Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (2): 141-147.doi: 10.7518/gjkq.2025032

• Expert Forum •     Next Articles

Revisiting toothbrushing techniques: an evidence-based reflection

Bin Chen(),Fuhua Yan()   

  1. Dept. of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China
  • Received:2024-10-31 Revised:2024-11-20 Online:2025-03-01 Published:2025-03-01
  • Contact: Fuhua Yan E-mail:361734128@qq.com;yanfh@nju.edu.cn
  • Supported by:
    Nanjing Medical Science and Technology Development Foundation(ZKX22054);Jiangsu Provincial Medical Key Discipline Cultivation Unit(JSDW202246)

RichHTML

68

PDF (PC)

663

Abstract:

Brushing, a fundamental practice in daily oral hygiene, is not only pivotal for oral health but also intimately linked to overall systemic health. In the face of a plethora of brushing techniques, selecting an approach that is effective and safe has emerged as a shared concern for the general public and the oral healthcare community. Currently, the Bass method and its modified variant (modified Bass method) are widely recommended in China. However, the Bass method also evidently harbors potential risks. This article delves into the significance of brushing, provides an overview of va-rious brushing techniques, discusses the necessity of adopting the Bass method, and underscores its potential hazards to caution clinical practitioners and popular science advocates to recommend brushing techniques tailored to individual circumstances.

Key words: brushing technique, periodontal disease, dental caries, oral health, brushing-related trauma

CLC Number: 

  • R781.4

TrendMD: 

Fig 1

Insufficient cleaning"

Fig 2

Toothbrushing injury"

