Oral hygiene

Dental hygiene, also known as oral hygiene, is the process by which preventative dental care is provided to avoid dental emergencies. At the core of dental hygiene is the in-home dental care regimen you perform. Your at-home regimen is supplemented with professional preventative dental care provided by dentists and licensed dental hygienists

While you are responsible for day-to-day dental maintenance, dental hygienists, along with general dentists, family dentists and cosmetic dentists, play an integral role in preventative oral care.

Tooth brushing is fundamentally important, though it alone will not remove the calculus (also called tartar or dental plaque) that builds up over time. Calculus must be removed to lower your risk of toothaches, cavities, periodontal disease or even the loss of all your teeth. By removing calculus, you can reduce your chances of needing root canals, tooth extractions, dental bridges, crowns and more.

Getting to the Root of Dental Hygiene

Over time, calculus builds up on the teeth. If calculus forms below the gum line, bacteria can invade and create a host of other dental problems. Furthermore, the surfaces and areas between the teeth and under the gum line must be maintained and treated on a regular basis in order to ensure proper dental hygiene. These areas are impossible for you to examine yourself; they require a professional touch.

Dental hygienists are often responsible for performing professional tooth cleaning, scraping hardened plaque (tartar), removing calculus deposits, taking X-rays, identifying changes in the bite (occlusion), investigating components that relate to the bone and setting up the nitrous oxide (“laughing gas”) that is used, when necessary, to relax people requiring more invasive treatment.

Your dentist then works with your hygienist by further examining the teeth, mouth and gums to provide any necessary treatment for tooth decay or gum disease. Regular dental visits are critical at any age for the maintenance of dental hygiene. The American Dental Association recommends that patients visit with their dentist and dental hygienist a minimum of two times each year to maintain proper dental hygiene.

Brushing

Is essential for cleaning teeth and gums effectively. Use a toothbrush with soft, nylon, round-ended bristles that will not scratch and irritate teeth or damage gums.

Unfortunately the toothbrush cannot reach inside pits and fissures on chewing surfaces of back teeth where over 80% or cavities occur, which is why tooth decay is the most common of diseases rivalling the common cold and with an economic impact of heart disease and diabetes.

Supertooth and Good Food Friends online school community dental health project is developing a toothbrush to chew toothpaste before brushing forcing the paste inside pits and fissures to neutralise any acid and remineralise demineralised tooth

Chew toothpaste on a suitable chewy aplicator before brushing.
Place toothbrush at a 35-degree angle against the gums.
Move the brush up and down gently in short (tooth-wide) strokes.
Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
Use the “toe” of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
Brush tongue to remove bacteria and freshen your breath.

Toothpaste

Flouride in various forms is the most popular active ingredient in toothpaste to prevent cavities. Although it occurs in small amounts in plants, animals, and some natural water sources, and has effects on the formation of dental enamel and bones, it is not considered to be a dietary essential and no deficiency signs are known. Sodium fluoride (NaF) is the most common form; some brands use sodium monofluorophosphate (Na₂PO₃F) or organic amine fluoride (AmF) olaflur. Application of fluoride also prevents moisture build-up in some surfaces. Other ingredients are less commonly used, including Hydroxyapatite nanocrystals and calcium phosphate for remineralization, and strontium chloride or potassium nitrate to reduce sensitivity.

Flossing

Flossing in between your teeth is an essential oral hygiene practice for avoiding gum disease and preventing tooth decay. Also known as periodontal disease or periodontitis, gum disease affects 75 percent of Americans and is one of the main causes of tooth loss in adults. Pervasive as the oral disease may be, it can be easily prevented by brushing and flossing your teeth.

Recent studies have determined a link between gum disease and increased risk of heart disease and stroke. Maintaining a good oral hygiene regimen may help to eliminate the inflammation factor associated with gum disease, potentially reducing the risk of heart disease and stroke. In general, maintaining good oral hygiene habits may help prevent more serious health complications.

Flossing your teeth is not hard, does not take much time and should be performed at least once daily. The following steps detail optimal flossing techniques for maximum effectiveness:

Select the type dental floss that you prefer.
Tear off a piece of floss about 18 inches long.
Wrap one end of the floss around either your middle or index finger
Wrap the other end of the floss around the finger on your opposite hand.
Grip the floss tightly between your thumb and finger.
Gently insert the dental floss between your teeth. Be careful not to snap the floss or you could damage your gums.
Gently move the floss back and forth against the tooth on both sides and underneath the gum line.
Repeat this process in between all of the upper and lower teeth.
It is important to floss against the backside of a tooth even if there is no tooth behind it.

There are different types of dental floss from which to choose. Among the different kinds of floss are dental tape, waxed floss, woven floss and unwaxed floss. Your hygienist or dentist can recommend which is most appropriate for you

Mouthwash

Mouthwashes come in a variety of compositions, many claiming to kill bacteria that make up plaque or to freshen breath. In their basic form, they are usually recommended to be used after brushing but some manufacturers recommend pre-brush rinsing. Dental research has recommended that mouthwash should be used as an aid to brushing rather than a replacement, because the sticky resistant nature of plaque prevents it from being actively removed by chemicals alone, and physical detachment of the sticky proteins is required.

