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28
Should You Rinse Your Mouth After Brushing Your Teeth?
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Are you supposed to rinse after brushing your teeth?  That’s a common question that people have about brushing.

At the Maine Dental Association meeting last year, a presenter was talking about the benefits of fluoride and asked his dental audience the following question:

“Does anybody here actually rinse out with water after brushing so that they rinse away the tooth-protecting fluoride?!?”

He said it in a tone that let you know that you would feel like a complete idiot if you raised your hand.  Although I do rinse out with water, I didn’t dare raise my hand!  From my vantage point, it looked like only two or three hands were raised out of the hundreds of dentists that were present.

Does that one dentist’s opinion mean that everyone should stop rinsing out with water after they brush their teeth?  No.  In fact, there are valid arguments on both sides of this issue.

Before I discuss whether or not you should rinse out with water after brushing your teeth, let’s take a look at both sides of the argument and some supporting studies.

The Reason Behind Not Rinsing with Water After You Brush Your Teeth

Should You Rinse After Brushing?As I pointed out above, if you rinse with water after brushing your teeth, then you are rinsing away the benefits that fluoride provides to your teeth.

Since most people only brush for somewhere around a minute, the fluoridated toothpaste doesn’t spend much time in contact with the teeth.  By not rinsing out after you’re done brushing, you give the fluoride more time to protect your teeth, which could translate to healthier teeth with fewer cavities.

This theory has been backed by research.

This study concluded that:

…there might be a relation between the caries activity and the retention of fluoride after toothbrushing, and that mouthrinsing with water after the brushing should be reduced to a minimum in order to get the maximum beneficial effect of the daily fluoride exposure through the dentifrice.

Even rinsing with a tiny amount of water and making a mouthwash out of the toothpaste left in your mout after brushing has been shown to be effective.  The textbook Dental Caries by Fejerskov states that “Clinical studies in which some of the participants have been taught to use a small volume of water and the toothpaste slurry left after brushing as a ‘mouthrinse’ have demonstrated that further reductions in caries are achievable. A 26% reduction in the incidence of approximal caries has been claimed for this method.”

Approximal caries is just a fancy way of saying “cavities between two teeth” (but hey, saying it like that wouldn’t have sounded as intelligent!)

It would appear from these academic sources that not rinsing or minimal rinsing with water after brushing can help prevent cavities from occurring.

The Reason Behind Rinsing with Water After You Brush Your Teeth

Many people who rinse after brushing say things like:

– Swallowing toothpaste will irritate your stomach.

– You need to rinse after brushing so you an rinse away all of the bacteria that you just brushed off of your teeth.

If you’re like me, you’ve been rinsing out with water after you brush for your whole life and you don’t feel like it’s really affected your life for the worse.  For example, Yahoo Answers user Just Me, recently stated the following about her brushing habits:

i always rinse after brushing…and not 2 brag…but i have really nice teeth!! idk good luck!! 🙂

If you’re never had a problem with your teeth and you rinse after brushing, is there really a reason to change what you’re doing?  Probably not, especially when you take a look at studies that contradict the studies above.

This study consisted of a clinical trial that lasted for three years and included 407 children.  It emphatically states:

Previous studies have indicated that rinsing the mouth with a beaker of water after toothbrushing may compromise the caries reducing effect of fluoride toothpaste.

It is concluded that post-brushing rinsing with water, under the conditions of this study, does not significantly affect the caries reducing effect of a fluoride toothpaste.

It looks like there is some scientific disagreement on whether or not rinsing with water after brushing really does improve oral health.

Should You Rinse Out With Water After Brushing Your Teeth?

I think the reason that there is some disagreement on this subject is because not rinsing after brushing appears to be only beneficial if you are at a high risk of getting cavities.

How at risk are you for cavities?  Here’s 25 things that make you more likely to get cavities.

Personally, I rinse out after brushing my teeth.  From time-to-time, I will use a fluoride mouth wash or simply put some new toothpaste into my mouth and use that as a mouth wash.  After brushing, I spit and then rinse.

If at your most recent dental checkup you were informed that you have some incipient lesions (small cavities that are just starting), then perhaps not rinsing your mouth out after you brush could help heal those small cavities and get you a clean bill of oral health at your next visit.

Do you have any questions regarding whether or not you should rinse out after brushing?  I’d love to hear what you have to say — simply leave a comment below.  Thanks for reading!

0
Five Ways to Get Better Teeth
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Many people think they’re taking great care of their teeth. They brush and floss, but they still end up having problems.

I wrote this post with those people in mind: the ones that want to have better, healthier teeth, but don’t know quite where to start. Even if you know that you’ll end up needing crowns or veneers on your teeth, it’s important to have excellent oral hygiene so that your future dental work will last a long time.

Here’s five simple things you can do to get better teeth.

How to Get Better Teeth: 5 Things You Can Do Today

How to Get Better Teeth1 – Floss

Many people don’t want to floss because they think it’s too hard. Before I talk any more about flossing, go ahead and read the following quote from Kevin McCallister in Home Alone:

I took a shower washing every body part with actual soap; including all my major crevices; including inbetween my toes and in my belly button, which I never did before but sort of enjoyed.

Neglecting to floss is like simply taking a shower without cleaning all of your major crevices!

Learn more about the right way to floss by reading these 10 flossing mistakes.

2 – Brush for At Least Two Minutes

How long do you spend brushing your teeth every day? A lot of people only brush for 30 seconds or so.  By brushing for two minutes, you will allow the fluoride in your toothpaste to spend more time providing your teeth with its many benefits.

When you brush, do you remember to brush all sides of your teeth?

3 – Only Eat Sugar with Your Meals

Every time you eat, the pH in your mouth drops to a level where it can hurt your teeth. You can see a graph of this process in the article What Happens in Your Mouth Every Time You Eat or Drink.

The more times you eat in a day, the more times your teeth get hurt.  By eating your sugary snacks with a meal rather than on their own, you will be reducing the number of times that your teeth come under attack.

You can try substituting fruit or vegetables for a sugary snack or simply have a great-tasting chewing gum.

4 – Don’t Sweeten Your Coffee & Tea With Sugar

Try sweetening your drinks with xylitol or an artificial sweetener.  The bacteria in your mouth would love to get their hands on some sugar so they can hurt your teeth.  If you starve them, you’ll have better teeth!

