Brushing teeth at night

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7 Nighttime Tips for Improving Your Oral Health

A lot can happen to your mouth in eight hours — especially when you’re sleeping and bacteria are gathering on your teeth. But don’t let the thought of nasty plaque, cavities, tartar, or gingivitis stop you from getting a good night’s rest. There are many ways to maintain your oral health while you sleep. Here are eight tips to get you — and your mouth — through the night.

1. Brush before bed. Brushing your teeth before you go to sleep at night helps protect against plaque buildup, tooth decay, and gum disease. If you are particularly susceptible to cavities and gum disease, dentists recommend that you brush immediately after dinner, then again right before bedtime.

2. Use good form. According to dentists, the best way to clean your teeth is to brush back and forth gently in short strokes. Brush the outer tooth surfaces first, then the inner tooth surfaces, followed by the chewing surfaces. To clean the backs of your front teeth, use the tip of the brush and stroke gently up and down.

3. Switch to an electric toothbrush. The rotating and oscillating movement of the electric toothbrush head removes plaque from your teeth more efficiently than a regular toothbrush. Be sure to choose an electric toothbrush that’s comfortable to hold, easy to use, and has the rotating-oscillating head.

4. Don’t just brush — floss! Flossing removes food particles and plaque buildup while it’s still soft. If this debris stays on the teeth, bacteria will increase throughout the night and feed off them while you’re sleeping. Furthermore, if the plaque is allowed to harden, it will turn into tartar, and tartar can only be removed by a hygienist or dentist during a professional cleaning. Flossing only at night is fine for most people, but if you’re prone to gum disease or tartar buildup, dentists recommend that you floss in the morning as well.

5. Rinse with mouthwash. Mouthwash isn’t just for fresh breath — therapeutic mouth rinses contain special ingredients that strengthen teeth and help treat certain oral health conditions. Rinsing with a therapeutic mouthwash before bed will help keep your teeth free of plaque and cavities and your gums safe from gingivitis. On the contrary, most commercial, over-the-counter mouthwashes — known as cosmetic mouthwashes — are designed to mask bad breath and they won’t do much to contribute to your oral health. Talk to your dentist about which mouthwash is right for you.

6. Be aware of teeth grinding. If you experience worn tooth enamel, increased tooth sensitivity, or torn cheek tissue, you may be grinding your teeth in your sleep. Though dentists can’t stop you from doing it, they can make you a mouth guard that you can wear at night to protect your teeth from the effects of grinding.

7. See your dentist regularly. Be sure to schedule regular dental checkups and cleanings. Your dentist and hygienist will help you keep your teeth clean and your gums healthy over the long run. Remember, preventive care and maintenance are just as important for a healthy mouth as good daytime and nighttime oral hygiene.

Is It Gross to Not Brush My Teeth Before Bed?

The Scenario:
You’ve never noticed your friend’s breath being rank or anything (except for that one time after eating a tuna and onion sandwich), but on a group trip in a shared hotel room, she jumped into bed without brushing her teeth. You asked what gives and she was all, “sometimes I do, and sometimes I don’t.” Then she added, “most of the time I’m too sleepy to.” You’re not judging, exactly, but you were raised to brush every morning and night.

Sometimes you skip out on flossing, but you’re confident that brushing before bed keeps cavities and other bacterial scaries away. Your friend, however, tells you her teeth are flawless, and that dental hygiene is a capitalist plot, so now you’re wondering if you’ve wasted hours of your life (a recommended two minutes a night) brushing your teeth before bed.

The Facts:
Unsurprisingly, our mouths are pretty gross. All warm and sticky, the oral cavity is the perfect environment for all sorts of bacteria to grow. “The most common preventable disease is dental caries , which is caused by the bacteria Streptococcus mutans,” says Alex Shalman, cosmetic dentist and clinical instructor at NYU College of Dentistry. “While we all have the S. mutans bacteria in our mouth…it thrives mostly in an acidic environment.”

As we stuff our faces with carbs, coffee, and straight up sugar, our mouths become progressively more acidic, which feeds bacteria like S. mutans and other bacteria that form plaque. The only way to keep these bacteria from staging a military coup in our mouths is to ‘disrupt’ them by brushing our teeth. The American Dental Association (ADA) recommends that you brush your teeth at least twice within a 24-hour period, so that these little suckers can’t settle in and cause major damage. “Brushing our teeth has a two-fold benefit,” says Shalman. First, regular brushing breaks up the dental plaque and bacteria already hanging around on our teeth, and it removes food which contributes to the acidic environment. So when we brush, we’re essentially slowing down tooth decay.

The Worst That Can Happen:
Shalman says that the worst case scenario of not brushing our teeth enough—again, in the morning and consistently at night—is having rampant decay. “Decay can then lead to painful infections which need extensive dental work, and ultimately the loss of teeth.” Another side effect of not brushing? Periodontitis, a.k.a. gum disease. And it can slide downhill from there. “If the bacteria that causes periodontal disease provokes our immune system to attack it, the collateral damage of this immune response can ultimately cause bone loss and tooth loss, as well as systemic effects to our internal organs,” Shalman warns. He goes on to say that our immune system sends out a crazy response to the offending bacteria, and destroys bone and anything else in its path. There’s also evidence that poor oral hygiene can contribute to heart disease. Yikes.

