This video dives deep into one of the most overlooked aspects of oral hygiene — the humble toothbrush. From the history of traditional Indian methods like neem sticks and charcoal, to choosing the ideal modern toothbrush, we explore what truly matters for maintaining healthy teeth.

Shahid Akhter, Editor at Healthyouonline, spoke to leading dental experts to understand the right way to brush, choose your toothbrush, and maintain long-term oral health.

Why Toothbrush

A toothbrush is a mechanical method by which one can remove the plaque and calculus that get deposited on the tooth surface. Earlier, we used to use mango sticks or use charcoal to remove this plaque and calculus deposits, or the local factors, as we call it. People used to use neem sticks and all those kinds of twigs. Those are very harmful because you can’t control the amount of pressure. It also strips the gingiva. 

Ideal Toothbrush

There are very various bristles on the toothbrush and they have different levels of hardness. You have soft, medium and hard. And I have heard a lot of patients telling me that if you use a hard bristle toothbrush, the efficiency of cleaning is better. But invariably you see that they are causing deterioration on the tooth surface on a long term basis. 

So ideally, we would advise the individuals to use all medium brush. And that depends on the diameter and length of the bristles. Soft is normally used for disease when you have a periodontal disease progression or those who have undergone periodontal surgeries. 

On a regular basis, we always advise the use of a medium bristled toothbrush. And again, all these three are detrimental if the technique of usage is different. Like in the sense if it is not used in the right manner, all the three can be detrimental. The only single rule for a toothbrush is buy a simple toothbrush, which has rounded bristles and which is soft or  medium.  Hard toothbrushes I would not recommend for brushing your teeth.  I think hard tooth brush should be avoided. The harder the toothbrush, the more tooth structure is going to wear off. So you would rather use a soft brush and repeat it more often than using a hard brush. That's going to last three months. 

A lot of people like to use the hard brush because it makes them feel good. They feel they've done something, but little do they realize that they're taking away a lot of that tooth structure, all the enamel, the protective layer, etc. By the time they realize it's probably too late and they need major restorative care. I would recommend that please carry the toothbrush that you are using to your dentist. He will advise you on hard, medium or soft bristles. He will advise you on the type of the head, on the size of the head of the toothbrush.

How to Brush

A tooth brush helps aid in the cleansing of the entire oral cavity on the tooth surface, as well as on the tooth gum margins. Again, technique of tooth brushing is very important. It is not about how hard you brush. It depends on how well you present, like the technique we use for brushing. So ideally we need to use a soft brush with less force. And the cleaning has to be done on all the areas. And specifically you should not brush on one specific area for a long time, which could cause aberration of the teeth, if you use excessive force on a specific area for a long time. 

Toothbrush has to be held at a particular angle, and you have to brush up and down along the long axis of the tooth and brush and avoid horizontal brushing. You have to brush all the surfaces on the outside, which is visible in the mouth, which is visible to everybody on the side of the tongue and on the side of the palate and on the biting surface. All surfaces must be covered. Well, it's not the time as much as the way the direction of brushing that matters, We are supposed to go vertical as well. It is often ignored.

Too Much Toothbrushing 

Some people are paranoid about the maintenance or cleansing of their teeth. They always feel that there are some remnants of food that are remaining on their teeth. So on one side, we have people who never brush and never take care of their oral hygiene. And on the other flip side, you have obsessive people who tend to brush after every meal, after each thing they eat or drink, or they brush for 10 to 15 minutes. My advice to all these people is that there is a protocol that we all need to understand: too much is too bad. We, as dentists, advise to the tune of 1.5 minutes. Two minutes. That is about 90 to 120. So restrict it to around a minute, a minute and a half, or two minutes.

When to Brush 

After your night dinner. You wait for two hours before you get to bed. So just prior to bedtime is the ideal time to brush. Every time you have a meal, you should at least rinse your mouth, and twice a day is ideal for brushing. But if your intake is not as much, if you're eating a lot of fibrous foods and not too many calories, the number of caramels you can just brush once a day is more than enough. But if it's supplemented with flossing, that would be the pinnacle of maintaining your health.  If you brush and floss, you can keep your teeth for life.

When to change your Brush

Somehow we are attached to a toothbrush very emotionally. We may discard other positions, but not the toothbrush. Please ensure that you change your toothbrush every 3 to 4 months, whenever there is a flaring of the bristles of the toothbrush. A flared bristle is no good to take care of the plaque and debris removal on your tooth surfaces.