We love helping our patients in Central Florida keep their teeth healthy. Some of our patients come all the way from Melbourne, The Villages, and all over the Orlando area for their dental cleanings! As talented and thorough as our dental hygienists are, however, there’s only so much we can do to keep your oral health in peak condition. The real work happens at home between visits. If you’ve ever wondered why dental home care is so important, or wanted to be sure you’re doing it right, keep reading!
The Key to Great Dental Home Care Is Understanding Your Enemy
Most people are aware that plaque can damage your teeth, but not many know exactly how plaque forms, what it’s made of, and the exact details of how it can lead to dental health problems. Plaque is a more complex subject than you might expect! Understanding the bacteria in your mouth and how they grow is key to great home care.
Plaque is made up of colonies of bacteria living together. These bacteria stick to a thin layer of salts and protein called the pellicle. The pellicle coats every surface of your teeth, gums, cheeks, and tongue. After a dental cleaning, the pellicle forms on your teeth after just a few hours. It’s an essential part of your body’s defenses against cavities and infections. Ironically, it’s also the foundation for bacterial cultures in your mouth.
The first few types of bacteria to set up shop on your teeth are usually the types that are normal for you. Many are actually beneficial and help fight off more damaging types of microbes! Bacteria live together in colonies and build a sticky, gel-like matrix to live in. That’s plaque.
As plaque builds up layer on layer, a complex system of channels forms to provide nutrients to the deepest layers. That’s where the action is. When plaque gets thick, different species of bacteria start to move in. Those are the ones that cause problems.
How Plaque Causes Gum Disease
Certain bacteria do best in environments with very little or no oxygen. As odd as it may sound to us air-breathing humans, oxygen can actually be deadly to many types of bacteria. As plaque gets thicker and develops under the gums, bacteria start to flourish in areas that are hidden from oxygen. Oxygen-free environments are the ideal habitat for bacteria that cause the most damage to your gums.
Plaque that contains these oxygen-hating (also called anaerobic) bacteria produce compounds that damage the gum tissue and trigger the immune system. Since the immune cells that race to the area can’t effectively fight off those bacteria, they end up damaging your own healthy cells even more. That ongoing cycle of inflammation is gum disease, which can progress from gingivitis to periodontal disease. Left untreated, gum disease damages the tissue that holds your teeth in place, causing them to become loose and eventually fall out.
Tartar adds another factor into the process. Plaque left on the teeth absorbs minerals like calcium and phosphorus from your saliva. These minerals turn the plaque from a sticky gel which you can remove with a toothbrush and floss into a hard, chalk-like deposit. Commonly called tartar (although the dental term is calculus), this hard buildup has a rough texture almost like fine grit sandpaper. It tends to form first along the gumline and below the gums. You can imagine how that rough texture can irritate your gums even more!
Fight Cavities with Better Home Care Habits
The bacterial that build up on your teeth don’t just irritate your gums. Bacteria eat, digest, and excrete waste products just like we do. Certain bacteria eat sugars and carbohydrates, which they digest and break down into strong acid.
Acid-producing bacteria are the ones that can break down the minerals in your enamel and cause cavities. The good news is that the calcium, phosphorus, and magnesium in your saliva along with the fluoride in your toothpaste can rebuild the mineral. There’s a constant ebb and flow of breakdown and rebuilding going on in your teeth.
When people say sugar is bad for your teeth, that’s not really the whole story. It’s more that when you feed sugar-loving bacteria too much, they produce so much acid that the rebuilding process can’t keep up. The enamel loses too much mineral and becomes softer, eventually caving in and becoming decay. Cavities that go untreated become bigger and bigger, and can eventually reach the inner part of the tooth, causing serious and even life-threatening infections.
Now that you understand how plaque builds up and why it’s a problem, we have some good news. All you have to do is disrupt the plaque every twelve hours or so! You don’t even have to remove every single bacterial cell. To create cavities, you need bacteria, and you need food for that bacteria to eat. Remove one or the other, and acid production can’t happen! As long as you mix up that biofilm, you’ll kill off many of the most damaging bacteria by exposing them to oxygen, and break up the colonies that protect bacteria and let worse species move in.
