EXPERTISE IN TREATMENT AND CARE
Tooth Brushing
Toothbrushing
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Brush twice a day in the morning and just before bed
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Brush your gums not just your teeth. Place the brush head where the gum meets the tooth, ensuring at least half of the toothbrush head is on the gum.
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Manual toothbrush: Favour a small headed soft toothbrush. Choosing a children’s toothbrush is ideal as it allows you to focus on a few teeth at a time. Remember that pushing or scrubbing isn’t good brushing. Focus on lightly agitating (jogging) the toothbrush back and forth at the gumline over no more than 3-4 teeth at a time. Then circle up the tooth. Change your toothbrush every 3 months.
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Sonicare: (sonic vibrating technology): Choose a small head for targeted brushing. Follow the instructions as above for manual toothbrushing. Change the head every 3 months and the handle every 3 years (even if you think it is working well).
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Oral B electric toothbrush (oscillating, rotating technology): Choose a small round head. Place the head halfway on the gum and tooth. Hold in position counting 2 seconds at the gumline of each tooth before moving on. Glide over the teeth like ‘a swan gliding over a lake’. Avoid pushing. Change the head every 3 months and the handle every 3 years (even if you think it is still working well).
Toothpaste
There is no need to use specific toothpastes unless you have a particular problem e.g. sensitivity
Flouride
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Use a pea sized amount of fluoride containing toothpaste (1450ppm) when brushing.
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Fluoride helps teeth resist acid attacks and is proven to prevent decay.
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Spit don’t rinse: DO NOT rinse with water or mouthwash after brushing. This rinses the goodness of the fluoride away. Fluoride needs to stay on your teeth for as long as possible to maximise its efficacy.
Whitening Toothpaste
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Avoid whitening toothpastes for daily use. (e.g. charcoal and bicarbonate of soda containing paste)
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They are highly abrasive and used in the long term can wear away gums and enamel.
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Whitening toothpastes can only remove SURFACE stain. If you want whiter teeth, attend a hygiene treatment and consider bleaching.
Sensitive Toothpaste
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If you have sensitive teeth make sure you use the sensitive toothpaste you have selected for at least 2 weeks to give it time to work.
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If after this time you don’t feel it is helping, try another. They all have different methods of action.
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If using sensitive toothpaste isn’t working in the long term, discuss this with your dentist (especially after deep gum treatment) as there are prescription only too toothpastes and varnishes that can be prescribed.
Mouthwash
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Mouthwash is not a substitute for brushing or cleaning in between your teeth.
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Some mouthwashes can hide the signs of your gum disease from you (e.g. bleeding) but this returns as soon as you stop using them.
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There is no need to use mouthwash unless advised to do so by a dental professional (e.g. for an extra dose of fluoride). If you do wish to use a mouthwash, make sure it contains fluoride and use it at an alternative time to brushing to prevent rinsing away fluoride in the toothpaste.
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Check the usage instructions on the bottle. More powerful mouthwashes can often only be used for a week or they will stain if used in the long term.
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Nick might ask you to dip your TePe brushes in hydrogen peroxide based mouthwash (e.g. Peroxyl). Peroxide based mouthwashes can help to kill the bacteria most associated with gum disease. They should not be used if you are allergic to aspirin.
Interdental cleaning
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Clean in between your teeth at least once a day. Brushing alone cleans only 60% of tooth surfaces, the remaining 40% of surface area is between the teeth.
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If you can, clean in between your teeth at night to prevent bacteria and other deposits being left on the teeth whilst you sleep. Bear in mind, your saliva flow drops at night, so the bacteria are not cleansed away as effectively as during the day.
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If it bleeds when interdental cleaning, ignore it and keep going. Whilst it can be worrying to see blood, bleeding is a sign of active gum disease (enflamed gums due to the presence of plaque bacteria). If you continue to clean in between your teeth, the bleeding will reduce and should eventually stop.
Toothpaste
Interdental Cleaning Aids
TePe brushes
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Colour coded bottle brushes in different sizes.
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The sizes you use can change over time, especially during the first few appointments, as gum inflammation reduces.
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The brush should offer resistance when being pushed through the interdental space (as otherwise you aren’t effectively touching the sides of the teeth).
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If you are in between sizes, choose the size that is most comfortable and make sure you swirl the TePe in the space going up and down making sure you touch both sides of the teeth. This will ensure you thoroughly clean both sides of the tooth.
Floss / Floss Tape
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The aim of flossing is to go underneath the gum, scraping one side of the tooth root and then the other.
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Avoid sawing in a back and forward motion.
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Most patients prefer using floss tape (such as Oral B Pro Expert premium tape or Oral B Satin Floss) as it easy to pass the thin side through the contact point of the teeth.
Floss picks / Flossettes
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These are mounted floss on a handle which works well for those new to flossing and assists with access to harder to reach areas.
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Most patients find Oral B Glide Floss picks easy to use, as the handle is bent enabling easy access to the back of the mouth.
Wisdom Brushes
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Coming in 3 sizes – fine, medium and large these plastic toothpicks with a rubber tip are ideal for practising cleaning in between the teeth especially for smaller gaps where a TePe brush might bend.
Interspace Brush
Use the interspace brush with a light swirling action into the gum / periodontal pocket. Imagine you are drawing little circles with the tip of the brush.
This versatile brush can be used to clean:
1. Orthodontic brackets
2. In between teeth
3. Into the pocket, inserting the tip under the gum
4. Wisdom teeth covered by a flap of gum
Plaque disclosing tablets
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Disclosing tablets dye areas of plaque bacteria a bright colour e.g. pink, green or purple colour. This enables you to see where you are missing when you brush.
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After having brushed your teeth, simply chew the tablet and swill it around your mouth and spit out.
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Focus your eye on where the gum meets the tooth and the sides (in between the teeth) to see how much dye has collected in these regions. Be very strict with yourself as a little bit of dye shows you 1000s of bacteria. (Some tablets are also designed to dye older plaque a darker colour, which shows you that you have been missing that spot for longer).
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As the tablets can dye your lips and tongue, it is best to use them at night and spit the remainder of the dye into a cup rather than the sink.