Oral hygiene is the practice of keeping the mouth clean and healthy by
brushing and flossing to prevent
and gum disease.
The purpose of oral hygiene is to prevent the buildup of plaque, the
sticky film of bacteria and food that forms on the teeth. Plaque adheres
to the crevices and fissures of the teeth and generates acids that, when
not removed on a regular basis, slowly eat away, or decay, the protective
enamel surface of the teeth, causing holes (cavities) to form. Plaque also
irritates gums and can lead to gum disease,
, and tooth loss. Brushing and flossing removes plaque from teeth, and
antiseptic mouthwashes kill some of the bacteria that help form plaque.
Fluoride, found in toothpaste, drinking water, or dental treatments, also
helps to protect teeth by binding with enamel to make it stronger. In
addition to such daily oral care, regular visits to the dentist promote
oral health. Preventative services that the dentist can perform include
fluoride treatments, sealant application, and scaling (scraping off the
hardened plaque, called tartar). The dentist can also perform such
diagnostic services as x-ray imaging and such treatments as filling
The Centers for Disease Control and Prevention report that dental caries
are perhaps the most prevalent of infectious diseases in children. More
than 40 percent of all children have cavities by the time they reach
kindergarten. It is, therefore, imperative that all parents learn the
importance of early oral care and that they teach their children proper
Good oral hygiene should start at the very beginning of a child's
life. Even before his or her first teeth emerge, certain factors can
affect their future appearance and health. Pregnant and nursing mothers
should be careful about using medications, as some, like the antibiotic
tetracycline, can cause tooth discoloration. Even before infants have
teeth, they have special oral hygiene needs about which all parents should
be aware. These include making certain the child receives adequate
fluoride and guarding against baby bottle decay.
Fluoride is beneficial for babies even before their teeth erupt. It makes
the tooth enamel stronger as the teeth are developing. In most municipal
water supplies, the correct amount of fluoride is added for proper tooth
development. If the water supply does not contain enough fluoride or if
bottled water is used for drinking and cooking, the doctor or dentist
should be informed. They may prescribe fluoride supplements for the baby.
Baby bottle decay is caused by recurring exposure over time to sugary
liquids. These include milk, formula, and fruit juices. These liquids pool
for prolonged periods of time as the child sleeps. This exposure can lead
to cavities forming, especially in the upper and lower front teeth. For
this reason, children should not be allowed to fall asleep with a bottle
of juice or milk in their mouths. An alternative is to give the child a
bottle filled with water or a pacifier recommended by the dentist. Even
breast-fed children are at risk. They should have their gums and teeth
wiped with a clean, damp washcloth or gauze pad following each feeding.
Baby teeth, also known as primary teeth, are just as important as
permanent teeth. They help the child to bite and chew food, help them
speak correctly, save space for the child's permanent teeth, and
help guide the permanent teeth into place. That is why it is so important
to initiate a program of good oral hygiene for children early on.
Once a baby has four teeth in a row, either on top or on the bottom,
parents should begin using a toothbrush two times a day. When choosing a
toothbrush, make sure the bristles are soft, polished, and made of nylon.
Parents should administer only a pea-size amount of fluoride toothpaste
that is made especially for children. Children tend to swallow, instead of
spit out, toothpaste. If the child does not like the flavor of the
toothpaste, using water alone is acceptable. Parents should also continue
to wipe the toothless gum areas with a washcloth or gauze.
As the child gets older, parents should demonstrate proper brushing
techniques. These include brushing the inside surface of each tooth first,
where plaque tends to accumulate most. Then they should clean the outer
surfaces of each tooth, angling the brush along the outer gum line. Next,
they should brush the chewing surface of each tooth, then using the tip of
the brush, clean behind each front tooth. They should use a gentle, back
and forth motion when brushing and finish by brushing the tongue.
Children will, at some point, decide they would like to try brushing their
teeth themselves. This is fine and should be encouraged, but parents
should remain in charge of keeping children's teeth clean until
they are between six to eight years old. Children do not have the
dexterity or coordination to perform brushing well until this time. Even
then, it is important that parents inspect their children's teeth
each time they brush. They should
A boy flosses his teeth as part of a daily regimen for good oral
(© Joh Feingersh/Corbis.)
pay special attention to the molars, as these teeth have lots of tiny
grooves and crevices where food particles can hide.
