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Taking Care of Your Teeth

Teeth for a Lifetime
Thanks to better at-home care and in-office dental treatments, more people are keeping their teeth throughout their lives. Some diseases and conditions can make dental disease and tooth loss more likely. But 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 is to brush and floss your teeth each day.

Most mouth woes are caused by plaque. Plaque is a sticky layer of bacteria, bits of food and other organic matter that forms on your teeth. The bacteria in plaque make acids that cause cavities. Plaque also leads to periodontal (gum) disease. This can become a serious infection. It can damage bone and destroy the tissues around your teeth.

The best defense is to remove plaque before it has a chance to build up and cause problems. Brushing removes plaque from the large surfaces of the teeth and from just under the gums. Flossing removes plaque from between your teeth. You also can use other tools to keep your mouth and teeth clean.

Brushing
Most of us learned to brush our teeth when we were children. We have stuck with the same brushing technique into adulthood. Unfortunately, many of us learned how to brush the wrong way. And even if we learned the right way, we might not always stick to it. Brushing correctly is tricky. You want to remove plaque without brushing too hard and damaging your gums.

There are different ways to brush correctly. Your dentist or dental hygienist can show you the method that might be best for you.

The modified Bass technique (below) is among the most popular for adults. Parents should supervise their children's brushing until age 9 or 10. Here are a few general pointers about brushing.

  • Brush at least twice a day — One of those times should be just before you go to bed. When you sleep, your mouth gets drier. This makes it easier for acids from bacteria to attack your teeth. Also try to brush in the morning, either before or after breakfast. After breakfast is better. That way, bits of food are removed. But if you eat in your car or at work, or skip breakfast, brush first thing in the morning. This will 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 midday cleaning. But brushing too often can damage your gums.
  • Brush lightly — Brushing too hard can damage your gums. It can cause them to recede (move away from the teeth). Plaque attaches to teeth like jam sticks to a spoon. It can't be totally removed by rinsing, but a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can't remove it. If you think you might brush too hard, hold 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. Two minutes is the minimum time you need to clean all of 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. This can help you cover every area of your mouth. If you do this routinely, it will become second nature. For example, you can brush the outer sides of your teeth from left to right across the top, then move to the inside and brush right 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 your gums.
  • Change your toothbrush regularly — Throw away your old toothbrush after three months or when the bristles start to flare, whichever comes first. If your bristles flare much sooner than every 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 — The type of brush you use isn't nearly as important as brushing the right way and doing it twice a day. 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 don't always use proper brushing techniques. They also are a good choice for people with physical limitations that make brushing difficult. Use a powered toothbrush for at least two minutes, and don't press too hard.

Toothpastes don't just clean teeth anymore. They have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or helping sensitive teeth.

Most toothpastes contain fluoride, which has been proven to prevent cavities. Fluoride also can stop small cavities from getting worse. It can even reverse early tooth decay.

Tartar-control toothpastes are useful for people who tend to build up tartar quickly. 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 age, 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 on any toothpaste. The seal assures that the toothpaste has met the standards set by the American Dental Association. Then, choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint: These work the same way, so pick the one you like.

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 toothbrush sideways against your teeth with some of the bristles touching your gums.
  • Tilt the brush so the bristles are pointing at your gum line.
  • Move the brush back and forth, using short strokes. The tips of the bristles should stay in one place, but the head of the brush should wiggle back and forth. You also can make tiny circles with the brush. This allows the bristles to slide gently under the gum. Do this for about 20 strokes or 20 circles. In healthy gums, this type of brushing should cause no pain. If it hurts, brush more gently.
  • 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, on the insides and outsides.
  • On the insides of your front teeth, it can be hard to hold the brush sideways. So hold it vertically instead. Use the same gentle back-and-forth or circular brushing action. 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 those surfaces.
  • 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.
  • You can clear even more bacteria out of your mouth by brushing your tongue. 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 new habit becomes second nature after only three weeks. If you have questions, ask your dentist or dental hygienist to give you a lesson.

Here are a few general pointers about flossing:

  • Floss once a day — Most dentists recommend flossing at least once a day. If you tend to get food trapped between teeth, you can floss more often.
  • Take your time — Don't rush.
  • Choose your own time — Most people find that just before bed is an ideal time to floss. But it's best to find the time that's most convenient for you. That way, you are more likely to floss regularly.
  • Don't skimp on the floss — Use as much floss as you need to clean both sides of every tooth with a fresh section. In fact, you may need to floss one tooth several times (using fresh sections of floss) to remove all the food. Some professionals think that reusing sections of floss may move bacteria from one tooth to another.
  • Choose the type that works best for you — There are many types of floss: waxed and unwaxed, flavored and unflavored, ribbon and thread. Try a few before you settle on one to use every day. Waxed floss works better in people with very closely spaced teeth. Tougher, shred-resistant varieties of floss work well for people with rough tooth edges.

How To Floss
Hold the floss in whatever way you prefer. The most common method is to wind the floss around your middle fingers. Then pull it tight 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. Some people just 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 floss is not as important as what you do with it. If you can't settle 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; 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 into the space between the tooth and gum.
  • Move the floss up and down with light to firm pressure to skim off plaque from the tooth. 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
To supplement your at-home brushing and flossing, your dentist or hygienist may suggest one or more of the following:

  • Interdental cleaners — These cleaners work better than floss for people who have large spaces between their teeth. Some look like tiny brushes. Others look like three-sided, wide toothpicks. These cleaners also work well in people who have braces or missing teeth, and in people who have had gum surgery. You can find them at most grocery stores and drugstores.

  • Oral irrigators — These are electrical devices. They pump water in a steady or pulsating stream. They do not seem to remove plaque that is attached to the tooth. But they are great for flushing out food and debris in pockets between teeth, or in braces. They also are used to deliver medicine to hard-to-reach areas. For example, prescription rinses can be sprayed into gum pockets with an oral irrigator.

  • Interdental tip — These flexible rubber nibs are used to clean between the teeth and just below the gum line. Plaque and bits of food can be removed by gently running the tip along the gum line.

  • Mouthwashes and rinses — As with toothpaste, your choice of mouthwash or rinse will be guided by your mouth care needs. Over-the-counter rinses can freshen the breath, add fluoride or kill the bacteria that cause gingivitis. Some mouthwashes are designed to help loosen plaque before you brush. Ask your dentist or hygienist to recommend the rinse that would be best for you. If you need to avoid alcohol, read ingredient labels carefully. Many over-the-counter mouthwashes contain high amounts of alcohol. In some cases, your dentist might prescribe a stronger fluoride or antibacterial rinse for you.

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