Optimize my home dental regimen
April 15, 2020 10:34 PM   Subscribe

I have TERRIBLE teeth. Despite brushing twice a day and flossing daily, every dentist I've ever had has eventually put me on a frequent cleaning schedule to keep the cavities at bay. These past couple of years I've spent thousands of dollars to fix things up after an 8 month gap (gasp!) between visits. I'm already overdue for my next cleaning and I have no idea when my next visit will be, for obvious reasons. Dentists of AskMe, though YANMD, what should I be doing to maximize my chances of getting through These Unprecedented Times with my teeth intact?

My current routine is: brush in the morning and before bed with electric toothbrush + stannous fluoride toothpaste. In the evenings, floss and use the rubber gum stimulator thingy prior to brushing. My brushing/flossing technique is hygienist approved (sometimes they even compliment how well I keep up my home care, and yet.) I try to keep my sugary/acidic drink consumption low, but I do have an unfortunate weakness for snacks and sweets, especially right now. Should I be brushing after every meal? Using mouthwash? Get a Waterpik? Hope me!
posted by btfreek to Health & Fitness (29 answers total) 34 users marked this as a favorite
IANA dentist.

Is your toothbrush soft? Using too hard a toothbrush isn't good for the enamel. Are you brushing within an hour after eating, which can cause excessive enamel wear?

Are you getting enough calcium & other bone-relevant minerals in your diet?

Are you drinking enough to keep your gums hydrated?

Could you have acid reflux that is getting acid into your throat / mouth at night?

Can you get a dentist to give you remineralizing toothpaste (Novamin/Calcium Sodium Phosphosilicate, there's a few others)?

Mouthwash is probably a good place to start. It probably won't hurt and might help. Get a non-alcoholic one that is anti-plaque and anti-gingivitis. I've found that generics feel harsher than name brands.
posted by Ahniya at 10:58 PM on April 15, 2020

I am also not a dentist, but my teeth were having a lot of problems until I got in the habit of chewing sugar free gum (I like eclipse) after every single meal/snack. This way I always make sure I remove any bits of food from my teeth that tend to get stuck in cavities otherwise, and it doesn't hurt your enamel the way brushing right after eating does. And yeah, mouthwash also helps, I prefer the "natural" clear listerine because it tastes less mediciney to me.
posted by JZig at 11:13 PM on April 15, 2020 [4 favorites]

From a fellow sufferer of bad enamel and genetically dodgy gums:

- get a very very soft manual toothbrush with a fairly small head and follow up the electric brushing with a manual one, sweeping from the gums to the chewing surfaces on both sides, making sure you get into all the nooks at the edges of the jaws

- order GC Tooth Mousse / GC Mi Paste (US name) and apply twice a day, without rinsing your mouth afterwards or eating/drinking for at least an hour

- try to eat something tooth-cleaning (apples are good, so's Orbit gum) after sweets

I've been able to drastically reduce cavities and cleaning issues with these three.
posted by I claim sanctuary at 11:17 PM on April 15, 2020 [2 favorites]

When I told my dentist that I'd started using a WaterPik in addition to my Sonicare she applauded. At the time I was on an every-three-months plan because of bad gum issues, possibly similar to yours.
posted by bendy at 11:27 PM on April 15, 2020 [1 favorite]

I came in to also recommend CG tooth Mousse/Mi Paste-- its a paste you put on your teeth, but not a toothpaste. You just let it sit there. I find it pretty good, although I have had good/better results with Recaldent stuff to be honest. (I use the gum but it looks like they have other products) if you can get it, it's good as it has both xylitol and a calcium milk protein. Since its a little expensive, I alternate with a standard xylitol gum. But yeah, I highly recommend recaldent stuff.

Also I got high quality (no alcohol) mouthwash recently which has seemed to help somewhat--research on mouthwash efficacy are mixed, but as someone who maybe over-brushed/brushed too harshly, it helped me.

