Healthy teeth: expert tips from a dentist

Dr Maximilian Donges runs Smile, a dental practice in downtown Hamburg. I talked to him about common brushing mistakes that are easy to avoid, how he takes care of his own teeth and what things to avoid to keep that healthy smile.

What can you tell us about your everyday dealings at the practice?
Dr Donges: Tooth decay’s definitely not as big as it was 20 years ago. This is thanks to better toothpaste, improved dental care and the fact that children are taught to brush their teeth earlier on and generally benefiting from preventative measures. Overall, there’s just more awareness around dental care. A German oral health study (in German) conducted by «Bundeszahnärztekammer», the Institute of German Dentists, coincides with Dr Donges’ observations regarding the decline of tooth decay. However, other problems are more prevalent today.

Which ones?
I often see teeth that are well looked after but have damaged enamel. This is often caused by a high consumption of acidic drinks such as energy drinks or Cola. The acid attacks the tooth enamel, which can lead to tooth erosion. Tooth enamel is a crystalline structure that can be decomposed by acid. What’s more, it can’t recover. Eroded areas are susceptible to bacteria, which ultimately lead to cavities.

Is this also the case if you brush your teeth well and often?
Yes, I’ve also seen this in patients who take good and frequent care of their teeth. For example, brushing your teeth right after drinking an acidic drink makes things even worse. You’re literally brushing away the enamel. It also makes it harder for saliva, which helps remineralise the enamel, to form a protective film on the teeth again.

Are there any other issues that can crop up despite or possibly as a result of incorrect tooth brushing?
Excessive brushing or brushing with too much force can damage tooth enamel – especially if you’re using a hard toothbrush. If you’re causing real damage to the enamel at the neck of the teeth, where the tooth meets the gum, this leads to increased pain sensitivity in the affected teeth.

So a soft toothbrush is the way to go?
At least avoid using a hard one. What’s important is to brush with as little pressure as possible and to apply the right technique. That’s why I’d recommend using a sonic toothbrush. It does most of the work for you and usually doesn’t require much pressure. After two minutes, you’re left with very good cleaning results and have avoided damage a hard or medium-hard manual toothbrush may have caused.

What’s important to look out for in an electric toothbrush?
In any case, there’s no need to go for the most expensive model. It may feature seven or eight different modes, but nobody really needs them. There are already very good models in the mid-price range. Consumer magazine «Stiftung Warentest» has carried out useful comparisons if you want more information. There are even start-ups out there that produce toothbrushes with a very long battery life. That’s a great feature if you’re going on holidays and need an electric toothbrush that will last.

Speaking of cleaning your teeth. How often should you use dental floss or interdental brushes?
Using one of them once a day is recommended.

At night, the body also produces less saliva, which helps wash away bacteria. Especially if you sleep with your mouth open, which leaves that area dry at night.

And how often should you brush your teeth in general?
Twice a day for two minutes is usually enough. However, this also depends on how prone your teeth are to tooth decay. If this is the case for you, try to reduce high-carb meals throughout the day. It’s also better for your teeth if you eat regular meals instead of snacking on sweets in between.

Does this make sugary chewing gum the worst-case scenario for your teeth?
As with most things, it depends on the quantity. Besides, most chewing gum’s sugar-free these days. But if you’re chewing gum throughout the day, there’s another problem you might be facing. Hard chewing or clenching your teeth stresses the temporomandibular joint.

People often clench or grind their teeth at night when they’re stressed, right?
Yes, and we see the result of that at the practice. The number of dental guards you wear during the night has increased significantly. People often grind their teeth while processing things in their sleep. However, some people also suffer from so-called daytime bruxism, which involves gritting your teeth throughout the day. Similar to chewing gum, this causes lots of tension in the chewing muscle and can leave to overcharging it. This not only causes damage to the teeth through abrasion, but can also lead to headaches, neck tension or even pain in completely different parts of the body, such as the back.

Does a dental guard help?
Yes, it does. It protects the teeth from abrasion and reduces the strain of the immense pressure put on the molars. What you can do is pay attention to whether you’re clenching your teeth during the day.

Try sticking a small red dot somewhere in your home or on your wallet, laptop or rear-view mirror in the car to remind you to check your teeth’s position from time to time.

Do you have any other tips?

It’s not done enough, even though the tongue’s a like a fluffy carpet that provides great places for bacteria to accumulate. The tongue is also a common cause of bad breath. You can get a special tongue cleaner, as regular toothbrushes often trigger a gag reflex because of the bristles. If you clean your tongue regularly, you’ll notice a difference after just two weeks. The colour will change because there’s less of a film on it.

And how do you take care of your own teeth?
I brush them twice a day for two minutes. Sometimes, I manage to squeeze in a lunchtime brush, too. Using dental floss is also part of my daily routine. Of course, there are days when I just don’t get round to it. But if you clean regularly and thoroughly, it’s not the end of the world if you don’t floss on the odd occasion. I also try to avoid acidic drinks as best I can and try not to eat sugary foods in between meals. This has proved a good strategy so far.