Most Replayed Moment: Don’t Brush Your Teeth After Sugar! The Best Oral Care Routine

Dr Victoria Sampson is a leading integrative dentist, researcher, and founder of The Health Society clinic in London. She is internationally recognised for her pioneering work on the oral microbiome and its links to systemic health. In today’s Moment, Dr Sampson reveals the link between oral bacteria and cancers, and how your daily habits - like when you brush your teeth or what you drink - can significantly influence your oral microbiome. She shares practical tips to protect your mouth and the domino effect that can have on your overall health. Listen to the full episode here: Spotify: https://g2ul0.app.link/cB5kBuhQ4Xb Apple: https://g2ul0.app.link/m1rg8qkQ4Xb Watch the Episodes On YouTube: https://www.youtube.com/c/%20TheDiaryOfACEO/videos The Health Society Clinic: https://www.thehealthsociety.co.uk/

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Steven Bartlett?

  I was reading about a study in mice that linked that oral bacteria to tumour growth. Are you familiar with that study?

• 0:11Speaker 01

  Yes, and it's that specific oral bacteria, so the Fusobacterium nucleatum, which has been shown to accelerate tumour growth within mice, but also for colorectal cancer and breast cancer as well.

• 0:22Steven Bartlett?

  And what's your belief there? I know this research is fairly new, but do you think there is a causal relationship, a significant causal relationship between the health of our oral microbiome and our probability of developing some form of cancer?

• 0:35Speaker 01

  I wouldn't yet say causal. I think that for most cancers, it is multifactorial and there are a lot of things that can impact whether or not you get the cancer and how aggressive the cancer is. I do think that oral health and some specific oral bacteria are risk factors and can definitely increase the aggression of those cancers or even the initiation of them. There's also been research, and I think I'm waiting for the research to be published, on what they're doing is they've created an antibiotic which only kills that oral bacteria that I was talking about, so Fusobacterium nucleatum.

• 1:18Speaker 01

  And they are going to be issuing that antibiotic to those patients who have the colorectal cancer, which has the oral bacteria, to see whether or not it slows down their progression or improves their prognosis. So if I see those results and it shows it, then there's for sure a strong causative link between the two, but for now, I would say that it's multifactorial and it's definitely a risk factor.

• 1:42Steven Bartlett?

  That oral bacteria that you're describing, that you called it Fusobacterium?

• 1:45Speaker 01

  Yeah.

• 1:46Steven Bartlett?

  What is it that causes that? Is it something that I'm eating? Is it a lifestyle choice I'm making?

• 1:51Speaker 01

  Uh, multiple things, poor oral hygiene. Um, some of us genetically will have higher levels of it. Um, it's what we eat, it's who we're kissing, it's what we're breathing in.

• 2:01Steven Bartlett?

  Does my girlfriend have it?

• 2:04Speaker 01

  So we'll have to see. Um, but it's, uh, and that's the thing, that's the beauty of being able to test these things now is that you can actually see. And also what's, it's strange is that green tea, um, you know, something so simple is extremely effective at killing fusobacterium nucleatum. So it's just knowing those types of things, being able to do the test, knowing the right treatment plans and recommendations based from that, we know green tea is good for us. And now we can really understand why.

• 2:30Steven Bartlett?

  Okay, that's interesting. You, you have actually tested Jack over there, right? And you said to me before we started recording that he's got a ton of that fusobacterium.

• 2:38Speaker 01

  Uh, yes, he does. Yeah.

• 2:40Steven Bartlett?

  And it's really getting out of control, is what you said.

• 2:41Speaker 01

  It's really badly out of control. So I've, um,

• 2:46Speaker 01

  I've given him a, a big vat of green tea as a gift.

• 2:49Steven Bartlett?

  Green tea?

• 2:50Speaker 01

  Yes.

• 2:51Steven Bartlett?

  Green tea?

• 2:53Steven Bartlett?

  This guy's gonna edit that out. This is the problem.

• 3:01Steven Bartlett?

  Green tea?

• 3:02Speaker 01

  Yeah.

• 3:02Steven Bartlett?

  That's good for my oral microbiome?

• 3:03Speaker 01

  Yeah, really good. Stains, but really good. Um, it's anti-inflammatory. Um, it helps with what we call oxidative stress. So this is, um, basically stress for the body. Um, and it's antibacterial. So it actually is very effective at killing fusobacterium nucleatum.

• 3:20Steven Bartlett?

  What is your opinion of the impact that coffee has on my oral microbiome?

• 3:25Speaker 01

  I'm slightly biased because I love coffee.

• 3:27Steven Bartlett?

  Okay.