Also get a really high-quality soft brush. Don't brush after eating sweets for like an hour or so, its much better to have some gum instead as others have said. Also, ymmv, but I don't use an electric any more. I took one up but it made my gums recede really bad and my teeth hurt when I ate stuff, even with a soft bristle and gentle settings. So I just use a good quality regular brush instead. As an aside: I get Japanese brushes now, after a trip to Japan where I misplaced my toothbrush, I bought one at a drug store there-- a small headed 'charcoal' one, and it was the best brush I ever used. So if i'm in that part of the world, I always buy a few. The one I buy is the Dentalpro Black, though at first the smaller head was hard to get used to, but I love it now as I noticed it really gets in there. I've tried some other brands and they are good too. I recommend it a lot but of course it might be difficult to get right now, though at least here in Australia you can get it at import dental stores and ebay.

Do you have good floss? I got glide floss (its like a teflon tape almost) and it's much better and it irritates my gums less. If your gums are starting to recede, you might be brushing or flossing too hard, in which case I would totally get a waterpik instead.

I hope that helps.
posted by Dimes at 12:10 AM on April 16, 2020 [4 favorites]

Not a dentist, but here's what I try to do:

- If I eat something starchy or gooey that sticks in between my teeth, like crackers or chewy bread/pasta, or anything like that, try to rinse and then brush - gently - or floss immediately afterward. Sandwiches do this, for example. It's the stuff that sticks that will get you.

- Use tartar control toothpaste. That really helps me.

- Notice how your mouth tastes generally. If it tastes sweet or acidic, rinse and/or floss. Try to avoid foods that lead to that condition just so I don't have to rinse/brush/floss so often.
posted by amtho at 12:35 AM on April 16, 2020

Oh, also:

When I brush my teeth, I try to get them just as clean-feeling as they feel after a dental appointment. I check them thoroughly, especially the outsides of the back molars.

I also developed a technique of positioning the toothbrush bristles (sideways) against the back of my front upper teeth, pushing against the bristles with my tongue, and then scraping the bristles up along the back of the teeth. It does get those surfaces feeling a lot smoother and cleaner -- they're hard to reach with the brush otherwise.

It's also worth looking at information about proper brushing technique.
posted by amtho at 1:52 AM on April 16, 2020

Don't brush right after sugary or acididic foods, your enamel is more vulnerable then. Drink water or chew gum instead. I especially like xylitol gum as the xylitol inhibits oral bacterial growth and prevents tooth decay.

A WaterPik was also a game changer. My dentist noticed a significant improvement when I went from daily flossing to daily WaterPik.
posted by quince at 2:27 AM on April 16, 2020 [4 favorites]

There are also flouride rinses you can use after brushing, ACT anticavity seems to be the main brand available. These are different than standard mouthwashes. You also aren't supposed to eat/drink for a while after using (30 mins maybe).

You could carry the plastic flosser picks with you to use (discreetly) during the day to help with oral care away from home. I can't stand if I can feel something stuck in my teeth with my tongue, drives me insane.

I've started brushing after eating at work (sometimes), especially if my teeth are feeling unclean, and it cuts down on my snacking slightly if I have clean teeth and a minty mouth. I've found those two in one toothpaste+ mouthwash small plastic bottles are more convenient toting around the office than a toothpaste tube.
posted by TheAdamist at 3:54 AM on April 16, 2020

I was coming in here to say xylitol gum also.
posted by hazyjane at 3:55 AM on April 16, 2020

Note: mint doesn't actually clean your teeth or mouth. We associate it with clean teeth because toothpaste is usually mint flavored. Notice other things that are part of the "clean teeth and mouth" experience and focus on those: texture/smoothness of teeth, lack of other flavors, etc.
posted by amtho at 4:03 AM on April 16, 2020

Water Pik. I had old-school braces growing up (each tooth had a full band surrounding it), so the water pik was the only way to refrain from having my breakfast all day.

I'm really...not very good about flossing, but my dentist compliments my gum health - I had one tooth that should have been lost , except my gums protected it.

