Ten tips for maintaining healthy teeth between dental visits

Most of what determines the state of your teeth happens at home, not in the chair. Two check-ups a year is roughly an hour; the other 8,759 are yours.

These are ordered roughly by how much difference they make.

1. Clean between your teeth, every day

If you only change one thing, change this. A toothbrush reaches three of the five surfaces of each tooth — about 60%. The surfaces between teeth are exactly where decay and gum disease most commonly start, and nothing but floss or an interdental brush will clean them.

Interdental brushes (Piksters and similar) are easier than floss for most people whose gaps will take them. Ask us which size fits.

Making it stick: attach it to something you already do without fail. Most people who floss consistently do it before brushing, standing at the same basin, at the same time of night. People who plan to do it "when I remember" do not do it.

2. Brush at the gumline, not just the teeth

Angle the brush at 45 degrees into the gumline. That junction is where plaque collects and where gum disease begins. A brush held flat against the tooth misses it entirely.

Twice a day, two minutes, and the night-time brush is the one that matters most — saliva flow drops while you sleep.

Check yourself: chew a disclosing tablet from the chemist after you brush. The stained patches are what your routine misses, and they are the same patches every time.

3. Spit, do not rinse

Rinsing with water after brushing washes the fluoride off before it has done anything. Spit out the excess and leave it. Same for mouthwash straight after brushing — use it at a different time.

This costs nothing and almost nobody does it. It is the highest return-per-effort item on the page.

4. Cut how often you eat, not just what

Every eating occasion starts an acid attack lasting 20 to 40 minutes. Six snacks does far more damage than the same food at two meals.

Keep sweet things to mealtimes. Drink water between meals — not juice, soft drink or sweetened coffee sipped across the morning. This one change is worth more than most people's entire brushing improvement.

The desk-coffee problem deserves naming: a sweetened coffee sipped over ninety minutes is a ninety-minute acid exposure. Drink it in one sitting, then water.

5. Use a soft brush, gently

Soft or extra-soft, always. Hard bristles and heavy pressure wear notches into enamel at the gumline and push gums into receding — and neither grows back. If your brush splays within a few weeks, you are pressing too hard.

Replace it every three months.

If you use an electric brush, let it do the work: hold it on one tooth for a few seconds, then move on. Do not scrub with it, and heed the pressure sensor if it has one.

6. Do not brush straight after acidic food or drink

Citrus, wine, soft drink, vinegar, or after vomiting: enamel is temporarily softened, and brushing then scrubs it away. Rinse with water and wait about 30 minutes.

This applies to the wellness habits too — lemon water first thing and apple cider vinegar are two of the more damaging routines we see, and both are usually followed immediately by brushing.

7. Chew sugar-free gum after meals

Ten minutes of chewing, ideally with xylitol, increases saliva flow substantially and helps clear acid. Very little effort, genuine benefit — particularly useful when you cannot brush.

Not for anyone with jaw joint pain, where chewing makes things worse.

8. Drink tap water

Melbourne's water is fluoridated. It rinses, dilutes acid and supports saliva. It is also the correct answer to almost every "what should I drink?" question about teeth.

A note on sparkling water: plain sparkling is mildly acidic and generally fine. Flavoured versions usually contain added citric acid and are considerably more erosive than people assume.

9. Do not ignore bleeding gums

Healthy gums do not bleed. Bleeding when you brush or floss is inflammation, and it is usually the earliest warning gum disease gives you — the only one, in many cases, before teeth start to loosen.

It is not a reason to stop cleaning the area; it is a reason to clean it properly. If it has not settled within two weeks, book an appointment.

10. Deal with grinding, dry mouth and other risks

Grinding or clenching — waking with a sore jaw, headaches, or flattened teeth. A splint can protect your teeth from wear that is otherwise permanent.

Dry mouth — hundreds of common medications reduce saliva, and saliva is your main natural defence against decay. If your mouth feels dry, tell us. It changes what we recommend.

Smoking — the single biggest modifiable risk factor for gum disease, and it masks the warning signs by reducing bleeding.

