Although tooth brushing tools date back as far as 3500 BC, the Chinese are credited with developing the earliest known natural bristled tooth brush. It was fashioned from the bristles from a pig’s neck and fastened to a bamboo or bone handle. The toothbrush as we know today with nylon bristles was introduced in 1938.

Floss was invented in 1819 by Levy Spear Parmly, a dentist from New Orleans. He recommended using a silken thread that was waxed to run through the neck of the tooth right above the gum. Floss began to be mass produced in 1882.

Brushing your teeth is the most effective way to remove plaque and harmful bacteria from your teeth and gums and prevent cavities.

General recommendations for brushing include:

  • Brush your teeth twice a day using a soft bristle brush. Place your tooth brush at a 45 degree angle to the gums, brushing 1-2 teeth at a time using a circular motion. Don’t forget to cover all surfaces of each individual tooth of the entire mouth. In addition, you should brush your tongue as well as the roof and floor of the mouth. This will help you keep your breath fresh and pleasant. It takes about three minutes to effectively remove plaque from the surfaces of all teeth. Studies have shown that people usually rush and generally spend only around 1.5 minutes brushing.
  • Replace your toothbrush every 3-4 months or earlier if the bristles look worn. Your toothbrush will no longer be effectively removing plaque if the bristles are frayed.
  • Talk to your dentist to determine what kind of brush and brushing technique would be best for your mouth. Even some brushes labeled “soft” are not truly soft, and coupled with an aggressive brushing style, may lead to gum recession and root wear.

Flossing is essential for removing plaque between your teeth where your tooth brush cannot reach. If plaque is not removed by brushing and flossing it can eventually turn into harmful tartar, also known as calculus. Not only is flossing an essential complement to brushing to prevent your teeth from developing cavities between your teeth, but it also helps prevent halitosis (bad breath). It increases blood circulation and helps to keep your gums healthy and strong. Studies have shown no difference between flossing before or after brushing. The most important is that it happens, and is done properly.

Children need to floss too. Adult caregivers should assist them until they are 10 or 11 years old and develop dextral maturity to floss on their own.

Flossing is not supposed to be painful. If you are new to flossing (or have not flossed regularly for some time), you will likely feel some initial discomfort and possibly mild bleeding of the gums. But if a proper flossing regimen is maintained and plaque is removed, the pain will stop within a short period of time (5-10 days).

How to floss:

Wrap each end of a 12-inch piece of floss around your middle fingers. Hold a small amount (about an inch) of the floss between your thumbs and index fingers. Hugging the floss tightly to the side of each tooth, rub the floss gently up and down. Keep the floss pressing tightly against your tooth, forming a C or U shape that hugs as much surface area of your tooth as possible. Each side of each tooth should be covered. Don’t forget to floss the back side of your last tooth (molar) in the mouth.

Fluoride is naturally found in a variety of sources, including fruit, vegetables, and tea. However, the main source of fluoride intake is usually from water. According to the guidelines of the World Health Organization, the level of fluoride should be 0.8-1.2mg/L to be most beneficial to the human body to prevent dental decay and bone fractures.

In 1951 fluoridation became an official policy in the U.S. Public Health Service and was widely implemented by 1960. For decades, fluoride has been considered by dental communities to be an important mineral that helps strengthen teeth and prevent decay. According to the American Dental Association, due to water fluoridation, dental decay has been reduced by 20-40% even in areas where other sources of fluoride, such as tooth pastes, are available. More than 144 million U.S. residents in more than 10,000 communities drink water from sources where fluoride is added as a supplement to public water supplies. Climate is the determining factor of the concentration of fluoride in public water supplies. For hotter climates, where people tend to drink more water, the concentration is correspondingly lower than in cooler climates.

There are, however, health issues that can arise due to excessive fluoride intake (above 1.5 mg/l). One such condition, called dental fluorosis, results in tooth defects such as pitting of tooth enamel and also deposits in bones. Not a problem in public water supplies, but some wells have too much, etc. You could flesh out this paragraph about excessive fluoride more—when do I need to be careful? If you bring it up people may worry.

The best way to maintain your beautiful smile is to make sure your teeth are healthy, your oral environment is clean, and intake of harmful foods is limited. Our staff is committed to helping you prevent dental cavities, preserving teeth that have been restored, keeping your teeth from fracturing, and making sure your gums are healthy. At your initial visit we review oral hygiene instructions and reinforce them at each subsequent visit.

The following recommendations are helpful:

  • Brush your teeth twice a day in a circular motion with a soft bristled toothbrush aimed at a 45-degree angle to the gum
  • Floss every night
  • Avoid smoking
  • Stay away from sticky, sugary foods
  • Eat a healthy, balanced diet
  • Use antimicrobial and fluoride rinses if directed
  • Have sealants placed on young permanent teeth

Keep in mind that dental decay is caused by dental plaque—a thin, sticky, colorless deposit of bacteria that is constantly forming on teeth. When any sugars (or carbohydrates that become sugars as they break down) are eaten, the bacteria in the plaque produce acids that break down the enamel of the tooth. After prolonged exposure to these acids the enamel breaks down and a cavity is formed. In order to prevent this process, it is essential to thoroughly remove dental plaque once every 24 hours. The following are factors that increase a person’s risk of developing cavities:

  • Frequent intake of sugars and sugary foods
  • Elevated oral bacteria count
  • Recent history of dental decay
  • Inadequate exposure to fluoride
  • Exposed roots due to receded gums
  • Poor or inadequate oral hygiene
  • Deep pits and fissures on chewing surfaces of teeth (see section entitled “Sealants” below)
  • Decreased flow of saliva (often medication related)

Dental sealants are barriers that help prevent cavities from forming on the chewing surfaces of teeth. Thorough brushing and flossing can clean plaque and food particles from smooth surfaces of the teeth. But often tooth brush bristles cannot adequately reach grooves on the chewing surface of teeth. Sealants form a durable barrier that helps keep plaque and foods from getting into the grooves (pits and fissures) of teeth. They are usually applied to molars and premolars at the back of the mouth, as this is where decay most often occurs. It is ideal for sealants to be placed soon after the teeth are fully erupted. During the procedure, your dentist will apply a liquid coating to the chewing surface of the tooth and directly harden it with a special curing light.