Brush your teeth first, to get rid of the big stuff, and also so you can see how much crap brushing is leaving behind. Use warm water - if you have separate tap handles, a little more hot water than cold. Start with the lowest pressure until you get the hang of it. Once a week, pour an ounce or two of peroxide in the water reservoir - your gums will foam, and it tastes *weird*, but let it set for a minute then brush again.

One last thing - when you brush, work on each tooth and each tooth surface. Move the body of the brush only enough to wiggle the bristles, but the tips of the bristles mostly stay on the same tooth. Analogous to the difference between dragging a broom across the floor to move dirt, and using the broom on one spot to loosen a bit of built-up dirt. Does that make sense?
posted by notsnot at 5:45 AM on April 16, 2020 [2 favorites]

Nthing make sure you're using the softest bristle brush you can find.

Someone said ACT up above and I'd like to echo that. If you're cavity prone, the best thing for you is regular flossing and a fluoride rinse. The ACT rinse they make for children is actually great (the blue SpongeBob flavor is delicious) and it's perfect for swishing after snacks between brushing. Cannot recommend it highly enough.

When you're flossing, make sure you're actually scraping the floss up and down the sides of each tooth, and down into the gumline. It's not enough just to do a quick pop between the teeth. I've been flossing religuously every day of my adult life, usually actually 2x a day, and I can definitely tell the difference between when I floss properly and when I just phone it in, even in only a day or two of lax flossing.
posted by phunniemee at 5:56 AM on April 16, 2020 [1 favorite]

I try to swish a baking soda-water solution in my mouth vigorously after I eat something acidic or sugary to neutralize the acid. Especially if that was the last thing I ate before brushing my teeth.
posted by needs more cowbell at 6:11 AM on April 16, 2020 [1 favorite]

I have the same problems you have. In addition to the excellent advice everyone has already given, I find it makes a big difference if I brush my teeth for a full two minutes at night. I use a timer; iOS 13 actually has a shortcut for this called “Brush teeth timer.”
posted by holborne at 6:28 AM on April 16, 2020

Not a dentist, have a mouth so full of filled cavities there's not much left to turn, but also recently got adult braces so dental stuff is at the forefront of almost everything I do these days... and as a result I've learned the missing piece was the waterpik. waterpik, waterpik, waterpik. It'll take a day or so to learn how not to drench your bathroom, and start at the lowest setting as the top one might as well be a pressure washer for your teeth, but waterpiks are amazing.
posted by cgg at 6:52 AM on April 16, 2020

Interdental toothbrushes changed my life. I can't believe how much stuff they regularly turn up even after a full round of electric brushing and flossing.
posted by dfan at 6:54 AM on April 16, 2020 [1 favorite]

Oh, and check what floss you're using - for dodgy gums, you want the gentle expandable stuff. Mine used to bleed with Oral-B Essential, but Jordan Expand is perfect. (Oral-B stopped making/distributing their expanding floss here for some reason.) These are all based on dentist recommendations.
posted by I claim sanctuary at 7:18 AM on April 16, 2020

What has worked for my shitty gums: Waterpik, every night without fail. I am constantly surprised how much stuff the waterpik will dislodge after brushing and flossing.

Also: dry brushing after regular brushing. My hygienist insists that dry brushing (wet toothbrush, no toothpaste) is essential in removing plaque that gets missed bc toothpaste reduces friction.
posted by gnutron at 7:24 AM on April 16, 2020

I have a cup at my desk and on my nightstand in which I keep these
GUM Soft-Picks Advanced
They took some getting used to, slow & gentle is the way to go otherwise they break easily

As well as these:
Disposable Flossers (slingshot style)

It's turned into kind of a soothing habit. Now I floss & pick every couple of hours & just swish with a little mouthwash (I keep in a little travel squirt bottle) or water & spit in a tissue. Sounds gross maybe but it works for me.
posted by i_mean_come_on_now at 7:58 AM on April 16, 2020

I quit eating ALL refined sugar and my dental hygienist no longer thought I needed frequent cleanings. It's probably not the answer you want, but it's the answer that works.

