Care Tips
Here’s the latest scientific evidence from published medical literature
and policy making institutions concerning frequently asked questions…
What’s the most effective way to brush your teeth?
When the Cochrane Oral Health Group– a group of specialist research dentists charged with publishing summaries of the best available evidence – looked at this issue, it concluded that, over three months, using an electric brush was associated with a 21% reduction in plaque and an 11% reduction in gum inflammation compared with manual brushing.
That is not to say that manual toothbrushes are useless, should you prefer to use a manual brush the Centre for Evidence-based Dentistry advises choosing one with a smallish head and medium bristles to ensure that you reach all the nooks and crannies.
When should I brush them?
At least twice a day – before bed, and at one other time.
An ongoing area of disagreement is whether you should brush before, or after, breakfast. It depends on what you have eaten, says Rebecca Moazzez, director of the oral clinical research unit at Kings College London Dental Institute: “The main thing to be careful of is fruit juice or fresh fruit, because they contain acid that can make the surface of the tooth quite soft.” This softening causes some of the calcium and phosphate in the protective enamel to leach out – a process called demineralisation – and if you brush your teeth at this point, you will be brushing some of these minerals away and weakening the teeth.
Do I have to use toothpaste?
“Brushing protects against gum disease, but it’s the fluoride in toothpaste that prevents tooth decay,” says Maria Therese Hosey, head of paediatric dentistry at Kings College London. Because of the foods we eat, our teeth are constantly demineralising and remineralising; if fluoride is present during the remineralisation process, it gets incorporated and strengthens the teeth. For this reason, adults should look for a toothpaste that contains at least 1,350ppm fluoride.
it’s best to avoid rinsing the mouth after brushing. “It means high levels of fluoride are retained on the teeth,” according to the Centre for Evidence-based Dentistry
What about mouthwash?
Using a fluoride mouthwash straight after brushing is fairly pointless: you’re flushing away fluoride and replacing it with more of the same. Where it can come in handy, however, is in topping up fluoride levels in between toothbrushing – particularly if you’re at high risk of cavities. “It can also be useful if you have had something acidic to eat, so don’t want to brush,” says Therese Hosey.
Mouthwashes contain more than just fluoride; many contain antiseptic agents such as chlorhexidine, which kill some of the bacteria your toothbrush misses, and help freshen the breath. But while there is some evidence that such mouthwashes can reduce plaque and gum inflammation, the Centre for Evidence-based Dentistry
ays: “If you’re brushing your teeth twice or three times a day with a fluoride toothpaste, the additional benefit you will get isn’t likely to be huge.”
And dental floss?
Plaque accumulates between the teeth, and is difficult to remove using a toothbrush alone. The risk here is gum disease, which in its early stages manifests as bleeding when you brush
When the Cochrane Oral Health Group looked at this issue, it concluded that people who brush and floss regularly experience less gum-bleeding compared with those who use brushing alone.
However, it said most trials assessing this have been of poor quality. Similarly, although there is some evidence that interdental brushes are more effective than floss at reducing gum inflammation, the quality of available evidence means it is difficult to say for sure.
Do I really need to visit my dentist every six months?
Possibly – if your teeth or gums are in bad shape.
The Cochrane Oral Health Group recently concluded that there was no good evidence to support six-monthly dental checkups; a finding echoed by the National Institute of Clinical Excellence; who suggests non smoking adults who are not in dental pain on a low sugar diet, that every 18-24 months should be adequate; unless specified by their dental practitioner to do otherwise.
