Why is it that even though they are most visible, our teeth are usually our most ignored body part? According to Vivek Soni, dean, and head of department, department of orthodontics, Dr DY Patil Dental College and Hospital, Mumbai, people generally fear regular dental check-ups.
He says that in India only 5% of people understand the power of prevention. The rest prefer to opt for cure. “They wait till the pain becomes unbearable and only then go sit on a dentist’s chair. By then the damage has already been done,” he says. Mukul Dabholkar, a cosmetic dentist with a private practice in Mumbai, agrees. “All of us covet white pearlies, but we don’t follow even the simple rules of their upkeep.”
According to Dr Soni, the problems are showing up increasingly among younger people. “Now both periodontal (gum-related) and tooth caries are plaguing people in their 20s. And that’s because our basic eating pattern nowadays includes a lot of sweets, aerated drinks and junk, all of which play havoc inside the mouth. What happened 20 years back in the US is now being repeated here,” he says. Ajay Sharma, senior consultant and dental surgeon at the Saket City Hospital, Delhi, says he too has seen a huge increase in younger people with halitosis (bad breath), sensitive teeth and bleeding gums. “All this is easily avoidable. There is ignorance among people even about simple rules of tooth hygiene,” he adds.
Keep in mind that “chronic gum disease may even contribute to the development of heart disease and osteoarthritis,” says Dr Soni, adding, “that’s because bacteria from infected gums often enter the bloodstream and go on to attach to the fatty deposits in the heart blood vessels, leading to formation of clots.”
Brushing basics
"Bacteria from infected gums often enter the bloodstream and go on to attach to the fatty deposits in the heart blood vessels, leading to formation of clots."
Change your toothbrush every two months, or even earlier if the bristles show wear and tear or after a bout of flu or cold, says Dr Dabholkar. Brushing twice a day is non-negotiable.
The essentials
Unless you live in highly fluorinated areas (like Rajasthan), opt for a fluoride-based paste. “Fluoride decreases cavities, helps brighten discoloured teeth and banishes bad breath. Don’t fall for marketing gimmicks, go by the ingredients: Besides fluoride, look for triclosan (protects gums and teeth). Don’t use non-branded tooth powders as they can be abrasive. Similarly, datun (neem stick) has fabulous antiseptic value (great to get rid of the bacteria) but it is not a replacement for toothpaste as it doesn’t clean properly. And please don’t brush with salt; it’ll scratch your enamel and lacerate the gums,” advises Dr Sharma.
Flossing at least once a day helps, as it removes bacteria from places where the toothbrush cannot reach (usually areas in between teeth) and thus helps prevent build-up of plaque. “It is important to learn how to floss right to prevent an injury. Plus only those with healthy teeth must floss, otherwise it may add to the problem. Go for a professional clean-up to a dentist to get the tartar (hardened plaque) cleaned up, and then begin flossing,” suggests Dr Soni, adding that only about 5% of Indians floss.
What we usually do right in India is the regular cleaning of the tongue. For those who don’t, Dr Soni’s advice is to invest in a tongue scraper (again, neither abrasive, nor too soft) and use twice daily to remove the bacteria that cause bad breath.
As far as mouthwash is concerned, Dr Dabholkar clarifies that it is not a replacement (for brushing)—it is an additional aid to prevent tooth decay. “While those with bad breath, or smokers, should use it twice a day, others must use it once at least (ideally at night after brushing),” he says, adding that one must keep changing brands as the bacteria get used to them fast enough.
What’s more, your teenager could be doing something right. Chewing gum helps neutralize acid formation on the teeth, making it harder for cavities to form. So chew a sugar-free one for a few minutes after a meal to clear your mouth of harmful sugars and buffer the acid by stimulating saliva production.
The problems
“Don’t take them lightly at all as stained and discoloured teeth can be a sign of a serious dental problem,” says Dr Dabholkar. “Basically yellow teeth could be because of an extrinsic reason (like some deposits, tea stains or due to smoking) or an intrinsic reason (high fluoride level, or over-usage of antibiotics during the early teeth development),” he adds. Check with your dentist for a full mouth cleaning or opt for teeth whitening (costs Rs.10,000-35,000 and the result lasts for three-five years).
Keep a look out for gum problems too. “Bleeding, red or tender gums, or if receding away from the teeth, and chronic bad taste in the mouth—are all classic signs of gum disease, which incidentally is the leading cause of tooth loss (and not cavities as it is widely believed),” lists Dr Sharma.
Don’t take bad breath lightly. While temporary bad breath could be the result of something you ate in the last meal (like, say, onion or cabbage, as these foods contain sulphur compounds which give our breath a foul smell), bad breath over a long term could be a sign of gum disease, kidney disease, liver disease, or serious plaque formation (90% of bad breath is because of serious plaque formation and this, left unchecked, can lead to gum disease).
