Section 3: Toothbrushing good practice

3.1 What is effective toothbrushing

Toothbrushing is a major contributor to regular maintenance of quality oral hygiene. To be done well, the type of toothbrush, the nature of the toothpaste used, how and when each is applied requires careful consideration. For children, the toothbrushes and brushing techniques need to be adapted to suit their age and ability. This is why adults are encouraged to supervise toothbrushing by children up to eight years of age.

3.2 Toothbrushes

Use a toothbrush with a small brush head, as this enables better access to the back of the mouth and to tooth surfaces when compared to a larger toothbrush.

A dedicated toothbrush with soft-medium texture bristles replaced at least every three months – or sooner if the bristles become splayed – is encouraged for use by each child and member of their family.

Faulty toothbrushing technique can arise due to excess pressure being applied. This causes the gum line to recede and exposure of the roots of the teeth (gingival recession), along with loss of tooth substance by mechanical abrasion. Holding the toothbrush in a pen grip using just the thumb and forefinger, as opposed to resting the toothbrush in the palm of the hand and gripping with four fingers, results in less pressure being applied.

3.3 Toothpaste

The quantity of toothpaste to use and also the type of toothpaste are important considerations. For infants and toddlers (0-2 years) a smear of toothpaste is sufficient. However, for children aged 3-6 years old this increases to a pea-sized amount.

Fluoridated toothpaste is recommended by the Department of Health. The amount of fluoride contained within toothpaste is measured in parts per million (usually abbreviated to ppm on toothpaste labels). For most children aged 0-6 years old, toothpaste with a fluoride content more than 1000ppm is suitable, however for children whose oral health is of concern a higher fluoride content of 1,350 – 1,500ppm is recommended.

3.4 Recommended toothbrushing technique

A gentle scrub technique with very short horizontal movements to dislodge plaque at the gum margins is effective for most people, is easy to teach and readily accepted. Careful use of this gentle scrub method using a toothbrush with densely packed, round-ended synthetic filaments of soft to medium texture helps with effective plaque removal. Following two minutes’ toothbrushing activity, spit out the toothpaste and do not rinse the mouth. This maximises retention of the fluoride and its protective action.

Summary of toothbrushing technique

  • Hold toothbrush in a pen grip. Avoid using excessive pressure
  • Gentle scrub technique
  • Use very short horizontal movements
  • Work slowly around the mouth brushing the teeth and the gums
  • Brush teeth for two minutes – use a timer
  • Spit out fluoride toothpaste
  • Do not rinse after brushing
  • Brush at least twice a day

Last updated: September 11, 2015

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