Regular teeth brushing and cleaning between teeth helps to keep your teeth and gums healthy, and helps to prevent tooth decay and gum disease. Other things that may help include mouthwashes, tongue cleaning, and eating a healthy diet, which includes limiting sugary drinks and foods. If you smoke, stopping smoking will improve oral hygiene. Have a dental check-up at least once a year.

Why is oral hygiene important?

Good oral hygiene helps to prevent dental problems - mainly plaque andtartar (calculus) which are the main causes of gum disease and caries (toothdecay). Good oral hygiene may also help to prevent or delay dental erosion.

  • Dental plaque is a soft whitish deposit thatforms on the surface of teeth. It forms when germs (bacteria) combine with foodand saliva. Plaque contains many types of bacteria. You can remove plaque bygood oral hygiene.
  • Tartar (calculus) is hardened calcified plaque.It sticks firmly to teeth. Generally, it can only be removed with specialinstruments by a dentist or dental hygienist.

    Some common dental problems related to poor oral hygiene
  • Tooth decay (caries)
    When holes form in parts of the enamel of a tooth, it is know as caries.A main cause of caries is due to a build-up of plaque. The germs (bacteria) inthe plaque react with sugars and starches in food to form acids. The acids arekept next to the teeth by the sticky plaque and dissolve the tooth enamel. Ifyou have tooth decay you may need fillings, crowns or inlays.
  • Gum disease (periodontal disease)
    Gum disease means infection or inflammation of the tissues that surround the teeth. Most cases of gum disease are plaque-related. Plaque contains many different types of bacteria and a build-up of some types of bacteria is associated with developing gum disease.

Depending on the severity, gum disease is generally divided into twotypes - gingivitis and periodontitis:

  • Gingivitis means inflammation of the gums. There are various types. However,most cases of gingivitis are caused by plaque.
  • Periodontitis occurs if gingivitis becomes worse and progresses toinvolve the tissue that joins the teeth to the gums (the periodontal membrane).

Gum disease is the most common cause of tooth loss in adults. It is alsoa main cause of bad breath (halitosis). However, gum disease is oftentreatable.

Tooth (dental) erosion

Tooth erosion is a common problem. It is the gradual erosion of toothenamel by the action of acid on the teeth. This is different to damage causedby bacteria resulting in tooth decay and caries. Tooth erosion affects theentire surface of the tooth. In time, tooth erosion can cause thinned enamel,and eventually can expose the softer dentine underneath the enamel. Dentine issensitive so erosion can lead to your teeth being more sensitive to hot, coldor sweet foods and drinks.

Routine oral hygiene

It is important to get into a regular habit of good oral hygiene. Inparticular, regular teeth brushing and cleaning between teeth.

Teeth brushing

Brush your teeth at least twice a day. Use a soft-tufted brush and atoothpaste that contains fluoride. The head of the brush should be small enoughto get into all the areas of the mouth. Spend at least two minutes brushing,covering all areas (the inside, outside, and biting areas of each tooth). Payparticular attention to where the teeth meet the gum. Get a new toothbrushevery 3-4 months. Studies suggest that powered toothbrushes with arotation-oscillation action (where the brush rapidly changes direction ofrotation) remove plaque and debris better than manual brushes.

Ideally, brush your teeth either just before eating, or at least an hourafter eating. The reason for this is to help prevent tooth erosion. Many foodscontain acids - in particular, fizzy drinks (including fizzy water) and fruitjuices. 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 tocounteract and reverse this softening. Therefore, do not brush teethimmediately after eating when the enamel tends to be at its softest. Inparticular, do not brush teeth straightaway after eating or drinking acid foodsand drinks. It is best to wait at least an hour after eating or drinkinganything before brushing.

Cleaning between teeth

Clean between your teeth after brushing once a day, but ideally twice aday. This is to remove plaque from between teeth. Dental floss is commonly usedto do this. However, some studies suggest that small interdental brushes may doa 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 aresurprised as to how much extra debris and food particles can be removed bydoing this in addition to brushing.

If you are not sure how to clean between your teeth then ask yourdentist or dental hygienist. Briefly: normal floss looks a bit like cottonthread. Cut off about 40 cm. Wind the ends round your middle fingers of eachhand. Then grab the floss between the thumbs and first finger to obtain a tight3-4 cm section which you can pull between teeth. Gently scrape the flossagainst the sides of each tooth from the gum outwards. Use a fresh piece offloss each time.

Some people prefer floss tape which slides between teeth more easilythan normal floss. Also, some people use disposable plastic forks with a smalllength of floss between the two prongs. These may be easier to hold andmanipulate. However, they are expensive. Some people use sticks, or smallinterdental brushes to clean the space between the teeth.

The gums may bleed a little when you first begin to clean between yourteeth. This should settle in a few days. If it persists then see a dentist, asregular 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. Acidfoods and drinks are also a main factor in tooth erosion. So, some tips:

  • Limit the amount of sugary foods and drinks that you have. Inparticular, don't snack on sugary foods.
  • Try to reduce the amount of acid in contact with your teeth. So, limitfizzy drinks (including fizzy water) and fruit juices as these tend to beacidic. 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, andmilk, 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 oftime.
  • 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.

Other things you can do

The measures above are usually sufficient. However:

  • Many people also use an antiseptic mouthwash each day to help preventgum 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 cando this with a toothbrush. You can also buy a special plastic tongue scraperfrom 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 tohelp clear any debris and acid remaining from the meal.

Some other general points

  • Children should be taught good oral hygiene as young as possible.
  • Have regular dental checks at intervals recommended by your dentist(this is normally at least once a year). A dentist can detect a build-up ofplaque and remove tartar (calculus). Early or mild gingivitis can be detectedand treated to prevent the more severe periodontitis. A dentist can also adviseabout special coating of children's teeth to help prevent tooth decay.

Oral hygiene, gum disease and heart disease

In addition to the benefits to your teeth, good mouth hygiene may haveeven further benefits. There is some evidence to suggest that poor oral hygieneis associated with an increased risk of developing heart diseases such as:

  • Heart attack and angina
  • Other blood vessel-related problems (cardiovascular disease)

One research trial followed over 11,000 Scottish people. The trial found that those who reported poor oral hygiene (never or rarely brushed their teeth)had an increased risk of developing a cardiovascular disease. It is not clear if this is a direct cause and effect or simply an association or chance finding. That is, it is not proved that poor oral hygiene can actually increase your risk of cardiovascular disease. However, there is a theory that mild inflammation and infection in the mouth from gum disease can enter the bloodstream to trigger mild inflammation in the blood vessels. This, over time, can lead to cardiovascular diseases.