Tartar and Plaque
Tartar and Plaque
24 Tooth-Care Tips
Take your fingernail and scrape it gently across the inside of one of your molars. Now look at your finger. See that white stuff under your fingernail? That's plaque.
Plaque is a stick film of living and dead bacteria that grows on your teeth. When plaque isn't removed, it can harden—50 percent within 48 hours, becoming rock hard after 12 days. That rock, called calculus, is more commonly known as tartar.
There are a lot of reasons you don't want either one of these tooth coatings. Tartar and plaque make your teeth look ugly, feel ugly, and smell ugly.
Enough? There's one more: A plaque and tartar crust on your teeth and gums leads to even uglier tooth problems such as gingivitis and periodontal disease.
You can't remove tartar. "It gets like a barnacle on a ship," and requires professional help to remove, says Robert Schallhorn, D.D.S., a private practitioner in Aurora, Colorado, and past president of the American Academy of Periodontology. But you can remove plaque. And by getting the plaque off your teeth, you'll prevent a lot of tartar. Removing plaque is easy. So wipe your finger off and read on.
Brusha, brusha, brusha. Think of your toothbrush as your sword and plaque as the enemy. What you want to do in this case is rub the bad guy out.
The friction of a toothbrush disrupts the bacterial plaque growth on the teeth—as long as you do it correctly. And most people don't, says William Campoli, D.M.D., a dentist with a private practice in Charlotte, North Carolina.
Up and down or back and forth isn't correct. What you need to do is turn your brush so the bristles are at a 45-degree angle to the area where your tooth and gum meet (the gum around the tooth). Now, very gently wiggle your brush in small circles, covering one or two teeth at a time.
Attack from the back. The back of your lower teeth is where the plaque is most likely to hide. "Too much emphasis is placed on brushing the smile surfaces, the upper teeth that are fairly accessible," says Dr. Campoli. "But the areas where the teeth come into contact with the tongue and cheek are neglected. That's where you need to concentrate your efforts."
Take two to clean. Two minutes, that is. "Most people brush the smile area and give the rest of the teeth a quick IOU," says Dr. Campoli. Studies show most of us brush about 30 seconds at a time and dentists—the experts who should be able to do it fastest of all—spend from 2 to 4 minutes brushing their teeth. Slow down!
Do it at night. Don't let a day's worth of debris sleep in your mouth. If you can brush only once a day, do it at night or you give your plaque 8 uninterrupted hours to set up housekeeping.
Buy a brush that fits. Think small when you choose your toothbrush. You want to reach all sides of your teeth, including those at the very back of your mouth, says Jerry F. Taintor, D.D.S., chairman of endodontics at the University of Tennessee College of Dentistry. A giant brush won't hurry your brushing along and it won't reach the little nooks and crannies those dirty germs like to hide in.
Choose soft, rounded bristles. Soft nylon bristles are easier on tooth enamel but just as tough on plaque, says Eric Shapira, D.D.S., an El Grenada, California, practitioner and assistant clinical professor and lecturer at the University of the Pacific School of Dentistry. Bristles should be rounded, not sculpted, adds Dr. Campoli. Sculpted bristles are often sharp and may slice into your gums.
Hold your brush like a pen. Finnish researchers have demonstrated that a pen grip, instead of the more common tennis racket grip, produces less gum abrasion and healthier gums and still gets rid of plaque.
C that you floss right. When it comes to plaque control, flossing is more important than brushing, says Richard Shepard, D.D.S., a retired dentist in Durango, Colorado. But you must floss correctly. Here's how. Break off 18 inches of floss and wind one end around the middle finger of one hand and the other end around the same finger on the other hand, leaving about an inch of floss between them. Using a gentle, back and forth motion, pass the floss between two teeth. When the floss gets to the gumline, curve it in a C against one tooth and slide the floss between the gum and tooth until you can feel some resistance. Now, curve it around the other tooth the same way. Scrape floss downward on upper teeth and upward on lower teeth.
Go gently. Whoa. Don't snap that floss up and down, in and out of your gums as if you were popping the plaque to death! You're whipping your gum tissue too. Slow down and take your time.
Remember that floss is floss. Find a floss you like and use it. Flavored, unflavored, waxed, unwaxed, string, or tape. Does it matter what you choose? Not really, says Dr. Taintor. Tape might be better for people with spaces between their teeth. Flavoring might make you feel a little fresher.
Get the seal of approval. Use a fluoride toothpaste recommended by the American Dental Association, says John D. B. Featherstone, Ph.D., chairman of the Department of Oral Biology at Eastman Dental Center in Rochester, New York. Generic toothpastes, he says, may not contain an active fluoride or may be too abrasive.
Try a baking soda scrub. Baking soda is an old standby that really works, says Dr. Shepard. Dip your brush directly into the box or mix a tablespoon of baking soda to a pinch of salt in a cup. Then wet your brush and scrub.
Use water alone. Don't let an empty tube of toothpaste prevent you from brushing. Wet your brush and go after the plaque, says Dr. Campoli.
