Methods of Plaque Control- Aids for Gingival Stimulation: Rubber Tip Stimulator, Balsa Wood Edge, Others: Gauze Strips, Water Irrigation device. Aids for Completely or Partially Edentulous Patients: Denture & Partial Clasp Brushes, Cleaning Solution. Tooth Brushing Techniques- Horizontal, Vertical (Leonard 1939), Circular (Fones 1934), Sulcular (Bass 1948), Vibratory (Stillman 1932), Vibratory (Charters 1948), Roll technique, Modified Bass/Stillman. Modified Bass Technique- 45 degree angle with tooth surface, Bristles angled towards sulcus, light pressure, Small back and forth motion. Modified Stillman Technique- Bristles placed on attached gingiva, 45 degree apically angled, Slightly firm pressure, Mesiodistal vibration. Charters Technique, Open interdental areas, 45 degree incisally or occlusally angle, 10-15 second vibration, More difficult. Roll Technique- Easy technique, Bristles placed on gingiva, 45 degree angle, Slight pressure, Rolling motion occlusally. Toothbrush- Frequency: Twice daily, Type of tooth brush: - Individual patient needs and preference, - Super soft, soft, medium, hard. Sequence - Start posteriorly, Most important: use same sequence all the time. Brushing time- 15-20 strokes per tooth. Electromechanical Toothbrush (EMB)- First electric brush introduced in 1960s, More expensive, Have timer, may motivate to brush for adequate time, More effective in removal of interproximal plaque. Effect of Tooth Brushing on Subgingival Plaque Formation, 28 molars in 4 monkeys, At baseline all supra and subgingival plaque and calculus removed, Brushing using bass method 3 times a week for 1 yr, Bristles of tooth brush can penetrate as far a 0.9mm below the gingival margin - mild to moderate cellular infiltration, Subgingival plaque formation can be prevented in areas accessible to toothbrush.
