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Have questions? We have answers

Frequently Asked Questions


What Causes Tooth Loss?
The most common causes of tooth loss are dental caries, also known as tooth decay, and periodontal disease, which affects the gums and bone structure that supports the teeth. Dental caries is the major cause of tooth loss in children, and periodontal disease is the major cause of tooth loss in adults; however, it too can afflict youngsters.

What Causes Periodontal Diseases?
Plaque, a thin, colorless, sticky film containing bacteria, which constantly forms on the teeth. These bacteria use carbohydrates—sugars and starches—to produce an acid that attacks the enamel covering the teeth. After repeated acid attacks, the enamel can be broken down and a cavity begins. Continued acid attacks eventually dissolve the enamel and penetrate the softer, inner layer of the tooth, where decay can spread rapidly throughout the tooth’s structure. Acid attacks begin immediately after every meal or snack and last about 20 to 30 minutes.

Can Periodontal Diseases Be Prevented?
Teeth can be protected from acid attacks by removing plaque, reducing the number of times and the amount of sugar and starches eaten, using fluorides, having plastic sealants applied to teeth, and by regular professional cleaning of teeth by a dental hygienist.

How Does Plaque Attack the Gums?
Plaque can also produce harmful byproducts that irritate the gums, causing gingivitis, the early stage of periodontal diseases. If plaque isn’t removed daily, it will build up into a hard deposit called calculus. If plaque continues to form on top of the calculus, it can irritate the gums, and a pocket may develop between the teeth and gums. Plaque build up can eventually destroy the gums and bone that support the teeth.

How Do You Stop Plaque Attacks?
Two key factors in preventing dental caries are fluoride and dental sealants. Fluoride compounds are found naturally in soil, water, and in many foods. Plaque attacks can’t be stopped, but you can help to prevent plaque build-up by following a good oral care program of brushing, flossing, rinsing, and regular visits to your oral health care professional.

What Is a dental hygienist?
A dental hygienist is a licensed health care professional, oral health educator, and clinician who, as a cotherapist with the dentist, provides preventive, educational, and therapeutic services supporting total health for the control of oral diseases and the promotion of oral health. A registered dental hygienist has graduated from a minimum two-year college program that includes classroom studies and extensive supervised clinical experience. A dental hygienist also must pass a national written exam and a comprehensive state clinical exam to earn the RDH license. Generally, the dental hygienist may work in general and specialty oral health practices. Other areas of employment include programs for research, professional education, and community health; hospital and institutional care of disabled persons; federal programs, such as the armed services; or other health service locations as specified in statute or as authorized by the state board of dentistry. More information about the careers available to dental hygienists is available at

What kind of educational preparation do I need to become a dental hygienist?
Most dental hygiene programs offer either an associate degree or a baccalaureate degree. The American Dental Association Commission on Dental Accreditation assures the minimal standards by accrediting quality programs, so the main thing is to be certain that the school you are interested in is accredited. Both associate and baccalaureate programs offer a strong clinical curriculum. The baccalaureate degree allows entry into some positions in teaching, administration, public health, corporate positions and other areas of dental hygiene practice that other types of dental hygiene education do not. It may also provide a broader base in the humanities and other areas outside dental hygiene. Generally an associate's degree takes two years to complete; however, most dental hygiene programs require prerequisite courses be taken before entry into dental hygiene, so in reality it may take longer than two years. Baccalaureate degree programs usually require approximately four years of study. Some schools require two years of prerequisite study and two years in program. Every school is a little different, so check out the schools in which you are most interested. Check out ADHA's Web site for a listing of dental hygiene schools and ways to contact them at Each school also differs in specific course requirements, but generally the basic courses include college-level English, speech, psychology, sociology, nutrition, chemistry, and specific biology courses. Be certain that you know what the prerequisite courses and entry requirements are for the school you would like to attend. Of course once you are in the program, curriculum content is specified by the ADA Commission on Dental Accreditation and the college you will be attending.

