How skipping night brushing routine can make you fall sick

Emeh Joy
By Emeh Joy

Basic medical scientist, health research writer with experience writing for health brands like Dentistry Brands LLC and KompleteCare.

People brush their teeth to avoid foul odour, have white teeth and a dazzling smile. But, what if you learn that not brushing has a profound impact on your health, increasing the risk of diseases? Would that make you brush more often?

Image od dentists examining a patient's teeth

The risks associated with poor dental hygiene goes far beyond a cosmetic issue and bad breath. General health and longevity can be affected as well.

“Taking good care of your teeth and gums is an important part of your daily routine, and a lifelong habit that should start in early childhood”, Dr Karen Ephlin, a paediatrician at Partners in Pediatrics-Hanover Street in Wilkes-Barre, said. 

Everyone must brush their teeth twice a day (morning and night). 

Brushing in the morning is usually not a problem for many people. After all, it’s a new day. Right? And it makes much sense starting a new day all freshened up. But, what happens when the day ends, and everybody comes back home exhausted from the day’s activity?

It is just so easy to skip the nightly routine of brushing. From skipping one night, it becomes a life-long habit of not brushing before bed. As tempting as not brushing at night might be, it can seriously jeopardise your oral and general health. 

Clacified Health image illustration

What happens when you don’t brush 

The human mouth harbours over 700 different bacteria strains.1 This is unsettling when you try to paint the picture in your mind, but it is the reality.

These tiny colonies of microorganisms are invisible to the naked eye, but they are there in your oral cavity, growing in your gums and in between your teeth. 

Most of the bacteria in the oral cavity are harmless; however, few can cause harm to dental health. The two bacteria that commonly cause dental health problems are Porphyromonas gingivalis and Streptococcus mutans

Streptococcus mutans typically feed on starches and sugars in the mouth and, in return, produces acids that erode tooth enamel, making the tooth more susceptible to decay.

Porphyromonas gingivalis is more harmful but less common than Streptococcus mutans. This harmful bacteria is associated with periodontitis. Periodontitis is a severe gum disease that damages the gum and can destroy the bones that support the teeth. 

When you don’t brush, food particles and debris build-up as “plaques” in the teeth; harmful bacteria like Streptococcus mutans and Porphyromonas gingivalis will also accumulate in the tooth and gums, causing significant damage to the oral cavity. 

They ingest the food particles and sugary debris, and with time, they penetrate the teeth enamel, attacking the layers underneath, causing tooth cavities, decay, gum disease and tooth loss. Ultimately, they create bad tastes and foul smells in the mouth.

Why you should brush before bed

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You might be wondering why you must brush at night before hitting the bed. 

When you sleep, the brain signals the gland in the mouth that produces saliva to decrease production. This means that saliva production diminishes drastically during sleep.5

While this is a welcome change (after all, it helps prevent drooling while sleeping), it also has its downside. The disadvantage of less saliva while sleeping is that our mouth becomes more vulnerable to bacterial agents that cause tooth cavities, tooth decay and gum diseases. 

The saliva has a powerful antimicrobial defence system that directly and indirectly prevents the uncontrolled growth of bacteria.6 In the absence or reduced production of our powerful antimicrobial saliva, the teeth are left at the mercy of the cavity-causing agents.

Brushing once a day will go a long way to keep harmful bacteria at bay; however, it may not be sufficient, especially for people who eat a lot of sugars. Brushing at night is even more important than brushing when you wake up in the morning.

Health problems associated with not brushing regularly

Health experts have recommended that people brush their teeth twice a day. Not brushing at night before sleeping is poor oral hygiene and not adhering to dental hygiene guidelines can cause harm to both dental health and overall health. Organs and systems of the body may be affected. 

Some health problems that may result from poor oral hygiene include:

Heart disease

Clacified health image illustration

According to researchers, people who went to the dentist regularly were less likely to experience heart-related issues.

A 2019 study found that those who brushed their teeth three times daily were less likely to experience heart failure and atrial fibrillation. According to the study, more missing teeth were linked to a higher risk of cardiovascular problems such as atrial fibrillation.2

This suggests that people who don’t brush up to two times have an increased risk of developing heart diseases. 

