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0:38

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0:41

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0:43

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0:46

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0:48

today, we're going to be talking about a very underrated part

0:51

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0:53

fascinated by our teeth? How do we make

0:55

them better? How do we make our mouths

0:57

more healthy? What can we do, and what

0:59

are we doing wrong? I'm going to be joined by

1:02

Dentist to the Stars, Dr. Rona

1:04

Eskander, and she's going to be giving us the truth

1:06

about cosmetic dentistry and general

1:09

tips on how to keep our teeth healthy. I'm also

1:11

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1:40

If It Ducks Like A Quack. In this bit of the show,

1:42

I'm going to be taking apart all of those medical

1:44

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1:46

But first, we've got What The Health. Let's see

1:48

what crazy new offerings we have in

1:50

the world of science.

1:59

face now with cancer is that although

2:02

we've got amazing scanning technologies like

2:04

PET scans and MRIs and CT scans

2:07

and we've also got amazing cancer drug therapies

2:09

and surgery, we still have the issue

2:11

of cancer recurrence. The cancer can

2:13

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2:16

with with any chemotherapy or radiotherapy

2:18

or things like that. It comes back and

2:20

then we face the same problem with dealing with cancer

2:22

again. And there are many reasons for this. There are just

2:25

some types of aggressive cancers which recur.

2:27

They come back because even one

2:29

cancer cell, if it remains in the body and isn't

2:32

cleared, can grow again and

2:34

cause the same large tumor

2:36

if it's allowed to propagate. Because when we offer

2:38

surgery or we use targeted therapies

2:40

like radiotherapy or chemotherapy

2:42

to attack the cancer, it's

2:45

directed against the large clusters

2:47

of cancer cells and the large tumors that

2:49

we can see macroscopically.

2:52

We can see the entire cancer has been removed,

2:54

but we can't see if the microscopic

2:57

cancer or the individual cell

2:59

clusters have been removed somewhere in the body.

3:01

We just don't know. And if they remain, like

3:03

I said, it could come back. Now

3:05

what's all of this got to do with a dead transparent

3:08

mouse? Well there's a team of scientists from the

3:10

LMU University Hospital in Munich which have

3:12

come up with a weird new

3:14

scanning technology called WILD DISCO.

3:17

First the scientists give a cocktail of chemicals

3:19

to strip the dead mice of

3:21

their fat and their pigment so they turn

3:23

into this weird biological

3:26

glass mouse model and then they can flood

3:28

this transparent mouse with fluorescent

3:30

antibodies to light the entire thing up and

3:32

give an unprecedented amazing

3:35

detailed image of the internal

3:37

body of the mouse. And this new high resolution

3:40

scanning technique could help us identify these

3:42

single clusters of cancer cells which

3:44

otherwise would not have been spotted. This allows

3:47

scientists to determine how cancer spreads

3:49

and how it grows but also improve

3:51

our cancer drug specificity. Now

3:54

this is obviously really groundbreaking and very

3:56

interesting but there's still a long way to go because

3:58

this technique of making making dead mice

4:01

transparent obviously only works in mice.

4:03

We can't make humans transparent because that

4:05

would kill them, which obviously defeats the purpose

4:08

of what we're doing. But if we can understand

4:10

a bit more about the biology

4:12

of cancer, how it spreads, we can make

4:14

even more targeted cancer therapies

4:17

to target those tiny hidden

4:19

cancer cells to reduce the risk of recurrence.

4:22

So watch this space.

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Why were medieval priests

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5:57

Join me, Kate Lister, on

5:58

Betwixt the Sheets, the history of... of Sex, Scandal

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6:33

Dr. Rona Escanda. Hello.

6:36

For someone listening and watching this, who

6:39

are you and what do you do?

6:40

So, my name is Dr. Rona, as you said, you can

6:42

call me Rona if you want. I like Dr. Rona for my online

6:45

persona. I am a dentist

6:47

based in Chelsea. I have a practice.

6:50

I have a very long story about my practice,

6:52

but in short, I own a practice with 22

6:54

members of staff. Yep.

6:57

And I'm also one of the co-founders

7:00

of Parler toothpaste tabs, which is the eco-friendly

7:03

solution to toothpaste.

7:05

And I've lived in London my whole life. I'm

7:08

Middle Eastern, so half Egyptian, half Lebanese.

7:10

I resonate more with the Lebanese side if anyone knows

7:12

what that means. And that's me.

7:15

Brilliant. Obviously, you know, this podcast

7:17

is all about giving people actionable take homes

7:20

and tips about their health. It seems

7:22

to me that on the one side, people

7:25

worry about the appearance of their

7:27

teeth. And, you know, there's this whole realm

7:29

of cosmetic dentistry and whitening, which we'll get into.

7:32

But there's also the other side

7:34

of health, you

7:35

know, the oral microbiome and actual gum

7:37

health and teeth health that people seem

7:39

to underrate and not really get into.

7:42

What are some very basics that you'd recommend

7:44

a first time patient or client

7:47

that comes to you just in easy,

7:49

low hanging fruits that they can do just to improve

7:52

their mouth cavity health?

7:54

I love that question because as you probably know,

7:56

we're going through a really bad time at the moment.

7:58

We're going through an NHS crisis. where people don't

8:00

have access to dentists. And

8:02

actually, dentistry is one

8:05

of those parts of medicines where people don't recognise

8:07

the importance of prevention. Some people that have

8:09

found themselves with severe gum disease or decay

8:11

have said, I was born that way. It's

8:14

genetic. And although there may be a genetic component

8:16

to the teeth, a lot of the diseases are actually

8:18

preventable with good diet and

8:21

good oral hygiene. But nothing

8:23

has actually been done, I think, within

8:25

the NHS or even in this country as

8:28

a whole to really kind of put that focus

8:30

on prevention. I think you know that as well as a doctor with

8:32

other parts of medicine. But some

8:34

of the things that you can do is brush twice a

8:36

day every day. It's the first thing in the morning and the

8:38

last thing before you go to bed, which is really important.