Learn more about what xylitol is and how it protects your teeth.

5 – Don’t Drink Soda Pop In Between Meals

The main theme of the last three items on this list is that sugar is an enemy to your teeth.  Soda pop combines sugar and acid to wreak havoc on your teeth.

If you’re thirsty between meals, water and milk are good choices, and I’m not the only one saying that: the textbook Dental Caries by Fejerskov agrees with me.  It says, “Water and milk are safe drinks between meals.”

Ideally, you would cut soda pop out of your diet, but who wants to do that?!  If you absolutely must have your sugary, carbonated fix, check out these guidelines on how to drink soda pop and keep your teeth happy.

Conclusion

Hopefully you can try at least one of these five suggestions so that you can be on your way to having better teeth.

Do you have any questions or comments about how to get great teeth?  I’d love to hear what you have to say in the comments section below.  Thanks for reading!

19
More Likely to Get Cavities
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Many people come into the dental school and tell us things like, “I just have bad teeth” and “My parents and grandparents all had soft teeth – and my teeth are soft too, so I get lots of cavities.”

Cavity In a ToothWhile it may be true that some people do have teeth that are more susceptible to cavities, there is usually another reason that these people have cavities.

As dentists, we can remove the tooth decay and make your tooth look shiny and new again, but we can’t prevent you from getting cavities in the future – that’s up to you.

The tooth pictured probably doesn’t look too glamorous.  Since most people don’t see what their dentist sees, I thought I’d put this picture up so you can see what an extensive cavity looks like.

If you’ve had a lot of cavities and want to know why, the following list just might give you some answers!

25 Risk Factors for Getting Cavities

1 – Cavities

I listed cavities first because if you’ve had cavities in the past, that’s usually one of the best predictors of whether or not you’ll get cavities in the future.  It makes sense that if you already have lots of cavities, that you’re more likely to keep getting cavities until you make some changes.

Also, if you have white spots on some of your teeth that have recently appeared, that could be the sign of a beginning cavity, which also puts you at risk for getting a cavity.

2 – Having Lots of Cavity-Causing Bacteria

There are millions of little bacteria in your mouth that eat your food every time you eat.  They make acid and smear it on your teeth.  The acid eats away at your tooth until a cavity develops.

Needless to say, if you have an abundant amount of cavity-causing bacteria in your mouth, you’re at a high risk for getting a cavity.

3 – Eating Sugar Frequently

If you eat sugar a lot, you give the bacteria exactly what it wants to eat: fermentable carbohydrates.  The more often you feed them, the more cavity-causing acid that they will produce.

Learn more about What Happens In Your Mouth Every Time You Eat or Drink.

4 – Bad Crowns and/or Fillings

If you have a poor quality filling or crown in your mouth, it may actually cause you to get a cavity by allowing plaque to hang out where you can’t reach it with routine brushing and flossing.

5 – Bad Oral Hygiene

If you don’t brush away the bacteria often, you will allow them to grow and destroy your teeth.

6 – High Acidic Foods Intake

Eating or drinking acidic foods can eat away at the hard, outer layer of your teeth known as the enamel.  Since the enamel is the layer of your teeth that is most resistant to cavities, if you wear it down, you will be putting yourself at risk for cavities.

Learn more about acidic drinks in the article,  Nine Drinks that Can Dissolve Your Teeth.

Another source of acid in your mouth is gastric reflux or even vomiting intentionally, which occurs in those with bulimia.

7 – Not Getting Enough Fluoride

Fluoride makes the enamel of your teeth stronger.  You can get it by brushing your teeth longer or using a fluoride mouthwash.

Curious about how fluoride works?  Learn about the three ways fluoride protects your teeth.

8 – Nursing Too Long (Bottle and Breast)

If you weren’t weaned from the breast or bottle until you were a toddler, this could have put you at a higher risk for getting cavities.  Most research points to the bottle, but I have heard conflicting reports regarding prolonged breastfeeding.

9 – Cavities Under Fillings

Getting a cavity under a filling means that there was a problem with the filling (age, done incorrectly, fractured, etc.) or that you weren’t taking very good care of the filling.  Either way, if you get a cavity under a filling, it puts  you at high risk for getting cavities in other teeth.

10 – Bad Family Dental Health

If your family has bad dental health, chances are that you will as well.  This could be related to lack of oral hygiene being taught in the home, genetic abnormalities in the teeth, or high numbers of the bad bacteria in your mouth.

11 – Exposed Root Surfaces

Receding gums will expose the root of the tooth, which does not have a protective enamel covering.  Consequently, the dentin that makes up the roots of your teeth dissolves at a higher pH than the enamel.  That means that weak acids that wouldn’t affect your enamel can eat away at the roots of your teeth and cause a cavity.

12 – Defect In Your Enamel

If you have a defect in your enamel, it could make you more susceptible to cavities.  Some examples might be enamel that didn’t form correctly, congenital defects like amelogenesis imperfecta, or a defect in enamel formation that can happen to a permanent tooth when its corresponding baby tooth gets knocked out.

13 – Having a Disability

If you have a disability, it can be more difficult for you to take care of your teeth.  Also, many caregivers may not pay very much attention to the oral hygiene of those under their care.

14 – Dry Mouth

When you don’t have enough saliva in your mouth, it is known as dry mouth or xerostomia.  Saliva helps your teeth in several ways.  If you suffer from dry mouth, your dentist may be able to help by prescribing you medication to help increase your salivary flow.

Are you taking one of these 348 medications that cause dry mouth?

15 – Genetic Abnormality of Your Teeth

The anatomy of a tooth can vary greatly.  Some people have deeper grooves in their biting surface that are hard to clean.  Some people’s enamel may not completely cover the whole tooth.  This can create pockets where bacteria can hide out and cause cavities.

There are many other genetic abnormalities that can affect the teeth, such as localized microdontia, which can make some teeth smaller than others and possibly make them harder to clean.

16 – Having Lots of Large Fillings

Many large fillings can put you at risk for developing cavities.  Having lots of large fillings increases the amount of tooth:filling interfaces that are present in your mouth.  If bacteria get in between the filling and the tooth, they can be nearly impossible to clean out and can cause cavities.

17 – Chemotherapy and Radiation Treatment

Having chemotherapy or radiation treatment in the head and neck area can reduce salivary flow and cause other oral problems which increase the risk of getting a cavity.

