Good oral hygiene is essential in preserving your teeth for a lifetime. A basic routine includes brushing and flossing. Every side of the tooth and the gums should be kept clean. Flossing takes care of the sides of the tooth, which the brush can not reach. Healthy gums should not bleed when brushing or flossing. All cleaning methods have the same goal: to remove plaque. Plaque is a thin, sticky layer of bacteria that must be removed daily. It is the cause of decay, periodontal disease, and bad breath. If left on the teeth for about 24 hours, it can harden into tartar deposits (calculus). Tartar generally can not be removed by brushing, and removal usually requires the help of a professional dental hygienist.

Brushing
Plaque is soft. Use a soft toothbrush. A hard one may scratch the enamel, and will not adapt to the curvature of your teeth. Hard toothbrushes can also wear away healthy gums.

Apply light pressure and small circular strokes while holding the brush bristles at an angle of 45 degrees against the gum line. Brush for at least 2 minutes to ensure thorough removal of plaque.

Flossing
Wrap the floss around you middle fingers while allowing about six inches between your hands. Use your free index fingers to guide about 1 inch of the floss. Run the floss between your teeth, and carefully push it under the gumline. Now pull the floss against the tooth, and pull down and out. This should wipe the side of one tooth. So now you have to go back between the same two teeth, and get the side of the other tooth. You can do it!

If you have a bridge, use a special floss threader or Superfloss to clean underneath. You can get decay around crowns and bridges, so don't skip them.

Rinsing
Listerine is clinically proven to kill oral bacteria. Dr. Coates recommends the new citrus flavor because it doesn't seem to burn as much. ACT fluoride rinse is an over-the-counter fluoride supplement. It can help harden and strengthen the teeth, but does not kill as may bacteria as Listerine.

Bad Breath
Also called halitosis. Two main causes of halitosis are odors from the mouth, and odors from the stomach. Lax muscles in the stomach or esophagus can allow odors from the stomach to escape. Sometimes, bacterial infections in the stomach are the culprit.

Usually, food trapped in the teeth, poor oral hygiene, and uncontrolled gum disease is to blame. If you have not been to the dentist's office for a cleaning in the past six months, that is a good place to start.

Mints and mouthwash can cover the problem, but you have to remove the source of the odor. Brush, floss, and then brush your tongue.

Clean your Tongue, too!
Dr. Coates recommends the use of a tongue scraper daily. Your tongue has a rough surface that traps minute food particles, and a bacterial film called plaque. Scraping your tongue will not only reduce the build-up of material at the back of the mouth, but it will also lower the amount of bacteria. Reducing the number of bacteria can improve the overall health of your mouth. Tongue scrapers are available in drug stores, and can help you get a super-clean feeling.

Decay

For roughly 50% of adults, who do not see a dentist regularly, the first indication that they may have advanced tooth decay is a toothache. By the time pain is felt in the tooth, the decay is often close to the nerve, and a simple, small filling is no longer an option. Dr. Coates can usually diagnose decay in teeth before the patient is aware of it. He uses dental x-rays, intraoral cameras, and surgical magnification eyewear to spot decay.

Tooth decay can spread through teeth over a long period of time (years). Oral bacteria (known as plaque) cause tooth decay. These bacteria digest sugar, and produce acid as a by-product. The acid eats away at the tooth’s hard outside enamel layer. Because enamel is made up of minerals and has no live cells or nerves, this stage is usually painless and often goes unnoticed. Once the decay eats through the 1-2 millimeters of enamel, it enters the relatively softer dentin. Decay spreads more rapidly in dentin, and the unsupported shell of enamel can crumble under chewing forces. That’s when people report breaking a tooth “all of the sudden”.

Decay in its early stages is relatively painless. Dr. Coates can detect decay while it is forming and before it causes pain by probing the area with instruments and taking x-rays. A tooth’s sensitivity to hot or cold, or noticeable pain after eating sweet foods, is a signal that tooth decay has begun. Sipping sodas is especially damaging to teeth because it contains sugar, and is usually very acidic. Even some diet sodas, without sugar, have enough acid to cause tooth decay.

You can eliminate toothaches entirely by following an oral hygiene program of daily brushing and flossing, and seeing your dentist and dental hygienist regularly. Remember that an ounce of prevention is worth a pound of cure (and it is a lot less expensive).

(Figure 1) The enamel layer is eroded away, then the decay penetrates the dentin, which is comprised of both minerals and living tissue. The patient will notice hot and cold sensitivity and even some pain. Since dentin is a softer tissue, the decay spreads faster through it, affecting the support of the enamel resulting in possible breakage.

(Figure 2) The untreated tooth decay will eventually reach the pulp of the tooth where nerve endings are located . A throbbing sensation, or pain is usually noticed. This requires immediate attention from your dentist or the tooth may be lost.

(Figure 3) The living tissue inside the tooth can get infected by oral bacteria. Ouch. This infection can spread to adjoining teeth or other parts of the body, including the heart or joints. If this abscess is caught early enough, the tooth sometimes can be saved by a root canal procedure. If the tooth cannot be saved, it will have to be extracted.