• 3:28Speaker 01

  But there is no negative impact of coffee on the oral microbiome directly. Um, coffee does dry your mouth out. Um, and so you have reduced saliva and that can actually Cause problems for the oral microbiome. So the saliva is super important in your mouth. It provides all of the food, the proteins, everything for the bacteria in your mouth. So it's kind of like this delivery service, your delivery is travelling around, providing all of the food and bacteria, um, sorry, food to the bacteria. And that's what keeps the good bacteria alive and happy. So when you have a dry mouth, let's say you're drinking lots of coffee

• 4:07Speaker 01

  or you're very nervous or you are on antidepressants, for example, um, which are a big one, then you just don't have as much saliva. So you, those bacteria don't have as much food and those bacteria die and then you get bad bacteria growing in replacement.

• 4:23Steven Bartlett?

  What about tea? We're a nation of tea drinkers in the UK.

• 4:26Speaker 01

  Um, similar. So it also does dry your mouth, not as bad as coffee, but otherwise no problems other than staining.

• 4:32Steven Bartlett?

  What about if I put loads of sugar in it? Cause a lot of people put a lot of sugar.

• 4:35Speaker 01

  Okay, yeah, no, no, no, never, no, no. So actually, sugar in your tea is even worse than you having a biscuit, for example. Um, so because the sugar dissolves in your hot tea and the tea is hot, when you drink it, um, it can actually cause more problems. Uh, another thing with sugar is, um, I have a sweet tooth, I love sugar, but it's about how you eat your sugar. So let's say if you have your hot tea with five lumps of sugar in there and you're sipping it over an hour or two, that's where you start to see a lot of problems. So actually you need to be having a sugar attack. So just all the sugar in one go. And that way your mouth has all the sugar in one go and it's able to neutralize the saliva and get back to a good state as quickly as possible.

• 5:19Speaker 01

  Every time you sip your, your tea with sugar, what happens is that the saliva has to go from acidic, back to neutral acidic, back to neutral acidic. And then it starts to just not work properly and the saliva just stays acidic and that's where you start to see decay.

• 5:33Steven Bartlett?

  So you wanna just down the tea?

• 5:35Speaker 01

  Down the tea or I don't know if you're a M and M guy, have all your M and M's in one go. Don't snack on M and M's every ten minutes.

• 5:42Steven Bartlett?

  What about other drinks like, I don't know, you know, Coca Colas and these other sort of fizzy drinks that might have artificial sweetness in, things like that?

• 5:50Speaker 01

  So they're not as bad as your natural sugars. But for example, something like your Coke or Fanta or whatever, it's also very acidic. And it can actually cause erosion as well. So this is essentially where the outer layer of your tooth, so the enamel, is just worn away from having lots and lots of these fizzy drinks.

• 6:11Steven Bartlett?

  So what are the very, having seen my results, but generally from seeing the thousands and thousands of results that you've seen.

• 6:17Speaker 01

  Yeah.

• 6:18Steven Bartlett?

  What are some of the easiest things that I could do to help correct that situation and have perfect oral health and a perfect oral microbiome?

• 6:28Speaker 01

  So what we've done is if you were to do the test, you would have all of the personalised recommendations for you. So we tell you to have green tea, to have honey, all of those types of things, which have been shown through research to benefit your microbiome, in your case specifically. But if we were just talking about someone who hasn't done the microbiome test and wants to just make sure that they have as balanced of a microbiome as possible, diet is obviously very important. So what we're talking about, that sugar attack, making sure that you only have one sugar attack a day, you're not having sugar consistently because it does alter your saliva pH. The type of toothpaste that you're using, I like to keep it simple. You don't need to, we don't need to make things super complicated. You don't have to spend that much money.

• 7:13Speaker 01

  Having the right toothpaste, right toothbrush and the right floss is honestly as much as, is the most necessary thing that you need.

• 7:22Steven Bartlett?

  Okay, so in terms of brushing though, you give some sort of practical advice around when we should brush. What is that? And is there any time where I shouldn't brush my teeth?

• 7:31Speaker 01

  You should never brush straight after anything acidic or sugary. So what you end up doing is grinding the sugar or the acid into your teeth.

• 7:42Speaker 01

  So actually, you should wait thirty minutes until you brush your teeth.

• 7:45Steven Bartlett?

  That's interesting, because when I eat something sugary, I feel like I need to brush my teeth to get rid of it.

• 7:49Speaker 01

  Yeah, no, no. So you want to wait thirty minutes. So instead, you can chew some sugar-free gum. Or there are lots of pastels that we use. So like, I use like chewable mints. And you can chew one of those, and it will actually neutralize your saliva really quickly. So that you don't have that acid causing the demineralization.

