My name is Anna Middleton, and I am a dedicated and passionate multi award-winning dental hygienist and founder of the brand ‘London Hygienist’. My mission: to change the way oral health care is delivered to patients. I studied at the Eastman Dental Hospital after working as a dental nurse and graduated in 2015 from the Faculty of Royal College of Surgeons. I currently partner with some of the world’s leading oral care brands as a Key Opinion leader and Ambassador while also lecturing and regularly writing for leading industry and consumer media. You can follow me on social media @LondonHygienist

Today, I’d like to give insight into the work of a dental hygienist as opposed to a dentist, common dental care mistakes and how to avoid them, recognising and treating gum disease, my view on teledentistry for the future of dental healthcare, and a few top tips on how you can improve your dental care at home.

#1 The difference between a dentist and my role as a London Hygienist

For patients, the difference between a dentist and a dental hygienist appointment is that the dentist can provide treatment for certain oral health and dental issues, whereas a hygienist performs a thorough dental cleaning and offers specialised care for gums, including the management of periodontal disease. It’s recommended that you visit the dentist once a year and your dental hygienist at least two times a year to receive a professional cleaning. These regular visits also mean there’s a medical record of any changes to your oral health. You can be screened for gum disease and dental decay (both which are totally preventable) as well as oral cancer (over 8,300 new cases of oral cancer were diagnosed last year). I advise my patients that incorporating visits to London Hygienist as part of their oral hygiene routine is pivotal to maintaining a healthy mouth. Routine visits and a tailored oral hygiene routine will keep your teeth and gums in good health.

#2 The most frequent dental care mistake and how to avoid it

Without doubt the biggest issue I see is not enough interdental cleaning! Regular toothbrushes are not capable of reaching in between teeth to remove unwanted debris. Brushing cleans only about 60% of your mouth, so interdental cleaning with floss or brushes is crucial. Cleaning between the teeth regularly helps prevent tooth decay and gum disease, which can occur when food and plaque are left lodged between teeth.If you have the space between your teeth, then opt for interdental brushes and always use the biggest size possible – you may need more than one brush size. If your teeth are tight together then dental floss is recommended. Do this once a day, preferably at night and in front of the mirror.

Another way to ensure proper removal of debris and promote good oral health is by using an electric / sonic toothbrush, for several reasons:

• You get a far more superior clean and effective plaque removal because you get more brush strokes per minute than you could ever generate yourself with a manual brush.
• Using an electric toothbrush with the correct technique will prevent overbrushing, which causes irreversible and permanent wearing away of the gums, known as recession.
• The exposed underlying tooth surface is not as strong as the tough outer enamel, leaving it more susceptible to further wear, dental decay, sensitivity and an unpleasing aesthetic appearance.
• Electric toothbrushes have much smaller heads and are designed specifically to ensure each tooth is cleaned individually, helping you get to all the hard to reach areas.

#3 Reading the signs: Bleeding gums and gum disease

Healthy gums are typically pink, and any change in the natural colour is a sign of poor health. While bleeding gums can indicate an issue, this isn’t always the case. For instance, if you notice bleeding when using an interdental brush or floss, don’t worry too much and keep going! It was just caused by pushing the gums with your floss or brush. However, bleeding gums can also be caused by plaque – the white sticky film that forms in all our mouths. Plaque is filled with bacteria – some of these bacteria are good and some are bad. If plaque is left behind after a period of time, it starts to irritate the gums and cause inflammation.

When gums are red and swollen, this is an indication that something is amiss. Sore, tender, bleeding gums generally indicate gingivitis, which is an early stage of gum disease. This stage is reversible, but if proper oral care is not taken, it will advance to severe stages of gum disease known as periodontitis, which can cause permanent damage such as recession and mobility. If you think you have gum disease, consult a dental professional immediately to receive a thorough evaluation of your gum health, followed by treatment with focused cleanings, known as root surface debridement and often referred to as ‘deep cleaning’. This treatment involves cleaning under the gums and the use of specific instruments that remove plaque and deposits away from the teeth and gums. 

#4 Teledentistry: An emerging platform for improved dental health services

A very exciting development in the area of dental medicine is teledentistry, and it’s something I have been interested in for some time. More people are turning to the internet for their information and this would serve as the platform for patients to connect with credible professionals to help them. Access to dental care has been difficult at times for people and again, remote contact would help overcome this barrier. Teledentistry can be used not only as a tool for consultations and treatment planning but also as a valuable platform to help coach patients in the prevention of dental diseases. From a clinician’s point of view, this can help screen patients and their needs as well as free up surgery time for treatment, allowing for improved time management to provide better care for more patients.

#5 Top tips for at-home oral health routines from the London Hygienist

Last but not least, I’d like to leave you with 5 tips from London Hygienist on how you can improve your oral health from home:

• Invest in an electric / sonic toothbrush. Brush twice a day with a fluoride toothpaste and be sure to include some form of cleaning in between the teeth, either with floss or interdental brushes
• Use a straw for drinks and try and rinse your mouth with water after consuming dark-coloured foods and drinks. 
• Keep acids and sugars to mealtimes only and aim for no more than three to four sugary/acidic snacks per day.
• Chewing gum is not just for freshening breath. Sugar-free gum increases salivary flow, which can neutralise plaque acids, help remove food debris, strengthen teeth and reduce dry mouth. I suggest only opting for chewing gums with Xylitol as an ingredient, as it can help fight tooth decay too.
• Make lifestyle changes. Quit smoking or cut back on the red wine and coffee. Your body will thank you and so will your teeth!