Dental Myths vs Fact - Doctor and Dentist Conversations - Dr Gill

hello and welcome back to the channel you've joined myself Dr James Gil for another medical video I've actually been joined by another doctor but not a medical doctor we've got Dr Alice mace here today and well you're not a medical doctor what sort of doctor are you no so I I'm a dentist uh so I look at the mouth so how how you know you you've come to medical school why given you already have a full proper job and career um yeah so if we're kind of go to my career in general so I qualified in 2020 from Newcastle um I did my Foundation year in a practice in Stanley which is a little Town and County Durham uh and then I moved to the dark side and worked in oral Maxa Facial Surgery uh so dealing with facial traumas and uh severe Dental infections facial deformities or cancers things like that and then I worked in the Northeast for two years in that so in newcast and Sunland and really enjoyed working in it and found it really interesting um but to be a consultant in orax of facial surgery it's the only specialty that you have to be dual qualified in so you have to do a medicine degree and a dental degree so I'm back at Medical School doing my medicine degree now so basically when it comes to IQ Smackdown she's got me licked quite considerably so I'm going to try very hard not to make a fool of myself here so you've you know you've joined us today to talk about some you know Dental myth which actually I think is a great thing there so often I see patients come to me with dental problems and actually I don't know how I can help them a lot of the time so what you know what sort of things do you come across regular that you wish you could change people's knowledge on yes there's lots and lots of dental mess out there um so I thought we could start from the most basic and work our way up um so the most basic being how many times a day should you brush your teeth I twice yeah great so yeah twice is what we recommend um um so ideally once in the evening that's the most important one and then once at any other time of day preferably around breakfast either before breakfast or about half an hour after breakfast why is the evening one most important cuz I have thought that the one in the morning was just LLY I'm not gassing everybody during the day yeah so it is a common misconception um but the one in the evening is the most important because when you sleep your mouth gets really dry and you have bacteria that sit on your teeth so that's plaque that you might I've heard of and those bacteria will sit there overnight and then they'll metabolize and produce their waste products which for them is acid and that will sit on the teeth and eat them away so what you want to do before you go to sleep is brush away as many of those bacteria as possible so they're not sitting on your teeth overnight producing all that acid okay so you know you said brushing twice a day could I you know make that even better and you know brush multiple times during the day um you could do what you might find there is if you brush too much you can actually cause um what we call abrasion cavities so where you brush away actual tooth tissue that would have to be if you were brushing very very hard lots and lots of times a day but we recommend just the twice a day is enough okay well that's you I'll definitely stay with it the twice a day certainly what so frequently I I'll get patients come into to me and they'll say oh you know i' I've got toothache you know I need to get antibiotics I can't get to see my dentist M now as a GP you know I'm told I'm not MediCal legally covered to provide dental care so often I say to those patients you know go speak to your dentist about it and they grous because it's you know they can't easily get an appointment same way as getting any medical appointment is difficult but I also have people say oh you know just you know play fair gives them the antibiotic you're actually a dentist what should I do in that situation yeah so it's a really tough one because when people come to you you want to be able to help them um but if someone just has toothache and when I say just toothache obviously it's an awful pain to have but if they don't have any facial swelling if they're not unwell in their self if they don't have any signs of sepsis there's actually no indication for antibiotics for toothache on its own um there was a big kind of evidence base behind that um from the cran Collective who did a big metaanalysis and showed that yeah there's no evidence behind antibiotics for toothache and with resistance as well what we want to be voiding is giving people more antibiotics than they need so if we don't have to give them you shouldn't absolutely so I'll keep on pushing them your way then yeah okay in terms of the things that you see people doing to their teeth when they they think that that's a good thing you just mentioned about you know brushing excessively what's you know one of the things that you you really like to help educate people to try and stop them doing yes so I think one of them is with mouthwashes so the main r rule with brushing your teeth is we say spit don't rinse so toothpaste itself has fluoride in um and so does mouthwash but toothpaste has a much higher concentration so it's got 1,450 parts per Mill fluoride in is the regular one that you can buy and you want that fluoride to sit there on your teeth and work on the teeth and strengthen them if you're rinsing your mouth out immediately afterwards either with water or with mouthwash you're actually washing away all of that fluoride and all of that good stuff that's in the toothpaste means it can't work as well so what we say is if you want to rinse with