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Good dental health is an important part of our general health and well-being. At this age lots of changes will be taking place both physically and emotionally so having healthy teeth and gums and being free from pain or discomfort will support young people to have a healthy balanced diet, speak more clearly and feel confident with their smile.

First teeth or milk teeth have played an important role and paved the way for the adult teeth. Establishing good habits in childhood and teenage years helps lay the foundations for a healthy mouth for life. By keeping our mouths healthy we are less likely to need treatment which can be costly as an adult when we have to pay for it!

At around the age of 11-13 all of the milk teeth should have been replaced by 28 adult teeth which should last a lifetime. 'Wisdom teeth' or 3rd molars at the very back of the mouth may or may not appear during late teens or early twenties. If they don't cause problems they can be left however, sometimes there may not be enough room for them to come through without causing discomfort, so your dentist may advise that they are removed.

These days many adults are keeping their own natural teeth well into old age, which has many positive health benefits.

The two most common diseases in the mouth are tooth decay and gum disease. Both of these are preventable with good oral hygiene, a healthy, balanced diet and regular dental check-ups.

Keeping a healthy mouth…

Here is some basic advice to help prevent problems in the mouth:

1. Brush twice a day; before breakfast and before bed, with fluoride toothpaste.

Oral hygiene should be a well-established part of the daily hygiene routine. Contrary to popular belief, brushing immediately after having sugary foods or drinks will not prevent damage to your teeth. Brushing effectively for 2 minutes morning and night with fluoride toothpaste is the best way to protect teeth and gums. Floss or interdental products can be used to remove plaque and food debris from between the teeth however should be used with care to avoid damage, perhaps ask a dentist or hygienist to demonstrate. If the tongue is brushed, do this very gently and always brush downwards only.

Toothbrushes should be soft and small so that you can brush around all the tooth surfaces and gums effectively, lifting off plaque, (the white, sticky stuff that forms around teeth and gums), which contains bacteria and causes gum disease. Toothbrushes should be replaced every 3 months or if the bristles become 'splayed', whichever is soonest. Never share toothbrushes, even among family members and allow brushes to dry out in air to reduce the risk of cross-infection. Toothbrushing also protects the hard surface or 'enamel' through fluoride.

Fluoride is a naturally occurring mineral which helps strengthen and protect tooth enamel and reduce the amount of acid made by plaque bacteria. Apart from what naturally occurs in our water, Shropshire is largely un-fluoridated and children's teeth can be more vulnerable to sugar and acids.

If you look on the back of the toothpaste tube you will find the fluoride level listed in the ingredients as 'parts per million' or 'ppm' (it may say 'sodium fluoride' or 'sodium monofluorophosphate'). The current recommendation is that over the age of 3 it is safe to use a standard family toothpaste containing 1,350-1,500 ppm and that this will protect teeth.

You should spit out after brushing to get rid of any debris, plaque etc however, you do not need to rinse as the protective effect of the paste will carry on after brushing. If a mouthwash is used, do this at a different time of the day. Ask your dentist or hygienist about any issues relating to fluoride, mouthwashes or oral hygiene in general.

2. Limit the amount and frequency of foods or drinks containing sugar and try to keep these to mealtimes.

Frequent intake of refined sugars and acids through foods and drinks will damage teeth and cause decay (rot) and/or erosion of the enamel. Damaged teeth can become very painful and, if left, can lead to infection (abscess) which will result in the need for emergency treatment, antibiotics and possibly the removal of teeth in the dental surgery or by general anaesthetic in hospital. By avoiding sugary foods and drinks or limiting these to mealtimes only we reduce the chance of damaging the teeth and stay generally healthier. Safer and healthier options would be fruit, vegetables, cheese, bread and milk or water. It's a good idea to check food and drink labels and watch out for 'hidden sugars' which can be labelled under many different names such as: sucrose, glucose, fructose, maltose, hydrolysed starch, invert sugar, corn syrup, maltodextrin and others.

