Brushing Your Teeth

Why Clean Your Teeth?

 The two most common dental problems, dental decay and gum disease. are both caused by the action of bacteria on teeth or gums. Bacteria are naturally present in the mouth and are often detectable as a thin (or thick!) sticky film over the teeth especially at gum level. This is referred to as plaque. These bacteria cannot be removed completely - the point of cleaning teeth is to remove as many as possible, and to maintain an environment that discourages the more ‘dangerous’ types of bacteria.

Most people brush their teeth at least once daily, and some more often, but it is usually done in an inefficient manner and too quickly, leaving a lot of plaque behind. Careful cleaning can take a bit longer, but for those patients without serious problems it will not involve too much extra effort.

Thorough cleaning will reduce the risk of decay or gum problems starting, or slow the rate at which they progress. It also produces fresher breath and a ‘cleaner’ feel to the teeth and mouth.

 

Electric Toothbrushes

 The new designs of mains rechargeable electric toothbrushes have improved brushing immensely. They brush very efficiently and encourage longer brushing times, and are suitable for all ages. The main differences from manual brushing are to move the brush slowly from tooth to tooth, tilted at around 45 degrees, and use a little less force.

There is no reason that children cannot use them.

So How Should I Be Using The Electric Brush?

Brush Type: The commonest problem we see is a brush that is too worn and ‘rounded’ or far too big. There are a huge variety on the market, but the basic things to look for are:

  • Soft or medium bristle ‘stiffness’
  • Compact head slightly smaller in length or width than the diameter of a £1 coin
  • A handle you can hold on to firmly.

Toothpaste: Very little real difference exists between brands despite all the brands available; basically, choose one you like the taste of. Another important factor to consider is if you need a toothpaste to reduce cold sensitivity, or possibly to combat tooth wear. It is recommended to use a toothpaste which contains fluoride. However, non-fluoride options are available, normally in good health food shops.

 Floss type: There are many types on the market. Beginners often find the tapes easier to use as there is more to hold onto. As with toothbrushes the proper technique is more important than the floss you use.

 Frequency: It is better to brush thoroughly once a day than quickly 3 or 4 times. Ideally, for the average set of teeth, brushing should be done thoroughly twice a day for at least two to three minutes. Flossing will take an extra minute or two.

 Timing: Traditionally, it was recommended that the best time to brush was straight after meals. Now, the only definite advice is to brush in the morning before breakfast if it includes acidic foods, and last thing at night after any food or drink.

 Rinsing: It has been shown that not rinsing with water after brushing reduces decay, as the fluoride has longer to act.

Brushing Technique

 To clean the outer surfaces of each tooth, tilt your toothbrush at a 45-degree angle against the gumline.

  • Move the brush back and forth, using short, gentle circular strokes.
  • Repeat this motion on the inside, outside and chewing surfaces of your teeth.
  • To clean the inner surfaces of your front teeth, hold the brush vertically and use gentle up-and-down strokes with the front part of the brush.
  • Pay extra attention to the gumline, hard-to-reach back teeth and areas around fillings, crowns or other restorations. Plaque builds up more on the areas of teeth covered by dentures.
  • For fresher breath, brush your tongue too! To do this grab, the tip with a clean facecloth or piece of gauze and scrub the top surface vigorously.

But My Teeth Are Really Sensitive When I Brush Them…

 If your gums are tender and bleed on brushing, you see improvement once you start brushing properly. This may take a couple of weeks to resolve. If they do not, arrange a visit with your dentist or one of our hygienists as professional cleaning or advice may be needed.

If you have cold sensitivity from the necks of the teeth, then this is a bit more of a problem to manage. The hard outer layer of enamel stops at the tooth neck, and a softer material - dentine - is exposed by the gums receding.

Modern diets are often quite acidic compared to the diets of 20 years ago, as they often include fruit juices, fruit, wine, fizzy drinks, etc.

Dentine is easily softened by these acids and can be brushed away exposing the tiny tubules in dentine that are associated with the sensitivity.

Management of the problem focuses on reducing the acid exposure through dietary changes, and brushing before the acid consumption, so the softened dentine has a chance to recover. This often means brushing before meals, using a soft brush and a gentle technique.

Anti-sensitivity toothpastes need to be used or applied gently after normal brushing and left to ‘soak in’ They work by trying to block the tubules.

Your dentist can also apply materials to block the tubules, or if the wear is deep enough, place a filling material over the neck of the tooth.

A Few Other Points:

Children are generally only able to use a simple scrub-brushing technique until they are 7 - 10. Assisted parental brushing and supervision on a regular basis is advisable to ensure it has been done properly. Their brushing can also be checked with disclosing tablets.

Patients with dentures need to be particularly thorough brushing not only their dentures to remove all the plaque, but also the areas of gum and tooth covered by a denture, which are more likely to develop gum and decay problems.

Brushing can become more difficult for patients put on certain drug treatments that may make their mouth drier. This is a side effect of very many drugs.

It is also possible for the gums to be directly affected by a few drugs, with one group of blood pressure control drugs being the commonest. If you think this is a possibility, then please discuss it with your dentist.