8:41

Forget that. Brush before breakfast and not after

8:43

breakfast. I know you did this debate and got

8:45

into a debate. I'll go into that. I'll go into

8:47

that. But ultimately with it, if

8:49

you wait 20 to 30 minutes after

8:52

breakfast, it's okay. But realistically, we're living

8:54

very hectic lives and we're doing from one

8:56

thing to another. I think the easiest things

8:58

to do is

8:59

when you get out of bed, just brush your teeth. Why? Because

9:02

the toothpaste that you use will provide protection

9:04

to breakfast foods.

9:06

So the acidic foods and drinks

9:08

from breakfast. Correct. And so you should

9:11

be using a toothpaste that has a minimum

9:13

of 1,400 parts per million fluoride. So

9:16

you can find it on the back of the box

9:18

or, you know, toothpaste tablets, whatever you

9:20

choose. That's the most important ingredient in toothpaste.

9:22

Correct. And most people think that fluoride

9:24

is bad for you. Conspiracy theorists 101. Yeah.

9:28

Kanye, I think, was the first one that I like. Really? I

9:30

love Kanye. He's the one that

9:32

put the idea out. But you want to use that.

9:35

And what happens is when you have your breakfast food,

9:37

so whether that's orange juice, cereals, etc., what

9:39

it does is it lowers the pH in your mouth.

9:42

So the fluoride

9:43

in the toothpaste and the ingredients help

9:46

neutralize the acid and provide protection

9:48

from those foods causing an acid attack on the teeth,

9:50

as it were. Clean in between your teeth. That

9:52

can look like floss, teepee brushes, a water

9:55

flosser. What's a teepee brush? The teepee

9:57

brush that everyone says they look like little toilet brushes. They're

9:59

the ones that...

9:59

Okay, little tiny bristles. Yeah. And

10:02

different colors prescribes like the different

10:04

size gaps that you've got essentially, but cleaning between

10:06

your teeth is really important.

10:08

Drinking plenty of water as well. Water is going to

10:10

be a better substitute for you than having like

10:12

fizzy drinks, diet, coke, sports drinks,

10:15

et cetera. Frequency is more important than

10:17

amount. What people don't realize is that constantly

10:19

sipping on sugary drinks or acidic drinks

10:21

is actually more harmful for you than having it in one go. So

10:24

say, for example, you love coke. Yeah. And then what happens

10:26

is, is that during your meal, you have glass

10:28

of Coca-Cola and then you're done for that, for the day.

10:31

If you're sipping with that Coca-Cola, what happens

10:33

is your mouth is in a constant state of low pH and

10:35

acidity, which allows the enamel

10:37

to soften. And it means also for the bacteria

10:40

to cause holes in your teeth. So actually

10:42

just having that can of coke and then just

10:44

like getting on with your day or having

10:46

water for the rest of the day for much better. So

10:48

minimize contact with the teeth? A hundred percent.

10:51

Um, straw obviously goes without saying. The other

10:53

thing is, is chewing sugar-free, chewing

10:55

gum with xylitol. People don't know this. So people

10:57

go, but what about my jaw? Because obviously it has an effect

10:59

on what we call the TMJ. The TMJ is your

11:02

jaw. Um, but sugar-free chewing

11:04

gum is great way to neutralize acid. So

11:06

obviously it's actually got ingredients to help neutralize

11:08

it. So I always chew on sugar-free chewing

11:10

gum just to neutralize the food

11:13

that I've had or anything acidic, et cetera. It

11:14

just brings out more saliva and helps to... Yeah, and xylitol is

11:17

actually, um, anti-ocaragenic.

11:19

So it actually does prevent decay as well. Really? Yeah, yeah.

11:21

Sugar-free chewing gum. Yeah, with xylitol.

11:23

And just, you know, more about the kind

11:25

of brushing routine. Occasionally I go in these

11:27

little rabbit holes about, you know, teeth and stuff.

11:29

Yeah. I read somewhere that the perfect

11:32

angle of using your toothbrush is sort of 45

11:34

degrees. Modified BASC. That's

11:36

what it's called. Modified BASC. BASC.

11:38

BASC. BASC. So is that so the toothbrush

11:41

doesn't start brushing into your gums and just targeting

11:43

the teeth only?

11:44

So that's a great question. Now, with regards

11:46

to technique, it's absolutely important. So not

11:48

only is that technique, but it's about the type of toothbrush

11:50

that you use. So we always say a medium bristled

11:53

toothbrush. That means not too soft and not too

11:55

hard. Why? Because too soft won't

11:57

provide that mechanical action of removing plaque.

12:00

and too hard means that you could actually end

12:02

up scrubbing away your gums and your teeth. And some

12:04

people have suffered from gum recession. So

12:06

what they've done is they've put so much pressure,

12:09

you know that classic kind of motion where you're going like

12:11

this.

12:11

Yeah, you're really going for it. Exactly, you can end up

12:13

causing gum recession, especially if

12:15

you have what we call a thin biotype, so that

12:17

your gums are naturally more thin than somebody

12:19

that has a thicker biotype. The best thing

12:21

you can do really is an electric toothbrush. Why? Because

12:24

the electric toothbrush heads means that you're not exerting too

12:26

much pressure on the teeth and the gums.

