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What is Oral Hygiene?
Oral hygiene is the practice of keeping the mouth clean and healthy by brushing and flossing your teeth to prevent tooth decay and gum disease.
Why is oral hygiene important?
Good oral hygiene helps to prevent dental problems - mainly plaque and calculus which are the main causes of gum disease and caries (tooth decay). Good oral hygiene may also help to prevent or delay dental erosion.
Some common dental problems related to poor oral hygiene.
Caries (tooth decay).
Caries is when holes form in parts of the enamel of a tooth. A main cause of caries is due to a build-up of plaque. The bacteria in the plaque react with sugars and starches in food to form acids. The acids are kept next to the teeth by the sticky plaque and dissolve the tooth enamel. If you have tooth decay you may need fillings, crowns or inlays.
Gum disease (periodontal disease).
Gum disease means infection or inflammation of the tissues that surround the teeth. Most cases of gum disease are plaque-related. Plaque contains many different types of bacteria and a build-up of some types of bacteria is associated with developing gum disease.
Depending on the severity, gum disease is generally divided into two types - gingivitis and periodontitis:
Gum disease is the most common cause of tooth loss in adults. It is also a main cause of bad breath (halitosis). However, gum disease is often treatable.
Tooth (dental) erosion.
Tooth erosion is a common problem. It is the gradual erosion of tooth enamel by the action of acid on the teeth. This is different to damage caused by bacteria resulting in tooth decay and caries. Tooth erosion affects the entire surface of the tooth. In time, tooth erosion can cause thinned enamel, and eventually can expose the softer dentine underneath the enamel. Dentine is sensitive so erosion can lead to your teeth being more sensitive to hot, cold or sweet foods and drinks.
Information about Children.
Parents and carers of children aged 0-2 are encouraged to brush their child's teeth as soon as the first tooth appears, using a soft toothbrush and water only. It is not recommended to use fluoride toothpaste for children aged 0-2 years. From age 2-7 years use a small pea size amount of fluoride toothpaste containing at least 1,000 ppm F (parts per million Fluoride)Parents/carers of children under the age of 7 should brush their child's teeth until they are able to do so properly themselves. Children should be encouraged to spit and not rinse after brushing so that the effects of fluoride toothpaste are not diluted. Brush twice a day - at bedtime and at one other time during the dayResearch shows if a child has dental decay at a young age that they are likely to have dental decay as an adult. We all want to have healthy teeth and nice smiles as adults and this starts with taking care of children's teeth from a young age.The health benefits of good oral health are immense; getting children actively involved in looking after their oral health from an early age improves both their oral and general health as adults.
Routine oral hygiene.
It is important to get into a regular habit of good oral hygiene. In particular, regular teeth brushing and cleaning between teeth.
Teeth brushing.
Brush your teeth at least twice a day. Use a soft-tufted brush and a toothpaste that contains fluoride. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (the inside, outside, and biting areas of each tooth). Pay particular attention to where the teeth meet the gum. Get a new toothbrush every 3-4 months. Studies suggest that powered toothbrushes with a rotation-oscillation action (where the brush rapidly changes direction of rotation) remove plaque and debris better than manual brushes.
Ideally, brush your teeth either just before eating, or at least an hour after eating. The reason for this is to help prevent tooth erosion. Many foods contain acids. In particular, fizzy drinks (including fizzy water) and fruit juices. After your teeth are exposed to acid, the enamel is a little softened. But, the action of calcium and other mineral salts in the saliva can help to counteract and reverse this softening. Therefore, do not brush teeth immediately after eating when the enamel tends to be at its softest. In particular, after eating or drinking acid foods and drinks. It is best to wait at least an hour after eating or drinking anything before brushing.
Cleaning between teeth.
Clean between your teeth after brushing once a day, but ideally twice a day. This is to remove plaque from between teeth. Dental floss is commonly used to do this. However, some studies suggest that small interdental brushes may do a better job than floss. The aim is to clean the sides of the teeth where a toothbrush cannot get to, and clear the spaces between teeth (the interdental spaces) of debris. Some people who have not cleaned between their teeth before are surprised as to how much extra debris and food particles can be removed by doing this in addition to brushing.
If you are not sure how to clean between your teeth, then ask your dentist or dental hygienist. Briefly: normal floss looks a bit like cotton thread. Cut off about 40 cm. Wind the ends round your middle fingers of each hand. Then grab the floss between the thumbs and first finger to obtain a tight 3-4 cm section which you can pull between teeth. Gently scrape the floss against the sides of each tooth from the gum outwards. Use a fresh piece of floss each time.
