The shocking truth about tooth decay and how to stop the rot
When studies suggest 60% of adults don’t brush their own teeth correctly, maybe it’s time we got right back to basics
You might think tooth decay is a thing of the past thanks to fluoride in drinking water and advances in modern dentistry, but it’s on the rise.
In total, 36,000 children under 16 go to hospital every year for tooth extractions caused by decay – and more than one million under-fives have at least two fillings.
Experts say the popularity of fruit juices is partly to blame because parents believe they are healthier.
But when studies suggest 60% of adults don’t brush their own teeth correctly, maybe it’s time we got right back to basics.
Brushing up on your technique
The average UK adult brushes their teeth for just 40 seconds instead of the recommended two minutes.
Karen Coates, dental adviser at the British Dental Health Foundation (www.dentalhealth.org) says: “Studies show electric toothbrushes – not the battery-operated ones that lose power – are up to 45% more effective at cleaning than manual brushes.
“The best ones are ones that oscillate and pulsate, have an in-built timer and include a pressure sensor that buzzes or flashes if you brush too hard.”
Children should use a soft brush with a small head, round-ended filaments and a chunky handle to make it easier to hold.
The head should be no bigger than 1.5cm long (2cm for over-10s and 2.5cm for adults).
Invest in electric brushes for your children when they are ready (no younger than three), but choose specially-designed models such as the Oral-B Stages Rechargeable Brush for Kids (£27.68, Amazon).
How to brush your teeth properly
Firstly, divide the mouth area into four separate sections and spend 30 seconds on each part.
Angle the brush head to 45 degrees so the bristles face up, and begin with the far corner.
Brush the outside, or buccal surface of the teeth – the part others see when you smile.
Use gentle circular motions for a count of three seconds per tooth if brushing manually.
If you have an electric brush, just hold for three seconds and move it steadily along the gum line. Never “saw” it back and forth.
When you reach your front teeth go back to your starting point and clean the inside or “palatal” surface of each tooth for three seconds each.
Go back to the start for a final time and brush the biting or “occlusal” surface. Repeat for all sections.
Spit but don’t rinse – and don’t wet the brush before brushing as residual toothpaste left offers extra fluoride protection.
Wait at least 30 minutes before eating or drinking.
What’s the right kind of toothpaste?
“Whether you spend £4 on a premium brand or 20p on a value brand, as long as the toothpaste contains the optimum amount of fluoride it will do the same job,” says Karen.
For children under three, that’s 1,000ppm (parts per million) of fluoride and for those over three, it’s the same as for adults: 1,350 to 1,500ppm.
If the kids don’t like a strong or minty taste, try fruit-flavoured pastes.
If you have sensitive teeth you might want to choose a desensitising toothpaste, or if you have gum disease, one with added antibacterial ingredients. However, these are optional extras and won’t actually clean your teeth any better.
Also, there is no such thing as “whitening” toothpaste because, by law, they can’t contain enough of the bleaching ingredients required to whiten, says Dr Mervyn Druian of The London Centre for Cosmetic Dentistry (www.londoncosmeticdentistry.com).
“These types of toothpastes contain an abrasive, which removes stains, but they don’t whiten your teeth.”
Children should only use a smear of paste, while a pea-sized amount is adequate for adults – forget the TV adverts illustrating an inch-length of paste!
Why flossing isn’t optional
As 40% of the tooth cannot be reached by brushing, it’s vital for adults to floss their teeth at least once a day. Do this before brushing so that any particles can then be brushed away.
You can also try interdental brushes and air and water flossers.
Mouthwashes are part of any good dental hygiene routine. There’s no clinical evidence that alcohol-based rinses cause oral cancer, says Karen, although rinses containing chlorhexidine can stain. Go for specially formulated ones for children.
When to brush..
Never brush your teeth straight after eating, you should wait at least an hour as food produces plaque acids that weaken the tooth enamel and brushing immediately afterwards simply wears away the weakened enamel.
If you can’t wait an hour (it takes this long for the mouth’s pH to rebalance after eating), it’s far better to brush before breakfast.
This has the added benefit of leaving a protective coating of fluoride on the teeth before you start eating.
If you want to freshen your mouth afterwards, rinse with water or a mouthwash before leaving the house – or chew some sugar-free gum.
Watch out for what causes decay
Fruit juices are no better than fizzy drinks when it comes to causing dental decay in children’s teeth – and dried fruit is one of the worst culprits.
“Breadsticks, nuts, seeds, rice cakes and cheese are better,” Karen says.
Both children and adults should try to avoid snacking because it takes an hour for saliva to neutralise plaque acids, so with each bite or sip the clock starts from scratch again.
You should also drink with a straw so sugars have less contact with teeth, and finish your meal with cheese rather than fruit, says Dr Druian.
“Cheese helps produce saliva, which is your best natural defence against cavities and gum disease,” he says.
Why milk teeth DO matter
They provide the foundation for strong, healthy adult teeth and, if lost early because of decay, the adult teeth may come through in the wrong position, requiring specialist orthodontic treatment later.