History A photo from 1899 showing the use of a toothbrush. As long as 3000 B.C., the ancient Egyptians constructed crude toothbrushes from twigs and leaves to clean their teeth. Similarly, other cultures such as the Greeks, Romans, Arabs and Indians  cleaned their teeth with twigs. Some would fray one end of the twig so that it could penetrate between the teeth more effectively. The Indian way of using tooth wood for brushing is presented by the Chinese Monk Yijing (635–713 CE) when he describes the rules for Monks in his book:Li, R., 2000. Buddhist Monastic Traditions of Southern Asia: A Record of the Inner Law Sent Home from the South Seas (p. 198). Numata Center for Buddhist Translation and Research. "Every day in the morning, a monk must chew a piece of tooth wood to brush his teeth and scrape his tongue, and this must be done in the proper way. Only after one has washed one's hands and mouth may one make salutations. Otherwise both the saluter and the saluted are at fault. In Sanskrit, the tooth wood is known as the dantakastha—danta meaning tooth, and kastha, a piece of wood. It is twelve finger-widths in length. The shortest is not less than eight finger-widths long, resembling the little finger in size. Chew one end of the wood well for a long while and then brush the teeth with it." Modern day toothbrushing as a regular habit became prevalent in Europe from the end of the 17th century. The first mass-produced toothbrush was developed in England in 1780 by William Addis. In the United States, although toothbrushes were available at the end of the 19th century, the practice did not become widespread until after the Second World War, when US soldiers continued the toothbrushing that had been required during their military service.. Many serious problems result from not maintaining proper oral hygiene. Not brushing your teeth causes harmful bacteria to build upon your teeth and gums. Bacteria growing in your mouth can infect your gums and then can travel into your blood vessels. When gingivitis and periodontitis bacteria move into your blood vessels, it can cause inflation and damaged vessels. It clogs blood vessels, making it hard for blood to flow and can lead to blood clots, heart attacks, and strokes. Although the study at Harvard Medical School has observed "remnants of oral bacteria within atherosclerotic blood vessels far from the mouth," there are other factors including gender, alcohol consumption, diabetes, exercise, smoking, and family history of heart problems that could increase the risk of coronary artery disease as well. These factors make it hard to judge how much not brushing your teeth elevates your risk of coronary heart disease, but there is a proven correlation between poor oral health and coronary heart disease. Another negative side effect of not brushing your teeth is halitosis or bad breath. According to The American Dental Association, not brushing properly allows remnants of food to collect on the teeth, gum line, and the surface of the tongue. Tooth plaque leads to gingivitis and periodontitis bacteria build-up, which produces bad smelling odors. Having bad breath is very common, and most people experience it, but not brushing your teeth makes you especially prone to bad odors . The ADA states that properly brushing your teeth to remove bacteria that contribute to oral odors will improve your oral hygiene and keep your breath smelling as fresh as possible. Toothbrushing guidelines Frequency A 2008 review cites studies from 1969-1973Brushing at least every 48 hours: that gum and tooth health were maintained if brushing removed dental plaque more often than every 48 hours, and gum inflammation happened if brushing happened at intervals longer than 48 hours. The 2008 review noted that toothbrushing can remove plaque up to one millimeter below the gum line, and that each person has a habitual brushing method, so more frequent brushing does not cover additional parts of the teeth or mouth. Neem, which is used by South Indians , in its full bloom, can aid in healing by keeping the area clean and disinfected. Dentists consider the extra abrasion of dentin from brushing multiple times per day to be insignificant, since modern toothpastes have Relative Dentin Abrasivity below 250. A 1997 study simulated six months of brushing with manual or sonic toothbrushes. Neither caused observable wear of tooth surface or fillings. Both caused a small loss of cement at the edge of gold inlays. A 2017 study put composite fillings on both sides of extracted teeth. The study simulated seven years of brushing one side of each tooth with a sonic toothbrush, then measured microleakage around the fillings. No leakage was found at any bond between filling and enamel. At bonds between filling and cementum, there was sometimes leakage, and it happened to the same extent on the brushed sides of teeth and the unbrushed sides. When asked to brush "to the best of their abilities  " young adults brushed longer, but