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More teeth are lost because of gum problems than because of tooth decay, so it is important to take care of your gums. Most adults have some degree of gum disease. Usually it progresses slowly and can be stopped from getting worse. Some people are genetically predisposed to developing gum problems.
When you don’t brush your teeth for a while, you will notice a yellowish sticky paste that accumulates on them. This material looks like food debris, but it’s actually a film of bacteria which forms on the surface of the teeth and gums every day.
Many of these bacteria are harmless. But others happily munch away at the same food you’re eating and then excrete toxins and enzymes – using the grooves where your tooth meets the gum as a toilet of sorts. Bacteria thrive in the plaque environment and multiply until they account for nearly 100% of the mass of the plaque. This is why it’s important to remove it.
When your body notices the toxins, it mounts a defense against them by creating lots of new little blood vessels in the area to fight of the infection. The new blood vessels make the gums look red and swollen. But the bacteria attack the blood vessels, which then become fragile and bleed easily.
This first stage of gum disease is called gingivitis, and it can be easily reversed. But gum disease is painless, and many people are unaware that they have it (most adults do have some degree of gum disease). As it progresses, the bone which anchors the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out or have to be taken out because of pain.
The trick is simple:
Clean the teeth thoroughly once per day (preferably last thing before going to bed).
The usual advice is to brush twice per day because sometimes people may skip a brushing or not do it thoroughly, because they are in a rush or because they are too exhausted at the end of a long day.
The requirements for Quality Brushing are the same as the requirements for doing any job well. You need to know what you are trying to achieve and then to employ the best means for achieving your goal. Don’t be in a hurry to get it done because this will mean cutting corners and making mistakes.
Slow down – do it well and you can then forget about it until tomorrow.
Your mission is to remove the soft sticky plaque deposit from every surface of every tooth. This plaque is very soft and easy to remove. You may have removed it with your nail at some time or other. If it does not come away easily, it is not plaque.
Such a hard deposit is tartar, also known as calculus, and no amount of brushing will remove it. A dentist or dental hygienist can remove it for you during a dental cleaning. Resist brushing harder, as this can cause toothbrush damage.
So how do you do it?
Use a soft toothbrush with a small brush head (to get in hard-to-reach spots), and a pea-sized blob of toothpaste.
Good Technique – Focus on the Gum
This involves putting the focus of cleaning on the little ditch called the sulcus, which is situated between the tooth and the gum around each tooth. This little ditch is the place where gum disease begins.
Because quality brushing is focused on the prevention of gum disease, the brush is angled at a 45 degree angle to the gum (into the little ditch). Obviously, this is 45 degrees upwards for the upper teeth and 45 degrees downwards for the lower teeth.
The movement of the brush should be a backwards and forwards vibration or short circular movements (similar to the cleaning action of a washing machine).No scrubbing please – this may cause damage to both gum and tooth tissue and should be avoided.
Many people find manual toothbrushes difficult to use properly. In this case, you may want to invest in an electric toothbrush. Not all electric toothbrushes are created equal.
You may have trouble using floss, for example due to a bad gag reflex or because you find it too fiddly (although this can often be overcome with practice).
Let your dentist or dental hygienist know and they will be able to recommend alternatives to you – for example, interdental brushes, floss holders (floss on a stick), or thin toothpicks.