How often should I clean my teeth?

It is important that you brush last thing at night and at least one other time during the day, with a toothpaste containing fluoride.

Eating and drinking foods containing sugar and acids naturally weakens the enamel on your teeth. Brushing straight afterwards can cause tiny particles of enamel to be brushed away. It is best not to brush your teeth until at least one hour after eating.

It is especially important to brush before bed. This is because the flow of saliva, which is the mouth's own cleaning system, slows down during the night and this leaves the mouth more at risk from tooth decay.

It is important to clean your teeth for two minutes, twice a day especially last thing at night and at least one other time during the day. Usually two minutes is enough to remove plaque and to clean properly. Some people find using a stop-watch or timer useful as two minutes is often longer than you think. If you eat or drink certain sugary or acidic foods you may need to clean more often.

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What do I need to clean my teeth properly?

There are many different oral care products you can get today. Your dental team will be able to recommend the best toothbrush and toothpaste for you to use, as well as the best way to clean between your teeth.

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Which is the best toothbrush to use?

It is usually recommended that adults use a toothbrush with a small- to medium-sized head with multi-tufted, soft to medium filaments (bristles). These filaments should be round ended and made from nylon.

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Are electric or power toothbrushes a good idea?

Some people prefer to use a power toothbrush. They are especially useful if you have limited movement or find cleaning particularly difficult. These toothbrushes usually have heads which either rotate and oscillate, or pulsate. Some power toothbrushes are meant to be thrown away when the battery runs down, and some are rechargeable. You can buy power toothbrushes from your local pharmacy, retailer or dental team.Power toothbrushes with rotating and oscillating heads have been proven to be the most effective. Many power toothbrushes have timers built in to help you brush for the correct amount of time.

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What about children's toothbrushes?

It is just as important for children to use the correct toothbrush. Look for a small-headed toothbrush with soft nylon bristles, suitable for the age of your child. There are many novelty toothbrushes for children that help encourage them to brush for the correct length of time. There are also power toothbrushes that have been specially designed for children to use. Children under the age of 7 should be supervised while brushing.

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What toothpastes are there?

There are many toothpastes, and some are designed for different needs. There are toothpastes for gum health, sensitive teeth and for smokers, ones with anti-bacterial agents, and others which help to restore the natural whiteness of your teeth. Your dental team can recommend the most suitable toothpaste for your needs.

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Should I use a fluoride toothpaste?

Yes. Most dentists recommend using fluoride toothpaste to prevent decay. Fluoride has been proven to reduce tooth decay by at least 40 percent, so everyone should be encouraged to use fluoride toothpaste. There may already be fluoride in your drinking water. Research has shown that children living in areas that don't have fluoride in the drinking water have more tooth decay than children living in areas that do have fluoride in the drinking water. Ask your dental team what amount of fluoride is right for you. 

It is important to use only a small, pea-sized amount of toothpaste for children, as they are likely to swallow some of it. All children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). After three years old, everyone should use a family toothpaste that has 1350ppm to 1500ppm of fluoride. After brushing you should spit out the toothpaste rather than rinsing, to prevent the fluoride being washed away.

If your dental team feel that you have a high risk of tooth decay, they may recommend and prescribe a toothpaste with more fluoride in it. This high level of fluoride can offer more protection to people more at risk of decay.

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My teeth are stained, what toothpaste should I use?

There are toothpastes which can help to remove staining. These are often called ‘whitening' toothpastes. It is important to realise that these toothpastes can only help you to restore the original shade of your teeth and will not change their natural colour. If you feel you need something stronger to whiten your teeth, talk to your dental team about how this could be done. If you are a smoker, there are special smokers' toothpastes that will remove the staining that can build up over time.

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My teeth are sensitive, what can I use?

There are several toothpastes that contain ‘desensitising agents' to help reduce the pain of sensitive teeth. Some people find that rubbing this toothpaste along the affected area and leaving it on overnight helps ease the discomfort.

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Are natural toothpastes available?

Yes, there are several toothpastes that contain special mineral salts and plant extracts. They are made of only natural ingredients and flavouring. Some products are produced without animal testing, and some are suitable for vegetarians and vegans. However, sometimes these toothpastes do not contain fluoride.

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What are 'total care' toothpastes?

