Expert tips: A dentist on how to have perfect teeth

Dentist Brenda Kennedy qualified from the University of the Witwatersrand, South Africa in 1991. She has worked in general practice in the UK and Ireland, and with the HSE in Co Waterford, and is currently one of the team at Kinsale Dental.

She shares some of her tips for dental care.

1. Teeth should be brushed twice a day. It's particularly crucial to clean your teeth thoroughly before you go to sleep.
2. Brush using an agitated circular motion – the Modified Bass Technique. Spend about 10 seconds on each surface area; the inside, the outside, and the biting surface. It should take 3-4 minutes.
3. The most important place to clean is where the tooth and gum meet. A bleeding gum needs more attention, more brushing. See your dentist if it doesn't settle in a day or two.
4. Softer, smaller brushes are better especially for children. Using a brush that is too hard can damage gums. Change your toothbrush every 6-8 weeks. Electric toothbrushes are very useful, though I'm not a fan of them for small children, unless they have an underlying medical or coordination issue.
5. Conventional floss is the most effective because it can be manipulated around the tooth.
6. Mouthwash is of little use, and often extremely harsh. You would be far better spending an extra minute cleaning your teeth to physically remove plaque. Only patients with gum disease, or another issue, may require a medicated wash.
7. Bad breath can be caused by digestive issues, but tends to come from not drinking enough water, or by an accumulation of bacteria in the mouth that can cause gum disease. Mouth washes won't knock that on the head.
8. Drinking water with your food neutralises acids and sugars. Anything else is going to change the Ph of your mouth to the detriment of your teeth.
9. Chewing gum also helps neutralise acids and sugars and prevent decay. A study done in Cork showed even sugared gum has a positive effect – though sugar free is obviously best. This is because you are producing saliva, washing your mouth.
10. Your best bet for staining is a good brush last thing at night with a fluoride toothpaste, and to visit your hygienist twice yearly for a scale and polish. Over the counter whitening products generally don't have a significant effect.
11. Fizzy drinks – or any sugar that comes in liquid form including tea with sugar and fruit juices – are lethal, as they wash around your mouth between teeth.
12. For children chocolate is better than sweets, and soft serve ice cream is better than an ice lolly. Anything that stays in your mouth, like lollipops, for any length of time, or gets between the teeth, like jellies, isn't good.
13. It is better to have all your sugar in one go. Have your drink and chocolate bar together, and then drink water to neutralise the acids.
14. When your child has teeth, breastfeeding during the night will not cause decay. However, it is important to stop giving bottled milk during the night from about 12 months of age, as this can cause caries.
15. Evidence shows an orthodontic dummy doesn't cause negative effects to a child's teeth and bite, but sucking a thumb will.
16. A child needs to learn the skills, and develop the manual dexterity, to brush properly. However, we were taught that parents should brush a child's teeth until they are 7. I would advise letting the child do a little bit themselves and then finish it off.
17. From the age of about 7, the best way to teach children to brush is with disclosing tablets from the pharmacy. Get the child to brush; use the disclosing tablet to show them the bits they have missed; and get them to brush again.
18. Brush with water only until the age of 2. From then a toothpaste with at least 1,000 parts per million of fluoride, is needed. Use flavourless paste if children don't like the taste. We notice that patients using well water are much more prone to decay, and need to ensure they use fluoride toothpaste.
19. If a child is comfortable around a dental surgery they will not be frightened if they do need treatment. I often tell patients to bring their young children with them to appointments. We invite them to get their teeth looked at too, and maybe polish them a little, so they get a feeling what working in their mouth feels like.
20. Ideally children should have their teeth checked every six months because their mouth is constantly changing. Check ups with the HSE school dentist are area dependent, but if you have a child (under 16) with a toothache, or any other emergency issue, you can ring the school dentist and ask to be seen.
21. Fissure sealants – a plastic coating to protect the biting surface – are the best way to protect children's teeth. The HSE has a protocol of fissure sealing all adult molars for children. However, these don't stop decay between the teeth.
22. If a baby tooth is knocked loose, push it gently back into position if possible. It may settle into place. If a baby tooth is knocked out, there is no need to put it back. In both cases consult a dentist as soon as possible.
23. If an adult tooth is knocked out, either try to put it back in its place holding it by the crown (don't touch the root) or hold it in the cheek of the mouth. Otherwise keep it moist in a cup of milk, or saline solution. If you can get to a dentist within the hour it may be possible to splint the tooth back into position. There's a good chance of successful re-implantation, especially if the patient is young.
24. If you are scared of the dentist find one you are comfortable with. Some dentists are more experienced with nervous patients than others. Anti-anxiety tablets can be prescribed in advance of treatment, while some surgeries use nitrous-oxide for anxious patients.
25. Oral disease can be connected to systemic illness. The sudden onset of gum disease sometimes indicates diabetes. Acute ulcerative gingivitis – painful bleeding gums – is common in young people who are stressed, over tired and not eating, and particularly prevalent in smokers. It is easily treated with good oral hygiene and antibiotics.
26. Recurring mouth ulcers can be a sign of anaemia or vitamin deficiencies especially in patients following restrictive diets. Certain types of bacteria in the mouth are even related to heart attacks. That's why it's so important to keep your teeth cleaned.

Read: A podiatrist on footcare