About your risk of tooth decay and if fluoride treatments are necessary
About your risk for gum diseases
About how best to clean your tongue
If you should use an anti-plaque rinse
How often you should have check-ups and cleanings
About xylitol chewing gum to protect your oral health
If you have pain and tenderness around your jaw joints, ears, or side of face
If you are pregnant or considering becoming pregnant
Visit the dentist regularly
Follow the instructions you may have received about how best to perform your daily oral hygiene
Try to keep your normal oral hygiene routine when travelling – it not only keeps you healthy, but also keeps you feeling fresh
Brush at least twice a day and clean between your teeth at least once a day
Interdental brushes are easy to use and just as effective as dental floss
Change your toothbrush at least every three months
Toothbrushes with tapered bristles clean under the gum and in other hard to reach areas
Most dental professionals recommend that toothbrushes be replaced at least once every three months. It may be necessary to replace the brush more frequently if the bristles begin to look bent or splayed out, or if the brush-head looks worn.
Toothbrushes should not be shared, as bacteria can be spread from mouth to mouth, and they should be rinsed clean of all toothpaste and left in the open air to dry after each use. Some dental professionals recommend that toothbrushes should be replaced after you or family members have had a cold or the flu.
Figure: Note the difference between a new brush and one that is worn, with the bristles splayed out, which should be replaced.
Mouth cleaning with a toothbrush alone is not enough. There are many areas between the teeth where the bristles of a toothbrush cannot reach.
Flossing will clean these areas and should be performed at least once per day. A wide variety of floss is available in different thicknesses, textures and coatings. Flossers and floss handles are also helpful to position the floss between the teeth. You should seek the advice of your dental hygienist to establish the optimal method for your own situation.
Cleaning between the teeth, and other hard to reach areas, can also be accomplished with interdental or interproximal brushes. These are generally much easier to use and are as effective.
There could be many reasons for this. Try these tips, below, and if your mouth still does not feel clean, then consult your dentist and dental hygienist so they can review your problem, check that there is no underlying dental cause, and help you adopt the best techniques for your individual circumstances:
- First, make sure you are using a high quality toothbrush. This should have a small or medium sized head with soft bristles that are packed tightly together. The bristles should be ‘tapered’ rather than have rounded-ends so they can reach under the gum line where the dental plaque is difficult to reach. The handle should fit comfortably into the palm of both hands and automatically line-up so that the bristles will be at a 45-degree angle to your teeth. GUM® Technique® Deep Clean toothbrushes meet all these requirements.
- Next, cleaning between the teeth in the hard to reach areas is important. Use either floss or interdental brushes for this. If you find floss hard to use, interdental brushes are easier and just as effective. You can purchase these in drugstores and major grocery chains.
- Brush with a fluoride toothpaste at least twice a day, and use floss or interdental cleaners at least once per day. See the section on Proper Brushing [weblink] for the best techniques to use.
- Don’t forget your tongue! Most of the bacteria in your mouth live on the back of your tongue. Try brushing it gently with your toothbrush or use a special tongue-cleaning device.
- Try finishing off with a mouth rinse. There are many different varieties and flavors, but a rinse with anti-plaque action will help control the growth of dental plaque in your mouth.
- Avoid sucking on sugary candies. The bacteria in your mouth love to eat sugar, which they convert into acids, and which may be contributing to your problem of not feeling clean. They also cause dental decay. Xylitol is a natural, sugar-free sweetener found in items like chewing gum that may help to protect against dental decay when used as part of an overall strategy that includes a healthy diet and good oral hygiene care.
Cleaning between the teeth is important. Flossing can be challenging and you should work with your dental hygienist to develop the best method for you. Flossing is not for everyone, and many people find the use of interdental brushes much easier and equally effective. Both flossing and interdental brushing remove dental plaque from between the teeth – if left undisturbed between the teeth, dental plaque builds up and can lead to cavities and gum disease.
Many things that are simple routines at home become hard to do when traveling. Routines and schedules change, there are usually several different time zones to cope with, and very different personal environments. However, a few familiar items cannot only help with keeping a routine, but also can be comforting when away from home and family. Keep a small bag packed with your same toothbrush, toothpaste, and between teeth cleaners (floss or interdental brushes). Having these items will help you stay in the same oral hygiene routine. Long haul travel, especially overnight flights or long car journeys, are not only exhausting, but also tiring and stressful to the system, too. Remembering to perform your normal oral hygiene regimen on arrival will help you feel fresher and cleaner, and will do your oral health a big favor, too.
