Confessions of a Dental Hygienist 

Xray showing tooth decay

When three-year-old Imogen walked into my surgery with tooth decay and a list of tooth extractions that was bigger than I had ever seen in an adult let alone a child, I had to question why it was that this beautiful little girl, with extremely caring parents and a diet diary that would rival even the most health conscious, was suffering with such extreme decay that I had been asked to extract all but two of her precious little baby teeth.

I have worked all over London as a Dental Hygienist (cleaning teeth) and a Dental Therapist (filling teeth) and I have treated all ages in the (almost) ten years I have been Qualified. If I ever have a day where I think I have seen it all, somebody invariably comes in and proves me wrong!

Brushing teethOne of my favourite parts of my job is playing detective. Being a dental Hygienist is all about preventing decay and gum disease and I personally try to do that by finding out about an individual and working with them to find easy solutions to help keep their mouths healthy. Some of the time I also have to play detective to work out what on earth has gone wrong with my patient’s mouth: why all the stain? What is this lump? Why they are suddenly very sensitive, etc.

Imogen had a habit.  Her three meals a day, lovingly created and monitored by her mother for nutritional content and balance, were being supplemented by a seemingly innocent addition to her daily routine. Tomato sauce. Not just with her meals, but as a treat – this wasn’t apparent on the diet sheet we routinely give to patients with decay because a ‘small pot of ketchup’ would have been fine with lunch.  Imogen loved ketchup so much she would sit with the pot while she played. And while watching TV.  And at dinner. Constantly dipping a finger and licking. And although this one pot of ketchup has only a limited amount of sugar, the constant introduction of sugar into her mouth was drip-feeding decay causing bacteria.

As a mother of three pre-school age children, I look back at my time working in a paediatric surgery and I can now really relate with Imogen’s mother.  There are pitfalls I would not have known about had I not become a Dental Hygienist.  There are some really simple changes we can make to help protect our family’s teeth – the start of this is to understand why things go wrong in our mouths.

Plaque Bacteria

With our mouths being a perfect environment for bacteria to grow in, it is little wonder things can get out of hand so quickly. Beat the build up by brushing thoroughly twice a day – before bed and one other time.

Bacteria deposit decay causing acids on the teeth, so limiting these acid attacks is most important – fluoride helps to re-mineralise enamel that has been de-mineralised by acid attacks.

Use a fluoride toothpaste containing 1400ppm fluoride.

Children: from when teeth erupt up to around 7 years old, should be using ATLEAST 1000ppm fluoride toothpaste and being helped with their brushing.

Diet

When it comes to dental health FREQUENCY of feeding bacteria in the mouth is the most important factor. Sticking to three meals a day and one snack is a great way to minimise your mouths exposure to acid attack

Remember Imogen – if she had just eaten the one pot of tomato ketchup with her lunch she would likely have kept all her little teeth and not suffered the decay we saw.

Fruit is lovely and healthy but fruit sugars are still sugars – eat with your meal, be especially aware of the amount of dried fruit (sultanas, etc.) as sticky sugars will linger on tooth surfaces for much longer and cause a prolonged acid attack.

‘No added sugar’ juice does not mean ‘no sugar’ try to stick to water between meals.  And no sugar in tea or coffee.

Oral Hygiene

I’ve talked about it a little already but this is one of the most important factors when working to keep your family’s mouths free from decay and gum problems.

Brushing your teeth disrupts bacteria and stops it from being able to live and stagnate on your teeth and gums. It is important that we brush twice a day because bacteria really are quick to resettle – like dust after dusting. Each tooth surface and gum line needs to be brushed in little circular motions like a massage.  Floss or interdental brushes will get to the areas your toothbrush cannot reach – these add up to around 30% of tooth surfaces so flossing really is important to get a full mouth clean.

Plaque Bacteria builds up between teeth and causes gum disease. Children need help brushing their teeth and I would suggest they are helped right up until they are starting secondary school.  Let your child brush their teeth and then have your turn to make sure it is all done.  There is no reason why they can’t have an electric toothbrush which can really help make brushing effective.

Babies need their teeth brushed as soon as they erupt – even if this happens before weaning. Brush gently and regularly and you should never have a battle on your hands with toddlers who can run away!

I personally like the Oral B toothbrushes with a pressure indicator (a little red light that flashes on when you push too hard) these are great for getting a good brushing technique and guiding you to brush for around two minutes and with the correct pressure.

I also really rate the Phillips Sonicare, but tend to reserve these brushes for adults as they are very powerful and do require you to have a good circular motion technique

Toothpaste

Toothpaste is designed to help you reduce the harm done to your teeth by bacteria.  It usually contains a mild abrasive to help remove plaque and fluoride to reduce decay.

Fluoride is the best defence against decay because it disrupts bacteria’s reproduction and also helps to harden enamel against acid attacks which occur when we eat acid or when bacteria produce it in our mouths.   Most toothpaste you can get in the supermarket will have 1450ppm fluoride.  There is no need to rinse out and no need to wet the brush before using it. You want to use fluoride to harden the enamel and to help fix any areas where acid has attacked it – so there is little point in rinsing it away.

There is really very little difference in all the different types and brands of toothpaste. Go for something you like. If you have sensitive teeth, then sensitive toothpastes like Colgate Sensitive or Sensodyne have been proven to help where the sensitivity is not related to decay.

Be wary of toothpastes that claim to whiten the teeth – it is very unlikely that any toothpaste will whiten your teeth to a noticeable degree as the bleach needed to do this is very heavily regulated and considered a prescription only medication

Children’s toothpaste should have AT LEAST 1000ppm fluoride (you are fine to just use adult toothpaste). Just use a smear on the brush and again, no need to rinse, just spit out if they can.  Once adult teeth start coming through it is important they have adult toothpaste with 1400ppm fluoride.

Visiting your Dentist and Dental Hygienist for regular check-ups and cleans will help to reinforce and develop healthy habits in your young ones and keep their teeth healthy into old age. Keeping regular with the Dentist means they can pick up on any issues developing and guide you to keep on track with great dental health.

Catherine is holding a free child dental health open day at Waterside Dental Health on Wednesday 16th August 2017.Children's Open Day

Bring your little ones along for a fun, relaxed dental experience – to show them around the dental surgery, have a ride in the chair, a free toothbrushing lesson and goody bag.

Sessions available so no pressure on the children to conform to appointment times.

Please call to register your interest: Waterside Dental Health, 0207 987 1212

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Catherine Mawson is a registered Dental Hygienist and Therapist who qualified from Kings College London in 2008. She is passionate about all things dental with a special interest in Child Dental Health and the management of anxious and nervous patients. She is a mother to twin girls and a baby boy and works part-time in a specialist dental practice in Canary Wharf.