Protect Your Teeth and Gums Day and Night

For many people, brushing their teeth is the last thing they do before turning in for the night. It’s also the first thing many individuals do upon waking up in the morning. But what happens in the mouth overnight during sleep? Apparently, a lot of things.

During sleep, people do not swallow. Swallowing carries saliva from the mouth to esophagus. This saliva carries millions of bacteria along with it. According to the magazine, Registered Dental Hygienist, a person swallows one liter of saliva on average per day, containing 100 billion bacteria. When swallowing stops, the bacteria stay in the mouth and multiply.

“Multiplying bacteria are hungry bacteria,” Dr. James Erpenbach, D.D.S. said. 

Erpenbach, a Knoxville, Tennessee, dentist cautions his patients to not feed the bacteria by leaving bits of food for them to feed on by skipping brushing or flossing before bed. 


“Patients should take the time to establish a good oral hygiene routine they practice each night before bedtime. Removing food particles removes the food source for bacteria that cause tooth decay and gingivitis,” he said.

Erpenbach recommends that patients include brushing and flossing in their pre-bedtime preparations. 

“Brushing and flossing both physically remove food particles from the teeth; they also help to remove sticky plaque,” Erpenbach said. 

Plaque is a biofilm that spreads over the teeth and gums and is a safe haven for bacteria to grow in. Plaque buildup leads to gingivitis, a type of gum disease characterized by inflammation, swelling and redness.

Erpenbach suggests his patients use a soft-bristled brush and toothpaste with fluoride. Using fluoride toothpaste helps to remineralize the teeth, which helps to make a difference in tooth decay.

It’s not only what patients are using to brush that concerns Erpenbach. Holding the brush at a 45-degree angle, patients should brush back and forth in small stroke. He suggests working from the outside of the tooth, then to the inside and finally the top or chewing surface of the tooth.

Patients should floss before or after brushing, to help remove food particles that toothbrush bristles cannot reach. Erpenbach recommends using 18 to 24 inches of floss, and working it between the gently, curving the floss around each tooth, moving back and forth. Patients should pay special attention to the area where the root of the tooth meets the gum, and move the floss in an up and down motion in this area. 

“Flossing not only removes those left behind food particles but also helps to disrupt plaque,” explains Erpenbach.

Some patients also rinse with mouthwash before turning in for the night. Erpenbach suggests that patients ask their dentist for a mouthwash or rinse recommendation to ensure it is beneficial to the health of their teeth and not just breath freshener. 

“Some products on the market have tremendous benefits for oral health, but it is always good to check with your dentist about what products they recommend,” Erpenbach said. 

Lastly, Erpenbach suggests that his patients limit late-night snacking. 

“Many times patients wake up for a midnight snack and skip brushing, and certainly do not take the time to floss, before going back to sleep,” Erpenbach said.

Particles left behind after a late-night fridge foray are the perfect fuel for hungry bacteria and in just a few short hours these bacteria grow rapidly. When patients routinely eat after brushing and skip their oral care routines, they can end up with cavities and gingivitis. 

“Take the time to take care of your teeth throughout the day and before sleep, and your teeth will take care of you,” Erpenbach said. 

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