The Oral Census Report

Brought to you by Listerine in association with the

British Dental Health Foundation

The straight truth about oral health

habits and attitudes in the UK today

The British Dental Health Foundation is the UK’s leading oral health charity, with a 40–year track record of providing public information and influencing government policy. The Foundation runs National Smile Month each May to promote greater awareness of the benefits of better oral health. For more information visit www.dentalhealth.org and www.smilemonth.org.

Amanda Hamilton: Amanda is a Nutritionist, broadcaster and writer, as well as a Senior Associate of the Royal Society of Medicine and a member of the Guild of Health Writers. Amanda often talks about being careful about the food you put in your mouth rather than the mouth itself, but of course it has an important role in our overall health.

Emma Kenny: Emma Kenny is a qualified behavioural psychologist. Emma believes that feeling good is all about believing that you are getting the very best out of your life and that motivating yourself to change for the better is all about choice. She was therefore keen to be involved with the Oral Census report to help encourage people to reassess their oral health and smile with confidence.

Professor Nairn Wilson, CBE, DSc (hc), FDS, FFGDP, FFD, FKC Nairn Wilson is the Honorary Professor of Dentistry, former Dean and Head of King’s College London Dental Institute. His expertise encompasses the regulation of dentistry, international trends in dental education, tooth-coloured filling materials and related systems and minimally invasive approaches to Conservative Dentistry.

ABOUT THE ORAL CENSUS: PREVENTION: The Future Of The Nation’s Oral Health

FOREWORD:by Dr Nigel Carter OBE, Chief Executive of the British Dental Health Foundation

“ There’s no doubt that oral care is improving overall in this country. But for all our advances in dental care, a surprising number of people are still lacking when it comes to looking after their teeth.

It is true that our teeth are lasting longer than ever these days. But we must accept far more responsibility for our oral health if we want our teeth to last us a lifetime.

Many people who visit a dentist may well remember when six-monthly dental check-ups used to be the norm. The National Institute for Clinical Excellence, however, now recommends that the recall interval between routine dental examinations can be as infrequently as every two years for adults.

This places an ever increasing importance on prevention and education. It’s by far the biggest challenge we face, and we need to ensure the continuation of investment in these areas if we are to see even greater improvements to oral health in future years.

The changing landscape of dental care in the UK and a push towards less frequent dental check-ups will undoubtedly see the focus shifting away from the dental surgery and into the home. However this survey reveals that some of our oral health behaviours such as the consumption of sugary foods and drinks, cigarettes and alcohol, are letting us down – a fact that contradicts society's obsession with celebrities and to achieve the perfect Hollywood smile.

With prevention becoming an increasingly important part of oral care, it is, however, essential to confront our bad habits. The LISTERINE® Oral Census has uncovered three key factors that are significantly affecting the state of the nation's dental health today. And it is these things – diet, stress and our oral care habits – that are the subject of this report.”

BRITISH DENTAL HEALTH FOUNDATION:

MEET OUR EXPERTS:

KEY FINDINGS: Listerine Oral Census: key findings

• Almost a quarter of women turn to food and drink – including sugary foods, when they’re stressed1

• When it comes to the idea of a beautiful smile, almost twice as many people are influenced by celebrities compared to those influenced by their dentist’s advice2

• Almost seven in 10 believe having bad teeth can hold you back in life3 – yet fewer than one in three floss every day4

• Three quarters of people think having bad teeth can shake your self-confidence when interacting with others5, but only a quarter of us brush for longer than two minutes6

• Less than half of people regularly use mouthwash4, despite bad breath being one of the top of a list of oral hygiene concerns7

How often do we see our dentist?8

More than every three months 5%

Every six months 49%

Once a year 22%

Once every 2 years 7%



Less than every 4 years 6%

Never 6%

Dr Nigel Carter OBEChief Executive of the British Dental Health Foundation

The British Dental Health Foundation is the UK’s leading oral health charity, with a 40–year track record of providing public information and influencing government policy. The Foundation runs National Smile Month each May to promote greater awareness of the benefits of better oral health. For more information visit www.dentalhealth.org and www.smilemonth.org.

