Patient Education - Dental Conditions and Treatments

Sensitive Teeth

Is the taste of ice cream or a sip of hot coffee sometimes a painful experience for you? Does brushing or flossing make you wince occasionally? If so, you may have sensitive teeth.

Possible causes include:

• Tooth decay (cavities)
• Fractured teeth
• Worn fillings
• Gum disease
• Worn tooth enamel
• Exposed tooth root

In healthy teeth, a layer of enamel protects the crowns of your teeth the part above the gum line. Under the gum line a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin.

Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.

Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity. Your dentist may suggest one of a variety of treatments:

• Desensitizing toothpaste - This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced.
• Fluoride gel - An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.
• A crown, inlay or bonding - These may be used to correct a flaw or decay that results in sensitivity.
• Surgical gum graft - If gum tissue has been lost from the root, this will protect the root and reduce sensitivity.
• Root canal - If sensitivity is severe and persistent and cannot be treated by other means, your dentist may recommend this treatment to eliminate the problem.

Proper oral hygiene is the key to preventing sensitive-tooth pain. Ask your dentist if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity.

Bleeding Gums

There are many reasons your gums could bleed.

In some cases, bleeding gums can be a sign of gingivitis, the early stage of periodontal disease. If your gums bleed easily or bleed when you brush, talk to your dentist about your oral health. Gingivitis is reversible and preventable.

If you've just started a new flossing routine, for instance, your gums may bleed at first as they get used to cleaning between the teeth. This usually goes away on its own in about a week. Some pregnant women develop a condition known as "pregnancy gingivitis," an inflammation of the gums that can cause swelling and tenderness. Gums also may bleed a little when brushing or flossing. If you take blood thinners, these medications may cause your gums to bleed. Contact your physician if the bleeding does not stop quickly. Your gums could also be bleeding if you brush too hard. Use an extra-soft or soft-bristled toothbrush when brushing your teeth.

If your gums bleed regularly or enough to worry you, make an appointment with your dentist or physician. It could be a sign that something else is wrong.

Always remember to brush your teeth twice a day, floss once a day and schedule regular dental visits.

Dental Filling Options

When it comes to having a cavity filled, it's important to know that you have the right to decide, after consultation with your dentist, what treatments and materials are used for your dental care. Your dentist considers materials to use on an individualized basis, taking into account the size and location of your cavity. Cosmetic considerations, how long the filling could last, insurance coverage and out of pocket costs are some other factors you might want to consider. The ADA encourages you to talk with your dentist so that together you may choose the material that's right for you.

Here are some common dental filling options:

• Composite resins, or tooth-colored fillings, are a mixture of glass or quartz filler that provide good durability and resistance to fracture in small- to mid-size fillings that need to withstand moderate pressure from chewing. They can be used on either front or back teeth.
• Dental amalgam, sometimes described as "silver-colored" fillings, is made from a combination of metals that include mercury, silver, tin, and copper. Dental amalgam has been used for generations by dentists. Amalgam is very durable and more affordable than tooth-colored or gold fillings; however tooth-colored materials are more natural looking.
• Gold fillings, also called inlays or onlays, are composed of an alloy of gold, copper and other metals. Gold has been used in dentistry for more than 1,000 years due to its durability; however, gold is more costly than amalgam and not natural looking like tooth-colored fillings.

Dental Crowns

If you want a smile that's your crowning glory, you may need a crown to cover a tooth to help restore it to its normal shape and size. A crown can make your tooth stronger and improve its appearance.

A crown can help strengthen a tooth with a large filling when there isn't enough tooth remaining to hold the filling. Crowns can also be used to attach bridges, protect a weak tooth from breaking or restore one that's already broken. A crown is a good way to cover teeth that are discolored or badly shaped. It's also used to cover a dental implant.

If your dentist recommends a crown, it is probably to correct one of these conditions. Your dentist's primary concern, like yours, is helping you keep your teeth healthy and your smile bright.

Dental Implants

If you are self-conscious because you have missing teeth, wear dentures that are uncomfortable or don't want to have good tooth structure removed to make a bridge, talk to your dentist to see if dental implants are an option for you.

