Teeth

Are your teeth important?  You bet they are.  They help when your smile, and they are the best way to chew your food.  Discover how and what to do to have the best teeth in town, when Julie talks with a Dentist of 40 years standing. 

Transcript

SPEAKER_00 0:36

Hello, Julie Fishley with you again for another episode of A World at War with Itself. Last week we started on the category of health, and we are continuing with that this week, only moving on to teeth. I'm not sure why, but many people are not aware of how our teeth can affect our lives, not only for chewing our food, but for many other things with our body. I have in the studio with me today Dr. Colin Morrison, a dentist of very long standing. Thank you, Colin, for coming in today to talk with me.

SPEAKER_01 1:04

Pleasure.

SPEAKER_00 1:05

Firstly, Colin, how long have you been a dentist?

SPEAKER_01 1:08

Over forty years, I'll see. It's been a while.

SPEAKER_00 1:11

That's a long time. And how many years of study did you have to take to become a dentist?

SPEAKER_01 1:15

Five years at that time. That's what the undergraduate course is, and still is, I believe.

SPEAKER_00 1:20

I have heard that it does take long to become a dentist and a doctor. Is this the case?

SPEAKER_01 1:25

If you want to be an oral surgeon, you've got to do the dental course and full medical course, so that can take you twelve years.

SPEAKER_00 1:32

Oh, that's a long time.

SPEAKER_01 1:34

Yes, exactly.

SPEAKER_00 1:35

As stated at the beginning, I'm sure many people do not realise how much our teeth can affect our health. Having had a brother placed into a coma in intensive care because of a rotten wisdom tooth, surely that means bad teeth can have a really bad effect on us.

SPEAKER_01 1:51

Absolutely. That's a very extreme case, but true, the infection from what you get in the mouth spreads right through the body, and it's well known that infections in the mouth can cause all kinds of general medical conditions.

SPEAKER_00 2:05

Is it only the teeth that can affect our health or are our gums just as important?

SPEAKER_01 2:10

Yes. Well the bacteria that live in the gum crevice, and that's where you get the specialist periodontalontists, they're particularly nasty because they can cause all sorts of effects on your heart and general system.

SPEAKER_00 2:24

In what way?

SPEAKER_01 2:26

Well, the toxins that they involve, you don't realize you've actually got a heart condition associated with the infection coming from your teeth. So it's really quite serious potentially.

SPEAKER_00 2:37

I'm presuming that's bacteria are always in the mouth, isn't it?

SPEAKER_01 2:41

Yes, but they change where they don't get oxygen.

SPEAKER_00 3:07

More reasons why you should clean your teeth properly.

SPEAKER_01 3:09

Absolutely.

SPEAKER_00 3:10

And is there a special way of cleaning your teeth thoroughly?

SPEAKER_01 3:13

Nowadays it everyone should be using an electric toothbrush. It's by far the best thing. You want one with a soft head and you want to be gum brushing as your main focus rather than toothbrushing. Because it's the gums and that crevice that I've mentioned is the dangerous bit, and keeping the gums tight, healthy, and fit. But you're thinking about a frictional health to your gums that allows the tissue to get tighter and thereby not allow the same bad bacteria to fester underneath the gums. The minute you've got bleeding gums, you've got a problem. Simple as that.

SPEAKER_00 3:49

Does that often happen?

SPEAKER_01 3:50

Yes. Even if you forget for a few days and then you go and brush, you'll find your gums are bleeding. And also that means that cleaning between the teeth is very important. So that's where little interdental brushes should be used if possible. If you're young and you've got newly erupted teeth, then there won't be room for brushes between your teeth. But as you get older and you get uh into middle age and then brushes between the teeth is important. Floss won't do anything because it's just like using a little string in the middle of corridor to try and clean it.

SPEAKER_00 4:20

Well, so your teeth separate when you get older?

SPEAKER_01 4:22

Well, the teeth move around. I mean orthodontics that we use is to get them straight, but they'll move around if they're not held in some form of retention. The natural thing is disorder. Having orderly teeth is not natural. That's where orthodontists come in.

SPEAKER_00 4:40

And does this mean when people have their teeth straightened, it's not just for the improvement of their smile?

SPEAKER_01 4:45

Yeah, well it make it easier to clean and you're going to have less likelihood of these trapping areas that I've said can harbour the nasty bacteria. So there is a health aspect of having straight teeth as well. But if you don't clean them, it doesn't matter whether they're straight or not.

SPEAKER_00 5:02

When you have braces on, though, and you're cleaning your teeth, can you really get them properly?

