All of us want to stay healthy throughout our lives. This includes keeping all or most of our natural teeth. Just the simple fact that we are keeping our natural teeth longer means our teeth are more ?at risk? of some dental conditions. Common oral conditions in adults can include tooth decay, gum disease, tooth wear, dry mouth and tooth sensitivity. There is growing awareness and concern about tooth erosion, which is explained in this brochure.

Tooth decay (caries)

The risk of tooth decay may be increased due to:

• dry mouth
• having too many sugary snacks or drinks
• not having enough daily fluoride protection
• not being able to clean away plaque.

Changes in lifestyle, such as starting a family, changing jobs, moving house, intensive athletic training or the psychological impact of losing a loved one, can disrupt normal daily care and diet, increasing the risk of caries. Medicines may contain high levels of ?hidden sugars? or may reduce saliva flow.

Decay in adults can be common around fillings and between teeth. A particular problem may be decay on the root surfaces of teeth when gums recede. When gums recede, teeth may appear to be getting longer, as the root of the tooth becomes more visible.

What to do

Have a look in your mouth regularly. Although you cannot check your mouth as well as a dental professional, you may see some early signs of tooth decay. Gently ?lift your lip? and look at your teeth near the gumline. Early decay may look like a white spot near the gumline. A dark spot may be decay or may be stain. Your dentist can confirm if you have tooth decay. Use a fluoride toothpaste at least twice daily, especially before bedtime If you have trouble brushing thoroughly, try a battery powered or electric toothbrush Use floss or other special cleaning aids to clean between teeth Make changes to your diet to reduce sugar intake If you have dry mouth, follow the advice for dry mouth in the next section of this brochure If your dentist confirms that you are "at risk" of tooth decay, you may need to increase your fluoride protection

Saliva flow (dry mouth)

Saliva is the body´s natural defence against tooth decay. Saliva washes away acids and puts minerals back into teeth. If you lack adequate saliva flow, your teeth can decay and wear away more easily and you can get more gum problems. Smoking, caffeine, some medicines and illnesses (including depression) that affect saliva glands may reduce your saliva flow. There is a simple test to see if you have normal saliva flow. Looking into a mirror, gently pull down your lower lip with one hand and dry the inside of your lip with a clean, dry cloth or tissue. Watch your lip closely, while breathing through your nose. If you have good saliva flow, you should see small beads of saliva ooze from the glands inside your lip within one minute. If the inside of your lip is still dry after one minute, you may have a problem with saliva flow. A dental professional can advise you further.

What to do

• If you do not have enough saliva, it is important to find out why. Then you can make changes that may help relieve the feeling of dry mouth or may help improve the amount of saliva your body produces. For example, if caffeine is found to be affecting your saliva flow, you might try to substitute other drinks. Never change any medicines without first talking with your doctor.
• The feeling of dry mouth can be relieved using a saliva replacement product, chewing sugarless gum, taking frequent sips of water or using a small spray bottle (atomiser) to frequently spray water in the mouth, particularly at meal times and bedtime. It is important NOT to suck on sugary sweets or to drink sugary drinks to relieve the feeling of a dry mouth. These habits can cause very rapid tooth decay.
• If a dental professional confirms that you have a problem with saliva flow, you might benefit from using products that give you more fluoride protection, such as fluoride rinses, gels or toothpaste with a higher level of fluoride.

Gum disease

Gum disease is preventable by thoroughly removing plaque everyday, but daily habits can be disrupted when you are too busy or too stressed. For some people, removing plaque is not a simple task because of failing eyesight or due to conditions that make holding a toothbrush difficult. Other people may have periods of time where they are too ill to brush at all.

Am I at risk of advanced gum disease?

For a number of reasons, not everyone has the same risk of developing advanced gum disease (periodontitis). Gingivitis (inflammation of gums) is very common and most people will have at least mild, temporary inflammation on some part of their gums at sometime. Attention to brushing and flossing can reverse this. About 10% of people are likely to develop severe periodontitis rapidly if daily plaque removal is not good. In most people, gum disease progresses more slowly. People who smoke are 2-3 times more likely to get periodontitis. People who have diabetes are much more likely to get periodontitis.

What to do

• Watch for signs of gum disease:
  • Bleeding gums when brushing or flossing
  • Red, puffy gums
  • Bad breath
  • Bad taste in the mouth
  • Spongy, soft gums
  • Tenderness of gums
• Where thorough plaque removal proves difficult, the use of products containing chlorhexidine (such as Colgate Savacol®) may help prevent build-up of plaque.
• For some people, a powered toothbrush may be of special assistance
• Special aids (besides floss) to help remove plaque between teeth include interdental brushes, floss holders and toothpicks.

Toothwear from toothbrushing

You can wear away (abrade) your teeth at the gumline by using a toothbrush that is too hard or by using a scrubbing action when brushing your teeth. This can also contribute to causing receding gums.

What to do

• Always use a SOFT toothbrush
• Use a gentle circular motion at the gumline
• Always let your toothbrush do the work! You don?t need to apply pressure
• The oscillating action of a battery powered or electric toothbrush can reduce the risk of abrasion that is caused by improper brushing action (scrubbing).

Toothwear from acids

Acids can dissolve (erode) tooth enamel. Often teeth that appear to be severely worn down have been affected by erosion. The acids that erode tooth enamel usually come from foods and drinks or from gastric reflux. Some inhalers, especially those containing steroids, can cause dental erosion.

The frequent need to use antacid products or a sour taste in your mouth may indicate that you have gastric reflux. Frequency of intake of acidic drinks or foods is an important factor in erosion. Sipping orange juice frequently, chewing vitamin C tablets, frequent intake of soft drinks or sports/energy drinks, or the generous use of vinegar in foods may contribute to tooth erosion.

Acidity of some common foods and drinks

What to do

• You need to see your doctor if you suspect that you have gastric reflux
• Changes in diet can be difficult, but even a little change in diet like substituting water for acidic soft drinks may make a big difference
• Do not brush your teeth after consuming acidic foods or drinks. Rinse with water and wait at least 30 minutes
• Where a dental professional confirms that you have dental erosion, additional fluoride protection is needed for a period of time until the cause of the erosion is found and controlled.

Sensitivity

Tooth sensitivity has a number of causes. Teeth can become sensitive when enamel is lost or when root surfaces of teeth are exposed.

What to do

First, you need to find out why your teeth are sensitive Sensitivity may need to be managed by a dental professional, for example, if the sensitivity is caused by a cavity. Dental professionals can also apply special products to teeth to give relief, if needed Special toothpastes and gels are available in supermarkets and pharmacies to help reduce sensitivity.