What Will Probably Happen:
If your friend is truly averse to slithering off the couch to brush before bed, only brushing once a day probably won’t yield a deteriorated jaw bone and missing teeth. What will happen, however, is plaque buildup which increases risk of cavities and gum disease. Here’s why night-time brushing is especially important: “At night the saliva flow is reduced tremendously and saliva is a natural lubricant. It flushes things away from the teeth,” says Mazen Natour, professor of periodontology and implant dentistry at the NYU College of Dentistry. “By having saliva at a reduced flow at night, things tend to stick easier and faster.” Natour adds that if you’re only brushing in the daytime, you’ve got a lot of hours and meals between brushing for plaque to build up on your teeth. “As a personal opinion, if you really want to choose to brush once a day, I would say at night.”

What You Should Tell Your Friend:
Tell your friend that they should really consider brushing before bed. And tell yourself, since you’re so smug, that you should consider brushing your teeth in the morning, after lunch and before bed. “Brushing once a day is better than not brushing at all, but it’s not ideal because we do not eat only once,” Natour says. “Every time we eat, we feed the bacteria and help it proliferate and… that leads to cavities and periodontal disease.” A recent study found that Korean adults who are encouraged to brush three times a day for at least three minutes had lower incidences of periodontal disease than Americans and Australians who are taught to brush twice a day. So yeah before you judge, you and your homie might both benefit from a little extra brushing.

Correction: A previous version of this article states that Mazen Natour is director of implant surgery at NYU College of Dentistry. He is director of the implant honors program at NYU College of Dentistry, as well as a professor of periodontology and implant dentistry.

Read This Next: Braces Can Actually Be Bad For Your Teeth

You had a late night out with friends and are finally headed back home in the wee hours of the morning. As soon as you’re in the house, you change right into your pajamas and can’t wait to get into bed. You’re completely exhausted and even the thought brushing your teeth seems too strenuous a task. Would it be so bad to fall asleep without completing your nighttime oral routine?

What Happens When You Don’t Brush Your Teeth

When you skip running a brush across your teeth, you’re allowing plaque to grow in your mouth. “Food debris combines with saliva to form plaque,” explains Timothy Chase, DDS, cosmetic dentist and cofounder of SmilesNY. “Plaque eventually hardens to form tartar. Plaque and tartar cause irritation, inflammation, and bleeding of the gums, as well as dental decay, also known as cavities.” He also added that gum disease can lead to the loss of the supporting gum and bone that hold your teeth in, eventually leading to tooth loss.

This is why brushing your teeth twice a day, every day, is so important. “Brushing your teeth regularly and correctly cleans the food debris and plaque from your teeth before it has a chance to turn into calculus and decay,” says Dr. Chase. Using a toothpaste like Pronamel is also a good option, as it strengthens and rehardens enamel and helps protect against the effects of enamel erosion.

How Bad Is Not Brushing Your Teeth Before Bed?

So now that we know why we need to brush daily and what happens when we don’t, is it really so bad to skimp on the bedtime oral care routine once in a while?

“Failing to brush your teeth at the end of the day gives the bad bacteria in your mouth many hours to feast on the debris and release acids that cause tooth decay and gum disease,” Dr. Chase says. “It can also be enough time to allow some of the soft plaque to harden into calculus that you cannot remove by brushing. Doing this once, or once in a while, may not be the end of the world, but it certainly is a cumulative issue where prior neglect builds into a bigger problem.”

Long story short? It’s never a good idea to fall asleep without brushing your teeth if you can prevent it. “Of course, a little cleaning is better than no cleaning,” says Dr. Chase, “but investing the time to do it correctly is the healthy way to go.”

5. Rinse or chew gum after meals. In addition to brushing and flossing, rinsing your mouth with an antibacterial rinse can help prevent decay and gum problems. Chewing sugar-free gum after a meal can also protect by increasing saliva flow, which naturally washes bacteria away and neutralizes acid.

6. Block blows to teeth. Sports and recreational activities build healthy bodies, but they can pose a threat to teeth. Most school teams now require children to wear mouth guards. But remember: unsupervised recreational activities like skate-boarding and roller-blading can also result in injuries. Your dentist can make a custom-fitted mouth guard. Another option: buy a mouth guard at a sporting goods store that can be softened using hot water to form fit your mouth.

7. Don’t smoke or use smokeless tobacco. Tobacco stains teeth and significantly increases the risk of gum disease and oral cancer. If you smoke or use chewing tobacco, consider quitting. Counsel your kids not to start.

8. Eat smart. At every age, a healthy diet is essential to healthy teeth and gums. A well-balanced diet of whole foods — including grains, nuts, fruits and vegetables, and dairy products — will provide all the nutrients you need. Some researchers believe that omega-3 fats, the kind found in fish, may also reduce inflammation, thereby lowering risk of gum disease, says Anthony M. Iacopino, DMD, PhD, dean of the University of Manitoba Faculty of Dentistry.

