Tips concerning tooth maintenance and care

How do I brush my teeth correctly so that my gums are not damaged?

Naturally much plaque always sticks to the edge of the gums. You should place and use the toothbrush at an angle of 45 degrees in this area. Try to avoid any shaking movements. Always brush the outside from red to white. This means that you should always brush from the gums towards the direction of the teeth. The direction from which you start cleaning your teeth is also important. Always start on the left and proceed rightwards.

You should clean the inside of your teeth with small circular shaking movements. Also make sure you always brush from left to right in this case. Certainly there are also places in your mouth which are difficult to access. In this case you may of course also move the toothbrush lenghtways.

Cleaning tooth spaces is also very important. For especially this area provides a breeding ground for caries. After having cleaned your teeth thoroughly with a toothbrush, dental floss is used. Wrap the dental floss around the tooth in a U shape. Then move the thread up and down for a few times. Clean up to the edge of the gums with light pressure. When cleaning with dental floss, make sure that the thread is never moved back and forth.

At the end of the dental cleaning rinse your mouth thoroughly with water which should not be too cold. Thus the effect of the contents of the toothpaste, the so-called fluorides, is increased. [further information on the topic of "brushing teeth the right way" !coming soon!]

My child still has milk teeth. A small piece of the incisor broke away. What should I do now?

Examine thoroughly if a little blood is dripping out of the break line. For as soon as you notice any blood the probability that the nerve of the tooth is exposed is very high. In order to avoid infections or major pains for the child it is advisable to consult a dentist immediately. If you can find the piece of tooth that broke away take it along to the dental practice.

If no blood is dripping out but the child suffers from toothaches it is advisable to press a cotton bud which has been heavily soaked in clove oil onto the break line. The child can then bite its teeth together and keep the soaked cotton bud in its mouth for a longer period of time. As needed, this procedure can be repeated several times. This also has a psychological effect as it quickly calms the child.

Consult a dental practice as soon as it is possible for you. Please also take the piece of tooth that broke away along in this case. In case the piece of tooth is large enough the dentist can adhere it to the tooth with special glue in most cases. Thus your child will not have any problems with the injured place until the final loss of its first teeth.

In case the size of the piece of tooth that broke away is not large enough to adhere it to the tooth as a rule the broken tooth will be reconstructed with a plastic composite at the chipped edges.

Only if the loss of all milk teeth is imminent the dentist will not ask your child to put up with these procedures. He should then advise you to remove the remaining tooth, the root of the milk tooth, from the jaw.

While I brush my teeth in the morning I often notice that my gums are bleeding lightly. How should I react?

As soon as the gum bleeding keeps on repeating with regularity or even occurs more often the assumption is obvious that a chronic gingivitis is involved or about to develop. A large part of the population suffers from this condition. In most cases this is caused by wrong nutrition and a lack of dental hygiene. In large part the reasons for the development of gum bleeding can also be found in the wrong and/or irregular handling of a toothbrush.

Thus the feared calculus develops inevitably and relentlessly. Actually, calculus is not a stone but instead a dental plaque in mineralized form. This calculus slowly settles between the tooth and the gum. This way the body is motivated to bring its defence reactions into effect. It tries to get rid of the calculus and to protect the tooth and gum from these exterior effects. Gum bleeding is the result.

For the gum not to continue withdrawing and to potentially start building up afresh you should get used to a different kind of nutrition for a certain period of time. Plenty of vitamin c-packed food is required. Brush your teeth with fresh-squeezed lemon juice for some days/weeks which you apply directly to the toothbrush. By this method the gums are directly supplied with pure, undiluted lemon juice, in other words with vitamin C. Try to avoid smoking, drinking coffee and if possible also drinking black tea.

In many cases the symptoms will improve, the gum bleedings will reduce and the good feeling in the oral cavity will come up again.

Nevertheless this does not change the actual cause, the existing calculus. The removal of the calculus requires a considerable restoration, in other words dental cleansing by your dentist. If you exercise enough patience and spend all sessions required in the dentist�s chair the symptoms can actually fade away completely. By means of the right and regular dental care you should be spared gum bleeding for a very long time.

