Oral Hygiene

Prevention is better than cure therefore by practicing good oral hygiene daily will help to keep your teeth and gums healthy.

How can I improve my dental hygiene at home?

Keeping a good daily oral cleaning routine is an essential facet of improving your level of dental health. It is easy to get your mouth clean and healthy, and keep it that way. A simple routine can help prevent most dental problems:

• Brush your teeth for two minutes, last thing at night and at least one other time during the day, using fluoride toothpaste.
• Spit toothpaste out after brushing and do not rinse.
• Use a toothbrush with soft to medium, multi-tufted, round-ended nylon bristles.
• Consider using an electric toothbrush.
• Use small, circular movements to clean your teeth.
• Change your toothbrush regularly, and at least every 3 months.
• Clean between your teeth every day using interdental brushes or dental floss.
• Have sugary drinks and foods less often.
• Drinking enough water is also important for dental health because it stimulates saliva production and washes away food particles.
• Visit your dental team regularly, as often as they recommend.

Fluoride Treatment

What is fluoride?

Fluoride is a natural mineral that is found in many foods and in all drinking water. The amount of fluoride in water varies from area to area.

What are the benefits of fluoride?

Fluoride can greatly help dental health by strengthening the tooth enamel, making it more resistant to tooth decay. It also reduces the amount of acid that the bacteria on your teeth produce.
Children who have fluoride when their teeth are developing tend to have shallower grooves in their teeth, so plaque can be more easily removed. Plaque is a thin, sticky film of bacteria that constantly forms on your teeth.

What about fluoride toothpaste?

Most toothpastes now contain fluoride, and most people get their fluoride this way. Fluoride toothpaste is very effective in preventing tooth decay. The amount of fluoride in toothpaste is usually enough to reduce decay.
In areas where the water supply has fluoride added, fluoride toothpaste gives extra protection.
All children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm
(parts per million). After three years old they should use a toothpaste that contains 1350ppm to 1500ppm.
Parents should supervise their children’s brushing, and use only a pea-sized smear of fluoride toothpaste until they are about 7 years old.
Spit out after brushing and do not rinse, so that the fluoride stays on your teeth longer.
Our dental team can apply fluoride to your teeth when necessary. These come as varnishes or gels and are more concentrated than ones you can apply yourself, so you do not need them as often. Some adults can benefit from these applications. Fluoride varnishes can help to reduce tooth decay – especially for people with dry mouth.
Some people are more likely to have tooth decay, and the dental team may also advise using a higher-strength fluoride toothpaste for extra protection.

Fissure Sealants

What are sealants?

Sealants are a safe and painless way of protecting your teeth from tooth decay. A sealant is a protective plastic coating, which is applied to the biting surfaces of the back teeth. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay.

Which teeth should be sealed?

Sealants are only applied to the back teeth – the molars and premolars. These are the teeth that have ‘pits’ (small hollows) and ‘fissures’ (grooves) on their biting surfaces. Your dental team will tell you which teeth should be sealed after they have examined them, and checked whether the fissures are deep enough for sealing to help. Some teeth naturally have deep grooves which will need to be sealed; others have shallow ones which will not need sealing.

What is involved?

The process is usually quick and straightforward, taking only a few minutes for each tooth. The tooth is thoroughly cleaned, prepared with a special solution, and dried. The liquid sealant is then applied and allowed to set hard – usually by shining a bright light onto it.

Will I feel it?

No, it is totally pain free, and the teeth do not feel any different afterwards.

How long do pit and fissure sealants last?

Sealants usually last for many years, but your dental team will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes the dental team need to add or replace some sealant to be sure that no decay can start underneath it.

How do pit and fissure sealants work?

The sealant forms a smooth, protective barrier by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves if they are not sealed.

When should this be done?

Sealants are often applied as soon as the first permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.

Do I still have to clean my teeth?

