Brushing

Brushing your teeth is the most important step in a good oral hygiene routine. Proper brushing should occur twice a day for at least two minutes. Holding the toothbrush at a 45 degree angle, brush the outside, inside, and chewing surfaces of all teeth. Gently move the brush in short strokes, brushing away from the gumline. To brush the inside of the front teeth, hold the toothbrush vertically and use short up and down strokes. Finally, brush the tongue to remove bacteria and freshen breath.

Choose a soft-bristled toothbrush that is small enough to fit comfortably in the mouth. It should be able to reach all areas of the mouth, including back teeth. Replace the toothbrush every three to four months, or when it starts to show wear. Choose a toothpaste that is ADA-accepted and contains fluoride.

Brushing is a simple activity, but it is easy to make mistakes that may jeopardize your oral health. The most common mistakes include not brushing twice daily, not brushing a full two minutes, keeping a toothbrush too long, and brushing the teeth too hard, which can damage gums. Plaque is soft, so a gentle cleaning is best. For best results, brushing should be coupled with flossing at least once a day.

Flossing

Flossing is an important part of a good oral hygiene routine that can prevent gum disease and cavities. Flossing removes plaque from hard-to-brush areas, including between the teeth and at the gumline. To floss, start with 18 inches of dental floss. Wrap most around one middle finger and the rest around the other middle finger, leaving a couple inches in between. Holding the floss tightly between your thumbs and forefingers, glide it gently up and down between teeth. Once it reaches the gumline, curve the floss into a C-shape around one tooth, and gently rub the side of the tooth up and down. Do this for the other tooth as well before moving on to the next space between teeth. Repeat this for the rest of the teeth. Unwrap additional clean floss from your middle finger and wrap the dirty floss on the other finger as you go along. Once complete, discard the floss. Attempting to reuse floss later could reintroduce bacteria to the mouth.

The American Dental Association recommends flossing once a day with an ADA-approved flossing product. Flossing can occur morning or night, and before or after brushing. The most important factor is that it’s done every day. Flossing may feel uncomfortable for the first week or two, but it should not be painful. If pain persists, speak to a dentist.

Fluoride

Fluoride is a mineral found in many foods and in water. It helps prevent tooth decay by making teeth more resistant to acid attacks from bacteria and sugars in the mouth. Fluoride protection can be increased through topical fluoride or systemic fluoride. Topical fluoride includes products applied directly to the teeth, such as toothpastes and mouth rinses. They also include foams and gels that may be applied directly by a dentist. Systemic fluoride is ingested, absorbed through the gastrointestinal tract, and then distributed by the blood throughout the whole body. Sources of systemic fluoride include food, beverages, fluoridated water, and fluoride supplements.

Fluoride intake is critical in children, as this is the time when teeth are coming in. However, adults benefit from fluoride’s decay-preventing properties as well. Contact your dentist or local water company to discover the fluoridation levels in your local tap water. (Those with wells can have a water sample tested.) Optimal levels are 0.7 to 1.2 parts per million. Fluoride is generally safe, but children under six who ingest toxic levels can develop fluorosis, defects in tooth enamel ranging from white specks to discolored brown enamel. It is difficult to reach toxic levels by consuming home-based fluoride products, but children should be monitored to ensure they are not swallowing toothpaste.

Oral Exam

Regular dental exams are also a part of a healthy oral hygiene regimen. During an oral exam, a hygienist or dentist will examine the teeth and gums to discover any potential problems. The hygienist will check the surfaces of each tooth for cavities and check the quality of any fillings. They may recommend replacement of any fillings that have worn down over time. Dental x-rays are not needed at every visit, but x-rays may be taken to help the dentist get detailed images of the mouth. Different types of x-rays can help the dentist examine an entire tooth and surrounding bone, how upper and lower teeth fit together when the mouth is closed, or the spacing of teeth.

Hygienists will also check for gum disease. They will insert a probe between the tooth and gum to measure gum adherence to the teeth. A recording of 4 or more millimeters can indicate potential gum disease. The hygienist will finish by cleaning each tooth, removing any deposits. They will then gently polish the teeth with toothpaste or baking soda. A fluoride treatment may be applied if necessary. After the exam, the dentist and hygienist will discuss any problems they found and recommend treatment options. They may also discuss preventative measures and best practices for oral health.