did not cover any additional parts of their mouths. They brushed especially long on the grinding surfaces of back teeth (occlusal), which are the prime location for cavities in young children, but not in adults, where sides are more prone to cavities. A 2005 review of dental studies found consensus that a thorough toothbrushing once a day is sufficient for maintaining oral health, and that most dentists recommended patients brush twice a day in the hope that more frequent brushing would clean more areas of the mouth. A 2018 review noted that toothbrushing is the most common preventive healthcare activity, but tooth and gum disease remain high, since lay people clean at most 40\% of their tooth margins at the gum line. Videos show that even when asked to brush their best, they do not know how to clean effectively. Another 2018 study found that dental professionals did clean their teeth effectively. Proper technique Take some clean, freshwater, put it in you mouth and gargle a couple of times . Grab your toothbrush and clean it once with waterafter that you can start with brushing . Standard advice is that the front and backs of teeth should be brushed with the toothbrush at a 45 degree angle towards the gum line, moving the brush in a back and forth rolling motion that makes contact with the gum line and tooth. To brush the backs of the front teeth  the brush should be held vertically to the tooth and moved in an up and down motion. The chewing surfaces of the teeth are brushed with a forward and back motion, with the toothbrush pointing straight at the tooth. Specialized advice for OralB rotating electric brushes is to follow the shape of each tooth and the gums, holding the brush against each tooth surface one at a time, for 1–2 seconds per tooth. Advice for Sonicare  is to use a slight angle, so longer bristles can reach between the teeth,  for 3-5 small circles in 1–2 seconds on each tooth. Bristles conform to tooth shapes. Toothbrushing before breakfast/dinner One study found that brushing immediately after an acidic meal (such as diet soda and common breakfast foods like orange juice, citrus fruit, dried fruit, bread,  pastries) caused more damage to enamel and the dentin , compared to waiting 30 minutes. Flushing the acid away with water or dissolved baking soda could help reduce acid damage exacerbated by brushing. The same response was recommended for acid re-flux and other acidic meals. Researchers and dentists have concluded that brushing immediately after consuming acidic beverages should be avoided. Better to brush before breakfast or dinner. If brushing after a meal, wait at least a half hour after eating to prevent damage to your teeth. When you're looking to protect your  tooth enamel, brushing right after you wake up in the morning is better than brushing your teeth after breakfast. If you have to brush your teeth after breakfast, try to wait between 30 and 60 minutes before you brush. Brushing in the morning , whenever you're able to do it, is still better than skipping the step of brushing your teeth at all. %DIFDELCMD < %DIFDELCMD < %%% Toothbrush Head of a toothbrush A toothbrush is an instrument used to clean teeth, consisting of a small brush on a handle. Toothpaste, often containing fluoride, is commonly added to a toothbrush to aid in cleaning. Toothbrushes come in manual and electric varieties. Although there is conflicting evidence as to which is more effective, most evidence points to electric toothbrushes with an oscillatory motion being more effective than manual toothbrushes, with toothbrushes lacking an oscillatory motion being equivalent. A 2014 Cochrane review found moderate evidence that electric toothbrushing reduce plaque and gingivitis more than the manual one . Overall, both manual and electric toothbrushes are effective, however, and it is often recommended that people use whichever one they feel comfortable with, determine what is affordable for them  and will be more likely to regularly brush with. Toothbrushes are offered with varying textures of bristles, and come in many different forms and sizes. Most dentists recommend using a toothbrush labelled "soft", since firmer bristled toothbrushes can damage tooth enamel and irritate gums as indicated by the American Dental Association. Toothbrushes are often made from synthetic fibers, although natural toothbrushes are also known in many parts of the world. Those with dentures may also brush their teeth with traditional tooth brushes , specially made denture brushes or denture cleaners. The first mass produced toothbrush was made in England in 1780. While languishing in jail, William Addis decided to drill holes into a sheep's tibia, and pulled through the bristles of boar hair . Which he made into a toothbrushwhich gave him the idea to mass produce it on the outside under the name Wisdom Toothbrushes. They stayed family owned until 1996. Tooth powder (or 'toothpaste powder') is an alternative to toothpaste. It may be recommended for people with sensitive teeth. Tooth powder typically does not contain the chemical sodium lauryl sulphate  which can be a skin irritant. The function of sodium lauryl sulphate is to form suds when teeth are brushed. It is a common chemical in toothpaste. Those with dentures may also use denture cleaner which can also come in powder format .
