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Getting Stuck In – The low-down on flossing and interdental cleaners

While tooth brushing is almost a universal practice amongst prople everywhere, interdental cleaning, including the use of dental floss is not practiced regularly by the majority of the population. Everyone should carry out dental flossing which is the most widely used interdental cleaning method. Tooth brushing, no matter how well it is performed, is unable to dislodge dental plaque in the interproximal areas where teeth contact each other. This is another vital area for gum health, as serious gum disease will often progress from this spot in the 10-15% of the population who are susceptible. Even those who are not susceptible to serious gum disease may experience localised gum infections that will respond to good oral hygiene practices including brushing and flossing.

How to use dental floss:

Step 1: Release 12 to 14 inches from the spool of floss.

Step 2: Wrap floss around both middle fingers leaving about 3 inches free.

Step 3: Use thumb of left hand and forefinger of right hand to guide the floss between contact points of the front teeth upper and lower.

Step 4: Use a sawing action to gently guide the floss down and up the side of each tooth, this removes the plaque effectively.

Step 5: For the back teeth use both forefingers to guide the floss into the contact points and use the sawing action to guide the floss up and down the side of each tooth.

Some people may find this task difficult especially if their manual dexterity is compromised in any way. There are several types of flossing aids with handles that make this easier. Dental floss should always be used with great care as rough handling could damage your gums; the sawing action protects against any unnecessary force being used. When gum disease is already established and the gum has receded from the interproximal area between neighbouring teeth, dental floss is no longer as effective. Interdental brushes are an effective substitute to dental floss and can be bought in a wide variety of sizes to fit exactly into the interdental spaces.

Don’t forget to clean your tongue:

The main benefit of tongue cleaning on oral health is to eliminate and prevent bad breath (halitosis). In individuals who have good gum health the accumulation of bacteria on the back of the tongue are the main sources of sulfide gases which are responsible for malodour giving rise to bad breath. Tongue brushing is highly recommended for individuals suffering from halitosis. Tongue cleaning may also benefit as part of the treatment of gum disease in helping to reduce the overall amount of pathogenic bacteria in the mouth.

Oral Health Nutrition

At any age, a complete oral health home program includes sound nutritional habits. Many of the foods that help your body build strong muscles and bones also help build strong, healthy teeth and gums.

Dairy products provide calcium and vitamin D for strengthening teeth and bones.
Bread and cereals supply B vitamins for growth and iron for healthy blood, which in turn contributes to healthy gum tissue.
Fruits and vegetables containing vitamin C (among other important vitamins) are essential to maintaining healthy gums.
Lean meat, fish, poultry and beans provide iron and protein for overall good health, and magnesium and zinc for teeth and bones.
And if you are among thousands of Irish people who smoke, your dental hygienist will educate you about the hazards of tobacco and work with you to establish a smoking cessation program.

Gum Disease

Periodontal Disease (Gum Disease) is caused by a bacterial infection.

In its early stages it is called gingivitis and this is totally reversible. However, if this is left untreated it can lead to periodontal disease which effects the gum tissues, bone and supporting tissues of the teeth.

Warning Signs:

Bad taste in the mouth
Bad breath
Red or swollen gums
Tender gums
Bleeding gums
Loose teeth
Sensitive teeth
Pain when chewing
Pus around the teeth and gums
Tartar (brown hard deposits) forming on the teeth

Prevention:

Visit the dental hygienist regularly
Good oral hygiene
Don’t smoke
Having a nutritional balanced diet

Adolescent Oral Health

Good nutrition and oral hygiene care practised at home are particulary important during the teen years. Proper diet, brushing and flossing play an important role in maintaining a healthy smile and preserving teeth during these challenging years.

Cavities and periodontal disease can be a threat to teens as well as adults. Recent survey results show that bleeding gums were most prevalent among adolescents.

Our dental hygienists recommend these tips:

Be sure to brush thoroughly after meals whenever possible and floss daily. Busy schedules and activities can encourage snacking. That is why choosing a proper diet will help you to maintain and preserve your teeth.
If you wear custom-made appliances, or braces, pay special attention to keeping spaces between the teeth and wires clean by using floss threaders. Orthodontic toothbrushes are specially designed to make cleaning teeth and braces easier.

Proper Brushing

Proper 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.

