Oral Hygiene

Oral Hygiene issues:

• Brushing, flossing and using a Waterpik and following a low sugar and low carbohydrate diet is critical for the successful outcome of our orthodontic treatment

• If our patients score less than 8 for oral hygiene, we automatically let you and your dentist know (by email) about the problem, so that urgent attention can be given to the problem and hopefully halt or reverse damage to the teeth and gums

• Plaque disclosing tablets should be used to show clearly where the plaque is

• The tongue carries a lot of plaque which is detrimental to your oral health and should be removed

• The sugars derived from sugars and carbohydrates in your diet feed the bacteria and other organisms in plaque and allow them to multiply, produce acid, and damage the teeth, gums, periodontal ligament and bone

• Your dietary intake of sugars and carbohydrate should be restricted - without sugars and carbohydrates in your diet; you cannot get tooth decay or gum disease

• A Waterpik is very useful in controlling plaque during braces treatment but does not fully replace the interdental brush or Superfloss, both of which are usually still necessary at least once a day

• Many mouth rinses are anti-bacterial and may kill off your normal oral flora, so we don’t usually recommend mouth rinses for long-term use (unless your dentist or periodontist has prescribed a mouth rinse for a specific condition)

• For inflamed or traumatised gums we recommend rinsing with a teaspoon of salt in a glass of warm water rather than mouth rinse

Oral Hygiene Score:

We rate oral hygiene on a scale of 1-10 where 1 is the very poorest and 10 is perfect oral hygiene.

Factors / Guidelines considered in this rating:

• Plaque on the teeth, gums and tongue: The amount and distribution of plaque is a big factor in determining the rating (Oral Hygienists usually score 1-7 depending on the severity and the presence or absence of the other factors below)

• Calculus (tartar on the teeth): The amount and distribution of the calculus also determines the score (any calculus makes the OH score 6 or less)

• Supragingival calculus: Is above the gum and can be removed with a Scale and Polish by your dentist or oral hygienist (OH usually score 5 or less)

• Subgingival calculus: Is below the gum and can only be removed with a Deep Scaling, often also necessitating Root Planing and Curettage by your dentist or periodontist (Usually OH score 5 or less)

• Plaque and debris on the tongue: Indicating that a tongue scraper is not being used (cannot score above 6)

• Decalcification: This is where the acids generated by the combination of plaque and sugars/carbohydrates has made white or brown marks on the teeth (OH usually score 6 or less)

• Gingivitis: This is inflammation of the gums due to inadequate brushing and flossing and incorrect diet. Gums should be pink and neatly scalloped – red swollen gums are infected (OH score usually 6 or less depending on severity)

• Mouth breathing: Dries out the gingiva and teeth and makes them more sticky and more prone to plaque accumulation (OH usually score 7 or less)

• Acid reflux: Causes decalcification and erosion of the teeth and also burn the gums, throat and nasopharynx leading to gingivitis and inflammation of the throat and causes sinusitis – eliminating sugars and carbohydrates, especially after midday, reduces acid reflux (OH score usually 7 or less)

• Gingival hyperplasia: Sometimes progresses from gingivitis and is swelling of the gums, which sometimes necessitates a gingivectomy by your dentist, orthodontist, the periodontist or oral surgeon (usually OH score 6 or less)

• Bone loss and periodontitis: This is when there is bone loss and periodontal pockets due to poor oral hygiene (OH typically score 5 or less)

• Peri-implantitis: This is when an implant is compromised by a process similar to periodontitis, generally due to inadequate flossing of the implant (OH score 6 or less)

• Debris/plaque/tartar between the teeth: Indicates improper flossing (OH score cannot be more than 7)