Give your smile a MOT

by GITA MENDIS, Evening Standard

There's more to having sparkling teeth than brushing twice a day, says a new report. So, what should we do?

We asked dentist Dr Tapeshwar Anand and hygienist Nicky Allon, both at the Q practice in Harley Street, to give their verdicts on three people's mouths.

Victoria Johnston, 27, a marketing manager from Fulham, has receding gums, probably because she brushes too vigorously.

The diagnosis: "Victoria's gums are receding on three teeth, and on one tooth the root is exposed," says Dr Anand. "She does not appear to suffer from periodontal (gum) disease, the main cause of tooth loss in adults, but she is left-handed and is simply brushing too hard on her right side.

Because of that, she now has the same symptoms as someone with moderate gum disease. If she carries on like this, more of the sensitive roots will become exposed. Unless she changes her ways, eventually Victoria's affected teeth will fall out."

The plan: hygienist Nicky Allon says Victoria should invest in an electric toothbrush. "Although she could easily use a manual toothbrush, it's hard to change a bad brushing habit. Electric toothbrushes with circular heads brush round, not back and forth. For cleaning in between teeth, Victoria needs to use dental tape (floss is too thin) every evening - even on her receding teeth.

Getting rid of plaque will make the gums healthier and the bleeding will stop. She must also buy a tongue scraper and scrape away the yellow coating, which contains bacteria, every day..

The verdict: "It's terrifying being told my teeth could fall out," says Victoria. "I had no idea. Dr Anand's comment about my gums not growing back was a wake-up call."

Dave Strange, 33, a manager from Wimbledon, has dentures on two front teeth, after a rugby accident when he was 21.

The diagnosis: Dr Anand says: "Dave takes out his dentures once every two weeks, which is not enough - he should do it every night. His dentures are 13-years-old and don't fit properly and are causing trauma to his gums. They move every time he eats or speaks and there are gaps big enough for food to become trapped. He has gum disease around the denture, making the gums sore and swollen."

The plan: Nicky says: "The best way to clean a denture is in a hand basin using soap and warm - not hot - water and a toothbrush. Dentures must be cleaned every day because bacteria builds up.

Also, the palate is suffocated by the plastic denture and needs time to breathe. You can get a fungal infection by leaving dentures in. On his teeth, he should use a 30 medium toothbrush. Hard brushes are too abrasive, soft brushes won't clean properly.

The technique Dave must learn is to brush in a circular motion, never back and forth. At a 45-degree angle to the gums, circulate the brush from the gums to the tip of the tooth, pushing the plaque away from the gum with a flick."

The verdict: "I'm really freaked out by the horrendous state of my mouth," admits Dave. I'm going to try to do everything they have suggested. I already have the small, red dental brush and it's great - it really gets everything out and makes my mouth and teeth feel really clean."

Susan Grant, 45, lives in Fulham and is creative director of a PR firm. She has been a five-a-day smoker.

The diagnosis: Dr Anand says: "Susan has nicotine stains on her teeth, especially the back of the teeth. Her gums don't look that bad, but the early signs of periodontal disease - bleeding - can be disguised by smoking, which reduces the blood supply to the gums.

As a result gum disease in smokers often goes undiagnosed and progresses until it is too late to save a tooth. Susan is showing signs of receding gums, so I would like her to have x-rays."

The plan: Nicky says: "Susan shows signs of acid erosion on her teeth. She's a wine drinker and may have often brushed her teeth after drinking wine, which causes real damage. She should limit her acidic food-and-drink intake late at night - that includes orange juice, wine or cola. Always wait at least two hours before brushing after eating or drinking something acidic.

Susan should use a 30 medium toothbrush. Because of her receding gums she should not brush hard or to and fro - the motion should be circular, from the gums and down the tooth.

To get rid of her nicotine stains she should see a hygienist regularly. Whitening and smoker's toothpastes are too abrasive, so I recommend she uses a normal toothpaste with flouride."

The verdict: "I could not believe how stained the backs of my teeth were - they were disgusting," says Susan. "I've learned a lot of interesting things about my teeth and I won't be taking them for granted any longer. The new plan starts tonight!"

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