Place bristles along the gumline at a 45-degree angle. Bristles should contact both the tooth surface and the gumline.
Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating back and forth rolling motion. Move the brush to the next group of 2-3 teeth and repeat.
Maintain a 45-degree angle with the bristles contacting the tooth surface and gumline. Gently brush using back, forth and rolling motion along all of the inner tooth surfaces.
Tilt the brush vertically behind the front teeth. Make several up and down strokes using the front half of the brush.
Place the brush against the biting surface of the teeth and use a gentle back and forth scrubbing motion. Brush the tongue from back to front to remove odor-producing bacteria.
Remember to replace your toothbrush every three months. Researchers have established that thousands of microbes grow on toothbrush bristles and handles. Most are harmless, but others can cause cold and flu viruses and bacteria that can cause periodontal infections.

Top Tip Guide For 2011

For consistent cleaning, brush your teeth and gums at the same time everyday, e.g. before breakfast and before going to bed.
Only use the recommended amount of toothpaste and ensure all teeth and gums are cleaned thoroughly. You can use different sized interdental brushes to clean plaque from inaccessible areas. Use plaque check tablets weekly to check if your technique is good.
Make a special effort to quit smoking. Smoking is a major cause of bad breath, stained teeth, tooth loss and oral cancer.
Change your toothbrush every three months. Remember a toothbrush is not for life, it’s just for three months.
Make sure to floss twice daily.
Use a high quality toothpaste that provides protection for your teeth and gums.
Reduce your intake of high sugar content foods. Keep snacks between meals to low-sugar or sugar-free foods.
Make a resolution to visit your dentist regularly so that small problems can be resolved before they become bigger, more complicated and expensive.
Arrange preventative fissure sealants for children reaching the age of six or seven as directed by the dentist. Follow up at six months intervals.
If you notice ulcers or lumps in your mouth or neck persisting for more than a week, arrange to have an oral cancer screening appointment with the dentist.

Dental Health and Your Child’s Teeth

The following chart shows when your child’s primary teeth (also called baby teeth) should erupt and fall out. It is important to note that eruption times can vary from child to child.

Primary Teeth Development Chart

Upper Teeth When tooth emerges When tooth falls out

Central Incisor 8 to 12 months 6 to 7 years

Lateral Incisor 9 to 13 months 7 to 8 years

Canine 16 to 22 months 10 to 12 years

First Molar 13 to 19 months 9 to 11 years

Second Molar 25 to 33 months 10 to 12 years

Lower Teeth

Central Incisor 6 to 10 months 6 to 7 years

Lateral Incisor 10 to 16 months 7 to 8 years

Canine 17 to 23 months 9 to 12 years

First Molar 14 to 18 months 9 to 11 years

Second Molar 23 to 31 months 10 to 12 years

As seen from the chart, the first teeth begin to break through the gums at about 6 months of age. Usually, the first two teeth to erupt are the two bottom front teeth (central incisors). Next, the top four front teeth emerge. After that, other teeth slowly begin to fill in, usually in pairs – one each side of the upper or lower jaw until all 20 teeth (10 in the upper jaw and 10 in the lower jaw) have come in by the time the child is 2 and a half to 3 years old. The complete set of baby teeth is in the mouth from the age of 2 and a half to 3 years of age to 6 to 7 years of age.

A general rule of thumb is that for every 6 months of life, approximately 4 teeth will erupt. Girls generally precede boys in tooth eruption. Lower teeth usually erupt before upper teeth. Baby teeth are smaller in size and whiter in colour than the permanent teeth that will follow.

Shortly after age 4, the jaw and facial bones of the child begin to grow, creating spaces between primary teeth. This is a perfectly natural growth process that provides the necessary space for the larger permanent teeth to emerge. Between the ages of 6 and 12, a mixture of both primary teeth and permanent teeth reside in the mouth.

While it’s true that primary teeth are only in the mouth for a short period of time, they play a vital role in the following ways:

They reserve space for the permanent teeth
They give the face its normal appearance
They aid in the development of clear speech
They help attain good nutrition (missing or decayed teeth make if difficult to chew causing children to reject foods)
They help to give a healthy start to the permanent teeth (decay and infection in the baby teeth can cause dark spots on the permanent teeth developing beneath it)