Yes. It is still very important to do this. The smooth, sealed surface is now much easier to keep clean and healthy with normal brushing. Using a fluoride toothpaste, last thing at night and at least one other time during the day, will help to protect your teeth. Pit and fissure sealing reduces tooth decay and the number of fillings you might need.

Who do I ask about the treatment?

If you would like to know more about the treatment, ask your dentist. They will tell you if fissure sealing will help your teeth, and if it is the right time to do it.

Cancer Screening

What is mouth cancer?

Most people have heard of cancer affecting parts of the body such as the lungs or breasts. However, cancer can appear in the mouth, where the disease can affect the lips, tongue, cheeks and throat.

Who can be affected by mouth cancer?

Anyone can be affected by mouth cancer, whether they have their own teeth or not. Mouth cancers are more common in people over 40, particularly men. However, research has shown that mouth cancer is becoming more common in younger patients and in women. There are more than 640,000 cases of mouth cancer diagnosed each year worldwide and it is the eleventh most common cancer. In the United States there are around 43,000 cases each year.
In some countries there is an increased risk because of problems such as tobacco chewing – in India, for example – and the rates are even higher. There are, on average, almost 7,800 new cases of mouth cancer diagnosed in the UK each year. The number of new cases of mouth cancer is on the increase, and in the UK has increased by over half in the last decade alone.

Do people die from mouth cancer?

Yes. More than 2,300 people in the UK die from mouth cancer every year. Many of these deaths could be prevented if the cancer was diagnosed early enough. As it is, people with mouth cancer are more likely to die than those having cervical cancer or melanoma skin cancer.

What can cause mouth cancer?

Most cases of mouth cancer are linked to tobacco and alcohol. Cigarette, cigar and pipe smoking are the main forms of tobacco use in many parts of the world. However, the traditional habits in some cultures of chewing tobacco, betel quid, gutkha and paan are particularly dangerous.
Alcohol increases the risk of mouth cancer, and if tobacco and alcohol are taken together the risk is even greater.
Over-exposure to sunlight can also increase the risk of cancer of the lips.
Many recent reports have linked mouth cancer to the human papillomavirus (HPV). HPV is the main cause of cervical cancer and affects the skin that lines the moist areas of the body.
HPV can be spread through oral sex, and research now suggests that HPV could soon rival smoking and drinking as one of the main causes of mouth cancer.
Practising safe sex and limiting the number of partners you have may help reduce your chances of getting HPV. Many people get HPV during their lives and for many this does not cause a problem.
There are now HPV vaccines for both girls and boys. They were developed to fight cervical cancer, but it is likely that they will also help to reduce the rates of mouth cancer. These vaccines are given at age 12 to 13 before sexual activity starts.

What are the signs of mouth cancer?

Mouth cancer can appear in different forms and can affect all parts of the mouth, tongue and lips. Mouth cancer can appear as a painless mouth ulcer that does not heal normally. A white or red patch in the mouth can also develop into a cancer. Be aware of any unusual lumps in your mouth or jaw area and any persistent hoarseness. It is important to visit your dental team or doctor if these areas do not heal within three weeks. If you aren’t sure, go for a check-up anyway.

How can mouth cancer be detected early?

Mouth cancer can often be spotted in its early stages by your dental team during a thorough mouth examination. If mouth cancer is diagnosed early, then the chances of a cure are good. Many people with mouth cancer go to their dentist or doctor too late.

Is there anything I can do at home?

Be aware of what is going on in your mouth. Examine yourself regularly. Ulcers that do not heal within three weeks, any unusual red or white patches, lumps in your neck or jaw area, or persistent hoarseness are all reasons for asking your dental team or doctor to examine you. There is probably nothing seriously wrong but an early diagnosis could save your life.

What is involved in a full check-up of the mouth?

The inside of your mouth and your tongue will be examined with the help of a small mirror. The examination will also look at your neck and underneath your jaw. Your dentist will carry out this examination as part of a routine dental check-up. Remember, your dental team can see parts of your mouth that you cannot see easily yourself.

