A brush with tooth decay
Today is World Oral Health Day, and what you thought you knew about caring for your teeth is all wrong
As defined by the FDI World Dental Federation, “oral health is multifaceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex”.
Good oral health is an essential component of general health and quality of life. But many people are under the erroneous assumption that drinking juices and eating fruit are good for your teeth.
The global burden of oral disease remains a paradox, affecting 3.9 billion people. Oral conditions such as tooth decay, gum disease and oral cancer are among the most common and widespread diseases. Tooth decay in children is five times more common than asthma and seven times more common than hay fever.The culprit? As always, sugar. But don’t be fooled into thinking that chocolate and fizzy drinks are solely to blame. Naturally sweetened “healthy” snack bars, fruit juices and smoothies that are the preserve of the middle-class store cupboard can be just as bad for your family’s teeth.
The 2018 World Oral Health Day theme is “Say Ahh”. The 2018 campaign sub-theme “Think Mouth, Think Health” introduces the link between oral health as being an indicator of general health and wellbeing. The campaign aims to educate people that keeping a healthy mouth is crucial to keeping it functioning correctly and for maintaining overall health and quality of life.
As fully functioning adults, keeping our teeth clean was one area we imagined we had covered. Taught as children, brushing our teeth is a ritual we all perform twice a day without question – so how wrong can we be getting it?
The older you get, the harder tooth decay is to reverse. Worse still, experts now believe that poor dental hygiene can lead to a whole host of seemingly unconnected mid-life diseases, including pancreatic cancer.
So how does the layman cut through the headlines screaming about the merits of using a traditional or electric toothbrush, brushing with cold or warm water, the benefits of flossing or using mouthwash?
Here, then, is a definitive guide to how to really look after your teeth:
GO ELECTRICYour dentist wasn’t exaggerating: an electric toothbrush is infinitely more effective than a regular brush. The good news is you don’t need a top-of-the-range one to get the job done, but you might need to change the way you brush to feel the benefit.
Dentist Toby Edwards-Lunn says that the sticky plaque on your teeth comes away with much less effort with an electric toothbrush.
Studies have confirmed that brushes with rotating heads are more likely to reach every bit of your mouth than manual brushing – just as long as you follow a few rules.
Rather than the traditional method of up-and-down brushing, hold the rotating head still on the tooth for a couple of seconds, before moving slowly to the next. It’s recommended that you mentally divide up your mouth into quartiles and spend at least half a minute on each zone. “You can get electric brushes that buzz every 30 seconds as a reminder,” says Edwards-Lunn. “Just make sure your toothbrush is fully charged at all times: the speed of its head rotation is key.”
STEER CLEAR OF FANCY TOOTHBRUSHESIf you prefer a manual toothbrush, pay attention to the bristles. Using a firm toothbrush may deliver a more satisfying, deep-clean feel, but studies show they can be abrasive and contribute to enamel erosion. Instead, dentists recommend sticking to toothbrushes with medium or soft bristles. Small-headed brushes are also preferable as they can better reach all three external surfaces of your teeth – the outside, the inside and the biting surfaces. Just make sure to replace it every three months.
Replacements for electric toothbrushes aren’t as cheap as the analogue variety, but don’t be dazzled by the entire range of orthodontic rotating brushheads on sale, says Edwards-Lunn. “One with end-rounded bristles and a small head the size of a molar tooth.”
DON'T BOTHER WITH MOUTHWASH“If you’ve got a good toothbrush and toothpaste, you don’t need a mouthwash,” says Edwards-Lunn. “Use it to freshen up between brushes, but otherwise it’s a waste of money.”
In recent years, some experts have also argued that mouthwashes, which mostly all contain alcohol, could be a contributory factor to mouth cancer. But, Edwards-Lunn says, while there has been no conclusive evidence to suggest as much, there is really no need to use it daily.
