Episode 3 Health: Truth or Scare

Every day, we're bombarded with conflicting messages

about how to live a healthy, happy life.

One minute, we're told something's the right thing to do.

The next, it's the complete opposite.

And we're left without a clue which advice to follow.

So we've been wading through the confusion

to separate the scare stories from the truth

to help you work out what's best for you.

Today, we're unpicking some of the confusing claims

about items you might well have in your bathroom cabinet.

It's the little pill with big powers.

But should more of us be taking an aspirin a day?

I've got to be absolutely honest, if I don't take it,

the next day, I know about it.

From soothing cuts and burns to helping weight loss

and even treating IBS,

do all the claims about aloe vera really stack up?

There's lots of different causes for IBS.

-Some people think IBS is started by stress.

-Yes, definitely.

-Sometimes, it's started by their poor diet.

-That's right.

So the thought that one particular substance,

whether it be medicine or whether it be aloe vera,

can be the cure for it is ridiculous,

because you're not treating the cause.

And is it time to toss the floss?

We investigate claims that flossing between your teeth is pointless.

We do have very good evidence about brushing your teeth.

When we get down to flossing,

we don't have the same amount of evidence.

You know, there aren't too many drugs

that can be bought for just a fraction of a penny a pill.

And yet, they are so powerful

they are frequently referred to as "wonder drugs".

But I tell you,

aspirin has been linked to all manner of health benefits.

One of the many headlines here...

And I can add to that list, actually.

It goes from curing sepsis to battling certain cancers,

boosting the chances of getting pregnant, even,

to reducing your risk of heart disease and stroke, of course,

-which we've known for a long time.

-Absolutely.

I've heard it's meant to be indispensable

for people who have had a heart attack.

And, of course, those who want to reduce

the risk of having another one.

Absolutely.

Well, it turns out that the list of things

that aspirin really can apparently do is longer than your arm.

But it's also been said to have some very dangerous side effects,

which I think is quite a worry.

So I thought it was time that I set out to discover

if aspirin really is one of the wonder drugs of the 21st century.

Just about to do a first stretch of the narrowing here.

Heart patient Ray Goodwin is in the middle of an operation

to fit what's called a stent -

a small tube that will help open up one of his arteries...

-So I'm coming in here, all right? Have you got the wire?

-Yeah.

..and improve blood flow to the heart.

The success of this operation has been helped enormously

by the fact that last night

Ray took a massive 600 milligram dose of this drug.

Now, we're not talking here about something that's a pioneering

or a multi-million pound drug

which is right at the cutting edge of medical science,

this is a drug that's been around for well over 100 years.

It's aspirin.

In specialist heart and chest hospitals,

like this one in Liverpool, aspirin really is essential

because it reduces the chances of blood clotting...

And maybe just zoom in a little bit.

..simplifying surgery for staff

like consultant cardiologist Raphael Perry.

The wire's gone down the blockage nice and smoothly.

Dr Perry, can I just ask you, how important aspirin is

to enable you to do this operation successfully?

It's really making it safer, in terms of...

..occasionally, when you've got instruments in the small arteries,

there's a propensity to clotting and blocking the artery,

maybe flying off down other arteries,

so the pre-loading with aspirin and any other drugs during the procedure

mitigate against that.

So, the bottom line is, really,

you couldn't have done this operation without aspirin.

Absolutely. We wouldn't do the procedure without.

For most of us, me included, aspirin is a humble painkiller.

But you don't have to look far for claims that,

in homes and hospitals up and down the country,

it's much more than that.

It's credited with increasing the chances of falling pregnant,

curing sepsis, targeting tumours,

fighting some cancers and fending off others.

But the boldest claims attached to this humble little pill

all revolve around one idea -

that lots of us should be taking a small dose of aspirin every day.

When Ray leaves here,

that's just what he'll be told to do for the rest of his life.

It'll help keep the blood flowing through the stent

and, of course, his heart.

-All done?

-All done.

-Successful?

-Successful.

-He's on aspirin now.

-He's on aspirin.

And his other usual drugs, if you like, for him to continue on.

And if he doesn't get any symptoms in the next three months,

you'd imagine you'll have a long-term success

from that stent procedure,

-not just a short-term value.

-Brilliant.

-So a good morning's work, then.

-Not bad.

Up on the wards, dozens of patients will all leave here

with instructions to take a small dose of aspirin a day.

And that's just what David has been doing for the past seven years.

David, you're looking very cheerful.

-But I gather you've had quite a serious operation.