9. Avoid sugary foods. When bacteria in the mouth break down simple sugars, they produce acids that can erode tooth enamel, opening the door to decay. “Sugary drinks, including soft drinks and fruit drinks, pose a special threat because people tend to sip them, raising acid levels over a long period of time,” says Steven E. Schonfeld, DDS, PhD, a dentist in private practice and spokesperson for the American Dental Association. “Carbonated drinks may make matters worse, since carbonation also increases acidity.” Sticky candies are another culprit, because they linger on teeth surfaces.

10. Make an appointment. Most experts recommend a dental check-up every 6 months — more often if you have problems like gum disease. During a routine exam, your dentist or dental hygienist removes plaque build-up that you can’t brush or floss away and look for signs of decay. A regular dental exam also spots:

  • Early signs of oral cancer. Nine out of 10 cases of oral cancer can be treated if found early enough. Undetected, oral cancer can spread to other parts of the body and become harder to treat.
  • Wear and tear from tooth grinding. Called bruxism, teeth grinding may be caused by stress or anxiety. Over time, it can wear down the biting surfaces of teeth, making them more susceptible to decay. If your teeth show signs of bruxism, your dentist may recommend a mouth guard worn at night to prevent grinding.
  • Signs of gum disease. Gum disease, also called gingivitis or periodontitis, is the leading cause of tooth loss in older people. “Unfortunately, by the time most people notice any of the warning signs of periodontitis, it’s too late to reverse the damage,” says Sam Low, DDS, professor of periodontology at the University of Florida and president of the American Academy of Periodontology. Periodically, your dental professional should examine your gums for signs of trouble.
  • Interactions with medications. Older patients, especially those on multiple medications, are at risk of dry mouth, or xerostomia. Reduced saliva flow increases the risk of decay and gum problems. As many as 800 different drugs cause dry mouth as a side effect, says Iacopino, dean of the University of Manitoba Faculty of Dentistry. “Always tell your dental professional about any medications you take,” he says. A change in prescriptions may help alleviate the problem. Saliva-like oral mouthwashes are also available.

“Almost all tooth decay and most gum disease can be prevented with good oral hygiene,” says Solie. “We’re talking about taking a few minutes each day to brush and floss. That’s not a lot in return for a lifetime of healthy teeth and gums.”

Oral health care domain – Care of older people toolkit

Medication – Polypharmacy can impact on oral health by causing dry mouth (xerostomia). Drug classes which especially contribute to dry mouth are those with anticholinergic effects such as ACE inhibitors and diuretics. For further information contact the Therapeutic Advice and Information Service.

Mobility – As a consequence of poor oral health, nutritional status may suffer and have an impact on maintaining weight, muscle mass and strength.

Nutrition – Tooth loss, poorly fitting dentures and oral infections affect appetite, food enjoyment and ability to chew which impacts on food intake and food selection.

Skin integrity – As a consequence of poor oral health, nutritional status may suffer and have an impact on skin integrity and wound healing.

How can I recognise problems with oral health?

When assisting with an older person’s oral hygiene check for and report/follow up on signs of the following oral health conditions:

  • soreness and cracks at corners of the mouth
  • sore, swollen or inflamed or coated areas on the tongue
  • red swollen mouth
  • bad breath
  • dry oral tissues
  • saliva which is thick, stringy or rope like
  • swollen red gums that bleed easily when brushed
  • loose or broken teeth or exposed tooth roots
  • oral pain or tooth sensitivity
  • difficulty eating and or speaking
  • changed behaviour and refusing to open mouth
  • poor oral cleanliness and food left in mouth
  • chipped or broken teeth on denture
  • chipped or broken acrylic areas on the denture
  • bent or broken mental wires or clips on partial denture
  • check for a name on the denture.

What can I do if I recognise an older person has problems with oral health?

It is recommended that an appropriate health professional such as registered nurse or doctor perform an oral health assessment using the Oral Health Assessment Tool (OHAT) on admission and repeat as required

A ‘healthy’ or ‘changes’ assessment can be managed using the Oral Health Care Planning Guidelines.

An ‘unhealthy’ assessment indicates a referral to a dental professional is recommended. As most referrals are likely to be of a non-urgent nature, this information should be included in discharge planning advice and correspondence.

What care or management principles should I follow if an older person has an oral health problem?

Management principals should be based on a Model of Oral Health Care which integrates 4 key oral health processes into general care:

  1. oral health assessment
  2. oral health care planning
  3. assistance with daily oral hygiene
  4. referral for dental treatment.

What should I consider when discharge planning to help an older person maintain good oral care?

Based on the findings of the Oral Health Assessment, discharge planning advice to the General Practitioner should acknowledge the patient’s need for dental examination. Options for dental treatment include both private and public pathways.

Further discharge planning may require Occupational Therapist or Dietitian follow up.

What can patients, families or carers do to help an older person maintain good oral health in hospital and at home?

For healthy teeth and gums follow these simple steps:

  • use a soft toothbrush
  • clean your teeth or dentures twice a day
  • use a fluoride toothpaste
  • drink water when you are thirsty
  • sip water if your mouth is dry
  • eat a healthy diet
  • avoid sweets and sugary drinks between meals
  • visit your dentist for a regular check up.

If you’re reading dental health tips online, chances are you are already conscious of the impact of oral health. So, you probably know the basics: Brush at least twice a day, floss, avoid sugary snacks, and so on.