Dental implants are a popular and effective way to replace missing teeth and are designed to blend in with your other teeth. They are an excellent long-term option for restoring your smile. In fact, the development and use of implants is one of the biggest advances in dentistry in the past 40 years. Dental implants are made up of titanium and other materials that are compatible with the human body. They are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth.

Most patients find that a dental implant is secure, stable and a good replacement for their own tooth. There are generally three phases to getting an implant:

• First, the dentist surgically places the implant into the jawbone. Your dentist may recommend a diet of soft foods, cold foods and warm soup during the healing process.
• Next, the bone around the implant heals in a process called osseointegration. What makes an implant so strong is that the bone actually grows around it and holds it in place. Osseointegration means "combines with the bone" and takes time. Some patients might need to wait until the implant is completely integrated, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.
• Finally, it's time for the placement of the artificial tooth/teeth. For a single tooth implant, your dentist will customize a new tooth for you, called a dental crown. The crown will be based on size, shape, color and fit, and will be designed to blend in with your other teeth. If you are replacing more than a single tooth, custom-made bridges or dentures will be made to fit your mouth and your implants. (Note: The replacement teeth usually take some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture to help you eat and speak normally until the permanent replacement is ready.)

If you are interested in dental implants, it's a good idea to discuss it carefully with your dentist first. If you are in good general health this treatment may be an option for you. In fact, your health is more of a factor than your age. You may be medically evaluated by a physician before any implant surgery is scheduled.

Chronic illnesses, such as diabetes or leukemia, may interfere with healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing.

Dentures

Dentures are removable appliances that can replace missing teeth and help restore your smile. If you've lost all of your natural teeth, whether from gum disease, tooth decay or injury, replacing missing teeth will benefit your appearance and your health. That's because dentures make it easier to eat and speak better than you could without teeth things that people often take for granted.

When you lose all of your teeth, facial muscles can sag, making you look older. Dentures can help fill out the appearance of your face and profile. They can be made to closely resemble your natural teeth so that your appearance does not change much. Dentures may even improve the look of your smile.

Types of dentures:

• Conventional - This full removable denture is made and placed in your mouth after the remaining teeth are removed and tissues have healed, which may take several months.
• Immediate - This removable denture is inserted on the same day that the remaining teeth are removed. Your dentist will take measurements and make models of your jaw during a preliminary visit. You don't have to be without teeth during the healing period, but may need to have the denture relined or remade after your jaw has healed.
• Overdenture - Sometimes some of your teeth can be saved to preserve your jawbone and provide stability and support for the denture. An overdenture fits over a small number of remaining natural teeth after they have been prepared by your dentist. Implants can serve the same function, too.

New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place. It is not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases. As your mouth becomes accustomed to the dentures, these problems should go away. Follow-up appointments with the dentist are generally needed after a denture is inserted so the fit can be checked and adjusted. If any problem persists, particularly irritation or soreness, be sure to consult your dentist.

Even if you wear full dentures, you still have to practice good dental hygiene. Brush your gums, tongue and roof of your mouth every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

Like your teeth, your dentures should be brushed daily to remove food particles and plaque. Brushing also can help keep the teeth from staining.

• Rinse your dentures before brushing to remove any loose food or debris.
• Use a soft bristle toothbrush and a non-abrasive cleanser to gently brush all the surfaces of the dentures so they don't get scratched.
• When brushing, clean your mouth thoroughly including your gums, cheeks, roof of your mouth and tongue to remove any plaque. This can help reduce the risk of oral irritation and bad breath.
• When you're not wearing your dentures, put them in a safe place covered in water to keep them from warping.
• Occasionally, denture wearers may use adhesives. Adhesives come in many forms: creams, powders, pads/wafers, strips or liquids. If you use one of these products, read the instructions, and use them exactly as directed. Your dentist can recommend appropriate cleansers and adhesives; look for products with the ADA Seal of Acceptance. Products with the ADA Seal have been evaluated for safety and effectiveness.