Amanda Hamilton: Amanda is a Nutritionist, broadcaster and writer, as well as a Senior Associate of the Royal Society of Medicine and a member of the Guild of Health Writers. Amanda often talks about being careful about the food you put in your mouth rather than the mouth itself, but of course it has an important role in our overall health.

Emma Kenny: Emma Kenny is a qualified behavioural psychologist. Emma believes that feeling good is all about believing that you are getting the very best out of your life and that motivating yourself to change for the better is all about choice. She was therefore keen to be involved with the Oral Census report to help encourage people to reassess their oral health and smile with confidence.

Professor Nairn Wilson, CBE, DSc (hc), FDS, FFGDP, FFD, FKC Nairn Wilson is the Honorary Professor of Dentistry, former Dean and Head of King’s College London Dental Institute. His expertise encompasses the regulation of dentistry, international trends in dental education, tooth-coloured filling materials and related systems and minimally invasive approaches to Conservative Dentistry.

ABOUT THE ORAL CENSUS: PREVENTION: The Future Of The Nation’s Oral Health

FOREWORD:by Dr Nigel Carter OBE, Chief Executive of the British Dental Health Foundation

“ There’s no doubt that oral care is improving overall in this country. But for all our advances in dental care, a surprising number of people are still lacking when it comes to looking after their teeth.

It is true that our teeth are lasting longer than ever these days. But we must accept far more responsibility for our oral health if we want our teeth to last us a lifetime.

Many people who visit a dentist may well remember when six-monthly dental check-ups used to be the norm. The National Institute for Clinical Excellence, however, now recommends that the recall interval between routine dental examinations can be as infrequently as every two years for adults.

This places an ever increasing importance on prevention and education. It’s by far the biggest challenge we face, and we need to ensure the continuation of investment in these areas if we are to see even greater improvements to oral health in future years.

The changing landscape of dental care in the UK and a push towards less frequent dental check-ups will undoubtedly see the focus shifting away from the dental surgery and into the home. However this survey reveals that some of our oral health behaviours such as the consumption of sugary foods and drinks, cigarettes and alcohol, are letting us down – a fact that contradicts society's obsession with celebrities and to achieve the perfect Hollywood smile.

With prevention becoming an increasingly important part of oral care, it is, however, essential to confront our bad habits. The LISTERINE® Oral Census has uncovered three key factors that are significantly affecting the state of the nation's dental health today. And it is these things – diet, stress and our oral care habits – that are the subject of this report.”

BRITISH DENTAL HEALTH FOUNDATION:

MEET OUR EXPERTS:

KEY FINDINGS: Listerine Oral Census: key findings

• Almost a quarter of women turn to food and drink – including sugary foods, when they’re stressed1

• When it comes to the idea of a beautiful smile, almost twice as many people are influenced by celebrities compared to those influenced by their dentist’s advice2

• Almost seven in 10 believe having bad teeth can hold you back in life3 – yet fewer than one in three floss every day4

• Three quarters of people think having bad teeth can shake your self-confidence when interacting with others5, but only a quarter of us brush for longer than two minutes6

• Less than half of people regularly use mouthwash4, despite bad breath being one of the top of a list of oral hygiene concerns7

How often do we see our dentist?8

More than every three months 5%

Every six months 49%

Once a year 22%




Less than every 4 years 6%

Never 6%

Dr Nigel Carter OBEChief Executive of the British Dental Health Foundation

Improving the nation’s diet is a key priority for government and healthcare professionals11. But a healthy, balanced diet is also recommended for the prevention of tooth decay and dental erosion12.

Experts agree that eating fewer foods containing non-milk extrinsic sugars (NMEs) – sugar added to food by consumers and food manufacturers – could make a major contribution to the improvement of our dental health13.

But it’s not just the obvious sweet foods that you have to be aware of” says Amanda Hamilton.

Some foods that are often considered to be healthy are also high in sugar, including dried fruits, honey, fresh fruit juices and smoothies.”

