About dental care

At school I was taught to brush your teeth to prevent cavities. They told us to brush the teeth before going to bed.

I imagine they were thinking it is better with a simple rule that does some good, than 5 rules that are too complicated.

Later in life I have picked up more information about dental care, and used that information to create a more nuanced understanding of dental care and also to refine the rules and behaviour from school.

Some facts about dental care that I have picked up from various sources:

1. Brush teeth to prevent cavities
2. Brushing with water only does not prevent tartar/discoloring.
3. After eating, the enamel is soft because of the acidity from the food. Avoid brushing the teeth after eating
4. The cause of cavities is acid from bacteria dissolving the hard tissues of the teeth
5. Sugar is the energy source of these cavity forming bacteria (Streptococcus mutans). Dietary sugar can cause caries.
6. Tooth paste is abrasive and may damage the dental enamel.
7. Fluoride prevent cavities.
8. Toothpaste with Novamin (Sensodyne Repair) rebuilds  the teeth.
9. Floss to clean between the teeth.
10. Brush gentle. Use a toothbrush with soft bristles and hold it like a pen to avoid damaging the enamel.
11. Toothpaste contains fluoride and other ingredients to strengthen the teeth and control the oral bacteria
12. Plaque builds up overnight.

Notice there is a contradiction between 3 and 4. After eating we have this dilemma. The enamel is soft, so we should not brush the teeth, at the same time we want to remove food residues (sugar) so that the caries bacteria will not multiply.

When and how to brush??? I've tried to make sense of these facts, and device my own understanding of dental care so that I can have a behavior that ensures strong teeth throughout my life.

My solution. I have redefined "tooth-brushing" into different into several categories.

• Post meal cleaning A  gentle tooth brushing with water in order to remove surface food residue. Only a few gentle strokes on each surface to remove food residue. Do it in combination with flossing. Around 10 min after eating. No toothpaste. [3, 4, 5, 6, 10]
• Restorative brushing Brush gentle with toothpaste and a manual brush with soft bristles. Wait at least 1.5 hours after eating. Restorative brushing is relatively short (~1 minute). It is more thorough than the post meal cleaning.  The main purpose is to expose the teeth to the toothpaste. The fluoride and other ingredients in the toothpaste (e.g. Novamin) helps to prevent cavities and in some cases may strengthen the enamel (if we believe the marketing). Leave the toothpaste in by not rinsing the mouth and avoid drinking afterwards. [7, 8, 11]
• Polishing A thorough tooth brushing with toothpaste and electric toothbrush to "polish" the teeth. This may be what other people refer to as "tooth brushing". The polishing will prevent tartar. I do wait several hours after the last meal of the day. Typically I do it before going to bed. Use a soft brush and gentle pressure, but polish relatively long.. 2-3 minutes. The teeth feels smooth afterwards. [2, 6]
• Morning cleaning A gentle and quick brushing with water to remove plaque/film. [12]

These four types of brushing actions is what I have deduced from the rules of dental care that I have picked up as a layman.

The purpose of the post meal cleaning is to shorten time that the teeth are in contact with food.

The polishing and restorative brushing is more similar to what we learned at school, and I guess it is how most do their dental care. Since it involves (abrasive) toothpaste it should be done several hours after a meal when oral acidity is reduced and the enamel is not so fragile.

Here is an example of a day with two meals (I do intermittent fasting)

If I do more meals, it is easy to adapt. Just do a post meal cleaning after each meal.

If  I am eating outside home, and it is planned, I can sneak out to the bathroom and do a quick cleaning with a toothbrush I have in my jacket.

How to brush?

Always use a tooth brush with soft bristles. Use very gentle pressure. A dentist recommended to hold it with a pen-grip, not a hammer grip. If the brush wears out too quickly, it is a sign that you are pressing too hard.

Use circular movements or up/down movements. With sideways strokes the bristles will not reach into the areas between the teeth where tartar build up.