Understanding The Basics of Oral Hygiene

According to the Federation Dentaire Internationale (FDI) definition of oral health, ‘Oral health involves the ability to speak, smile, smell, taste, touch, chew, swallow, and show emotions through various facial expressions with confidence and without pain, discomfort, or disease of the craniofacial complex (head, face, and oral cavity)’ [1]. Simply put, oral hygiene refers to the practices that keep the mouth healthy in both appearance and feel. No matter how old you are, good oral health is vital to your overall health and well-being.

What is the Importance of Oral Hygiene?

There is significant evidence linking oral health to overall systemic health. For instance, poorly controlled diabetes can cause gum diseases like periodontitis to start and get worse [2]. Conversely, severe periodontitis may negatively impact blood sugar control in people with diabetes, creating a two-way relationship [2]. Emerging research also suggests a link between chronic inflammation from gum disease and an increased risk for cardiovascular issues and other systemic conditions, though more study is needed to confirm direct causation [3].

Essential Tips for Maintaining Good Oral Hygiene

Maintaining a consistent oral hygiene routine is essential for long-term health. By following these helpful tips, you can ensure your teeth and gums stay healthy for years to come.

• Use fluoride toothpaste twice daily when brushing your teeth.
• Clean between your teeth daily. Regular interdental cleaning helps to remove plaque. Use dental floss, interdental brushes, or a water flosser, as a dentist directs. This daily step is crucial for reaching areas a toothbrush cannot.
• Go to the dentist regularly for checkups and cleanings. Frequency depends on individual risk, but many experts recommend at least once or twice per year [4].
• During the office visit, your dentist or dental hygienist may apply a fluoride treatment, such as a varnish or foam, if you are at increased risk for tooth decay (for instance, if you have a dry mouth due to medications you take). Or, the dentist may suggest a prescription fluoride gel or mouthwash for at-home use.
• Your dentist might recommend more frequent visits if you have a chronic condition like diabetes or another illness that increases your risk of developing gum disease [2].
• Don’t smoke. If you have a habit of smoking, you are more likely to get gum disease. Smoking restricts blood flow to the gums, hindering the body’s natural healing process [5]. If you smoke and want to stop, there are many ways to get help.
• If you’re trying to get pregnant, consider checking your teeth. Because of the changing hormones during pregnancy, a woman may get gingivitis and have gums that swell and bleed easily. This is sometimes referred to as ‘pregnancy gingivitis’ and is generally reversible after delivery [6]. During pregnancy, taking care of your teeth and gums is especially important to keep them healthy.

Oral Hygiene Tips by Age Group

Oral hygiene tips for babies (0-12 months)

• Use a soft, clean cloth or a finger-brush to gently wipe the gums twice a day, removing bacteria and sugars that can cause cavities.
• Do this in the morning after the first feeding and before bed.
• When the first teeth come in, brush them twice daily with plain water and a soft, small-bristled toothbrush.
• By your baby’s first birthday, you should take them to the dentist to look for signs of dental problems and establish a dental home [7].
• Consult with your dentist or doctor about applying fluoride varnish to your child’s teeth as soon as the first tooth appears.
• If you want fluoride toothpaste for a child under two, consult your doctor or dentist first.

Oral hygiene tips for children (1-3 years)

• Must brush their teeth twice a day with a smear (size of a grain of rice) of fluoride toothpaste.
• Adult supervision is necessary. Brush your child’s teeth for them until they have good brushing skills.
• If your child is under six, keep an eye on how they brush their teeth. Make sure they don’t swallow the toothpaste after using a pea-sized amount; instead, have them spit it out.
• When necessary, request that your child’s dentist apply dental sealants to the chewing surfaces of the back teeth to prevent decay [8].
• Children living in areas with lower socioeconomic status are reported to have a significantly higher prevalence of dental caries than those from higher-income families [9].
• Fluoride-containing tap water should be consumed where available, as community water fluoridation is a highly effective measure for preventing tooth decay [10].

