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Tooth care

Taking care of teeth is essential we need our teeth to chew food and speak clearly, teeth even effects the appearance of our face and our smile.

Tooth decay

Tooth decay results from a bacterial infection of your teeth. Our mouths are full of millions of tiny bacteria and when we consume food and drink that are high in carbohydrates (typically sugary or starchy foods or drinks), the bacteria breaks the carbohydrates down into acid.
The acid then combines with the bacteria, the saliva in your mouth, and small particles of food to produce a sticky film known as plaque. Over time the plaque begins to break down the surface of your tooth. Left untreated, the plaque can completely destroy the outside of the tooth, exposing the nerves inside. Once this happens you will experience toothache.
When you eat anything sugary, the bacteria in plaque turn the sugar into the energy they need, producing acid at the same time. The acid softens and dissolves the hard enamel surface of the teeth (demineralisation). Over time, frequent demineralisation causes cavities to form in your teeth. This is called tooth decay, or caries.
Enamel doesn't contain any nerves so you won't feel any pain at first. Eventually a cavity may reach the dentine - the yellowish substance underneath the enamel that forms the bulk of a tooth. Dentine is sensitive to pain so more advanced cavities may be sensitive, especially when eating or drinking anything hot, sugary or acidic.

Gum disease

Gum disease describes swelling, soreness or infection of the tissue supporting the teeth. There are two main form of gum disease:
  • Gingivitis
  • Periodontal disease
Gingivitis means inflammation of the gums. If plaque isn't cleaned off your teeth regularly, your gums will become red, swollen and shiny, and they may bleed. Often the swollen gums bleed when they are brushed during cleaning. This is the early stage of gum disease.
Ongoing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.
All gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surface of the teeth and gums every day. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day; this is done by brushing and flossing.
Smoking can also make gum disease worse. Patients who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums fail to heal. Smoking causes people to have more dental plaque and for gum disease to progress more rapidly than in non-smokers. Gum disease still remains the most common cause of tooth loss in adults.
The first sign is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Breath may also become unpleasant.
The first thing to do is visit your dentist for a thorough check-up of your teeth and gums. The dentist can measure the 'cuff' of gum around each tooth to see if there is any sign that periodontal disease has started. X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important, so the correct treatment can be prescribed for you.
Your dentist will clean your teeth thoroughly to remove the scale. You'll also be shown how to remove plaque successfully yourself, cleaning all surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dentist or hygienist.

Dental erosion

Erosion is the loss of tooth enamel caused by acid attack. Enamel is hard, protective coating of the tooth, which protects the sensitive dentine underneath. When the enamel is worn away, the dentine underneath is exposed, which may lead to pain and sensitivity.
Every time you eat or drink anything acidic, the enamel on your teeth becomes softer for a short while, and loses some of its mineral content. Your saliva will slowly neutralise this acidity in your mouth and restore it to its natural balance. However, if this acid attack happens too often, the mouth does not have a chance to repair itself and tiny particles or enamel can be brushed away. Over time you would start to lose the surface of our teeth.
How to prevent erosion
  • Limit acid products and fizzy drinks to mealtimes to reduce the number of acid attacks on your teeth.
  • Drinks should be drunk quickly without holding in or 'swishing' around your mouth. Or use a straw to help drinks go to the back of your mouth and avoid long contact with your teeth.
  • Finish a meal with cheese or milk as this will help neutralise the acid.
  • Chew sugar-free gum after eating to help produce more saliva to help cancel out the acids which form in your mouth after eating.
  • Wait for at least one hour after eating or drinking anything acidic before brushing your teeth. This gives your teeth time to build up their mineral content again.
  • Brush your teeth twice a day with a small-headed brush with medium to soft bristles and fluoride toothpaste.

Taking care of teeth

  • Brushing is the most effective way to remove plaque. Here are some tips for getting the most benefit from brushing your teeth.
  • Brush at least twice a day. Make sure you brush every surface of every tooth. To do this properly can take longer than you think. Most dentists would recommend around two minutes.
  • Use fluoride toothpaste to protect against decay.
  • Use a toothbrush with a small head and synthetic bristles.
  • Start at one side of your mouth and move round to the other side, brushing all the tooth surfaces thoroughly.
  • Pay particular attention to the gumline, angling the bristles into the crevices where the gum meets the teeth.
  • Replace your toothbrush every month.
Some people prefer an electric toothbrush. There is some evidence that certain types of electric toothbrush are more efficient at removing plaque than brushing by hand. However, the thoroughness of the cleaning is much more important than what type of brush you use.

Flossing appreciated

Dental floss or inter-dental brushes remove plaque and particles and particles of food from between the teeth and under the gumline. These are areas that a toothbrush cannot reach. Correct technique is important.
The following suggestions may help:
  1. Break off about 18 inches of floss, and wind most of it around one of your fingers. Twist the remaining floss around the same finger of the other hand. As you use the floss, you will take up the used section with this finger.
  2. Hold the floss tightly between your thumb and forefingers, with about an inch of floss between them, leaving no slack. Use a gentle 'rocking' motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.
  3. When the floss reaches the gumline, curve in into a C-shape against one tooth until you feel resistance.
  4. Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum. Repeat on the other side of the gap, along the side of the next tooth.
  5. Don't forget the back of your last tooth.
When flossing, keep to a regular pattern, start at the top and work from left to right, then move to the bottom and again work from the left to right. This way you're less likely to miss any teeth. At first it also helps to look in the mirror.

Alcohol and tobacco

Drinking alcohol and smoking or chewing tobacco are associated with an increased risk of developing mouth cancer.
Smoking also stains the teeth and increases the risk of gum disease and tooth loss. Alcoholic drinks, and the mixers used with them, often contain lost of sugar, and so increase the risk of tooth decay.

Dentist and hygienist

Dentists and hygienists play an important role in preventing problems such as tooth decay, gum disease and erosion. At check-ups, they will be able to detect any problems early, and provide advice and treatment.
Your dentist will give you advice about how often you should have a check-up. For adults, this can vary from six months upwards. For people with healthy mouths they may be advised to return every two years.
Children, and adults who are at high risk of developing dental disease, need to see a dentist more often. You may be at high risk if you smoke, have a diet high in sugar, or have had lots of dental treatment in the past. Even thorough brushing and flossing can't remove every trace of plaque. Most people have irregularities in their teeth where plaque can build up out of reach and harden into tarter. This can only be removed by a dentist or hygienist using special tools in a process called scaling. Polishing, using a rotating brush and abrasive paste, removes stains from teeth.
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Editor: Ryan Cranston

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All content within this article is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. Health Matters is not responsible or liable for any diagnosis made by a user based on the content of the Health Matters website. Health Matters is not liable for the contents of any external internet sites listed. Always consult your own GP if you're in any way concerned about your health.

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