What makes a smile “healthy”? October is National Dental Hygiene Month and the American Dental Hygiene Association is using this month to promote its answers.

Protecting Your “Pearly Whites”

Most babies start out toothless and begin “teething” around age six months. At six years, the first permanent teeth usually “erupt.” Commonly, we each get 20 “baby” teeth, followed by 32 permanent teeth.

If we care for them properly, our teeth can last a lifetime.

The essential element in proper care is cleaning. The teeth must be cleaned regularly and well. Otherwise, harmful substances accumulate, sometimes directly destroying part of a tooth (as in a cavity) and often seriously undermining the teeth’s foundation, causing them to fall out.

Dental Dangers

Today’s diets contain too many sugared and starchy foods. Together with sugar and starch, bacteria that exist naturally in the mouth form a sticky film called plaque. The plaque attaches to the teeth and gums, turns acidic and attacks the teeth and gums to which it has adhered. If left alone, plaque will build into tartar, a hard substance that will have to be scraped off your teeth by a dentist or oral hygienist.

Plaque causes tooth decay. If a tooth decays, a dentist must drill out the decayed portion and replace it with an artificial filling.  If the decay is advanced, treatment may require a root canal or extraction.

Plaque also causes gum disease, known in its early stage as gingivitis. Left untreated, gingivitis can develop into periodontitis, a more serious gum disease that may require oral surgery.

The problem with gum disease – aside from its discomfort, bad look and, sometimes, bad smell – is that it weakens the gums, which hold the teeth in place, and can seep below the gums to the bones which are the support foundation for the teeth. An early sign of gum disease is bleeding when the teeth are brushed or flossed. Red, swollen or tender gums indicate a more serious problem. Once the gums and bones are sufficiently weakened, even healthy teeth will fall out.

Gum disease may also have negative effects on other parts of the body. For instance, while diabetes can worsen gum disease, gum disease can make diabetes harder to control. If you have diabetes, be sure to tell your dentist and dental hygienist. Also, some researchers have suggested a relationship between oral bacteria and cardiovascular disease. While there is no clear evidence that oral bacteria cause heart attacks or stroke, good oral health care may help prevent some cardiac infections.

Prevention and Care

The basic goal of good oral hygiene is cleaning away any accumulations of plague. Three routines are recommended:

  • Brush your teeth twice daily, after breakfast and before going to bed.
  • Floss your teeth once a day.
  • Get a dental check-up and cleaning twice a year.

Hygienists recommend brushing for three minutes to make sure your efforts are thorough. Use a soft bristled brush so that you do not damage the gums. Flossing may seem difficult at first but can be readily mastered with a week or two of daily practice.  It only takes a minute.

Some oral health professionals also recommend the daily use of a mouthwash with fluoride (most common mouthwashes contain fluoride; check the label). Fluoride adds protection by hardening the outer surface of the teeth. While a majority of American municipal water systems add fluoride to drinking water as a public health measure, the effect has been weakened in recent years by the increasing use of bottled water, which does not contain fluoride. Many dentists and oral hygienists also recommend use of an electric tooth brush or water pick.

The use of tobacco – such as cigarettes, chew, cigars and pipes – contributes to the build up of plague and the discoloration of teeth. From an oral health perspective (as well as general health), it is a good idea to quit tobacco.   Avoiding sugary and starchy foods will also minimize plague.

Children, Too

Good oral health practices are not just for adults. One in four children will have cavities by age four, some as young as age two. Parents should brush their children’s teeth until they are able to do it themselves. Then, it is a good idea to use a timer in the bathroom to keep them brushing for at least two minutes. Children should have their first dental visit around the time of their first birthday. If children are introduced to good oral hygiene at an early age, the habits they establish will protect them for life.


These websites provide additional information on oral health care, including instructions on how to brush and floss.

American Dental Hygiene Association

American Dental Association

Simply Teeth

American Diabetes Association

American Heart Association

[Steve Clark]