12:28

Automated, gentle pressure. Correct, and

12:30

also some of them have a bounce back. Some of them have

12:32

sensors to alert you that you're brushing too

12:34

hard. And you should put them on the gums

12:36

and the teeth as well. So always brush the gums

12:38

and the teeth. Again, people forget that. So a lot of people

12:40

don't do that, brushing the actual gums itself.

12:42

Correct. And the tongue, gonna brush the tongue as well? Yes,

12:45

but the modified bass is, as you said, a 45

12:47

degree angle which brushes the gums and the teeth

12:50

and ensures that you don't overbrush.

12:52

So that's why, but how many people are going to really

12:54

pay attention to that 45 degrees? That's why

12:57

we say make life simple and buy an

12:59

electric toothbrush so that you know that it's doing the hard

13:01

work for you. Now,

13:04

we've taken it a step further because we've recognized

13:07

the importance of the oral microbiome. As

13:09

you said, the oral microbiome has massively

13:11

been overlooked. When we think about

13:13

gut health, we think about our gut microbiome,

13:16

right? I'm one of those people that massively

13:18

brought probiotics and has suffered

13:20

with my gut. And then when we did

13:23

more research, we found that the oral microbiome

13:25

is key. So you can actually enhance your oral

13:27

microbiome, tip in the favor

13:29

of the good bacteria versus the bad bacteria

13:32

by providing a oral probiotic.

13:34

I think, yeah, and that's

13:36

the thing. I mean, people have

13:39

those buzzwords gut health and gut microbiome,

13:41

but actually they fail to recognize that

13:44

the microbiome is on every

13:46

surface and inner cavity in

13:48

our bodies, from our skin to our mouth to

13:50

our gut. And the bacteria

13:53

that are in your mouth have similar requirements

13:55

to the bacteria in your gut. I

13:57

often tell patients that I see that you need... prebiotic

14:00

fibers, and similarly your mouth, if

14:02

you have a high vegetable

14:05

or fiber content and you're chewing

14:07

it, you basically create that mulch and

14:09

that compost for the bacteria in your

14:11

own cavity to then feast on and do

14:14

the good stuff. Now, I wanted

14:16

to ask you specifically about this

14:18

thing. Some of the bacteria

14:20

that we have in our mouths

14:23

are involved in the production of nitric

14:25

oxide, which contributes

14:27

to regulating our blood pressure in other parts of

14:29

the body.

14:29

Because

14:30

it vasodilates and causes the blood

14:32

vessels to widen nitric oxide, which

14:35

helps to reduce blood pressure. So

14:38

anecdotally in some people who have got heart

14:40

conditions and high blood pressure, they may not

14:42

have good oral health, and these

14:45

bacteria which produce nitric acid may

14:47

not be flourishing. Exactly. So

14:49

I saw a video online of this complete

14:52

charlatan online talking about how

14:55

mouthwash is the worst thing ever

14:57

for your oral microbiome. Now, there's clearly

15:00

some kernels of truth here, but

15:02

when you're speaking to clients and patients about

15:04

mouthwash, what's your take on it? Is it

15:07

good, bad, or what's the nuance here?

15:09

This is exactly right what

15:11

you're saying. A lot of mouthwashes on the market,

15:13

I say it's a bit like using deodorant without

15:15

taking a shower. They don't want to do

15:18

the hard work as in like clean properly,

15:21

and they think that it can mask bad odors.

15:23

Okay, so that's what a lot of mouthwashes

15:26

have been geared towards. Now,

15:28

the problem is when you have bad breath,

15:31

there is a reason for that bad breath. So

15:33

for example, it could be gum disease. So

15:35

as you quite rightly said, if you have gum disease, the bad

15:37

bacteria are flourishing and can cause that

15:40

odor. It could be because you've got cavities

15:42

that have been untreated. Again, that contributes.

15:44

It could be other things, as you probably know,

15:46

like constipation. Have you got gut problems

15:49

that can contribute to bad breath? So just masking

15:51

it is not going to be a good thing. But

15:54

ultimately, you need to find out the cause of bad

15:56

breath, and the mouthwash really needs to

15:58

be non-alcoholic.

15:59

And as a kind of adjunct

16:01

to your brushing, it's absolutely fine. You know, there

16:03

was a recent article which came

16:05

out, a study looking at actually

16:08

those people who didn't

16:10

brush their teeth at a higher risk of brain

16:12

shrinkage, particularly in areas associated

16:15

with memory, like the hippocampus. They found that

16:17

the hippocampal volume, so the brain

16:19

region associated with memory, that volume was

16:22

reducing people who didn't brush their teeth. Now,

16:24

their hypothesis was probably

16:26

due to the bacterial concentrations,

16:29

maybe going out of kilter and out

16:31

of sink if you didn't brush your teeth.

16:33

And we know that bacteria have

16:35

effects throughout the body, systemic effects,

16:37

in the gut, the heart, the brain.

16:39

It's actually like the portal to the rest of the

16:41

body. That's what I say. And I think that people overlook

16:44

it a lot because they really separate dentistry

16:46

from medicine, but actually it's a part of medicine.

16:48

In a way, it's a bit of a specialist field, right? If you think

16:50

about it. Also, it's been linked to erectile

16:52

dysfunction. I don't know if you know that as well. No, I didn't. I've

16:55

gone with disease, more content for you.

