Teeth before hygiene, chemical agent for staining plaque (used for educational purposes so that the patient can see areas that cannot be cleaned) and the state after hygiene.
There are a lot of questions about brushing your teeth, so let’s go over the main ones:
- What happens if you don't brush your teeth?
- Is it possible to brush your teeth rarely, but go to the dentist from time to time so that he can “powerfully clean” them for you?
- How is teeth cleaning performed in dentistry?
- Why do the Swiss brush their teeth without toothpaste at all?
- Does chewing gum work?
- Which brushes to choose and how? What about electric ones?
- Is it true that you should throw away the brush when at least one lint deviates from the vertical?
- Why do we need tongue scrapers, interdental brushes, dental floss and everything else?
- Does an irrigator replace brushing your teeth?
- Is mouthwash a good topic?
- When is it more important to brush your teeth - in the morning or in the evening?
- How does an IT professional differ from the average patient's oral health history?
Why brush your teeth at all? What happens if you don't touch them?
The oral cavity is the site of an ongoing battle between approximately 700 species of microflora.
Saliva is one of the most active fluids in the body. On the one hand, it must neutralize biological threats from the outside world, on the other, pre-process food, and on the third, protect teeth. From the point of view of evolutionary biodesign, the problem is solved very well if you eat what evolutionary biodesign offers from the outside world. For example, apples, large animals with tough meat, then unripe wild pears, carrots, and so on. Hard food cleans teeth perfectly without your help. Several tens of thousands of years ago, something went wrong, and man learned to cook food over fire. This gave rise to the first problems, but at that time they were not very significant, since in the light of the development of medicine and the lack of antibiotics, teeth were not the most important problem. But already in the twentieth century, when fast food, forced high-carbohydrate diets and soft, inconsistent food entered the masses, real difficulties began.
Plaque is a biofilm of bacteria that sticks to your teeth and does its best to protect itself from aggressive saliva and other cleaning methods. In this regard, bacteria are greatly helped by adhesive microfragments of food, which remain in the form of such glue on the teeth. For example, crumbly cookies or pizza dough combined with dead cells create a good bioglue. Bacteria land on it and begin to colonize your tooth. Their goal is to get inside and set up a base there. We call this caries. Most often, developed caries is just amphora-shaped: a small entrance hole and a sea of destruction inside the tooth.
This is how the patient comes:
Here is hidden caries revealed:
And here is the end of the therapist’s work:
Hidden caries can, in principle, be detected by radiography and transillumination.
If you remove this biofilm in time, there will be no caries. But it is quite strong, so either a strong antiseptic is needed (the same alcohol, which also harms other parts of the system, starting with the oral cavity), or mechanical treatment (with an apple or a toothbrush). A large amount of saliva partially washes away the films, but not all of them: for example, they remain at contact points and under the edge of the gums.
Several layers of biofilm form a calculus - tartar. This is a pretty disgusting reinforcement of bacteria. It is disgusting with its unique smell and taste (which your partner often feels with every kiss). But from a medical point of view, this is not the main thing. The main thing is that tartar still puts pressure on the gums and impedes the blood supply to the gums, creating complex inflammations. Well, no one ruled out caries. Imagine that several grains of sand have stuck into your hand, and they stick out there for months, gradually increasing in size. Tartars are about as unpleasant, but due to the nature of their innervation, you almost don’t feel them.
So, if you don’t brush your teeth, a biofilm will form very quickly. And if you don’t touch the biofilm, a calculus forms, which triggers many unpleasant processes. It is an accepted medical practice to brush your teeth after breakfast and dinner.
Myths about prosthetics and implantation
16. When installing a crown on a tooth, you need to remove the nerve from it..
Not anymore . Modern technologies in dentistry make it possible to treat a tooth and prepare it for prosthetics without resorting to nerve removal. When processing a tooth, a minimal amount of its tissue is removed, and after grinding the tooth is coated with a special agent that reduces its sensitivity.
17. Gold never causes allergies in the mouth.
It is a myth. Everything is very individual . Some people may experience inflammation where gold crowns touch the oral mucosa.
