Oral Health Promotion Prevention

Tooth Brushing Information

Brushing twice a day with fluoride toothpaste will help keep your teeth and mouth healthy.

Your mouth contains bacteria, which live on your teeth, gums, lips and tongue. Some bacteria are healthy if present in the right place, at the right time and in the right numbers. Our body needs these 'friendly' bacteria to function. Other bacteria can be harmful and cause problems, especially if they attach themselves, in the form of plaque, to the enamel that covers your teeth.

Plaque is a film of bacteria that coats the teeth. These bacteria feed on the sugars in our food and drink, and they produce acids that can destroy tooth enamel and cause decay. Plaque forms if you don’t brush your teeth properly or look after your gums, which enables bacteria to multiply. Plaque contributes to gum disease, tooth decay and cavities.

When should I brush my teeth?

Brush your teeth in the morning before breakfast and last thing at night before you go to bed (and ideally at least an hour after your evening meal).

Brushing your teeth straight after a meal can damage your teeth, especially if you've had fruit, fizzy drinks, wine or any other food that contains acid. This is because tooth enamel is softened by the acid and can be worn away by brushing. Waiting an hour gives your saliva chance to neutralise the acid.

Avoid frequent intake of acidic food and drinks – keep them to meal times.

Should I use an electric or manual toothbrush?

The type of toothbrush you use is important. For most adults, a brush with a small head and a compact, angled arrangement of long and short, round-end bristles (filaments) is fine. Medium or soft bristles are best for most people. If in doubt, ask your dentist.

An electric brush with an oscillating or rotating head will reduce plaque and the risk of developing gum disease more effectively.

What type of toothpaste should I use?

The cleansing agents and particles in toothpaste help to remove plaque from your teeth, keeping them clean and healthy.

Most toothpastes contain fluoride, which helps to prevent and control cavities. It’s important to use a toothpaste with the right concentration of fluoride for you or your child. Check the packaging to find out how much fluoride each brand contains.

• Children aged up to three: use a smear of toothpaste containing no less than 1,000ppm (parts per million) fluoride. This means you can use the family toothpaste and don't need a special baby toothpaste.
• Children aged three to six: use a pea-sized amount of toothpaste containing 1,350-1,500ppm fluoride.
• Adults: use a toothpaste that contains at least 1,450ppm fluoride.

Brushing tips

The British Dental Health Foundation gives the following advice on how to brush your teeth:

• Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45 degree angle against the gum line. Move the brush in small circular movements, several times, on all the surfaces of every tooth.
• Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gum line.
• Use the same method on the inside surfaces of all your teeth.
• Brush the chewing surfaces of the teeth.
• To clean the inside surfaces of the front teeth, tilt the brush vertically and make several small circular strokes with the toe (the front part) of the brush.
• Brushing your tongue will freshen your breath and clean your mouth by removing bacteria.

How to floss:

Flossing isn't just for dislodging food wedged between your teeth. Regular flossing may reduce gum disease and bad breath by removing the bacterial film (plaque) that forms along the gum line.

• Take 30–45cm (12–18 inches) of floss and grasp it so that you have a couple of inches of floss taut between your hands.
• Slip the floss between the teeth and into the area between your teeth and gums, as far as it will go.
• Floss with eight to 10 strokes, up and down between each tooth, to dislodge food and plaque.
• Floss at least once a day. The most important time to floss is before going to bed.
• You can floss before or after brushing.

Should I use mouthwash?

Mouthwashes containing fluoride can be beneficial. Some may contain chlorhexidine or other antiseptic chemicals. These may improve plaque control and gum health when used in addition to tooth brushing. Or they can be used alone if you can't brush your teeth for some reason. Mouthwashes that contain essential oils or other chemicals aren’t as effective.

Many mouthwashes contain alcohol, so they're not suitable for children as they could swallow them accidentally. If you use a mouthwash with alcohol, you may get a very dry mouth and dry, cracked lips due to the drying effect of the alcohol. You can avoid this by using an alcohol-free mouthwash instead.

