Toothpastes & Mouthwashes: Which Help And Which Harm?
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Toothpastes and mouthwashes: which kinds help, and which kinds harm?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
For today, let’s look at toothpastes and mouthwashes, to start!
Toothpaste options
Toothpastes may contain one, some, or all of the following, so here are some notes on those:
Fluoride
Most toothpastes contain fluoride; this is generally recognized as safe though is not without its controversies. The fluoride content is the reason it’s recommended not to swallow toothpaste, though.
The fluoride in toothpaste can cause some small problems if overused; if you see unusually white patches on your teeth (your teeth are supposed to be ivory-colored, not truly white), that is probably a case of localized overcalcification because of the fluoride, and yes, you can have too much of a good thing.
Overall, the benefits are considered to far outweigh the risks, though.
Baking soda
Whether by itself or as part of a toothpaste, baking soda is a safe and effective choice, not just for cosmetic purposes, but for boosting genuine oral hygiene too:
- Enhanced plaque removal to improve gingival health: 3-month randomized clinical study of the effects of baking soda toothpaste on plaque and gingivitis
- The effects of two baking-soda toothpastes in enhancing mechanical plaque removal and improving gingival health: A 6-month randomized clinical study
- The efficacy of baking soda dentifrice in controlling plaque and gingivitis: A systematic review
Activated charcoal
Activated charcoal is great at removing many chemicals from things it touches. That includes the kind you might see on your teeth in the form of stains.
A topical aside on safety: activated charcoal is a common ingredient in a lot of black-colored Halloween-themed foods and drinks around this time of year. Beware, if you ingest these, there’s a good chance of it also cleaning out any meds you are taking. Ask your pharmacist about your own personal meds, but meds that (ingested) activated charcoal will usually remove include:
- Oral HRT / contraceptives
- Antidepressants (many kinds)
- Heart medications (at least several major kinds)
Toothpaste, assuming you are spitting-not-swallowing, won’t remove your medications though. Nor, in case you were worrying, will it strip tooth enamel, even if you have extant tooth enamel erosion:
Source: Activated charcoal toothpastes do not increase erosive tooth wear
However, it’s of no special extra help when it comes to oral hygiene itself, just removing stains.
So, if you’d like to use it for cosmetic reasons, go right ahead. If not, no need.
Hydrogen peroxide
This is generally not a good idea, speaking for the health. For whitening, yes, it works. But for health, not so much:
To be clear, when they say “alter”, they mean “in a bad way”. It increases inflammation and tissue damage.
If buying commercially-available whitening toothpaste made with hydrogen peroxide, the academic answer is that it’s a lottery, because brands’ proprietorial compounding processes vary widely and constantly with little oversight and even less transparency:
Is whitening toothpaste safe for dental health?: RDA-PE method
Mouthwash options
In the case of fluoride and hydrogen peroxide, the same advice (for and against) goes as per toothpaste.
Alcohol
There has been some concern about the potential carcinogenic effect of alcohol-based mouthwashes. According to the best current science, this one’s not an easy yes-or-no, but rather:
- If there are no other cancer risk factors, it does not seem to increase cancer risk
- If there are other cancer risk factors, it does make the risk worse
Read more:
- Does the use of alcohol mouthwash increase the risk of developing oral cancer?
- Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review
Non-Alcohol
Non-alcoholic mouthwashes are not without their concerns either. In this case, the potential problem is changing the oral microbiome (we are supposed to have one!), and specifically, that the spread of what it kills and what it doesn’t may result in an imbalance that causes a lowering of the pH of the mouth.
Put differently: it makes your saliva more acidic.
Needless to say, that can cause its own problems for teeth. The research on this is still emerging, with regard to whether the benefits outweigh the problems, but the fact that it has this effect seems to be a consensus. Here’s an example paper; there are others:
Effects of Chlorhexidine mouthwash on the oral microbiome
Flossing, scraping, and alternatives
These are important (and varied, and interesting) enough to merit their own main feature, rather than squeezing them in at the end.
So, watch this space for a main feature on these soon!
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Own Your Past Change Your Future – by Dr. John Delony
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This one is exactly what it says on the cover. It’s reminiscent in its premise of the more clinically-presented Tell Yourself A Better Lie (an excellent book, which we reviewed previously) but this time presented in a much more casual fashion.