Last month a new health study suggested red wine could be beneficial to oral health, reducing the ability of plaque-causing bacteria to stick to the teeth and gums. Researchers found compounds from the drink, known as polyphenols, helped fend off harmful bacteria in the mouth. But before you start rinsing with Pinot Noir, bear in mind that the acidic nature of wine means it can damage the enamel.
Which is why you should:
NEVER BRUSH TEETH AFTER A NIGHT OUTThe one occasion you should not brush your teeth before going to bed is after a spot of heavy carousing.
With that horrible furry feeling still on your teeth, Edwards-Lunn explains that, rather than reaching for the toothbrush, swill a little mouthwash and then brush in the morning. Otherwise you could be doing more damage than good – especially if your alcoholic drink of choice was fizzy.
“If you have been on the Prosecco, or spirits with a cola mixer, the surface of your teeth is going to have been been softened by the drink’s acidity. This is not the time to be brushing that softened enamel, as you risk causing permanent damage. If you want to freshen up before going to bed, this is one of the few times mouthwash is of any use at all.”
CHECK YOUR TOOTHPASTE CONTAINS ENOUGH FLUORIDEDo you choose your toothpaste based on the PPM (parts per million) of fluoride it contains, or the mintiness?
Edwards-Lunn explains that it is the amount of fluoride in toothpaste that counteracts the “demineralisation” which occurs in the mouth when we eat sugar. “With tooth decay, the only two things we can have an impact on is the amount of plaque in your mouth, and the amount of sugar that you put together with that plaque. Because if you put sugar with plaque, you are going to get tooth decay, or demineralisation.
“But that is a reversible process. You can put the mineral back into your teeth with the fluoride in toothpaste.”
Adults should be using a toothpaste with at least 1,400PPM of fluoride, he explains.
“Toothpaste brands will often have added ingredients like calcium phosphate which aids remineralisation.” But if you’re looking for fluoride (the most important ingredient in toothpaste) opt for a supermarket brand which will usually have 1,400PPM.
Beware of toothpastes claiming to be dentally sound. Euthymol, with its strong medicinal taste, apothecary-style packaging and which brands itself as a “scientific dental preparation”, contains no fluoride at all.
And one word of warning: “For children under the age of six use a children’s formula toothpaste because kids often swallow it and an adult level of fluoride is too much for them to ingest every day.”
FLOSS EVERY DAY OR NOT AT ALLFlossing is, without doubt, the best way to release the plaque that builds up between your teeth. But if you aren’t going to do it every single day without fail, Edwards-Lunn says it isn’t worth the effort at all.
“After 24 hours, plaque – that film you feel if you run your tongue around your mouth – is starting to do its damage. If you leave it two or three days between flosses, your gums will already have begun to react to that plaque, and that damage just carries on.”
If realistically you’re only ever going to be an occasional flosser, it’s time to give up altogether as you’re not achieving a great deal by this sporadic flossing.
NEVER BRUSH STRAIGHT AFTER BREAKFAST
The time of day when you choose to brush is crucial. It should be the last thing you do before you go to sleep, but you should never, Edwards-Lunn says, wash your mouth out after brushing. Spit … and go to bed.
“That way, it stays on your teeth as you hit the pillow. It’ll be in your mouth for around 20 minutes, really doing some good, remineralising your teeth.”
Then, in the morning, resist the temptation to wait until after breakfast to brush your teeth – do it as soon as you wake up. “You’ll have less plaque after brushing your teeth, which means fewer cavity-forming bugs. That way, when you sit down for breakfast, the risk of decay is lower.”
USE SUGAR FREE GUMThe worst time to brush your teeth is immediately after drinking or eating anything acidic – so, instead of brushing, it’s better to neutralise the acidity a different way. Drink or eat something which contains a high level of calcium and phosphate, such as cheese or a glass of milk, as they will help to reverse the damage being done to the outer surfaces of the teeth.
“Chewing sugar-free gum will also help by encouraging your mouth to generate more saliva, which in turn will start to neutralise the acidity in your mouth,” says Edwards-Lunn.
© The Daily Telegraph