Good dental hygiene is very important as our mouth is the gateway to our body. We are what we eat. An unhealthy mouth means that all the infected debris and bacteria in and around the teeth enter our body while chewing food. This debris then causes diseases in the digestive, cardiovascular and reproductive systems of the body.
The oral cavity is comprised of the teeth, the gums, the oral mucosa and the tongue. We need to clean them all to have good oral health.
- When to start the oral care:
- Infants: The oral care should start from the day the baby is born. The common problems of oral thrush, teething blues, baby bottle caries, crying babies and diarrhea are due to neglected oral hygiene of the babies. Since the infants don't have a spitting reflex and tend to swallow fluids, they should be given a spoonful of clean warm water after the feed (preferably breast feed the infant). A clean damp muslin cloth should be wrapped around the index finger to clean the gum pads, inner cheeks, lips and the tongue. Never use cotton (its fibers can irritate), and never use nylon as it can cause injuries on the tender lining of the oral cavity. Brushing should start when the first tooth erupts. A small baby brush, without toothpaste (babies swallow paste) should be used by the parent to clean the tooth. To rinse, just give a spoonful of water to the baby to swallow. And make sure that the last feed should be followed by water. Avoid bottle feeds during the night as the sweet milk remnants lead to dental caries (cavities) called the baby bottle caries.
- Toddlers and older: Never allow the toddler to brush themselves as they don't have the required dexterity and use the brush as a toy, dirtying it and infecting themselves by using it again. It is one of the causes of diarrhea in some countries. Brush the teeth of the child twice daily till he or she reaches the age of five. The tooth paste should be fluoride-free as the kids swallow the paste and can get fluoride side-effects after prolonged use. The amount of paste should be pea-sized.
- School-going children: They should be given proper tooth brush training by the dental personnel. They can safely use the fluoride tooth paste as the spitting reflex is fully developed now.
- Children with braces: They should use special orthodontic brushes to clean the teeth as caries and periodontal disease are common due to improper brushing.
- Children and people with special needs: Since they lack the dexterity or are not intelligent enough to take care of themselves, the parents or the care-givers should clean the teeth with manual or motorized toothbrushes. Special attention should be paid to patients on immuno-suppressant drugs, diabetics, heart patients and mentally challenged patients on long term medications.
- The role of diet in good oral hygiene: Faulty diet is the major cause of caries in children and adults. Make a habit of taking a balanced diet everyday. Diets high in sugar and carbohydrate content should be taken to a minimum. Include fibrous foods (like salads), crunchy veggies (like carrot, radish, cucumber etc.) and fruits while snacking, as they act as natural cleansers (removing the dental plaque) and also have plenty of vitamins and minerals in them. And the peridontium also strengthens by this eating exercise, leading to strong teeth. Milk and milk products like yogurt and cheese should be taken 2 to3 times by the growing kids and especially the women as the calcium in them is good for teeth and bones. Munching uncooked cheese can protect the teeth against caries, and yoghurt keeps the oral flora healthy.
- Fluids: They should include more of water and less of beverages like colas and fruit juices as these are high in acidic content and demineralize the calcium of the teeth leading to caries and hypersensitive teeth. Water acts as a natural cleanser and buffer.
- Tools to clean the teeth: The various tools used globally are: Toothbrushes, herbal chew sticks and dental powders. All have their benefits and should be given the due consideration. The other tools are dental floss, tongue cleaners and mouthwashes.
- Herbal chew sticks like Azadirachta Indica (Neem, Indian Lilac, Margosa Tree), Acacia arabica /Acacia nilotica (Babool, Kikar, Indian gum tree) are the preferred though many more herbal equivalent must be in use around the world.
The benefits of chew sticks: Exercise of the peridontium, antibacterial effect of Neem, astringent effect of the Acacia (stops the bleeding of gums), easy availability and free of cost for the poor. The juice of the chewed stick is used as mouth wash. Toothpaste can be put on the chew stick where toothbrushes are not affordable.
- Dental powders: These are used to clean the teeth with fingers or tooth brushes. They are cheap and hence affordable.
- Toothbrushes: These are manual or motorized. The preferable tooth brush is small, super soft or soft, angular with flexible head to go around the last tooth during brushing. Keep the brush in a safe dry place. Discard the brush when the bristles start fraying and never share the brush. Brushes should be stored separately as bacteria love jumping from one brush to another.
- Toothpastes and mouthwashes: Pastes can be fluoride or fluoride-free and medicated. Fluoride-free toothpastes are not advised in endemic fluoride areas. Fluoride strengthens the enamel against acidic attack but excessive fluoride mottles the teeth and causes skeletal fluorosis (a debilitating disease). Medicated pastes should be used only on prescription. Do not rinse or rinse lightly only once when using fluoride toothpaste so that the fluoride gets time to attach to the enamel (WHO guidelines). Mouthwashes consist mainly of Chlorhexidene. Read instructions before use and follow them strictly as ingestion of Chlorhexidene is a medical emergency and needs stomach wash as treatment. Keep them away from children and elderly who need assistance in care. Use them for a few weeks only as the mouthwashes tend to change the flora of the mouth, leading to side-effects. Rinse with Chlorhexidene should be half an hour after brushing as it can react with the paste. Do not swallow the saliva, eat or drink for twenty minutes after rinsing with Chlorhexidene.
- Dental floss: It is used for inter-dental cleaning. Use only waxed flosses. Floss before brushing at night. Do not force the floss in between the teeth. Use rubber tips on the handle of the brush for wide inter-dental spaces. Do not use pins, sticks or tooth-picks as these can injure the gums and infect them with hidden germs.
- Tongue Cleaners: Use the tooth brush as your cleaner. Metal or plastic cleaners can cause injury on the tongue.
- Method of brushing: Brush your teeth correctly twice a day. Night brushing is important as the food remnants in the teeth and dental plaque tend to rot the teeth. Place the brush alongside the teeth at a 45 degree angle. Use short sweeping strokes in a circular motion from the gum line towards the edge of the teeth, cleaning the teeth and massaging the gums. Clean the inside of the teeth and the chewing surfaces of the teeth as well. Brush for two to three minutes with tender care. Overzealous brushing can injure gums and abrade the enamel of the teeth.
- Dental check-up: Get your dental check up regularly. And get your teeth serviced twice a year. This practice will help detect any caries or periodontal disease. If there is caries of the teeth or periodontal disease, get the treatment as early as possible.
Remember teeth are as important as the other organs of the body. Take care of them; they will shine happily as pearls in your mouth lending beauty and grace and working as dedicated chewing machines all your life.