Dr. Delony favors focusing on telling stories, and indeed this book contains many anecdotes. But also he bids the reader to examine our own stories—those we tell ourselves about ourselves, our past, people around us, and so forth.
To call those things “stories” may create a knee-jerk response of feeling like it is an accusation of dishonesty, but rather, it is acknowledging that experiences are subjective, and our framing of narratives can vary.
As for reframing things and taking control, his five-step-plan for doing such is:
- Acknowledge reality
- Get connected
- Change your thoughts
- Change your actions
- Seek redemption
…which each get a chapter devoted to them in the book.
You may notice that these are very similar to some of the steps in 12-step programs, and also some religious groups and/or self-improvement groups. In other words, this may not be the most original approach, but it is a tried-and-tested one.
Bottom line: if you feel like your life needs an overhaul, but don’t want to wade through a bunch of psychology to do it, then this book could be it for you.
Click here to check out Own Your Past To Change Your Future, and do just that!
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10 Oft-Ignored Symptoms Of Diabetes
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Due in part to its prevalence and manageability, diabetes is often viewed as more of an inconvenience than an existential threat. While very few people in countries with decent healthcare die of diabetes directly (such as by diabetic ketoacidosis, which is very unpleasant, and happens disproportionately in the US where insulin is sold with a 500%–3000% markup in price compared to other countries), many more die of complications arising from comorbidities, and as for what comorbidities come with diabetes, well, it increases your risk for almost everything.
So, while for most people diabetes is by no means a death sentence, it is something that means you’ll now have to watch out for pretty much everything else too. On which note, Dr. Siobhan Deshauer is here with things to be aware of:
More than your waistline
Some of these are early symptoms (even appearing in the prediabetic stage, so can be considered an early warning for diabetes), some are later risks (it’s unlikely you’ll lose your feet from diabetic neuropathy complications before noticing that you are diabetic), but all and any of them are good reason to speak with your doctor sooner rather than later:
- Polyuria: waking up multiple times at night to urinate due to excess glucose spilling into the urine.
- Increased thirst: dehydration from frequent urination leads to excessive thirst, creating a cycle.
- Acanthosis nigricans: dark, velvety patches on areas like the neck, armpits, or groin, signalling insulin resistance.
- Skin tags: multiple skin tags in areas of friction may indicate insulin resistance.
- Recurrent Infections: high blood sugar weakens the immune system, making skin infections, UTIs, and yeast infections more common.
- Diabetic stiff hand syndrome: stiffness in hands, limited movement, or a “positive prayer sign” caused by sugar binding to skin and tendon proteins.
- Frozen shoulder and trigger finger: pain and limited movement in the shoulder or fingers, with a snapping sensation when moving inflamed tendons.
- Neuropathy: numbness, tingling, or pain in hands and feet due to nerve and blood vessel damage, often leading to foot deformities like Charcot foot.
- Diabetic foot infections: poor sensation, weakened immune response, and slow healing can result in severe infections and potential amputations.
- Gastroparesis: damage to stomach nerves causes delayed digestion, leading to bloating, nausea, and erratic blood sugar levels.
For more on all of these, plus some visuals of the things like what exactly is a “positive prayer sign”, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Cost of Insulin by Country 2024 ← after the US, the next most expensive country is Chile, at around 1/5 of the price; the cheapest listed is Turkey, at around 1/33 of the price.
Take care!
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Are you over 75? Here’s what you need to know about vitamin D
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Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even more crucial as we age.
New guidelines from the international Endocrine Society recommend people aged 75 and over should consider taking vitamin D supplements.
But why is vitamin D so important for older adults? And how much should they take?
OPPO Find X5 Pro/Unsplash Young people get most vitamin D from the sun
In Australia, it is possible for most people under 75 to get enough vitamin D from the sun throughout the year. For those who live in the top half of Australia – and for all of us during summer – we only need to have skin exposed to the sun for a few minutes on most days.
The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.
But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society recommends people get 800 IU (international units) of vitamin D a day from food or supplements.
Why you need more as you age
This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D.
Overall, older adults also tend to have less exposure to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors.
As we age, our skin also becomes less efficient at synthesising vitamin D from sunlight.
The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it harder for the body to maintain adequate levels of the vitamin.
