Oral Hygiene Matters

Do You Have a Dirty Mouth?

Or did you listen to the wiggles brush your teeth song as a kid? 

A recent report from the Australian Health Policy Collaboration revealed that your mouth might not be as clean as you think.

Mouth bacteria may not only be unflattering from a bad breath point of view but it also leads to further complications.

According to the report, only half of us are brushing our teeth the recommended two times a day. That might explain why nine out of 10 of us have at least some tooth decay.

Kids aren’t immune to lax dental hygiene, either.

The same report found that more than a third of five-year-olds have decay in baby teeth, and children between the ages of five and nine have the highest rate of hospital admissions with preventable dental diseases.

And if that’s not enough to have you enquiring about oral health services; our dental habits are only part of the problem.

The report revealed that our dietary habits are lacking, too. Most children eat far too much sugar and sweet treats, and we adults have some risky alcohol and smoking behaviours that are putting our teeth and gums at risk.

We’re skipping dental checkups, and we’re losing teeth as a result.

If you want a healthier, cleaner smile, the time to take action is now and at least digest the information presented by an oral health therapist.

In this article, we take a deeper look into the side effects of poor oral health and how to protect your self against them.

Figure 1: Plaque and gingivitis in a patient who was not brushing well enough

Dr Anthony Hopkins on Dental Hygiene

Anyone embarking on orthodontic treatment needs to have good oral hygiene. Before you even begin treatment, your gums should be healthy, and your teeth should be free of plaque and tartar. If you’re already struggling to keep your teeth clean before orthodontic brackets and wires are applied, it’s just going to get harder with the appliances in place.

Plaque is going to have even more places to stick, making it virtually impossible to keep your teeth clean. (Figure 1)

Poor dental hygiene is bad for your teeth in general, but during orthodontic treatment, the consequences can be even worse. First, with enough time, the right surface and environment, plaque can cause permanent changes in the dental enamel.

At first, this might look like white spot changes (Figure 2) on the tooth, but eventually, it will cause a cavity. Second, the plaque will irritate the gums and trigger an inflammatory response called gingivitis.

Left long enough, the superficial inflammation will progress and lead to inflammation around the supporting tissues around the teeth, called periodontitis, causing irreversible gum changes.

Figure 2: A patient with poor hygiene and damage to the enamel is already visible as white marks on the tooth

I recommend that my patients brush twice a day for at least two minutes at a time. Brushing more often, especially after meals, is also excellent. I recommend using a fluoride toothpaste from any of the main toothpaste brands. You also need to clean between your teeth using either interdental brushes or Superfloss because plaque and bacteria like to hide here.

The Science Behind Oral Disease

Do you know what it takes to have a healthy smile?

The oral environment is complicated with all kinds of bacteria, fungi and viruses calling your mouth home. Many of them are normal, healthy parts of the flora of your mouth. When they’re balanced, they’re harmless or even beneficial.

Unfortunately, some conditions can throw your mouth out of balance, allowing acid-producing bacteria to grow excessively. These bacteria are harmful to your teeth and gums, and the acid they produce dissolves the enamel on your teeth and contributes to cavities.

Oral bacteria live in a biofilm called plaque. Plaque is especially sticky, and it grows on the teeth and along the gumline. It hardens into a calcified substance called tartar and accumulates along the length of the tooth if it isn’t cleaned regularly through brushing and flossing. This can irritate your gums and lead to gingivitis.

If the inflammation isn’t stopped, it can spread deeper, and the gums will pull away from the teeth, creating pockets of infection.

Once a pocket is formed, it’s almost impossible to keep it clean at home. Plaque and bacteria will build up inside it. The inflammation will just keep getting deeper, and the periodontitis will worsen. Eventually, you could be at risk of losing teeth.

