Causes of Tooth Abscess

Abscess is basically the collection of the pus that has accumulated in a cavity formed by the tissue. The organisms or foreign materials kill the local cells, resulting in the release of toxins. The toxins trigger an inflammatory response, which draws large numbers of white blood cells to the area and increases the regional blood flow.

Similarly an Tooth Abscess is the collection of the pus in the Pocket of the bone, at the apex of the root, near the opening of the apical foramen.

it result due to the bacterial infection.Infection results in a collection of pus (dead tissue, live and dead bacteria, white blood cells) and swelling of the tissues within the tooth.This causes sever pain



Causes of the Tooth abscess.

• Tooth decay


• Trauma to the Tooth, fracture


• Poor oral hygiene, (such as not brushing and flossing properly or often enough


• faulty tooth restoration


• Carious formation


• pulpitis

Symptoms

Toothache

Severe, continuous pain

Pain when chewing

Sensitivity of the teeth to hot or cold

Bitter taste in the mouth

Breath odour

Swollen glands of the neck

General discomfort, uneasiness, or ill feeling

Swollen area of the upper or lower jaw -- a very serious symptom

sometimes causes difficulty in breathing.



Treatment

People who have cavities or toothaches can take medicines, such as ibuprofen or naproxen as needed for relief of pain and inflammation.

If an abscess ruptures by itself, warm water rinses will help cleanse the mouth and encourage drainage.

Surgical drainage of the abscess or extraction of the affected tooth may be necessary.

Root canal therapy may be recommended in an attempt to preserve the tooth.



Complications

Loss of the tooth

facial cellulitis, Ludwig's angina

spread of infection to the jaw bone (osteomyelitis of the mandible or maxilla)

Spread of infection to other areas of the body resulting in brain abscess, endocarditis, pneumonia, or other disorders



Prevention

• Remember to brush and floss after every meal and at bedtime.


• Avoidance of cigarette smoking and excess alcohol.


• early diagnosis of caries and treating it.


• should treat fracture tooth

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Causes of Toothache

Toothache" is pain around the teeth or jaws. Toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (temporo- mandibular joint), or spasms of the muscles used for chewing. The pain can be mild to sever The pain may be aggravated by chewing or by cold or heat.


Pain around the teeth and the jaws can be symptoms of diseases of the heart (such as angina or heart attack), ears (such as inner or external ear infections), and sinuses (air passages of the cheek bones). For example, the pain of angina is usually located in the chest or the arm. Infections and diseases of the ears and sinuses can also cause pain around the teeth and jaws. Therefore, evaluations by both dentists and doctors are sometimes necessary to diagnose medical illnesses causing "toothache."


Causes of Toothache

• dental caries
• dental abscess
• gum disease
• irritation of the tooth root
• cracked tooth syndrome
• temporomandibular disease
• impaction, and eruption.

Cracked Tooth syndrome: It id refers to toothache caused by a broken tooth or tooth fracture. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects.

Dental caries: it is most common form of toothache. Dental caries(cavity) is define as irreversible microbial disease of hard tissue of tooth causing dismeneralization of the inorganic substance and destruction of the organic substance resulting into cavity formation. Certain bacteria in the mouth convert simple sugars into acid. The acid softens and (along with saliva) dissolves the enamel and dentin, creating cavities. Small shallow cavities may not cause pain and may be unnoticed by the patient. The larger deeper cavities can collect food debris. The inner living pulp of the affected tooth can become irritated by bacterial toxins or by foods that are cold, hot, sour, or sweet-causing toothache.

Gum disease: it is refer to inflammation of the gingiva and abnormal loss of bone that surrounds the teeth.Gum disease is caused by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria. Early symptoms of gum disease include gum bleeding without pain. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of gum pockets. Bacteria in these pockets cause gum infection, swelling, pain, and further bone destruction. Advanced gum disease can cause loss of otherwise healthy teeth.

