Jump to the following topics:

1. Brushing.
2. Flossing. 
3. Irrigating devices.  
4. Mouthwashes.
5. Fluoride.
6. Food for healthy teeth.
7. Possible dental problems.
8. Dentists.

Brushing.

1. The toothbrush.
   • Buying a toothbrush. A good toothbrush has the following qualities:
     • It has been approved by the American Dental Association.
     • It is the proper shape for your mouth. "One size does not fit all." We might want one which has an angled brush or a small head.
     • The bristles are soft and rounded, so they can go under the gums without hurting them.
   • Caring for a toothbrush.
     • Between uses, put the brush in a place where it will dry thoroughly. If you brush often, alternate among two or more brushes, so they will have enough time to dry.
     • Replace the brush when the bristles become frayed. Old brushes don't clean effectively, and they can injure the gums.
2. The toothpaste.
   • Buy a toothpaste which contains fluoride.
   • If you want to use a whitening toothpaste, ask your dentist for a recommendation. Some whitening toothpastes are very abrasive.
3. The technique of brushing.
   • Timing.
     • Brush within 15 minutes after eating, so that the food particles won't linger in the mouth.
     • Brush after every meal, but not too often or too much; excessive brushing can damage the gums and wear away the teeth's enamel.
   • The areas to be brushed.
     • Brush beneath the gum line. Aim the brush at a 45-degree angle toward the gum -- 45 degrees downward on the bottom teeth, and 45 degrees upward on the upper teeth. Adjust this angle to let the brush enter the space between the gums and the teeth as much as possible without discomfort. While the brush is in there, vibrate it for a few seconds.
     • Brush the tops of the bottom teeth, and the bottoms of the top teeth. Brush in a circular or back-and-forth motion.
     • Brush the front and back sides. On the front and back sides of the teeth, brush from the gumline to the tip; don't use a side-to-side movement, which would scour away the enamel. Using short strokes, brush lightly in one place for ten seconds, and then go to the next place.
     • Brushing other areas of the mouth. Brush the tongue and the inner side of the cheeks, to remove bacteria.
   • The alternatives.
     • When you are not at home:
       • Use the type of collapsible toothbrush which travelers carry.
     • When you do not have access to a toothbrush:
       • Put some warm water into your mouth and swish it around vigorously. Do this several times.
       • Use sugarless gum. It stimulates saliva, to wash away food particles.

Flossing. Floss removes plaque from places that a toothbrush can't reach.

1. Use it once a day.
2. Any type of floss is effective; choose the type which seems best for you. The choices are: waxed or unwaxed, tape or thread, flavored or unflavored, wide or narrow. If your teeth are close together, you will be able to clean between them more easily if you use waxed floss and narrow floss.
3. Use this technique for flossing.
   • Cut off about 18" of floss. Wrap it a few times around one finger or thumb on each hand, leaving one inch of floss between them.
   • Put the floss between two teeth and wrap it into a horizontal "V" shape around the edge of one of the teeth; you will be cleaning that tooth first.
   • Keeping the floss level horizontally, move it downward toward the gum, gently scraping the tooth back-and-forth as you go.
   • When you reach the gum, gently continue downward beyond this point, until the floss won't go any further.  
   • With the same back-and-forth scraping motion, return to the top of the tooth.
   • Repeat this action five times on that side of the tooth. When you start on another side, use a clean area of the floss.

Irrigating devices. These products (such as Water Pik) wash away bacteria and food particles which remain after brushing and flossing.

1. Brush and floss in addition to using the irrigating device; the device is not a substitute for brushing and flossing.
2. Don't use an irrigating device if you have a tooth abscess, inflamed gums, or severe gum disease.

Mouthwashes.

1. For dental care, use a mouthwash which contains a plaque-reducing chemical: cetylpyridinium chloride or domiphen bromide. Most mouthwashes do nothing to protect the teeth; their only purpose is to freshen the scent of our breath.
2. Use a mouthwash which contains fluoride.
3. Don't use a mouthwash too often; it can burn the mouth's lining.

Fluoride. This is a mineral which strengthens the tooth enamel (to prevent cavities); it also helps the root surfaces which have no enamel. Even if your city's water has fluorine, use a fluoride toothpaste and a fluoride mouthwash.

Food for healthy teeth.

1. The good foods.
   • Raw vegetables and raw fruits. When we chew these foods, they stimulate blood circulation in the gums.
   • Foods which contain vitamins A and C.
2. The harmful foods.
   • Sugar. Sugar is the favorite food of the bacteria which cause tooth decay. Brush after eating food which contains any type of sugar, particularly "sucrose" (i.e., "table sugar," which is found in chocolate bars, etc.) or "fructose" (which is found in fruit).
   • "Sticky" foods -- candies and dried fruits (e.g., raisins). Because those foods adhere to our teeth, the bacteria accumulate there.

Possible dental problems. They can occur in this order, as the condition worsens:

1. Plaque. This is a deposit where bacteria accumulate, primarily between our teeth and at the gum line. Plaque can be removed by brushing and flossing. It is colorless, so we don't know whether we are successful in removing it by brushing and flossing unless we use "disclosing" tablets or solution (which can be purchased at a drug store). The tablets or solution are put into the mouth after flossing; any plaque which was missed will show up as a red stain.
2. Tartar or calculus. If we do not remove plaque within 24 to 36 hours, it hardens into a substance called tartar, which can be removed only by a dentist. Tartar can damage the gums and cause an infection which attacks the bone at the base of the teeth.
3. Gingivitis. If the tartar is not removed, the result can be gingivitis -- the early stage of gum disease. At first, you might feel no discomfort -- but later, the gums will become sensitive, swollen, red, and liable to bleed.
4. Periodontal disease. When gingivitis worsens, it becomes periodontal disease. The gums are severely inflamed, and they pull away from the teeth, allowing bacteria to migrate to the bone, which is dissolved by the bacteria. When the bone is no longer able to support the teeth, the teeth loosen and eventually fall out.

Dentists.

1. If you don't already have a dentist, get a referral from a friend or the local dental association.
2. See a dentist twice a year for a checkup and cleaning.
3. If you need expensive dental work, be a smart consumer:
   • Get a written estimate for the work.
   • If you want a second opinion, ask the first dentist to send your X-rays to the second dentist.