Your teeth vary in shape and size depending on their position within your mouth. These differences allow the teeth to do many different jobs. Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly. Finally, teeth help to give our face its shape. A healthy smile can be a great asset and because this is so important, it makes sense to give your teeth the best care possible.

Tooth decay can be painful and unsightly. If tooth decay is not treated, the nerve of the tooth can become infected and die, causing an abscess. This may then need root canal treatment or even extraction. Gum disease is the largest cause of tooth loss in adults. Gum disease is a preventable condition and can be treated and kept under control with regular cleaning sessions and check-ups, preventing further problems. If teeth are lost, it may be necessary to fill the gaps with bridges, dentures or implants.

It is easy to get your mouth clean and healthy, and keep it that way. A simple routine of brushing and cleaning between the teeth, good eating habits and regular dental check-ups can help prevent most dental problems. Although most people brush regularly, many don’t clean between their teeth and some people don’t have dental check-ups. A few small changes in your daily routine can make a big difference in the long run. Your dentist or dental hygienist can remove any build-up on your teeth and treat any gum disease that has already appeared. But daily dental care is up to you, and the main weapons are the toothbrush and interdental cleaning.

Plaque is a thin, sticky film of bacteria that constantly forms on your teeth.

Enamel is the hard protective outer coating of the tooth and is the hardest part of the body. It does not contain any nerves or blood vessels and is not sensitive to pain. Dentine lies under the enamel, forming most of the tooth and can be very sensitive to pain. Dentine covers the central pulp of the tooth. The pulp is a soft tissue which contains blood vessels and nerves and is in the middle of the tooth. When you eat foods containing sugars and starches, the bacteria in plaque produce acids, which attack tooth enamel. The stickiness of the plaque keeps these acids in contact with teeth. After repeated acid attack, the tooth enamel breaks down forming a hole or cavity.

Once the cavity has reached the dentine your tooth may become sensitive, particularly with sweet foods and drinks, and acidic or hot foods. As the decay gets near the dental pulp you may suffer from toothache. If the toothache is brought on by heat or sweet foods this may last for only a few seconds. As the decay gets closer to the dental pulp the pain may last longer and you may need to take painkillers – paracetamol or ibuprofen – to control the pain. You must visit your dentist immediately as the tooth is dying and you may develop a dental abscess if it is not treated.

Plaque can harden into something called calculus another name for it is ‘tartar’. As calculus forms near the gumline, the plaque underneath releases poisons causing the gums to become irritated and inflamed. The gums begin to pull away from the teeth and the gaps become infected. If gum disease is not treated promptly, the bone supporting the teeth is destroyed and healthy teeth can become loose and fall out. Gum disease is the biggest cause of tooth loss in adults and can lead to the need for dentures, bridges or implants.

It is important to remove plaque and food debris from around your teeth as this will stop your gums from swelling and becoming infected. If you leave plaque on your teeth it can harden into tartar, which can only be removed by the dentist or hygienist. It is important to keep up your regular appointments so that your teeth can have a thorough cleaning if they need it.

Gum disease (gingivitis) will usually show itself as red, swollen gums that bleed when brushed or flossed. Many people are alarmed when they notice this bleeding and will then brush more gently, if at all. It is important that you continue to clean regularly and firmly in order to fight the condition.

Daily brushing and cleaning between your teeth is important because it removes plaque. If the plaque isn’t removed, it continues to build up, feeding on the food debris left behind and causing tooth decay and gum disease.

Your dentist or dental hygienist will be able to recommend a toothbrush suitable for you. However, adults should choose a small to medium size brush with soft to medium multi-tufted, round-ended nylon bristles or ‘filaments’. The head should be small enough to reach into all parts of the mouth: especially the back of the mouth where it can be difficult to reach. Children need to use smaller brushes but with the same type of filaments.

You can now get more specialised toothbrushes. For instance, people with sensitive teeth can now use softer bristled brushes. There are also smaller headed toothbrushes for those people with crooked or irregular teeth.

Some people find it difficult to hold a toothbrush, for example because they have Parkinson’s disease or a physical disability. There are now toothbrushes, which have large handles and angled heads to make them easier to use.

An electric brush often has rotating or vibrating head, which provides a large amount of cleaning action with very little movement needed from the user, although you do need to position the brush correctly. Tests have shown that certain electric toothbrushes are better at removing plaque. They are particularly useful for people with limited movement, such as disabled or elderly people, who often find that using a normal toothbrush does not allow them to clean thoroughly. Electric toothbrushes can also be better for children as they may be more inclined to brush regularly because of the novelty of using an electric toothbrush. Discuss the idea with your dentist or hygienist to find out if you would benefit from using an electric toothbrush.

Brushing removes plaque and food particles from the inner, outer and biting surfaces of your teeth.

Here is one method of removing plaque:

1. Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45 degree angle against the gumline. Move the brush in small circular movements, several times, on all the surfaces of every tooth.

2. Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gumline.

3. Use the same method on the inside surfaces of all your teeth.

4. Brush the chewing surfaces of the teeth.

5. To clean the inside surfaces of the front teeth, tilt the brush vertically and make several small circular strokes with the front part of the brush.

6. Brushing your tongue will help freshen your breath and will clean your mouth by removing bacteria.

Plaque can be stained with special dye painted onto your teeth with a cotton bud or with special disclosing tablets which you can get from the dentist. The stain is harmless and will show any areas of your mouth which need better brushing. Look particularly where your teeth and gums meet. Further brushing will remove the stained plaque.