History A photo from 1899 showing the use of a toothbrush. Teeth-cleaning twigs have long been used throughout human history. As long ago as 3000 B.C., the ancient Egyptians constructed crude toothbrushes from twigs and leaves to clean their teeth. Similarly, other cultures such as the Greeks, Romans, Arabs and Indians also cleaned their teeth with twigs. Some would fray one end of the twig so that it could penetrate between the teeth more effectively. The Indian method of using wood for brushing was presented by the Chinese Monk Yijing (635–713 CE) when he described the rules for monks in his book:Li, R., 2000. Buddhist Monastic Traditions of Southern Asia: A Record of the Inner Law Sent Home from the South Seas (p. 198). Numata Center for Buddhist Translation and Research. Modern-day tooth brushing as a regular habit became prevalent in Europe from the end of the 17th century. The first mass-produced toothbrush was developed in England in 1780 by William Addis. In the United States, although toothbrushes were available at the end of the 19th century, the practice did not become widespread until after the Second World War, when US soldiers continued the tooth brushing that had been required during their military service.. Many serious problems result from not maintaining proper oral hygiene. Not brushing teeth causes harmful bacteria to build up on teeth and gums. Bacteria growing in the mouth can infect the gums and then can travel into blood vessels. When gingivitis and periodontitis bacteria move into the blood vessels, it can cause inflation and damaged vessels. It clogs blood vessels, making it hard for blood to flow and can lead to blood clots, heart attacks, and strokes. Although the study at Harvard Medical School has observed "remnants of oral bacteria within atherosclerotic blood vessels far from the mouth," there are other factors including gender, alcohol consumption, diabetes, exercise, smoking, and family history of heart problems that could increase the risk of coronary artery disease as well. These factors make it hard to judge how much not brushing one's teeth elevates the risk of coronary heart disease, but there is a proven correlation between poor oral health and coronary heart disease. Another negative side effect of not brushing one's teeth is halitosis or bad breath. According to the American Dental Association, not brushing properly allows remnants of food to collect on the teeth, gum line, and the surface of the tongue. Tooth plaque leads to gingivitis and periodontitis bacteria build-up, which produces bad-smelling odors. Having bad breath is very common, and most people experience it, but not brushing one's teeth particularly increases the risk . The ADA states that properly brushing teeth to remove bacteria that contribute to oral odors will improve oral hygiene and keep breath smelling as fresh as possible. Tooth-brushing guidelines Frequency A 2008 review cites studies from 1969–1973Brushing at least every 48 hours: that gum and tooth health were maintained if brushing removed dental plaque more often than every 48 hours, and gum inflammation happened if brushing happened at intervals longer than 48 hours. The 2008 review noted that tooth brushing can remove plaque up to one millimeter below the gum line, and that each person has a habitual brushing method, so more frequent brushing does not cover additional parts of the teeth or mouth. Neem, which is used by South Indians in its full bloom, can aid in healing by keeping the area clean and disinfected. Dentists consider the extra abrasion of dentin from brushing multiple times per day to be insignificant, since modern toothpastes have relative dentin abrasivity below 250. A 1997 study simulated six months of brushing with manual or sonic toothbrushes. Neither caused observable wear of tooth surface or fillings. Both caused a small loss of cement at the edge of gold inlays. A 2017 study put composite fillings on both sides of extracted teeth. The study simulated seven years of brushing one side of each tooth with a sonic toothbrush, then measured microleakage around the fillings. No leakage was found at any bond between filling and enamel. At bonds between filling and cementum, there was sometimes leakage, and it happened to the same extent on the brushed sides of teeth and the unbrushed sides. When asked to brush "to the best of their abilities , " young adults brushed longer, but did not cover any additional parts of their mouths. They brushed especially long on the grinding surfaces of back teeth (occlusal), which are the prime location for cavities in young children, but not in