What happens if my dentist finds a problem?

If they find something unusual they will refer you to a consultant at the hospital, who will carry out a thorough examination of your mouth and throat. A small sample of the cells may be gathered from the area (a biopsy), and these cells will be examined under the microscope to see what is wrong.

What happens next?

If the cells are cancerous, more tests will be carried out. These may include overall health checks, blood tests, x-rays or scans. These tests will decide what course of treatment is needed.

Can mouth cancer be cured?

If mouth cancer is spotted early, the chances of a complete cure are good, and the smaller the area or ulcer the better the chance of a cure. However, too many people come forward too late because they do not have regular mouth examinations.

How can I make sure that my mouth stays healthy?

Stop smoking, and cut down on the amount of alcohol you drink.
Eat a balanced, healthy diet with at least five portions of fruit and vegetables a day. This can also help protect against many other cancers.
Visit your dental team regularly, as often as they recommend.

Dietary Advice

What is tooth decay?

Tooth decay damages your teeth and leads to fillings or even extractions. Decay happens when sugar reacts with the bacteria in plaque. This forms the acids that attack the teeth and destroy the enamel. After this happens many times, the tooth enamel may break down, forming a hole or ‘cavity’ into the dentine. The tooth can then decay more quickly.

What foods can cause decay?

All sugars can cause decay. Sugar can come in many forms. Usually ingredients ending in ‘ose’ are sugars, for example: sucrose, fructose and glucose are just three types. These sugars can all damage your teeth.
Many processed foods have sugar in them, and the higher up it appears in the list of ingredients, the more sugar there is in the product. Always read the list of ingredients on the labels when you are food shopping.
When you are reading the labels remember that ‘no added sugar’ does not necessarily mean that the product is sugar free. It simply means that no extra sugar has been added. These products may contain sugars such as those listed above, or the sugars may be listed as ‘carbohydrates’. Ask your dental team if you are not sure.

Can food and drink cause erosion?

Acidic food and drinks can cause dental erosion – the gradual dissolving of the tooth enamel Anything with a pH value lower than 5.5 may cause erosion. ‘Alkalis’ have a high pH number and cancel out the acid effects of sugars.

Can I eat snacks?

It is better for your teeth and general health if you eat 3 meals a day instead of having 7 to 10 snacks. If you do need to snack between meals, choose foods that do not contain sugar. Fruit does contain acids, which can erode your teeth. However, this is only damaging to your teeth if you eat an unusually large amount. Try not to have a lot of dried fruit as it is high in sugar.
If you do eat fruit as a snack, try to eat something alkaline such as cheese afterwards. Savoury snacks are better, such as:

• Cheese.
• Raw vegetables.
• Nuts.
• Breadsticks.

Can I eat sweets?

The main point to remember is that it is not the amount of sugar you eat or drink, but how often you do it. Sweet foods are allowed, but it is important just to have them at mealtimes.
To help reduce tooth decay, cut down on how often you have sugary foods and drinks and try to have sugar-free varieties. Confectionery and chewing gum containing the artificial sweetener Xylitol may help to reduce tooth decay.
Sugary foods can also cause a range of health problems including heart disease and being overweight.

What should I drink?

Still water and milk are good choices. It is better for your teeth if you drink fruit juices just at meal times. If you are drinking them between meals, try diluting them with water.
Diluted sugar-free fruit drinks are the safest alternative to water and milk. If you make these, be sure that the drink is diluted 1 part fruit drink to 10 parts water. Some soft drinks contain sweeteners, which are not suitable for young children – ask your dental team if you are not sure.
Fizzy drinks can increase the risk of dental problems. The sugar can cause decay and the acid in both normal and diet drinks can dissolve the enamel on the teeth. The risk is higher when you have these drinks between meals.

Should I brush my teeth after every meal?

