A Guide to Dental Hygiene

A few years back, while giving an interview a dentist told me that even educated people did not know how to take care of their teeth. He had given me an instance of one of his patients who had done MBA. On the insistence of the doctor, who had examined his teeth, the patient had brought his tooth brush, which had completely flared. There was no point in using that brush at all. I happen to remember this conversation with the doctor and thought it only right to ask some expert to shed light on some basic information on taking care of teeth, which are very important for digestion. A Journalist Reveals contacted Dr. Arjun Bedi for his opinion.

Q. First tell us in any which ways you have saved people’s teeth in your career. You can share a couple of case studies, which you feel are different.
A. Every case in dental practitioner comes with a new difficulty. Two of the cases which were really challenging for me to operate are as follows:
Case 1:
Brief about the problem: Patient was having severe generalised bone loss with inflamed gums due to which he was having Grade 1 mobility in maximum of his teeth and even Grade 3 mobility in approximately 8-9 teeth. No local cause identified at the time of inspection. We did few tests and x rays to find out the aetiology behind that condition as oral hygiene was fine. After few tests, we came to know that he was diabetic of which he was not aware of.
Age of Patient: 25 Years
Major Problems: Problem in chewing food, weight loss.
Treatments Given:
a) Removed 8 teeth as the bone was completely depleted beneath them and the infection was increasing.
b) Removed Grade 3 mobile teeth followed by scaling and curettage.
c) Did flap surgery for each quadrant (the mouth is divided into 4 parts by dentists to work conveniently) to raise the gums level upwards and artificial bone grafts were placed to improve the conditions and formation of bones.
d) After approximately 6 months, when we saw results which helped him that generalised mobility decreased at a huge rate, gum level raised, intact gums formed, no pockets left and bone formation started.
e) Replaced his missing teeth with the help of dental implants and bridges as applicable.
f) Prescribed a healthy diet to follow in daily routine.
Total Duration: Complete treatment took over 1year to achieve the best possible results and it’s been 2 years now after treatment he is doing very well and became regular with his dental check-ups.
Case 2:
Nowadays, children at a very early age, say, 1.5-2 years have mutilated milky teeth known as nursing bottle carries. In this condition, teeth are completely decayed and appear almost brown black broken teeth. Most of us don’t bother much about baby’s oral hygiene maintenance and even are unaware that children should use a toothpaste different from the adults.
Brief about the Problem: Girl with upfront 4 teeth completely decayed and pus discharging from gums around those teeth, heavily infected condition. Girl stopped smiling as she became a quiet child due to her lost teeth.
Age: 4 years
Treatment given:
a) We took 2-3 sessions to make the child familiar with the equipment and machines. Also few medications were given so as to reduce the severity of the infected area.
b) After 3 sessions, we treated her step by step and gave her temporary anterior teeth crowns just to make her look normal.
c) Pus drainage.
d) Pulpectomy of all 4 teeth.
e) Temporary crowns with post and core build up.
f) Temporary crowns lasted for 1.5 years which was adequate enough.
g) After 6-7 months, they got replaced with permanent teeth at the age of 6 years.
Total Duration: Almost 2 years
Q. What is the difference between food particles lodging in cavities, plaque formation and tartar formation?
A. If a dental cavity is present in the mouth then it is common that whatever a person eats gets accumulated and lodged there in the mouth cavity space which leads to severity of cavities and leads to food particles lodging. Dental cavities occurs due to various reasons like improper or irregular brushing, bad eating habits i.e. faulty oral hygiene maintenance.
Dental plaque is a mass of bacteria that grows on surfaces within the mouth. It appears as a white or pale yellow soft deposits “slime layer” which is commonly formed between teeth and cervical margins of teeth. It can give rise to dental caries, bad breath and bleeding gums etc. If it is not removed regularly with the help of brush or flossing then it may accumulate and get harden to form calculus which cannot be removed by toothbrush and can only be removed with the help of ultra-sonic scaler in dental clinics.
Tartar or dental calculus is a form of hardened dental plaque. Tartar may cause adverse effects on health of teeth and gums. Along with the causes of plaque, it may cause bleeding gums, chronically inflamed gingiva.

