Dental appointments are ever harder to come by. The pandemic backlog, coupled with a shortage of dentists, means that patients in some areas of the country are facing agonising delays for crucial treatments.
Calls to emergency dentists have shot up 452 per cent since last year in some parts of the UK, according to the NHS users’ watchdog Healthwatch.
The British Dental Association has warned of a postcode lottery for treatment, with patients in certain areas forced to wait up to a year for an urgent tooth extraction.
And with surveys showing that 40 per cent of dentists are considering taking early retirement in the next year, the problem will only get worse.
If ever there was a time to look after your oral health at home, and avoid trips to the dentist, it’s now.
The good news is that most dental problems are entirely preventable. Gum disease affects almost half of Britons and is the precursor to the majority of oral health conditions.
If ever there was a time to look after your oral health at home, and avoid trips to the dentist, it’s now. The good news is that most dental problems are entirely preventable. Gum disease affects almost half of Britons and is the precursor to the majority of oral health conditions.
The build-up of bacteria eventually causes ulcers, infections and, ultimately, tooth loss.
And it’s our everyday habits, such as whether we brush our teeth before or after eating, and what we choose to snack on, that can encourage bacteria to accumulate, increasing the risk of gum disease.
To find out what you should, and more importantly shouldn’t be doing, we spoke to dental experts who revealed a raft of simple steps that will help better protect your mouth from the perils of oral bacteria.
From exactly when to use mouthwash, to how to stand when brushing, here’s everything you need to know to save yourself a trip – or three – to the dentist.
1) ALWAYS BRUSH BEFORE BREAKFAST
It might seem sensible to brush after you’ve eaten breakfast – but don’t.
‘It is the worst thing you can do,’ says Dr Mervyn Druian, dentist and founder of the London Centre for Cosmetic Dentistry.
‘Eating food causes a build-up of acid in the mouth. And if you drink orange or grapefruit juice, it’s even worse.’
This acid causes a temporary softening of the tooth enamel – and brushing when enamel is soft can erode it.
It might seem sensible to brush after you’ve eaten breakfast – but don’t. [File image]
Dr Druian says: ‘I always recommend brushing teeth as soon as you wake up, and not again until you’re about to go to bed.
‘Some people start their day with lemon and hot water, then brush their teeth straight afterwards, which makes the teeth very soft. And this can be disastrous, causing teeth to become ultra-sensitive, thin and brittle.’
2) LEAN FORWARD TO GET TO THE DIFFICULT BITS
Most people don’t brush their teeth properly, says Bernita Shelley, dental hygienist at the London Centre for Cosmetic Dentistry.
‘You should start with the front surface of every tooth, then do the top and then move on to the back. Make sure the toothbrush makes contact with every surface of every tooth.’
To make this easier, lean forward when you brush the bottom teeth.
Shelley says: ‘Plaque most commonly forms behind our bottom teeth because it is difficult to reach without tipping the head forward,’ says Shelley.
And remember to focus.
Most people don’t brush their teeth properly, says Bernita Shelley, dental hygienist at the London Centre for Cosmetic Dentistry. [File image]
Ben Atkins, dentist and trustee of the Oral Health Foundation, says: ‘If you’re not concentrating on brushing every tooth for at least five seconds, you will miss teeth out.
‘Most people end up missing out the same patch every time, so bacteria quickly accumulates and causes damage.
‘Use a disclosing tablet – they show up plaque so you can see where it has collected – so you know which areas to target.’
3) DRINKING MILK WILL HELP TO KEEP YOU SMILING
Your morning bowl of cereal will help wash bacteria away, say the experts.
When we eat sugary foods, bacteria in plaque on our teeth produces acids that can harm the tooth enamel.
Researchers at the University of Illinois found that after volunteers ate a bowl of dry, sugary cereal, drinking a glass of milk effectively reduced the amount of acid on the teeth.
Milk helps neutralise the acid in the mouth, and the combinations of minerals in dairy products – such as calcium and phosphate – help strengthen the enamel on teeth
Of course, very few of us will eat dry cereal in the morning, but experts say a glass of milk is worth including at breakfast, whatever you eat.
Milk helps neutralise the acid in the mouth, and the combinations of minerals in dairy products – such as calcium and phosphate – help strengthen the enamel on teeth.
If you’re not a milk drinker, having a small piece of cheese instead has the same effect.
4) DON’T BRUSH TOO OFTEN: TWICE IS NICE
Timing is crucial for mouthwash
Don’t rinse out straight after brushing, either with water or mouthwash, says Bernita Shelley.