Permanent Teeth Eruption Chart

Upper Teeth When tooth emerges

Central Incisor 7 to 8 years

Lateral Incisor 8 to 9 years

Canine 11 to 12 years

First Premolar 10 to 11 years

Second Premolar 10 to 12 years

First Molar 12 to 13 years

Wisdom Teeth 17 to 21 years

Lower Teeth When tooth emerges

Central Incisor 6 to 7 years

Lateral Incisor 7 to 8 years

Canine 9 to 10 years

First Premolar 10 to 12 years

Second Premolar 11 to 12 years

First Molar 6 to 7 years

Second Molar 11 to 13 years

Wisdom Teeth 17 to 21 years

Very often the central incisors will come into the mouth inside the baby teeth. This is not unusual and they will be pushed forward by the tongue as they come into the mouth. Permanent teeth begin to come in around the age of 6. In some children, the first permanent molars are the first to emerge, in others the incisors are the first to emerge. By the age of 13, most of the 28 permanent teeth will be in place. One to four wisdom teeth emerge between the ages of 17 and 21, bringing the total number of permanent teeth up to 32.

Fallacies About Gum Disease

Get the facts about this serious infection to save your teeth and protect yout health.

FALLACY: Tooth loss is a natural part of aging.

FACT: With good oral hygiene and regular professional care, your teeth are meant to last a lifetime. However, if left untreated periodontal (gum) disease can lead to tooth loss. It is a primary cause of tooth loss in adults 35 and over.

FALLACY: People who have gum disease are “dirty” and don’t brush their teeth.

FACT: Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease.

FALLACY: Gum disease doesn’t affect overall health.

FACT: Emerging research links periodontal disease to other health problems including heart and respiratory diseases; preterm, low birthweight babies; stroke; osteoporosis; and diabetes.

FALLACY: Gum disease is a minor infection.

FACT: The mass of tissue in the oral cavity is equivalent to the skin on your arm that extends from the wrist to the elbow. If this area is red, swollen and infected, you would visit your doctor. Gum disease is not a small infrection. Its result, tooth loss, leads to a very different lifestyle – dentures. The changes in your appearance, breath and ability to chew food are dramatic.

FALLACY: Bleeding gums are normal.

FACT: Bleeding gums are one of nine warning signs of gum disease. Think of gum tissue as the skin on your hand. Other signs of gum disease include:

Bleeding Gums
Red, swollen or tender gums
Sores in your mouth
Gums that have pulled away from the teeth
Pus between the teeth and gums (leaving bad breath)
Persistent bad breath
Loose or separating teeth
A change in the way the teeth fit together
A change in the fit of partial dentures

FALLACY: Treatment for gum disease is painful.

FACT: New periodontal procedures including local anesthesia and over-the-counter medications, have made patients’ treatment experiences pleasant and comfortable. Many patients find they are back to normal routines on the same day or by the next day.

FALLACY: Gum disease is easy to identify, even in its early stages, so my dentist would tell me if I had it.

FACT: Millions of people don’t know they have this serious infection that can lead to tooth loss if not treated. You should always get involved in your dental care, so that problems are detected in the early stages. You should inform your dentist if any signs of gum disease are present; or if any changes in your overall health or medications occurred in between visits. Most importantly, you should ask your dentist about your periodontal health and what method was used to evaluate its condition. This level of participation enables you to work in a team approach with your dentist to identify subtle changes that may occur in the oral cavity.

FALLACY: Once teeth are lost, the only treatment options are crowns, bridges or dentures.

FACT: Dental implants are a permanent tooth-replacement option for teeth lost to trauma, injury or periodontal disease. Dental implants are so natural-looking and feeling that many patients forget they ever lost a tooth.

FALLACY: Cavities are the number-one cause of tooth loss.

FACT: Periodontal disease is the number-one cause of tooth loss. According to the 1996 American Dental Association/Colgate survey, U.S. dentists say gum disease is a more pressing oral health concern than tooth decay by a 2-to-1 margin.

FALLACY: Because gum disease is a bacterial infection, antibiotics can be used to treat it.

FACT: Research demonstrates that antibiotics can be a helpful adjunct to treating periodontal disease. However, medical and dental communities are concerned about the overuse of these medications in treating infections because of the possibility of the development of antibiotic resistant strains of bacteria. This overuse would be detrimental to patients if they develop a life-threatening illness for which antibiotics would no longer be helpful.

FALLACY: Pregnant women should skip professional dental health checks.

FACT: Teeth and gums are affected during pregnancy like other tissues in the body. In order to decrease the risk of damaging the gums and tissues surrounding the teeth, pregnant women should schedule an appointment for a periodontal evaluation.

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