Oral Health: The Complete Guide

Key numbers at a glance

How your teeth, gums and saliva work

Each tooth has three main layers. The outer enamel is the hardest substance in your body, but it contains no living cells, so once it is lost your body cannot grow it back. Beneath it lies dentin, a softer, slightly porous layer that carries sensations toward the center of the tooth. At the core is the pulp, which holds the nerve and blood supply. The root sits in a socket in the jawbone, held in place by a thin ligament and covered at the neck of the tooth by your gums, which form a tight seal around each tooth.

Saliva is the part of the system most people never think about, and it does an enormous amount of work. It washes food away from the teeth, neutralizes the acids that bacteria produce, and carries calcium and phosphate that rebuild the surface of enamel after an acid attack. It also contains antibodies and enzymes that keep the mouth's bacteria in check. When saliva is reduced, as it often is with certain medicines, every other defense in the mouth becomes weaker.

Your mouth is home to hundreds of kinds of bacteria, most of them harmless. Some of them gather into a sticky film called plaque that forms on the teeth continuously, particularly along the gumline and between the teeth. Plaque that is not removed can harden into tartar, also called calculus, which you cannot brush away at home; only a professional cleaning removes it. Both of the great dental diseases, tooth decay and gum disease, begin with plaque. That single fact explains why daily cleaning sits at the center of nearly all oral health advice.

Why oral health matters for the rest of your body

Dental problems are easy to dismiss until they arrive, and then they affect almost everything. Toothache disrupts sleep, eating and concentration. Missing or painful teeth change what people choose to eat, often pushing them toward softer, more processed foods. Visible decay or missing teeth can affect confidence, speech, job interviews and social life. Many people end up in the emergency room with dental pain, where staff can usually offer pain relief and sometimes antibiotics but cannot fix the underlying tooth, so the problem comes back.

The link between gum disease and diabetes runs in both directions. High blood sugar makes gum infections more likely and harder to control, and severe gum disease is linked to making blood sugar harder to manage. That is why dentists ask about diabetes and why looking after your gums is a genuine part of diabetes care rather than a separate concern. If you have diabetes, tell your dentist, and if your dentist notices rapidly worsening gum disease, it is reasonable to ask your doctor whether your blood sugar has been checked recently.

Gum disease has also been linked with heart disease and other conditions in research, but a link is not the same as proof that one causes the other. The two share risk factors, smoking in particular, and the honest summary is that keeping your gums healthy is worthwhile for your mouth whatever the outcome of that research. What is not in doubt is that dental infections can occasionally spread into the face and neck. A swollen face with a toothache is never something to wait out.

Tooth decay: how cavities form and how to stop them

Tooth decay is a balance between attack and repair. When you eat or drink something containing sugar or refined starch, bacteria in plaque ferment it and produce acid. That acid draws minerals out of the enamel. Over the following period, saliva neutralizes the acid and returns minerals to the surface. If the attacks are occasional, repair keeps up. If they are frequent, the balance tips toward loss, and a weakened area eventually collapses into a cavity.

This is why how often you have sugar matters as much as how much. A can of soda finished with lunch causes one acid attack. The same can sipped across an afternoon keeps your teeth under attack for hours. The same goes for grazing on snacks and sweetened coffee drinks through the morning. US dietary guidelines recommend keeping added sugars to less than 10 percent of daily calories from age 2, and avoiding added sugars altogether for children under 2. Keeping sweet foods to mealtimes and drinking water or milk between meals protects teeth whatever your total intake.

Decay begins as a chalky white spot where enamel has lost minerals. At that stage it can still be reversed with fluoride and good habits. Once the surface breaks down, a cavity forms, and decay spreads faster through the softer dentin beneath. If it reaches the pulp, the nerve becomes inflamed and can die, and an abscess can form at the root. Early decay is usually painless, which is the main reason regular dental checks find problems that you would not notice until they were much larger.

Fluoride

Fluoride is one of the most effective tools for preventing decay. It makes enamel more resistant to acid, helps weakened areas take minerals back in, and interferes with the bacteria that make acid. You get it mainly from fluoride toothpaste, and in many communities from tap water. Your local water utility can tell you whether your water contains fluoride. Dentists and children's doctors can also apply fluoride varnish, and people at high risk of decay may be prescribed a stronger fluoride toothpaste or gel. After brushing, spit out the excess toothpaste rather than rinsing with water, so the fluoride stays on your teeth longer.