-Yes.

-Yes, quite serious.

-What did they do?

I've had a bypass graft

and they've changed the aorta valve.

Dare I say, I got two for the price of one!

It was quite complicated, by the sound of it.

But, now, aspirin...

How important has aspirin been to you?

Because you had a heart attack how many years ago?

The first one I had

was probably about seven years ago, I would have thought.

But I've been on soluble aspirin ever since.

But I've got to be absolutely honest, if I don't take it,

the next day, I know about it.

-Would you have thought something as humble as an aspirin...

-No.

-..could be that...

-No.

-..important to you?

-No. No.

No. When my doctor said, "I'm putting you on aspirin,"

I thought, "Well, I took aspirin as a kid."

You know, it was sort of the last resort, aspirin.

But I never thought that it would still be going now.

-But it obviously is.

-Yeah.

-And how long now before you go home?

-I'm hoping early next week.

Well, David, we hope that you do get home next week

-and that you stay well.

-Thank you so much. Lovely to meet you.

And pleasure to see you, too. Thank you.

David and, indeed, many of the other patients in this hospital

will be told to take aspirin

to treat the heart conditions they already have.

But looking at some of the reports about aspirin,

there are claims that it would benefit those of us

who don't have a heart problem.

Dr Raphael Perry says they are broadly true.

Well, there is good evidence

that taking aspirin daily is of benefit,

because it reduces the effects of vascular disease,

in particular, heart attack and stroke.

There's a lot of data published on this,

which is, should people just take aspirin

in the hope that they're not going to have something wrong with them in the future?

And if you aggregate all those trials,

there is a benefit in taking aspirin

to reduce both heart and vascular disease.

But there's a catch... Aspirin has side effects.

You can have...

quite significant bleeding side effects.

And you have to pick the patients that are going to benefit most

in order to mitigate that risk, in a sense.

So people should be aware that, if they're taking aspirin,

-it will thin their blood significantly.

-Absolutely.

Although rare, the greater chance of bleeding

can increase the risk of some types of strokes.

And aspirin can also irritate the stomach lining,

causing indigestion, nausea

and, in extreme cases, even leading to ulcers.

Dr Perry says, if you've only got a very low risk

of developing heart disease,

an aspirin a day isn't right for you.

You just have to take that into the mix and say, "Is it worth it?"

And for someone who's 40 and well, with no family history,

normal cholesterol, no risk factors for heart disease,

then the risk of them having a heart attack

or something develop with their heart

over that ten years is very low.

It's maybe 4% or something of that order.

And once it starts to creep up to that 15% or a higher risk,

then the value of aspirin becomes more significant.

But some reports don't always make that trade-off clear.

And seeing stories like this about an American study,

which recommended that everyone over the age of 51

should be taking a small dose of aspirin a day,

you might be tempted to do the same thing

without knowing the full story.

What strikes me is that aspirin

is such a cheap thing to buy over the counter,

it would be very easy for people to think

that they have to self-medicate,

just go and buy it because they think there might be a risk.

But you, obviously, would recommend against that.

I think that it's a long-term treatment.

The benefit isn't really evident until year ten or 11.

I would always recommend that,

if you're going onto something long-term, in particular,

then you should do that through your doctor

-with some advice and a professional view.

-Mm.

But while the vast majority of us

don't need to take an aspirin a day,

elsewhere in the hospital, there are dozens of patients who do.

Including bypass patient Doreen.

Doreen, you look very happy for a lady

-who's had pretty major surgery, I think.

-Thank you very much.

-What was your surgery?

-I had a triple bypass.

Good Lord!

So what have they told you now about aspirin in the hospital?

They just explained to me that, obviously,

I now need to take some aspirin,

just to help me through my heart condition.

So, yes...

And you may have to be on it for a very long time.

I don't mind. It's one of those, isn't it?

I've been given my second chance.

So...I'm going to take that second chance, aren't I?

You're Ian, aren't you?

Hello, Ian, how are you doing today? What have you had?

I've had a bypass operation.

-How are you feeling?

-Absolutely perfect.

-Are you taking your aspirin?

-Yes, I am.

Well, you'll be up and about doing the fandango before you know it.

I will do, yes.

When Doreen and Ian return home,

they'll take with them aspirin provided by the hospital's pharmacy.

Danny, hello, good to see you.

Danny Forrest is the hospital's deputy chief pharmacist.

So, Danny, we're right in the nerve centre of the hospital here,

in the pharmacy.

