Oral Hygiene Education

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Children's dentistry

General Information


Children's Dentistry

When should my child have their first dental appointment?

We believe that in order to prevent dental problems, your child should see your family dentist when their first tooth appears, or no later than their first birthday. This appointment will provide you with good advice regarding sound health and hygiene maintenance and will also assist in assessing any early signs of developmental problems that may be rectified by early intervention.


How important are primary teeth?

Primary teeth are a very important part of your child’s development. They help children learn to speak clearly and chew naturally, and aid in forming a path that permanent teeth can follow when they are ready to erupt.


When should children start brushing?

From birth gums can be wiped down with a soft cloth or gauze and water.

As soon as the first primary tooth erupts the teeth should be brushed at least once daily, ideally at bedtime with a soft infant toothbrush. Initially brush with water, and slowly add increments of toothpaste.

Once children are older they can start to do the brushing themselves under supervision.


What toothbrush to use?

The toothbrush should have soft nylon bristles and a small head. Specific brushes for infants and children are available. The toothbrush should be able to reach all the teeth easily.

A good ‘softness’ test is to brush the bristles along the skin on the inside of your wrist. Don’t use any toothbrush on your child’s gums that isn’t soft enough to use on this area.


When should I start using toothpaste to brush my child’s teeth?

Start brushing with water, and slowly add incremental increases of toothpaste up until the age of 2.
Once your child is 2 they can use a pea sized amount of toothpaste.


What toothpaste should children use?

Kids 6 years and under should use a pea-sized amount of specially formulated children’s toothpaste with lower fluoride content, and should be encouraged to spit, not swallow toothpaste when brushing.

Any normal fluoride toothpaste should be used sparingly with no more than a pea-sized dab on the toothbrush, under supervision to make sure it is spat out.

This is because unlike fluoride in water, fluoride in toothpaste is only meant to work topically. While fluoride is important for healthy strong teeth, children who ingest excessive amounts of it (rather than spitting toothpaste out) when their permanent teeth are still developing under the gums can develop a condition called fluorosis.


Fluorosis:

Dental fluorosis (the mottling of tooth enamel) is a cosmetic condition that affects the teeth. It is caused by excessive exposure to fluoride during the ages of birth to 6 years, when the permanent teeth are still being formed under the gums. This is mainly caused by children swallowing fluoridated toothpaste and not spitting it out.

Symptoms of fluorosis range from tiny white spots or streaks that may be unnoticeable, to dark brown stains and rough or pitted enamel. These stains are ‘intrinsic’, meaning they can’t just be polished off by a dentist.

The best way to prevent fluorosis is to supervise children when brushing and ensure they spit the toothpaste out and don't swallow it.


How to help prevent tooth decay in primary teeth: ‘Baby bottle decay’

‘Baby bottle tooth decay’ or ECC (Early Childhood Caries) are terms used to describe the effects of frequent and long-term exposure of children’s teeth to liquids containing sugars.

When children are given sweetened liquids, or when natural sugars (such as milk and formula) cling to an infant’s teeth for a long time, the bacteria in the mouth thrive off the sugar and make acids that attack the teeth and can cause decay. When a child sips from a cup, the sugar moves past the teeth quickly and does less harm, but when a bottle is sucked slowly the sugar lingers in the mouth.

Bottles are for breast milk, water, milk and formula. Infant bottles should not be filled with sugary drinks such as fruit juices, soft drinks or cordials.

When feeding formula, take the bottle away when the child has had enough.

Bottles should be finished and removed before the child goes to bed.

Don’t allow your child to fall asleep with a bottle containing anything but cool boiled water. Even natural sugars found in milk and formula are harmful when they cling to a child’s teeth for a long period of time. The flow of saliva also decreases during sleep which usually helps to wash away sugars.

Never dip the teats of dummies or bottles in anything sweet, such as honey or syrups. These are not easily cleaned from the mouth and the sugars will linger on the teeth.

