The importance of proper oral hygiene

Teaching proper oral hygiene cannot start too early. A large number of scientific experiments have proven that tartar and gingivitis damage both teeth and general health: it may cause heart disease, focal infections (hair loss; different types of dermatitis, gynaecological inflammation and eye disease, etc.) as well as premature delivery.

Periodontitis or gum disease (widely known as receding gums) is the inflammatory disease of the tissues surrounding the teeth, which is caused by bacteria. Its early signs include bleeding of the gum, increased tartar formation and bad breath. Gum disease is caused by the changed composition of bacteria found in the oral cavity, by the increased number of certain aggressive pathogenic types. The source of these is plaque and tartar, which form as a result of an incorrect brushing technique or accumulate at the edges of not perfectly fitting fillings and crowns.

The essentials of proper oral hygiene: toothbrush, toothpaste, dental floss and different kinds of mouthwash. An effective brushing is that which lasts for the appropriate time, is done regularly and with the correct technique. A lot of people say that they do not have enough time for thorough toothcare. They rush to work in the morning; they are too tired in the evening. In the most ideal case, people should be able to brush their teeth after each meal. If this is not possible, make sure that you brush in the mornings and evenings. You must never miss brushing before going to bed; at night, the decrease in saliva production means less protection and cleansing for the teeth, so plaque formation increases. It is important not to eat after the last brushing of the day. Most people brush their teeth incorrectly because they do not move the toothbrush properly, and so they do not clean all the surfaces of the teeth: the outer, inner and chewing surfaces and sides. When you brush, do not apply great pressure. With circular movements, go along all the surfaces of the lower and upper sets of teeth. Avoid strong, horizontal brushing as it causes the gum to recede and horizontal lines to appear on the teeth. Plaque can very easily form in these grooves. Finally, it is useful to massage the gum gently, with circular movements and towards the teeth. This has the same good effect on the gum as a nice massage on the muscles. For perfect oral care, at night the brushing should be followed by flossing and rinsing with mouthwash, since a toothbrush can only clean the outer, inner and chewing surfaces.

The best type of brush has a small head and a rounded end. The handle should be comfortable to grip and non-slip. After use, do not put the brush in water or a case because it makes the number of bacteria and fungi increase on the bristles. It is advisable to use a brush with soft bristles in case of gingivitis or after oral surgery. Toothbrushes should be replaced at least every thee months, as during this time the bristles get worn and the brushing becomes less effective. Of all the known tools, none are as useful for removing pieces of food from between the teeth as dental floss. Cut off a length of floss, about fifty centimetres. Wind the two ends around your index or middle fingers, so that about ten centimetres remain between your fingers. With your thumbs or index fingers, guide the floss between two teeth, and make sawing movements from the root to the crown. Take care not to harm the gum. Flossing can be supplemented by using an interdental brush. Their use partly overlaps, but the interdental brush can be more widely utilized. It can go under fixed braces, which makes it an essential tool for young people.

All dentists agree that oral hygiene depends most on the toothbrush and the correct brushing technique. However, even the best brush and the most thorough cleaning is only able to remove about half of the plaque. And plaque is the most dangerous factor of tooth decay and periodontitis. The mouthwash is a useful supplement to everyday oral care. A thorough rinsing effectively reduces plaque, also reducing the number of bacteria that cause gum disease and other infections. Antibacterial mouthwash can reach places a toothbrush or floss cannot. Some kinds even alleviate the symptoms of sore throat.

The bacteria in the oral cavity settle and start multiplying in the food particles in the mouth, forming plaque on the teeth. If the brushing is too fast, not thorough or is omitted, crystalloids from the saliva harden (or calcify) in the plaque. The result of this process is a hard layer on the tooth: tartar.

The presence of tartar is highly dangerous. We lose more teeth because of disease caused by tartar than due to tooth decay. When tartar forms below the gum, it often causes inflammation; signs of this are the reddish colour, pain or bleeding of the gum, and bad breath; also, the gum recedes from the teeth. As a result, dental pockets may form next to the teeth, so inflammation may spread to the deeper tissues causing decay in the alveolar bone. This process leads to the loosening, then the loss of the tooth.

To cure gingivitis and gum disease, dentists begin with scaling. They remove plaque, tartar and other deposits. This is usually done with an ultrasonic scaling tool, which is the gentlest method. First the mucous membrane is anaesthetized with Lidocaine spray. Polishing closes the treatment as it is more difficult for plaque to deposit on a smooth tooth surface.

During ultrasonic scaling, the ultrasound blasts off the tartar softly, and does not affect the enamel that is much harder than tartar. It removes smaller deposits as well, and the fine points of the ultrasonic tool can reach the deeper area of the gum without damaging it. Tartar below the gum (sub-gingival tartar) may be indicated by abnormalities in the gum or abnormal tooth surfaces found during the probing of the gum. This type of tartar can also be present if despite proper oral hygiene, the chronic gingivitis does not improve. There are two different methods for removing tartar above and below the gum line; when cleaning below the gum, the inflamed tissues and infected cementum is also removed. This destroys most of the bacteria. Dental curettage is performed under local anaesthesia, therefore it is painless. It is done with specially designed, sterile, hand-operated Gracey instruments. They clean the surface of the root mechanically with their sharp tips, and they lift the infected soft tissues (which cause and sustain the inflammation) out of the dental pockets with their blunt part. With this treatment, within a short time in two days, all the infected dental pockets are cleaned; preventing re-infection from non-treated pockets. At the end of the treatment, antiseptic medicine is also placed in the pockets. This, to some extent and time, prevents bacteria from settling again.

In conclusion it can be said that nowadays a wide range of oral healthcare products is available on the market. With these supplemented by correct brushing technique and regular annual check-ups, we can ensure lasting, healthy teeth and good health.

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