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Oral Hygiene


How to Brush


In most cases, we recommend the Modified Bass Technique for brushing of teeth. For patients with gum disease we recommend brushing after meals and at bedtime which may be as much as four times per day.


  • While brushing the surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet; directly over the chewing surface of the teeth. Gently move the brush in a circular motion several times using small, gentle strokes for about two minutes. Warm up the bristles under warm water and use gentle pressure while putting the bristles between your teeth, but not so much pressure that you feel any discomfort.


  • When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth. To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically and still try to work in a circular motion over each tooth. Next, clean the biting surfaces of your teeth. To do this, use short, gentle strokes.


  • Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. Don’t forget to gently brush the surrounding gum tissue. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.


If you have any pain while brushing or have any questions about how to brush properly, please be sure to call Dr. Peter Elfar’s
office at: Port Macquarie on 02 6583 3533 or in Wauchope on 02 6585 2015.



















How to Floss


Since periodontal disease usually appears between the teeth where your toothbrush cannot reach, flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique, which takes time and practice.


  • Start with a piece of floss (waxed is easier) about 30cm long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand. To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it into place.


  • Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that you will want to clean in each space.


  • Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section. To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, both upper and lower.


  • When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be using too much pressure or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.


Dr. Peter Elfar often gets questions about the best frequency for flossing. Many patients say they only floss when they get something stuck between their teeth. Since the toothbrush does not have access between the teeth, Dr. Elfar recommends flossing at least once a day.














Caring For Sensitive Teeth


Sometimes after dental treatment, your teeth may feel sensitive to hot and cold temperatures. If you keep your mouth clean, this sensation should not last long. However, if you don’t keep your mouth clean, the sensitivity will remain and could become more severe. If your teeth are especially sensitive, consult with Dr. Peter Elfar. He may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth. Sometimes, the sensitivity may be resolved with a minor adjustment to your occlusion as teeth shift during treatment.


Choosing Oral Hygiene Products


There are so many products on the market that choosing the right one can be difficult. Here are some suggestions for selecting dental care products that will work for most patients:


  • The cornerstone of oral hygiene is brushing and flossing to access all around the teeth and gums. Thus, for all patients who have their own teeth or dental implants, some form of brushing and flossing is required.


  • Like any dental device, electronic toothbrushes can be safe and effective for the majority of users. Dr. Peter Elfar has seen excellent results with the commercially available “Sonicare” and “Braun Oral-B” which have built in two minute timers.


  • Many patients ask Dr. Peter Elfar about oral irrigators (water spraying devices); these are an extra step beyond brushing and flossing. They tend to rinse your mouth thoroughly, but will not remove plaque. With these types of devices, patients tend to think that more power is better, but this is not the case. When the power on an irrigator is too strong it can tear the gum tissue or disrupt healing tissue, so Dr. Elfar recommends the use of powered irrigators only until the gums are healthy. You still need to brush and floss in conjunction with the irrigator.


  • Some toothbrushes have a rubber tip on the handle that is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so be sure to discuss proper use with Dr. Elfar.


  • If used in conjunction with brushing and flossing, fluoride toothpastes and mouth rinses can reduce tooth decay by as much as 40 percent. Remember, these rinses are not recommended for children under 6 years of age.


  • Tartar control toothpastes will reduce tartar above the gum line, but because gum disease starts below the gum line, these products have not been proven to reduce the early stages of gum disease. Anti-plaque rinses, approved by the Australian Dental Association, contain agents that may help control signs of early gum disease. Use these in conjunction with brushing and flossing.


  • Beyond regular fluoride toothpaste, many other products have come on the market with adjunctive ingredients or are completely adjunctive, and some patients may be sensitive to these ingredients. If you come across something new, let Dr. Elfar or his staff know, and they will be happy to discuss your options further.




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