Conservation biologists know that reintroductions are usually more expensive and less likely to succeed than in-situ conservation. This must also hold true for teeth: keeping your own teeth clean and safe in situ by observing regular hygiene practices is a lot cheaper and gives better prospects than having a professional (or even worse a non-professional) replace them with some prosthetic contraption after they’ve all declined to extinction over the years. Not to mention the stage before that: unoccupied patches in your mouth can have several negative effects and will surely reduce your reproductive success.
As I (slowly) progress through the ranks my research involves sitting in the office for an increasing proportion of my time, therefore I try to maintain a healthy lifestyle: have breaks every now and then to stretch muscles and improve circulation, reduce my energetic intake, adopt an ergonomically-sound posture on my chair. Medical associations worldwide advocate for these habits as they can have beneficial effects across our increasingly sedentary society, and serious workplaces promote healthy habits among the workforce, as they should.
One other thing I do: I keep a tootbrush and toothpaste, as well as floss, in one of my drawers. After I finish my lunch, I head down to the restroom and have a quick (but not too quick) brush. If needed I floss too, although I normally do that only once a day, at home before going to bed. I have never seen anyone else in the department do so, however I assumed it was common practice, after all I also try to do it when no one’s in the restroom, essentially not to cause a queue of people needing to use the sink.
So when some of my office mates questioned my habit and thought it was hilarious and completely-out-of-this-world, subtly suggesting only a freak would brush his/her teeth after lunch, I was at first surprised. Then a bit upset. Then very confused – when I was a kid mum, dad, relatives, dentists (the only one category you would really listen to, since they are allowed to legally use torture to prove their point) all vehemently told me I should brush after eating meals, breakfast lunch dinner. So what makes me so completely out of place now? Here comes the scientist, or at least the person with access to Web of Science and some need for procrastination.
The main reason why we brush our teeth is to remove accumulated plaque from our mouths: plaque is constituted by bacteria that live normally in the mouth, but reproduce and thrive on residuals of food, particularly sugary ones, in the loose sense of “sugar”, i.e. sucrose but also other carbohydrates. As bacteria grow in numbers, they produce acids, which then destroys tooth enamel and even bones. This process is faster at night, as the mouth tends to become drier with less saliva (which prevents tooth decay and bacterial growth), and when we keep our mouth shut, as anaerobic bacteria will benefit from that. It is also interesting that some sources suggest we should wait 20-30 minutes before brushing, especially if we have had acidic foods. So my understanding is that we want to:
- gently remove the plaque that accumulates every few hours (gently: brushing too hard is not necessary and may result in damaging enamel and gums).
- get rid of food residuals that will provide food for bacteria: flossing is actually the best way to do so, and it is recommended that you use it once a day.
- keep bacteria under control and protect teeth: by the way, this is the reason behind the addition of fluoride to water, which I won’t go into here.
So brushing is important, but how often should I do it? Is more than twice a day ridiculous and even a bit creepy? Does brushing after every meal reveal a worrying compulsion? A bit of googling can quickly get you lost: generally, it seems that the official policy is usually at least twice a day, that more than four times a day can be detrimental, that flossing should be done once a day, and that the duration and quality of your brushing is also extremely important! As conservationists know, the precautionary approach is important and when someone says “at least” in regard to something that can have a profound effect on my health, I want to get something better than that. Below I attach some quotes from Dental Associations from different countries:
The American Dental Association: “Brush your teeth twice a day with an ADA-accepted fluoride toothpaste.” (but it also says “at least” in a couple of other passages)
The Australian Dental Association: “Brush your teeth at least twice a day (after meals) and use a fluoride toothpaste”.
The British and International Dental Health Foundation: “Be sure to brush thoroughly with a fluoride toothpaste for two minutes, at least twice a day, more often if your dentist recommends it”.
The Canadian Dental Association: “Ideally, you should brush after every meal, because the bacterial attack on teeth begins minutes after eating. At the very least, brush once a day and always before you go to bed”.
The French Dental Association: “Brushing three times a day (and as a minimum after breakfast and dinner)” My translation, original here.
The Italian Dentists’ Association: “It is important to brush your teeth at least twice a day” My translation, original here.
If you want to see what your local dental association says and/or test your language skills, Wikipedia has a complete list with links.
Finally, you may be interested in knowing that a study over 54,551 individuals in China showed that a higher frequency of brushing (after every meal) was positively related to lower risk of diabetes, hypertension, high TG and/or low HDL-C both in men and women after adjusting for age, BMI, smoking, alcohol consumption and daily walking time.
I am more convinced than ever than dental hygiene should be included in workplace health and safety regulations, just as we do with washing hands and flu vaccination sessions. What else have I learnt from this? I don’t know. Should I floss after lunch as well? Should I swap my medium brush for a soft one to ensure I don’t damage my gums? Should I replace after-lunch brushing with chewing gums or a mouth wash (I sometimes do)? I see some need for structured multi-criteria decision analysis here.
But I’m pretty sure the fear of looking “dorky” is not one of those criteria, nor is decreasing the number of my brushing sessions from three to two an alternative I’ll consider. I’ll keep brushin’
hard soft. There can only be one great, matchless, toothless Shane MacGowan.
DISCLAIMER: I am not a doctor nor have been trained in anything related to dental hygiene (except my mum told me how to brush my teeth when I was a kid) and this post does not represent professional advice nor is it meant to. I am not familiar with medical research so I cannot guarantee on the quality and/or reliability of the links provided above. I am in general not responsible for anything.