Yes, but the best dental filling material is no dental filling at all! All commonly used filling materials are safe, and dental amalgam has been in use over 150 years. Some concerns are raised from time to time over the safety of dental amalgam fillings as they contain mercury. The mercury added to the mixture of other metals when the filling is prepared forms a safe and stable material. The American Dental Association, the FDA, the Centers for Disease Control and Prevention, and the World Health Organization all agree, based on all the available scientific evidence, that dental amalgam is a safe and effective filling material.
Dental cleanings remove deposits and stains that can build up on teeth. Generally, if your oral hygiene regimen is good, few stains and deposits will occur. Your dentist will recommend the frequency with which you should have check-ups and, typically, a cleaning will be performed immediately before the check-up so the teeth and gums can be thoroughly examined. Cleanings are not harmful and help keep your mouth healthy and looking good. Your dental hygienist is the expert in helping you clean your teeth most effectively, as well as in removing stains and deposits that build up between dental visits. Ask your dental hygienist for advice about cleanings and their frequency.
Dental x-rays (radiographs) are a diagnostic tool and help the dentist detect conditions not always visible to the human eye. They can help detect dental decay and gum disease involving the bone, and are helpful in monitoring a child’s growth and development. Your dentist will assess the benefits of the additional information the x-rays will provide after reviewing your dental history and examining your mouth, and then will advise whether x-rays are needed.
Many x-rays are now digital, require even smaller levels of radiation than previously, and are safer for the environment, as no chemicals are necessary to develop the films.
Dental x-rays require very low levels of radiation exposure and various protective mechanisms limit exposure to the rest of the body – like a lead apron and thyroid collar. If you are pregnant, tell your dentist. Generally, x-rays do not need to be delayed if you are trying to become pregnant, are pregnant, or are breast-feeding.
Yes. Fluoride is one of the most effective agents for preventing dental decay. Dental decay can develop in the teeth of all age groups. The greatest risk of decay occurs in the very young and the very old, but it also occurs in other age groups if risk factors change – mainly an increase in the amount and frequency of sugar intake – but changes in the quality and quantity of saliva and poor oral hygiene are also important. Fluoride is available in many low-concentration daily forms such as municipal water supplies, toothpastes, and mouthrinses that help protect everyone from dental decay. There are also higher concentration forms that your dentist may prescribe if you are at high risk of developing dental decay. These may be ‘treatments’ with gels or varnishes applied in the office, or rinses or special toothpastes for home use.
If your dentist diagnoses dental decay, ask about how to minimize your risk and prevent further cavities.
There are several ways your dental team can improve the color of your teeth. Once they know the cause, they can recommend the best solution.
Not everyone’s teeth are going to be bright white. Most teeth are slightly yellow or gray, and become more so as we age. Some experts believe that the color of the teeth should match the shade of the whites of the eye. Teeth that do not have a natural bright appearance can sometimes be whitened; however, success depends on the cause of any discoloration. If you are concerned about the color of your teeth, seek the advice of a dentist. Teeth may become more yellow due to certain prescription medicines or a condition that dissolves away the enamel (tooth erosion), allowing the more yellow dentin to show. Teeth may also look yellow if they simply are not being cleaned very frequently or if you use tobacco products. Ask your dental hygienist if the color of your teeth has anything to do with how you take care of them.
Figure: Teeth have many different shades and hues, even within the same mouth. Dentists have standard shade guides to assess tooth color.
Schedule a dental check-up as soon as possible and ask your dentist and dental hygienist for any specific advice they have to offer for your own situation. Dental care is safe during pregnancy. Your dental team will work to schedule the optimal time for any treatment needed, contacting your medical team if appropriate.
