Looking after your teeth and gums: brushing, cleaning between teeth and dental check-ups

How do brushing and fluoride help?

The NHS recommends brushing with fluoride toothpaste twice a day for about two minutes. It says electric and manual toothbrushes are both effective when every surface is cleaned. The NHS advises spitting out after brushing rather than rinsing, because rinsing washes away the fluoride still on the teeth. A fluoride mouthwash can help if it is used at a different time from brushing.

What about cleaning between teeth and sugar?

The NHS describes cleaning between the teeth with floss or interdental brushes to remove plaque along the gum line. It says wooden toothpicks can damage the gums. The NHS advises cutting down on sugary food and drink, especially between meals. Its effect depends on how often the teeth are exposed to sugar as well as how much is eaten. Acidic drinks such as fruit juice and squash can also wear teeth.

What is gum disease?

Bacteria in dental plaque build up on the teeth and along the gum line, and plaque is the main driver of gum disease. Gingivitis, the early stage, makes the gums swollen and red, and they can bleed. It can often be reversed with effective cleaning. Untreated, gingivitis can progress to periodontitis, which damages the bone and tissue that support the teeth and cannot be reversed, though treatment can control it. Gum disease is often painless, so it may not be noticed until a dental check. A Leeds Teaching Hospitals leaflet says smoking significantly increases the risk of gum disease, and the NHS lists stopping smoking among the advice for early-stage gum disease.

How often are dental check-ups needed?

NICE guideline CG19 says the longest interval between oral health reviews for adults should be 24 months, and the shortest for routine recall should be 3 months. It says longer intervals suit people who have shown they can maintain good oral health and are not at risk of oral disease. NHS inform says people in Scotland are seen according to their oral health needs, which may mean more frequent visits or fewer if their oral health is good.

Who gets free NHS dental care, and when is a dentist needed?

NHS dental treatment in England is free for some groups, including children under 18 (or under 19 in full-time education), pregnant women and women who had a baby in the past 12 months, and people on certain benefits. The NHS advises having red, swollen, sore or bleeding gums checked by a dentist. NHS pages say people not registered with a dentist can search for one on the NHS website, and that NHS 111 can put them in touch with an urgent dental service in England.