Questions on brushing programming/electric brushes

[MeMyself]

Hi guys

I've had clear braces for about 6-7 months now on my top set of teeth only. So far I think I've been brushing very thoroughly, appointment before last my orthodontist did commend me on how clean it all was when I visited, though last time he didn't say anything specifically on that (though I didn't necessarily take that to mean it wasn't clean). Basically I constantly alternative between worrying about over-brushing on the one hand, and not brushing enough on the other.

I use an electric toothbrush, Oral B Triumph 4000 (it has several modes), and use a regular oral B 'precision head' for all surfaces without the brace.Over the brace I use the oral B 'orthodontic head'. I was specifically recommended this brush with these heads by my orthodontist at the start. I also sometimes occasionally use the oral b 'sensitive head' instead of the precision one, which has slightly more soft, flexible bristles, for a more forgiving brush. NOTE: I was going to post pictures of each brush type but can't seem to post URL's. I guess the important one is the orthodontic head, which is not a full head of bristles, but has some in the middle and all around the edge with a space in between, so it kind of 'fits 'over the bracket (pictures can be found with simple image search).

Basically I started off brushing 3 times a day and using mouthwash twice a day. I always try to brush after meals, but usually try give it 30 minutes as to avoid enamel erosion. Depending on when I eat, I usually give it an hour after my dinner so I'm brushing a bit closer to bed at night. I rinse after meals with water and only drink water in between meals. I just spit, don't rinse, and try to avoid drinking any liquids for about half an hour after brushing. I use mouthwash twice a day and at different times to brushing. Usually half an hour after my brush in the morning and an hour after my brush at night (usually before bed).

My method of brushing has been as follows. As noted I switch heads for surfaces. For brace, the shape of the orthodontic heads make it easier to place the head directly over the bracket and let it do the work. I have been simply holding it directly over for about 5-6 seconds (longer than for regular surfaces) and I have assumed that this has been doing a thorough cleaning. I can switch modes so it is faster/slower depending on what I feel I need. After brushing I use inter-dental brushes to gently clean in between the brackets, underneath the wire. I usually end up going over the 2 minute mark for brushing with the electric brush; it is probably about 2 minutes for all non-brace surfaces and another 45 seconds to a minute for the brace surfaces (so probably more like 3 minutes in total, minus interdental brushing/flossing).

This was working quite well but I had been suffering from dry mouth really bad over night for the first few months. I figured I was over-brushing (and I am constantly worried about wearing off the enamel, 9 minutes a day with electric brush seemed excessive), and also using too much whitening products (toothpaste/mouthwash) which also seem more drying. So I amended my routine slightly to brushing thoroughly only twice a day (morning and night), sometimes I would skip brushing in the middle of the day, but generally I would use the sensitive head and gently brush toothpaste over all surfaces (generally without actually switching it on, though if I did just over the brace with slower setting) and spit. This I would only use the whitening products in the morning, and instead use a pro-enamel/alcohol-free mouthwash at night.

This seems to have helped, and my mouth is somewhat less dry at night (but still quite dry, so I always keep a bottle by my bed, and I drink a lot of water during the day). But I am concerned my brushing could be better. As I said, I thought I've been brushing well, and probably assumed I was more over- than under-brushing. But I just noticed on one of my canines (which I had noticed are a bit more yellow than my other front teeth) there appears to be a small brown spot forming just behind one of the hooks on the bracket there. I have only just noticed this. Either it has only just started developing or I didn't see it. Basically it appears to be becoming discoloured, and so I'm worried I haven't been brushing properly. It could just be behind that spot (only hooks on the canine brackets), but I was still shocked and very distressed to see it there, especially since I HAD been giving extra attention to the top parts of my incisors and canines which seem to be yellower and accumulate more plaque closer to the gums. In fact, in the first few months of brushing I'd generally just hold the orthodontic head over for 5-6 seconds or whatever, but in past few months I've been coming back over (usually starting with fast mode then switching to one of the slower ones), trying get closer to the bracket and focus close on the gums. At first I was prone to a bit of bleeding from the gums in my top front teeth, but I never do any more.

So I guess my question is, does it look like my brushing is cutting it? I think I am going to try brushing more thoroughly 3 times a day from now on, but I am still worried about brushing away enamel. Also, might my dry mouth start causing problems? I'm worried that there is too long a gap between when I brush at night and when I brush in the morning. I actually do usually eat dinner fairly late in the evening, but if I brush an hour after I'm not brushing directly before bed (though I don't eat anything after that). I do use mouthwash closer to bed. But then when I rise, I eat (and over night there has been time for plaque to form, probably worse with dry mouth), wait, THEN brush (though sometimes I brush before if I awake with a really horribly dry mouth). There could very well be 12 hours between these brushings, especially if I go to bed and wake up late (which I have been doing a lot this year, student in final year). Is this bad? I can't see a way around this unless I brush after every meal AND before bed. I actually saw somebody saying that they did this, that they brushed morning/night AND after every meal - possibly up to 5 times a day, which just seems insane! I was advised to brush after every meal by orthodontist but not first thing morning and at night as well. In fact, one of the leaflets I was given says 'brush thoroughly twice daily with a fluoride toothpaste, rinse with water after every meal, and use a fluoride rinse once a day, ideally at a different time to brushing'.

