Keeping your teeth strong, your gums healthy, and your smile bright is not just a day job; your mouth needs protection at night too. Donna L. Zak, D.D.S., of Zak & Frankel Dental Associates in New York City, explains: "Nighttime oral hygiene is important because while we're sleeping, we're not swallowing, so the bacteria in our mouths increase throughout the night. The nighttime goal is to avoid giving the bacteria anything to break down and feed off."
There are three basic steps to nighttime hygiene: brushing, flossing, and rinsing with mouthwash. Dr. Zak says the order doesn't matter, as long as the food particles and plaque are removed. However, she adds, "My preference is for brushing, flossing, and then mouthwash because I feel that brushing first makes it easier to floss."
Steps for Basic Nighttime Oral Hygiene:
Brushing your teeth helps protect them from plaque buildup and tooth decay. Using a soft-bristled brush and toothpaste that contains fluoride, start brushing your teeth at a 45-degree angle to the gums. The correct method, according to the American Dental Association, is to brush back and forth gently in short (tooth-wide) strokes. The ADA suggests brushing the outer tooth surfaces first, then working your way through the inner tooth surfaces and the chewing surfaces of your teeth. The association also recommends using the "toe" of the brush to clean the backs of your front teeth with gentle up-and-down strokes.
Whether you should brush right after dinner, before bed, or both depends on your susceptibility to dental disease. Because recent studies have shown that the risk for dental disease varies from person to person, dentists are now following medical models of dental disease to determine their patients' susceptibility and the type of care they need. "People who are at a low risk for cavities and gum disease can certainly wait until bedtime to brush (though the timing isn't as crucial for them). Higher-risk patients would benefit from both an after-dinner and a bedtime brushing," says Dr. Zak.
Cleaning between your teeth with floss allows you to reach plaque that you can't remove with a toothbrush. Flossing at least once a day will also help prevent periodontal (gum) disease. To floss properly, the ADA recommends using an 18-inch-long strand, winding most of it around your middle fingers (to manage the floss as it gets dirty), and then holding the remaining floss tightly between your thumbs and forefingers. Next, use a gentle rubbing motion to guide the floss between your teeth. As you move toward the gum line, curve the floss into a C shape against each tooth, rubbing back and forth against the tooth as you go. When you get to the root of the tooth, slide the floss into the space between the gum and the tooth and keep rubbing gently. Then slowly move the floss away from the gum with an up-and-down motion, and repeat for the rest of your teeth, including the backsides of your last teeth on the top and bottom.
Dr. Zak says that flossing is important because it enables you to remove plaque while it's still soft: "Once the plaque hardens and forms tartar, only a professional cleaning by a hygienist or dentist can remove it. Patients who are very susceptible to gum disease or tartar buildup may want to consider flossing twice a day."
Rinsing With Mouthwash
Rinsing with a therapeutic mouthwash will help keep your breath fresh, your teeth plaque- and cavity-free, and your gums safe from gingivitis. Most mouthwashes are sold over the counter, though some require prescriptions. Follow the instructions on the packaging for best results.