Teeth whitening

More and more people are paying for brighter, whiter teeth. But does teeth whitening work and is it safe? Here are the answers to common questions about the treatment.

What is teeth whitening?

Teeth whitening involves bleaching your teeth to make them lighter. Teeth whitening can't make your teeth brilliant white, but it can lighten the existing colour by several shades.

Who can perform teeth whitening?

Teeth whitening is a form of dentistry and should only be performed by a dentist or another regulated dental professional, such as a dental hygienist or dental therapist, on the prescription of a dentist.

Some beauty salons offer teeth whitening, but this is illegal if there's no dental professional present, and it may put your oral health at risk.

You can also buy DIY home teeth whitening kits but these may also carry risks.

What happens during teeth whitening at the dentist?

If you have teeth whitening you will need to make several visits to the dental surgery over a couple of months.

The dentist will take an impression of your teeth to make a mouthguard and will instruct you how to use it with a bleaching gel. Then, using your mouthguard at home, you regularly apply the gel for a specified period of time over two to four weeks. Some whitening gels can be left on for up to eight hours at a time, which shortens the treatment period to one week.

Another type of teeth whitening system that a dentist can provide is called laser whitening, which is also known as power whitening. This is where a bleaching product is painted onto your teeth and then a light or laser is shone on them to activate the whitening. Laser whitening takes about an hour.

Can any dentist whiten teeth?

Yes, provided they are registered with the General Dental Council. Registered dental therapists and dental hygienists can also carry out teeth whitening on the prescription of a dentist.

To find out if a dental professional is registered with the GDC you can check online or call 0207 167 6000.

What about home kits and beauty salons for teeth whitening?

Only go to a registered dental professional for teeth whitening because whitening by people who aren't qualified, for example in beauty salons, is illegal. Home kits also carry risks.

What are the risks of home kits and salon teeth whitening?

Some home kits don't contain enough of the whitening product to be effective. More generally, if a dental professional is not doing the whitening, the mouthguard provided may not fit properly so some of the bleaching gel may leak out onto your gums and into your mouth, causing blistering and sensitivity.

Where teeth whitening is carried out in beauty salons by staff without any training or dental qualifications it not only carries a risk to your oral health, but is also illegal.

Can you have your teeth whitened on the NHS?

You can only have your teeth whitened on the NHS if there's a medical reason for it. For example, this might be to lighten teeth that have discoloured because the nerve has died.

Otherwise, teeth whitening by a dentist or other dental professional can only be done privately because it's considered to be a cosmetic treatment. Costs vary and, as a general rule, laser whitening is more expensive than professional bleaching.

Find out which dental treatments are available on the NHS.

How do you go about getting teeth whitening?

Your dentist will advise you whether whitening is right for you. It may be that teeth whitening isn't suitable, for example if you have gum disease or crowns.

Find your nearest dentist here.

What questions should I ask the dentist before going ahead?

Don't be afraid to ask simple questions about the types of whitening treatment available, what results you can expect and whether the work is guaranteed for a certain amount of time. Also, ask them what they consider to be the risks in your particular case, for example increasing sensitivity of the teeth.

Try to talk to other people who have had the same treatment or visit another dentist for a second opinion until you feel confident. Always ask for a written treatment plan and price estimate before going ahead.

Is teeth whitening permanent?

No, teeth whitening isn't permanent. It can last from a few months to up to three years, but this varies from person to person. Generally, the whitening effect won't last as long if you smoke or drink red wine, tea or coffee, which can all stain your teeth.

Will teeth whitening work on false teeth?

No. Teeth whitening won't work on dentures, crowns, fillings or veneers.

What are the risks of teeth whitening?

No matter what treatment you use, there is a chance your gums can be sensitive to the chemicals used in teeth whitening, especially if you already have sensitive teeth. There's also a chance of burns to gums and some of the whitening kits used at home can harm tooth enamel.

What if I'm not happy with the results?

If you're concerned that teeth whitening by a dental professional has harmed you, contact the Dental Complaints Service on 0208 253 0800. This is an expert, free and independent service that can help if you have a complaint about private dental care.

If you think your teeth whitening has been carried out illegally (that is, by someone not qualified or registered to perform it) contact the General Dental Council on 0207 167 6000 or email illegalpractice@gdc-uk.org.