If you have any questions about your dentures, or if they stop fitting well or become damaged, contact your dentist. Be sure to schedule regular dental checkups, too. The dentist will examine your mouth to see if your dentures continue to fit properly.

Bad Breath

Whether you call it bad breath or halitosis, it's an unpleasant condition that's cause for embarrassment. If you're concerned about bad breath, see your dentist. Bad breath can be caused by a number of sources, and he or she can help identify the cause and determine the best treatment.

What causes bad breath?

• Food - What you eat affects the air you exhale, like garlic or onions. If you don't brush and floss daily, particles of food can remain in the mouth, collecting bacteria, which can cause bad breath. Dieters may develop unpleasant breath from infrequent eating
• Gum disease - Persistent bad breath or a bad taste in the mouth can also be one of the warning signs of gum disease; which is caused by plaque
• Dry mouth - This occurs when the flow of saliva decreases and can be caused by various medications, salivary gland problems or continuously breathing through the mouth. Without enough saliva, food particles are not cleaned away. If you suffer from dry mouth, your dentist may prescribe anartificial saliva, or suggest using sugarless candy or increase your fluid intake.
• Smoking and tobacco - In addition to staining teeth and being bad for overall health, tobacco can add to bad breath. Tobacco reduces your ability to taste foods and irritates gum tissues. Tobacco users are more likely to suffer from gum disease and are at greater risk for developing oral cancer. If you use tobacco, ask your dentist for tips on kicking the habit.
• Medical conditions - Some diseases have symptoms related to bad breath. Sinus or lung infections, bronchitis, diabetes, and some liver or kidney diseases may be associated with bad breath.

If you're concerned about what's causing your bad breath, make an appointment to see your dentist. Regular checkups allow your dentist to detect any problems such as gum disease or dry mouth. Bad breath may be the sign of a medical disorder. If your dentist determines that your mouth is healthy, you may be referred to your primary care physician.

Maintaining good oral hygiene, eliminating gum disease and scheduling regular professional cleanings are essential to reducing bad breath. Brush twice a day and clean between your teeth daily with floss. Brush your tongue, too. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning.

It's important to note that mouthwash will only mask the odor temporarily. Mouthwashes are generally cosmetic and do not have a long-lasting effect on bad breath. If you must constantly use a breath freshener to hide unpleasant mouth odor, see your dentist.

Pregnancy

Congratulations on this exciting and busy time of your life! You have so much to think about during pregnancy but don't forget about your teeth and gums. It may be easy to overlook your mouth, but all the changing hormone levels that occur with pregnancy can actually make some dental problems worse. Brushing and flossing contributes to your overall health, too, and if your mouth is healthy, it's more likely that your baby's mouth will be healthy.

See your dentist

It's important to continue to see your dentist during pregnancy for oral examinations and professional teeth cleanings. Make sure to tell your dentist that you are pregnant and about any changes you have noticed in your oral health. Good daily care is vital.

That means always brushing your teeth twice a day with fluoride toothpaste, cleaning between your teeth once a day, eating a balanced diet and limiting between-meal snacks.

To assist you in making healthy eating choices, the National Maternal and Child Oral Health Policy Center has compiled a list of tips to follow during pregnancy that can be found here.

Gum Disease

Gum disease is an infection of the tissues that surround and support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by plaque, the sticky film of bacteria that is constantly forming on our teeth.

Here are some warning signs that can signal a problem:

• gums that bleed easily
• red, swollen, tender gums
• gums that have pulled away from the teeth
• persistent bad breath or bad taste
• permanent teeth that are loose or separating
• any change in the way your teeth fit together when you bite
• any change in the fit of partial dentures

Some factors increase the risk of developing gum disease. They are:

• poor oral hygiene
• smoking or chewing tobacco
• genetics
• crooked teeth that are hard to keep clean
• pregnancy
• diabetes
• medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives

See your dentist if you suspect you have gum disease because the sooner you treat it the better. The early stage of gum disease is called gingivitis. If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.

Advanced gum disease is called periodontitis. Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.

Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.

