Prevention of Dental Disease
Toothbrushing
Regular and efficient tooth brushing is important because:
- it helps prevent gum disease.
- it helps prevent tooth decay through the action of fluoride.
- it helps maintain good breath.
The advice is as follows:
- Brush your teeth for a full 2 minutes (physically-timed) as it is known that it takes this long to brush your teeth properly. For those patients who have lost a few teeth, ask your dentist if this period of time still applies.
- Brush your teeth twice a day.
- Ensure that you always use fluoride toothpastes and check the ingredients panel to ensure that the concentration of fluoride is at least 1400ppm. Fluoride is known to help prevent tooth decay.
- During brushing, ensure that you can see and, more importantly, feel the bristles of the brush on your teeth and your gums at the same time at all times. That way you never miss the gum line, which is the most important part. Please remember that gum bleeding is NEVER normal. Consult your dentist for advice that leads to a resolution.
- After tooth brushing, ensure that you:
- spit the contents of your mouth out and walk away.
- don’t rinse your mouth with anything afterwards (for 30-60 minutes) because:
- this gives the fluoride time to work.
- mouthwash fluoride is not as concentrated as toothpaste fluoride.
- rinsing with water will wash away all the good fluoride that you have just applied by brushing your teeth.
Mouthwashes
The best mouthwash available is one with 0.2% chlorhexidine as its active ingredient. This mouthwash is only recommended for short-term use because: it stains teeth, increases tartar build-up and can lead to an allergy in some patients. All other mouthwash active ingredients are usually compared to chlorhexidine in dental research and have generally been shown to be half as good (at best). There is very good clinical evidence that proves that efficient and regular mechanical cleaning (toothbrushing and interdental cleaning) is effective in preventing gum disease. The long-term use of chlorhexidine-based mouthwashes (for the treatment of gum disease) is not only ineffective, it has the side effects outlined above.
Please use alcohol-free mouthwashes as there is a theoretical (unproven) increased risk of mouth cancer when used in the long-term. Alcohol-free alternatives are as effective as alcohol-based ones.
Fluoride-based mouthwashes should be used in the middle of the day. The key is to use them at a totally different time to teethbrushing
Diet
Refined sugar in your diet causes decay (holes in teeth). Holes in teeth can lead to fillings, extractions, toothaches, infections, amongst other things.
An unfilled tooth is ALWAYS better than a filled one, therefore it is best to avoid fillings which are a result of holes in teeth.
Sugar is sugar irrespective of where it comes from. Some common examples of sources of sugar are:
- Sweets, biscuits, chocolate, cakes, processed fruit (including dried or really ripened), fizzy drinks, cordial, squash, crisps.
- There are some foods that don’t taste like they contain sugar but they do e.g. salt and vinegar crisps.
The advice is:
- Restrict sugary foods to meal times ALONE. Maximum of three times a day. This is still too much for some patients. Please consult your dentist.
- Have your sugary foods as a desert and NOT a snack.
- Have larger, nutritious meals as this reduces the need for snacking.
Remember:
- If you have one tonne of sugar once a day at meal times, as long as you follow the advice above, you are highly unlikely to get decay.
- If you have one grain of sugar between meals 5 times a day, you are highly likely to get decay.
- Tooth brushing after having a sugary snack does NOT make a difference; you are still highly likely to get decay. This is because no one (including dentists) can brush perfectly.
- The only way of reducing the risk of decay is to restrict sugary foods to meal times ALONE!!!
Interdental Cleaning (cleaning between teeth)
This is important because, for the vast majority of people, the toothbrush does not get between your teeth. For most people, the tight gaps between teeth are where gum disease begins. If you keep these areas clean, you significantly reduce your chance of getting gum disease. You also increase your likelihood of having fresh breath.
The advice is:
- Clean between all your teeth (including the back ones) at least once a day with:
- Dental floss, interdental brushes etc. Consult your dentist or hygienist.
IF THE ASSOCIATED BLEEDING DOES NOT SUBSIDE, PLEASE CONSULT YOUR DENTIST - BLEEDING IS NEVER NORMAL.
Denture Hygiene
Dentures can be a fantastic option for the replacement of teeth in some patients. It however can cause some significant problems including: decay, gum disease, localised thrush infections, etc
The advice is:
- Take your denture out before going to sleep every night and soak in a proprietary denture cleaner (follow the manufacturer’s instructions and ensure it is compatible with your denture.
- Brush the denture first thing in the morning and last thing at night
- After every meal, give the denture a rinse and better still, brush it properly.
We hope you find this advice helpful. If you have any suggestions about how this can be made more user-friendly and applicable to you, please let us know.
Dr OM Sodeinde MSc(Rest Dent) BDS MFDS RCS(Ed)
Revised in March 2011
