Standards Spotlight

Are you brushing your teeth the right way? According to an article by the BBC, probably not. Studies have found that most people do not use an ideal brushing technique – in part because most have never been giving explicit instructions on how to brush, and also because there is so much conflicting information on how to brush effectively.

When brushing your teeth, you should actually aim to brush your gum line. This is where bacteria and other microorganisms can infiltrate gum tissue, and eventually cause conditions like periodontitis. If you brush your gum line, the teeth will automatically get brushed as well. Different brushing techniques abound – the Bass technique angles the toothbrush 45 degrees to the long axis of the teeth and vibrates the toothbrush with short strokes; the Stillman uses the sides of the toothbrush bristles instead of the ends for cleaning; and the Fones (ideal for children and those with limited manual dexterity) uses circular motions with a 90 degree angle. Regardless of the method chosen, all recommend brushing the gum line for two minutes, twice per day (waiting at least one hour after eating to brush), along with flossing. Mouthwash is optional but may be beneficial to add to the routine, especially for treating gingivitis.

Standards support oral health at home and in the dentist’s chair. The requisite twice-daily brushing is guided by standards for toothbrushes, paste, and floss:

• ANSI/ADA 119, Manual Toothbrushes, developed by the American Dental Association (ADA), offers requirements and test methods to promote the safety of manual toothbrushes.
• ANSI/ADA 120, Powered Toothbrushes, developed by the ADA, provides test methods and physical properties for the safety of powered toothbrushes.
• ASTM E2978-15, Standard Guide for Screening and Training of Assessors and a General Approach for the Sensory Evaluation of Toothpaste Appearance, Flavor, and Texture, developed by ASTM International, includes guidelines for toothpaste descriptive analysis evaluations.
• ISO 28158, Dentistry – Integrated Dental Floss and Handles, specifies requirements and test methods for dental floss picks. It was developed by the International Organization for Standardization (ISO) Technical Committee (TC) 106, Density, subcommittee 7, Oral care products. The ADA is the ANSI-accredited U.S. Technical Advisory Group (TAG) administrator to this TC and SC.

Annual dental x-rays are an important preventative measure to assure dental health. IEC 61223-3-4, Evaluation and Routine Testing in Medical Imaging Departments – Part 3-4: Acceptance Tests – Imaging Performance of Dental X-ray Equipment, assures the performance of dental x-ray equipment. This international standard was developed by the International Elecrotechnical Commission (IEC) TC 62, Electrical equipment in medical practices, SC 62B, Diagnostic imaging equipment. AAMI is the USNC-accredited TAG administrator to TC 62, and NEMA is the TAG administrator to SC 62B.

Two additional documents address more modern facets of dental practices that take into account protection of the patient as well as the environment. ADA TR 1030, Dental Provider’s Guide to the Electronic Dental Record, is a technical report developed by the ADA intended to increase the awareness and knowledge of dental healthcare providers about key concepts of the Electronic Dental Record and the standards development process. ASTM E3014, Standard Practice for Managing Sustainability in Dentistry, developed by ASTM International, is a management system framework that assists dentists and dental service organizations to enhance their organizational performance and effectiveness, offering an integrated framework to manage social, economic and environmental aspects of an organization's activities.

Learn more about tooth brushing techniques in a BBC Future article: The best way to brush your teeth.