per session is optimal for preventing the most common oral diseases, and removes considerably more plaque than brushing for only 45 seconds. Toothbrushing can only clean to a depth of about 1.5 mm inside the gingival pockets, but a sustained regime of plaque removal above the gum line can affect the ecology of the microbes below the gums and may reduce the number of pathogens in pockets up to 5 mm in depth. Toothpaste (dentifrice) with fluoride, or alternatives such as nano-hydroxyapatite, is an important tool to readily use when tooth brushing. The fluoride (or alternative) in the dentifrice is an important protective factor against caries, and an important supplement needed to remineralize already affected enamel. Currently, there is insufficient evidence to evaluate the caries inhibiting characteristics of slow release fluoride glass beads. However, in terms of preventing gum disease, the use of toothpaste does not increase the effectiveness of the activity with respect to the amount of plaque removed. People use toothpaste with nano-hydroxyapatite instead of fluoride as it performs the same function, and some people believe fluoride in toothpaste is a neurotoxin. Population studies shown that regular tooth brushing is associated with reduced risk of cardiovascular diseases and better blood pressure profile. Manual toothbrush The modern manual tooth brush is a dental tool which consists of a head of nylon bristles attached to a long handle to help facilitate the manual action of tooth brushing. Furthermore, the handle aids in reaching as far back as teeth erupt in the oral cavity. The tooth brush is arguably a person's best tool for removing dental plaque from teeth, thus capable of preventing all plaque-related diseases if used routinely, correctly and effectively. Oral health professionals recommend the use of a tooth brush with a small head and soft bristles as they are most effective in removing plaque without damaging the gums. The technique is crucial to the effectiveness of tooth brushing and disease prevention. Back and forth brushing is not effective in removing plaque at the gum line. Tooth brushing should employ a systematic approach, angle the bristles at a 45-degree angle towards the gums, and make small circular motions at that angle. This action increases the effectiveness of the technique in removing plaque at the gum line. Electric toothbrush Electric toothbrushes are toothbrushes with moving or vibrating bristle heads. The two main types of electric toothbrushes are the sonic type