Dental hygiene is the practice of keeping your mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, and bad breath. There are also oral pathologic conditions in which good Dental hygiene is required for healing and regeneration of the oral tissues. These conditions included gingivitis, periodontitis, and dental trauma, such as subluxation, oral cysts, and following wisdom tooth extraction.
Cleaning of teeth
Teeth cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, gum disease, and tooth decay. Severe gum disease causes at least one-third of adult tooth loss.
Tooth decay is the most common global disease. Over 80% of cavities occur inside pits and fissures on chewing surfaces where brushing cannot reach food left trapped after every meal or snack, and saliva or fluoride have no access to neutralise acid and remineralise demineralised teeth, unlike easy-to-reach surfaces, where fewer cavities occur.
Dental sealants, which are applied by dentists, cover and protect fissures and grooves in the chewing surfaces of back teeth, preventing food from becoming trapped thus halting the decaying process. An elastomer strip has been shown to force sealant deeper inside opposing chewing surfaces and can also force fluoride toothpaste inside chewing surfaces to aid in remineralising demineralised teeth.
Since before recorded history, a variety of Dental hygiene measures have been used for teeth cleaning. This has been verified by various excavations done throughout the world, in which chew sticks, tree twigs, bird feathers, animal bones and porcupine quills were recovered. Many people used different forms of teeth cleaning tools. Indian medicine (Ayurveda) has used the neem tree, or daatun, and its products to create teeth cleaning twigs and similar products; a person chews one end of the neem twig until it somewhat resembles the bristles of a toothbrush, and then uses it to brush the teeth. In the Muslim world, the miswak, or siwak, made from a twig or root, has antiseptic properties and has been widely used since the Islamic Golden Age. Rubbing baking soda or chalk against the teeth was also common.
Generally, dentists recommend that teeth be cleaned professionally at least twice per year. Professional cleaning includes tooth scaling, tooth polishing, and, if tartar has accumulated, debridement; this is usually followed by a fluoride treatment. However, the American Dental Hygienists’ Association (ADHA) publicly stated in 1998 that there is an absence of evidence that scaling and polishing provides therapeutic value. The Cochrane Oral Health Group reviewed nine studies but found them to be of insufficient quality and not enough evidence to support the claims of the benefits of regular tooth scaling or tooth polishing.
Between cleanings by a dental hygienist, good Dental hygiene is essential for preventing tartar build-up which causes the problems mentioned above. This is done through careful, frequent brushing with a toothbrush, combined with the use of dental floss to prevent accumulation of plaque on the teeth.
Plaque is a yellow sticky film that forms on the teeth and gums and can be seen at gum margins of teeth with a food dye. The bacteria in plaque convert carbohydrates in food (such as sugar) into acid that demineralises teeth, eventually causing cavities. Daily brushing and flossing removes plaque and can prevent tartar from forming on the teeth.
Plaque can also cause inflammation of the gum (gingivitis), making it red, tender and can easily bleed when flossing or brushing your teeth. If this is not treated, bones around the teeth can be affected by the various inflammatory factors, eventually leading to bone resorption. This condition is called periodontitis, which is mostly seen in the adult population. If not treated, the loss of bone structure may cause teeth to become mobile. The treatment is to remove plaque inside the deep pockets between the tooth surface and the soft tissues using specialized dental equipment. If the treatment is successful, the gum will pull away from the teeth (receding gums) as a result of the cessation of the inflammatory swelling. Eating a balanced diet and limiting snacks can prevent tooth decay and periodontal disease. The Fédération dentaire internationale (FDI World Dental Federation) has promoted foods such as raw vegetables, plain yogurt, cheese, or fruit as dentally beneficial—this has been echoed by the American Dental Association (ADA).
The use of dental floss is an important element of Dental hygiene, since it removes plaque and decaying food remaining stuck between the teeth. This food decay and plaque cause irritation to the gums, allowing the gum tissue to bleed more easily. Acidic foods left on the teeth can also demineralise teeth, eventually causing cavities.
Flossing for a proper inter-dental cleaning is recommended at least once per day, preferably before brushing so fluoride toothpaste has better access between teeth to help remineralise teeth, prevent receding gums, gum disease, and cavities on the surfaces between the teeth.
A dental hygienist demonstrates dental flossing.
It is recommended to use enough floss to enable easy use, usually ten or more inches with three to four inches of taut floss to put between teeth. Floss is then wrapped around the middle finger and/or index finger, and supported with the thumb on each hand. It is then held tightly to make taut, and then gently moved up and down between each tooth. It is important to floss under visible areas by curving the floss around each tooth instead of moving up and down on gums, which are much more sensitive than teeth. However, bleeding gums are normal upon first usage of floss, and will harden with use. One should use an unused section of the floss when moving around different teeth. Removing floss from between teeth requires using the same back-and-forth motion as flossing, but gently bringing the floss up and out of gaps between teeth.
An interdental brush, also called an interproximal brush or a proxy brush, is a small brush, typically disposable, either supplied with a reusable angled plastic handle or an integral handle, used for cleaning between teeth and between the wire of dental braces and the teeth. Brushes are available in a range of widths, color coded as per ISO 16409. Interdental brushes are classified according to ISO standard 16409:2006. The ISO brush sizes range from 1 to 7. The ISO brush size is determined by the PHD or Passage Hole Diameter in mm. This PHD is the minimum diameter of a hole that the interdental brush will pass through without deforming the brush wire stem. A peer-reviewed clinical study has found that using a toothbrush and an interdental brush more effectively removes plaque than using a toothbrush and dental floss.
Cleaning the tongue as part of daily Dental hygiene is essential, since it removes the white/yellow bad-breath-generating coating of bacteria, decaying food particles, fungi (such as Candida), and dead cells from the dorsal area of the tongue. Tongue cleaning also removes some of the bacteria species which generate tooth decay and gum problems.
Massaging the gums with toothbrush bristles is generally recommended for good oral health.
Some dental professionals recommend oral irrigation as a way to clean teeth and gums.
Oral irrigators reach 3–4 mm under the gum line. Oral irrigators use a pressured, directed stream of water to disrupt plaque and bacteria.