Total care toothpastes contain a number of ingredients to make them an effective ‘all-round' toothpaste. They contain anti-bacterial agents, ingredients which help control plaque and prevent gum disease, fluoride to help prevent tooth decay and flavours which help to freshen the breath. They may also contain whitening or tartar-control ingredients.

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What about cleaning between my teeth?

Brushing alone only cleans three of the five surfaces of your teeth, so it is important that you also clean between your teeth every day using interdental brushes or floss. Your dental team will be able to show you how.

Interdental brushes:

To clean the small gaps between your teeth you can use special ‘interdental' brushes. These can be on long or short handles for easier use and are generally colour coded for the different-sized gaps between your teeth. Ask your dental team for advice on how to use these products correctly and safely.

Dental floss and tape

There are several different types of dental floss or tape, including mint-flavoured, wax-coated and ones containing fluoride. Many people prefer tape to floss, as it is wider and can be gentler on the gums. You can also get floss ‘harps'. These have the floss attached to a handle which may make the floss easier to use.

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Should I use a mouthwash?

Many people use a mouthwash as part of their daily oral health routine. Some mouthwashes contain an anti-bacterial ingredient to help reduce plaque and prevent gum disease. Mouthwashes may contain fluoride to help prevent decay, and all will help to freshen your breath and wash away bits of food.

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What are disclosing tablets and solutions?

These contain a dye. After brushing and cleaning in between your teeth, you can use a disclosing tablet or solution to dye any plaque that hasn't been removed. This can help to show any places you are missing when brushing. You can easily remove the dye afterwards by brushing.

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Why do some mouthwashes contain alcohol?

Some mouthwashes contain alcohol because it helps to enhance the taste, helps with cleansing and adds to the antibacterial effect. However, some people find alcohol mouthwashes too strong and prefer milder ones that are alcohol free.

Mouthwashes containing alcohol should be kept away from children. 

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Are there any mouthwashes for gum problems?

Some mouthwashes, especially ones containing Chlorhexidine, are particularly effective at treating gum infections. They are also very effective at treating other mouth problems, such as those  following a tooth extraction or when a  wisdom tooth is coming through. Take your dentist's advice on how to use these as they can cause staining, although this can be easily removed by the dental team.

 

What is dental erosion?

Dental erosion is the loss of tooth enamel caused by acid attack. Eventually the enamel can be worn away, exposing the dentine underneath which may lead to pain and sensitivity.

 

What about 'total care' mouthwashes?

Some mouthwashes contain anti-bacterial ingredients which work against the bacteria responsible for causing bad breath and plaque. They also contain fluoride to help prevent decay.

 

What is a denture fixative?

Denture fixatives are products which help to stick or hold a denture in place and to stop it moving around and causing irritation and sores. Fixatives can come in different forms, including creams, powders and strips.

 

Should I use a fixative?

Dentures are custom made to fit your mouth and you shouldn't need to use a denture fixative. Some people prefer the extra confidence that a fixative gives them. Over time, as your mouth shrinks, your denture may become loose and may not fit as well. If this happens you may prefer to use a fixative in the short term before you have the denture replaced with a new and better-fitting one.

 

Should I use any special products to help prevent erosion?

A good fluoride toothpaste - 1350 to 1500 parts per million (ppm) of fluoride - will help to put back the minerals lost from your teeth and help to strengthen the enamel. There are specialist ‘enamel formula' toothpastes you can use if you feel that your diet is high in acid and you think that you may be at risk of acid erosion. You should also try to cut down as much as possible on the amount of acidic foods and drinks that you have. These foods and drinks include white and red wine, fruit juices, smoothies, fruit teas, fizzy drinks and fruit.

 

What about products for bad breath?

Often bad breath is a short-term problem caused by smoking, or eating or drinking something that has a strong smell. Using products designed to fight bad breath will help to stop this. Long-term bad breath could be a symptom of a dental problem such as gum disease. So if the bad breath continues you should ask your dental team for advice. Bad-breath products will only mask the smell and will not remove any underlying problem.

 

What products could I use to help get rid of bad breath?

Good brushing, and cleaning in between the teeth, is the most important way of controlling bad breath. In the short term you can use mouth rinses, sugar-free gum and sugar-free mints. Many of the bacteria causing bad breath live on your tongue, so brushing your tongue or using a tongue scraper will also help.

 

What is dry mouth?