Be sure to brush thoroughly with a fluoride toothpaste at least twice a day, more often if your dentist recommends it. If you regularly keep getting discomfort or bleeding after brushing you should see your dentist.

Worn-out toothbrushes cannot clean your teeth properly and may damage your gums. It is important to change your toothbrush every few months, or sooner if the filaments become worn. When bristles become splayed, they do not clean properly.

A fluoride toothpaste. Fluoride helps to strengthen and protect teeth, which can reduce tooth decay in adults and children. As well as regular family toothpastes, there are many specialist toothpastes. These include tartar control for people who are prone to tartar build-up, and ones for people with sensitive teeth. Total care toothpastes include ingredients to help fight gum disease, freshen breath and help reduce plaque build-up. Whitening toothpastes are good at removing staining, but are not strong enough to change the natural shade of the teeth.

All children and adults should use a toothpaste with a fluoride level of at least 1000 ppm. Special children’s toothpastes have about half the level of fluoride that adult toothpastes have. They only give limited protection for the teeth. If your children are under 7 you should keep an eye on them when they brush their teeth and encourage them not to swallow the toothpaste.

You do not need to cover the head of your brush in toothpaste. A pea-sized amount is enough. Children should use a pea-sized smear of toothpaste.

One way to clean between your teeth is with dental floss or tape. Dental tape is thicker than floss and many people find it easier to use. Flossing removes plaque and food particles from between your teeth and under the gumline, areas a toothbrush can’t reach. You should clean between your teeth at least once a day with floss. We can show you proper flossing techniques.

The following suggestions may help:

1. Break off about 18 inches of floss, and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the other hand. As you use the floss, you will take up the used section with this finger.

2. Hold the floss tightly between your thumb and forefingers, with about an inch of floss between them, leaving no slack. Use a gentle ‘rocking’ motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.

3. When the floss reaches the gumline, curve it into a C-shape against one tooth until you feel resistance.

4. Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum. Repeat on the other side of the gap, along the side of the next tooth.

5. Don’t forget the back of your last tooth.

When flossing, keep to a regular pattern. Start at the top and work from left to right, then move to the bottom and again work from the left to right. This way you’re less likely to miss any teeth. At first it also helps to look in the mirror.

It is also very important to clean around the edges of any crowns, bridges or implants. This can be difficult to do effectively using traditional floss and there are now specialist flosses to do the job thoroughly (such as super floss and specialist floss threaders). We can advise how to use these properly and which method you should use.

Your gums may bleed or be sore for the first few days that you floss. This should stop once the plaque is broken up and your oral hygiene has improved. If the bleeding does not stop, tell your dentist. It may be that you are not flossing correctly or your teeth and gums need a more thorough clean by your dentist or hygienist.

You can use a floss holder or an interdental cleaning aid. Interdental cleaning aids include woodsticks or small interdental brushes used to remove plaque from between the teeth. Your dentist or hygienist can explain how to use these properly.

Oral irrigation devices use a stream of water to remove food particles from around the teeth. These devices can be helpful for people wearing orthodontic appliances or fixed bridges where it is difficult to clean, but they do not work sufficiently well on their own, i.e. they may remove gross debris, but careful interdental brushing or flossing is also necessary to remove all plaque deposits.

Mouthwashes are mainly used to freshen breath. If you have to keep using a breath freshener to hide any bad breath, see your dentist. Bad breath can be a sign of unhealthy teeth and gums or of poor general health. A fluoride mouthwash can help prevent tooth decay. Your dentist may recommend an antibacterial mouthwash to help control plaque and reduce gingivitis (gum disease).

Many people think that it is a high level of sugar in your diet that causes decay, but this is not so. It is how often you have sugar in your diet, not the amount, that causes problems. It takes an average of 40 minutes for the mouth to neutralise the acid caused by eating and drinking sugar. It is therefore important to limit the number of attacks by keeping sugary foods and drinks to mealtimes.

Smoking can lead to tooth staining, gum disease, tooth loss and in more severe cases mouth cancer. Patients who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums fail to heal. Smoking causes people to have more dental plaque and for gum disease to progress more rapidly than in non-smokers. Gum disease still remains the most common cause of tooth loss in adults.

There are special toothpastes for people who smoke. They are sometimes a little more abrasive than ordinary pastes and should be used with care. Your dentist may recommend that you use these toothpastes alternately with your usual toothpaste. There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining and therefore may improve the overall appearance of your teeth.

It is just as important to clean dentures as it is to clean your natural teeth. Food can become caught around the edges of dentures and clasps, and can rot if not cleaned thoroughly.

You should keep a separate toothbrush for cleaning your dentures. The general rule is: brush, soak, brush. Clean your dentures over a bowl of water in case you drop them. Brush your dentures before soaking, to help remove any food debris. Soak the dentures overnight in a mild cold-water solution of Dentural from Boots, or Milton solution for dentures with no metal parts. Thenn brush the dentures again in the morning – as you would your natural teeth. Make sure you clean all of the surfaces of the dentures, including the surface which comes into contact with your gums. If you notice a build-up of stains or scale, have your denture cleaned by your dentist or hygienist. Most dentists still recommend a small to medium-headed toothbrush.

It is important to check on dental decay and gum disease, so that any problems can be caught early and treated more easily. Even for people with no natural teeth, it is a good idea to see a dentist every couple of years for an oral health check and to check the fitting of dentures, as our mouths change gradually year by year.