It is a detailed description of the various brushing techniques practiced. It is a presentable seminar which is easy to understand. It helped me a lot to learn the technique in detail. I would like to thank everyone associated with me and this presentation.

1. TRIVENI INSTITUTE
OF
DENTAL SCIENCES,
HOSPITAL AND RESEARCH
CENTRE
D. LAKSHMI
BDS

2. INTRODUCTION
• Brushing our teeth is an important part of our dental care routine.
• For a healthy mouth and smile the ADA recommends-
• Brush your teeth twice a day with a soft-bristled brush. The size and
shape of your brush should fit your mouth allowing you to reach all areas
easily.
• Replace your toothbrush every three or four months, or sooner if the
bristles are frayed. A worn toothbrush won’t do a good job of cleaning
your teeth.
• Make sure to use an ADA specified fluoride
toothpaste.

3. BRUSHING TECHNIQUES
• THE BASS OR SULCUS CLEANING METHOD.
• MODIFIED BASS TECHNIQUE.
• MODIFIED STILLMAN’S TECHNIQUE.
• FONES OR CIRCULAR OR SCRUB METHOD.
• VERTICAL OR LEONARD’S METHOD.
• CHARTER’S METHOD.
• SCRUB BRUSH METHOD.
• THE ROLL TECHNIQUE.
• PHYSIOLOGIC OR SMITH METHOD.

4. THE BASS METHOD OR SULCUS
CLEANING METHOD
It is the most accepted and effective method for the removal of dental plaque
present adjacent to and underneath the gingival margin.
INDICATIONS:
 It is most adaptable for :
• Open interproximal areas.
• Cervical areas beneath the height
of contour of enamel.
• Exposed root surfaces.
 It is recommended for patients
with or without periodontal
involvement.

5. The bristles are placed at a 45º angle to the gingiva and moved in small
circular motions.
Strokes are repeated around 20 times,3 teeth at a time.
On the lingual aspect of the anterior teeth, the brush is inserted
vertically and the heel of the brush is pressed into the gingival sulci
and proximal surfaces at a 45º angle.
The bristles are then activated.
Occlusal surfaces are cleaned by pressing the bristles firmly
against pit and fissures and then activating the bristles.
TECHNIQUE

6. ADVANTAGES:
o Effective method for removing plaque.
o Provides good gingival stimulation.
o Easy to learn.
DISADVANTAGES:
o Overzealous brushing may convert very short strokes into scrub technique of
brushing and cause injury to the gingival margin.
o Time consuming.
o In certain patients dexterity requirement is too high.

7. MODIFIED BASS TECHNIQUE
This method differs from bass technique in that it has sweeping motion from
cervical to incisal or occlusal surface.
INDICATION:
 As a routine oral hygiene
measure.
 Intrasulcular cleansing.
ADAVANTAGE:
 Excellent sulcus cleaning.
 Good inter proximal and
Gingival cleaning.
 Good gingival stimulation.
DISADVANTAGE:
 Dexterity of wrist is required.
Toothbrush
positioned on
facial and
maxilloproximal
surfaces of
maxillary molars.
Palatal position on
molars and pre
molars.

8. • This technique combines the vibratory & circular movements of the Bass
technique with the sweeping motion of the Roll technique. The toothbrush is
held in such a way that the bristles are at 45° to the gingiva.
• Bristles are gently vibrated by moving the brush handle in a back & forth motion.
• The bristles are then swept over the sides of the teeth towards their occlusal
surfaces in a single motion.
Brush position on the
occlusal surface used with
Bass, Stillman, Charter's
method.
Palatal position on
incisors.
Intrasulcular position
of the brush at 45º
angle to the long axis
of the tooth.

9. MODIFIED STILLMAN’S TECHNIQUE
INDICATION:
• Dental plaque removal from the cervical areas below the height of contour of
enamel and from exposed proximal surface.
• Cleaning tooth surfaces and gingival massage.
• It is recommended for cleaning in areas with progressing gingival recession
and root exposure to prevent abrasive tissue destruction.
• A soft toothbrush is indicated for this technique.
DISADVANTAGE:
• Time consuming.
• Improper brushing can damage the epithelial attachment.

10. The sides of the bristles are pressed against the teeth and gingiva, while
moving the brush with short ‘back and forth’ strokes in a coronal direction.
Modified Stillman’s Technique

11. TECHNIQUE
The bristles are pointed apically
with an oblique angle to the long
axis of the tooth.
The bristles are positioned partly
on the cervical aspect of tooth and
partly on the adjacent gingiva.
The bristles are activated with
short back and forth motion and
simultaneously in coronal direction.
20 strokes are applied and
procedure is repeated
systematically on adjacent teeth.

