There are three key categories to maintaining good oral health. Good oral hygiene, routine oral checkups and cleanings, and management of diet, habits, and other health issues.
For this blog, I will discuss oral hygiene, which any preventative maintenance used to help keep our mouths clean, including our teeth, gums, and tongue. The reasons for keeping our mouths clean are to help prevent disease. Disease can lead to costly dental procedures, pain, or tooth loss.
The backbone of good oral hygiene is brushing and flossing. When it comes to brushing your teeth, it is generally recommended to brush for two minutes, two times per day with a fluoridated toothpaste and flossing daily. However, there are instances when I recommend that my patients brush for a longer amount time and brush and floss more times per day. Some of these include patients with braces, patients with poor hand/eye coordination or limited mobility, and those with moderate to severe oral disease.
Brushing ideally should be done with an electric toothbrush or extra soft bristle or soft bristle manual toothbrush using the modified “BASS” technique. The technique includes angling the toothbrush bristles at 45 degrees into the gum line so that the bristles go into the sulcus, or gap between the gum and tooth, and brushing in short front to back strokes incorporating a small circular motion with a sweep away from the gums for a minimum for two minutes, two times per day. For patients with problems with poorly managed disease, limited ability to brush, and braces, I recommend brushing three minutes, three times per day.
Daily flossing should be done in such a way as to cleanse the gums between the teeth, and not just the teeth themselves. A small “C” shape backward and forwards is made to wrap around the curve of each tooth being flossed, with a gentle up and down motion above and below the gum line. It doesn’t matter what time of the day flossing is done. Just find a time that works well for you and make it a habit. For my patients with poorly managed gum disease, I recommend flossing two times per day.
For most people, brushing and flossing are sufficient to maintain good oral health, however, we can use additional methods to keep our mouths clean. There are devices or prescribed items that we recommend for different people, and this depends on multiple factors such as anatomy of the mouth, systemic diseases, missing teeth, added prostheses like dental implants, bridges, and full or partial dentures.
Some of the devices that we recommend patients use besides toothbrush and floss include interdental brushes, floss aids to help get floss under bridges, rubber tips or pointed brushes to get between exposed roots, and tongue cleaners. We will sometimes prescribe toothpaste with increased concentrations of fluoride or other ingredients to desensitize or increase the strength of the teeth or prescribe antimicrobial mouth rinses to help with poorly managed gum disease.
Everyone’s mouth is unique and requires different techniques to keep your mouth in good health. Ideally, you should have discussions with your dentist and hygienist at every checkup and cleaning appointment about cleaning your teeth and gums, and certainly, if you have problems with your teeth and gums like pain or bleeding.