Tooth Root Sensitivities : The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to recede, exposing the roots. The exposed roots can become sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone. The sensitivities may be so severe that the patient avoids any cold or sour foods.

Impaction & Eruption:Impacted (teeth pressing together) or erupting (tooth growing out or "cutting") molar teeth (the large teeth in the back of the jaw) can cause pain. As the molar teeth erupt, the nearby tissues can become inflamed and swollen

Temporo-Mandibular Joint Syndrome: Pain in the temporo-mandibular joints can be caused by acute trauma (such as a blow to the face), inflammatory or degenerative arthritis or by the mandible being pushed back towards the ears whenever the patient chews or swallows. Sometimes, muscles around the TMJ used for chewing can go into spasm, causing head and neck pain and difficulty opening mouth normally. These muscle spasms are aggravated by chewing or by life "stress," which cause the patients to clench their teeth and further tighten these muscles.

Be serious about your Teeth

In day to day life people hardly get times to take care of their teeth or regularly visit dentist.
Most people visit dentist only when their occur pain in tooth or their is swelling in mouth or they just want to whiten their teeth. People have wrong perception that if problem occur dentist will take care of it. Truth is he can only prevent it from getting worst, or provide substitute.

people go to gym to improve their appearance , take yoga class, join some clubs, etc. But they take little care of their teeth. Tooth problem is often neglected and it grow in to big problem.
don't open the door of destruction it is in your to prevent yourself.

Improper brushing , taking excessive sweet, cold drink, Sticky foods, etc
The bacteria convert all foods -- especially sugar and starch -- into acids. Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth.Plaque that is not removed from the teeth mineralizes into tartar.bacteria in lower PH cause dismeralization, and lead to caries i.e loss of structure of enamel..formation of cavities.Untreated tooth also destroys the internal structures of the tooth (pulp) and ultimately causes the loss of the tooth.
you don't want to lose tooth early in your life or have to wear partial denture or go for excessive implant. caries can occur in any years of life.
(proper way of brushing)

Calculus, plaque , food impaction cause irritation of gingiva lead to gingivitis. if not clean lead to periodontitis, pocket formation causes destruction of surrounding structure of tooth. causes cause loosening of tooth lead early fall of teeth.

Bad habit such as thumb sucking , biting of nail can lead to Malocclusion. unplaced tooth causes injury to the surrounding structure, prone to fracture, difficulties in mastication,
malocclusion can congenital it should be treated early in life.

Bad habit of smoking ,tobacco
development of oral cancer, tongue cancer, lip cancer.

help your self.. don't shorten your life
Remember, you don't feel it that doesn't mean your free from disease.

What is DENTAL PLAQUE

Dental Plaque

Dental plaque is a general term for the diverse microbial community (predominantly bacteria) found on the tooth surface, embedded in a matrix of polymers of bacterial and salivary origin. Plaque develops naturally on teeth, and forms part of the defence systems of the host by helping to prevent colonisation of enamel by exogenous (and often pathogenic) microorganisms (colonisation resistance).
Plaque is an example of a biofilm; current research is showing that the properties of bacteria associated with a surface in a biofilm can be markedly different than those of the same cells growing in liquid broth (planktonic cells). Plaque is found preferentially at protected and stagnant surfaces, and these are at the greatest risk of disease.

How Plaque is formed

• absorption of salivary proteins and glycoproteins, together with some bacterial molecules, to the tooth surface to form a conditioning film (the acquired pellicle).


• Long-range (>5Onm), non-specific interaction of microbial cell surfaces with the acquired pellicle via van der Waals attractive forces.


• Shorter-range (10-20nm) interactions, in which the interplay of van der Waals attraction forces and electrostatic repulsion produces a weak area of attraction that can result in reversible adhesion to the surface.


• Irreversible adhesion can occur if specific inter-molecular interactions take place between adhesins on the cell surface and receptors in the acquired pellicle.


• Secondary or late-colonisers attach to primary colonisers (coaggregation), also by specific inter-molecular interactions.


