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Taking care of your teeth and gums

Looking after your teeth and gums is the key to reducing the amount of dental treatment you need - avoiding gum disease and tooth decay - and keeping your mouth healthy. With the joint efforts of the dentist, the hygienist and you, the patient, fillings and extractions can be avoided or at least kept to a minimum.

When you visit your dentist, he or she can advise on getting your teeth and gums into excellent condition, and work out a plan to help you keep them that way. But there’s a lot you can do too – here we take a look at the basics of taking care of your teeth and gums.

What are the main reasons to take care of teeth and gums?

By looking after your teeth and gums, you can expect to keep your own teeth for life. The main reason for brushing and flossing is to remove the build-up of plaque inside your mouth.

Plaque is a thin, almost invisible film of bacteria which forms constantly on the surface of the teeth and gums. When you eat foods containing sugars and starches, the bacteria in plaque produce acids which attack the outer hard surface of the tooth (the tooth enamel) and the stickiness of the plaque keeps these acids in contact with the tooth. After many of these ‘acid attacks’the tooth enamel breaks down and a hole – or cavity -- forms.

  

If plaque is not removed with daily brushing, it eventually hardens and forms tartar (calculus), which can only be scraped away by the hygienist using special tools. When plaque and calculus are left near the gum line, the gums can become irritated and inflamed. They swell and may start to bleed (a condition called gingivitis).

Eventually, gingivitis can progress to a point where the gums begin to pull away from the teeth and form pockets that allow infection around the teeth. As the disease gets worse, the bone holding the teeth in the jaw is destroyed, making the teeth loosen and eventually fall out.

Gum disease actually causes more loss of teeth than tooth decay – it may surprise you to know that over three quarters of adults aged between 16-24 and almost nine out of ten of adults over 55 have some degree of gum disease. There are often no symptoms until it is too late, so it’s never too early to start fighting back.

What can I do at home?

It is very important that you keep up a good routine to maintain the health of your teeth and gums at home. Your dentist or hygienist can remove tartar from your teeth and treat gum disease that has already appeared. But daily dental care to remove plaque is in your hands and the main weapon is the toothbrush.

Brushing

Regular brushing removes plaque and food particles from the inner, outer and biting surfaces of your teeth. Several different methods are effective, which your dentist or hygienist will demonstrate. One of the most common is to use small circular motions on the teeth holding the brush at a 45 degree angle to the gum, and ensuring that all surfaces of the teeth are cleaned. In addition, brushing your tongue will help freshen your breath and clean your mouth by removing bacteria.

Be sure to brush thoroughly twice a day using a pea-sized amount of fluoride toothpaste. Brushing too hard or using too hard a toothbrush can cause damage to the gums, eventually making them recede, which may cause your teeth to become sensitive.. If you notice any repeated discomfort or notice bleeding after brushing, see your dentist.

Your dentist or hygienist will be able to recommend a toothbrush to you. A small to medium-sized brush with soft to medium multi-tufted, round-ended nylon bristles is usually best. Worn-out toothbrushes cannot clean your teeth properly and may actually injure your gums -- it is important to replace your toothbrush every two to three months, or sooner if the bristles look worn. As soon as they start to splay they will not be doing their job properly.

Electric toothbrushes are more effective than manual brushes, and can be easier to use if you have physical difficulties which make it hard for you to reach all areas of your teeth and gums.

To check if you have removed all the plaque, special disclosing tablets are available from the chemist. You chew these after brushing to stain any remaining plaque and show up areas of your mouth which need closer attention. Further brushing will remove the stained plaque.

Flossing

Dental floss or tape removes plaque and food particles from between your teeth and under the gumline, areas a toothbrush can’t easily reach. Your dentist or hygienist can show you proper flossing techniques. When flossing, be systematic and establish a regular pattern. This way you’re less likely to miss any teeth.

You may find that your gums are sore (and may even bleed) for the first five or six days after you start to floss. This should stop once the plaque is broken up and the bacteria removed. If bleeding does not stop, contact your dentist as incorrect flossing may be harming your gums. People who have trouble handling floss could try a commercial floss holder or interdental cleaning aids like interdental sticks or small interdental brushes. Your dentist or hygienist can explain the proper use of these.

Diet / Lifestyle

Take care to limit how often you consume sugary foods or drinks that encourage tooth decay. Cutting down on sweet things and snacks between meals will help considerably. Foods such as cheese, fruit, nuts and vegetables are tooth-friendly substitutes for sweets, biscuits and chocolate, and your figure will thank you too!  Recent research also shows that smokers have more gum disease and lose more teeth than non-smokers, due to the irritant effects of smoke on the gums and the fact that smokers tend to have dry mouths which affects the bacterial balance in the mouth.

There is also a link between gum disease and heart disease.

Use of dental products

When choosing a toothpaste or gel, look for a product containing fluoride. Fluoride helps reduce tooth decay in both adults and children. If you have sensitive teeth, your dentist may recommend a special toothpaste. There are now many specialised brands available including toothpastes for tartar control, sensitive teeth and all-round care. Look for products carrying the BDHF logo, which means that the claims made by the manufacturer have been independently checked and are clinically proven.

Your dentist may suggest the use of fluoride rinses, tablets or drops as an extra help against decay for use at home. (Fluoride in drinking water is currently available to only 12% of the UK population, largely in the West Midlands and North East, and greatly helps in reducing tooth decay). Only use extra fluoride if you have been advised to do so, and follow the instructions carefully. Your dentist may also recommend antibacterial mouth rinses to help control plaque and reduce gingivitis.

What can the dentist and hygienist do?

You will need regular checks from your dentist or hygienist to monitor your dental health and give you any help and encouragement you need. Achieving a healthy mouth does not happen instantly
 - it may take several months and will need ongoing care to keep up in the future. The dentist will advise you on how often to come for a check up, and the frequency of checks and treatment will depend on your particular circumstances.

As well as advising you on brushing and flossing techniques - and recommending products for you to use at home - the hygienist's main role is to clean and polish your teeth. This is usually called ‘scaling and polishing’ and the aim is to remove any deposits of plaque and tartar which have formed.

You may also benefit from certain preventative measures carried out in the surgery such as the professional application of fluoride or fissure sealing.

Finally, your dentist may recommend treatment to reinforce a tooth to make sure that it does not break. For example, if the dentist sees that a tooth is cracked, or is weak and in danger of breaking, they may advise a new filling or perhaps a crown or 'onlay' to protect it. This is always better than waiting till the breakage happens and then working out how best to deal with it, perhaps as an emergency.