Teeth for a Lifetime
Thanks to better at-home care and in-office dental treatments, more people than ever before are keeping their teeth throughout their lives. Although some diseases and conditions can make dental disease and tooth loss more likely, most of us have a good deal of control over whether we keep our teeth into old age.
The most important thing you can do to maintain good oral health is to brush and floss your teeth regularly.
Most mouth woes are caused by plaque, that sticky layer of microorganisms, food particles and other organic matter that forms on your teeth. Bacteria in plaque produce acids that cause cavities. Plaque also leads to periodontal (gum) disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth.
The best defense is to remove plaque daily before it has a chance to build up and cause problems. Brushing removes plaque from the large surfaces of the teeth and, if done correctly, from just under the gums. Flossing removes plaque between teeth.
Most of us learned to brush our teeth when we were children and have kept the same technique throughout our lives. Unfortunately, many of us learned the wrong way. Even if we learned the correct method, it's easy to become sloppy over the years. Brushing correctly isn't instinctive. Getting the bristles to remove plaque without damaging your gums is a little trickier than you might think.
There are different ways to brush teeth, and your dentist or dental hygienist can show you the method that he or she feels would be best for you. The modified Bass technique is among the most popular for adults and is very effective in removing plaque above and just below the gum line. Children, however, may find it difficult to move the toothbrush this way. A dentist or dental hygienist can explain to your child the best way to brush. Parents should supervise their children's oral hygiene until age 9 or 10.
Here are a few general pointers about brushing:
- Brush at least twice a day — Many oral health professionals recommend brushing just before going to bed. When you sleep, saliva decreases, leaving the teeth more vulnerable to bacterial acids. Teeth should also be brushed in the morning, either before or after breakfast, depending on your schedule. After breakfast is ideal so food particles are removed. But if you eat in your car, at work or skip breakfast entirely, make sure you brush in the morning to get rid of the plaque that built up overnight.
- Brush no more than three times a day — Brushing after lunch will give you a good mid-day cleaning. Remember, though, that brushing too often can cause gums to recede over time.
- Brush lightly —Brushing too hard can cause gums to recede. Plaque attaches to teeth like jam sticks to a wooden spoon. It can't be totally removed by rinsing, but just a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can't remove it, so brushing harder won't help. Try holding your toothbrush the same way you hold a pen. This encourages a lighter stroke.
- Brush for at least two minutes — Set a timer if you have to, but don't skimp on brushing time. Longer is fine, but two minutes is the minimum time needed to adequately clean all your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.
- Have a standard routine for brushing — Try to brush your teeth in the same order every day. Some oral health professionals feel that this helps patients remember to brush all areas of their mouths. If you do this routinely, it eventually will become second nature. For example, brush the outer sides of your teeth from left to right across the top then move to the inside and brush rights to left. Repeat the pattern for your lower teeth.
- Always use a toothbrush with "soft" or "extra soft" bristles — The harder the brush, the greater the risk of harming gum tissue.
- Change your toothbrush regularly — As soon as the bristles begin to splay, the toothbrush loses its ability to clean properly. Throw away your old toothbrush after three months or when the bristles flare, whichever comes first. If you find your bristles flaring much sooner than three months, you may be brushing too hard. Try easing up.
- Choose a brush that has a seal of approval by the American Dental Association — Oral health-care professionals say, "It's not the brush, it's the brusher," meaning that the exact type of brush you use isn't nearly as important as your brushing technique and diligence. Any approved brush will be a good tool, but you have to know how to use it.
- Electric is fine, but not always necessary — Electric or power-assisted toothbrushes are a fine alternative to manual brushes. They are especially useful for people who are less than diligent about proper brushing technique or for people with physical limitations that make brushing difficult. As with manual brushes, choose soft bristles, brush for at least two minutes and don't press too hard or you'll damage your gums.
- Choose the right toothpaste for you — It can be overwhelming to face the huge number of toothpaste choices in the average supermarket. Remember, the best toothpaste for you may not be the best toothpaste for someone else.
Toothpastes don't merely clean teeth anymore. Different types have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or desensitizing teeth.
Most toothpastes on the market today contain fluoride, which has been proven to prevent, stop or even reverse the decay process. Tartar-control toothpastes are useful for people who tend to build up tartar quickly, while someone who gets tooth stains may want a whitening toothpaste. Whitening toothpastes will remove only surface stains, such as those caused by smoking, tea or coffee. To whiten teeth that are stained at a deeper level, talk with your dentist.
Your needs will likely change as you get older, so don't be surprised if your hygienist recommends a type of toothpaste you haven't used before. Look for the ADA seal of approval, which assures that the toothpaste has met the standards set by the American Dental Association. Once these conditions are met, choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint — these work alike, so let personal preference guide your decision.
Some people find that some toothpaste ingredients irritate their teeth, cheeks or lips. If your teeth have become more sensitive or your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.
How To Brush
Modified Bass brushing technique:
- Hold the head of the toothbrush horizontally against your teeth with the bristles part-way on the gums
- Tilt the brush head to about a 45-degree angle, so the bristles are pointing under the gum line.
- Move the toothbrush in very short horizontal strokes so the tips of the bristles stay in one place, but the head of the brush waggles back and forth. Or use tiny circular motions. This allows the bristles to slide gently under the gum. Do this for about 20 strokes. This assures that adequate time will be spent cleaning away as much plaque as possible. Note: this is a very gentle motion. In healthy gums, this should cause no pain. Brushing too vigorously or with large strokes can damage gum tissue.
