Keeping up good dental hygiene, including brushing your teeth and visiting a dentist regularly, is a crucial part of caring for your teeth. This factsheet describes some of the most common dental problems and ways to keep your teeth healthy.
The surfaces of all your teeth are always covered with a thin, sticky layer of bacteria. This layer of bacteria is called plaque.
When you eat anything sugary, the bacteria on your teeth turn the sugar into energy and acid. This acid softens and dissolves the hard enamel surface of your teeth in a process called demineralisation. Over time, demineralisation can cause cavities to form in your teeth. This is known as tooth decay or dental caries.
The enamel surface of your teeth doesn't contain any nerves, so you won't feel any pain when you first start to get a cavity. Eventually, however, a cavity may reach the dentine – the substance underneath the enamel that forms the bulk of your tooth and covers the blood vessels and nerves. Dentine is sensitive to pain, so more advanced cavities may cause pain, especially when you eat or drink anything hot, sugary or acidic.
Saliva helps to wash away and neutralise the acid on your teeth. It contains minerals that replace those that are lost from the enamel during demineralisation. This replacement process is called remineralisation.
Demineralisation and remineralisation happen every time you eat or drink something sugary. If you consume sugary food or drinks too often, the saliva doesn't get long enough to fully remineralise your teeth. This will increase your risk of getting tooth decay.
Gum disease is inflammation of your gums and may also involve damage to the bone that anchors your teeth into your jaw. Gum disease is very common and affects more than half of adults who have their own (natural) teeth.
If you don't clean plaque off your teeth regularly, your gums will become red, swollen and shiny and they may bleed. This is the early stage of gum disease called gingivitis. You can easily treat gingivitis by removing the plaque through thorough brushing and flossing, and your gums will get better.
It’s important to treat gingivitis because otherwise your gums may begin to pull away from your teeth, leaving a little pocket around each tooth. This is known as periodontitis. If you develop this, plaque that you can't reach with a toothbrush can become trapped in the pockets around your teeth. Over time the plaque will harden to become tartar (calculus), which you can’t remove by brushing. Plaque and tartar can build up and cause further irritation.
As time goes by the pockets can get deeper and more difficult to clean, so they are more likely to become infected. The plaque attacks your gums and can start to attack the bone that holds them in place, making them wobbly and sensitive. If left untreated over a number of years, your teeth may become very loose and need to be taken out by a dentist.
You can prevent gum disease by controlling the amount of plaque and tartar that build up on your teeth. Regular visits to your dentist and hygienist, brushing and flossing your teeth properly and stopping smoking will help.
Dental erosion is the loss of enamel and dentine caused by acid attacking the surfaces of your teeth. However, unlike with tooth decay, the acids don’t come from plaque bacteria. They usually come from acidic drinks such as fruit juices, fizzy drinks and squashes – this includes the 'diet' varieties. Certain foods, for example crisps or vinegary sauces such as ketchup, can also cause dental erosion. Dental erosion is common and often affects children.
You can help to prevent dental erosion by limiting the number of acidic drinks you consume. If you have a young child, try to give him or her only water or milk to drink. If your child does have an acidic drink, make sure he or she has it at meal times and drinks it out of a cup or uses a straw – this reduces how much of the drink comes into contact with the teeth. Don’t give your child acidic drinks in a feeding bottle.
Stomach acid in vomit can also cause dental erosion. If you have a health condition that causes you to be sick frequently (for example bulimia nervosa or digestive problems), you may risk damaging your teeth.
You can’t reverse the damage done by dental erosion. It can cause your teeth to become sensitive if the dentine becomes exposed. If this happens, your teeth may look yellow (because dentine is this colour) and you’re more likely to get tooth decay.
Good oral hygiene is very important to help prevent tooth decay and gum disease. It involves cleaning your teeth at least twice a day with fluoride toothpaste, visiting the dentist and hygienist regularly and limiting the amount of sugar in your diet.
Brushing your teeth regularly is very important for removing plaque. To get the most benefit from brushing your teeth:
You may prefer to use an electric toothbrush. There is some evidence that certain types of electric toothbrush are more efficient at removing plaque than brushing by hand. However, the thoroughness of your cleaning is much more important than what type of brush you use.
Dental floss or interdental brushes can help to remove plaque and small bits of food from between your teeth and under your gumline – these are areas that a toothbrush can't reach. It's important to use the correct technique, so ask for advice from your dentist or hygienist.
However, even thorough brushing and flossing may not remove all plaque. This is because most people have irregularities in their teeth where plaque can build up and harden into tartar. This can only be removed by a dentist or hygienist using special tools in a process called scaling.
Fluoride mouthwashes can help to prevent tooth decay. Some antiseptic mouthwashes reduce plaque bacteria on your teeth and help to prevent gum disease. If you use mouthwash to freshen your breath, talk to your dentist for advice as bad breath may be a sign of poor oral hygiene (see our frequently asked questions for more information). Always choose an alcohol-free mouthwash, read the information on the box or bottle and if you have any questions, ask your dentist or hygienist for advice.
Chewing sugar-free gum after a meal stimulates the production of saliva, which helps to neutralise plaque acid. Some chewing gums contain a sugar-free sweetener called xylitol, which may help to reduce tooth decay. However, more research is needed to understand how this might work. It’s important to remember that chewing gum isn’t a substitute for brushing and flossing.
Eating sugary foods and drinks encourages tooth decay. However, it's how often you eat these sugars, rather than the amount, that is important. Try not to eat or drink them between meals to give your teeth a chance to be remineralised by saliva. Limiting sugar between meal times is particularly important for children. It's also good for your general health to reduce your sugar intake.
Smoking can stain your teeth and increase your risk of gum disease and tooth loss. Certain alcoholic drinks and the sugary mixers used with them often contain lots of sugar and so increase the risk of tooth decay.
Dentists and hygienists can help you to keep your teeth healthy.
At check-ups your dentist will try to find any problems early and give you advice and treatment. He or she can advise you on how often you should have a check-up. For adults, this can vary from every three months to every two years if you have very good dental health and hygiene.
Children and adults who are at high risk of developing dental problems may need to see a dentist more often. You may be at high risk if you smoke, have a diet that is high in sugar or have had lots of dental treatment in the past.
Reviewed by Polly Kerr, Bupa Health Information Team, August 2013.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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