{"id":4113,"date":"2020-01-28T08:00:00","date_gmt":"2020-01-28T07:00:00","guid":{"rendered":"http:\/\/dubawa.org\/dir\/?p=4113"},"modified":"2020-01-28T08:50:25","modified_gmt":"2020-01-28T07:50:25","slug":"are-you-brushing-right","status":"publish","type":"post","link":"https:\/\/dubawa.org\/dir\/are-you-brushing-right\/","title":{"rendered":"Are You Brushing Right?"},"content":{"rendered":"\n

A smile is worth a thousand words but what is a bad smile worth?<\/strong><\/p>\n\n\n\n

The importance of oral health is common knowledge. It is vital to every aspect of our lives- from eating, drinking, heart and bone health to that smile at first meet. This is perhaps the reason dental practises are instilled in so many; as early as childhood, the notion being that good dental hygiene practises from childhood ensure good teeth and gums for life. With all the information from dental health programs, it is no surprise that so many of us think we know just how to brush our teeth. <\/p>\n\n\n\n

However, we may be wrong and our practices may not be keeping with new research and recommendations. According to the World Health Organisation\u2019s (WHO) data, oral diseases are the most common non-communicable diseases worldwide. This also goes for Nigeria as WHO identified<\/a> that a large proportion of the Nigerian population have poor oral health. WHO estimates that between 15% and 58% of Nigerians have periodontal disease (that is gum disease) and that up to 30% of Nigerians endure the pain of dental caries (cavities).<\/p>\n\n\n\n

This is all so interesting, to put it mildly especially in light of the recent tweet<\/a> by twitter user- OurFavOnlineDoctor. The influencer advised his 110,000 mostly Nigerian twitter followers to remember NOT to rinse their mouth after brushing but rather, spitting out what is left of the toothpaste. He further added that this gave the fluoride time to work on your teeth. The tweet is gaining quick traction and to date, has over 5,000 retweets and over 8,000 likes reads: <\/p>\n\n\n\n

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Verification<\/strong><\/h2>\n\n\n\n

It is evident the precarious state most Nigerians are in with respect to dental health from the statistics outlined in the introduction. And while diet and underlying disease conditions are key factors, it is worth noting that poor daily brushing habits is the key factor for such conditions; hence our vested interest in Doctor Harvey\u2019s recommendations. <\/p>\n\n\n\n

Spit don\u2019t rinse<\/strong><\/h2>\n\n\n\n
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A poll for National Smile month revealed<\/a> that almost two in three of us rinse out the toothpaste after brushing our teeth. However, the Oral Health Foundation<\/a> has directly advised people against this practice. The UK\u2019s National Health Service (NHS<\/a>) also lists this don\u2019t rinse practice as a key recommendation for keeping your teeth clean. <\/p>\n\n\n\n

While most people in their morning and night routines still prefer to rinse their mouth after brushing, it is, in effect, counterproductive as evidence shows.<\/p>\n\n\n\n

Post brushing practices <\/strong><\/h2>\n\n\n\n

Most people know the right way to brush your teeth is to brush at least twice a day<\/a> and for approximately 2 minutes. What you do after you brush your teeth is equally important.<\/strong> The new recommendation is that one should leave behind in the mouth a concentrated mixture of a crucial toothpaste component- fluoride. <\/p>\n\n\n\n

Fluoride is the single most important<\/a> constituent of your everyday toothpaste. Fluoride remains on the teeth from your toothpaste. It inherently acts as a coating agent on the teeth so by not rinsing, this promotes fluoride retention and therein prolongs its beneficial effects in the mouth. <\/p>\n\n\n\n

These benefits<\/a> range from strengthening the enamel, preventing tooth decay and the growth of bacteria in the oral cavity.<\/p>\n\n\n\n

Expert opinion <\/strong><\/h2>\n\n\n\n

Dubawa reached out to Dr Lawan Balami, a Community Dentistry Lecturer at the University of Maiduguri and a Public Health Practitioner with over 7 years of experience. <\/p>\n\n\n\n

\u201cin my years of experience, approximately 2 out of every 10 Nigerians know how to brush their teeth the right way. And this includes knowledge of post-brushing techniques.\u201d<\/strong><\/p> Dr Lawan Balami- Community Dentistry Lecturer at the University of Maiduguri <\/strong><\/cite><\/blockquote>\n\n\n\n

