Gum Care at Home

How Should I Brush?

• Use a fluoride toothpaste, twice a day, for two minutes. Last thing at night matters most, because saliva flow drops while you sleep
• Angle the bristles at about 45 degrees towards the gum line, so they clean the groove where the gum meets the tooth
• Use small, gentle movements, a few teeth at a time, rather than long scrubbing strokes
• Work your way round in the same order every time, outside, inside and biting surfaces, so nothing gets missed
• Don't scrub hard. Pressure doesn't clean better, and over the years it wears the gum and the root surface away
• Replace your toothbrush or brush head every three months, or sooner once the bristles splay

Most people brush the cheek side of their front teeth well and miss the inside surfaces of the lower front teeth and the gum line of the back teeth. Those are the places where tartar builds up first.

Electric or Manual?

Either can clean well. What matters is reaching every surface and the gum line for the full two minutes. That said, a good electric toothbrush makes thorough brushing easier for most people: the head does the work, so you only need to guide it slowly along the gum line, and many have a timer and a pressure sensor that lights up when you're pushing too hard. If you use a manual brush, choose a small head with soft or medium bristles. Hard bristles don't remove more plaque; they just damage the gums.

How Do I Clean Between My Teeth?

Brushing cleans the surfaces you can see, but plaque between the teeth and under the gum line between them is what causes most gum disease, and a toothbrush can't reach it. Interdental brushes are the most effective way for most adults. Choose the size that fits snugly into each gap without forcing it; most mouths need two or three sizes, with smaller ones at the front and larger ones at the back. Slide the brush in gently, move it back and forth a few times, and rinse it. Once a day is enough, ideally before brushing at night.

Floss works where the gaps are too tight for even the smallest brush. Curve it around each tooth in a C shape and slide it just under the gum. A water flosser is a useful extra around implants, bridges and braces, though it doesn't replace brushes or floss where they fit. At your hygiene visit we measure your gaps and show you which sizes to use where.

My Gums Bleed. Should I Stop?

No. Healthy gums don't bleed, so bleeding is a sign of inflammation caused by plaque that's been sitting along the gum line, not a sign you're brushing too hard. The instinct is to go easy on the sore area, which leaves more plaque behind and makes the bleeding worse. Keep cleaning gently and thoroughly, including between the teeth, and the gums should firm up and stop bleeding within about two weeks. If they don't, or if the bleeding is heavy, book a hygiene visit so we can check for gum disease and remove the tartar that's keeping the inflammation going.

Toothpaste and Mouthwash

Any toothpaste with fluoride does the main job of protecting against decay. After brushing, spit out the excess but don't rinse with water, because rinsing washes the fluoride away before it can work. If you like a mouthwash, use it at a different time of day, such as after lunch, for the same reason. Mouthwash isn't a substitute for brushing and cleaning between your teeth, and the strong antibacterial rinses are best kept for short courses when we recommend them, as long-term use can stain teeth. If your gums are sensitive or you're prone to decay, ask us at your visit which toothpaste suits you.

What Else Helps?

• Don't smoke. Smoking narrows the blood vessels in the gums, which hides the bleeding that would warn you of gum disease, and it makes gum disease progress faster and heal more slowly
• Keep diabetes well controlled. Gum disease and diabetes make each other harder to control, so tell us if you have it
• Cut down how often you have sugary food and drinks, rather than just how much. Every sugary snack feeds the bacteria in plaque
• Tell us if you're pregnant. Hormone changes can make gums swollen and more likely to bleed, so cleaning carefully matters even more
• Mention any new medicines, as some cause gum overgrowth or a dry mouth
• Keep your hygiene visits, usually every three to six months, so tartar is removed before it does damage

Around Implants and Aligners

Implants need cleaner gums than natural teeth, because the bone around an implant has less defence against infection. Brush around the implant crown, use interdental brushes in the gaps beside it and, if you have a bridge, under it, and keep up regular professional cleaning. Invisalign aligners trap plaque against the teeth if you put them in without brushing, so clean your teeth before every aligner goes back in. Composite bonding and veneers need the same care as the teeth underneath; the gum line around them is where stain and plaque gather first. Bronagh O'Dowd, one of our dental therapists, has a special interest in gum care for implant, Invisalign and bonding patients.

When Should I See Us?

Book a visit with our dental therapists if your gums bleed for more than two weeks despite good cleaning, look red or swollen, have shrunk back so that teeth look longer, if you have persistent bad breath, or if a tooth feels loose or has moved. A 30-minute hygiene visit is £70, or £100 with air polishing, and both are included in our dental plans. You don't need to wait for your next dental examination to book one, and if your gums are sore we can numb the area first.

Questions

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