She explains: ‘Fluoride, which is the active ingredient in toothpaste, works by stopping bacteria from producing the acid that erodes teeth. It also strengthens enamel. So you don’t want to immediately wash it all away. You can spit excess toothpaste out, but it’s important to make sure the fluoride is coating your teeth.’
Ben Atkins recommends using a fluoride-containing mouthwash a couple of times a day, in the middle of the day.
‘Use mouthwash after lunch or around tea time. This washes away any lingering bacteria and makes sure there is a top-up of fluoride throughout the day.’
Shelley recommends Fluorigard mouthwash, with is particularly high in fluoride, but gentle. ‘Beware of potent anti-bacterial mouthwashes such as Corsodyl, which should be used only if you have an abscess or infection,’ she says.
‘Even if it has been recommended by a dentist, it shouldn’t be used for longer than a week as the bacteria in the mouth become resistant to it.
‘It can also cause discoloration and even staining of the teeth that’s difficult to get rid of.’
In the UK, the advice is to brush twice a day – in the morning and evening.
But elsewhere around the world, such as in South America, it is custom to brush three times, or even more frequently.
Stick to twice, says Shelley, especially if using a manual toothbrush.
She explains: ‘It’s not likely to cause harm if you brush three times with an electric device because they have in-built pressure controls.
‘But many people apply too much pressure when using a manual brush and, over time, this can lead to gum damage and abrasion – when the enamel on the teeth wears away. This can eventually pave the way for cavities to form.
‘There’s generally not much of a need to brush teeth more than twice a day.’
And brushing for two minutes is still a good rule of thumb.
Recent studies show that two-minute routines lead to better oral health than shorter brushing periods, such as 40 seconds.
The motion you should use depends on whether you’re using a manual or electric toothbrush.
‘Most people use a sawing or scrubbing method, going side-to-side, over and over,’ says Atkins.
‘But this isn’t ideal – whether you’re using manual or electric – as it risks damaging the gums, and isn’t moving the bacteria down, and off the teeth, and into the mouth where it can be swallowed.
‘Instead, use a gentle circular movement. I also tell patients to start at a different spot every time they brush their teeth, to make sure every tooth is brushed.’
And there is a technique for electric brushes.
Shelley says: ‘The bristles move for you, so you don’t have to move the brush up and down the tooth. Just lightly hold it at the base of each tooth for five seconds, then move on.’
5) RENEW YOUR BRUSH EVERY THREE MONTHS
Bacteria accumulates on toothbrush heads, so it is important to change either electric toothbrush heads or manual toothbrushes every three months.
Alternatively, experts recommend sterilising the bristles using a UV light device, widely available at online stores such as Amazon.
If the bristles start to splay or discolour, it’s time to change the brush.
Bacteria accumulates on toothbrush heads, so it is important to change either electric toothbrush heads or manual toothbrushes every three months. [File image]
And don’t use your brush if the bristles are damaged – not only can older, frayed bristles cause tiny cuts in the sensitive gum tissue, they make the brush less effective at ‘digging out’ bacteria.
If bristles splay unusually early, it may be an indication that you’re brushing too hard, says Shelley.
6) SHARING IS BETTER THAN NOT BRUSHING
If you get caught short on a weekend away, avoid using someone else’s toothbrush if possible – but sharing is OK if it’s your only option.
‘Your partner’s toothbrush could be teeming with bacteria – and you’re putting that inside your mouth, and between your teeth,’ says Ben Atkins.
‘If you have been fastidious about your oral health, you may have a very small number of bacteria colonising in the mouth. You’ll use a partner’s toothbrush once and immediately undo all your hard work, if they have poor oral health.’
If you get caught short on a weekend away, avoid using someone else’s toothbrush if possible – but sharing is OK if it’s your only option. [File image]
Other experts recommend using a clean flannel or cloth to simply buff the surface of the teeth and rinse with a fluoride mouthwash.
But Bernita Shelley says it’s far better to brush with someone else’s toothbrush than none at all.
‘The benefit of brushing the teeth properly after a full day of eating is probably greater than the risk of coming into contact with another person’s bacteria,’ says.
‘Just make sure you don’t make a habit of it.’
7) FLOSSING DOES WORK… BUT ONLY IF DONE PROPERLY
Flossing is an essential part of most people’s oral health routine. But recent studies have suggested it might be of little benefit.