Have you any idea how many boxes of aspirin

or how many individual aspirin tablets

you send out of here in a year?

Well, something in the region of about 6,000 boxes of aspirin

are dispensed from this pharmacy every year.

-And how many tablets in a box?

-28.

And it's 10p a box, so...

That's 168,000 aspirin every year in this hospital.

In the whole of England last year,

doctors wrote a massive 26 million prescriptions for aspirin.

But the cost is comparatively small.

In fact, aspirin is so cheap that this place spends just £600

on its supply for the whole year.

Do you think that's why perhaps,

amongst all the drugs that are available to us,

because we're familiar with it, that's what makes it so popular?

Perhaps. But also, again, it's very cheap.

A lot of the newer drugs are costing

anywhere in the region of £40, £50, sometimes £100 per box.

So in the cash-strapped NHS,

in terms of its cost effectiveness,

it's high up on the list.

Every day, Danny and his team send hundreds of aspirin

to wards and clinics around the hospital.

And because this one specialises in cardiac treatment,

every single department uses it.

So we have medicine, we have cardiology here,

we also have cardiac surgery.

So it'd be sent to patients that have had cardiac bypass grafting,

patients that have had valve replacements.

I have to say, I am rather taken aback by the number of aspirin

they get through here in a week, never mind in a year.

But then, this is a hospital that specialises in heart disease,

so what would you expect?

But then, of course, the one area where you can honestly say

that aspirin is a miracle drug is in treating cardiac patients.

There are other areas, though, where it's not such a miracle drug,

even though there are plenty of reports

that might make you think that it is.

Some suggest it might cure sepsis or even help increase

the chances of some women getting pregnant.

But unfortunately, there's just not enough evidence

for aspirin to claim those accolades.

There is, however, a mounting body of research that says

it could be a powerful weapon against another big killer, cancer.

And Nicola Smith from Cancer Research UK says that,

for the most part, these stories can be believed.

The evidence around cancer prevention and aspirin

has been building for some decades now.

There are some cancer types where we have really good evidence

that aspirin could reduce the risk of those cancers developing.

Bowel, oesophageal and stomach cancer,

we have good evidence that if you take an aspirin every day,

between 50 and 65, that you will have a lower risk of those cancers.

But there's a word of caution here, too, and it's just the same as for

anyone tempted to take an aspirin a day to prevent heart disease.

If you're taking higher doses and taking it every day

for a number of years, which is what's needed to see

the benefit in terms of reducing the risk of cancer,

there are potential side-effects,

and those are things like strokes,

but also gastrointestinal bleeding, so bleeding in your stomach,

for example, and that can kill in some instances.

It also claimed aspirin could be powerful in treating cancer

that's already developed,

but Nicola says there's not enough evidence to prove that just yet

because, perhaps surprisingly for a drug that is more than

a century old, new uses for it are still being uncovered.

There are some trials that are ongoing looking at whether

aspirin might be able to stop cancer returning.

So it wouldn't be the first thing you're given when you go in

for cancer treatment, but there are trials looking at whether

it might be helpful in terms of stopping the cancer coming back.

There are also trials looking at aspirin alongside

other conventional cancer treatments,

so for example we're funding a trial looking into radiotherapy

and whether, if people are taking aspirin while they're having

radiotherapy for rectal cancer, that the outcomes are better.

But that's still a work in progress.

While that research continues, aspirin's powers against cancer

remain in prevention rather than treatment.

But back in Liverpool,

it's a different story when it comes to heart disease,

and Danny feels that in the future aspirin may prove indispensable

to an even wider range of patients.

Can you see aspirin in the future being used for things other than

pain relief, for cardiovascular?

We're now hearing that it may have some effect on some cancers.

Is there no end to what it's going to be able to do?

I know there is a lot of interest within the fields of oncology

and obstetrics and gynaecology, so who knows?

But I think certainly aspirin's here to stay for a good while longer.

Back at the operating theatre, Ray,

who I last saw having a stent fitted,

has recovered from his surgery and is ready to go home.

-You've waited for me.

-Oh, look at that! Happy man.

Want to see your happiness.

How are you feeling?

I'm feeling like I should jump over the world.

-Oh!

-And I probably could.

-Well done.

-Oh, it's fantastic.

-Thanks for letting us join you in there.

-Well, I'm glad you did.

-And I'm glad it was a success.

-Amazing.

-So, all health in the future to you.

-Dancing on Monday.

-Absolutely.

-Strictly Come Dancing next November. Are you on? Partnership?

