Q+A with Anna Middleton AKA London Hygienist

We all know we should regularly get our teeth checked but when was the last time you saw a dental hygienist? Meet Anna Middleton AKA London Hygienist, a dedicated and passionate award-winning dental hygienist. She started her business 'London Hygienist' with the mission to change the way oral health care is delivered to patients. ​She shares her wisdom on all these teeth related, how she got into dentistry and gives us some tips on how to keep your gnashers healthy.

Can you tell us a bit about how you came to be a dental hygienist?

I had a strong desire to study again after college and I’d never been to university. Medicine and biology always interested me but I was never sure which route to go down. I had been in and out of the dentist chair my whole life and one day a friend suggested I become a dental nurse.

I started as a float nurse and spent the majority of my time with the hygienist who became my inspiration, and a year later I was training as one. I then started 'London Hygienist' to change the way oral health care is delivered to the public.

I meet a lot of patients who have had bad experiences at the dentist, so I love trying to flip them and give them a positive experience filled with lots of motivation and encouragement. Seeing my patients smile after their appointment and knowing they are happy is a great feeling, and when they return I feel good knowing I’ve eliminated their fears.

What’s the difference between a dental hygienist and a regular dentist?

Dental hygienists have a specific scope of clinical procedures to promote and maintain good oral health. A major role of a dental hygienist is to perform 'periodontal therapy' which includes various types of cleaning of the teeth and gums. Hygienists work to help patients control oral disease by providing tailored treatment and oral hygiene plans.

Dental hygienists can also carry out whitening procedures if they have had additional training and prescription from a dentist. Dentists carry out a wide range of treatments such as extractions, fillings, root canal treatment and various restoration procedures. We both work closely together to ensure the best care for patients.

What’s the most common brushing mistake people make?

1. Not using an electric toothbrush: You get a far more superior clean and effective plaque removal because you get more brush strokes per minute than you could ever generate yourself with a manual brush. Electric toothbrushes also have much smaller heads and are designed specifically to ensure each tooth is cleaned individually, helping you get to all the hard to reach areas
2. Brushing too hard: Using an electric toothbrush with the correct technique will prevent over brushing, which causes irreversible and permanent wearing away of the gums, known as recession. The exposed underlying tooth surface is not as strong as the tough outer enamel, leaving it more susceptible to further wear, dental decay, sensitivity and an unpleasing aesthetic appearance.
3. Not changing your toothbrush regularly: This should be done every 3 months to ensure efficacy from the bristles and prevent bacteria from building up.
4. Rinsing after brushing: You should spit but don't rinse. You want to leave some fluoride toothpaste behind to protect your teeth from dental decay. If you use a mouthwash, try and use it at a separate time to brushing.
5. Not brushing enough or for long enough: 1 in 4 adults admit they do not brush twice daily, with 1 in 10 admitting they regularly 'forget' to brush. Brush twice a day for two minutes. It's non-negotiable.
6. Missing the gums: It is important to make sure your toothbrush is positioned half on the tooth, half on the gums. Angle the bristles at a 45 degree angle into the gums to ensure effective plaque removal.

What do you think about all these new dental trends i.e charcoal, fluoride-free toothpaste, coconut oil pulling

The market can often seem very oversaturated and confusing as there are an array of dental products. However, some may not actually fulfil the claims they make. For example, whitening/charcoal toothpaste will not actually change the colour of your teeth and physically whiten them.

Neither contain whitening ingredients but instead aim to remove surface staining with abrasive particles. However, there is no evidence to prove its effectiveness on stain removal. In fact, it may even contribute to negative aesthetic effects as the charcoal particles can become embedded in cracks in the teeth or restoration margins around crowns, veneers and fillings, attracting further yellowing and staining over time. I have even seen the particles embedded into the gum margin.

Sometimes when people use these types of toothpaste there seems to be a tendency to ‘scrub’ while brushing which over time can cause abrasion and permanent damage to the enamel and gums. It’s worth noting often these products can be missing keys ingredients required to maintain healthy teeth, such as fluoride.

Whitening is a popular procedure but should only be carried out by a dental professional who can either make you custom made whitening trays or carry out a whitening treatment for you in the dental surgery.

I do not advise whitening strips. They are not custom made for your teeth so they come with a risk. There have been cases where users have burnt their gums or experienced extreme sensitivity. I would not advise buying any whitening products online or from anyone other than a dental professional to ensure your safety. Most do not even contain enough active ingredients due to the law surrounding whitening in the UK.

How often do you recommend xylitol mints and gum to your patients?

To get the best benefits I advise to have a piece of gum or mint with xylitol after every meal or snack, ideally 5 times a day. The best thing about xylitol is that it kills the bacteria responsible for dental decay by up to 90%. Not only does it neutralise the plaque acids, it actually prevents them from starting in the first place, making it harder for plaque to stick to your teeth in the future. Thank you Mother Nature!

What are your top tips for people who are nervous or lazy about going to the dentist?

Prevention over intervention is what I say! Regular visits to the dentist and hygienist are crucial to protect yourself from dental decay and gum disease. Good news, both are entirely preventable.

While the thought of a visit to the dentist or hygienist may be daunting, routine screening can save you a lot of time, money and pain in the future. Visit the dentist at least once a year and the hygienist twice a year. 

I'm sure we're all keen to get our teeth checked now, how can we book an appointment with you? 

Patients can book by simply calling the practice they want to be seen at (Chelsea & Clapham) and asking to book with me. All details can be found here. Subscribe at my website for 10% off your first clean.