Read more about how to look after your teeth.

Braces and orthodontics

Braces are in high demand. More than 200,000 children and adults in England and Wales started orthodontic treatment last year. Here are the answers to some common questions about this type of dental treatment.

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Why have braces?

The purpose of orthodontic treatment is to make the best of your teeth. This includes allowing you to bite correctly, eat more comfortably, and to care for your teeth and gums more easily. And your smile will benefit, too.

Treatment almost always involves using braces to straighten crooked, crowded or protruding teeth, close gaps between teeth, and correct the bite of the teeth so the top and bottom teeth meet when you close your mouth.

Treatment usually lasts from 18 months to two years, and visits to the orthodontist are needed every four to six weeks.

How common is orthodontic treatment?

According to the British Orthodontic Society, 202,300 people started orthodontic treatment in England and Wales in 2014-15.

The vast majority were children, with 72,300 children under 13 years old and 128,500 children aged 13 to 17 beginning orthodontic treatment to straighten their teeth last year. Braces are usually more successful in children, which is why most orthodontic patients are children.

Fewer than 1 in 100 orthodontic patients are adults – just 1,500 adults began orthodontic treatment in England and Wales in 2014-15. But more adults than ever now want treatment, many having missed out when they were children.

Are braces available on the NHS?

Orthodontic treatment is only available at no cost on the NHS for young people under the age of 18.

NHS orthodontic treatment is not usually available for adults, but may be approved on a case-by-case basis if needed for health reasons. Your dentist can give you more information.

Can I have private treatment?

Private treatment is widely available but expensive. The British Orthodontic Society says fees vary, but are usually around £2,000 to £2,500. However, they can be much higher.

One advantage of private treatment is you have a wider choice of braces, including clear or invisible ones.

What's the best age to have braces?

The ideal age to have orthodontic treatment is around 12 or 13, while you're still growing. The opportunity for improvement in an adult is more limited and surgery is more likely to be needed.

How do I get braces fitted?

To get braces fitted you need to be referred to an orthodontist by your dentist.

If you want to check the qualifications of your orthodontist, use the definitive list of specialist orthodontists held by the General Dental Council. By law, only registered specialists can call themselves a specialist orthodontist.

What are braces like?

There are many different types of braces. Some are removable, which you take out at night, to eat a meal, or clean. Some are fixed and stay in all the time. NHS braces are made of metal, but plastic and ceramic ones are also available privately. Some of these are clear, so you can hardly see them on your teeth.

Read more about different types of braces.

How successful are braces?

Orthodontics usually works very well, but it's important to look after your teeth while you're wearing braces. Braces can trap food and cause more plaque to build up than usual.

You need to take extra care cleaning your teeth and watch what you eat – for example, by avoiding sugary foods and drinks. You also need to see your dentist regularly while having orthodontic treatment.

Read more about looking after your teeth while wearing braces.

What if my child is refused NHS braces?

If you think your child is being refused NHS treatment unfairly or the waiting list for treatment is unreasonably long, contact your local area team of NHS England, Health in Wales and NHS Health Scotland.

Find out more about orthodontics or braces.

The health risks of gum disease

The state of your teeth affects your overall health, with gum disease linked to lots of health problems in other parts of the body. Therefore, brushing your teeth can prevent gum disease and improve your overall health.

Spot gum disease

Signs of gum disease include:

• Gums that bleed when you brush your teeth
• Blood in your saliva
• Red, swollen gums
• Bad breath
• Wobbly or loose teeth
• Abscessed teeth
• Tooth loss

If you're concerned that you may have gum disease, visit your dentist.

Did you know that gum disease isn’t just bad news for your teeth, it’s also linked to serious health problems in other parts of your body?

Gum disease may increase your risk of all kinds of other health complications, including stroke, diabetes and heart disease. Gum disease has even been linked with problems in pregnancy and dementia.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, explains: "The link between oral health and overall body health is well documented and backed by robust scientific evidence. Despite this, only one in six people realises that people with gum disease may have an increased risk of stroke or diabetes. And only one in three is aware of the heart disease link."