18 – Eating Disorders

Eating disorders can increase the risk of a cavity in a couple of ways.  Those with eating disorders tend to not have a very balanced diet, which may contribute to cavities.  Also, bulimics bathe their teeth in acid each time they purge.  This wears away the tough enamel surface of the tooth which makes the tooth mores susceptible to cavities.

19 – Drug and/or Alcohol Abuse

Those that abuse drugs and/or alcohol put themselves at a greater risk for developing cavities.

Take a look at what drug abuse can do to your teeth.

20 – Irregular Dental Care

By not going to the dentist regularly, you avoid learning about the condition of your mouth.  The dentist can point out small problems before they turn into cavities.  By avoiding your checkups, you lose out on the opportunity to take care of small problems before they become big.

21 – Not Knowing What Plaque Is

Many people don’t know what plaque is.  If you don’t know what’s happening inside of your mouth, you probably won’t do anything about it.

Avoid this risk factor by reading: What Every Human Needs to Know About Plaque and How Plaque Disclosing Tablets Can Help You Brush Better.

22 – Not Knowing How to Remove Plaque

Even if you know what plaque is, if you’re not removing it then you will probably end up getting some cavities.

Learn about these 12 Weapons of Plaque Destruction.

23 – Being Poor

People with a lower socioeconomic status tend to get more tooth decay.  There are exceptions to this rule, but this is one of the main reasons that so many states provide free dental care to low-income children.  Unfortunately, these programs haven’t eliminated the gap in dental health between the rich and the poor, and many poor parents simply don’t find the time to take their kids to the dentist.

Interestingly, our computer software at my dental school tells us to ask each patient if they have a “low socioeconomic status.”  It can be an awkward question, and almost everyone skips over it.

24 – Dental Anxiety

If you have a dental phobia, chances are that you will neglect getting dental work done.  If you want to try to understand your dental phobia, take a look at these 15 common reasons people are scared of the dentist.

25 – Braces

Although braces can straighten your teeth and make them look great, they do increase the risk of getting cavities.  Braces make it harder to brush your teeth and make it nearly impossible to floss.  In order to floss with braces, you have to use a floss threader to get under the wire – I know I didn’t do that when I was a teenager!

I hope you enjoyed the list and it helped you pinpoint the cause(s) of your cavities.  I compiled the above list from my own experience as well as information from the following textbooks:

Do You Have a Lot of Cavities?

Did anything on this list ring a bell for you?  Although I tried to include everything I could think of that would cause cavities, I may have missed something.  I’d love to hear about what you think is causing your cavities whether it’s on the list or not.  Feel free to leave a comment in the comments section below.

Thanks for reading!

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Should You Floss Before or After Brushing?
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One night, shortly after my wife and I got married, we were getting ready for bed and she noticed that I brush my teeth after I floss.  She had always brushed before flossing. We probably would’ve discussed this fascinating subject in more detail if we hadn’t been so tired…

Do You Floss Before or After Brushing?Interestingly, we had both been brushing and flossing in a different order for twenty-some years of our lives before we met each other and we both had pretty good results to show for it.

My thought process goes like this: it wouldn’t make sense to wash your hands, and then pick out all of the stuff under your nails because that would just get the dirt all over your freshly-washed hands.  So why would anyone in their right mind floss after brushing?

Well, here’s why: Those who advocate flossing after brushing state that when you floss first, you don’t brush the plaque away, you simply push it back into the spaces between your teeth where it can grow and cause cavities.

So who’s right?  Should you floss before brushing your teeth?  Or should you brush your teeth before flossing?

Should You Floss Before or After Brushing?

After plowing through several dental hygiene-related textbooks, I couldn’t find any information on whether you should brush or floss first.

After reading online, I noticed that there are people who are very passionate about this subject — as this forum post demonstrates!

I think the reason that there’s not really any concrete recommendations about whether you should brush or floss first is because it really doesn’t matter whether you brush or floss first.

The main reason we need to brush and floss is because every time we eat or drink fermentable carbohydrates, the little bugs that live in our mouth grow, reproduce, and build homes on our teeth.  Their waste products are what harm our teeth.

Learn more about plaque by reading What Every Human Needs to Know About Plaque.

The best way to combat plaque is to disrupt it, or destroy the intricate colony that it has built on your teeth.  When the bugs are floating around in your mouth, they don’t harm your teeth.  They only harm your teeth when they have attached to your teeth and grown into a layer on top of your teeth.  By brushing and flossing, you remove the bugs from your teeth temporarily.  They will re-attach, but then you can simply brush and floss again to disrupt their little home once again and put them in their place.

As long as you are disrupting the bacteria that live between your teeth regularly, they won’t be able to cause cavities. When you floss, you scrape them away from their home and it will take them a some time to regroup, get organized, and start growing again between your teeth.

Does It Matter If You Brush or Floss First?

It really doesn’t matter!  In fact, you don’t even need to brush and floss at the same time.  As long as you’re eating good foods, brushing twice a day, flossing once per day, and avoiding these ten common flossing mistakes, you should be fine.

Want more tips on how to combat the plaque in your mouth?  Read about these Top 12 Weapons of Plaque Destruction!

Do you have any questions, comments, or thoughts on whether you should brush or floss first?  In what order do you brush and floss?  Feel free to leave your opinions below in the comments section.  Thanks for reading!

10
Weapons of Plaque Destruction
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About five years ago, I was sitting in the first lecture of an Introduction to Dentistry class.  The professor, a local dentist, was talking about how plaque forms on our teeth and how it causes our teeth to decay.  Something clicked inside of me that day, and that lecture helped solidify my desire to become a dentist.

Weapons of Plaque DestructionI summarized that lecture in my first post ever on Oral Answers back in January 2010 entitled What Every Human Needs to Know About Plaque. If you haven’t read it and you’re curious about how tooth decay begins, you might want to take a look at it.

Because plaque can eventually cause you to lose your teeth, it is important to remove it and try to minimize its formation.  Here are 12 easy ways you can do that: The Top 12 Weapons of Plaque Destruction.

Top 12 Weapons of Plaque Destruction

Weapon #1 – Brushing Your Teeth

Brushing your teeth not only removes plaque, but some toothpastes also contain antimicrobials, such as Triclosan in Colgate Total. Toothpaste also contains abrasives which can help mechanically remove plaque from your teeth.