That’s why we recommend brushing twice per day. It gives you an opportunity to break up that plaque every twelve hours, which is about how long it takes for the biofilm to build up deep enough for aggressive bacteria to get comfy. We recommend two minutes per brushing session to give yourself enough time to hit every surface of every tooth without missing a spot, as well as to make sure you’re spending enough time in each area to actually disturb the plaque. Unfortunately, if you’re not timing yourself, most people only brush for about thirty to forty-five seconds. Truly effective brushing takes a little longer than that!
Choosing the Right Brush for You
Brushing twice per day for two minutes can break down plaque deposits before they have a chance to absorb minerals and harden into tartar. Removing bacteria also means reducing acids that can lead to cavities, as well as irritants that can create gum disease. It’s a win win! But having the right tool for the job is essential.
When it comes to choosing a toothbrush, there are seemingly endless options. So how can you be sure you’re choosing the right brush for you?
Better Dental Home Care with Less Work? It’s Electric!
Modern electric toothbrushes take out the guesswork to make sure you’re getting a great brush every time. Most will time you for the full two minutes and turn off on their own at the end of a complete brushing cycle. Many will also break up that two minutes into thirty-second sections so you know when to move from one area to the next!
Each electric toothbrush works slightly differently. Some, like the Sonicare, vibrate at a frequency that can break up biofilm several millimeters away from the bristles of the brush. That means they’re effective at removing plaque under the gums and deep in the crevices of your molars. However, the vibrations can be irritating to some people.
Other brushes, like the Oral-B, use a rotating action to scrub the teeth. While this can be super effective above the gums, it doesn’t reach as far under the gumline as the Sonicare. There’s also the Quip, which is awesome because they send you replacement brush heads through the mail so you don’t have to worry about forgetting to refresh your brush every three months.
No matter which brush you choose, the key to using an electric toothbrush is to let it do the work for you. Scrubbing with an electric toothbrush interferes with the carefully engineered action of the brush and cuts down on its effectiveness. Be sure you’re letting the brush work all the way at the gumline, and address each area slowly, one by one. It’s important not to apply too much pressure. You can try using your non-dominant hand, or holding the brush loosely in your dominant hand to avoid pushing on the brush.
The Best Brushing Technique for Less Plaque and Better Oral Health
Manual toothbrushes are a cost-efficient option that can get great results if used properly. However, they’re surprisingly technique sensitive. When choosing a manual toothbrush, look for soft or extra-soft bristles. As counter-intuitive as it seems, medium and hard bristle brushes don’t remove plaque as effectively. They can also be very rough on the gums and cause toothbrush abrasion (wearing away of the enamel) over time.
When using a manual toothbrush, it’s vital to avoid hard scrubbing with long strokes. Instead, concentrate on two or three teeth at a time. Set the brush at a forty-five degree angle toward the gums, right where they meet the tooth. Instead of scrubbing, jiggle the brush at the gumline. Then, give a few swipes from gums toward the chewing or biting edge of the tooth. Move up to the next few teeth and repeat!
Breaking up your brushing in this way will keep you from scrubbing, which can harm the gums. It will also help prevent skipping any teeth and ensure good plaque removal in all areas.
Brushing Is Only Half the Battle
Effective brushing is the cornerstone of good home care, but it only removes plaque from the exposed tooth surfaces. But even the best toothbrush can’t effectively clean out the areas between the teeth. The contact point where teeth touch is the number one place cavities tend to start. The gum tissue between teeth is usually the first to become inflamed as well.
That’s because plaque biofilm can build up so easily in these protected areas where they won’t get disturbed by your tongue, teeth, or rough foods. And since most of us aren’t great about flossing, there’s no stopping them!
