Keeping the teeth clean is like a never-ending war against the bacteria that settle in the spaces between our teeth and gums and on the tongue. If you do not remove the bacteria, its number can increase there. This condition can become the cause of serious gum disease. But there are many ways through which you can prevent this condition.
An important reason for bad breath is periodontitis. This is called gum recession. In this, the gum tissue starts separating from the teeth and the roots of your teeth become visible. Dr. Praveen Sharma, Associate Professor of Restorative Dentistry at Birmingham University in Britain, told BBC’s program ‘What’s Up Docs’, “Half of the adult population suffers from gum disease in some form or the other.”
He explains, “You can call objective bad breath as bad breath. About 90 percent of bad breath is due to the oral cavity. In the remaining 10 percent of cases, the reasons are something else.” Dr. Sharma says, “If diabetes is not under control, then your breath can have a special kind of smell.” “If a patient has gastrointestinal or digestive problems like gastric reflux etc., then there can be bad breath.” That is, some internal diseases of the body can also give signals through the mouth. So then how can this problem be solved?
If you don’t clean the bacteria that has accumulated between your teeth and gums, it can lead to microscopic wounds and then bleeding gums. This is gingivitis, the initial stage of gum disease. The good news is that it is completely curable. Dr. Sharma says, “Gingivitis means inflammation of the gums. When you brush, your gums are red, swollen and bleeding. These are the symptoms.” He says, “If it is not prevented, it can turn into periodontitis.”
So when you brush, pay attention to whether the gums are red, swollen or bleeding. But there is no need to panic about it. It can be cured. Dr. Sharma explains, “Often when people feel pain in their gums or see blood while brushing, they avoid brushing that part. They think that they can harm their gums by doing so.” He says, “But in reality the opposite happens. If the gums are bleeding, then it should be considered a sign that you have to brush more properly. This means that the cleaning has not been done properly.”
Dr. Sharma says that give full time to brushing. He says, “While brushing, pay full attention to this. Do not brush while doing any other work.” He says that the best way is to stand in front of the mirror and brush properly. Many right-handed people brush the left part of their mouth for a long time and left-handed people brush the right part for a long time.
But this causes more bleeding in the part where the left hand is not working. Inflammation can occur where there is less brushing. Be careful about which hand you are using. Make sure that both sides are brushed carefully and equally.
Dr. Sharma says that one should start with interdental cleaning first. He says, “It is better to use interdental brushes to remove plaque that accumulates on the teeth and keep the gums healthy.” Interdental brushes help in removing plaque i.e. sticky substance that accumulates on the teeth and bacteria, where big toothbrushes cannot reach. After using the interdental brush, when you move the toothbrush in the mouth, it is good to follow a fixed method. One should not hurry in doing this. Remember that it is important to clean every tooth carefully.
This may surprise many people, but the minimum time to brush teeth is two minutes. Many people place the toothbrush on the teeth at an angle of 90 degrees and press it back and forth, but this method can cause the gums to recede. Place the toothbrush on the teeth at an angle of about 45 degrees and brush slowly. When cleaning the lower teeth, move the bristles of the brush downwards towards the gums and upwards on the upper teeth. This helps remove bacteria hidden below the gum line.
Many of us have been taught that we should brush our teeth after eating. But Dr Sharma says, “The best way is to brush your teeth before breakfast,” he says. “Sour foods like lemon, orange and vinegar can cause acid in the stomach. The acid in food softens the protective enamel on the outer surface of your teeth and the dentin underneath, so brushing your teeth immediately after eating can damage your enamel. “If you prefer to brush after breakfast, wait a while between breakfast and brushing,” says Dr Sharma. You should rinse well and then wait a bit. Brushing twice a day for two minutes each is ideal. But for some people, brushing properly once a day may be enough.
When you sleep, the flow of saliva in the mouth reduces, giving bacteria more opportunity to damage teeth. So if you clean your teeth thoroughly only once a day, the best time is at night.
Choose a brush with medium-hard bristles. Toothpaste doesn’t have to be expensive. “As long as you’re sleeping, it’s fine to use a toothbrush that’s not bristly,” says Dr Sharma. “Toothpaste is fine as long as it contains fluoride.” Fluoride strengthens tooth enamel and prevents decay. Spit out the foam after brushing. But don’t rinse so that the toothpaste and fluoride stay in the mouth and help prevent tooth decay.
If you are experiencing early signs of gum disease, using a mouthwash can also be beneficial as it reduces plaque and bacteria. But don’t use a mouthwash immediately after brushing as it can wash away the fluoride in the toothpaste.
If gum recession or periodontitis progresses, you will notice that spaces start forming between the teeth. This causes the bone that holds the teeth together to melt. This causes the teeth to loosen. If this is not controlled, the bone loss can be so severe that teeth may fall out You may also experience persistent bad breath. If you notice these symptoms, visit a dentist immediately. Finally, here are some simple tips to keep your breath fresh: Drink plenty of water, as bacteria can grow easily in a dry mouth. Clean your tongue with a tongue scraper. This removes food particles, bacteria and dead cells that can cause bad breath. If you’re not sure how fresh your breath is, ask a friend or family member. But be careful who to ask. This content is taken from the BBC’s What’s Up Docs podcast. It aired on 29 April 2025.
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