Basic oral hygiene can be maintained by brushing regularly, cleaning the tongue, using a mouthwash and flossing for deep cleaning. 

Brushing is the most common type of oral hygiene practice people indulge in. There are 9 types of brushing techniques that are recommended for different dental conditions. For instance, Fones technique is recommended for children whereas Modified Stillman’s technique is for people with the receded gum line.

Flossing is another most important aspect of complete oral hygiene. It is an efficient and harmless way of removing food stuck between your teeth. It has two methods of using, the spool method and the loop method.

Tongue scraping not only cleans the tongue but also prevents the chances of getting bad breath.

Mouthwashes are used for masking the bad breath and also decreasing the overall bacterial count in the mouth. There are two types of mouthwashes available in the market, cosmetic mouthwash and therapeutic (medicinal) mouthwash.

  1. Brushing
  2. Mouthwash
  3. Tongue cleaning
  4. Flossing
  5. Techniques of brushing
  6. Types of brushes

Brushing is the most important part of the oral hygiene routine. You should brush your teeth twice a day, once right after you wake up and once before sleeping at night, with a soft or ultra-soft bristled toothbrush. 

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Mouthwashes are an adjunct to other oral hygiene measures. Mouthwashes should be diluted before using. Mouthwash should be used consecutively for 21 days and then should be discontinued for at least 2 weeks before continuing the use.

Types of mouthwashes

Mouthwashes are of two types: 

1. Cosmetic mouthwash

Cosmetic mouthwashes have no medical benefit. They just temporarily control bad breath and leave behind a pleasant taste. They are easily available in the market for regular use.

2. Therapeutic mouthwash

Therapeutic mouthwash has active ingredients which help control or treat conditions like bad breath, gingivitis (inflammation of gums), plaque accumulation and cavities.

Chlorhexidine digluconate (0.2%) is the most widely recommended mouthwash for therapeutic purposes.

These mouthwashes can be prescribed by your dentist to maintain proper oral hygiene. They are also prescribed for orthodontic treatments (braces) and after dental surgeries like flap surgery (surgery of diseased gums). 

Oral hygiene does not end at only cleaning the teeth - cleaning the tongue is an equally important aspect of a completely clean mouth. Tongue scrapers are easily available in the market and are also sometimes present on the non-bristle end of the toothbrush. This is how you can clean your tongue:

  • Stand in front of the mirror, open your mouth and stretch your tongue as far out of the mouth as possible. 
  • Mostly the debris (yellowish-white coating of food particles) is found in the back portion of the tongue. Place the tongue cleaner or scraper at the place of the debris. Do not place the scraper too far back or else you may start gagging. 
  • Apply slight pressure on the scraper to flatten the tongue. Make sure that the scraper contacts the whole of the tongue.
  • Now pull the tongue scraper forward slowly to the front of the mouth. 
  • Clean the debris off the scraper under a stream of running water.
  • You may repeat this twice or thrice depending on the amount of debris on the tongue.

Dental floss is the best way of cleaning the space between the teeth. It might require more time than a toothpick but ensures that no harm comes to either the gums or the teeth.

Ways of flossing

Dental floss can be used in two different ways: the spool method and the loop method.

1. Spool method

  • Take a piece of floss approximately 12 inches long. 
  • Lightly wind 2-3 rounds of floss around the middle finger of one hand and wind the rest of the floss similarly around the same finger of the opposite hand. 
  • Clench the last three fingers of both the hands and move the hands apart, pulling the floss tightly.
  • Secure the floss with your index finger and thumb of each hand. 
  • Pass the floss between two teeth at a time to clean the interdental area.

2. Loop method

  • Take out an 18 inches long piece of floss and make it into a circle by securely tying it with three knots. 
  • Place all the fingers in the loop except the thumbs. 
  • Hold the floss with the help of fingers and thumb with a gap of one inch between both hands. 
  • Pass the floss between two teeth at a time to clean the interdental area.

Types of dental floss

There are different types of floss available in the market. 

  • Depending upon the coating of the thread: Waxed or unwaxed
  • Depending upon the width of the thread: Thin or thick
  • Depending upon the design of the thread: Twisted or untwisted

Benefits of flossing

These are the benefits of flossing:

  • Flossing removes plaque and debris stuck between the teeth in the embrasure area, dental fillings and braces.
  • It not only removes the interdental plaque but also massages the gums over the embrasure space.  
  • Regular cleaning of spaces between the teeth (interdental space) reduces gingival bleeding.
  • Regular flossing removes the food stuck between your teeth, thus reduces the chances of getting cavities between two teeth and also prevents bad breath.

There are 9 different types of brushing techniques which are recommended for different dental conditions.

Modified Bass technique

It is a modified and better version of the Bass technique as it ensures better cleaning between the teeth.

  • Place the bristles of the brush at an angle of 45° to the gum line, on the outer surface of your teeth and move in to and fro motion, followed by a circular motion.
  • After every 10-15 strokes roll the brush towards the top surface of the molars and premolars and brush them using short back-and-forth strokes.
  • On the inner surface of the teeth, the top bristles of the brush are placed just below the gum line. The brushing is then done in a repeated swipe-out motion.
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Smith technique

It is also called the physiologic way of brushing used by people with the severely recessed gum line. It is not widely used by people and is not recommended for everyone. 

