Dr. Terry Papneja and Associates

Step One: Take about 18 inches (50cm) of floss and loosely wrap most of it around each middle finger (wrapping more around one finger than the other) leaving 2 inches (5cm) of floss in between.

Step Two: With your thumbs and index fingers holding the floss taut, gently slide it down between your teeth, while being careful not to snap it down on your gums.

Step Three: Curve the floss around each tooth in a "C" shape and gently move it up and down the sides of each tooth, including under the gumline. Unroll a new section of floss as you move from tooth to tooth. At first, flossing might feel awkward. But stick with it! With just a little patience and practice, it will begin to feel as natural as brushing your teeth.

A: The fact is, flossing provides unmistakable benefits that start from day one. After flossing, your teeth and gums feel cleaner because the floss reaches areas your toothbrush can't. Your breath will be fresher, and the health of your gums will improve. So, if your dental floss is gathering dust on the bathroom shelf, why not pick it up and try again? Even if it feels awkward at first, keep practicing. Pretty soon, you'll feel the difference and find that it becomes part of your daily routine.

A: It is quite common for your gums to bleed when you first start flossing. It may be a sign that you have some form of gum disease. After a few days of flossing, the bleeding should stop as your gums become healthier. If bleeding persists, consult your dentist.

A: It's never too late. Whatever your age, interdental cleaning provides major benefits to your teeth and gums that you'll notice right away, so the sooner you start, the better. Interdental cleaning makes your teeth and gums feel clean because it reaches areas a toothbrush can't reach. It also keeps your breath fresh and, more importantly, it can stop gum disease in its tracks.

A: While there are a number of different kinds of floss, they are all designed to reach between the teeth and below the gumline to remove plaque. The most important factor is finding floss that is comfortable and easy for you to use.

Some of the newer flosses are designed to be easier to use. They are shred-resistant and slide smoothly between the teeth.

If you have trouble holding or using floss, you may want to try a dental flossette. It eliminates the need to wrap and guide the floss between the teeth with the fingers, and can give you better control. Once the flossette is inserted between the teeth, use the same method of flossing as above. Flossettes are often easier for children to use as they start to learn how to floss their own teeth.

A: If you have braces or restorative dental work (such as a bridge) that interferes with normal flossing, you may want to try threading floss. Superfloss is unique because it has three sections in each strand: a stiffened end that allows it to be threaded in between your teeth, around braces, or under bridgework; a spongy floss, to clean in wide spaces, and a regular floss for cleaning natural teeth, and under the gumline. Toothpaste, fluoride or an antibacterial agent can be used on the spongy floss section.

A: Even if you have widely spaced teeth, plaque still forms between them and below the gumline-areas your brush can't reach. In addition to flossing, your dentist or hygienist may also recommend using an interdental toothbrush. This toothbrush has a very small tapered or cylindrical head with fine bristles, ideal for removing plaque between wider-spaced teeth.

In addition to floss, there are other products designed for cleaning between your teeth. Ask your dentist or hygienist to help you determine which products are best for you. Their recommendation will be influenced by a number of factors:

• the amount of space between each of your teeth
• the presence of orthodontic braces or restorations, like a bridge
• the presence of implants or if you are recovering from gum surgery
• the relative ease with which you use dental floss

If you have widely spaced teeth, braces, bridges, or implants, you may benefit from an interdental toothbrush. This toothbrush has a very small tapered or cylindrical head with fine bristles.

The Proxa Brush comes with a handle and two disposable brushheads - you just need to replace the brushhead when the bristles show wear. Also available, for patients with sensitivity, is the soft foam brushhead that provides a very gentle interdental cleaning sensation.

And for cleaning between your teeth when you are on the move, various products come in travel size (with travel cap) and are ideal size for your purse or pocket.

These, like the Oral-B OxyJet, or Teledyne waterpik use a pressurized stream of water to help clean around the gumline. They also have adjustable settings for use on sensitive areas and has a water tower large enough to clean the whole mouth.

A: Consult your dentist, but a good rule of thumb is when two teeth touch. This usually happens first with the back teeth. To begin with, you will have to floss their teeth for them, but they will eventually need to learn to do it for themselves. Using a dental flossette may help you and your child get used to flossing. You should continue to supervise flossing until your children are able to do a thorough job on their own.