Dr Balami went on to note \u201cwhen you rinse with water after brushing your teeth you are washing away part of the fluoride contained in the toothpaste which reduces its effectiveness in preventing tooth decay. Randomized control trials have shown the incidence of tooth decay to be higher in individuals who rinse with large volumes of water after tooth brushing compared to those who do not.\u201d <\/p>\n\n\n\n

Dr Balami says the benefit is that the method \u201chelps maintain contact between teeth and fluoride contained in dentifrices (any agent used to clean the teeth such as a powder, paste or liquid) such as toothpaste longer than would be the case with mouth rinsing\u201d. <\/p>\n\n\n\n

What do studies say?<\/strong><\/h2>\n\n\n\n

A Swedish study<\/a> noted fewer cavities in a three year period for preschool children who rinsed with a “slurry”. It surmised a higher effect of fluoride retention in the children who used this method over children who did not.<\/p>\n\n\n\n

Factors affecting fluoride retention<\/strong><\/h3>\n\n\n\n

Another study<\/a> found that factors which increased fluoride retention included fluoride concentration in toothpaste. So opt for toothpaste with a higher fluoride concentration. Dr Balami says the recommended fluoride concentration is \u201cabout 1350 \u2013 1500ppm [parts per million] of Fluoride\u201d. Similarly, the WHO<\/a> notes a 6% increased benefit for every 500ppm. Any higher than 1,500 ppm and you might require a prescription<\/a> in some countries. <\/p>\n\n\n\n

Other factors<\/a> that affect fluoride attention include brushing duration (2 minutes being the recommendation) and toothpaste quantity. Additionally, the clearance of saliva and rate of salivary flow are also consequential<\/a> to fluoride retention. This is something we can\u2019t help, but it\u2019s worth knowing. <\/p>\n\n\n\n

Alternatives for the die-hard rinsers <\/strong><\/h2>\n\n\n\n

Fret not, there are other post-brushing practises that could extend fluoride retention.<\/strong><\/p>\n\n\n\n

Conserve that aqua <\/strong><\/h3>\n\n\n\n

A study<\/a> provided some consolation for people who do not want to leave the remaining toothpaste in their mouth. This alternative is to rinse but only with a small amount of water. This reduces the minty toothpaste taste that bothers so many; yet allowing a small amount of fluoride to remain in the mouth. <\/p>\n\n\n\n

One study<\/a> correlated fluoride retention with how many times participants rinsed. Participants who rinsed three times had a lower retention than those who rinsed once. A 1996 study had the same results. It showed a higher retention of fluoride when participants rinsed with a teaspoon quantity of water for a minute<\/span> than participants who rinsed briskly<\/span> with a sizeable quantity three times! <\/p>\n\n\n\n

Try mouthwash <\/strong><\/h3>\n\n\n\n

Secondly, opting for fluoride-containing mouthwash is a good call too. A study noted that fluoride-containing mouthwashes have \u201csimpler formulations and can have better oral fluoride retention profiles than fluoride toothpastes, depending on post-brushing rinsing behaviour\u201d.  <\/p>\n\n\n\n

However, be sure to wait <\/strong>30 minutes<\/strong><\/a> before eating or drinking for the full effect.<\/strong> <\/p>\n\n\n\n

You are also encouraged to use it at a different time than when you just brushed your teeth. This is because the mouthwash (though fluoride-containing), has the ability to get rid of some of the concentrated fluoride in your teeth from regular brushing. <\/p>\n\n\n\n

Less is more<\/strong><\/h3>\n\n\n\n

Lastly, another method is to find a toothpaste without a chemical called- sodium Laureth sulfate. Anecdotal evidence tells us that a major deterrent for not engaging in the spit not rinse method is the strong minty flavour of toothpaste which lingers. Sodium Laureth sulfate as an ingredient in toothpaste is responsible<\/a> for this strong flavour; interestingly, it also suppresses your taste bud receptors (this is why food tastes bad afterwards).<\/strong> Also, using toothpaste without this ingredient has an added benefit of less lather. This is because sodium Laureth sulfate is responsible for toothpaste foaming. So in essence, you get no foam to rinse and no unpleasant taste- win-win. <\/p>\n\n\n\n

The implications of poor oral health in Nigeria <\/strong><\/h2>\n\n\n\n
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Photo Credit: Daily Post Nigeria<\/strong><\/figcaption><\/figure>\n\n\n\n

The complications that can arise as a result of poor oral hygiene include but not limited to tooth loss and decay, heart disease, respiratory infection as well as<\/a> accompanying pain, discomfort and facial disfigurement. Poor oral hygiene can also result in less known complications including some non-communicable diseases such as: <\/p>\n\n\n\n