• Cell division of the attached cells to produce confluent growth, and a bioflim

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Denture Vs Implant

DENTURE :Many people with missing teeth wear conventional upper and lower dentures or partial dentures because they are cheaper.Lower dentures never fit or feel like natural teeth. They become loose fitting due to shrinking gum tissue, which then causes irritation to the mouth, sores and pain. The only relief is in using messy dental adhesive to improve the fit.

Upper dentures are easier to wear because the suction in upper palate (roof of the mouth) helps keep the denture in place. But having the palate covered can also reduce the taste of foods that you are eating. Sores and pain in chewing and talking are quite frequent as the gum tissue shrinks, and many people suffer from having to use dental adhesive with upper dentures as well.

The advantage of upper and lower dentures is that they can be constructed quickly and they initially cost less than implants. They may last a lifetime, but over the years with aging, new sets need to be made to fit the changing gum tissue and chewing surfaces of the teeth in the dentures.

DENTAL IMPLANT

With the introduction of dental implants, the need to suffer with uncomfortable restorations has been eliminated. As our life span has been increasing, the need for some type of highly functional dental replacement system has become increasingly important. Dental implants are permanent dental replacements that are both natural looking and very functional. Implants look much better and feel better, and offer the same force for biting as natural teeth. If you are a non-smoker with good oral hygiene habits, dental implants should last for a lifetime.
Dental implants are a major investment and the procedure can be time consuming. As with any complex surgery, there is always the risk of complication even after a thorough examination and consultation prior to care. But dental implants are a dependable and life long solution to missing teeth. Compared with dentures, which can be loose and unstable, implants provide a permanent solution that is both functional and natural in appearance, giving you the confidence to smile and show your pearly whites.

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What is DENTAL FLUOROSIS

DENTAL FLUOROSIS

It is an hypoplasia and hypomineralisation of the Teeth,enamel, dentin caused by the chronic ingetion of excessive amount of fluoride during the stage of teeth developement.
fluorosis can't occur after the eruption of the teeth.
usually result in whit spot, yellowing of the teeth, mottling of enamel,white tips of teeth, or fine, lacy chalklike lines
Source of such excessive amount of fluoride come from

• water fluoridation
• Toothpaste
• beverages and food Dietary supplements that include fluoride (tablets)
• Other dental products (mouth rinses, gels, and foams)

Tooth Anatomy

People use their teeth to bite and chew food - they are the first step in the digestion of food. The long, sharp canine teeth tear up food (like meat). The wide, flat molars grind and mash up food. While we chew food, the tongue pushes the food to the teeth and saliva helps digestion and wets the food. Teeth also help us say certain sounds. People have two sets of teeth in their lives, the primary teeth (also called the baby, milk or deciduous teeth) and the permanent teeth (also called the adult or secondary teeth). Children have 20 primary teeth; they are replaced by the permanent teeth by about age 13. Adults have 32 permanent teeth.

Primary Teeth:Most babies are born with no visible teeth -- the teeth are forming inside the gums. The 20 primary teeth (also called baby teeth or first teeth) erupt (poke through the gums) over the time from when a baby is from about 6 months to a year old.
Permanent Teeth:Primary teeth fall out and are replaced by 32 permanent teeth (also called the adult teeth). This happens over the time from when a child is from about 6 to 14 years old.
As a permanent tooth forms under the gums and in the jawbone, the roots of the primary tooth it is replacing dissolve. Then the primary tooth becomes loose and falls out. The permanent tooth will fill the space.
Wisdom Teeth:
Wisdom teeth (also called the third molars) are molars that usually erupt from the ages of 17 to to 21.
Tooth Glossary:
Cementum - a layer of tough, yellowish, bone-like tissue that covers the root of a tooth. It helps hold the tooth in the socket. The cementum contains the periodontal membrane.
Crown - the visible part of a tooth.
Dentin - the hard but porous tissue located under both the enamel and cementum of the tooth. Dentin is harder than bone.
Enamel - the tough, shiny, white outer surface of the tooth.
Gums - the soft tissue that surrounds the base of the teeth.
Nerves - nerves transmit signals (conveying messages like hot, cold, or pain) to and from the brain.
Periodontal membrane/ligament - the fleshy tissue between tooth and the tooth socket; it holds the tooth in place. The fibers of the periodontal membrane are embedded within the cementum.
Pulp - the soft center of the tooth. The pulp contains blood vessels and nerves; it nourishes the dentin.
Root - the anchor of a tooth that extends into the jawbone. The number of roots ranges from one to four