It is possible to have gum disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential to help keep periodontal disease from becoming more serious or recurring.

Remember: You don't have to lose teeth to gum disease. Brush your teeth twice a day, clean between your teeth daily, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

Cavities

Tooth decay is the destruction of your tooth enamel, the hard, outer layer of your teeth. It can be a problem for children, teens and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and over time the enamel can break down. This is when cavities can form. A cavity is a little hole in your tooth.

Cavities are more common among children, but changes that occur with aging make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. It's common for people over age 50 to have tooth-root decay.

Decay around the edges, or a margin, of fillings is also common for older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

• Brush twice a day with a fluoride toothpaste.
• Clean between your teeth daily with floss or interdental cleaner.
• Eat nutritious and balanced meals and limit snacking.
• Check with your dentist about the use of supplemental fluoride, which strengthens your teeth, and about use of dental sealants (a plastic protective coating) applied to the chewing surfaces of the back teeth (where decay often starts) to protect them from decay.
• Visit your dentist regularly for professional cleanings and oral examination.

Diabetes

Diabetes is a chronic disease which affects your body's ability to process sugar. The resulting high blood sugar can cause problems with your eyes, nerves, kidneys, heart and other parts of your body. Diabetes can lower your resistance to infection and can slow the healing process.

If you have diabetes, you are at greater risk of developing some oral health problems. The most common oral health problems associated with diabetes are:

• Gum disease. Recent research suggests that the connection between gum disease and diabetes goes both ways. On the one hand, because of lowered resistance and a longer healing process, gum disease appears to be more frequent and more severe among those with diabetes. Conversely, it appears that treating gum disease in people with diabetes can help improve blood sugar control.
• Fungal infections. Since diabetes compromises your immune system, you may be prone to developing fungal infections. Symptoms include painful sores and difficulty swallowing. If you develop a fungal infection, see your dentist.
• Infection and delayed healing. If you are having extensive oral surgery, your dentist may prescribe antibiotics to minimize the risk of infection. To help the healing process, keep your blood glucose levels under control before, during and after surgery.

Good oral hygiene habits, including professional cleanings at the dental office, are important if you are to control the progression of gum disease and other oral health problems. Regular dental checkups and periodontal screenings are important for evaluating overall dental health and for treating dental problems in their initial stages. Your dentist may recommend more frequent evaluations and preventive procedures, such as teeth cleaning, to maintain good oral health

Eating Disorders

More than 10 million Americans currently are affected by serious eating disorders such as anorexia, bulimia and binge eating, according to the National Eating Disorders Association. While anyone can suffer from an eating disorder, they are most common in teenagers and young adult women. In addition to having a negative impact on an individual's health and quality of life, eating disorders also affect self-image, relationships with families and friends, and performance in school or at work. If you suffer from an eating disorder, it's important to talk to your health care provider.

Eating disorders can also affect a person's oral health. Without the proper nutrition, gums and other soft tissue inside the mouth may bleed easily. The glands that produce saliva may swell and individuals may experience chronic dry mouth. Throwing up frequently can affect teeth too. That's because when strong stomach acid repeatedly flows over teeth, the tooth's enamel can be lost to the point that the teeth change in color, shape and length. The edges of teeth become thin and break off easily. Eating hot or cold food or drink may become uncomfortable.

Types of eating disorders:

• Anorexia - This typically involves an extreme fear of gaining weight or a dread of becoming fat. Even though these individuals may be very thin or even extremely underweight, they see themselves as "fat." They may attempt to reach or maintain what they think is their perfect body weight by literally starving themselves. They may also exercise excessively. Others may eat excessive amounts of food in one sitting and then attempt to get rid of the food and calories from their bodies by forcing themselves to "throw up" or by the misuse of laxatives or enemas.
• Bulimia - Like anorexia, bulimia also includes the fears of being overweight. But it also includes hidden periods of overeating (binge eating) which may occur several times a week or even several times a day. While overeating, individuals may feel completely out of control. They may gulp down thousands of calories often high in carbohydrates and fat in amounts of food that would be greater than what an average person would eat at one sitting. After they overeat, the individuals try to "undo" the fact that they ate too much as quickly as possible by forcing themselves to "throw up" or by the misuse of laxatives or enemas. This is often referred to as "binging and purging."
• Binge Eating or Compulsive Overeating - This may affect almost as many men as women. In the past, these individuals were sometimes described as "food addicts." They overeat (binge eat) as noted in bulimia above, but do not regularly try to get rid of the food immediately by throwing up or by misusing laxatives or enemas. Feelings of guilt may make it easier for the person to overeat again.

