Oral hygiene and preventive dental care for healthy teeth

Oral and dental health play an important role in overall health and also mental well-being. For many people, beautiful and healthy teeth are not only important because of their function, but also have a social value. Those who have beautiful teeth and a radiant smile usually feel more attractive and are more confident. If teeth or the periodontium become diseased, the result may be lost teeth. In that case, not only are chewing and eating often restricted, but well-being and quality of life are impaired.

The health of the mouth and teeth depends considerably on the bacterial community in the mouth. The mouth is colonized by various bacteria. Some of them are “good” and harmless, and others are “bad” kinds that can potentially cause disease. If the bacterial balance shifts toward “bad” bacteria, various diseases can develop in the mouth. In particular, these include caries, gum infections (gingivitis) and atrophy of the periodontium caused by inflammation (periodontitis). Left undetected and untreated, they can lead to tooth loss.

There is already much that everyone can do to maintain oral and dental health. In particular, good oral hygiene is a highly effective preventive measure against caries. That includes brushing the teeth at least twice a day. In addition to brushing teeth, other tools should be used to clean in between the teeth. But dentists can also help keep the teeth and gums healthy, and detect and treat emerging diseases early.

Good oral hygiene is essential for keeping the teeth and periodontium healthy. However, dental and oral health also seem to go beyond the mouth. In recent years, more and more connections have been made between diseased teeth or diseases of the periodontium (periodontitis) and a diseased body.

For example, an inflammation of the endocardium (endocarditis) can be caused by bacteria originating in the mouth. For cardiovascular diseases, especially atherosclerosis, diabetes and lung diseases like COPD, there are also indications that their development might be encouraged by existing diseases in the mouth.

There may also be a connection between dementia illnesses like Alzheimer’s disease and oral health. Both caries and gingivitis/tooth loss were associated in studies with an increased risk of mental impairments and dementia.

Paying attention to the health of the mouth and teeth thus seems important not only to prevent tooth loss. It can also contribute to preventing the development or some diseases outside the mouth and this protecting overall physical health.

To maintain healthy teeth, particular attention should be paid to four points known as the 4 pillars of oral hygiene. They include a tooth-friendly diet, the use of fluoride products, thorough dental hygiene and dental check-ups.

Tooth-friendly diet

A healthy and balanced diet can prevent many diseases, including caries. For this, it is important to be sensible with foods that contain sugar. Sugar is converted into acid by many bacteria that live in the mouth. The acid then damages the tooth enamel. Abstaining as much as possible from foods and beverages containing sugar is the way to protect teeth. The same is true of acidic drinks like fruit juices and soft drinks, because the acid they contain can directly attack the tooth enamel, particularly if they are consumed in small portions throughout the day.

A healthy and balanced diet with an optimal amount of fibers and minerals is also important for the health of teeth and the tissue surrounding them.

Fluoride products

Fluoride hardens the tooth enamel and makes the teeth less sensitive to harmful influences like acid. Furthermore, it can help the body repair early caries damage. In addition, fluoride inhibits the growth of mouth bacteria that are harmful to teeth.

Certain amounts of fluoride are contained in some foods such as milk and eggs. Moreover, table salt in Germany is normally enriched with fluoride. Additionally, toothpaste containing fluoride should be used. If there is an increased risk of caries, mouthwash solutions containing fluoride can also be used daily, or fluoride varnishes used once a week.

Thorough dental hygiene and oral hygiene

The top priorities in dental and oral hygiene are regularity and thoroughness. The teeth should be brushed at least twice a day. The time required for this depends on the condition of the teeth and gums. The team at the dentist’s practice can provide oral hygiene recommendations for the particular situation.

Children are usually taught to firstly brush the chewing surfaces with back and forth movements, then the outer surfaces with circular movements and finally the inner surfaces with rotating movements from gums to teeth. This is sometimes referred to as “KAI-Technik” in German. As a general rule, another technique is better suited to adolescents and adults, whereby the teeth are cleaned with gentle shaking movements from gums to teeth. Plaque can thus be removed more effectively and bacteria are not moved under the gums. Specific cleaning of the transition zone between the teeth and gums is especially important too.

The interdental spaces must also be cleaned daily as food residue can accumulate in these areas. After individual instructions from the dental team, interdental brushes should preferably be used for that. Only where even the smallest interdental brush does not fit can dental floss be resorted to.

