DENTAL CARE
   
Rules for Cleaning and Techniques
   
Brushing is not all the same
   
Daily brushing is the most effective way to fight cavities and peridontosis, when, with the help a toothbrush and toothpaste, bacterial plaque is removed through friction and rinsed out with water. Likewise, the formation of tartar is prevented or delayed. Brushing also creates fresh breath and a pleasant sensation in the mouth. However, not only the frequency and regularity is important, but also the brushing technique. Poor brushing cleans teeth inadequately and can even irritate gums.

       
How often? For how long?
   
Ideally, teeth should be brushed after every meal and every snack, in order to remove the food particles upon which dangerous bacteria thrive. Because this is often very difficult to follow due to our modern lifestyle, here is one basic rule: Brush at least twice a day (morning and night), for at least 2 to 3 minutes each time—only then can teeth be cleaned properly.
   

Brushing is half the battle
   
The correct method for brushing not only cleans teeth thoroughly, but it also softly massages the gums. Dentists recommend what is called the “bass technique”: Place the brush at a slant to the gum line, at about a 45° angle to the edge of the gum. Then brush each tooth, one by one, using a slightly vibratory, circular motions. In so doing, plaque is loosened and then brushed away towards the crown (i.e., away from the gums). Starting from the front teeth, brush all teeth of the upper jaw, from front to back, and then back again. This process is then repeated for the lower jaw. One should take special care in brushing areas where the toothbrush is turned—these are the areas where one tends to “skimp” the most.

After brushing the outer sides of the teeth, the chewing surfaces should be cleaned following the same principle. It is important to remember that cavities develop mainly on the surface of the molars, because the toothbrush often cannot reach the crevices between the teeth. Plaque remains there, and its bacteria destroys the enamel. This area in particular should therefore be thoroughly cleaned. Again, brushing in circular motions is best for accessing these tiny crevices.

Finally, the inner sides of the teeth should be brushed. Hold toothbrush vertically and brush away from the gums using the aforementioned vibrating motions. Scientific studies have shown that only a small number of people use the correct brushing technique; most either forget the proper way or quickly return to their old habits (e.g., brushing too hastily).

Small children brush most effectively using the “Fones technique.” First, place bristles at the back of closed teeth. Then, brush towards the front using lightly circular motions, sweeping over both the upper and lower teeth.

One final tip: Spit out foam after brushing teeth, but do not rinse with water. Fluoride requires some time before it is absorbed by the tooth enamel.
       
“I don’t want to brush my teeth…!!!”
   
The method described above is best learned while still young, even though kids often consider brushing to be unnecessary and tedious. They can be encouraged, however, to brush regularly through the example set by their parents and through special products (brushes and toothpastes) geared toward children. After all, at a young age the foundation is laid for lifelong healthy teeth.
       
Things to avoid
   
The number one thing to avoid when brushing teeth is to practice the traditional, “horizontal scrubbing.” This refers to holding the toothbrush horizontally and scrubbing teeth in wide motions. This technique is not very thorough, and it can also lead to abrasions in teeth and gum damage. In order to protect the gums and tooth necks, it is important to brush without applying pressure.
Remember: Scrubbing with pressure does not clean teeth better than gentle brushing!
       
Implements and aids
   
The classic toothbrush
   
Red or blue, large or small, modern or traditional—toothbrushes come in all colors and shapes. But what requirements should they fulfill? And how are they best used?
Medically recommended brushes feature a bristle shape that allows for freedom of movement, even when the mouth is closed, and is able to reach into the back corners. Bristles are synthetic and available in varying degrees of firmness (soft, medium, hard). Bound into small bundles, they are arranged in either a V or straight configuration. Bristle tips should be rounded so that they do not irritate or injure gums.
Some brushes feature two kinds of bristles: softer, longer ones on the outside to gently massage gums, and shorter, stronger ones on the inside to remove film. Modern toothbrushes often have a rounded handle, so that they lay more comfortably in one’s hand. Special children’s brushes have a smaller bristle head and shorter handle.