Gum disease dangers

Gum disease is an infection of the tissues that support the teeth. It's mainly caused by bacteria from plaque build-up. In some patients who are susceptible to gum disease, the body over-reacts to the bacteria around the gums and causes too much inflammation. In others, the inflammation doesn’t clear up properly. The result of the intense gum inflammation is that it also affects the bloodstream, and is believed to slowly damage blood vessels in the heart and brain over a long period of time.

What’s the damage?

Gum disease has been linked to a variety of other health problems, including:

• heart disease and heart attacks
• diabetes and its control
• stroke
• rheumatoid arthritis

Preventing problems

The good news is that brushing your teeth properly and looking after your gums can prevent and treat gum disease, improve your overall health and help to reduce your risk of health problems, such as heart disease.

Follow a routine of brushing your teeth for a full two minutes twice a day with a fluoride toothpaste, plus cleaning between your teeth with floss or interdental brushes.

Visit your dentist and dental hygienist regularly for cleaning and check-ups. It’s especially important to look after your teeth and gums if you’re pregnant. NHS dental care is free for pregnant women and during the 12 months after you've given birth.

Find out how to brush your teeth properly.

Dental check-ups

You may assume you should have a dental check-up every six months, but some people may not need to go so often and others may need more frequent checks.

Your dentist will suggest when you should have your next check-up based on how good your oral health is.

The time between check-ups can vary from three months to two years, depending on how healthy your teeth and gums are and your risk of future problems.

Why do I need a dental check-up?

A check-up allows your dentist to see if you have any dental problems and helps you keep your mouth healthy. Leaving problems untreated could make them more difficult to treat in the future, so it's best to deal with problems early, or, if possible, prevent them altogether.

What happens during a dental check-up?

At each check-up, your dentist should:

• Examine your teeth, gums and mouth.
• Ask about your general health and any problems you’ve had with your teeth, mouth or gums since your last visit.
• Ask about, and give you advice on, your diet, smoking and alcohol use, and teeth-cleaning habits.
• Discuss a date for your next visit.

How often should I have a dental check-up?

After your check-up, your dentist will recommend a date for your next visit. The time to your next check-up could be as short as three months or as long as two years (or up to one year if you're under 18).

Generally, the lower your risk of dental problems, the longer you can wait before your next check-up. So people with good oral health will probably need to attend only once every 12 to 24 months, but those with more problems will need check-ups more often.

Dental treatments

This is a guide to the main treatments carried out by dentists. Some are readily available on the NHS, while some may only be available on the NHS in certain circumstances.

As with glasses and prescription costs, you have to pay a contribution towards the cost of your NHS dental treatment. The cost depends on the type of treatment and which cost band the treatment is covered by.

With the exception of teeth whitening and implants, the treatments on this page are usually available on the NHS.

Find out more about NHS dental charges.

Always ask your dentist whether the treatment they're recommending is available on the NHS and how much it will cost before you go ahead.

Bridges

A bridge is a fixed replacement for a missing tooth or teeth. It's made by taking an impression of the surrounding teeth, which will eventually support the bridge. A bridge is usually created from precious metal and porcelain and will be fixed in your mouth (unlike dentures, which can be removed).

Crowns

A crown is a type of cap that completely covers a real tooth. It's made from either metal, or porcelain and metal, and is fixed in your mouth. Crowns can be fitted where a tooth has broken, decayed or been damaged, or just to make a tooth look better.

To fit a crown, the old tooth will need to be drilled down so it's like a small peg the crown will be fixed onto. It can take some time for the lab to prepare a new crown, so you probably won't have the crown fitted on the same day.

Fillings

Fillings are used to repair a hole in a tooth caused by decay. The most common type of filling is an amalgam, made from a mixture of metals including mercury, silver, tin, copper and zinc. Your dentist will offer the most appropriate type of filling according to your clinical needs. This includes white fillings, if appropriate.

Root canal treatment

Root canal treatment (also called endodontics) tackles infection at the centre of a tooth (the root canal system).

When the blood or nerve supply of the tooth has become infected, if root canal treatment is not carried out, the infection will spread and the tooth may need to be taken out.

During treatment, all the infection is removed from inside the root canal system. The root canal is filled and the tooth is sealed with a filling or crown to stop it from becoming infected again. Root canal treatment usually requires two or three visits to your dentist.

Read more about root canal treatment.