Acidic foods and drinks can also cause dental erosion, such as soft drinks (including carbonated, non-carbonated and ‘diet’ varieties), wine, cider, spirits with mixers, fruit juice, fruit tea, vinegar and pickles.”

STRESS, SUGAR AND SELF-MEDICATION DIET AND DENTAL HEALTH:

Stress is undoubtedly a concern for many people, with 38% of participants admitting it has an impact on their lives. 20% admit that their lives have been impacted by long working hours.9

While some people turn to alcohol, cigarettes and caffeine, our survey shows that far more of us eat, drink and indulge in extra sugary snacks when we’re stressed. When asked what are you most likely to do when stressed, 21% say they eat more sugary snacks. 21% generally eat and drink more, with 9% turning to alcohol, 6% drinking more caffeine and 7% smoking more than usual.

In today’s busy modern life many of us are running around trying to maintain and balance work, social and family life,” says leading behavioural psychologist Emma Kenny. “Not only do we sometimes want sweet foods to make us feel better when we’re run down from stress, but we also know that it can give us a short-term boost to get us through a few hectic hours.”

According to nutritionist Amanda Hamilton, the impact all that sugar may be having on our teeth cannot be underestimated. “Sugar, it seems, is our crutch of choice, especially when we’re stressed,” she says. “And because we lead increasingly stressful lives, we’re eating more of it than ever before. This has an obvious impact on your teeth.

Just like other crutches we have for stress such as alcohol, caffeine and nicotine, it’s worth remembering that a short-term boost can have a long-term impact – in this case, on your smile.”

BAD HABITS:

SUGAR CONTENT:

Amanda Hamilton

1

What food labels mean14

21%

HIGH LOW

OR MORE PER 100g OR LESS PER 100g

7%Cigarettes

Sugary Treats

21%Food & Drink

9%Alcohol

15g 5g6%Caffeine

%d & DrinkFooFoo

What we turn to when we’re stressed10

“

“

“

“

“

Improving the nation’s diet is a key priority for government and healthcare professionals11. But a healthy, balanced diet is also recommended for the prevention of tooth decay and dental erosion12.

Experts agree that eating fewer foods containing non-milk extrinsic sugars (NMEs) – sugar added to food by consumers and food manufacturers – could make a major contribution to the improvement of our dental health13.

But it’s not just the obvious sweet foods that you have to be aware of” says Amanda Hamilton.

Some foods that are often considered to be healthy are also high in sugar, including dried fruits, honey, fresh fruit juices and smoothies.”

Acidic foods and drinks can also cause dental erosion, such as soft drinks (including carbonated, non-carbonated and ‘diet’ varieties), wine, cider, spirits with mixers, fruit juice, fruit tea, vinegar and pickles.”

STRESS, SUGAR AND SELF-MEDICATION DIET AND DENTAL HEALTH:

Stress is undoubtedly a concern for many people, with 38% of participants admitting it has an impact on their lives. 20% admit that their lives have been impacted by long working hours.9

While some people turn to alcohol, cigarettes and caffeine, our survey shows that far more of us eat, drink and indulge in extra sugary snacks when we’re stressed. When asked what are you most likely to do when stressed, 21% say they eat more sugary snacks. 21% generally eat and drink more, with 9% turning to alcohol, 6% drinking more caffeine and 7% smoking more than usual.

In today’s busy modern life many of us are running around trying to maintain and balance work, social and family life,” says leading behavioural psychologist Emma Kenny. “Not only do we sometimes want sweet foods to make us feel better when we’re run down from stress, but we also know that it can give us a short-term boost to get us through a few hectic hours.”

According to nutritionist Amanda Hamilton, the impact all that sugar may be having on our teeth cannot be underestimated. “Sugar, it seems, is our crutch of choice, especially when we’re stressed,” she says. “And because we lead increasingly stressful lives, we’re eating more of it than ever before. This has an obvious impact on your teeth.

Just like other crutches we have for stress such as alcohol, caffeine and nicotine, it’s worth remembering that a short-term boost can have a long-term impact – in this case, on your smile.”

