Improving the oral health routine and diet

Every patient should be educated in how to care for their teeth and gums. The dental team should be in charge of helping patients understand what is involved in an effective daily routine. 

This includes oral hygiene practices such as toothbrushing with an electric toothbrush with a 1450ppm fluoride toothpaste last thing at night and at one other day during the day. 

Patients should also be encouraged to clean in between their teeth interdentally once a day with a water flosser or interdental brushes. 

For those patients at higher risk of caries, a fluoride mouthwash may be advised like Colgate Fluorigard mouthwash. Patients should be urged to use mouthwash once a day, at any time in between brushes. 

Patient groups at high risk of caries, or with previous history of caries should also be advised to reduce the amount and frequency of sugar (carbohydrate) consumption. 

 This includes limiting sugar consumption to mealtimes and being discouraged from unhealthy snacking.

Another behaviour habit that can help patients at increased risk of caries include chewing sugar free gum with xylitol. This can help promote saliva flow. 

High fluoride toothpaste

Prescription high fluoride toothpaste is a simple, evidenced-based means for helping prevent dental caries in adolescents and adults. It is particularly advised for patients at risk from multiple caries.

High fluoride toothpaste is an evidenced-based method of early intervention. 

WHAT CAUSES PERIODONTAL DISEASE?

Self-care is vitally important to prevent and manage plaque-induced periodontitis. 

A healthy mouth contains over 700 different types of bacteria – most of which are harmless. The type that causes periodontal disease is aptly called periodontal bacteria. Normally, this bacteria doesn’t cause any problems, but under certain circumstances it can become harmful. This happens when the layer of bacteria and food particles, known as plaque, is not removed by regular brushing.

When plaque is left undisturbed, it creates a breeding ground for periodontal bacteria to multiply. This produces harmful by-products that set off your body’s natural inflammatory response, leading to swollen, inflamed gums. If this is left untreated periodontal disease can get worse as plaque hardens into tartar, a rough deposit that can’t be removed by brushing alone.

As tartar develops it encourages more plaque growth towards the root of the teeth and inflammation can become chronic. Pockets form where the gum begins to detach from the tooth and, as harmful bacteria continues to grow in these spaces, infection spreads causing damage to the jaw bone and structures around the teeth, ultimately leading to tooth loss.

The patient’s existing method of brushing may need to be modified to clean all tooth surfaces systematically, maximise plaque removal and to brush the gum line carefully. No particular technique has been shown to be better than another.

For people with periodontal diseases this becomes vitally important throughout the rest of life and good oral hygiene may take longer than the recommended 2 minutes.

As well as speaking to your dentist and attending regular check-ups, there are several things you can do to remove plaque bacteria and, in doing so, help treat swollen gums.

1. Brush with Corsodyl Complete Protection Toothpaste, which is 4x more effective than a regular toothpaste at removing the build-up of plaque along the gum line (the area where the gum meets the tooth), helping to keep gums healthy and teeth strong.

2. Use an electric toothbrush with soft round bristles and a small head, paying careful attention to the space where the gums and teeth meet.

3. Floss with a water flosser or use interdental brushes, which can help remove plaque bacteria from difficult to reach areas, like in between your teeth.

4. Use a mouthwash such as Corsodyl Complete Protection Mouthwash, which is designed to provide everyday gum protection.

Adopting a good oral health routine like this is the best home treatment for swollen gums.

Proper oral hygiene is the key to optimal health. 

Toothbrushing is widely practiced across the UK. In a 2009 national survey of adults, more women reported cleaning their teeth at least twice a day than men (82% compared with 67%). Toothbrushing is important throughout life. 

The overall goal is to achieve and maintain good oral hygiene as follows: clean all tooth surfaces, and the gum line, thoroughly with an electric toothbrush and fluoride-containing toothpaste (ideally up to 1500ppmF) at least twice a day (last thing at night or before bed and one other time), spitting out the excess toothpaste use additional cleaning aids to reach interproximal surfaces, such as a water flosser and interdental brushes. 

