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Comment by WalterBright | Hacker News Reader

When I was 21, my dentist recommended removal of my wisdom teeth. I asked why, he said because they are difficult to clean, and so I'd lose them anyway by 30. I switched dentists.

I'm old now, still have those teeth, and they are the healthiest teeth in my mouth.

If you want to keep your teeth,

1. get an electric toothbrush

2. brush for the full 2 minutes, twice a day

3. floss twice a day, gently (overdoing it will erode the teeth)

4. run one of those rubber pointy tools (gently) around the gum line twice a day

Take a look at people 60 and up. Most have false teeth. Do 1..4, your old self will thank you.

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0. Be born with the right genetics.

There is this idea that the only thing you need for good oral health is to simply do the maintenance. This couldn't be further from the the truth, and an honest dentist will tell you so.

There are plenty of folks that take exceptional care of their teeth, yet still have issues and there are plenty of folks that don't take care of their teeth the way their dentist recommends and still have healthy teeth. Genetics plays a massive role in oral health and this has been known at least since I have been a kid (almost 40 now).

Very true. I've got the genes that require aggressive and thorough efforts to keep my teeth. It's still a losing battle.

1. Be born (and stay in) the right part of the world, too.

I'm fairly lucky to be in my 40s with all my wisdom teeth intact and zero cavities, in spite of not flossing, never seeing a dentist, and only brushing once a day with a plain toothbrush. That is clearly genetic, since out of my entire immediate family, one sister has had one cavity and that is it for all 6 of us.

But we've always lived in first-world cities with fluoride in the water. My ex-wife had impeccable dental health for a long time until she did a military deployment to Djibouti for 12 months, and came back with 8 cavities. In the 15 years since then, she's never gotten another.

I think this was the only heathcare thing I ever fought with my mom over, in high school. Demanded we get a second opinion. The oral surgeon agreed that my teeth were fine. Still have them 20 years later, still no cavities. It just seemed nuts to me to remove something through surgery that wasn't causing problems.

My favorite "reason" for why they should come out was, "you're more likely to bite your cheeks."

One of my wisdom teeth is laying sideways and I've been told I need to get rid of it for ... twenty years now and still haven't bothered, since the cost of getting rid of it now and when it starts to do whatever horrible thing it's plotting to do is basically the same, I continue to punt.

My current dentist is ambivalent about it.

One of my teeth is currently being resorbed. It has no known cause and is untreatable, eventually resulting in tooth loss. The dentist wanted to preemptively remove it. It could fail tomorrow, or 5 years from now. I opted to do nothing until it does fail. So far, it's been a year and a half.

Don't it bother you? I got constant minor infections with mine. Difficult to clean. Moved about occasionally causing a fair amount of pain.

There is no reason to floss twice daily. This doesn't even really make sense - what would you be flossing out in the morning upon waking?

Flossing once per day is plenty.

You also need not use a 'rubber pointy thing' - proper flossing goes just below the gum line and will get everything you need removed.

Super agree that you should get an electric, though. Heck, I switched from an oral-b to a phillips sonicare and my staining improved enormously, but that's really just cosmetic. ymmv.

> what would you be flossing out in the morning upon waking?

Bacterial colonies.

> There is no reason to floss twice daily. This doesn't even really make sense - what would you be flossing out in the morning upon waking?

The bacteria colonies re-establish themselves after 12 hours. I can also vouch for much better state of my gums when flossing twice a day.

> You also need not use a 'rubber pointy thing' - proper flossing goes just below the gum line and will get everything you need removed.

The rubber pointy thing gets in places the floss doesn't. I know this from experience. Pockets develop that the floss doesn't get in.

BTW, if you're young it's easy to dismiss all this advice. It takes decades for poor dental hygiene to catch up with one.

Agreed that the rubber pointy thing is important.

It was the last piece in the puzzle (in addition to the toothbrush and flossing and flour) that has kept my teeth fine although I didn't visit the dentist for many years (before last time). This, thanks to their good advice (the dentists where I lived at the time, many years ago)

What is the rubber pointy thing? Where do you find one?

Can we get an actual dentist to weigh in here?

What techniques are most helpful? I see plenty of armchair mouth experts (I, myself almost spoke up, too), but I'd like to give space to someone who went to school for this stuff.

Appeal to authority though.

BTW, mouthwashes don't do diddly squat. I tried every one of them, including prescription ones. A waterpic is only of marginal utility.

Try Xylitol. Place 1/4 - 1/2 tsp in your mouth. Let it melt and swish it around. Spit. Can also brush with it.

I got mine out recently in mid 40s. Wish I had done it sooner. Constant minor infections. And every so often the would move and cause a lot of pain, especially in 2020, when it was all arranged then got cancelled for the covid overreaction.

Anything particular I should look out for when picking an electric toothbrush?

Also, I'm intrigued by the rubber pointy tools. Are those the gum stimulators with replaceable tips?

The cheapest sonicare works 99% as well as the most expensive one.

0. Something food something.

If I eat certain things my teeth feel so much cleaner at the end of the day then other things. I do not believe that is not a very big factor.

Seriously! Grains, sugars, and alcohol are pretty much no-nos if you want to have teeth when you're older.

I've had a dentist comment on how he wished he had so few issues.

I brush like once a day just for hygiene/bad breath or whatnot, and that's pretty much it.

Without the sugars and starches, the bacteria that would cause cavities just don't cause cavities.

> I've had a dentist comment on how he wished he had so few issues.

Ok, but your anecdote doesn’t really say much. I’ve had a dentist tell me that too, and I intake plenty of sugar, grains, and alcohol. Haven’t had a cavity or other major dental issue in 38 years. I brush twice a day and floss once, and only sporadically see a dentist.

Fair enough...

What's the evidence for the rubber pointy tools?

They clean between the teeth and the gums where the gum overlaps the tooth. The evidence is your gums bleed the first time you do it, which is evidence of inflammation. A few days doing it, and the bleeding stops.

Sorry, but reading this came across as bullshit.

You are predicting that gums will bleed, so something that hasn't yet occurred is evidence of inflammation, so keep on doing it until your body adapts to it.

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