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Recent research has found that Water Fluoridation has a positive impact on the long-term oral health of children. The research took place over a seven-year period. The results showed that those exposed to water fluoridation typically have stronger oral health than those who are not exposed to it. Therefore, these findings evidence the benefits of water fluoridation.

Recent research has analyzed the long-term impact that water fluoridation has on the oral health of children. The research took place over a seven-year period, and largely produced promising findings.

In positive news, the research team found that exposure to water fluoridation resulted in a “modest” benefit to the dental health of children [1].

What is Water Fluoridation?

Water fluoridation refers to the process of adding a small concentration of Fluoride into the public water supply [2].

Fluoride has been praised for instigating a strong reduction in cavities [3]. Furthermore, it is seen as a crucial ingredient in oral health, and can help keep our teeth strong.

However, water fluoridation is a controversial topic that has caused heated debate. For example, many countries have banned its use. Controversies involve the ethics of water fluoridation, the dangers of over-exposure to fluoride and the issue over a lack of choice.

How did the Research work?

The research was led by the University of Manchester in the United Kingdom. Now, their findings have been published in the Public Health Research journal [1].

This was an important study, as it presented researchers with a chance to complete a first-of-its-kind study, which produced a contemporary review of the effects of the initiation of a water fluoridation scheme in the UK since fluoride toothpaste became widely available in the 1970s [1].

The study assessed the dental health of two cohorts of young children over a six year period. The children were based in two parts of Cumbria – a county in England. In 2013 fluoride was reintroduced to the water supply [1].

One group, consisting of 1,144 participants, were born after 2013 [1]. Therefore, these were five/six years of age by the conclusion of the study.

The other group had been born in 2008 or 2009. There were 1,192 children in this group. Therefore, this cohort were aged 10 or 11 by the conclusion of the study [1].

Adopting such an approach ensured that one group would be exposed purely to fluoridated water. However, the other group would have reached the age of 5 before being introduced to fluoridated water.

This arrangement would ensure that the researchers would be able to compare the oral health of the two groups.

To measure the results, dental teams carried out regular dental examinations on the children [1]. Moreover, pictures were taken. These images were blinded to the fluoridation status of each participant to remove any potential issue of bias.

The Results

The results were interesting. In the cohort that had been exposed to fluoridated water, 17.4% of the children had decayed, filled or missing milk teeth [1].

However, in the cohort that had not benefitted from water fluoridation, 21.4% of the children had decayed, filled or missing milk teeth [1].

Therefore, there was a 4% reduction in teeth problems – with those in areas with water fluoridation having less problems [1].

These results are unsurprising, and are consistent with other findings. For example, in general, since fluoride was first introduced 40 years ago, the number of children affected by tooth decay has fallen dramatically [1].

The impact on the NHS

Dental fees are not free, unlike the majority of healthcare in the United Kingdom. However, free dental care is available for pregnant women and those on a low-income.

But dental pain often results in people seeking help in Accident & Emergency departments, rather than dental clinics. Consequently, this costs the United Kingdom’s NHS a substantial amount [4].

Therefore, another positive finding with this study was that the researchers believed that water fluoridation was a cost-effective way of reducing some of the money spent on dental caries by the NHS – which equates to around £1.7billion per year [5].

Author Comments

The authors of the research commented on the findings. They noted that tooth decay is typically worse in disadvantaged groups and vulnerable populations [5].

With this in mind, Professor Mike Kelly noted that “health inequalities are a feature of all societies, including the UK” [5]. Continuing, he said that “the most disadvantaged communities and the excess number of children having general anesthetics each year still needs to be addressed” [5].

Therefore, Kelly said that there is a “need to continually look at measures which can help prevent the unnecessary burden of pain and suffering” of this group [5].

But the authors were slightly surprised that the amount in difference between the two groups wasn’t higher than 4% [5]. There seemed to be a general expectation that water fluoridation’s impact would be more noticeable.

Summary

This is a positive finding. Water fluoridation does appear to have a strong effect on the oral health of children. Childhood is a crucial time for oral health, as they can get into strong habits that can carry them through life.

These findings may result in more of an uptake of water fluoridation – both around the United Kingdom and further abroad.

Thinking points…

1) It is important as adults to set a good example to children. As part of this, we should ensure that we demonstrate strong oral hygiene in front of them, which includes brushing frequently. This will help children to get into good habits that can help their oral health throughout life. A crucial part of oral health is to visit a dentist for a check-up at least twice a year. We recommend booking one soon!

