How often has your dentist told you to brush more, floss more? Most people feel frustrated when they get this speech from the dentist or hygienist. Although brushing after each meal is important, it is simply not enough to maintain healthy teeth and gums.

Lack of hygiene and improper hygiene play a significant role in the development of gum disease. One study indicated that when individuals with healthy teeth and gums stopped trying to remove plaque, gum disease developed within ten to twenty-one days. If not thoroughly removed within twenty-four hours, byproducts of the bacteria irritate the gums and cause inflammation (gums become red, tender, and swollen).

Not only is plaque control important in the prevention of gum disease, it is also primary in the healing process after gum and bone surgery. Studies have shown that, all else being equal, if proper hygiene is maintained after gum surgery, healthy gums are maintained over the years. Poor oral hygiene results in the repeated need for surgery and the return of gum disease.

Effective plaque control refers to the specific measures needed to prevent plaque build-up. It appears that mechanical removal of plaque is the most reliable method of controlling and preventing its build-up. A toothbrush and floss are the fundamental tools required for this mechanical removal. Several useful adjuncts to brushing and flossing include water-irrigating devices, balsa-wood wedge toothpicks, and rubber-tip stimulators. Whatever device you use, proper technique is essential. (Refer to Oral Hygiene in Part Three for more detailed information regarding these individual devices.)

Even when daily hygiene is maintained, a professional cleaning every six months by the dentist or hygienist must be included in your dental regimen. If your daily hygiene is not adequate, you will develop a buildup of tartar (hardened plaque). In this case, the dentist or hygienist will use a special instrument called a cavitron to clean your teeth. This device uses high-frequency sound vibrations in water to break up and wash away the tartar. Your dentist may even recommend more frequent cleanings, depending on the condition of your gums and bone.

Toothpastes contain mostly flavoring agents, detergents, and abrasives. Other common ingredients are listed on the following page. Do not use toothpastes that contain sparkles or added sweeteners, including saccharin or other artificial sweeteners. These chemicals are absorbed through the tissues into the blood stream. Some toothpastes that claim to remove or retard tartar may actually cause tooth sensitivity due to the harsh chemicals they contain. Baking soda is excellent for use as a toothpaste.

Ingredient	Function	Comments
Alcohol	Antiseptic, arrests the growth of bacteria. Used in commer- cial mouthwashes	High doses are toxic. When used routinely, it may dry the tissues, contributing to cavities and cancer.
Aloe vera	Soothes and acts as an anti-inflammatory.	Extracted from the leaves of the aloe vera plant.
Anise	Flavors toothpastes.	Known for its ability to aid in digestion.
Carrageenan	Thickener and stabilizer in toothpastes.	A seaweed gum by-product.
Chlorhexidine	Preservative, has antiplaque and antiseptic properties. Used in mouthwashes such as Peridex.	Possible side effects include staining of teeth and alterations in taste.
Ginseng	Thought to enhance endurance, slow the aging process, protect cells from radiation damage, prevent heart disease, and increase the flow of saliva.	Derived from the root of the ginseng plant. Most uses have not been fully proven scientifically. Any benefits to teeth and gums have not been substantiated.
Glycerin	Prevents drying out of products.	Derived from palm oil.
Goldenseal	Exerts influence on the mucous surfaces and on the tissues they contact.	Extracted from the root of the goldenseal plant
Hydrogen peroxide	Disinfects, cleanses, bleaches, and liberates oxygen.	Long-time use is not recommended.
Jojoba	Soothes, may relieve swelling.	Obtained from the jojoba bean. Has no known side effects.
Myrrh	Antiseptic, used to treat halitosis (bad breath).	Obtained from trees and shrubs of the genus Commiphora.
Quaternary ammonium compound	Reduces plaque by acting as an antiseptic, solvent, and emulsifying agent. Used in Cepacol and Scope.	Adverse reactions may include a burning sensation in the mouth.
Sage	Astringent.	Extracted from leaves of salvia officinalis. An excellent gargle for sore throat. May cause dry mouth.
Sanguinarine	Reduces bacteria's ability to attach to teeth and gums. Also retards the acid-producing ability of bacteria. Used in Viadent toothpaste and mouthwash.	Derived from the bloodroot plant. Chemical name is benzophenathradine. Adverse effects may include a burning sensation in the mouth.
Sodium citrate	Anticoagulant.	A chemical.
Tea tree oil	Said to have antiseptic and antifungal properties. Used in toothpastes found in health-food stores.	Essential oil of the plant Melaleuca alternifolia. Research into its benefits has been limited.
Thyme essence	Used in some toothpastes and mouthwashes for its antiseptic action.	Also known as oill of thyme (thymol), an extract of leaves and flowers of thymus vulgaris.
Titanium dioxide Witch hazel	A whitening agent used in toothpastes.	TiO2, derived from titanium, a metallic element.
Witch hazel	Used in mouthwashes for its astringent properties, has a mild anti-inflammatory effect.	Extracted from bark and leaves of the witch hazel shrub.
Zinc chloride	Astringent, used in some mouthwashes.	A mineral.
Zinc oxide	Has mild, soothing astringent properties. Used in some toothpastes.	A mineral.