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Caring for your teethPublished by BUPA's health information team, healthinfo@bupa.com, June 2007. This factsheet is for people who would like information about caring for their teeth. We need teeth to chew food and speak clearly. They also affect the appearance of your face and smile. It's very important to look after them well. Maintaining good oral hygiene, including toothbrushing and visiting your dentist or hygienist regularly, is a crucial part of caring for your teeth.
Tooth decaySoon after brushing your teeth, a thin, sticky layer forms on the surface of all your teeth. This layer contains many bacteria and is called plaque. 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 surface covering the tooth (enamel) to slowly produce a cavity (demineralisation). 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 white substance underneath the enamel that forms the bulk of a tooth. Dentine is sensitive to pain so you will feel advanced cavities, especially when eating or drinking hot, sugary or acidic things. Saliva helps to wash away and neutralise the acid. It also contains minerals to replace those lost from the enamel during acid attack (remineralisation). Demineralisation and remineralisation are repeated every time we eat or drink something sugary. It's an ongoing battle between the acid and our saliva. If sugary food or drinks are consumed too often, the saliva doesn't get long enough to fully remineralise the teeth, making tooth decay more likely. Gum diseaseGum disease is very common, affecting most adults in the UK to some degree. When plaque remains on the teeth for too long, it collects near your gums and turns into a hard substance called tartar (or calculus). Tartar, and plaque, causes your gums to become irritated, red and swollen. This is the early stage of gum disease and is called gingivitis. The most common sign of gingivitis is your gums may bleed when you brush them. This should be a sign you need to clean you teeth more thoroughly rather than less. If gingivitis isn't treated, the tissue and bone supporting the teeth is gradually lost. This is called periodontal disease. After a long time teeth affected by periodontal disease can become wobbly, and may eventually fall out. To prevent gum disease you need to regularly brush your teeth and clean between your teeth with floss or interdental brushes. This reduces the build up of plaque and tartar. Dental erosionDental erosion is the loss of the enamel, caused by acid attacking the surface of your teeth. This time the acids aren't from bacteria. Instead, they usually come from drinks such as fruit juices, fizzy drinks and squashes - even fizzy water. These drinks are so popular that nearly half of the children in the UK have some dental erosion by the age of six. Dental erosion is irreversible and can result in sensitivity and pain if the dentine becomes exposed. This also makes tooth decay more likely, and it can be unsightly as eroded areas of teeth are darker. Erosion can be prevented by drinking acidic drinks less often, and only at meal times. You may be able to reduce the amount of contact your teeth have with acidic liquids by drinking through a straw. How to look after your teethMaintaining good oral hygiene is critical to prevent tooth decay and gum disease. This means cleaning your teeth twice a day with a fluoride toothpaste, visiting the dentist and hygienist regularly and controlling how often you consume sugar. Brush your teethBrushing is the most effective way of removing plaque. Here are some tips for getting the most benefit out of toothbrushing:
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. You must clean every surface of every tooth and a small toothbrush, whether electric or not, will help. Clean between your teethDental floss or interdental brushes remove plaque and particles of food from between the teeth and under the gumline. These are areas that a toothbrush can't reach. Correct technique is important, so ask for advice from your dentist or hygienist. You may find interdental brushes easier and more convenient than floss. Consider mouthwashFluoride mouthwashes can help to prevent tooth decay. Some antiseptic mouthwashes reduce the number of plaque bacteria and help prevent gum disease. If you are regularly using mouthwash to freshen your breath, talk to your dentist for advice, as this may be sign of poor oral hygiene. Always read the instructions on the box or bottle. Chew gumChewing sugar-free gum after a meal stimulates the production of saliva, which helps to neutralise plaque acid. Some chewing gums contain a sugar-free sweetener called xylitol, which suppresses certain types of plaque bacteria. Research is currently looking at whether this prevents decay. Control sugar in your dietSugary foods and drinks encourage tooth decay. But it's how often these sugars are eaten - rather than the amount - that is important. Avoiding sugars between meals gives your teeth a chance to be remineralised by saliva. Limiting sugar between mealtimes is particularly important for children. Children who eat sweets or drink sugary juice over a long period are more likely to develop tooth decay. It's also good for your general health to reduce your sugar intake. Don't frequently eat acidic food or drink, like fizzy drinks or citrus fruit juice, as these also encourage tooth decay and erosion. Alcohol and tobaccoDrinking alcohol and smoking or chewing tobacco is 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 lots of sugar, and also increase the risk of tooth decay. Visiting the dentist and hygienistDentists 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. DentistsYour dentist will give you advice about how often you should have a check-up. For adults, this should be at least once a year. 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. HygienistsEven thorough brushing and flossing can't remove every trace of plaque. Most people have irregularities in their teeth where plaque can accumulate out of reach of brushing and harden into tartar. This can only be removed by a dentist or hygienist using a special scaling instrument. Polishing, using a rotating brush and abrasive paste, removes stains from teeth. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Jason Leitch BDS FDRCS (Eng) FDSRCS (Ed) FDSRCPS (Glas) DDS MPH (Harvard), lecturer/honorary consultant at the University of Glasgow Medical School and fellow of the Health Foundation/Institute for Healthcare Improvement, and by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: June 2007. Expected review date: June 2009.
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