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EIGHT STEPS TO DENTAL HEALTH

It takes more than just brushing.

OK, so you know about brushing and flossing. But there are other steps you should take if you want to keep your teeth for a lifetime. Some people assume they will lose their teeth as they age. That doesn't have to happen. David A. Albert, D.D.S., M.P.H., an associate professor of dentistry and public health at the Columbia University medical center, suggests these steps to keep your teeth and your mouth healthy:

Step 1: Understand your own oral health needs

"Your oral health depends on many factors," Dr. Albert said. "These include what you eat, the type and amount of saliva in your mouth, your habits, your overall health and your oral hygiene routine." Changes in your overall health status often result in changes in your oral health. "For example, many medicines, including more than 300 common drugs, can reduce the amount of saliva in your mouth, resulting in dry mouth," he said.

Women who are pregnant go through oral changes. This often includes inflammation of the gums, which is called pregnancy gingivitis. Another interesting association has been found between periodontal disease and birth outcomes including intrauterine growth restriction.

Patients with asthma often breathe through their mouths, particularly when sleeping. This can result in dry mouth and increased plaque formation and gingivitis. People with braces have more difficulty cleaning their teeth and can get more cavities. Diabetes has been associated with periodontal disease and is considered one of the complications of diabetes mellitus. Periodontal disease has also been associated with cardiovascular diseases including stroke and heart disease.

Step 2: Commit to a daily oral health routine

Talk to your dentist or dental hygienist about your oral health practices. Based on the discussion, come up with an effective routine. It should be easy to follow and should take your situation into account. For example, if you have a condition like arthritis that makes it harder for you to maneuver dental floss, your dental professional can recommend special tools that make flossing easier to do.

Step 3: Use fluoride products

Everyone can benefit from fluoride, not just children. Fluoride strengthens developing teeth in children. It also helps prevent decay in adults and children. Over the counter toothpastes and mouthwashes are good sources of fluoride. Your dentist can prescribe a higher-concentration fluoride product that can provide more protection against cavities than over-the-counter products. Those prescription fluoride products are available as gels, pastes, or rinses.

Step 4: Brush and floss to remove plaque

Everyone should brush at least twice a day. It's even better to brush three times a day or after every meal. In addition, you should floss at least once a day. These activities remove plaque, which is a complex mass of bacteria that constantly forms on your teeth. If plaque isn't removed every day, it can turn the sugars found in most foods and drinks into acids that lead to tooth decay. Bacteria in plaque also cause gingivitis and other periodontal (gum) diseases. It's important to brush and floss correctly and thoroughly. You need to remove plaque from all sides of the tooth and where the tooth meets the gums.

Step 5: Limit snacks, particularly those high in simple sugars, and eat a balanced diet

Every time you eat, bits of food become lodged in and around your teeth. This food provides fuel for the bacteria in plaque. The bacteria produce acid when they digest the sugars in the food. Each time you eat food containing sugars or processed foods containing starches (complex sugars), your teeth are exposed to these acids. This occurs more often if you eat snacks and the food stays on your teeth for a while. These repeated acid attacks can break down the enamel surface of your teeth, leading to a cavity. If you must snack, brush your teeth, or chew sugarless gum afterward. Gum that is sweetened with xylitol can also help to reduce the bacteria that cause tooth decay.

A balanced diet is also important. Not getting enough minerals and vitamins can affect your oral health, as well as your general health.

Step 6: If you use tobacco in any form, quit

Smoking or using smokeless tobacco increases your risk of oral cancer, gum disease and tooth decay. Using tobacco also contributes to bad breath and stains on your teeth.

Step 7: Examine your mouth regularly

Even if you visit your dentist regularly, you are in the best position to notice changes in your mouth. Your dentist and dental hygienist see you only a few times a year, but you can examine your mouth weekly to look for changes that might be of concern. Changes in your mouth that you should look for include:

  • Swollen gums
  • Chipped teeth
  • Discolored teeth
  • Sores, bumps or lesions on your gums, cheeks, or tongue

A regular examination is particularly important for tobacco users, who are at increased risk of developing oral cancer. If you smoke or use smokeless tobacco, your dentist or dental hygienist can show you where a sore, spot, patch or lump is most likely to appear.

Step 8: Visit the dental office regularly

Talk to your dentist about how often you should visit. If you have a history of cavities or crown and bridge work, or are wearing braces, you should visit the dentist more often. Some people, such as diabetics or smokers, have more risk for gum disease than the general population. They also should visit the dentist more often. People with suppressed immune systems also are more likely to have dental problems. Examples include people with HIV or those who are receiving cancer treatment. More frequent visits for these groups are important to maintain good oral health.

 

Last updated June 30, 2021

 

References:

  • Albert DA, Ward A, Allweiss P, Graves DT, Knowler WC, Kunzel C, Leibel RL, Novak KF, Oates TW, Papapanou PN, Schmidt AM, Taylor GW, Lamster IB, Lalla E. Diabetes and oral disease: implications for health professionals. Ann N Y Acad Sci. 2012 May;1255:1-15. doi: 10.1111/j.1749-6632.2011.06460.x. Epub 2012 Mar 12. PMID: 22409777; PMCID: PMC3429365.
  • Maguire A. ADA clinical recommendations on topical fluoride for caries prevention. Evid Based Dent. 2014 Jun;15(2):38-9. doi: 10.1038/sj.ebd.6401019. PMID: 24971851.
  • Tomar SL, Hecht SS, Jaspers I, Gregory RL, Stepanov I. Oral Health Effects of Combusted and Smokeless Tobacco Products. Adv Dent Res. 2019 Oct;30(1):4-10. doi: 10.1177/0022034519872480. PMID: 31538806; PMCID: PMC7577287.
  • Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Clin Periodontol. 2018 Jun;45 Suppl 20:S171-S189. doi: 10.1111/jcpe.12947. PMID: 29926486.
  • Ananth CV, Andrews HF, Papapanou PN, Ward AM, Bruzelius E, Conicella ML, Albert DA. History of periodontal treatment and risk for intrauterine growth restriction (IUGR). BMC Oral Health. 2018 Sep 29;18(1):161. doi: 10.1186/s12903-018-0623-2. PMID: 30268113; PMCID: PMC6162907.