Oral Hygiene

Why is oral hygiene so important?

Adults over 35 lose more teeth to gum disease (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and oral hygiene techniques, performed daily.

Periodontal disease and decay are both caused by bacterial plaque. Plaque is a colorless film which sticks to your teeth at the gum line. Plaque constantly forms on your teeth.  By thorough daily brushing, using interproximal brushes and flossing,  you can remove these germs and help prevent periodontal disease.

How to Brush

We prefer using an electric toothbrush vs. a manual toothbrush. When using an electric toothbrush with proper technique, the results are markedly better. The brush that we recommend is the Braun io. One must hold the brush lightly at the gum line 3-4 seconds per tooth and move slowly tooth by tooth. It should take at least 2 minutes to brush your teeth when moving at a slow proper pace.  If you do not brush long enough, the brush has a timer which has an attitude and will give you a frown. If timed properly, you will get a smiling face. The Braun io has a 3 light system, which teaches and reinforces the proper pressure.  White is too light, red is too hard, and green is the proper force.  “Stay in the green“.

We often recommend patients who build a lot of tarter on the back of the lower anterior teeth to start in that location first using a dry brush. Then add  fluoride toothpaste to the brush.

To clean the outside surfaces of the upper back teeth, close your mouth halfway, then slide your jaw to the side that you are brushing.  This will cause a space to open up, which will enable one to gain access to the surfaces with the small brush head.

When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth. You will see and feel a big improvement in your gum health.

How to Floss

Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from these surfaces. However, it is important to develop the proper technique. The following instructions will help you; but remember it takes time and practice.

Start with a piece of floss (waxed is easier) about 18″ long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.

To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss between the teeth, using a back-and-forth motion. Do not force the floss or try to snap it into place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth.  Avoid cutting the gum tissue between the teeth, by hugging the tooth surface snugly with the floss.  As the floss becomes soiled, turn from one finger to the other to get a fresh section.

To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the backside of the last tooth on both sides, upper and lower.

When you are done, rinse vigorously with water to remove plaque and food particles.  Do not be alarmed if during the first week of flossing your gums bleed or are a little sore.  If your gums hurt while flossing, you could be doing it too hard or pinching the gum.  As you floss daily and remove the plaque, your gums will heal and the bleeding should stop.


For patients undergoing extensive dental treatment, we recommend prescription-strength fluoride nightly.  We recommend regular non- prescription fluoride toothpaste in the morning.  1.1% prescription sodium fluoride helps to mineralize and harden the outside of the teeth, helping to prevent decay and to make restorations and fillings last longer, which is a major goal of our office.  Place a small amount of toothpaste on the Braun io toothbrush and brush for at least 2 minutes.  Swish what is on your mouth (NO WATER) and NO eating, rinsing or drinking for 30 minutes.  If you drink sooner than 30 minutes after using the fluoride, the effectiveness of the prescription fluoride is reduced by 80%.

Fluoride toothpastes and mouth rinses, if used in conjunction with brushing and flossing, can reduce tooth decay as much as 40%.  Remember, these rinses are not recommended for children under 6 years of age.  Tartar control toothpastes will reduce tartar at the gum line, but gum disease starts below the gum line; so these products have not been proven to reduce the early stages of gum disease.

Caring for Sensitive Teeth 

Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean.  If the mouth is not kept clean, the sensitivity will remain and could become more severe.  If your teeth are especially sensitive, consult our office and we may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.

Choosing Oral Hygiene Product

There are so many products on the market that it can become confusing, and choosing among all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.

There are tiny interproximal brushes (soft picks and proxy brushes) that clean between your teeth.  We highly recommend the use of soft picks and proxy brushes and, when used properly, often clean between teeth better than floss.  If these are used improperly, you may injure your gums; so discuss proper use with Dr. Wetreich or one of our staff.

Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush, use interproximal brushes and floss in conjunction with the irrigator.  We see excellent results with electric toothbrushes.  We do not recommend water picks when patients have a lot of crown restoration on natural teeth; because water picks tend to wash out cement under the crowns, causing leakage.  Oral irrigators can be used around implant restorations.

Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with the above products.


Good nutrition plays a large role in your dental health.  Brushing and flossing help keep your teeth and gums stay healthy and strong.  However, a balanced diet will help to boost your body’s immune system, leaving you less vulnerable to oral disease.

How often and what you eat have been found to affect your dental health.  The bacteria in your mouth feed on starchy foods, such as crackers, bread, cookies and candy; which causes the bacteria to produce acid, which can lead to tooth decay and periodontal disease.  The bacteria produce acids which attack your teeth for up to 20 minutes or more. Foods that stick to your teeth or are slow to dissolve give the acids more time to work on destroying your tooth enamel.

Sticky/slow to dissolve foods:

  • granola bars
  • chewy fruit snacks
  • dried fruit
  • potato chips
  • hard candy

Starchy foods:

  • crackers
  • breads
  • cookies
  • candy

Sticky and starchy foods create less acid when eaten as part of a meal. Saliva production increases at mealtime, rinsing away food particles and neutralizing harmful acids.

Foods such as nuts, cheese, onions, and some teas have been shown to slow growth of decay-causing bacteria in the mouth.