We are often asked about how to clean teeth, and while many feel that this is a routine thing to do, an article published by Which magazine suggested that 40% of people don’t brush their teeth every day. The problem with this is that it leads to a build-up of plaque, a sludge produced by bacteria which live in our mouths. Plaque sticks to our teeth and if left there for long enough, can cause holes to develop in our teeth, staining, gingivitis and in 10% of the population, bone loss. The breakdown products of things in our mouth become smelly and of course this leads to bad breath.
So there are many reasons why brushing is important. We recommend brushing at least twice each day for at least two minutes. The most important time for the health of the teeth and gums is before bed at night and then socially, it is important in the morning. There is still a health benefit to brushing in the morning of course.
Toothbrushes can vary a lot but use what works for you. It is always best to buy a well-known make such as Oral B, Sensodyne or other well known makes. If there is a BDA logo, it means that the British Dental Association have acknowledged the product as being a good one to use.
Electric toothbrushes are generally more effective than manual brushes but should still be used for at least two minutes. The best ones to use are those with an App, which can be used to give you feedback on how well you are brushing.
Using a fluoride toothpaste or tablet is also important. This gives added protection to the teeth, the agent is designed to froth and allow debris and plaque to be removed from the teeth and the fluoride gives added protection to the enamel. When finishing brushing it is better to just spit the debris out but there is no need to rinse. If you just spit out, this will leave a film of protective agent on the surface of the teeth, giving added protection.
Mouthwash can be useful but not as an alternative and better used at other times of the day. So if brushing in the morning and at night, why not just mouth rinse lunch and evening meal. Cleaning is better carried out 20 minutes after meals because often the mouth becomes more acid particularly if drinking fruit juice. By waiting 20 minutes a small film of enamel dissolved into solution over the surfaces of the enamel can safely return to the tooth as the mouth buffers the saliva, making it more neutral.
Cheese is also a good thing to have at the end of a meal!
Flossing is another addition to cleaning and is best carried out each day at the end of the day. It means any food deposits and other debris that have developed between the teeth during the day can be removed before going to sleep. This is a time where the saliva flow in our mouths drops and thus allows bacteria to do more damage to our teeth.
For some people an interspace brush can be more useful, particularly if there is some gum recession. We have small triangular spaces between our teeth and so passing an interspace brush through them (We suggest Tepe brushes which have different sizes) can really help to remove bits safely.
Now of course we are an orthodontic practice in Birmingham and many people come to see us to have braces fitted and this will affect the cleaning regimen. The most commonly used orthodontic appliances are commonly known as fixed braces fitted to the outside of the teeth. They can be made in metal or ceramic material and become a barrier to cleaning. As they can be in place for a few years, good cleaning is essential, so if you don’t use an interspace brush, you will probably need to with a fixed brace.
Floss can still be used but just take more time because it needs to be threaded under the archwire that connects the brace together. The most important area to keep clean is the channel between the gum and the brace. This area can get really furred up quickly and will lead to swollen gums that become very difficult to control. If this happens then removing the brace becomes the only alternative. By this time damage may have already occurred to the teeth or gums, so prevention by good brushing from day 1 is the best policy.
Sometimes we use elastics which become stained with food and liquids, going bright yellow. This is not damaging to the teeth, but sometimes, just changing the elastics is all that is needed.
Lingual braces are similar in structure to the fixed braces we normally see. They are stuck on the inside surfaces of the teeth, so they are more difficult to clean. The brackets are also quite close together on the front teeth. Using a mirror can help but interspace brushes and floss are also very useful. We can help by showing you how to use these if necessary.
With Invisalign braces you can just take the aligners out to brush them and so it is more about the cleaning agents used to keep the Aligners clean. Invisalign do produce some cleaning crystals which can be used to keep them clean. When brushing them, always use cold water otherwise they aligners can become distorted.
With Removable Braces, like Invisalign, you can take the brace out to clean your teeth and so using a brace cleaner is possible for the brace. Products such as Brace Mate and Retainer Brite are very useful but Milton can also be used and is very effective but should only be used for 10 minutes because otherwise the wires can start to go rusty.
Bonded Retainers which are stuck to the back of the front teeth need to be cleaned around with a toothbrush. Floss can still be used but only down to the level of the bonded retainer. Superfloss can also be used. Oral B produce a good one. This can be pushed between the teeth and can then allow one to clean in the areas under the bonded retainer. Also, insterspace brushes can be used. It is worth remembering not to put too much force on the retainer wire when cleaning.
Some people have more of a tendency to build up plaque and calculus (the hard deposits on our teeth (which toothpaste companies tend to use a 19th-century term “Tartar”). This means more regular visits to see a hygienist. Visits should normally be every 6-12 months but see your dentist for advice on how often you need a scale and polish. Remember to follow your dentist’s advice. If your gums start bleeding when brushing, this is normally a sign that you are not brushing enough!