FREQUENTLY ASKED QUESTIONS

Q: How does plaque cause tooth decay?

A: The bacteria in plaque react with sugar in the foods we eat to produce acids that can attack and weaken tooth enamel (the hard, protective covering on our teeth), opening the way for cavities to develop.

Q: What is a cavity?

A: A cavity is the space inside a tooth that remains once decay is removed. There are three different places where a tooth can experience decay.


Decay on the biting surfaces of the teeth occurs when plaque becomes trapped in the grooves. This is most common in children because they often miss these areas when brushing.


Decay between the teeth occurs when plaque is left to build up on these hard to reach surfaces. These areas cannot be reached by a toothbrush alone and may develop if you do not floss, or clean between your teeth, regularly.


Decay at the root surfaces of the teeth occurs if you have suffered gum recession or bone loss, often associated with gum disease, or periodontitis. It is also more common as you get older because gums have started to recede. If plaque is left to build up on the exposed roots of the teeth, which are not protected with enamel, then cavities will quickly develop.

If plaque is not regularly removed from teeth, including the areas below the gum line, it can irritate the gums, leading to gum disease. Regular brushing and cleaning between teeth is essential to help prevent gum disease.

Q: How does plaque cause gum disease?
A: If plaque is left to build up, the bacteria produce toxins that can irritate the gums and damage teeth. The earliest stage of gum disease is called gingivitis. This is an inflammation of the gums, which may cause swelling, tenderness and bleeding when brushing or flossing.

Q: Who is at risk for gum disease?

A: Gum disease can affect any age group, including children. However, it most often affects adults. In fact, about three out of four adults over age 35 have some form of gum disease now or have had it in the past.
Your risk of getting gum disease increases if you smoke or have certain medical conditions. It is therefore vital to keep your dentist informed of your general health.

Q: What should I do if I think I have gingivitis?

A: Fortunately, with proper oral care every day and regular visits to the dentist, you can help prevent gingivitis from ever developing. It is best prevented and, in most cases quickly healed, by following a routine to remove plaque every day - this is a two step process of brushing with a soft bristled toothbrush and cleaning between teeth. Together they prevent plaque from building up on tooth surfaces and under the gum line.
Gingivitis is not a permanent condition. It can be reversed, because no permanent damage has occurred to the bone supporting the teeth.

Q: What is periodontitis?

A: Left untreated, gingivitis may progress to a more severe form of gum disease called periodontitis, or periodontal disease. Periodontitis damages the bone and gums that support the teeth. Once periodontitis develops, the damage can't be reversed: only a professional treatment program and an improved level of daily oral care at home can keep it from getting worse.
If you have periodontitis your dentist will provide you with a tailored program for maintaining your teeth and gums, to halt the progress of the disease. There are a range of oral hygiene products that are safe to use if you have periodontitis, including a range of power toothbrushes. Because the power toothbrushes have been proven to remove more plaque than a manual toothbrush, you can improve your level of oral hygiene, which is a critical factor in controlling gum disease.

Q: What symptoms should I be looking out for?

A: Periodontitis may initially occur without many visible symptoms, therefore regular dental exams are critical for early diagnosis.
Common symptoms of periodontitis are red, swollen gums that have started to pull away from the teeth, creating pockets. This is often associated with tooth sensitivity, a feeling of intense pressure between the teeth or bleeding when brushing or flossing.
In more advanced stages, you may experience gum recession, root decay, pus between teeth and gums, and loosening or eventual loss of teeth.

Early Periodontitis	Moderate Periodontitis	Advanced Periodontitis

Q: How do I help prevent periodontitis from developing?

A: By adopting a thorough oral care routine you can help avoid periodontitis - here are some useful tips:

- Brush thoroughly twice a day, with a soft bristled toothbrush and fluoride toothpaste - preferably in the morning and before bed
- Clean between your teeth daily to remove plaque from areas your toothbrush can't reach
- Visit your dentist and hygienist regularly - at least once every six months, for a cleaning and exam
- Avoid smoking and using tobacco
- Dentists recommend that you change your toothbrush at least every three months or earlier if the toothbrush looks worn, because research shows that a new toothbrush can remove more plaque than one that's three months old.*

* - [ Warren PR et al. J Clin Dent 2002; 13: 119 - 124]

BRUSHING

Proper brushing is the first step to maintaining healthy teeth and gums. It takes at least two minutes using a recommended technique to do a good job of brushing your teeth. Whether you are using a regular toothbrush or a power toothbrush, you should spend 30 seconds brushing each section of your mouth (upper right and left, lower right and left).

Q: What's the best way to brush your teeth?

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!

Q: How do I brush with a power toothbrush?

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

Q: What is tartar?

A: Every time you brush, you remove the plaque that is constantly forming on your teeth. If you allow plaque to build up, it can harden into tartar (also called calculus) which can then only be removed by your dentist or hygienist.

Q: How do I keep my teeth naturally whiter between dental visits?

A: Everybody wants to have white teeth and there are many products available that lighten teeth - using a chemical process, called bleaching. In fact, we have devoted a whole section to tooth whitening.
However, brushing your teeth regularly with toothpaste will remove some of the stain that builds up on the teeth - as a result of drinking coffee or tea, and red wine.

FLOSSING

It is important to clean in between your teeth daily because it is a front-line of defense in preventing gum disease and bad breath, and can play a role in preventing tooth decay too. It allows you to get to the areas beyond the reach of your toothbrush.

Using dental floss daily is one of the common ways to clean between your teeth.

Q: How should I floss?
Step 1:

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 2:

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 3:

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.

Q: How long does it take for flossing to start paying off?

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.

Q: My gums bleed when I floss; should I stop when this happens?

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.

Q: I've never cleaned in between my teeth before; is it too late to start?

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.

Q: What kind of floss is best?

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.

Q: Are there flosses for special conditions? 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.

Q: My teeth have wide gaps between them; do I still have to floss?

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.

Q: Are there other methods of cleaning in between?

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

Interdental brushes

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.

Irrigators

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..

Q: When should children start flossing?

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.

For more information on children's oral care, refer to the section which is dedicated to helping you care for your child's teeth and gums.

TOOTHBRUSHES

Did you know that, in addition to your brushing technique, and the frequency and time you spend brushing, experts believe that the type of toothbrush you use will directly affect how well you remove plaque.1

Q: How do I choose the right toothbrush for me?

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.