4-7.
MANIPULATING THE BRUSH
To cleanse the occlusal surfaces of teeth, the tips of the bristles should be
worked into the pits and fissures with enough vibration to loosen and dislodge all debris.
To cleanse exposed axial surfaces, the sides of the bristles should be placed against
the gingival tissues to avoid lacerating them with the bristle tips. Then, holding the
sides of the bristles against the gingiva, rotate the bristles toward the occlusal or incisal
surfaces. The bristle should be worked between teeth and into interproximal areas to
dislodge accessible food debris and plaque. When the brush is used to stimulate or
massage the gingiva, the sides of the bristles should be placed against gingival tissues
near the bristle tips. With light pressure, the brush should be rotated slightly to flex the
bristles against the gingiva, and a vibrating motion should be transmitted through the
handle.
4-8.
MAJOR TOOTHBRUSHING METHODS
a. Bass Method. This method is useful for all types of dental conditions,
especially periodontal problems. With bristles pointed at a 45-degree angle into the
gingival sulcus, vibrate the brush gently back and forth about 20 times. Move the brush
forward and repeat.
b. Rolling Stroke Method. This method is useful for stimulation of the gingiva.
Place the brush above the free gingiva with the bristles pointed toward the apices.
Exerting light pressure, draw the brush toward the occlusal surface using a rolling
stroke. Use a scrub technique on the occlusal surface.
c. Charter's Method. This method is useful for patients with severe loss of
interdental papilla height, fixed prosthetic appliances, previous gingival surgery, or
subsided ulcerative gingivitis. Perform the rolling stroke first to remove debris from the
teeth. Direct the bristle tips toward the occlusal or incisal surface. Gently rotate the
handle, flexing the bristles and bringing them into contact with the interdental tissues
and exposed proximal surfaces. Vibrate the handle of the brush with a slow, circular
motion.
d. Modified Stillman's Method. This method is useful for patients with
hypersensitive gingiva or slightly reduced interdental papilla. Use the rolling stroke
method while vibrating the bristles in a lateral motion.
e. Fone's Method. This method is useful for small children or others with poor
manual dexterity. First, occlude the teeth. Then, lightly press the bristles against the
posterior teeth and the gingiva. Revolve the brush head in a fast, circular motion, using
circles of large diameter. Continue the circular motion, and slowly move the brush head
toward the anterior until all facial surfaces have been brushed. With the mouth open,
use the same circular motion on the maxillary and mandibular lingual surfaces.
MD0513
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