More than just poor dental hygiene can increase your risk of gum disease. Some common risk factors include:

• Advancing age
• Smoking/tobacco use
• Medications such as ones which have side effects that cause dry mouth
• A family history of periodontitis
• Certain hormonal changes in women
• Certain infections that can compromise a person’s immunity i.e. diabetes
• Stress

The best way to keep oral bacteria under control and your oral microbiome balanced is with proper dental hygiene.

Problems That Arise Due to Poor Oral Hygiene

Refusing to stick to good oral hygiene can lead to various problems. Let’s start with issues that take place in the mouth:

• Gum Disease: Also called gingivitis, gum disease is when the gums are inflamed. It happens when plaque has built up in large amounts. Symptoms include swelling and bleeding of gums when you brush or floss.
• Bad Breath: Not just a dental disease, having halitosis can seriously cause you to lose confidence. By regularly brushing and flossing, you can get rid of bad breath. In some instances, however, it is due to an underlying health problem or medication.
• Dental Caries or Cavities: Also known as tooth decay, cavities are among the most common dental issues. When you have caries, it means that there are damaged parts of the tooth and may even have holes (cavities) in them. This common dental issue occurs when bacteria and food coat the teeth. Acid is produced and forms a plaque, eating away at the tooth enamel and the connective tissue or dentin. Unfortunately, it can cause permanent tooth damage.
• Oral Cancer: It can be in the gums, tongue, lips, and cheeks. A dental professional will tell you if you have oral cancer. Although tobacco is the most common cause of oral cancer, having good oral hygiene can help, especially if you regularly visit your dentist.

For a more comprehensive list of oral health issues, please read our blog post here.

If you continue to have bad oral hygiene, your teeth and gums are not the only ones affected. Believe it or not, your whole health can be jeopardised. Science has confirmed that improper dental hygiene can cause the following problems:

• Endocarditis: This health issue infects the heart valves or chambers, particularly their inner lining. It happens when bacteria and germs from the mouth and other parts of the body reach the bloodstream. They then attach themselves to some parts of the heart.
• Cardiovascular Problems: There is no single explanation of how and why the connection between your oral health and cardiovascular system occurs. However, research has shown that oral bacteria can lead to clogged arteries, stroke, and heart disease.
• Birth Complications: Gum disease is usually linked to premature birth. Children whose mother is diagnosed with periodontitis have low birth weight.
• Dementia: Because of poor oral health, the brain can also be affected. Substances from inflamed gums can kill brain cells, resulting in memory loss. Gingivitis may also be a contributor to Alzheimer’s disease.
• Respiratory Infections: Bacteria in the teeth, gums, and mouth can travel to the lungs through the bloodstream. It may lead to acute bronchitis, pneumonia, and chronic obstructive pulmonary disease (COPD).

Diabetes is also associated with poor oral health. While it is not often considered a cause, it does contribute to the severity of this health problem. People with diabetes are already more susceptible to infections, which is why it is common for them to have gum disease. The issue here is that oral diseases can make diabetes even more difficult to manage.

Blood sugar levels can quickly go haywire due to gum disease. It is why it is more important than ever to take care of your oral health if you have diabetes.

Toothbrushing 101- Are You Brushing Effectively?

Chances are, the answer is no.

Maybe you’re speeding through or zoning out while you brush. Either way, taking a few minutes to review your toothbrushing technique is one of the best things you can do for your teeth.

1. Apply a pea-sized amount of fluoride toothpaste to your toothbrush, and hold it at a 45-degree angle towards your gums.
2. Use a gentle circular motion as you brush the outside surfaces and inside surfaces of your teeth. Use a back-and-forth motion to clean the chewing surfaces.
3. Spend at least two minutes to clean all surfaces of your teeth. Any less than that just isn’t enough to get your teeth clean.
4. Once you’ve cleaned for the recommended time, spit out the excess toothpaste, but there’s no need to rinse. The extra fluoride in the remaining toothpaste will continue to fight bacteria even after the brushing is over.
5. Don’t forget to floss! Toothbrush bristles aren’t small enough to clean between your teeth or along the gumline effectively, so you need to use an interdental cleaner or flosser to remove plaque and bacteria.
6. Remember to replace your toothbrush every three to four months or whenever the bristles start looking bent or frayed. If you prefer, you can also use a powered toothbrush for greater control over brushing pressure, timing and other details.

