Unless a friend mentions your smelly breath, your attention is often not drawn to gum disease until your teeth begin to loosen and move out of position. These ten tips will help you maintain healthy gums and keep your own teeth for your lifetime.
1. Invest in an electric toothbrush
An electric toothbrush is much more effective at removing sticky plaque and food debris than an ordinary toothbrush. Various companies make them, and I personally like Oral B.
Nowadays there’s a hierarchy of models and prices, but there’s no need to get one with whistles and knobs on it.
Here’s a photo of our entry-model Oral B Vitality…
The brush unit normally sits on the white base unit to keep the battery charged, of course.
Tip: We got ours in Watson’s pharmacy in MidValley MegaMall for only RM99.
As you can see, the brush-head is small, which makes it easy and comfortable to reach all the nooks and crannies in the mouth, including behind the last top tooth each side.
Oral B brushes come with a different coloured clip-on ring to identify your own brush, so the base unit can be shared.
2. Gently does it
When you’re using your e-brush, guide it slowly around each tooth, letting the vibrations and movements of the brush do the work. Be gentle. There’s no need to scrub backwards-and-forwards, or up-and-down with it.
Guide the brush not only over the outside, inside, and biting surfaces, but also around the edges of the gums. Gums like to be cleaned and the massaging effect helps to keep them healthy.
If you see a spot of blood from your gums, don’t panic. Carry on brushing. (See section below about periodontal disease)
3. Brush your tongue
After you’ve finished brushing you teeth and gums, stick your tongue right out and brush any deposits off it, too.
Tip: If you thrust your tongue stiffly out, and scrub it vigorously rather than tickle it, you’ll avoid seeing your lunch again.
4. Wait before brushing
Wait 20 minutes or so after a meal before brushing your teeth. This allows minerals that may have been lost from the surfaces of your teeth while you were chewing, to be replenished from the depot of minerals contained in your saliva.
Brushing and rinsing too soon after eating can result in permanent loss of the minerals and gradual thinning of your tooth enamel.
5. Clean between teeth
Even the very best toothbrush will not reach between your teeth. And if you don’t clean those areas, you’ll still end up with gum disease, no matter how enthusiastically you’ve cleaned everywhere else.
Flossing is good, but not enough on its own. The strand of floss will remove food remnants from tooth surfaces, only where it touches. If a tooth has a natural small depression in its surface the floss will skate over the top of the dip, without cleaning in the hollows.
Floss reaches about 2 mm under the gum edge, which means debris deeper than that remains untouched.
b. Inter-dental brush
In addition to floss, use a small inter-dental brush. These look like miniature bottle brushes on the end of a small handle.
They come in various sizes, so in theory, you can choose one that fits the natural gaps between your teeth. Start with the thinnest one you can find, about 0.8 mm.
Here are the ones from DentalPro we use:
To avoid poking your gums, look in the mirror while using the brush and gently insert it between your teeth.
I find it best to start between the last two teeth on one side of my top jaw and slowly work around to the other side, repeating the process for the lower jaw. You may like to start somewhere else, which doesn’t matter at all, as long as you clean each between-teeth space.
Poking around blindly with sharp toothpicks, or scrubbing too hard with the ‘bottle brush’, can push the pointed bits of gum between your teeth downwards, creating the appearance of little gaps between your teeth.
Don’t let the thought of little gaps stop you cleaning, though. Be gentle and you’ll not create any gaps.
c. Oil pulling
Swishing between your teeth with an edible oil is surprisingly effective at removing debris.
Choose a natural oil like olive oil or coconut oil, instead of an un-natural processed oil like sunflower, corn, or canola. Personally, I prefer the taste of coconut oil rather than olive oil.
If you can manage it, swish for at least 5 minutes then spit out the oil. Needless to say, don’t swallow it.
The germs that cause gum disease live not only in the sticky film we can see on the outside surfaces of teeth. They also cling to the inside surfaces of gum pockets, and float about in the fluids deep within.