Toothbrushes should always be thoroughly rinsed with hot water after brushing and replaced every three months. This is because over time the bristles tend to fray, as well as collect bacteria. For this reason, always store toothbrushes where they can keep dry!

Electric toothbrushes?
   
More and more people are brushing with electric toothbrushes, whose motor-activated bristles imitate the correct brushing motion. Electric brushes can provide a good alternative to the good old brushes. However, according to experts, the difference in their effectiveness is not substantial. It is therefore up to the consumer to decide, as a matter of taste.

In any case, an electric toothbrush also must be rinsed thoroughly in hot water after every use and stored in a dry place.

Note: These brushes make cleaning easier, but do not shorten the necessary brushing time. Thus, one should still brush for two to three minutes as with regular brushes.
   
Skillfully threaded- with dental floss
   
Flossing is critical for optimal dental care. The reason: Even with the most sophisticated brushing technique or high-tech toothbrush, one is able to clean only about 60% of surfaces on the teeth. The remaining 40% is found between teeth. Here, undisturbed bacteria can eat into enamel. Flossing is also recommended for use on bridges, crowns and for gum deformities, because only in this way can these areas be cleaned effectively. The use of dental floss requires an in-depth explanation as well as some practice, in order to prevent gum damage. Therefore, it is best to have your dentist show you how it’s done.

Our tip: Flossing twice daily significantly reduces the risk of developing cavities. Use dental floss before brushing teeth, so that a small amount of ingredients in toothpaste can reach the areas between teeth and therefore work more effectively.

Toothpicks
   
Medicinal toothpicks differ from common toothpicks in their triangular shape. They can access the spaces in between teeth more easily to remove food particles contained there. The advantage of toothpicks is that they can reach up to 2mm underneath the gums—an area that neither dental floss nor a toothbrush can reach. However, caution is advised, because rough usage may lead to gum damage.
       
Interdental brushes
   
These brushes are effective in cleaning spaces around braces, bridges and larger interdental spaces. Like a pipe cleaner, this special brush forces itself between those areas that are too narrow for a toothbrush and too wide for dental floss. Interdental brushes are available in various sizes, due to the various widths of spaces between teeth. Ask your dentist which size is right for you.

Water pick
   
This is an electric device that generates a fine stream of water through a nozzle to penetrate specific areas between teeth to remove food particles. It can also be directed at the gums for a massaging effect. Dangerous bacterial plaque is not, however, significantly removed by this process.
   

Oral hygiene products
   
In the fight against cavities and periodontosis, as well as for fresh breath and white, healthy teeth, it is not enough to rely only on water and a toothbrush. Complete oral hygiene requires products that aid the cleaning process. The daily use of toothpaste as well as mouthwash offers complete, all-around protection for teeth and gums. Their ingredients keep the mouth healthy and are the most important components to individual home prophylaxis.

The Basics: toothpastes and gels
   
Toothpaste is available in tube form and, since 1977, in upright dispensers. The technology of the dispenser offers many conveniences, because the product can be dispensed easily and in controlled amounts with simply the “touch of a button.” The contents of the dispenser can be almost completely emptied as well—an improvement upon the tube form.

In addition, the dispenser avoids the common (almost clichéd) annoyance of crushed tubes and unscrewed caps. Next to the traditional creams, there are new forms available, which distinguish themselves in their appearance and ease of use: gels, for example, are predominately clear and often have a fresher aroma in comparison with toothpaste.

What are the benefits of “2 in 1” products?
   
“2 in 1” products—another new product form—serve a double purpose: They can also be used as a mouthwash when mixed with water. Their optimized consistency and fluidity allow for quick and easy distribution of active ingredients inside the mouth.
       
Additional features
   
Depending upon composition, toothpastes may also possess additional features that extend beyond their conventional function. These products, such as those that particularly focus on gum care and protection, contain special plant extracts.