What Discolor Your Teeth

Stained or yellow Teeth

Stained Teeth is a very common dental problem that makes a lot of people to feel uncomfortable when they have to talk or smile, due to the color of their teeth. Discolored teeth require teeth whitening treatment. The acquisition of colored substances onto the tooth pellicle is the main reason that makes teeth to lose their natural white color. Human teeth naturally vary in color. Not all are lucky to have a bright white as the natural color of their teeth. Slightly yellow teeth is normal for most people.
Enamel is more or less translucent, so it is the underlying dentin's color that determines the tooth color. Normal variations in dentin structure can affect the color of the reflected light, resulting in not perfectly white teeth.


What stains your teeth:
Stained teeth, that have lost their natural white color and need teeth whitening, may be the result of many different reasons :

• Colored organic compounds from some foods and drinks - tea, coffee, red wine, blueberries, curry and other - are absorbed on teeth enamel, resulting in yellow teeth. Other foods that contain much chlorophyll may result in green stains.
• Common dental restorative materials, as the amalgam in silver-colored fillings, may turn adjacent areas of teeth black or gray.
• Prescribed antiseptic mouthwashes containing chlorhexidine are associated with causing yellow-brown stains on teeth. Repeated use of stannous fluoride can result in a light brown or yellowish stain.
• Metallic stains can be caused by metallic salts, such as in iron supplements.
• Systemic disorders (as alkaptonuria, erythropoietic porphyria, hyperbilirubinemia etc.) also can cause tooth discoloration or enamel hypoplasia.
• In fluorosis, chalky white spots or brown marks are caused by excessive fluoride intake. (Whitening does not remove the white spots but lightens background so they are less noticeable).
• Trauma may cause tooth discoloration by allowing hemosiderin to enter to dentinal tubules. Trauma may change a tooth to a pink, yellow, or dark gray color. Chips or other injuries that damage the pulp of a tooth can also cause discoloration and yellow teeth.
• Some medications, such as the antibiotics tetracycline and minocycline, may become incorporated into the structure of a tooth, causing intrinsic staining of the teeth with a brown-gray color. Use of tetracyclines should be avoided during the period of tooth formation, from 4th month of pregnancy until 7 years of age.
• Other habits as smoking are also responsible for stained teeth.
• Teeth also change with age. As the mineral structure of the tooth becomes less porous it appears darker. Aging also contributes to the yellowing of teeth. The enamel wears thin, allowing the underlying layer of yellowish dentin to show through.

Tooth discoloration may be classified as either extrinsic (external) or intrinsic (internal

• Extrinsic discoloration — This occurs when the outer layer of the tooth (the enamel) is stained as by some drinks or foods or by smoking.
• Intrinsic discoloration — This is when the inner structure of the tooth (the dentin) darkens or gets a yellow color. Fluorosis or tetracycline stains are examples of common intrinsic stains.
• Age-related discoloration — This is a combination of extrinsic and intrinsic factors

contiune reading how to get rid of bad breath

how to brush your teeth

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Malocclusion

Many treatment options are available for malocclusion (poor bite), and expert opinions differ about timing. Your dentist or orthodontist may give you a choice between early or later treatment or may prefer one particular approach. Adults have effective treatment options as well.
The general categories of orthodontic devices (appliances) are functional and fixed.

Functional appliances use the movements of the muscles and jaw to create gradual bone movement.