-I'm on.

When I started making this film,

obviously I was already aware of some of the properties that

aspirin had, but was I sure that it could be described as a wonder drug?

Well, maybe not.

And certainly, some of the claims made for it

are a bit difficult to believe.

But nevertheless,

having seen what has happened here in this hospital,

I think there's no doubt that aspirin really is

a life-changing and in many cases life-saving drug.

And I'm sure Ray would agree.

Well, from a truly remarkable drug that, well,

I suppose it's been around for the best part of 100 years now,

-hasn't it?

-Yeah.

To one that I think has been around for even longer than that

but has only very recently come to the fore, and that's aloe vera.

Now, for most of the time I think it's been used for treating burns,

-I think I'm right in saying.

-That's right, yeah.

But, well, these days it's cropping up

in all sorts of beauty-based products,

everything from shampoos and toothpaste to body creams and,

well, just about everything you can imagine.

Yeah, and that's because some of the claims being made for how good

aloe vera is for us are, well, pretty dramatic.

It's even been said to help treat IBS and Type II diabetes.

Bold statements.

But almost as vocal as its fans are its critics,

who say, "Well, the science really doesn't stand up."

So, with its popularity fanned by aloe vera parties

in living rooms up and down the country,

I thought the only way for me to really find out

if it's all it's cracked up to be

was, well, to throw a party of my own.

My invitation's still in the post, then, is it?

HE CLEARS HIS THROAT

It's the latest must-have health product

with all kinds of supposed medicinal and healing properties.

Aloe vera is in just about anything these days.

Mouthwash.

Juice.

Sham...poo.

Toothpaste.

And facemasks.

The market is worth billions.

And with celebrities widely reported

to have added it to their beauty regimes and their diets,

the aloe vera craze shows no sign of slowing.

But there's another side to the story, too,

with some very bold claims about how it can treat conditions

such as irritable bowel syndrome, diabetes

and even cancer.

It doesn't take too much of an internet search

to see how aloe vera really can divide opinion.

Bodies like the Royal College of Nursing

warn that claims about the health benefits of aloe vera

should be met with caution, while Cancer Research UK

says that there is no scientific evidence to prove

that aloe vera can treat any type of cancer,

and that it may cause severe side-effects when used in this way.

One thing that some of these sites do agree

is that aloe vera can treat burns.

But, other than that, the jury's still out.

So I'm having a little soiree to find out if this wonder plant

is everything it's cracked up to be.

And, oddly enough, it's aloe vera parties like this

that have led to the huge rise in the super plant's popularity.

-DOORBELL

-Come on in, welcome.

-You OK?

-How are you?

'My guests include aloe vera fans Leila and Domitilla,

'two medical herbalists, Dalbinder and Sue...'

Yeah, come on in, come on in.

-How are you? You all right?

-Hi, yes.

'..GP Dr Arun Ghosh,

'dermatologist Dr Juba Haffejee...'

Doctor Juba. Nice.

'..and, finally, dietician Dimple Thakrar.'

Very well. Welcome to our aloe vera party.

'They all use aloe vera,

'or have patients and clients who ask them about it,

'but they don't all agree on its merits.

'I'm getting the party started with aloe's best-known use, for the skin.

'This is one area that is agreed to be quite effective,

'and it's the one Domitilla, Leila and herbalist Dalbinder

'all say they use it for.

'Dermatologist Dr Haffejee agrees,

'but says we shouldn't get carried away.'

Well, aloe vera has soothing properties.

It will soothe the skin, it will moisturise the skin

and, you know, if somebody has a sunburn for example, you know,

if you've got aloe vera handy, not a bad thing.

There's a lot of evidence out there for its benefits on the skin,

from its antimicrobial properties, anti-ageing properties...

But really, when you look at the literature,

although there's a lot of interesting evidence out there,

the quality of the evidence isn't as good as what we would like.

At the moment, we've got a lot of questions unanswered.

You know, if it works for the patient, great.

But I think a lot more evidence needs to be undertaken.

As Dr Juba says, skincare is the one area

where aloe vera's claims do have some medical support.

It's been shown in small studies to be effective

at treating burns and wounds.

But aloe vera fan Leila loves it in another product altogether. Drinks.

If you're constantly drinking aloe vera...

I'm not talking, like, for a couple of weeks, I'm talking months,

-you know, to actually see the benefits.

-OK.

You know, your hair will be better condition, your nails,

your skin, and you'll just feel better.

