Caring for your teeth

Published by Bupa's Health Information Team, May 2011.

This factsheet is for people who would like information about caring for their teeth.

Keeping up good dental hygiene, including brushing and visiting a dentist regularly, is a crucial part of caring for teeth. This factsheet describes some of the most common dental problems, and ways to keep teeth healthy.

Tooth decay

Soon after you brush your teeth, a thin, sticky layer of bacteria forms on the surfaces of all your teeth. 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 caries.

The enamel surface of your teeth doesn't contain any nerves, so you won't initially feel any pain when you start to get a cavity. Eventually, however, a cavity may reach the dentine – the yellowish substance underneath the enamel that forms the bulk of your tooth. 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 to replace those lost from the enamel in a process 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

Gum disease is inflammation of your gums and 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. Gingivitis is completely reversible. If you remove the plaque, your gums will get better.

If you don’t get treatment for gingivitis, your gums may begin to pull away from your teeth, leaving a little pocket around each tooth. These pockets trap plaque that you can't reach with a toothbrush. Over time, the plaque will harden to become tartar (calculus).

Plaque and tartar build up and can cause further irritation, which may gradually spread to the bone structures around your teeth. As time goes by, the pockets can get deeper and more difficult to clean, and your gum and bone may shrink. This is called periodontitis. If your gums shrink, they can expose some of the roots of your teeth, making them wobbly and sensitive. If left untreated over a number of years, your teeth may fall out, or 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 or hygienist, brushing and flossing your teeth properly, and stopping smoking will help.

Dental erosion

Dental erosion is the loss of enamel and dentine, caused by acid attacking the surfaces of your teeth. But unlike tooth decay, the acids aren't from bacteria. They usually come from acidic drinks such as fruit juices, fizzy drinks and squashes – even the 'diet' varieties. Over half of all children aged 15 to 18 in the UK have some dental erosion.

You can help to prevent dental erosion by limiting the number of acidic drinks you consume. If you have a young child, try to only give him or her water or milk to drink. Or, when your child does have an acidic drink, give it to him or her in a cup rather than in a feeding bottle and only at meal times.

Stomach acid in vomit can also cause dental erosion. If you have a health condition that makes you sick often (for example bulimia nervosa, alcohol or stomach problems), you may risk damaging your teeth.

Dental erosion is irreversible. It can cause your teeth to become sensitive if the dentine becomes exposed. If this happens, your teeth may look yellow (since dentine is this colour) and you are more likely to get tooth decay.

How to look after your teeth

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.

Brush your teeth

Brushing is the most effective way to remove plaque. To get the most benefit from brushing your teeth:

• use a toothbrush with a small head and synthetic bristles
• use fluoride toothpaste to protect against decay
• start at one side of your mouth and move round to the other side, brushing all the tooth surfaces thoroughly
• pay particular attention to your gumline, angling the bristles into the crevice where your gums meet your teeth
• brush at least twice a day and for around two minutes to allow time to do it properly
• replace your toothbrush every two to three months, or sooner if the filaments look worn

Some people 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.

Clean between your teeth

Dental floss or inter-dental 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 every trace of 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. Polishing using a rotating brush and abrasive paste can help to remove stains from your teeth.

Use mouthwash

Fluoride mouthwashes can help to prevent tooth decay. Some antiseptic mouthwashes reduce the number of 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. Always read the information on the mouthwash box or bottle and if you have any questions, ask your dentist or hygienist for advice.

Chew gum

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.

Control sugar in your diet

Eating sugary foods and drinks encourages tooth decay. But it's how often you eat these sugars, rather than the amount, that's important. Try not to eat or drink them between meals to give your teeth a chance to be remineralised by saliva. Limiting sugar between mealtimes is particularly important for children. It's also good for your general health to reduce your sugar intake.

It's also important not to eat acidic foods or drinks, such as fizzy drinks or citrus fruit juice, between meals as these also encourage tooth decay and erosion.

Alcohol and tobacco

Drinking alcohol and smoking or chewing tobacco can increase your risk of developing mouth cancer. Smoking also stains teeth and can increase your risk of gum disease and tooth loss. Alcoholic drinks, and the mixers used with them, often contain lots of sugar, and so increase the risk of tooth decay.

Animation - how to brush your teeth

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How to floss your teeth

Visiting the dentist and hygienist

Dentists and hygienists can help you to keep your teeth healthy.

At your 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 three months upwards. For people with very good dental health and hygiene, this can be up to every two years.

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’s high in sugar, or have had lots of dental treatment in the past.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.