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Dental Health

Dental Health

The NHS advice on dental health:

Dental health in the UK among adults and children is better than ever before.

Our dental health has improved in recent years because we're taking better care of our teeth.

Thanks to the widespread use of fluoride toothpaste, which helps to prevent and control decay, the number of adults with none of their own natural teeth has fallen from 37% in 1968 to 12% in 1998 (the last year for which figures were compiled).

Children's teeth are also healthier than ever. Twelve year olds in England have the best teeth in Europe and 6 out of 10 children start school with no tooth decay.

Here's how you and your children can have healthy teeth and keep trips to the dentist to a minimum:

Brush your teeth twice a day with fluoride toothpaste.

A healthy lifestyle, including eating well, not smoking and limiting your alcohol intake, is good for your whole body, including your teeth, gums and mouth.

Help your child have healthy teeth for life by establishing a good dental health routine.

It's important to have regular check-ups with your dentist. Your dentist will decide how often you should have a check-up. It can vary from three months to two years (or up to one year if you're under 18). Generally, the lower your risk of dental problems, the longer you can wait before your next check-up. So people with good oral health will probably need to attend only once every 12 to 24 months, but those with higher treatment needs will need check-ups more often.

Don't put off going for a check-up at the dentist. Detecting problems early can mean they're easier to treat. If problems are not treated, they may lead to damage that is harder, or even impossible, to repair.

Teeth-cleaning Guide:

Brushing with fluoride toothpaste twice a day for at least two minutes at a time will help keep your teeth and mouth healthy.

Your mouth contains bacteria, which live on your teeth, gums, lips and tongue. Some bacteria are healthy if present in the right place, at the right time and in the right numbers. Our body needs these 'friendly' bacteria to function. Other bacteria can be harmful and cause problems, especially if they attach themselves, in the form of plaque, to the enamel that covers your teeth.

Plaque is a film of bacteria that coats the teeth. These bacteria feed on the sugars in our food and drink, and they produce acids that can destroy tooth enamel and cause decay.

Plaque forms if you do not brush your teeth properly or look after your gums, which enables bacteria to multiply. Plaque contributes to gum disease, tooth decay and cavities.

Toothbrush Tips:

Replace your brush or brush attachment every three months.

Never share your toothbrush as this can spread infections.

Brush your teeth twice daily with fluoride toothpaste for at least two minutes.

When should I brush my teeth?

Brush your teeth for at least two minutes in the morning before breakfast and last thing at night before you go to bed (and ideally at least an hour after your evening meal).

Brushing your teeth straight after a meal can damage your teeth, especially if you've had fruit, fizzy drinks, wine or any other food that contains acid. This is because tooth enamel is softened by the acid and can be worn away by brushing. Waiting an hour gives your saliva chance to neutralise the acid.

Avoid frequent intake of acidic food and drinks; keep them to meal times.

Should I use an electric or manual toothbrush?

The type of toothbrush you use is important. For most adults, a brush with a small head and a compact, angled arrangement of long and short, round-end bristles (filaments) is fine. Medium or soft bristles are best for most people. If in doubt, ask your dentist.

An electric brush with an oscillating or rotating head will reduce plaque and the risk of developing gum disease more effectively.

What type of toothpaste should I use?

The cleansing agents and particles in toothpaste help to remove plaque from your teeth, keeping them clean and healthy.

Most toothpastes contain fluoride, which helps to prevent and control
cavities. It is important to use a toothpaste with the right concentration of fluoride for you or your child. Check the packaging to find out how much fluoride each brand contains.

Children aged up to three: use a smear of toothpaste containing no less than 1,000ppm (parts per million) fluoride. This means you can use the family toothpaste and don't need a special baby toothpaste.

Children aged three to six: use a pea-sized amount of toothpaste containing 1,350-1,500ppm fluoride.

Adults: use a toothpaste that contains at least 1,450ppm fluoride.

Brushing tips:

The British Dental Health Foundation gives the following advice on how to brush your teeth:

Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45 degree angle against the gum line. Move the brush in small circular movements, several times, on all the surfaces of every tooth.

Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gum line.

Use the same method on the inside surfaces of all your teeth.

Brush the chewing surfaces of the teeth.

To clean the inside surfaces of the front teeth, tilt the brush vertically and make several small circular strokes with the toe (the front part) of the brush.

Brushing your tongue will freshen your breath and clean your mouth by removing bacteria.

Flossing isn't just for dislodging food wedged between your teeth. Regular flossing may reduce gum disease and bad breath by removing the bacterial film (plaque) that forms along the gum line.

How to floss:

Take 30-45cm (12-18 inches) of floss and grasp it so that you have a couple of inches of floss taut between your hands.

Slip the floss between the teeth and into the area between your teeth and gums, as far as it will go.

Floss with eight to 10 strokes, up and down between each tooth, to dislodge food and plaque.

Floss at least once a day. The most important time to floss is before going to bed.

You can floss before or after brushing.

Should I use mouthwash?

Mouthwashes containing fluoride can be beneficial. Some may contain chlorhexidine or other antiseptic chemicals. These may improve plaque control and gum health when used in addition to tooth brushing. Or they can be used alone if you can't brush your teeth for some reason. Mouthwashes that contain essential oils or other chemicals aren not as effective.