Prevention

Eating disorders arise from a variety of physical, emotional and social issues all of which need to be addressed to help prevent and treat these disorders. Family and friends can help by setting good examples about eating and offering positive comments about healthy eating practices. While eating disorders appear to focus on body image, food and weight, they are often related to many other issues. Referral to health professionals and encouragement to seek treatment is critical as early diagnosis and intervention greatly improve the opportunities for recovery.

If you suffer from an eating disorder these practices can reduce oral health problems associated with it:

• Maintain meticulous oral health care related to toothbrushing and flossing.
• Immediately after throwing up, do NOT brush but rinse with baking soda to help neutralize the effects of the stomach acid.
• Consult with your dentist about your specific treatment needs.
• See your dentist regularly.

Dry Mouth

Dry mouth also called xerostomia results from an inadequate flow of saliva. It is not a disease, but a symptom of a medical disorder or a side effect of certain medications, such as antihistamines, decongestants, pain killers, diuretics and many others.

Saliva is the mouth's primary defense against tooth decay and maintains the health of the soft and hard tissues in the mouth. Saliva washes away food and other debris, neutralizes acids produced by bacteria in the mouth and provides disease-fighting substances throughout the mouth, offering first-line protection against microbial invasion or overgrowth that might lead to disease.

Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, trouble speaking, difficulty swallowing, hoarseness or dry nasal passages. In some cases, dry mouth can be an indicator of Sjögren's (pronounced SHOW-grins) syndrome. Sjögren's syndrome is a chronic autoimmune disorder in which the body's immune system mistakenly attacks its own moisture-producing glands, the tear-secreting and salivary glands as well as other organs.

Without saliva, extensive tooth decay can also occur. Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

For more information, visit the Sjögren's Syndrome Foundation.

Smoking and Tobacco

You know smoking is bad for your health, so it should be no surprise that cigarettes and chewing tobacco are also harmful to your oral health. For one, tobacco products can cause bad breath, but that's only the beginning.

Other possible oral health impacts of smoking and all tobacco products include:

• stained teeth and tongue
• dulled sense of taste and smell
• slow healing after a tooth extraction or other surgery
• difficulties in correcting cosmetic dental problems
• gum disease
• oral cancer

Quitting is the only way to decrease your risk of these and other tobacco-related health problems. The addictive quality of nicotine, which is found in cigarettes, cigars and chewing tobacco, can make this especially difficult. That's why it's important to have a plan and a support network, people to help you stick to your plan. Write down your reasons for quitting. Exercising, chewing gum and keeping yourself occupied can help you quit. Talk to your dentist or doctor to see if the medications available would help you to stop using tobacco.

Bottom line: A smoke-free environment is healthier for you and for those around you. Make a plan to quit, stick to it and start living a healthier life.

For more information and free resources on how to quit, visit Smokefree.go

Jaw Pain

Many adults suffer from chronic jaw and facial pain. Some common symptoms include pain in or around the ear, tenderness of the jaw, pain when biting, or headaches. Many things can cause facial pain, which can make it difficult to diagnose and treat. Your dentist will conduct a thorough exam, which may include X-rays, to determine the cause of the pain.

Possible causes of jaw pain or facial pain include:

• sinus problems
• toothache
• infections
• arthritis
• injury
• tooth grinding
• periodontal disease
• problems with your jaw or the temporomandibular joint

Your dentist's plan for treatment will depend on the source of your facial pain, but recommendations may include:

• mouth protector
• muscle relaxants
• exercises
• anti-inflammatory drugs
• antibiotics
• root canal therapy
• periodontal treatment
• extraction

If you suffer from jaw pain or facial pain, speak with your dentist or physician for diagnosis and treatment.