16:56

Oh yeah, yeah, yeah. Brush your teeth, guys. Guys

16:58

out there, brush your teeth. We've just now

17:01

made the case as to how important

17:03

the mouth is as the kind of almost first

17:05

thing that most people have to

17:07

interact with their environment, that sensory organ. Why

17:10

is it then that in the NHS specifically,

17:14

we almost treat the mouth and the

17:16

oral cavity as an exception to the body. If

17:18

someone has a broken leg, they go

17:20

to the emergency room and get it fixed

17:22

for free on the NHS. But if someone

17:24

has a dental abscess or some

17:27

tooth problem, majority of people cannot

17:29

get free dental treatment. Why

17:31

is that?

17:32

Oh gosh, this is such an important

17:34

topic right now. And we are really in a national

17:37

crisis. In fact, the

17:39

average waiting list at the moment to have access

17:41

to an NHS dentist is about five years. It's

17:44

mad. And I think that we really need to go back

17:46

and understand. First of all, you said a really important

17:48

thing. Why is it treated differently? Well, I think unfortunately,

17:51

dentistry was never really considered with

17:54

the rest of medicine. So for example, the contract

17:57

that was set out and the system that has been created.

17:59

is not right and it's not fit

18:02

for purpose. Recently Rishi

18:04

Sunak came out, I don't know if you know this, about two weeks

18:06

ago and said that

18:08

NHS dentists, i.e. graduates,

18:10

are going to be forced to do NHS

18:13

dentistry for a certain period

18:15

of time. The president of

18:17

the BDA came out and said you cannot

18:20

force people or tie people to a

18:22

sinking ship. But let me talk

18:24

to you a little bit about the way the system works and this

18:26

is what it was like when I graduated. We

18:28

worked in a system called units of dental activity.

18:30

So that means say you needed 10 fillings

18:33

and you needed a lot more care than the person

18:35

next to you, Joe Bloggs, that needed one filling. That

18:38

dentist would get, I cannot say, remunerated,

18:42

exactly the same for those 10 fillings and those

18:44

one fillings. It doesn't take, so if your appointments

18:46

take over four appointments you get paid the same. It's

18:49

not sustainable to run a practice that way,

18:51

why? Because it doesn't account for the materials, the

18:53

staff, the time. But what happened was

18:55

that they put us on a treadmill. So I had to achieve

18:57

a certain number of UDA's a month or I just lose my job.

19:00

That means I had to do checkups in like 10 minutes

19:03

or I'd had to do fillings in 20 minutes and I

19:05

just couldn't provide the adequate care. I worked on the NHS

19:08

for 10 years. I was intended to work on

19:10

the NHS and it wasn't really an option to just

19:12

go private. But I suffered

19:14

from burnout. Dentistry has one of the highest

19:16

suicide rates of any profession if you know

19:18

that. And I was, you know, my mental health

19:20

was like hanging on a string and I just, I cannot do

19:23

this anymore. Now take it a step forward, 2020, the

19:25

pandemic. What happened during the pandemic,

19:27

as you know, you were allowed to work. We weren't

19:29

allowed to work. Yeah. You were given no guidance,

19:32

no guidelines. The government didn't tell us. So

19:34

you guys were dealing with, I'm sure you knew this

19:36

during the pandemic. Hey, I have a toothache. Well, I'm

19:38

a doctor. I'm not a dentist. People didn't know

19:40

what to do. They were just been given antibiotics. A

19:43

lot of reversible diseases like cavities

19:45

turned into irreversible diseases. So

19:47

those irreversible diseases become more expensive

19:50

to treat, right? Then when we were

19:52

allowed to be open, we had to work under such

19:54

horrible restrictions. So we had to allow for

19:56

fallow time. That means we could see less

19:58

patients.

19:59

So that means there was

19:59

was a backlog, a backlog, a backlog. This has

20:02

been building over three years. So eventually

20:04

dentists had to close the door to NHS patients

20:06

so we can't treat our own patients.

20:09

We're dealing with the irreversible diseases

20:11

that could have been treated, people missing checkups

20:13

and so forth during the pandemic. And

20:15

I think ultimately more and more people are feeling

20:18

that they can't work under this system.

20:19

So it's seemingly an insurmountable,

20:23

a climb now where you've got the backlog but

20:25

also the working conditions. How often

20:28

should people be seeing their dentist if

20:30

they can get appointments? Like

20:31

what's in- Twice a year, every six months, but

20:33

it's tailored to each individual depending on their

20:36

needs whether they're high needs or low needs. And also

20:38

a hygienist and a hygiene therapist,

20:40

which by the way, they haven't been utilised

20:43

enough, hygiene therapists, they're qualified to do fillings,

20:45

checkups and cleans. Really? Yes, but they have

20:47

not been utilised again by the system to

20:49

allow the dentist to do like the very complicated

20:51

things like extractions,

20:53

et cetera.

20:54

So obviously we've spoken

20:56

so far about the how to

20:58

improve our health

21:00

and looking at the sort of disease states.

21:02

But obviously there is a whole

21:04

other world with people who have healthy

21:07

teeth and wanna make them or

21:09

give the impression that they're even healthier than

21:11

they are. And that's the world of cosmetic dentistry

21:13

and aesthetics as well, which you're heavily involved

21:16

in. When you see patients who

21:18

come in and who want pearly

21:20

white teeth, there's so many things

21:23

going on in terms of teeth whitening

21:25

strips that people can do at home and just

21:27

so much confusion. What is

21:29

it that people want in terms of whitening

21:31

their teeth and is there any danger behind

21:34

that? Or is it, you know, kind of like an innocuous

21:36

thing and just aesthetics only? You must

21:37

have whitened your teeth already, check them out. Me?

21:40

Yeah, I've never whitened my teeth. Really? We would

21:43

call you a BL3 or 2. What does that

21:45

mean? It's like top

21:47

tier white teeth. Really? Yeah, that's what

21:49

people try to aim for when they go for whitening.

