Your teeth vary in shape and size depending on where they are in your mouth. These differences allow the teeth to do many different jobs. Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly. Finally, teeth help to give our face its shape. A healthy smile can be a great asset; and because this is so important, it makes sense to give your teeth the best care possible.

Tooth decay can be painful and lead to fillings, crowns or inlays. If tooth decay is not treated, the nerve of the tooth can become infected and die, causing an abscess. This may then need  root canal treatment or even for the tooth to be removed. It is very important that you keep up a good routine at home to keep your teeth and gums healthy. Gum disease is common and, if left untreated, may lead to bone loss around the teeth. In some cases, it may lead to loose teeth and teeth being lost. Gum disease is preventable. It can be treated and kept under control with regular cleaning sessions and check-ups, preventing further problems. If teeth are lost, it may be necessary to fill the gaps with bridges, dentures or implants.

It is easy to get your mouth clean and healthy, and keep it that way. A simple routine can help prevent most dental problems:

Brushing your teeth last thing at night and at least one other time during the day, with a fluoride toothpaste

Spit out after brushing and do not rinse with water, so that the fluoride stays on your teeth longer

Cleaning between the teeth with ‘interdental’ brushes or floss at least once a day

Good eating habits – having sugary foods and drinks less often, and

Regular dental check-ups. Although most people brush regularly, many don’t clean between their teeth and some people don’t have regular dental check-ups. A few small changes in your daily routine can make a big difference in the long term. Your dental team can remove any build-up on your teeth and treat any gum disease that has already appeared. But daily dental care is up to you, and the main weapons are the toothbrush, toothpaste and interdental cleaning (cleaning between your teeth).

Plaque is a thin, sticky film of bacteria that constantly forms on your teeth.

When you eat foods containing sugars and starches, the bacteria in plaque produce acids, which attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth. After constant acid attack, the tooth enamel breaks down forming a hole or cavity.

It is important to remove plaque and bits of food from around your teeth as this will stop your gums from becoming inflamed and swollen, and becoming infected. If you leave plaque on your teeth it can harden into tartar, which can only be removed by the dental team. It is important to keep up your regular appointments so that your teeth can have a thorough cleaning if they need it.

Gum disease is generally painless, even though it damages the bone supporting the teeth. Gum disease (gingivitis) will usually show itself as red, swollen gums that bleed when you brush or clean between your teeth. Many people are worried when they notice their gums are bleeding and then brush more gently, or stop altogether.

In fact, it is important that you continue to clean regularly and thoroughly if you are to fight the gum disease. If the bleeding does not go away within a few days see your dental team to ask for their advice.

• Gums bleed when they are irritated and inflamed which is not considered normal. This is due to plaque (a soft film of bacteria) being left on the teeth which causes inflammation called gingivitis and if not addressed can develop into gum disease. Over time, if not cleaned off through daily brushing and interdental cleaning, the plaque can turn into a hard deposit called tartar or calculus which will require professional scaling by your dentist or hygienist to remove it.
• It is important even if your gums bleed they are still brushed to keep the mouth clean otherwise the bacteria build up in the mouth will make gum inflammation worse. After a few days of thorough cleaning, your gums should stop bleeding. If this does not happen you will need to ask the advice of your dental team as you may need professional cleaning.
• A good oral care regime should be able to prevent your gums from bleeding if done correctly. We would always suggest that you have regular examinations at your dentist. This can help diagnose and treat anything unusual in your mouth so you get the correct care and advice.
• You may have to use a softer brush whilst the gums are inflamed until they become healthier. It is also important to clean in between teeth daily using interdental brushes or floss.
• Smoking can cover up a gum problem as it restricts the blood flow to the mouth. If you have recently given up smoking this could allow the gums to get a better circulation and therefore start to bleed

Your dental team will be able to recommend a toothbrush suitable for you. However, adults should choose a small- to medium-sized brush head. This should have soft to medium, multi-tufted, round-ended nylon bristles or ‘filaments’. The head should be small enough to reach into all parts of the mouth: especially the back of the mouth where it can be difficult to reach. Children need to use smaller brushes but with the same type of filaments.

You can now buy more specialised toothbrushes. For instance, people with sensitive teeth can now use softer-bristled brushes. There are also smaller-headed toothbrushes for people with crooked or irregular teeth. Some people find it difficult to hold a toothbrush, for example because they have Parkinson’s disease or a physical disability. There are now toothbrushes which have large handles and angled heads to make them easier to use.