But, believe it or not, dentistry makes advances every day, just as any other branch of medicine. Dental health professionals are constantly learning new things about our mouths, and developing new ways to heal, protect, and care for our teeth and gums.

How to Improve Your Overall Dental Health

Based on that new research, here are a few dental health tips you might not have heard before:

  1. Get a new angle on things. When brushing your teeth, the position of the bristles matters. The head should be at a 45-degree angle near the gum line, and again when you go to clean the inside surfaces of your teeth.
  2. Give your tongue some attention. Plaque and bacteria can gather on, around, and under your tongue too. Clean the surface of your tongue daily, either with your toothbrush or with a tongue cleaner. This will also help prevent bad breath!
  3. Seal off trouble. Sealants are thin protective coatings applied to the back teeth that can help prevent decay and cavities (caries). Sealants are an especially good idea for kids, who often have trouble reaching their back teeth while brushing.
  4. Suit up those teeth. Sports are good for our bodies, but they also provide opportunities for bangs, bumps, and crashes. In fact, most school teams now require children to wear mouth guards to safeguard teeth, especially for rougher sports. So it’s not a bad idea to have one yourself, for any sort of recreational activities. This is true even if it’s not a team sport – skateboarding, rock climbing, or even just hitting a ball against a wall can all present a threat to your teeth.
  5. Make fluoride earn its keep. You should already be using a toothpaste with fluoride. But you might not be receiving its benefits if you rinse with mouthwash right after you brush. Mouthwash can rinse away fluoride before it has a chance to work, so wait 15 minutes or let the fluoride get to work on your enamel.
  6. Chew your way to better dental health. Chewing sugar-free gum after eating or drinking can help protect your teeth and gums, especially after eating sugary foods. Better yet, finish your meal with a cube of cheese. This can help reduce the effect of acids from food on your teeth.
  7. Get more sun. Specifically, get more Vitamin D – which you can get from supplements or exposure to the sun. Both Vitamin D and calcium help keep teeth and gums strong.
  8. Practice the basics. Even if you follow these healthy tips, they will do little if you are not already practicing the basics, brushing, and flossing twice daily. You also want to avoid bad habits that can cause damage to your teeth over time.
  9. See a dentist when everything is fine. Most people don’t bother with a dentist appointment until something goes wrong: A tooth falls out, a sudden pain makes it hard to chew, or an injury causes a chip or crack. But most problems can be prevented if their underlying cause is found early. A regular check-up more than pays for itself by preventing costly dental procedures down the road.

The Happy Tooth Can Help You Get on Track

Good oral health is not complicated, but it does take some discipline and know-how. Want more expert advice on how you and your family can keep a healthy smile? Visit The Happy Tooth professionals at a location nearest you!

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How Can I Prevent Gingivitis?

To keep your mouth healthy, the American Dental Association says you should:

1. Brush your teeth twice a day. Use a soft-bristled brush and fluoride toothpaste. Replace your toothbrush every 3 months or sooner if the bristles become frayed. Old, worn out ones won’t clean teeth as well.

2. Floss every day. Don’t wait until something gets stuck between your teeth. Daily flossing gets plaque out of places your toothbrush can’t reach. Don’t like flossing? Try interdental cleaners, picks, or small brushes that fit in between teeth. Ask your dentist how to use them so you don’t damage your gums.

3. Rinse your mouth out. Antibacterial mouthwash not only prevents gingivitis, it fights bad breath and plaque. Ask your dentist which mouthwash would work best for you.

4. Visit your dentist every 6 months. Once tartar forms on your teeth, only your dentist or hygienist can remove it. Depending on your overall oral health and risk factors, you may need to see him more often.

5. Eat healthy foods. Bacteria in your mouth feed on sugars and starches from food, fueling them to release the acids that attack tooth enamel. Junk food and candy have a lot of extra sugar and starch. Avoid them to keep your teeth and gums healthy.

6. If you smoke, quit. Not only is smoking bad for your heart and lungs, it can also harm your teeth and gums. Smoking or using smokeless tobacco can make you more likely to get severe gum disease, which can lead to tooth loss.

Brush, floss, rinse, and repeat. Gingivitis can come back any time. So build good oral care habits, and stick with them.

At a recent dentist appointment, I smiled confidently for my doctor, Jeffrey Rappaport, DDS (and entrepreneurial badass behind Afora Dental Care). I take pride in my pearly whites, brushing them two or three times daily, flossing nightly, yadda yadda. Rappaport has seen a lot of smiles, but I was sure he’d be impressed.

Wrong.

“Your gums could be healthier,” he tells me after the routine flossing. Apparently I don’t floss firmly enough, as evidenced by the blood I had to spit into that cute little sink beside my chair. “The real way to have healthy teeth is to ensure you have healthy gums,” doc continued. “It’s where the teeth are lodged, after all. Unhealthy gums can lead to tooth loss.”

I’m thinking “D’what?!” like the kid who crammed all weekend for the final exam and somehow still only got a B. Rappaport reassured me, though, that I’m well on my way to a perfect oral grade. I’m no candidate for tooth loss, but I needed to brush up on my gum care. I left wondering how I could do better next time, but also more curious about the gums in general. I hadn’t heard any dentist emphasize them as much before, aside from general flossing rules, so I reached out to Dr. Rappaport with a few questions.

