Oral-Care Guide: Brushing, Diet and More

Good oral care is mostly a few simple habits done every day. This guide sets out the basics, based on guidance from the Indian Dental Association, the NHS and the American Dental Association.

Brushing

• Brush twice a day: once in the morning and once last thing before sleep. The night-time brush matters most, because less saliva is made during sleep and plaque has longer to act.
• Brush for 2 minutes with a soft-bristled brush and a fluoride toothpaste. Use a pea-sized amount.
• Hold the brush at a slight angle to the gum line and use small, gentle circles. Pressing hard does not clean better and can wear the gums and enamel.
• Clean all surfaces: outer, inner and chewing surfaces, and gently brush the tongue.
• Spit, do not rinse. Leaving a little toothpaste in the mouth keeps fluoride on the teeth for longer.
• Change your brush every 3 months, or sooner if the bristles splay. Electric brushes are fine and can help if you find hand-brushing difficult, but the technique still matters.
• If you have just eaten something acidic, such as citrus or a fizzy drink, wait about 30 minutes before brushing.

Cleaning between the teeth

A toothbrush cannot reach the sides of the teeth, where about a third of the surface lies. Clean between your teeth once a day, using:

• dental floss or floss tape
• small interdental brushes, which are often easier for wider gaps, bridges or braces
• a water flosser, as an addition, particularly with braces or implants

Slide the floss gently in a C-shape around each tooth, just below the gum line. Gums may bleed for the first week or two if you have not been cleaning there. This should settle with daily cleaning. If it does not, see the post on why gums bleed.

Mouthwash can be an extra, but it does not replace brushing and cleaning between the teeth. Gargling with water after meals helps to wash away food, but it does not remove plaque.

Diet and snacking

Tooth decay is caused by sugar and the bacteria that feed on it, so how often you have sugar matters more than how much at once.

• Keep sweets, biscuits, chocolates and sweet drinks to mealtimes, rather than grazing through the day.
• Sticky foods such as toffees, dried fruit and sweet chikki stay on the teeth longer.
• Water is the safest drink between meals. Limit fizzy drinks, packaged juices, sweetened tea and coffee.
• Crunchy fruit and vegetables such as carrot, cucumber and apple are good snacks and stimulate saliva, but they do not replace brushing.
• Cheese, nuts and plain curd are kind to teeth.
• Chewing sugar-free gum after a meal can help to increase saliva.

Children

• Wipe a baby's gums with a damp cloth. From the first tooth, brush twice a day.
• Use a smear of fluoride toothpaste (rice-grain size) until age 3, then a pea-sized amount until 6. Help with brushing until around age 7 or 8.
• Do not give a baby a bottle of milk or juice in bed, and avoid sweets and sticky snacks between meals.
• Take your child to a dentist by their first birthday, or when the first tooth appears. See your child's first dental visit.
• Use a mouthguard for contact sports.

More about children's dentistry.

Tobacco, gutka and paan

Chewing tobacco, gutka, khaini, paan masala with tobacco, areca nut and smoking all harm the mouth. They cause staining, gum disease and tooth loss, and they are a major cause of mouth cancer in India. Areca nut also causes oral submucous fibrosis, a condition in which the mouth gradually becomes stiff and hard to open.

• The safest option is to stop. Your dentist or doctor can help with a plan.
• Look at your mouth in a mirror regularly. A mouth ulcer that does not heal in 3 weeks, a white or red patch, a lump, or difficulty opening the mouth should be checked without delay.
• If you use tobacco in any form, have your mouth examined at least once a year.

Dentures and missing teeth

• Remove dentures at night, and keep them in water in a clean container.
• Clean dentures daily with a soft brush and mild soap or denture cleaner. Do not use hot water, which can warp them, and do not use toothpaste, which is abrasive.
• Brush your gums, tongue and any remaining teeth every day.
• A denture that has become loose, or sore spots that last more than a few days, needs adjustment. Do not try to fix it with glue.
• Bone shrinks after teeth are lost, so dentures need review every year or so.

Missing teeth can be replaced in several ways. See dentures and dental implants.

When to see a dentist

Aim for a check-up and clean about every 6 months, or as often as your dentist advises. See how often you should see a dentist.

Do not wait for the next routine visit if you have:

• tooth pain that lingers or wakes you at night
• bleeding gums that continue for more than 2 weeks
• swelling of the gum or face
• a loose, broken or chipped tooth
• a mouth ulcer or patch that has not healed in 3 weeks
• bad breath that does not go away despite cleaning

Facial swelling with fever, or any trouble swallowing or breathing, needs a hospital straight away. For first aid in other urgent situations, see dental emergency: what to do.