mouthwash either do it before you brush or half an hour afterwards or use it after meals and it's fine then but just spit out after you brush don't rinse with anything hold on you say it's fluide I'm I'm sure I've seen videos saying FL is going to grow me an extra head and it's you know it's you know make me a communist isn't fluide the devil no absolutely not um so fluoride is actually really beneficial for teeth um it helps strengthen the enamel that's there so teeth have three layers to them so you've got enamel on the outside dentine in the middle and you've got the nerve that sits on the inside and that enamel is that protective coating that helps strengthen teeth what that fluide does is it helps strengthen that enamel which then decreases your risk of Decay um the only risks that fluoride pose is if someone's under three and they eat a lot of it so if your child gets into your toothpaste tube and eats a lot there is a risk or something called fosis do they glow in the dark they don't glow in the dark no um but otherwise it's generally fairly safe okay um in terms of myths Etc somebody once told me that um because my my dental my teeth aren't that great if you've got an early cavity that Flora can actually prevent and reverse that decay is that right yeah absolutely so what if you see your dentist and you're perceived to be at higher risk of getting Decay you might be prescribing a higher dose of fluoride so um either 2,500 parts per million or 5,000 parts per million of fluoride which can really help with halting that decay in its tracks if there is some or preventing more forming what you might have when you go to the dentist as well is a varnish which is an even stronger strength of fluoride painted onto your teeth which helps strengthen that animal even more fantastic so it definitely sounds like you know being anti florid is has quite a conspiracy theory rather absolutely yeah now you just mentioned that your teeth is got three layers we've got the enamel we've got the dentine and the nerve staying with toothpaste and the like can you know these uh toothbrushes that reduce sensitive teeth actually penetrate that far into a tooth yeah so there are sensitive toothpastes that exist out there and they do actually work fairly well so how sensitivity works is you have that nerve that sits on the inside and it has little tendrils that sit in the dentine and it sits in little tubes and is normally covered by that enamel so nothing can get to it insensitivity what happens is some of that enamel is worn away either because it's at the gum line and it's been brushed away or it just hasn't formed in the first place what happens is those little tubes with the nerves in are exposed so every time you have something really cold or potentially when you touch it it's really sensitive so what the toothpaste do is aim to block those holes and then prevent those stimuli getting to that nerve and which helps the sensitivity there are lots of Brands out there that you can pick it's just finding which one works best for you fair enough okay so staying with that you know you said the little holes in the space between the teeth and all that let's be fair flossing is a pain in the neck can't I just vigorously swir with mouth wash that'll get between the teeth won't it um not necessarily um the best thing to do is to floss or use the little brushes the little inter Dental brushes between your teeth if you think each tooth sits together and there's contact with the one next to it so they sit together quite tight when you brush your teeth you can only really brush the front the the back and the tops of the teeth you can't brush between them um so what the flossing helps to do or the little brushes is to get rid of any bacteria that's built up between the teeth you can either use floss the string or the little floss pics or you can use the brushes to really help get rid of that between your teeth okay so it sounds like a lot of the stuff that we can buy at the supermarket is actually there to do us good yeah are there products that we can buy in the supermarket shelves you wish we couldn't yeah so I think one of the things is charcoal toothpaste H but hold on loads of brands have got the charcoal toothpaste and it's going to make my smile 50 times better isn't it so as soon as you use it it might look a little bit whiter because anything looks whiter if you put a black background next to it but with charcoal toothpaste it is actually really abrasive so what it can do is wear away that enamel surface of the tooth and expose the dentine that dentine is more yellow in color so if you think if you've worn away the thing that sits over the top of it you've got got more yellow shining through so then you've lost some enamel which is bad because you've got more risk of sensitivity and your teeth potentially look more yellow which is the opposite reason to why you're using the charcoal toothpaste in the first place okay so I'm going to double check what's in the cabinet when I get home there anything that makes my teeth more sensitive is absolutely no no as far as I'm concerned okay so we're not going to be buying any more um charcoal bath toothbrush uh toothpaste is there anything else that you're particularly you know opposed to on those shelves I think the only other thing really is toothpicks um for cleaning between your teeth as we just said floss and the little little brushes are much better than toothpicks um with toothpicks you've got a risk that a you might slip you might stab yourself in the gums you might tear them and you might even get bits of wood stuck in your gums so they're not very effective at getting rid of that bacteria between your teeth and they might actually cause you harm