Teeth and gums: brushing, flossing and the dentist

No one checks whether you brushed before bed once you live alone, and dental treatment abroad can be expensive or slow to book. A few precise habits, done properly, protect your teeth for life and cost almost nothing.

Brushing the NHS way

• Brush twice a day for about 2 minutes with fluoride toothpaste, and make one of those times last thing before bed (NHS).
• Clean the inside, outside and chewing surfaces of every tooth (NHS). Work round your mouth in the same order every time so you do not skip a section.
• Adults should use toothpaste with at least 1,350 ppm fluoride (NHS). The ppm figure is printed in small text on the tube; check it when you buy own-brand toothpaste abroad.
• Spit out the excess but do not rinse with water afterwards. The NHS explains that rinsing washes away the fluoride that is still protecting your teeth.
• Electric and manual brushes work equally well if you clean every surface (NHS). Buy the one you will actually use properly.

Cleaning between your teeth

• Clean between your teeth once a day with floss or interdental brushes; the NHS suggests doing this before brushing.
• Flossing method from the NHS: use 30 to 45 cm of floss, hold 3 to 4 cm tight between your fingers, guide it between the teeth, curve it into a C shape round each tooth and slide it up and down.
• Interdental brushes are a good alternative, especially where you have gaps, and should fit snugly (NHS). Pharmacies sell mixed-size packs so you can find your size.
• Avoid wooden toothpicks, which the NHS says can damage gums and lead to infection.
• If you use mouthwash, use it at a different time from brushing, such as after lunch, and do not eat or drink for 30 minutes after a fluoride mouthwash (NHS).

Your toothbrush

• Most adults should use a small-headed brush with medium or soft bristles (NHS). The American Dental Association (ADA) recommends soft bristles to lower the risk of irritating your gums.
• Replace your toothbrush or electric brush head about every 3 to 4 months, or sooner if the bristles look frayed (ADA).
• Store it upright and let it air dry. The ADA says a damp brush in a closed container grows more microbes than one left open.
• Never share a toothbrush (ADA). In a shared bathroom, keep yours in your caddy or room rather than in a communal cup.

Bleeding gums and warning signs

• Bleeding when you brush or floss, and red, swollen or sore gums, are signs of gum disease, which the NHS says is caused by a build-up of plaque.
• Do not stop brushing because your gums bleed. Keep brushing and cleaning between your teeth, and book a dentist if it continues (NHS).
• See a dentist soon (non-urgently) for bleeding gums, painful or swollen gums, or bad breath that will not go away (NHS).
• Get urgent dental help for very sore or swollen gums, loose teeth, or a lump, ulcer or red patch in your mouth or on your lip (NHS).
• Not smoking helps prevent gum disease (NHS).

Finding and using a dentist when you move

• The NHS advises seeing a dentist if it has been 2 years since your last check-up, or 1 year if you are under 18. Your own dentist may suggest a different interval.
• Book a check-up and any treatment at home before you move abroad, so you start with a clean slate.
• Read your student health insurance before you travel. Dental cover is often limited or separate, so find out what is included (see the Health Admin module).
• Save the details of a local dentist, and your university's advice on emergency dental care, in your phone during your first week. Looking for one while in pain is much harder.