Let’s face it, flossing feels like a big chore for most of us. Even though it only needs to be done once per day, and only takes about one to two minutes, many of us just can’t bring ourselves to get it done. There are many ways to try and improve your flossing routine. Try flossing first before brushing; floss in the shower; floss while you’re watching TV; use floss picks in the car; after lunch might be a great option. The list goes on and on. It’s really about finding a time in your day when you can realistically mix it into your routine.
It can also help to leave floss where it can’t be ignored. Hiding your floss in the medicine cabinet is a sure way to forget it exists. Some people find it helpful to set an alert on their phone to remind them it’s time to floss.
Ideally, flossing should be done once every day. Don’t tell anyone we said it, but even a few times per week can make a huge improvement in your dental health. Once you realize how much better your teeth and gums feel, and how much fresher your breath is, you might even feel motivated to shoot for a daily habit!
Just like toothbrushes, there are a ton of options for floss! So how do you know what kind of floss to get? In the end, this is a trial-and-error process to find the kind of floss you like. Tape style flosses can be great for patients with tight contacts and crowded teeth. However, some patients find smooth flosses like Glide don’t have enough texture to remove their plaque. Waxed floss works well for some people, but for others it can leave a filmy feeling behind. Unwaxed floss removes plaque very effectively, but can be painful on the gums for some patients.
Listerine makes a great floss called UltraClean. It’s stretchy, which keeps it from pinching the gums. It’s thin, but textured, so it fits between teeth but removes plaque effectively. Many patients have had great results with this option.
When flossing, take a nice long piece so you have plenty to work with. Wrap the floss around the middle finger on each hand, leaving a middle section between them about four to six inches. The exact distance doesn’t matter; find a length that makes it easy to control the floss. Use your index finger and thumb to pinch the floss on each side of the middle section.
Using a gentle sawing motion, work the floss between each pair of teeth. It will go through a tight spot. That’s the contact. Be sure to work the floss past that tight spot and into the loose area below the contact. Pushing against one tooth, wrap the floss in a C shape around the tooth, then slip the floss under the gums until you feel resistance. The gums aren’t attached at the top edge, so this shouldn’t hurt! Move the floss up and down (NOT side-to-side) several times, scooping debris out from under your gums. Then, come up and over the gum tissue and scoop against the opposite tooth before pulling the floss out and moving to the next pair of teeth. Once you get the technique down, you’ll get faster and faster and before long flossing will feel like second nature!
Rather Skip the Floss? WaterPik to the Rescue!
If flossing doesn’t work for you, a WaterPik can take its place! It’s a must-have for anyone with braces, dental bridges, a permanent denture, limited use of their hands, or anyone who just doesn’t like to floss. In fact, it’s a great addition even for daily flossers!
A water flosser uses a concentrated stream of water to remove plaque and debris from hard-to-reach areas. It does an amazing job cleansing between the teeth, beneath dental work, and under the gums. A water flosser can also reach places even the floss can’t get.
It’s super easy to use, too. You just aim the stream of water at the gumline and follow the edge all the way around the full arch of your teeth, then do the same on the other side. It’s best to gently close over the WaterPik, and lean over the sink to let the excess water dribble out as you work. It can be messy at first, but it’s easy once you get the hang of it. There are also fully waterproof travel water flossers you can use in the shower if you’re worried about splashing! (For a great demonstration of the method, there are tons of videos on YouTube that show you exactly how to do it.)
We’re Here to Set You Up for Oral Health Success
Cleaning between your teeth and under dental work can be a challenge. But for every obstacle making it difficult to fully clean those hard-to-reach places, there’s a special tool or gadget that can help. If you’re in doubt, ask your dental hygienist what tools are right for you, and how to use them!
We hope your new year has gotten off to a great start. We’re here to make 2023 a year of great smiles for all our patients and helping you kick the year off with great dental home care habits is just one way we can make that happen. If you haven’t already, call us to schedule your first cleaning of the year so you can get started on the right foot! Keep smiling your healthiest smile yet, Orlando!