Introduce infants to a feeding cup between 6 and 8 months of age.


General Information

What is the difference between plaque, tartar and calculus?

Plaque:
Plaque is a soft, sticky, colourless film containing millions of bacteria that builds up on teeth daily. It begins developing on teeth between 4 to 12 hours after brushing.

When not removed with proper brushing and flossing, the build-up of plaque can trap stains on your teeth and irritate your gums, weakening the connections holding your teeth in place. Also, the bacteria in plaque digest the food and drink residues left on your teeth. Bacteria convert sugars and starches from these residues into acid. This acid then slowly penetrates through and dissolves the enamel (hard outer shell) that protects your teeth, eventually causing the enamel to break down resulting in holes called cavities.

Tartar and Calculus:
Tartar and calculus are different terms for the same substance that forms during the second stage of plaque accumulation, where the bacterial film begins to harden.
If not thoroughly removed through good oral hygiene practices and 6 monthly appointments with a dental hygienist, plaque will eventually harden into tartar, which collects at the gum line making brushing and flossing more difficult. Once plaque has hardened into tartar brushing will not remove it – it can only be removed through scaling and polishing by a dental hygienist.

As the plaque and tartar increase, the gum tissue can become red, swollen and cause bleeding when you brush your teeth. This is called gingivitis, an early stage of gum (periodontal) disease.


What toothbrush should I use?

You should use a soft toothbrush with a small head.

The small head can access your back teeth better which allows for proper brushing.

Soft bristles help minimise damage to teeth and gums. Medium and hard bristles will abrade teeth and gums.

A good test is to brush your toothbrush along the skin on the inside of your wrist. If it is too hard on this area then don’t use it in your mouth.


The best way to store your toothbrush

After brushing, first thoroughly rinse your toothbrush with tap water to remove any remaining toothpaste and debris.

Store the toothbrush in an upright position and allow the toothbrush to air-dry until it is used again. This is because the bacteria that cause gum disease are anaerobic, meaning they live in a low oxygen environment and are killed by exposure to air. If more than one brush is stored together in the same holder, keep them separated to prevent cross-contamination.

Do not routinely cover your toothbrush or store it in a closed container. This does not allow the toothbrush to receive adequate ventilation, which creates a moist environment ideal for the growth of bacteria (microorganisms).


What’s better: manual or electric toothbrushes?

It doesn’t matter which toothbrush you use – they will both achieve the same results.

The important thing is to make sure you are using them properly – scroll down to find out how to brush your teeth properly. Also be aware you need to brush differently with an electric toothbrush.


How often should I replace my toothbrush?

Throw out your toothbrush, or change the head of your electric toothbrush, at least every two to three months. This is important for two reasons:

 To limit the bacteria on your toothbrush

 To maintain effective brushing. Over time toothbrush bristles can become frayed and worn, and may lose effectiveness when brushing. Clinical research shows that new toothbrushes can remove more plaque.


What toothpaste should I use?

Use a toothpaste that contains fluoride, as it helps to harden tooth enamel and reduces your risk of tooth decay.


How often should I brush my teeth and how long for?

You should brush your teeth at least twice a day (morning and night) with a fluoride toothpaste for at least two minutes.

This is because saliva (which keeps cavity-causing plaque off teeth) dries up at night, so it’s important to clean all the plaque off your teeth before sleep. Plaque may also build up while you sleep so you need to brush first thing in the morning to get rid of it (and other bacteria that cause ‘morning breath’).


How to properly brush your teeth (with steps)


  1. First brush the outside surfaces of all the lower and upper teeth in a circular motion.
    Hold the toothbrush at a 45 degree angle against the gums, this ensures you also clean around the gum line.

The yellow areas on the picture are what surfaces should be brushed.

Holding the toothbrush at a 45 degree upward angle against the gums.

  1. Then brush the lower and upper flat chewing surfaces in a back and forth motion.

The yellow areas on the picture are what surfaces should be brushed.

