What really keeps your mouth and gums healthy?
Daily brushing supplemented with interdental brushes is the best foundation for a healthy mouth; if you have diabetes, regular gum care pays extra dividends for your blood sugar.
Dental plaque, the bacterial film that forms on your teeth every day, is the main cause of gum inflammation and gum disease. That is robustly established. Brushing daily to remove that plaque mechanically is therefore the absolute foundation of good oral health.
Toothbrushing alone does not reach the spaces between teeth. Interdental brushes (small brushes designed to clean between teeth) appear to be the most effective tool for that purpose: they reduce gum inflammation more than flossing does, though the evidence for plaque is inconsistent. Flossing helps too, but the difference compared with brushing alone is small and the evidence is of low certainty. Water flossers are disappointing: a small effect on gum inflammation seen after one month disappeared thereafter, and no benefit over brushing alone was found for plaque. The practical conclusion: interdental brushes are your best supplement to the toothbrush, flossing is an acceptable alternative, and a water flosser is no substitute for mechanical cleaning.
If you have type 2 diabetes, gum care is especially important. Poor blood sugar control increases the risk of serious gum disease, and conversely a significant gum infection can make your blood sugar harder to manage. Getting treatment pays off: professional cleaning by the dentist lowered average blood sugar levels (HbA1c) by an average of 0.43 percentage points after three to four months. That is a clinically meaningful effect, comparable to what some medication adjustments achieve. Yet far from everyone with diabetes knows this interaction exists; if your doctor or diabetes nurse does not bring it up, it is worth raising the subject yourself.
In elderly residents of nursing homes, oral health is often alarmingly poor: more than half have tartar, around 30% have moderate to severe gum disease and up to 40% have problems with a denture. This is linked to cognitive decline and reduced ability to care for oneself, and in turn affects nutrition and quality of life. Active support from carers and dental professionals is indispensable here.
Finally, mastic gum, a resin that is sometimes promoted as an oral health supplement, showed antibacterial effects in laboratory and small clinical studies. However, there are very few studies in humans, and the results are not yet reliable enough to act on. It has not been proven to work.
Based on a Cochrane-style review on interdental cleaning (PMID 30968949), a meta-analysis of 35 studies on periodontitis treatment in diabetes (PMID 35420698), observational research on diabetes and oral health behaviour (PMID 29716561), a study on oral health in nursing homes (PMID 31717812) and a review on mastic gum (PMID 37148405).
How do you recognise gum recession early, and which habits can inadvertently make the problem worse?
Gum recession is widespread and often present without being noticed; the main habit that worsens it is abrasive horizontal brushing with a hard toothbrush, although cause and effect have not been conclusively proven here. Have it checked regularly by your dentist, especially if your teeth become more sensitive or appear to be getting longer.
How do I keep my kidneys healthy as I age?
The two best-supported steps to limit kidney damage as you age are keeping your blood pressure under control and exercising regularly. Moderate salt intake and a healthy weight demonstrably contribute to both.
Does having a pet benefit your health and longevity?
A pet can contribute to more physical activity, less loneliness, and a better sense of wellbeing, but whether it also extends your lifespan has not yet been demonstrated. If you are considering a pet primarily for your health, a dog is the best-supported choice, but weigh the practical burdens as well.
How do I keep my joints supple and prevent osteoarthritis?
Exercise and maintaining a healthy weight are the best-supported ways to prevent osteoarthritis and manage symptoms; however, no treatment stops the disease once it has begun.
How do I keep my eyes healthy and prevent cataracts or macular degeneration?
Protect your eyes with UV-filtering glasses, a diet rich in vegetables and fruit, good diabetes management and regular eye check-ups. If cataracts have advanced significantly, surgery is the only proven solution.
Does oil pulling (rinsing your mouth with oil) actually work?
Oil pulling has preliminary indications of a modest effect on gums and plaque, but the evidence is still too weak to recommend it as a full alternative to chlorhexidine. As a supplement to brushing and flossing it is probably not harmful, but do not expect miracles.