Brushing and Flossing

Proper Oral Hygiene


Effective Tooth Brushing

A toothbrush removes the bacterial film from the outer, the inner and the biting surfaces of the teeth. It will not however remove plaque from in between the teeth which is why flossing is necessary. Brushing should be performed gently but with enough pressure to feel the bristles on the gum. Do not use so much pressure that you feel discomfort.

A back and forth scrubbing technique with short strokes including small circle strokes is recommended (the modified bass technique). For the outside surfaces of all teeth and the inside surfaces of the back teeth position the brush with the bristles at the junction between the teeth and gums. Then move the brush back and forth with short strokes several times. For the inside surfaces of the upper and lower front teeth, hold the brush vertically and make several gentle back and forth strokes over the gum tissue and teeth. The use of a fluoride tooth paste is strongly recommended when brushing.

Electric toothbrushes, specifically the Sonicare™ or Braun™ are highly recommended and can help keep your teeth cleaner than brushing with a regular tooth brush. One of their most important attributes is the timer that acts as a personal coach while brushing which helps you brush longer.

Effective Dental Flossing

Flossing is necessary because the in between areas of the teeth are inaccessible to the tooth brush. Patients with advanced periodontal disease may also need to use specialized brushes called “proxy brushes” to access these difficult areas. To floss properly, cut off a piece of floss about 3 feet long. Lightly wrap the ends of the floss around your middle finger. To clean between the upper right back teeth pass the floss over your right thumb and the forefinger of your left hand. The thumb is to the outside of the teeth, and helps hold the cheek back. To clean between the upper left teeth pass the floss over your left thumb and the forefinger of your right hand. Now the left thumb is outside the teeth and the right forefinger is on the inside. To clean between all lower teeth hold the floss with the forefingers of both hands. You will be able to insert the floss gently between all lower teeth with the floss over your forefingers in this position.

Flossing tips

  1. The fingers controlling the floss should not be more than one-half inch apart.
  2. Do not force the floss between the teeth. Insert it gently by sawing it back and forth at the point where the teeth contact each other. Let it slide gently into place.
  3. With both fingers move the floss up and down six times on the side of one tooth, and then repeat on the side of the other tooth until the surfaces are “squeaky” clean.
  4. Go to the gum tissue with the floss, but not into the gum so as to cause discomfort.
  5. When the floss becomes frayed or soiled, a turn from one middle finger to the other brings up a fresh section.
  6. At first flossing may be awkward and slow, but continued practice will increase skill and effectiveness.


Rinse vigorously with water after flossing to remove food particles and plaque. Also rinse with water after eating when you are unable to floss or brush. Rinsing alone will not remove the bacteria plaque but it can remove food particles caught between the teeth. Water spraying devices such as a water-pik, are effective in removing debris caught between the teeth but are not very effective removing bacterial plaque. Therefore, they should never be used as a substitute to brushing and flossing.

ADA-sealThe ADA Seal of Acceptance

Always look for the American Dental Association (ADA) Seal of acceptance on all purchased dental products. The seal is granted only to those products that have been shown to be clinically effective and truthful in their marketing. For example, one heavily marketed rinse claims that if used, it will reduce plaque by 50%. The claim is true, but what they don’t tell you is that rinsing with tap water will do the same! So always choose dental products with the ADA Seal of Acceptance.