1. Why is gum health just as important (if not more important) than tooth health?

“Our gums are the foundation to healthy teeth and a beautiful smile. When gum tissue becomes infected with bacteria from dental plaque and tartar, bone loss and tooth loss occur. This advanced gingivitis is called periodontal disease. Periodontal disease also puts patients at a higher risk for other medical conditions such as heart disease, dementia, and diabetes. And in women, it can also lead to premature birth.”

2. What are the signs of unhealthy gums? How do we know if they need more attention?

“Do your gums bleed when you brush your teeth? Inflamed and bleeding gums are early symptoms of gingivitis and periodontitis. Healthy gums are firm and pink.”

3. What am I doing wrong?

“Smoking and tobacco use are the big offenders. These patients are at a higher risk for gum disease. Also, poor nutrition and stress will compromise gums. These habits are putting you at a higher risk for gum disease. Plaque (that sticky stuff on your teeth) begins to form soon after brushing, and if it isn’t removed, it begins to calcify and spread below the gum line. The bacteria from plaque and tartar causes the gums to swell and bleed as our immune systems kick in to try and fight it.

“Also, don’t skip flossing because it ‘wakes you up’ before bed, or only brush for a few seconds when you’re rushing out the door. And ignore the anti-flossing rumors.”

4. What are the best ways to maintain healthy gums?

“Good oral hygiene is your first and best defense against gum disease. Brushing twice a day, routine flossing, and adding a rinse helps keep plaque and bacteria from sticking around. Flossing below the gum line is important to remove food debris and plaque where our toothbrushes can’t reach.”

(This was my offense—not flossing low enough. That’s why my gums were sensitive and bled easily.)

“Make sure you are keeping up with regular visits to your hygienist and dentist, too. Most people should go every six months. Patients with crowded teeth or hard-to-reach areas, active orthodontic patients, smokers, and tobacco users are at higher risk for gum disease and may need to have their teeth cleaned every three months.”

Improve Your Oral Hygiene: How to Get Healthier Gums and Teeth

Do you have good oral hygiene? Do you keep your teeth and gums in tip-top condition?

I used to be very lazy where oral care is concerned. For example, I would brush my teeth in the morning, but I rarely brushed at night, simply because I never knew if I would be eating after brushing. Flossing was also never a habit. I didn’t like using the mouthwash either because it would burn my mouth. I didn’t think there would be any implications from a few nights of neglecting my oral care.

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Well a few nights turned into weeks, which then turned into months, and then turned into years. It became a longstanding bad habit. Last year, a visit to the dentist revealed that I had a few dental caries (i.e. decays) in my molars. It made me realize the importance of cleaning my teeth every day, and thereafter helped me cultivate the habit of good oral care.

I’ve put together this guide with the quintessential steps to achieve healthy gums (and also healthy teeth). Obviously, I’m no dentist or periodontic expert, just someone who has successfully improved her oral hygiene, and wants to share what I have picked up. If anything, this guide is meant as a reminder of what we should be doing for better oral hygiene, but may not be doing yet.

If you have poor teeth or gum condition, don’t expect your dentist to solve your problem for you, because he/she wouldn’t be able to provide a magic pill that can fix your oral problems. Chances are he/she are going to tell you the same stuff which I’m going to share next. It all boils down to you reading this guide and following the steps.

Good luck, and let me know how the tips work for you!

#1. Use a good toothbrush

Go for a toothbrush with soft and round bristles, so that it does not hurt your gums while you are brushing it. It really makes a difference. I’ve tried brushing with a soft toothbrush and a hard toothbrush before – The former feels gentle to touch, while the latter feels like you’re poking your gums with a sharp object. The soft one is definitely the way to go.

Secondly, use the ones with crisscross bristles. They help to reach tiny creases and remove elusive plaque that’s stuck in between your teeth. They also help to brush away plaque that’s stubbornly stuck on your teeth, since there is a larger surface area of contact.

(Image: Hybrid Medical Animation)

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A good toothbrush may cost more than regular ones, but considering you use it at least twice a day, invest in a good quality one . It’s just a few dollars more expensive anyway – no point scrimping on daily essentials that can make a big difference.

Perhaps you are wondering: How about electric toothbrushes? To be honest, I’m neutral about them. I suppose they are good if you are lazy, but I find the batteries run out really fast (like, less than a month). Not exactly environmentally friendly if you ask me. With proper brushing technique (see below), a good, regular toothbrush can clean your teeth as well as an electric one.

#2. Floss – Every day

Flossing is one of the tasks we will be working on in the third week of Live a Healthier Life in 21 Days (21DHL). 😀 Yes I know – flossing is boring and a pain in the *ss, but it’s important! I used to hate flossing and never did it in the past, but I’ve finally accepted it as part of my daily routine now, along with brushing my teeth.

I think what made the mental shift was when I consistently saw the amount of plaque and food debris I would dislodge as a result of flossing – despite having brushed my teeth earlier. It made me realize flossing does make a big difference – it serves a unique function that brushing is unable to fulfill. If I don’t floss, I would be going to sleep with little food pieces stuck between my teeth, which then serve as nests for bacteria to gather. Definitely not something I want happen.