The biggest claims for aloe vera are for its effects

on digestive conditions like irritable bowel syndrome, or IBS.

Domitilla, who used to run her own business

selling aloe vera products, claims it really works.

I can tell you that I have saved some people

from going on the operating table.

Through IBS, colitis...

All of these, internally, are very terrible problems.

NICE, the Government's health watchdog, has said that

it discourages people from using aloe vera to treat IBS.

The reason why NICE have chosen to say it's not to be used...

The problem is that, when it's given for a long period of time,

people become resistant to it,

and it can actually cause problems with the bowel.

So there's lots of different causes for IBS.

-Some people's IBS is started by stress.

-Exactly that.

Sometimes it's started by their poor diet.

Sometimes it's because they're positionally sitting down all day,

-and not stimulating their bowels.

-That's right.

So the thought that one particular substance,

whether it be medicine or whether it be aloe vera,

can be the cure for it is ridiculous,

because you're not treating the cause.

Aloe vera has also been used as a natural remedy to treat

constipation for years. But it can have side effects of diarrhoea

and cramping, as well as being linked to kidney and liver problems.

It's for this reason, in 2002, the US Food and Drug Administration

banned it from being sold over the counter as a laxative.

But there's another popular use of aloe vera, for weight loss.

Indeed, Domitilla believes they helped her to lose weight,

and some of her customers come to her hoping for similar results.

But what does dietician Dimple Thakrar think?

-Would you advocate aloe vera for weight loss?

-No.

I certainly wouldn't be advocating aloe vera for weight loss,

and the reason for that is a lot of the weight loss programmes

-that include aloe vera are actually a very low calorie diet.

-OK.

So, if you were to take a very low calorie diet,

and I'm talking 600, 700 calories a day, you would lose weight.

-Definitely lose weight with that!

-It's not rocket science.

Dieticians warn against any kind of very low calorie diet,

because it's very easy to miss out on essential nutrients too.

And Arun says when that is combined with another side-effect

of some aloe vera products, there could be serious implications.

Some people can actually get adverse reactions, they can actually

break out in rashes, their bowels can actually be quite...

Quite strongly react to it. So always take those things with caution.

Some aloe vera products can cause adverse reactions

when they're eaten or drunk,

if they contain the rind or the latex of the plant.

Many companies avoid those parts of the plant and just use the gel

from the centre of the leaf in their products.

But Domitilla says it's always important

to read the label to be sure.

Now, when the aloe vera becomes laxative

is when the company uses the rind.

So what you're reading when you're buying a product,

you must read - does it have the rind?

If it has the rind, go away from it.

After casting doubt on aloe vera's weight loss credentials,

dietician Dimple's equally quick to question some other claims too.

We've got internal cleansing tablets, or colon cleansing.

-What are your thoughts on this?

-The same sort of thing.

It does have a natural laxative in it,

and that is going to obviously cleanse your colon.

But, actually, your colon doesn't need to be cleansed.

-It's meant to have bacteria in it.

-How can they...

How can they advertise that and sell that if, medically, it's not sound?

Because aloe vera doesn't come under a drug, it's actually a food.

So therefore it's not regulated in the same way

as a drug would be regulated.

But while some of the adverse effects linked to aloe vera

aren't always easy to find out about,

the claims for how great it is can be hard to miss.

An article last year said that taking aloe vera

lowered your blood cholesterol,

lowered your blood pressure and improved your immune system.

-What are your thoughts on that?

-This was some work done in rats,

and it's not been extrapolated to the human.

So therefore, again, more evidence - we need more evidence.

And I always think, "How would I treat my own family?"

My dad's diabetic and he's hypertensive.

I certainly won't be going out and buying him aloe vera juice

to try and treat that for him.

Until we get that evidence, we cannot recommend aloe vera,

and we cannot say that it does the things that you've said,

lowering cholesterol, blood sugars...

People think, "Oh, maybe I can just treat my blood pressure

"or my blood sugar by using aloe vera."

So a viewer who has now been introduced to aloe vera,

they've seen the headlines saying,

"Aloe vera can help you with weight loss,

"it can improve your immune system," what's the answer?

So what they need to do is do their research.

They need to find out, where is the evidence?

If they're not sure, they need to be speaking to their medics.

What they shouldn't be doing is googling it

and reading the first thing that comes up on Google.

And I'm not anti-aloe vera in any shape or form,

but what I want my patients to be is well-informed.

We've got to be really careful that they're getting

reasonable information so they can make their own informed decision.