SPEAKER_01 5:15

It's only for a couple of years maximum and then it's over. Is that all?

SPEAKER_00 5:19

That's all most of the things.

SPEAKER_01 5:23

It can be, depending on what's going on. There are times when there's surgery involved in all sorts of things. For most orthodontics, two years is the time it takes.

SPEAKER_00 5:31

What age does a child lose their baby teeth and their adult teeth start to come through?

SPEAKER_01 5:36

Right from birth, even it can be happened. Unfortunately, the thing is that the baby teeth are only there for the first few years, and once the timing is for that individual for their permanent teeth to erupt, the body eats away the roots of the baby teeth and then they come out, they get loose and and they come out. That's a very individual thing. Some kids are born with teeth even and are very early developers, and then they're starting moving their teeth on their first teeth only after two or three years. That's the freakish quick one. The average is about six that you're starting to lose your front baby teeth. And there's various orders of that as well. It can be the lowers or the front upper front ones first. And then it just takes a few years for everything to turn over until you're about twelve. Or the normal ages for starting potentially to have all your permanent teeth erupted.

SPEAKER_00 6:30

Are the m milk teeth important?

SPEAKER_01 6:33

Absolutely vital. Well they both give you something to chew with for those years. Um a training uh method for cleaning. But yes, if you started off with permanent teeth, your jaw hasn't formed, so you've got to realize there's formation of the jaws and an increasing in size. Creation is wonderful, however, it all happens, and that's what creates that.

SPEAKER_00 6:53

I can remember as a small child going to a dentist through the school in England and discovering the pain one gets when a tooth is drilled. I was told it didn't hurt, but it did. Especially with the drills they had in the mid-1940s. Now, this would have been my milk teeth. Why would the dentist think it wouldn't have been painful?

SPEAKER_01 7:13

Well, they may have been telling a little porky and just trying to keep you calm while they were doing it in the hope that it didn't hurt, because sometimes you're lucky and it doesn't hurt. But really, without anesthesia, a lot of drilling will hurt. But then having a local anesthetic, especially back then they had bigger needles and everything, it would have hurt even more. So the trouble is that it was a difficult time to do dentistry, even now it's difficult, and we actually send children to be knocked out to have work done because it's painful. You know, all the nerves in the teeth are there to pass back a message that something's wrong and you're putting too much pressure and a protective measure. That's what pain is. But when you're working on teeth, unless the nerves died off and you're just working within the tooth, but then anything else, you need some anesthesia or it's going to be painful.

SPEAKER_00 8:03

Does the pain get worse as one gets older or is it the same no matter what age?

SPEAKER_01 8:08

No, it's it's a very individual thing, pain. Some people seem to hardly feel anything, whether it's lucky or not, because you've got to realize it's you get self-injury if you're not feeling things. If you don't feel something, you've you're not going to stop doing it. Hitting your head against the wall. It should be sore, otherwise people, you know, would hurt themselves a lot. So really, yes, the pain is a necessary feedback that something's you're doing something too much. When we're doing dentistry, by using local anesthesia or using some means of and but when you're a child, you've really got to be knocked out because the needle itself or having that form of of pain relief isn't enough because you're actually causing too much pain and weirdness to the area where it's numb that they can't stand that and that can be very off-putting. So nowadays if you've got somebody who's unlucky enough to get their teeth decaying early, then they really need to go and see a specialist or somewhere to be knocked out fully and then the work done on the So what some people have been put into ho kids have been put into hospital to have their teeth done. There's certain places that will have sedation without going to the hospital for children and be able to do it that way or use nitrous oxide, etc.

SPEAKER_00 9:17

And when I was young it was laughing gas or nitrous oxide. But now it is an injection, which is better.

SPEAKER_01 9:24

The nitrous oxide is only a sedative a little bit and it doesn't really take the pain away. It makes you less caring about the pain, hopefully. But in itself, nitrous oxide is not a satisfactory anesthetic. So it's more a means of having somebody more relaxed and able to take the local anesthetic or whatever other anesthetic. It's a sort of leader into something more, either being fully sedated or having a local anesthetic.

SPEAKER_00 9:55

Fluoride was introduced into the water here in Australia in the late 1950s, early sixties. Because I was in my late teens, the effect on me was minimal. But my daughter grew up with fluoride. When she went to see a dentist in England several years later, she was told she had good strong teeth, and it was due to the fluoride. There are people around the world who think fluoride is dangerous. Can you please give me your opinion of fluoride?