18. It is not necessary to place an implant if there is no tooth.
On the contrary, it is very necessary . When a tooth is missing, the bone tissue of the jaw deteriorates , pits and cavities form, the load on the remaining teeth increases, but the quality of chewing suffers, and this is fraught with diseases of the gastrointestinal tract. Well, in the end, a person with a full row of teeth has a more aesthetic appearance.
When is it more important to brush your teeth - in the morning or in the evening?
It may seem that brushing your teeth in the morning and at night is equally important.
But no, evening cleansing is much more important. At night, your body produces less saliva (this is one of the reasons why your mouth is dry in the morning). Less saliva on your teeth means less protection for them. Less protection means faster biofilm formation. That is, if you brush your teeth in the morning so that your breath does not smell when talking, then in the evening you need to brush your teeth for medical reasons. Most teeth brushing techniques suggest that evening brushing should be longer than morning brushing.
Myths about tooth extraction
19. It is cheaper to remove a diseased tooth than to treat it.
It depends on situation . If there are no direct indications for tooth extraction, it must be preserved and cured. The tooth extraction itself can indeed be much cheaper, but as we have already stated above, there should not be empty spaces in the mouth. But dental implantation will still cost more than treating your own tooth.
20. A diseased tooth must be treated to the last minute and under no circumstances should it be removed..
Of course, tooth extraction is far from the best option, but a diseased tooth is a source of infection , which also adversely affects the health of the body . Everything is very individual . There are cases when a seemingly non-viable tooth can be cured, but a seemingly healthy tooth has to be removed.
21. After tooth extraction, the oral cavity must be thoroughly disinfected.
This is true, but you must not overdo it so as not to wash the blood clot out of the wound. It helps in better healing. So it’s better not to touch this place for 2-3 days.
Is it possible to independently assess areas of biological damage?
Yes, you can. To do this, you need to buy either Curaprox, Dynal tablets, or Curaprox, PresiDENT liquid at your nearest pharmacy. The tablets are chewed to a cheerful foam and spat out. Considering that you need to carefully and thoughtfully read the instructions to the end, it is better to buy a liquid; it is applied with a special swab or cotton swab. It will be more reliable. But if you have not had hygiene for the last two to three months, then it is better to do it on Friday evening. In fact, it washes off almost immediately, but there is a chance that particularly severe lesions will be stained for about 50 hours. This happens quite rarely and with poor hygiene, but it is a matter of chance.
What happens during dental hygiene?
First, the hygienist looks at the size of the stones.
If there are very large ones, then we break them up with ultrasound. Next, we work with the plaque manually using rotating brushes, rubber bands and paste. If you need to get under the gum, there are curette hooks that can be used to clean difficult areas and smooth the surface of the roots so that rotting food does not linger there. Then each gap between the teeth is treated with floss and fine sandpaper. The teeth are then polished. The next stage is strengthening: a disposable mouthguard with a remineralizing solution is placed on the teeth. It then discusses how best to brush your teeth in the future. Then there are two approaches: “industrial” and “archaeological”. If you see sandblasting on soda, then in front of you is a hygienist who wants to do it quickly and powerfully. However, due to the design features of this equipment, it is very difficult to ensure a balance of efficiency and safety, so we consider this approach not the best from the point of view of its relationship to the tissues of the oral cavity (the rough surface of the tooth after a large abrasive gives greater adhesion to sticky food, gum damage is not uncommon). Manufacturing companies are trying to solve this problem, but for now our choice is mechanical contact cleaning.
During cleaning, various chemical agents and “soft” abrasives can be used. If there is inflammation of the gums (which is often associated with “blockages” of stones), then treatment with special antiseptics and agents may be necessary to relieve inflammation. In this case, the appointment is often divided into two: first, the stones above the gum line are removed, then five to seven days pass until the inflammation caused by them subsides, and then the stones below can be worked relatively safely. If you do everything in one go, it won’t be very beautiful: there will be blood in all directions. It’s not that we feel sorry for doing this, it’s just that it prevents us from properly assessing the results of the work inside this bloody mess. That's why we love it when it's clean, the patient doesn't break out and doesn't panic. Gingivitis starting from the middle stage = two doses a week apart.