A: There is a lot of choice when it comes to purchasing a toothbrush, which makes it difficult to know what to look for. A good starting point is to ask your dentist and hygienist for a recommendation.

In addition, here are some tips on what to look for:

• Choose a toothbrush with a small brushhead and a bristle design that helps you to get to the hard-to-reach places of your mouth.
• Your toothbrush should have soft bristles that are gentle on your teeth and gums.
• Pick a toothbrush with a comfortable handle. Many have non-slip grips which make them easy to use even if wet.

Remember that regular replacement of toothbrushes contributes to maintaining a consistently high level of oral hygiene because clinical research shows, a new toothbrush can remove up to 30% more plaque than one that 's three months old.

There are many ways to brush your teeth. Ask your dentist or hygienist for their recommendation. However, here's an example of one frequently recommended method, using a regular toothbrush:

Step One: For the outer tooth surfaces, place the toothbrush at a 45-degree angle toward the gumline. Use gentle, short strokes, moving the brush back and forth against the teeth and gums.

Step Two: Use this same motion to clean the chewing and inner tooth surfaces.

Step Three: To clean the inner front tooth surfaces, hold the brush upright and use gentle up-and-down strokes with the tip of the brush.

Step Four: Don't forget to brush along the gumline, and make sure you reach the teeth right at the back. Also give your tongue a brushing - it'll help keep your breath fresh!

A: Refer to the brushing instructions supplied with your power toothbrush. Instructions for using the Oral-B range of rotating power toothbrushes are as follows:

Step One: Guide the brushhead slowly from tooth to tooth, following the curve of the gum and the shape of each tooth. Hold the brushhead in place for a few seconds before moving on to the next tooth.

Step Two: Don't forget to reach all areas, including the inner and chewing surfaces, and behind your back teeth.

Step Three: Direct the brushhead along the gumline. It isn't necessary to press hard or scrub. Simply let the brush do all the work

The average healthy adult visits the dentist twice a year. The average healthy two-year-old has never been to the dentist. By kindergarten, twenty-five percent of children have never seen a dentist, yet according to the Surgeon General's Oral Health Report 2000, dental decay is the single most common chronic childhood disease in Canada.

The culprit? A combination of misinformation about when a child should first visit the dentist, when a parent should start caring for a child's teeth and the frequent and long-term exposure of sugary liquids to a child's teeth.

It is highly recommended a child first visit the dentist six months after the eruption of the first tooth. During this first exam, the dentist can teach parents the best way to guard against early childhood tooth decay by wiping down the teeth with a damp cloth once a day and remind parents to limit sugary beverages.

Frequent and long-term exposure of a child's teeth to sugary liquids is commonly called baby bottle tooth decay. Most parents and dentists are aware of baby bottle tooth decay however, parents may not know that the long-term and regular consumption of sugary liquids in a bottle or cup puts children's growing teeth at increased risk for decay.

"Unsweetened fruit juices, teas and water are always best for children to help promote oral and overall health," says Cindi Sherwood, DDS, spokesperson for the Academy of General Dentistry, an organization of general dentists dedicated to continuing dental education.

According to the Canadian Association of Pediatrics, fruit juice causes tooth decay if children are allowed to hold a bottle, cup or box of juice in their mouth through the day.

If left untreated, baby bottle tooth decay can result in pain and infection. Baby teeth are important because they hold the place for permanent teeth and help guide them into correct position. Severely decayed teeth may need to be extracted which could effect the development of permanent teeth, a child's speech and chewing."

Caring for children's teeth beginning in infancy promotes good oral health care habits for a lifetime and increases the chances of a child maintaining healthy permanent teeth.

• Wean a child from the bottle or breast by age one.
• Use spill-proof cups as a transitional step in the development of children, not a long-term solution.
• Don't allow children to use spill-proof cups throughout the day. Save spill-proof cups for snack and mealtimes when increased salivary activity helps clean teeth.
• Drink sugary beverages through a straw. The best spill-proof cups to protect against decay are those with collapsible rubber straws.
• Introduce oral health care habits early. Wipe children's teeth with a damp cloth once a day. Introduce brushing with a soft-bristle brush and fluoridated toothpaste by age two under the supervision of a parent.