Dental hygienists

[Dave B]

Latest post of the previous page:

... and her only advice has been to brush my tongue as well as my teeth!

How incredibly fucking stupid! Brushing the tongue is, despite the "knowledge" on the internet, pretty bloody pointless and either does nothing or contributes to "geographic tongue" (depending on the individual.)

AIUI there are essentially two dental problems we need to deal with:

• Plaque, which is dealt with by brushing, especially of the gum-tooth interface. This is what the sadist DH inexpertly scrapes away.
• Decay, which is primarily results form acid degradation of the enamel; the acid is produced by bacteria feeding on sugars. Brushing the teeth when they are acidic aids enamel destruction! The saliva is naturally alkaline, and will eventually neutralise acids, but the acids resulting from a sugar overload will not necessarily be dealt with in this way.

Best advice: Reduce your sugar intake and wait at least 3h after a meal before brushing; when brushing, concentrate on the gums.

Disclaimer: IANAD

Hmm, interesting. I also had an appointment with a maxilofacial consultant last week, he asked me if I brushed my tongue. I replied that I had just started but found the gag reaction a problem - he advised me on how to reduce that reaction rather than tell me to stop doing that.

Now: do I see some problems with what you said, TT?

I will agree that plaque is only removed by mechanical action, no toothpaste required. Until I improved my brushing tecnique I had a terrible plaque/calculus problem behind my lower front teeth especially. In the past couple tear there has been no need for any scraping at all by the dental staff.

Can't quite work out why brushing teeth when the mouth environment is acidic is a problem. Tooth pastes are alkali surely, the one that I am currently contains sodium hydroxide, another contains sodium bicarbonate. The brushing will help get the paste to all surfaces and disturb any bacteria. Washing the mouth out will dilute any acid surely. On my dentist's advice I am using a "sensitive" toothpaste and was advised not to wash out, just spit, to leave some of the active ingredient in the mouth. I would say that brushing the teeth immediately after eating any kind of fruit is good sense.

Since the "sensitive" stuff is twice the price of ordinary stuff I work a fiddle. I brush with the cheaper stuff first, wash out, then do another quick brush round with a tiny blob of the expensive stuff, which I do not wash out. Seems to work.

Where did you get your advice from, TT? Can't find anything on the net to say that tongue brushing causes geographic tongue, though I can see that over vigorous or over prolonged would do damage to the tongue's surface which might promote that condition. But, as ever, there is a load of crap out there if one is not careful with the sites one chooses!

[Nick]

@Skyfrog: BTDTGTTS!

Huh?

Been there, done that, got the tee-shirt.

Aaah! TVM!

@jaywhat: It's a very specialised (and vile) species of masochist sadist that scours your teeth and gums if you have plaque, gum disease, etc.

Thank you for correcting my contribution so it says what I meant it to say.

My pleasure

[Tetenterre]

@Dave:

The stuff re geographic tongue was advice given to my daughter by her doctor.

I don't recall the source of brushing teeth when they are acidic, but the context was (IIRC) the use of wood-ash (alkaline) by the San to reduce tooth decay. I also partly heard something similar on R4 "Today" a few weeks ago, (partly because I was in the shower at the time) -- the advice was to wait at least 3 hours after eating/drinking before brushing. The reasoning went like this: When the mouth is acidic, the acid starts to soften the enamel; brushing removes the softened enamel. As I understand it, if the acid is neutralised (e.g. by saliva), the enamel will slowly re-harden; the alkali in toothpaste does neutralise the acid, but does not immediately re-harden the enamel.

I absolutely take on board what you say about a lot of crap being out there, but the logic seems, to my understanding of the biology, physics and chemistry involved, to be pretty sound.

The "softening" logic is similar to the old trick of getting an egg into a bottle, by softening the shell with vinegar beforehand. I did something similar with a molar I'd had extracted as a demonstration to a GCSE Science class I was teaching -- left it soaking in a flask of coca cola for a weekend; the result was a gelatinous mass.

[Dave B]

Hmm, still not sure about the delay between eating and brushing - but I am no expert of course.

My thoughts go like this: the acid is a bi-product, pee I suppose, from the bacteria that live on the detritus on and between one's teeth. Eat some food, acquire new detritus. It takes a little while for the germs to multiply, 20 - 30 mins for some to double from memory - so in that delay time they are multiplying and peeing in this nice rich environment.