For the best results, brush twice a day or after meals, and floss at least once a day.

Flossing

Flossing using a dental floss product is a simple way of dealing with food particles that brushing alone cannot remove. There are areas that your toothbrush is unable to reach, especially in between teeth.

A common question regarding flossing is “When should you floss?” Is it better to floss before or after brushing? Some people choose to floss after brushing. It’s not bad, but there is one problem with this sequence. Any plaque, bacteria, or food particle released after flossing will remain in your mouth. You only get rid of it the next time you brush.

On the other hand, if you floss before brushing, you release the particles first. Then, brushing removes them from the mouth. There is less risk of dental plaque and gum disease. A 2018 study also confirmed that fluoride toothpaste works better if it is used after the particles are removed between the teeth.

Flossing at least once a day is enough to support brushing. You can floss in the morning or before you go to bed. Always be gentle when doing this task. Flossing aggressively can make your gums bleed.

Professional Teeth Cleaning

Are brushing and flossing at home enough to keep your teeth healthy?

They’re a great start, but you also need to schedule regular dental visits.

Even with the best dental habits, you’ll still need periodic professional cleanings. This is even more important when you’re undergoing orthodontic treatment. During orthodontic work, your gums can become more sensitive, and the appliances can make it harder to keep your teeth clean.

Traditionally, dentists have recommended biannual cleanings and checkups. However, that schedule might not be appropriate for all patients. Dr Hopkins can help you determine the best cleaning schedule based on your current dental health, your orthodontic needs and other factors, like your dental health history and overall health status.

Your dentist or hygienist will do several things during a professional cleaning, including:

• Examining your teeth for decay or other problems
• Evaluating your gum health and measuring your pocket depth
• Taking dental X-rays
• Using specialized instruments to remove plaque and tartar buildup
• Polishing teeth to remove superficial stains and leave teeth squeaky clean

Other treatments or procedures can also be used based on your specific needs to keep your smile and your whole body healthier.

The Link Between Dental and General Health

Did you know that your smile reflects not just your mood but your health, too?

Little things like the state of your teeth or the condition of your gums can reveal significant things about the state of your general health.  For example, gum disease can be made worse by conditions such as diabetes and other diseases.

Your gums can affect your health, and there is evidence that Periodontal disease can be a factor in heart disease and may even be associated with strokes.

Good dental habits can help you keep your smile and your whole body healthier!

Healthy Daily Habits

You brush, clean between your teeth and schedule check-ups regularly. Is there anything else you can do to protect your smile?

We’re glad you asked! There are several other things you can do to keep your teeth bright and your smile healthy, including:

1. Drinking plenty of water – Soft drinks might be pretty tasty, but nothing can beat plain water when it comes to your health. Drink water after every meal to dilute oral acids. Water can also be a good source of fluoride, which helps counteract oral bacteria and strengthen dental enamel.
2. Limiting sugary and acidic foods and drinks – Oral bacteria convert sugar into acid, which erodes enamel, and that causes cavities. Skip or limit sugary sweets/lollies, biscuits, baked goods and other treats to protect your teeth. Acidic foods and drinks, wine and soft drinks, can have the same effect. If you decide to indulge in something sweet or acidic, drink plenty of water after to dilute the acids.
3. Eating more of the right foods – Processed foods are easy to grab and eat on the go, but they aren’t good for your teeth. Fresh, crunchy fruits and vegetables are full of the vitamins your gums need for health and also help mechanically clean teeth. Cheese and yoghurt are rich in enamel-building calcium. Choose fresh, whole foods instead of processed foods, and your smile will thank you.

