Personal Dental Hygiene
Brushing cleans half of the teeth, the bits you can see. The important place to clean is the gum line. Do not brush up and down, side to side or many teeth at once. Try to clean between the gum and teeth. Push down and make small circles with a soft brush. If there is bleeding, this is not because you have been too rough, you have just discovered some inflammation, stagnation of plaque.
Gum should be pink and hard, keratinize like the skin on your hand – this would not bleed if you brushed it. The bleeding is caused by that biofilm making the gums soft and inflamed.
Cleaning between your teeth is essential. Flossing is the gold standard but it is difficult beyond the anterior teeth. I prefer little interdental brushes like bottle brushes. They come in varying sizes and can be used in the car or in front of the television. They make a huge difference to the feeling of freshness in your mouth. They are also useful diagnostically since they easily detect sore, soft and bleeding gums. Sometimes, I use mouthwash when using these brushes, but rarely otherwise. I feel their effect of just rinsing is generally superficial.
Mouthwash may contain fluoride – this may be useful. Most are based either on phosphoric acid or alcohol. I prefer the alcohol variety, the phosphoric acid will soften the enamel – so it must always be used after brushing, not before.
Chlohexadine is the common component of mouthwash. Just be aware that it is so efficient that it can change your oral flora if used for too long. This produces chromogenic bacteria which stain the teeth black.
Six months – where did that come from?
I have patients who I see every two years or two months depending on need.
Most are simply abrasives of varying coarseness with a bit of fluoride – never use a whitening paste, it will simply over time accelerate the loss of your nice white enamel and as the enamel becomes thinner, the teeth will become yellower. If you have superficial stains, have them removed professionally. Toothpaste is not a magic bullet for halitosis or decay but four are useful
- Pink sensodyne: for tooth sensitivity. The only desensitizing toothpaste that actually works. Do not buy the other sensodyne products; they are only competing with other types of toothpastes. All of which are useless. Some claim to rebuild or cover the sensitive tubules of the dentine. This is based on the work of Melbourne University in producing tooth mousse. This is a patented product and contains CPP-ACP. Unless the toothpaste which claims to rebuild the dentine contains this specific, it probably does not work.
- Colgate Neutrafluor 5000 for rampant decay. If you must eat sugar, this will mitigate the effect. After radiotherapy, salivary glands may be harmed and the loss of saliva can be catastrophic with the loss of saliva’s defensive capacity.
- Curasept: this is the only paste that I can find that is a non-abrasive gel. If you have large white anterior fillings, these will become scratched with abrasive toothpaste and the scratches become stained. The gel will preserve the surface polish and prevent discolouration.
- Colgate Total Toothpaste is an everyday toothpaste. It contains 12 hours of antibacterial activity. If you want to give this a try, please let Dr Nguyen or Dr Robinson at your next appointment.
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