3.  Visit the dentist for regular check-ups.

Even if you are not keen on going to the dentist it's a good idea to have a check-up every 6 months at this age. NHS dental treatment is free up to the age of 18 (or 19 if still in full-time education) and regular check-ups mean the health of the teeth and gums can be maintained and monitored with any issues identified and treated earlier. (For more information about free NHS dental treatment go to NHS Choices at:

NHS Dental services in Shropshire

You no longer need to 'register' with a dentist to get regular treatment, simply contact a local practice offering NHS dentistry and ask if you can have an appointment. NHS Choices and the British Dental Association both have postcode search facilities so you can try to find an NHS dentist in your area.

If you are having problems finding an NHS dentist or need urgent treatment, further information for Shropshire residents is on the local CCG website:

Orthodontic treatment

Sometimes teeth come through crooked or out of line. Regular check-ups in childhood means a dentist can keep an eye on the positioning of teeth and whether there may be any overcrowding requiring orthodontic treatment ('braces'). There may have been x-rays taken to check the positions of teeth that are still to come through. Once all the first teeth have gone this can be reassessed and your dentist may discuss what, if anything could be done to correct any overcrowding or misalignment of teeth. The best time to have orthodontic treatment is around the age of 13; it can be done later in life however teeth take longer to move and this can be more costly. If a dentist or orthodontist advises that there is a clear clinical need to have braces it can be done free of charge on the NHS under the age of 18 (or 19 if still in fulltime education). If a patient requests braces purely for cosmetic reasons the average cost ranges from £2,000 to £6,000.

Tooth whitening

Many young people want to achieve a 'Hollywood' smile of 'pearly white' teeth. Some celebrities achieve this by having costly, extensive treatment. We all have different shades of teeth as we do skin, hair and eyes and adult teeth are not as 'white' as milk teeth. By brushing thoroughly for 2 minutes morning and night and avoid things that will stain like red wine, smoking or lots of tea and coffee, we can help keep our teeth at their natural shade.

Whilst it is not possible to make teeth brilliant white it may be possible to make them a few shades lighter than your own natural shade if you feel very self-conscious about them. This is done by bleaching the tooth surface and should only be carried out by a registered dentist. Some beauty salons may offer tooth whitening but this is illegal if there is no dentist present. DIY home kits can be purchased but are not recommended as they carry serious health risks.

Tooth whitening is not offered on the NHS unless there is a specific medical need and when done privately can be very expensive. For more information about how tooth whitening is carried out go to NHS Choices or The British Dental Health Foundation.

Mouth Injuries

Anyone involved in contact sport or activities where your mouth could be at risk of injury is recommended to wear a mouth guard or 'gum shield'. These can be purchased from sports retailers or ideally made to fit your mouth by a dentist. The cost will vary however it is worth the investment if it saves having to pay for expensive treatment later on in life.

If there is an injury to the mouth, seek attention from a dentist or medical practitioner immediately. If an accident causes the loss of an adult tooth it is sometimes possible to save it provided emergency treatment is carried out straight away. If a tooth is knocked out whole the complete tooth should be replaced in the socket, (the space in the gum where the tooth came from), as soon as possible, ideally in under 30 minutes although teeth have been successfully replaced up to 60 minutes after. Avoid handling the root and if it is very dirty, rinse it with milk or tap water. Do not clean it with disinfectant or let it dry out. Place the tooth into the socket carefully ensuring it is the right way round. Sometimes teeth can be splinted in the mouth and saved; treatment may be needed at a later stage. If a tooth is lost and not replaced and you need to treat bleeding gums, use a clean cotton handkerchief, flannel or gauze folded up, then hold it over the socket and close your jaws together to apply pressure. If you need something for the pain don't take any medication containing aspirin as this can encourage further bleeding. Do not apply clove oil or anything else to the wound and seek medical attention as soon as possible.

Mouth Cancers

Mouth cancer is becoming increasingly more common among young people. It is closely linked to smoking, alcohol and oral sex (through HPV virus). When detected early the chances of a cure are good. Look out for red or white patches or ulcers on the mouth, lips or tongue that do not heal after 3 weeks and if this occurs see a dentist as soon as possible.

Smoking, alcohol and substance misuse can all make you much more likely to need dental treatment due to damage to the teeth and gums. Evidence shows you are more likely to quit with help and support from stop smoking services. If you or someone you know is affected by addiction there is more information and details about help and support within this Healthy Shropshire website and the links given.

Further information…

For more information about dental health for all the family follow the links on this page or speak with your dentist.


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