21:51

I was tempted

21:52

once to get

21:55

my teeth whitened out the dentist. This

21:57

is when I was just visiting India, where I

21:59

think it would have just cost me.

21:59

me maybe 20 pounds, but I didn't trust.

22:02

No, don't do it. Yeah, so I didn't do that. I didn't have

22:04

any regulations for that stuff. So when

22:06

someone, you just said I'm a BL3, so

22:08

there's a whole range of things

22:11

and that depends on someone's skin tone as well?

22:13

No, so okay, so there's a plethora

22:15

of reasons why people have discolored

22:18

teeth and I think it's important to separate the difference between

22:21

intrinsic colour and extrinsic colour, right? Because

22:23

people can have discolored teeth because they

22:26

smoke, because they drink black coffee,

22:29

red wine, turmeric lattes,

22:31

all that stuff, right? So that's no, that's extrinsic,

22:33

right? Intrinsic is the medication stuff that you're

22:35

talking about. So either they could have a genetic disorder,

22:38

or they could just be genetically have more yellow

22:40

teeth. So we have what we call a Vita

22:42

shade guide. The shade guide will tell us what

22:45

you are on the scale. The B shades

22:47

are the best colour. So they're the whiter colours

22:49

that people try to aim for. B1

22:51

is usually the whitest that you can find in nature.

22:54

What happens is that most patients that come

22:56

in, well, first of all, they go online and they might see

22:58

brands, I'm not going to out them obviously on a podcast,

23:00

especially on TikTok. And they're like, Oh my God, my

23:02

teeth have like turned from like yellow

23:05

to white in 5.3 seconds. Well,

23:07

first of all, there are some products that

23:10

work in terms of stain removal. So you

23:12

might find non abrasive whitening toothpaste,

23:15

that they can help remove the stain. So if you think

23:17

about it, when we talk about abrasivity, we

23:19

can think about like, fan particles, right?

23:21

So then they're going to scrub off, right? They're like stoking. And

23:23

that's safe. Depends on how abrasive

23:25

it is. Because if it's literally like sandpaper,

23:28

imagine

23:28

wearing away the enamel.

23:29

Correct, correct. Then you've got

23:31

the intrinsic causes. So if you've got

23:33

things like genetic disorders, or you've had

23:35

trauma or antibiotics, that

23:38

stuff's really not going to do anything because it's

23:40

not dealing with the root cause. Yeah.

23:42

That's when you need to consult a dentist. And

23:44

that is when they will give you options

23:47

or products that will cause the chemical reaction.

23:50

For some people, for example, with mild tetracyte,

23:52

they have to have a long course of whitening,

23:55

which involves the key ingredient hydrogen peroxide.

23:58

Hydrogen peroxide is the key

23:59

The ingredient causes a chemical reaction that turns

24:02

your teeth from yellow to white and that's

24:04

the only thing that will

24:04

work. But again, that can be quite abrasive.

24:07

No, no. Legally in

24:09

the UK, we can use 6%

24:11

hydrogen peroxide as prescribed by a dentist

24:14

or 16% carb myperoxide.

24:16

But what about if the peroxide gets to your

24:18

gums?

24:18

Again, all the over-the-counter stuff that use

24:20

peroxide, if they give you a gum shield that allows

24:23

the peroxide to just be free-floating in your mouth,

24:25

not good for you. Number two, the other

24:27

thing is that the hydrogen peroxide

24:29

over the counter is 0.1%, so it's going

24:31

to do nothing. It's really, really low. When you go

24:33

to a dentist, they'll create bespoke trays

24:35

that fit your mouth in a certain way,

24:38

which means that you don't have harm of that

24:40

reaching your gums and it makes sure that it's in a protected,

24:42

secure way. It's being delivered. Now, obviously,

24:44

the whitening

24:47

is a superficial aspect of cosmetic

24:49

dentistry. We've got more invasive

24:51

approaches and you've seen these people online who

24:54

almost wear down their teeth, though it's like shark

24:56

teeth and all sorts of weird

24:59

things. For the average person listening

25:01

or watching this and you hear things like

25:04

veneers and porcelain and this and that, what

25:07

is all of that and how invasive

25:10

can you get with cosmetic

25:12

dentistry?

25:13

Cosmetic dentistry is what I do all day,

25:15

so this is something that obviously that I'm so

25:17

passionate about. The problem is, so with

25:19

the NHS crisis and also, I think,

25:22

with the pressure of social media and body

25:24

dysmorphia and people feeling they need to look a certain

25:26

way, I think that people really feel

25:28

the pressure to have perfect teeth. At

25:31

the end of the day, in a lot of countries

25:34

like the USA, Europe,

25:36

UK, it's almost become unaffordable

25:39

to have

25:40

cosmetic dentistry. What they're doing is they're

25:42

going abroad and having their teeth cut

25:45

down to pinpoint. What happens

25:47

is they're sold the dream of having veneers,

25:49

but they're actually getting crowns. So

25:52

crowns are when you cut around

25:54

the whole surface of the tooth. The case is a 360 degree

25:56

cut down of the tooth. When

25:58

you cut down the teeth, it's irreversible.

25:59

veneers are when you only

26:02

shave down the front surface of the tooth, okay?

26:04

So perhaps in some cases you could

26:06

lose as little as 3% of

26:09

the natural tooth surface and

26:11

maybe... It's not a lot. Yeah, and

26:13

in the more invasive 30%. So I try to stay on the 3% depending

26:16

on the case, but there's lots of other factors

26:17

as well. Those are

26:19

veneers. Correct. Rounds, you can

26:22

end up losing 70, 80% of your natural tooth surface,

26:24

especially in the ones that we're seeing online.