The procedure itself is painless, but sometimes patients feel ticklish. Sometimes grinding an instrument against your teeth causes unpleasant emotions. There is no problem doing everything under local anesthesia: this is exactly the case when you don’t need to be afraid to ask for it.
Hygiene is done before any more or less serious intervention, since it allows for correct diagnosis later and correctly taking into account the shape of the teeth. Well, the fewer dangerous bacteria there are during invasive procedures near the field, the better.
Caries - prevention, treatment, photo
Caries is a disease associated with damage to the hard tissues of teeth, which leads to the loss of the enamel’s ability to accumulate fluoride and other minerals and the subsequent formation of voids. Caries is caused by bacteria that feed on glucose. They accumulate on the surface of the enamel in places where it is softened or damaged. Symptoms of caries:
- the appearance of whitish spots on the enamel, which begin to darken over time;
- feeling of roughness of tooth enamel, chips, scratches, small holes on it;
- unpleasant and painful sensations when eating hot, cold, sweet or sour foods.
Stages of disease development
Stage of white (fissure) caries
Damage occurs to the chewing surface of the lateral teeth. The enamel gradually dissolves, which leads to the destruction of dentin and darkening of the spots. It is difficult to notice white spots on the enamel on your own, so the dentist uses methylene blue (a special coloring agent) for diagnosis. Using the remineralizing therapy method makes the process reversible and prevents further leaching of calcium.
Stage of superficial caries
If preventive measures have not been taken to restore the mineral balance of the enamel, the disease begins to progress. Irreversible changes occur in the structure of the enamel and the structure of its prism. The peculiarity of superficial caries is damage only to the surface of the tooth without penetration into the tissues. Black or brown spots appear, and a white (yellow) coating forms more actively. If caries is concentrated at the neck of the tooth, pain may occur when eating cold, hot or sweet food. Consequences: infection penetrates into the deep layers of the tooth.
Stage of middle caries
It is characterized by an increase in the size of black and brown spots, the occurrence and intensification of pain symptoms. At this stage, it is imperative to contact a dentist, otherwise... Consequences: there is a high risk of damage to the dental nerve.
Stage of deep caries
The carious process penetrates deep into the dentin, which leads to increased sensitivity of the dental nerve to hot/cold food. The size of the dark spots increases. Consequences : if you do not put a filling at this stage, then after some time inflammation of the dental pulp (nerve) will occur.
How to brush your teeth correctly?
A colleague of mine recently wrote about the characteristic “programmer teeth”.
About half of the problems in these cases are associated with insufficient salivation of the oral cavity: this is a completely predictable consequence of night work, stressful focus on the task and various problems with eating. Since I have very little faith that after reading this someone will suddenly start eating right or change their daily routine, let’s tell you how to properly brush your teeth using the Swiss method. It is most suitable for those who have a busy schedule, stress and poor nutrition. That is, for all adults in large cities. It's called the BASS technique (more precisely, the advanced Bass teeth brushing technique). It is one of about two dozen techniques available. Note that we still don't know which teeth cleaning technique is best out of all the different ones out there. If you are interested, this issue was raised in Nature: here is an analysis of recommendations from various sources, textbooks and a selection of studies. The result is that the Bass technique is too complicated for children, but for adults it gives the best results. Moreover, all studies that numerically confirm this were carried out over a fairly short observation period.
Sorry for the compression, this is the original image quality from a study of 180 healthy children.
Blue was and became - this is your usual horizontal brushing, red - circular with closed teeth, green - according to Bass. Here is another study with a longer follow-up period. This is partly due to the fact that it is difficult to follow patients and stand over them every time they brush their teeth. Nevertheless, this method is currently one of the best, judging by scientific data and practice. Here's what to do:
1. Buy a soft toothbrush with the most bristles. The shape is strictly straight (both the handle and the fleecy part without bends or protrusions). You still won’t be able to do anything better with a hard or medium-hard brush, but a soft one cleans much better and without damage: we will work on the border with the gum.
