Manual tooth brushing works well if you use the following standards:

1. Brush for two minutes. The average time people brush with a manual toothbrush is 30 seconds.
2. You have to brush gently and ALWAYS use a soft toothbrush. It is not good to brush hard and fast. It is better to slow it down and let the bristles works in between your teeth.
3. Brush in a small circles. This is easier said than done. Ask your hygienist to show you, or demonstrate your technique for her/him.
4. Most people miss their front teeth. They brush real quick in the front and spend most of there time in the back. I always tell my patients to count to ten in the front to ensure they stay there long enough.
5. If you have any recession or you brush too hard, lighten your grip on the toothbrush by releasing your last two fingers off the tooth brush. Brush with three fingers. It is very frustrating because you will realize how hard you like to brush. It takes two weeks to get used to a new way to hold your toothbrush. I am toothbrush abrasion queen. I had my first gum graft at 24 from brushing too hard. I know use three fingers and it reminds me to lighten up. Longer and slower toothbrush strokes are better than hard and fast. If all else fails, get an electric so it does this motion for you.
6. Lastly, it is really hard to clean the inside of the lower back teeth along the gumline. Try using a swipe technique. I start from the back and angle the toothbrush towards the inner surface of the tooth and swipe forward to the front of your mouth pushing the toothbrush towards the gum line. I would do this three times. It is really hard to do small circles in these back areas. Most people have a strong gag reflex when trying to brush this part of the tooth. Try spitting all the toothpaste out of your mouth and then brush these hard to reach areas.

Click here to see some of the manual toothbrushes I recommend.