Some people prefer floss tape which slides between teeth more easily than normal floss. Also, some people use disposable plastic forks with a small length of floss between the two prongs. These may be easier to hold and manipulate. However, they are expensive. Some people use sticks, or small interdental brushes to clean the space between the teeth.
The gums may bleed a little when you first begin to clean between your teeth. This should settle in a few days. If it persists then see a dentist, as regular bleeding may indicate gum disease.
Food and drink.
Sugars and sugary foods in the mouth are the main foods that bacteria thrive on to make acid which can contribute to tooth decay. Acid foods and drinks are also a main factor in tooth erosion. So, some tips:
Limit the amount of sugary foods and drinks that you have. In particular, don't snack on sugary foods.Try to reduce the amount of acid in contact with your teeth. So, limit fizzy drinks (including fizzy water) and fruit juices as these tend to be acidic. Perhaps just limit yourself to one fizzy or fruit juice drink a day. Otherwise, choose drinks that are much less acidic, such as still water, and milk, tea, or coffee (without sugar).Drink any acid drinks, such as fizzy drinks and fruit juices, quickly - don't swish them around your mouth or hold them in your mouth for any period of time.Brush your teeth at least an hour after eating or drinking anything - especially acidic foods and drinks. (See above for reasons.)Likewise, do not brush your teeth within an hour of vomiting (as stomach acid will be part of the vomit).
Other things you can do.
The measures above are usually sufficient. However:
Many people also use an antiseptic mouthwash each day to help prevent gum disease. In particular, for those who are unable to use a toothbrush, regular rinsing with an antiseptic mouthwash will help to clean the teeth.Many people also clean their tongue after cleaning their teeth. You can do this with a toothbrush. You can also buy a special plastic tongue scraper from pharmacies.If you smoke, you should aim to stop smoking. Smoking is a major risk factor for developing gum disease.If children need medicines, wherever possible use sugar-free medicines.Some people chew sugar-free gum after each meal. Chewing gum increases the flow of saliva. Saliva helps to flush the mouth to help clear any debris and acid remaining from the meal.
Tooth Brushing technique for Children aged 3-10 years old.
Start by placing the toothbrush bristles at a 45 degree angle on the front surface of the back teeth. Move the toothbrush in small circular motions. Make sure that you brush the tooth and especially the area where the tooth meets the gums. With this circular motion, slowly move forward towards the front teeth. Don’t rush!! Be sure to take your time and clean off all food debris and plaque. If you are having the problems with the brush fitting in your mouth, angle it vertically and continue to brush at a 45 degree angle the front surface and gum line. Continue to move around the arch and cover the back teeth on the opposite side. Repeat these steps with the back of the teeth as well (the side of the teeth that is closest to the tongue) Next, place the toothbrush bristles on the chewing surfaces of the teeth (known in the dental world as the occlusal surface). Move the toothbrush back in forth in a “scrubbing motion”. Be sure to brush the chewing surfaces of all teeth, even the front teeth. Rinse your toothbrush, place on tongue, and gently run the bristles over your tongue. The tongue can also harbor bacteria and cavity causing germs and must be cleaned as well.
Tooth Brushing technique for Adults.
Hold the toothbrush sideways against your teeth with some of the bristles touching your gums.Tilt the brush so the bristles are at 45 degree angle and pointing at your gum line.Move the brush back and forth, using short strokes. The tips of the bristles should stay in one place, but the head of the brush should wiggle back and forth. You also can make tiny circles with the brush. This allows the bristles to slide gently under the gum. Do this for about 20 strokes or 20 circles. After the vibratory motion has been completed in each area, sweep the bristles over the crown of the tooth, toward biting surface of the tooth.Repeat for every tooth, on the insides and outsides.The toe bristles of the brush can be used to clean the lingual (tongue) surface of the anterior teeth.
GUM DISEASE RISK FACTORS
The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.
AGE
Studies indicate that older people have the highest rates of periodontal disease. Data from the Centers for Disease Control and Prevention indicates that over 70% of Americans 65 and older have periodontitis.
SMOKING/TOBACCO USE
Tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.
GENETICS
Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime.
STRESS
Stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.
MEDICATIONS
Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.
CLENCHING OR GRINDING YOUR TEETH
Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.
OTHER SYSTEMIC DISEASES
Other systemic diseases that interfere with the body's inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis.
POOR NUTRITION AND OBESITY
A diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums. In addition, research has shown that obesity may increase the risk of periodontal disease.
