By: Prof. Dr. Aruni Tilakaratne, Dr. Goh Yet Ching
Have you ever experienced the clean, soothing feeling of your mouth after you brush your teeth? In fact, thorough brushing of your teeth does much more than soothe, but a fresh breath and a bright smile too!
Why we brush our teeth is to remove ‘plaque’, which is a sticky, whitish coating of bacteria adhering to our teeth and gum margin. Plaque is the main reason for gum disease and tooth decay. Bacteria in plaque becomes the culprit here, as they produce toxic products which irritate your gums, leading to gum disease. The early stage of gum disease is called ‘gingivitis’, it presents in general as redness of gum and bleeding during brushing, which can be reverted back to normal gum health, if proper preventive or treatment measures are followed without delay. However, the late stage of gum disease called ‘periodontitis’ is irreversible, as the tooth supporting structure underneath the gum (e.g., bone) gets destroyed. Eventually, the jaw bone can no longer hold the teeth in place, and the teeth become loose, and you may lose teeth!
Therefore, thorough plaque removal undeniably helps in maintaining good oral health status. In return, good oral health status rewards you with good general health too. This means, oral health is closely connected to the general health of the body, where severe gum disease has found ramifications with the commonly reported non-communicable diseases like diabetes and heart disease. Periodontal diseases have also been linked with poor pregnancy outcomes, causing adverse consequences to the mother and her baby.
Keeping your teeth and gums in good condition is simple enough, if you get into the habit of proper cleaning of the teeth every day. Twice daily toothbrushing (once in the morning after breakfast and then before going to bed) with a fluoride-containing toothpaste can keep you out of the common oral diseases like caries and gum disease. Fluoride is proven to help prevent tooth decay. However, the choice of fluoride toothpaste for young children should be balanced against the risk of fluorosis.
In the first place, effective toothbrushing is only possible, if you select the correct toothbrush. An important feature of a toothbrush is that it fits well into the size of the mouth, where the brush head (bristle part) is short enough (2.0-2.5cm for an adult) to place even in the areas of far back in the mouth. The bristles should also be soft and arranged evenly. Brush handle should have a good grip without slipping. When the bristles become curved and worn out, it is time to change your toothbrush. It is recommended to change your toothbrush in about every two to three months.
A new toothbrush removes up to 30% more plaque than a brush which is 3-months old. It is also essential to perform brushing in an orderly manner, where you start from one extreme corner of the jaw (upper or lower), and finish-off at the extreme corner of the opposite jaw. This is to ensure that cleaning of outside, inside and biting surfaces of all teeth is completed without missing any. It is important that you direct the toothbrush bristles towards the gum margin. You may also follow a brushing method recommended by your dentist. Generally, it takes about three minutes to remove plaque sufficiently.
Although brushing helps you remove most plaque, toothbrush in general fails to reach the tooth sites in between your teeth (interdental sites). Therefore, it is necessary to use interdental brushes or floss to clean these interdental sites daily. If not, you may be leaving as much as 40% of your tooth surfaces uncleaned. There are different modes to clean between teeth. Interdental toothbrushes, dental floss, soft rubber toothpicks, oral irrigators are some of the recommended modalities.
It would also be a good practice if you get your teeth checked by a dentist, once in every six months. During a dental check-up, your dentist is most likely to examine the teeth and gums. Your dentist may also professionally clean the teeth to remove hardened plaque (tartar) from teeth and below the gumline. Your dentist can also guide you with instructions on how to brush and use interdental brushes or floss. Additionally, a dental X-ray may be recommended, if any severe gum disease is suspected.
As you see, maintaining good oral health may not be as difficult as you thought. Healthy mouth and healthy body irrefutably boost your psychological health and overall well being.
Above all, “prevention is better than cure” is a universally-accepted rule of the thumb.
The authors are from the Faculty of Dentistry, Universiti Malaya, and may be reached at gohyetching@um.edu.my