• At your initial visit, your new dentist will take all of your personal details, such as your address and date of birth. They will also take a full medical history to make sure that they are fully aware of any illnesses or medication that you may be taking and they can then treat you safely.
• The dentist will then carry out a full check-up and chart all of your teeth and previous treatment, they will also assess the condition of your gums and your general oral hygiene. They may also take diagnostic x-rays.
• If you need to have any dental treatment, your dentist will discuss this with you. They may give you a treatment plan and tell you what the cost is going to be.
• You can make any further appointments as necessary.

• You can try using a toothpaste specifically designed for sensitive teeth. Brush your teeth as normal using de-sensitising and then rub a little toothpaste into the sensitive area when going to bed as it helps protect the surface.
• Try to avoid strongly acidic foods and drinks and wait at least an hour after eating before brushing as this could cause even more sensitivity. Grinding your teeth can also increase sensitivity and a mouth guard maybe necessary.
• If the pain continues, speak to your dental team and they may be able to offer further care to reduce your symptoms. A number of things can cause sensitivity and your dental team will be able to identify these and advise the correct care.

A power brush has an oscillating rotating or vibrating head. These provide a large amount of cleaning action with very little movement needed from the user, although you do need to position the brush correctly.

Tests have shown that power toothbrushes are more effective at removing plaque. Those with heads that rotate in both directions (‘oscillating’ heads) are the most effective. Everyone can use a power brush. They are particularly useful for people with limited movement of the arm or hand, such as disabled or elderly people, who often find that using a normal toothbrush does not allow them to clean thoroughly.

Power brushes can also be better for children as they may be more likely to brush regularly because of the novelty of using a power brush. Discuss the idea with your dental team to find out if you would benefit from using a power brush with an oscillating, rotating head

Brushing removes plaque and bits of food from the inner, outer and biting surfaces of your teeth.

Here is one way to remove plaque – discuss with your dental team which is the best for you:

Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45-degree angle against your gumline. Move the brush in small circular movements, several times, on all the surfaces of every tooth.

Brush the outer surface of each tooth, upper and lower, keeping the bristles angled against your gumline.

Do this again, but on the inside surfaces of all your teeth.

To clean the inside surfaces of your front teeth, tilt the brush vertically and make several small, circular strokes with the front part of the brush.

Brush the biting surfaces of your teeth.

Brush your tongue to help freshen your breath and clean your mouth by removing bacteria.

Be sure to brush thoroughly with a fluoride toothpaste last thing at night and at least one other time during the day. If you regularly keep getting discomfort or bleeding after brushing you should see your dentist.

How do I know if I have removed all the plaque?
You can stain the plaque with special dye, which you can paint onto your teeth with a cotton bud, or you can use special disclosing tablets. You can get these from your dental practice or pharmacy.

The stain is harmless and will show any areas of your mouth which need better brushing. Look particularly at where your teeth and gums meet. Further brushing will remove the stained plaque.

Worn-out toothbrushes cannot clean your teeth properly and may damage your gums. It is important to change your toothbrush every two to three months, or sooner if the filaments become worn. When bristles become splayed, they do not clean properly.

As well as regular family toothpastes, there are many specialised toothpastes. These include tartar control for people who get tartar build-up, and a choice of toothpastes for people with sensitive teeth. ‘Total care’ toothpastes include ingredients to help fight gum disease, freshen breath and reduce plaque build-up. ‘Whitening’ toothpastes are good at removing staining to help restore the natural colour of your teeth, but are not strong enough to change the natural shade of the teeth.

Some children’s toothpastes only have about half the fluoride that adult toothpastes have. They only give limited protection for the teeth. If your children are under 7 you should supervise them when they brush their teeth. Encourage them not to swallow the toothpaste and to just spit, not rinse with water, after brushing.

To have a clean and healthy mouth you need to use the correct dental-care products. Ask your dental team to tell you what choices there are and to give their recommendations.

Yes. Fluoride helps to strengthen and protect teeth, which can reduce tooth decay in adults and children.

All children up to three years old should use a smear of toothpaste with a fluoride level of no less than 1000ppm (parts per million). After three years old they should use a pea-sized amount of toothpaste that contains 1350ppm to 1500ppm.