To find out what else is in toothpaste, read The 10 Main Ingredients In Your Toothpaste.

Weapon #2 – Flossing

Flossing helps remove plaque that is stuck between your teeth.  Cavities between teeth are so common that the two fillings required by the most popular dental board exam both have to include a cavity that is between two teeth.

Think you could use some tips on flossing?  Start by reviewing these 10 common flossing mistakes.

Weapon #3 – Fluoride

Fluoride has three different ways that it makes our teeth stronger and more resistant to the bad effects of plaque.  Fluoride is the only active ingredient in most toothpastes sold in the United States.  Fluoride is also added to many municipal water systems.  There is a strong, ongoing debate about whether or not it’s okay to add fluoride to everyone’s water.

Weapon #4 – Xylitol

Xylitol is a sugar alcohol that somehow helps fight plaque.  Xylitol is found in many chewing gums and you can also buy it in solid form from many health food stores or from Amazon.  Then you can use it to sweeten drinks like tea and coffee.

To learn more about this valuable plaque-fighting sugar alcohol read the article, Xylitol: What It Is and How It Protects Your Teeth.

Weapon #5 – Anti-Plaque Mouthwash

Many plaque-fighting mouthwashes contain ingredients such as cetylpyridinum chloride (CPC) which can kill the bacteria responsible for causing cavities.

Weapon #6 – Water

Drinking water or rinsing your mouth out with water after eating sugary foods can help wash away food that sticks around in your mouth. Since the bacteria live off the food you eat, you will be starving them by rinsing out your mouth.

Weapon #7 – Saliva

Saliva helps protect the teeth in many ways.  You can read about the six main ways that your spit protects your teeth in the post, How Saliva Protects Your Teeth.

If you suffer from dry mouth, you may be losing the war against plaque in your mouth.  Learn about six causes of dry mouth and 348 medications that can cause dry mouth.

Weapon #8 – Plaque Disclosing Tablets

If you don’t know where the plaque is, it’s hard to destroy it.  Plaque disclosing tablets work by coloring the plaque on your teeth so that you can make sure you’re removing it all when you brush and floss.

To learn more about plaque disclosing tablets, including the best places to buy them, read How Plaque Disclosing Tablets Can Help You Brush Better.

Weapon #9 – Chewing Gum

Chewing stimulates your salivary glands.  Some types of chewing gum are better than others.  Make sure you’re chewing the right type of gum for your oral health by reading about which of the three types of chewing gum is best for your teeth.

Weapon #10 – Your Tongue

Your tongue is a big weapon of plaque destruction.  Your tongue (with the help of your saliva – see weapon #7) can help clean sugary food off of your teeth so that you swallow it rather than letting it sit on your teeth and feed the plaque.

Weapon #11 – Certain Foods

Certain foods can actually help your teeth repair themselves after you eat a sugary snack.  Cheese contains phosphates and calcium that your saliva can utilize to help remineralize your teeth after they get “attacked” by the acid from plaque.  To appreciate this effect, you might want to read about what happens in your mouth every time you eat or drink.

Not sure what to eat for healthy teeth?  Learn about 16 delicious foods that you and your teeth will enjoy.

Weapon #12 – Sealants

Sealants are mainly used on children’s permanent molars.  Sealants are a strong plastic material that dentists can flow into the small grooves on the biting surfaces of your children’s teeth.  By covering up these grooves, you remove a nice, hard to brush place where plaque loves to hide.  Sealants are very effective at preventing tooth decay on the biting surface of molar teeth.

Conclusion

Hopefully this article gave you some good ideas about how you can help win the war against plaque in your mouth and help your teeth to live a long life.

Do you have any questions or anything you’d like to say about oral health or hygiene?  I’d love to hear your comments below, and I’ll try to personally respond to each one.  Thanks for reading!

3
Brush All Sides of Your Teeth
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Not long ago, I did a cleaning on one of my patients and found something very similar to what I find in most of my patients — that this particular patient takes a lot better care of the side of the teeth that he can see in the mirror than the back (tongue) side of the teeth.

Brushing TeethMaybe you do the same thing.  Many years ago, some researchers spied on 85 adolescents brushing their teeth.  They found that people spent the most time brushing the sides of the teeth that you can see, a moderate amount of time brushing the biting surfaces, and the least amount of time brushing the tongue-side of the teeth!  Interestingly, the kids also spent more time brushing the lower teeth than the upper teeth.

Another study videotaped tooth brushing behavior in people aged 5 to 22 and found that less than 10% of the time was spent brushing the tongue-side of the teeth.

Why Do We Not Brush the Tongue Sides of Our Teeth?

I think we spend less time brushing the tongue-side of our teeth for a couple of reasons:

1 – We tend to focus more on cleaning the sides of the teeth that we actually see.
2 – It’s easier to brush the front side of the teeth without the obstruction of a tongue.

It seems that the more difficult something is to do, the less likely people are to do it. I think this goes along with the two reasons most people don’t floss: It’s too hard and they can’t see in between their teeth.

Speaking of flossing, are you making one of these 10 common flossing mistakes?

Do You Really Need to Brush the Tongue Side of Your Teeth?

Brushing the tongue-side of the teeth is very important.  If you don’t brush this surface of your teeth, you let the bacteria in your mouth grow on your teeth.  This can eventually cause cavities or destroy the bone that holds your teeth in your mouth.

If you’re not brushing away the plaque daily, then it can harden.  Once the plaque has hardened into tartar or calculus (click to see a picture of tartar), it can only be removed by a dental professional.  More often than not, we have to spend a lot more time removing tartar from the tongue side of the teeth when patients come in for their dental cleanings.

Conclusion

If you’re not sure if you brush the tongue side of your teeth, you can ask your dentist how you’re doing.  It might also be helpful to get some plaque disclosing tablets (be careful, some plaque disclosing solutions don’t actually highlight plaque!) and a dental mirror at a pharmacy and check for yourself.

Another helpful hint is to time how long you spend brushing the front side of your teeth and then make sure you spend just as much time brushing the tongue-side of your teeth.

Do you have any questions about brushing your teeth or dental hygiene in general?  I’d love to hear your questions, comments, and concerns in the comments section below.  Thanks for reading!

