What is good oral hygiene?
It is important to get into a regular habit of good oral hygiene - in particular, regular teeth brushing and cleaning between teeth.
Brush your teeth at least twice a day. Use a soft-tufted brush and a toothpaste that contains fluoride. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (the inside, the outside and the biting areas of each tooth). Pay particular attention to where the teeth meet the gum. Get a new toothbrush every 3-4 months. Studies suggest that powered toothbrushes with a rotation-oscillation action (where the brush rapidly changes direction of rotation) remove plaque and debris better than manual brushes.
Ideally, brush your teeth either just before eating, or at least half an hour after eating. The reason for this is to help prevent tooth erosion. Many foods contain acids - in particular, fizzy drinks (including fizzy water) and fruit juices. After your teeth are exposed to acid, the enamel is a little softened. But, the action of calcium and other mineral salts in the saliva can help to counteract and reverse this softening. Therefore, do not brush teeth immediately after eating when the enamel tends to be at its softest. In particular, do not brush teeth straightaway after eating or drinking acid foods and drinks. It is best to wait at least half an hour after eating or drinking anything before brushing.
What about cleaning between teeth?
Clean between your teeth after brushing once a day, but ideally twice a day. This is to remove plaque from between teeth. Dental floss is commonly used to do this. However, some studies suggest that small interdental brushes may do a better job than floss. The aim is:
- To clean the sides of the teeth where a toothbrush cannot reach.
- To clear the spaces between teeth (the interdental spaces) of debris.
Some people who have not cleaned between their teeth before are surprised as to how much extra debris and food particles can be removed by doing this in addition to brushing.
If you are not sure how to clean between your teeth then ask your dentist or dental hygienist. Briefly: normal floss looks a bit like cotton thread. Cut off about 40 cm. Wind the ends round your middle fingers of each hand. Then grab the floss between the thumbs and first finger to obtain a tight 3-4 cm section which you can pull between teeth. Gently scrape the floss against the sides of each tooth from the gum outwards. Use a fresh piece of floss each time.
Some people prefer floss tape which slides between teeth more easily than normal floss. Also, some people use disposable plastic forks with a small length of floss between the two prongs. These may be easier to hold and manipulate. However, they are expensive. Some people use sticks, or small interdental brushes to clean the space between the teeth.
The gums may bleed a little when you first begin to clean between your teeth. This should settle in a few days. If it persists then see a dentist, as regular bleeding may indicate gum disease.
Food and drink
Sugars and sugary foods in the mouth are the main foods that germs (bacteria) thrive on to make acid which can contribute to tooth decay. Acid foods and drinks are also a main factor in tooth erosion. So, some tips:
- Limit the amount of sugary foods and drinks that you have. In particular, don't snack on sugary foods.
- Try to reduce the amount of acid in contact with your teeth. So, limit fizzy drinks (including fizzy water) and fruit juices as these tend to be acidic. Perhaps just limit yourself to one fizzy or fruit juice drink a day. Otherwise, choose drinks that are much less acidic, such as still water, and milk, tea, or coffee (without sugar).
- Drink any acid drinks, such as fizzy drinks and fruit juices, quickly. Don't swish them around your mouth or hold them in your mouth for any period of time. Drinking through a straw makes it less likely that the acid will come into prolonged contact with your teeth.
- Brush your teeth at least an hour after eating or drinking anything - especially acidic foods and drinks. (See above for reasons.)
- Likewise, do not brush your teeth within an hour of being sick (vomiting). This is because stomach acid will be part of the vomit.
What other things can I do?
The measures above are usually sufficient. However:
- Many people also use an antiseptic mouthwash each day to help prevent gum disease. In particular, for those who are unable to use a toothbrush, regular rinsing with an antiseptic mouthwash will help to clean the teeth.
- Many people also clean their tongue after cleaning their teeth. You can do this with a toothbrush. You can also buy a special plastic tongue scraper from pharmacies.
- If you smoke, you should aim to stop smoking. Smoking is a major risk factor for developing gum disease.
- If children need medicines, wherever possible use sugar-free medicines.
- Some people chew sugar-free gum after each meal. Chewing gum increases the flow of saliva. Saliva helps to flush the mouth to help clear any debris and acid remaining from the meal.
Further reading and references
Oral health promotion: general dental practice; NICE Guidance (December 2015)
Halitosis; NICE CKS, November 2014 (UK access only)
Dental Information for the Public; British Dental Association
Yaacob M, Worthington HV, Deacon SA, et al; Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev. 2014 Jun 17(6):CD002281. doi: 10.1002/14651858.CD002281.pub3.
de Oliveira C, Watt R, Hamer M; Toothbrushing, inflammation, and risk of cardiovascular disease: results from BMJ. 2010 May 27340:c2451. doi: 10.1136/bmj.c2451.
Slot DE, Dorfer CE, Van der Weijden GA; The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review. Int J Dent Hyg. 2008 Nov6(4):253-64.
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