawson, Nathaniel C.; Beck, Preston; Oster, Robert A.; Burgess, John O. (1 February 2017). "Microleakage around Class V Composite Restorations after Ultrasonic Scaling and Sonic Toothbrushing around their Margin". Journal of Esthetic and Restorative Dentistry. 29 (1): 41–48. doi:10.1111/jerd.12262. ISSN   1708-8240. PMC   5292089 . PMID   27612323.
  25. 1 2 Deinzer R, Ebel S, Blättermann H, Weik U, Margraf-Stiksrud J (October 2018). "Toothbrushing: to the best of one's abilities is possibly not good enough". BMC Oral Health. 18 (1): 167. doi: 10.1186/s12903-018-0633-0 . PMC   6194646 . PMID   30340623.
  26. Attin T, Hornecker E (2005). "Tooth brushing and oral health: how frequently and when should tooth brushing be performed?". Oral Health & Preventive Dentistry. 3 (3): 135–40. PMID   16355646.
  27. Deinzer R, Schmidt R, Harnacke D, Meyle J, Ziebolz D, Hoffmann T, Wöstmann B (March 2018). "Finding an upper limit of what might be achievable by patients: oral cleanliness in dental professionals after self-performed manual oral hygiene". Clinical Oral Investigations. 22 (2): 839–846. doi:10.1007/s00784-017-2160-9. PMID   28676902. S2CID   3400704.
  28. Frazelle MR, Munro CL (24 January 2012). "Toothbrush Contamination: A Review of the Literature". Nursing Research and Practice. 2012: 420630. doi: 10.1155/2012/420630 . PMC   3270454 . PMID   22315679.
  29. Takenaka S, Ohsumi T, Noiri Y (November 2019). "Evidence-based strategy for dental biofilms: Current evidence of mouthwashes on dental biofilm and gingivitis". The Japanese Dental Science Review. 55 (1): 33–40. doi:10.1016/j.jdsr.2018.07.001. PMC   6354555 . PMID   30733843.
  30. Jones M. "How to brush your teeth". www.thetoothbrushexpert.com. Retrieved 8 June 2021.
  31. 1 2 3 "Proper Brushing" (PDF). American Dental Hygienists Association. Retrieved 30 June 2015.
  32. "Using a Rechargeable Electric Toothbrush". Oral-B. Retrieved 12 March 2021.
  33. 1 2 Love J (10 November 2019). "How to brush your teeth properly". www.electricteeth.com. Retrieved 12 March 2021.
  34. "Proper Teeth Brushing Technique: Correcting Bad Brushing Habits". Philips. Retrieved 12 March 2021.
  35. "How to Brush with Philips Sonicare" (PDF). Philips.
  36. "Sonicare DiamondClean electric toothbrush". Philips. Retrieved 12 March 2021.
  37. 1 2 Wainwright, J.; Sheiham, A. (August 2014). "An analysis of methods of toothbrushing recommended by dental associations, toothpaste and toothbrush companies and in dental texts". British Dental Journal. 217 (3): E5. doi: 10.1038/sj.bdj.2014.651 . ISSN   1476-5373. PMID   25104719. S2CID   3332995.
  38. Chrysanthakopoulos, Nikolaos Andreas (2011). "Aetiology and Severity of Gingival Recession in an Adult Population Sample in Greece". Dental Research Journal. 8 (2): 64–70. ISSN   1735-3327. PMC   3177396 . PMID   22013465.
  39. "Should You Brush Your Teeth Before or After Your Morning Coffee?". HuffPost. 16 February 2021. Retrieved 22 September 2022.
  40. O'Connor A (21 May 2012). "Really? Never Brush Your Teeth Immediately After a Meal".
  41. O'Hehir TE (1 February 2004). "Brush before eating". RDH. Endeavor Business Media, LLC.
  42. Seo, Hannah (1 November 2022). "Is It Better to Brush Your Teeth Before Breakfast or After?". The New York Times.
  43. 1 2 Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM (June 2014). "Powered versus manual toothbrushing for oral health". The Cochrane Database of Systematic Reviews. 2014 (6): CD002281. doi:10.1002/14651858.CD002281.pub3. PMC   7133541 . PMID   24934383.
  44. "Learn More About Toothbrushes". American Dental Association. Retrieved 1 July 2015.
  45. Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV (March 2015). "Xylitol-containing products for preventing dental caries in children and adults". The Cochrane Database of Systematic Reviews. 2015 (3): CD010743. doi:10.1002/14651858.CD010743.pub2. PMC   9345289 . PMID   25809586.
  46. Herlofson BB, Barkvoll P (October 1994). "Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study". Acta Odontologica Scandinavica. 52 (5): 257–9. doi:10.3109/00016359409029036. PMID   7825393.
  47. 1 2 Council on Clinical Affairs (2016). "Guideline on Perinatal and Infant Oral Health Care" (PDF). American Academy of Pediatric Dentistry . 38 (6): 16–17.

Further reading