Why Hygiene Matters

Why Does Oral Hygiene Matter Beyond Your Teeth?

Oral hygiene matters because the bacteria that build up on your teeth cause the two most common diseases in the mouth: tooth decay and gum disease. Left alone, both can lead to pain, infection and lost teeth. Gum disease in particular is also associated with wider health conditions, including diabetes and heart disease, so a healthy mouth is one part of looking after your general health.

The good news is that both diseases are largely preventable. Daily cleaning at home does most of the work, and regular professional cleaning removes what brushing can't reach.

As a dental hygienist and therapist, most of my working day is spent helping people get from "my gums bleed a bit" to "my gums are healthy", and showing them how to keep it that way.

Plaque and Tartar: What's Actually Building Up?

Plaque is a soft, sticky film of bacteria that forms on your teeth constantly. Within hours of brushing, it starts to build up again, especially along the gum line and between teeth. You can't always see it, but you can often feel it as a furry coating on your teeth.

If plaque isn't removed, minerals from your saliva harden it into tartar (also called calculus). Tartar:

• sticks firmly to the tooth and can't be brushed or flossed off
• has a rough surface that collects even more plaque
• often forms behind the lower front teeth and on the outer surfaces of the upper molars, near the salivary ducts
• can form below the gum line, where it's out of sight

Once tartar is there, only professional cleaning will remove it. That's the main job of a hygiene visit.

How Plaque Causes Tooth Decay

Bacteria in plaque feed on sugars and other fermentable carbohydrates from your food and drink. As they do, they produce acid. Each time you have something sugary, the acid softens the enamel surface for a while, until saliva gradually neutralises it and helps repair the damage.

The problem is frequency. If sugary snacks and drinks keep coming through the day, your teeth never get time to recover, and small areas of enamel break down into cavities. Decay is often painless until it's quite deep, which is why dental examinations and X-rays matter.

Fluoride toothpaste strengthens enamel and helps reverse very early decay. Keeping sugar to mealtimes rather than grazing makes a real difference too.

Gum Disease: From Bleeding Gums to Loose Teeth

Gingivitis is the first stage. Plaque at the gum line irritates the gums, which become red, puffy and bleed when you brush or floss. Gingivitis is very common and fully reversible with better cleaning and a professional clean.

Periodontitis is the more advanced stage. The inflammation spreads below the gum line and starts to destroy the gum attachment and bone that hold your teeth in. Pockets form between the gum and tooth, collect more bacteria and are impossible to clean at home. Over time, teeth can loosen, drift and eventually be lost.

Signs to watch for:

• gums that bleed when you brush, floss or eat
• persistent bad breath or a bad taste
• gums that look red or swollen, or have shrunk back
• teeth that feel loose or have moved

Bone lost to periodontitis doesn't grow back, but the disease can usually be stabilised with treatment and good home care. Smoking and poorly controlled diabetes make it more likely and harder to treat. Our gum disease treatment page explains the options.

Your Mouth and General Health: What the Evidence Says

There's good evidence that gum disease and some general health conditions are linked, but it's important not to overstate it. In most cases, researchers have found an association rather than proof that one causes the other.

• Diabetes. The relationship works both ways. People with diabetes are more likely to develop gum disease, and severe gum disease is associated with poorer blood sugar control. Treating gum disease may help a little with diabetes control in some people.
• Heart and circulation. Gum disease is associated with a higher risk of cardiovascular disease. The reasons aren't fully understood, and shared risk factors such as smoking play a part.
• Pregnancy. Hormonal changes make gums more prone to bleeding, and severe gum disease has been associated with some pregnancy complications.
• Older or frail adults. Good mouth care in people who are frail or in care has been associated with fewer chest infections.

What this means in practice: looking after your gums is worthwhile in its own right, and it's one sensible part of looking after your overall health. If you have diabetes, a heart condition or are pregnant, let us know, as it helps us tailor your care.

What Happens at a Hygiene Visit at Comely Bank Dental?

Every visit is tailored, but a typical appointment with our hygiene team follows these steps.

1. Catching up. We check your medical history and medicines, and ask about any bleeding, sensitivity or concerns.
2. Gum assessment. We gently measure around your teeth with a fine probe to check for bleeding and pockets. This gives a score we can compare from visit to visit.
3. Removing tartar. We use an ultrasonic scaler, which vibrates tartar off with a cooling water spray, followed by fine hand instruments for the areas that need detail.
4. Polishing. We remove surface stain and smooth the teeth so plaque has less to cling to. Airflow polishing, which uses a fine jet of powder, air and water, is available as an add-on for £30 and is particularly good at lifting stain from awkward areas.
5. Home care advice. We show you exactly where plaque is being missed and which interdental brush sizes fit your teeth. No lectures: just practical advice for your mouth.
6. Planning. We agree when you should come back, and refer you to the dentist if we spot anything that needs a closer look.

If your gums are sensitive, we can use numbing gel or a local anaesthetic so you're comfortable throughout.

Which Hygiene Visit Do You Need, and What Does It Cost?

The length of visit depends on how much build-up there is and the health of your gums. We'll recommend the right one at your first appointment.

If you have periodontitis, a course of gum treatment is usually carried out in stages, at £167 per stage.

Members of our dental plan save 10% on hygiene visits and most private treatment. All fees are guide prices, confirmed in writing before treatment starts.

How Often Should You See the Hygienist?

There's no single right answer. Your recommended interval depends on your gum health, how quickly tartar builds up for you, and risk factors such as smoking, diabetes, crowded teeth, braces or implants.

As a rough guide:

• every 6 months suits many adults with healthy gums
• every 3 to 4 months is often better for people with a history of gum disease or heavy tartar
• every 3 months for dental implants or a full-arch bridge, which our implant guarantee also asks of you
• once a year may be enough for a few people with very low build-up and excellent cleaning at home

We'll suggest an interval at your visit and review it over time. If you're new to the practice, our new patients page explains how to register.

What Makes the Biggest Difference at Home?

Professional cleaning helps, but what you do every day matters far more.

• Brush twice a day for two minutes, last thing at night and one other time, with a fluoride toothpaste. An electric toothbrush makes it easier for many people.
• Spit, don't rinse after brushing, so the fluoride stays on your teeth.
• Clean between your teeth once a day, with interdental brushes where the gaps allow, or floss where they're tight.
• Keep sugary foods and drinks to mealtimes rather than spreading them through the day.
• Don't smoke, as it hides bleeding and makes gum disease worse.

In my experience, interdental brushes are often the single biggest change people in Comely Bank, Stockbridge and across Edinburgh can make. Bleeding usually improves within a couple of weeks of cleaning between the teeth properly.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.