How many times a day should I brush my teeth?
The American Dental Association advocates brushing twice each day. Although there is research indicating that brushing once a day is sufficient to disrupt the formation of plaque that feeds the bacteria that cause decay, this may not be enough for some people, depending on factors such as their diets and the efficacy of their brushing technique. ADHA recommends that you discuss this with your dental hygienist who understands your individual oral health needs and will be able to make a recommendation appropriate for you.

Which is better: a manual toothbrush or an electric one?
Comparisons have been made between power-assisted (electric) toothbrushes and manual toothbrushes to look at the ability of each to remove plaque and prevent or reduce calculus (tartar) buildup, thus reducing gingivitis (gum disease). These research studies have shown both powered and manual toothbrushes to be equally effective when used correctly. So probably, in practical terms, which brush you use is not the critical factor, but how you use it. The ADHA Web site ( instructions for proper toothbrushing technique with a manual brush, and product packaging shows the best way to use powered brushes.

What kind of toothpaste should I use?
There are a lot of products to choose from, and much of the decision depends on individual preference. A fluoride toothpaste is essential for optimal oral health. Beyond that, your dental hygienist and dentist can alert you to any other features that make one product more suitable than another for you as an individual.

What is the best way to get my teeth whiter?
Most people have teeth that are naturally darker than "pure" white. If you want them whiter, the best thing you can do is talk to your professional oral health care provider about your options. Different people respond differently to different procedures used to whiten teeth, and it will take an in-person consultation with a professional to determine what is best for you. Sometimes all it takes is professional prophylaxis to remove stain and then abstinence from behaviors that stain teeth, such as drinking coffee or tea, or smoking tobacco. Some people respond well to the use of whitening toothpastes while some do not. Other options available include bleaching, at home or in the office, with chemicals or with lasers, as prescribed by a dentist. Sometimes a combination of options is used.

I don't have insurance/can't afford the dental care I need. What resources are available to me?
Contact dental offices in your area to find out if they offer services on a no- or low-cost basis, and ask for ideas if they can't help. Contact nearby dental schools to ask what is needed to become a patient there. Contact the local public health department or dental societies to find out what they can recommend. Ask local charities for suggestions.

What procedures is it legal for a dental hygienist to perform?
This depends on the state dental practice act, which varies from state to state. Most state boards of dentistry can be contacted through the state licensing authority. ADHA can provide your state licensing authority contact information and a 51-state overview chart of permitted functions.

When should a child have his or her first dental appointment?
The American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend that a child have his or her first oral health care appointment around age one. ADHA suggests an oral health visit as soon as a baby's first tooth erupts.

If I use fluoride toothpaste and the water in my area is fluoridated, do I still need additional fluoride?
This depends on your oral health status and any additional sources of fluoride that you may be receiving. Talk to your oral health care professionals about this topic for individualized information.

How do I get rid of bad breath?
That depends on what is causing it. Often, bad breath results from less-than-optimal oral health, and sometimes people are not aware that they are not performing oral hygiene as effectively as they could be. A dental hygienist or dentist will be able to evaluate your oral health procedures and make recommendations for improvement; also, these professionals will be able to recognize any associated problems that might be contributing to an unpleasant mouth odor. In addition to evaluating and suggesting alterations to your brushing, flossing, and tongue deplaquing regimen, your dental hygienist may recommend products such as a mouthrinse that contains zinc. If it turns out that the problem isn't in the mouth, a physician appointment is advisable. Sinus problems, stomach problems, certain foods and medications, and other factors can contribute to bad breath.

Can you help me with my homework?
Not too much. Dental hygiene and dental students typically have assignments that require too much information in too much detail to be answered adequately here, and it is not within ADHA's purview to provide students with a shortcut to doing their own research as part of the educational process. We refer most of these students back to their school libraries and to Medline, DHNet, or other online resources many of which are available through ADHA's links page. Primary school students looking for information on dental hygiene as a career are urged to review these FAQs carefully before emailing a question. Helpful link:Federal Resource for Educational Excellence.