The routine, written out

What is actually worth having in the bathroom

• A soft or extra-soft manual brush, or an electric with a timer and pressure sensor
• Fluoride toothpaste. The fluoride is the active ingredient; most of the rest of the box is marketing
• Floss or interdental brushes, in the size that fits your gaps
• A tongue scraper, if breath is a concern
• Optional: a fluoride mouthrinse for high decay risk, used at a different time from brushing
• Optional: sensitivity toothpaste, used as your regular paste rather than occasionally

What is not worth the shelf space: charcoal pastes (abrasive, usually fluoride-free), whitening pastes bought hoping for a shade change, and most cosmetic mouthwashes.

Habits worth breaking

Each of these turns up regularly as a cracked tooth or a broken restoration.

• Chewing ice. The most common cause of an avoidable cracked molar
• Biting nails, pens and glasses arms
• Opening packaging, bottles or hair clips with your teeth
• Holding pins, nails or thread between the front teeth
• Chewing on one side only, usually to avoid a tooth that is already a problem
• Sucking lozenges or mints through the day
• Using teeth as a third hand generally

A monthly self-check

Two minutes, in good light, with a mirror. You are not diagnosing anything — you are noticing changes worth mentioning.

1. Gums — pink and firm, or red, puffy, receding?
2. Bleeding — anywhere that bleeds when you clean it?
3. Teeth — any new chips, cracks, dark spots, or a filling that feels rough?
4. Bite — does anything feel high, or different from last month?
5. Soft tissues — cheeks, tongue (lift it and look underneath), palate, floor of mouth. Any ulcer, lump, or white or red patch
6. Breath and taste — a persistent bad taste can indicate a problem

Anything that has lasted more than two weeks gets an appointment. That rule is the single most useful thing on this page for spotting something serious early.

Adjusting for your situation

If you are pregnant — gums inflame more readily. Keep the cleaning up, keep your check-ups, and do not brush immediately after morning sickness.

If you take medication for blood pressure, depression, allergies or pain — dry mouth is common and raises decay risk substantially. Tell us what you take.

If you have braces — brush after every meal, use an interdental brush under the wire, and keep seeing your general dentist alongside the orthodontic visits.

If you have implants, crowns or bridges — the cleaning around them matters more, not less. Superfloss or a threader under a bridge; careful cleaning around the neck of an implant.

If you have dentures — out at night, cleaned with a denture brush and cleaner rather than toothpaste, and your gums and tongue still need brushing.

If cleaning is physically difficult — an electric brush, a thickened handle, floss holders. Tell us and we will adjust the advice to what is achievable.

If you are travelling — a check-up before a long trip is worth more than anything you pack. Take a spare brush head, and do not let the routine lapse for three weeks.

Do not wait for your next check-up if

• Pain wakes you at night, or lingers after hot or cold
• A tooth is chipped, cracked, loose, or a filling has come out
• Gums bleed persistently despite good cleaning
• An ulcer, lump, or red or white patch lasts more than two weeks
• Your bite suddenly feels different

And if severe pain suddenly stops on its own, that is not recovery — it often means the nerve has died. Get it seen.

Go to a hospital emergency department, not a dentist, for spreading facial swelling, difficulty breathing or swallowing, or fever with dental pain. See dental emergency.

Questions we are asked

Is an electric brush worth it? For most people, yes — mainly because the timer and pressure sensor fix the two things people get wrong. A well-used manual brush still beats a badly used electric one.

Does mouthwash replace flossing? No. Nothing replaces physically disturbing the biofilm between teeth.

How long should a tube of toothpaste last? If you are using a pea-sized amount twice a day, considerably longer than most people expect. Using more does not clean better.

My teeth feel fine. Do I still need to come in? Dental problems are painless until they are not. That is the entire argument for check-ups.

I have not been for years. Common, and nobody will comment on it. The appointment is about what to do from here.

Who provides this here

Victorian Dental Group is a general dental practice in Malvern East and holds no specialist registration. At a check-up we will show you on your own teeth where your routine is missing, which is considerably more useful than any general list. Ask us to.

Read more about check-up and hygiene, the right way to brush or flossing.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · book online

General information only, not personal dental advice. See our disclaimer.