Should you brush your teeth before bedtime I

From archeology and an understanding of the Egyptian way of life, they are believed to have been the first to use a paste to clean their teeth in or around 5000BC and this is where the story started … whether or not they did so before bed is unknown.

Toothpaste a natural history – and which one should we use?

As our evening meal is a time of peak acid exposure, brushing immediately may potentially cause micro-erosive tooth wear, so wait at least 30 minutes after dinner before you brush.

Always avoid snacking after that as the bacteria in the biofilm covering the teeth feeds off of any oral carbohydrates, especially refined carbohydrates

The absence of our antibacterial and pH buffering saliva at night, we are more vulnerable to cavity causing agents and gum desiccation and disease,.

Ingesting carbohydrates constantly throughout the day also leaves people more prone to cavities of course. Clearly allowing the oral environment an opportunity to return to its normal pH is beneficial.

During a typical meal, your saliva levels are higher, working to protect your teeth and aid in digestion. eating throughout the day (or even slowly sipping a cup of coffee), are repeated “exposures” and increase bacterial growth.

Saliva can be used as an indicator of prognosis during periodontal treatment.

Within the limitations of this study, it has been observed that there is a correlation between pH of saliva and periodontal diseases when compared with healthy groups.

Salivary pH in patients with chronic generalized gingivitis was more alkaline than that in patients with clinically healthy gingiva. This is addressed elsewhere.

The most important thing to remember: It doesn’t matter exactly when you brush your teeth, so long as you head into the night without bacteria (and the food they feed on) in your mouth. Just be sure to brush again in the a.m. and floss to remove the bacteria from between your teeth.

As regards to toothbrushes, it is likely that the finger,  twigs or chewing sticks would have been used when there was reason to rub the teeth or to remove a foodstuff caught there.

The Egyptians are believed the first to made a tooth powder

The Egyptians made a tooth powder, which consisted of powdered ashes of ox hooves, myrrh, powdered and burnt eggshells, and pumice.

Ancient Greeks and Romans are also known to have used toothpastes, improved the recipes by adding abrasives such as crushed bones and oyster shells.

Toothpaste was used in China and India in around 500BC. The Chinese used added flavourings to their pastes such as Ginseng, herbal mints, and salt.

Like so many other inventions and customs, “toothpaste” generally worked its way westward. These “powder/pastes,” were probably used in conjunction with early toothbrushes (chewing sticks).

During the time Johnson was writing his best-known work the ‘Dictionary of the English Language’ and James Boswell was writing his “The Life of Johnson”, a biography of his friend Samuel Johnson – people were at that time, known to brush their teeth with a powder that was made up of mainly burnt bread.

Colgate started to mass produce toothpaste in jars

Not much of significant occurred then,  until much later in the 1850’s when John Harris then added chalk, and in 1873, when Colgate started to mass produce their soap-based toothpaste in jars.

Before toothpaste as we know it today, people tried several different things to clean their teeth such as, eggshells, ash, ground oyster shells, salt and various other abrasives.  

The poor continued to use these in the late 1800s and even soot has been described as a cleaning agent – although I can’t imagine teeth were very white following this.

Although most people probably think that the desire to have whiter teeth as one of those distinctly modern obsessions, yet people wanted whiter teeth over 100 years ago too.

The Johnson & Johnson brothers made something to fill that desire.  In the late 1800s, Johnson & Johnson made a tooth cream called ‘Zonweiss’, which means “white teeth” in German.  ‘Zonweiss’ was packaged in small jars and sold in drugstores or by mail order and had a catchy promotional “poem”. 

Consumers applied it to their toothbrushes with a small spoon that came with each jar.  ‘Zonweiss’ was advertised in major magazines of the day, including Harper’s Magazine. 

‘Zonweiss’ was advertised in major magazines

The other benefits of toothpaste and tooth cleaning may have very profound associations to other body diseases.

Anyone seeking health and longevity will be interested in the balance and understanding of inflammation and antioxidants. An imbalance can accelerate the formation of free radicals.

Free radicals are unstable compounds and evidence indicates these contribute to ageing and disease, including periodontal or gum disease (PD).

This delicate balance can be disturbed by trauma, stress, exercise, nutrition, degenerative diseases, immune disturbances and hormonal imbalance.

Gum disease (PD) is initiated by the colonization of gums by bacterial pathogens resulting in host tissue damage due to free radical production.

Studies have reported a significantly reduced total salivary antioxidant capacity in PD patients; hence damage is heightened in individuals with PD because of the lack of adequate antioxidant defense.

An imbalance between antioxidants and pro-oxidants may result in cellular damage even predisposing toward cardiovascular and other oxidative stress and oral/dental diseases, particularly PD. 

Nearly 20 years ago, it was reported that PD is associated with lower antioxidant capacity in whole saliva and lower antioxidant concentrations in the gingival crevicular fluid contributing to  increased damage to the gums and surrounding structures.

Oral cancer is the sixth commonest malignancy in the world. Free radicals such as ROS and reactive nitrogen species (RNS) that induce oxidative and nitrosative stress are main contributors to oral carcinogenesis.

Oxidative stress plays an important role in the pathogenesis and complications of diabetes too. Oxidative stress is increasingly recognized as one of the major factors contributing to the chronic inflammatory process such as rheumatoid arthritis too.

Removing potential causes of oxidation and a diet rich in antioxidants with dietary supplementation with antioxidants are, I believe, both prudent ways forward.

Since saliva reflects general health status of the human organism and is easy to collect, it can be used as a non-invasive diagnostic tool of the markers that reflect oxidative attack.

Already we are beginning to look at inflammatory markers in blood, but one wonders if salivary inflammatory biomarker (chemical mediators) screening may become an adjunct to the biomarkers (bacteria) some offices provide and opportunity to enhance dietary antioxidants. Maybe dentists will be providing this screening test in their offices one day?

The evaluation of oxidative stress status is proposed as an important factor in diagnosing the development and progress of such general diseases as periodontal disease, oral cancer, diabetes, rheumatoid arthritis, chronic renal failure, obstructive sleep apnea syndrome, and HIV.

Measurement of oxidative stress in salivary fluid may provide a tool for diagnosing, monitoring and treatment of some systemic diseases as well as of local pathologic disturbances such as periodontal disease (PD).

Good sleep is crucial to good health and longevity.

Dr. Stephen Bray 2020

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