Some children’s toothpastes only have about half the fluoride that adult toothpastes have. They only give limited protection for the teeth. If your children are under 7 you should keep an eye on them when they brush their teeth and encourage them not to swallow the toothpaste.

You do not need to cover the head of your brush in toothpaste. Children under three should use a smear, and children over three, a pea-sized blob of toothpaste. Remember to spit out after brushing and do not rinse with water, so that the fluoride stays on your teeth longer.

Your gums may bleed or be sore for the first few days that you clean between your teeth. This should stop once the plaque is broken up and the health of your mouth has improved. If the bleeding does not stop, tell your dental team. It may be that you are not cleaning correctly, or that your teeth and gums need a more thorough clean by your dental team.

You can clean between your teeth with an ‘interdental’ brush or dental floss. Cleaning in between your teeth removes plaque and bits of food from between your teeth and under your gumline – areas a toothbrush can’t reach. When flossing or using interdental brushes, keep to a regular pattern and remember not to miss any teeth. It helps to look in the mirror.

Don’t forget the backs of your last teeth. It is also very important to clean around the edges of any crowns, bridges or implants. You should clean between your teeth at least once a day. Your dental team can show you how to clean between your teeth properly.

Interdental brushes come in various sizes. It may be helpful to ask your dentist or hygienist to show you the correct sizes for your mouth.

Hold the interdental brush between your thumb and forefinger. Gently place the brush through the gap between your teeth. Do not force the brush head through the gap. If the brush splays or bends then it is too big – you will need a smaller brush head for this space.

Flossing
Break off about 45 centimetres (18 inches) of floss, and wind some around one finger of each hand.

Hold the floss tightly between your thumbs and forefingers, with about an inch of floss between them, leaving no slack. Use a gentle ‘rocking’ motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.

When the floss reaches your gumline, curve it into a C-shape against one tooth until you feel resistance.

Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum. Repeat on the other side of the gap, along the side of the next tooth.

Don’t forget the back of your last tooth.

When flossing, keep to a regular pattern. Start at the top and work from left to right, then move to the bottom and again work from the left to right. This way you’re less likely to miss any teeth.

Oral irrigators use a stream or jet of water to remove plaque and bits of food from around your teeth. They can be particularly helpful if you wear an orthodontic appliance (‘brace’) or a fixed bridge that is difficult to clean, or if you find it difficult to use interdental brushes or floss.

A fluoride mouthwash can help prevent tooth decay. Your dental team may recommend an antibacterial mouthwash to help control plaque and reduce gum disease. If you find that you are regularly using a mouthwash just to freshen your breath see your dental team, because bad breath can be a sign of unhealthy teeth and gums or of poor general health.

Many people think that it is a high level of sugar in your diet that causes decay, but this is not true. It is how often you have sugar in your diet, not the amount, that causes problems. It takes up to an hour for your mouth to cancel out the acid caused by eating and drinking sugar. During this time your teeth are under attack from this acid. It is therefore important to limit the number of attacks by having sugary foods and drinks just at mealtimes. Chewing sugar-free gum and drinking water after meals or snacks can also help to cancel out the acid more quickly.

As well as causing decay, sugary fizzy drinks, fruit juices, sports drinks, and wine can be acidic – which can also cause dental erosion. This is when the acid in foods and drinks gradually wears away the hard enamel coating of the tooth. This may lead to the tooth being sensitive.

It is just as important to clean dentures as it is to clean your natural teeth. Food can become caught around the edges of dentures and clasps, and the food can rot if you do not clean them thoroughly.

You should keep a separate toothbrush for cleaning your dentures. The general rule is: brush, soak and brush again. Clean your dentures over a bowl of water in case you drop them. Brush your dentures before soaking them, to help remove any bits of food. Soak the dentures in a specialist cleaner for a short time and then brush the dentures again. Brush them like you would your natural teeth.

Make sure you clean all the surfaces of the dentures, including the surface which fits against your gums. If you notice a build-up of stains or scale, have your dentures cleaned by your dental team. Most dentists still recommend a small- to medium-headed toothbrush.

Your dental team or oral surgeon will tell you how to care for your implants after surgery. It is very important to make sure you clean them regularly and thoroughly to prevent gum disease and possible infection. Follow the instructions your dental team or oral surgeon gives you.