Getting at the little buggers as soon as possible, i.e. brushing teeth immediately after a meal, seems like a good tactic to me. The action of the acid dissolving the enamel will be continuing so long as there are germs and food, they will be just as active between meals (on dirty teeth) as immediately before or after it seems to me.

If saliva is alkali then it does not seem to be high enough to prevent tooth decay in those with bad dental habits. My dentist's comment last time I saw her was, "Still no signs of decay, keep it up!"

I often wonder if dentists being too keen to get people to clean their teeth is actually destroying their market! The other thought was, "An apple a day keeps the doctor away," converts to, "An apple a day keeps the dentist in pay," if you leave the bits in the mouth long enough - and from my experience there are always bits between the teeth after eating such a fruit!

[Dave B]

TT, looks like you were right in the respect that there is a critical couple of hours after eating!

The frequency of which teeth are exposed to cariogenic (acidic) environments affects the likelihood of caries development.[33] After meals or snacks, the bacteria in the mouth metabolize sugar, resulting in an acidic by-product that decreases pH. As time progresses, the pH returns to normal due to the buffering capacity of saliva and the dissolved mineral content of tooth surfaces. During every exposure to the acidic environment, portions of the inorganic mineral content at the surface of teeth dissolves and can remain dissolved for two hours.[34] Since teeth are vulnerable during these acidic periods, the development of dental caries relies heavily on the frequency of acid exposure.

That's from: http://en.wikipedia.org/wiki/Dental_caries

Still trying to work out whether cleaning the teeth in this period means that one looses the dissolved tooth material that might re-mineralise the teeth. On the other hand using a good quality toothpaste, with alkali and designed to reduce caries, should also aid in the re-mineralisation process. Using a good quality mouth wash first might help even more I gather.

[Skyfrog]

My demon dental hygienist really told me off for using a manual toothbrush. "Dentists have recommended against using these for more than 20 years," she scolded me, "everybody should use an electric toothbrush". I was so cowed that I dutifully purchased an electric toothbrush at the reception desk. It is currently sitting next to the armchair in my living room, its cardboard box unopened. Somehow I can't muster up the enthusiasm to start using it...

[Dave B]

My demon dental hygienist really told me off for using a manual toothbrush. "Dentists have recommended against using these for more than 20 years," she scolded me, "everybody should use an electric toothbrush". I was so cowed that I dutifully purchased an electric toothbrush at the reception desk. It is currently sitting next to the armchair in my living room, its cardboard box unopened. Somehow I can't muster up the enthusiasm to start using it...

Well, there yer go! Every expert has a different opinion from the next. When I asked my dentist about electric brushes she said it would not do any better than I am achieving now, not to bother. No dentist has ever recommended such a device to me.

[Alan H]

Although my dentist many years ago said much the same thing - that they weren't any better than a good manual brush - I've been using a Braun 3D for years and I find it very good. After the first few uses, my teeth felt as clean as they did after t visit to the hygienist. I'd thoroughly recommend one, but make sure its a Braud/Oral B 3D onr or possibly an ultrasonic one.

[getreal]

Another bloody filling has fallen out!!! Is this what happens when you reach 50? I seem to be losing fillings at a tremendous rate. On the plus side, I have at last found a sensitive toothpaste which actually works. Sensodyne Rapid Relief. My hygenist (and my dentist) have recommended applying the paste (after brushing) like a cream to the most painful teeth--which in my case is almost all of them!

This thread is surprisingly popular......

[Alan C.]

getreal
This thread is surprisingly popular......

That's cos we're all old buggers [UK definition]

[Dave B]

getreal
This thread is surprisingly popular......

That's cos we're all old buggers [UK definition]

Even in the UK that means we like a bit of . . .

Long in the tooth, more of the gnashers available as residential property for the bloody bugs!

[Dave B]

TT, asked the dentist I saw today about delay between eating and brushing. His version was that it only mattered if the food was particularly acidic, citrus fruit etc., because the acid would soften the tooth surface and brushing could then damage it. He did add that simply washing the mouth out with water first would be enough to stop the process. One assumes that the "harder" the water the better that would work!

Wonder if there are figures comparing tooth decay in hard and soft water areas? Took a look, loads of stuff on fluoride and problems with drinking only bottled water (seems it is mineralised but perhaps with not the right minerals and no fluoride) but no direct comparison anywhere near the surface.

Fluoride is a whole new subject for discussion!

[Tetenterre]

@DaveB: Noted, thanks.

[Janvier_8]

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