Teeth: Quick Fire Questions

Our dental experts take on our toothy questions.
27 November 2018

Interview with 

Nick Williams, Devonshire House Dental Practice & Gordon Ramage, University of Glasgow


Toothbrush in water


Chris and Izzie had some quickfire dentistry questions for Nick Williams the dentist and Gordon Ramage from the dental school at the University of Glasgow.  First question was for Nick, what exactly is the association between gum disease and heart disease?

Nick - So essentially the plaque bacteria in the mouth can cause inflammation in the gum tissue which then becomes more porous really to the bacteria coming into the body. Your immune system is then trying to fight that off and you’ve essentially got a chronically inflamed state which will then trigger all other inflammatory disorders in the body, which heart disease is one of them. The inflammation the coronary arteries, but also rheumatoid arthritis, dementia, diabetes... There are links to all of these diseases.

Chris - Goodness it's quite far reaching then. And Gordon do we know what microbes are the particular culprits or causative reason why there is this association between poor oral health and heart disease?

Gordon - I think it's more about the functionality of the groups of organisms. If you have more nitrate reducing bacteria, they’re more healthier and depending on the composition of those we can handle nitrates in our diet then that has an implication in terms of overall inflammatory system. And in terms of rheumatoid arthritis, we know absolutely that there's an organism called Porphyromonas gingivalis, a bit like the dinosaurs from earlier really, that we know that produces auto antibodies and that's the driver of rheumatoid arthritis.

Izzie - Oh gosh! Right then, another thing I'd like to know is charcoal toothpaste; this is something that supposedly gives you a dazzling smile. It's the latest craze. Does it actually work?

Nick - Most studies have been done on conventional fluoride toothpastes. The charcoal toothpaste, again, it's getting people to clean their teeth more but a lot of their claims are actually unsubstantiated. So you know go for fluoride toothpaste, the charcoal can be a bit abrasive. it can damage your teeth in fact.

Izzie - Yeah I wondered if it's actually making your teeth whiter because it’s just scratching them down.

Nick - Yeah it can be the case.

Chris - And you raise the question of whitening. How does that work? And is that good or bad?

Nick - Excellent. There was a bit of a wave of popularity of veneers which partly came across in America you know perfect white smile. You see a lot of Americans almost like the piano keys teeth..

Chris - Their teeth are quite frankly whiter than my toilet! Especially celebrities on television. Is that because they've glued stuff on the front of their teeth? That's not their real tooth I'm looking at...

Nick - Absolutely. Now I mean the generic name for them is porcelain. Essentially nowadays we try whitening the teeth with a hydrogen peroxide gel which just releases stains locked into the teeth and encourage people to combine whitening with adult orthodontics. If the teeth are straight too easy to clean, so it's a win win.

Izzie - And what's worse, Nick; sweeties, fruits, crisps? What's the worst thing for our teeth?

Nick - Certainly high sugar options are best avoided. So sweets, certainly carbonated fizzy drinks that  have sugar in. There also a few which are considered a healthy choice which can be damaging as well. Dried fruit is a it's one best avoided.

Izzie - Oh, really?

Nick - Yeah. Essentially, the water's been removed from the fruit and it then becomes very sticky and adheres to the teeth and it can stay there for some time.

Izzie - Say parents, for example, your child comes home from school, you give them some dried fruit because you think well that's the best thing for them. So what would be a better alternative to dried fruit?

Nick - Great question. I think certainly fresh fruit or raw carrot batons are a great option. If your child can eat nuts, they're fantastic as well.

Chris - What about flossing? We haven't talked about flossing much. As a dentist once said to me, “You don't have to floss all of your teeth, just the ones you want to keep!”

Nick - Perfect message! It's certainly some that I do. If you're doing it on alternate days, you're going to be removing food to fuel bacteria from between the teeth, which will help with bad breath. It's the contact points of the teeth where you often see a lot of tooth decay starting. So if you're flossing in that region,o certain studies have shown you can reduce tooth decay by 50 percent with that.

Izzie - And when should we be brushing? In the morning, should I brush before or after breakfast.

Nick - Great. If you're having fruit juices breakfast that can soften the enamel. If you brush after that then you can remove some enamel.

Chris - Is that because it's acidic?

Nick -  Absolutely. You get erosion then you can brush away the softened tooth structure. But actually, I brush beforehand and then sugar free chewing gum after breakfast is excellent. Removing cereals and things that actually will stick to the teeth. If you're pressed for time getting out of the door you can actually leave that on the teeth so sugar free chewing gum in the car. Perfect.

Izzie - Now Nick if you got a final piece of advice for us?

Nick - I think, Izzie, the thing to remember is tooth decay is preventable. So really avoid those sugary snacks. And if I could go for a second one definitely fluoride toothpaste. Get in there twice a day. And just brush really well.


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