2) As this research shows, fluoride is very important for oral health. Therefore, at a minimum, remember to use fluoridated toothpaste. As well as this, remember to try and avoid sugar where possible. If you need some advice on your oral health, or have any questions about it, why not have a discussion with your dentist? They will be able to assist you and help where possible.

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice aimed at improving oral health.

It is very important to brush your teeth at least twice a day and to floss regularly. Moreover, eating healthily and trying to avoid sugary foods and drink can be helpful.

We advise our patients to attend our Calgary-based dental clinic twice a year for a regular dental check-up. When problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals.

Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, teeth whitening and Invisalign[TM]! Many people find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, all of our services at our Calgary dental clinic Savanna Dental are in line with the Alberta Dental Fee Guide.

We would love you to visit our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Goodwin, M., Emsley, R., Kelly, M. P., Sutton, M., Tickle, M., Walsh, T., Whittaker, W., & Pretty, I. A. (2022). Evaluation of water fluoridation scheme in Cumbria: the CATFISH prospective longitudinal cohort study. Public Health Research. 10 (11). DOI: https://doi.org/10.3310/SHMX1584.

[2] Iheozor-Ejiofor, Z., Worthington, H. V., Walsh T., O’Malley, L., Clarkson, J. E., Macey, R., Alam, R., Tugwell, P., Welch, V., & Glenny, A-M. (2015). Water fluoridation for the prevention of dental caries. The Cochrane Database of Systematic Reviews. 18 (6): CD010856. DOI: https:/www.doi.org/10.1002/14651858.CD010856.pub2.

[3] Slade, G. D., Grider, W. B., Maas, W. R., & Sanders, A. E. (2018). Water Fluoridation and Dental Caries in U.S. Children and Adolescents. Journal of Dental Research. 97 (10): p1122-1128. DOI: https://doi.org/10.1177%2F0022034518774331.

[4] Nsubuga, J. (2017). People who go to A&E with toothaches are ‘costing NHS up to £18m a year’. Available: https://metro.co.uk/2017/01/07/people-who-go-to-ae-with-toothaches-are-costing-nhs-up-to-18m-a-year-6367655/. Last accessed: 18th November 2022.

[5] Addelman, M. (2022). Study sheds new light on benefits of water fluoridation to children. Available: https://medicalxpress.com/news/2022-11-benefits-fluoridation-children.html. Last accessed: 18th November 2022.

We all use our toothbrush a lot, and it helps us to maintain healthy teeth, fight off bacteria and protect our gums. But many people are unsure of which type of toothbrush they should use, as well as questions over when to replace toothbrush heads, and the topic of bristles. Now, a dental professional has answered these questions and provided general guidance, which is useful for us all.

The toothbrush is the main tool that we use for our oral health. It is what we use each day to clean our teeth, with the aim of keeping harmful bacteria and tooth decay at bay.

Despite its importance, not many people put a lot of thought into their toothbrush. Instead, most people just use it, put it away and pick it up again later in the day – before the cycle repeats.

But in actual fact, it is important to think about our toothbrush. This includes knowing when to swap one toothbrush for another, whether a manual or electric brush is better, and then the question over using hard or soft bristles.

Now, Jane Cotter – Assistant Professor at Texas A&M University’s Caruth School of Dental Hygiene – has spoken about these questions [1]. As an expert in her field, she has been able to provide answers on these areas, which is very useful.

The different choices of toothbrush

The two different types of toothbrushes are electric and manual. Electric toothbrushes are brushes that – as the name suggests – are powered by electric, resulting in rapid and automatic bristle movement. Manual toothbrushes are brushes that a person will use to brush their teeth by hand.

Cotter commented on the different choices. She remarked that “research has consistently shown that electric toothbrushes clean better than manual toothbrushes” [1]. Research affirming this dates all the way back to 1989 [2].

Cotter also mentioned about how electric toothbrushes usually have 2 minute timers, which lets the user know when they have completed the recommended brush time [1]. Many also have pulses at each 30-second interval – with the intention of letting the user know it is time to move onto a new quadrant. These user-friendly features help to ensure that each part of the mouth gets adequate attention.

Going further, there is also the choice between soft and hard bristles. The bristles are found at the head of the brush, and are what actually clean the teeth. Some people prefer harder bristles, while others prefer softer ones.