A piece of my filling or of my tooth broke away. What should I do first?

Carefully observe if it becomes evident that toothaches will occur. You can usually tell this by an unpleasant dragging pain which cannot be precisely localized yet. If this is not the case you do not have to hurry to the dentist. Check with your tongue if sharp edges have formed when the tooth broke away. If this should be the case it is perhaps possible to cover the tooth with a piece of chewing-gum until the treatment.

If the tooth has removed from the gum upwards or can easily be moved you should by all means try to press it back into the gum. This can be done by carefully biting onto a soft item for a longer period of time. In a pinch shift a piece of handkerchief between and keep your teeth bit together for a longer period of time. Thus the root skin can not dehydrate and the process which is crucial for healing cannot be jeopardised.

Now go to straight to your dentist. If it is possible you should sit in the treatment room within one hour. This way it is almost sure that the dentist can affix the loosened tooth and that no unnecessary complexities will occur during the healing process.

Please check in your records when the last protection by vaccination against tetanus was carried out and if it is still adequate. Take the vaccination certificate along to your dentist in any case.

For quite some time I get toothaches when I eat sweets or when I brush my teeth.

The advice not to eat any sweets again or not to brush ones teeth is certainly not the right advice. In most cases this is caused by a very great sensitivity or also oversensitivity of the tooth necks. This problem, the dragging pain inside or on the tooth mostly occurs for the first time if the gums start withdrawing with increasing age. As a result the very sensitive dentine will lay open bit by bit.

At this stage you should only use a very soft toothbrush and should exercise as little pressure on the gums as possible while brushing your teeth. Do not brush crossways but instead always very carefully up and down. Furthermore, use a toothpaste that contains a small portion of so-called cleaning particles. If you procede in the stated manner you can spare the tooth necks which are very sensitive and widely be spared from the unpleasant dragging pain.

Of course you should talk to your dentist about a (mostly long-term) treatment for the restoration of your gums.

I have bit a piece of bone between my back teeth and now it�s stuck there. How do I proceed best?

Using a toothpick to remove a foreign object from the tooth spaces is the wrongest thing to do. At this it is not relevant whether you use a normal toothpick or the medical one. In both cases the danger of pushing the foreign object into the tooth space is very great. Moreover you can easily injure the affected gums even more or damage the sensitive tooth necks.

The best method to remove a foreign body from a tooth space is the use of the so-called dental floss. Cut a piece of dental floss with a length of approx. twenty centimetres off with scissors and tie a knot at one end. Carefully pass the dental floss into the tooth space in which the foreign body is stuck. Now pull the dental floss through this tooth space and the foreign body will be removed in most cases. Apart from a slight feeling of pressure everything is alright after this procedure.

In case a foreign body should stick between the teeth in the same location again and again you should consult your dentist. Ask him to check if this tooth space can be closed to the extent that no foreign bodies can get stuck in there any more.

My mouth odour bothers me incresingly. Despite the fact that I constantly brush my teeth and gargle I feel uncomfortable. How do I get rid of it?

Nowadays mouth odour is a great, very widespread problem despite of or even because of the increasing hygiene. Almost every second German citizen is affected by it. In most cases mouth odour is caused by the gum. The gum is exposed to considerably more stress due to different kinds of food, drinks, alcohol, coffee and spices. The gum has to regenerate itself over and over again and also fight against these so-called "enemies".

These so-called enemies of the gum are gases which are generated by simple bacteria. These bacteria are extremely resistant and even adaptive. Thus they lead to a withdrawal of the gum in the course of time.

In order to delay this process it is possible to gargle with the preparation chlorine hexidine after each meal and also in between. Herewith the oral hygiene improves increasingly and a clean feeling, caused by the good taste in the mouth, comes up again.

As all sole efforts restore good taste in your mouth only in very rare cases and mouth odour will not disappear permanently you should consult a dentist in any case.

Does the pustule on my child�s gum disappear by itself?

