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Preventative Care

 

What steps can I take to prevent problems with my teeth?

The most important step is to maintain good dental and oral hygiene by brushing your teeth twice a day to help prevent the build-up of plaque, a sticky film of bacteria which constantly forms on the teeth and gums. Left un-checked, plaque can lead to tooth decay and gum disease (see The Good Dentist Guide to Gum Disease).

 

It is also important to visit a dental hygienist regularly to have your teeth professionally cleaned; to visit your dentist for regular check ups; and to eat a healthy and balanced diet avoiding foods and eating habits that encourage the build-up of plaque. Smoking can cause tooth staining, tooth loss, mouth cancer and make gum disease worse, so if possible you should give up.

Why is dental and oral hygiene important?

Every time you eat or drink something containing sugars – and this means the sugars found in fruit and carbohydrates as well as actual sugar - the bacteria present in everyone’s mouths break these sugars down and produce acid. These acids attack the teeth and start to soften and dissolve the enamel, the hard protective outer coating of the tooth. About an hour after eating or drinking, the natural action of your saliva neutralises the acid, causing the enamel to re-mineralise and harden again.

 

If your oral and dental hygiene is poor, food fragments will collect between the teeth or within the pits and fissures of the biting surfaces of your teeth; in addition the sticky film of bacteria called plaque will build up on the teeth and gums. Sugars in the food fragments will be broken down to produce acid; the plaque, which starts to harden in 48 hours, will form a barrier preventing the saliva from re-mineralising the tooth; and the tooth surface will progressively break down leading to cavities or decay, also called dental caries.

 

After about 3-5 days plaque hardens into tartar or calculus, which adheres strongly to your teeth and is not easily removed by brushing or flossing. Areas of tartar act as plaque “traps” where yet more plaque accumulates.

 

As well as attacking your teeth, acids produced by the bacteria also cause inflammation of the gums, which is worsened if tartar forms below the gumline. Inflammation of the gums can lead to gum disease (see The Good Dentist Guide to Gum Disease) and eventual tooth loss: more teeth are lost through gum disease than through tooth decay.

 

So removing plaque by cleaning your teeth regularly and correctly will reduce your chances of developing tooth decay and gum disease, and will leave you with clean, sound teeth, healthy gums and fresh breath.

 

What is the best way to clean my teeth?

It is important to clean not only the surfaces of your teeth, using a brush, but also the spaces between your teeth - where food fragments can be trapped and plaque can build up – using dental floss or interdental brushes.

Brushing your teeth

You should brush your teeth for two to three minutes, at least twice a day; try to brush after every meal or snack.  Use fluoride toothpaste because fluoride binds to the tooth and makes it more resistant to demineralisation. 

 

Your brushing technique is important and your dentist or hygienist can show you how to brush properly with gentle, circular movements to move plaque away from the gum line and off the tooth surface. As well as the outer and inner surfaces, it is important to carefully brush the chewing surfaces, especially of the back teeth, since these are uneven with pits and fissures in which food particles and plaque can be trapped. You can also brush your tongue and the roof of your mouth if you have problems with bad breath.

 

After brushing spit out the toothpaste remaining and rinse thoroughly with water.

 

Choose a small to medium size toothbrush with a head size and shape that feels comfortable and can reach all your teeth surfaces easily; make sure it has soft, multi-tufted, round-ended nylon bristles. If you are considering an electric toothbrush the same criteria apply and you should additionally choose one with pressure sensors, as they help to regulate the speed of the brush and avoid damaging the teeth and gums,  and a built-in timer to help you control the duration of brushing and ensure that you brush for the correct amount of time. 

 

After brushing, wash and rinse your toothbrush well, and store upright and uncovered so it can dry thoroughly; replace toothbrushes (or electric toothbrush heads) every 3-4 months or sooner if the bristles lose their natural position.

Cleaning between your teeth

Dental floss is a soft nylon or Teflon thread, available either waxed or unwaxed, flavoured or unflavoured, which is used to slide between the teeth to remove plaque and food particles trapped in the gaps.

 

There are several flossing aids to assist those who find flossing difficult.  These include “Y”-shaped floss holders; flossing sticks; and power flossers, which work similarly to an electric toothbrush and have a beneficial massaging effect on the gums.

 

Whichever type of floss or flossing aid you use, technique is important and your dentist or hygienist can show you how to guide the floss between two teeth without damaging your gums, then curve the floss around the first tooth, scraping the floss against the tooth surface from gum upwards; then repeat for the second tooth.  You should work methodically from one gap to the next, using a new length of floss for each.  

 

Aim to floss after each time you brush your teeth.

 

Many people find Dental tape is more effective than dental floss as it can be more efficient at removing the plaque between the teeth and is less likely to tear or shred.