'So, with a resounding word of caution for anyone using aloe vera

'on anything other than their skin, my guests start to head home.'

We asked some of the companies behind the leading aloe vera brands

about the things my guests discussed and they told us that their

products are enjoyed by millions of people seeking

a natural alternative to support their health.

Some pointed out that not all companies made claims about

the medical benefits of using their products.

And one brand added that its on-pack instructions make it clear that

their products are not a substitute for a healthy balanced diet,

and that anyone with existing medical conditions should

always seek advice from their GP before using them.

It was really good, it was really insightful, I learned quite a lot.

Obviously, I've got my own ideas about aloe vera.

They're still the same, I'm still going to use the products.

It just shows, it's really difficult for the general public to

make an informed decision about things.

There's so much in the press that they've got to really make sure

that they understand and are happy with.

I met a lot of interesting people that had different views on

the aloe vera, I enjoyed it so much.

Very, very awakening.

I think aloe vera's a wonderful plant, it's got its benefits.

I don't think it's the miracle that it's maybe held up to be.

'I have to say, after what I learned tonight, I agree with Sue.

'Not all the claims really stand up to scrutiny

'and whilst for the most part, they won't do you any harm,

'we should probably all be wary of any claims that aloe vera is a cure for all ills.'

Now, for millions of people,

cleaning your teeth doesn't just stop when you're done brushing.

-Angela, do you floss?

-Only on those occasions when I know I've got something kind of stuck

in between them and there is no other way of getting it out but I...

I put my hands up, I'm not a regular flosser.

Well, I've got to put my hand up as well because I only used to floss

just before I went to the dentist until obviously the dentist said,

"Kev, you've got to floss all of the time."

Now, when we woke up to this headline...

I mean, we can't have been the only ones taken aback and left

wondering whether we'd been wasting time and money for all those years.

It's a pretty positive statement, that, isn't it?

So, we asked committed flosser Danny Crates if

he would look behind these headlines and find out once and for all

whether or not we'd actually all be a lot better off by getting

to bed just a couple of minutes earlier and moving that reel

of floss out of the bathroom cabinet and dropping it in the bathroom bin.

DANNY: Like millions of others, I start and end my day in the bathroom,

taking the time to care for my pearly whites.

Now, I'm a committed flosser and I've been using trusty little

flossing wands like this twice a day, every day, for years.

I always believed that flossing keeps my mouth

that little bit cleaner and in better shape than it would if I didn't.

But last year, a story hit the news that poured cold water all

over my twice daily ritual.

It said there is no evidence that flossing does any good.

Now, for decades,

dentists have recommended we should floss once a day.

But how useful is flossing?

An investigation by the Associated Press suggests there is

insufficient proof that it's beneficial.

But those reports were quickly met by others telling us not to give up.

Because, just as our dentists have long been telling us,

flossing cleans between our teeth,

keeps plaque at bay and helps us avoid fillings.

So, with all the conflicting information, the future of

the floss in my bathroom cabinet is, well, hanging by a thread.

But what is going on inside my mouth when I floss?

And is it really as good for my gnashers as my dentist has been telling me?

CHOIR SINGS

To help me find out, I have recruited a group of people

whose teeth are on show more often than most, the Salford Choral Society.

'They've agreed to take part in our very own flossing experiment.

'Now, it's time to see which dental habits produce the most decibels.'

Who here flosses regularly?

THEY SING NOTE

'Not exactly taking the roof off there.'

So, who here flosses but not regularly?

THEY SING NOTE

'That was definitely a few decibels louder than our regular flossers.'

Who has never flossed before?

THEY SING NOTE

'Finally hitting a quiet low note there are our non-flossers.

'But what are the reasons behind our choir's flossing habits?'

I am a flosser.

Because I was advised by my dentist, because my gums were bleeding.

When my electric toothbrush doesn't remove all the stuff between my teeth, I floss.

I've been advised by my dental hygienist to floss at least once a day.

I don't always live up to her commands, I'm afraid.

The first fillings I ever had in my life were for cavities

between my teeth, so the dentist said, if I'd flossed

I probably wouldn't have had them.

And I've flossed ever since and I haven't had any more fillings.

It just doesn't appeal to me, I don't think it works.

And it looks painful and I hear tales of people who have cut

their gums with their floss.

Of the 52 singers that put their hands up, 11 have never flossed,

27 claim to do it occasionally

and only 14 floss every day.

It might not sound like many, but it's roughly the same as the

national average, because less than a quarter of us floss regularly.

