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Oral hygiene

author icon By Dr. George Ghidrai

Oral hygiene is the practice of keeping the mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, and bad breath.

Some oral conditions require good oral hygiene for healing and regeneration of the oral tissues ( for example gingivitis, periodontitis or following various surgical procedures).

oral hygiene

Why is oral hygiene so important ?

The existence of healthy teeth and long-lasting dental restorations (fillings, dental crowns, dental bridges, removable dentures, dental implants etc.) is directly conditioned by a regular and thorough oral hygiene.

The oral hygiene measures aim to prevent cavities, gingivitis, periodontitis, and tooth decay :

  • Periodontal diseases and their complications cause at least one-third of adult tooth loss.

  • Tooth decay is the most common global disease. Decays can cause demineralization and destruction of the hard tissues of the teeth ; if not treated, decays can produce irreversible changes in tooth structure as well as infections in the surrounding tissues, which eventually lead to tooth loss.

  • A proper oral hygiene is a prerequisite for successful dental implant rehabilitations. Moreover, the most sophisticated and expensive dental restorations will have a very short lifespan in the absence of an accurate and thorough oral hygiene. In a word, a poor oral hygiene greatly increases the risk of failure.

What can happen in the absence of a proper oral hygiene ?

After every meal, dental plaque accumulates on the surface of teeth, gums or dental prostheses, particularly near the gingival margin. Dental plaque is a biofilm, usually a pale yellow, that develops naturally on the teeth formed by colonizing bacteria trying to attach themselves to the tooth's smooth surface.

dental plaque

dental plaque build up

dental tartar

dental tartar

Plaque is a haven for oral micro-organisms and continues to build up in the oral cavity until it can mineralize into calculus (also known as tartar).

Bacteria from the dental plaque and calculus are the leading cause of periodontal disease and tooth decay ; therefore, one of the main goals is to effectively remove dental plaque.

Generally, dentists recommend that teeth be cleaned professionally at least twice per year. Professional cleaning includes tooth scaling, tooth polishing, usually followed by a fluoride treatment.

Between professional cleanings (which are very effective), a good oral hygiene is essential for preventing plaque and tartar build-up which can cause the problems mentioned above.

Tooth brushing

Tooth brushing is the most important aspect of a proper oral hygiene. Modern medical research has shown that brushing teeth properly can prevent cavities, and periodontal, or gum disease, which can cause tooth loss.

Tooth brushing technique

Proper tooth brushing takes at least 2 minutes. It is important to pay extra attention to the gumline, hard-to-reach back teeth and areas around fillings, crowns or other restorations. Removable dentures are removed and cleaned separately.

  • Clean the outer surfaces of the upper teeth, then the lower teeth

  • Clean the inner surfaces of the upper teeth, then the lower teeth

  • Clean the chewing surfaces

  • For fresher breath, be sure to brush the tongue, too

tooth brushing technique tooth brushing technique tooth brushing technique

Selecting the toothbrush

A soft-bristled brush is best for removing plaque and debris from the teeth. Small-headed brushes are also preferable, since they can better reach all areas of the mouth, including hard-to-reach back teeth.

A powered toothbrush (or electric toothbrush) can do a better job of cleaning teeth, particularly for those who have difficulty brushing or who have limited manual dexterity.

tooth brushes tooth brushes tooth brushes

A toothbrush should be replaced when it begins to show wear, or every three months, whichever comes first.

Selecting the toothpaste

There is a wide variety of toothpaste designed for many conditions, including cavities, gingivitis, tartar, stained teeth and sensitivity. In these situations, it is better to ask the dentist which toothpaste is recommended.

!!!It is important to remember that not the type of toothbrush or toothpaste, but the way you brush your teeth, as well as the frequency and duration of the brushing sessions are the most important factors for effective oral hygiene and good health of your teeth.

Interdental brushes

An interdental brush, also called an interproximal brush or a proxy brush, is a small brush, typically disposable used for cleaning between teeth and between the wire of dental braces and the teeth.

interdental brushes

interdental brushes of various sizes


The use of dental floss is an important element of oral hygiene, since it removes plaque and decaying food remaining stuck between the teeth. This food decay and plaque cause irritation to the gums, allowing the gum tissue to bleed more easily.

Because plaque build-up can lead to tooth decay and gum disease, daily flossing is highly recommended.

Flossing technique

  • Starting with about 50 cm (20 inches) of floss, wind most of the floss around each middle finger, leaving a small part (about 5 cm) of floss to work with

  • Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between the teeth

  • Gently curve the floss around the base of each tooth, making sure to go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue

  • Use clean sections of floss as you move from tooth to tooth

  • To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth

flossing teeth technique flossing teeth technique flossing teeth technique


Mouthwash or mouth rinse is an antiseptic solution used as an effective home care system by the patient to enhance oral hygiene.

Common use involves rinsing the mouth 20 to 30 seconds two times a day after brushing. By rinsing, it may reach areas in the mouth that cannot be cleaned with a toothbrush.

However, the use of mouthwash does not eliminate the need for both brushing and flossing.

Last review and update: November 2020

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