Plaque is your enemy. It is a sticky white substance consisting of millions of bacteria that grows on the surface of everyone’s teeth, feeding on the debris and food in the mouth.

Plaque commonly accumulates between the teeth and at the edge of the gums. It attacks on two fronts. First, bacteria in the plaque produce an acid that attacks the enamel surface of the teeth. Secondly, it attacks the gums.

Acid from plaque bacteria gradually dissolves the enamel making a hole where other bacteria take over causing caries, a major dental problem for people under 30.

If the caries is not removed by the dentist, decay will continue until it reaches the living pulp deep within the base of the tooth.

Up to this point, the tooth will be painful only if it is stimulated by hot, cold or sweet food. But when the softer dentine beneath the enamel becomes infected, real toothache begins.

The tooth will become extremely painful when the pulp at the center becomes infected, but this pain will suddenly cease as pressure builds up, cutting off the blood supply, and killing the nerves in the pulp.

The relief is short-lived. The infection passes through the minute nerve channel to create an abscess which causes even more swelling.

The positive way to protect your teeth

You may never flash a film star’s smile, but you will be saved a lot of pain and embarrassment if you think about what you eat. The basic rule is this: cut down on sugar. And cut out sweet things between meals.

There is ample evidence to prove the link between sugar and tooth decay. Plaque thrives on sugar and it is not a pretty prospect.

Historically, it can be demonstrated that tooth decay became worse as the sugary content of people’s diet increased over the past 100 years. Eskimos, for instance, rarely suffered from tooth decay until they adopted the sweeter Western-style diet. And in many countries, there was less tooth decay during the Second World War when sugar was scarce and sweets rarer still.

If you must eat sugary things, do it at mealtimes. In 1954 the unfortunate inmates of a Swedish institution were subjected to an experiment which showed that sweet things taken at mealtimes caused less decay than sweet things taken between meals. The reason is simple: continually drenching the teeth in sugary liquid makes the plaque produce acid which continuously dissolves the protective enamel of the teeth.

Many people believe that the unhealthy effects of a sweet diet can be avoided by eating honey instead. No such luck. The plaque will continue to flourish just as well on honey as it does on sugar.

A sweet tooth is a habit that can be gradually altered by cutting down on sugar in cooking; the amount of sugar in cakes, for instance, can usually be halved without making much difference. But it’s better never to allow children to develop a sweet tooth.

Cut out all sweet snacks between meals and avoid sweetened drinks – especially the syrupy ones. Beware of baby’s rusks, which may consist of almost 50 percent sugar. Offer children (and adults) fruit or nuts as snacks.

Cutting out sugar is the most negative way toward better teeth. Adding fluoride to our diet is the most positive way.

Fluoride is a chemical compound, which, in essence, hardens teeth to increase their resistance to decay.

Adding fluoride to the home water supply is the simplest and best way for a community to add it to the diet. But it is also the most controversial. An alternative open to individuals is to buy it in tablet form from chemists.

Cleaning your teeth

To clean teeth effectively you must remove plaque from the crevices, gaps between the teeth and from around the edge of the gums.

Too many people push the brush in and out of the mouth, backward and forward. This wears a trough in the teeth and can damage the gums. To brush correctly, manipulate the bristles between the teeth into areas where the plaque accumulates. Give the crevices and the edges of the gums a mini-scrub in a small circular motion and then brush upwards and downwards to remove plaque from between the teeth. It should take you at least three minutes!

Is an electric toothbrush worthwhile? Yes and no. Don’t do anything that an ordinary toothbrush cannot do. But there are three things to be said for the electric brush if you use it in the right place:

  1. The motor provides the right scrubbing action.
  2. The small head enables you to clean all the teeth.
  3. You are more likely to do it long enough.

For manual cleaning use a soft or medium, nylon or bristle brush – not a hard one since this can damage your gums. Choose a brush with a small head.

Are fluoride kinds of toothpaste best? Yes. Fluoride in toothpaste hardens the exposed surface enamel of the teeth.

Is dental floss worth using? Yes. sometimes for shifting stubborn pieces of food. Take care not to damage the gums.

Save your gums

Lovely teeth, lousy gums? “I had to have all my teeth out although the dentist said they were perfect.” This unlikely-sounding tale is only too often true. Gum disease is the major problem for people over 30, and again plaque is the cause.

It collects at the base of the teeth, continually attacking the gums, and forms tartar, a hard white deposit that irritates the gums, causing further swelling and soreness. The first symptoms of this attack are bleeding gums and a pink toothbrush; the gums themselves may be painless. See a dentist.

You can treat mild gum infection yourself between just a few teeth by removing offending plaque with a toothpick or floss, and by a thorough cleaning. However, if gum disease is allowed to become really advanced through neglect (pyorrhea), then it must be treated surgically by scraping and cutting away the unhealthy tissue. If you leave gum disease it spreads to the root of the tooth, which loosens in its socket and finally falls out.

Regular, careful toothbrushing is the only way to save your gums. Dentists can help, though. Scaling and polishing remove the tartar and gives the gums a new lease of life – provided you follow up by proper brushing. In any case, you should see your dentist twice a year. If you’re lucky, scaling and polishing will be all that the dentist prescribes. If you’re not so lucky, don’t despair.

Admittedly, not even the prettiest nurse, the softest music, the most comfortable bed-type chair or the most riveting television program will ever make the dental surgery particularly popular. Dentists in some countries have tried all these ideas to woo their patients in recent years. But none have had remotely the impact of the high-speed drill. This means that the nastiest part of the dentist’s work is over more quickly – and less painfully.

And always remember: postponing a visit to the dentist doesn’t make your teeth any better. The odds are that it will be still more painful next time.

If you still get a toothache

You’ve eaten the right things, brushed zealously night and morning, devotedly used fluoride toothpaste, regularly seen your dentist and your teeth are hurting like hell.

Don’t despair and give up all your good habits; you’ve probably had bad habits for longer. But do see a dentist.

If you’re really unlucky the toothache will strike at the weekend. If you have to bear it, this is what you can do to help relieve the pain:

  • Take aspirin, compound codeine tablet or any proprietary painkiller. Swallow it – never hold it in the cheek against the aching tooth since this will cause a painful ulcer or aspirin burn on the gums.
  • Try not to lie down since this increases the blood pressure in the head – and the pain.
  • Hot mouthwashes of salt and water may relieve the pain a little if gums are the problem – but not if the tooth is sensitive to heat.
  • Finally, if things look really bleak, you could try whiskey or other spirits. But if you’ve already taken aspirin, spit out the whiskey and use it simply as a mouthwash. Otherwise, alcohol with aspirin may cause serious stomach irritation.
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