So basically I'm wondering how best to 'programme' my daily brushing routine that helps both optimize plaque removal and keeping my teeth clean as well as avoiding that horrible dryness at night. Also, does anyone else use these orthodontic heads and use them as I described? After all this I'm thinking manual brushing might be better since I'm doing the work and not blindly believing my electric brush is doing it properly (and a lot of the instructional videos on brushing braces show placing the brush, usually with full-headed bristles, at a 45 degree angle to the brackets and brushing that way, rather than placing a brush like mine straight over). Are these orthodontic heads in conjunction with interdental brushes ideal? What would be the ideal method of brushing, how long for, how many times a day?

Thanks, and so sorry for the long post!

I'll try discuss this with my dentist/orthodontist and maybe try get an appointment with a hygienist too. Unfortunately here in the UK NHS dentists can be very dismissive and it is hard to discuss these things at length (though my ortho is private).

[MeMyself]

basically I constantly alternate*

[MeMyself]

Also (sorry to make this longer), what could this discolouration be? Just that, discoloration, or the start of a cavity/decay? I don't see how it could be the latter, especially on the front surface of a front tooth, when I brush so often. Can such discolouration be removed by a dentist? I'm getting worried that I'll need veneers to achieve the tooth appearance I want; I really like the shape of my teeth, and I think they'll be great once they're aligned properly. But the appearance is another story, since right now they're off-white and quite stained, and I can't get them whitened until after.

[Mylene]

Have you tried brushing with baking soda and rinsing with hydrogen peroxide? They're both very gentle, and they're great at whitening teeth.

[MeMyself]

Have you tried brushing with baking soda and rinsing with hydrogen peroxide? They're both very gentle, and they're great at whitening teeth.

Thank you for the response, I haven't actually, what does it involve precisely? Can I find out how to brush with these just by googling, or could you elaborate/post a link to a guide?

Thanks! I'm willing to try it out, when I look at my teeth close in the mirror I'm not too displeased with the overall appearance, though they're obviously not as white as they could be. But when I look from further away my teeth don't stand out (they kind of appear dull), whereas I want them to have that nice bright, glossy appearance.

[Mylene]

I have an elaborate description of my nightly oral hygiene on my blog at http://www.sevinsense.com. All you need to do to add baking soda to your routine is to sprinkle baking soda on your toothbrush and brush normally for 30-60 seconds; as you'll read on my blog, I do this first before everything else and I use a manual toothbrush so I can also brush the braces themselves without trashing my expensive electric toothbrush heads.
At the end of my routine, I rinse, first with only hydrogen peroxide and then I add some fluoride mouthwash, just for flavor.
The ironic thing is that the two most valuable dental care products are so cheap - less than a dollar for a big bottle of hydrogen peroxide, and only two dollars for a huge box of baking soda.
Give it a try and please tell me what you thinnk!

The blogpost's exact address is http://sevinsense.com/index.php/blog/or ... 8wld4l5mc0.

[MeMyself]

I have an elaborate description of my nightly oral hygiene on my blog at http://www.sevinsense.com. All you need to do to add baking soda to your routine is to sprinkle baking soda on your toothbrush and brush normally for 30-60 seconds; as you'll read on my blog, I do this first before everything else and I use a manual toothbrush so I can also brush the braces themselves without trashing my expensive electric toothbrush heads.
At the end of my routine, I rinse, first with only hydrogen peroxide and then I add some fluoride mouthwash, just for flavor.
The ironic thing is that the two most valuable dental care products are so cheap - less than a dollar for a big bottle of hydrogen peroxide, and only two dollars for a huge box of baking soda.
Give it a try and please tell me what you thinnk!

The blogpost's exact address is http://sevinsense.com/index.php/blog/or ... 8wld4l5mc0.

Thank you! That is very helpful. Just a couple of questions. Is baking soda basically bicarbonate of soda, and will any type/brand of this be suitable to use? And what percentage of hydrogen peroxide solution do you use? Do you mix it with fluoride mouthwash prior to use? How exactly do you use it? Can it just be used on its own or is it too strong?

Thanks!

[Mylene]

I have an elaborate description of my nightly oral hygiene on my blog at http://www.sevinsense.com. All you need to do to add baking soda to your routine is to sprinkle baking soda on your toothbrush and brush normally for 30-60 seconds; as you'll read on my blog, I do this first before everything else and I use a manual toothbrush so I can also brush the braces themselves without trashing my expensive electric toothbrush heads.
At the end of my routine, I rinse, first with only hydrogen peroxide and then I add some fluoride mouthwash, just for flavor.
The ironic thing is that the two most valuable dental care products are so cheap - less than a dollar for a big bottle of hydrogen peroxide, and only two dollars for a huge box of baking soda.
Give it a try and please tell me what you thinnk!

The blogpost's exact address is http://sevinsense.com/index.php/blog/or ... 8wld4l5mc0.

Thank you! That is very helpful. Just a couple of questions. Is baking soda basically bicarbonate of soda, and will any type/brand of this be suitable to use? And what percentage of hydrogen peroxide solution do you use? Do you mix it with fluoride mouthwash prior to use? How exactly do you use it? Can it just be used on its own or is it too strong?


Any type/brand that is at the store should work - since it should be all the same thing. It's exactly what you wrote, soda bicarbonate, the white powder. The hydrogen peroxide you find in the store should all be 3%, in the brown bottle. I usually gargle it straight and then after a few seconds add in mouthwash, but if you want you can make a mixture of hydrogen peroxide and mouthwash, 50/50.

Thanks!