The Bass Brushing Technique

The Bass Brushing Technique was developed to offer a more efficient way to remove plaque that accumulates along the gum line, and we can even say that it is the best technique for preventing gingivitis.

The Bass brushing technique, also known as the Bass technique, was developed by Charles C. Bass, an American dentist who lived from 1875 to 1975. He is widely recognized for his contributions to dentistry and is considered a pioneer in promoting oral hygiene and preventing periodontal disease.

Simply telling someone, "Brush your teeth well!" can be a very subjective recommendation. What does "brushing well" mean? Is it brushing a lot? With force? Less force? What is "force"? For how long? Three times a day? Why not two or four?

In this article, we want to clearly describe the technique described by Dr. Charles Bass. You will see that it is possible to answer all the questions above and, with a little discipline, develop an efficient hygiene routine. You will see that it really works.

What is a license plate?

In dentistry, the specialty that cares for gum health is periodontics. As a professional who specifically treats gum and tooth problems, I know how important it is to pay attention to the presence of bacterial plaque on teeth because plaque is a silent villain that can lead to serious dental problems if its quantity is not controlled. So in this article, I will explain what plaque is, how it forms on teeth, and how to remove it effectively.

Dental plaque is also known as dental biofilm. Plaque is a sticky, colorless layer of bacteria that forms on teeth. It's a mixture of bacteria, food debris, saliva proteins, and acids that adhere to the teeth and hide in the space between the gums and teeth. Plaque is the main cause of cavities, gingivitis, and periodontitis.

Bacteria produce substances that cause calcium loss from tooth enamel. Furthermore, the prolonged presence of these bacteria near the gums triggers a chronic inflammation called gingivitis. Gingivitis is a chronic inflammatory process of the gums that causes bleeding, swelling, and redness. If left untreated, it can progress to periodontitis, a more serious inflammation that can lead to the destruction of the tissues supporting the teeth and tooth loss.

Plaque on Teeth

Plaque forms on teeth when bacteria feed on sugars and starches found in the food you eat. When bacteria digest these sugars and starches, they produce acids that erode tooth enamel and can lead to cavities.

Dental plaque forms continuously on teeth, and it's important to remove it regularly to prevent dental problems. It also accumulates in the areas between teeth and at the gum line, where it is more difficult to remove.

How to Remove Plaque From Teeth

It's important to make it very clear that there is no magic toothbrush, magic toothpaste, much less mouthwash, that can replace effective oral hygiene. The "secret" lies in... as Use a toothbrush and dental floss.

The Bass brushing technique is an effective way to remove plaque from teeth. To use this technique, you position the toothbrush at a 45-degree angle to your teeth and make very short back-and-forth movements: the handle of the brush moves back and forth, but the bristles should barely move. Be sure to gently brush the gum line to remove plaque that accumulates there.

The Bass Brushing Technique is based on four actions:

1. Position the toothbrush so that the bristles are at a 45-degree angle to the surface of the teeth. This also means that the tips of the bristles will be pointing towards the area of the teeth that meets the gum line.

2- Perform a small, short, sweeping motion on your teeth, where the body of the brush moves back and forth but the bristles barely move. This forces you to brush two or three teeth at a time.

3- Be disciplined and distribute the same amount of time – 5 to 7 seconds or ten movements – to each group of 2 or 3 teeth, moving on to the next neighboring group until you complete a cycle at the point where you started (figure 02). Therefore, do not brush randomly without thinking about what you are doing. Random behavior leads the individual to an automatic habit of brushing too many easily accessible areas to the detriment of other, more difficult-to-reach areas that are forgotten or poorly brushed.

4- Finish brushing on the occlusal surfaces, that is, the surface where the dimples used to grind food are located. In this area, the brush should be parallel to the horizontal plane (or occlusal plane), but the brushing motion will continue to be a short, concentrated movement on 2 teeth at a time. This Video This can be very helpful in understanding the position and movement of the brush.

Follow this cycle regularly:

You might be thinking: but doing all this takes time! Yes, you need to set aside between 10 and 15 minutes, and we haven't even talked about flossing. You can start brushing without toothpaste and apply it to the brush in the final minutes, for example when you're finishing on the occlusal surfaces.