Many mouthwashes contain alcohol, so they're not suitable for children as they could swallow them accidentally. If you use a mouthwash with alcohol, you may get a very dry mouth and dry, cracked lips due to the drying effect of the alcohol. You can avoid this by using an alcohol-free mouthwash instead.

The little extras:

Toothpicks. Avoid using toothpicks as you could cause your gums to bleed, which can lead to an infection. Floss is gentler on your teeth and gums.

Interdental brushes. These are a better way to clean between your teeth than toothpicks.

Plaque-disclosing tablets. These work by dyeing plaque either blue or red. They dye all bacteria, but because your mouth contains a lot of "friendly" bacteria, the tongue and gums also get dyed. You don't need to clean this off, but as the staining can last for some hours, it is best to use these tablets at bedtime or when you're not expecting visitors.

Caring for your Childs Teeth:

As soon as your babys teeth start to come through, you can start brushing them. Use a baby toothbrush with a tiny smear of fluoride toothpaste. Check with your dentist whether the brand you?re using has enough fluoride for your babys needs.

Do not worry if you do not manage to brush much at first. The important thing is to get your baby used to teeth-brushing as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.


Fluoride is a natural element that can help prevent tooth decay. It occurs naturally in foods, and is added to the water supply in some areas, although the level is usually too low to be of much benefit.

Most (90%) of the UK population lives in areas with little or no fluoride added to the tap water. There are fluoridation schemes in Bedfordshire, Cheshire, Cumbria, Derbyshire and Nottinghamshire. In the West Midlands and North-East, extra fluoride is added to the water supply.

You can give extra fluoride in the form of drops (for babies) or tablets (for children), but you should not do this if you live in an area where fluoride is naturally present or has already been added to the water. Ask your dentist for advice. Fluoride in toothpaste is very effective.

Brushing tips:

Use a tiny smear of toothpaste for babies and a pea-sized amount for children.

Gradually start brushing your childs teeth more thoroughly, covering all the surfaces of the teeth. Do it twice a day: just before bed, and at another time that fits in with your routine.

Not all children like having their teeth brushed, so you may have to keep trying. Don't let it turn into a battle. Instead, make it into a game, or brush your own teeth at the same time and then help your child finish their own.

The easiest way to brush a babys teeth is to sit them on your knee with their head resting against your chest. With an older child, stand behind them and tilt their head upwards.

Brush the teeth in small circles covering all the surfaces and let your child spit the toothpaste out afterwards. Rinsing with water has been found to reduce the benefit of fluoride.

You can also clean your babys teeth by wrapping a piece of damp gauze with a tiny amount of fluoride toothpaste on it over your finger and rubbing this over their teeth.

Carry on helping your child brush their teeth until you?re sure they can do it well enough themselves. This will normally be until they?re at least seven.

Cutting down on sugar:

Sugar causes tooth decay. Children who eat sweets every day have nearly twice as much decay as children who eat sweets less often.

This is caused not only by the amount of sugar in sweet food and drinks, but by how often the teeth are in contact with the sugar. This means sweet drinks in a bottle or feeder cup and lollipops are particularly damaging because they bathe the teeth in sugar for long periods of time. Acidic drinks such as fruit juice and squash can harm teeth too. This is why it is better to give them at mealtimes, not in between.

The following measures will help you reduce the amount of sugar in your childs diet and prevent tooth decay.

From the time your baby is weaned, encourage them to eat savoury food. Check if there is sugar in pre-prepared baby foods (including the savoury ones), rusks and baby drinks, especially fizzy drinks, squash and syrups.

Only give sweet foods and fruit juice at mealtimes. Well-diluted fruit juice containing vitamin C and given in a cup with a meal can also help iron to be absorbed. Between meals, stick to milk or water.

Don't give biscuits or sweets as treats, and ask relatives and friends to do the same. Use items such as stickers, badges, hair slides, crayons, small books, notebooks, colouring books, soap and bubble baths. They may be more expensive than sweets but they last longer.

If children are having sweets or chocolate, it is less harmful for their teeth to eat them all at once and at the end of a meal than to eat them little by little and/or between meals.

At bedtime or during the night, give your baby milk or water rather than baby juices or sugar-sweetened drinks.

If your child needs medicine, ask your pharmacist or GP if there?s a sugar-free option.

Don't give drinks containing artificial sweeteners, such as saccharin or aspartame. If you do, dilute them with at least 10 parts water to one part concentrate.

It is OK to use bottles for expressed breast milk, infant formula or cooled boiled water but using them for juices or sugary drinks can increase tooth decay. It is best to put these drinks in a cup and keep drinking times short.

Between six months and one year, you can offer drinks in a non-valved free-flowing cup.

Check your whole familys sugar intake, and look for ways of cutting down.
Sucrose, glucose, dextrose, maltose, fructose and hydrolysed starch are all sugars. Invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado and concentrated fruit juices are all sugars.

Maltodextrin is not a sugar, but can still cause tooth decay.

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