9
Age When Kids Can Brush Their Own Teeth
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Have you ever heard any of the following quotes regarding the age that kids should start brushing their teeth by themselves?

  • “My daughter could brush all by herself when she turned two years old!”
  • “Kids can brush alone when they can cut through a thick New York strip steak without any help.”
  • “They can brush alone when they are old enough to color in a coloring book and stay inside the lines.”
  • “They can be in charge of their own teeth when they are old enough to tie their shoes.”
  • “They’ll be able to brush by themselves when they can write in cursive.”
  • “They can brush their teeth alone when they’re old enough to hit a moving target 20 feet away with a paintball gun while standing on one leg.”

Age When Kids Can Brush Their Own Teeth

I might have made up that last one, but as you can see there’s a lot of confusion about the exact age at which a child can brush their own teeth and do a good enough job.

So when exactly are kids really old enough to brush their teeth all by themselves?  The answer really depends on a couple of other questions which we’ll go over first.

Are Younger Children Worse at Brushing Their Teeth?

Can Kids Brush Their Own Teeth When They Can Write?
Some Say That Kids Can Brush When They Can Write In Cursive

What if you could videotape people of different ages brushing their teeth and figure out at what age kids finally “get it” enough to remove the slimy layer of plaque from their teeth?

Two researchers decided to do just that.  They recorded a group of 5 year-olds, 11 year-olds, and 18-22 year-olds to see exactly how much plaque they removed when they brushed.  Here’s what they found:

  • 5 year-olds only brushed 25% of the surfaces of their teeth
  • 11 year-olds only brushed 50% of the surfaces of their teeth
  • 18-22 year-olds brushed 67% of the surfaces of their teeth

As you can see, as people get older, they appear to be able to clean their teeth better.  Interestingly, only developmental age has been shown to be associated with how well people brush their teeth.  The older they are developmentally, the better they brush.  The textbook Dentistry for the Adolescent and Child by McDonald & Avery states, “Although both chronologic and developmental ages were found to be predictors of plaque removal ability, only developmental age demonstrated statistically significant predictive power.”

As children get older, they develop better dexterity and hand-eye coordination.  If we strictly went by the information in the study above, we probably wouldn’t even trust 18 year olds to brush their teeth by themselves!  Maybe, brushing has more to do with learning the right brushing technique rather than getting older.

For example, what if someone tried to teach the 5 year-old to brush?  Wouldn’t they be able to brush by themselves if they knew what they needed to do?

Can Younger Children Be Taught to Brush Their Teeth Better?

Recently, a group of researchers tested some new technology geared at helping small children learn how to brush their teeth better.  They created a technology known as Ubicomp that uses computers to help children learn how to brush their teeth utilizing the Playful Toothbrush. Here’s what they found:

“After using the Playful Toothbrush for five consecutive days, kindergarten children exhibited significant improvement in effectiveness of teeth cleaning, increased number of brushing strokes, longer brushing time and more thorough brushing coverage in teeth areas.”

You can read a PDF file of the complete study to learn more about the technology used and how it improved the kindergarteners’ brushing skills.

So At What Age Can Kids Brush Their Own Teeth?

Ultimately, there isn’t one answer that will cover every child.  Each child is different.  Of the three pediatric dentistry textbooks I read while researching for this article, I found that two of them glossed over this question, which demonstrated to me that it is a difficult question to answer.  The textbook Dentistry for the Adolescent and Child by McDonald & Avery was the only one that alluded to an age when kids can brush their own teeth.  The authors state:

“Although children in the preschool age range begin to demonstrate significant improvements in their ability to manipulate the toothbrush, it is still the responsibility of the parent to be the primary provider of oral hygiene procedures.  All too often, parents of these children feel that the child has adequately achieved the skills necessary to clean the teeth.  It is important to stress to the parents that they must continue to brush their child’s teeth.”

They believe that children 3-6 years old still lack the fundamental skills necessary to brush their own teeth.  In the next section dealing with children ages 6 to 12, they state:

“The 6- to 12-year stage is marked by acceptance of increasing responsibilities by the children.  The need to assume responsibility for homework and household chores tends to occur during this time.  In addition, the child can begin to assume more responsibility for oral hygiene.  Parental involvement is still needed.  However, instead of performing the oral hygiene, parents can switch to active supervision.  By the second half of this stage, most children can provide their basic oral hygiene (brushing and flossing).  Parents may find they only need to brush or floss their child’s teeth in certain difficult-to-reach areas of the mouth or if there is a compliance problem.  Parents do need to actively inspect their child’s teeth for cleanliness on a regular basis.”

The magic age at which kids can brush their own teeth seems to be sometime between the ages of 6 and 9.

Conclusion

Since every child is different, you will need to individually figure out when your child is ready to begin brushing without any help.  A good way to do this is to use plaque disclosing tablets or solutions.  These plaque disclosing agents turn the plaque on your child’s teeth a different color so that it is easy to visualize and remove.  As long as your children are removing almost all o the color-stained plaque from their teeth, they are able to brush by themselves.

I currently have very young children who are eager to do things independently.  Rather than letting toothbrushing become a battle every night before bed, I have the following deal with my kids: They get to brush first and then I tell them I’m going to “check to see if they got everything clean” as I help them finish up.  My wife and I plan to continue doing this for a few more years.  Once they are a little bit older we will likely start using plaque disclosing tablets more regularly.  When we begin to notice that they are removing much of their plaque independently then we will transition to letting them brush by themselves.

Do you have any questions or comments about the age when a child can begin brushing their own teeth?  Please join in the discussion by leaving a comment below.  I’d love to hear about what you’ve done to help your child brush all alone, at what age you got your child to brush, and if they ended up getting any cavities after they took over their oral hygiene routine.

Thanks for reading!

3
Replace Toothbrush After Being Sick?
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Have you ever heard that you should replace your toothbrush after you are sick?  I had heard that you should, but I never understood why.  After you get sick, your body figures out how to fight the illness and then makes you healthy again.

Once your body knows how to fight off the illness, you usually won’t ever get that exact same illness again.  Because of this, I wondered why some people recommend changing your toothbrush after you get sick.

The Case For Replacing Your Toothbrush After You’ve Been Sick

Should You Change Your Toothbrush After You Get Sick?The book Primary Preventive Dentistry says, “In addition to regular [toothbrush] replacement, replacement after contagious illness is imperative.”

…and that’s all.