Sealants

The chewing surfaces of the back teeth have deep grooves that trap food and are hard to clean, which is where many cavities in children start. A dental sealant is a thin protective coating painted into those grooves. Placing one is quick and painless and needs no drilling. Sealants are commonly placed on permanent molars soon after they come in, and some adults with deep grooves and no decay can benefit too. Ask your dentist whether sealants make sense for you or your child; school-based programs in some areas offer them as well.

Acid erosion is a different problem

Erosion is the loss of enamel from acid itself rather than from bacteria. It comes from acidic drinks such as soda, including diet soda, fruit juice, sports and energy drinks, and wine, and from stomach acid in people with reflux or frequent vomiting. Teeth can look thinner, more yellow or glassy at the edges, and become sensitive. Drinking acidic drinks with meals rather than sipping them, using a straw, rinsing with water afterward, and waiting a while before brushing all reduce the damage.

Gum disease: common, quiet and preventable

Gum disease starts when plaque along the gumline irritates the gums. The first stage, gingivitis, makes gums red, puffy and prone to bleed when you brush or floss. At this stage no permanent damage has been done, and gingivitis can be reversed with careful daily cleaning and a professional cleaning to remove tartar, which is why early bleeding is worth acting on.

If gingivitis continues, inflammation can spread below the gumline into the tissues that hold the teeth in place. This is periodontitis. The gum pulls away from the tooth, forming pockets that collect more bacteria, and the bone and ligament supporting the tooth are slowly destroyed. Teeth may become loose, drift apart or change how they meet when you bite. The bone that has been lost generally does not grow back on its own, but the disease can be controlled, and teeth can often be kept for many years with treatment and good care at home.

Periodontitis is usually painless until late, which is why many people do not know they have it. Smoking makes this worse in a second way: it reduces blood flow to the gums, so smokers may see less bleeding even when disease is advanced. Treatment usually begins with a deep cleaning below the gumline, called scaling and root planing, followed by more frequent maintenance visits. Some people are referred to a periodontist, a dentist who specializes in gum disease, and more advanced cases may need surgery. Knowing your own risk factors, listed below, helps you and your dentist decide how closely to watch your gums.

• Smoking or using any tobacco product, the strongest changeable risk factor
• Diabetes, particularly when blood sugar is not well controlled
• Plaque left behind because cleaning between the teeth is skipped
• Hormonal changes, including pregnancy
• Medicines that cause dry mouth or gum overgrowth
• Conditions or treatments that weaken the immune system
• A family history of gum disease or early tooth loss

Daily care that actually works

The core routine is short: brush twice a day for two minutes with a fluoride toothpaste, clean between your teeth once a day, limit how often you have sugary food and drink, and see a dentist at the interval they recommend for you. Toothpastes and between-teeth cleaners that carry the American Dental Association Seal of Acceptance have been evaluated for safety and effectiveness, which is a useful shortcut when the store shelf is crowded.

Of the two daily brushings, the one before bed matters most. Saliva flow drops sharply while you sleep, so plaque and food left on your teeth overnight have hours to produce acid with little to stop them. If you only manage one thorough clean, make it the bedtime one, and do not eat or drink anything except water afterward. Brushing in the morning then clears what built up overnight.

Brushing technique

Use a soft-bristled brush and gentle pressure. Angle the bristles toward the gumline, where plaque collects, and use short, gentle strokes, working around every surface: the outer surfaces, the inner surfaces that face the tongue and roof of the mouth, and the chewing surfaces. Scrubbing hard does not clean better; it wears enamel and pushes gums back. Manual and electric brushes both work well when used properly. An electric brush can make good technique easier for people with arthritis, limited hand movement, braces or simply a tendency to rush.

Cleaning between your teeth

A toothbrush cannot reach the tight spaces between the teeth, where both decay and gum disease often begin. Clean there once a day using floss, small interdental brushes, a water flosser or wooden or plastic picks. The best tool is the one you will actually use every day, and many people find interdental brushes easier than floss for wider gaps. Your gums may bleed when you start. That usually lessens as they become healthier with regular cleaning; if bleeding continues, see your dentist.

Mouthwash, tongue cleaning and toothbrush care

Mouthwash can be a useful addition but never a replacement for brushing and cleaning between the teeth. Cosmetic rinses only freshen breath for a short time. Therapeutic rinses contain ingredients such as fluoride or antimicrobial agents and can help specific problems; your dentist can tell you whether one would help you. Avoid alcohol-containing rinses if you have a dry mouth, and do not give mouthwash to young children who may swallow it. Gently cleaning your tongue with a brush or scraper removes the coating that is a common source of bad breath. Replace your toothbrush, or the head of an electric brush, every three to four months, or sooner if the bristles are frayed, and store it upright to air-dry rather than in a closed container.

