- A new two-part BBC series shows the implications of poor dental hygiene
- Research shows if you have chronic inflammation, it will affect your health
- Studies demonstrate how using cheap dental products are effective too
- An experiment also noted how DIY whitening kits make no difference
My wife was anything but keen on the no-brushing experiment and there was a lot less kissing during that fortnight. And she was right to be worried about the outcome.
For two weeks, I wore a gum guard on one side of my mouth whenever I brushed my teeth, so that side didn’t get cleaned. At the end of this time, I brushed my teeth without the gum guard on and my gums bled a bit and there was pink, blood- spattered spit in the bathroom washbowl. I had developed mild gum disease. Carry on like this and not treat the problem and I could theoretically lose some teeth.
So what’s new in that, you might think? Not much. But something much more significant had also happened to me. Tests conducted with Professor Iain Chapple, at the University of Birmingham School of Dentistry, showed that by not brushing my teeth for just two weeks I had damaged my immune system. Lab tests using my white blood cells — the soldiers of the immune system — showed they had become less effective at moving towards an infectious invader when it was introduced to them.
Chronic inflammation can also damage other cells throughout the body, such as our organs and circulatory system. Instead of heading straight towards the invader to attack it, the white cells were heading there slowly in random, inefficient ways.
This result indicated that my whole body had become inflamed as a result of an infection in my gums. Inflammation is the medical term for our body’s reaction to infection — typically seen on the outside of the body as red, swollen tissue.
When that reaction is short-term, it is a healthy response. But when our body is constantly reacting to chronic damage or infection — such as long-term gum disease — it can push our immune system into damaging overdrive that sets off chain reactions that cause harm throughout our bodies.
This can be seen in the way that my white blood cells became less effective. But chronic inflammation can also damage other cells throughout the body, such as our organs and circulatory system.
BAD GUMS COULD LEAD TO DIABETES
A swathe of recent science has revealed that if you have chronic inflammation, it will seriously affect the rest of your health and your life. It is strongly linked with the development of illnesses such as heart disease, type 2 diabetes, Alzheimer’s, stroke and cancer.
Professor Chapple reassured me this inflammation is completely reversible if you induce it for only a couple of weeks. But if you leave gum disease for significantly longer, you will be doing yourself chronic, irreversible damage.
Gum disease isn’t just bad for your teeth, it shortens your life — simple as that. So, looking after your teeth is one of the most important health interventions you can make.However, this area is something that few doctors know about.
Even as an infectious diseases specialist, I knew almost nothing about teeth before I did these programmes. It’s not something you learn about at medical school.
This crucial connection between the health of your gums and the health of your entire body is relatively neglected by doctors. As a result, we miss many opportunities to educate patients about the importance of dental care. This makes it even more vital that children learn the habit of brushing teeth properly at a young age.
As a way of setting them up for a healthy life, it is better than breastfeeding, probably as effective as vaccination and as important as good nutrition. But if you leave children to their own devices, they don’t brush their teeth correctly, as we discovered when making this BBC series. We’re meant to spend two minutes on the task. But a five-year-old can’t judge what two minutes is, so they won’t brush for anything near that long. The answer is to supervise children’s tooth-brushing (though you can get gadgets such as apps and waterproof stopwatches for the bathroom to help them time it).
But it’s not just about timing; how you brush is just as important. Serpil Djemal, the clinical lead at King’s College, London, dental unit, advises ‘tickling’ (light brushing) every surface of every tooth.
£1 BRUSH IS AS GOOD AS ELECTRIC
But having healthy teeth isn’t just about teeth brushing. Very few of us get to the age of 30 without having fillings. That damage is a sign not just of poor brushing but poor diet. I am lucky. At the age of 37 I have only one filling. But I have changed my habits since making this series. Like most people, I had no idea what a difference your daily eating pattern will make to your teeth health.
