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You know that brushing your teeth regularly is key for good dental health. But did you know that brushing is not enough? Or that mouthwash can actually increase your risk for oral cancer?

According to Ariel Blanchard, DMD, an oral and maxillofacial pathologist, everyone--adults and children--should see their dentist twice a year to have their teeth cleaned and checked for cavities or any other abnormalities. “Some people may need to see their hygienist more often if their dentist recommends it,” Dr. Blanchard says.

And everyone should brush their teeth twice a day--especially before bed--and floss once a day. “If you’re not flossing, then you’re not cleaning between 35% and 40% of your teeth surface,” Dr. Blanchard says. What’s more, she adds, “If you’re not flossing, then your gums are going to bleed due to inflammation. If you floss regularly, they’ll stop.”

Preventing Plaque and Decay

Poor dental hygiene--e.g., inadequate brushing or flossing--can also cause dental plaque to accumulate on your teeth and gums. Dental plaque is a sticky film of bacteria that forms on teeth and produces acids that can destroy tooth enamel. Plaque can also develop under the gums on tooth roots and deteriorate the bones that support the teeth. Without removal by brushing and flossing, plaque hardens into tartar, which can lead to cavities and gingivitis (gum disease).

Plaque can also cause your gums to swell, Dr. Blanchard says. “Accumulated plaque causes an inflammatory response by the body,” she explains. “If you haven’t been flossing or brushing well and then start, your gums won’t be as swollen. The reduced inflammation or swelling may cause your gums to look as if they’ve receded but they’re really just becoming healthy,” she adds. If you are unsure about the proper way to floss, then ask your dental hygienist for help. “It’s their job to instruct,” Dr. Blanchard says.

Be careful about the kind of mouthwash you use. Many brands contain alcohol, which is a carcinogen and risk factor for developing oral cancer, Dr. Blanchard says. “The alcohol in mouthwash also dries out your mouth, which can give you bad breath, which is the reason you’re using mouthwash in the first place and will make you want to use more,” she says. The more mouthwash you use, however, the drier your mouth will become. “Dry mouth is a risk factor for cavities,” she notes.

Protecting Against Cavities

Besides brushing and flossing, the best protection against cavities is fluoride. Fluoride prevents tooth decay, and although public water supplies contain it, dentists generally urge patients to use a fluoride toothpaste. “We recommend using a fluoride toothpaste and if you use mouthwash, then use one with fluoride in it, Dr. Blanchard suggests.

Some dentists recommend dental sealants to prevent cavities. Dental sealants are routinely placed in the pediatric population. Dental sealants are plastic coatings that dentists or hygienists apply to the chewing surfaces of the back teeth where most decay occurs, but they are not necessary in adults unless you develop cavities on a regular basis, Dr. Blanchard says. If your drinking water is not fluoridated, then ask your dentist about the best way to protect your and your family’s teeth. Some people choose to brush their teeth with baking soda, but this can be too abrasive and cause sensitivity, she notes.

And make sure you are brushing your teeth properly. Dr. Blanchard urges gentle brushing where the gums meet the teeth. “Brush your gums and your teeth,” she stresses. She recommends using an electric toothbrush to avoid damaging your teeth or gums by brushing too hard. “Let your toothbrush do the work,” she says. If you need pointers on tooth-brushing, then review your technique with your hygienist. “A good hygienist will review tooth brushing with you,” she says.

Although there are dentists who specialize in gum disease (periodontist), for most people seeing a general practitioner is enough, Dr. Blanchard says. “General dentists are trained to recognize periodontal disease and can refer you to a periodontist if necessary.”