Brushing may come before flossing in the dictionary, but it shouldn’t when it comes to our teeth according to the Oral Health Foundation.

That’s because new research has shown interdental cleaning before brushing is the best way to clean our teeth effectively.

The study found that flossing loosens bacteria and food debris from between the teeth, which allows brushing to be much more successful at removing plaque.

Those that interdentally cleaned before brushing were left with a much cleaner mouth than those who did it afterwards.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, believes the findings of the study illustrate why it is so important to make interdental cleaning part of our daily routine.

Dr Carter says: “While brushing twice a day with a fluoride toothpaste is absolutely essential for a good oral health routine, this study shows that interdental cleaning also has a big part to play when it comes to keeping our teeth and gums healthy.

“Brushing alone only cleans three of the five surfaces of our teeth, so cleaning between them before we pick up our toothbrush is hugely beneficial. It helps to prevent gum disease by removing plaque from areas the toothbrush alone cannot reach.

“It is a myth that having a good oral health routine begins and ends with brushing our teeth twice a day. This is simply not true.

“The importance of looking after the health of our teeth and gums by cleaning interdentally and then brushing cannot be stressed enough. Doing this alongside maintaining a balanced, low-in-sugar diet and regularly visiting the dentist will make us far less likely to encounter problems with our oral health.”

The charity is keen to highlight the importance of a healthy mouth following a number of recent studies linking poor oral health to heart disease, diabetes, dementia and even erectile dysfunction.

The Oral Health Foundation’s Guide to Interdental Brushing

Interdental brushes come in a range of different sizes, from as thin as 0.4mm to as thick as 1.5mm. Whichever one you have should be able to fit between your teeth comfortably, you shouldn’t have to use much force. You may find you need a couple different sizes but the best way to find out is to ask your dentist or hygienist the next time you have an appointment.

Hold the interdental brush between your thumb and forefinger.
Gently place the brush through the gap between your teeth – don’t force the brush through the gap.
Brush in and out of each space between your teeth.
The research, published in the Journal of Periodontology, also found that cleaning interdentally before brushing is better for our teeth because more fluoride is likely to remain in your mouth afterwards.

“Fluoride is a natural mineral that protects teeth against tooth decay and reduces the amount of acid that the bacteria on teeth produce,” adds Dr Carter.

“Having great oral health doesn’t come down to any one thing. It is important to understand how the different choices you make each day can have an impact on the health of your teeth and gums.”

Scientists tested saliva samples from more than 1,000 adults and found that, compared to non-drinkers, those who had one or more alcoholic drinks per day saw a reduction of healthy bacteria in the mouth, with a significant increase of harmful bacteria also detected.

Such changes could contribute to alcohol-related diseases such as gum disease, tooth decay, head and neck cancer, and digestive tract cancers.

The Oral Health Foundation wants to raise awareness about the dangers of alcohol and the impact that regular consumption can have on the mouth and overall health.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, says: “There are hundreds of different types of bacteria in the mouth and they all play a highly significant role in a person’s wellbeing. These bacteria are finely balanced and important for maintaining everything from the immune system and how the body deals with pollution in the environment, to protecting the teeth and gums and aiding with digestion after eating and drinking.

“The bacterial imbalance from drinking alcohol can cause serious problems in the mouth, such as gum disease, as well as increase the risk of head and neck cancer and heart disease.”

The study also found the type of alcohol consumed also affects for the type bacteria in the mouth, with researchers testing wine, beers and spirits.

They found that wine drinkers produce more bacteria responsible for gum disease when compared to non-drinkers while those who consume beer produce an increase in bacteria that are linked to dental decay.

Researchers were able to show that alcohol consumption is associated with decreased abundance of Lactobacillales, a bacterium beneficial to oral health by reducing the risk of tooth decay. They also found that alcohol suppresses the growth of pathogens that can help reduce gum inflammation.

“A number of high profile studies have previously pointed to the dangers around drinking alcohol to excess but this research offers an additional cause for concern,” adds Dr Carter.

“It is therefore important to be aware of the effects that even moderate alcohol consumption can have on oral and overall health, if drinking is sustained over a prolonged period of time.

“The best way for somebody to protect themselves from alcohol-related disease is to drink moderately, both in volume and frequency.

“It is also especially important that before bed, teeth are brushed correctly after drinking alcohol. Don’t allow the bad bacteria to build up overnight.

“By giving the mouth a good clean last thing at night, bacteria in the saliva can be neutralised and help prevent any unwanted oral health or general health problems.”



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