Section II. TOOTHBRUSHING
The teeth are brushed to remove bacterial mucin plaque and stains and to
improve the health of the gingival tissues through stimulation. Effective brushing can be
done only with a suitable toothbrush. The toothbrush should be durable with soft nylon
bristles arranged so as to give the most cleansing action without injuring tissues or the
adjacent soft tissues. A patient should have enough toothbrushes to ensure that a
clean, dry brush is available for each brushing. See figure 4-1. Brushes with bristles
that have become loose or have lost resiliency should be replaced.
Figure 4-1. Toothbrushes.
Several toothbrushing techniques are satisfactory. Whatever technique is used,
four points should be remembered.
a. The first point is to clean the teeth and to stimulate gingival tissues without
injuring tooth structure, gingiva, or other oral tissues.
b. The second point is to brush every surface of every tooth and to provide
stimulation to gingival tissues.
c. The third point is to devote enough time to each area to ensure adequate
d. The fourth point is to pay special attention to brushing hard-to-reach areas.
SEQUENCE OF BRUSHING
A sequence of brushing should be developed in which every tooth and area is
adequately reached. The sequence should also provide enough brushing time in each
area and in places where areas overlap.