It is important that you brush last thing at night and at least one other time during the day, with a toothpaste containing fluoride.
Eating and drinking foods containing sugar and acids naturally weakens the enamel on your teeth. Brushing straight afterwards can cause tiny particles of enamel to be brushed away. It is best not to brush your teeth until at least one hour after eating.
It is especially important to brush before bed. This is because the flow of saliva, which is the mouth’s own cleaning system, slows down during the night and this leaves the mouth more at risk from decay.
Children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). Three-year-olds to adults should use a toothpaste that contains 1350ppm to 1500ppm of fluoride.

Why is a healthy diet important for my oral health?

Every time you eat or drink anything sugary, your teeth are under acid attack for up to one hour. This is because the sugar will react with the bacteria in plaque (the sticky coating on your teeth) and produce harmful acids. So it is important to have sugary foods or drinks just at mealtimes, limiting the amount of time your mouth is at risk.
Acidic foods and drinks can be just as harmful. The acid ‘erodes’ or dissolves the enamel, exposing the dentine underneath. This can make your teeth sensitive and unsightly.
A diet that is rich in vitamins, minerals and fresh fruit and vegetables can help to prevent gum disease. Gum disease can lead to tooth loss and cause bad breath.

Does chewing gum help?

Chewing gum makes your mouth produce more saliva, which helps to cancel out the acid in your mouth after eating or drinking. It has been proven that using sugar-free chewing gum after meals can prevent tooth decay. However, it is important to use only sugar-free gum, as ordinary chewing gum contains sugar and therefore may damage your teeth.
You may be asked by your dentist to complete a diet analysis at your check up appointment if you have a high caries risk.

Smoking Cessation

How can smoking affect my oral health?

Most people are now aware that smoking is bad for their health. It can cause many different medical problems and, in some cases, fatal diseases. However, many people don’t realise the damage that smoking does to their mouth, gums and teeth.
Smoking can lead to tooth staining, gum disease, tooth loss, and in more severe cases mouth cancer.

Why are my teeth stained?

One of the effects of smoking is staining on the teeth due to the nicotine and tar in the tobacco. It can make your teeth yellow in a very short time, and heavy smokers often complain that their teeth are almost brown after years of smoking.

How will smoking affect my gums and teeth?

Smoking can also lead to gum disease. People who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums don’t heal. Smoking causes people to have more dental plaque and causes gum disease to get worse more quickly than in non-smokers. Gum disease is still the most common cause of tooth loss in adults.

How is smoking linked with cancer?

Most people know that smoking can cause lung and throat cancer, but many people still don’t know that it is one of the main causes of mouth cancer too. Every year thousands of people die from mouth cancer brought on by smoking.

Are there special dental products I can use?

There are special toothpastes for people who smoke. They are sometimes a little more abrasive than ordinary toothpastes and you should use them with care. Your dental team may recommend that you use these toothpastes alternately with your usual toothpaste. There are several ‘whitening’ toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining, and therefore may improve the overall appearance of your teeth.

What about mouthwashes?

People who smoke may find they are more likely to have bad breath than non-smokers. Fresh-breath products such as mouthwashes may help to disguise the problem in the short term, but will not cure it.

How often should I visit my dentist?

It is important that you visit your dental team regularly for a normal check-up and a full mouth examination so that any other conditions can be spotted early.
You should visit your dental team regularly, as often as they recommend. People who smoke are more likely to have stained teeth, and therefore may need appointments more often with the dental hygienist.

What can my dentist do for me?

Your dentist will carry out a regular examination to make sure that your teeth and gums and whole mouth are healthy.
Your dental team will also examine your cheeks, tongue and throat for any signs of other conditions that may need more investigation.
Your dentist will be able to put you in touch with organisations and self-help groups who will have the latest information to help you stop smoking.

Will I need any extra treatment?

Your dentist may also refer you to a dental hygienist, for extra treatment, thorough cleaning and to keep a closer check on the health of your mouth. Your dental hygienist will be able to advise you on how often you should visit them, although this should usually be every three to six months.