This is especially so between teeth, where the gum crevices are very difficult to reach and clean properly.
Even with efficient use of an electric brush, floss, an inter-dental brush, and oil pulling, you’ll probably not remove every scrap of food debris from the depths of a gum pocket, simply because you cannot reach all the way down to the bottom of the pocket.
An irrigating device can reach those neglected areas, though. The Germans call it a ‘Munddusche‘, which literally means ‘mouth shower’, and it’s a good description of what the machine actually does.
It’s basically a small tank to hold water, a pump to pulse the water through flexible tubing and out through a nozzle you can guide around and between your teeth.
The pulse of water hoses food remnants out of gum pockets, and is especially useful for cleaning debris out of the gaps between your teeth.
You’ll be quite amazed what comes out of your mouth into the sink, even though you’ve just finished cleaning your teeth!
Waterpik is probably the best-known make. The company has been at it a long time. Other companies make oral irrigation devices, too, as you’ll see if you search Google or nip along to your local shopping centre.
For an extra germ-killing boost, dissolve a little Himalayan salt or bicarbonate of soda in the tank instead of using just plain warm water.
6. Have your pockets measured regularly
It’s not possible for you – or your dentist – to see how deep the crevices and pockets around your teeth are, by staring at them in a mirror.
Ask your dentist to measure the depth of your gum pockets when you go for your regular check-up. It’s very easy to do, and painless.
A thin probe with a blunt rounded end and graduated markings is slid gently between gum and tooth at various places around each tooth, and the depth of the crevice at the different points noted in your patient file. This is usually called a periodontal charting.
In this simple way, your dentist can find areas where the gum crevice is deeper than the healthy 1-2 mm.
Most times a thorough cleaning by your dentist, followed by good home care, paying particular attention to the deeper areas during your cleaning routines, will enable you to reverse the disease process before it really gets a hold.
My personal maxim is that prevention is far cheaper – and much more comfortable – than the cure. Don’t wait until your gums have lost their attachments to your teeth: get your crevices measured at your next visit to your dentist, and have it done regularly thereafter so you can monitor how effective you are cleaning your teeth and gums between visits to your dentist.
Basically, teeth are held in their sockets by tiny ligaments, one end of which is attached to the surfaces of the roots, and the other end to the bone of the jaws. They’re like little elastic supports that allow a tiny degree of tooth movement when you chew.
Tiny ligaments also hold the gum onto the bone underneath. If you pat your gums dry and look at them in a mirror, you should see a stippled appearance, rather like orange peel.
The stipples are the result of the tiny ligaments pulling the gums tightly onto the underlying jawbone, creating tiny dips in the gum surface.
Apart from an orange-peel appearance, healthy gums are usually pink and may have much darker areas, depending on your cultural background. And they don’t bleed when you clean your mouth.
Gums that are not healthy are usually red and glistening. The tiny ligaments are being destroyed, so there is very little or no stippling left.
An obvious sign of something amiss is if your gums bleed when you brush your teeth.
If left unchecked, the inflammation gets worse, your gums become increasingly red and swollen, bleed at the slightest touch, and your teeth begin to loosen.
Gums suffering from advancing periodontal disease are also quite smelly.
The process of destruction starts with food debris being left in the gum crevices and between teeth. Bacteria move in and set up home in the food deposits, especially if the deposits have sugar in them, which the bacteria love and can easily ferment.
The chemical compounds produced by the fermentation processes attack the gum tissues, the tiny supporting ligaments, and also start destruction of the tooth enamel, leading to cavities.
In the mix also, are cells of the immune system, which mount a defence against the bacteria, and trigger an inflammatory response.
This is just a brief outline of gingivitis (gum inflammation) that leads to periodontal disease (a process that destroys the tissues holding teeth in place) and cavities (dental decay).
Check out the Wikipedia pages on gingivitis, periodontal disease, advanced periodontal disease (trench mouth), and tooth decay for more details of the disease processes and treatments.
