What is plaque? In developed countries we are taken to the dentist at an early age, educated about good dental hygiene and given toothbrushes and toothpaste. We have access to clean running water for daily brushing. Professional dental care is widely available. In Uganda this is not the case. The following are some dental issues common to us all that need addressing in East Africa. Plaque is a sticky film of bacteria that forms on teeth and gums. Following a meal or snack, the bacteria in plaque release acids that attack tooth enamel. Repeated attacks can cause the enamel to weaken, eventually causing tooth decay. Many of the foods we eat cause plaque bacteria to produce acids. If you snack often, you could be having acid attacks all day long. Plaque that is not removed with thorough daily brushing and cleaning between teeth can eventually harden into calculus or tartar. Plaque also produces substances that irritate the gums, making them red, tender or bleed easily. After a while, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, periodontal (gum) disease is a main cause of tooth loss in adults. One way to prevent tooth decay and periodontal (gum) disease is by eating a balanced diet and limiting the number of between-meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit. What are some tips for daily oral care? Before going forward with this section, we recognize that some of the things we are recommending are NOT always available and that different people do different things to maintain oral hygiene. Our point is to make you aware that whatever means you have to keep your teeth and gums in good condition, is critical. Some will have to make do with local mechanisms to insure good oral health. So, if you have tooth brushes, toothpaste, etc, the following is the considered to be the best way to maintain hygiene. The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces. Brush your teeth twice a day, with a soft-bristled brush or whatever you use to clean your teeth. The size and shape of your brush, or makeshift brush, should fit your mouth, allowing you to reach all areas easily. Use a toothpaste that contains fluoride, if possible, which helps protect your teeth from decay. If you have access to dental floss (you may be able to use simple thin thread that you use to sew clothes, if floss is not available), using it to clean between the teeth once a day removes plaque from between the teeth, areas where the toothbrush can't reach. It is essential in preventing periodontal (gum) disease. By taking care of your teeth, eating a balanced diet and visiting your dentist regularly, you can have healthy teeth and an attractive smile your entire life. Follow these tips to keep your teeth and mouth clean: How do I brush my teeth? • Place your toothbrush at a 45-degree angle against the gums. • Move the brush back and forth gently in short (tooth-wide) strokes. • Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth. • Use the "toe" of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke. • Brush your tongue to remove bacteria and freshen your breath. How do I floss my teeth? • Break off about 18 inches of floss (or a thin thread) and wind most of it around one of your middle fingers. Wind the remaining floss or thread around the same finger of the opposite hand. This finger will take up the floss or thread as it becomes dirty. Hold the floss or thread tightly between your thumbs and forefingers. • Guide the floss or thread between your teeth using a gentle rubbing motion. Never snap the floss or thread into the gums. • When the floss or thread reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth. • Hold the floss or thread tightly against the tooth. Gently rub the side of the tooth, moving the floss or thread away from the gum with up and down motions. • Repeat this method on the rest of your teeth. • Don't forget the back side of your last tooth. Go to http://www.ada.org/public/games/animation/index.asp to see how it's recommended to brush your teeth. Malaria.