BAD HABITS:

SUGAR CONTENT:

Amanda Hamilton

1

What food labels mean14

21%

HIGH LOW

OR MORE PER 100g OR LESS PER 100g

7%Cigarettes

Sugary Treats

21%Food & Drink

9%Alcohol

15g 5g6%Caffeine

%d & DrinkFooFoo

What we turn to when we’re stressed10

“

“

“

“

“

The Listerine Oral Census shows that nearly 8 in 10 people believe your teeth’s appearance has a moderate to significant impact on your self-confidence15 - in fact 68% of respondents believe having bad teeth can hold you back in life.3

Three quarters of us think having bad teeth also affects our self-confidence while interacting with others.5 Despite this, only a quarter of us brush for more than two minutes6 and 44% of 18-24-year-olds have never been to a dental hygienist16.

The way we feel we look can affect the way we carry ourselves in our day to day lives, and in turn directly affects our self-confidence,” says Emma Kenny. “If we feel that we don’t look our best, this can sometimes impact negatively on our work, professional lives and also on our relationships.”

The big question is, if image is so important to us – and, for so many people, that means having a great smile – why aren’t we more mouth motivated?”

These days the influence of celebrities has spread to many areas of our daily lives, including our oral health; with 25% admitting we’re influenced by celebrities2.

SMILING WITH CONFIDENCE:The Nation’s Dental Psyche

FIVE-STEP CHARTER FOR A HEALTHIER SMILE

While many people may realise how important it is to have healthy teeth and gums, the Listerine Oral Census has uncovered significant deficiencies in the nation's oral health habits. Accepting that prevention is a priority is one thing, but putting it into practice requires action. Here are five things everyone can do differently starting today for a better, healthier smile...

Which Celebs Have The Best Smiles?17

THE INFLUENCE OFCELEBRITY CULTURE:Emma Kenny

We all make very fast judgements of each other based on a smile – we know from research that clean, white teeth are an integral part of that,” explains Emma. “Cheryl Cole is likely to have achieved a high score here because she has a wide confident smile, which in human communication terms suggests openness and confidence.”

Stick to the two-minute ruleOnly a quarter of people brush for the recommended amount of time6, so resolve to brush your teeth for at least two minutes, twice a day. Cover the outer, inner and biting surfaces, giving equal time to each tooth surface18. If you’re not sure you can get the timing right, invest in an electric toothbrush with a built-in timer.

1.Commit to better cleaningWhile brushing is essential, regular flossing helps to remove plaque that forms under the gum line that brushing misses18. However only 27% of people floss daily4. Getting into flossing on a regular basis may reduce gum disease and bad breath19, so make a habit of cleaning between your teeth daily. If you find using conventional floss tricky, try flossers or interdental brushes.

2.

Resolve to rinse regularlyBrushing only cleans 25% of the mouth, mouthwash will clean virtually 100%. Yet only 4 in 10 say they use mouthwash on a regular basis4. Mouthwash also has benefits such as helping to beat bad breath and reducing plaque bacteria to maintain gum health. So make using mouthwash an indispensible part of your daily oral hygiene routine.

3.Eat for your teethBe kind to your teeth and eat fewer sugary snacks, even when you're under stress. If you must have something sweet, only have it at mealtimes, as the saliva produced in your mouth during a meal may help protect your teeth against decay. Also avoid brushing your teeth for at least an hour after eating or drinking anything acidic, such as orange juice or fruit. Being exposed to acids in food and drink is thought to soften your teeth's enamel, so if you brush immediately afterwards, it could increase the chance of dental erosion.20

4.

Make prevention a priorityAs a result of the latest NICE guidelines (published in 2004) on recall intervals between check-ups, you may no longer enjoy six-monthly dental check-ups if you have good oral health21. That means it's more important than ever to practise effective oral health behaviours at home to prevent any problems developing between visits to your dentist. So make brushing for the recommended amount of time, flossing and rinsing daily, and eating a tooth-friendly diet – as well as seeing your dentist and hygienist as regularly as they recommend – a priority.

5.