Is there a chord that's going to show these beautiful pearly whites?

I think so. Roddy?

PIANO PLAYS CHORD

THEY SING SUSTAINED NOTE

I don't know about the choir's 14 flossers

but I floss because I've been told it's vital for getting rid of

bacteria which causes tooth decay and gum disease.

It's a message dentist Ben Atkins delivers to his patients every day.

Floss, traditionally,

has been used to clean in between the patient's teeth.

That's often the place we get all our dental decay starting.

So, we take round about a metre of floss, so what we'll do then

is get to the top of the tooth and slide up and down.

And then you move on from one side and you roll it on,

so you're using a fresh piece of floss, so it's cleaning,

not transferring the bacteria around,

and you go back into the same place and lean on to do the side

of the tooth and go up and down, until it goes squeakily clean,

so you'll actually hear a slight squeak, and everything's clean there.

It's quite tricky but it's to make sure we don't get

a build-up of plaque, which eventually can cause gum

disease or decay and holes in our teeth.

'When put like that, it all sounds very simple.

'And quite different to the impression I got from some of those reports.

'But when I showed some members of the choir those stories,

'they had the same instant reaction as me.'

Flossing teeth has no health benefit.

It'll make me feel less guilty when I don't floss.

THEY LAUGH

It would make me continue to not floss.

"Flossing is a waste of time, now they tell us!"

I disagree with it because I know it's had benefits for me.

It's difficult to believe that it does any good, the floss.

I disagree, I floss once a day and after a meal,

if stuff is stuck between your teeth, it does get rid of it.

'But as a lifelong flosser, I think it does do some good,

'so to find out whether flossing is really a waste of time,

'I've asked the choir to help us run a test.

'We've asked 10 members who either floss regularly,

'occasionally, or not at all, to let us test the levels of plaque-causing bacteria in between their teeth.'

I'm going to pass these around, take one of these flossing wands.

'If flossing really does reduce the amount of bacteria,

'then the flossers should all have less of it between their teeth than the non-flossers.'

So, how was your first flossing experience?

-Horrid!

-THEY LAUGH

-It's hard to get in between your teeth.

-It is.

'With all the samples bagged up,

'I'm sending them off for expert scrutiny -

'to Doctor Chloe James of the University of Salford,

'who is an expert in the microbiology of the mouth.

'Thanks to the unique mix of saliva, fluid and food,

'the mouth is the perfect place for bacteria to thrive.

'Chloe's going to compare the amount of pathogenic bacteria of

'those who do clean in between their teeth versus those that don't.'

That's the bacteria that can cause plaque that leads to tooth decay,

and can also cause periodontal disease,

otherwise known as gum disease.

What I'm expecting to see is that we'll get more material

from those people that don't normally clean between their teeth,

because there'll be a lot of compacted food and bacteria there.

A number of larger studies have been done similar to this study

and they have found, in certain cases,

that flossing makes a big difference,

particularly for children. If they are being flossed by a professional,

depending on your technique,

flossing can determine

how much bacteria you're able to dislodge from between your teeth.

Chloe will leave these samples to culture for 72 hours,

and we'll find out the results later.

But while that's happening,

I'm off to find out more about the stories that started this argument.

They first cropped up in America,

but some reports say there could be implications for the NHS, too.

One high-profile flossing critic in this country

is Professor Damien Walmsley

who's a scientific adviser for the British Dental Association.

And he says those stories are right.

Because, even though we've been flossing the decades,

there's very little proof it actually does any good.

So, Professor, in some of the press articles,

you've been quoted as being quite critical of flossing.

I mean, why is that?

We don't have the clinical trials,

the really rigid clinical trials around flossing

to make categorical statements and say, "Yes, it is beneficial."

So, we do have very good evidence about brushing your teeth.

When we get down to flossing,

we don't have the same amount of evidence.

But the professor isn't saying we shouldn't clean between our teeth.

The idea is a good one, because what you're trying to do

is to disrupt the home of the bacteria.

But there are other ways of cleaning.

You do a routine of brushing your teeth for three minutes a day

and brushing where the tooth comes away from the gum.

You want to systematically remove the bacteria

that are formed along the lines of the teeth.

Now, some people need to get in between the teeth,

especially if they've got all the teeth like this,

-and there's these tight gaps.

-Instead of floss,

the professor says we could use interdental brushes like these.

They're wider, so fill more of the gaps between our teeth

and remove more bacteria.

