Toothbrushes should be replaced approximately every three to four months or more often if the bristles become matted or frayed. Storing a moist toothbrush in a closed container promotes microbial growth more so than leaving it exposed to the open air. Store toothbrushes in an upright position after use and allow them to air dry. Rinse the toothbrush thoroughly after each use to remove any remaining paste and debris. Sharing a toothbrush could result in an exchange of bodily fluids and microorganisms between people. Here are some toothbrush care tips to share with your patients: SEM images comparing new and used toothbrush bristles (Used with permission from Applied Science Accessed April 25, 2016). Also, when brushing, the ADA recommends that people use a soft-bristled toothbrush and apply gentle pressure, both of which may help reduce the risk of gingival injury. Regardless of the technique used, brushing should touch upon all surfaces-inner, outer and chewing. 4 To clean the inside surfaces of the front teeth, they should tilt the brush vertically and make several up-and-down strokes. 
3 In general, the American Dental Association suggests that people place the toothbrush against the gumline at a 45-degree angle to remove plaque from above and just below the gingival margin, and move the toothbrush gently back and forth in short strokes. There are a number of techniques for brushing teeth any of which may have advantages depending on a patient’s particular needs.
Brushing for two minutes has been shown to achieve clinically significant plaque removal 1 and use of a toothpaste containing fluoride enhances fluoride concentration levels in biofilm fluid and saliva, and is associated with decreased risk of caries and remineralization of teeth. The American Dental Association recommends brushing teeth twice a day for two minutes using a fluoride toothpaste.
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