Oral hygiene is the complete and efficient removal of dental plaque from all tooth surfaces to such a standard as to maintain oral health. This standard may vary according to how individual patients' immune systems react to plaque. This means in order to prevent gum disease some people need to clean their teeth more efficiently than others.
Personal oral hygiene is necessary to remove microbial plaque which forms on tooth surfaces continuously whether food is eaten or not.
Complications
If plaque is left in the mouth the consequences may be:
- Gum inflammation and gum disease
- Halitosis (bad breath)
- Dental caries (tooth decay)
The two major dental diseases gum disease and dental caries are preventable. Plaque accumulating in a crevice beneath the gum margin causes gum disease. Dental caries is caused by bacteria in plaque feeding off a high dietary sugar intake.
Tooth loss is not an automatic event in the ageing process, it can be prevented by seeking professional advice and the patient taking responsibility for daily removal of plaque.
Fillings,
crowns, bridges and dentures all retain plaque and add to the complexity of oral hygiene.
Recommendations for the removal of dental plaque
All surfaces of all teeth must be cleaned thoroughly at least once a day. For this to be effective it is a relatively time consuming process. Cleaning to remove gross debris may be carried out in addition to this thorough cleaning.
Toothbrushing
This may be with a manual or mechanical brush. The head should be small, the filaments soft-medium and the handle designed to reach the difficult areas at the back of the mouth. The toothbrush will not clean in between the teeth. The toothbrush normally needs to be changed every 3 months. A small amount of fluoride toothpaste is recommended. The use of disclosing tablets helps to highlight the plaque for more efficient removal. An intra-oral plastic mirror is also useful. As the tongue harbours more bacteria than the gums, brushing of the top surface of the tongue is also recommended.
Flossing/Taping
Toothbrushing should be combined with using dental floss or tape to clean in between the teeth. This is a recommended daily procedure. Professional advice is required to master the technique.
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Interdental Toothbrushes
There are areas in any mouth, which simply cannot be cleaned with a conventional toothbrush. Specialist help may be required to use brushes to clean in between teeth with large spaces or teeth standing alone.
Denture/Brace Hygiene
Dental plaque sticks to dentures or orthodontic braces. These must be removed from the mouth before cleaning and during sleep. Brushing the denture on all surfaces will remove the plaque and prevent odours. A mild denture cream can be used. Soaking overnight in appropriate solutions after brushing will destroy bacteria. Clasps (clips) on partial dentures must be thoroughly cleaned of plaque.
Mouthwashes
Generally speaking mouthwashes purchased over the counter are not effective in plaque removal. The feeling of freshness of the breath must not be confused with effective plaque removal or the prevention of gingivitis. Except where specific professional advice is given mechanical plaque removal (using brushes, floss etc.) is the method recommended.
Advice
Advice on oral hygiene may be sought from a dentist who may refer the patient to a dental hygienist.
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