Hygiene of clothing and footwear

Requirements for the working part and bristles

The choice of material and toothbrush head design directly affects the quality of plaque removal and safety for the gums. Historically, natural bristles were used; however, they have a number of critical drawbacks: the presence of a central channel that inevitably fills with microorganisms, a porous surface with burrs, and the inability to round the tips. Artificial (synthetic) bristles are free from these flaws: they are smooth, non-porous, and the ends of the fibers can be treated to be atraumatic.

To ensure freedom of movement in the distal areas and effective cleaning, the head design must meet strict parameters:

• Bristle arrangement: located in separate tufts rather than a solid mass. This promotes deep penetration into the interdental spaces and facilitates drying.
• Metrics: the distance between tufts should be 2.5–3 mm. The optimal number is no more than 3 tufts in a transverse row and 6–8 along the length of the head.
• Profile (trim): a concave surface is ideal for the anterior group of teeth (matching the curvature of the dental arch), while a horizontal trim cleans chewing molars better.
• Head shape: slightly curved.

According to their degree of firmness, toothbrushes are divided into hard, medium-firm, soft, and extra-soft. Medium-firm brushes are the gold standard. Soft options are indicated in pediatric practice, for increased enamel wear, wedge-shaped defects, and a tendency of the gums to bleed. Minor bleeding during the adaptation period to a new toothbrush is considered a variant of normal.

Sanitary and hygienic rules and microbiology

A toothbrush is a strictly personal hygiene item. With careless care, it becomes a vector for infection transmission, provoking the development of purulent processes and periodontal disease.

Preparation and storage:

1. A new toothbrush must be thoroughly rinsed with hot water and soap and treated with alcohol. Boiling is strictly not recommended.
2. After each brushing, the tool is rinsed with running tap water, wiped with a clean towel, and placed in a cup.
3. The toothbrush should be placed with the working surface facing down. This eliminates the need to touch the head with hands, preventing secondary contamination. Relying on the bactericidal effect of drying when stored head-up has no evidence base.
4. Travel cases are intended exclusively for transportation; storing them in closed cases continuously creates a humid environment favorable for bacteria.

According to studies by A.A. Minkh, bacterial contamination of toothbrushes is extremely high. In addition to streptococci, staphylococci and diphtheroid bacilli are detected in 10% of cases. The detection of E. coli (4–5% of cases) directly indicates infection of the tool with dirty hands. Historical sterilization methods (carbolic acid solution, salt water with iodine) or the method of A.I. Evdokimov (leaving soap foam on the bristles until the next day) currently have no practical use.

Brushing technique and electric toothbrushes

The basic hygiene regimen involves brushing twice a day: in the morning (after breakfast) and in the evening. The morning procedure eliminates the nighttime accumulation of mucus, toxins, and bacteria that cause bad breath and a coated tongue. The evening procedure aims to remove food residues.

Rules for manual brushing:

• Movements should be vertical ("sweeping"). On the upper jaw — from top to bottom (away from the gums), on the lower jaw — from bottom to top.
• Chewing surfaces are cleaned longitudinally and transversely.
• The procedure starts with the molars on one side, successively moving to the palatal, lingual, and chewing surfaces.
• Area of special attention: the lingual surfaces of the lower teeth, where plaque rapidly mineralizes into dental calculus.

Electric toothbrushes operate via vibration, with oscillating-rotating technology recognized as the most effective. Their main advantage is the presence of a "controlled pressure" mechanism (pressure sensor) that automatically deflects the brush under excessive pressure, preventing periodontal trauma. The kit often includes attachments for tongue cleaning, whitening, and rubber attachments for gum massage. Important: hardware gum massage is a potent procedure and is used only under the strict supervision of a physician.

Tooth powders and pastes

Dental cleaning products perform the function of mechanical plaque removal and enamel polishing.

Tooth powders have a pronounced abrasive action. Their base is chemically purified chalk with added flavorings (menthol, peppermint, eucalyptus oils). Powders are indicated only for individuals with healthy teeth and gums who are prone to active tartar formation.

Toothpastes are more hygienic due to tubes and provide a gentle effect. The basic composition includes chalk, glycerin, dicalcium phosphate, and antiseptics. According to their purpose, pastes are divided into:

• Hygienic (mechanical cleaning only, e.g., "Mint").
• Therapeutic and prophylactic (contain biologically active substances: salts, enzymes, trace elements, chlorophyll). They are prescribed purposefully to relieve inflammation, effectively remove deposits, and consolidate the results of dental treatment (e.g., "Lesnaya").

Briefly: answers to topical questions

Class and exam questions

What else to study on this topic

• Clinical criteria for choosing a toothbrush firmness in various periodontal pathologies.
• The effect of biologically active substances in therapeutic and prophylactic toothpastes on the mucous membrane.
• The dangers of hardware gum massage with rubber attachments without medical supervision.
• Alternative oral hygiene regimens: justification for brushing teeth once a day.
• Pathogenesis of dental calculus formation in retention sites and the lingual zone of the lower teeth.

Other topics in "Chapter 9. Personal Hygiene and Healthy Lifestyle"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.