So-called “whitening creams” are particularly effectively at removing discolorations and deposits caused, for example, by coffee, tea and tobacco consumption. Their intensive cleaning and polishing agents gently restore teeth to their natural color. Smokers toothpastes keep the mouth feeling fresh through their minty taste.
   

Children’s toothpaste
   
Toothpastes geared for the particular needs of children are made from different formulas than those for adults. The prevention of cavities is the main component of children’s dental care. At this age, the largest amount of sweets are consumed, as well as other foods extremely high in sugar. The fluoride content of children’s toothpastes is specifically set according to the age of the child. They also contain milder cleansing substances with finer ingredients, in order to ensure gentle care for sensitive baby teeth.
The color and taste of these products are also geared toward children’s tastes, such as a pink-colored cream with strawberry taste. Fun, colorful packaging also helps to bring more fun to dental care. Thus, even the youngest children can begin to develop a positive association with dental hygiene—and won’t consider it a chore.
       
What kind of rinse should I use?
   
The classic benefits of mouthwash are the noticeable improvement of breath and a pleasant sensation in the mouth, through fresh taste and aromatic ingredients. Antibacterial ingredients in modern toothpastes fight bacteria and germs inside the mouth and help to prevent cavities, periodontosis and bad breath. However, no new and effective mouthwash can replace daily brushing. They only can provide supplemental care.

2 in 1 products: These are toothpastes which can also be used as a mouthwash. During rinsing, their ingredients access the tight spaces between teeth. In addition to acting as a necessary prophylaxis, they also fulfill an array of consumer needs, such as gently whitening the teeth or providing extra care for gums through herbal extracts.

There are even 2 in 1 products for children of school age, which combine an effective toothpaste for kids with a fluoride rinse. This provides cavity protection for young teeth, whose enamel is not yet very resistant. A fruity taste and colourful packaging encourage kids to brush and rinse regularly.
   
   

The ingredients
   
What ingredients are found in creams and gels? How do the various oral hygiene products work?

• fluoride: First mentioned in 1874 in connection with cavities and prophylaxes, this substance is now contained within virtually all modern teeth cleaning products. Fluoride penetrates the dental enamel and strengthens its resistance to corrosive acids. Fluoride also hinders the growth of bacteria in the mouth, so that fewer acids are produced from the outset. Products are available in various fluoride concentrations, depending upon one’s age and individual needs.
• cleansing agents: These are the insoluble substances with a granular structure. They remove plaque through friction, without damaging the enamel.
• minerals: Acids wash minerals out of the enamel and thereby weaken it. To compensate for this (i.e., to replenish lost minerals), toothpastes contain calcium and phosphate compounds.
• vitamins: Vitamin complexes, such as vitamin A and provitamin BS, strengthen and revitalize gums. With the infection-reducing effect of vitamin formulas, gums receive the protection, care and strength that they need to form the foundation for healthy, beautiful teeth.

Toothpaste and mouthwash often also contain ingredients to hinder the spread of bacteria, to prevent tartar buildup and to normalize oversensitive tooth necks.
       
Additional ingredients
       
Tensides (surfactants)
   
These substances—also present in detergents and skin cleansers—allow for a balanced, long-lasting mixture of individual toothpaste ingredients. They are also responsible for the foaming of toothpaste during brushing, so that ingredients are distributed easily and completely. Consequently, ingredients are even transported to less accessible areas of the mouth (e.g., spaces in between teeth). Friction from the toothbrush aids in this process. Dissolved deposits can no longer attach themselves due to the cleaning effect of the foam.
        
Aromas and sweeteners
   
These make toothpaste and mouthwash “tasty,” motivating us to use them more often. Plant-based aroma oils are often used, such as peppermint, eucalyptus and lemon oil. The most common sweetener is saccharine. It sweetens around 500 times stronger than sugar, but does not cause cavities.
       
Ingredients for thickening, moisture, and consistency
   
These give toothpaste its desired structure and long life. Thus, toothpaste remains elastic even after long storage, and will not dry out or become too watery.