Oral hygiene tips and tricks and advice on bad breath treatment

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Oral hygiene tips and tricks and advice on bad breath treatment

I’m a retired dentist. And In this video tutorial on oral hygiene tips and tricks and advice on bad breath, I will share with you my daily oral hygiene routine. How I brush, floss and at the end of this video tutorial I will talk a bit about tongue cleaning and bad breath or halitosis treatment at home. Why is good oral hygiene important?  The prime object of oral hygiene is to remove plaque bacterial from teeth because dental plaque is the root cause of tooth decay and gum disease also known as gingivitis and more seriously periodontitis.

A clean mouth not only looks good, feels good, smells good and tastes good, it costs very little. In addition, we are starting to understand how oral health can have a significant impact on our general health.

It is good to understand that there is no single correct way of performing oral hygiene, everyone’s mouth is different and so it is important to follow the instructions of your own dental health professionals because their advice is specifically tailored to your circumstances.

I need to emphasise that good oral hygiene starts with a visit to one’s own dental professionals for a check-up, tooth cleaning and correction of any tooth or gum problems. Good oral hygiene is not possible if the teeth are coated in tartar or calculus or if there are cavities or defective restorations, sepsis, gum disease etc. All this needs to be corrected before it is possible do a decent job of maintaining oral health.

I like use good quality soft brush with quite a small head so that I can get in those tight spaces near the back of my mouth. When I run my thumb over the bristles they should feel smooth and soft and they should recoil to the original shape. I replace my brush about once every 6 weeks or so, when the tips of the bristles start curling I know it is time to chuck it. Bend bristles cannot penetrate the many crevices in my mouth that need to be cleaned. This diagrams explains what I mean.

Old vs new toothbrush

Toothpaste I use a fluoridated, non-abrasive toothpaste which has a nice taste, the brand is not important to me.

Floss, there are many types of floss available and which one you chose may depend on how your teeth are stacked together, chat to you dental professionals for advice. I use this one, Oral B Glide.

Finally about once or twice a week I gently scrape scrap the debris off the surface of my tongue with a tongue scraper. I don’t find the tongue cleaners on some of the toothbrushes to be very effective. I will tell why I think this is important in a moment.

The cost of these items is not great, brush about $5 Floss about $5 this tongue scraper, I designed and made this one myself but they are about $5-10 but they last for years. So let’s say you buy brushes and floss and toothpaste about 5 times a year; that is about $60-70 a year. Electric toothbrush heads cost about the same and I will tell you why I prefer an electric toothbrush in a minute. Compare this cost to the cost of 1 filling which is well over $100. While root canals, crowns, bridges, implants and gum surgery can run into thousands. So if you avoid 1 filling a year you already have your money back with some change. Think of it this way, it’s like your dentist paying you for the five or 10 minutes you spend cleaning your teeth, it’s the easiest money you will ever make. And as I said, you will look better, feel better, taste better and smell better, there is no downside.

Right enough chatter, let’s get on with it.

Brushing

The object of brushing is to remove dental plaque from your teeth. Plaque is a complex growth of bacteria which clings to teeth much like algae would cling to the side of a swimming pool. Soft like cottage cheese and creamy/yellow in colour, it does not rinse off although some will be removed from exposed surfaces of your teeth during chewing of fibrous foods. So one have to mechanically remove it with brushing and flossing. The plaque bacteria don’t adhere very well to clean smooth tooth enamel so they tend to get a foothold in crevices like between teeth, between teeth and gums and in the natural fissures in teeth. So that is where I focus my brushing effort. But why should we remove plaque? Well because plaque bacteria can cause decay to our teeth and inflame our gums ultimately adding to the risk of tooth loss down the road. So how do we get rid of plaque? Usually brushing twice a day and flossing once a day will keep dental plaque at bay. However it is good to understand that plaque grows faster when there is sugar in the mouth so if one is a snacker between meals it may be necessary to brush more frequently. Sugar is like fertiliser for plaque so it’s good to reduce the frequency of sugar intake, ideally don’t have sweet snacks or drinks between meals. It is also import to understand that plaque that is not removed for a few days will start to harden in to calculus or tartar. This is a substance similar to the scale that accumulates in a kettle and it becomes impossible to dislodge with normal brushing and flossing so professional cleaning will eventually be required. In addition it has a rough porous surface which is ideal for bugs to live in and on. Tartar is very deleterious to gums and often sets off gum disease.

When brushing I make a point of remembering all the surfaces that need to be cleaned:- Top jaw outside, inside and biting surfaces. Bottom jaw outside, inside and biting surfaces. I also always use the same sequence each time I brush. If I lose concentration because I am think about my next video or something, then it is easy for me to know where I am up to because I follow the same sequence each time.