Changing hormone levels may lead to redness and puffiness in the gums as a result of how your gums now react to dental plaque. Pregnancy gingivitis is quite common and can be controlled by good dental plaque removal. Strive for the best oral hygiene. Use good quality toothbrushes that are designed to reach under the gum line and other hard to reach areas. Always use fluoride toothpaste and brush at least twice a day. Cleaning between the teeth, where regular toothbrushes do not reach, is essential – use floss or specially designed interdental brushes to clean between all your teeth at least once a day. Ask your dental hygienist for any specific advice and if you could benefit from an anti-plaque rinse.
Figure: Close-up of the changing appearance of the gums during pregnancy. Note the red swelling between the upper central incisors
Keep a well-balanced diet that is low in added sugars, and try to avoid snacks between meals. Changes to your diet will no doubt occur from time to time throughout your pregnancy. If you find yourself eating and drinking a lot of sugary or acidic foods and beverages, consult your dentist, as these increase your risk of cavities and acid-erosion. A fluoride rinse may be recommended in addition to your regular oral hygiene routine.
If you have morning sickness and vomit frequently, the acid can damage your teeth. To keep this to a minimum, avoid brushing for at least an hour after vomiting as the acid softens the enamel surface of the teeth, making them susceptible to wear from the abrasives in the toothpaste. Rinsing with a solution of a teaspoon of baking soda in a cup of water will help neutralize the acid and freshen your mouth.
Figure: Left image shows teeth recently emerged into the mouth fully covered with dental enamel that is shiny and white; Right image is moderate erosion with sensitive and dull yellow dentin exposed, as enamel is lost.
Temporo-mandibular disorder (TMD) can be a very painful and distressing condition that may last only a few days or weeks, or for many years. More women than men experience TMD and it mainly occurs in the twenties and thirties, though it can occur at any age.
The most common signs and symptoms of TMD include:
- Pain or tenderness in the jaw joint area that may extend towards the neck and shoulders, up into the temporal region, and even into the ear; pain is usually brought on when moving the jaw for chewing, eating, laughing, or yawning, but can occur spontaneously
- Clicking or popping sounds upon opening the jaw
- Swelling of the side of the face and over the joint area
- Grinding of the teeth, or a feeling that the upper and lower teeth are not fitting together properly
The causes of TMD are not clear, but most dentists and otolaryngologists believe the condition arises due to problems in how the muscles, the joints, and the teeth all work together, and on both sides. The jawbone is the only bone in the body where both left and right joints have to work in harmony, similar to a hinge movement. The factors that contribute to TMD are stress (which leads to jaw clenching), damage to the joint itself through injury or arthritis, and grinding the teeth that puts excessive pressure on the joints.
There are many other conditions with similar symptoms, so you should arrange to see your dentist for a full evaluation and diagnosis.
While waiting to see your dentist, some relief can be obtained by:
- Eating soft foods
- Avoiding excessive jaw movements
- Applying hot or cold packs to the affected area
- Taking an over-the-counter pain reliever, the same as you may take for a headache, for example
It is important to continue your daily oral hygiene routine as best you can, but try to avoid opening your mouth very wide as this may make the condition worse.
Figure: Pain from TMD radiates from the joint, just in front of the ear, and may affect the side of the cheeks, the temples, and around the ear itself.
Dry mouth is an increasingly common condition. The mouth feels ‘dry’, and speech and swallowing can be difficult, due to the perceived lack of saliva and its ability to lubricate the mouth. A normal level of saliva in the mouth is needed for many reasons, in addition to lubrication for speech and swallowing. Saliva keeps the mouth fresh, rinsing away food debris and bacteria; it bathes the teeth in minerals such as calcium, helping them to resist damage from acids in the diet and to heal very early dental decay; and it contains antiseptic agents that help control the growth of bacteria.
Other consequences related to lack of saliva are:
- Bad breath/lack of freshness in the mouth (lack of rinsing effect)
- Faster growth of dental plaque (lack of antiseptic effect)
- Dental decay and acid erosion (lack of minerals)
Not only is the quality of life compromised by these difficulties, but also the mouth can develop an odor that would be described as bad breath.
The most common cause of dry mouth is medications – both prescription and over-the-counter. Other causes include diseases of the salivary glands and the side effects of radiotherapy for head and neck cancers.
Bad breath, sometimes referred to as oral malodor or halitosis, is a fairly common condition and, for most people, very transient. For others it can be more a permanent issue.
