Teeth are an important asset. They are for life, so we should take good care to keep them healthy and clean. Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly. Finally, teeth help to give our face its shape and a healthy smile.
The most important thing we can do to maintain good oral health is to brush and clean in between our teeth regularly, using either a floss or interdental brushes. This removes the plaque from the teeth. If the plaque isn’t removed, it continues to build up, feeding on the bits of food left behind and causes cavities (teeth decay) and gum disease.
What is Plaque: Plaque is a sticky layer of microorganisms, food particles and other organic matter that forms on our teeth. Bacteria in plaque produce acids that cause cavities (teeth decay). Plaque also leads to periodontal (gum) disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth.
Gum disease: If plaque is not removed by brushing, it can harden into something called ‘calculus’ – another name for it is ‘tartar’. As calculus forms near the gumline, the plaque underneath releases harmful poisons causing the gums to become irritated and inflamed. The gums start to pull away from the teeth and the gaps become infected. If gum disease is not treated promptly, the bone supporting the teeth is destroyed, and healthy teeth can become loose and fall out. Severe gum disease can lead to teeth falling out and needing to be replaced.
How do I keep my teeth and gums healthy:
It is easy to get your mouth clean and healthy, and keep it that way. A simple routine can help prevent most dental problems:
- brushing your teeth last thing at night and at least one other time during the day, with a fluoride toothpaste
- cleaning between the teeth with ‘interdental’ brushes or floss at least once a day
- good eating habits – having sugary foods and drinks less often, and
- regular dental check-ups.
Although most people brush regularly, many don’t clean between their teeth and some people don’t have regular dental check-ups. A few small changes in your daily routine can make a big difference in the long term. Your dental team can remove any build-up on your teeth and treat any gum disease that has already appeared. But daily dental care is up to you, and the main weapons are the toothbrush, toothpaste and interdental cleaning (cleaning between your teeth).
Which type of toothbrush should I use: Your dental team will be able to recommend a toothbrush suitable for you. However, adults should choose a small- to medium-sized brush head. This should have soft to medium, multi-tufted, round-ended nylon bristles or ‘filaments’. The head should be small enough to reach into all parts of the mouth: especially the back of the mouth where it can be difficult to reach. Children need to use smaller brushes but with the same type of filaments.
You can now buy more specialised toothbrushes. For instance, people with sensitive teeth can now use softer-bristled brushes. There are also smaller-headed toothbrushes for people with crooked or irregular teeth.
Some people find it difficult to hold a toothbrush, for example because they have Parkinson’s disease or a physical disability. There are now toothbrushes which have large handles and angled heads to make them easier to use.
Electric tooth brushes: A power brush has an oscillating rotating or vibrating head, which provides a large amount of cleaning action with very little movement needed from the user, although you do need to position the brush correctly.
Tests have shown that power toothbrushes are more effective at removing plaque. Those with heads that rotate in both directions (‘oscillating’ heads) are the most effective. Everyone can use an electric tooth brush. They are particularly useful for people with limited movement of the arm or hand, such as disabled or elderly people, who often find that using a normal toothbrush does not allow them to clean thoroughly.
These brushes can also be better for children as they may be more likely to brush regularly because of the novelty of using a power brush. Discuss with your dental team to find out if you would benefit from using an electric toothbrush and different kinds available.
How to effectively brush teeth: Brushing removes plaque and bits of food from the inner, outer and biting surfaces of your teeth.
Here is one way to remove plaque – discuss with your dental team which is the best for you:
- Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45-degree angle against your gumline. Move the brush in small circular movements, several times, on all the surfaces of every tooth.
- Brush the outer surface of each tooth, upper and lower, keeping the bristles angled against your gumline.
- Do this again, but on the inside surfaces of all your teeth. To clean the inside surfaces of your front teeth, tilt the brush vertically and make several small, circular strokes with the front part of the brush.
- Brush the biting surfaces of your teeth.
- Brush your tongue to help freshen your breath and clean your mouth by removing bacteria.
Some pointers:
- Be sure to brush thoroughly with a fluoride toothpaste last thing at night and at least one other time during the day. If you regularly keep getting discomfort or bleeding after brushing you should see your dentist.
- To check if all the plaque are removed, we can use special disclosing tablets or dyes. They stain the plaque layer on tooth and will show any areas of your mouth which need better brushing. Look particularly at where your teeth and gums meet. Further brushing will remove the stained plaque.
- Worn-out toothbrushes cannot clean your teeth properly and may damage your gums. It is important to change your toothbrush every two to three months, or sooner if the filaments become worn. When bristles become splayed, they do not clean properly.
Use of Fluoride tooth paste: Fluoride helps to strengthen and protect teeth, which can reduce tooth decay in adults and children.