And we can't help but comment on the model of ideal brush For applying the Bass Brushing technique:

You should use a brush with a small head, with three rows of bristles, or a tolerance of four rows, with soft or extra-soft bristles of the same height, without applying force. It's a simple brush. Therefore, there's no need for wavy or taller tufts, nor thick rubber tufts in the middle of the bristles.

And what about bleeding gums?

If you have gingivitis – if your gums are bleeding slightly or not so slightly – this bleeding should stop three days after you start brushing. Follow this method and these steps correctly, and your gingivitis should heal. If your gums don't stop bleeding, you may have periodontitis or other factors that promote this permanent inflammatory state.

If the bleeding doesn't stop in 3 or 4 days, there may be other interfering factors. You should schedule an appointment with a dentist to identify and eliminate these possible causes. Therefore, seek professional help.

Note: I haven't talked about using dental floss yet; we'll discuss that in another article. It's necessary to use dental floss. You can't avoid it. You need to do the work of sliding the floss firmly against the surface of the tooth, going into the gingival sulcus and the spaces between adjacent teeth to remove plaque.

Stillman's Brushing Technique

I think it's appropriate to make an observation regarding this other way of brushing your teeth: The Stillman brushing technique was proposed by the dentist and researcher Dr. Paul Stillman. He wasn't a university professor; he was a professional in the dental field and left us this great contribution. He developed this technique to help improve oral hygiene and prevent periodontal problems.

We don't understand why most dentists teach their patients the Stillman technique, but it's undoubtedly the most common form of instruction. I say this because almost all the patients who told me they had learned how to brush showed me they were using Stillman. Perhaps because it's more exotic or because of the illusion of being able to avoid gum recession by making a "combing" motion from the gum line towards the teeth.

In fact, this technique has become quite popular, at least in Brazil; however, it has weaknesses and disadvantages compared to the option suggested by Dr. Bass. Let's compare them briefly.

Bass brushing technique or Stillman brushing technique?

Stillman's brushing technique, also known as the Stillman technique, involves gliding the brush from the gum line towards the teeth, as if combing the gums. The central argument supporting this movement is the intention to prevent the formation of gingival recessions, popularly known as "gum retraction." Because of this, some people have even been led to believe that "combing" the gums will make them grow back and cover exposed root surfaces! It takes a lot of faith! This doesn't happen.

At first, this idea seems to make sense, but in practice, the fact that Stillman proposes a movement that is so unnatural and laborious for those who use it, in addition to not preventing recession in cases where recession will occur, this technique does not offer cleaning inside the gingival sulcus, precisely the place where bacteria initiate the inflammatory process of the gums. .

Combining the two techniques: Bass + Stillman?

Some names related to prevention have suggested an association between the Bass and Stillman techniques, which is fortunate! The idea is to perform a combing motion on the gums while simultaneously incorporating a short, back-and-forth motion, directed at a 45º angle towards the gums, which is Bass's major contribution. However, it's necessary to consider whether this movement will become too complex. This could discourage the user of the technique.

Finally, this short video demonstrates the association of Bass + Stillman. The "combing" motion of the gums occurs at the end of the Bass stroke. The difference is in the small details.

So, between the two techniques, give preference to the Bass Technique because it is simpler, and the movement is more natural to perform. The bristles of the brush should concentrate on the area most colonized by plaque, including penetrating into the gingival sulcus. The short brushing motion produces low attrition with the tooth surface; this, over the years, prevents or at least reduces the abrasion that wears down the enamel and dentin in the cervical region of the teeth (the area of the teeth that follows the gums).

The Bass Brushing Technique: What to do with all this information?

Furthermore, what can I say to you if you feel your brushing technique isn't producing the right results? Try it! Initially, it requires discipline to become a habit, but you'll notice results in the first few days. You'll find that the taste in your mouth when you wake up is fresher.

If you are practicing the Bass or Bass+Stillman technique correctly, it works. You will prevent cavities and gingivitis.

Author: Nivaldo Pinho Gonçalves, Periodontist, CROSC 9696.

Suggestion: https://www.acm.org.br/revista/pdf/artigos/1285.pdf