Dry mouth or ‘xerostomia' is a condition which affects the flow of saliva, causing your mouth to feel dry.

 

Are there any products I can use to ease dry mouth?

There are a number of products designed to provide moisture and comfort. These include rinses, toothpastes, gels and sprays. If you prefer, you can also get lozenges and chewing gums for when you are out and about. Some people also find chewing sugar-free gum helps to increase the flow of saliva and reduce the problems.

 

What is the advantage of chewing sugar-free gum?

If you chew sugar-free gum for 10 minutes after eating or drinking anything, this can help your saliva to cancel out the acid more quickly. The acid is produced when we eat or drink, and it can cause tooth decay and dental erosion.

 

How could a probiotic help my oral health?

Probiotics are ‘friendly' bacteria and have been commonly used to help healthy digestion. There are now ‘oral' probiotics which may help to keep up the balance between the friendly bacteria in your mouth and the harmful bacteria which can cause plaque build-up, gum disease and bad breath. These products are relatively new and research is continuing.

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Gum Disease 

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What is gum disease?

Gum disease is described as swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.

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What is gingivitis?

Gingivitis means ‘inflammation of the gums'. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.

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What is periodontal disease?

Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out.

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Am I likely to suffer from gum disease?

Probably. Most people suffer from some form of gum disease, and it is a major cause of tooth loss in adults. However, the disease develops very slowly in most people, and it can be slowed down to a rate that should allow you to keep most of your teeth for life.

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What is the cause of gum disease?

All gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surface of the teeth every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease.

To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and cleaning in between the teeth with ‘interdental' brushes or floss.

See our advice on 'caring for my teeth and gums' for how to do this.

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How will smoking affect my gums and teeth?

Smoking can also make gum disease worse. People who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums don't heal. Smoking causes people to have more plaque and the gum disease to get worse more quickly than in non-smokers. Gum disease is still a major cause of tooth loss in adults.

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What happens if gum disease is not treated?

Unfortunately, gum disease does not usually cause pain as it gets worse so you do not notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can be more difficult.

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What do I do if I think I have gum disease?

The first thing to do is visit your dental team for a thorough check-up of your teeth and gums. They will measure the 'cuff' of gum around each tooth to see if there is any sign that periodontal disease has started.  X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important, so the correct treatment can be prescribed for you.

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What treatments are needed?

Your dental team will remove all plaque and tartar from your teeth. You will also be shown how to remove plaque successfully yourself, cleaning all the surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dental team. A good oral care routine at home with brushing and interdental cleaning is the most important thing you can do to help prevent gum disease getting worse.

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What else may be needed?

Once your teeth are clean, your dental team may need to treat the roots of the teeth to make sure that the last pockets of bacteria are removed. This is called ‘root planing'. You'll probably need the treatment area to be numbed before anything is done. Afterwards, you may feel some discomfort for up to 48 hours.

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How do I know if I have gum disease?

The first sign is blood on your toothbrush or in the toothpaste you spit out after cleaning your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.

 

Once I have had periodontal disease, can I get it again?

There is no cure for periodontal disease, but it can be controlled as long as you keep up the home care you have been taught. Any further loss of bone will be very slow and it may stop altogether. However, you must make sure you remove plaque every day, and go for regular check-ups by the dental team.

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I have heard gum disease is linked with other health conditions – is this true?

In recent years gum disease has been linked with general health conditions such as diabetes, strokes, cardiovascular disease, poor pregnancy outcomes and even dementia. More research is needed to understand how these links work but there is more and more evidence that having a healthy mouth and gums can help improve your general health and reduce the costs of medical treatment.

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Bad Breath

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What is Halitosis?

Halitosis, known commonly as bad breath is a very common problem. It can become a cause of great embarrassment both socially and professionally. Most people are unaware they have Halitosis or more commonly known as bad breath. 

Often bad breath can be caused for many reasons, in most cases is is the result of a build up of oral bacteria in your mouth.

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Our Dental Hygienist at William Street Dental who will offer the best advice, tips and a treatment plan to help you deal with Halitosis. 

Often, most oral bacteria can be removed by adopting a thorough oral hygiene routine.

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If you believe you may have Gum Disease or Halitosis please contact us at William Street Dental to arrange an appointment on 02751424 or email us queries@williamstreetdental.ie

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Source OralDentalHeakth.org/Dr.Mark Foley