In the Western world, the primary approach to dental hygiene is brushing and flossing. The purpose of oral hygiene is to remove and prevent the formation of plaque or biofilm[100], although studies have shown that this effect on caries is limited.[101] Although there is no evidence that flossing prevents tooth decay,[102] the practice is still generally recommended.[103]
Toothbrushes can be used to remove plaque on accessible surfaces, but not between teeth or inside the pits and fissures on chewing surfaces. When used properly, dental floss removes plaque from areas that could otherwise develop from proximal caries but only if the depth of the sulcus has not been penetrated. Additional aids include interdental brushes, water droppers, and mouthwashes. The use of rotating electric toothbrushes may reduce the risk of gingivitis and periodontitis, although it is unclear whether this is of clinical significance.[104]
However, oral hygiene is effective in preventing periodontal disease (gingivitis/periodontal disease). Food is forced into the pits and crevices under masticatory pressure, demineralizing acid and carbohydrates where brushing, fluoride toothpaste, and saliva cannot reach to remove trapped food or neutralize acid or mineralized tooth enamel. (occlusal caries represent 80-90% of caries in children) (Weintraub, 2001). Unlike brushing, fluoride leads to a proven reduction in the incidence of cavities by approximately 25%; Higher concentrations of fluoride (>1,000 ppm) in toothpaste also help prevent cavities, with the effect increasing as the concentration reaches a plateau. [105] A randomized clinical trial demonstrated that toothpastes containing arginine had greater cavity protection than regular fluoride toothpastes containing only 1450 ppm.[106][107] A Cochrane review confirmed that the use of fluoride gels, which are usually applied by a dental professional from one to several times a year, helps prevent dental caries in children and adolescents, underscoring the importance of fluoride as a primary means of caries prevention. [108] Another review concluded that regular, supervised use of a fluoride mouthwash significantly reduced the incidence of caries in children’s permanent teeth. [109]
Chewing on fiber like celery after eating saliva is claimed to force trapped food to loosen any carbohydrates like sugar, neutralize acid, and remineralize teeth. The teeth most susceptible to acute lesions are the permanent first and second molars due to their long period of time in the oral cavity and the presence of complex surface anatomy.
Occupational health care consists of regular dental check-ups and occupational prophylaxis (cleaning). Sometimes complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible caries development in high-risk areas of the mouth (eg ‘bit-bit’ X-rays visualizing the crowns of back teeth)
Alternative methods of oral hygiene also exist throughout the world, such as the use of twigs to clean teeth like toothpicks in some Middle Eastern and African cultures. There is some limited evidence of the effectiveness of these alternative oral hygiene methods.[110]
