Oral hygiene

Oral hygiene is the practice of keeping the mouth clean and healthy by brushing and flossing to prevent tooth decay and gum disease. Brushing and flossingprevent the build-up of plaque, the sticky film of bacteria and food that forms on the teeth. Plaque sticks to grooves in the teeth and produces acids that can slowly eat away, or decay, the protective enamel surface of the teeth,causing holes (cavities) to form. Plaque also irritates gums and can lead togum disease and tooth loss. In addition to brushing and flossing, antisepticmouthwashes improve oral hygiene by killing some of the bacteria that help form plaque. Fluoride--in toothpaste, drinking water, or dental treatments--also helps to protect teeth by binding with enamel to make it stronger. Daily care is important in oral health, but so are regular visits to the dentist. Atthe dentist's office, the dentist or dental hygienist can perform preventiveservices such as fluoride treatments, sealant application, and scaling (scraping off the hardened plaque, called tartar). Diagnostic services, such as x-ray imaging and oral cancer screening, and treatment services, such as fillings, crowns, and bridges, can also be performed.

Maintaining oral hygiene should be a lifelong habit. An infant's gums and, later, teeth should be kept clean by wiping them with a moist cloth or a soft toothbrush. However, only a pea-sized amount of fluoride toothpaste should beused, as too much fluoride can be harmful to young children.

Even people with partial or full dentures should maintain good oral hygiene.Bridges and dentures must be kept clean to prevent gum disease. Dentures should be relined and adjusted by a dentist as necessary to maintain proper fit so the gums do not become red, swollen, and tender. Dentures should not be worn overnight.

Brushing should be performed with a toothbrush and a fluoride toothpaste at least twice a day and preferably after every meal and snack. Effective brushing must clean each outer tooth surface, inner tooth surface, and the flat chewing surfaces of the back teeth. To clean the outer and inner surfaces, the toothbrush should be held at a 45-degree angle against the gums and moved backand forth in short strokes (no more than one tooth width distance). To cleanthe inside surfaces of the front teeth, the toothbrush should be held vertically and the bristles at the tip (called the toe of the brush) moved gently upand down against each tooth. To clean the chewing surfaces of the large backteeth, the brush should be held flat and moved back and forth. Finally, thetongue should also be brushed using a back-to-front sweeping motion to removefood particles and bacteria that may sour the breath.

Toothbrushes wear out and should be replaced every three months. The best toothbrushes to use have soft, rounded, nylon bristles. The size and shape should allow for reaching all tooth surfaces easily.

Flossing once a day helps prevent gum disease by removing food particles andplaque at and below the gumline as well as between teeth. To begin, most of an 18-in (45-cm) strand of floss is wrapped around the third finger of one hand. A 1-in (2.5-cm) section is then grasped firmly between the thumb and forefinger of each hand. The floss is eased between two teeth and worked gently upand down several times with a rubbing motion. At the gumline, the floss is curved first around one tooth and then the other with gentle sliding into thespace between the tooth and gum. After the space between each two teeth is cleaned, a fresh section of floss is unwrapped from one hand as the used section of floss is wrapped around the third finger of the opposite hand. Flossingshould be done between all teeth and behind the back teeth.

Dental floss comes in many varieties (waxed, unwaxed, flavored, tape). The choice of dental floss is a matter of personal preference. People who have trouble handling floss can use floss holders and other types of cleaning aids, such as brushes and picks.

Brushing and flossing should not be done so vigorously as to irritate or damage sensitive tissues. When a person first starts flossing regularly, the gumsmay be sore and may bleed for a few days. Bleeding that continues for more than a week should be brought to a dentist's attention. As a general rule, anymouth sore or abnormal condition that does not disappear after 10 days should be examined by a dentist.

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