i' never thought about trying to clean my teeth as a high-risk activity okay that's a new one that's a new one gosh okay I'm GNA thread that on your side then is there you know a particular Dental myth that you know you really wish that people didn't hold on to something that actually stops them you know getting good health yeah so I think one that's quite topical at the moment is um going to Turkey to have your teeth done um we''re seen quite a lot with more and more influencers going to Turkey and promoting turkey teeth is what we call them who have had this full full mouth of veneers um and come back and promoted the service that they've had um and said it's the best thing that's ever happened to them what we're finding is that it's not so when people go to Turkey for these veneers that's not what they're getting so what veneers are is they're a thin porcelain covering that sits over the top tops of your teeth and makes them look better and they require very minimal preparation and they don't really remove that much tooth tissue at all what we're finding is that patients who've gone to Turkey for these veneers have actually had a full mouth crowns fitted I was about to say where's the inverted Comas from gosh so yeah so what what a crown is in comparison to aene ear it's essentially like a hat that sits on top of the tooth and if you think about your teeth at the moment there's not much space to get a hat to fit on them so you have to prepare the teeth down to get it to fit but unlike a veneer it's a very very high prep thing to have a crown done teeth don't really like having that done to them either so then there's a risk that that tooth might actually die off as a result of it so they're having these full mouth of crowns done and then they come back to the UK and then the issue start where the teeth start to die off but then because they've had the treatment done abroad a lot of UK dentists don't want to treat these patients because they don't know what they've had done which is fair enough but then your only option is to go back to Turkey to have them treated which isn't ideal it really sounds like someone's trying to get a a small way of improving proving things that make things potentially catastrophically worse yeah absolutely especially kind of looking longer term because if these teeth do require root canal treatment that's obviously not very pleasant for the patient and there have been cases where someone's come back from turkey and they've required a whole mouth of root canal treatment so every single tooth in their mouth has required root canal treatment which obviously isn't ideal especially when their previous state before they went to Turkey was the teeth was absolutely fine looking further in the future as well crowns only have a lifespan of about 10 years so if we look 10 years in the future all of these crowns will need replacing so that's that expense of going to Turkey doubled again and then when you prepare for a new Crown you have to remove more tooth tissue so there's less tooth there again again increased risk of root canals fast forward 20 years from that initial appointment again those crowns might need replacing again there's less and less tooth tissue Le left each time and then so you're looking at potentially ending up losing all of your teeth because of something you did when you were 20 to improve their appearance okay hold on there plain Devil's have you know we are medical colossa you know technologically wondrous you know beings now in the west does that matter can't I just have a artificial tooth put in yeah so there are things you can do to fill in the spaces between teeth um you can do bridges for if it's just a small amount of teeth replacing which require preparing a tooth in front or behind um to stick that falce tooth in you can do dentures which are teeth on a plate that you remove in and out of your mouth and then there are implants as well so little metal screws that we screw into the jaw and then put false teeth on top but they're surely as good as my normal tooth aren't they um not quite so there's no real way of replicating normal teeth with anything that we can provide prosthetically implants are kind of what we call the gold standard for replacing teeth but they still have their flaw you can't feel the way you bite into things as well with implants so you lose that kind of sensation of biting into stuff and then implants are also susceptible to similar diseases that teeth get so if you don't look after them there's still a risk that they might fail and they're really expensive gosh okay I think that might be a good opportunity to bring it to a close I think I've got I think I've got a a plane flight plain to cancel um okay is there any other particular myths and things you think could be worth watch to wrap up with today uh I think just the main point to do is teeth are really important we could go on all day about how important they are and I mean I studied them for 5 years and there's still stuff that I don't know and you're constantly learning but there are loads and loads of myths out there so if anyone did have any myths that they wanted to ask or questions feel free to leave them in the comments uh and we can try and get back to them and to be honest I think that's a really good you know point for you guys at home um this has been a TR with ourselves you know having a dentist with us and you know allowing me to learn things I didn't know if you'd like us to do a greater series with this you know um and seeing what other Dental issues and things that we can approach please you know shout out to the comments and we can see what we can do well with that I think we'll say cheer and we'll see you in the next one [Music] tby