  1. Brush the inside surfaces of all the back teeth on the upper and lower jaws, using a circular motion.
    Don’t brush the area behind the front 12 teeth (shown in red) yet, as this circular motion will not reach them correctly.
    Hold the toothbrush at a 45 degree angle against the gums, this ensures you also clean around the gum line.

The yellow areas on the picture are what surfaces should be brushed.

Holding the toothbrush at a 45 degree upward angle against the gums.

  1. Lastly brush the area behind the front 12 teeth (shown in red), by making short vertical up-and-down strokes from the gum to the bottom of the teeth.

The yellow areas on the picture are what surfaces should be brushed.

  1. Brush your tongue to remove bacteria and freshen your breath.

How to properly brush your teeth with an electric toothbrush

For any steps where it says to manually brush in a circular motion, the electric toothbrush does this part for you. Instead of brushing in a circular motion, just hold the brush on the tooth and move the brush slowly along the teeth making sure to get all the surface areas.


What does flossing do?

Floss allows you to get into the tight spaces between your teeth and gums to remove plaque and debris where a toothbrush can’t.

Flossing is as important as, if not more important than brushing your teeth. The decay-causing plaque (bacteria) between your teeth can cause more damage than the plaque on the outer surfaces of your teeth, including periodontal (gum) disease and tooth loss.


Alarming reasons why you should floss

Built up plaque between teeth that is not removed from flossing can cause gum disease. Unhealthy gums have too much blood in them (as your body sends blood to the gums to fight off the infection and bacteria) so they often bleed during brushing and flossing.

The human mouth is teaming with bacteria. It is estimated there are over 100 million bacteria in every millilitre of saliva from more than 600 different species. While a lot of these are good bacteria that help aid digestion or protect teeth and gums, many are harmful.

When you have bleeding gums caused by gum disease, this is an open window for the harmful bacteria to get into your bloodstream and travel around your body. Many researchers are finding possible links between the harmful bacteria of gum disease and an increased risk of chronic diseases such as heart disease, stroke, diabetes, dementia, osteoporosis and respiratory disease. In pregnant women it can also cause complications during pregnancy, premature births and low birth weight babies.

So, make sure you floss to keep your gums healthy, as it will have a positive effect on your overall health as well!


How often should I floss?

Once a day, ideally at night before bed.


How to floss properly (with steps)


  1. Break off about 45cm of floss and wind it around the middle fingers of each hand.
    Hold the floss tightly between your thumbs and forefingers.
  2. Gently guide the floss into the space between your teeth using a zig-zag motion.
    Do not snap the floss on your gums.
  3. Around one tooth, curve the floss into a C shape, hold it firmly and slide it up-and-down in a zig-zag motion.
  4. When you reach the gum line, gently slide it into the space between the tooth and gum.
  5. Bring the floss back to the contact point between the teeth, form it into a C shape around the other tooth.
    Repeat sliding it up and down and under the gum on this tooth.
  6. Repeat this entire process with the rest of your teeth, ‘uncoiling’ fresh sections of floss as you go.
  7. Don’t forget to floss the backs of your last molars on each side.

Do I need to use mouthwash?

The short answer is no, you do not need a mouthwash to maintain your oral health. However, mouthwashes will have a favourable effect on your breath and general feeling of wellbeing. The alcohol they contain will have a mild bacteriostatic (reduced mouth microorganisms) effect and may have a generalised mild reduction in plaque. It should be noted that mouthwash is no substitute for careful tooth brushing and flossing.


What mouthwash should I use?

Make sure it has a mild alcohol content only. Most mouthwashes have too much alcohol which can dry out tissues in your mouth, making them more susceptible to bacteria.


How to check if your breath smells

To check if your breath is fresh, lick your palm and smell it while it’s still wet.


Is chewing gum beneficial?

