1. What is periodontosis?

2. What is the difference between dental plaque and dental calculus?

3. Have smoking and stress any effect on the development of periodontal diseases?

4. What complications may occur after professional tooth cleaning?

5. Is tooth elongation always a symptom of a disease?

6. What type of toothbrush should I choose?

7. How frequently should I replace my toothbrush?

8. How should I brush my teeth?

9. Is a toothbrush alone sufficient?

10. What toothpaste should I choose?

11. How can dental plaque be combated, apart from cleaning the teeth?

1. What is periodontosis?

Periodontosis is a widespread disease of the tissues adjacent to the teeth, the periodontium, which consists of the loss of tissues fixing the tooth to the bone, which leads to loosening of the teeth, their migration and protrusion, exposure of tooth roots, and eventually spontaneous tooth loss. The principal cause of periodontosis is the dental plaque, being a reservoir of bacteria attacking the periodontium; however, there are several factors influencing the development and course of the disease, such as:

  • genetic factor;
  • older age;
  • smoking;
  • stress;
  • diabetes;
  • osteoporosis;
  • other systemic diseases.

Periodontosis is a curable disease, but combating it requires patience and the commitment of both the patient and dentist (perfect oral hygiene, self-descipline, regular attendance at check-up visits and observation of the dentist’s recommendations).

2. What is the difference between dental plaque and dental calculus (tartar)?

Dental plaque is a strongly adherent, soft, white to yellowish deposit that occurs on the surface of the teeth, gums and prosthetic appliances. It comprises various organic material (elements of saliva, food debris, dead cells) and a wide range of bacteria. Tartar is a further stage in the development of plaque – mineralised dental plaque, which is formed due to its saturation with minerals contained in the saliva.

3. Have smoking and stress any effect on the development of periodontal diseases?

Numerous studies have undoubtedly confirmed the effect of smoking and stress on the development of periodontal diseases. Smoking increases the build-up of dental deposit, reduces immunity of the body and promotes the growth of harmful bacteria. The effect of stress may consists of hygiene negligence, improper nutrition, frequent smoking and decreased immunity, which are commonly associated with stress.

4. What complications may occur after professional tooth cleaning?

In general, the only complication that may occur after tooth cleaning with a toothbrush, as well as by means of scaling or sandblasting, is hypersensitivity of the teeth to temperature changes. An excellent remedy for the problem is the application of a fluoride varnish, which relieves it instantly and permanently.

5. Is tooth elongation always a symptom of disease?

Tooth “elongation” may not necessarily indicate disease, as there is a phenomenon called senile atrophy of the periodontium. The process begins at 25-30 years of age and develops up to the end of life. It consists of a slow migration of the connection between the tooth and adjacent tissues in the direction of the end of the tooth root. The tooth crown elongates with associated lowering of the gum level. The process is in general painless, but unavoidable.

6. What type of toothbrush should I choose?

The selection of an appropriate toothbrush is of significant importance to oral hygiene. As there is a huge diversity of toothbrushes available, you may have some problem in choosing the most suitable. The most important is that the size and bristle hardness of the toothbrush is matched individually to the patient’s needs. The toothbrush should not be too big and should have a long thin neck, allowing access to molar teeth. Usually medium or medium-hard toothbrushes with multiple bunches, made of synthetic bristle of gently polished and rounded tips, are recommended. In the case of any periodontal disease, a soft toothbrush with a flexible neck that reduces pressure on the gums should be used. There are various versions of bristle pattern. The bristle may be of various lengths or serrated to improve cleansing of dental gaps (longer tips easily penetrate between the teeth) and to massage the gums.

7. How frequently should I replace my toothbrush?

In general your toothbrush should be replaced every two months. After that period the bristles stiffen and irritate gums. Some toothbrushes have a wear indicator in the form of a bristle bunch in a different colour, which discolours as the toothbrush wears. To function properly, the toothbrush needs to be taken care of. After brushing your teeth, the toothbrush should be thoroughly rinsed and stored in a place where it can dry. You should also pay attention to whether the bristle in your toothbrush is crushed, if it is, this indicates that you press your toothbrush against your teeth too firmly.

8. How should I brush my teeth?

In general, each method of brushing the teeth is good provided that it is efficient and not harmful to teeth and gums. Ideally, the tooth brushing technique should be chosen individually by a dentist or hygienist depending on the patient’s needs, the condition of his or her dentition and gums and dexterity. Regular tooth brushing should last at least three minutes. The minimum frequency of the procedure should be twice a day: in the morning after breakfast and in the evening after the last meal. However, in some circumstances, e.g. in patients wearing permanent braces, teeth should be brushed after each meal.

9. Is a toothbrush alone sufficient?

Efficient tooth care requires that all their surfaces (facial, lingual, masticatory and interproximal ones) be cleaned. However, only the first three of them are accessible to a toothbrush; thus, a toothbrush alone is not sufficient for maintaining appropriate oral hygiene. You should use additional tools:

  • Dental floss – a bunch of waxed silk threads formed into a band, used for cleaning interdental spaces where teeth are close together;
  • Dental toothpicks made of soft, non-splintering wood and saturated with fluorine compound are designed for people with spaced or missed teeth;
  • Interdental toothbrush – a bristle spiral used similarly to a toothpick, and also for maintaining oral hygiene in people with permanent braces;
  • irygator – urz?dzenie dzia?aj?ce na zasadzie bicza wodnego, strumie? p?ynu oczyszcza przestrzenie mi?dzyz?bowe i kieszonki dzi?s?owe, masuje dzi?s?a;
  • Dental irrigator – a device producing a water stream that cleans interdental spaces and gingival pouches, as well as massaging gums.

A single bunch toothbrush used for cleaning difficult to reach back teeth.

10. What toothpaste should I choose?

The selection of toothpaste is not as important as the selection of the toothbrush; however, the use of an appropriate toothpaste may improve the efficiency of brushing. Most of the toothpastes marketed conform to basic requirements and contain clinically proven substances, such as polishing agents (help in the removal of dental plaque and deposit), foaming agents, fluorine compounds (sodium fluoride, calcium fluoride or amine fluorides). In particular circumstances you may choose a toothpaste containing appropriate additional ingredients:

  • protective toothpastes containing fluorine;
  • herbal toothpastes containing herbal extracts that relieve the gums;
  • whitening toothpastes that remove food-related discolorations (caused by tea, coffee, smoking and red wine);
  • multi-action toothpastes, that include the above-mentioned properties.

11. How can dental plaque be combated, apart from cleaning the teeth?

A very efficient method of combating dental plaque, which assists but does not replace mechanical tooth cleaning, is the use of a disinfecting mouthwash. In particular, chlorhexidine-based mouthwashes (Corsodyl, Eludril) are recommended, as the substance efficiently inhibits the build-up of the plaque and kills bacteria. However, note that the period of use of such mouthwashes should be limited up to two weeks, to prevent a side effect, i.e. discoloration of the teeth, dental fillings and tongue. Other recommended products are fluorine mouthwashes.