Scale and polish

This is when your teeth are professionally cleaned by the hygienist. It involves carefully removing the deposits that build up on the teeth (tartar).

Braces

Braces (orthodontic treatment) straighten or move teeth to improve the appearance of the teeth and how they work.

Braces can be removable, so you can take them out and clean them, or fixed, so they're stuck to your teeth and you can't take them out.

They can be made of metal, plastic or ceramic. Invisible braces are made of a clear plastic.

Braces are available on the NHS for children and, occasionally, for adults, depending on the clinical need.

Read more about braces (orthodontics).

Wisdom tooth removal

The wisdom teeth grow at the back of your gums and are the last teeth to come through, usually in your late teens or early twenties. Most people have four wisdom teeth, one in each corner.

Wisdom teeth can sometimes emerge at an angle or get stuck and only emerge partially. Wisdom teeth that grow through in this way are known as impacted.

Impacted wisdom teeth can be removed on the NHS. Your dentist may perform the procedure or may refer you to a dentist with a special interest or to a hospital's oral and maxillofacial unit.

You will usually have to pay a charge for wisdom tooth removal. If you are referred to a hospital for NHS treatment, you will not have to pay a charge.

Your dentist can also refer you for private wisdom teeth treatment if you wish.

Find out more about wisdom tooth removal.

Dental implants

Implants are a fixed alternative to removable dentures. They may be the only option if the loss of teeth has caused the mouth to shrink so that it can no longer support dentures. You can use implants to replace just a single tooth or several teeth.

To fit an implant, titanium screws are drilled into the jaw bone to support a crown, bridge or denture.

Replacement parts take time to prepare. This is to ensure that they fit your mouth and other teeth properly. Therefore, they may not be available on your first visit to the dentist.

Implants are usually only available privately and are expensive. They're sometimes available on the NHS for patients who can't wear dentures or whose face and teeth have been damaged, such as people who've had mouth cancer or an accident that's knocked a tooth out.

Dentures or false teeth

More commonly known as false teeth, dentures are fitted in place of natural teeth. A full set is used to replace all your teeth. A part set is used to replace one or more missing teeth. Dentures are custom-made using impressions (mouldings) from your gums. They're usually made from metal or plastic.

They're removable so you can clean them, although part dentures can be brushed at the same time as your other teeth. A full set needs to be removed and soaked in a cleaning solution.

Dentures are important if you lose your natural teeth, as losing your teeth makes it difficult to chew your food, which will adversely affect your diet and may cause your facial muscles to sag.

Read more about dentures and false teeth.

Broken or knocked out tooth

It's common to break, chip or knock out a tooth.

If the tooth is just chipped, make a non-emergency dental appointment to have it smoothed down and filled, or to have a crown.

If the tooth has been knocked out or is badly broken, see a dentist immediately. Your dentist may fit a denture or bridge. If you need an implant, you'll be referred to a dental hospital.

Treatment of whatever type can be provided by an NHS dentist and the cost covered on the NHS.

Read more about broken or knocked out teeth.

Teeth whitening

Teeth whitening involves bleaching your teeth to make them a lighter colour. Teeth whitening can't make your teeth brilliant white, but it can lighten the existing colour by several shades.

Standard teeth whitening involves several visits to the dentist plus sessions at home wearing a mouthguard containing bleaching gel. The whole process takes a couple of months.

A newer procedure called laser whitening or power whitening is done at the dentist's surgery and takes about an hour.

Teeth whitening is cosmetic and therefore generally only available privately.

It is occasionally available on the NHS if you have a clinical need, for example to whiten a tooth that's gone black because the nerve has died.

Read more about teeth whitening.

Dental veneers

Veneers are new facings for teeth which disguise a discoloured (rather than a damaged) tooth. To fit a veneer, the front of the tooth is drilled away a little. An impression is taken, and a thin layer of porcelain is fitted over the front of the tooth (similar to how a false fingernail is applied).

Veneers are generally only available privately unless you can show a clinical need for them.

Common dental Q&As

Read answers to the most common questions about dentists and dental charges.

Fear of the dentist

One in four of us dreads a visit to the dentist, but there are ways to overcome your fear.

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Being afraid of the dentist means different things to different people. Maybe it's the thought that treatment will hurt, or that the sounds and smells bring back memories of bad experiences as a child.