And if your teeth are really tightly packed,

that's when floss could come in handy.

Because cleaning between your teeth at all

is better than never doing it.

It's down to when you have that talk with your dentist or your hygienist.

So, if you're having problems cleaning

and you've got very, very tight contacts between your teeth,

then, they may advocate, on top of all the tooth brushing you're doing,

and the interdental, to do some flossing.

So, the professor is wary of any report that says

we should forget about flossing altogether.

Which makes me feel better about the decades I've spent avidly flossing.

But I'm not going to concede defeat from my trusty floss just yet,

so I'm back to Salford with Dr Chloe to get the results of our test.

Hi, guys.

'We took samples from ten choir members, some who floss regularly,

'some who floss occasionally and some who've never flossed.

'If flossing is effective at reducing the amount of bacteria

'in our mouths, then the samples from the non-flossers

'will show more bacteria.'

-So, are you ready to see the results? ALL:

-Yes!

Some had to be quarantined.

LAUGHTER

That's not true.

'But the results were a bit of a surprise to Chloe.'

So, it looks pretty spectacular,

but what does this actually tell us?

Overwhelmingly, hopefully, what you can see

is there's not much difference between them.

So, depending on whether you are a frequent flosser,

or you don't floss at all, the level of bacteria

that we're seeing from the floss there isn't very different.

It might look like there's more bacteria on some slides,

but Chloe says there's actually very little difference

in the number of bacteria. They've just clumped together differently.

So, even though our sample was small,

the results seem to back up those scientific studies.

So, looking at these, would you say there's any benefit in flossing?

Looking at these results, it's very hard to see a benefit of flossing.

But that doesn't mean there isn't a benefit of flossing.

What you can see, OK, there's not a lot of difference,

but you can see there's a lot of bacteria there.

So, by that short amount of flossing,

you were able to dislodge a lot of bacteria from between your teeth.

Flossing can dislodge bacteria and food.

Food, if staying between your teeth, gets digested by the bacteria

and turned into acid, that can lead to tooth decay.

So, the most bacteria that you can remove from your mouth, the better.

So, in my opinion, flossing is still very important.

But, as Professor Damien Walmsley told me earlier,

flossing isn't the only way to get that bacteria

from between our teeth.

When we took the floss samples from the choir last week,

we just asked them to floss on their upper jaw,

and gave them interdental brushes for their lower jaws.

It's much better, I'm enjoying this, yeah..

Fab!

When Chloe tested the brushes,

she discovered they remove far more bacteria than flossing.

You removed more bacteria and more food from between your teeth

with the interdental brushes.

On average, there were about ten times more bacterial cells

than there were with the flossing.

And you might expect that because they're bigger.

So, if our flossers had used those interdental brushes instead,

there could have been a big difference between them

-and the non-users.

-Would you say, then,

from the differences between the floss and the interdental,

there might be some advantages in using both?

Yeah, absolutely. Dentists often suggest that you use both.

One thing that they do have a look at

is the architecture of your mouth.

So, some people will have large gaps

in between some of their teeth

in which the flossing doesn't really do very much.

Other people have very tightly packed teeth,

and they're not going to get an interdental brush anywhere.

And so, for those people, flossing's more important.

Do any of you that don't floss,

are you considering that you might pick up flossing now,

after seeing those results?

Not the flossing.

Because, having experienced them both,

the interdental brushes were a lot less unpleasant.

So, how about you? What do you think?

Well, I've always flossed regularly.

Never been a fan of the interdental brushes,

I've always found them really uncomfortable.

But, I think, seeing these results,

I definitely see the benefit of using them, and that'll be something

I'll bring into my dental hygiene. Definitely.

'So, while it might not be time to toss the floss just yet,

'it is astonishing that the flossers' teeth

'didn't have fewer bacteria

'than those who have never flossed at all.'

Thank you so much for your help.

With amazing voices like that,

I'm sure, whether you're a flosser or not,

you will have happy teeth and gums.

Any chance of a little chorus when I leave, though?

-ALL:

-Yes.

Three, four.

# Alleluia! #

I think it was really reassuring to hear that,

when it comes to almost all of the claims

that are made about aspirin,

-you really can believe what you read.

-It is.

If only the claims they made about aloe vera were true,

-we'd have a couple of miracles on our hands, I think, Angela!

-Yes!

Unfortunately, though, that's where we have to leave it for today.

But we'll be back very soon to debunk some more headlines.

-But, until then, thank you very much for joining us. Bye-bye.

-Bye-bye.