Proper tooth Brushing Techniques are very important to maintain Oral Health, by following the correct tooth brushing technique you will be able to remove food debris and plaque which will in turn prevent the onset of Dental Caries.

The main reason for Dental caries is food lodgement in teeth, which are the food for the Bacteria and Microorganisms residing in the Oral cavity. The microorganisms consume the food lodged and then produce acid which lead to the demineralization of the Enamel leading to onset of Dental caries. Not just caries but most of the Gingival related problems like – Gingivitis, Periodontitis can also be prevented with the help of proper tooth brushing techniques. 

Tooth brushing techniques differ for various conditions – Tooth brushing techniques in Periodontitis and Gingivitis. There are many other dental conditions which arise as a result of improper brushing techniques such as – Abfraction. 

Classification of Tooth Brushing techniques based on Brushing Motion/Movement:

  1. Horizontal Reciprocating Motion: Horizontal Scrub Technique 
  2. Vibratory Motion: Bass(Sulcular Technique) or Stillmans Brushing Technique, Charters Brushing technique
  3. Vertical Sweeping Brushing Technique: Rolling Stroke (Press Roll)– Modified Stillman brushing technique, Modified charters, Modified Bass Leonard Smith-Bell (Physiologic technique)
  4. Rotary Brushing Technique: Fones Technique

Description of Brushing Techniques in detail:

  • Horizontal Scrub Method: It is the most commonly used method in brushing, where the bristles are activated in gentle, horizontal scrubbing motion.

Method/Technique: The brush is placed on the teeth either on Left or Right Side and the brush in moved along the line of dentition to the posterior region and pulled back again. 

Advantages/Disadvantages: This method of tooth brushing is used by everyone and this is not beneficial on the long run as Cervical Abrasion is caused mainly due to this type of brushing for long duration.

  • Bass Method or Sulcular Brushing Technique: It is one of the most effective brushing techniques because of its property to remove plaque or Bio Film and clean the area directly beneath the gingival margin which helps in controlling periodontal infections. 

Method/Technique: Bristles are directed apically at 45degrees (up for Maxillary and Down for Mandibular) to long axis of tooth,mostly it is difficult to place at 45 degrees so placing parallel to teeth is also beneficial. Now press the bristles slightly so that they enter the gingival sulcus and embrasures. Vibrate the Brush back and fort with short strokes for 10-15 strokes for each position and move to the next teeth. 

Indications: For open proximal areas, cleaning of cervial areas beneath the height of contour of Enamel, in case of teeth with exposed root surface. 

  • Stillman’s Brushing Technique: Similar to Bass technique with a slight modification to remove debris more effectively from the embrasures. Bristles are directed apically and angles same as bass, bristles are placed partly over cervical part of tooth and partly on adjacent gingiva. 

Method/Technique: This technique is similar to Bass technique with just the slight modification of occlusal movement along with short horizontal strokes. (Shortback and forth strokes are used and brush head is moved occlusally with lightpressure) 

Indications: In case of gingival recession, for gingival stimulation,to clean from large embrasures, remove plaque and biofilm from cervical region.

  • Charter’s Brushing Technique: It is a technique used mostly in presence of any appliances in the oral cavity, it effectively cleans the interproximal areas between teeth. 

Method/Technique: Position the Bristles towards the occlusal or crown of the tooth. The sides of the bristles are placed at the gingival margin at 45 degrees to long axis of tooth. Short back and forth strokes are given mostly like vibratory motion. 

Indications: Effective cleaning of inter proximal areas.  Used in case of fixed prosthodontic appliances and in case of patient undergoing Orthodontic treatment and patients who have just undergone periodontal surgery for temporary cleaning of surgical site. 

  • Modified Bass, Modified Stillman’s and Modified Charter’s: These techniques are very simple to understand if you know the 3 main tooth brushing techniques – Bass, Stillman and Charter’s all you have to do is follow these technique and at the end roll the brush tufts occlusally towards the crown. 

Method/Technique: Follow the techniques mentioned above about the 3 techniques Charter’s, Stillman’s or Bass and at the end of each technique roll the brushes towards the occlusal surface of the teeth, roll tufts occlusally after cervical area is cleaned by prescribed method. This will help is clearing out the debris, biofilm out of the embrasures. 

Indications: Clean entire facial/ buccal and lingual surfaces, rolling motion avoids damaging the base of the gingival sulcus. 

  • Fone’s (circular) Brushing Technique: It is the simplest of all methods of brushing, all you have to do is move the Brush in a circular motion around a set of teeth and move on to the next set, it is useful in teaching children to brush. But the down side is, it is the least effective brushing technique. 

Method/Technique: Place the Tooth Brush on a set of teeth, then activate the bristles by slightly pressing them against the teeth and give circular motion motion 4-5 times on each set of teeth and move on to the next set. 

Indications: Its mostly indicated for children but it can also be applied to adults. It is a simple technique but it has shown to be less effective then the rest of the methods. 

  • Roll Stroke Brushing Technique: This is another very simple brushing technique which does not need much practicing, all you have to do is place the bristles on the gingiva towards the root and give a upward stroke towards the occlusal surface.

Method/Technique: The Bristles are pointed apical towards the root and placed on the gingival margin and then a stroke is given to roll the brush occlusally cleaning the inter proximal and the tooth surface in one stroke. 

Indications:Used mostly in addition to Bass, Stillman’s and Charter’s techniques where we give this roll stroke at the end of each such technique. 

Following the proper tooth brushing techniques is useful in maintaining your oral hygiene, ask your dentist for the preferred tooth brushing technique for your oral cavity. The brushing techniques required for each patient is different and it is important to get the information from your dentist before you pick a particular brushing technique.