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 be painful and 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 (gumboil). This may then need root canal treatment or even extraction.

It is very important that you keep up a good oral hygiene routine to keep your teeth and gums healthy at home. Gum diseaseis the largest cause of tooth loss in adults and has been linked to other medical problems such as, heart disease, strokes, diabetes and respiratory (lung) disease. Gum disease is a preventable condition and can be treated and kept under control with regular cleaning sessions and 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 for two minutes, twice a day with a fluoride toothpaste and cleaning between the teeth, good eating habits, having sugary food and drinks less often 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 regular 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 of plaque or tartar 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 gums and 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 constant acid attacks, the enamel covering the tooth breaks down forming a hole or cavity.

How can plaque cause gum disease?

If plaque is not removed, it causes 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 quickly, the bone supporting the teeth is destroyed and healthy teeth can become loose and fall out. Gum disease is the biggest cause of tooth loss in adults and can eventually lead to a need for 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 and sore. If you leave plaque on your teeth it can harden into tartar, which can only be removed by the dentist or hygienist. It is important to have 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 usually show itself as red, swollen gums that bleed when brushed or flossed. Many people are alarmed when they notice their gums are bleeding and 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 of your teeth and gums 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 suitable for 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 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 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 often should I brush my teeth?

Be sure to brush your teeth last thing at night and on at least one other occasion with a fluoride toothpaste, more often if your dentist recommends it. If you regularly keep getting discomfort or bleeding after brushing you should see your dentist.

How do electric toothbrushes work?

An electric brush often has a rotating or vibrating head, which provides a large amount of cleaning action with very little movement needed from the user, although it is important that you position the brush correctly.

Do electric toothbrushes clean better?

Tests have proved that electric toothbrushes are more effective at removing plaque. Those with heads that rotate in both directions (‘oscillating' heads) and pulsate are the most effective. They are particularly useful for people with limited movement, such as disabled or elderly people, who often find that using a manual toothbrush does not allow them to clean thoroughly.

Electric or battery-operated 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.

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 biting 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 front part of the brush.
6. Brushing your tongue will help freshen your breath and will clean your mouth by removing bacteria.

How do I know if I have removed all the plaque?

Plaque can be stained with special dye painted onto your teeth with a cotton bud or with special disclosing tablets which you can get from the dentist. The stain is harmless and will show any areas of your mouth which need better brushing. Look particularly where your teeth and gums meet. Further brushing will remove the stained plaque.

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.

What sort of toothpaste should I use?

A fluoride toothpaste should be used to brush teeth. Fluoride helps to strengthen and protect teeth, which can reduce tooth decay in adults and children.

All children up to three years old, should use a smear of toothpaste with a fluoride level of no less than 1000ppm (parts per million). After three years old, they should use a toothpaste that contains 1350ppm -1500ppm.

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 keep an eye on them when they brush their teeth and encourage them not to swallow the toothpaste.

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.

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.

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 pea-sized smear of toothpaste.

How should I clean between my teeth?

You can clean between your teeth with interdental brushes dental floss, , or tape. Dental tape is thicker than floss and many people find it easier to use. Flossing removes plaque and food particles from between your teeth and under the gumline, areas a toothbrush can't reach. You should clean between your teeth at least once a day. 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

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 about on how to use these properly and which method you should use. right. This way you're less likely to miss any teeth. At first it also helps to look in the mirror.

Should my gums bleed when I floss?

Your gums may bleed or be sore for the first few days that you floss. 

This should stop once the plaque is broken up and your oral hygiene has improved. 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 cleaning by your dentist or hygienist.  

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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.

You should keep a separate toothbrush for cleaning your dentures. The general rule is: brush, soak, brush. Clean your dentures over a bowl of water or towel in case you drop them. Brush your dentures before soaking, to help remove any food debris. Soak the dentures in a specialist cleaner for a short time and then brush the dentures again - as you would your natural teeth. Make sure you clean all of the surfaces of the dentures, including the surface which comes into contact with your gums. If you notice a build-up of stains or scale, have your denture cleaned by your dentist or hygienist.

Most dentists still recommend a small to medium-headed toothbrush or a denture brush.

Are oral irrigators useful?

Oral irrigation devices use a stream of water to remove food particles from around the teeth. These can be particularly helpful for people wearing orthodontic appliances or fixed bridges where it is difficult to clean.

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, you should see your dentist. Bad breath can be a sign of unhealthy teeth and gums or of poor general health.

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 my diet help?

Many people think that it is a high level of sugar in your diet that causes decay, but this is not necessarily so. It is how often you have sugar in your diet, not the amount that causes problems. It takes an average of an hour for the mouth to neutralise 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.

Why should I visit the dentist regularly?

Prevention is always better than cure. If you visit your dentist regularly, you will need less treatment and your dentist will spot any problems earlier, making any treatment easier.

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 as instructed to prevent gum disease and possible infection.

The last word

Good dental health begins with you. By following this simple routine, you can keep your mouth clean and healthy:

• Brush your teeth for two minutes twice a day using fluoride toothpaste.
• Use a small to medium size toothbrush.
• Use a toothbrush with soft to medium multi-tufted, round-ended nylon bristles.
• Use small circular movements to clean your teeth.
• Change your toothbrush regularly, every 3 months or earlier if the filaments are worn.
• Clean between your teeth using interdental brushes, dental floss or dental tape.
• Have sugary drinks and foods less often.
• Visit your dentist regularly, as often as they recommend.

What do I do if I have difficulty 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.