I recommend Curaprox ultrasoft 5460, Revyline, TePe brushes, but you can choose any similar ones.
2. Take the brush like a handle (not in a fist) and place it at a 45-degree angle to the gum vertically, so that the bristles go under the edge of the gum. You will feel it. Half of the brush should be on the crown of the tooth, half on the gum. Next, start moving the brush so that you get such long ovals. Gradually work your way across all teeth from the front, working at the edge of the gum.
Do not move the brush with your elbow or forearm, only with your hand. You should get very soft smooth movements.
3. Brush the inside of your teeth in the same way, but hold the brush vertically.
4. After this, make the usual horizontal movements along the edges of the teeth and their frontal surfaces.
The procedure is slower than usual haphazard cleaning, since you need to go over all the teeth very carefully at the edge with the gum. In the morning it takes three minutes, in the evening - more than five minutes. In Switzerland, people brush their teeth for seven to ten minutes, leaving the bathroom with a brush without toothpaste. This is a very good practice, and I recommend it: just take a brush and sit down to watch YouTube or do something else and work gently along the edge of the gum. The point of the method is not only that you can do something else while brushing your teeth (fortunately there is no toothpaste), but also that you do not see your reflection. When you control a brush based on visual cues, it always dramatically reduces the quality of brushing compared to brushing without a mirror, because different sensory systems are involved. And sensations are more important than vision here.
Is it true that you should throw away the brush when at least one lint deviates from the vertical?
Yes, if the bristles on your brush are no longer vertical, it is better to change it.
Typically, brushes are changed about once a month, but high-quality options from the recommendations above can be changed once every three months with the right manual skills. It is also very important to change your brush after hygiene at the dentist: they “restart” the microbiota of your oral cavity, and it is not very good to introduce old pathogenic ones from an old brush.
Pharmacies sell disposable toothbrushes with dry granules and beneficial enzymes. I recommend keeping one in your bag; it's a great option if you find yourself wanting to look and smell perfect.
Myths about toothache
6. If you have a toothache, apply cotton wool with alcohol or crushed aspirin to the tooth.
It is very dangerous . This will not make a sick tooth feel any better, but if held for a long time, it will cause burns in the mouth
7. For toothache, you need to apply garlic to your wrist.
This is how a certain group of sectarians were treated . Their faith in this method helped them. You can try it too.
8. If your teeth don’t hurt , then you don’t need to go to the dentist.
As a rule, diseases of the oral cavity initially occur painlessly . In addition, in the early stages the disease is much easier to cure. Therefore, you must visit the dentist twice a year.
9. Any visit to the dentist is scary and painful.
This is wrong . Dentistry today means modern treatment methods, clinics are equipped with silent devices and a variety of painkillers.
Why do we need tongue scrapers, interdental brushes, dental floss and everything else?
A tongue scraper is very important because the tongue needs to be cleaned too. You can do this with a separate brush, but a scraper is much more convenient and effective. I recommend double scrapers, here are a couple of examples: Curaprox double and TePe. It is better to use the scraper before the main cleaning, passing over the tongue literally three to four times.
Dental floss is not recommended at this time. More precisely, it is very good for cleaning fiber from meat after a restaurant (and better than not having it at all), but it is bad if you do not know how to use it correctly. But almost no one knows how: you can’t touch your gums with it. Therefore, a more modern approach is interdental brushes. They look like this:
As you can see, they are different colors for different intervals. They need to be selected with a doctor using a special probe, which is inserted between specific pairs of teeth. It’s better not to do this on your own. To summarize: it is better to forget about brushes, as well as about thread, until your doctor directly advises you to do so.
Mouthwash is good during the day after meals, as long as it does not contain alcohol. It works better with alcohol, but damages teeth and soft tissues (primarily mucous membranes). Without alcohol it is worse and is not suitable as a replacement for a full-fledged cleaning, that is, it is better to use it only during the day if you need to get rid of odor or clean your mouth after eating.
