A Patient’s Guide to Better Oral Health By Smile Cliniq
You may think that maintaining good oral health hygiene sounds easy and involves only brushing your teeth. In reality, it means much more than just brushing. It involves correct tooth brushing, flossing, inter dental brushing, a healthy diet and maintaining a correct daily fluoride intake. All of these procedures carried out along with regular dental checkups will not only enhance your beautiful smile and self-esteem but can also prevent problems in the future.
Good oral hygiene helps prevent dental problems such as tooth decay and plaque deposits which is a main cause of gum disease. Brushing removes plaque from the large surfaces of the teeth and from just under the gums. Flossing and interdental brushing is also important as it removes plaque from between your teeth where your toothbrush cannot reach.
This dental guide is designed to help you develop and maintain a complete programme for your oral health. Below is an easy to follow step by step instructions on correct brushing, rinsing and flossing techniques.
- Brush at least twice a day – Once in the morning, before eating and drinking and just before you go to bed
- Brush no more than three times a day – brushing after lunch will give you a good midday cleaning but brushing too often can damage your gums
- Brush lightly – brushing too hard can damage your gums and cause them to recede (move away from the teeth). If you think you are brushing too hard, hold your toothbrush the same way you hold a pen. This will encourage a lighter stroke
- Brush for at least two minutes – two minutes is the minimum time you should spend on brushing all your teeth. Set a timer if you have to or some people brush to the length of a song on the radio
- Use a toothbrush with soft or medium bristles – the harder the brush the greater the risk of damaging your gums
- Change your toothbrush regularly – throw away your old toothbrush after three months or when the bristles start to flare (whichever comes first)
- Electric toothbrushes – they are more efficient in removing plaque than manual, however the thoroughness of the cleaning is much more important than what type of the brush you use. Whether you are using a manual or an electric toothbrush using the correct technique is essential.
- Fluoride Toothpaste – For people above 6 years of age, use a fluoride containing toothpaste with a concentration of 1000ppm-1450ppm, most well known brands have this amount.
How to brush your teeth
Modified Bass brushing technique:
- Hold the toothbrush sideways against your teeth with some of the bristles touching your gums.
- Tilt the brush so the bristles are pointing into your gum line. (It should be at about 45°to the teeth)
- Move the brush in small circular motions. This allows the bristles to slide gently under the gum. Do this for about 20 strokes or 20 circles. In healthy gums, this type of brushing should cause no pain. If it hurts, brush more gently.
- Roll or flick the brush so that the bristles move out from under the gum toward the biting edge of the tooth. This helps move the plaque out from under the gum line.
- Repeat for every tooth, on the insides and outsides.
- On the insides of your front teeth, it can be hard to hold the brush sideways. So hold it vertically instead. Use the same gentle circular brushing action. Finish with a roll or flick of the brush toward the biting edge.
- To clean the biting or chewing surfaces of the teeth, hold the brush so the bristles are straight down on those surfaces.
- Gently move the brush in tiny circles to clean the entire surface. Move to a new tooth or area until all teeth are cleaned.
- Rinse with water.
- You can clear even more bacteria out of your mouth by brushing your tongue. Brush firmly but gently from back to front. Do not go so far back in your mouth that you gag. Rinse again.
How to floss your teeth?
Flossing is essential in your every day oral health as it removes plaque and food particles from in between your teeth and under the gum line where toothbrush cannot reach. Plaque build up can lead to tooth decay and gum disease and daily flossing is therefore recommended.
- Floss once a day
- Take your time – don’t rush
- Choose your own time – most people find that ideal time for flossing is just before they go to sleep and before you brush your teeth
- Choose the type of floss that works best for you – there are many types of floss: waxed, unwaxed, flavoured, unflavoured, tape and thread. Try a few before you settle on the one you use every day
Flossing incorrectly can have the same effect as not flossing at all and, if it is done incorrectly, it can damage your gums. To receive maximum benefits from flossing, use the following technique:
Hold the floss in whichever way you prefer. How you hold the floss is not important as what you do with it. The most common method is:
- Break off a piece of floss about 18 inches long and wrap most of the floss around either middle or the index finger on both hands
- Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
- Gently curve the floss around the base of each tooth, making sure you go slightly beneath the gum line. Never snap or force the floss, as this may cut or bruise delicate gum tissue
- Use clean sections of floss as you move from tooth to tooth
- To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth
After you first start to use floss, your gums may bleed a little as you start to get rid of the buildup of plaque. However, you should continue flossing your teeth, as the bleeding should stop by the fifth or sixth time you floss. If you are still experiencing regular bleeding after this, tell your dentist.
