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What is oral hygiene?
Clean and healthy teeth and gums are essential for good oral health. It is important to develop good hygiene habits of brushing and flossing to maintain oral health and prevent tooth decay, gum disease and tooth loss.
Together with regular dental check-ups and a healthy, balanced diet, your teeth can and should last a lifetime.
Good hygiene habits
For healthy teeth and gums:
- Brush at least twice a day - once after breakfast and then after dinner, before going to bed;
- Floss at least once a day, preferably after dinner;
- Special interdental brushes or toothpicks may be used instead of floss, depending on your dental situation. Seek advice from your dentist;
- Use a fluoride-containing toothpaste, and;
- Limit the number of snacks you eat between meals, as these cause continuous plaque build-up that damages your teeth.
How to brush effectively
When brushing your teeth, it is best to aim for two minutes of continuous brushing. The movement should be short, gentle strokes, with careful attention paid to gum lines and hard-to-reach areas. Clean all surfaces of each tooth including the outside, inside and chewing surface. It is also important to brush your tongue.
Your toothbrush should have a small head with soft bristles, so it can reach into small spaces and not damage your teeth or gums. Electric toothbrushes are also effective for proper brushing, especially for people who have limited time to brush their teeth or have trouble manoeuvring a manual brush around their mouth. Be careful to choose an electric toothbrush with a round head and a rotating or oscillating (back and forth) action, as these are most effective.
Replace your toothbrush or electric toothbrush head every 2-3 months, or when the bristles start to spread out. Indicator bristles that fade as the toothbrush wears out can help remind you when to replace your toothbrush. A worn out, shaggy-looking toothbrush is no longer effective in removing plaque. Rinse your toothbrush well after use and allow it to air dry.
Do not share your toothbrush with other people, as this can spread various contagious diseases. Discard your toothbrush if you have been ill, as viruses and bacteria can remain on your toothbrush and prolong your illness. As a rule of thumb, it is best to replace your toothbrush every three months.
How to floss effectively
Dental floss is used to clean between the teeth, where the toothbrush cannot reach. This is particularly important if your teeth sit close together and have no spaces. Dental floss can be either waxed or unwaxed, flavoured or plain. Most people find waxed floss easier to use, particularly if their teeth are very close together.
Interdental brushes are an effective way of cleaning between the teeth for people who cannot manage floss, or where the spaces between teeth are too large for floss to be useful. They are used in the same manner as a toothpick and are very effective in removing plaque and food that a toothbrush cannot reach. People who have bridges or dental implants may also be advised to use interdental brushes by their dentist. People with braces should also use interdental brushes or modified floss to clean between the teeth. Your dentist may also recommend that you use an antibacterial gel on an interdental brush if you have a gum infection, or fluoride gel if you have a high risk of tooth decay.
Other aids for dental cleaning may be recommended by your dentist, depending on your personal needs:
Pre-threaded floss can make flossing easier for people who have trouble winding normal floss around their fingers and working it in between their teeth, or who cannot reach some areas of their mouth easily.
Water mouth irrigators
Water mouth irrigators spray a fine pressurised stream of water between the teeth and under the gum line to remove plaque and food debris. These can be a good substitute for flossing, especially where areas are difficult to reach. Angled attachments are available for mouth irrigators for hard-to-reach places in the mouth.
Mouthwashes may be recommended by your dentist depending on your needs. If you are at high risk of tooth decay, or have recently had a high rate of decay, a fluoride mouthwash used regularly can help repair tooth damage and prevent further decay. An antibacterial mouthwash is helpful for people with gum disease, or who have had some kind of mouth surgery. It is often recommended for people who have had dental implants in order to keep the implants healthy.
Causes of tooth decay and gum disease
Plaque is the cause of most tooth decay, gum disease and subsequent tooth loss. It is a soft, whitish, sticky substance that contains bacteria and food debris. The bacteria feed off the sugars and starches in the foods we eat and multiply in our mouths. The bacteria then release acids that destroy tooth enamel and create holes, or cavities, in our teeth. When the cavities grow large, they cause toothaches and can destroy the teeth completely.
Layers of plaque can also harden on the tooth's surface and create a rough, stony substance called tartar. This cannot be removed by normal brushing. Your dentist has to use special cleaning instruments to remove the tartar. If left untreated, tartar and plaque release chemicals that irritate the gums and cause gum inflammation. This is called gingivitis. Gingivitis-affected gums appear red, swollen and bleed easily, especially when brushed directly or flossed.
