Taking Care of Your Teeth
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.
Brushing
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 certain
ingredients irritating to teeth, cheeks or lips. If you find that your teeth
have become more sensitive or that 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.
Flossing
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 — Use 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 —
There 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.
Reviewed by the Faculty Columbia University
College of Dental Medicine
Provided by Aetna
Dental Plans