As well as regular family toothpastes, there are many specialised toothpastes. For example: ‘Total care’ toothpastes include ingredients to help fight gum disease, freshen breath and reduce plaque build-up, ‘Whitening’ toothpastes are good at removing staining to help restore the natural colour of your teeth, but are not strong enough to change the natural shade of the teeth.
Some children’s toothpastes only have about half the fluoride that adult toothpastes have. They only give limited protection for the teeth. If your children are under 7 you should supervise them when they brush their teeth. Encourage them not to swallow the toothpaste and to just spit, not rinse, after brushing.
To have a clean and healthy mouth you need to use the correct dental-care products. Ask your dental team to tell you what choices there are and to give their recommendations.
Cleaning between teeth: Best known aids in cleaning in between your teeth are to use a floss or interdental brushes.
Cleaning in between your teeth removes plaque and bits of food from between your teeth and under your gumline – areas a toothbrush can’t reach. When flossing or using interdental brushes, keep to a regular pattern and remember not to miss any teeth. It helps to look in the mirror. Don’t forget the backs of your last teeth. It is also very important to clean around the edges of any crowns, bridges or implants. You should clean between your teeth at least once a day. Your dental team can show you how to clean between your teeth properly.
Interdental brushing:
Interdental brushes come in various sizes. It may be helpful to ask your dentist or hygienist to show you the correct sizes for your mouth.
Hold the interdental brush between your thumb and forefinger. Gently place the brush through the gap between your teeth. Do not force the brush head through the gap. If the brush splays or bends then it is too big – you will need a smaller brush head for this space.
Flossing:
- Break off about 45 centimetres (18 inches) of floss, and wind some around one finger of each hand.
- Hold the floss tightly between your thumbs and forefingers, with about an inch of floss between them, leaving no slack. Use a gentle ‘rocking’ motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.
- When the floss reaches your gumline, curve it into a C-shape against one tooth until you feel resistance.
- Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum. Repeat on the other side of the gap, along the side of the next tooth.
- Don’t forget the back of your last tooth. When flossing, keep to a regular pattern. Start at the top and work from left to right, then move to the bottom and again work from the left to right. This way you’re less likely to miss any teeth.
Other Cleaning Tools:
To supplement your at-home brushing and flossing, your dentist or hygienist may suggest one or more of the following:
- Oral irrigators — These electrical devices pump water out in a slim steady or pulsating stream. Although they do not seem to remove plaque that is attached to the tooth well, they are very effective at flushing out food and bacteria by-products in periodontal pockets or that get caught in orthodontic appliances. They are particularly useful for delivering medication to hard-to-reach areas. For example, prescription antibacterial rinses can be sprayed into gum pockets with an oral irrigator. Irrigators should be used in addition to brushing and flossing, not as an alternative.
- Interdental tip — These soft, flexible rubber nibs are used to clean between the teeth and just below the gum line. Plaque and food debris can be removed by gently running the tip along the gum line.
- Mouthwashes and rinses — As with toothpaste, your choice of mouthwashes or rinses will be guided by your personal mouth care needs. Over-the-counter rinses are available to freshen the breath, add fluoride or kill plaque bacteria that cause gingivitis. Some mouthwashes are designed to help loosen plaque before you brush. Ask your dentist or hygienist to recommend the type of rinse that would be best for you. If you need to avoid alcohol, read ingredient labels carefully. Many over-the-counter mouthwashes contain significant amounts of alcohol. In some cases, the dentist might prescribe a stronger fluoride or antibacterial rinse.
- Cleaning dentures – It is just as important to clean dentures as it is to clean your natural teeth. Food can become caught around the edges of dentures and clasps, and the food can rot if you do not clean them thoroughly.
You should keep a separate toothbrush for cleaning your dentures. The general rule is: brush, soak and brush again. Clean your dentures over a bowl of water in case you drop them. Brush your dentures before soaking them, to help remove any bits of food. Soak the dentures in a specialist cleaner for a short time and then brush the dentures again. Brush them like you would your natural teeth. Most dentists still recommend a small- to medium-headed toothbrush.
Final words: Good dental health begins with you. By following these simple tips, you can keep your mouth clean and healthy:
- Brush your teeth for two minutes, last thing at night and at least one other time during the day, using fluoride toothpaste.
- Use a toothbrush with a small to medium-sized head.
- Use a toothbrush with soft to medium, multi-tufted, round-ended nylon bristles.
- Consider using a power (electric) toothbrush.
- Use small, circular movements to clean your teeth.
- Change your toothbrush regularly, and at least every 3 months.
- Clean between your teeth every day using interdental brushes or dental floss.
- Have sugary drinks and foods less often.
- Visit your dental team regularly, as often as they recommend.