The authors don’t say why you should replace your toothbrush after you get sick, and they don’t even bother to cite any studies that support their recommendation.

Colgate mentions on their oral health care website that you should replace your toothbrush after you’ve been sick:

It is also important to change toothbrushes after you’ve had a cold, the flu, a mouth infection or a sore throat. That’s because germs can hide in toothbrush bristles and lead to reinfection.

Again, they don’t give any references.  Let’s look more closely at the case against replacing your toothbrush after you’ve been sick to determine the strength of their argument.

The Case Against Replacing Your Toothbrush After You’ve Been Sick

Now don’t get too excited, but the American Dental Association has a whole page dedicated to their policy on toothbrush care — don’t worry, I read it so that you don’t have to!

The ADA never states on that page that you should replace your toothbrush after you get sick.  In fact, they even acknowledge that bacteria is almost always on your toothbrush and that your toothbrush can even be contaminated before you buy it because toothbrushes aren’t required to be sold in sterile packaging.

Ultimately, the ADA has this to say:

Although studies have shown that various microorganisms can grow on toothbrushes after use, and other studies have examined various methods to reduce the level of these bacteria, there is insufficient clinical evidence to support that bacterial growth on toothbrushes will lead to specific adverse oral or systemic health effects.

Basically, the ADA is at a loss when it comes to finding evidence linking bacteria on your toothbrush to any bad health effects.

About a year ago, I asked one of the dentists at my school what she thought about changing your toothbrush after you’re sick.  She told me that there is no scientific evidence that says that you should.  She also brought up the point that it would be hard to know exactly when to change your toothbrush since you can’t really tell when you’re very first infected and when your body has finally eliminated all of the bacteria/virus that caused the illness.

Conclusion

Although I don’t think it’s necessary to change your toothbrush after you get sick, I do believe that it’s a good idea to replace your toothbrush every 3 to 4 months because your brush can become a nice home for all of the bacteria that live in your mouth.  There may be exceptions if you have a compromised immune system or if you have other health issues that affect your ability to fight off infection.

What are your thoughts? Do you replace your toothbrush after you’re sick?  I’d love to hear about your views in the comments section below!

2
Importance of Baby Teeth
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Have you ever wondered why we have baby teeth?  It’s kind of interesting that we are born with permanent limbs and other body parts, but the first teeth we have are only temporary.

You, like many parents, may have even wondered the following:

Why should I take care of my child’s baby teeth?  They’re just going to fall out someday and can’t I just make sure that we take better care of the permanent teeth?

A common misconception among parents is that the baby teeth are “practice teeth” and therefore aren’t important.  To be honest, if your child has a lot of cavities and ends up losing their baby teeth early, this will probably affect their permanent teeth.

Let me explain some of the reasons why baby teeth are important.

Why Baby Teeth Are Important

Baby Teeth are Important1 – The baby teeth are placeholders for the permanent teeth. The body naturally loses baby teeth in a certain order to allow enough room for the permanent teeth to come in.  If the teeth fall out earlier, you disrupt this order and there may not be enough room for the permanent teeth.  Luckily, a dentist can make an appliance called a space maintainer or spacer that will make sure there’s enough space for the permanent tooth to come in.

To learn more about space maintainers, read What a Space Maintainer is and Why Your Child Might Need One.  If you want to see how a space maintainer might look inside of your child’s mouth, you can see a picture in my article What a Space Maintainer Will Look Like In Your Child’s Mouth.

2 -Cavities in baby teeth can cause infections that can harm your child and damage the developing permanent teeth. If the baby teeth are damaged, the damage isn’t isolated to the baby teeth.  When a cavity reaches the pulp (the nerve) inside the tooth, it enters the bloodstream and can cause an infection.  Usually the infection stays around the root of the tooth, but it can spread to other places in the body.  The infection can cause a swelling in the cheek area or rarely it can spread to the brain, as in the tragic story of Deamonte Driver.

If a baby tooth gets a cavity that infects the pulp inside the tooth, it can cause an infection at the end of the tooth that is close to the developing permanent teeth.  There is some evidence that has shown that inflammation in the root area of baby teeth can damage the permanent teeth.

3 – Baby teeth allow the child to develop good oral hygiene habits. It is much easier to teach a child the right brushing and flossing habits when they are young than it is to retrain an older child who has had bad habits for years.  While I don’t like to consider the baby teeth to be “practice teeth”, I do think parents should use the time before their children’s permanent teeth come in to teach them how to take care of their teeth.  If this is done, there will be fewer problems with the child’s permanent teeth because the child will know how to take care of them.

4 -Unhealthy baby teeth can cause a child to have low self-esteem. The most common place for cavities in children is in between the front teeth.  If a little boy or girl has to walk around with brown spots on their front teeth, it can make them self-conscious and decrease their sense of self-worth.

5 – They help children eat nutritious food. That may not seem like a very big deal, but the American Academy of Pediatric Dentistry has noted that kids with lots of cavities may be severely underweight due to pain when they try to eat.  Painful eating can cause them to lose the desire to chew foods and may cause them to choose foods that aren’t very nutritious.  The American Academy of Pediatric Dentistry has also noted that nutritional deficiencies during childhood can impact cognitive development.

Although having healthy teeth to chew food may not seem too important, it can help ensure adequate development of your child.

Conclusion

I can’t stress enough the importance of taking care of your child’s baby teeth.  Keep in mind that cavities are caused by bacteria, and tooth decay is a serious disease — the most common disease in children!

Luckily we do get two sets of teeth, but it is important to take care of both sets!

If you know anyone who doesn’t understand the importance of baby teeth, please consider sharing this article with them.  If you have any questions, comments, or anything that I might have left out above about the importance of baby teeth, please leave a comment below. Thanks for reading!

3
Listerine Agent Cool Blue Review
©Andrey Popov/Shutterstock.com

A lot of people think that a popular dental health product, Listerine Agent Cool Blue, will show you where the plaque is on your teeth as plaque disclosing tablets do.

Listerine Agent Cool BlueI was under the same impression myself.  I got a bottle so that my son could try it.  Unfortunately, I realized after testing it that Agent Cool Blue isn’t a plaque disclosing solution.