All of this combined means older adults need more vitamin D.
Deficiency is common in older adults
Despite their higher needs for vitamin D, people over 75 may not get enough of it.
Studies have shown one in five older adults in Australia have vitamin D deficiency.
In higher-latitude parts of the world, such as the United Kingdom, almost half don’t reach sufficient levels.
This increased risk of deficiency is partly due to lifestyle factors, such as spending less time outdoors and insufficient dietary intakes of vitamin D.
It’s difficult to get enough vitamin D from food alone. Oily fish, eggs and some mushrooms are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference.
In some countries such as the United States, most of the dietary vitamin D comes from fortified products. However, in Australia, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it.
Why vitamin D is so important as we age
Vitamin D helps the body absorb calcium, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis.
Keeping bones healthy is crucial. Studies have shown older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured.
People over 75 often have less exposure to sunlight. Aila Images/Shutterstock Vitamin D may also help lower the risk of respiratory infections, which can be more serious in this age group.
There is also emerging evidence for other potential benefits, including better brain health. However, this requires more research.
According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is moderate evidence to suggest vitamin D supplementation can lower the risk of premature death.
The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all.
Should we get our vitamin D levels tested?
The Endocrine Society’s guidelines suggest routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75.
There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders.
Routine testing can also be expensive and inconvenient.
In most cases, the recommended approach to over-75s is to consider a daily supplement, without the need for testing.
You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation.
Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.
Elina Hypponen, Professor of Nutritional and Genetic Epidemiology, University of South Australia and Joshua Sutherland, PhD Candidate – Nutrition and Genetic Epidemiology, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Barley Malt Flour vs chickpea flour – Which is Healthier?
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Our Verdict
When comparing barley malt flour to chickpea flour, we picked the chickpea.
Why?
First, some notes:
About chickpea flour: this is also called besan flour, gram flour, and garbanzo bean flour; they are all literally the same thing by different names, and are all flour made from ground chickpeas.
About barley malt flour: barley is a true grain, and does contain gluten. We’re not going to factor that into today’s decision, but if you are avoiding gluten, avoid barley. As for “malt”; malting grains means putting them in an environment (with appropriate temperature and humidity) that they can begin germination, and then drying them with hot air to stop the germination process from continuing, so that we still have grains to make flour out of, and not little green sprouting plants. It improves the nutritional qualities and, subjectively, the flavor.
To avoid repetition, we’re just going to write “barley” instead of “barley malt” now, but it’s still malted.
Now, let’s begin:
Looking at the macros first, chickpea flour has 2x the protein and also more fiber, while barley flour has more carbs. An easy win for chickpea flour.
In the category of vitamins, chickpea flour has more of vitamins A, B1, B5, B9, E, and K, while barley flour has more of vitamins B2, B3, B6, and C. A modest 6:4 victory for chickpea flour.
When it comes to minerals, things are much more one-sided; chickpea flour has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while barley flour has more selenium. An overwhelming win for chickpea flour.
Adding up these three wins for chickpea flour makes for a convincing story in favor of using that where reasonably possible as a flour! It has a slight nutty taste, so you might not want to use it in everything, but it is good for a lot of things.
Want to learn more?
You might like to read:
- Grains: Bread Of Life, Or Cereal Killer?
- Gluten: What’s The Truth?
- Sprout Your Seeds, Grains, Beans, Etc
Take care!
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Blood, urine and other bodily fluids: how your leftover pathology samples can be used for medical research
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A doctor’s visit often ends with you leaving with a pathology request form in hand. The request form soon has you filling a sample pot, having blood drawn, or perhaps even a tissue biopsy taken.
After that, your sample goes to a clinical pathology lab to be analysed, in whichever manner the doctor requested. All this is done with the goal of getting to the bottom of the health issue you’re experiencing.
But after all the tests are done, what happens with the leftover sample? In most cases, leftover samples go in the waste bin, destined for incineration. Sometimes though, they may be used again for other purposes, including research.
Kaboompics.com/Pexels Who can use my leftover samples?
The samples we’re talking about here cover the range of samples clinical labs receive in the normal course of their testing work. These include blood and its various components (including plasma and serum), urine, faeces, joint and spinal fluids, swabs (such as from the nose or a wound), and tissue samples from biopsies, among others.