Q. Let’s come to some basics. When is the right time to dump a tooth brush and get a new one?
A. As every element on earth has its own functional life span so does a toothbrush. It also has its limited functional life. On an average after every 6-8 weeks i.e. approximately after 2 months a toothbrush should be changed. A brush should be changed when its bristles get flared but should not be flared before 4-6 weeks. And in case if it happens, that is a sign of wrong brushing technique which may harm you in various ways.
Q. What is the normal routine of taking care of teeth? Is brushing and flossing enough? Do we have to use mouthwash also?
A. Follow simple ways to take of your teeth:
• Brushing for approximately 2 minutes with gentle pressure and correct technique twice a day is mandatory for all. Specially brushing at night plays more important role in oral hygiene maintenance and in prevention of dental caries.
• Rinse your mouth after every meal.
• Warm saline rinse once or twice a day is good for oral health especially for gums.
• Avoid unusual sticky and sweet food too frequently in your diet.
• Intake of citrus fruits having Vit C is good for intra-oral musculature.
• Fibrous food have self cleansing effect on teeth.
Brushing and flossing is the basic key to maintain good oral hygiene. If one can follow all this in routine then many dental problems can be prevented.
There are Fluoride and Anti-septic mouthwashs available in the market but they can only be used after a dentist prescription and recommendation.
Q. Brushing twice daily is the best, this is a known fact. How many times should we floss and use mouthwash every day?
A. Brushing twice daily is best but for how much time and its technique plays more important role.
Floss depends upon every individual’s dentition. It should be done once daily during night. It will help you clean the inter-dental spaces present in between the teeth.
Mouthwashes are of various types. All are medicated. Every major component of the mouthwashes are indicated for some specific conditions so it should be used by with the dentist’s advice.
Q. I read in an article recently on the net that if we floss in the wrong way our gums can get injured. So what is the right way to floss?
A. Yes, it is a known fact that flossing in wrong direction can harm your gums. Basically, we should use it gently in up and down with a to and fro motion. You should not push it deeper into the gums to prevent any gum injury like laceration or bleeding may occur. It is used to remove the food lodgement in inter-dental spaces i.e. spaces in between every two adjacent teeth.
Q. We find this (pic) kind of floss cum tooth pick in the market in India as well today. What do you think about this product? Is it good enough for flossing?

A. Yes, this product is good for flossing. It is available in market by various brands like Oral B, ICPA, STIM, etc. They are good to use but depending upon its availability in market. In this picture, the floss is available with handle which is more comfortable to use.
Q. I have heard that we should change a body soap brand often because the micro-organisms will otherwise become resistant to it. Is the same true about the toothpaste and mouthwash brands? If yes then how often should we change the same?
A. Yes, it is always beneficial to change your toothpaste and mouthwash brands after every 6-7 months to avoid any resistance of micro-organisms intra-orally. But one should not use medicated toothpaste without the dentist’s advice.
Mouthwashes are not meant to be used for a long period of time because it may harm your teeth and gums. Few mouthwashes produce stains or yellowness over your teeth after prolonged use.
Maximum people are still unaware about the functions and indications of each specific tooth brush, medicated tooth pastes and mouthwashes.
About Dr. Arjun Bedi: The doctor is a young dental surgeon based out of Rohini, Delhi. Dr. Bedi holds up more than four years of experience in dental industry. He has completed his Bachelor’s in Dental Surgery from C.C.S University, Meerut. At such an early age, Dr. Bedi is running his own dental clinic by the name of Dr. Bedi’s Dent ‘O’ Care in Rohini, Delhi along with practicing in few other dental setups.