Common oral health mistakes you may be making

Don't do self-treatment. [iStockphoto] Did you know that by the time most people are 34 years old, they will have had at least one cavity? In fact, when surveyed, most adults report having experienced dental pain in the previous year. According to the Centres for Disease Control, dental emergencies requiring unplanned care result in an average of over 34 million lost school hours and over USD45 billion (Sh5.98 trillion) in lost productivity annually. Which brings us to our list of common mistakes that lead to poor oral health: Waiting to have a problem "This is the first mistake. Seek help if you can prevent a problem. And it's so easy," says Dr Alberto Casella, a dental surgeon at the Aga Khan University Hospital dental clinic. He stresses the importance of preventive dental care to avoid costly treatments and maintain oral health (the health of the teeth, gums and the entire oral-facial system that allows us to smile, speak and chew). "Prevention means that if we can teach and tell people to get consultations and oral hygiene sessions at least once a year, or better yet, twice a year. Any small thing can be intercepted before," he adds. Brushing your teeth with force rather than technique Dr Paul Ngugi, a dental surgeon, emphasises the value of technique over force when brushing teeth. "Some people have a very strong grip and they use a lot of force. That is one of the biggest mistakes people make. They end up damaging some parts of the teeth," Dr Ngugi says. "We advise clients on an easier way to brush without putting too much force. At the end of it all, make sure all the teeth are touched in the process of brushing," he adds. Brushing your teeth horizontally Speaking of technique, Dr Casella suggests remembering a simple rule. "There is a very simple rule from red to white. That means instead of brushing our teeth horizontally, we brush vertically. So that means, from the gum to the teeth, the goal is to remove the plaque. Plaque means food particles, but especially bacteria," he adds. Brushing before breakfast Dr Casella says that it's important to brush your teeth after breakfast and not before. "Brush when you wake up but after breakfast then brush before you go to bed and don't eat anything else," he says. "If you brush and then you go to watch television and you eat something sweet or some cake or anything and this remains in your mouth the entire night, what was the scope of even brushing your teeth?" says Dr Casella. Keeping the same toothbrush for too long According to Dr Ngugi, some people hold the misconception that a brush should last a very long time, but a change between three and six months is recommended. "The moment you see the bristles are bending and are not as straight, it is a sign that you need to change your brush," he says. Neglecting your oral hygiene Dr Casella says inadequate hygiene can cause oral inflammation which manifests with symptoms like bleeding gums. "The problem is lack of knowledge. The moment you wake up in the morning and you brush your teeth and on the toothbrush, you see blood, or when you spit and you rinse your mouth, you see blood or little blood. Blood means inflammation of the gum," Dr Casella explains. "This inflammation at that stage, when you start to see blood, is something very simple to treat and we are so much at the beginning of the problem, which can be treated very fast with no pain and the problem is solved," he says. "But if we leave this inflammation to go on, it starts to become an infection of the gum. The problem is that our gum - not only the gum but also the bone that is holding the teeth - reacts to the inflammation and the infection goes away. So the result is that, at some point, the teeth start to move. Why? Because the bone around the root is resorbing (gradually breaking down)." "Anytime you're brushing your bleeding, there is a problem. Either you have gum disease, you are using a very hard brush, or your technique is not right. If it doesn't go away by you changing some of the habits, you must seek a doctor's advice," Dr Ngugi emphasises. Skipping flossing Oral health professionals recommend using dental floss, a special thin soft thread, to clean in-between where the brush cannot reach. However, some instruments in the market are intended to achieve the same results. "Some people can purchase the machinery for water flossing, which is fine. I prefer the physical kind of flossing. Not even the one with the tongs (dental swords) but the one you wrap around your fingers and manually put in-between your teeth, because that way you are more careful about damaging your gums," Dr Ngugi advises. "What I tell my patients is that if you have to travel and you don't have one gram more to put in your luggage, leave the toothbrush at home and bring the dental floss with you. This is how important it is to floss your teeth twice a day," Dr Casella says. Using too much toothpaste Remember those toothpaste