Especially children often have problems with pustules. This is partially caused by major caries affection. Then it can occur that the tooth dies off as a result of this caries affection. The tooth root becomes soar and bothersome pustules develop on the tooth.

These pustules consist of nothing else but dead red blood cells. They conglomerate around the centre of inflammation at the tip of the tooth root.

Until you and your child reach a dentist and make an appointment you can help yourselves in the mean time. Put a big ice cube on top of the affected area at the gum. As soon as the cold has caused a feeling of numbness you can slit the gum open in this area. For this purpose you best use a sewing needle which you should of course disinfect well beforehand. As soon as you have slit the gum open where the pustule is the purulence can drain off. The pressure reduces immediately, the pain and the swelling decrease. Your child will have a rest for some time.

The development of pustules among grown-ups is a different case. In this case the pustules develop as a direct result of other causes in most cases. A very profound inflammation of the gingival pockets often precedes this. But it can also be caused by other reasons such as the penetration of foreign bodies between the tooth root and the gum.

Very forceful toothbrushing can help against the pressure and the increasing pain. Stroke the place where the pustule is with a hard toothbrush towards the direction of the edge of the gum. If you repeat this procedure long enough the the purulence can drain off. When practising this procedure repeatedly rinse your mouth with lukewarm to hot solutions. These solutions should consist of sage, camomile and chlorine hexidine. This will be soothing. But now hurry up to get a quick appointment at the dentist.

If I drink warm or cold liquids I get toothaches.

If you have already reached the �middle� age you can assume that your tooth�s nerve is very likely to suffer from major caries affection. But what exactly is caries?

Dental caries is also described as tooth decay, more precisely as a whole in the tooth. This tooth decay is always caused by bacteria. Caries is considered the most common infectious disease in mankind. Thus it is assumed that more than 90 % of Europeans suffer from caries.

Technically speaking, in the case of caries the dental enamel is affected by bacteria, subsequently the actual tooth substance is steadily attacked and finally destroyed. At the last stage the tooth�s nerve is attacked. This leads to dying-off and finally to the loss of the tooth. You should consult a dentist of your choice as soon as possible.

A crown fell off my tooth.

The visible part of a natural tooth which is covered with enamel is called a tooth crown. Apart from this the clinical tooth crown also exists. In this case the part of the tooth is treated that projects into the oral cavity, thus the visible part. Hence the tooth crown is the dental replica or also the artificial replacement of a destroyed tooth.

In the case of a filling which is always anchored on or also inside the tooth the dental crown covers the tooth stump. The remaining tooth has been treated for this procedure beforehand. The coating can consist of metal, ceramics or a combination of both contents. Some of the following kinds of dental crowns are the most common ones.

The banded crown, galvano-ceramic crown, foil crown and cast crown. The jacket crown especially plays an important role in the visible area as it can be adjusted to the actual colour of the tooth almost by 100 percent.

The actual preparation of the dental crown is done in the laboratory, therefore outside the mouth. The actual, permanent fixation is done by means of the different fixation cements. The purpose of a dental crown is reconstructing the tooth in its actual function and protecting it on the long run if possible.

If the work had been done properly by a dentist you should not feel any pain after 48 hours and you should also not have the feeling of a foreign body inside your mouth. If you should still have pain after this period or the pains should not have worn off it is advisable to cover the affected tooth again as it does not dispose of an enamel coat. Consult your dentist as soon as possible.

After the placement of a filling I now get toothaches.

It is natural that the placement of a filling results in toothaches. Due to the dentist�s polishing and drilling the tooth nerve is very irritated. This irritation even worsens due to the application of the filling material.

A tooth filling is also referred to as a seal. This is the replacement of no longer existing or also diseased tooth substance. Your dentist should try to establish a cosmetically correct situation by applying suitable filling materials after the removal of the destroyed tooth substance. Of course the actual (chewing) function should be given priority here. After the treatment you should not feel any difference from the actual, natural tooth substance.

The body, in other words your tooth�s nerve reacts differently to the different filling materials. This can be a plastic adhesive filling, the so-called composite. Furthermore gold inlay fillings are used. You dentist may have used ceramic and plastic inlay fillings here.