The little extras

• Toothpicks. Avoid using toothpicks as you could cause your gums to bleed, which can lead to an infection. Floss is gentler on your teeth and gums.
• Interdental brushes. These are a better way to clean between your teeth than toothpicks.
• Plaque-disclosing tablets. These work by dyeing plaque either blue or red. They dye all bacteria, but because your mouth contains a lot of "friendly" bacteria, the tongue and gums also get dyed. You don't need to clean this off, but as the staining can last for some hours, it’s best to use these tablets at bedtime or when you're not expecting visitors.

Taking care of your general health as well as your teeth is the key to making the most of your smile.

Brushing your teeth twice a day with fluoride toothpaste, flossing them daily and having regular check-ups with a dentist can help keep your teeth healthy. But diet, smoking and drinking alcohol also have an effect on dental health.

A healthy diet

What you eat and drink can help prevent (or cause) tooth decay, so a healthy diet is important for your teeth. A healthy diet contains foods from different groups, including fruit and vegetables, starchy foods (rice, pasta, bread and potatoes), some protein-rich food (such as fish, meat, eggs and lentils) and some dairy foods. Find out more about a balanced diet.

Sugar

Limiting the amount of sugar you eat and drink is important to prevent tooth decay. Have sugary food and drink only at mealtimes and don't eat sugary snacks between meals.

Most of the sugars we eat and drink are contained in processed and ready-made food and drinks. These include:

• Sweets, chocolate, cakes and biscuits.
• Buns, pastries and fruit pies.
• Sponge puddings and other puddings.
• Table sugar added to food or drinks, such as tea.
• Sugary breakfast cereals.
• Jams, marmalades and honey.
• Ice cream.
• Dried fruit or fruit in syrup.
• Syrups and sweet sauces.
• Sugary drinks, including soft drinks, fizzy drinks, milk drinks and alcoholic drinks.
• Fruit juice.

A glass of fruit juice counts towards your five portions of fruit and vegetables a day, but it also contains sugar. When you have sugary food or drink with a meal, it can be less damaging to your teeth than if you eat or drink it on its own. Try to drink fruit juice only at meal times.

Smokers' teeth

Smoking can prevent you from having gleaming, healthy teeth. Smoking turns your teeth yellow, causes bad breath and increases your risk of gum disease, breathing problems and lung cancer. If you smoke 20 or more cigarettes a day, you're six times more likely to develop mouth cancer than someone who doesn't smoke. So giving up smoking is important if you want to look and feel better.

Alcohol

Excessive consumption of alcohol has been linked to an increased risk of developing mouth cancer. According to Cancer Research UK, 75-80% of mouth cancer patients say they frequently drink alcohol. Alcohol can also erode the enamel on the outside of your teeth, leading to decay. If this happens, you may need to go to the dentist for a filling.

A whiter smile

If you want to keep your teeth as white as possible, try cutting out substances that can stain them. Wine, cigarette smoke, tea and coffee can all discolour teeth. Keep these to a minimum or cut them out completely to stop your teeth from becoming stained.

Children

Establishing good habits can help your child avoid oral health problems, such as tooth decay and gum disease.

Can I let my child have sweets?

Most children want sweets, but you can help prevent problems by making sure they don’t eat them often and encouraging them only to eat their sweets with a meal. This way, your child avoids having extra 'acid attacks' from eating sweets between meals. This helps prevent tooth decay by giving the teeth time to recover from the effects of the acids. Try not to give sweets or sweet drinks as rewards.

What are the best snacks to give my child?

The best snacks are fruit and raw vegetables. Try tangerines, bananas, pieces of cucumber or carrot sticks. Other good snacks include breadsticks, crackers, rice cakes and plain popcorn.

Should I let my child have fizzy drinks?

No. Fizzy drinks contain acids that can affect the enamel on your child's teeth, making it thinner.

What are the best drinks for my child?

