November 21, 2006

Oral Health-Chewing stick vs Toothbrush

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Chewing stick
Chewing sticks are used very widely in Africa and Asia as a means of maintaining oral hygiene. They are made from the roots, twigs, or stem of a plant. The preferred part or parts are cleaned with water to remove dirt, cut to a convenient length which varies from 15-30 cm long, and tied into a bundle. The user holds one end directly in his mouth and chews it into a fibrous brush-like fringe, which is used to scrub the surfaces of the teeth. A combination of vertical and horizontal strokes of the “brush” on tooth surfaces removes plaque. The tongue is scrubbed as well. Cleansing movement is directed away from the gingival margin to avoid induced recession and undue damage to the gums. Chewing sticks are used in the mornings before breakfast and at night after supper for daily oral hygiene maintenance. About five minutes of complete devotion to this exercise is deemed adequate to achieve good cleansing. According to Sote and Wilson, chewing sticks obtained form a variety of selected plants are used as a traditional method of mechanical oral hygiene by up to 80–90% of Nigerians. Studies by Danielsen et al. Van Palentstein Helderman et al, Aderinokun et al., and Almas and Al-Zeid have demonstrated chewing sticks are at least as effective as toothbrushes in maintaining oral hygiene. Sathananthan et al. reported Africans that use chewing sticks have fewer carious lesions than those that use toothbrushes, and their use has been encouraged by the World Health Organization. Apart from their mechanical effects, many of these chewing sticks have been shown to have significant antimicrobial activity against a broad spectrum of microorganisms.
Toothbrush
The 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 are offered with varying textures of bristles, and come in many different sizes and forms. Most dentists recommend using a toothbrush labelled "Soft", since firmer bristled toothbrushes can damage enamel and irritate gums. Toothbrushes are often made from synthetic materials, although natural toothbrushes are also known in many parts of the world.


What is the proper technique for teeth brushing?
Because every mouth is different, there is more than one technique of brushing that has proven to be effective. Deciding which technique is most appropriate for you depends largely on your teeth position and gum condition. Consult your physician and/or dentist to determine which brushing technique is most appropriate for your mouth.
Generally, most dentists recommend a circular technique for brushing. This includes brushing only a small group of teeth at a time -- gradually covering the entire mouth. The importance of maintaining a circular or elliptical motion is emphasized as using a back and forth motion may cause the following:
· a receded gum surface
· an exposed and tender root surface
· a wearing down of the gum line
Instead, dentists recommend the following method:
Step 1: Place the toothbrush beside your teeth at a 45-degree angle.
Step 2: Gently brush teeth only a small group of teeth at a time (in a circular or elliptical motion) until the entire mouth is covered.
Step 3: Brush the outside of the teeth, inside of the teeth, the chewing surfaces, and in between each tooth.
Step 4: Gently brush the tongue to remove bacteria and freshen breath.
Step 5: Repeat steps 1 through 4 at least twice daily, especially after meals and snacks.

What type of toothbrush should be used?
A toothbrush head should be small -- about 1 inch by 1/2 inch -- and should have a handle suitable for firm grasping. The bristles of the brush should be soft, nylon, and rounded at the ends. This helps ensure that the brush bristles are reaching the spaces between the teeth as well as the surface. Some brushes are too abrasive and can wear down the enamel on teeth. Thus, in most cases, medium and hard bristles are not recommended.

How often is brushing necessary?
Generally, brushing is recommended twice a day for at least three to four minutes each time. Patients generally think they are brushing long enough, when, in fact, most people spend less than one minute brushing. In addition, it is generally better to brush 3 to 4 minutes twice a day instead of brushing quickly five or more times throughout the day.
Dentists advise brushing your teeth during the day while at work, school, or play. Keeping a toothbrush handy -- in your desk or backpack -- increases the chances that you will brush during the day.

What is toothpaste?
Also called dentifrice, toothpaste is comprised of the following cleaning ingredients (stated in approximate percentages):
· humectant and water - 75 percent
· abrasive - 20 percent
· foaming and flavoring agents - 2 percent
· pH buffers - 2 percent
· coloring agents, binders, and opacifiers - 1.5 percent
· fluoride - .24 percent
Facts about toothpaste:
Brushing with toothpaste (particularly toothpaste with fluoride) helps to accomplish the following:
· remove plaque
· resist decay
· promote remineralization
· clean and polish teeth
· remove teeth stains
· freshen breath

Which type of toothpaste is best?
Fluoride is the most crucial ingredient in toothpaste. As long as the toothpaste contains fluoride, the brand, nor type (paste, gel, or powder) generally does not matter. All fluoride toothpastes work effectively to fight plaque and cavities, and clean and polish tooth enamel. The brand you choose should bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled, clinical trials.
Some toothpastes offer tartar control pyrophosphates to prevent the build-up of soft calculus deposits on teeth, while others offer whitening formulas to safely remove stains making teeth brighter and shinier. But, contrary to clever advertising and popular belief, fluoride is the true active ingredient that works the hardest to protect your teeth.

Are you going to use a chewing stick or a toothbrush?