• Some functional appliances are removable, while others are bonded to the teeth.
• A functional appliance may fit between the upper and lower teeth (a splint) or may span across the mouth between the molars, pressing the bone outward.
• Headgear can attach to bands on the teeth to speed up treatment time.

Fixed orthodontic appliances are sets of wires and brackets that are cemented to the teeth. These are commonly called braces. Over a period of months, the wires are tightened and adjusted, gradually applying enough force to move the teeth (bone remodeling).

• Retainers are removable appliances made of molded plastic and wire. They hold the teeth in place after braces are taken off. If the teeth start to move back out of position, the orthodontist may bond a short retaining wire to the back of some teeth. This will hold the teeth in place until the wire is removed.

Child and adolescent treatment

During the childhood and teen years, the orthodontist will time the treatments to match with your child's natural growth spurts to move permanent teeth into place.
Treatment for crowding, the most common malocclusion problem, may mean removing (extracting) some permanent teeth, but orthodontists avoid removing permanent teeth when they can.
The malocclusion treatments for children and adolescents are:

• Growth modification. This involves wearing fixed or functional appliances during the day and night to move the jaw into a better position.
• Extraction (serial removal). Removing some baby teeth may ease severe crowding.
  Fixed appliances (braces). For children and teens, this treatment phase usually lasts about 24 months; for adults, about 28 months.
• Retainers. Retainers hold the teeth in place after orthodontic treatment. Some orthodontists recommend that retainers be worn for many years, because teeth have a natural tendency to drift out of place.
• Space maintainers, made of metal or plastic. Spacers keep the surrounding teeth from moving (drifting) into open spaces created when teeth are pulled or lost in an accident.

Adult treatment

• Most adults have little or no jaw growth. This means that surgery is the only way to correct jaw-related bite problems. Some adults may benefit from simply camouflaging, or hiding, a jaw-related problem. Using braces, the orthodontist can move the teeth so that they fit together, despite the jaw discrepancy. 2 However, surgery is the best way to treat more severe jaw problems.
• Orthodontic treatment for malocclusion is a popular option for adults, due in part to better technology. In the past, wide silver bands held braces in place. Today they are less obvious. Instead of the wide bands, a small metal or ceramic fastener is bonded to each tooth, and a narrow wire passes through the fasteners.

New options include:
Clear plastic instead of silver wires.
Lingual braces. These braces attach to the back of the front teeth.
Removable clear plastic aligners (Invisalign). These are molded specifically for you.
Lingual braces and aligners don't work for everyone. They aren't options for children. Your orthodontist can tell you the best choices for your situation.
Orthodontic treatment for adults may also involve:
Removal (extraction) of teeth to create more space.


Orthognathic surgery of the jaw.
A retainer, after braces are removed.
Adjustments, such as grinding of high tips of teeth, to prevent continued or increased malocclusion for adults
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What is Crowding of Teeth or Malocclusion

"Malocclusion" or crowding of teeth is simple term abnormal position of Teeth.Incorrect relation between the teeth of the mandible and maxilla

Most people have some degree of malocclusion, although it isn't usually serious enough to require treatment.Those who have more severe malocclusions may require orthodontic and sometimes surgical treatment (orthognatic surgery) to correct the problem. Correction of malocclusion may reduce risk of tooth decay and help relieve excessive pressure on the temporomandibular joint. Orthodontic treatment is also used to align for aesthetic reasons.

Malocclusion is capable of adversely affecting the facial appearance of an individual

As Treatment take a long time, depending upon severity.It is necessary to identify malocclusion early in life. Parent should be educated enough to identified abnormality in occlusion of their chlid.