The good news is that more and more dentists understand their patients' fears. With a combination of kindness and gentleness they can do a lot to make dental treatment stress free.

Karen Coates, a dental adviser at the British Dental Health Foundation, says the organisation's dental helpline receives many calls about fear and phobia.

Karen says: "People who are scared of the dentist often call us for help because they're at the end of their tether. Their teeth don't look nice any more or they're in a lot of pain with toothache, and they want to make the first step to seeing a dentist and getting their teeth sorted out.

"Some people have such bad dental phobia that they haven't seen a dentist for years. It's common for us to hear from someone in their twenties or thirties or even older who hasn't been to the dentist since childhood. Recently, a 16-year-old girl whose mother has a dental phobia called the helpline. The mother had never taken the daughter to the dentist – and now the girl desperately wanted to have a dental check-up."

Dental advances

If you haven't seen a dentist for several years because of fear or anxiety, be reassured that you should find the experience more bearable nowadays.

"Most people who are scared of the dentist have bad memories from childhood of the smells and sounds of the surgery," says Karen. "Modern dental surgeries are much friendlier environments, with flowers in the waiting room, art on the walls, a pleasant reception area and polite staff.

"It's altogether a gentler experience. Of course, you'll still have the smells and sounds of the dental surgery but these are less noticeable than they used to be with instruments hidden from sight and background music playing. Even drills aren't as noisy as they used to be," she adds.

Advances in technology have also improved dentistry. Treatment can now be completely painless. The dental wand (a computerised injection system that looks like a pen and delivers the anaesthetic very slowly so it is painless) is great for anyone with a needle phobia. A numbing gel can also be used to numb your gums before an injection so you don't feel the needle.

8 tips to ease dental fear

If you're anxious about seeing the dentist, here are Karen's tips to ease the fear:

• Find an understanding dentist. Ask friends and family if they can recommend one or look for someone who advertises themselves as an expert with anxious patients. Search for your local dentists here.
• Once you've found someone you think may be suitable, visit the surgery to have a look around, meet the receptionist and dentist and see the environment. Tell the dentist that you're anxious so they know beforehand.
• Pick an appointment time early in the morning so you have less time to dwell on it.
• The first appointment will simply be a check-up so don't worry that you'll be launched into having a filling, the drill or a needle. See this first visit as your chance to get to know the dentist.
• Take a friend with you to your appointment. The dentist won't mind if they accompany you throughout the check-up or treatment.
• Agree a sign with the dentist to signal that you need a break and want them to stop. It can be as simple as pointing your finger, and will help you feel more in control.
• If you think it will help, start gradually with a clean and polish then work up to more extensive treatment once you've built up trust and rapport with your dentist.
• Take a personal stereo with you to listen to music during your visit. It will help you relax.

NHS sedation clinics

If you're extremely nervous, ask your dentist to refer you to an NHS sedation clinic. These clinics are specifically for nervous dental patients.

Some people find simple inhalation sedation very helpful to relax them for dental treatment. This is a bit like gas and air given during childbirth, but instead of being delivered through a mask it comes through a nosepiece.

If you're extremely nervous you may prefer intravenous sedation (through an injection into your hand or arm) during treatment. The drugs won't send you to sleep – you'll be awake and able to talk to the dentist – but they'll calm and relax you so deeply you probably won't remember much of what happened.

Common dental Q&As

Read the answers to common dental health questions.

Sweets, fizzy drinks and bottles

10 tips for parents on the top causes of tooth decay in children – and how to avoid them.

Establishing good habits can help your child avoid oral health problems, such as tooth decay and gum disease.

Can I let my child have sweets?

Most children want sweets, but you can help to prevent problems by making sure they don't have a large amount or very often, and particularly not before bed, when saliva flow lessens.

Try not to give sweets or sweet drinks as rewards.

What are the best snacks to give my child?

The best snacks are fruit and raw vegetables. Try tangerines, bananas, pieces of cucumber or carrot sticks. Other good snacks include toast, rice cakes and plain popcorn.

Dried fruit is high in sugar and can be bad for teeth, so only ever give it to children with meals – for instance, as a dessert – and never as a snack between meals.

The NHS Change4Life website has tips and ideas for cutting down on sugary foods and drinks.

