Teeth in adolescents

Between twelve and eighteen several things change at once: the parents no longer brush again afterwards, eating happens on the move, many wear a fixed brace, and the hormonal change makes the gums more sensitive. A large part of the caries a person gets in their life therefore arises in these years — and almost all of it would be avoidable.

The fixed brace

It is the most demanding situation that home oral hygiene knows. A margin remains around every bracket, and the wires get in the brush's way. The typical consequence is white decalcification spots that remain visible after it is removed — visible on exactly the teeth that have just been straightened.

• Brush after every meal, not just morning and evening.
• A special brush with a thinned-out middle for bracket and tooth in one pass.
• Single-tuft brushes for the bracket edges, interdental brushes beneath the wire.
• Rinse with a fluoride solution daily, use a fluoride gel weekly. With a fixed brace that is compulsory, not optional.
• Avoid hard and sticky foods — they loosen brackets.
• Professional tooth cleaning at shorter intervals, roughly every three months.

With aligners something else applies, but no less: while the appliance is in the mouth, drink only water. Everything sugary and everything acidic is held beneath the plastic and acts far longer than it otherwise would.

Energy drinks and drinks on the move

Energy drinks are an unfavourable combination for the teeth: a lot of sugar and markedly acidic. The acid content alone attacks the enamel, including in sugar-free variants. Drunk in small sips across the day, that acts for several hours.

Sports drinks and iced tea are little better. What helps: drink with a meal rather than spread across the day, rinse with water afterwards and do not brush straight after. Water remains the drink against which nothing speaks in this respect.

Smoking, e-cigarettes, nicotine pouches

Nicotine pouches are widespread among adolescents, and their effect is clearly visible in one place: where the pouch lies, the gum recedes and the mucosa changes to a whitish colour. This recession does not come back. E-cigarettes dry out the mucosa and increase plaque formation; tobacco smoke is the strongest known risk factor for the periodontium.

The changes can be recognised at a dental check-up — which means that a conversation about it will take place anyway and can be conducted honestly.

Piercings

Tongue and lip piercings rest permanently against teeth and gums. The two most common consequences are mechanical and well documented: chipped enamel edges and crown margins from the jewellery striking them, and a local recession of the gum at the point of contact — with a lip piercing usually at the lower incisors.

Anyone deciding on one should choose a small piece of jewellery, have the length of the bar adjusted once the swelling has subsided, and have the contact site inspected regularly. Gums that have receded do not grow back.

What remains important in these years

Clean the Individual prevention is a health insurance service twice a year up to the eighteenth birthday. After the end of childhood it is the only appointment at which brushing technique is practised at all — and at this age it is skipped particularly often.

For the bonus booklet, between the twelfth and eighteenth birthday: two entries a year. These years help decide how high the health insurance contribution towards dentures will be decades later.