BAD HABIT: Such as "Thumb sucking" should not be taken lightly. It may result in

• Tongue Thrusting
• Lip sucking and lip biting
• Nail biting
• Posture

Effect of Malocclusion

• Risk of Trama: Their is high risk of injury especially during play or by an accidental fall
• Abnormalities of funtion: Many malocclusions cause abnormality in the functioning of the stomatognathic system such as improper deglutition, defects in speech, improper respiration
• Temperomandibular joint problems: Malocclusion associated with occlusal prematurities and deep bite is believed to be a cause of TMJ problems such as pain and dysfunction.
• Risk of caries: it make oral hygiene maintenance a difficult task, thereby increasing the risk of caries.
• Predisposition to periodontal disease: Malocclusion associated with poor oral hygiene is a frequent cause of periodontal disease. In addition, teeth that are placed in abnormal position can be a cause for traumatic occlusion with resultant periodontal tissue damage.
• Psychological disturbances: Malocclusion that adversely affect the appearance of a person leads to psychological disturbances. Unsightly appearance of teeth makes a person highly self-conscious and turns him into an introvert. Thus treatment of malocclusion im such patients helps in improving the mental well being amd confidence

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How to Get Rid of Bad Breath

How to Get Rid of Bad Breath
Suppose you conduct a 'breath test' as you make your way to an important meeting, and you fail. Don't worry - the following quick fixes can help to minimize your horrible halitosis. If your gums, tongue and teeth are harbouring odour-causing bacteria, you'll want to adopt some rigorous daily hygiene habits to inhibit them. That's when special rinses, attention to toothpaste and regular brushing and flossing can begin making bad breath good.

Steps

• Learn the side effects of any medications you may be taking, are they causing your bad breath? If so, you may wish to call your doctor to see if you can switch medications if bad breath is a big issue for you.
  
• Follow your diet for a few days. Are you eating a lot of something known for causing bad breath? For example, garlic, onions and some types of fish are known to cause bad breath.
  
• Cut back on the foods that cause bad breath.
  I
• f you'd like to fix the problem herbally, rather than going the "usual" route: Chew, do not swallow, a sprig of parsley or mint before and after eating to get rid of post-meal halitosis if you chose the herbal route.
  
• If you'd rather go the usual route, gargle with a mouthwash but don't chew a stick of gum, as they actually worsen your breath, try mints however they may have sugars that feed the bacteria on your tongue, so if you are particularly oral health concious, just stick with the mouthwash.
  
• Drink plenty of water throughout the day to assure a fresh, clean feeling.
  
• Purchase and use a tongue scraper and/or vigorously brush your tongue--your teeth are not the only place where odor-causing bacteria form. Make sure to brush the back of your tongue, not just the front.
  
• Floss on a regular basis, preferably after each meal. This is still necessary, even after a toothbrush cleaning.
  
• Consider that your bad breath may be stemming from within. While some bad breath is "superficial," (ie caused by bacteria in the mouth) it is often times the result of poor digestion.
• 
  
• To alleviate this type of bad breath, make it a point to eat a serving of "active culture" yogurt every day. The healthful bacteria in the yogurt will aid in digestion, and quickly eliminate any traces of internally generated bad breath.

Tips

• Chances are, your breath is not as bad as you think it is. Ask someone you trust (and will give you an honest answer) if they think you have bad breath.
  
• General rule of thumb: if you have a taste in your mouth, however light, you have bad breath. This only applies during periods of time when you aren't eating.
  
• With so many choices of toothpastes on the market, pick one that you like the flavor of so that you'll enjoy brushing your teeth.
  
• Don't drink bad-smelling liquids, as these particularly stick around in your mouth - drink lots of water but not milk, because it makes your breath smell REALLY bad, and don't go heavy on juice or liquor.
  
• The people of South America start their mornings by gargling with one teaspoon of honey and cinnamon powder mixed in hot water. This keeps their breath fresh throughout the day.
  
• To keep your toothbrush free of bacteria, store it, head down, in a lidded plastic tumbler of hydrogen peroxide. Rinse the brush down well before you use it.
  
• Here's how to properly check for bad breath (the classic way of blowing into the palms and smelling them is a placebo: you may think you're ok but you are not): Lick the back of your hand and then smell it, if no odor is sensed - just the 'presence' of normal saliva, then you are good to go!