12. FONES METHOD
OR
CIRCULAR/SCRUB METHOD
INDICATION:
 Young children.
 Physically or emotionally
handicapped individuals.
 Patients who lack dexterity.

13. TECHNIQUE
The child is asked to stretch his/her
are such that they are parallel to the
floor.
The child is asked to draw big circles
using whole arm in the air.
The diameter of circles is reduced
untill small circles are not formed in
front of the mouth.
The child is now ready to make circles
on the teeth with the toothbrush,
making sure that all teeth and gums
are covered.

14. ADVANTAGE:
 It is easy to learn.
 Shorter time is required.
DISADVANTAGE:
 Possible trauma to gingiva.
 Interdental areas not properly cleaned.
 Detrimental for the adults especially who use the brush vigorously.

15. VERTICAL METHOD-LEONARD’S
METHOD
Vertical stroke is used.
Maxillary and mandibular teeth are brushed separately.
ADVANTAGE:
• It is the most convenient and
effective for small children
with deciduous teeth.
DISADVANTAGE:
• Interdental space of the
permanent teeth of adult are not properly cleaned.

16. TECHNIQUE
The bristles of the toothbrush are placed at 90° angle to the facial
surface of teeth.
With the teeth edge to edge, place the brush with filaments against the
teeth at right angle to the long axis of teeth.
Brush vigorously without great pressure with a stroke which is mostly up
and down the tooth surfaces with a slight rotation or circular movements
after striking the gingival margin with force.
It is not intended that the upper and lower teeth shall be brushed in the
same series of strokes.
The teeth are placed edge to edge to keep the brush slipping over the
occlusal or incisal surface.

17. CHARTER’S METHOD
INDICATIONS:
• Individuals having open inter
dental spaces with missing
papilla and exposed root surfaces.
• Those wearing fixed partial
dentures or orthodontic appliances.
• For patients who have had
periodontal surgery.
• Patients with moderate
interproximal gingival recession.

18. TECHNIQUE
A soft/medium multi-tufted
toothbrush is indicated for this
technique.
Bristles are placed at an angle of
45° to the gingiva with the bristles
directed coronally.
The bristles are activated by mild
vibratory strokes with the bristle
ends lying interproximally.

19. ADVANTAGE:
• Massage and stimulation of marginal and interdental gingiva.
DISADVANTAGES:
• Brush ends do not engage in the gingival sulcus to remove sub gingival
bacterial accumulations.
• The correct brush placement is limited or impossible, therefore modifications
become necessary which add to the complexity of the procedure.
• Requirements in digital dexterity are high.

20. SCRUB BRUSH METHOD
This method of brushing requires vigorous horizontal, vertical and circular
motions. It is the virtual free style of the brushing scene.
DISADVANTAGE:
• Not very effective at plaque removal.
• Tooth abrasion and gingival recession.

21. THE ROLL TECHNIQUE
• This method of brushing is also known as the Rolling Stroke method
or ADA method or the Sweep method. It works fairly well for patients
with anatomically normal gingival tissues.
INDICATIONS:
• Children.
• Adult patient with limited dexterity.
• Useful for preparatory lesson for
modified Stillman’s technique since
the initial brush placement is the same.

22. TECHNIQUE
The bristles are
placed at a 45°
angle.
Toothbrush is rolled
across the tooth
surface towards the
occlusal surface.
This technique
requires some
flexibility around the
wrist.

23. ADVANTAGE:
• Provide gingival massage and stimulation.
DISADVANTAGE:
• Brushing too high during initial placement can lacerate the alveolar mucosa.
• Tendency to use quick, sweeping strokes resulting in no brushing for cervical
third of the tooth, since the brush tips pass over rather than into the area and
likewise for the interproximal area.
• Replacing the brush with filament tips directed into the gingiva may produce
punctuate lesions.

24. PHYISIOLOGIC METHOD- SMITH
METHOD
The physiologic method was described by Smith and advocated
later by Bell. It was based on the principle that toothbrush should
follow the physiologic pathway that is followed by food when it
transverses over the tissues during mastication.

25. TECHNIQUE
Bristles are pointed incisally or occlusally and
then moved along and over the tooth surfaces
and gingiva.
The motion is gentle sweeping from incisal or
occlusal surface over to facial surface and
progressing towards and over the gingiva.
It is almost an attempt to duplicate nature’s self
cleansing and gingival stimulation mechanism
during mastication of food.

26. ADVANTAGE:
• Natural self cleansing mechanism.
• Supragingival cleaning is good.
DISADVANTAGE:
• Interdental spaces and sulcular areas of teeth are not properly cleaned.