7. Grandma’s tip
Ordinary bicarbonate of soda, which you can find in the baking section of your local supermarket, is an effective killer of the germs lurking around teeth and under gums.
That’s because the germs that cause tooth decay and gum disease love an acid environment, and sodium bicarbonate is mildly alkaline.
Last thing at night, we dab or toothbrushes into some bicarb so they get a powder dusting on top of the toothpaste, and then brush with the mixture.
After we’ve finished brushing, we rinse with warm water, swishing the water between our teeth to remove any remaining debris. The slightly alkaline environment helps to reduce the number of disease-producing bacteria while we’re sleeping.
Personally, I avoid alcohol-based mouth-washes, as I believe they kill some bacteria and not others, thereby disrupting the normal healthy balance of bacteria in the mouth and throat.
If you must rinse and gargle, try plain water. Or water with a pinch of Himalayan salt, or bicarbonate of soda in it.
If you’ve read the ingredients label on toothpastes, you’ll know most of them are an astounding mix of chemicals.
Recently, a germ-killer called triclosan has been flagged as a ‘contaminant of increasing concern‘, and fluoride is considered harmful now, too. Heide and I avoid toothpastes containing either of those two chemicals.
Melaleuca’s tooth polish does not have fluoride or triclosan, and contains the natural cleaners papain from papaya, myrrh oil, and tea tree oil.
Does a good job of cleaning teeth and gums, and freshening our breath. Let me know in the comment box below if you want more details of Melaleuca’s tooth polish.
10. Consider nutritional supplements
Most people are aware that modern farming methods, particularly mono-culture, has depleted the arable lands of nutrients.
Vegetables, fruits, and grains grown in depleted soils are therefore low in the nutrients humans need for optimal health.
It’s a good insurance to take supplements to fill dietary gaps, and they’re needed for healthy gums, too. In particular, I would suggest:
- multi-mineral, multi-vitamin
- omega 3
- vitamin C
- vitamin D
Most of the biochemical processes going on in our cells require vitamins and minerals in order for them to work properly.
Taking a good-quality multi every day helps to ensure our cells have the nutrients they need to keep our bodily systems working efficiently. The healthier our cells are, the healthier we are.
Among a myriad of other functions, omega 3 fats from marine animals are very effective balancers of our inflammation systems.
In particular, EPA and DHA are of utmost importance. We can’t make them ourselves, so we have to get them from food.
Oily fish like sardines, mackerel, anchovies, or wild salmon are good choices for omega 3 fats. If you don’t like oily fish, you can get the omega 3’s in supplement form.
Actually, we eat oily fish and take supplements to be sure we’re keeping any inflammation as low as possible.
Dr Barry Sears, of ‘Zone Diet’ fame, is an expert on human biochemistry and how omega 3 and omega 6 fats work in the body. Well worth a Google search.
The basic ‘skeleton’ of bone and gum tissue is collagen. Without collagen the bone and gum around teeth cannot be formed properly, and any pockets you may have won’t heal well.
One of the important building blocks of a collagen molecule is vitamin C.
As everyone knows, vitamin C is water soluble, and is not stored in the body like fat-soluble vitamins are. So, in order to maintain a healthy collagen production throughout the day, vitamin C needs to be supplied regularly.
Centuries ago, sailors survived for months at sea on a diet of dry biscuits and salted meat, neither of which contains vitamin C. They all had horrible skins and toothless grins as a result of scurvy, the name of the medical condition caused by chronic lack of vitamin C (and therefore an inability to make collagen).
Because blood vessels have a collagen structure, advanced scurvy also weakens arteries and veins and sometimes resulted in fatal internal bleeding.
Thanks to an enlightened ship’s surgeon, who gave them limes to eat, British sailors no longer suffered from scurvy – and got the nickname ‘Limeys’.
Vitamin D is made in the skin from cholesterol, using energy from sunlight.