Food, drink, tobacco and alcohol

A mouth-friendly diet looks much like a generally healthy one. Plain water is the best drink between meals, and fluoridated tap water adds protection. Milk, plain yogurt and cheese are low in added sugar and contain calcium and phosphate. Crunchy vegetables and whole foods need more chewing, which stimulates saliva. Chewing sugar-free gum after a meal also increases saliva flow and can help neutralize acid. The things to limit are frequent sugary snacks and drinks, and acidic drinks sipped over long periods. Sports and energy drinks deserve a special mention: most combine sugar with acid, the worst pairing for teeth, and water is enough for most everyday exercise.

Tobacco and vaping

Tobacco in any form is one of the biggest threats to your mouth. Smoking is a major cause of gum disease and tooth loss, slows healing after dental treatment, stains teeth and causes bad breath, and is a leading cause of mouth and throat cancer. Smokeless tobacco, such as chewing tobacco and snuff, also causes oral cancer and wears away the gums where it is held. The effects of vaping on the mouth are still being studied, and nicotine in any form reduces blood flow to the gums. Quitting helps at any age. Free coaching is available by calling 1-800-QUIT-NOW, and your doctor, dentist or pharmacist can talk you through quit medicines.

Alcohol

Heavy drinking is a risk factor for mouth and throat cancer, and the risk is far greater when heavy drinking and smoking are combined than with either alone. Alcohol also dries the mouth, and many alcoholic drinks are acidic or sugary. If you drink, US guidelines suggest no more than two drinks a day for men and one for women, and drinking less is better for health overall.

Warning signs, mouth cancer and dental emergencies

Most mouth problems develop slowly and send small signals first. Gums that bleed regularly, teeth that have become sensitive, a bad taste or bad breath that does not go away, a tooth that aches when you bite, or a change in how your teeth fit together are all reasons to book a dental visit rather than wait for your next routine one. Toothache lasting more than a day or two needs a dentist.

Oral cancer can affect the lips, tongue, floor of the mouth, gums, cheeks and roof of the mouth, and cancers of the throat behind the mouth are closely related. The main risk factors are tobacco and alcohol, especially together. Infection with human papillomavirus, HPV, is linked mainly to cancers of the throat, and the HPV vaccine, routinely recommended for preteens and for some young adults, protects against the types of HPV most strongly linked to these cancers. Too much sun on the lips raises the risk of lip cancer.

Early oral cancer is often painless, which is why it is frequently found late. The two-week rule is the most useful thing to remember: any sore, ulcer, lump, or red or white patch in your mouth that has not healed within two weeks needs to be checked by a dentist or your doctor. Most will turn out to be harmless, but finding oral cancer early makes a real difference to treatment and outcomes. Persistent hoarseness, difficulty or pain when swallowing, a lump in the neck, or numbness in the mouth also need prompt assessment.

Once a month or so, in good light and with a mirror, take a minute to look around your mouth so that you know what is normal for you. Remove dentures first. You are not trying to diagnose anything, only to notice changes early enough to get them checked. The checklist below covers the areas to look at, and anything that lasts more than two weeks goes to your dentist or doctor.

• Lips: look at the outside and inside for sores, lumps or color changes
• Gums: check for swelling, bleeding, or red or white patches
• Cheeks: pull each cheek out and look at the inside lining
• Tongue: look at the top, both sides and underneath
• Floor and roof of the mouth: look under the tongue and tilt your head back
• Neck: feel along both sides and under the jaw for lumps

Dental emergencies

If a permanent tooth is knocked out, act immediately. Pick it up by the crown, not the root, rinse it briefly if it is dirty without scrubbing, and if possible gently push it back into its socket and bite on a clean cloth. If you cannot, keep it in milk and get to a dentist straight away, because the chance of saving it falls quickly with time. Never try to put a baby tooth back in. A broken tooth, a lost filling with pain, or bleeding after an extraction that will not stop also need prompt dental care.

A dental abscess can cause throbbing pain, a swollen gum or face, a bad taste and fever. It needs urgent dental care the same day if possible. Call 911 or go to the emergency room if swelling spreads to your eye or neck, affects the floor of your mouth, or makes it hard to breathe, swallow or open your mouth, because a spreading dental infection can become life-threatening.

