Brushing up on tooth care
You don't need me to tell you how to polish your pearly whites. Twice a day, for two minutes, plus regular flossing. You know the, errr, drill. But are you heading to the bathroom after your breakfast, or before it? Scheduling your morning maintenance might be more controversial than you thought.
“This is one of the biggest subjects for debate among our patients,” says Dr. Sameer Patel, clinical director at Elleven Dental Wellness in central London. For him the answer is simple: “brush before breakfast.”
For tooth decay to start, he explains, three things are required: bacteria, sugar and time. “Overnight, you naturally develop plaque,” he says. “Plaque is, in essence, a sticky film of bacteria. That's why you don't wake up with great breath. If you don't brush, you then introduce sugar to the equation at breakfast.”
Brush before breakfast instead, and “you go into eating with no bacteria, so that process of decay doesn't start.” This science might be simple to Patel's mind, but it is still a surprise to many of us. Last year, dentist Anna Peterson made a Tiktok video on the virtues of pre-breakfast brushing which has garnered almost 167,000 likes.
Dr. Olivia Johnson King, orthodontist, agrees, because when we eat, the ph levels inside our mouths drops, becoming more acidic and making the outer surface of our teeth — the enamel — softer.
“So if we brush directly after breakfast, in the long-term we could be weakening that outer surface and damaging our teeth,” she says. Partial to a coffee with breakfast? On a health kick and starting your day with fruit salad or oats? Then brushing before breakfast may be especially important, as acidic foods risk your enamel yet further.
There's more. According to a U.S. study, brushing stimulates saliva production and saliva helps to break food down. If your pre-breakfast brush involves a toothpaste containing fluoride, so much the better. Fluoride is a key weapon in the war against demineralization — that's when key minerals like calcium and phosphate are stripped from enamel. Use it on your teeth, and you're suiting them up in armour against your breakfast.
But here's the rub. Carmel Mchenry, spokesman for the British Dental Association, agrees that “overall, it's probably best for people to brush their teeth before breakfast.” But that's only because our busy schedules tend to make it hard to wait the necessary time for the ph levels in our mouths to neutralize again, post-porridge (about 30 minutes, according to Johnson King). If time is no object, or you can carry a toothbrush to work and let between 30 minutes and an hour elapse between breakfast and brushing, then both Mchenry and Johnson King suggest that there's really not that much in it.
Not everyone agrees. Dr. Carlos Gonzalez-cabezas, dentist and professor at the University of Michigan School of Dentistry, says: “People think brushing is all about removing food and plaque. It's also an extremely important delivery method for fluoride.” Fluoride strengthens teeth and prevents decay. Brushing before breakfast removes much of it as you eat, he argues.
And what of the idea that you should remove plaque before exposing your teeth to your breakfast? “There's some sense there,” says Gonzalez-cabezas. “But the reality is that 95 per cent of people aren't able to remove plaque from the places where cavities develop when they brush.” Plus, he points out, people tend to eat breakfast quickly, not giving bacteria and food much time to do damage.