‘Almost seven in 10

believe having bad teeth

can hold you back in life

while three quarters think

having bad teeth can

shake your self-confidence’

3

5

‘When it comes to the idea

of a beautiful smile,

more than twice as many people

are influenced by celebrities

rather than their dentist’ Tulisa Contostavlos

Kate Middleton

Holly Willoughby

Julia Roberts

Angelina Jolie

Cameron Diaz

Emma Watson

14%

13%

12.6%

5%

4.5%

4%

Cheryl Cole 18%

2%

“

“

“

The Listerine Oral Census shows that nearly 8 in 10 people believe your teeth’s appearance has a moderate to significant impact on your self-confidence15 - in fact 68% of respondents believe having bad teeth can hold you back in life.3

Three quarters of us think having bad teeth also affects our self-confidence while interacting with others.5 Despite this, only a quarter of us brush for more than two minutes6 and 44% of 18-24-year-olds have never been to a dental hygienist16.

The way we feel we look can affect the way we carry ourselves in our day to day lives, and in turn directly affects our self-confidence,” says Emma Kenny. “If we feel that we don’t look our best, this can sometimes impact negatively on our work, professional lives and also on our relationships.”

The big question is, if image is so important to us – and, for so many people, that means having a great smile – why aren’t we more mouth motivated?”

These days the influence of celebrities has spread to many areas of our daily lives, including our oral health; with 25% admitting we’re influenced by celebrities2.

SMILING WITH CONFIDENCE:The Nation’s Dental Psyche

FIVE-STEP CHARTER FOR A HEALTHIER SMILE

While many people may realise how important it is to have healthy teeth and gums, the Listerine Oral Census has uncovered significant deficiencies in the nation's oral health habits. Accepting that prevention is a priority is one thing, but putting it into practice requires action. Here are five things everyone can do differently starting today for a better, healthier smile...

Which Celebs Have The Best Smiles?17

THE INFLUENCE OFCELEBRITY CULTURE:Emma Kenny

We all make very fast judgements of each other based on a smile – we know from research that clean, white teeth are an integral part of that,” explains Emma. “Cheryl Cole is likely to have achieved a high score here because she has a wide confident smile, which in human communication terms suggests openness and confidence.”

Stick to the two-minute ruleOnly a quarter of people brush for the recommended amount of time6, so resolve to brush your teeth for at least two minutes, twice a day. Cover the outer, inner and biting surfaces, giving equal time to each tooth surface18. If you’re not sure you can get the timing right, invest in an electric toothbrush with a built-in timer.

1.Commit to better cleaningWhile brushing is essential, regular flossing helps to remove plaque that forms under the gum line that brushing misses18. However only 27% of people floss daily4. Getting into flossing on a regular basis may reduce gum disease and bad breath19, so make a habit of cleaning between your teeth daily. If you find using conventional floss tricky, try flossers or interdental brushes.

2.

Resolve to rinse regularlyBrushing only cleans 25% of the mouth, mouthwash will clean virtually 100%. Yet only 4 in 10 say they use mouthwash on a regular basis4. Mouthwash also has benefits such as helping to beat bad breath and reducing plaque bacteria to maintain gum health. So make using mouthwash an indispensible part of your daily oral hygiene routine.

3.Eat for your teethBe kind to your teeth and eat fewer sugary snacks, even when you're under stress. If you must have something sweet, only have it at mealtimes, as the saliva produced in your mouth during a meal may help protect your teeth against decay. Also avoid brushing your teeth for at least an hour after eating or drinking anything acidic, such as orange juice or fruit. Being exposed to acids in food and drink is thought to soften your teeth's enamel, so if you brush immediately afterwards, it could increase the chance of dental erosion.20

4.

Make prevention a priorityAs a result of the latest NICE guidelines (published in 2004) on recall intervals between check-ups, you may no longer enjoy six-monthly dental check-ups if you have good oral health21. That means it's more important than ever to practise effective oral health behaviours at home to prevent any problems developing between visits to your dentist. So make brushing for the recommended amount of time, flossing and rinsing daily, and eating a tooth-friendly diet – as well as seeing your dentist and hygienist as regularly as they recommend – a priority.