26:26

People aren't recognizing the long-term implications

26:29

and what they're thinking is like, I'm going to have a big white

26:32

smile. And as you know, like the types

26:34

of smiles that are coming out very thick, they're very opaque.

26:37

There's so many dangers we're giving your teeth done abroad.

26:40

And can you imagine that a lot of people

26:42

that

26:42

are going abroad are between 20 to 30 years

26:45

old. Yeah. Let's

26:47

say they hope to live till they're 80, 90 or more.

26:49

What are they going to do in... Decades with dentures

26:51

or no teeth.

26:52

Correct. So I said, hey,

26:54

I once sent out a message on Instagram

26:57

pretending to be a patient. See my teeth? Yeah.

27:00

Okay. We can agree they're nice teeth, just like yours.

27:02

I said, hey guys. And it was a famous clinic abroad

27:05

that had treated a lot of people. And

27:07

I said, what would you recommend? They recommend 28 out crowns

27:09

for my teeth. I have no disease. I have no pathology.

27:12

My teeth are pretty white, but that's their standard

27:14

treatment plan for most people. But that

27:17

in the UK, if I prescribed that

27:19

treatment plan to you, I would

27:21

literally lose my license. So

27:23

you cannot justify that from the health

27:25

kind of pathological reasoning

27:28

of why you would do that.

27:29

That's actually really scary to know. Stuff

27:31

like that's happening. And it's good to know

27:34

at least people like you are out there calling

27:36

this out and highlighting the awareness of these

27:38

things on social media. You know the

27:40

thing you say that obviously one of the worst

27:42

things for your teeth is constant acid exposure.

27:45

I see a lot of patients with acid reflux. I

27:49

feel that dental health in that

27:51

population is potentially a lot

27:53

worse because I feel

27:56

that if they get acid reflux and they're constantly

27:59

getting a barrage of acid reflux, of, you know, saliva

28:01

and acid into their oral cavity after

28:03

a night of, you know, poor sleep or poor

28:05

habits, they're eroding their sort of that

28:08

enamel layer of their teeth and they're worsening their

28:10

oral health.

28:11

But not much is being done to target that

28:13

of those medical conditions which are

28:15

unrelated to dental

28:18

health. You know, it could be they've got a hernia which

28:20

is causing them to reflux, or they've got a

28:22

hiatus hernia, or they've got some gastric

28:25

conditions which result in them, you know, regurgitating

28:27

their food more. And

28:29

a lot of medical practitioners like

28:31

myself who obviously aren't taught

28:33

about dental health specifically in medical

28:36

school,

28:37

they don't know about these strategies to improve

28:39

oral health. And it should be almost commonplace

28:42

for doctors in hospital, nurses, doctors, surgeons,

28:45

to also consider dental health given

28:47

how wide reaching it is to our wider

28:49

body health.

28:50

You know, it's just like nutrition, don't you think? Because

28:53

obviously, did we learn how important

28:55

nutrition was? Not really. And really

28:57

how so many diseases are linked to

28:59

diet and stress and all these things that, you know,

29:01

perhaps we consider a bit more woo woo,

29:03

you know, because we're kind of in there, you know, into the sort

29:06

of like... The second

29:06

time I've heard that word today. Woo woo. So,

29:09

but the thing is, is that, and it really interferes with my job,

29:12

by the way, because as I said, a lot of people seek

29:14

cosmetic work. And when they do, I

29:16

say, look, you've got erosion. I asked them about eating the

29:18

sword in their history. I'm like, have you been tested for GERD?

29:21

You know, like gastroesophageal reflux? Yeah.

29:24

Oh, I don't know what that is. Okay, you need to go back to

29:26

your doctor and you need them to do a test. Because

29:28

if it's not under control, everything I

29:30

do will fail. It's going to be wasted. Exactly. And

29:32

actually, you're going to end up in the same position. So

29:34

like, there's all these important things that I tell people

29:37

to consider.

29:37

That's the

29:38

thing, I think when we see patients,

29:40

we can see the main cause,

29:43

the elephant in the room. But realistically,

29:45

you know, there's other factors for

29:47

long term sustainability of body health,

29:49

dental health. Yeah, those need to be addressed

29:52

before just papering over the crack of removing

29:54

the elephant from room. We need to make sure the foundation's in

29:56

place. Like I said, yeah, thank you so much for coming

29:58

on and shining a light on

29:59

and dental health and keep doing it what you're doing online.

30:02

Thank you. I'm sure we'll speak again. Thank you so

30:04

much. Now before I let you go, you

30:06

did have a question for me. I don't know what

30:08

it is. I've not been exposed to this. So

30:12

yeah, fire away.

30:13

Does fluoride damage your third eye?

30:15

Oh, god. From a spiritual

30:18

point of view, what is it? You know, the

30:21

ancient yogis and Ayurvedic

30:23

practitioners in ancient India believed in some

30:25

sort of third eye. What does

30:27

a third eye

30:27

mean? Intuition, isn't it? Some sort

30:29

of gut instinct. I mean, the scientific

30:32

way of thinking about the third eye is potentially

30:34

the suprachiasmatic nucleus, which is

30:36

a small cluster of neurons

30:39

and cells, which is your biological clock.

30:42

Is that your third eye? Who

30:44

knows? But with regards

30:46

to crystals and third eye being

30:49

awoken by something, it's probably

30:51

someone trying to sell you a course or a supplement,

30:54

right?