Should I let my child have fizzy drinks?

No. Fizzy drinks can contain large amounts of sugar, which will increase the risk of tooth decay. Fizzy drinks (both those containing sugar and sugar-free or "diet" versions) also contain acids that can erode the outer surface of the tooth.

Find out about healthier drinks to give your child.

What are the best drinks for my child's teeth?

The best drinks for children over one year old are plain still water or plain milk.

Your child should have full-fat milk (whole milk) from the age of 12 months to two years.

Semi-skimmed milk can be introduced from the age of two, as long as your child is a good eater and growing well for their age.

Skimmed milk can be given to children aged five and over.

Cow's milk is not suitable as a drink for babies under 12 months of age.

Is it OK to drink fruit juice or smoothies?

Even unsweetened juices and smoothies contain sugars and acids, so although they can contribute towards their 5 A DAY, restrict your child to no more than one small glass (about 150ml) of fruit juice or smoothie each day and only at mealtimes.

Also, be aware that unsweetened 100% fruit juice, vegetable juice and smoothies can only ever count as a maximum of one portion of their 5 A DAY.

For example, if they have two glasses of fruit juice and a smoothie in one day, that still only counts as one portion.

If your child is thirsty, it's better to give them water than to encourage a taste for sweet drinks.

Try to avoid giving babies fruit-flavoured "baby juices", and never give them in feeding bottles. Fruit juice should not be given to babies under six months.

Read more about healthy drinks to give your children.

Will milk at bedtime damage my child's teeth?

Teeth are at most risk at night because there is less saliva in the mouth to protect them.

Water is the best drink to give at bedtime, but if you do give milk, don't add anything to it. Chocolate-flavoured drinks and milkshake powder usually contain sugars, which will increase the risk of decay.

Are sugar-free medicines better for my child's teeth?

Yes. Always ask if a sugar-free medicine is available and remind your doctor about this if you're being given a prescription for your child. This is especially important if your child is taking long-term medication.

When should my child give up bottles?

Your child should begin moving off the bottle and on to a free-flow feeder cup at six months. Try to get them off bottles completely by the age of one, because the teats and spouts encourage children to suck for long periods of time, meaning the drinks that cause tooth decay stay in contact with your child's teeth for a long time.

Are sippy cups good for teeth?

There's no need for a child to use a sippy cup. They're similar to a bottle in that they require the child to suck to make them work. A free-flow feeder cup is better, as it doesn't have valves and the flow of liquid is unrestricted. This means that children learn to drink normally rather than by sucking.

Read more about cups for children.

Will a dummy or thumb sucking harm my child's teeth?

No, but they will encourage an open bite, which is when teeth move to make space for the dummy or thumb. They may also affect speech development. That's why you should avoid using dummies after 12 months of age.

Thumb sucking won't cause permanent problems, as long as the habit stops by the time your child gets their second teeth, but it can be a hard habit to break.

Discourage your children from talking or making sounds with their thumb or a dummy in their mouth, and don't dip dummies in anything sweet, such as sugar or jam.

Read more about how to care for your child's teeth.

Common dental Q&As

Read the answers to common questions about NHS dentistry.

Lifestyle tips for healthy teeth

Taking care of your general health and your mouth is the key to making the most of your smile.

Brushing your teeth twice a day (last thing at night before you go to bed and on one other occasion) with fluoride toothpaste and having regular check-ups with a dentist can help to keep your teeth healthy. Diet, smoking and drinking alcohol also have an effect on dental health.

A healthy diet is good for your teeth

What you eat and drink can cause tooth decay, so a healthy diet is important for your teeth.

A balanced diet includes plenty of fruit and vegetables, as well as starchy foods, such as bread, rice, potatoes and pasta (choose wholegrain versions and eat potatoes with their skin where possible).

You should also eat sources of protein such as meat, fish, eggs, beans or other non-dairy sources of protein, and some milk and dairy foods (ideally lower-fat options).

Only eat small amounts of food and drinks high in fat and sugar. The eatwell plate shows how the different types of food should make up your diet.

Reduce sugar to prevent tooth decay

Limiting the amount of sugar you eat and drink is important to prevent tooth decay.