I like this joke which PE reader, Charles, shared with us during last year’s run of 21DHL. He asked his dentist which teeth he should floss, of which his dentist replied with a tongue-in-cheek comment: “Only floss the teeth you want to keep!” Makes you realize how important flossing is, especially if dentists harp on it all the time!

Here’s a short 1:54 minute video on how to floss your teeth properly:

#3. Brush at least twice a day

Do you brush your teeth at least twice a day? Once after you wake up, and once before you sleep?

Most of us know we should, but we don’t. We opt for the lazy path, going to bed without brushing our teeth. While it’s convenient, doing this for a prolonged period is only going to bite us in the future.

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Some hard core hygienists clean their teeth right after every meal. Personally, I think that’s very admirable. Though it’s not something I do currently because I usually go for multiple small meals vs. several large meals (which makes cleaning my teeth every time I eat too much of a hassle), it is a standard I aspire to achieve in the future. Perhaps I may consider adjusting the frequency of my meals in the future to make this more feasible.

#4. Use a mouthwash

Mouthwash has its unique role in oral hygiene, because our teeth makes up only 25% of our mouth. There is also our tongue, area near our throat, our palate (roof of our mouth), and our gums, which are neglected during brushing. You want to eliminate bacteria in your mouth, so that plaque cannot form, since plaque is the building block of many oral diseases.

I know there are a lot of commercial mouthwash brands out there, and I’m personally not informed enough about these products to make a recommendation for nor against them. There are a lot of controversies about some of the ingredients that can be found in these mouthwashes, such as fluoride (a common ingredient in toothpastes, which helps prevent tooth decay) and alcohol (which has been said to potentially increase the risk of oral cancer).

While it remains open on whether mouthwashes with such ingredients are beneficial or detrimental for us, my point of recommending a mouthwash is to let you know that (a) simply brushing and flossing alone is insufficient in oral care, since that only cleans about 25% of our mouth (b) and as such, you need to consider a solution to cleanse your mouth and teeth – be it a commercial mouthwash with said ingredients or an alternative mouthwash, such as a salt mouthwash or herbal mouthwash. Mouthwash doesn’t automatically mean a solution that contains fluoride and/or alcohol, so take note of the distinction.

As to which mouthwash you should use, I recommend you to do your due research before making your choice. Here’s a simple fact sheet provided by Oral Care and Health Daily, which shares common mouthwash ingredients and popular benefits linked to them.

WANT TO … LOOK FOR …
Help prevent cavities? Fluoride. Its ability to prevent tooth decay is well-established.
Fight gum disease? Cetylpyridinium chloride (CPC) or chlorhexidine gluconate. Recent research has shown these ingredients help prevent gingivitis and dental plaque.
Moisten your mouth? Carboxymethylcellulose or hydroxyethylcellulose, both of which simulate natural saliva. Bonus points if the rinse also contains fluoride, since dry mouth contributes to cavities.
Soothe canker sores or mouth abrasions? Hydrogen peroxide. It’s a safe bet because it’s antimicrobial without being overly abrasive.
Freshen your breath? Methyl salicylate and chlorhexidine gluconate. These antiseptics help fight the bacteria that contribute to bad breath. Additional herbs, scents and flavorings help mask odor.

#5. Get braces if you need them

Braces are orthodontic tools to straighten your teeth, such that you have a correct bite and have an easier task cleaning your teeth from there on. It’s commonly used to address “crowding” or crookedness of teeth, an issue that arises when one’s mouth is small and cannot accommodate the full set of teeth. It is also used to address overbites, underbites and crossbites.

I wore braces when I was 19-21. My main issue was crowding of my teeth, both in my lower and upper sets of teeth. As part of my orthodontic treatment, I had to remove 4 teeth, not including my 2 lower wisdom teeth which I had removed when I was 18.

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While it was troublesome due to the regular dental checkups, frequency in which food would get dislodged (in my braces) and difficulty in cleaning my teeth, these only lasted during the time I had my braces, which was about 1 year and 9 months. The long-term rewards definitely more than made up for the short-term hassles, which are just a figment of my memory now.

What are the benefits? Firstly, with straightened teeth, it was easier for me to clean them. That’s less time spent brushing and flossing every day. Secondly, straighter teeth meant a nicer look, which made me more confident about my smile. 😀 Thirdly, the effects are long-term. As long as you wear your retainers regularly (every night if you can), your teeth will remain straight. I only wear my retainers once every 1-2 months now (though I should wear it more regularly), and my teeth are still very straight.

If you are contemplating whether to get braces or not, think about it this way – The sooner you wear them, the faster you can take them off! This was what sealed the deal for me. Also, there are many braces options now, from the traditional metal braces, to ceramic, clear braces (which are tooth-colored and hence less visible), to colored braces (which makes wearing braces a fun and fashionable experience), to lingual braces (where the braces are bonded to the back of your teeth, hence making them invisible), to even removable ones! (Invisalign).

#6. Avoid soft drinks

Soft drinks have a load of sugar, which makes it easy for plaque to form, which in turn contributes to gingivitis (gum disease). They are also highly acidic, eroding your tooth enamel bit by bit every time you drink them. Not only that, they are unhealthy with tons of chemicals, and contribute to weight gain. Seriously, need I say more?