Be resourceful. Your luggage is on its way to Hawaii and you are in Cleveland. No excuses! If you're left defenseless you can use ordinary thread from your travel sewing kit, says Dr. Schallhorn. (Your airline or hotel should have some if you don't.) Use the thread like floss.
Go swish, swish, swish. After every meal, especially when you can't carry a toothbrush, dash to the bathroom and swish a mouthful of water around those teeth. One good swish will remove debris and may save you from spinach-in-the-teeth embarrassment.
Try Listerine. Listerine has been shown to be effective in reducing plaque when used alone or when used to supplement regular toothbrushing, according to studies at the University of Gothenburg in Sweden and at the University of Maryland at Baltimore. A study of 145 adults in Baltimore showed people who rinse with Listerine can reduce plaque by 22 percent and gingivitis by 28 percent.
Make your own mouthwash. For a homemade mouthwash, a half-and-half mixture of 3 percent hydrogen peroxide and water will do the trick, says Roger P. Levin, D.D.S., of Baltimore, Maryland, president of the Baltimore Academy of General Dentistry.
Put the pressure on. Gently hose down your teeth and gums with a dental water sprayer such as the Water-Pik. You will remove the food the plaque will eat. "But be careful," warns Dr. Campoli. "It's like a brushless car wash. If you use enough water pressure to blast the plaque off, it might hurt the gums." Remember, however, that using a waterspray device does not mean that you can forget about brushing and flossing.
Opt for full disclosure. Tally your score against plaque with a disclosing tablet, available at most drugstores. The tablets contain a dye that will stain plaque left on your teeth after brushing. Chew the tablet, then look in the mirror and inspect your teeth. The color will be darkest near the gums where plaque is the thickest. Brush again, and be sure to target the plaque-catching areas each time you brush.
Make your own plaque spotter. It's easy. First coat your lips with petroleum jelly to avoid staining. Then put a teaspoon full of food coloring into your mouth, swish it around, and spit it into a basin, advises John Beresford, a dentist in England and author of Good Mouthkeeping. Rinse with clear water. Then look for plaque, stained by the dye. Brush. Each time you brush, pay special attention to the areas stained by the dye.
Say cheese, please. Avoid the chips and reach for the cheese appetizers, suggest studies at the University of Iowa's Dow Institute for Dental Research. Researchers found that 5 grams of cheese—that's less than an ounce—eaten before meals eliminates the acid production of plaque. But you must choose an aged cheese, such as cheddar, says James S. Wefel, Ph.D., a researcher at Dow. Why?
"The mechanism is unknown," says Dr. Wefel. "It may act as a buffering agent." But he does know that young cheeses don't work. "Something must happen in the aging process, but we haven't put our finger on it yet." Aged cheese, "the smellier, the better," works best.
Make sugarless gum your last bite. When you can't brush after a meal, pop a stick of gum in your mouth and chew your way to cleaner teeth, says Dr. Wefel. Spend about 20 minutes chewing sugarless gum after meals or snacks. As you chew, your saliva, a natural buffering agent in your mouth, will wash your teeth and neutralize the acid in the plaque before it attacks your teeth. Moving the gum around in your mouth may also dislodge food stuck between your teeth, Dr .Wefel says.
Try an electric brush. Forget the conventional toothbrushes that vibrate the plaque off your teeth. There's a new breed of electric toothbrush with bristles that rotate while the stem remains still. There are several brands for sale, including the Interplak, Rota-dent, and Superbrush. They work like the brushes used by dental hygienists and they're the perfect instrument for people with arthritis or those who have a handicap that prevents them from using a regular toothbrush effectively. For someone not inclined to brush well, "it's a novelty item. So maybe he would use it more," Dr. Campoli says.
According to research, these new brushes remove as much as 98.2 percent of plaque from tooth surfaces versus as little as 48.6 percent removed by hand brushing.
PANEL OF ADVISERS
William Campoli, D.M.D., is in private practice in Charlotte, North Carolina.
John D. B. Featherstone, Ph.D., is chairman of the Department of Oral Biology at Eastman Dental Center in Rochester, New York, and deputy director of the Rochester Cariology Center.
Roger P. Levin, D.D.S., is president of the Baltimore Academy of General Dentistry and a guest lecturer at the University of Maryland in Baltimore.
Robert Schallhorn, D.D.S., has a private practice in Aurora, Colorado, and is past president of the American Academy of Periodontology.
Eric Shapira, D.D.S., is in private practice in El Grenada, California. He is an assistant clinical professor and lecturer at the University of the Pacific School of Dentistry in San Francisco, California, and has a master's degree in science and biochemistry.
Richard Shepard, D.D.S., is a retired dentist in Durango, Colorado. He edits the newsletter for the Holistic Dental Association.
Jerry F. Taintor, D.D.S., is chairman of endodontics at the University of Tennessee College of Dentistry in Memphis. He is author of The Oral Report: The Consumer's Common Sense Guide to Better Dental Care.
James S. Wefel, Ph.D. is a researcher at the Dow Institute at the University of Iowa in Iowa City.