• 8:09Steven Bartlett?

  And you said that I should brush my teeth first thing in the morning and last thing before I go to bed?

• 8:13Speaker 01

  Yes.

• 8:14Steven Bartlett?

  Okay, just because that's the sort of biggest window, I guess, that's the best way to.

• 8:18Speaker 01

  Yeah, the most important time to brush your teeth is right before you go to bed. Because you spend two minutes spreading all this lovely goodness on your teeth. And then when you go to sleep, going back to saliva, when you sleep, your saliva flow reduces massively. So all of a sudden, these bacteria are left to their own devices. And if you don't have good toothpaste there, then they can cause a lot of problems.

• 8:39Steven Bartlett?

  And do I spit or do I rinse after I've brushed my teeth?

• 8:43Speaker 01

  Spit. So you should never rinse your mouth out with water after you brush your teeth. So. Brush, brush, brush, spit into the basin, and that's it. Reason being, again, going back to my sunscreen analogy. Imagine you spend two minutes putting all this lovely sunscreen all over your skin. To then just go and have a shower right before you go into the sun. So with the toothpaste, you spend two minutes putting all of that on your teeth. And then if you rinse it, then you're actually removing all of that goodness from your teeth and gums. And it's kind of like you haven't done anything.

• 9:14Steven Bartlett?

  Toothbrushes?

• 9:15Speaker 01

  Yes.

• 9:16Steven Bartlett?

  Which toothbrush should I use? This one or an electric one?

• 9:20Speaker 01

  I generally prefer an electric toothbrush.

• 9:22Steven Bartlett?

  Why?

• 9:23Speaker 01

  Usually, they kind of do the work for you. So it just means that. Patients have better oral health, because most people don't know how to brush their teeth properly, actually. We're never really taught or trained, or we get taught by our parents. Our parents don't really know. They've been taught by their parents. So a lot of people don't actually know how to brush their teeth, number one. Number two, we often don't brush for as long as we think that we are. So we're meant to brush for two minutes. The average is twenty to thirty seconds. And we think that we're brushing for two minutes, but we're not. So with an electric toothbrush, it times you. And then also a pressure sensor. So the electric toothbrush often will have a pressure sensor. Which will show you whether or not you're brushing too hard, or you're brushing at the right pressure. And that will reduce your chance of recession.

• 10:05Steven Bartlett?

  Can you show me on one of those tooth models in front of you, the area of the mouth and teeth that people most often overlook?

• 10:13Speaker 01

  Yes. Can I have your teeth?

• 10:15Steven Bartlett?

  Yes.

• 10:17Speaker 01

  So I would say the area that people usually um struggle with the most is the insides of their very back bottom teeth.

• 10:25Steven Bartlett?

  So inside, where, where, next to my tongue?

• 10:27Speaker 01

  Basically, yeah, just near your tongue, basically. What a lot of people will do is they'll kind of, they'll go on the inside, they brush their teeth like this. Okay, whereas actually you want to get your elbow up and you want to brush a lot more like a ninety degree angle when you're getting there.

• 10:41Steven Bartlett?

  It looks like you're brushing the gums a little bit.

• 10:43Speaker 01

  A little bit, yes, you actually do want to brush the gums a little bit. And then when we're on the outsides of the teeth, uh we want to kind of brush at a thirty degree angle. So rotational movements and at a thirty degree angle, so not straight like a ninety degree, but kind of towards the gum margin. And by doing circular mo- uh movements, we're essentially kind of massaging the gums and getting rid of the bacteria from under the gum and then flicking it out.

• 11:05Steven Bartlett?

  Okay.

• 11:06Speaker 01

  Yeah, so just like that. And then I always tell everyone it's really important to kind of have a method behind your tooth brushing. So don't go like brush and then go there and then up there and, you know, because you'll never brush properly. Um, so always start, let's say, on the left hand side, go do all the outsides and then do all the biting surfaces and then do all the insides and then do the same on the top teeth as well.

• 11:28Steven Bartlett?

  And that model there, you've got another model in front of you, which is like a see-through model. What does that show us?

• 11:34Speaker 01

  Um, so this is to show you um what an implant looks like. A lot of people don't know what implants look like um and how it looks like if it was within your jaw, also what all the roots look like. And then also, if you look on the other side, you can see um this tooth which has the black within it.

• 11:49Steven Bartlett?

  Yeah.