I stopped drinking soft drinks years ago and I’m glad I stopped when I did. They are basically sugared water that has zero value. I’ve never looked back since.

Read: 5 Reasons To Quit Drinking Soda Drinks (And How to Do It)

#7. Don’t smoke

Smoking has consistently been linked with gum disease and oral diseases. I’ve met a few smokers before, and they always have yellow teeth and eroded gums. Not a pleasant sight. Not to mention they usually have bad breath too.

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From American Academy of Periodontology:

How does smoking increase your risk for periodontal disease? As a smoker, you are more likely than nonsmokers to have the following problems:

  • Calculus – plaque that hardens on your teeth and can only be removed during a professional cleaning
  • Deep pockets between your teeth and gums
  • Loss of the bone and tissue that support your teeth

If the calculus is not removed during a professional cleaning, and it remains below your gum line, the bacteria in the calculus can destroy your gum tissue and cause your gums to pull away from your teeth. When this happens, periodontal pockets form and fill with disease-causing bacteria.

If left untreated, periodontal disease will progress. The pockets between your teeth and gums can grow deeper, allowing in more bacteria that destroy tissue and supporting bone. As a result, the gums may shrink away from the teeth making them look longer. Without treatment, your teeth may become loose, painful and even fall out.

Bottom line? Don’t smoke, unless you relish the idea of having yellow teeth and receding gums.

#8. Brush using the right technique

It’s one thing to brush your teeth diligently every day. It’s another thing to brush it with the right technique, such that your plaque gets eradicated.

Here’s a simple video on how to brush your teeth:

#9. Destroy all bacteria “nests”

This is probably the most important oral care tip I’ve ever picked up.

For many years, I had unhealthy gums. By unhealthy, I mean gums that are slightly reddish, swollen, and that bleed when I brush too hard. My gumline was always brighter and redder in color than the rest of my gums, which would be a healthy pink.

Not only that, it was receding *very*, *very* slowly over the years. Not good, especially if I want my teeth to be intact when I’m 60, 80, or even 100!

When I went to the dentist, I discovered I had a mild case of gingivitis, which is the inflammation of gums. It is estimated that more than 75% of the population experiences gingivitis on some level (Source). From US National Library of Medicine:

Gingivitis is a form of periodontal disease. Periodontal disease involves inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets (alveolar bone).

The thing though, was that my gums remained inflamed even though I began to brush my teeth diligently and use the mouthwash regularly. I was somewhat expecting to be stuck with unhealthy gums, only because I had them for so long and didn’t think they were reversible.

My friend, a dentistry student, then told me it was due to an incorrect brushing technique, and taught me this tip. I tried it with a dose of skepticism, and was pleasantly surprised when my longstanding gum inflammation issue resolved itself after one to two weeks! For the first time, I have fully pink gums, vs. semi-pink and red gums with a reddish gumline.

Here’s how it works. Look at the area between your tooth and your gum, i.e. your gumline. This is a hot spot where bacteria gathers (my dentist friend analogizes this to ant nests). You want to destroy these nests every time you brush, because if you don’t do it, it will give rise to plaque, which then becomes dental calculus, which is rock-hard and extremely difficult to remove.

So when brushing, pay special attention to this area. What I found helpful is to (a) angle your toothbrush at 45 degrees against the area (b) make very quick, rapid motions, which helps to “break” the nests (c) repeat two to three times per tooth until it feels clean and non-sticky to touch.

#10. Use plaque locator products

Sometimes you may have brushed, flossed, and used the mouthwash, and still have plaque embedded somewhere – because you missed out on a blind spot.

But there’s no way you’d know, especially since plaque is transparent. And waiting till you get cavities from plaque that is built-up over weeks, even months, is not exactly a solution. This is where plaque locator tablets come in.

If you don’t know what they are, they are pink tablets which help uncover the plaque in your mouth by coloring them pink after you chew them. See picture below:

*Areas colored pink means there is plaque. The deeper the pink, the more plaque there is. (Image: Total Teeth Care)

This way, you know the areas you missed, so you can return to clean them up. Once you remove the plaque, the stain will be gone. And the next time you brush, pay special attention to these areas, so you get everything covered.

IMO, plaque locator tablets is one of the best inventions in the realm of oral care. I used to think I do a good job cleaning my teeth, until I tried the tablets and saw a good area of my teeth colored pink! They were typically along the gumline (where it’s easiest for plaque to build up) and the creases between my teeth. Knowing what a poor job I was doing cleaning my teeth made me more diligent in my oral hygiene.

There have since been numerous plaque locator products in the market, from plaque locator swabs, to plaque locator solutions, to even plaque locator floss! You should be able to buy them in pharmacies, drugstores or dental clinics.

#11. Go for a dental checkup once every 6 months

It’s always good to go for a dental checkup once every 6 months, because then you can fix any issues with your teeth or gums before it’s too late. It’s also a good chance to get your teeth scaled and polished, which makes it harder for plaque to form, hence making it easier for you to maintain your oral hygiene.