According to a 2016 review of 25 studies on flossing, it can be ‘of little value’. But experts say the problem lies with the way we floss.
‘Flossing once a day can help prevent the build-up of plaque,’ says hygenist Bernita Shelley.
‘Plaque is a sticky film that forms on teeth when saliva, food and bacteria in the mouth combine. If plaque isn’t removed, it can harden, damaging tooth enamel. Over time, the bacteria in plaque can irritate the gums and infect them, causing gum disease.
‘But most people don’t know how to floss properly and just move the string aimlessly in between their teeth.’
Flossing is an essential part of most people’s oral health routine. But recent studies have suggested it might be of little benefit. [File image]
The ideal way to do it is to wrap the floss around each middle finger until only roughly five centimetres is left in the middle, pulled tight.
Then move the floss between the teeth, making sure to curve the floss so it wraps against each side of the tooth.
Move the floss both up and down under the gum line and side to side, flicking out the gunk in between. And every time you move from tooth to tooth, use a clean section of floss.
Experts also recommend using an interdental brush, such as the TePe. But these can irritate gums, so should be used only once a day.
Don’t make the mistake of brushing before flossing. Floss first and then you brush away any bacteria dislodged by the flossing.
And don’t be put off if you bleed.
‘Bleeding can be the first sign of gum disease,’ says Shelley. ‘It means the gum is reacting with the bacteria on the tooth and becoming irritated. But if you keep flossing for a couple of weeks to remove the bacteria, the bleeding should subside.’
Those who struggle to reach certain areas of the teeth may benefit from using a dental water jet – a battery-operated device that clears debris between the teeth using a pressurised water stream.
8 SNACK ON CELERY… IT’S A GREAT CLEANER
Celery isn’t only waistline-friendly, it also boasts benefits for your teeth.
Experts recommend Britons snack on celery sticks at least a couple of times a day, as celery contains acids that have natural cleaning properties.
Specifically, celery is high in malic acid, which promotes saliva production. A heavy flow of saliva can stop bacteria lingering around the teeth – they are either swallowed or spat out.
If you don’t like the taste of celery sticks, experts recommend incorporating the vegetable into soups or smoothies.
Specifically, celery is high in malic acid, which promotes saliva production. A heavy flow of saliva can stop bacteria lingering around the teeth – they are either swallowed or spat out. [File picture]
But Shelley advises: ‘Avoid smoothies with lots of fruit as they contain a high amount of acid. I see a lot of patients who have eroded their tooth enamel by drinking lots of what they see as healthy smoothies.’
Apples are commonly thought of as the least tooth-friendly fruit. But experts say the acid content isn’t any higher than many other fruits.
‘Lots of foods we eat, and some drinks, are more acidic than apples,’ says Atkins. ‘In fact, patients are often surprised to learn that prosecco contains a lot of acid – and is terrible for teeth.’
9 STOP CHEWING GUM AFTER 20 MINUTES
Dentists encourage the use of chewing gum – especially the sugar-free types that contain flouride, which helps protect the teeth from bacteria.
‘Chewing gum triggers production of buffering saliva, which is alkaline and neutralises the acid, helping to remineralise or harden the teeth,’ says Dr Druian.
But he says you shouldn’t chew for more than 20 minutes, as any longer can strain the sensitive joints in the jaw and lead to aches and pains.
Experts also recommend those with a constant snacking habit should try chewing gum instead.
‘Every time you eat, there is a residue of acid produced by plaque bacteria and the sugars in food and drink,’ says Dr Druian.
‘And it can take up to an hour for acid levels in the mouth to go back to normal. So if you’re snacking all the time, acid levels will remain high, increasing the risk of erosion to the teeth.’
10 CRAVE SWEETS? EAT THEM AT NIGHT
Bernita Shelley doesn’t demand her patients give up sweet treats – even though the interaction between sugar and bacteria on the teeth triggers the production of excessive acid, destroying tooth enamel.
She says acid production can be kept to a minimal if the sugar is washed away shortly after eating.
Bernita Shelley doesn’t demand her patients give up sweet treats – even though the interaction between sugar and bacteria on the teeth triggers the production of excessive acid, destroying tooth enamel. [File image]
‘If you’re going to eat sweets or sugar, do it just before you go to bed, and minutes before you brush your teeth.
‘That way the sugar isn’t sitting on your teeth for hours, and there’s no chance for acid to be produced.’
And eating sweets with other foods such as sugar-free yogurts can reduce the amount of pure sugar that gets stuck to the teeth.