adults, where sides are more prone to cavities. A 2005 review of dental studies found consensus that a thorough tooth brushing once a day is sufficient for maintaining oral health, and that most dentists recommended patients brush twice a day in the hope that more frequent brushing would clean more areas of the mouth. A 2018 review noted that tooth brushing is the most common preventive healthcare activity, but tooth and gum disease remain high, since lay people clean at most 40\% of their tooth margins at the gum line. Videos show that even when asked to brush their best, they do not know how to clean effectively. Another 2018 study found that dental professionals did clean their teeth effectively. Proper technique Gargle clean, fresh water a couple of times and rinse the toothbrush with water . Standard advice is that the front and backs of teeth should be brushed with the toothbrush at a 45-degree angle towards the gum line, moving the brush in a back-and-forth rolling motion that makes contact with the gum line and tooth. To brush the backs of the front teeth , the brush should be held vertically to the tooth and moved in an up-and-down motion. The chewing surfaces of the teeth are brushed with a forward and back motion, with the toothbrush pointing straight at the tooth. Specialized advice for OralB rotating electric brushes is to follow the shape of each tooth and the gums, holding the brush against each tooth surface one at a time, for 1–2 seconds per tooth. Advice for Sonicare brushes is to use a slight angle, so longer bristles can reach between the teeth, making 3–5 small circles for 1–2 seconds on each tooth. Bristles conform to tooth shapes. Tooth brushing before breakfast/dinner One study found that brushing immediately after an acidic meal (such as diet soda or common breakfast foods like orange juice, citrus fruit, dried fruit, bread, or pastries) caused more damage to enamel and dentin compared to waiting 30 minutes. Flushing the acid away with water or dissolved baking soda could help reduce acid damage exacerbated by brushing. The same response was recommended for acid reflux and other acidic meals. Researchers and dentists have concluded that brushing immediately after consuming acidic beverages should be avoided. It is better to brush before breakfast or dinner. If brushing after a meal, wait at least a half hour after eating to prevent tooth damage. To protect tooth enamel, brushing immediately after waking is better than brushing after breakfast. If it is necessary to brush after breakfast, try to wait between 30 and 60 minutes before brushing. Brushing at any point in the morning is still better than skipping the step of brushing at all. %DIFDELCMD < %DIFDELCMD < %%% Toothbrush Head of a toothbrush A toothbrush is an instrument used to clean teeth, consisting of a small brush on a handle. Toothpaste, often containing fluoride, is commonly added to a toothbrush to aid in cleaning. Toothbrushes come in manual and electric varieties. Although there is conflicting evidence as to which is more effective, most evidence points to electric toothbrushes with an oscillatory motion being more effective than manual toothbrushes, with toothbrushes lacking an oscillatory motion being equivalent. A 2014 Cochrane review found moderate evidence that electric toothbrushes reduce plaque and gingivitis more than manual ones . Overall, both manual and electric toothbrushes are effective, however, and it is often recommended that people use whichever they feel comfortable with, determine is affordable for them , and will be more likely to regularly brush with. Toothbrushes are offered with varying textures of bristles, and come in many different forms and sizes. Most dentists recommend using a toothbrush labelled "soft", since firmer-bristled toothbrushes can damage tooth enamel and irritate gums as indicated by the American Dental Association. Toothbrushes are often made from synthetic fibers, although natural toothbrushes are also known in many parts of the world. Those with dentures may also brush their teeth with traditional toothbrushes , specially made denture brushes or denture cleaners. The first mass-produced toothbrush was made in England in 1780. While languishing in jail, William Addis decided to drill holes into a sheep's tibia, and pulled through the bristles of boar hair , creating a toothbrush. This gave him the idea to later mass-produce toothbrushes under the name Wisdom Toothbrushes. The company stayed family owned until 1996. Tooth powder (or 'toothpaste powder') is an alternative to toothpaste. It may be recommended for people with sensitive teeth. Tooth powder typically does not contain the chemical sodium lauryl sulphate , commonly used in toothpaste, which can be a skin irritant. The function of sodium lauryl sulphate is to form suds when teeth are brushed. Those with dentures may also use denture cleaner which can also come in powder form .
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