Get the manifesto version of this article: The Guide To Healthier Gums and Teeth

This is part of the Cultivate Good Habits Series. Be sure to check out the full series:

  1. 21 Days To Cultivate Life Transforming Habits
  2. 21-Day Lifestyle Revamp Program
  3. Waking Early: 9 Reasons to Wake Up Early | 21 Tips To Wake Up Early
  4. Quitting Soda: 5 Reasons To Quit Drinking Soda (& How to Do It)
  5. Improve Your Posture: Benefits Of A Good Posture (& 13 Tips To Do It)
  6. Be TV-Free: 10 Reasons You Should Stop Watching TV
  7. Being On Time: 17 Tips To Be On Time
  8. Meditation: 10 Reasons You Should Meditate | How to Meditate in 5 Simple Steps
  9. Manage Emails Effectively: 7 Tips to Spend Less Time on Email
  10. Run Barefoot: 10 Reasons You Should Start Running Barefoot
  11. Weight Loss: 25 Of My Best Weight Loss Tips
  12. Emotional Eating: How to Stop Emotional Eating (6-part series)
  13. Better Oral Care: How to Attain Healthier Gums and Teeth – An Important Guide

Images: Oral care, Crisscross Toothbrush

Don’t Skip Brushing Before Bed – Here’s Why

While it may seem tempting to skip brushing your teeth at night if you’re already comfortably lying in bed, the importance of brushing your teeth twice a day goes beyond fresh breath. It’s an essential part of dental hygiene that helps prevent cavity, tooth decay, and gum disease.

Not convinced that brushing before bed is necessary? Our family dentist in Cary is sharing the in-depth reason you need to visit your toothbrush before visiting your bed at night!

The Importance of Brushing Twice a Day

Brushing your teeth at least twice within a 24-hour period is extremely important. By regularly removing food particles, debris, and bacteria, you’re preventing the most common causes of tooth decay and gum disease. Every time you skip brushing your teeth, you are encouraging the buildup of bacteria that would’ve been destroyed with an easy, two-minute brush.

Is It Better to Brush Your Teeth in the Morning or Night?

While it’s optimal to brush your teeth both in the morning when you wake up and at night before you go to bed, brushing at night is actually more important. During the day, the foods you eat leave particles and debris on your teeth that feed bacteria.

Normally, saliva helps act as your mouth’s natural defense against bacteria in the mouth because it has anti-bacterial properties, neutralizes the acid level in your mouth, and washes away food remnants. However, saliva production decreases at night, allowing plaque to form and bacteria to attack your tooth enamel. If you don’t remove those before bed, it has all night to damage your teeth. Over time, this can add up to significant damage.

How Plaque Builds Up When You Don’t Brush

Bacteria in your mouth that stays there after you skip brushing before bed creates plaque. Plaque is the sticky, fuzzy substance you feel along your teeth when you haven’t brushed in a while. It takes about 24 hours for the plaque that bacteria produce to build up and mature in your mouth.

When you do brush, you destroy this growth of bacteria that has developed since you last brushed.

When plaque stays on your teeth after you skip brushing, it calcifies by becoming harder, rougher, and more yellow. This new substance is known as tartar, and it continues to grow the more you skip brushing your teeth. Eventually, tartar buildup can cause cavities and tooth loss because it feeds the bacteria that causes tooth decay and can only be removed by your Cary family dentist.

Skipping Brushing Leads to Gum Disease

In addition to cavities and tooth decay, not brushing your teeth regularly can cause gum disease. As the bacteria, particles, and food debris form plaque, then tartar on your teeth, this can also attack your gums.

Gum disease can range from mild and fairly easily treatable to severe, with symptoms ranging from receding gums and bleeding gums to loose teeth. In the most severe cases, gum disease can cause gum deterioration and bone loss which can lead to losing your teeth.

What to Do if You Haven’t Brushed Your Teeth in a While

If you’ve gotten out of the habit of brushing your teeth, whether it’s been a few weeks, months, or longer, the first thing to do is replace your toothbrush and get back in the habit. Set a reminder on your phone to brush your teeth five minutes after your alarm goes off in the morning and at the same time near bed each night.

You should also immediately schedule an appointment with a family dentist in Cary. You most likely have tartar buildup that needs to be removed with a teeth cleaning, and you should also have a thorough exam and dental x-rays to check for tooth decay or cavities. It’s never too late to get back on the path of good dental hygiene and getting the care you need to restore a healthy mouth, but it’s important to do it sooner, rather than later!

Brushing Your Teeth the Right Way

When you do brush your teeth, both before bed and when you wake up in the morning, make sure you’re truly doing the best for your teeth. Using a soft-bristled toothbrush, brush your teeth for two minutes, taking care to brush up and down toward the gum lines and behind your back teeth. You should also use this time to floss your teeth to ensure all debris is gone before you go to bed.

Contact Our Family Dentist in Cary for Teeth Cleaning

Whether you brush twice a day regularly or you have gotten out of the habit, it’s important to maintain regular checkups with your dentist. If you don’t have a regular dentist in Cary, we can help! Schedule an appointment today by filling out the form below or calling us at (919) 467-0654.

Dr. Keith is steadfast in his commitment and dedication to his patients and their care. He strives to help his patients maintain and improve their oral health, quality of life, and appearance. Dr. Keith and Dr. Wayne Beavers are dedicated to providing professional, quality care for general, cosmetic and restorative dental procedures.

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