Oral Health Advice & Guidance

• Breastfeeding provides the best nutrition for a baby’s overall health. Babies should be exclusively breastfed for around the first 6 months
• Continue breastfeeding while introducing solids from around 6 months
• For parents/carers feeding babies by bottle, only breastmilk, infant formula or cooled boiled water should be given in a bottle
• Babies should be introduced to drinking from a free-flow cup from the age of 6 months
• Feeding from a bottle should be discouraged from the age of 1 year
• Gradually introduce a wide variety of solid foods (of different textures and flavours) from around the age of 6 months. Sugar should not be added to food or drinks given to babies and toddlers
• Parents/carers should brush their children’s teeth as soon as they erupt
• Brush twice a day. Last thing at night and on one other occasion each day
• Use a toothpaste containing at least 1000ppm
• Using only a smear of toothpaste
• Minimise consumption of sugar-containing foods and drinks
• Use sugar-free versions of medicines, if possible
• Avoid sugar-containing foods and drinks at bedtime when saliva flow is reduced, and buffering capacity is lost
• Children should have their first dental appointment as soon as their first tooth erupts.

Teeth should be brushed by a parent/carer:

• On all tooth surfaces
• At least twice a day
• Last thing at night and on at least one other occasion each day 
• With toothpaste containing at least 1000ppm fluoride – for children who are showing concerns we would recommend a toothpaste containing 1,350 to 1,500 ppm fluoride.
• A pea-sized amount of toothpaste is to be used
• Spitting out after brushing rather than rinsing.
• Minimise the amount and frequency of consumption of sugar-containing food and drinks
• Use sugar free versions of medicines, if possible
• Avoid sugar-containing foods and drinks at bedtime when saliva flow is reduced, and buffering capacity is lost.

Dental Professional intervention:

• Apply fluoride varnish to teeth 2 times a year

• Brush teeth at least twice daily- with assistance from parent or carer.
• Last thing at night and on at least one other occasion each day
• With a toothpaste containing 1350-1500ppm fluoride
• Spitting out after brushing, not rinsing
• Minimise amount and frequency of consumption of sugar containing food and drinks
• Avoid sugar-containing foods and drinks at bedtime when saliva flow is reduced, and buffering capacity is lost.

Dental Professional intervention:

• Apply fluoride varnish to teeth 2 times a year

Trauma First Aid

• This is only for adult teeth.
• Never replant a baby tooth as this can cause damage to the growing tooth.
• Pick up the tooth by the crown of the tooth.
• Lick the tooth if it is dirty or pour water over it for less than 10 seconds
• Gently stick it back into position and bite down on a handkerchief to keep the tooth in place
• Go immediate to a dentist.

For more information please visit this website: dentaltrauma.co.uk/Public.aspx

• Brush all tooth surfaces at least twice a day with fluoride toothpaste
• Ensure that every surface of each tooth and the junction between the gum and tooth are cleaned carefully
• Brush last thing at night and on at least one other occasion each day
• With a toothpaste containing 1350-1500ppm fluoride – using a pea sized amount
• Spitting out after brushing, not rinsing
• Minimise amount and frequency of consumption of sugar containing food and drinks
• Avoid sugar-containing foods and drinks at bedtime when saliva flow is reduced, and buffering capacity is lost
• Both electric and manual toothbrushes are effective for plaque control
• For most patients an appropriate brush will be a small-headed toothbrush with medium texture bristles
• Daily interproximal cleaning should have started by age of 18 years – this can be done with floss or interdental brushes if appropriate
• Thorough cleaning may take at least 2 minutes. There are toothbrushing timers or downloadable apps available to aid with correct length of time
• Disclosing agents can help to indicate areas of the mouth that are being missed and guide more effective cleaning

Interdental Cleaning:

• This is the cleaning in the spaces between teeth. This can be done using floss or interdental brushes and, in some case, can be done by a water flosser
• This is to be done to help prevent gum diseases. There are different stages of gum disease and if it progresses to the later stages, the damage cannot be reversed as it leads to the destruction of the bones which supports the teeth
• The British society of Periodontology have a useful leaflet to explain gum disease: bsperio.org.uk/assets/downloads/Perio_leaflet_2_sides.pdf

Adaptive Toothbrushes/Sensory Toothpaste:

To aid with toothbrushing, especially those who struggle gripping and holding a toothbrush, a larger handle with a silicone cover can increase comfort and help improve manual dexterity. These can be used by younger children and those who suffer with arthritis and limited hand strength

• There are other types of toothbrushes which can also help those who struggle to brush including 3-sided toothbrushes
  • https://growingsmiles.co.uk/shop/great-grip-toothbrush/ 
  • https://growingsmiles.co.uk/shop/dr-barman-superbrush/ 
  • https://www.colliscurve.co.uk/shop/black-top 
• Oranurse is a toothpaste which is completely flavourless and non-foaming which can be great those with sensory issues

• The aging population will most likely experience poly-pharmacy, this is one of the biggest causes of dry mouth
• Encourage drinking more water or chewing sugar-free gum. There are over the counter gels, sprays and lozenges which can help alleviate symptoms
• Root caries- due to the older population suffering more frequently with gum recession, this exposes root surfaces which are more vulnerable to root decay
• The root surface does not have an enamel layer so is less protected from root decay. Encouragement to brush all surfaces of the teeth and roots can help prevent decay
• This is a helpful easy read leaflet on caring for adults: gerodontology.com/content/uploads/2015/06/ER-Mouthcare-for-Older-People-Information-for-Carers-BSG1205upload.pdf

Brushing your teeth and your fixed appliance may take a little longer than normal. It is important to brush all aspects above, below and around your brackets. It is still important to use a pea sized amount of fluoride toothpaste containing 1350ppm-1500ppm, and it is crucial to spit not rinse.

Interdental brushes and single tufted brushes can help to clean about the brace and between your teeth. Your dental professional can help provide tailored advice with effective oral hygiene.

An alcohol-free fluoride mouth rinse should be used daily at a different time of day from brushing.

It is importance to take care of your teeth and brace and to prevent damage to both you should:

• Avoid eating between meals
• Avoid sticky, chewy, and hard foods
• Avoid all fizzy drinks, fruit squashes, fruit cordials, sports energy drinks and large amounts of fresh fruit drinks. Milk and plain water are best.

Denture cleaning:

• Should be cleaned at least once a day
• Should be cleaned with a denture brush and mild soap
• Do not use toothpaste
• The soft tissues should be cleaned even if no natural teeth are present
• If natural teeth are present, then they must be cleaned with a fluoride toothpaste and toothbrush twice daily
• Always cleaned over a bowl of water
• To be removed overnight to allow soft tissues to ‘breathe’ and recover from being worn during the day
• Soaking your denture in water overnight will give your soft tissues a rest and help prevent any fungal infections
• Soaking your denture in denture cleaning tablets can cause damage to your denture so please speak to your dental professional before using these

If you have any concerns speak to your dental professional for tailored advice.

• No amount of tobacco use is safe

• Tobacco use both in smoke form and smokeless form has serious effects on oral health and general health

• The most significant harms on the oral cavity are oral cancers and pre-cancers, increased severity and extent of periodontal (gum) diseases, tooth loss and poor wound-healing post-operative
• The goal is to reduce tobacco use and then quit smoking
• If you need additional support with quitting smoking please use this link: healthycornwall.org.uk/make-a-change/smokefree-cornwall/

Visit our Smile Together Patient Hub for more Mouth Cancer Awareness resources here