Other suggestions I don't see listed: make sure you have enough vitamins and minerals in your diet. Make sure you're eating food with live cultures in it, eg., sauerkraut.
posted by aniola at 8:54 AM on April 16, 2020 [3 favorites]

Best answer: I am a dentist, but not yours, of course.

There has been some solid advice here already, but here's what I will add.

Carbonated drinks are awful, so cut those out as much as you can. Sweet/starchy snacks are only problematic if the pH in your mouth goes down and stays down, so rinsing or brushing after sweet snacks is a good idea (someone above mentioned not to brush right after snacks but that's poor advice, get those carbs off of your teeth).
Sugar free gum or xylitol gum bring the pH of your mouth back up to neutral, which is why they are good. Nuts are a pretty good snack too.
Dark chocolate is close to neutral pH, so isn't so bad, but milk chocolate has a lot of added sugar, so falls into the same category as sweets.
Citric acid is bad.

Ask your dentist to Rx you some 5000 ppm fluoride toothpaste. the higher fluoride content will help at-risk areas stay stable until you can be seen for routine hygiene.

Floss. Learn to make this a habit right now while you've got extra time for it and it will be a habit for years to come.

Stay hydrated.

Stay healthy, we're all in this together.
posted by OHenryPacey at 10:02 AM on April 16, 2020 [3 favorites]

OHenryPacey, when you say "Carbonated drinks are awful, so cut those out as much as you can", do you include plain carbonated water?
posted by chromium at 1:03 PM on April 16, 2020 [2 favorites]

Carbonic acid from co2 in drinks is acidic. If you guzzle a drink then it does little harm, if you sip it over 15-30 mins, or even longer, then the pH in your mouth remains low and damage begins to occur. Pop (or soda) often has sugar, which makes this much worse. So in that sense plain ol' fizzy water is not as harmful as pop, but for an at-risk patient I'd say pick another beverage.
posted by OHenryPacey at 1:55 PM on April 16, 2020 [3 favorites]

A Waterpik (or, rather, a cheaper version from Amazon, identical to this one) has been life-changing in terms of my gum health. I used to have receding, bleeding gums but since I started using a water flosser about 2 years ago, my gum health has improved immeasurably and even visibly.
posted by essexjan at 1:55 PM on April 16, 2020

I read this thread with interest even though I have horse teeth, thank you for asking this. But I wanted to add to all the suggestions about xylitol gum--if you keep it around and you have dogs, please make sure to keep it somewhere they absolutely can't get it. It's incredibly toxic to them, can be fatal. (Xylitol is also often in peanut butter, which is so not good.)
posted by kitten kaboodle at 6:12 PM on April 16, 2020 [2 favorites]

My dentist told me I could drink coffee if I drank all the coffee for the day in half an hour. And he said I should quit seltzer entirely. I just smiled gently at him with my soft, crumbly, saltine cracker teeth, and presently he moved away to North Carolina. There's only so much I'm capable of, and limiting myself to a single cup of coffee per day and that gulped down in one half-hour period is not something I can consider. He should count it as a major win that I don't daydrink and eat Reeses peanut butter cups continuously all the time I'm awake, but some people are never satisfied.
posted by Don Pepino at 6:19 PM on April 16, 2020 [3 favorites]

Getting a Waterpik is the only thing that helped my gums.
posted by meepmeow at 9:43 AM on April 17, 2020

Response by poster: Thanks all! My scheduled trip to Target turned into a Dental Health Expedition, yielding

- Sugar-free gum
- Waterpik (the cordless kind)
- Extra-soft toothbrush (I've always thought that I'm much more focused on brushing with a manual toothbrush, rather than just zoning out waiting for the timer to finish on my Sonicare, so this is definitely worth a try)
- Alcohol-free mouthwash in "coconut-lime" flavor (purchased out of baffled curiosity more than anything else)

At some point I had an rx for a high-fluoride toothpaste from my dentist, so I also sent an email to her office to see if I could get a new one (though who knows if anyone is checking the inbox right now..)

If I remember, I'll try to report back after my next checkup :)
posted by btfreek at 12:55 PM on April 17, 2020 [3 favorites]

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