SPEAKER_01 10:22

Well, without doubt, it's a totally naturally occurring element. It was discovered, as you say, in the late 50s, that certain places in the world naturally had a higher level of fluoride in the water and that this corresponded to having better teeth and stronger teeth. So the epidemiologists or whoever were the people doing that research and that got together the dentists and then they worked out oh it's the fluoride that's actually in the teeth, that's actually making the teeth less it more acid resistant. In other words, when you have fluoride in your teeth, it takes more acid to break down the tooth, and that's what is produced by bacteria and leads to decay, is the acid. So when you've got fluoridated teeth you need to be looking after them worse and and creating a whole lot of bacteria cre producing a lot of acid to break through. Whereas when you don't don't have the fluoride, then your teeth decay more quickly, and then once you've got that, there's more decay in the population, because it's really a contagious disease. You pass it on through your saliva in your family group or your social group, whoever you're kissing, whoever you're sharing food with. Of course, kids slobber all over each other all the time, and it's at that time that a lot of the decay is passed on between the children, and then into the family group who are kissing each other as well, and sharing the same utensils and whatever else, and that's how decay is passed. But as I say, when fluoride comes in, it slows it all down and changes the whole ecosystem.

SPEAKER_00 12:00

It's amazing, isn't it? I I didn't realize that's what it worked. No.

SPEAKER_01 12:04

And a lot of people think, oh, the fluoride and water is helping my teeth. No, it's helping the forming teeth of all the children that are being born and in their first years of life while their teeth are forming. After that, it does very little. You have to you have to use the fluoride in the toothpaste to surface top up that fluoride anti-acid effect. People don't understand that's how fluoride works. I get patients coming in saying, Oh, they've I've got fluoride in the water, and I say, that's for the kids, that's not for you.

SPEAKER_00 12:36

Right. Well, that's something new I've learned today. That's good. When children are young, one can have great difficulty in getting them to brush their teeth regularly. Is there some trick that one can use to encourage them to brush at least every night before going to bed?

SPEAKER_01 12:51

The example's the thing to do, make sure it's something that you're all doing as a family and that it becomes a habit. It really is something that shouldn't be unpleasant and it should just be started off right at the off. When you've got a young infant, you just start with a little face cloth sort of something and on your finger to actually just clean the teeth and get them clean that way and let them start with that sort of thing, and then have them playing with a toothbrush as well, and then show them by example. So it becomes one of those things that should just become a a lifestyle thing that they don't even think about not brushing. Yeah, no, don't even think about not brushing their teeth. And if you work that into the family routine, it's it's it should be easy. Nowadays, as I said, electric toothbrushes is the way to go though. And you start that quite early, there's no reason to not start that quite early, and then you haven't got the scrubber dub dub. See the trouble with manual toothbrushes is that people can damage their teeth through using too much pressure or too much grit in the toothpaste in the one spot and start a weakness in the tooth, or should I say, just abrade their teeth.

SPEAKER_00 13:50

You go to get a toothbrush from the supermarket or wherever you go to the store, and they come in soft, medium, and uh hard. Yes. Um I usually choose a medium. I find the hard's too too heavy, but the soft one doesn't do anything. Well why do they give you the choice of three?

SPEAKER_01 14:07

Funnily enough, as I said, they should have called them gum brushes, not toothbrushes. That's something that most people don't realize, is that it's your gums you want to be brushing. So the hard ones are hardly suitable for anybody. Because you've got to have incredibly tough tissues to handle the hard one on your gums. Especially when they first come out of the packet. Obviously that that's what will happen is a hard one will turn to a medium, it'll turn to a soft over time, but then it is bending and it's going to be less efficient. I personally just go for soft and I'm thinking of it as gum brushing, not toothbrushing. Because the area where all this nasty bacteria and any decay and everything is going to start is either in crevices in the teeth and places that you can't get at with a toothbrush, or right at the crevice between the gum and the teeth, where you're not removing that material at that gingival third, as we call it, next to the gum. And as I say, you need to keep the gum healthy, not bleeding. So that's why think about the positioning of your toothbrush being sort of half on the gums and half on the teeth, inside and out, and then using something between the teeth if you're older, a brush or floss.

SPEAKER_00 15:19

Soft drink seems to be containing more and more sugar. Is it sugar that damages the teeth? What part of the tooth is it actually damaging?