Good oral hygiene remains important as children grow into
. In fact, adolescence can often be a time when cavities and periodontal
disease happen more frequently. This higher rate is usually caused by an
increased intake of junk food and sugary foods such as soft drinks, as
well as inattention to oral hygiene procedures. Add to that the fact that
many older children and teens wear braces, making the cleaning of teeth
even more challenging. Parents should talk to their children about how
important good oral hygiene is in preventing not only cavities, but teeth
stains, bad breath, and an assortment of other dental problems.
Flossing once a day helps to prevent gum disease by removing food
particles and plaque at and below the gum line, as well as between teeth.
Parents do not need to initiate flossing until the child has teeth that
touch each other, which normally occurs in the molar areas first. Parents
should continue to floss their child's teeth until they are six or
seven years old. They should continue to monitor the child's
techniques and consistency thereafter.
Proper flossing technique is essential in removing as much plaque as
possible in a safe manner. The following procedure is recommended by
dental hygienists. Wind 18 inches (45 cm) of dental floss around the
middle fingers of each hand. Pinch the floss between the thumbs and index
fingers, leaving about 1–2 inches (3–5 cm) length in
between. Use the thumbs to direct the floss between the upper teeth. Try
to keep the floss taut
between the fingers. Use the index fingers to guide floss between lower
teeth. Gently guide the floss between the teeth by using a zig-zag motion.
Contour the floss around the side of each tooth. Slide the dental floss up
and down against the tooth surface and under the gum line. Floss each
tooth thoroughly with a clean section of floss.
Dental floss comes in many varieties (waxed, unwaxed, flavored, tape) and
may be chosen based on personal preference. For those who have difficulty
handling floss, floss holders and other types of interdental (between the
teeth) cleaning aids are available. Some floss holders have animal and
cartoon characters on them, which might make flossing more appealing to a
It is important that younger children only use a very small amount of
fluoridated toothpaste since using too much fluoride can be toxic to
infants. Though brushing and flossing are important, neither should be
performed too vigorously. The rough mechanical action may irritate or
damage oral tissues. Parents should change their child's toothbrush
three to four times a year and after every illness to avoid bacteria and
Another factor that may affect a child's oral health is the
increasingly popular practice among adolescents of oral piercings
involving the tongue, lips, and cheeks. These piercings have been
associated with infections, tooth fractures, periodontal disease, and
nerve damage. Some life-threatening complications have occurred, including
bleeding and airway obstruction. The American Academy of Pediatric
Dentistry strongly opposes the practice of oral piercings.
The primary risks arise from a lack of proper oral hygiene practices.
These major oral health problems are plaque, tartar, gingivitis,
periodontitis, and tooth decay.
—Plural, calculi. Any type of hard concretion (stone) in the
body, but usually found in the gallbladder, pancreas, and kidneys. They
are formed by the accumulation of excess mineral salts and other organic
material such as blood or mucous. Calculi (pl.) can cause problems by
lodging in and obstructing the proper flow of fluids, such as bile to
the intestines or urine to the bladder. In dentistry, calculus refers to
a hardened yellow or brown mineral deposit from unremoved plaque, also
—A hole or weak spot in the tooth surface caused by decay.
—Inflammation of the gums in which the margins of the gums near
the teeth are red, puffy, and bleeding. It is most often due to poor
—The dental specialty concerned with the dental treatment of
children and adolescents.
—A deposit, usually of fatty material, on the inside wall of a
blood vessel. Also refers to a small, round demyelinated area that
develops in the brain and spinal cord of an individual with multiple
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211 East Chicago Avenue, Suite 700, Chicago, IL 60611. Web site:
American Dental Hygienists' Association.
444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. Web site:
"Oral Health Resources."
Centers for Disease Control and Prevention.
Available online at http://www.cdc.gov/OralHealth/index.htm
(accessed October 26, 2004).