5.

‘Almost seven in 10

believe having bad teeth

can hold you back in life

while three quarters think

having bad teeth can

shake your self-confidence’

3

5

‘When it comes to the idea

of a beautiful smile,

more than twice as many people

are influenced by celebrities

rather than their dentist’ Tulisa Contostavlos

Kate Middleton

Holly Willoughby

Julia Roberts

Angelina Jolie

Cameron Diaz

Emma Watson

14%

13%

12.6%

5%

4.5%

4%

Cheryl Cole 18%

2%

“

“

“

ABOUT LISTERINE®

Your mouth is incredible. Just think about it. You do so much with it, and more importantly, to it, all day – every day. Every single thing you put into your mouth is covered in germs. There could be as many as seven billion bacteria in your mouth at any one time. That’s so many, that not even brushing can get rid of them all! Brushing may leave your teeth feeling clean, but it doesn’t get rid

of all the bad bacteria that have set up home in your mouth.

But don’t worry, keeping your mouth at its best isn’t as hard as you may think. LISTERINE® powers through your whole mouth to provide a deep clean in even those hard-to-reach places. It kills up to 97% of germs left behind after brushing, keeping your mouth fresh for up to 12 hours.

With a variety of different product variants, you’re sure to find one that suits you.

LISTERINE® – Power To Your Mouth

For more information on the LISTERINE® range, visit www.listerine.co.uk

References:1Listerine/One Pole Consumer Questionnaire, June 2012, Q202Listerine/One Pole Consumer Questionnaire, June 2012, Q29 3Listerine/One Pole Consumer Questionnaire, June 2012, Q33 4Listerine/One Pole Consumer Questionnaire, June 2012, Q44 5Listerine/One Pole Consumer Questionnaire, June 2012, Q34 6Listerine/One Pole Consumer Questionnaire, June 2012, Q16 7Listerine/One Pole Consumer Questionnaire, June 2012, Q31

8Listerine/One Pole Consumer Questionnaire, June 2012, Q3 9Listerine/One Pole Consumer Questionnaire, June 2012, Q23 10Listerine/One Pole Consumer Questionnaire, June 2012, Q20

11The Department of Health, 2007, The NHS Plan: a plan for investment a plan for reform - 13 Improving health and reducing inequality (online) Available at: http://webarchive.nationalarchives.gov.uk/+/www.dh.gov-

.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_5207943 Accessed 06.03.1312NHS Choices, 2011, Healthy life and teeth –Live Well (online) Available at: http://www.nhs.uk/Livewell/dentalhealth/Pages/Keepteethhealthy.aspx

Accessed on 06.03.1313The National Institute of Clinical Excellence, 1990, Sugars in the diet (online) Available at: http://www.nice.org.uk/nicemedia/documents/sugarsin-

thediet_briefing.pdf Accessed on 06.03.13 14NHS Choices, 2011, Food Labelling – Live Well (online) Available at: http://www.nhs.uk/Livewell/Goodfood/Pages/food-labelling.aspx Accessed on

06.03.1315Listerine/One Pole Consumer Questionnaire, June 2012, Q2716Listerine/One Pole Consumer Questionnaire, June 2012, Q4

17Listerine/One Pole Consumer Questionnaire, June 2012, Q3018British Dental Health Foundation, 2010, Tell me about – Caring for my teeth (online) Available at: http://www.dentalhealth.org/tell-me-about/top-

ic/caring-for-teeth/caring-for-my-teeth Accessed on 06.03.1319British Dental Health Foundation, 2010, Tell me about – Bad Breath (online) Available at: http://www.dentalhealth.org/tell-me-about/topic/sun-

dry/bad-breath Accessed on 06.03.1320British Dental Health Foundation, 2010, Tell me about (online) Available at: http://www.dentalhealth.org/tell-me-about Accessed on 06.03.1321The National Institute of Clinical Excellence, 2004, When should my next check-up be? (online) Available at: http://www.nice.org.uk/niceme-

dia/live/10952/29494/29494.pdf Accessed on 07.03.13

Documents

The Oral Census Report