There are also foams like Water Dent - they restore the environment to a slightly alkaline environment, which is much better than the acidic environment after a meal (and especially after coffee). Some mouthwashes work the same way.
Basic rules for maintaining hygiene - expert advice
To maintain oral hygiene, it is enough to follow simple basic rules. Here's what dental and hygiene experts recommend in this regard:
- Cleaning twice a day is the first and main rule. Moreover, you should use an individually selected brush and paste, and in this regard it is better to consult your dentist personally,
- use floss and rinse your mouth every time after eating - to quickly remove food debris,
- limit your consumption of sweets, especially before bed - sugar and simple carbohydrates pose an increased risk to enamel health,
- clean your tongue - it is on its surface that the most bacteria are concentrated, which become a source of unpleasant odor. To remove plaque from the tongue, you can use the reverse ribbed surface of the brush or a special scraper.
Proper oral hygiene will help maintain healthy teeth for a long time.
It is also important to visit the dentist’s office at least twice a year - for preventive maintenance and professional procedures. hygiene. Even with regular quality care, bacteria remain in the mouth and lead to the formation of deposits. Only a doctor can remove them, using hand tools, ultrasound, laser or sandblasting. Following all of the above recommendations will help you maintain a beautiful smile for many years.
1Grudyanov A.I., Ovchinnikova V.V. Inflammatory periodontal diseases as a risk factor for the development of pathology of the cardiovascular system, 2007.
Does the irrigator work?
A toothbrush removes about 70% of biofoci. The rest are located where mechanically cannot be reached, for example, at contact points. So yes, the irrigator complements regular teeth cleaning very well. If you can, use it every time. But just don’t take stationary ones that require connection to a household power supply. Practice shows that my patients do not use these because of the difficulty of turning them on in the bathroom. It’s better to use mobile phones with batteries, they are much simpler and always at hand near the sink.
Which pasta to choose?
Any with low abrasiveness is suitable.
Pastes with calcium work, but only if the paste is left on the teeth for a long time. I do not recommend whitening toothpastes, toothpastes for smokers or coffee lovers. Look at the abrasiveness index, the best options are around RDA 50–70 units. In the morning you can use antibacterial, but in the evening - only regular. I recommend pastes such as Biorepair Night, Apadent, ROCS “Active Calcium”, Curaprox. I don’t particularly recommend the Russian versions of Colgate and Blendamed: they have changes relative to the foreign composition, which makes the environment more aggressive. Milk and cottage cheese do not affect teeth (calcium from them almost does not enter the enamel). Pastes have little effect, but with 10-minute cleanings the results are noticeable. Usually, when a patient has problems with calcium, special gels are prescribed in courses of two weeks every three months.
A couple of links to research.
Is it true that dentists don’t want to teach us how to brush our teeth?
It may seem that the dentist has a vested interest in you brushing your teeth incorrectly.
Because if you teach it correctly, you won’t come back with caries or without a tooth at all. There are two exceptions:
- Hygienists who want to help the patient. This is either an ordinary human desire to do well, or the basis of the clinic’s work: good service is noticeable, and such a clinic is trusted much more (that is, they return much more often, and if a patient has been with the clinic for 10 years, then sooner or later he will statistically need expensive services) .
- And manufacturers of paste brushes and irrigators understand that the right set of consumables and instruments in the patient’s hands brings them quite a lot, so they try to train people in the correct processes, including through clinic hygienists.
We created the clinic as a way to make money at the cutting edge of applied science, but very quickly clients began telling their friends about us as one of the most caring dentistry in Moscow.
We were counting on “the most technically advanced”, but that was also nothing. I hope that “the most caring” contains my contribution, because I explain in great detail and detail how to avoid getting into the chair next time. And with me, you can practice brushing your teeth separately from the appointment: a hygiene lesson lasts 40–60 minutes, and the price includes the necessary set of brushes and brushes. PS If you come to our clinics, then say that you are from Habr, there will be a 5% discount.
