Dentists say that the most important part of tooth care happens at home. Brushing and flossing properly, along with regular dental checkups, can help prevent tooth decay and gum disease.

If you're like most people, you don't exactly look forward to facing a dentist's drill. So wouldn't it be better to prevent cavities before they begin?

Giving Plaque the Brush-Off

To prevent cavities, you need to remove plaque, the transparent layer of bacteria that coats the teeth. The best way to do this is by brushing your teeth twice a day and flossing at least once a day. Brushing also stimulates the gums, which helps to keep them healthy and prevent gum disease. Brushing and flossing are the most important things that you can do to keep your teeth and gums healthy.

Toothpastes contain abrasives, detergents, and foaming agents. Fluoride, the most common active ingredient in toothpaste, is what prevents cavities. So you should always be sure your toothpaste contains fluoride.

About 1 person in 10 has a tendency to accumulate tartar quickly. Tartar is plaque in a hardened form that is more damaging and difficult to remove. Using anti-tartar toothpastes and mouthwashes, as well as spending extra time brushing the teeth near the salivary glands (the inside of the lower front teeth and the outside of the upper back teeth) may slow the development of new tartar.

If you have teeth that are sensitive to heat, cold, and pressure, you may want to try a special toothpaste for sensitive teeth. But you'll still need to talk to your dentist about your sensitivity because it may indicate a more serious problem, such as a cavity or nerve inflammation (irritation).

Tips on Proper Brushing

Dentists say that the minimum time you should spend brushing your teeth is 2 minutes twice a day. Here are some tips on how to brush properly:

• Hold your brush at a 45-degree angle against your gumline. Gently brush from where the tooth and gum meet to the chewing surface in short (about half-a-tooth-wide) strokes. Brushing too hard can cause receding gums, tooth sensitivity, and, over time, loose teeth.
• Use the same method to brush all outside and inside surfaces of your teeth.
• To clean the chewing surfaces of your teeth, use short sweeping strokes, tipping the bristles into the pits and crevices.
• To clean the inside surfaces of your top and bottom front teeth and gums, hold the brush almost vertical. With back and forth motions, bring the front part of the brush over the teeth and gums.
• Using a forward-sweeping motion, gently brush your tongue and the roof of your mouth to remove the decay-causing bacteria that exist in these places.
• Use an egg timer or play a favorite song while brushing your teeth to get used to brushing for a full 2 to 3 minutes. Some electronic toothbrushes have timers that let you know when 2 minutes are up.

Facts on Flossing

Brushing is important but it won't remove the plaque and particles of food between your teeth, under the gumline, or under braces. You'll need to floss these spaces at least once a day.

The type of floss you choose depends on how much space you have between your teeth. Dentists usually recommend unwaxed floss because it's thinner and easier to slide through small spaces. However, studies have shown that there is no major difference in the effectiveness based on the type of floss used.

With any floss, you should be careful to avoid injuring your gums. Follow these instructions:

• Carefully insert the floss between two teeth, using a back and forth motion. Gently bring the floss to the gumline, but don't force it under the gums. Curve the floss around the edge of your tooth in the shape of the letter "C" and slide it up and down the side of each tooth.
• Repeat this process between all your teeth, and remember to floss the back sides of your back teeth.

Tooth-Whitening Products

Some toothpastes claim to whiten teeth. There's nothing wrong with using whitening toothpastes as long as they also contain fluoride and ingredients that fight plaque and tartar. But these toothpastes alone don't contain much in the way of whitening ingredients and probably won't noticeably change the color of your teeth.

It's easy to be lured by ads telling people they need gleaming white teeth. But these ads are really targeted to older people. The truth is that most teens don't need tooth whitening because teeth usually yellow as a person gets older.

If you think your teeth aren't white enough, though, talk to your dentist before you try any over-the-counter whitening products. Your dentist may be able to offer you professional treatment, which will be suited to your unique needs and will work better than over-the-counter products.

Be careful when buying over-the-counter whitening products. Some bleaching agents may damage your gums and mouth. So always follow the instructions on any whitening product you use.