Dr Hopkins highly recommends that patients not only limit how much sugar they eat but also how often they eat it. He suggests eating sugar not more than three times a day and to also avoid snacking on sugar between meals and before bed. Patients should also avoid juice and carbonated drinks, which tend to be highly acidic and high in sugars.

Protecting Orthodontic Appliances With Diet

Braces are securely attached to teeth, but they can be damaged by the wrong foods. A broken wire or dislodged bracket can be inconvenient and disrupt your treatment. Dr Hopkins recommends taking a few simple steps to protect your braces and treatment experience.

1. Avoid hard foods – This includes popcorn and nuts or raw fruits and vegetables, which can instead but cut into small, bite-sized pieces for easier eating.
2. Avoid sticky foods – Caramels and lollies are high in sugar, which makes them a poor choice, but they’re also sticky, which can stick to your braces, too, and be impossible to get off.
3. Avoid chewy foods. Toffee, licorice and similarly chewy foods can break or damage your wires. This includes sugar-free gum, which can be useful for your teeth but not so good for your braces.

Dental Disease Warning Signs

Gum disease and dental decay don’t just happen overnight, but many people don’t notice the signs right away. Because symptoms can be subtle, paying attention to your teeth and gums each time you brush, and floss can help you catch these signs right away and get the care you need sooner.

If you have any of these symptoms, contact Oasis Orthodontics:

• Gums that bleed when you brush or floss
• Gums that look red or swollen
• Chronic bad breath
• Gums that are pulling away from teeth or teeth that look longer
• Sudden sensitivity to temperature changes or pressure
• Teeth that feel loose
• Swelling anywhere in the face, cheek or jaw or a pimple along the gumline
• Pain when you bite or chew

Quick treatment can stop the inflammation in its tracks, prevent further damage and restore your oral health.

Better Dental Hygiene: Review

• Brush twice a day.
• Use a powered toothbrush with a timer to keep track of your brushing sessions or a manual toothbrush with soft or medium strength bristles.
• Use Superfloss, or interdental brush to clean between teeth and along the gumline.
• Visit your dentist regularly for cleanings and checkups.
• Replace your toothbrush or toothbrush head every few months or when the bristles show wear.
• Use fluoride treatments as recommended.
• Eat a balanced diet and limit processed foods, sweets and acidic foods and drinks.
• Clean carefully around your orthodontic appliances

The Connection Between Oral and Your Overall Health

Many Australians do not know that oral health is connected to the health of the entire body. In fact, dental professionals see the mouth as the window to the physical health of the body. It serves as a useful vantage point for systemic disease detection, such as diabetes and HIV/AIDS. These mentioned health conditions often show their first signs and symptoms in the mouth through lesions and other oral issues.

Doctors typically collect saliva for testing and finding different substances. For instance, saliva tests can show the cortisol levels in the body. This type of medical check is to determine the stress response of a newborn child. Saliva is also used to determine if there is a significant bone loss in men and women with a risk of osteoporosis. Some cancer markers can also be detected in the saliva.

The same test can also measure if there are any illegal drugs in your system, as well as environmental toxins and hormones. Your saliva is also used to check for antibodies that indicate HIV infection or hepatitis. In the future, it is possible that saliva testing can replace blood testing for the diagnosis of certain diseases, such as diabetes, liver cirrhosis, and Parkinson’s disease.

Like the other parts of your body, the mouth is teeming with bacteria. There’s nothing to be scared of because they are mostly harmless. But the mouth is especially significant. It is the entry point to the insides of your body, namely your respiratory and digestive tracts. Unfortunately, some of the bacteria can lead to disorders in those mentioned areas.

With the help of the natural defences in the body, good oral health care can keep harmful bacteria under control. However, skipping brushing and flossing can lead to bacteria multiplying, reaching levels that can lead to tooth decay, gum diseases, and other oral infections.