Dental checkups, cleanings and treatment

There is no single right interval between dental checkups for everyone. Your dentist will recommend one based on your history of decay and gum disease, your risk factors and how well your mouth is doing; some people need a visit every few months, others less often. What matters is going at the interval that is right for you, and not waiting until something hurts.

A checkup typically starts with questions about your health and any medicines you take, because many conditions and drugs affect the mouth. The dentist then examines your teeth for decay and wear, measures the space between your gums and teeth to check for gum disease, examines your soft tissues for signs of oral cancer, and checks your bite and any existing fillings or crowns. X-rays are taken based on your individual needs rather than on a fixed schedule. A hygienist will usually clean your teeth, removing tartar that home care cannot.

If treatment is needed, the options depend on the problem. Small cavities are cleaned out and filled. A badly damaged tooth may need a crown, a cap that covers and protects it. When decay or injury reaches the pulp, a root canal treatment removes the infected tissue and seals the tooth, which often saves a tooth that would otherwise be lost. Missing teeth can be replaced with bridges, dentures or implants, and gum disease is managed with deep cleaning and regular maintenance.

Talking to your dentist and doctor

Bring an up-to-date list of all your medicines and supplements. Tell your dentist if you take blood thinners, medicines for osteoporosis, or medicines that suppress the immune system, and if you have diabetes, a heart condition, a joint replacement, or are pregnant. A small group of people with certain heart conditions need antibiotics before some dental procedures; your doctor and dentist will tell you if you are one of them. If you are anxious about dental visits, which is very common, say so at the start. Dental teams can explain each step, agree on a signal to pause, and discuss options to make treatment more comfortable. Before agreeing to treatment, ask what it will cost, whether there are alternatives, and to be shown the problem on an X-ray or in a mirror.

Oral health through life

The basics of oral health stay the same from the first tooth to old age, but the risks shift. Young children depend on adults for nearly everything, teenagers face new risks from sports, braces, tobacco and diet, pregnancy affects the gums, older adults are more likely to have dry mouths and exposed roots that decay easily, and people with some long-term conditions need closer attention.

Babies and young children

Cavities are one of the most common chronic conditions of childhood in the US, and they are largely preventable. Wipe a baby's gums with a clean, damp cloth, and start brushing as soon as the first tooth appears. Use a smear of fluoride toothpaste no bigger than a grain of rice until age 3, then a pea-sized amount from 3 to 6, and supervise brushing until your child can brush well and spit reliably. Take your child to the dentist by their first birthday. Fluoride varnish is recommended for young children from the first tooth through age 5, and your child's doctor or dentist can apply it.

Baby teeth matter even though they fall out. They help children chew, speak clearly and hold space for the permanent teeth, and decay in them can cause pain and infection. Never put a child to bed with a bottle or sippy cup of milk, juice or any sweet drink, offer only milk or water between meals, and avoid sharing spoons or cleaning a pacifier in your own mouth, which passes decay-causing bacteria to your child.

Older children and teens

Ask about sealants when the permanent back teeth come in. Children and teens who play contact sports should wear a mouthguard, which costs far less than replacing a broken tooth. Braces make cleaning harder, so extra care and interdental brushes help. Teens are also the age group targeted by vaping and tobacco products, and frequent sports drinks, energy drinks and snacking can cause decay and erosion. Self-induced vomiting can wear away the enamel on the backs of the front teeth, and dentists are sometimes the first to notice the signs of an eating disorder.

Pregnancy

Dental care, including cleanings, needed X-rays with appropriate shielding, local anesthesia and treatment of decay, is safe during pregnancy and is recommended, according to the American College of Obstetricians and Gynecologists. Hormonal changes make many pregnant people's gums more likely to swell and bleed, so keeping up cleaning and checkups matters. If morning sickness causes vomiting, rinse with water afterward rather than brushing straight away. A healthy mouth during pregnancy also lowers the chance of passing decay-causing bacteria to the baby later.

Older adults

Losing teeth is not an inevitable part of aging. Many older adults keep their natural teeth for life, but they face particular risks. Gums that have receded expose roots, which decay more easily than enamel. Many common medicines cause dry mouth, which speeds up decay. Dentures should be cleaned every day, taken out at night unless your dentist advises otherwise, and checked if they become loose or cause sores. Oral cancer is more common with age, so the soft-tissue check at each visit becomes more important, not less.