30:54

And that's why a lot of people are stopping fluoride. So I'm

30:56

glad the doctor has said it. The doctor has spoken. I

30:58

mean, the fluoride's in our water supply

31:01

to help with our oral health and various other

31:03

things. So I don't believe

31:06

that there's this whole entire conspiracy theory

31:08

and that all the dentists are in on it and the

31:10

doctors are in on it. And let's control the population.

31:13

I mean, that would be fanciful thinking. But yeah,

31:16

I don't subscribe to that at all.

31:17

Perfect. Thank you so much. Thank

31:20

you.

31:59

do for all concerned is to brush it under

32:02

the lightly soiled carpet and pretend everything

32:04

is okay. So join me, Safina

32:07

and my secret sidekick and mum friend Emma

32:09

Jones. Hiya. Just search and follow The Secret Mum

32:11

Club wherever you get your podcasts.

32:16

Hello listeners of The Referral, it's

32:18

me Dr Curran. Are you tired of scouring

32:20

the internet for medical answers only to end

32:22

up on shady websites? Is your For You

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32:27

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32:29

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33:29

It's

33:32

now time to take down those fallacies,

33:34

misinformation and general nonsense

33:36

that you hear about online. So this myth is a

33:38

throw forward to the conversation we're going to be having

33:41

about all things fertility next week. The

33:43

myth is being on the pill for too

33:45

long will delay how quickly you can

33:47

get pregnant. Now, obviously, there's lots of different types

33:50

of contraceptives out there. There are implants, there's the Mirena

33:52

coil, there's the oral contraceptive

33:56

pill, there's the morning after pill. There's a lot

33:58

of variants out there. But But the studies have

34:00

shown that taking contraceptive medication

34:03

does not affect long term fertility,

34:06

but it might delay somewhat how

34:08

quickly you get pregnant afterwards because depending

34:11

on the type of contraception you take,

34:13

it might have longer lasting effects. But

34:16

usually within a few days to weeks

34:18

if it's just the pill you're taking, the women

34:21

should be back to a normal period cycle,

34:23

somewhat in a matter of days to

34:25

weeks, which means then the person can then

34:27

begin to try for a pregnancy. Now the majority

34:30

of studies have shown that if you take any

34:32

oral contraceptive pill, it should not

34:34

have any long term effect on

34:36

future fertility. And after stopping these medications,

34:39

your natural body hormone levels should

34:41

begin to normalize within days to

34:44

weeks, which means that you should be able to

34:46

achieve a normal menstrual cycle and

34:49

then begin to try for a pregnancy. Now if

34:51

you want to learn more about contraception and fertility

34:53

in general, how to boost our fertility,

34:55

whether you're a man or whether you're a woman and things

34:58

we're doing which directly affects our fertility,

35:01

you want to tune in to next week's episode where

35:03

I have Dr. Helen O'Neill. She's

35:06

a fertility expert. That's going to be a spicy

35:08

conversation. This next one is just

35:10

plain weird. I saw a video

35:12

recently about artistic swimmers

35:15

doing milk shots to the eyeball.

35:17

Yes, milk shots, actual milk that

35:19

you drink into your eyeballs. And I made a video

35:21

about this as well, but given that

35:24

original milk shotting video got

35:26

somewhere in the realms of 20 million views,

35:29

I think it's fair I tell

35:29

you about why you probably shouldn't

35:32

use milk in your eyes. So to paint

35:34

you a picture, there are these artistic swimmers.

35:36

So these are, you know, synchronized swimmers

35:39

who do their sport underwater

35:41

and their sport defines that you

35:44

can't wear swimming goggles when

35:46

you're actually competing in the sport. You can potentially

35:48

wear swimming goggles if you're training or rehearsing,

35:51

but even then sometimes they don't. So obviously

35:54

if you've got your eyes open for long periods of time

35:56

in the water, the chlorine will get in

35:58

your eyes, cause some irritation. and you'll

36:00

get red eyes and it feels stingy,

36:03

it's itchy, it's red, not nice. And

36:05

these artistic swimmers online who posted the

36:07

video, and apparently it's a pretty widespread,

36:10

you know, thing which swimmers do, is they

36:13

fill their swimming goggles with shots, like

36:15

you would a, you know, a shot of alcohol, and

36:17

they shot it directly into their eyeballs. And

36:19

the theory revolves that the milk can

36:22

help to soothe the eyes and

36:24

relieve the irritation caused by

36:26

the chlorine in the water. Now, there may

36:28

be some science which helps to back

36:30

this up. Obviously, the milk will have

36:32

some sort of cooling effect, assuming it's

36:35

chilled milk, and that may help to soothe

36:37

the irritated eyeballs. And there

36:39

is also limited evidence, very limited

36:41

evidence, to suggest that the casein, a

36:43

protein found in milk, may have some

36:46

anti-irritative, anti-inflammatory properties,

36:49

again, which may help to relieve

36:51

the symptoms of itching and irritation.

36:54

If, for whatever reason, you feel

36:56

that you need to put milk in your eyeballs,

36:58

something which I do not condone, by the way, if

37:00

you still feel the need to ignore me and

37:03

do this, please use pasteurized

37:05

milk, which will obviously limit the amount of

37:07

sneaky bacteria which could get into your eyeballs,

37:10

which obviously you don't want. And you

37:12

might want to dilute the milk with water first,

37:14

it's a bit more gentle on your eyes. Again,

37:16

I repeat, I would not suggest

37:19

putting milk in your eyes, just leave it for

37:21

your beverages. But an alternative

37:24

would probably be to use specific artificial

37:26

gel tears or eye drops, either

37:29

before or after having your eyes

37:31

open in water. And if you can avoid it, probably

37:34

avoid just going in the sea

37:36

or in water with your eyes

37:38

open and maybe use goggles if you can.