If gingivitis is left untreated, it progresses to gum disease or periodontitis. This is an inflammation and infection of the gums, the ligaments surrounding the tooth and the underlying jawbone. The bone that holds the teeth in place is eventually broken down by the gum disease. The teeth can appear longer, become mobile or wobbly and eventually fall out.
A tooth-friendly diet
Our mouths naturally contain millions of bacteria that feed on the food we eat. They are particularly fond of the sugary and starchy foods we consume and multiply rapidly, forming plaque that spreads over the teeth and gums. When sugary and starchy foods are eaten frequently between meals, more damage is done by the plaque. It is better to eat these foods mostly at mealtimes, when more saliva is being produced to wash away food particles and sugars, and neutralise the acids produced by bacteria.
For good oral health, avoid foods high in sugars and starch, especially sticky lollies, cakes and biscuits. These result in greater production of plaque and cause more tooth decay. Check the labels on processed foods for added sugar. Many foods labelled 'low fat' often have large amounts of sugar added to compensate.
Water is the best drink for good oral health. Soft drinks, sports drinks, cordials and fruit drinks contain large amounts of hidden sugar. They are often very acidic, which is extra harmful to teeth. Sipping on these sugary, acidic drinks throughout the day can have disastrous and irreversible effects on the teeth. Avoid these drinks, or consume them only occasionally. Your teeth will benefit greatly.
A well-balanced diet with plenty of fruit, vegetables, cereals, dairy and protein is best for our general health, as well as oral health. Choose snacks such as cheese, plain yoghurt, fruit or vegetables. Rinse your mouth with water after snacking, or brush your teeth.
Chewing sugar-free gum after meals can help to stimulate saliva flow, which will neutralise the acids produced by bacteria. This will help protect your teeth from the effects of acid attack. It is important that the gum is sugar-free, otherwise the sugar will be feeding the oral bacteria and cause more acid-related damage to your teeth. Saliva flow is typically high while we are eating. The saliva not only helps us digest our food, but also makes it easier to swallow. When we have finished our meal, saliva flow slows down. Any food or sugars left behind in our mouths are rapidly consumed by bacteria, which then produce acid. Stimulating saliva by chewing gum ensures sugars are washed away and acids are neutralised, preventing them from damaging our teeth.
Fluoride and teeth health
Fluoride is a naturally occurring mineral that helps prevent tooth decay or dental cavities by strengthening the enamel on teeth and controlling bacterial levels in our mouths. In addition, fluoride can repair a tooth where decay has just started. Fluoride is naturally present in some foods, such as tea, and in some natural water springs.
Scientific studies over many decades have shown fluoride to dramatically reduce the incidence of tooth decay in children and adults. The most effective way to get the dental health benefits of fluoride is to drink fluoridated tap water.
Many city councils add a carefully controlled amount of fluoride to the town water supply. If you live in an area where the water is not fluoridated, your dentist can recommend fluoride supplements appropriate to your needs. These are usually given to children whose teeth are still forming, so that the fluoride can be incorporated into their developing enamel and make it more resistant to tooth decay.
It is important to note that most bottled water has little or no fluoride. People who exclusively drink bottled water should discuss with their dentist any need for fluoride supplementation.
Fluoride applied to the surfaces of the teeth in forms such as toothpastes, mouthwashes and gels is called topical fluoride. This is effective in protecting the tooth's surface from decay and can sometimes stop and even reverse the decay process. Fluoride gels applied to specific teeth can help with tooth sensitivity and help to repair early decay. Fluoride gels have much higher concentrations of fluoride. For this reason, they should only be used on your dentist's recommendation and kept out of reach of children.
Fluoride in children
Fluoride should be used in children with caution. Even small amounts of concentrated fluoride can be harmful. Special children's toothpastes with lower levels of fluoride are recommended for very young children, but only if they can reliably spit out after brushing. For children under two years of age, toothpaste is not recommended. Any products containing fluoride should be kept out of the reach of children. Swallowing excessive amounts of fluoride can result in fluorosis of the teeth. Fluorosis appears as permanent white spots on the teeth and in extreme situations, the enamel can develop brown, pitted defects that are unsightly, sensitive and brittle.
Regular six-monthly visits to your dentist will ensure that any problems with your mouth are detected early and treated appropriately. Early detection of many dental problems means that treatment is much simpler and less costly than waiting until serious problems develop. This is the best path towards keeping healthy teeth for life.