Listerine Agent Cool Blue tints the teeth a very slight blue color.  The product is intended to make brushing more fun for kids.  To use the solution, your child swishes the solution in their mouth before brushing, which tints their teeth blue.  Then your child brushes their teeth and checks afterward to see if any blue remains on the teeth.  In theory, this enables the child to see which surfaces of their teeth were  missed when they brushed.

On the front of the bottle it says that it is a “tinting rinse.”  As you will see below, I find it to be a very poor tinting rinse simply because it is not very noticeable and because it is so easily removed.  I also believe most people are disappointed with it simply because most people assume that Agent Cool Blue dyes plaque, like traditional plaque disclosing solutions.  To its credit, it does have a nice minty flavor and, as a safety feature, the bottle measures exactly 10 milliliters for you as you can see in the picture above.

How Listerine Agent Cool Blue Dyes Your Teeth

Here’s a quick before and after picture I took after rinsing with Agent Cool Blue (the AFTER picture was taken before I brushed my teeth):

Listerine Agent Cool Blue Test

You will notice it does NOT show you where the plaque is.  But, as you can see from the photo above, my teeth did change color slightly.   Since the product is marketed towards kids, I think the color change needs to be more dramatic to really motivate them to brush.

To see a before and after picture with regular plaque disclosing tablets, read the article How Plaque Disclosing Tablets Can Help You Brush Better.

What Agent Cool Blue Claims To Do

Listerine Agent Cool Blue InstructionsTo the right is a picture of the back of the bottle.  I noticed that they never come out and say that it will dye your plaque blue.

Technically, Agent Cool Blue does what it is supposed to do — it tints the teeth blue.

In my opinion, the color change is not enough to really be effective.  I don’t think a 6 year old is going to notice if he got all of the blue off of his teeth since the color is so faint.

The simple fact that people think it should mark the plaque on your teeth has caused Agent Cool Blue to receive some terrible reviews at Amazon.  I couldn’t find one positive review.  Below, I copied some highlights from the reviews.

What People Say About Listerine Agent Cool Blue

Here’s an excerpt from a review that PghYinzer wrote about Listerine Agent Cool Blue:

This stuff does not do what I thought it does. I thought it stuck to plaque and showed the really nasty areas. My brother and I used some red disclosing solution as kids – I thought that’s what this was. Brush your teeth, use the red stuff, see how poor a job you did.

This just dyes everything pale blue. I guess in theory you have to brush everything to get all the blue off but it comes off very easily so it really doesn’t do much good.

Very disappointing. I’m going to purchase something sold as disclosing solution instead. I squeezed all of the agent blue out and poured it down the sink – total waste of money and total waste of counter space.

A Fan “Breezy” had this to say about Agent Cool Blue:

This stuff is useless. The taste is bad and it discolors the toothbrush bristles. It seems that even after a lot of brushing, teeth still retain a slight tint of blue.

The only slightly positive review I did find was from Noname, who said:

It was so pale, I don’t think most kids would notice. Just a slight brushing will remove it. In fact, if I brush one side and not the other, the toothpaste removes it from the whole mouth…The blue tint makes them spend more time brushing, so that earns this product a bump up to three stars.

Was Listerine Agent Cool Blue Ever Recalled?

Listerine Agent Cool Blue was recalled back in 2007 due to contamination with microorganisms.  The Listerine Agent Cool Blue currently on your local shelves should be safe.

If you go to the site above that talks about the recall, you’ll notice that they describe Agent Cool Blue by saying, “the rinse makes plaque show up blue on your teeth in an attempt to encourage better brushing.”  Even The Consumerist thinks that Agent Cool Blue sticks to plaque!

Conclusion

In summary, I wouldn’t recommend Listerine Agent Cool Blue with so many superior plaque disclosing solutions out there.

Do you have any questions, comments, or suggestions on how to better remove the plaque from your teeth?  Leave them below in the comments section.  Thanks for reading!

15
Dental Tartar and Calculus
©Lighthunter/Shutterstock.com

Earlier this week, one of my friends told me a joke that made me groan. She asked, “What is a dentist’s favorite subject in high school?”  I told her I didn’t know, and then she blurted out “Calculus!”

Sorry.

So what exactly is calculus?  Calculus, commonly known as tartar (as in tartar-control toothpaste) is plaque that has hardened.  In the picture below, the calculus looks like a thick, creamy coating sticking to the teeth between the teeth and the gums.

Tartar / Calculus

Here’s two other photos of the same mouth shown in the photo at the top of this article.  Before a dental cleaning:

Dental Tartar and Calculus Before Cleaning
©Lighthunter/Shutterstock.com

And the same set of teeth after a good scraping by the hygienist:

Dental Tartar and Calculus After Dental Cleaning
©Lighthunter/Shutterstock.com

What Is Tartar / Calculus?

Tartar and calculus are the same thing.  Tartar is the more common term and most dentists and dental hygienists will call it calculus.  No matter what you call it, tartar is simply plaque that has sat on your teeth for a while and hardened.

A while back, I talked about how saliva helps our teeth by repairing teeth with calcium to undo the damage done by eating sugar.  Unfortunately, that same calcium can get incorporated into plaque, turning it into hard tartar.

The book Carranza’s Clinical Periodontology describes calculus by saying, “It is usually white or whitish yellow in color, hard with claylike consistency, and easily detached from the tooth surface.  After removal, it may rapidly recur, especially in the lingual area of the mandibular incisors.  The color is influenced by contact with such substances as tobacco and food pigments.”

Where Is Tartar Usually Found?

Tartar can be found on any tooth surface and even below the gumline.  A common hideout is on the tongue side of your lower front teeth.  The salivary glands under your tongue put out a lot of calcium, which helps the plaque harden into tartar rather quickly.

How Can You Prevent Calculus and Tartar from Forming In Your Mouth?

The best way to prevent calculus from forming is by brushing twice a day and flossing.  The book Carranza’s Clinical Periodontology says that plaque can start to mineralize (the process that helps it turn into tartar) in as little as a couple of hours!

How Is Calculus Removed from Teeth?

Once plaque has hardened into calclulus, you need to have it removed by a dental professional.  Your dentist or dental hygienist removes calculus using metal instruments or with an ultrasonic dental instrument.

It’s important to visit your dentist regularly so you can get any calculus or tartar build-up removed.

What Happens If You Never Get Calculus Removed From Your Teeth?

