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What is "preventive care"?
Preventive care is a modern approach to dentistry. Preventive dentists and hygienists aim to reduce the amount of dental treatment that you need by working together with you (it is a team effort) to maintain a healthy mouth. The hope is to avoid the traditional cycle of fillings and extractions. Preventive dentistry can help you to keep your own teeth for a lifetime.

Is it really possible to prevent dental decay and disease?
The two main causes of tooth loss are decay and gum disease. With modern dental techniques and oral hygiene products it is possible to prevent or at least substantially reduce these diseases in the mouth. Preventive dentistry can benefit anyone who has some of their own teeth – it’s never too late to start.

What is the process?
Your dentist will assess your teeth and gums and devise an individual plan of action for you. Your dentist and hygienist will work together to give you appropriate advice and help to look after your mouth. They will tell you about and demonstrate the best methods of brushing and flossing to remove the build up of dental plaque (see below). They’ll advise you, as necessary, about fluoride products and the effect of diet on oral health. If you follow this advice and continue to have regular check-ups, it should ensure that your mouth stays healthy.

Your dentist and hygienist may also carry out SRP therapy (ie scaling and root planing - also called "periodontal treatment") to remove any build-up of hard tartar (calculus).

If your teeth have already been damaged (by decay, etc), your dentist will devise a treatment plan to repair the damage and will discuss the treatment options with you. In the interests of prevention your dentist may recommend that weakened teeth are repaired with a filling or crown before they break.

The overall aim is to make you "dentally fit" (ie get your mouth healthy) and to keep you that way so that dental problems don’t recur in the future. It isn’t likely that decay or gum disease will be a real problem in a healthy mouth.

What are plaque and tartar (calculus)?
Plaque is an invisible film of bacteria that forms constantly on the teeth and gums. When you eat or drink, the bacteria in the plaque turn the sugar in the food into acid. The acid changes the pH in your mouth, causing minerals in your teeth to dissolve in your saliva and be lost. This weakens the teeth and is what we call "tooth decay". If allowed to continue, the process will lead to cavities so that your teeth need fillings and possibly extraction if the decay has gone too far. Over time, plaque builds up into hard tartar (calculus) that needs to be removed by your dentist and hygienist.

Both plaque and tartar can cause inflammation of your gums. This "gum disease" can eventually lead to the gum line receding, loosening the teeth. In the worst cases, the teeth fall out. Regular removal of the plaque (by you) and of the calculus (by your dentist & hygienist) helps to stop this happening.

What can be done to stop dental disease?
As with most health matters, it is largely up to you and how well you look after yourself:

Brushing and flossing: You need to get rid of any plaque regularly. Your dentist and hygienist will tell you about brushing and flossing, which helps to do this. It is recommended that you brush your teeth twice every day with fluoride toothpaste. The best times are before breakfast and last thing at night. Don’t brush straight after eating – eating weakens the enamel of your teeth (see above) and brushing straight afterwards can cause damage. It is particularly important to brush before bed. Saliva stops your mouth becoming too acidic, reducing the risk of decay, but when you are asleep the amount of saliva you produce is reduced. Brushing before bed helps to protect your teeth overnight.

For the majority of people, the most effective method of tooth cleaning is with an electric toothbrush, twice a day for two minutes. "There is evidence from both short and long term controlled clinical trials that…automated toothbrushes are somewhat superior to manual brushes in plaque removal and gingival inflammation control": Group B Consensus Report, Proceedings of the European Workshop on Mechanical Plaque Control, Berne, Switzerland May 9-12 1998. This is why hygeia recommends electric toothbrushes.

In addition, special miniature interspace or interdental brushes are needed to clean between your teeth every day. Some people also use floss.

Fluoride: Fluoride supplements can help to arrest and even reverse tooth decay. There is fluoride in most toothpaste but there are also fluoride mouth rinses, tablets and drops that may help (NB: South West Water do not add fluoride to any public water supplies in Devon and Cornwall). Your dentist and hygienist will advise you as to which are appropriate for you: be sure to follow their advice (and any instructions on the packaging) carefully.

Diet: When you eat or drink your teeth are exposed to acid that causes decay. The "attack" on your teeth can last for an hour, so if you eat snacks regularly during the day your teeth will be under attack most of the time. Foods that are high in sugar (most foods contain some sugar) can cause most damage. It isn’t so much the amount of sugar you eat that matters – it’s how often - so confine sugary foods to mealtimes or, better still, eat something else like cheese, nuts or vegetables.

Also, drink plain water or milk. Soft drinks can increase the risk of dental problems because most contain sugar or acid or both. Fruit and fruit juices contain acid but this is only a problem if you eat or drink a very large amount. If you snack on fruit, try to eat something alkaline like cheese afterwards. The alkaline food cancels out the acid.

Lots of processed foods have sugar in them but it’s often called sucrose, glucose, fructose, carbohydrate or something else on the label. Remember that "no added sugar" doesn’t mean sugar free – there may have been sugar in the food before it was processed – especially in fruit drinks. Sugary foods aren’t just bad for your teeth – they can contribute to a range of health problems like heart disease and obesity.

Chewing sugar free gum makes your mouth produce more saliva that cancels out the acid in your mouth after eating. There is evidence that it can help prevent tooth decay.

Regular check ups: Even if you follow all our preventive advice, you will still need regular sessions with your dentist and hygienist to monitor the health of your teeth and gums. It is important that your dentist and hygienist check that you are cleaning your teeth and gums properly so that any further problems are prevented but also so that if any decay begins it is detected and treated quickly before it becomes a major problem. To help prevent gum disease, your dentist and hygienist need to use special tools to remove any tartar (calculus) that builds up. Good cleaning, good diet and fluoride all help but aren’t enough on their own to guarantee long-term oral health.

It will also be necessary for your dentist to take routine x-rays at intervals of 6 months to 2 years (depending on how good your oral health is). This is because dental decay can start in places where it can’t be felt or seen until it is very advanced, by which time it may be too late and you may need a filling or root canal treatment. X-rays can show up decay even if it is hidden from view, which helps with prevention of dental problems.

Your dentist might also recommend a preventive treatment called a fissure sealant. It can be placed by either your dentist or hygienist, and it involves coating vulnerable teeth in a special sealant that can both halt decay or stop it before it even starts. It is quick, cheap and easy - and it really works. It reduces the need for fillings in the future and this means you can avoid discomfort and expense.

Once your mouth is really healthy, the frequency of your visits to the dentist may be reduced – from, say 6 months to 9 or 12 month intervals.

Summary
With ongoing co-operation between you, your dentist and hygienist, preventive dentistry can change the traditional pattern of continuing treatment to one of continuing dental health so that your teeth last a lifetime. This is important because your teeth help you to chew and digest food, to pronounce different sounds properly and they give shape to your face. A healthy smile is a great asset.

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