Cotter recommends that we should use soft-bristled toothbrushes to clean our teeth. Because hard-bristled toothbrushes can potentially damage tooth enamel, it is better to use soft-bristled toothbrushes [1]. However, hard bristles can still be effective if used carefully.

How often should a toothbrush be replaced?

It can be tempting to use a toothbrush until it is completely worn out. However, this isn’t advisable for a number of reasons.

Cotter states that “The American Dental Association recommends that toothbrushes need to be replaced every three months” [1]. She mentioned that if brushes are used for longer than three months, the bristles could become frayed [1]. Therefore, this could lead to damage to the gums.

The three-month timeline mentioned above is applicable to both manual and electric toothbrush heads. We should note that when talking about replacing a toothbrush, we mean the head, rather than the whole brush!

But the three-month period should be seen as a maximum. If there are signs that the brush is becoming worn, is fraying or spreading out, then you should replace it. Cotter points out that “some toothbrushes have bristles that change color over time to help patients know when they need replacing” [1].

A note on toothbrush storage

Something that most of us don’t think of is how to safely store toothbrushes between use. Cotter actually mentions a useful point about the environment in which the toothbrush is located.

According to Cotter, toothbrushes shouldn’t be routinely kept near to those of others. This is because viruses, including cold, flu and the coronavirus, thrive in a moist environment and can spread through physical contact [1]. Therefore, with the mouth being so crucial in all of the above, it can be dangerous for toothbrushes to be near one another.

Commenting on the above, Cotter says that “it is important to store your toothbrush in a vertical, upright position in the open air so that it will dry out between uses”, which “helps control bacterial and fungal growth on the bristles” [1].

Moreover, this is particularly important given how bacteria is a major factor in the development of several oral health conditions. Recent research shows that those who keep their toothbrush clean and use it well host less microbial communities – meaning less bacteria is present [3]. This adds another reason to use the toothbrush both frequently and effectively.

While the above forms the opinion of an expert, everyone needs to find their own way of brushing their teeth in a comfortable way. The evidence does show that soft-bristled electric toothbrushes that have their head changed at least once every three months and kept in the open air – provide optimum benefit to oral health.

Thinking points…

1) Cleaning our teeth is crucial for our oral health, and forms the best way of protecting our teeth. This article provides some great advice in this area. But brushing alone won’t always stop cavities or other problems from forming. Therefore, always keep in regular contact with your dentist, and remember to see them for appointments at least twice a year. If you have not had an appointment recently, we urge you to book an appointment now!

2) This article offers a great chance to reflect on your toothbrush habits. For example, how often do you change your brush head? Or what type of bristle do you use – and where do you keep your brush overnight? Have a think about the above questions, and how they compare to Cotter’s recommendations. It could be worth making some changes, or at least having a discussion with your dentist about practical ways of improving your oral hygiene and brushing.

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide their patients with advice, a comfortable experience and treatment to improve oral health where needed.

Importantly, we recommend brushing your teeth at least twice a day and flossing regularly. Moreover, eating healthily and trying to avoid sugary foods and drink is helpful.

We advise our patients to attend our Calgary-based dental clinic twice a year for a regular dental check-up. When problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals.

Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, tooth whitening and Invisalign™! Many people find that these treatments have a positive impact on your appearance, confidence and self-esteem.

In addition, all of our services at our Calgary dental clinic Savanna Dental are in line with the Alberta Dental Fee Guide.

We would love you to visit our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca .

References

[1] Brock, L. (2022). How to choose a toothbrush and when to throw it out. Available: https://medicalxpress.com/news/2022-05-toothbrush.html. Last accessed: 20th May 2022.

[2] Boyd, R. L., Murray, P., & Robertson, P. B. (1989). Effect of rotary electric toothbrush versus manual toothbrush on periodontal status during orthodontic treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 96 (4): p342-347. DOI: https://doi.org/10.1016/0889-5406(89)90354-5.

[3] Blaustein, R. A., Michelitsch, L-M., Glawe, A. J., Lee, H., Huttelmaier, S., Hellgeth, N., Maamar, S. B., & Hartmann, E. M. (2021). Toothbrush microbiomes feature a meeting ground for human oral and environmental microbiota. Microbiome. 9 (32). DOI: https://doi.org/10.1186/s40168-020-00983-x.