SPEAKER_01 15:28

Yeah. Sugar, if you haven't got any bacteria on your teeth, the sugar could do nothing to your teeth harmful. The sugar is the food for the bacteria to produce the acid that creates the decay. You need the sugar, but you will get that in just about anything you're eating, or even starch will degrade to sugar in the mouth with the enzymes you've got in your mouth. So you've got to realize that the sugar is just the fuel for the bacteria. The bacteria produce acid as their metabolic process, and that is what creates the decay. So lots of sugar will give you more of a chance for decay because you're almost bound to have some bugs that you're not quite cleaning off as well. In the ideal world, if you were cleaning your teeth absolutely perfectly and you have been using fluoride, then the amount of sugar you take is harmful to you in lots of other ways, so I'm not saying to to have sugar, but it's not the thing that's causing the problem, it's just the fuel.

SPEAKER_00 16:30

Some people have told me that when they've had their teeth removed, the dentist has complained of the difficulty it had removing the tooth. Why would that be?

SPEAKER_01 16:40

To take teeth out, it's got to do with the shape of the roots of the tooth, how much tooth you had to get hold of to take it out, whether the individual bone you've got, some people have got very strong bone and doesn't give at all. If you've not got anywhere to get a hold of it, it's going to be difficult to take out. So some people have roots that go off in strange directions in multi-rooted teeth, and you can't take it in one direction without breaking the other one. So something's got to give. It can require, as we nicely call it, sectioning of the tooth to get some teeth out where we're having to take it out in pieces on the roots and and other pieces because it's never going to come out as one piece.

SPEAKER_00 17:21

It sounds terribly painful.

SPEAKER_01 17:23

It's not pleasant for anybody concerned. Not even the dentist. No, uh I mean I I've done thousands, but the thing is it doesn't make it a pleasant thing for me. It's just one of those things you get better at with practice. But other than that, it's not good.

SPEAKER_00 17:36

In the nineteen twenties it was the rage to have all one's teeth removed and replaced with dentures. My father had it done, complained about it for the rest of his life. Firstly, why did it become the thing to do then? And what is recommended now instead?

SPEAKER_01 17:51

Dentures back in those days was because though they didn't know about fluoride, as we've just talked about, and the thing is that that would lead to decay that was untreatable because they didn't have a satisfactory amalgams of filling material, but they didn't have a satisfactory cure. Once you were getting decayed teeth, the only thing was taking them out. And then once you've got some decaying teeth, unless you take them out quickly, they're a source of the wrong bacteria that then will cause further decay. So it's it's a vicious circle you're in. And back then the only restorative was amalgam or something like that. But having said that, once you've got a certain amount of it, that you've got all that and no teeth, you had to be affluent for that as well. So a lot of people it was no take the teeth out, in fact, we'll save uh money and time and trouble and do it when they've good solid teeth which are easier to take out because you've got something to grip onto, and then give people dentures. So that was a stage of dentistry that's not a very proud one, because it really was reactive to not being able to stop the decay at that time, and the the solution was to have bits of plastic called dentures, and that's what people had to put up with.

SPEAKER_00 19:03

And no wonder your father was unhappy, because that's really something that I would put he could eat an ice cream, which most of us couldn't without any complaints.

SPEAKER_01 19:10

Yes, it it stops sensitivity of teeth, that yes.

SPEAKER_00 19:13

But he could never eat an apple. No, he always had to cut it. Yeah.

SPEAKER_01 19:17

No ch no chance with dentures.

SPEAKER_00 19:18

It's one of the things when we uh the grandchildren used to say, Why aren't you doing that, grandad?

SPEAKER_01 19:24

You've got to realize that in taking the teeth out young when that which was being done then, the bone all resorbs because there's no function on the bone from dentures, so you end up with nothing for the dentures to hold on to when you if you get older and it reduces your whole life expectancy, uh having your teeth out and having dentures. You don't have to think about it very much, but that's why we're living longer. Ah, one of the reasons.

SPEAKER_00 19:49

My final question is if you were to recommend one thing to help people look after and keep their teeth, what would that be?

SPEAKER_01 19:58

The one way that you keep your teeth, as we've just talked about, is the good brushing, that uh regime of gum cleaning and cleaning between your teeth and making sure that the gums are healthy, which is where the nasties can hide. Seeing your dentist is obviously going to help. I'm I should be saying that first when I think about it. But no, it's important you just do your cleaning really well. Use fluoride toothpaste and use electric toothbrushes now, and really there's not many excuses if you do that.

SPEAKER_00 20:29

I've learned a lot about this today. Thank you, Colin, for coming in. It's been very enlightening. I have been speaking with Dr. Colin Morrison, a dentist of many years. I do hope you found this discussion as interesting as I did. And that's it for this Wednesday. Please join me again next week when I'll bring you another episode of A World at War with Itself. Until then, keep brushing those teeth. They're important.