Clinical pathology labs often use leftover samples to practise or check their testing methods and help ensure test accuracy. This type of use is a vital part of the quality assurance processes labs need to perform, and is not considered research.
Leftover samples can also be used by researchers from a range of agencies such as universities, research institutes or private companies.
They may use leftover samples for research activities such as trying out new ideas or conducting small-scale studies (more on this later). Companies that develop new or improved medical diagnostic tests can also use leftover samples to assess the efficacy of their test, generating data needed for regulatory approval.
What about informed consent?
If you’ve ever participated in a medical research project such as a clinical trial, you may be familiar with the concept of informed consent. In this process, you have the opportunity to learn about the study and what your participation involves, before you decide whether or not to participate.
So you may be surprised to learn using leftover samples for research purposes without your consent is permitted in most parts of Australia, and elsewhere. However, it’s only allowed under certain conditions.
In Australia, the National Health and Medical Research Council (NHMRC) offers guidance around the use of leftover pathology samples.
One of the conditions for using leftover samples without consent for research is that they were received and retained by an accredited pathology service. This helps ensure the samples were collected safely and properly, for a legitimate clinical reason, and that no additional burdens or risk of harm to the person who provided the sample will be created with their further use.
Another condition is anonymity: the leftover samples must be deidentified, and not easily able to be reidentified. This means they can only be used in research if the identity of the donor is not needed.
Leftover pathology samples are sometimes used in medical research. hedgehog94/Shutterstock The decision to allow a particular research project to use leftover pathology samples is made by an independent human research ethics committee which includes consumers and independent experts. The committee evaluates the project and weighs up the risks and potential benefits before permitting an exemption to the need for informed consent.
Similar frameworks exist in the United States, the United Kingdom, India and elsewhere.
What research might be done on my leftover samples?
You might wonder how useful leftover samples are, particularly when they’re not linked to a person and their medical history. But these samples can still be a valuable resource, particularly for early-stage “discovery” research.
Research using leftover samples has helped our understanding of antibiotic resistance in a bacterium that causes stomach ulcers, Helicobacter pylori. It has helped us understand how malaria parasites, Plasmodium falciparum, damage red blood cells.
Leftover samples are also helping researchers identify better, less invasive ways to detect chronic diseases such as pulmonary fibrosis. And they’re allowing scientists to assess the prevalence of a variant in haemoglobin that can interfere with widely used diagnostic blood tests.
All of this can be done without your permission. The kinds of tests researchers do on leftover samples will not harm the person they were taken from in any way. However, using what would otherwise be discarded allows researchers to test a new method or treatment and avoid burdening people with providing fresh samples specifically for the research.
When considering questions of ethics, it could be argued not using these samples to derive maximum benefit is in fact unethical, because their potential is wasted. Using leftover samples also minimises the cost of preliminary studies, which are often funded by taxpayers.
The use of leftover pathology samples in research has been subject to some debate. Andrey_Popov/Shutterstock Inconsistencies in policy
Despite NHMRC guidance, certain states and territories have their own legislation and guidelines which differ in important ways. For instance, in New South Wales, only pathology services may use leftover specimens for certain types of internal work. In all other cases consent must be obtained.
Ethical standards and their application in research are not static, and they evolve over time. As medical research continues to advance, so too will the frameworks that govern the use of leftover samples. Nonetheless, developing a nationally consistent approach on this issue would be ideal.
Striking a balance between ensuring ethical integrity and fostering scientific discovery is essential. With ongoing dialogue and oversight, leftover pathology samples will continue to play a crucial role in driving innovation and advances in health care, while respecting the privacy and rights of individuals.
Christine Carson, Senior Research Fellow, School of Medicine, The University of Western Australia and Nikolajs Zeps, Professor, School of Public Health and Preventive Medicine, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Many Faces Of Cosmetic Surgery
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Cosmetic Surgery: What’s The Truth?
In Tuesday’s newsletter, we asked you your opinion on elective cosmetic surgeries, and got the above-depicted, below-described, set of responses:
- About 48% said “Everyone should be able to get what they want, assuming informed consent”
- About 28% said “It can ease discomfort to bring features more in line with normalcy”
- 15% said “They should be available in the case of extreme disfigurement only”
- 10% said “No elective cosmetic surgery should ever be performed; needless danger”
Well, there was a clear gradient of responses there! Not so polarizing as we might have expected, but still enough dissent for discussion
So what does the science say?