Dementia

Studies have established that people with dementia usually suffer from tooth decay. But it doesn’t end there. Research also showed that dental decay could be associated with an increased risk for dementia.4

The research was carried out to review a possible link between inflammatory dental conditions such as periodontal disease and brain inflammation that can lead to neurodegenerative diseases like dementia.

This study review showed a possible link between poor oral hygiene and dementia; however, it is inconclusive. 

Diabetes

People with diabetes have a higher risk of having dental problems like gum infections, teeth cavities and infection of the bones the teeth are attached to. This is usually because of insufficient blood supply to these areas. 

In turn, having gum disease can make it harder for your body to control blood glucose. Poor dental health increases inflammation and may increase the risk of developing insulin resistance and diabetes. 

Diabetes is a condition marked by high glucose in the blood. If you have diabetes, you must take your dental health seriously.

When glucose levels in the saliva are high, it helps breed harmful bacteria, which combines with food debris to form the sticky film called plaque

Pneumonia

A study showed that good oral hygiene reduces mortality from aspiration.3 Aspiration is when you breathe foreign objects into your airways. Foreign objects could be food, stomach content, or saliva containing bacteria!

The available scientific report showed that oral health is the major risk factor for aspiration pneumonia in older adults. Aspiration pneumonia is caused by bacteria that normally reside in the nasal pharynx and oral cavity

When someone mistakenly breathes in something (like food) via the airways instead of swallowing it into the oesophagus, the germs from the substance may infect the airways leading to aspiration pneumonia. Practising good oral hygiene may save a life in this case. 

Dental problems

Poor dental hygiene ultimately leads to dental problems. When plaques containing bacteria coat the teeth, they penetrate the enamel, attacking the vulnerable inner tooth layers. This leads to cavities.

If cavities are not treated, they can lead to dental infections and tooth loss.

Aside from causing cavities, plaques can also weaken the gums, leading to gingivitis, a form of gum disease in which the gums are inflamed, puffy and prone to bleeding. Plaques can also lead to periodontitis, a severe infection that affects the bones that support the teeth. 

How long should you brush?

Photo by Andrea Piacquadio on Pexels

According to the American Dental Association (ADA), the standard recommendation is for people to brush their teeth for two minutes twice a day using a brush that has soft bristles.

Also, in order to maintain healthy gums and teeth, you should:

  • Floss regularly
  • Avoid sweetened foods and drinks
  • Avoid smoking
  • Use toothpaste that contains fluoride
  • Replace your toothbrush with a new one every 4 months
  • Visit a dentist once a year for dental cleanings and exams.

References

  1. Aas, J. A., Paster, B. J., Stokes, L. N., Olsen, I., & Dewhirst, F. E. (2005). Defining the normal bacterial flora of the oral cavity. Journal of clinical microbiology, 43(11), 5721–5732. https://doi.org/10.1128/JCM.43.11.5721-5732.2005 
  2. Chang, Y., Woo, G., Park, J., Lee, S and Song, T. (2019). Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study. European Journal of Preventive Cardiology, 27(17): 1835-1845. https://doi.org/10.1177/2047487319886018 
  3. Müller F. (2015). Oral hygiene reduces the mortality from aspiration pneumonia in frail elders. Journal of dental research, 94(3 Suppl), 14S–16S. https://doi.org/10.1177/0022034514552494 
  4. Noble, J. M., Scarmeas, N., & Papapanou, P. N. (2013). Poor oral health as a chronic, potentially modifiable dementia risk factor: review of the literature. Current neurology and neuroscience reports, 13(10), 384. https://doi.org/10.1007/s11910-013-0384-x 
  5. Thie, N. M., Kato, T., Bader, G., Montplaisir, J. Y., & Lavigne, G. J. (2002). The significance of saliva during sleep and the relevance of oromotor movements. Sleep medicine reviews, 6(3), 213–227. https://doi.org/10.1053/smrv.2001.0183 
  6. van 't Hof, W., Veerman, E. C., Nieuw Amerongen, A. V., & Ligtenberg, A. J. (2014). Antimicrobial defence systems in saliva. Monographs in oral science, 24, 40–51. https://doi.org/10.1159/000358783