When something's wrong with your mouth, you really know about it. And this isn't just because a large part of your brain is allocated to respond and help deal with it.

As Professor Hans Zoellner from the Faculty of Dentistry at The University of Sydney says, ‘If you have real trouble with your teeth, not only will you suffer pain, it can be embarrassing too, and undermine the way you feel about yourself.'

However, dental disease is nothing to be ashamed of. Many of us believe that flossing and brushing will prevent poor dental health, so if someone has problems with their teeth it's all their fault. But this isn't entirely correct.

‘It's true, brushing is important,' Professor Zoellner says. ‘But factors including changes in saliva and the immune system may make individuals more likely to develop decaying teeth and inflamed gums.'

Daily care is still very important to keep your mouth healthy, and it will reduce your risk of decay and disease.

All mouths contain bacteria, which can live in the gums and build up around the base of the teeth. This accumulation is called plaque and can cause an infection of the gums known as gingivitis. Although not usually painful, it can cause gums to swell and bleed.

If left untreated, the plaque spreads to the periodontal area - the pockets in which the teeth sit. If these pockets becomes inflamed, it's known as periodontitis, and if it isn't treated, the bones, gums and connective tissue that support the teeth can be destroyed. Teeth may eventually need to be removed.

Heart risk

The bad bugs in the gums and peridontal area are also associated with arteriosclerosis and heart disease. Experts aren't exactly sure why this is so, but they think the germs may burst from the gums into the blood vessels and set the body's inflammatory response alight. This may cause the blood vessels feeding the heart to become fragile and the artery walls to become damaged and form clots.

Prevention involves the daily use of dental floss together with soft brushing twice a day, to help clear plaque and food from the gums.

Regular visits to your dentist will also help remove plaque, while an antiseptic mouthwash may help to cut down the number of bugs around your teeth.

Fluoride

Fluoride is a naturally occurring element found in our environment. It's added to the water we drink at a level of around 0.7 to 1.0 parts per million. This is good news for the community as it helps make our teeth more resistant to decay by encouraging remineralisation of the tooth surfaces, which can help in repairing early decay before it causes a cavity.

To get the best protection and to add to the benefit of drinking fluoridated water, you should also use fluoride toothpaste. But you need to be careful where your kids are concerned because they often swallow toothpaste, which can put them at risk
of fluorosis (see right).

Wear and tear

Even those of us who do the correct dental detail on a daily basis - flossing and brushing, sipping fluoridated water and using fluoride toothpaste - can still be in for teeth trouble
in the form of acid wear.

The symptoms of acid wear include changes to the appearance of teeth - they lose their lustre and can go yellow. While it mostly occurs in people with a condition called gastric reflux, where the acid of the stomach comes up the throat and into the mouth, it
can happen to anyone, of any age. Eating and drinking highly acidic foods and drinks, and over-brushing teeth are all causes of acid wear. Acidic foods that can contribute include vinegary salad dressings, red wine and fresh orange juice. To help prevent acid wear:

Don't let acidic foods and drinks linger for too long in the mouth before you swallow.

Drink tap water whenever you feel thirsty.

Don't allow your children to suck on bottles containing sugary or acidic drinks.

Don't brush your teeth straight after eating or drinking acidic foods and beverages - this is when the enamel is at its weakest and brushing may cause further erosion.

Use a soft toothbrush to minimise damage to the enamel.

Ask your pharmacist for toothpastes containing fluoride, which are designed to protect enamel.

Boosting saliva

Saliva plays an important role in the health of your mouth. As well as controlling bacteria, it washes away food particles, delivers minerals and chemicals necessary to keep the surfaces of your teeth hard, and protects against infection. If you don't make enough saliva, you'll suffer discomfort and bad breath.

To boost saliva levels:

Don't let your body become dehydrated.

Consider alternative medicines if the ones you use dry out your mouth.

Limit the alcohol and caffeine you consume.

Chew sugarless gum to stimulate saliva flow. Mouthwash can reduce decay, and Professor Zoellner suggests using one containing chlorhexidine.

‘You don't want to use it every day because it can stain your teeth, but using it once a week is a good idea,' he says.

What is fluorosis?

If fluoride levels are consistently too high, children's teeth can be badly damaged. Fluorosis interferes with the development of the enamel, resulting in small white flecks on the teeth. In severe cases, brown marks can appear, and teeth can weaken and become disfigured.

To avoid fluorosis

Provide your child with fluoride-free toothpaste until they reach 18 months. Switch to a low-fluoride toothpaste for kids aged 18 months to six years.

Don't give kids fluoride tablets as it works best on contact as opposed to being ingested. ‘It's ironic that fluoride both protects teeth and, in large doses, harms teeth,' Professor Zoellner says. ‘But you can't get fluorosis simply by drinking tap water.'

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