It is very normal to wake up in the morning with bad breath. The mouth can get dry at night as both the flow of saliva that normally keeps the mouth clean and fresh decreases and many people start to breathe through their mouth and/or snore, which further dries the mouth. Bacteria can grow and it is these bacteria, together with their waste products, that cause an odor. Early morning breath can be reduced by good oral hygiene before sleeping and then again early in the morning. Mild odor is fairly normal and nothing to worry about.
An odor that lasts throughout the day and is persistent over several days may be the sign of something more serious, such as an infection in the mouth, nose, or throat. Some malodor may also come from the stomach, especially if spicy or pungent foods are regularly eaten. Again, good oral hygiene will help, but it is wise to seek the advice of a dentist to check for oral conditions in the mouth such as gum disease and dental decay, or a physician to check for causes in the nasal passage and throat, as well as the stomach.
Experts believe most oral malodor originates on the surface of the tongue. Good oral hygiene should include tongue cleaning.
One of the most common sources of bad breath is the surface of the tongue. The surface of the tongue is made up of numerous grooves and ridges that trap bacteria and food debris.
Regular cleaning of the tongue should be part of good oral hygiene. Cleaning the tongue can be a challenge, as it is very sensitive or ticklish. The simplest way to clean the tongue is to brush its surface with your toothbrush as you finish brushing all your teeth. Many people find this difficult, as the surface is very soft and spongy. Specially designed tongue-cleaners are shaped in accordance with the contours of the tongue, and they easily lift off the bacterial biofilm, food debris, and dead cells, which together produce bad-smelling compounds and gases – the most common causes of bad breath, also known as oral malodor or halitosis.
Your dental hygienist can help you in determining the most effective way to clean your tongue. If you believe you have bad breath, or people tell you that your breath odor is unpleasant, consult your dentist or dental hygienist so they can investigate the source and help you overcome it.
Figure: The surface of the tongue is made up of numerous grooves and ridges that trap bacteria and food debris.
Tooth sensitivity can have many different causes. Tooth sensitivity should not be taken lightly, as it may be a symptom of something developing in a tooth such as decay, a broken filling, or a dental abscess. However, most tooth sensitivity is a condition known as dentin hypersensitivity and can easily be managed. Only a dentist can make a detailed examination and a proper diagnosis for someone experiencing sensitivity.
Dentin hypersensitivity is a result of one of two common processes:
- One process is gum disease, especially periodontitis that has resulted in gum recession, exposing the sensitive root of the tooth. Gum recession can also be caused by aggressive or abusive toothbrushing habits.
- The other process is loss of the enamel covering of the crown of the tooth, known as acid erosion. This occurs most often due to acids in the diet, but also from acids regurgitated by the stomach, softening the surface enamel, enabling it to be worn or dissolved away.
Figure: Gum recession exposes the sensitive roots of the teeth
Figure: Loss of the enamel as a result of erosion exposes the underlying sensitive dentin
It is important to know what the underlying condition is, so a visit to the dental office is recommended. Your dentist and dental hygienist will provide advice about oral hygiene techniques, the selection of the most appropriate toothbrushes and other aids, as well as how to avoid the damage from acids in the diet.
Relief for many cases of dentin hypersensitivity can be gained from a simple change in your everyday toothpaste, to desensitizing or anti-sensitivity toothpaste, and a change in toothbrush to a soft-bristle, sensitivity toothbrush. This will relieve the symptoms, but not the underlying cause, emphasizing the need to visit the dental office and to use the correct oral hygiene aids and technique.
If the change in toothpaste does not bring about symptom relief, various treatment options can be applied in the dental office by a dentist or dental hygienist.
Chewing sugar-free gum has been shown to promote good dental health when used regularly after meals. Xylitol has been studied over many years and has been shown to be both safe and effective when used to promote oral health. Sugar (sucrose) present in many foods and beverages as an added ingredient can cause tooth decay, as the bacteria in the dental plaque easily convert sugar into acids that will destroy the teeth. Xylitol cannot be used by the bacteria, so it does not cause any acid production. For this reason, xylitol is added to items like chewing gum and sugar-free candies, as a sugar substitute, to help reduce tooth decay. When selecting a xylitol product for its oral health benefits, check the ingredients to confirm that there are no additional sugars.