  • Place the brush on the outer surface, towards the edge of the teeth and start brushing upwards, towards the gum line.
  • Repeat the same motion 5-6 times
  • On the inner surface of the teeth, the heel of the brush is placed just below the gum line. The brushing is then done in a swipe out motion.

Roll technique

It is one of the best techniques that can be used by both adults and children with healthy gums.

  • Place the bristles of the brush at an angle of 45° onto the outer surface of your upper teeth and swipe it down.                                          
  • Now place the brush similarly onto the outer surface of your lower teeth and swipe it up.
  • On the inner surface of the teeth, the heel of the brush is placed just below the gum line. The brushing is then done in a swipe out motion.

Scrub brush technique

It is probably the most commonly used toothbrushing method. 

  • Touch your upper teeth with the lower teeth and put the brush on the outer surface of the teeth.
  • Now brush your teeth using a to-and-fro motion (horizontally) and then up-down motion (vertically) followed by circular strokes.
  • Repeat the to-and-fro and up-down motions for the inner surface of the teeth.

Charter's technique

An ultra-soft bristled toothbrush is recommended for this method. It is mostly recommended for people with braces or with a receded gum line.

  • Place the bristles of the brush at an angle of 45° onto the top gum line.
  • Now swipe it down to the edge of the lower teeth and repeat the motion 5-6 times.
  • Follow the same process for the upper teeth. 

Leonard's technique

It is one of the more convenient methods for children to clean their teeth. It is also known as the vertical method.

  • Touch your upper teeth with the lower teeth and put the brush on the outer surface of the teeth.
  • Now brush your teeth in a vertical motion (up-down strokes).
  • On the inner surface of the teeth, the top bristles are placed just below the gum line. The brushing is then done in a swipe out motion.

Fones technique

It is most commonly used to make children brush their teeth. It is also called the circular technique.

  • The child is asked to clench the teeth softly and put the brush on the outer surface of the teeth.
  • Ask the child to make small circles with the bristles of the brush on the surface of the teeth.
  • Repeat this motion 10 times and then ask them to put the brush on the top surface of the molars and brush back and forth.

Modified Stillman's technique

It not only cleans the teeth but also massages the gums. This technique can be used for people with a receded gum line.

  • Place the bristles of the brush at an angle of 45° onto the outer surface of your teeth, with the bristles placed partly on the gums and partly on the teeth.
  • Brush your teeth by using a left-right motion.
  • After about 15 strokes, move your brush to the top surface of the molars and premolars and brush them using short back-and-forth strokes.
  • On the inner surface of the teeth, the top bristles of the brush are placed just below the gum line. The brushing is then done in a swipe out motion.

Bass technique

It is the most effective way of brushing the teeth as it thoroughly cleans the entire surface of the teeth.

  • Place the bristles of the brush at an angle of 45° to the gum line, on the outer surface of your teeth and move in a circular motion.
  • Repeat the strokes 20 times, about 3 teeth at a time.
  • On the inner surface of the teeth, the top bristles of the brush are placed just below the gum line. The brushing is then done in a repeated swipe-out motion.
  • For cleaning the top surface of the molars and premolars, bristles are pressed firmly into the pits and fissures and then short back and forth strokes are given. 

There are different types of brushes which are used to clean the teeth. Some of them are the regular ones which you normally use in your daily life whereas there are some other kinds of brushes which access those regions of the teeth which can’t be accessed by the regular ones.

Single tuft brushes

Single tuft brushes are used in the areas where there is no gum on the embrasure area. The chances of food lodgement are high in such a situation. It looks like a normal brush but with bristles on only the top part of the brush.

Interproximal brush

Interproximal or interdental brushes have conical or tapered heads. As the name suggests, they are designed to clean the areas like spaces between the teeth which cannot be cleaned by a regular brush. They have a flexible handle that can be easily angled to facilitate better cleaning of the embrasure area. Embrasure is triangular space between your teeth, near the gums.

They are available in various widths as different brushes are used for different concerns. For instance, a person with normal embrasure area will use a smaller width interdental toothbrush whereas a person with space between his/her teeth will use a larger width toothbrush.

Electrical brush

These brushes were introduced for those with a physical or learning disability, aged people and terminally-ill patients but can be used by anyone. It works on the principle of rotating, oscillating and pulsating. These brushes have a small round head with stationary bristles attached to it. The head moves in a 60-degree counter-rotational motion which provides approximately 7600 strokes per minute. An electric toothbrush cleans your teeth just as well as a manual toothbrush.

Manual brush

These are the regular toothbrushes that we use on a daily basis. These brushes come in four different forms depending on the thickness of the bristles:

  • Ultra-soft: 0.10 mm
  • Soft: 0.15–0.18 mm 
  • Medium: 0.18–0.23 mm 
  • Hard/Extra hard: 0.23–0.28 mm
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