A lot of the sugars we eat and drink are in food and drinks such as:

• sweets, chocolate, cakes and biscuits
• sugary drinks, including soft drinks, fizzy drinks, milky drinks with added sugar, and alcohol
• fruit juice, including unsweetened fresh fruit juice and smoothies
• buns, pastries and fruit pies
• sponge puddings and other puddings
• table sugar added to food or drinks, such as tea
• sugary breakfast cereals
• jams, marmalades, honey and syrups
• ice cream and sorbets
• dried fruit or fruit in syrup
• syrups and sweet sauces

Here's why sugar is bad for your teeth, plus how to cut down on sugar.

Stick to one glass of fruit juice or smoothie a day

Sugars occur naturally in foods such as fruit and milk, but we don't need to cut down on these types of sugars.

However when fruit is juiced or blended, as in smoothies, the sugars are released from the structure of the fruit.

Once released, these sugars can damage your teeth so it's best to drink fruit juice or smoothies at mealtimes.

Your combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day – which is a small glass.

For example, if you have 150ml of orange juice and 150ml smoothie in one day, you’ll have exceeded the recommendation by 150ml.

Get ideas for healthy drinks that won't harm your teeth.

How smoking damages teeth

Smoking can stain your teeth yellow, cause bad breath, and increases your risk of gum disease, as well as causing many other serious health problems.

Find advice on how to stop smoking.

Alcohol and oral health

Alcohol can also erode the outer surface of the teeth, leading to a loss of enamel. If this happens, you may need to go to the dentist for a filling.

Drinking too much has also been linked to an increased risk of developing mouth cancer.

The most important risk factors for mouth cancer are the combined effect of smoking AND drinking alcohol.

It's estimated that heavy drinkers and smokers have a 38 times increased risk of developing mouth cancer than people who neither drink nor smoke.

Get tips on how to cut down your drinking.

Foods and drinks can stain your teeth

Wine, cigarette smoke, tea and coffee are all teeth-staining culprits. Keep them to a minimum to stop your teeth becoming stained.

Your dentist or hygienist can give your teeth a professional clean, which may help to reduce the staining.

If you want to find out about other options, such as teeth whitening, have a chat with your dentist.

Common Q&As

Read the answers to common questions about dental health.

How to keep your teeth clean

Brush your teeth with fluoride toothpaste twice a day for about two minutes to help keep your teeth and mouth healthy.

Plaque is a film of bacteria that coats your teeth if you don't brush them properly. It contributes to gum disease and tooth decay.

Tooth brushing stops plaque building up. Try to make sure you brush every surface of all your teeth.

Check out Brush DJ on our Digital Apps Library. The app plays two minutes of your music so you brush your teeth for the right amount of time.

Toothbrush tips

• Replace your brush or brush attachment every three months
• Never share your toothbrush, as this can spread infections
• Brush your teeth twice a day with fluoride toothpaste for about two minutes

When should I brush my teeth?

Brush your teeth for about two minutes last thing at night before you go to bed and on one other occasion every day.

Your dentist or hygienist may give you more advice based on your own dental health and needs.

Should I use an electric or manual toothbrush?

It doesn't matter whether you use an electric or manual toothbrush. They're both equally as good, as long as you brush all the surfaces of all your teeth and you use fluoride toothpaste. However, some people find it easier to clean their teeth thoroughly with an electric toothbrush.

What should I look for in a toothbrush?

For most adults, a toothbrush with a small head and a compact, angled arrangement of long and short round-end bristles is fine. Medium or soft bristles are best for most people.

If you're using an electric brush, one with an oscillating or rotating head may work better than a manual toothbrush.

However, making sure you thoroughly clean your teeth at least twice a day is more important than the type of brush you use. If in doubt, ask your dentist.

What type of toothpaste should I use?

It's important to use a toothpaste with the right concentration of fluoride. Check the packaging to find out how much fluoride each brand contains.

• Adults should use a toothpaste that contains at least 1,350 parts per million (ppm) fluoride.
• Children don't need to use special "children's toothpaste". Children of all ages can use family toothpaste, as long as it contains 1,350-1,500ppm fluoride. Children aged six and under who don't have tooth decay can use a lower-strength children's toothpaste, but make sure it contains at least 1,000ppm fluoride.
• Below the age of three, children should use just a smear of toothpaste. Children aged three to six years should use a pea-sized blob of toothpaste. Make sure children don't lick or eat toothpaste from the tube.