Dental check-ups

The costs for dental early detection screenings are covered for people with statutory health insurance from the age of 6 months. That is just about the time when the first tooth appears. 6 examinations altogether are then provided up to the age of 6 years. After that, the statutory health insurance bears the costs for check-ups twice a year. Regular participation in these examinations makes it possible for dentists to detect diseases at an early stage and treat them.

Along with the check-ups, the costs for tartar removal are also accepted once a year, and for periodontitis screening every 2 years. For children aged up to 18 years, the preventive examination additionally includes a nutrition and oral hygiene consultation for parents and the children themselves, and a recommendation for suitable fluoridation agents such as fluoridated table salt or fluoride tablets.

Toothbrush

The toothbrush is an essential aid for daily oral hygiene. It is up to everyone to decide whether to use a manual toothbrush or an electric one. Right now about two-thirds of Germans prefer a traditional manual toothbrush. Regardless of the toothbrush used, brushing should be done for at least 2 minutes. Making sure to brush systematically is important. This ensures that all accessible tooth surfaces are cleaned.

Toothpaste

Toothpaste is as much a part of brushing teeth as a toothbrush. When choosing a toothpaste, it is especially important for it to contain fluoride, generally about 1500 ppm. Most toothpastes have that amount of fluoride nowadays. For children up to and including six years, there are special toothpastes with a lower fluoride content (1000 ppm). Otherwise, toothpaste can be selected according to personal taste. A pea-sized amount is sufficient for each brushing process. For children aged up to 24 months, only a rice grain-sized amount is used.

Dental floss and interdental brushes

A toothbrush does not reach the interdental spaces. But these are particularly good at catching scraps of food, which then feed bacterial growth. It is thus important to also clean these areas regularly, preferably once a day before brushing. Interdental brushes can be used for this. Dental floss should only be used for very narrow gaps that no interdental brush can fit into. Interdental brushes are available in a variety of sizes, because the distances between teeth can vary considerably. Dentists can provide advice on choosing the right size.

Mouthwashes

Mouthwashes have a disinfectant effect, reduce plaque and can thus prevent gum inflammation. Furthermore, many mouthwash solutions also contain fluoride, which gives the tooth enamel additional strength. Using them, for instance always after brushing teeth, can support oral hygiene, especially in people with a particular need for assistance or limited motor skills.

Tongue cleaner

If bacteria settle on the tongue and form a coating, this can cause bad breath. To get rid of this coating and the bad breath, a tongue scraper or tongue brush can be used as an aid. After cleaning, the mouth should be rinsed out with water and the tongue cleaner washed off under running water.

Fissure sealing

Children and adolescents aged between 6 and 18 years, who are especially susceptible to caries, may get fissure sealing. Fissures are the grooves in the premolars that are deeper in some people than others. A toothbrush does not reach into deep grooves or only accesses them very poorly. Bacteria can thus multiply there undisturbed. To prevent this, dentists can seal these fissures with a thin plastic. The costs are covered by statutory health insurance.

Fluoridation

For small children aged between 6 and 33 months, the costs of enamel hardening with fluoride varnish are borne twice a year by statutory health insurance providers. Older children and adolescents up to the age of 18 can also get fluoridation if they have an increased risk of caries. The dentist performing the treatment then decides on the necessity and frequency of the fluoridation.

Professional tooth cleaning

Many dental offices offer professional tooth cleaning as an private, self-payer service. This is meant to prevent the development of caries and periodontitis. Up to now however, there has been no clear evidence that professional cleaning of teeth on its own offers people with healthy teeth and gums an additional advantage over oral hygiene education and instructions about effectively brushing teeth at home. Health insurance providers are not required by law to bear the costs of either measure. However, many health insurance funds subsidize these measures.

In a professional tooth cleaning, the dentist or qualified dental assistant will undertake a detailed examination of the teeth and oral cavity. Plaque on the teeth and in the interdental spaces is then thoroughly removed. Following that, the teeth are polished and fluoridated. Furthermore, the dentist or qualified assistant gives advice concerning oral hygiene measures at home and instructions about correct implementation of these. That is one of the most important aspects of the treatment. The extent of the treatment – and thus also the costs – is based on the patient’s individual situation. There can also be differences between individual dental offices.

You can learn how much professional tooth cleaning costs and its advantages and drawbacks at gesundheitsinformation.de.