Non-Surgical

How to Brush

The object of brushing is to remove plaque from the tooth surface and from under the edge of the gum, on the inside and outside of the tooth. It is important to remember that periodontal disease starts under the gum edge, and placing the bristles in the sulcus is important when brushing. Also remember that brushing cannot access plaque that forms under the gum's edge between the teeth, and flossing is needed to complete that important step of oral hygiene.

Toothbrush at 45 degree angle to tooth, allowing bristles to slide between the tooth and gum, to clean plaque hidden in the sulcus.

To brush, angle the bristles of the brush at 45 degrees to the side of the tooth. This allows the bristles to slide under the edge of the gum, reaching the hidden plaque. Think of sliding broom bristles under the edge of a refrigerator to remove dirt. The brush should not be scrubbed back and forth, but rather shimmied or rotated in small circular motions. This allows the bristles to remain under the gum's edge, and also prevents wearing the gum.

Brushing the inside of the upper back teeth. Angle the bristles at 45 degrees and make a jiggling motion.	Brushing the outside of the upper back teeth. Do not scrub.
Brushing the inside of the lower back teeth.	Brushing the outside of the lower back teeth.
Brushing the outside of the upper front teeth.	Brushing the outside of the lower front teeth.

When all the teeth have been brushed under the edge of the gum, the top surfaces can be brushed. Brush the cheeks and tongue as well, for plaque forms throughout the mouth. Remember that brushing does not clean between the teeth, and flossing is needed to complete your daily oral hygiene.

How to Floss

Brushing removes the bacterial plaque from the sides of the teeth, but no brush is able to go between the teeth AND under the gums. Unfortunately this is where most periodontal disease starts, so it is critical to remove plaque from these areas. Flossing is the most important contribution you can make to your own oral health. To learn to floss properly takes time and patience, and most patients feel awkward flossing at first. However, once learned, it is an easy task that you will enjoy because your mouth will feel cleaner than ever before. It is not important when you floss, only that you do it at least once a day. Because it is not necessary to rinse when flossing, many patients find that after learning the technique, they can floss while watching television.

First, break off an 18-inch length of floss (any kind you like). Wrap the floss around your middle fingers, allowing enough room to control the floss with your index fingers and thumbs.

Floss wrapped around middle fingers leaving 4 - 5 inches between hands	Floss crosses over top of index fingers, which act to guide floss between teeth
Using index fingers allows easy placement of floss in back regions of the mouth	Floss may also be used by crossing over an index finger and opposite thumb
Using thumb and index finger for flossing front teeth

Gently slide the floss between two teeth, allowing it to pass through the contact of the two teeth. Many people think this is the stopping point , but it is only the preliminary step.

Flossing going past the contact point of the front two teeth. The gum has not yet been cleaned.

Once the floss "breaks the contact", slide it between the gum and one of the teeth as far as it will go, without causing discomfort. The floss is moved up and down several times, until the plaque is dislodged. When you hear the floss "squeak", the tooth surface is clean. Don't remove the floss, but rather slide the floss against the other tooth, and repeat the procedure. Each time the floss goes between two teeth there are two places that must be flossed: the side of one tooth and the side of the other tooth. These are two separate steps.

Slide the floss under the edge of the gum of one tooth, wrapping around the tooth. Gently move the floss up and down.	Next guide the floss under the gum of the adjacent tooth, wrapping the floss and guiding it up and down.

Once the floss has cleaned between the two teeth, move to the next contact and repeat the procedure until all the teeth have been flossed, front and back.

Flossing the back of the canine, pulling the floss forward to wrap around the tooth.	Flossing the front of the adjacent tooth by pushing the floss backward to wrap around the tooth

At first it may take 10-15 minutes to complete the mouth, but when you become proficient, flossing should take a total of less than 5 minutes. This is the best investment of time you can make toward your oral health.