The timing of your eating is very important. If you eat sugars, there is a period of danger in which your enamel is at risk of being eroded by the acidic environment these create. That will fix itself if that danger period lasts for only a short time.
So a day where you eat sweet things only at breakfast, lunch and dinner is actually OK.But if you eat exactly the same amount of sugar, but space it at five-minute intervals through the day, your mouth will remain acidic all day. You are in the danger zone. All the brushing technique in the world won’t save you from a habit like that. To find out how the timing of eating affects teeth, we persuaded a family in Birmingham — a couple with six children — to change their eating habits, rather than what they ate.
For the experiment, half the family ate their sweet snacks between meals while the other half ate them at the end of meals. We then measured their mouth acidity every hour — and found that the snackers had dangerous acidity levels for much more of the day than the others did.
The other revelation was just how cheap good dental hygiene can be. I have spent several hundred pounds a year on high-tech electric toothbrushes that I manage to lose, break or wear out. But we found that you can brush your teeth perfectly adequately for only £1 a year. It’s not the quality of the brush that counts (despite the marketing, an electric toothbrush is no more effective than a cheap, properly used manual one), it is the quality and duration of the brushing that really makes a difference.
And if you don’t rinse and spit throughout brushing, a tube of toothpaste will last a very long time — as our experiments showed, up to a year, if you use a pea-sized amount each time and use it properly. Not rinsing and not spitting is crucial, and not just because it saves you money. The only useful thing in toothpaste is the fluoride and you want it to stay on your teeth all night. So do not rinse and spit while brushing or even afterwards.
SAFE WHITENING KITS WON’T WORK
For increasing numbers of people, dental hygiene isn’t enough — they want whiter teeth. We collectively spend millions of pounds on over-the-counter kits to make them whiter. A survey last year by Mintel found that more than one in ten Britons had used a whitening product in the previous month. But these DIY kits simply don’t work.
We took four different tooth-whitening kits and got 12 volunteers to test them — three people tried each kit. Beforehand, we measured the volunteers’ teeth whiteness with a spectrophotometer.
After they had used the kits, the results were consistent with the small number of studies that have been done in this area: there was no visible difference in the whiteness of their teeth. This is because the European Commission has set maximum safe levels for the bleaching agent in whiteners to prevent damage to tooth enamel.
These levels are too low for the whitening kits to have any visible effect. If you buy a kit over the internet that does whiten your teeth, then it is dangerous and illegal. People may be convinced their legal tooth-whitening kits work, but that’s a placebo effect, possibly caused by the fact there’s a lot of complicated procedure involved in using them, such as the precise intervals of time required between painting your teeth with the bleaching agent.
The kits are expensive, too. Some cost almost £100, which helps to convince gullible buyers they work. I tried a kit. After ten days, it made no visible difference — but I was made more conscious of the yellowness of my own smile.
And yet, as the dentists we spoke to explained, yellowness is not a sign of the health of your teeth. That yellowness is mostly genetic.
It is a result of how translucent your tooth enamel is. The inside of your tooth is yellow, so if your enamel is translucent, that’s what shows through.
If we brush our teeth properly, they will be healthier and will look good, but you won’t get that ice-white Hollywood smile — that’s just marketing hype. The real truth about dental health goes so much deeper than ice-white teeth.
As we learned, good brushing and dental healthcare will improve your life in almost every way imaginable. And it’s cheap! But there is good news on the horizon if you end up suffering tooth decay. Until now, tooth enamel could never regrow: once a dentist drills away the decayed bit of tooth, it will never grow back. Fillings are essentially inadequate replacements.
But researchers at the University of Leeds have developed a solution containing tiny pieces of protein that, when applied to a tooth, can help them ‘regrow’ over holes if they are discovered at an early stage. The pieces of protein act as a scaffold onto which the hard calcium that makes up our teeth can be laid down. The product is still in development, but the early results are promising.
Published: 1 June 2015. By DR CHRISTOFFER VAN TULLEKEN
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