Dental Disease Prevention and Home Care
Use a soft toothbrush and brush at a 45 degree angle to your teeth, wiggling the brush up and down. Avoid scrubbing the gum line area too hard, as it can cause erosion, or wearing away, of the gums.
Toothbrushing should not be performed immediately after consuming acidic food or drink since it can contribute to erosion if the tooth enamel is soft from exposure to acid. It is better to rinse with water right after an acidic food exposure and wait a while to brush.
Either waxed or unwaxed floss can be used as a matter of preference, unless a dental professional recommends a specific type for an individual concern. One brand of floss that we particularly like is Glide floss. To floss, work the floss between the teeth and bend the floss to make a "C" each way - forward and backward - to access the hard to reach area near the gum line.
Oral Irrigation Devices
There is renewed evidence that oral irrigation devices can help alter biofilm. While studies have shown that irrigation does not effectively remove plaque as does a toothbrush, it does help to control inflammation, affect bacteria within plaque, alter the thickness of plaque, and improve immune response. These mechanisms of oral irrigation have resulted in improvement in periodontal conditions, with reduction in bleeding and of periodontal pocket depths. The Water Pik ® brand of oral irrigation device has received the ADA Seal of Acceptance.
Orthodontic Home Care
Teeth require special care when orthodontic braces are in place. Toothbrushes made especially for orthodontic use are shaped to have the best effect around braces. In addition, floss threaders must be used to clean where floss cannot go because of orthodontic wire. A fluoride rinse or gel is also strongly recommended for use while brackets are in place. It is very important to have this special oral hygiene demonstrated by a dentist or hygienist as soon as orthodontic treatment begins.
Care of night guards or other appliances
Nightguards and other plastic appliances should be brushed with a toothbrush after use and kept in a case. Cleaning the appliance occasionally with an antimicrobial rinse such as Listerine can be effective for disinfection. Keep the appliance away from heat or direct sun to prevent any warping of the plastic, and never leave appliances on a counter or wrapped in a paper towel since they can easily be discarded by someone else.
Fixed Bridge Care
Since bridges are connected, regular floss cannot be used. Floss threaders, which are thin yet firm plastic loop holders for floss, allow access to the hard-to-reach area with floss. Another product, called a Proxibrush, which has a small bristle area at the tip, also allows one to get into the area under the false tooth area of the bridge to clean. An intraoral irrigation device such as Water Pik ® can also help remove food particles under a bridge. It is important to have proper care of a bridge demonstrated by a dentist or hygienist.
Care of Partial or Full Dentures
The use of a commercially available product with the ADA seal is usually the safest way to keep partials and full dentures clean and disinfected. Home recipes for cleaners or use of household cleaners can cause corrosion of the metal parts of a partial denture. We also recommend removing partial or full dentures at night to give the supporting tissues a rest.
Care of Implants
Implants should be brushed and flossed like normal teeth, but caution should be used because the titanium in them is a soft metal that is easily scratched or abraded. Anyone with implants should take special care to use gentle products when cleaning implants, as advised by the dentist or hygienist.
Products Available for Home Care
There are so many products available for home use that we felt it was a good idea to go over which products make sense and which are a waste of money. We have also briefly described the basic processes of caring for teeth and gums, but it is always a good idea to have these methods demonstrated personally by a dental professional.
ADA Seal of Acceptance
The American Dental Association conducts testing of many dental products to determine if claims made are accurate and to approve the product as safe and effective for oral heath cares. The ADA seals have been awarded to toothbrushes, toothpastes, at-home whitening products, an emergency tooth preservation kit, floss and interdental stimulators, mouthrinses, sugar-free chewing gum to prevent cavities, topical brush-on fluoride gels, and water filters that don’t remove fluoride. We encourage patients to visit the website at http://www.mouthhealthy.org/en/ada-seal-products/ make hyperlink for up-to-date information on dental products.
There are many different gimmicks with toothbrushes today, but the only important point to note is to choose a soft toothbrush to avoid too much abrasion when brushing. Buy the right size toothbrush; a rounded tip may be more comfortable. Other factors such as bent tips, special alignments of bristles, and other unique qualities are all just a matter of personal preference. Some very inexpensive toothbrushes may not have smoothly finished bristles and can be uncomfortable. We advise checking for current ADA Seals when shopping for a new toothbrush. It is important to keep a toothbrush clean. Rinse after using and keep in an upright position to air dry. Do not routinely keep toothbrushes covered as that can contribute to microorganism growth. Toothbrushes should be replaced every three-four months, or when bristles appear frayed.