The best drinks for children aged over one year old are water or milk. Cow’s milk is not suitable as a drink until your baby is 12 months old.

Use full-fat milk (whole milk) from the age of 12 months to two years. Semi-skimmed milk can be introduced from the age of two, provided your child is a good eater and growing well for their age. Skimmed milk doesn't contain enough fat, so is not recommended for children under five.

Fruit juices contain sugars and acids so it's best to have these at mealtimes and use a straw. If your child is thirsty, it's better to give them water than to encourage a taste for sweet drinks. It's best to avoid giving babies fruit-flavoured 'baby juices', and never give them in feeding bottles.

Fruit juice is not suitable for babies under six months.

Can I let my child have milk at bedtime?

Water is the best drink to give at bedtime, but if you do give milk, don't add anything to it. Chocolate-flavoured 'bedtime' drinks and milkshake powder usually contain sugars, which can increase the risk of decay if given at bedtime.

Are sugar-free medicines better for my child?

Yes. Always ask for sugar-free medicines and remind your doctor about this if you're being given a prescription for your child. This is especially important if your child is taking long-term medication.

When should my child give up bottles?

Your child should begin moving off the bottle and on to a feeder cup at six months. Bottles should be given up completely by the age of one because the teats and spouts encourage children to suck for long periods of time, which can mean the drinks that cause tooth decay stay in contact with your child's teeth for a long time.

Should my child use sippy cups?

There's no need for a child to use a sippy cup. These are similar to a bottle, in that they require the child to suck to make them work. A feeder cup is better as it doesn't have valves and the flow of liquid is unrestricted. This means children learn to drink normally rather than by sucking.

Will a dummy or thumb sucking harm my child's teeth?

These won't harm teeth but will encourage an open bite. This is when teeth move to make space for the dummy or thumb. They may also affect speech development. Thumb sucking and dummies won't cause permanent problems as long as the habit stops by the time your child gets their second teeth, but it can be a hard habit to break. Discourage your children from talking or making sounds with their thumb or a dummy in their mouth, and don't dip dummies in anything sweet such as sugar or jam.

What is fluoride varnish and should my child have it done?

This is a special varnish that is painted onto a child's teeth to help protect them. This is done at the dental surgery. Talk to your dentist to find out if your child would benefit from this extra protection.

How often should I see the Dentist (Dental Recall)

You may be used to having regular dental check-ups every six months, but now check-ups may not need to be so often (or in some cases, more frequent).

Your dentist will suggest your next check-up depending on your clinical need.

The time between check-ups can vary from three months to two years depending on how healthy your teeth and gums are and your risk of future problems.

Why is a check-up important?

A check-up allows your dentist see if you have any dental problems and helps you keep your mouth healthy. Leaving problems untreated could make it more difficult for them to be treated in the future, so it's best to deal with the problem early, or, if possible, prevent them altogether.

What happens during a check-up?

At each check-up, your dentist should:

• Examine your teeth, gums and mouth.
• Ask about your general health and any problems you’ve had with your teeth, mouth or gums since your last visit.
• Ask about, and give you advice on, your diet, tobacco and alcohol use, and teeth-cleaning habits.
• Discuss with you a date for your next visit.

How often should I come back for a check-up?

After your check-up, your dentist will recommend a date for your next visit. The time to your next check-up could be as short as three months or as long as two years (or up to one year if you're under 18).

Generally, the lower your risk of dental problems, the longer you can wait before your next check-up. So people with good oral health will probably need to attend only once every 12 to 24 months, but those with higher treatment needs will need check-ups more often.

What about other treatments?

The advice above is about routine check-ups only. You may have other appointments for treatments such as fillings, teeth cleaning (scale and polish), having a tooth taken out or emergency treatment.

If you have problems with your teeth between check-ups, contact your dental surgery to make an earlier appointment. In an emergency outside normal working hours, contact your surgery on its usual number and you will be told how to access emergency dental care.

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