Modern life is mostly indoors, away from the sun. A lack of sun exposure, combined with an unfounded phobia of cholesterol, has resulted in many people suffering from vitamin D deficiency.
The importance of fat-soluble vitamin D in the prevention of inflammation, and in the strength of the immune system, among a myriad of other functions, is the subject of much research.
If you can’t get 10 minutes of unprotected sun exposure every day, take a vitamin D3 supplement, but don’t take too much.
There is a simple blood test to measure how much vitamin D you have floating about in your blood, and from that your doctor can work out how much vitamin D you need to supplement.
Basically, antioxidants can be divided into fat-soluble ones called carotenoids, and water-soluble ones called flavonoids.
They’re the natural compounds that give colour to vegetables like bell peppers, and coloured fruits like berries. Green leafy vegetables have them too, but they’re obscured by the strong green of the chlorophyll.
A daily supply of water-soluble flavonoid antioxidants, and fat-soluble carotenoid antioxidants, work hand-in-hand with vitamin C to help you maintain healthy gums – and a host of other tissues made from collagen, like skin, hair, nails, bones, and blood vessels.
You can get antioxidants by enjoying:
- red, yellow, and purple berries
- red, yellow, and orange fruits like papaya, cling peaches, water melon, citrus, plums
- green leafy vegetables like spinach, cabbage, kale, lettuce, and Asian ones like kai choy, kai lan, pak choi, and many others
- coloured vegetables like pumpkin, tomato, paprikas, beetroot, orange, and purple sweet potato
- spicy foods like garlic, ginger, turmeric, chili, clove, cinnamon, nutmeg, rosemary, thyme, oregano, parsley, to name just a few.
The United States Department of Agriculture website has extensive lists of antioxidant-rich foods. Here’s the link to the list of flavonoid-containing foods.
And this page has the search results for carotenoids.
If you download the lists you can see the amount of antioxidants in different foods. And you’ll also see which foods have hardly any antioxidants in them at all.
Interestingly, you can also find out the nutritional content of any particular food you like to eat, too, at this usda page.
If you’re going to be eating, you might as well eat antioxidant-rich foods.
Oral inflammation is an important disease indicator
Dentists have a unique opportunity to see the start of the inflammatory process and to help their patients understand the potential ramifications of it.
A recent study at the University of Freiburg, Germany, looked at how to improve gum health by reducing generalised inflammation.
In the study, a group of volunteers was given a diet with these features:
- low in overall carbohydrate
- restricted fructose, sugar, sweet drinks, flour, rice, potatoes
- complex carbohydrates from vegetables and fruits were allowed, as long as total carbohydrate intake was not exceeded
- rich in omega-3 fats from fish, flax-seed oil, and fish oil capsules
- restriction of omega-6 fats from processed seed oils like sunflower, corn, soy bean
- restriction of trans fats from fried food, crisps, donuts, and baked goods
- daily intake of vitamin C from two kiwis, or one orange, or one bell pepper, etc
- daily intake of vitamin D from 500 i.u. supplement, 300g avocado, or 15 minutes unprotected in the sunshine
- daily intake of antioxidants from berries, green tea, coffee, etc
- daily intake of fibre from vegetables and fruit but observing reduced overall carbohydrate intake
Here’s the conclusion of the researchers:
‘A diet low in carbohydrates, rich in Omega-3 fatty acids, rich in vitamins C and D, and rich in fibers can significantly reduce gingival and periodontal inflammation.’
If you’d like to read through the details of this very interesting study, here’s the link to it.
Although not part of the study, generalised inflammation is known to be the driver of most of the so-called lifestyle diseases, so whatever you can do to reduce inflammation is a superb investment for your enjoyment of a disease-free life.
Changing to a diet of real, whole food – the cornerstone of the LCHF lifestyle – is the most effective way of putting out the fires of inflammation burning inside you.
If you have any questions about teeth, gums, or general health please jot them in the comment box below and I’ll answer you a.s.a.p.