People with long-term conditions

People with diabetes need close attention to their gums. Anyone due to have radiation to the head and neck, chemotherapy or certain bone-strengthening medicines should ideally see a dentist before treatment starts, to deal with problems that could cause complications later. People with conditions that cause dry mouth, such as Sjogren's disease, may need extra fluoride. People with disabilities and their caregivers can ask the dental team about adapted brushes, positioning and routines that make daily care practical.

Paying for dental care in the US

In the US, dental coverage is usually separate from medical insurance, which surprises many people. Employer-sponsored dental plans often cover preventive care such as checkups and cleanings at a higher level than fillings, crowns or dentures, and many have yearly limits on what they will pay. Before you need treatment, find out what your plan covers, whether there are waiting periods, and which dentists are in network.

Original Medicare generally does not cover routine dental care such as checkups, cleanings, fillings, extractions or dentures. It may cover certain dental services that are closely tied to other covered medical treatment. Many Medicare Advantage plans include some dental benefits, and stand-alone dental plans can be bought separately. Compare these carefully, because the benefits, yearly limits and networks vary widely from plan to plan.

Dental care is a covered benefit for children enrolled in Medicaid and the Children's Health Insurance Program, CHIP. Dental coverage for adults on Medicaid varies by state, from comprehensive care to emergency-only services. For children, dental coverage is one of the essential health benefits in plans sold through HealthCare.gov, and adults there can often buy dental coverage as part of a plan or separately.

• Federally funded community health centers, many of which offer dental care on a sliding fee scale based on income
• Dental schools and dental hygiene schools, where supervised students provide care at reduced cost
• School-based programs that offer sealants and fluoride varnish to children

Myths and what the guidance actually says

A lot of what people believe about teeth comes from habit or marketing rather than evidence. The list below sets some of the most common misconceptions against what US guidance supports. The common thread is that prevention is cheap and simple, while treatment is costly and complicated. Most of the guidance that matters fits on an index card; the hard part is doing it every day.

• Myth: bleeding gums mean you should stop brushing that area. Guidance: bleeding usually means plaque has been left there; keep cleaning gently and see a dentist if it persists.
• Myth: if nothing hurts, your teeth are fine. Guidance: early decay, gum disease and oral cancer are often painless, which is why checkups matter.
• Myth: harder brushing cleans better. Guidance: a soft brush and gentle pressure clean well and protect enamel and gums.
• Myth: baby teeth do not matter because they fall out. Guidance: decay in baby teeth causes pain and infection and can affect the permanent teeth.

A practical four-week plan

Changing habits works best one step at a time. This plan builds a complete routine over a month, starting with the changes that make the biggest difference; if you already do some of it, move on to the next week. After the first month, the yearly part is simple: see the dentist at the interval recommended for you, replace your toothbrush every three to four months, check your mouth now and then for anything lasting more than two weeks, and review your dental coverage during open enrollment, before you need treatment.

• Week 1, the bedtime brush: buy a soft-bristled brush and a fluoride toothpaste, brush for a full two minutes before bed every night, spit rather than rinse, and have nothing but water afterward. Add a second daily brush if you are not already doing it.
• Week 2, between the teeth: choose floss, interdental brushes, a water flosser or picks, and use it once a day straight after the bedtime brush so the two become linked. Keep going gently through any early bleeding, and note areas that do not improve.
• Week 3, sugar and acid frequency: for a few days, notice how often you have something sweet or acidic. Then cut the number of occasions: move sweet foods to mealtimes, switch between-meal drinks to water, and finish any soda or juice in one sitting.
• Week 4, book and plan: book a dental checkup if you are due or unsure, check what your coverage includes or find a community health center or dental school nearby, do your first mouth self-check, and if you use tobacco, set a quit date and call 1-800-QUIT-NOW.

Every guide in this topic

• The Evidence on Toothbrushing, Without the Hype
• Gum Disease: Sorting the Evidence From the Noise
• Tooth Decay: Sorting the Evidence From the Noise
• Dental Checkups: What Published Guidance Supports
• Mouth Ulcers: What Published Guidance Supports
• What the Guidance Really Says About Bad Breath
• Sensitive Teeth: What the Evidence Actually Says
• The Evidence on Children's Teeth, Without the Hype
• The Evidence on Mouth Cancer Awareness, Without the Hype
• Dry Mouth: What Published Guidance Supports

Frequently asked questions

Is an electric toothbrush better than a manual one?

Both can clean teeth well when used properly for two minutes with gentle pressure. An electric brush can make good technique easier, especially if you have arthritis, braces or limited hand movement, or if you tend to rush. Many have built-in timers and pressure warnings. Whichever you choose, use soft bristles and replace the brush or head every three to four months.