Sealants were implemented around 1970, and today are widely recommended by dentists. Teenagers and children are great candidates for preventative measures like sealants. Even adults, who have not had any decay on the chewing surfaces of their teeth can benefit from sealants. Sealants can prevent tooth decay for up to 10 years but should be checked for chipping and wear at your regular dental appointments every six months.

Mouth rinses are used by the general population for a variety of reasons—to freshen breath, prevent tooth decay, and reduce the number of bacteria that cause plaque build up. Mouth rinses are divided into two categories—therapeutic and cosmetic. Therapeutic rinses contain fluoride and help fight cavities, plaque, and gingivitis (inflammation of the gums).

Cosmetic rinses help treat unpleasant breath odor and leave a pleasant taste in the mouth. They do not address the cause of bad odor and do not help fight harmful bacteria that cause tooth decay and inflammation.

People who have difficulty brushing due to lack of physical ability (due to aging or diseases such as arthritis) can benefit from good therapeutic mouth rinses.

Mouth rinses do not replace thorough cleaning by brushing and flossing, which are still the most effective ways to keep your mouth healthy.

Dental x-rays help dentists to identify diseases associated with teeth and their surrounding structures which cannot be seen with a simple clinical oral evaluation. In addition, they help dentists to find and treat compromised teeth early in disease development. These early findings can prevent patients from unnecessary discomfort, lead to a conservative procedure rather than tooth loss, and can even help save a life.

In adults dental x-rays can be used to:

  • Show decay that is starting between the teeth or under an existing filling
  • Reveal bone loss due periodontal disease
  • Show build up (calculus) underneath the gums
  • Reveal an abscess (an infection around or at the tip of the root)
  • Show possible developmental abnormalities such as cysts and some tumors
  • Assist in preparation for dental implants, braces, dentures, or other dental procedures

In children dental x-rays are used to:

  • Detect decay
  • Analyze and determine if a child has enough space in his or her mouth for all developing teeth
  • Determine if tooth development and loss (loss of baby teeth) is appropriate and on time

When X-rays pass through the mouth, more x-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (gums and cheeks). These differences are exposed on film or a digital sensor to create an image. Teeth appear lighter because fewer x-rays penetrate to reach the sensor, while cavities and gums appear dark because more x-rays pass through. The reading and interpretation of these x-rays allows dentists to accurately and safely detect dental decay and abnormalities.

The frequency of dental x-rays depends on the patient’s individual health needs. Some people may need x-rays as often as every six months, while others who are free of dental decay and come for regular dental visits may only need them once every few years. The schedule for needing x-rays varies according to your age, risk factors, and signs and symptoms of disease. If you are a new patient, your dentist will need to take a full set of x-rays of your entire mouth to establish your baseline record.

Starting your baby off with good dental habits will lead to healthy adult teeth. The ADA recommends babies to be seen by dentists by their first birthday or six months after the appearance of the first tooth. This is critical to insure proper development of your child’s dentition. Treat this appointment as you would a well-baby checkup with child’s physician. Your dentist can detect any problems early on, help treat them, and guide you through specific needs your child might have.

Habits like thumb sucking or the prolonged use of pacifiers can have adverse effects on tooth and jaw development, including malformed teeth and poor bite relationships.

The following are good points to follow:

  • Begin cleaning your baby’s mouth in the first few days after birth with a clean, moist gauze or washcloth. It is helpful for your baby if you develop a routine (for example, wiping their mouth after a diaper change in the evening). This will help your child be receptive to brushing their teeth as soon as they appear.
  • Start brushing your baby’s teeth as soon as they appear.
  • Brush your baby’s teeth thoroughly with a small-head toothbrush with a rice grain-sized amount of fluoridated toothpaste.
  • For children 3-6 years of age, use a pea sized-amount of toothpaste and brush twice a day. Parental assistance is important at this age, as thorough removal of plaque is essential to prevent decay. If you choose to let you child brush independently, it is advised that you follow up with brushing their teeth yourself, especially before going to bed.
  • Supervise your children when they are handling fluoridated toothpaste to prevent excessive ingestion of fluoride.
  • Encourage your child to drink from a cup by his/her first birthday
  • Encourage healthy eating habits

It is important to note that tooth decay can begin with cavity-causing bacteria being passed from the mother, father, or caregiver to the infant. These bacteria are passed through the saliva when the baby’s pacifier or spoon is licked by the caregiver.

To prevent your baby’s teeth from decay you should avoid:

  • Putting your baby to sleep with a bottle – this will cause prolonged exposure to sugars (from milk or juice)
  • Sharing saliva through common use of spoon or licking pacifiers
  • Putting anything sweet like sugar or honey on your child’s pacifier