Clean teeth are simultaneously healthy teeth and gums
Bacterial plaque is the main cause of dental problems
The surface of a tooth is an ideal place for the growth of bacterial plaque, a layer of a vast number of different bacteria with a tendency to accumulate, and to do so constantly. These bacteria are responsible for such complaints as tooth decay and periodontitis. Teeth are not capable of cleaning themselves, therefore they need our help on a daily basis. It is not enough to use an antibacterial mouthwash or good (advertised) toothpaste: bacterial plaque cannot be rinsed or lathered from the skin like dust. It may be compared to a deposit that forms on a stone in water, and is possible to remove solely by mechanical means. Most important then is brushing and flossing. We deal with it without the use of great force, and since teeth have an irregular shape, key to cleaning them is appropriate technique.
Brushing teeth, not cleaning
A brush is best when selected individually by a doctor, in that he or she takes into account the shape and firmness of the bristles. With the aid of the brush we clean the accessible surface of each tooth, beginning at the gum. This procedure should neither hurt nor harm the gum though the bristles do touch it. We apply the brush to the surface of the tooth at an angle of 45º, allowing us without effort to reach (partially) into the interdental space and the groove of the gum. A scrubbing-sweeping movement is used, running from the gum to the tooth (from 'pink to white'). We do not press too strongly in order to protect the enamel from excessive abrasion and the gum from injury.
The need to floss
A brush does not permit the precise cleaning of two of the five surfaces of a tooth: those touching the neighbouring teeth. In the meantime bacterial plaque is collecting. Flossing is necessary.
We insert a taut length of floss close to the gum in a zigzagging movement, such that the gum is not cut by an excessively strong vertical movement. When the floss clears the tangent point, we move it loosely toward the gum until we sense resistance. After this we pull the floss tight against the tooth and with a vertical movement, in continuous contact with the surface of the tooth, we drag out all that the floss encounters on its way. We enter every space twice, working separately on each of the two neighbouring surfaces. In summary, we run the length of floss inwards with a delicate sweeping movement and run it out vertically in firm contact with the tooth. The floss fulfils a similar role to a windscreen wiper on a car, seizing and dragging away everything but the healthy surface of the tooth.
If during cleaning the floss frays or breaks or there are difficulties withdrawing it, report to a dentist immediately. Possible causes are contact with the rough edge of an imprecise filling, tartar at a point out of sight or a cavity in the process of forming.
Interdental brushes – an important complement
Tooth shape is an individual matter and highly diversified, and it often happens that we find hollows on tangent surfaces, inaccessible to floss. For just such situations the interdental brush was created.
An interdental brush must always be selected individually by a doctor, since correct cleaning requires a correct size: too small and it will make no contact with the wall of the tooth, and thus fail to clean it; too large and it will cause discomfort and may damage the periodontium. We insert the brush right up against the gum and, in contact with the wall of the tooth, scrub horizontally.
Bleeding gums – am I doing something wrong?
Bleeding of the gums is always a symptom of inflammation. Very often with the first use of floss or an interdental brush the gums will bleed. This is a normal symptom. With time, and the permanent disappearance of toxic bacteria from the surface of the tooth, this bleeding will pass. As such, bleeding gums cannot justify an end to cleaning. It is important, however, that procedures for hygiene do not hurt, and if we feel pain or discomfort while cleaning or flossing, we must consult a doctor. Equally, a visit to a doctor is necessary should the bleeding not abate within two weeks.
Why toothpaste and mouthwash?
Toothpaste and mouthwash work only on a tooth surface that has been properly cleaned by mechanical means. Their effects vary according to composition, some reinforcing the surface of the tooth, some preventing oversensitivity and some having the effect of discouraging bacteria from recolonising. They fulfil an auxiliary role and this fact should be borne in mind.
Bad breath
An unpleasant smell emanating from the oral cavity is largely the product of bacterial changes.
The tongue too may be a reservoir of bacteria which can lead to bad breath. It is advisable to clean it with a movement running from back to front, with the scrapers designed for this purpose performing well.
In the case of the tongue the situation is a little better than in the case of the teeth. The tongue is capable of cleaning itself (though slowly) in that the epithelium which covers it peels off. That said, the bacteria which coat it cause very serious complaints such as tooth decay and periodontitis, as in the case of teeth.
Special cases – prosthodontics, implantology and orthodontics
Prostheses such as bridges, implants and orthodontic braces are a challenge in oral cavity hygiene. These form an additional impediment to cleaning and a site for retention of food remains and bacterial plaque. They require special cleaning implements, whether a single-tuft toothbrush, floss for bridges (of the Superfloss type) or a douche.
These implements reach into such recesses with greater ease. The douche fulfils an auxiliary role since the pressure of the stream is unable to remove bacterial plaque, solely food remains.
Professional prevention
A check-up should take place at the dental surgery at least twice per year, a dentist or hygienist assessing whether or not we are maintaining oral cavity hygiene. If necessary, they establish an individual procedure for the care of our teeth and help deal with possible neglect with scaling and fluoridation. It is better to prevent a complaint than to treat its effects.