1 Peres MA, Macpherson LMD, Weyant RJ, et al. Oral diseases: a global public health challenge[J]. Lancet, 2019, 394(10194): 249-260.
2 Kumar S, Tadakamadla J, Johnson NW. Effect of toothbrushing frequency on incidence and increment of dental caries: a systematic review and Meta-analysis[J]. J Dent Res, 2016, 95(11): 1230-1236.
3 Sälzer S, Graetz C, Dörfer CE, et al. Contemporary practices for mechanical oral hygiene to prevent periodontal disease[J]. Periodontol 2000, 2020, 84(1): 35-44.
4 Kapila YL. Oral health’s inextricable connection to systemic health: special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions[J]. Periodontol 2000, 2021, 87(1): 11-16.
5 Bao J, Li L, Zhang Y, et al. Periodontitis may induce gut microbiota dysbiosis via salivary microbiota[J]. Int J Oral Sci, 2022, 14(1): 32.
6 Li L, Bao J, Chang Y, et al. Gut microbiota may mediate the influence of periodontitis on prediabetes[J]. J Dent Res, 2021, 100(12): 1387-1396.
7 Matsui S, Kajikawa M, Maruhashi T, et al. Decreased frequency and duration of tooth brushing is a risk factor for endothelial dysfunction[J]. Int J Cardiol, 2017, 241: 30-34.
8 Ehrenzeller S, Klompas M. Association between daily toothbrushing and hospital-acquired pneumonia: a systematic review and Meta-analysis[J]. JAMA Intern Med, 2024, 184(2): 131-142.
9 Kobayashi D, Takahashi O, Shimbo T. Frequency of daily tooth brushing and development of any type of malignancy[J]. Anticancer Res, 2019, 39(8): 4415-4421.
10 Lindhe J, Lang NP. Clinical periodontology and implant dentistry[M]. 6th ed. New Jersey: Wiley-Blac-kwell, 2015.
11 乔丹, 张杨珩, 闫福华. 影响刷牙方法选择的因素[J]. 中国实用口腔科杂志, 2020, 13(5): 272-276.
Qiao D, Zhang YH, Yan FH. Factors affecting the selection of brushing methods[J]. Chin J Pract Stomatol, 2020, 13(5): 272-276.
12 Hansen F, Gjermo P. The plaque-removing effect of four toothbrushing methods[J]. Scand J Dent Res, 1971, 79(7): 502-506.
13 Janakiram C, Varghese N, Venkitachalam R, et al. Comparison of modified Bass, Fones and normal tooth brushing technique for the efficacy of plaque control in young adults-a randomized clinical trial[J]. J Clin Exp Dent, 2020: e123-e129.
14 Wiegand A, Schlueter N. The role of oral hygiene: does toothbrushing harm[J]. Monogr Oral Sci, 2014, 25: 215-219.
15 Addy M, Hunter ML. Can tooth brushing damage your health? Effects on oral and dental tissues[J]. Int Dent J, 2003, 53(): 177-186.
16 Rajapakse PS, McCracken GI, Gwynnett E, et al. Does tooth brushing influence the development and progression of non-inflammatory gingival recession? A systematic review[J]. J Clin Periodontol, 2007, 34(12): 1046-1061.
17 Wiegand A, Burkhard JP, Eggmann F, et al. Bru-shing force of manual and sonic toothbrushes affects dental hard tissue abrasion[J]. Clin Oral Investig, 2013, 17(3): 815-822.
18 Harnacke D, Mitter S, Lehner M, et al. Improving oral hygiene skills by computer-based training: a randomized controlled comparison of the modified Bass and the Fones techniques[J]. PLoS One, 2012, 7(5): e37072.
19 Rajwani AR, Hawes SND, To A, et al. Effectiveness of manual toothbrushing techniques on plaque and gingivitis: a systematic review[J]. Oral Health Prev Dent, 2020, 18: 843-854.
20 Frandsen A. Mechanical oral hygiene practices[M]//Kleinman D, Löe H. Dental plaque control measures and oral hygiene practices. Oxford: IRL Press, 1986: 93-116.
21 Heasman PA, Holliday R, Bryant A, et al. Evidence for the occurrence of gingival recession and non-ca-rious cervical lesions as a consequence of traumatic toothbrushing[J]. J Clin Periodontol, 2015, 42(): S237-S255.
22 Ikawa T, Mizutani K, Sudo T, et al. Clinical compa-rison of an electric-powered ionic toothbrush and a manual toothbrush in plaque reduction: a rando-mized clinical trial[J]. Int J Dent Hyg, 2021, 19(1): 93-98.
23 United Nations Department of Economic and Social Affairs, Population Division. World population prospects 2024: summary of results[R]. New York: Uni-ted Nations, 2024.
24 Worthington HV, MacDonald L, Poklepovic Pericic T, et al. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries[J]. Cochrane Database Syst Rev, 2019, 4(4): CD012-018.
25 Takase N, Tabuchi Y, Tsunekawa N, et al. Clinical evaluation of plaque removal efficacy using interdental cleaning devices[J]. Japan J Conservat Dent, 2005, 48(2): 272-277.
26 孟焕新. 牙周病学[M]. 5版. 北京: 人民卫生出版社, 2020.
Meng HX. Periodontology[M]. 5th ed. Beijing: People’s Medical Publishing House, 2020.
27 Liu F, Pelekos G, Jin LJ. The gingival biotype in a cohort of Chinese subjects with and without history of periodontal disease[J]. J Periodontal Res, 2017, 52(6): 1004-1010.
28 杨文丽, 林雪峰, 张新春, 等. 下颌前磨牙颈部硬组织非线性接触的应力分布有限元分析[J]. 实用口腔医学杂志, 2007, 23(5): 652-655.
Yang WL, Lin XF, Zhang XC, et al. Finite element contact stress analysis of the mandibular premolar cervix[J]. J Pract Stomatol, 2007, 23(5): 652-655.
[1] Meng Lu,Wenchuan Chen,Yi Gao. Strategies for preventing periodontal diseases in the restoration of subgingival tooth defects [J]. Int J Stomatol, 2025, 52(2): 238-245.
[2] Mengying Cao,Rui Shi,Hanwen Yu,Chengcheng Liu. Progress in research on the application of remote-sensing imaging technologies in the diagnosis and treatment of oral diseases [J]. Int J Stomatol, 2025, 52(1): 107-116.
[3] Xingyue Wen, Junyu Zhao, Chongjun Zhao, Guixin Wang, Ruijie Huang. Research progress on chitosan in periodontal disease treatment [J]. Int J Stomatol, 2024, 51(4): 416-424.
[4] Dongna Li, Haoyan Zhai, Chunyan Liu. Research progress on combined orthodontic-periodontal treatment [J]. Int J Stomatol, 2024, 51(3): 326-336.
[5] Abulaiti Guliqihere,Qin Xu,Zhu Guangxun. Research progress of mitophagy in the onset and development of periodontal disease [J]. Int J Stomatol, 2024, 51(1): 68-73.
[6] Wang Xue,Chen Manman,Nie Rong.. Reliability and validity test of the Chinese version of self-efficacy scale of oral health among pregnant women [J]. Int J Stomatol, 2023, 50(2): 172-176.
[7] Cheng Yifan,Qin Xu,Jiang Ming,Zhu Guang-xun.. Research progress on innate lymphoid cells in periodontal diseases [J]. Int J Stomatol, 2023, 50(1): 32-36.
[8] Li Weiguang,Wu Yafei,Guo Shujuan.. Research progress on the use of inorganic nanoparticles in the diagnosis and treatment of periodontal disease [J]. Int J Stomatol, 2022, 49(6): 724-730.
[9] Gong Tao,Li Yuqing,Zhou Xuedong.. Research progress on sugar transporter and regulatory mechanisms in Streptococcus mutans [J]. Int J Stomatol, 2022, 49(5): 506-510.
[10] Li Guiping,Qin Xu,Zhu Guangxun.. Research progress on adenosine monophosphate-activated protein kinase in periodontal disease [J]. Int J Stomatol, 2022, 49(3): 343-348.
[11] Zhu Jinyi,Fan Qi,Zhou Yuan,Zou Jing,Huang Ruijie. Research progress of salivary proteins as predictive biomarkers for early childhood caries [J]. Int J Stomatol, 2022, 49(2): 212-219.
[12] Mu Xinyue,Liu Shutai. Research progress on motivational interviewing in the management of patients with periodontal disease [J]. Int J Stomatol, 2022, 49(1): 94-99.
[13] Liu Chengcheng, Ding Yi. Clinical diagnosis, treatment, and management strategies of common oral infectious disease during pregnancy [J]. Int J Stomatol, 2021, 48(6): 621-628.
[14] Bai Haoliang,Yang He,Zhao Lei. Research progress on periodontal disease risk assessment and prognosis judgment tools [J]. Int J Stomatol, 2021, 48(6): 696-702.
[15] Zhou Wanhang,Li Yanfei,Xu Ricong,Wan Qijun. Effects of non-surgical periodontal treatment on risk factors of chronic kidney disease and systematic inflammatory levels in patients with chronic kidney disease and periodontal disease: a Meta-analysis [J]. Int J Stomatol, 2021, 48(5): 528-535.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[7] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[8] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[9] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[10] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .