Ignore Your Teeth and They'll Go Away

Think you know how to floss, which brush is best and how often to see your dentist? Even with all the best intentions, you still might not have all the right answers. According to the American Dental Association (ADA), up to 90 percent of us don’t. It turns out that our notions of which toothbrush is best and why we use mouthwash may be all wrong. Here’s the right way to keep your pearly whites healthy.  

Swish or Floss?

First, ignore the advertisements telling you that using mouthwash is as good as flossing. That’s comparing apples to oranges. “A lot of people think flossing is just for removing debris, but the main purpose is to remove plaque,” says Paula Jones, DDS, and spokesperson for the Academy of General Dentistry. Although mouthwashes kill the bacteria in plaque for about three hours, they leave the plaque behind. These rinses are mainly intended to briefly make your breath minty-fresh; they provide little or no long-term benefit. Decay-causing plaque still lingers between teeth where toothbrush bristles can’t reach.

What exactly is plaque?

It’s a thin film made up of the bacteria that live in your mouth and the food particles between your teeth. Fortunately, “it takes a good 24 hours for bacteria to form a plaque colony, so if you floss once a day, you prevent plaque from developing,” says Jones. Some of the bacteria in this colony emit unpleasant odors; some release acids that dig cavities; and others produce toxins that cause gum disease (gingivitis), all of which are bad for your teeth. Eventually, the plaque mineralizes into tartar, which must be professionally removed.

Flossing is all about technique: Gently curve the floss into a C-shape around the side surface of your tooth, scraping up and down to dislodge the sticky plaque. “Many people don’t like to floss because it makes their gums bleed, but if you slide the floss down along the tooth and slightly below the gumline, you won’t cut into your gums,” says Gordon Isbell III, Doctor of Dental Medicine (DMD), vice chairman of the ADA’s Council on Dental Practice and spokesperson for the Academy of General Dentistry. When you can’t floss, use mouthwash to inhibit bacteria growth, suggests Isbell—just be sure to swish for 30 seconds to get the most benefit. “But mouthwash won’t do as good a job as floss,” he notes.

Old School or New-Fangled?

Traditionally, inhabitants of India, Asia and the Arab world chewed twigs from the neem or “toothbrush” tree for clean teeth. In 1498, China developed the modern brush—boar’s hair in an ivory handle. Today, we have dozens of toothbrush choices, but the most basic decision is manual vs. electric. Electric (also known as rotary) brushes have grown rapidly in popularity. Not only are electric toothbrushes easier to maneuver for people with conditions such as arthritis, but Jones says they do a better job of cleaning teeth. Most of us just move our manual brushes a few times per tooth. Matt Messina, DDS, ADA consumer advisor, believes that electric brushes are more effective per second of use, so if you’re going to brush quickly, electric might be the better choice for you. If you’re willing to take a little more time with a manual brush, though, you can accomplish everything with the manual kind that you can with an electric.

Ultimately, “whatever toothbrush makes someone brush is the one I recommend,” says Ludwig

Leibsohn, DDS, past president of the Academy of General Dentistry. Most electric brushes have

replaceable brushheads and a plugged-in rechargeable base with rechargeable batteries that last

for years. Prices for brand-name products start at $6 for battery-powered and range from $15 all the way up to $150 for rechargeables. Brand-name replacement heads range from $2.50 to $15 each, but cheaper generic versions are cropping up everywhere. And remember to replace these rotary brushheads as frequently as a regular toothbrush—about every six to eight weeks—since all brushes grow bacteria and wear out.

How Often is Too Often?

How often do you need to visit your dentist? “Each person is different, so patients should be reviewed on a case-by-case basis,” Jones says. “Usually it’s every six months, but gum disease patients need careful monitoring, so it’s every three months for them.” Leibsohn agrees: “Lots of things can go wrong in a year—a visit every six months may save a patient from losing a tooth or having a root canal.” 

Thinking about reducing your visits to just once a year? “In your 20s and 30s, once a year might be fine, but when you get into your 40s and beyond, things can happen faster, and twice or more a year is best,” says Messina.

Your genetics, tooth position, nutrition, dental routine and lifestyle help determine how frequently you need to see your dentist (see “Tips for Teeth,” opposite, for more on how diet affects your teeth). The bottom line is no shocker. Oral hygiene is something you can make an effort to control, but it’s still essential to see your dentist regularly to keep your teeth strong and healthy.

Relieved to discover that the dentists in this article approve her use of small, child-sized toothbrushes, freelance writer Nancy Brand Patel now tries to floss every day.