Scientific evidence suggests three main types of mouthwash:

Plaque inhibiting – this prevents dental disease
Antigingivitis – this prevents gum disease
Fluoride – designed to strengthen enamel, preventing cavities or repairing existing ones to some degree

Interdental brushing

Periodontologists nowadays prefer the use of interdental brushes to dental floss. Apart from being more gentle to the gums, it also carries less risk for hard dental tissue damage. There are different sizes of brushes that are recommended according to the size of the interdental space.Tongue cleaning

Cleaning the tongue as part of the daily oral hygiene is essential, since it removes the white/yellow bad breath generating coating of bacteria, decaying food particles, fungi (such as Candida), and dead cells from the dorsal area of tongue. Tongue cleaning also removes some of the bacteria species which generate tooth decay and gum problems.

Gum care

Massaging gums with toothbrush bristles is generally recommended for good oral health. Flossing is recommended at least once per day, preferably before bed, to help prevent receding gums, gum disease, and cavities between the teeth.

Oral irrigation

Dental professionals usually recommend oral irrigation as a great way to clean teeth and gums.

Oral irrigators can reach 3-4 mm under the gum line, farther than toothbrushes and floss. And, the jet stream is strong enough to remove all plaque and tartar. The procedure does leave a feeling of cleanliness and freshness, and does disrupt more plaque or bacteria as floss since it cleans deeper.

Food and drink

Foods that help muscles and bones also help teeth and gums. Breads and cereals are rich in vitamin B while fruits and vegetables contain vitamin C, both of which contribute to healthy gum tissue.(8) Lean meat, fish, and poultry provide magnesium and zinc for teeth. Some people recommend that teeth be brushed after every meal and at bedtime, and flossed at least once per day, preferably at night before sleep. For some people, flossing might be recommended after every meal.

Beneficial foods

Some foods may protect against cavities. Fluoride is a primary protector against dental cavities. Fluoride makes the surface of teeth more resistant to acids during the process of remineralisation. Drinking fluoridated water is recommended by some dental professionals while others say that using toothpaste alone is enough. Milk and cheese are also rich in calcium and phosphate, and may also encourage remineralisation. All foods increase saliva production, and since saliva contains buffer chemicals this helps to stabilize the pH to near 7 (neutral) in the mouth. Foods high in fiber may also help to increase the flow of saliva. Sugar-free chewing gum stimulates saliva production, and helps to clean the surface of the teeth.

Detrimental foods

Sugars are commonly associated with dental cavities. Other carbohydrates, especially cooked starches, e.g. crisps/potato chips, may also damage teeth, although to a lesser degree since starch has to be converted by enzymes in saliva first.

Sucrose (table sugar) is most commonly associated with cavities. The amount of sugar consumed at any one time is less important than how often food and drinks that contain sugar are consumed. The more frequently sugars are consumed, the greater the time during which the tooth is exposed to low pH levels, at which point demineralisation occurs (below 5.5 for most people). It is important therefore to try to encourage infrequent consumption of food and drinks containing sugar so that teeth have a chance to be repaired by remineralisation and fluoride. Limiting sugar-containing foods and drinks to meal times is one way to reduce the incidence of cavities. Sugars from fruit and fruit juices, e.g., glucose, fructose, and maltose seem equally likely to cause cavities.

Acids contained in fruit juice, vinegar and soft drinks lower the pH level of the oral cavity which causes the enamel to demineralize. Drinking drinks such as orange juice or cola throughout the day raises the risk of dental cavities tremendously.

Another factor which affects the risk of developing cavities is the stickiness of foods. Some foods or sweets may stick to the teeth and so reduce the pH in the mouth for an extended time, particularly if they are sugary. It is important that teeth be cleaned at least twice a day, preferably with a toothbrush and fluoride toothpaste, to remove any food sticking to the teeth. Regular brushing and the use of dental floss also removes the dental plaque coating the tooth surface.

Chewing gum assists oral irrigation between and around the teeth, cleaning and removing particles, but for teeth in poor condition it may damage or remove loose fillings as well

Other

Smoking and chewing tobacco are both strongly linked with multiple dental diseases. Regular vomiting, as seen in bulimics, also causes significant damage.

Mouthwash or mouth rinse improve oral hygiene. Dental chewing gums claim to improve dental health.

Retainers can be cleaned in mouthwash or denture cleaning fluid. Dental braces may be recommended by a dentist for best oral hygiene and health. Dentures, retainers, and other appliances must be kept extremely clean. This includes regular brushing and may include soaking them in a cleansing solution.

Oral hygiene and systemic diseases

Several recent clinical studies show a direct link between poor oral hygiene (oral bacteria & oral infections) and serious systemic diseases, such as:

Cardiovascular Disease (Heart attack and Stroke),

Bacterial Pneumonia,

Low Birth Weight,

Diabetes complications,

Osteoporosis.