I always angle the bristles at about 45 degrees towards the gums (like this) so that they can penetrate the natural crevice between gum and teeth. The brush will cover about 2-3 teeth at a time. I use a circular motion a) so as not to wear grooves in the roots and b) to allow the bristles to randomly find all the crevices in the teeth. After about 6 circles I sweep away from gums this cleans the gaps between teeth a little way in. Then I move on to the next 2 teeth and so on. I always use light pressure because fresh plaque brushes away very easily. If I notice blood on my toothbrush, It could be I’m being too aggressive or there is some inflammation due to plaque or tartar. So I make sure I clean that area especially well but gently and usually the bleeding will stop after a few days if it persists then I know it needs attention from my dentist. I also focus on the areas where I often used to find cavities in my patients, not surprisingly the difficult to get to areas, top jaw outside back molars. A trick for getting access here I find is to almost close my mouth that relaxes muscles and moves my bottom jaw away. Another favourite spot for decay is bottom back molars outside where the cheek lies over them and on the inside the tongue covers them. So what I do is use the back of the brush to push tongue or cheek away so that I can get my toothbrush bristles onto those surfaces. This is also why a favour a smallish head on my brush.

For the past 5 years I have been using an electric tooth brush and I find it great. It does a very good job with minimal effort and in less time. I use an Oral B 3D which oscillates and pulsates at very high frequency. I feel it does a better job in my hands then a manual brush. You still have to get the brush to all those areas I have described but, it has a nice small head so easy to reach tight spots and once you get it there the head does all the work, so much easier. Obviously with the electric brush I don’t need to do the circles but I still sweep away from the gums to better penetrate the embrasures between the teeth. I find brushing twice a day is adequate for my situation.

Flossing

Why? Because the tooth brush cannot penetrate to clean the surfaces where teeth are in contact with each other. For that reason tooth decay often attacks the surfaces and that’s why flossing is important and why dental professionals take x-rays to enable them to discover these lesions early.

So flossing performed to remove plaque from between the teeth and the best way to do that, I find, is with a scaping action. To get maximum efficiency I wrap the floss tight around the tooth as far as possible this helps to avoid the little papilla of gum between teeth and also allows me to clean a the crevice between gum and tooth which extends a little way below the gum. I flossing once a day is adequate for me. If I don’t the gaps between teeth become tight and occasionally my gums will bleed. If my gums bleed despite regular flossing then I know it is time to consult a professional same as if the floss hooks or breaks in the same gap.

Now even though I described flossing after brushing, in real life I prefer to floss before brushing because flossing opens the gaps between teeth to let the fluoride in my toothpaste penetrate the gaps and do its job. Also debris loosened with flossing is then washed away with my brushing.

After brushing I normally just spit out rather than rinse because I believe the longer the Fluoride in the toothpaste is in contact with my teeth the better.

Tongue cleaning

The surface of the tongue is rough and it has fissures and crevices which contain the taste buds. When we eat or drink whatever we are consuming mixes with saliva and flows into the crevices containing the taste buds and we get a sense of what it is we are eating. Because of this complex anatomy it is easy for bacteria and debris mixed with mucous to attach to the surface of the tongue and form a coating mostly at the back of the tongue. If this happens it cuts off the oxygen in the crevices allowing anaerobic bacteria to thrive. These bacteria produce waste products know as volatile sulphurs compounds (VSCs ) which unfortunately stink. It is thought that this is one of the common causes of bad breath. Fortunately if one cleans the tongue by gently removing the coating and allowing oxygen in again the anaerobes diminish because they don’t like oxygen. It is also worth noting that the VSCs are highly water soluble so while your mouth is moist they stay in solution and don’t contaminate the air we breathe out. That’s probably what causes morning breath. Dry mouth and mouth breathing can have a similar result. One can do a simple test to check this. Lick the back of your hand with the back of your tongue then smell it straight away and then again when it is almost dry. You will notice that it smells worse as it dries because the VSCs are evaporating into the air.

So how do I clean my tongue?

I use a tongue scraper which I drag gently from back to front over my tongue. If I am too rough my tongue gets very tender so gentle is the way to go and 2-3 strokes is enough. If I still seen some coating after that I leave it because mostly it is the surface of the mucosa and if I keep going a) it does not come off and b) my tongue gets very sore. I don’t do tongue cleaning every day I find about twice a week is sufficient for me.

Some tooth brushes like this one have sort of a tongue scrapper on the back, these don’t really work for me. I find that they just move the debris around and don’t really remove it. I prefer the tongue scraper for 2 reasons. To demonstrate I used a sponge filled with white salad dressing (for effect) is supposed to represent my tongue. I press down gently with the scraper it expresses the old stale fluid from deep in the crevices then gently drag the tongue scraper forward whilst continuing to press down lightly. This allows the fluid in the crevices to be renewed with fresh saliva and this works marvels for my sense of taste, I can even taste water after tongue scraping. If often wondered why Professional food and drink tasters don’t use one of these. The second reason is that as I draw the tongue cleaner forward over my tongue with gentle downward pressure it works like a bulldozer blade dragging debris with it. Look at that, at the end of the stroke I rinse it before the next stroke.

It is important to realise that bad breath can have other causes such as infection of sinuses, nasal passages, tonsils and respiratory system. There are also systemic possibilities like kidney failure, liver disease, uncontrolled diabetes, constipation, dehydration. Certain foods and drink can secrete volatile substances in the exhaled breath like garlic or alcohol. The bottom line here is, if you have good oral hygiene and still have chronic bad breath it would be wise to have it investigated by your health professions.

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