Yes, but it must be sugar-free gum. Here’s why:

Saliva helps keep the mouth moist. It increases in flow when we eat which allows us to chew and swallow our food, and helps to wash away any remaining food particles and debris. Saliva also has a protective effect by neutralising acids released by the bacteria in plaque (which are harmful to tooth enamel) and re-mineralising teeth as it contains calcium and phosphate, which helps to strengthen tooth enamel.

Both the act of chewing gum and the flavour of artificial sweeteners in the gum stimulate ten times the normal rate of saliva flow. Increased saliva flow results in more acids neutralised, more food particles washed away and higher rates of calcium and phosphate produced. Clinical studies have shown that chewing sugar-free gum for 20 minutes after meals or snacks can help prevent tooth decay.

Why sugar-free? Sugar-containing gum will also increase saliva flow, but the bacteria in plaque will feed off the sugars and create more of the decay-causing acids that you are trying to neutralise.

Chewing gum regularly is also similar to strength training; it makes your saliva gland cells larger and more efficient. This means you won’t only increase saliva when you are chewing, but also during ‘rest periods’ when you are not chewing anything; which has a big influence on reducing the amount of acids and bacteria in your mouth.


What foods are bad for my teeth and when should I avoid them most?

Acidic low pH foods, starchy foods and foods containing sugar are all bad for your teeth. Why? Because they all end up as acids in your mouth which soften teeth, resulting in enamel erosion and diminished tooth size. How? See below:

1. Starchy foods
Examples: potato chips, white bread, pizza and pasta.
How: The carbohydrates they contain block the natural saliva flow and aren’t easily dissolved. To counteract this, saliva contains amylase, an enzyme that breaks down starch into sugars to allow for saliva flow and clear the mouth. Why are sugars bad? Read on.

2.  Sugary foods
Examples: lollipops, cakes and dried fruits.
How: The bacteria in dental plaque thrive off sugar and change the sugars into acids. Acid is the real culprit of tooth decay, read on to see what it does.

3.  Acidic foods
Examples: soft drinks, fruit juices, sour candies and pickles.
How: Acids attack your teeth and dissolve important minerals on their surface (‘decalcify’ your teeth). This softens your teeth and results in enamel erosion and decay over time.

Citric acid is the worst acid for your teeth, and some sour candies have a pH so low it nears battery acid. Even sour gummy vitamins can be bad for your teeth.

This is worse for children, as their tooth enamel isn’t mature until a decade after their teeth have erupted, meaning they are softer and more susceptible to acid.

You should avoid eating any of these foods between meal times as ‘snacks’. If you are going to consume them, do so at mealtimes as their harmful effects can be minimised by consuming them along with other foods.

After consuming acidic food or drinks, you should also wait at least one hour before brushing your teeth because acid leaves the enamel softened, it is more prone to erosion during brushing. You can however (and this is recommended) drink a glass of water straight after to rinse your mouth.

To view our chart "Acidity (pH) of Common Drinks" please click here. You may be very surprised how acidic some of your favourite drinks are. Just think of how much damage they do to your tooth enamel if you consume them every day!


What foods are good for my teeth?

These foods are all good options for snacks, but they are also good to finish off a meal with; especially if you won’t be able to brush your teeth for a while after.

Detergent Foods:

Foods that are firm or crisp help to clean the teeth as they’re eaten and they also stimulate saliva flow. Examples are raw apples, carrots and celery.

Alkaline foods:

The higher the pH level (the more alkaline) on the surface of the teeth, the more they are protected against enamel erosion. Dairy products like cheese and milk help to neutralise the acids in your mouth. They also stimulate saliva flow and the calcium and phosphates they contain help to re-mineralise the teeth.

Green and black teas:

Both contain polyphenols that interact with the bacteria in plaque. They can help to suppress the bacteria and reduce tooth-attacking acid. Depending on the type of water used in your tea, they can also be a source of fluoride.

The general information provided by VC Dental is intended as a guide only. It is not to be taken as personal, professional advice. Before making any decision regarding your dental or medical health, it is important to consult with your dentist or medical practitioner.

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