Root Planing

Root planing and scaling are a treatment for gum disease (periodontal disease) that deep cleans below the gumline. Gum disease is caused by the bacteria in plaque. When not properly removed through brushing and flossing, the bacteria can grow and inflame the gums, causing them to pull away from the teeth and form “pockets.” Plaque and bacteria then get trapped in these pockets and cannot be removed from regular brushing. If left untreated, gum disease will advance and can lead to bone or tooth loss. Scaling and root planing is a non-surgical procedure that is often used as a first option in treating chronic periodontal disease.

Deep cleaning involves two steps. Scaling removes the plaque and tartar from beneath the gumline. Root planing smooths the tooth roots. This helps the gums reattach to the teeth. The process may take more than one appointment, and the dentist may apply a local anesthetic to minimize discomfort. During follow-up visits, the dentist will check the healing of gums and measure the depth of pockets. Patients with chronic periodontitis may be placed on a schedule of maintenance visits. Thus, scaling and root planing is also known as conventional periodontal therapy or non-surgical periodontal therapy.

Plaque

Plaque is a soft, sticky, thin film of bacteria that is constantly forming on teeth. The bacteria in plaque feed on the sugars in food and produce acids that eat away at tooth enamel. This can result in cavities and tooth decay. Bacteria in plaque along the gumline can cause inflammation, leading to gum disease. Plaque that is not removed daily can harden and form tartar, which cannot be removed through brushing and requires a dental visit.

Good oral hygiene is the best way to remove plaque and prevent tartar buildup. Brush teeth at least twice a day for two minutes with a soft-bristled toothbrush. Brushing after meals and before bed can minimize plaque buildup by limiting the bacteria’s exposure to sugars found in food. Floss daily to remove plaque between teeth. Mouthwash can loosen plaque, but mouthwash alone does not remove enough plaque to be effective. Use mouth rinses alongside brushing and flossing. Some mouthwashes with alcohol may cause dry mouth, which promotes bacteria growth. Saliva helps keep the mouth healthy, so speak with a doctor if experiencing dry mouth. Finally, visit the dentist twice a year. Dental exams can lead to early detection of tooth decay and gum disease, and regular cleanings remove tartar build up.

Tooth Scaling

Scaling and root planing are a two-step deep cleaning procedure used to treat gum disease (also known as periodontal disease or periodontitis). Gum disease is an inflammation in the tissues surrounding the teeth, including the gums. It is caused by bacteria in plaque, a sticky, colorless film that constantly builds on teeth. If plaque is not removed through brushing and flossing, it hardens into tartar. As the bacteria in plaque and tartar continue to build, they can infect the gums and cause gum disease. Gums begin to pull away from the teeth, forming infected spaces or “pockets.” Bacteria continues to grow beneath the gum line, and the body’s immune response destroys gum tissue and bone. In advanced periodontitis, tooth loss can occur. Treatment options include deep cleaning, also known as tooth scaling and root planing.

Scaling is the most common nonsurgical method of treating gum disease. The dentist or periodontist manually removes plaque and tartar buildup below the gumline. They may use a handheld scaler and curette or an ultrasonic scaling instrument. Scaling is followed by root planing, which smooths the tooth root to help the gums to reattach to the teeth. The dentist or periodontist will follow up to ensure that the gums are healing and to measure the depth of remaining pockets.

Sealants

A sealant is a thin, protective coating that adheres to the chewing surface of back teeth (molars). Sealants prevent cavities from forming and stop current tooth decay from becoming full cavities. Sealants are recommended for children, since school-age children without sealants have almost three times more cavities than children with sealants. Adults may also get sealants on teeth that do not already have cavities or a sealant present.

Back teeth have grooves (fissures) that can be difficult to clean. Plaque can accumulate in these fissures, and acid from the bacteria in plaque eat away at the tooth enamel and cause tooth decay and cavities. Sealants protect teeth by providing a smooth area that covers fissures, keeping bacteria out and making the tooth easier to clean.

Getting a sealant is a simple and painless process. The hygienist cleans the tooth, and then applies the sealant material with a brush. A self-curing light bonds the sealant to the tooth and hardens it. Sealants last for years and can be replaced if necessary.