Your dentist may advise you or your child to use a toothpaste with a higher concentration of fluoride, if you need it.

How to brush your teeth

Make sure you brush all the surfaces of all your teeth, which should take about two minutes. Remember to brush the inside surfaces, outside surfaces and the chewing surfaces of your teeth.

How to help children brush their teeth

Children need to be helped or supervised brushing their teeth until they're at least seven years old.

More tips on brushing children's teeth.

Don't rinse with water straight after toothbrushing

After brushing, spit out any excess toothpaste. Don't rinse your mouth immediately after brushing, as it will wash away the concentrated fluoride in the remaining toothpaste, thus diluting it and reducing its preventative effects.

Should I use mouthwash?

Using a mouthwash that contains fluoride can help to prevent tooth decay, but don't use mouthwash – even a fluoride one – straight after brushing your teeth or it will wash away the concentrated fluoride in the toothpaste left on your teeth. Choose a different time to use mouthwash, such as after lunch. Don't eat or drink for 30 minutes after using a fluoride mouthwash.

How to use dental floss

Flossing isn't just for dislodging food wedged between your teeth. Regular flossing may also reduce gum disease and bad breath by removing plaque that forms along the gum line. It's best to floss before brushing your teeth.

• Take 12-18 inches (30-45cm) of floss or dental tape, and grasp it so you have a couple of inches of floss taut between your hands.
• Slip the floss or dental tape between the teeth and into the area between your teeth and gums, as far as it will go.
• Floss with 8-10 strokes, up and down between each tooth, to dislodge food and plaque.

Read about why it's important to floss.

How to use interdental brushes

You can use interdental brushes or single-tufted brushes instead of flossing, especially if there are gaps between your teeth. The brush should fit snugly between the teeth.

Never use toothpicks to remove trapped food from between your teeth, as you may damage your gums, which could lead to an infection.

Your dentist or hygienist can advise you on the best way to use interdental cleaning for your teeth.

Read more about interdental brushes.

Common Q&As

Read the answers to common questions about NHS dentistry.

Meet the dental team

A visit to the dentist can involve a lot of people, from the dental nurse to the hygienist. Each member of the team has a specific job. Here's what they do.

Dental receptionist

The dental receptionist makes appointments, answers phone calls and often deals with the paperwork for the practice. The receptionist is usually the first person you'll meet at the practice. It is their job to make patients feel welcome and relaxed before they see the dentist or other professionals.

The dentist

Dentists are probably your main point of contact with the surgery. They treat and prevent dental and oral health problems, such as tooth decay, gum disease and injuries. They can also offer advice and tips on how to care for your mouth and teeth.

Dental hygienist

A dental hygienist's role is to prevent dental problems and to promote oral health. A dental hygienist carries out procedures such as scaling and polishing, applying topical fluoride treatments and fissure sealants (white plastic coatings painted onto the biting surface of back teeth), and sometimes teeth whitening.

Any patients treated by a dental hygienist on the NHS must first be examined by a dentist, and any treatments must be detailed in writing beforehand.

Dental therapist

Dental therapists are the least common of the dental healthcare professionals. The types of treatment they carry out are similar to those of a hygienist, but can also include fillings on both permanent and baby teeth, pulp treatment, stainless steel crowns and extractions of baby teeth.

Dental therapists also work with patients with special requirements, such as those who are scared of dentists, who have physical or learning disabilities, who have medical problems or cannot easily access dental treatment.

As with hygienists, any patients receiving NHS treatment from a dental therapist must first be examined by a dentist, and any treatments must be detailed in writing beforehand.

Dental nurse

A dental nurse assists the rest of the dental team in all aspects of patient care. This includes getting instruments ready, sterilising instruments, mixing materials, taking notes and ensuring patients are comfortable.

Dental technician

Dental technicians work with dentists to make dentures (false teeth), crowns, bridges and braces for patients. They may work in specialist areas, such as making dentures for or helping to reconstruct the faces of patients injured in accidents or damaged by disease.

The orthodontist

Orthodontics usually involves straightening or moving teeth using braces. Orthodontics can be carried out by a general dentist or a dentist who specialises in this area (known as an orthodontist).