The risk of dental caries and periodontal diseases can both be reduced by the practice of regular careful oral hygiene involving toothbrushing with fluoride toothpaste. 

The particular benefit in preventing dental caries, relates to the fluoride in toothpaste. Good oral hygiene reduces the risk of periodontal diseases; however, periodontal health also requires effective interproximal plaque removal. 

Why are my teeth so sensitive?

Have you ever felt pain or discomfort after a bite of ice cream or a spoonful of hot soup? If so, you’re not alone. While pain caused by hot or cold food could be a sign of a cavity, it’s also common in people who have sensitive teeth. Tooth sensitivity, or “dentin hypersensitivity,” is exactly what it sounds like: pain or discomfort in the teeth as a response to certain stimuli, such as hot or cold temperatures. It may be a temporary or a chronic problem, and it can affect one tooth, several teeth, or all the teeth in a single individual. It can have a number of different causes, but most cases of sensitive teeth are easily treated with a change in your oral hygiene routine.

What causes sensitive teeth?

Some people naturally have more sensitive teeth than others due to having thinner enamel. The enamel is the outer layer of the tooth that protects it. In many cases, the tooth’s enamel can be worn down from:

• brushing your teeth too hard using a hard toothbrush

• grinding your teeth when sleeping

• eating or drinking certain foods and drinks

Sometimes, other conditions can lead to tooth sensitivity. Reflux, for example, can cause acid to come up from the stomach and esophagus, and may wear down teeth over time. Conditions that cause frequent vomiting can also cause acid to wear down the enamel.

Recession of your gums can leave sections of the tooth exposed and unprotected, also causing sensitivity.

Tooth decay, chipped teeth, broken teeth, and worn-down fillings or crowns can leave the dentin of the tooth exposed, causing sensitivity. If this is the case, you’ll likely only feel sensitivity in one particular tooth or region in the mouth instead of the majority of teeth.

Your teeth may be temporarily sensitive following dental work like fillings, crowns, or teeth whitening. In this case, sensitivity will also be confined to one tooth or the teeth surrounding the tooth that received dental work. This should subside after several days.

There are many toothpastes and mouthwashes designed for sensitive teeth available over the counter.

If these aren’t effective, talk to your dentist about prescription toothpaste and mouthwash. 

You should try and keep regular check-ups with your dentist so you can get treatment quickly and prevent complications.

Tooth wear in the UK

The 2009 national (England, Wales and Northern Ireland) survey of dentate adults found that 2% had severe tooth wear (exposing the pulp or secondary dentine), 15% had moderate wear (exposing a large area of dentine on any surface) and 77% had some wear present. T

his varied with age, since damage is cumulative: 44% of dentate adults aged 75 to 84 years had some moderate wear compared with 4% of 16 to 24 year olds. Moderate wear was more common in men (19%) than women (11%).

Prevalence of tooth wear amongst adults had increased slightly since the 1998 survey, when 11% of adults had moderate wear. The increase was greatest in younger adults: in 2008, 4% of 16 to 24 year olds had moderate tooth wear, compared with only 1% in 1998.

Advice to prevent oral disease in general should, therefore, focus on the following points:

• brush all tooth surfaces with an electric toothbrush at least twice a day (last thing at night or bedtime and on at least one other occasion), with fluoride toothpaste like Sensodyne Proenamel or Repair & Protect.

• ensure that every surface of each tooth and the junction between the gum and tooth (gumline) are cleaned carefully.

• for young people and adults, the patient’s existing method of brushing may need to be modified to maximise plaque removal, emphasising the need to systematically clean all tooth surfaces by the use of a water flosser or interdental brushes

• electric toothbrushes are most effective for plaque control

• there is low-certainty evidence that medium and soft bristle brushes are less likely to cause gingival lesions than hard bristle toothbrushes; for most patients, an appropriate brush will be a small-headed toothbrush with medium texture bristles.