Implementing Your Daily Oral Hygiene Routine

If you practice good oral hygiene habits (brushing and flossing), you can maintain a good chance of keeping your dental health for the rest of your life.

1. Brushing

Brushing your teeth at least twice a day is not just a great idea but also a requirement for optimal health. However, brushing is about removing the plaque from your teeth and removing any food particles that have fallen into your gums and between the teeth.

Brushing tips for maintaining oral hygiene are as follows:

• Make use of fluoride toothpaste. Fluoride is what keeps teeth protected from decay (cavities). It prevents tooth decay by strengthening the tooth’s hard outer surface, known as enamel.
• To clean between the gums and teeth, angle the bristles towards the gum line.
• Brush with small, circular motions.
• Brush each tooth on all sides. Do not apply excessive pressure or scrub vigorously back and forth.

2. Interdental Cleaning (Flossing)

Flossing is a daily oral hygiene routine that we all need to follow. Keeping your teeth and gums healthy is a priority, and it’s also good for the rest of your body! Flossing helps remove plaque and food debris between your teeth, which can cause bleeding and tooth decay. It also helps prevent gum disease by reducing inflammation in the gums. The American Dental Association (ADA) suggests flossing before brushing, as one study indicated this order removes more plaque [11].

Some individuals find flossing difficult due to arthritis or other conditions. If floss is challenging to hold, try a plastic or wooden dental pick or one of the following alternative interdental cleaning aids:

• Floss holder: A small device with dental floss so that it does not need to be wrapped around the fingers.
• Floss threader: Like a needle and thread, floss is threaded through tight spaces (often used with braces or bridges).
• Water flosser: This is a handheld water sprayer that uses a stream of water to remove plaque and debris.
• Interdental brushes: These brushes are designed specifically to clean between the teeth.

3. Rinsing

Oral rinsing is an essential part of a complete oral hygiene regimen. Mouthwash can supplement, but not replace, brushing and interdental cleaning. To keep your mouth as clean as possible, it’s a good idea to rinse after every meal if you can’t brush, or to use water to rinse vigorously.

You can use a mouthwash that contains antibacterial ingredients like chlorhexidine gluconate (often prescription-only for short-term use) or cetylpyridinium chloride (CPC) in over-the-counter options to help keep your teeth and gums healthy.

After brushing with fluoride toothpaste, avoid rinsing vigorously with water or mouthwash, as this can wash away the concentrated fluoride left on the teeth. Instead, spit out the excess toothpaste. This allows the fluoride to remain on your teeth longer for better protection [12].

4. Regular Dental Visits

Dental visits are essential to keeping your mouth healthy. The dentist can check for tooth caries, gum disease, and other symptoms of tooth infection and provide a dental treatment plan.

According to the U.S. Centers for Disease Control and Prevention (CDC), the frequency of dental visits should be determined by a dental professional based on an individual’s specific needs, although a general guideline of one or two visits a year for routine cleaning and check-ups is common [4]. Some people may need more frequent visits if they have certain health conditions or risk factors (such as smoking or existing gum disease) [2].

What are the Effects of Poor Oral Hygiene on Overall Health?

Poor oral hygiene is a risk factor for both oral and overall health problems. While the exact mechanisms are complex and often involve chronic inflammation, chronic health problems associated with poor dental hygiene include:

a. Endocarditis

This is an infection of the heart’s inner lining, chambers, and valves. Bacteria from the mouth, especially from severe gum disease, can enter the bloodstream (bacteremia) and attach themselves to heart tissue. This is a rare but serious complication, especially in individuals with pre-existing heart conditions [3].

b. Cardiovascular Disease

The chronic inflammation associated with periodontitis may play a role in the development of atherosclerosis (clogged arteries) and an increased risk of heart disease and stroke [3].

c. Diabetes

Severe gum disease (periodontitis) is a common complication of diabetes and can make blood sugar control more difficult. Treating gum disease can sometimes improve blood sugar control in people with diabetes [2].

d. Pregnancy

Due to hormonal fluctuations in the body’s chemistry, pregnancy can occasionally cause periodontal disease. If left untreated, plaque and bacteria can enter the bloodstream. Research suggests an association between severe gum disease and adverse pregnancy outcomes, such as low birth weights and preterm births [6].

