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1. Clean your teeth after eating by toothbrush and dental floss. Use a correct toothbrush, and brush and floss correctly.
2. Visit the dentist regularly. Periodontal disease of gums is common in adults and in older people. The dentist can remove plaque from teeth, reducing the number of bacteria – a key to helping prevent tooth decay and gum disease.
3. If you experience the following, then you have chances of a periodontal disease:
   Gums bleeding during brushing
   Red and/or swollen gums
   Gums that have pulled away from the teeth, Pus between the teeth and gums
   Bad breath
   Loose teeth.
4. Don’t ignore gums that bleed when you brush or floss or changes in the way your teeth fit together when you bite.
5. Ask your dentist about cosmetic options for improving the appearance of teeth that are stained or chipped.
6. Don’t use tobacco products; they can increase your risk of gum disease and cancer of the mouth and throat.
7. Don’t chew on hard objects that could crack a tooth.
8. Wear a mouth guard when playing active sports.
9. Eat a balanced diet for good overall health, selecting a variety of foods from the five main food groups (bread, cereals, and other grain products; fruits; vegetables; meat, poultry, fish and alternatives; milk, cheese, and yogurt), and limit snacks.
10. Eating sweetened cereals dry is bad for teeth, always add milk.
11. Drinking frequent cups of tea or coffee with sugar added will increase the risk of teeth decay.
12. When less saliva is available on very hot days, one should not consume foods containing sugars that stick in the teeth.
13. Chewable vitamin C tablets with or without sugar are acidic and are a hazard for not only children’s teeth but also to adult’s teeth. Do not use lemon juice for whitening because vitamin C will cause the teeth to lose calcium damaging teeth quicker than anything else.

Tooth decay

Tooth decay is one of the most common diseases in the world. Despite rates of dental caries falling in the last 30 years, it affects almost half of children and adolescents and more than 55 per cent of adults in the UK. Dental caries is a disease caused by acids – fermented sugars and starches – breaking down the tooth. It can be very painful and unsightly, and may lead to tooth loss if not managed. Thankfully it’s preventable and manageable if detected early.

The white visible section of the teeth is called the tooth enamel. It’s made up of minerals, especially calcium and phosphate. It’s constantly being dissolved (demineralised) and reformed (remineralised) depending on its environment. The bacteria in our mouths produce acids when they break down carbohydrates. In the presence of these acids, some of the calcium within the enamel dissolves and is lost from the tooth surface. This process is known as demineralisation.

At this stage, surface damage to the tooth can be repaired. Saliva is one of the mouth’s natural defences against this process and protects against dental caries in several ways:

• It helps to remove food from the teeth
• It contains bicarbonate that helps neutralise the acid production
• It delivers minerals such as calcium, phosphate and fluoride to the surface of the tooth, enabling remineralisation to take place.

Tooth decay occurs when there’s more demineralisation than remineralisation.

The teeth of children under six years old, and the elderly are particularly vulnerable to demineralisation. In children the tooth enamel is still being developed and is relatively soft and in the elderly, the tooth enamel is worn.

Dental erosion is the irreversible loss of tooth enamel and the dentine layer below which are dissolved away by acid in the diet or other outside factors (eg gastric acid from vomiting). In severe cases erosion can lead to total destruction of the tooth. Sugary or carbonated soft drinks, sweetened yoghurts, pickles and acidic fruits and fruit juices all put the enamel at risk. Erosion can also be a sign of someone with an eating disorder including self-induced vomiting.

Diet and dental health

Diet plays a significant role in both dental caries (cavities or tooth decay) and dental erosion. Good nutrition prevents many dental problems and is important from the outset. From good nutrition during pregnancy to breastfeeding in infancy, a balanced diet throughout childhood and adulthood is as good for the teeth as it is for general health.

The modern UK diet contains a mix of sugars and other carbohydrates that can be fermented in the mouth by oral bacteria to produce acid. Research has shown that people in countries that eat more sugar have significantly higher levels of caries. Studies also show that when people ate less sugar, for example during World War II, there was also a reduction in dental caries.

Both total sugar intake and the frequency with which it’s eaten are factors. Small amounts of sugar consumed frequently over a period of time will cause more damage than the same quantity consumed on a single occasion. Constant sugar nibbling encourages continuous demineralisation and the saliva doesn’t have time to neutralise the acids. Sticky or chewy foods that remain in the mouth longer also cause more damage as the bacteria have more time to produce the acid.

As well as correct brushing and flossing and regular dental checks, the following dietary measures can help minimise tooth decay and erosion:

• Eat sugary foods less often, particularly those of a sticky or chewable nature. Remember that dried fruits can provide sugar and a sticky surface on teeth that encourage bacterial growth and acid production
• Limit snacking of any foods, and therefore the amount of time your teeth are exposed to a bacteria-friendly environment
• Choose raw vegetables, wholemeal bread, unsweetened yoghurt or cheese as snacks
• Avoid sugary or acidic drinks between meals. Water or milk are the best options
• If you do have sweets, eat them all at once. Avoid ‘grazing’ over extended periods. For example have a whole chocolate bar in one go rather than constantly dipping in to a bag of sweets
• End a meal with milk or cheese to help neutralise the acid
• Leave a gap of one to two hours each time you eat or drink to allow remineralisation to occur
• Don’t have anything except water after you’ve brushed your teeth at night – less saliva is produced at night
• Don’t brush your teeth immediately after eating acidic foods or drinks. If teeth are brushed when in a demineralised state, a layer of tooth enamel or dentine may also be removed
• Drink through a straw. Liquids sucked through a straw have less contact with teeth and are less damaging than those consumed from a glass
• Chew sugar-free gum after a meal to help produce more saliva to neutralise the acid