Daily Oral Hygiene

Maintaining daily oral hygiene is our best defense against tooth decay and gum disease. And as important as that is, it’s not just a matter of protecting our oral health. New studies have been published in recent years establishing links between gum inflammation and Alzheimer’s disease and rises in blood sugar. If a person uses removable prosthetic teeth or oral appliances, they also have to protect themselves from the growth of fungus. For most people, maintaining daily oral hygiene is not particularly difficult, but does require some knowledge. In this month’s newsletter, we’re going to take a closer look at how to brush and floss, including for people who have disabilities or who are caregivers to someone else.


Tooth decay is caused by bacteria secreting acid as a by-product of their metabolization process. Simple sugars are easier for bacteria to digest than carbohydrates, although the more of either is available to them on the surfaces of teeth, the more acid they will produce. When you brush your teeth, you’re clearing out both the debris bacteria consume as well as the gooey matrix of acid and bacteria that builds up on tooth surfaces.

Brushing should be done at least twice per day, but not immediately following a meal if you ate or drank something acidic. At that time the enamel of the teeth’s outer layer will still be a bit weak. After about thirty minutes your saliva will have had a chance to neutralize the acid, and you can brush for two full minutes. Hold the toothbrush at a forty-five degree angle, and if it’s non-motorized, use a circular motion to brush. You’ll need to use a toothbrush with soft bristles (the kinds with hard bristles aren’t actually intended for teeth), and use fluoridated toothpaste. There are many varieties of toothpaste available, but all of the ones that are approved by the American Dental Association are adequate. Manual toothbrushes can get just as good results as electric toothbrushes when both are used properly, but many people, especially those with arthritis, find electric toothbrushes easier. Some also come with timers or can interact with apps that would inform someone whether they’ve brushed all of their tooth surfaces.


Flossing is not meant to remove plaque from below the gum line, but it can remove food debris that is caught between teeth. To floss, people should use an eighteen-inch long strand and wrap it around each middle finger. They should slide the strand along each side of each tooth, going slightly into the gingival tissue but not enough to hurt. They should then pull the floss against the tooth and wriggle it back out, winding floss from one finger to the other as they scrape each side of each tooth. People with fixed orthodontics will need to use a threader, and flossing is especially difficult for people with conditions similar to arthritis. If they are also unable to use a floss pick, they may get good results from using a water pick. Simply moving the floss into the gap between each pair of teeth is not enough, and the backs of the back teeth need to be flossed as well. Flossing should be done at least once per day.

The Tongue and Appliances

The papillae of the tongue provide a refuge for bacteria and fungus, and while they may not contribute to tooth decay, they can cause bad breath. There are several solutions to this, including brushing the tongue, scraping the tongue, and using antibacterial mouthwash. Drinking large amounts of water will also flush out the tongue, and is necessary for the production of adequate saliva to neutralize oral acid and combat the spread of microbes. Dentures, retainers, and mouth guards have to be brushed or soaked in a cleaning solution, but a patient may wish to retain a separate toothbrush for them, as they can be damaged by fluoridated toothpaste. 

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