Caring for my teeth
Why are my teeth so important?
Your teeth vary in shape and size depending on their position within your mouth. These differences allow the teeth to do many different jobs. 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. A healthy smile can be a great asset and because this is so important, it makes sense to give your teeth the best care possible.


What can go wrong?
Tooth decay can lead to fillings, crowns or inlays. If tooth decay is not treated, the nerve of the tooth can become infected and die, causing an abscess. This may then need root canal treatment. Gum disease is the largest cause of tooth loss in adults. Gum disease is a treatable, preventable condition and can be kept under control with regular check-ups, preventing further problems. If teeth are lost, it may be necessary to fill the gaps with bridges, dentures or implants.


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 of brushing and cleaning between the teeth, good eating habits and regular dental check-ups can help prevent most dental problems. Although most people brush regularly, many don’t clean between their teeth and some people don’t have dental check-ups. A few small changes in your daily routine can make a big difference in the long run. Your dentist or dental hygienist 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 and interdental cleaning. (Cleaning between the teeth).


What is plaque?
Plaque is a thin, sticky film of bacteria that constantly forms on your teeth. The plaque reacts with food, turning sugar into acid, which then dissolves the enamel on your teeth.


How can plaque cause decay?
When you eat foods containing sugars and starches, the bacteria in plaque produce acids, which attack tooth enamel. The stickiness of the plaque keeps these acids in contact with teeth. After the teeth are attacked in this way many times, the tooth enamel breaks down forming a hole or cavity.


How can plaque cause gum disease?
Plaque can harden into something called calculus (another name for it is ‘tartar’). As calculus forms near the gumline, the plaque underneath releases poisons causing the gums to become irritated and inflamed. The gums begin 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 may be lost. Gum disease is the biggest cause of tooth loss in adults and can lead to dentures, bridges or implants.


How can I prevent gum disease?
It is important to remove plaque and food debris from around your teeth as this will stop your gums from swelling and becoming infected. If you leave plaque on your teeth it can develop into tartar, which can only be removed by the dentist or hygienist. It is important to keep up your regular appointments so that your teeth can have a thorough cleaning if they need it.


How do I know if I have gum disease?
Gum disease (gingivitis) will show itself as red, swollen gums that bleed when brushed or flossed. Many people are alarmed when they notice this bleeding and will then brush more gently, if at all. It is important that you continue to clean regularly and firmly in order to fight the condition.


Why is brushing important?
Daily brushing and cleaning between your teeth is important because it removes plaque. If the plaque isn’t removed, it continues to build up, feeding on the food debris left behind and causing tooth decay and gum disease


Which type of toothbrush should I use?
Your dentist or dental hygienist will be able to recommend a toothbrush to you. However, adults should choose a small to medium size brush with soft to medium multi-tufted, round-ended nylon bristles or ‘filaments’. The head should be small enough to get into all parts of the mouth: especially the back of the mouth where cleaning can be difficult. Children need to use smaller brushes but with the same type of filaments.

You can now get more specialised toothbrushes. For instance, people with sensitive teeth can now use softer bristled brushes. There are also smaller headed toothbrushes for those 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.


How should I brush?
Brushing removes plaque and food particles from the inner, outer and biting surfaces of your teeth.

Here is one method of removing plaque:
1. Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45 degree angle against the gumline. Move the brush in small circular movements, several times, on all the surfaces of every tooth.
2. Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gumline.
3. Use the same method on the inside surfaces of all your teeth.
4. Brush the chewing surfaces of the teeth.
5. To clean the inside surfaces of the front teeth, tilt the brush vertically and make several small circular strokes with the toe (the front part) of the brush.
6. Brushing your tongue will help freshen your breath and will clean your mouth by removing bacteria.
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Hold the brush at a 45 degree angle


How often should I brush my teeth?
Be sure to brush thoroughly with a fluoride toothpaste at least twice a day, more often if your dentist recommends it. If you keep getting discomfort or bleeding after brushing go to see your dentist about it.


How often should I change my toothbrush?
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.


How do electric toothbrushes work?
An electric brush often has rotating or vibrating head, which provides a large amount of cleaning action with very little movement needed from the user.


Do electric toothbrushes clean better?
Tests have proved that certain electric toothbrushes are better at removing plaque. They are particularly useful for people with limited movement, such as disabled or elderly people, who often find that using a normal toothbrush does not allow them to clean thoroughly. Electric toothbrushes can also be better for children as they may be more inclined to brush regularly because of the novelty of using an electric toothbrush. Discuss the idea with your dentist or hygienist to find out if you would benefit from using an electric toothbrush.