The risks of cosmetic surgery outweigh the benefits: True or False?
False, subjectively (but this is important).
You may be wondering: how is science subjective?
And the answer is: the science is not subjective, but people’s cost:worth calculations are. What’s worth it to one person absolutely may not be worth it to another. Which means: for those for whom it wouldn’t be worth it, they are usually the people who will not choose the elective surgery.
Let’s look at some numbers (specifically, regret rates for various surgeries, elective/cosmetic or otherwise):
- Regret rate for elective cosmetic surgery in general: 20%
- Regret rate for knee replacement (i.e., not cosmetic): 17.1%
- Regret rate for hip replacement (i.e., not cosmetic): 4.8%
- Regret rate for gender-affirming surgeries (for transgender patients): 1%
So we can see, elective surgeries have an 80–99% satisfaction rate, depending on what they are. In comparison, the two joint replacements we mentioned have a 82.9–95.2% satisfaction rate. Not too dissimilar, taken in aggregate!
In other words: if a person has studied the risks and benefits of a surgery and decides to go ahead, they’re probably going to be happy with the results, and for them, the benefits will have outweighed the risks.
Sources for the above numbers, by the way:
- What is the regret rate for plastic surgery?
- Decision regret after primary hip and knee replacement surgery
- A systematic review of patient regret after surgery—a common phenomenon in many specialties but rare within gender-affirmation surgery
But it’s just a vanity; therapy is what’s needed instead: True or False?
False, generally. True, sometimes. Whatever the reasons for why someone feels the way they do about their appearance—whether their face got burned in a fire or they just have triple-J cups that they’d like reduced, it’s generally something they’ve already done a lot of thinking about. Nevertheless, it does also sometimes happen that it’s a case of someone hoping it’ll be the magical solution, when in reality something else is also needed.
How to know the difference? One factor is whether the surgery is “type change” or “restorative”, and both have their pros and cons.
- In “type change” (e.g. rhinoplasty), more psychological adjustment is needed, but when it’s all over, the person has a new nose and, statistically speaking, is usually happy with it.
- In “restorative” (e.g. facelift), less psychological adjustment is needed (as it’s just a return to a previous state), so a person will usually be happy quickly, but ultimately it is merely “kicking the can down the road” if the underlying problem is “fear of aging”, for example. In such a case, likely talking therapy would be beneficial—whether in place of, or alongside, cosmetic surgery.
Here’s an interesting paper on that; the sample sizes are small, but the discussion about the ideas at hand is a worthwhile read:
Does cosmetic surgery improve psychosocial wellbeing?
Some people will never be happy no matter how many surgeries they get: True or False?
True! We’re going to refer to the above paper again for this one. In particular, here’s what it said about one group for whom surgeries will not usually be helpful:
❝There is a particular subgroup of people who appear to respond poorly to cosmetic procedures. These are people with the psychiatric disorder known as “body dysmorphic disorder” (BDD). BDD is characterised by a preoccupation with an objectively absent or minimal deformity that causes clinically significant distress or impairment in social, occupational, or other areas of functioning.
For several reasons, it is important to recognise BDD in cosmetic surgery settings:
Firstly, it appears that cosmetic procedures are rarely beneficial for these people. Most patients with BDD who have had a cosmetic procedure report that it was unsatisfactory and did not diminish concerns about their appearance.
Secondly, BDD is a treatable disorder. Serotonin-reuptake inhibitors and cognitive behaviour therapy have been shown to be effective in about two-thirds of patients with BDD❞
~ Dr. David Castle et al. (lightly edited for brevity)
Which is a big difference compared to, for example, someone having triple-J breasts that need reducing, or the wrong genitals for their gender, or a face whose features are distinct outliers.
Whether that’s a reason people with BDD shouldn’t be able to get it is an ethical question rather than a scientific one, so we’ll not try to address that with science.
After all, many people (in general) will try to fix their woes with a haircut, a tattoo, or even a new sportscar, and those might sometimes be bad decisions, but they are still the person’s decision to make.
And even so, there can be protectionist laws/regulations that may provide a speed-bump, for example:
Take care!
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