An unusual species, we Homo sapiens. Although most of us share the same carbon base, we all have our own individual ways of doing things. Give 10 people a toothbrush and then watch them exhibit their personalities through their brushing habits. No two will do it the same. That's what makes us so interesting to psychologists, psychotherapists, and alien life forms.
Every good hygienist has instructed patients about the correct technique for optimal tooth and gum brushing. The patient can take that information and do two things with it. He can throw it in his mental circular file, along with his last visit's flossing instructions and the date of his mother's birthday. Or he can use the information to ensure he keeps his teeth as long as possible. The following is an independent study of the peculiar ways some brushers use, or abuse, perfectly good hygiene instructions.
Let's start with the Roamer, usually male and in his early teens. This patient is energetic, preoccupied, and has little time for any personal grooming that takes longer than 30 seconds. The toothbrush may be in his mouth and even have toothpaste on it as he wiggles it here and there. But he's clueless as to where it's been or where it's going. He lacks a system (uppers first, right side first, etc.), but he has just come up with the perfect battle strategy for his next struggle with the dreaded computerized intergalactic alien scum. This brainstorm, by the way, can only develop fully while pacing. The square footage in a standard bathroom is clearly inadequate when used while forming a successful battle plan. This is why Roamers are often found wandering the halls as they deliberate and scrub.
When he is sure of a decisive victory, the toothbrush is left somewhere in the bathroom, bubbling with toothpaste. The sink is likewise decorated, but it's off to war! Damage reports confirm more alien vessels blasted by photon torpedoes than teeth hit with the toothbrush.
In comparison to the Roamer, the Stationary Brusher becomes another fixture in the bathroom. She plants her feet, bends over the sink and begins some serious brushing. She knows exactly where to start, where to go next, or when she's done. Never interrupt a Stationary Brusher before she has completed her brushing cycle. She will lose her place and have to begin again. This form of brusher seldom comes up for air before the job is finished. She is in the dental state of mind and will be neither rushed nor moved. Every tooth is addressed properly and then the toothbrush is rinsed and put away. She is certainly a credit to herself, her family, and hygienists everywhere!
A strange conglomeration of the two preceding categories is the Stationary Yet Transported Brusher. The SYT patient is a highly intelligent perpetual thinker of profound thoughts. Although he is physically standing in the bathroom brushing, his mind is a thousand light years away. What is the meaning of life? Brush, brush. Where did God come from? Scrub, scrub. Is Bill Clinton ever going away? Scrub, brush. The more profound and unanswerable his questions, the more time this type of brusher will remain in position. Unfortunately, no one - not even this philosopher - really knows the answer to this question ... how many teeth did he succeed in deplaquing?
A fourth patient profile is the Mirror-Struck Brusher. These are usually younger patients who have not yet grown uninterested (or disappointed) by what they see in the mirror. They liberally apply toothpaste, managing to get some on the brush, and smile at their reflections as they scrub away. The number of teeth brushed is directly proportionate to the width of their smile. The rationale here is that only the teeth you can see need to be brushed. Much spitting and smiling ensues, and, when it's all over, the toothbrush is replaced but seldom rinsed. Everyone loves this happy brusher, especially bacteria on the posterior teeth.
College kids use the Student Assailant method of brushing. In the wee hours of the morning - say about two or three o'clock - the college student's plan is to ambush the bacterial plaque while it's busy chowing down on leftover pizza and tacos. It's sort of a sneak attack. The unsuspecting plaque wrongfully assumes that "if one were going to brush, one would surely have brushed by now." And so they party hardy.
But that's why our kids go to college ... to get smarter than bacterial plaque. They purposely wait up till 2 or 3 a.m., then pounce on the unwary little bugs before they can run. What an ingenious plan! And I thought my daughter just liked staying up late.
So far, we have limited ourselves to the manual toothbrushers. Let's now turn our attention to the brushing habits of those using powered devices. The only brusher truly compatible with this type of brush is the Stationary Brusher. She is already in the bent position, which is recommended to deal with the amount of effervescence that will be produced. In comparison, these brushes are seldom used by Roamers, as the froth and foam from some toothpastes make it impossible to stray any distance from the sink. The Stationary Yet Transported Brusher sometimes uses an electric toothbrush, but can be jolted back to reality by the two-minute automatic shut-off on some models. The Mirror-Struck Brushers have an unfortunate habit of turning the brush on before inserting it into their mouths. So much for the mirror. The Student Assailants find that the two-minute auto-off models wake them up long enough to expectorate and replace the brush in its recharger.
I recently ventured into the master bath of a 46-year-old man (OK, it was my husband's bathroom) and wondered where he got the strangely shaped white chalk sculpture on his sink. I was even more curious when he picked it up and it buzzed. But when he told me it was the Sonicare I bought him last year, I had to leave. Powered brushes need maintenance too!
In conclusion, this study has brought to light one truth. No matter how articulate the home care instructions, the character holding the brush will always determine compliance and effectiveness. We can only do our best as health-care professionals. Let's hope some of those Roamers propose a few ingenious battle plans for fighting gingivitis and periodontal disease. Die, bacterial scum!
Joanne Iannone Sheehan, RDH, is a frequent contributor to RDH. She is based in Huntsville, Ala.