Britain has long had a global reputation for bad teeth, and scientists now say we may have the worst in the nation’s history. After examining the teeth of 17th-century skulls, researchers from Queen Mary University of London found fewer missing teeth and less decay than today, blaming widespread sugar consumption and lack of basic hygiene for the sorry state of our teeth. Here, then, is an ultimate guide to optimum dental care.
The steadfast rule of brushing is to stick to the two-minute rule using a good fluoride toothpaste. “The optimum level of fluoride for anyone aged three and over is between 1,350ppm and 1,500ppm, so it doesn’t matter too much which brand you’re using as long as it has that level of fluoride,” says Karen Coates, a dental adviser at the Oral Health Foundation. “There’s no need to wet the brush. With a pea-sized amount of toothpaste – you don’t have to fill the whole brush – use small, circular movements concentrating on every area of the teeth.”
Coates adds: “There’s a fine line between brushing effectively and overbrushing. There is evidence that electric brushes give a better clean than a manual, and also have the benefit of a timer (so you’re more likely to brush for two minutes) and a pressure sensor (so you can’t press too hard). Overbrushing can damage the teeth and gums, and can cause recession.”
The consensus is: spit, don’t rinse. “Once you’ve brushed your teeth, just spit out the excess, but don’t rinse your mouth, as you’d just be rinsing out all that fluoride you’ve just put on,” says Coates. “The residual bits of fluoride will stay on the teeth for about 30 minutes after brushing.”
Damien Walmsley, a scientific adviser for the British Dental Association, recommends using a medium-sized toothbrush that can get to hard-to-reach places at the back of the mouth. Brushing can clean the sides, the inside and the biting surface, but a toothbrush alone will only clean about 60% of the teeth, so it’s best to use interdental brushes or floss to clean in between your teeth once a day.
“Mouthwash is not a substitute for brushing your teeth with a fluoride toothpaste,” says Walmsley. “It only has a small effect in terms of freshening your breath and having a nice taste.” Coates adds that rinsing with mouthwash straight after brushing the teeth is counterproductive as it removes the fluoride. “If you’re going to use mouthwash, do this at a different time to brushing your teeth because one will counteract the other,” she says. “Rinse after lunch, maybe, as that will neutralise the acid produced when you eat or drink anything. Mouthwash isn’t necessary unless it’s been prescribed by your dentist, but most people use it for cosmetic reasons.”
Teeth are most vulnerable straight after food or drink. “When we eat or drink, any sugars lower the pH level in the mouth, making it acidic. This is what causes dental decay,” says Coates. “If you brush your teeth too soon [after eating], you could loosen microscopic amounts of loosened enamel from the acid attack. It takes about an hour for that to neutralise.” So, you shouldn’t brush your teeth for at least an hour after eating or drinking anything. “It’s recommended to brush your teeth last thing at night and at least one other time during the day,” says Coates. “Most people will do this in the morning, although this should be at least 30 minutes before having food or drink or about an hour after.”
“The NHS criteria for orthodontics is tight so only the worst cases tend to be corrected – it comes down to function rather than appearance,” says Coates. “This means you may reach adulthood and become unhappy with the position of the teeth. The option then is to go private, if you can afford it. You can also go private to get braces for your child if they don’t meet the criteria.”
Highly coloured food that contains tannins such as tea, coffee, red wine, and some curries (not to mention smoking) can stain the teeth. “If you are going to have something sugary or acidic, it’s better to have it as part of mealtime, as it’s not the amount you have; it’s the frequency,” says Coates. “If you’re snacking or sipping something sugary, for example, throughout the day, your teeth will potentially be under an acid attack all day. So if you do need to eat or drink between meals, you’re better off drinking water or milk and snacking on nuts, seeds, rice cakes, breadsticks, cheese, vegetables, etc, which are a much safer pH for the teeth.” As well as regular visits to the dentist, a whitening toothpaste can help to keep the staining down.
Coates explains that at home, you are not going to be able to do much other than removing staining by using a whitening toothpaste, for instance. “The legal limit for hydrogen peroxide in a product is 0.1%, which isn’t high enough to make a difference to the shade of your teeth. Professional treatment with a dentist is the only legal and reliable route to safe, lasting teeth whitening.” Walmsley also warns that “fad” whitening treatments can sometimes be abrasive and actually damage the teeth.
We’re often told to go to the dentist twice a year, but is this really necessary for everyone? “It’s only by going to see your dentist that you can determine how often you need to see them,” says Walmsley. “Depending on the state of your teeth, they will decide if you need to see them on a regular basis or have a more personalised plan.”
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