There are two different kinds of fillings. The indirect kind of filling which is also referred to as an inlay filling includes a dental treatment comprising several sessions with work pieces which were manufactured in a laboratory. After the preparation by means of a dental cast a model is created which serves as the foundation for the work pieces manufactured in the laboratory. Then the result of both techniques is applied by the dentist by means of fixation cement.

The direct way of filling, which is also referred to as plastic filling, comprises the treatment of teeth with plastic filling materials. Amalgams are suitable as materials in particular. Especially cements and composite materials made from plastic-containing and inorganic bulking agents are used in the area of the front teeth.

If you still feel pains after a week you should by all means consult your dentist again. In that case it can be assumed that your dentist has not placed the filling in your tooth properly.

I had a lower lip piercing done about 3 weeks ago. Now I have the feeling that I have shrinking gums. Is that possible?

Shrinking gums can be caused by the most diverse reasons. In this context one has to be aware of the fact that the gums form the end of the periodontal apparatus on the actual tooth, in other words the tooth neck. Technically speaking, gums are part of the oral mucosa. Gums should provide a protective wall against microorganisms in connection with the tooth enamel and the root element and thus protect the body effectively. In the ideal case they should provide a bacteria-proof seal of the body surface.

It is basically possible that a lower lip piercing exercises pressure on the gums inside the lip or on the edge of the lip. The result could be a regression of gums. Also, the material of the piercing can lead to a reaction which the body does not tolerate. In case of doubt it is advisable to remove the piercing. Of course, the exact diagnosis by a doctor or dentist is advisable.

Which toothbrush is the right one for me?

The toothbrush should be a short head toothbrush. The brush has a bristle area with a length of 25-30 mm. A medium hard toothbrush with bristles which are arranged in a narrow distance is best. At this you have to make sure that the individual bristles dispose of rounded-off ends. Furthermore the toothbrush has to dispose of a solid handle so that it handles well and toothbrushing is made easier. The individual bristles should be made of plastic as it is much easier to keep them clean than natural bristles and as they dispose of a longer durability.

What do I have to bear in mind when buying toothpaste?

The ingredients have to be clearly stated on the package of the toothpaste. In this case it is important how these special ingredients affect the mouth and the teeth. Decalcified places on teeth can occur as a result of various attacks on the tooth. They can be restored with the help of the right ingredients of toothpaste. Natrium fluoride and aminoflouride are very suitable for this purpose. Fluorides remineralise decalcified places and furthermore prevent against caries. They protect and strengthen dental enamel. Further additives in different toothpastes, for example hydroxylapatite and potassium compounds are very soothing in the case of upcoming pains on the teeth and especially exposed tooth necks. The emergence of calculus is prevented by pyrophosphates or zinc compounds.

Which toothpaste do I use for radiant white teeth?

The toothpastes for radiant white teeth offered in different kinds of media as whiteners a rule contain ingredients which contain rough abrasives of most diverse materials. Hereby it is possible to remove discolorations caused by tea, coffee or excessive smoking to a certain extent. However the dental enamel is also affected and attacked by these rough abrasives. Especially for this reason it is not advisable to use whitening toothpastes for a longer period of time or even durably.

What do I have to consider while using dental floss?

Dental floss suits perfectly for cleaning connected crowns, bridges or larger tooth spaces. However when buying dental floss you should make sure that the floss does not have a wax coating. For exactly this wax leads to the effect you want to avoid and get rid of when cleaning with dental floss. Wax gets stuck between the tooth spaces while cleaning and thus provides an ideal breeding ground for bacteria. Therefore always make sure that the dental floss does not have a wax coating and that is has a larger cleaning part for dental cleaning which should moreover be spongy.

Are water picks important for dental care?

The water picks which are available in retail only dispose of a very limited detergence in most cases. Therefore the cleaning effect can only be considered superficial. For this reason water picks are not suitable for the sole cleaning of teeth and dental care. A toothbrush should always be used additionally. However water picks are an excellent replacement and very recommendable for cleaning fixed braces.