Conclusion

Investing in your oral health is directly beneficial to your overall systemic health. Contact your dentist as soon as you notice a problem with your oral health.

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional, such as a dentist or physician, with any questions you may have regarding a medical condition or treatment plan.

FAQs

How to regain healthy teeth?

Avoid foods that cause tooth damage, particularly those high in sugar or acid. Eat more enamel-strengthening foods like dairy products (cheese, plain yogurt) and those high in fiber, which increase saliva flow. Brush your teeth properly (twice a day with fluoride toothpaste). Stop grinding your teeth (bruxism). If you grind your teeth, consult a dentist for a protective night guard. Schedule regular dental check-ups.

What is more important for dental health, brushing or flossing?

Both are equally essential for comprehensive dental health. The American Dental Association (ADA) says that flossing your teeth before you brush will make brushing more effective, as it removes plaque and debris that the toothbrush can then sweep away [11]. They work together to clean the entire tooth surface.

What is the biggest misconception about oral hygiene?

Common misconceptions include: 1. Drinking sugar-free sodas is better for my teeth. (They can still be highly acidic, which erodes enamel). 2. The health of my teeth doesn’t affect my overall health. 3. I only see the dentist in emergencies. 4. A cavity in a baby tooth isn’t as bad as a cavity in an adult tooth. (Cavities in baby teeth can cause pain and affect the permanent tooth underneath). 5. Not many people have gum disease. 6. Pregnant women should not worry about bleeding gums.

References

[1] FDI World Dental Federation. (2016). FDI’s definition of oral health. https://www.fdiworlddental.org/fdis-definition-oral-health

[2] World Health Organization. (2022, November 18). Oral health. https://www.who.int/health-topics/oral-health#tab=tab_1

[3] World Health Organization. (2022, November 18). The link between oral health and general health. https://www.who.int/health-topics/oral-health#tab=tab_1

[4] U.S. Centers for Disease Control and Prevention. (2022, August 8). Dental visits – Health, United States. https://www.cdc.gov/nchs/hus/topics/dental-visits.htm

[5] Centers for Disease Control and Prevention. (2023, April 18). Smoking and oral health. https://www.cdc.gov/oralhealth/conditions/smoking-and-oral-health.html

[6] American Dental Association. (2022, November 18). Pregnancy and oral health. https://www.ada.org/resources/e-periodicals/perio-brief/pregnancy-and-oral-health

[7] American Academy of Pediatric Dentistry. (2021). Policy on the dental home. The Reference Manual of Pediatric Dentistry, 50-51. https://www.aapd.org/globalassets/media/policies_guidelines/bp_dentalhome.pdf

[8] Centers for Disease Control and Prevention. (2022, November 10). Dental sealants. https://www.cdc.gov/oralhealth/dental-sealant-program/index.html

[9] U.S. Department of Health and Human Services. (2020). Oral Health in America: Advances and Challenges. National Institute of Dental and Craniofacial Research. https://www.nidcr.nih.gov/sites/default/files/2021-03/Oral-Health-in-America-Full-Report.pdf

[10] Centers for Disease Control and Prevention. (2020, December 16). Community water fluoridation. https://www.cdc.gov/fluoridation/index.html

[11] American Dental Association. (2023). Flossing before or after brushing? Experts weigh in. https://adanews.ada.org/huddles/flossing-before-or-after-brushing-experts-weigh-in/

[12] Oral Health Foundation. (n.d.). Which comes first, brushing or flossing? New study shows that we should clean between our teeth before brushing. https://www.dentalhealth.org/news/which-comes-first-brushing-or-flossing-new-study-shows-that-we-should-clean-between-our-teeth-before-brushing