Warnings

Do not stop prescription medication without your doctor's consent.

If none of the aforementioned techniques work for you, and you know you have severe bad breath, seek medical attention as bad breath can, in some rare cases, be a symptom of a far more serious disease.

Make sure you see a dentist regularly to fill up any cavities that may cause an unpleasant odor

Things You'll Need

• A knowledge of the side-effects of any medication you may be taking (if you're not sure, contact your doctor or pharmacist).
• Notebook and pen to track your diet.
• Sprigs of parsley and mint if you choose the natural route.
• Mints, and mouthwash (better to use mouthwash as there are very few oral health implications) if you choose the standard route.
• Water.
• Tongue cleaner.
  
• Toothbrush, toothpaste, and dental floss

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How to Brush Your Teeth

How to Brush Your Teeth
Brushing your teeth is very importantto do.You must brush your teeth every day so you wont get cavities or a gum deases.

Steps

Get all of your stuff ready. Things like toothbrush, tooth paste, floss and a mouthwash solution must be available in your home. Take these into the bathroom!

Floss before brushing. This will ensure that there is no large barrier of bacterial plaque between the brush and your teeth.

Wet your toothbrush slightly. By doing this, your gums will not be torn by the sharp bristles of the toothbrush.

Squeeze a pea-size amount of toothpaste onto a soft-bristled toothbrush. Your toothpaste should contain fluoride and be recognized by your local dental association.
Start brushing! Use circular strokes to clean the outside and inside surfaces of the teeth, as well as the chewing or "horizontal" surfaces for eight times, on each side. Follow with up-and-down motions to clean the inside surfaces of the front teeth. As a word of precaution, do this gently, because you may get excited and accidentally knock your gums using the woody part of your toothbrush.

Brush along the gum line. This is extremely important, as gum disease starts here. Brush gently to avoid damaging your gums. Make sure to return to the molars or the teeth at the back, where bacteria like to hide.

Brush your tongue to remove bacteria that cause bad breath. Do this gently also, because your tongue has very delicate taste buds which may easily be torn off.

Spit into the sink. Wash your mouth out with water to remove all remaining toothpaste.

point to note

• Brushing should take about 2 1/2 to 3 minutes.
• Get a soft toothbrush; the packaging should identify it as such. Never use medium or hard brushes because they can damage your gums and cause recession.
• Brush your teeth at least two to three times a day, and after each meal if you can. You might want to set a brushing schedule so you keep at it.
• Brush the backside (or inside) surfaces of your teeth - both upper and lower. Take your time and be gentle when doing this. It requires angling the tooth brush to get these surfaces. For the lower front teeth, angle the brush so the bristles are slightly below the gum line and gently pull up and out so the brush lifts any plaque and debris from around your lower gumline and teeth. Repeat this approximately five to seven times for each area of the front teeth.
• When your toothbrush bristles fray out or become too soft, usually after 3 months, it is time to get a new toothbrush. (You can find toothbrushes that change color when the brush is ready to be thrown out.)
• If your gums start bleeding, it means they are out of shape. Make sure you are brushing properly!
• Visit a dentist at least once a year for an exam and x-rays, and a cleaning.
• Consider using mouthwash after you brush for a fresh, clean feeling and added protection against gingivitis, etc.
• Floss daily.
• If you want to have your teeth whiter, carry sugar free gum which says 'whitening' on the pack.
• Don't keep your toothbrush close to the toiletbowl, because it can carry germs through the air
• Never use someone else's toothbrush. You can transfer germs, bacteria, and diseases through microscopic cuts in your mouth.
• Do not go two or more days without brushing your teeth. If you do, your mouth can become very nasty and you increase your risk of periodontal disease and cavities.
• Never use the toothbrush that is used for your daily brushing for other cleaning purposes, like cleaning the tiles of the bathroom or cleaning your ears.
• Replace your tooth brush after every illness you suffer, as bacteria may live in the moist interior of the bristles and reinfect you.

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