Tooth care products, such as toothpaste, toothbrushes and dental floss, help keep your teeth clean and prevent conditions such as tooth decay and gum disease. There is a wide range of products available. This factsheet explains some of the different types, what they do and how you should use them.
 
Toothpaste
Toothbrushes
Interdental cleaning
Mouthwash
Plaque disclosing tablets

Toothpaste

 
The main purpose of toothpaste is to help clean your teeth and to provide fluoride. In small amounts fluoride helps to prevent tooth decay. It's found in many foods and tap water, although depending on where you live there may be more or less fluoride in the water. In some areas, fluoride has been added to tap water supplies. This has caused controversy because some people believe that it may be harmful. However, research has shown no evidence that the levels of fluoride added to drinking water cause any harm to health.
 
You can find out how much fluoride is in your toothpaste by looking on the box - this will be given as "ppmF", meaning parts per million fluoride.
 
There are many different types of toothpaste on offer. Your dentist will be able to give you more information about which are the most suitable for you and your family.
 

  • Standard “family” toothpastes (eg Colgate Total or Aquafresh Complete Care) usually contain 1,350 to 1,500ppmF. They contain mild abrasives such as calcium carbonate, which give the toothpaste its cleaning power. There will also be a detergent such as sodium lauryl sulphate and there are flavourings and ingredients such as sorbitol to give the toothpaste a good consistency and make it foam up.
     
  • Children's toothpastes contain less fluoride than standard toothpastes (for example Aquafresh Milk Teeth contains 500ppmF). This helps to limit the amount of fluoride that children may swallow when they are brushing their teeth.
     
  • Sensitive toothpastes (eg Sensodyne) aim to desensitise nerve fibres in the teeth. As well as the ingredients found in standard toothpastes, sensitive toothpastes contain elements such as strontium or potassium.
     
  • Whitening toothpastes (eg Colgate Total Plus Whitening) contain added ingredients that may remove superficial stains from the enamel covering your teeth. However, the colour of your teeth is determined by the layer underneath (dentine) and they don't appear to change the colour of this. Whitening toothpastes can be abrasive and so some dentists advise you to use them only with manual toothbrushes and not electric ones. Always follow the instructions on the toothpaste packet.
     
  • “Natural” toothpastes (eg Toms of Maine, Kingfisher) usually contain plant-based/herbal ingredients and are often non-fluoridated (though many brands also offer a fluoridated product).

 
If young children have too much fluoride, it can lead to a condition called dental fluorosis. Although this isn't harmful, it means that their permanent teeth develop a mottled or stained appearance. Therefore, it's best to use only a very small amount of toothpaste when your children are brushing their teeth. The general rule is to use a smear of 1000ppmF toothpaste for children under three, and a pea-sized blob of standard family toothpaste for those aged three to six. Your family dentist can give you more information tailored specifically for your child’s needs. Keep a close eye on your children to make sure they don't swallow too much toothpaste, and never let them lick paste from the tube.

Toothbrushes

There are many different types of toothbrush available, both manual and electric. Ideally, it's a good idea to choose one that:
 

  • has a small head so it's easier to move around inside your mouth
  • has bristles made of nylon that aren’t too hard

 
There is some evidence to suggest that certain electric toothbrushes may be more effective at removing plaque and preventing gum inflammation. These are the ones that work with a rotation oscillation movement - meaning that the toothbrush head spins in opposite directions in quick bursts. Other electric toothbrushes don't seem to be any more or less effective than manual ones. However, the novelty value may appeal to children and electric toothbrushes with built-in timers may help people brush for the full two minutes. The most important thing is to brush every surface of every tooth.
 
Most dentists recommend that you should replace your toothbrush every two to three months.
 
Your dentist and/or dental hygienist will be able to give you advice about how to brush your teeth properly.

Interdental cleaning

There are many interdental cleaning tools that can help you clean between your teeth and under your gumline. Dental floss is widely-used. Dental floss is a thin thread that may be waxed or unwaxed. Some types have a mint flavouring that may make flossing more pleasant. The basic technique is:
 

  • take a length of the floss (about 45cm) and wrap it round the middle finger of each hand
  • keep about 5cm of floss between your fingers and gently rock it down between your teeth
  • pull the floss tight, slide it up and down against your tooth surface and under your gumline,  
  • repeat this action for both sides of all your teeth making sure that you use a clean length of floss for each one

 
There are a number of alternatives to dental floss. Your dentist or hygienist will recommend the products that are most appropriate for your teeth. He or she will show you how to use them so that you don’t damage your gums.
 

  • Dental tape is like floss but flat and wider. You use it in the same way you use dental floss.
  • Wood sticks can also be used to clean between your teeth but only remove large debris.
  • Interdental brushes look like tiny bottle brushes, and can be very effective for cleaning any small spaces between your teeth. Interdental brushes come in various sizes; your dentist or hygienist will recommend the correct size for you.

Mouthwash

The best way to get rid of plaque is through brushing and flossing your teeth, but mouthwashes can be helpful as an extra method of cleaning.
 
There are many different mouthwashes available and they do a variety of things.

  • Fluoride mouthwashes - if your dentist thinks you need additional fluoride to strengthen your teeth, he or she may suggest you use a fluoride mouthwash. A commonly used solution is sodium fluoride. You will usually be advised to use these mouthwashes at a different time of day to brushing your teeth (so that your teeth get an additional fluoride “hit” during the day).
     
  • Antiseptic mouthwashes - your dentist may recommend an antiseptic mouthwash if you suffer from bad breath (halitosis) or if you have a gum or mouth infection. Many of these products contain a chemical called chlorhexidine, which helps to prevent the growth of bacteria. Chlorhexidine mouthwash can temporarily stain your teeth, alter your sense of taste, and gives some people a sore mouth, so always follow the advice of your dentist or hygienist.
     