Many people find inter dental brushes easier to use than floss. The brushes have small, bristled heads that are specially designed to clean between your teeth removing plaque and food particles that brushing missed. They can be used instead of floss or when gaps between your teeth are slightly bigger. They are available in different widths to match the sizes of the gaps. The most well known and recommended brand are the TePe inter-dental brushes and they can be purchased from us.
Many people also clean their tongue after cleaning their teeth. You can do this with a toothbrush or you can buy a special plastic tongue scraper. Cleaning the tongue as part of your daily oral hygiene is essential, since it removes the white/yellow coating of bacteria, decaying food particles and fungi. Tongue cleaning also removes some of the bacteria which generate tooth decay, bad breath and gum problems. A high percentage of bacteria accumulate in the inaccessible area of the back of the tongue. Tongue bacteria produce fatty acids and accounts for 80 to 90 percent of all cases of bad breath. Clean this area gently with an efficient tongue cleaner specifically designed to do the job perfectly.
As with toothpaste, your choice of mouthwash will be guided by your mouth care needs and your personal preferences. Over the counter mouthwashes can freshen the breath, add fluoride or kill the bacteria that cause decay and gingivitis. A mouthwash reaches places that brushing cannot. Use twice a day: in the morning brush before breakfast and perhaps use the mouthwash after breakfast and at night use last thing, after brushing. When buying a mouthwash opt for a fluoride, alcohol-free mouthwash.
REGULAR DENTAL CHECK-UP
In addition to good home regime of oral hygiene, you should visit your dentist and hygienist regularly as recommended by them. This will ensure you are using the correct oral hygiene techniques and will detect any problems with your teeth and gums early before they can get worse and lead to extensive and expensive treatments.
Fluoride is the best cavity fighter you can find, giving a lifetime of bright smiles! It keeps the whole family’s teeth strong – no matter what their age.
Fluoride varnish is one of the best options for increasing the availability of topical fluoride, regardless of the levels of fluoride in the water supply. High quality evidence of the caries-preventive effectiveness of fluoride varnish in both permanent and primary dentitions is available and has been updated recently.
A number of systematic reviews conclude that applications two or more times a year produce a mean reduction in caries increment of 37% in the primary dentition and 43% in the permanent (Delivering Better Oral Health, June 2014). The evidence supports the view that varnish application can also arrest early existing lesions on the smooth surfaces of teeth and roots of permanent teeth. Much of the evidence of effectiveness is derived from studies which have used sodium fluoride 22,600ppm varnish for application.
Fluoride varnish for use as a topical treatment has a number of practical advantages. It is well accepted and considered to be safe. At Smile Cliniq, we offer fluoride varnish application on teeth with early decay, in aim to allow remineralisation of the tooth enamel. This could prevent the need for a filling and protect the strength and longevity of the tooth.
How fluoride works?
Every day, the enamel on your teeth is attacked by acids produced in dental plaque and your diet. These acids can erode through the enamel and result in decay. That is where fluoride comes in. As it reaches your teeth, fluoride is absorbed into the enamel to form a stronger, more resistant form of enamel, the enamel changes from calcium hydroxyapetite based crystalline structure to a fluorohydroxyapatite based one. Fluorohydroxyapatite is much harder than the naturally occurring hydroxyapetite and stronger as well as more resistant to the acid produced by oral bacteria, hence rendering the tooth less prone to dental decay
Fluoride can also enter the bacterial cell and kill it. It can also remain in your mouth as a reservoir ready to protect the teeth from attack.
You can get the benefits of fluoride from a variety of sources. At home, you should brush with fluoride toothpaste at least twice a day. Fluoride rinses can also provide additional protection. Your dentist can apply a fluoride varnish to your teeth in the surgery if necessary.
Improving periodontal health
UK surveys show that some level of irreversible periodontitis affects almost half of all adults (Steele and O’Sullivan, 2011) although this might be an underestimate of true disease levels. Periodontal health will therefore be an issue for most patients at one time or other. In view of the chronic nature of the disease, ongoing prevention and management will be the keys to success. Age is not a barrier to good periodontal health (Lindhe et al. 1985, Axelsson et al. 1991, Wennstrom, 1998, Needleman, 2011). Biologically, there is no overall damaging effect of ageing on the periodontal tissues, although changes in cognitive and motor skills might significantly complicate self-care plaque control and treatment. Maintaining periodontal health and preventing the development of periodontitis is based on the following:
- Prevention of gingivitis. Gingivitis, if not controlled, will lead to periodontitis in the majority of individuals
- Early detection of periodontitis using the basic periodontal examination (BPE) which is performed by the dentist and hygienist.
- Managing risk factors that either increase the risk of developing periodontitis or complicate its successful care
- Supportive periodontal therapy (maintenance) for patients treated for periodontitis
To control gum disease the physical removal of plaque is the important element of toothbrushing as it reduces the inflammatory response of the immune system.
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