How attuned are you to your oral health and what you can do to improve it? It’s something Dr Sarah Flannery of Azure Dental is passionate about. Even though today she is best known as one of Ireland’s top practitioners in aesthetic dentistry, the Blackrock, Co Dublin, dentist actually started out as a dental hygienist.
After studying science Flannery studied dental hygiene in Trinity College Dublin and practised the discipline for three years at Dublin’s Dental Hospital. That helped her fund her way through her subsequent dentist’s degree and, ultimately a master’s degree in aesthetic dentistry.
It’s why, throughout her career, educating patients about oral health has remained a central focus. “It’s actually a passion of mine and the foundation of everything I do,” she says.
For her, a nice smile and a healthy mouth go together, reducing the risk of gum disease and all the expense that decay can bring in terms of root-canal treatments, implants and other interventions.
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But there are even greater reasons for protecting your oral health.
New research shows that regular flossing is associated with a 22 per cent lower risk of ischemic stroke, which happens when a blockage cuts off the blood supply to part of your brain, and a 44 per cent lower risk of cardioembolic stroke, which happens when a clot is pumped from the heart and blocks blood vessels in the brain.
The findings, published in January at the American Stroke Association’s international stroke conference, shows that people who floss once a week also have a lower risk of the irregular heart rhythm called atrial fibrillation, AFib, that can lead to a stroke. “So holistically, it’s really important,” says Flannery.
That’s on top of all the general benefits that come with good oral health, “such as the confidence of knowing you don’t have bad breath, that you don’t have any disease in your mouth and that you are pain free,” she points out.
The fact that pregnant women with gum disease are much more likely to give birth prematurely shows just how foundational oral health is.
The good news is that it really doesn’t take much to achieve and maintain it.
“Our daily habits is step one. We should be brushing our teeth a couple of times a day. Electric toothbrushes have been shown to reduce plaque by 21 per cent compared with a manual toothbrush, so it’s worth investing in one,” says Flannery.
One of the first steps she takes with any new patient is to provide them with a mirror and show them how to brush properly, because the amount of people who don’t know “is incredible”, she says.
The most important area to clean is the junction where the tooth comes out of the gum. Focus on that junction, holding the bristles of your brush at a 45-degree angle.
“Be systematic. Start at the very back tooth in one corner and do all the way around on the outside and then all the way around on the inside. That’s important because when you’re doing a bit here and a bit there, you don’t know which ones you are doing,” says Flannery.
Always brush the top teeth and the bottom teeth separately. “Don’t just put your teeth together and scrub. It’s that little pocket where the tooth comes out of the gum that plaque builds up, and indeed where it gets into the bloodstream,” she adds.
When your gums are healthy they shouldn’t bleed but if they do, it means you have identified a spot you need to focus on more.
Flossing reaches in between the teeth and will help prevent gum disease and decay where a toothbrush won’t reach.
With so many toothpastes on the market, double check that yours has fluoride in it – not all do and it really does help. But don’t worry about mouthwash. If you brush correctly and floss regularly you don’t need it, and many contain alcohol which can disrupt your mouth’s microbiome, Flannery points out.
Drinking water helps wash away food fragments and reduce your sugar intake. If you are going to eat sweets, be aware that eating them all in one go is far easier on your mouth than eating them slowly over a period of time.
That’s because every time we eat sugar the pH level in our mouth drops, and it takes our saliva time to neutralise the acids. If there is no plaque, well and good. But if there is, that’s when it will start to attack your teeth. It’s the combination of plaque and an acidic mouth that does the damage.
“If you’re having something every half-hour, your mouth is constantly acidic,” says Flannery.
Beat the fear
Afraid of the dentist? You’re not alone. But chances are you’re a person of a certain age who grew up at a time when pain relief was a contradiction in terms.
“There is just nothing to be afraid of now but, as a dentist, you have to acknowledge the fear a patient might have, which is like an ingrown memory that they cannot get rid of, and just visiting the dentist stirs it all up,” says Dr Sarah Flannery of Azure Dental.
If you’re battling such memories, or simply suffer anticipation anxiety, talk it through with your dentist.
But first, find one you feel comfortable with. “You are looking for somebody who is understanding and empathetic, who is going to listen to you, who is going to stop when you ask them to stop, and who is going to be gentle,” says Flannery.
“Modern anaesthesia is so fantastic that you need never feel anything at the dentist’s again. But there is a knack to giving it so that it’s not going to hurt – and the secret is to do it slowly, which is why you need to find the right person who is going to be gentle.”
Again that means choosing a dentist with the soft skills as well as hard ones. “Whether it’s adults or children, I will always talk them through every step, to let them know what is happening next, so that there are no surprises and everything is expected, that’s really helpful as well,” she says.