These toothbrushes can be very helpful for people with braces, or with people who have limited dexterity. Recommendations for the best brand for individual problems can be made by a hygienist.
Any fluoride toothpaste with the American Dental Association seal has been proven to be effective at preventing cavities and is recommended. Some extra whitening toothpastes are abrasive and are not recommended. Some tartar control toothpastes may increase cold sensitivity in teeth. The hygienist can help determine the correct toothpaste to use for any specific problems.
Rinses and Gels
Mouth rinses or gels are marketed to provide fluoride to resist decay or to reduce tooth sensitivity, to control bad breath, reduce gingivitis, or alleviate dry mouth. Below are descriptions of some that are recommended at our office. As with other dental products, we advise checking for the ADA Seal for any products purchased.
Phosflur® is a strong fluoride rinse designed for patients who have poor resistance to decay and can also be used to alleviate the problem of sensitive teeth.
Gel-Kam® is a prescription strength gel form of fluoride, used to treat tooth sensitivity or for patients with excessive decay.
Fluoride rinses such as Act® are fluoride rinses with a lower concentration of fluoride than Phosflor, as described above. They may be helpful in preventing cavities.
Peridex® is chlorhexidine gluconate, an antimicrobial rinse that is used in periodontal therapy or for treatment of soft tissue infections.
Listerine® is an antimicrobial rinse that does have some effect on the bacteria that cause gingivitis. Other mouthwashes that advertise to help bad breath may help in some cases, but if bad breath is a continual problem it is best to have an evaluation made at the dental office since bad breath is often an indicator of other serious problems such as periodontal disease. Any mouth rinse used should be alcohol-free because alcohol is known as a risk factor in oral cancer and products containing it should not be swished around the mouth.
Biotene® rinse is used to alleviate dry mouth that occurs as a side effect of many medications and as a symptom of some medical conditions.
Tooth Whitening or Bleaching Products
Any tooth whitening product purchased over-the-counter for at-home use used should have an American Dental Association Seal of Approval. Some products can be unpredictable and can affect soft tissue, and are often not as effective as the products prescribed by the dentist. For patients who are interested in tooth whitening, at our office we can check patients’ oral conditions to make sure there are not contraindications for whitening, and can provide prescription-strength options for administration in-office or at-home.
Interproximal Brushes/ Interdental Stimulators
Interproximal brushes are used to clean between teeth when floss can’t be used, as in the case when fixed bridges or orthodontic wires prevent access. Interdental stimulators may be advised for specific oral conditions.
These are handles that allow floss to be used in back teeth areas where it can be hard to reach otherwise. These can be helpful for people with very large hands or for those with arthritis who have trouble reaching their back teeth.
As described in bridge care and orthodontic care, this product allows flossing access to clean around orthodontic wires or bridge pontics (the false tooth part of the bridge). Threaders are a requirement for anyone with either full orthodontic brackets or a fixed bridge.
Electric Periodontal Products
Periodontal irrigators are recommended to help deliver antibacterial solutions to the periodontal area. Specific recommendations as to the best product for individual problems can be made by a hygienist.
These are used to clean plaque from the tongue area and have been advised for some people who have bad breath. There is no problem in using one, but they are not generally necessary for oral care. Anyone who has bad breath should be evaluated by the dentist, as this condition can be a symptom of more serious dental problems.
Purchased mouthguards to be used for sports can be appropriate to prevent injury. We strongly recommend the use of mouthguards for any contact sport, as we are constantly repairing chipped teeth in young people who were not wearing these appliances. Mouthguards can also be custom-made at our office.
There are many good commercial products available. Always check for the American Dental Association seal of approval.
The need for denture adhesives is usually a sign of an improper fitting denture, and it should probably be remade. There are some cases where the dentist may recommend an adhesive but professional evaluation of the denture is the best way to decide the proper course of action.
Toothache Drops or Gels
Some products that contain the active ingredient oil of cloves may give temporary relief from some toothaches but are not a substitute for dental care. Products containing oil of cloves should not be used for infant teething.