Fit & Proper: Brushing your teeth twice a day is not good enough

Suman Pahuja, 31, is in office from 10 am to 6 pm. She usually has two cups of coffee at work and lunch in the office cafeteria. In between she also chews gum, which, she believes, helps keep her teeth clean and breath fresh. She ensures that she brushes her teeth twice a day, especially before going to bed. She used to think that her dental hygiene regime was impeccable - until she found that one of her molars had started to decay. She was clearly not getting something right.
Doctors sometimes encounter these questions: "I read somewhere that brushing your teeth twice a day does not guarantee optimal oral hygiene - is this true? Is there an oral hygiene protocol that needs to be followed?"

Yes, there is certainly an oral health protocol that needs to be followed, for both children and adults. First of all, it's critical to brush the teeth twice a day and floss once a day. Brushing or at least rinsing your mouth after each meal is even better.

The most common dental disease I have come across in clinical practice is decay and multiple deposits on the teeth. This leads to the need for early extractions and subsequently results in poorly aligned teeth, as the teeth next to the extraction site shift into the empty spaces. When tooth decay is ignored, it leads to bigger problems. A well-established oral care routine will help to prevent decay and the problems it causes when ignored.

However, brushing alone does not guarantee optimal oral health. As we say, "If brushing twice daily were enough, every child would have great teeth." Regular visits to the dentist are very important. Oral prophylaxis, or cleaning of the teeth by a dental surgeon, will remove deposits that everyday brushing cannot. Dentists can administer sealants and fluoride treatment to protect young teeth from decay. The dental surgeon will also be able to address developing problems as well as some of the harmful habits like thumb sucking that can eventually cause dental problems such as crooked teeth.

Parents of young children must take special care of their kids' teeth in order to establish good habits from an early age. With school-going children, brushing should be part of a family ritual in which parents lead by example. Parents should examine their child's mouth once a month to look for dark spots or patches which could be signs of a problem. Pain or swelling in the mouth is the ultimate warning and should not be ignored. Parents should also be vigilant regarding growing spaces in the mouth or crooked teeth; these should be addressed immediately.


QUICK TIPS

• Brush your teeth at least twice daily and after meals.
• Hold your toothbrush at a 45-degree angle toward the gums and brush in a back-and-forth motion, making sure to reach every surface of each tooth. Brush the tongue as well.
• Brush longer, not harder. Brush for at least two minutes using a soft-bristled toothbrush and replace your toothbrush every three months.
• Choose the right toothpaste; your dentist can help identify the right one for you.
• Floss at least once a day.
• Rinse with an anti-bacterial mouthwash to remove the bacteria that cause dental plaque.
• Visit your dentist every six months for a professional cleaning.
• Take your child to the dentist regularly from the age of 12 months.
• Help your child brush until he/she can brush independently, usually around the age of eight.

Vimal Arora
Chief clinical officer, Clove Dental,

New Delhi