What sort of toothpaste should I use?
As well as regular family toothpastes, there are many specialist toothpastes. These include tartar control for people who are prone to tartar build-up, and ones for people with sensitive teeth. Total care toothpastes include ingredients to help fight gum disease, freshen breath and help reduce plaque build-up. Whitening toothpastes are good at removing staining, but are not strong enough to change the natural shade of the teeth.

Children’s toothpastes have about half the level of fluoride that adult toothpastes have. They still provide extra protection for the teeth, but as children have a tendency to ‘eat’ their toothpaste, there is less risk of them taking in too much fluoride.

To have a clean and healthy mouth you need to use the correct dental care products. Ask your dentist or hygienist to tell you the options and give their recommendations.


Should I use a fluoride toothpaste?
Yes. Fluoride helps to strengthen and protect teeth, which can reduce tooth decay in adults and children.


How much toothpaste should I use?
You do not need to cover the head of your brush in toothpaste. A pea-sized amount is enough. Children should use a small scraping of toothpaste


How should I clean between my teeth?
One way to clean between your teeth is with dental floss or tape. Flossing removes plaque and food particles from between your teeth and under the gumline, areas a toothbrush can’t reach. Your dentist or hygienist can show you proper flossing techniques.

The following suggestions may help:
1. Break off about 18 inches of floss, and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the other hand. As you use the floss, you will take up the used section with this finger.
2. Hold the floss tightly between your thumb 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.
3. When the floss reaches the gumline, curve it into a C-shape against one tooth until you feel resistance.
4. 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.
5. 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.

It is also very important to clean around the edges of any crowns, bridges or implants. This can be difficult to do effectively using traditional floss and there are now specialist flosses to do the job thoroughly (such as super floss and specialist floss threaders). Ask your dentist or hygienist on how to use these properly and which method you should use.


Should my gums bleed when I floss?
Your gums may bleed or be sore for the first five or six days that you floss. This should stop once the plaque is broken up and the bacteria has gone. If the bleeding does not stop, tell your dentist. It may be that you are not flossing correctly or your teeth and gums need a more thorough clean by your dentist or hygienist.


What do I do if I have difficulty using floss?
If you have trouble using floss you can use a floss holder or an interdental cleaning aid. Interdental cleaning aids include woodsticks or small interdental brushes used to remove plaque from between the teeth. Your dentist or hygienist can explain how to use these properly.


Are oral irrigators useful?
Oral irrigation devices use a stream of water to remove food particles from around the teeth. These devices can be particularly helpful for people wearing orthodontic appliances or fixed bridges.


Should I use a mouthwash?
Mouthwashes are mainly used to freshen breath. If you have to keep using a breath freshener to hide any bad breath, see your dentist. Bad breath can be a sign of poor general health as well as unhealthy teeth and gums. A fluoride mouthwash can help prevent tooth decay. Your dentist may recommend an antibacterial mouthwash to help control plaque and reduce gingivitis (gum disease).


Can watching my diet help?
Many people think that it is a high level of sugar in your diet that causes decay, but this is not so. It is how often you have sugar in your diet, not the amount, that causes problems. It takes an average of 40 minutes for the mouth to cancel out the acid caused by eating and drinking sugar. It is therefore important to limit the number of attacks by keeping sugary foods and drinks to mealtimes.


What do I do if I have 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 can rot if not cleaned thoroughly.

Clean your dentures using a denture brush and plain soap. Always clean dentures over a bowl of water or folded towel to stop them breaking if you drop them.


I have implants, do I have to do anything special?
Your dentist or oral surgeon will tell you how to care for your implants after surgery. It is very important to make sure you clean them regularly and thoroughly to prevent gum disease and possible infection.


Why should I visit the dentist regularly?
Prevention is always better than cure. If you visit your dentist regularly, you will need less and your dentist will spot any problems earlier. It will also be easier to put these problems right.


Are accredited products better?
Look for products carrying the British Dental Health Foundation 'Approved' symbol on the packet. These products have been clinically and scientifically proven to the satisfaction of a panel of experts. The claims made on the labels must be accurate in what they say and what they imply.


What should I do regularly to care for my teeth?
Good dental health begins with you. By following this simple routine, you can keep your mouth clean and healthy:
· Brush your teeth twice a day using fluoride toothpaste.
· Have sugary drinks and snacks less often.
· Use a small to medium size toothbrush.
· Use a toothbrush with soft to medium multi-tufted, round-ended nylon bristles.
· Use a pea-sized amount of toothpaste.
· Use small circular movements to clean your teeth.
· Change your toothbrush regularly.
· Clean between your teeth using dental floss or wood sticks.
· Visit your dentist at least once a year.
· Look out for products with the 'British Dental Health Foundation Approved' symbol.