Tips for a Radiant Smile

Key Points

Smiling boosts your mood—especially when you can confidently show off your radiant teeth. In this summary, you'll learn the best techniques for brushing your teeth, using floss correctly, and maintaining proper oral hygiene to keep your smile bright and healthy.

How does brushing affect bacteria and biofilms?

Every day, approximately 330 billion cells in your body are renewed—a process called cell turnover. Even the epithelial cells in your mouth are replaced roughly every 14 to 21 days. This is good news because bacteria in your mouth form biofilms on non-shedding surfaces like teeth and roots, where they can firmly settle. Using tools like toothbrushes, interdental brushes, or floss is the only way to disrupt and reduce these biofilms.

Within minutes of thoroughly cleaning your teeth, a pellicle forms. This thin layer, made of proteins and glycoproteins in saliva, covers the tooth surface. Soon, the first bacteria attach loosely to the pellicle. Other microorganisms then adhere to these primary settlers, forming microcolonies. Over time, these colonies grow and mature into complex structures, giving their residents metabolic advantages. Like humans, bacteria build little villages on tooth surfaces that eventually grow into sprawling cities. Once they occupy all available surfaces, they begin constructing towering skyscrapers.

After 24 hours, the population within these skyscrapers begins to shift. Bacteria buried in the "basements" and "sewers" of these biofilm structures change their metabolism and turn into "the bad guys." They begin causing trouble and damage. This is why it’s not enough to only disturb the upper layers of the colonies—the real danger lies in their foundations.

To combat this, the goal is to use your toothbrush, interdental brushes, or floss to create the biggest tsunami or the most massive earthquake in your mouth, destroying these bacterial skyscrapers. The relatively short-lived bacteria (most die within a few hours to a day) won’t have enough time to adapt to these sudden changes in their environment and will perish en masse.

This is why we refer to the process as mechanical plaque control rather than plaque removal—it’s impossible to eliminate plaque entirely. Instead, the aim is to disrupt the bacteria, disorganize the biofilm, and demolish their skyscrapers twice a day—but perfectly!

Effective plaque disruption

Plaque must be primarily disrupted in the sulcus. The sulcus is the natural space between the tooth surface and the surrounding gum tissue where the tooth and gum meet.

This area is critical because the thin tissue that adheres to the tooth in this tiny space serves as the first line of defenseagainst microorganisms that could penetrate it, enter the body, and spread. Plaque also needs to be disrupted on all other tooth surfaces to ensure effective oral hygiene and overall health.

Healthy gums are firm, ranging from pink to brown, and fit tightly around the tooth. A good indicator of a healthy gingival sulcus is a depth of 3 mm or less, which is regularly measured by the dentist.
Plaque buildup in the sulcus and reddened, swollen gums, with the tissue bleeding slightly upon touch, are signs of gum inflammation and infection (gingivitis).
If left untreated, gingivitis can progress into periodontitis, which can be moderate (top) or advanced (bottom).

Untreated periodontitis can destroy bone, loosen teeth, and even lead to tooth loss.

Which methods and tools are best?

There are several methods and tools to help thoroughly clean your teeth. It’s important to understand all options, including their pros and cons.

Interdental brushes

While a toothbrush cleans about 70% of the tooth surface, the crucial 30% found in the interdental spaces, where issues like cavities and periodontitis begin, remain untouched. This is why interdental brushes are essential.

A good interdental brush has long, soft bristles that can expand and adapt. These properties allow it to fully clean the interdental area (1) and reach the curvatures of teeth and the papillae (2).

1. Interdental cleaning with a suitable interdental brush

2. Cleaning of interdental spaces despite tooth contours

Traditional interdental brushes (3) and dental floss (4) cannot adequately clean these tricky areas. Additionally, traditional interdental brushes can harm the bone and papilla in tightly closed interdental spaces. That’s why a professional should recommend the right brush for you.

3. Conventional interdental brush

4. Dental floss in the interdental space

Dental floss

If interdental spaces are irregular or too narrow—due to rotated, misaligned, or tightly packed teeth—an interdental brush may not fit. In such cases, dental floss can be used. However, floss is less effective than interdental brushes and is often improperly used, which can make it aggressive on gums and teeth.

Manual toothbrush

With manual toothbrushes, both the brush itself and the technique are critical. Choose a small-headed toothbrush with densely packed, ultra-soft bristles for thorough yet gentle cleaning.

The Bass technique is the only method that effectively reaches the sulcus. Hold the toothbrush at a 45° angle so that half the bristles rest on the gum and half on the tooth. Holding the toothbrush gently like a pen helps to avoid excessive pressure on teeth and gums.

Bass technique

Single-tufted brush

For extra care, a special single-tufted brush with a small head allows you to clean each tooth individually, without pressure or toothpaste. While it takes longer than typical brushing, it can be done anywhere and anytime, freeing you from the confines of the bathroom.

This brush is especially useful for preventing fissure cavities on the chewing surfaces of molars, which are prone to decay. It is also ideal for cleaning wisdom teeth, which are often misaligned, rotated, or partially erupted and therefore hard to reach.

Electric and sonic toothbrushes

Electric toothbrushes with rotating-oscillating heads and sonic toothbrushes are great alternatives to manual brushes.

Electric brushes have small, round heads that rotate in alternating directions. Sonic brushes have small heads that move side-to-side, with longer outer bristles that gently touch the tooth surface for mechanical cleaning. Shorter central bristles move freely, creating a hydrodynamic effect that mixes saliva, toothpaste, and water to clean tooth surfaces.

For optimal hydrodynamic effects, use a sonic toothbrush with at least 30,000 movements per minute. A toothpaste without sodium lauryl sulfate (SLS) can prevent excessive foaming.

Toothpaste

Toothpaste can improve oral hygiene and prevent cavities with fluoride.

However, avoid products with harsh ingredients like SLS, plastic microbeads, and triclosan. These can cause long-term harm, including allergies, canker sores, and bacterial resistance.

Highly flavored toothpaste can numb your tongue, impairing your ability to feel whether your teeth are smooth and clean.

How Often and How Long Should You Brush?

Consistency is key: clean one tooth at a time, one surface at a time. For interdental cleaning, use your brush or floss daily, ideally with one smooth movement, “in and out,” for each accessible space.

Once in...

...once out

It’s not realistic to clean your teeth thoroughly in just two minutes. Brush until your teeth feel clean. Your tongue can help you detect smooth and clean surfaces.

Remember, the frequency and quality of brushing must go hand in hand. Aim to clean all five surfaces of each tooth (chewing surfaces, inner, outer, and interdental surfaces) twice daily to disrupt and disorganize plaque effectively.

The five surfaces of a tooth.

Sources

This lesson was created in collaboration with Curaprox and their video tutorials on proper dental tool use.

Glossary

Pellicle (pellicula dentis): A thin film on the tooth surface.
Interdental spaces: The gaps between teeth.
Fissures: Grooves on the chewing surfaces of molars.
Rotating-oscillating: Moving in a circular, alternating motion.
Hydrodynamic effect: Movement of fluid to clean surfaces.
SLS (Sodium Lauryl Sulfate): A foaming agent found in some toothpaste.
Triclosan: An antibacterial ingredient.
Aphthae: Painful but non-contagious inflammations in the mouth.