General Dental Daily Care Rationale

There are several concepts and techniques that I find myself repeating to patients as they come to the office. Information on how to take care of teeth at home on a daily basis that is not all common knowledge. These concepts include: Brush 2 times a day (after breakfast and after dinner). Floss 1 time a day (bacteria takes about 12 to 24 hours to build up enough of a colony to start damaging teeth with their acid by product). Use mouth rinses and/or water picks as an adjunct to these basic procedures. It is important to brush for a total of 2 minutes with 30 seconds per quadrant of the mouth. Brush in small circles with a 45 degree angle to get the bristle tips into the small pockets around the teeth. Use a soft bristle toothbrush and it is good to get all sides of the teeth evenly without being too aggressive to cause damage to the gums or teeth. While flossing, wrap the floss around the tooth as moving up and down a few times, then wrap the floss around the other tooth in the contact and do the same thing. It is important to not damage the gums, but you will go below the gum levels into pockets around the teeth a little. Some people with larger openings between their teeth may need to use small proxy brushes that look like small tree tops that fit in between the teeth to aid in debris removal that floss is too thin to reach.
Proper saliva flow will bathe teeth to aid in mechanically removing debris and the spit mineralizes the enamel. If your spit is not plentiful enough from various sources of dry mouth (medications, gastro-intestinal tract suppression from a condition, glands blocked or suppressed), then it would be to your benefit to stimulate saliva flow by drinking more water, chewing sugarless gum, mints, or spray. The enamel on your teeth are in a continuous state of losing minerals and re-acquiring them. If your mouth does not have the proper minerals to allow the teeth to mineralize, then teeth look chaulky, dull and get very soft that is vulnerable to more cavities. If your saliva flow is adequate, then the oral environment needs to be stable and neutral in order for the minerals in your spit to mineralize your teeth. The mouth takes about 30 minutes after eating or drinking a meal or snack to recover to a stable and neutral enviroment. If a person is snacking all day, drinking soda, coffee, or tea all day; then, the mouth is in a constant state of attack that favors bacteria and acids that remove the minerals from teeth and cause cavities. So let the mouth recover after a meal and try to enjoy your favorite beverages during the meal to minimize frequency of acid attack on teeth. This diliemma is not over. If there is plaque, looks like wet bread on your teeth, then your saliva cannot reach those spots on your teeth to mineralize them. The plaque is subsequently mineralized and is then called tartar or calculus. This hard material will not be removed by a toothbrush easily, so that is when regular dental visits remove this build up. The build up is common on the upper back teeth on the cheek side of the teeth and on the lower front teeth on the tongue side. If the saliva can reach the teeth in a stable and neutral environment, then it has a good chance to mineralize your teeth and they will be shiny and smooth. The plaque, tartar or calculus that prevent saliva from reaching the teeth also act as caves for bacteria to thrive and generate more acid to cause cavities. That is why daily plaque removal after meals is great to get it off while it is still soft and let your spit get to your teeth throughout the day.
Sugarless gum, mints, sprays, and rinses often have sugar substitutes in them that are not damaging to teeth. But one sugar substitute actually creates an environment to favor an oral flora that does not cause cavities and kicks out the bad bacteria that does cause cavities. It is called Xylitol and is derived from tree bark. It is the third ingredient in some common gum brands; but if you can get it as the first ingredient, then it will be much more affective in aiding this process.
Flouride is a good source to harden enamel. It is an ion that replaces one of the minerals in enamel and makes it more difficult for bacteria to cause cavities. It is in toothpastes and flouride rinses. Not all rinses have flouride in them. Some rinses are antiseptics that kill bacteria in the mouth and some rinses are flouridated to harden your teeth. So it is important to know which rinse is being used for the different end results in the mouth. Flouride tootpastes often do not have enough time on the teeth to do much, so it is important to let it sit there for the full 2 minutes of brushing that was discussed above. Children's flouride toothpaste have much lower dosage due to kids like to swallow it. But establishing a routine early in life to brush 2 times a day and with the proper technique is important for children because bacteria attack teeth all the same on baby teeth as they do on adult teeth. It is most beneficial to have a child's good oral environment to progress to their adult teeth because a cavity is an active infection that can spread. It is imperative to not let a child's adult teeth be damaged for the rest of their life before they are even an adult.
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