Oral Health

Oral health touches every aspect of our lives but is often taken for granted. Your mouth is a window into the health of your body. It can show signs of nutritional deficiencies or general infection. Systemic diseases, those that affect the entire body, may first become apparent because of mouth lesions or other oral problems.

Whether you are 80 or 8, your oral health is important. Most Americans today enjoy excellent oral health and are keeping their natural teeth throughout their lives; however, cavities remain the most prevalent chronic disease of childhood. Some 100 million Americans fail to see a dentist each year, even though regular dental examinations and good oral hygiene can prevent most dental disease. Many people believe that they need to see a dentist only if they are in pain or think something is wrong, but regular dental visits can contribute to a lifetime of good oral health. If you are experiencing dental pain, don't put off seeing a dentist. With dentistry's many advances, diagnosis and treatment are more sophisticated and comfortable than ever.

You can practice good oral hygiene by always brushing your teeth twice a day with a fluoride toothpaste, cleaning between your teeth once a day with floss or another interdental cleaner, replacing your toothbrush every three or four months and by eating a balanced diet and limiting between-meal snacks. Don't forget to schedule regular dental check-ups to keep your smile, and yourself, healthy.

Brushing Your Teeth

Brushing your teeth is an important part of your oral hygiene routine. For a healthy mouth and smile the ADA recommends you:

• Brush your teeth twice a day with a soft-bristled brush. The size and shape of your brush should fit your mouth allowing you to reach all areas easily.
• Replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won't do a good job of cleaning your teeth.
• Make sure to use an ADA-accepted fluoride toothpaste.

The proper brushing technique is to:

• Place your toothbrush at a 45-degree angle to the gums.
• Gently move the brush back and forth in short (tooth-wide) strokes.
• Brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth.
• To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.
• Brush your tongue to remove bacteria and keep your breath fresh.

Of course, brushing your teeth is only a part of a complete oral care routine. You should also make sure to:

• Clean between teeth daily with floss or an interdental cleaner. Tooth decay-causing bacteria still linger between teeth where toothbrush bristles can't reach. This helps remove plaque and food particles from between the teeth and under the gum line.
• Eat a balanced diet and limit between-meal snacks.
• Visit your dentist regularly for professional cleanings and oral exams.

Download the How to Brush PDF

Talk to your dentist about what types of oral care products will be most effective for you. The ADA Seal lets you know the product has met ADA criteria for safety and effectiveness. Look for the ADA Seal on fluoride toothpaste, toothbrushes, floss, interdental cleaners, oral irrigators, mouth rinses and other oral hygiene products.

Flossing

Flossing is an essential part of any oral health care routine. The American Dental Association recommends flossing at least once a day to achieve optimal oral health. By flossing daily, you help remove plaque from the areas between your teeth where the toothbrush can't reach. This is important because plaque that is not removed by brushing and flossing can eventually harden into calculus or tartar. Flossing also helps prevent gum disease and cavities.

The most important thing about flossing is to do it. Pick a time of day when you can devote an extra couple of minutes to your oral hygiene. People who are too tired at the end of the day may benefit from flossing first thing in the morning or flossing after lunch.

And don't forget, children need to floss too! You should be flossing your child's teeth as soon as he or she has two teeth that touch. Because flossing demands more manual dexterity than very young children have, children are not usually able to floss well by themselves until they are age 10 or 11.

Keep in mind that flossing should not be painful. You may feel discomfort when you first start flossing, but don't give up. With daily brushing and flossing, that discomfort should ease within a week or two. If your pain persists, talk to your dentist.

If you find flossing difficult, consider a different flossing method. People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner such as a wooden plaque remover, dental pick or pre-threaded flosser. Ask your dentist how to use them properly to avoid injuring your gums. It could be that you simply need to try another type of dental floss waxed, unwaxed, thick or comfort floss. Stick with it and you'll have adopted a healthy hobby for life.

Download the How to Floss PDF