A toothbrush is one of the single most important everyday cleaning tools that help to improve your oral hygiene and health. Therefore, choosing the right toothbrush and following the correct method of brushing is important for one to get the best hygiene outcomes.
Following the invention of the toothbrush by the Chinese in 1498, using naturally available products such as animal hair and bamboo, we have come a long way in terms of advancement currently. The modern-day toothbrushes come in a variety of shapes, types, materials and bristle varieties and can also be battery powered. The best parameters to choose a toothbrush would be
Bristle Variety
Most dental professionals advise the use of ‘Soft’ or ‘Medium bristle varieties. This choice can be made based on the amount of pressure used while brushing. Brushes with a hard bristle variety or the use of excessive force while brushing can lead to avoidable, commonly irreversible damage to the outermost layer of the tooth- the enamel. This enamel layer protects the tooth and prevents tooth sensitivity. Loss of enamel can not only make the tooth sensitive, but it can also lead to yellowish discoloration of the tooth and easy wearing off (attrition) of the tooth.
Hard bristle varieties are usually only indicated by a dentist in patients having any neurological or cognitive dysfunctions, making it difficult for a person to brush effectively. Likewise, extra soft bristle varieties might be prescribed only in the event such as widespread tooth enamel loss or hypoplasia. Therefore, using a soft or medium bristle variety is suggested unless otherwise, a dentist prescribes a hard or extra soft variety.
Brush size and shape:
This usually depends on individual comfort, age, dexterity and ease of access. The brush should be effectively used to access and clean hard to reach areas such as behind the molars and a decision on size and shape should be made accordingly.
Manual or electric toothbrush:
For most healthy individuals with no challenging conditions, both the manual as well as the electric toothbrush will be equally effective to remove plaque from the teeth surface and maintain oral hygiene. However, in those with any underlying conditions which affect dexterity, hand function or movement, such as Parkinson’s disease, arthritis, stroke, etc. Or in very young or elderly persons, an electric toothbrush might be a better option.
When to change your toothbrush?
Research studies have suggested that a toothbrush needs to be changed every 3 months. Even if a toothbrush appears visibly in good condition after 3 months, it would be best to change it. Reasons that warrant a toothbrush to be changed prior to 3 months are:
• Frayed/Damaged bristles- This usually means the person is applying too much pressure while brushing. The brush needs to be changed immediately, however, reducing the brushing pressure would be equally important.
• Post sickness/flu- Toothbrush bristles tend to gather micro-organisms and can lead to harboring of these microbes for a long period of time. Therefore, following sickness or an episode of flu, it would be best to change the toothbrush to avoid any repeated infection.
• If you find your toothbrush having traces of old tooth paste or dirt and you are unable to clean it, it would be the best time to get a new one.

Toothbrush care
• Always keep the toothbrushes in a covered cabinet or holder. This is to prevent any contamination by water in the washbasin, shower or flush. It also prevents cross-contamination with other brushes kept near it
• Keep the toothbrush in an upright position, this will help excess water to drain away easily.
• Store the brush in a dry, clean, ventilated environment
• Avoid storing a toothbrush in a zipped pouch or closed space. This would facilitate the multiplication of microorganisms on it
• Always wash the toothbrush before and after use. Using warm water would be more advisable.
• Storing a toothbrush in 70% alcohol solution occasionally is a good way to disinfect it
• Keep multiple brushes away from each other, to avoid any contact between the bristles.
Tooth-brushing techniques
The most commonly advised brushing technique is the Bass or Modified bass technique. Key points include:
• Place the brush bristles at a 45-degree angle, keeping the brush parallel to the tooth surface.
• Use gentle, firm pressure and move the brush in a vibratory, circular motion along the tooth surfaces.
• Continue to clean all the teeth in a span of 2 minutes, covering all surfaces including the surface towards the tongue and the chewing surfaces.
• For the lower front (anterior) teeth, use the brush vertically, with a pushing stroke from the gum line to the outer edge.
• Clean the tongue surface
• Brush twice daily, for 2 mins each using a pea-sized quantity of toothpaste.
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