Tooth or Consequences

Plaque is an invisible film composed of colonies of living bacteria that digest the food we eat, forming toxins and acids that can destroy the teeth, normal gum tissue, and underlying bone. To control dental disease, these plaque deposits must be mechanically disorganized by brushing and flossing once every 24 hours. Unfortunately, there is no chemical or mouthwash that will destroy plaque.

A combination of brushing and flossing is necessary to leave the mouth 100% clean. Each compliments the other by cleaning areas it can't reach. For instance, the toothbrush can't reach between the teeth, and floss cannot clean the total exposed surface of any tooth.

Toothbrushing:

Selection of a proper toothbrush is important. Use a multi-tufted brush with soft, rounded nylon bristles (contrary to what some may believe, soft bristles clean better and safer than stiffer ones—they can be gently pressed into the nooks and crannies around the teeth). The toothbrush head should be small enough to reach all sides of all your teeth.

Start by applying the brush to the outside tooth surfaces at about a 45 degree angle directed toward the area where the teeth and gums meet. When properly applied, the rounded tips of the bristles should spread, fan-like, at the gum margins at the necks of the teeth. Press to slide the bristles against the teeth and slightly under the gums (see figure 1).

Then use tiny side-to-side vibrating or "shimmying" strokes (without scrubbing), barely moving the brush and continuing to hug the necks of the teeth and gum margins (figure 2).

Finally, twist the brush toward the biting surfaces to sweep the debris out (figure 3). Repeat this on two or three teeth at a time on the outer and inner surfaces of all teeth.

Brush the inside surfaces of the front teeth by holding the brush tilted vertically and using the tip with up and down as well as side-to-side motions, sometimes cleaning only one tooth at a time (figure 4).

Chewing surfaces require short back-and-forth scrubbing motions. Finish by brushing your tongue and palate to help freshen the breath and remove bacteria.

Note: the tips of the bristles do the cleaning, so don't squash them. Change the toothbrush's position frequently, moving slowly across all surfaces of every tooth. The toothbrush can only clean two or three teeth at a time, and it will probably take about three minutes of brushing to clean the teeth adequately.

Despite the plethora of newly designed toothbrushes that seem to have flooded the market, independent studies do not show any of these to be superior than a conventional brush used properly. I think that the GUM Brush by Butler is one of the best conventional brushes and the Total Brush by Colgate to be one of the best of the new breed of designer brushes.

Many people are more thorough when using an electric toothbrush and that's probably the best choice for them. Persons with physical disabilities may find electric toothbrushes easier to use, and children may find them appealing enough to use more often. The Braun/Oral-B Electric Brush is an excellent choice for a powered brush and is one that people with periodontal (gum and bone) disease should consider using. Unfortunately, water irrigating devices do not remove plaque.

Use a fluoride toothpaste low in abrasion. The American Dental Association tests these products and approves those that seem to be safe and effective. I would recommend using a paste with the ADA Seal. Many people will get sensitive teeth when using gel or tartar-control pastes, if so switch to a plain white paste product. If sensitive teeth persist, your dentist may recommend special toothpastes or rinses to use. Recently Colgate has introduced Total Toothpaste, a product I like. Several pastes have received the American Dental Association Seal of Acceptance for protection against cavities, so far only Total has received it for plaque and gingivitis reduction, as well.

Mouthwashes only temporarily freshen the mouth and breath, they do not remove plaque. Do not rely on mouthwashes for a prolonged period to relieve pain or other symptoms. Bad breath may be a sign of poor oral health or a systemic disease. If bad breath persists despite good oral hygiene, consult your dentist.

Well that’s the tooth, the whole tooth and nothing but the tooth.

--Richard B. Shapiro, D.D.S.
 Reprinted from The Bond Community Star