• 11:49Speaker 01

  Um, and it's got like a red bubble at the root of it. So this is a tooth that's had a root canal done to it and has an infection at the root of that tooth. So that's an abscess. Um, and a lot of people don't actually know what that looks like. Um, they only feel toothache, but this is what toothache is actually in their jaw.

• 12:05Steven Bartlett?

  When our teeth get teeths, is that the right word? Is that a plural? When our tooth, what's the plural of teeth?

• 12:11Speaker 01

  Just teeth, yeah.

• 12:12Steven Bartlett?

  Yeah. When our teeth get stained.

• 12:14Speaker 01

  Yes.

• 12:15Steven Bartlett?

  What we often do is we'll take some sort of whitening toothpaste or we'll go to a dentist or a hygienist or something and ask them to whiten our teeth. Now, I've always been a bit scared of that because. There must be a cost to this whitening industry. Should we be whitening our teeth? Is there any healthy way to whiten our teeth?

• 12:33Speaker 01

  Yes, um, so you've got two different types of staining. One, which is extrinsic, so that's basically your coffee, your tea, your smoking. Super easy to get rid of. You just have to go to your hygienist and get a hygiene done and they'll get rid of the stains pretty quickly. Or you can try a whitening toothpaste. Be very careful with a lot of those whitening toothpaste because they can be quite abrasive and damage the enamel, actually. So it's kind of like exfoliating your teeth, but your teeth don't grow back. So if you keep on exfoliating and getting rid of that surface layer of enamel over a long amount of time, that can be quite an issue and quite problematic.

• 13:09Steven Bartlett?

  You get sensitive teeth.

• 13:10Speaker 01

  Yeah, sensitive teeth and then the underlying tooth will start to shine through and that's quite yellow. So you actually start ending up doing the opposite of what you wanted to do. Then whitening, so you could, you should do that professionally. Don't go and buy some over the counter online thing. Because a lot of the time, either they don't have the right percentages and they can actually damage the teeth and the gums really badly. So you want to get that done professionally. If you get it done by a good brand, and even within the professional world, there are some whitening products out there which are really bad for the teeth and others which are actually really good for the teeth. So we use one in particular, it's called Enlighten.

• 13:51Speaker 01

  And the whitening for one day is the equivalent of having a Coca-Cola. So thinking about it, I mean, I'm sure everyone has had one Coca-Cola in their life. Having a Coca-Cola every day for, let's say, five or six days is okay in the grand scheme of things. It's not going to massively damage your teeth at all.

• 14:10Steven Bartlett?

  Okay, so there is safe ways to do it.

• 14:11Speaker 01

  Yeah.

• 14:11Steven Bartlett?

  Okay, good. And is there any way to remove plaque yourself without having to go to a dental hygienist?

• 14:17Speaker 01

  So you can try a water flosser.

• 14:19Steven Bartlett?

  I've just bought one of those things, but it doesn't feel powerful enough. Because when I go to the hygienist, I don't know what they're using, but it like, it like, it's so strong.

• 14:27Speaker 01

  Yeah.

• 14:28Steven Bartlett?

  That it like blasts my mouth off. My mouth feels so different after.

• 14:31Speaker 01

  Yeah.

• 14:32Steven Bartlett?

  And I wanted to know if I could buy one of those for my home. But I think it's a little bit dangerous.

• 14:36Speaker 01

  Well, the reason I think that the water flosses are not that high intensity is because people can damage their teeth if they don't use it correctly. So kind of know there are some supplements that you can take to reduce the amount of plaque that builds up.

• 14:52Speaker 01

  And that actually does work quite effectively.

• 14:54Steven Bartlett?

  I mean, what are you, there were two more there. There's a couple more things there that you have in your pile that we not talked about.

• 14:59Speaker 01

  These are probiotics.

• 15:00Steven Bartlett?

  Okay.

• 15:01Speaker 01

  So going back to our microbiome, probiotics are basically good bacteria. So not everyone needs them, but a probiotic essentially will put good bacteria into the microbiome. And if it's got the right environment to live in, then it will continue to grow there, basically.

• 15:17Steven Bartlett?

  If you're eating the right things.

• 15:18Speaker 01

  Exactly. If you're eating the right things, you've got prebiotics, you know, all of those types of things, then then this will be really effective. So these are two different options. This is a mouthwash. And again, on the microbiome test that we've created, ORALIS ONE, we look at all the levels of good bacteria and then we'll recommend a probiotic based on what good bacteria you are missing. So a lot of us are actually genetically, we've been born without certain good bacteria in our microbiomes. And so this is really lovely to supplement them. So this is, it's a mouthwash, but it's in a powder form. So you take a teaspoon, you mix it with some water and that activates the probiotic and then you rinse it around and you swallow it. So it's a kind of a two in one for your gut.