If you don’t go to the dentist to get calculus removed from your teeth it can start to irritate your gums and over time may cause periodontal disease, a major cause of tooth loss.  If you look again at the picture above, you can see that the patient’s gums appear to be falling down, because they are irritated from all of the tartar.

Chances are that if you have calculus visible on your teeth then there is also some below the gumline.  It’s important to see your dentist so that you can keep your teeth clean and free of periodontal disease.

Conclusion

In summary, bacteria cling to your teeth and grow, forming plaque.  If you don’t remove the plaque by brushing and flossing, it can get hard and turn into mineralized plaque known as tartar or calculus.

If you don’t get it cleaned off, tartar can irritate your gums, contributing to periodontal disease.

If you have any questions, comments, or good jokes to share about tartar or calculus, feel free to leave them below in the comments section.  Thanks for reading!

18
Dental Plaque Disclosing Tablets Solution
©Rob Byron/Shutterstock.com

Would you vacuum your carpet if it didn’t look dirty?  Probably not. Unfortunately, many people look in the mirror and don’t see anything on their teeth so they assume that their teeth are clean.  If only they knew the truth! There are millions of bacteria that live in our mouths and cling to our teeth.  You can read more about dental plaque here.

Plaque Disclosing TabletsThe problem is that plaque is very hard to see for the untrained eye. Luckily, there are products such as plaque disclosing tablets and plaque disclosing solutions.  This is a type of dye that adheres to plaque in your mouth allowing you to easily visualize it – and remove it. If you see plaque on your teeth, you will want to remove it!  Once you have used plaque disclosing tablets and/or solution a few times, you will figure out where the plaque tends to hide in your mouth, thus increasing your brushing efficiency.

Our Plaque Disclosing Experiment

A few days ago, my wife and I didn’t brush all day.  At the end of the day, we took pictures of our teeth, and then chewed a plaque disclosing tablet and took another set of pictures.  Here’s a photo montage  showing how our teeth looked:

Seeing the Dental Plaque on Our Teeth

My wife didn’t rinse out as well as me, so only the very dark pink areas are plaque on her teeth.  Also, we don’t usually smile like this…we were trying to show more of our teeth for the picture 🙂

Where Most Plaque Lives On Teeth

Pink Dental Plaque on a Single ToothAs you can probably tell, most plaque accumulates between our teeth.  The area between our teeth is an area where plaque are less likely to be swept away by our tongue when chewing or by our toothbrush when we brush.  The best way to remove the plaque between our teeth is by flossing. To the right is a close-up of one of my upper pre-molars, clearly showing all of the plaque living between my teeth.  Pretty gross, right?

Where to Get Plaque Disclosing Tablets

Do you want to find out where the plaque is on your teeth?  Or do you need help motivating your toddler to brush?  Try showing him or her where the “bugs” are living on their teeth. Actually seeing the plaque will motivate children and adults alike. Young Dental Plaque Disclosing SolutionYou can find plaque disclosing tablets at most local pharmacies. If you’re into buying things online, here are a few options from Amazon: 1 – Butler GUM Red-cote Dental Disclosing Tablets Pack of 250 tablets – Name brand chewable tablets. 2 – Young Dental 2 Tone Disclosing Tablets Pack of 40 – Great chewable tablets. 3 – Young Dental 2 Tone Disclosing Tablets Pack of 250 – Large pack of chewable tablets. 4 – Young Dental 2 Tone Disclosing Solution 2 Fl Oz [Pictured] – This is the same liquid that most dentists and hygienists use. You can easily swab it onto your (or your child’s) teeth with a q-tip to find out where the plaque is lurking. Do you have any questions or comments about plaque disclosing tablets or solution? Feel free to leave them below in the comments section. Thanks for reading!

4
Tips to Get Rid of Gingivitis
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If you’ve noticed that your gums are red and puffy, or that they bleed whenever you brush your teeth, you may have gingivitis.

Toothbrush with ToothpasteGingivitis is defined as an inflammation of the gums without any loss of the attachment to the tooth.  When the gums start to recede from the tooth, gingivitis has advanced to a disease known as periodontitis.  Please note that in this article, I am referring to gingivitis caused by plaque build-up.  There are many other causes of gum enlargement you can read about here.

Luckily, gingivitis is completely curable.  It is important to remember that gingivitis doesn’t just spontaneously occur, it is usually associated with poor oral hygiene.  The secret to curing gingivitis lies in improving oral hygiene.

Four Tips to Cure Gingivitis

1. Brush Your Teeth. Brushing helps remove plaque.  Since most gingivitis is caused by plaque, you can reduce the gingivitis by removing the cause — plaque.  It is a good idea to try to brush twice daily.  If you brush too much, you can end up irritating your gums.

2. Floss Daily. Flossing can remove a lot of the plaque that gets stuck under the gum line.  If you let the plaque grow under the gums, it can really irritate your gums and cause gingivitis.  By removing this sub-gingival plaque, the swelling in your gums will go down.

3. Using an irrigation device such as a WaterPik will drastically reduce gingivitis by flushing the bacteria out of your mouth.  Irrigation devices can reach under the gums and dislodge plaque that might otherwise be inaccessible.  This hard-to-remove plaque is one of the main causes of gingivitis and removing it will greatly improve gingival health.  Many devices provide a pulsating stream of water, which has been shown to be ideal.

Once your gums return to a nice coral-pink color, it is not necessary to use a WaterPik or other irrigation device unless your gingivitis returns.  The main benefit of these irrigation devices is in reducing gingivitis, not maintaining gum health.

4. Use a Mouth Rinse. The book Primary Preventive Dentistry by Norman O. Harris recommends using “over-the-counter products with essential oils, such as Listerine, or dentist prescribed chlorhexidine mouthrinses.”

Many mouth rinses have antibacterial properties that will help your gums return to health.  The best rinse to help fight gingivitis is chlorhexidine (marketed in the USA under the brand name Peridex.)  However, it can sometimes be expensive.  If you are open to trying new things, there have been some studies to suggest that oil pulling may be a cheaper alternative to chlorhexidine in fighting gingivitis.

Good Luck

It is fortunate that gingivitis can be cured.  Unfortunately, after about a month of not brushing, gingivitis can progress to periodontitis which can cause you to lose your teeth.

If you follow the tips above, you should get your gums back to good health in a week or two.

If you have any questions or comments about gingivitis, I would love to hear about them in the comments below.