 

Interdental brushes are an alternative method of cleaning between your teeth. These brushes have plastic handles and “bottle-brush” heads and are small enough to be held between finger and thumb. A variety of sizes is available, colour-coded for easy identification, and you may need to use several sizes to properly clean all the varying-sized gaps between your teeth. This method is more effective for when the teeth are not very close together or the gaps are such that floss or tape will not remove the plaque effectively.

 

A twisting movement is used to slide the brush between two teeth; it is then gently pulled out to brush out plaque and food debris, repeating as necessary, before rinsing the brush and moving on to the next gap. Bending the brush into a curve will help with the back teeth, and the correct size of brush should be used for each gap to avoid damaging teeth or gums by forcing.  As with flossing, interdental brushing should be done methodically and you should use them after each time you brush your teeth.

Mouthwash

Broadly speaking, there are three types of mouthwash.

Cosmetic mouthwashes are designed purely to combat bad breath; they rarely have the power to combat bacteria or plaque.

Antiseptic mouthwashes actively fight plaque and protect your teeth against decay to some degree, reducing plaque by up to 25%. However this kind of mouthwash should never be used as a substitute for proper cleaning of your teeth.

Fluoride mouthwashes are available for people who are particularly susceptible to tooth decay. However as most of us get the fluoride we need from drinking water and fluoride toothpastes, you should not add extra fluoride to your oral health regimen without consulting your dentist first.

How can a dental hygienist help?

No matter how conscientiously you brush and floss your teeth, there will always be some plaque and stubborn tartar that remains.

Dentists and dental hygienists are better equipped to remove this as they have specialised tools at their disposal:

  • an electric or ultrasonic scaler has a very fine tip that vibrates at high speeds and also emits a jet of water; together, the scaler and jet of water scrape away the calculus and clean away the debris lodged between the teeth
  • hand scalers of all different shapes and sizes can be used to reach the more awkward spots
  • a rotating electric brush and toothpaste to give your teeth a thorough polish

How do diet and eating habits affect my teeth?

Eating a balanced diet plays an important role in maintaining overall health, which includes dental health. A balanced diet includes fruits and vegetables, milk products, meat, fish, vitamins and minerals.

 

Foods that encourage oral health include:

  • Foods high in fibre, such as fresh fruits and vegetables - they increase the saliva flow, which neutralises acids, helping to clean the teeth of food particles and sugars during chewing
  • Foods without high concentrations of sugar - milk, yoghurt, rice, meat, fish, fruits
  • Fruits and vegetables that contain a high volume of water - pears, melons, celery, and cucumbers

 

Foods that cause tooth decay include:

  • Foods with a high concentration of sugar - cakes, biscuits, sweets, ice cream, honey, dried fruit such as raisins
  • Acidic drinks which can damage the tooth enamel
  • Sticky foods which do not get washed away from the tooth surface easily by the saliva, hence increasing the exposure of teeth to sugar and acids and, consequently, tooth decay

 

It is just as important to think about eating habits as it is to think about the foods eaten. 

Bacterial action breaks down sugars in the food you eat to produce acid which attacks tooth enamel; however about an hour after eating, the natural action of your saliva neutralises the acids, allowing the enamel to recover.  

 

If sweets or other sugar-rich foods are eaten between meals, the acid production will start up again before the tooth enamel has had a chance to remineralise, leaving it more vulnerable to attack. If you must eat sugar-rich foods, do so at mealtimes when saliva production is increased.

 

Similarly if acidic drinks are taken between meals, the acid will attach tooth enamel before it has a chance to remineralise; drink water or milk instead.

 

How can I improve the dental health of my child?

The basics of good oral and dental hygiene apply to children just as they do to adults.

 

Cleaning your child's teeth should be part of their daily hygiene routine. For infants below the age of two, special infant toothbrushes are available, including one that fits over your finger to clean their teeth. For older children choose a toothbrush with soft bristles, a small head and a flexible neck to absorb excessive brushing pressure, and use a small amount of a child’s fluoride toothpaste. Children brushing their own teeth should be supervised until at least the age of seven, and you should make sure they spit out the toothpaste and do not swallow it.

 

Try to make sure your child eats a diet that promotes oral and dental health, and discourage snacking between meals.

 

In preparation for their own future visits, accustom your child to the sights, sounds and smells of the dental practice by taking them with you to your own regular dental appointments; they should ideally have their first dental check up from age 18 months onwards and an orthodontic check-up no later than age 7.

 

Discuss with your dentist the use of dental fissure sealants.  Fissure sealants are often applied as soon as the permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.

 

Sealants are only applied to the back teeth - the molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. Your dentist will tell you which of your child’s teeth should be sealed after they have examined them, and checked whether the fissures are deep enough for sealing to help. Some teeth naturally form with deeper grooves which will need to be sealed, others with shallow ones will not.

 

 






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