37:42

Just before we go, we've got a listener question

37:44

for Crowd Science. Today, it's Cami

37:47

from Scotland. Is vaping

37:50

better than smoking? Cami, that is

37:52

a very, very interesting and very

37:54

important question as well, because there's lots of misinformation

37:56

about this. There have been lots of recent studies

37:59

looking at... whether e-cigarettes and vaping

38:02

are safer alternatives than smoking. And overall,

38:05

our understanding of the impact

38:07

of e-cigarettes and vaping on the human body is

38:09

still limited because, you know, they've

38:11

only been around for, you know, 20 odd

38:13

years. It was only 50 years ago that

38:16

doctors realized that smoking wasn't

38:18

good for you because, you know, before then,

38:20

many decades ago, doctors

38:23

used to recommend cigarettes for a cough,

38:25

but tummy ache, headache, they used to recommend you

38:28

smoke mental cigarettes or something like that. So

38:30

it was only once the dead body started

38:32

to pile up, people realized, hey,

38:34

smoking isn't so good for you and it causes this

38:37

and this and this. We may still be

38:39

in that stage in that curve with vaping.

38:42

Obviously, we know now there's increasing evidence

38:44

that there is e-cigarette related

38:46

lung injuries because of the superheated

38:48

chemicals that goes into vaping and

38:51

that can cause injury to the delicate

38:53

membranes and the linings which line

38:56

our respiratory system and our airway. So

38:58

clearly, any heated chemicals which come

39:00

into contact with those thin delicate surfaces can

39:03

have an impact on blood flow, on

39:05

free radical production which can increase the risk

39:08

of inflammation and damage and

39:10

thus increase risk of chronic lung diseases.

39:13

And in fact, some of the studies I mentioned

39:15

before do suggest that vaping

39:18

can actually increase the rate

39:20

of chronic lung injury compared to smoking

39:23

and if you combine smoking and vaping,

39:25

that's even worse. And not to mention there are various

39:28

dangerous chemicals which have been found

39:30

in these e-cigarettes as well and it's

39:32

safe to say that we now have

39:34

lots and lots of warnings on the

39:37

cigarette boxes about the dangers

39:39

of tobacco and cigarettes. We

39:41

are still not at that level of marketing

39:44

and awareness about the dangers of

39:46

vaping. It still seems somewhat

39:48

unregulated and the problem is because

39:51

vaping is being sold as this

39:54

smoking cessation aid which there is no

39:56

evidence for at the moment given the literature,

39:58

we've got people who otherwise

40:01

would never have smoked or vaped just

40:03

vaping for the sake of it. So it's potentially

40:06

a dangerous gateway substance into

40:09

more dangerous things like tobacco. But

40:11

to answer your question, is vaping

40:13

safer than smoking cigarettes? Perhaps

40:15

in some ways, it may be. There's clearly

40:19

not an abundance of carcinogens that

40:21

you do find in tobacco smoke, and you aren't

40:23

inhaling smoke in that sense, but

40:26

you are inhaling these heated chemicals, and

40:28

we're still understanding the effects of it. So

40:30

we just don't have the long-term data. And what

40:32

I'm trying to say is right

40:35

now, if you had to pick between vaping

40:37

and smoking, I would prefer you pick

40:39

nothing. Cammie, that was a great question. I hope you

40:41

learned something from that and just be aware of

40:43

the dangers of vaping as well. It is

40:46

not as innocuous as it seems. And in this

40:48

week's extra episode, I'll be answering a question

40:50

from Darren all the way from Manchester.

40:53

So Darren says, Hi, Dr. Curran.

40:55

I absolutely love these fizzy effervescent

40:58

delicious vitamin C tablets. I

41:00

always drink them when I feel hungover and then

41:02

as and when I feel tired or even just

41:04

fancy a fizzy drink. Are there

41:07

benefits to drinking this thirst quenching

41:09

and good for you drink? Do they

41:11

do what they say on the tin? I've always wanted

41:13

to know. You're the best, he says. And that

41:16

is true. Great question, Darren. If you want

41:18

to hear my answer to that question about

41:20

vitamin C tablets and a deep dive into

41:22

a bunch more questions, you can subscribe

41:25

to The Referral Plus and check out

41:27

our extra episodes called Crowd Science

41:29

Extra. And you also get ad-free listening to

41:32

every episode of the show. Just visit the Referral

41:34

Show page on Apple Podcasts and hit the

41:36

Try Free button at the top of the page to

41:38

begin your free trial today. And you'll

41:40

see the extra episode, which sits right under

41:42

this episode, on the feed. And don't forget, you can

41:44

get your question featured on the show. Just

41:47

get in touch at thereferralpod.com.

41:50

Thanks for listening to this episode of The

41:53

Referral. Yes, I am a real doctor,

41:55

but I'm not your doctor. So if you require

41:57

any specific medical advice, please contact...

41:59

your own healthcare professional. And remember,

42:02

nothing on this show is intended to provide

42:04

or replace any specific medical advice

42:07

that you would otherwise receive from your own

42:09

healthcare practitioner. This has been a Sony

42:11

Music Production. Production management was Lily

42:14

Hamble, videos by Ryan O'Meara,

42:16

studio engineer was Ed Gill, DOP

42:19

Teddy Riley, music by Josh Carter,

42:22

Grace Lakewood and Hannah Talbot were the producers

42:24

and Gaynor Marshall and Chris Skinner are the executive

42:27

producers.

42:56

you you