Health Advice

It is important that you brush last thing at night and at least one other time during the day, with a toothpaste containing fluoride.

It is especially important to brush before bed. This is because of the flow of saliva, which is the mouth’s own cleaning system, slows down during the night and this leaves the mouth more at risk from decay.

Eating and drinking foods containing sugar and acids naturally weakens the enamel on your teeth. Brushing straight afterwards can cause tiny particles of the weakened enamel to be brushed away. It is best not to brush your teeth until at least one hour after eating.

It doesn’t matter whether you use an electric or manual toothbrush. They’re both equally as good, as long as you brush all the surfaces of all your teeth for two minutes and you use fluoride toothpaste. However, some of our patients find it easier to clean their teeth thoroughly with an electric toothbrush as it has a built-in timer which encourages cleaning for the right amount of time.

For most adults, a toothbrush with a small head and a compact, angled arrangement of long and short round-end bristles is fine. The small head makes it easier to get to all of the nooks and crannies especially towards the back of the mouth and the inside surfaces. Soft or medium bristles are best for most people.

If you are considering using an electric brush, research shows one with an oscillating or contra-rotating head may work better than a manual toothbrush. Three useful features to have would be:-

• Two minute timer
• Thirty-second interval timer. This feature helps you give an equal amount of time when dividing the area of the mouth into four zones i.e. two zones in each jaw. Thirty seconds would be devoted to each quadrant of the mouth. Your brush indicates each thirty-second chunk of time by briefly changing frequency or buzzing/beeping.
• Pressure sensor – to avoid applying too much pressure when brushing.

However, making sure you thoroughly clean your teeth at least twice a day is more important than the type of brush you use. If in doubt, please ask your dentist.

It’s important to use a toothpaste with the right concentration of fluoride. Check the packaging to find out how much fluoride each brand contains.

• Adults should use a tooth-paste that contains at least 1,350 parts per million (ppm) fluoride.
• Children under the age of three should use a toothpaste containing 1000 parts per million of fluoride. Children three years old and above can use family toothpaste if they are happy with the flavour, as long as it contains 1,350-1,500ppm fluoride. However,some children will prefer to continue with the milder flavour of a “children’s toothpaste”. Children aged six and under who don’t have tooth decay can use a lower-strength children’s toothpaste, but make sure it contains at least 1,000ppm fluoride.
• Below the age of three, children should use just a smear of toothpaste. Children aged three to six years should use a pea-sized blob of toothpaste. Make sure children don’t lick or eat toothpaste from the tube.

Your dentist may advise you or your child to use a toothpaste with a higher concentration of fluoride if you need it.

Make sure you brush all the surfaces of all your teeth, which should take about two minutes. Divide the time evenly by spending one minute on all of the surfaces of the upper teeth and one minute on all of the surfaces of the lower teeth. A rotating sweeping action is best for the vertical surfaces as the brush will sweep from the tooth onto the gum junction with the tooth. Remember to brush the inside surfaces, outside surfaces and the chewing surfaces of your teeth.

Children need to be helped or supervised brushing their teeth until they’re at least seven years old.

After brushing, spit out any excess toothpaste. Don’t rinse your mouth immediately after brushing, as it will wash away the concentrated fluoride in the remaining toothpaste, thus diluting it and reducing its preventative effects.

Mouth-rinses can be useful in certain specific situations but when it comes to cleaning plaque from your teeth and gums, brushing and flossing are best.

Nothing beats brushing and flossing at removing plaque.

Research shows the harmful bacteria in plaque are very vulnerable to physical “attack” with a toothbrush or floss but they are not so vulnerable to chemical “attack” from a mouthwash.

Fluoride mouth-rinses are useful. Using a mouthwash that contains fluoride can help to prevent tooth decay, but don’t use mouthwash – even a fluoride one – straight after brushing your teeth or it will wash away the concentrated fluoride in the toothpaste left on your teeth (even if the mouthwash has fluoride, your toothpaste’s fluoride is more effective at protecting teeth). Choose a different time to use mouthwash, such as after lunch. Don’t eat or drink for 30 minutes after using a fluoride mouthwash.

There are other specific conditions and situations where different types of mouthwash can be very beneficial – your dentist or hygienist will advise you.

Flossing isn’t just for dislodging food wedged between your teeth. Regular flossing may also reduce gum disease and bad breath by removing plaque that forms along the gum line between the teeth. It’s best to floss before brushing your teeth.

• Take 12-18 inches (30-45cm) of floss or dental tape, and grasp it so you have a couple of inches of floss taut between your hands.
• Slip the floss or dental tape between the teeth and into the area between your teeth and gums, as far as it will comfortably go.
• Floss with 8-10 strokes, up and down between each tooth, to dislodge food and plaque.

You can use interdental brushes or single-tufted brushes instead of flossing, especially if there are gaps between your teeth. The brush should fit snugly between the teeth. It’s best to use interdental brushes before brushing your teeth.

Never use toothpicks to remove trapped food from between your teeth, as you may damage your gums, which could lead to an infection. Your dentist or hygienist can advise you on the best way to use interdental cleaning for your teeth.

All sugars can cause decay. Sugar can come in many forms. Usually, ingredients ending in ‘ose’ are sugars, for example, sucrose, fructose and glucose are just three types. These sugars can all damage your teeth and leads to fillings or even extractions. Decay happens when sugar reacts with the bacteria in plaque. This forms the acids that attack the teeth and destroy the enamel.

After this happens many times, the tooth enamel may break down, forming a hole or ‘cavity’ into the dentine. The tooth can then decay more quickly.

Many processed foods have sugar in them, and the higher up it appears in the list of ingredients, the more sugar there is in the product. Always read the list of ingredients on the labels when you are food shopping.

When you are reading the labels remember that ‘no added sugar’ does not necessarily mean that the product is sugar-free. It simply means that no extra sugar has been added. These products may contain sugars such as those listed above, or the sugars may be listed as ‘carbohydrates’. Ask your dental team if you are not sure.

Acidic food and drinks can cause erosion – the gradual dissolving of the tooth enamel. Many healthy foods such as citrus fruit are acidic. Listed below are the acidity levels or ‘pH values’ of some food and drinks. The lower the pH number, the more acidic the product. Anything with a pH value lower than 5.5 may cause erosion. ‘Alkalis’ have a high pH number and cancel out the acid effects of sugars. PH 7 is the middle figure between acid and alkali.

• mineral water (still) pH 7.6
• milk pH 6.9
• cheddar cheese pH 5.9
• lager pH 4.4
• orange juice pH 3.8
• grapefruit pH 3.3
• pickles pH 3.2
• cola pH 2.5
• red wine pH 2.5
• vinegar pH 2.0

When eating or drinking anything with a high acid content it is best to avoid brushing until at least one hour afterwards. Also try to avoid repeated acid attack from food and drink throughout the day. For example it is better to eat the segments of an orange within a few minutes rather than ‘snack’ on one segment per hour.