The Nutrition Connection

Eating sugar, as you probably already know, is a major cause of tooth decay. But it's not just how much sugar you eat — when and how you eat it can be just as important to keeping teeth healthy.

When you eat sugary foods or drink sodas frequently throughout the day, the enamel that protects your teeth is constantly exposed to acids. Hard candies, cough drops, and breath mints that contain sugar are especially harmful because they dissolve slowly in your mouth. Many experts suggest that you take a 3-hour break between eating foods containing sugar.

Sugary or starchy foods eaten with a meal are less harmful to your teeth than when they're eaten alone, possibly because the production of saliva, which washes away the sugar and bacteria, is increased. Eating sugary foods before you go to bed can be the most damaging (especially if you don't brush your teeth afterward) because you don't produce as much saliva when you sleep.

For most people, it's hard to cut out sweets completely, so try to follow these more realistic guidelines:

• Eat carbohydrates (sugars and starches) with a meal.
• If you can't brush your teeth after eating, rinse your mouth with water or mouthwash, or chew sugarless gum.
• Don't eat sugary foods between meals.
• If you snack, eat nonsugary foods, such as cheese, popcorn, raw veggies, or yogurt.

Going to the Dentist

The main reason for going to the dentist regularly — every 6 months — is prevention. The goal is to prevent tooth decay, gum disease, and other disorders that put the health of your teeth and mouth at risk.

Your first consultation with a dentist will probably consist of three main parts: a dental and medical history (where the dentist or dental hygienist asks you questions about your tooth care and reviews any dental records), a dental examination, and a professional cleaning.

The dentist will examine your teeth, gums, and other mouth tissues. He or she may also examine the joints of your jaws. The dentist will use a mirror and probe (a metal pick-like instrument) to check the crown (visible part) of each tooth for plaque and evidence of looseness or decay. The dentist also will check your bite and the way your teeth fit together (called occlusion).

Your dentist will examine the general condition of your gums, which should be firm and pink, not soft, swollen, or inflamed. He or she (or an assistant) will use the probe to check the depth of the sulcus, the slight depression where each tooth meets the gum. Deep depressions, called pockets, are evidence of gum disease.

After examining the visible parts of your teeth and mouth, your dentist will take X-rays that might reveal tooth decay, abscesses (collections of pus surrounded by swollen tissue), or impacted wisdom teeth.

Professional cleaning is usually performed by a dental hygienist, a specially trained and licensed dental professional. Cleaning consists mainly of removing hard deposits using a scaler (a scraping instrument) or an ultrasonic machine, which uses high-frequency sound waves to loosen plaque deposits. The particles are then rinsed off with water.

After cleaning, the dental hygienist will polish your teeth. The process cleans and smoothes the surfaces of the teeth, removing stains and making it harder for plaque to stick to the teeth. Finally, the hygienist may treat your teeth with a fluoride compound or a sealant to help prevent decay.

At the end of your visit, the dentist will let you know if you need to return to fill a cavity. Your dentist also may refer you to an orthodontist if he or she thinks you may need braces or have other issues.

More Dental Problems

Dental caries (tooth decay) can attack the teeth at any age. In fact, 84% of 17-year-olds have the disease. Left untreated, caries can cause severe pain and result in tooth loss. Losing teeth affects how you look and feel about yourself as well as your ability to chew and speak. Treating caries is also expensive. So prevention and early treatment are important.

It may surprise you to know that 60% of 15-year-olds experience gingivitis, the first stage of gum disease. Gingivitis, which involves the gums but not the underlying bone and ligament, is almost always caused by an accumulation of plaque. As with caries, treatment can be expensive.

If you remove plaque regularly and follow good oral hygiene habits, your gums usually will return to their healthy state. However, more serious gum disease can cause gums to swell, turn red, and bleed, and sometimes causes discomfort. How dentists treat gum disease depends on the extent of the disease.

Reviewed by: Charlie J. Inga, DDS
Date reviewed: November 2011