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Interview: “For most people, toothbrushing is an unconscious action. iTOP changes this.”

Dental hygienist Dr Fabio Angelini teaches dental professionals and dental students perfect brushing habits at an iTOP seminar in Prague. (Photograph: CURADEN)
Kasper Mussche, DTI

Kasper Mussche, DTI

Tue. 4. June 2019


Although toothbrushing is the most decisive factor in preventing oral disease, only a few patients and dental professionals know how to brush perfectly. After earlier working as a dental technician and also as a dancer, Dr Fabio Angelini qualified as a dental hygienist and is now teaching internationally as an instructor in CURADEN’s iTOP programme. Individually trained oral prophylaxis (iTOP) is an interactive programme that teaches dental students and professionals perfect oral hygiene habits, so that they, in turn, can train their patients to achieve oral health that will last a lifetime.

Dr Angelini, what is iTOP and what does individually trained oral prophylaxis mean?
In the iTOP programme, dental professionals become a personal coach to their patients, guiding them and teaching them how to keep their gingivae and teeth clean and perfectly healthy using the correct tools and the correct techniques on their own and with conscious thought. I say “conscious” because, for most people, toothbrushing is a purely unconscious action. iTOP changes this. The word “individually” is very important to iTOP, as dental professionals and, later, their patients are literally taken by the hand and individually instructed on how to brush their teeth perfectly.

iTOP is also based on the scientific statement that a clean tooth cannot become diseased, or at least that the risk of periodontal disease, caries or tooth loss is significantly reduced by mechanical prevention. iTOP has become a philosophy over the years, thanks to the hard work of all the people who believe in it and teach it.

Is correct brushing a skill that is often overlooked?
When clinicians start their careers, they already have many years of studying behind them and have been taught the best flap techniques, how to place an implant the best way and so on. However, what they have never been taught is how to brush correctly, although it is the most fundamental skill of all to prevent oral disease. More often than not, we have been doing it the same way since we were just old enough to hold a toothbrush. It is often just an automatic movement and we have never learnt exactly how to brush. In reality, however, brushing teeth is an art; it’s a science. Brushing teeth properly, efficiently and atraumatically is not easy, nor is it something you should do without thinking.

How can iTOP help patients and dental professionals?
iTOP helps patients because dental professionals can offer them the knowledge which they themselves have gained at a seminar. They can teach patients to control biofilm formation on their teeth and gingivae and how to do this in the most effective and atraumatic way. Patients who incorporate the techniques taught at an iTOP seminar into their daily brushing routine can expect to achieve optimal oral health. The tools and techniques used at an iTOP seminar are really a gateway to lifelong oral health, which in turn offers benefits to the whole body.

For dental professionals, the acquired iTOP skills can play a key role in their daily practice, for instance, as an essential part of therapy after oral surgery or periodontal treatment. iTOP gives professionals the skills to work to the best of their ability, and it is really personal teaching which allows clinicians to ally with their patients in order to obtain and maintain good oral health.

How strong is iTOP currently in Italy?
In Italy, the interest of dental professionals in iTOP is growing day by day. There are some professionals who have attended a seminar in the past but many are new to the concept and have only just heard about it. Moreover, iTOP is gaining importance at universities too, as there are more and more students participating in the seminars or student camps that take place all around Europe and South America. For dental students these camps are a really good way to get in touch with their peers from other countries, exchange experiences, get to know a new culture or language, network, learn all about prevention and, of course, have fun. It’s a unique opportunity for students and ideal as an addition to the Erasmus projects organised by universities.

What is touch to teach?
Touch to teach is the most important aspect of iTOP. It means that, as an instructor, you take participants by the hand and let them feel or discover a specific movement or sensation. As Dr Jiri Sedelmayer, the dentist who invented the iTOP programme, once said: “It is impossible to understand how to brush your teeth from reading a book”. What this means is that theory is not enough to develop the best skills. You have to do it yourself, practise, have an instructor correct you and try again. Because of touch to teach, participants have the opportunity to truly understand and experience the sensation of having the thousands of bristles of a CS 5460 working together in the sulcus. For the professionals we teach, it is an exciting tactile experience and they can teach their patients in turn. If no one shows them how it is really done, then how can they achieve the best oral hygiene?

What is the main lesson participants take home from an iTOP seminar?
The greatest lesson clinicians take home is the knowledge of how significant the impact of instruction is on their patients’ long-term oral health and how the iTOP skills can be used right away. From the very next day, patients can put prevention into practice and see how a change in their oral hygiene habits will help to improve their oral health.

For more info on an iTOP seminar near you, visit

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