• 16:00Speaker 01

  This is a pill, so it's a tablet, you chew it and then you can swallow it. So this is a, this is super easy to, and, and I love these as well, very easy to use.

• 16:10Steven Bartlett?

  Victoria, what's the most important thing that we haven't talked about today that we should have talked about today?

• 16:16Speaker 01

  The only thing that I think you haven't mentioned that your viewers might benefit from is the use of straws. Straws are very, very important to, to use for sugar and also for acid. So drinking through a straw actually helps you bypass all of your teeth. So if you're having something acidic or really sugary, or even something staining, then it bypasses the teeth and goes straight to back of your throat. So you can swallow it. So this helps reduces your chance of decay of toothwear and also staining as well.

• 16:45Steven Bartlett?

  But specifically if it's bad for you, because you, I'm sure there's some things which are good for the oral microbiome that you do want to be in the mouth.

• 16:51Speaker 01

  Yes, yeah, yeah. So if you're taking your probiotics or whatever, then of course those are great. Like for example, you know, I'm human, I like a nice Coca-Cola once in a while and I'll drink it through a straw. Um. Or if I have alcohol, I'll also drink that through a straw as long as it's not wine, but.

• 17:07Steven Bartlett?

  About smoking and vaping?

• 17:09Speaker 01

  Um. So, yes, smoking and vaping, neither of them are good for the oral microbiome. Um. It goes back to um dry mouth. So smoking will dry your mouth out and then you don't have the saliva and the saliva can't do what it wants to. It stops um vascularisation, so it stops blood flow to your mouth. And so a lot of uh smokers actually will not have bleeding gums. That doesn't mean that they don't have gum disease. But because they um are smoking so much, the blood vessels are already really tight and constricted from the nicotine. Um. So they don't ever get bleeding gums, even though they have gum disease. Um. And then the third thing is that actually we know that smoking is very strongly associated, it's one of the biggest risk factors for gum disease.

• 17:53Steven Bartlett?

  If someone's now curious about their oral microbiome and the work that you're doing, what is the sort of easiest entry point to learn more, to get themselves checked or to, I don't know, to resolve some of the issues that are causal or a consequence of having a unhealthy microbiome? Where where do they start? How do they find you?

• 18:12Speaker 01

  We have a clinic in central London called the Health Society. Um. We opened about a year and a half ago now, and our aim was to put the mouth back into the body, to explain to patients exactly what's going on in their mouth. And we can do that through microbiome testing, other saliva tests. Um. We look at your blood glucose levels, your vitamin D levels, we've got packages, we have an infrared sauna, we have a nutritionist, and the idea is that we're working all together. Because one of the issues I was seeing was that patients, they want to understand what's going on in their mouth and they want to optimise it, but they don't understand a lot of what dentistry is all about. We used to live in a world where the dentist would say, okay, you need two fillings and you've got gum disease and you're not brushing your teeth,

• 18:55Speaker 01

  and that was the end of it. And you would just listen to them and you'd get your work done. But now we are trying to essentially decode dentistry and explain it in a way that patients can understand. So I would say, I'm biased, but come over, come to the clinic, we can explain everything. Um. Or you can do an oral microbiome test and you can actually understand yourself, what bacteria, what genetic mutations you have, what inflammation you have, what products you should start using. And then based on that, decide on what dentist you want to go to for any treatment if needed.

• 19:24Steven Bartlett?

  What if I'm in Australia or Canada or New Zealand or America? What can I do?

• 19:28Speaker 01

  So we're actually rolling out the oral microbiome test to all of those countries. So you can actually buy it at the moment through that. You just have to email us, but otherwise, you know, I'm not the only one. There are other people who are doing this type of dentistry and are thinking in this type of way. So you would have to do a little bit of research, but I guess maybe follow me on Instagram and I can give some top tips.

• 19:52Steven Bartlett?

  And if we sit here in 10 years' time, what are you hoping the world looks like as it relates to the oral microbiome? People's understanding of the regulations? What are you hoping for? If you could wave a wand.

• 20:02Speaker 01

  I am hoping that the mouth is put back into the body in the sense that dentistry and medicine are fully integrated within each other. So you can go to your dentist and you can get a saliva test and that could flag up issues with your heart or diabetes. And you will go and see your diabetologist and we link everything together. Also, my other dream is that people start testing their saliva and they understand that, you know, blood is not the only way that we can understand things that are going on within our body.

• 20:34Steven Bartlett?

  What you just listened to was a most replayed moment from a previous episode. If you want to listen to that full episode, I've linked it down below. Check the description. Thank you.