talkhealth meets... Anna Middleton


Anna Middleton is a multi-award-winning dental hygienist and founder of London Hygienist. She is at the forefront of a wave of modern hygienists who provide their patients with a more holistic approach to general health from the dentist's chair. 

Anna hosted an Expert Webinar on the relationship between oral health and general health. Before the event she took some time out to answer a few of our questions. Read on to find out more about the sound engineer turned dental hygienist...



When did you realise that you wanted to be a dental therapist? What’s your story?

After working in hospitality for most of my life I studied sound engineering and music technology. I decided I wanted a career change and became a dental nurse and hygienist; I’ve been qualified for nearly 6 years now! After university, I started my business, London Hygienist, to change the way oral healthcare is delivered and to improve access to dental care. I returned to university last year to become a dental therapist so that I could extend my scope of practice. As a hygienist and therapist, I focus on dental decay and gum disease prevention. Think of me as a mini dentist. I routinely provide professional teeth cleaning, but I also offer dental examinations, take x-rays and provide filings.

How do our mouths act as a mirror to the rest of our health and body?

The mouth can tell us a lot about our health. If you have poor health, systematic signs can appear in your mouth and vice versa. When we take certain medications or undergo hormonal changes, our mouth reflects this. Sometimes even nutritional deficiencies and gastrointestinal diseases can be diagnosed in the mouth.

Why is good oral health so important?

 Oral health is important because the bacteria associated with gum disease can migrate to other parts of the body in the blood and cause health issues. Gum disease and dental decay are entirely preventable and even reversible in their early stages. 

What are the key signs of poor general health that can be spotted in our mouths? 

From bleeding gums to recurrent ulcers, numerous signs could mean something’s amiss. Poor oral health can be a result of poor oral hygiene, but nutritional deficiencies and systemic illnesses play their role too. For example, gum disease and type 2 diabetes have a bidirectional relationship, meaning poor oral hygiene can affect diabetic control and poor glycaemic control can affect gum health. 

Should we all be thinking about our oral health more because of the Covid-19 pandemic? Why?

A new study revealed the relationship between gum disease and Covid-19 complications. It found that those with gum disease were 3 times more likely to end up in ICU, 4.5 times more like to need a ventilator and 9 times more likely to die. 

Another study found that poor oral hygiene increased the duration of viral shedding of Coivd-19 from approximately 20 days to 50 days (meaning the virus is detectable for longer in your saliva even if your symptoms have resolved if you are not brushing properly). Therefore, improved oral health can reduce the duration of Covid-19 infection.

How does gum disease affect our general health? How can we get healthier gums?

The bacteria associated with gum disease causes inflammation, that’s why bleeding gums are a warning sign, and when left to become chronic this inflammation damages tissue. The chemical process and by-products of inflammation affect not only the mouth but the whole body. 

We can keep our gums healthy by brushing twice a day along the gum line and cleaning in between the teeth with interdental brushes or floss. Maintaining routine visits to the dentist/hygienist/therapist at least once to twice a year for oral health screenings and professional cleaning is also very important.

Dental hygienists provide more holistic, general health, support nowadays. Why do you think that this is?

We are no longer just seen as ‘gum gardeners’. Our understanding of the links between the mouth and body are becoming more and more prevalent. We are often the first to spot when something is amiss – sometimes even before GPs! By taking an overall healthcare approach we can provide patients with the highest level of care. We can help signpost patients and refer them to other medical professionals to prevent late detection of health issues.

What is your advice for those who might be worried about their dental/oral health who haven’t been able to see their HCP in lockdown?

 You can see hygienists and dental therapists privately under something called direct access, meaning you don’t need to see a dentist first. As a therapist, I handle much of the routine dental work carried out by dentists, such as check-ups and fillings. For anything out of our scope of practice, we can refer you to the appropriate health care professional. If you are not able to visit a clinic then you can still call for advice and many clinics offer online consultations.  

What are your top three tips for a healthy mouth?

  1. Always brush your teeth with an electric toothbrush and fluoride toothpaste, twice a day. 
  2. Brushing only cleans 60-65% of the tooth surfaces so it’s extremely important to get in between your teeth with either floss or interdental brushes. This will reduce the risk of gum disease or dental decay starting in those spaces. 
  3. Try and keep all sugars and acids to mealtimes only, with no more than 3-4 attacks per day. It’s not the amount of sugar or acid you have, it’s how often you are having that damages the teeth.


If you, or someone you know, need some extra support with your dental health, our mydentalcare support programme provides you with practical information on how to keep your teeth healthy between dental visits.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 23 February 2021
Next review: 23 February 2024