Oral Health Advice

The advice given below has been published by the Department of Health following extensive research and discussion with experts in preventive dentistry and health promotion.

Dental Decay is caused by frequency of sugar intake.

Advice to Adult Patients

Prevention of caries

• Brush twice daily with fluoridated toothpaste
• Use fluoridated toothpaste (1350ppm fluoride or above)
• Brush last thing at night and on one other occasion
• Spit out after brushing and do not rinse
• The frequency and amount of sugary foods and drinks should be reduced

Periodontal disease (Gum disease) is caused by failing to remove adequately plaque deposits from the teeth and gums, and made worse by smoking and alcohol consumption.

Prevention of Periodontal Disease (Gum disease) – to be used in addition to caries prevention

• Self-care plaque removal
• Remove plaque effectively using methods shown by the dental team. Daily effective plaque removal is more important to periodontal health than scaling and polishing by the clinical team
• Brush gum line AND each tooth twice daily (before bed and at least on one other occasion).
• Clean daily between the teeth to below the gum line before toothbrushing
  – For small spaces between teeth: use dental floss or tape
  – For larger spaces: use interdental or single tufted brushed
  – Around orthodontic appliances and bridges, use kit suggested by the dental profession
• Do not smoke
• Maintain good diabetes control
• Be aware that some Medications may affect gingival health

Oral Cancers in the UK are caused mainly by smoking, chewing certain products, and alcohol consumption.

Prevention of Oral Cancer

• Do not smoke
• Do not use smokeless tobacco (e.g. Paan, chewing tobacco, gutkha)
• Reduce alcohol consumption to moderate (recommended) levels
• Increase intake of non-starchy fruit and vegetable

If you are at a higher risk of dental ill-health, or your oral health is giving concern, additional measures are advised and these will be discussed with you by your dentist or hygienist

Advice to Young Patients

Children aged up to 3 years

• Breast feeding provides the best nutrition for babies
• From 6 months of age infants should be introduced to drinking from a cup, and from age one year feeding from a bottle should be discouraged
• Sugar should not be added to weaning foods
• Parents should brush or supervise toothbrushing
• Use only a smear of toothpaste containing no less than 1000ppm fluoride
• As soon as the teeth erupt in the mouth brush them twice daily
• Brush last thing at night and on one other occasion
• The frequency and amount of sugary foods and drinks should be reduced Sugar free medicines should be recommended

Children aged 3 -6 years

• Brush at least twice daily with a fluoridated toothpaste.
• Brush last thing at night and at least on one other occasion
• Brushing should be supervised by an adult
• Use a pea-sized amount of toothpaste containing more than 1000 ppm fluoride
• Spit out after brushing and do not rinse
• The frequency and amount of sugary foods and drinks should be reduced Sugar free medicines should be recommended

Plus: Dentists should apply fluoride varnish to teeth twice yearly

Children aged from 7 years

• Brush twice daily with a fluoridated toothpaste
• Brush last thing at night and on one other occasion
• Use fluoridated toothpaste (1350ppm – 1500 ppm fluoride)
• Spit out after brushing and do not rinse
• The frequency and amount of sugary foods and drinks should be reduced.

Plus: Dentists should apply fluoride varnish to teeth twice yearly

If your child is at a higher risk of dental caries, or is giving concern, additional measures are advised and these will be discussed with you by your dentist.

Evidence-based advice about healthier eating

• The frequency and amount of consumption of sugars should be reduced
• Avoid sugar containing foods and drinks at bedtime when saliva flow is reduced and buffering capacity is low
• Amount and frequency of consumption of sugars should be reduced
• Avoid sugar containing drinks at bedtime
• Added sugars should provide less than
• 10% of total energy in the diet OR 60g per person per day
• (for young children 30g per day – one teaspoon is c 5-6g)
• Eating the right amount of food relative to how active a person is to be a healthy weight
• Eating a range of foods in line with the ‘eatwell plate’.
  – Plenty of fruit and vegetables 5< portions a day – variety for different fibres, vitamins, nutrients
  – Plenty of starchy foods (bread, pasta, rice, potatoes) – base meal on starchy foods
  – Some milk and dairy foods
  – Some meat, fish, eggs, beans and other non-dairy sources of protein. (eat more fish, especially oily fish)
  – Foods and drinks high in fat, sugar, or salt – consume infrequently in small amounts
  – Saturated v unsaturated fats, no more than 6g salt/day,
  – Drink 6-8 glasses water/day (1.2 lts)

Principles of toothbrushing for oral health

• Start as soon as first primary tooth erupts
• Twice daily as a minimum, last thing at night before bed + 1
• Children under 3 – no less than 1000 ppm Fl-
• Children under 3 – only a smear, must not eat or lick toothpaste from tube
• Family toothpaste (1,350-1,500 ppm Fl-) for all other children
• Children 3-6 – a pea size amount of toothpaste
• Children need to be helped/supervised up to 7 years old
• Rinsing after toothbrushing (water, mouthwashes or mouthrinses –even fluoride ones) reduces effect of toothpaste – should be discouraged
• Patient’s own method of toothbrushing may be modified to maximise plaque removal, systematically cleaning all tooth surfaces
• No method/technique is better than another
• Disclosing tablets help to indicate cleanliness
• Brushing is more effective with small headed toothbrush, medium texture bristles (ISO 20126 (2012))