Toothbrushing and sensitivity – improving patients’ awareness

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  Posted by: Dental Design      2nd February 2024

Regular toothbrushing is the cornerstone of every good oral hygiene routine. It is fundamental for removing plaque and maintaining healthy teeth and gingiva. As clinicians, it’s important to assess each patient’s oral hygiene, and ensure they have a good understanding of how best to remove plaque and maintain a healthy mouth. This means ensuring that patients are using the most effective tools for them, be it a manual or electric toothbrush, interdental tools, or even the correct technique. Sometimes, patients use too much pressure when brushing, thinking that this will help to remove any plaque, debris, and staining, but they may be doing more harm than good. A combination of patient education and recommending the right equipment is needed to improve patients’ oral hygiene routines.

How can toothbrushing lead to gingival recession

If patients brush their teeth too hard, especially when using a brush with firmer bristles, they may be causing trauma to their gingiva.[i] In some cases, patients may even “brush the teeth away” wearing away their enamel and facing increased sensitivity to temperature and cavities.[ii] Using hard bristled brushes and more abrasive toothpaste is likely to cause this,[iii] as well as the force used during brushing.

When patients brush too hard, over a long period of time, they can cause irritation and trauma to the gingiva, eventually leading to gingival recession.[iv] This in itself can be problematic, leaving the ‘neck’ of the tooth exposed, causing increased sensitivity to heat and cold, and potentially becoming more susceptible to cavities. Significant gingival irritation and inflammation may also trigger gum disease. If this is allowed to progress, it may lead to periodontal disease which can have serious implications for oral health, including tooth loss.

Manual toothbrushing – doing it properly

For the best results and optimal plaque removal, it’s important that patients understand how to brush properly using a manual toothbrush. It may be helpful to provide these instructions during appointments, perhaps offering a demonstration and asking patients to copy the movements to ensure they have a good understanding. This will also help them to establish the correct pressure to apply during brushing, as well as allow you to get an insight into which patients may be brushing too hard, and offer appropriate advice.

Offering manual toothbrushing instructions can be simple. Advise patients to form a 45-degree angle between the brush and the gums, and gently move the brush up and down, front to back, and in circles. Patients must brush every part of the teeth including the buccal, lingual, and chewing surfaces for optimal plaque removal. Advise patients to be careful not to brush their teeth too aggressively, particularly if they normally use a hard bristle brush, as this can irritate the soft tissues, eventually leading to inflammation, gingival recession, and tooth sensitivity in the exposed area.

Additionally, advise patients on the use of dental floss, or interdental brushes to ensure that they are removing plaque from all areas of the mouth – especially as interdental spaces are areas where plaque can easily accumulate and build up.

Could soft brushes help those with sensitivity?

In addition to adopting the correct manual toothbrushing techniques, patients with gingival recession, or those who wish to prevent it, may benefit from using a soft or ultra-soft toothbrush. Research suggests that toothbrushes which have soft or ultra-soft bristles tend to be safer[v] and less abrasive than hard bristles, therefore avoiding damage to the teeth and soft tissues. It is also indicated that there are more severe gingival abrasions and recession in patients who have used a hard toothbrush, compared with those who have not.[vi] This suggests that, while twice daily toothbrushing is essential for removing plaque, avoiding a hard toothbrush is beneficial to the health of the soft tissues.

Unlike many conventional products that have around a thousand bristles, the Curaprox wood ultra-soft has 4,440 densely packed filaments. Curaprox toothbrushes are gentle but decisive against plaque. This is mainly thanks to the Curen® filaments, which form a dense and efficient cleaning surface. With a diameter of just 0.1 millimetres, the filaments (bristles) of the new wooden toothbrush are exceptionally fine, smooth, and efficient. This is also a fantastic option for eco-conscious practices and patients – the Curaprox wood ultra-soft uses Swiss beech wood from sustainable forest management to create a reliable, durable, and sustainable solution.

By advising patients on the best way to maintain good oral hygiene, you enable them to take better care of their oral health. With many misconceptions about the best way to brush, and some patients applying too much force to their teeth and gingiva, it’s important to remind each patient to be gentle, so as not to cause irritation and further problems.

For more information about Curaprox products, please visit




[iv] Litonjua, Luis A., et al. “Toothbrushing and gingival recession.” International dental journal 53.2 (2003): 67-72.

[v] Ranzan, Nicolle, Francisco Wilker Mustafa Gomes Muniz, and Cassiano Kuchenbecker Rösing. “Are bristle stiffness and bristle end-shape related to adverse effects on soft tissues during toothbrushing? A systematic review.” International dental journal 69.3 (2019): 171-182.

[vi] Zanatta, Fabrício Batistin, et al. “Biofilm removal and gingival abrasion with medium and soft toothbrushes.” Oral Health Prev Dent 9.2 (2011): 177-83.

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