GUEST POST: Time to spring clean your teeth!

27/05/2025

440 8 minutes read

Photo credit: Greta Hoffman : https://www.pexels.com/photo/close-up-shot-of-a-person-brushing-her-teeth-9475383/

by Dr Deborah Lee, Dr Fox Online Pharmacy
Dr Fox is a fully accredited online pharmacy run by NHS GPs.

It seems that hardly anyone can get to see an NHS dentist. The Nuffield Trust says the situation is in terminal decline. Current figures show that six million fewer patients recently received NHS dental treatment than in 2019. Also, in 2023/4, £500 million less was spent on dental care, compared to 2014/15.

The seriousness of this cannot be understated. This has enormous health consequences for all of us. What can we do about it? Read on and find out.

What makes dental care important?

The health of your mouth mirrors closely represents the health of your body.

Firstly, your mouth contains structures that are essential for your health. Your teeth, tongue and other facial structures that allow you to breathe, speak, eat, chew and swallow. If your mouth and dental tissues are not working properly, this affects all your basic body functions. Without good dental care, the human body cannot survive.

Your dental needs last a lifetime, from cradle to grave. Poor dentition and missing teeth cause older people to have great difficulty chewing and swallowing. I remember my mother constantly telling me to always look after my teeth.

What a lack of dental care means for your health

Poor dental care is linked to the following –

Higher risk of heart disease

Plaque builds up in the mouth because poor mouth/dental care means the combination of sugar, food debris and bacteria build up on the teeth and gums. Not brushing your teeth properly and not brushing regularly enough, as well as not seeing the dental hygienist, and missing dental check ups, means more and more plaque accumulates on the teeth and gums and under the gum line.

Plaque is a type of sticky bacterial biofilm which accumulates between the teeth and the gums. It is thick, sticky and colourless to start with, but then sets to become yellow or brown deposits. Plaque causes tooth decay.

Tiny bits of plaque can break off and enter the bloodstream. These can then clog up the arterial blood supply to the heart muscle, causing a heart attack. The same small segments of tissue can clog arteries in the brain causing a stroke.

The presence of gum disease increases the risk of a heart attack by 28%. Those with gum disease have double the risk of stroke as compared to those without gum disease.

Higher blood sugar

Most bacteria like to grow when glucose levels are high. Constantly eating high sugar foods encourages an excess of bacteria in the mouth. Your body switches on the immune system to try and defend itself against the attack. This chronic inflammation worsens insulin resistance (the ability of the body’s cells to respond to insulin). This then further increases blood glucose levels.

Diabetics, who have inherent difficulty controlling their blood glucose levels, are at higher risk of dental caries, gum disease and losing their teeth.

Respiratory conditions

Having more bacteria in your mouth due to untreated gum disease means you have an increased risk of inhaling droplets of infected saliva. This means you are at increased risk of pneumonia (chest infections).

Higher risk of cancer

Poor dental hygiene increases the risk of cancers of the mouth, head and neck. Cancers of the pancreas, kidney and blood are also linked to poor dental hygiene. Smokers are a high-risk group owing to poorer dental hygiene. High levels of bacteria in the mouth enter the bloodstream and cause chronic inflammation. Cancer is believed to start from DNA mutations which occur due to chronic inflammation and oxidative stress.

Mouth pain

No one wants to have mouth or dental pain which can be excruciating. It can lead to having to take time off work, insomnia, tiredness, fatigue, loss of self-esteem and relationship/family issues. Recurrent or chronic dental pain leads to social withdrawal and isolation.

Pregnancy complications

Women are known to be at higher risk of gum disease during pregnancy. High levels of bacteria in the mouth increase the risk of premature delivery, low birth weight babies and pre-eclampsia (high blood pressure in pregnancy).

Delay in conception

Unfortunately, gum disease has been linked to difficulty with conception. Women with poor dental health may take longer to conceive than those with good dental health.

Impotence – Erectile dysfunction (ED)

It may not seem obvious, but gum disease causes bacteria to be released in the bloodstream, and this can then affect the ability of a man to get a good erection. Chronic inflammation is a recognised cause of ED.

Rheumatoid Arthritis (RA)

Rheumatoid Arthritis is an autoimmune disease which may be caused by poor dental care. People with RA have been noted to have twice the risk of gum disease than those without. A specific bacterium called Porphyromonas gingivales, often present with gum disease, converts the amino acid arginine to citrulline. As a result, the body produces anti-citrullinated peptide antibodies (ACPAs), which then attack the joints. Up to 70% of RA sufferers have positive ACPAs.

Mortality risk is increased

We know that you can reduce your mortality by brushing your teeth every night, flossing once a day and regularly visiting a dentist. In a 2011 systematic review and meta-analysis of dental hygiene in the elderly (ages 52-105), not brushing their teeth every night increased the risk of death by 20-35%. Not flossing increased the risk of death by 30%. Not seeing a dentist once every 12 months increased the risk of death by 30%-50%. Losing teeth also increased the risk of dying by 30%. The message is simple – if you want to live to old age, it’s imperative to look after your teeth.

