Today in all the newspapers there are articles (from america) that state that flossing is unnecessary:
CLICK HERE TO SEE ARTICLE
Here is my view on this:
- It is hard to conduct a good clinical trial to show the significance that flossing has. ie You need a control group who are instructed to brush their teeth in the proper way (modified bass technique in case you feel geeky and want to look it up), and then the trial group who brush AND floss. I am not surprised that there is no ‘significant difference’ in the results. ie both outcomes will show very good results. So do we conclude, therefore, that flossing is not worth it just because of this?
- What I would like to see is a psychology experiment, where people are chosen at random from the general population and they look at plaque scores of those who floss versus those who don’t. I would expect the ‘flossers’ to have better results. Not necessarily because they floss, but because they are generally more interested in oral hygiene. This is because oral hygiene is not a technical thing (we can all brush our teeth if we bother!! -), but it’s dictated by the person’s attitude. Let’s face it, if we all did what the hygienist actually asked us to do then our mouths would be a far better place.
- Flossing mainly cleans the part that is the contact point. This is where ‘interproximal caries’ starts (look that up, I find it hard to put in basic terms – it’s the decay we look for when we take x-rays and can sometimes be missed). So therefore I advocate it. For the front six teeth it is especially important. Round the back then the ’embrasure’ is more triangular and so I recommend brushes (e.g tepe brushes).
- There are different types of floss and many of my patients have implant restorations, or advanced crown, veneer and bridge work and frankly flossing is essential in these cases. No mention of this in all the articles!!
- So should we still floss – YES. !! Is there a ‘significant difference’ (in clinical trials) – NO.
- Finally – Do not take everything that you read in newspapers as ‘good evidence’. In fact it is one of the lowest form of evidence. Fortunately you see a dentist who is a bit geeky (me) and I have been trained on how to interpret medical literature. For real ‘evidence’ I recommend the cochrane library, where evidence and clinical techniques are scrutinised based on studies with strict inclusion criteria, and formulated from cohorts of studies.
I welcome the news in the recent budget on increasing the tax paid on sugary drinks. It is alarming how bad things have got with respect to presentation of decay in the younger population. I think we are failing this generation with a seemingly lack of education on oral health issues. The consequences are dramatic and devastating.
- Brush twice daily with the correct fluoridated tooth paste
- Do not rinse away after brushing. Brush before breakfast and before bed time
- Do not consume sugary products in-between meals
- Ensure kids are well hydrated and offer water only in between meals
- Ensure kids have a good stable diet so that they are not encouraged to ‘graze’ (This is where they have snacks too often). Grazing is the biggest risk factor. Teeth need time to recover after eating anything
- Ensure your child visits the dentist often to check on the progression of the dental development and diagnose any changes early
Good oral hygiene and preventative care is not just because we are looking after the risk factors that affect the teeth, namely decay and gum disease. The link goes further than that. Here are some facts:
Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.
Scientists believe that inflammation caused by periodontal disease may be responsible for the association.
Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedure
Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.
Research has found that bacteria that grow in the oral cavity can be aspirated into the lungs to cause respiratory diseases such as pneumonia, especially in people with periodontal disease.
Researchers found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.
Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications.
People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don’t have their diabetes under control are especially at risk.
Research has suggested that the relationship between diabetes and periodontal disease goes both ways – periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.
Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications.
TREATING REFUGEES IN CALAIS – NOVEMBER 2015
In November I went to Calais with a colleague to treat the refugees who are suffering from horrific dental conditions. The situation for them is extremely sad and we had an incredible time helping them with their dental problems. A particularly moving moment was having two Syrian refugees come over to us who were both dentists. It was very humbling to meet them and they were so helpful, staying with us all day, and assisting with translation, and even taking the odd tooth out under our guidance. Through dentaid a portable dental unit has been provided and all the necessary equipment to provide emergency dental care. Other dentists from around the country will be getting involved to go out periodically to use the facility, in particular a group called ‘Manchester Refugee crisis’, who helped pioneer getting the equipment stored in a caravan on the camp.
It is a privilege to be able to offer our professional skills to those who need it most. I am passionate about growing support for dentaid so more projects like this can be facilitated. I hope to go back out again in the New Year, and in the meantime am pleased to know that the care can be continued as a rota of volunteer dentists is set up.
This man had been suffering with dental infection for 2 years. The infections was so long-standing that it was now draining through the skin of his chin, of which, if we had an x-ray we would have seen huge defects in the jaw bone. By simply removing the infected teeth and cleaning the area, it will now heal and his suffering can come to an end. A big ‘thumbs up’ to that!!
September 2015 is Oral Health Month and the practice is focusing on ‘Children’s dentistry’.
Offers that are running this month for Families are:
1. Come and pick up FREE educational materials for your children
2. New Patient Family Offer – Initial Consultation £45 (usually £80) and Children of registered adult patients are seen for FREE
3. Sports gumshields – 20% off (usually £60) – be inspired by RWC 2015!!
4. Prize Draw – Those joining a dental plan in September entered to win a top of the range Sonicare Electric toothbrush
This document is to provide information on Infant Oral Mutilation and has been produced from a review of the literature, and research gained as part of an elective project in Tanzania.