Should I rinse my mouth after brushing?

It is better to spit out the excess toothpaste and not rinse with water. Rinsing washes away the fluoride left on your teeth, which keeps working after you finish brushing. If you use a fluoride mouth rinse, use it at a different time of day from brushing so you get extra contact with fluoride rather than replacing it.

My gums bleed when I floss. Should I stop?

No. Bleeding is usually a sign of gingivitis caused by plaque that has been left between the teeth, and gentle daily cleaning is what helps it settle. Bleeding often lessens as the gums become healthier. If it continues, or you also notice receding gums, loose teeth or persistent bad breath, see a dentist to check for gum disease.

How often do I really need to see a dentist?

It depends on your own risk. Your dentist will recommend an interval based on your history of decay and gum disease, your general health and how well your mouth is doing. Some people need visits every few months and others less often. Go at the interval recommended for you, and book sooner for pain, bleeding gums or any change that worries you.

Are dental X-rays safe?

Dental X-rays use low doses of radiation, and US guidance is that dentists should take them based on your individual needs rather than on a fixed routine schedule. They show decay between teeth, bone loss from gum disease and problems below the gumline that cannot be seen in an exam. Tell your dentist if you are or might be pregnant.

When should my child first see a dentist?

By their first birthday, or within six months of the first tooth appearing. Early visits let the dentist check for early decay, apply fluoride varnish if needed and show you how to clean your child's teeth. Your child's doctor may also apply fluoride varnish at well-child visits, which is recommended from the first tooth through age 5.

What can I do about bad breath?

Most bad breath starts in the mouth, from bacteria on the tongue and between the teeth, gum disease, decay or dry mouth. Clean between your teeth daily, gently clean your tongue, drink water and see a dentist. Mints and mouthwash only mask it. If it persists after dental care, see your doctor, as sinus problems, reflux or medicines can contribute.

Why are my teeth suddenly sensitive?

Sensitivity usually comes from exposed dentin, caused by gum recession, enamel erosion from acidic drinks, hard brushing or grinding. A desensitizing toothpaste used every day can help, though it may take weeks. See a dentist if the pain is severe, in one tooth, lingers after hot or cold has gone, or wakes you, since it may be decay or a crack.

Does Medicare pay for dental care?

Original Medicare generally does not cover routine dental care such as checkups, cleanings, fillings, extractions or dentures, though it may cover certain dental services tied to other covered medical treatment. Many Medicare Advantage plans include some dental benefits, and separate dental plans are available. Compare benefits, yearly limits and in-network dentists carefully before choosing.

Can I get dental treatment while pregnant?

Yes. The American College of Obstetricians and Gynecologists says routine dental care, needed X-rays with shielding, local anesthesia and treatment of decay are safe during pregnancy. Hormonal changes make gums more likely to bleed, so keeping up checkups matters. Tell your dentist you are pregnant, and get urgent care for any dental infection rather than waiting until after the birth.

When to speak to a doctor

See a dentist for toothache lasting more than a day or two, gums that bleed regularly, receding gums, loose teeth, persistent bad breath or new sensitivity. See a dentist or your doctor promptly for any mouth sore, lump, or red or white patch that has not healed within two weeks, persistent hoarseness, or difficulty swallowing, which need checking for oral cancer. Get same-day dental care for a knocked-out permanent tooth, facial swelling, or fever with toothache. Call 911 or go to the emergency room for swelling that spreads to the eye or neck or makes it hard to breathe, swallow or open your mouth, or bleeding from the mouth that will not stop. For a child who has swallowed a large amount of fluoride toothpaste or mouthwash, call Poison Control at 1-800-222-1222.

Where this comes from

• American Dental Association — Brushing Your Teeth
• American Dental Association — Baby Teeth
• National Institute of Dental and Craniofacial Research — Tooth Decay
• National Institute of Dental and Craniofacial Research — Periodontal (Gum) Disease
• US Preventive Services Task Force — Prevention of Dental Caries in Children Younger Than 5 Years: Screening and Interventions
• Dietary Guidelines for Americans — Dietary Guidelines for Americans, 2020-2025
• American Cancer Society — Signs and Symptoms of Oral Cavity and Oropharyngeal Cancers
• American College of Obstetricians and Gynecologists — Oral Health Care During Pregnancy and Through the Lifespan
• Medicare.gov — Dental services
• Medicaid.gov — Dental Care

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.