advertisements on TV where toothpaste gets squeezed along the length of the bristles? Well, according to Dr Ngugi, only a small amount is required. And it's not for economical reasons. "It's because it has the right quantity of fluoride or the components of a tube. And that's the recommendation. It's even written that we should use just a pea size," Dr Ngugi says. On the use of toothpaste, Dr Casella emphasised on mechanical plaque removal with the toothbrush rather than the toothpaste brand. Minding toothpaste over technique "In my point of view, the important thing is the mechanical removal of the plaque, which is done by the toothbrush itself. The toothpaste is a facilitator of this; it makes your mouth feel fresh," Dr Casella says. "Every day, when my patients ask about what kind of toothpaste they should use, my answer is any. It's not about the toothpaste. In only one case, some toothpastes are against sensitivity. When a patient has a lot of sensitivity, maybe that particular one can have a little help," Dr Casella says. Rinsing your mouth after brushing In movies, the act of rinsing isn't skipped to save time. It's actually because rinsing isn't recommended. "The components of toothpaste are supposed to protect your teeth. For example, there is fluoride, which is supposed to protect and cause regeneration (growing back) of the secondary dentine (hard bony tissue beneath the enamel, the visible part of the tooth). It grows back. So the components of toothpaste are meant to stay around. Also, we want the saliva to be in an alkaline state to help you keep your mouth in a sterilised state," Dr Ngugi explains. Not minding your sugar intake Dr Ngugi advised against consuming carbonated drinks and other sugar foods in excess. "The principle is this, we do not want your state of saliva to be in an acidic state, or your mouth in that sugary state," Dr Ngugi says. "When it is in a sugary state, it's a good site for bacterial collusion. So we want your saliva to be in an alkaline state. That way, if there is an area with a bacterial infection, it can easily be killed," he explains. "I recommend that after taking something very sugary, drink water to take the state of your sweetness to an alkaline state. If possible, if it's in the evening, please make sure you have brushed. If it is in the morning and the kids have taken their biscuits whatever in the morning, let them brush," he emphasises. Using harmful techniques or treatments Dr Casella acknowledges that there are not many risks associated with doing dental treatments at home. However, he advises against using abrasive materials like soda or herbs and aggressive brushing techniques. "For example, the local toothbrush is the one that is done using a stick of wood, isn't it? It's not as bad as people believe. The only problem is that it's probably too aggressive. That's why we say, 'Don't be so hard on brushing' because you can get a traumatic lesion (injury) of the gum," he notes. "Using soda, bicarbonate, or any kind of herb. The risk is getting a lesion of the gum, of the tissue; the gum is very strong, but at the same time, it is soft tissue," Dr Casella warns. Too much fluoride Dr Ngugi distinguished between children's toothpaste with and without fluoride, emphasising the advantages of fluoride for the preservation of permanent teeth. "Between zero and six, a child should never use anything with fluoride because, during that time, the paste that they use is slightly sweet so they will tend to swallow but as long as it doesn't have fluoride, it won't be harmful," he says. Dr Ngugi further emphasised proper dental hygiene education and water quality awareness to prevent fluorosis, particularly in regions with unregulated water sources. "We wish to do a lot of community education; 'Do not just treat borehole water as any other water.' Borehole water should be tested first, reserved somewhere, tested and confirmed if it's good for consumption, cooking, or drinking," he says. "With that, we will protect even the kids and prevent more fluorosis because fluorosis will happen during those early stages when teeth are being formed." "Permanent teeth are formed after the child is born. So it will be effective in terms of what they have been taking in. And that is what will affect them now when the teeth start erupting after six years." Dr Ngugi further explains. "That is when you realise that their new teeth have formed and they are all brown," he adds. Self-treating teeth "My suggestion is just don't do self-treatment. Don't go to the supermarket or go to a pharmacy; buy whitening things and use them by yourself," Dr Casella says. "Frequent polishing helps a lot when it comes to whitening. Yes, charcoal does, but whitening should be done in conjunction with a discussion with the dentist so that they can weigh the plan better and guide you on the best way to whiten your teeth and prevent sensitivity afterwards," Dr Ngugi says.

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