Time to spring clean your teeth

As you can see, there are numerous serious and even fatal consequences if you do not care properly for your teeth. This should be a wake-up call for us all.

The thing to remember is that tooth decay is entirely preventable. Don’t wait for dental pain to strike. You need to take action before this happens.

Here are some top tips on what you can do.

Brush your teeth

Brush your teeth properly – Learn how to brush your teeth properly, using a good toothbrush and fluoride toothpaste. This is especially important for children. Brush all around your teeth, inside and out, paying attention to where the tooth meets the gum, as well as the articular surface of the teeth.

Brush for 2 minutes, twice a day – You should brush for 2 minutes twice a day. Why not set the timer on your phone to make sure you are doing it for long enough? Don’t rinse and spit after the last brush to allow the fluoride to stay in contact with your teeth. You can get more information and watch an NHS video on toothbrushing here.

Use fluoride toothpaste – Fluoride toothpaste has been shown to strengthen tooth enamel and reduce tooth decay.

Use mouthwash if recommended by your dentist – The use of mouthwash is controversial as it can damage the natural microbial flora of your mouth which is not good for your health. Having said that, for those who find cleaning their teeth difficult, smokers, the elderly or anyone with a health condition such as mouth ulcers or dental infections, the use of an alcohol-free mouthwash is helpful. Ideally, use this once a day, around midday, 30 minutes after lunch.

How to floss your teeth

Flossing removes sticky plaque from in between the teeth – Flossing is also very important as the tape gets in between the teeth where the toothbrush can’t reach. When you floss, you remove food particles and plaque that are stuck in between the teeth. Left in place, these attract bacteria which cause tooth decay.

Floss once a day – We should all floss once a day, ideally just before bed.

How to do it – Get 30-40cm of flossing tape, and stretch it taught so you have 304 cm of tape between your two thumbs. Insert the tape gently between two teeth, bend the tape into a C shape so it curves around the tooth and move the tape firmly up and down against the tooth 8-10 times. Slowly work your way around your mouth flossing each tooth. You can watch a video on how to floss here

Throw away an old toothbrush

You should replace your toothbrush every 3 months, or if the bristles look worn down, after you’ve been ill, or if it starts to smell. There is no clear benefit between a manual or an electric toothbrush.

Less sugary foods and drinks

Eat less sugar – Sugar is no friend to your teeth. For many health reasons, we should all be reducing the amount of sugar in our diets. The bacteria in your mouth feed on sugar and cause sticky plaque to develop around your teeth. This then attacks the enamel of the tooth, causing tooth decay and dental caries.

Drink fewer sugary drinks – Drink water or sugar-free drinks – not fizzy, sugary drinks or sweetened fruit juices or smoothies.

Foods to avoid – Avoid high-sugar breakfast cereals, jams, sweetened yoghurts, and sugary snacks such as biscuits, cakes and desserts. Instead, eat fresh fruit, lean protein and whole grains. Try not to snack.

Wait for 30 minutes to clean your teeth – Sugar starts to damage your teeth 20 minutes after eating it. It’s not advised to clean your teeth until at least 30 minutes after eating, as saliva helps combat sugar. Brushing too soon after sugar can just spread the acidic fluids around your teeth further.

Try sugar-free gum

Chewing sugar-free gum, which contains xylitol (a natural sugar substitute) in between meals and after snacking has been shown to help protect you from dental caries. Chewing stimulates the production of saliva which helps protect your teeth. Xylitol has been shown to reduce bacteria on gums and teeth between meals by 90%.

Go to the dentist

I am appalled that no one can find an NHS dentist. It flies in the face of the NHS Constitution. However, you and I can’t do anything about it – it’s up to the government – and nothing is likely to change in the near future. During this time, your teeth will be suffering.

I believe that paying for dental care has to be a top priority. I would humbly suggest that somehow you put this at the top of your household expenses. Paying for a dentist is more important than a birthday meal out, a new mobile phone or a holiday. This is about your health, your quality of life and your future.

It costs me £40.00 a month for 2 dental check-ups and 4 visits to the hygienist every year and I think it’s money, very well spent.

Even children cannot get to see an NHS dentist, and families sadly need to resort to private dental care. Dental care is vital for the health and well-being of children. It’s scandalous that the most common reason for a child between the age of 5 and 9 to be admitted to hospital in the UK is for a tooth extraction due to dental decay.

Final thoughts

I hope I have convinced anyone reading this that caring for your teeth just has to be a number one priority. Not looking after your teeth results in toothache – which can be excruciating – and hugely expensive dental treatments. Ultimately we then start losing our teeth. With the cost of a dental implant at around £2,500, this is not something many of us can afford to pay for.

Your mouth is the window of the body. Your mouth’s health mirrors your body’s health.