- 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, so that all tooth surfaces and gum lines are cleaned.
- For the insides of your front teeth, where the horizontal brush position is cumbersome, hold the brush vertically instead. Again, use gentle back and forth brushing action and 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 the flat surface of the molars.
- Gently move the brush back and forth or in tiny circles to clean the entire surface. Move to a new tooth or area until all teeth are cleaned.
- Rinse with water to clear the mouth of food residue and removed plaque.
- You can clear even more bacteria out of your mouth by brushing your tongue. With your toothbrush, brush firmly but gently from back to front. Do not go so far back in your mouth that you gag. Rinse again.
Many people never learned to floss as children. But flossing is critical to healthy gums and it's never too late to start. A common rule of thumb says that any difficult new habit becomes second nature after only three weeks. If you have difficulty figuring out what to do, ask your dentist or dental hygienist to give you a personal lesson.
Here are a few general pointers about flossing:
- Floss once a day — Although there is no research to recommend an optimum number of times to floss, most dentists recommend a thorough flossing at least once a day. If you tend to get food trapped between teeth, flossing more often can help remove it.
- Take your time — Flossing requires a certain amount of dexterity and thought. Don't rush.
- Choose your own time — Although most people find that just before bed is an ideal time, many oral health professionals recommend flossing any time that is most convenient to ensure that you will continue to floss regularly. Choose a time during the day when you can floss without haste.
- Don't skimp on the floss —se as much as you need to clean both sides of every tooth with a fresh section of floss. In fact, you may need to floss one tooth several times (using fresh sections of floss) to remove all the food debris. Although there has been no research, some professionals think reusing sections of floss may redistribute bacteria pulled off one tooth onto another tooth.
- Choose the type that works best for you — tThere are many different types of floss: waxed and unwaxed, flavored and unflavored, ribbon and thread. Try different varieties before settling on one. People with teeth that are closely spaced will find that waxed floss slides more easily into the tight space. There are tougher shred-resistant varieties that work well for people with rough edges that tend to catch and rip floss.
How To Floss
How you hold the floss is a matter of personal preference. The most common method is to wind the floss around the middle fingers then pull it taut and guide it with your index fingers. You also can wind it around your index fingers and guide it with your thumb and middle fingers or simply hold the ends of the floss or use a floss-guiding tool. (If you have a fixed bridge, a bridge threader can help guide floss under the bridge for better cleaning.) How you hold the thread is not as important as what you do with it. If you can't settle in on a good method, ask your dentist or hygienist for suggestions.
- Hold the floss so that a short segment is ready to work with.
- Guide the floss gently between two teeth. If the fit is tight, use a back-and-forth motion to work the floss through the narrow spot. Do not snap the floss in or you could cut your gums.
- Hold the floss around the front and back of one tooth, making it into a "C" shape. This will wrap the floss around the side edge of that tooth.
- Gently move the floss toward the base of the tooth and up into the space between the tooth and gum.
- Move the floss up and down with light to firm pressure to skim off plaque in that area. Do not press so hard that you injure the gum.
- Repeat for all sides of the tooth, including the outermost side of the last tooth. Advance the floss to a clean segment for each tooth edge.
Other Ways To Clean Between The Teeth
Many people have larger spaces between their teeth and need additional tools, called interdental cleaners, to remove food particles and bacterial plaque adequately. You may have larger spaces that need extra care if you have had gum surgery or if you have teeth that are missing or out of alignment.
Small interdental brushes are tiny bristle or filament brushes that can fit between teeth and come in a variety of sizes and handle designs. These brushes clean better than floss when the gum tissue does not completely fill the space between your teeth. These little brushes also can help people with orthodontic bands on their teeth to remove bacterial plaque from around the wires and brackets.
Another tool for cleaning between teeth is wooden interdental cleaners. These long, triangular strips of wood can be softened and used to clean between teeth.
You can find these interdental cleaners at most drugstores and grocery stores. Your dentist or dental hygienist can show you how to use these cleaners to remove plaque between your teeth.
Other Cleaning Tools
To supplement your at-home brushing and flossing, your dentist or hygienist may suggest one or more of the following:
- Oral irrigators — These electrical devices pump water out in a slim steady or pulsating stream. Although they do not seem to remove plaque that is attached to the tooth well, they are very effective at flushing out food and bacteria byproducts in periodontal pockets or that get caught in orthodontic appliances. They are particularly useful for delivering medication to hard-to-reach areas. For example, prescription antibacterial rinses can be sprayed into gum pockets with an oral irrigator. Irrigators should be used in addition to brushing and flossing, not as an alternative.
- Interdental tip — These soft, flexible rubber nibs are used to clean between the teeth and just below the gum line. Plaque and food debris can be removed by gently running the tip along the gum line.
- Mouthwashes and rinses — As with toothpaste, your choice of mouthwashes or rinses will be guided by your personal mouth care needs. Over-the-counter rinses are available to freshen the breath, add fluoride or kill plaque bacteria that cause gingivitis. Some mouthwashes are designed to help loosen plaque before you brush. Ask your dentist or hygienist to recommend the type of rinse that would be best for you. If you need to avoid alcohol, read ingredient labels carefully. Many over-the-counter mouthwashes contain significant amounts of alcohol. In some cases, the dentist might prescribe a stronger fluoride or antibacterial rinse.
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