  • Total care mouthwashes - these help to control decay and freshen your breath.

 
You should be aware that many mouthwashes contain alcohol. Check the list of ingredients if you are concerned about this. Most dentists usually recommend using an alcohol free mouthwash.

Plaque disclosing tablets

Thorough toothbrushing can be tricky because plaque is often white, so it’s not easy to see in the nooks and crannies around your teeth. Disclosing tablets contain a harmless dye that stains plaque a bright colour, showing up areas that you’ve missed when brushing your teeth. Disclosing tablets won't remove the plaque but it’ll be easier for you to brush away once you can see it.

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
 
How should I clean my teeth if I have a brace?
What cleaning products should I use on my denture?
Can I chew gum instead of brushing my teeth?

How should I clean my teeth if I have a brace?

 

Answer

People who wear orthodontic braces are at particular risk of tooth decay and gingivitis because there are even more places for plaque to accumulate. However, this is entirely preventable if you keep your teeth and brace clean and restrict the sugar in your diet. Your dentist or orthodontist can show you special techniques for keeping your brace clean.

Explanation

You should brush your teeth twice a day using fluoride toothpaste. This will help to control plaque and prevent gum disease. Your dentist or orthodontist can recommend a toothbrush suitable for you and your brace. You should choose a brush with a small head so it's easier to move around in your mouth. The brush should have soft to medium nylon bristles. If you prefer to clean your teeth with an electric toothbrush, ask your orthodontist for advice, as it could damage your brace.
 
You may find interdental brushes helpful to clean between your teeth, under your gumline and around the brackets of a fixed brace.
 
It’s a good idea to use a fluoride mouthwash once a day to prevent decay around your brace.
 
Plaque disclosing tablets can be used to show up areas that you might have missed when brushing your teeth. They contain a harmless dye that stains plaque a bright colour. Disclosing tablets won't remove the plaque but it’ll be easier for you to brush away once you can see it.
 
If you have a removable brace you should take it out to clean it. It's important that you clean a removable brace thoroughly after every meal using toothpaste and a separate toothbrush. It’s a good idea to brush over a bowl of water to prevent damaging your brace if you drop it. When you clean your brace, be careful not to damage the wires.

What cleaning products should I use on my denture?

 

Answer

 
It's important that you clean your denture thoroughly. This will help to remove food deposits and prevent tooth decay and gum disease on any remaining teeth

Explanation

There are numerous products on the market for denture hygiene, but experts recommend simply cleaning your denture after every meal using a soft toothbrush and soap. It’s a good idea to brush over a bowl of water to prevent damaging your denture if you drop it.
 
You should take your denture out at night and leave it in a glass of water or denture cleaning solution. If you have metal clasps or a soft lining on your denture, you must ask your dentist for advice before using any denture cleaning solutions because these are more delicate.
 
Don’t soak your dentures in any type of bleach or very hot water, as this can weaken them and change their appearance.
 
Over time you may notice a build-up of plaque on your denture. Your dentist or hygienist can remove the plaque using a specialist cleaning machine. He or she can also help clean off stubborn stains that you can't remove with regular brushing.
 

Can I chew gum instead of brushing my teeth?

 

Answer

No, you shouldn't replace your daily brushing and flossing routine with chewing gum. However, some research suggests that chewing sugar-free gum after meals reduces the formation of tooth decay.

Explanation

When you eat and drink, acid is produced by the bacteria in your mouth. Over time, the acid breaks down tooth enamel and dentine, resulting in tooth decay. Saliva helps to protect your teeth against decay by washing away food particles and neutralising the acid in your mouth.
 
Chewing sugar-free gum after a meal or snack stimulates saliva production (makes your mouth more “watery”) and may help to protect your teeth against decay. It's important that you only chew sugar-free gum as normal chewing gum contains sugar that can damage your teeth. Chewing gum is not recommended for children under six years of age.
 
Chewing sugar-free gum shouldn’t replace your daily brushing and flossing routine. Brush twice daily using fluoride toothpaste and clean between your teeth using dental floss or interdental brushes. It's a good idea to restrict sugary food and drinks to mealtimes, as snacking in between times increases your risk of tooth decay.

Further information

 

Sources

  • Marinho VCC, Higgins JPT, Logan S, Sheiham A. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD002278. DOI:10.1002/14651858.CD002278
  • Delivering better oral health: an evidence-based toolkit for prevention. Department of Health and the British Association for the Study of Community Dentistry, 2009. www.dh.gov.uk
  • Guide to fluoride. National Fluoride Information Centre, www.fluorideinformation.com, accessed 2 October 2009
  • Poulsen S, ErrboeM, LescayMevil Y,Glenny AM. Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001476. DOI: 10.1002/14651858.CD001476.pub2.
  • Mitchell DA, Mitchell L. Oxford Handbook of Clinical Dentistry. 4th ed. Oxford University Press. 2007:261
  • Chestnutt IG, Gibson J. Churchill’s Pocketbook of Clinical Dentistry. 3rd ed. Elsevier 2007:162
  • Finding the right toothbrush for you. BDA Smile, www.bdasmile.org, accessed 2 October 2009
  • Robinson P, Deacon SA, Deery C, Heanue M, Walmsley AD, Worthington HV, Glenny AM, Shaw BC. Manual versus powered toothbrushing for oral health. Cochrane Database of Systematic Reviews 2005, Issue 2. Art.No.: CD002281. DOI: 10.1002/14651858.CD002281.pub2.
  • Caring for my teeth. British Dental Health Foundation. www.dentalhealth.org.uk, accessed 2 October 2009



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