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Healthy Mouth...The Doc's Blog

Companion Blog to this website on oral health issues

Brush and Floss - No one likes the twice annual lecture from their dentist or hygienist regarding the ills of poor oral hygiene, particularly flossing. We really are not as plaque obsessed as we seem. The reason to remove plaque thoroughly from all surfaces at least once a day are fairly simple. Both decay and periodontal diseases are infections caused by a number of specific bacteria which live in the plaque deposits. Once removed it takes about twenty four hours for the bacteria to grow to pathologic (disease causing) levels. Brushing only allows these germs to thrive between the teeth, so flossing daily is imperative. The simple act of proper daily hygiene will prevent the majority of dental troubles in most people.

Fluoride- Fluoride helps prevent decay in two ways. Fluoride molecules integrated into tooth structure, either systemically during development or topically once teeth are erupted, make the enamel more resistant to acid attack. Bacteria use acid to dissolve tooth structure as the integral part of the decay infection. Fluoride is also toxic to many bacteria, including those involved in decay. Topical fluoride via toothpaste and rinses lowers bacterial counts significantly. This double whammy helps fluoride reduce decay to its current historically low levels in fluoridated communities. Always use fluoride toothpaste, and anyone with an increased risk of decay should use rinses. Fluoride rinses are most effective if used at bedtime.

Do Not Smoke-Smoking is just plain terrible for your mouth. Stain and yellow teeth are the obvious problems, but the hidden damage is far more threatening. Smokers are much more likely to suffer oral cancer than non smokers. Periodontal disease in smokers is more severe, progresses faster, and responds very poorly to treatment. Smokeless tobacco is problematic as well, with a high risk for oral cancer and gum damage.

Visit the Dentist Regularly- Sticking to prescribed recall periods is obviously important for the control of periodontal disease. However the regular check up is important as well, including x-rays. Almost all oral diseases are asymptomatic in their early stages; including periodontitis, gingivitis, decay, and oral cancer. In addition, these problems are much easier and less expensive to fix when caught early. A filling costs less than a root canal and crown, early non surgical treatment is cheaper and easier than gum surgery, and small oral cancers are easily cured whereas advanced lesions result in complex, disfiguring treatments or even death.

Sealants- Most decay in children and young adults is found in the grooves on the biting surfaces of the back teeth. These deep pits and fissures are out of the reach of toothbrush and toothpaste. The bacteria that cause most cavities love to hide out in these areas, waiting to infect the teeth. Sealants literally seal off these microscopic caverns, eliminating the environment where these bacteria thrive. Sealants not only work locally, but research has shown well placed sealants will reduce specific bacteria counts in the whole mouth. Sealants are not just for kids either. Any person with susceptible grooves and evidence of decay activity would benefit from sealants.

Mouthwash- Listerine and generic equivalents used twice daily help reduce gingivitis when accompanied by proper brushing and flossing. Chlorhexidine containing rinses may be prescribed by your dentist. These mouthwashes are more effective than Listerine but are available by prescription only.

Sugarless Gum - Chewing sugarless gum has been shown to reduce cavities. Look for gums sweetened with xylitol, which has been shown to reduce cavities much more than those using other sweeteners. Gum chewing stimulates saliva flow which buffers acids and aids in the immunity of the mouth. Xylitol helps reduce the activity of decay causing bacteria.

Reduce Frequency of Sugar Intake - The amount of sugars eaten throughout the day is not as important as the frequency of intake. This includes both simple sugars and starches. The mouth has a natural buffering capacity in the saliva which neutralizes the bacterial acids, thus minimizing decalcification of enamel. Frequent sugar doses overloads this ability.

Update Medical History with Dentist -Many medical conditions adversely impact your oral health both directly (diabetes, AIDS, Sjogren's, etc.) and indirectly due to medications used (hypertension, heart disease, depression, cancer, etc.). Your dentist must be aware of all conditions and medications, even if it does not seem pertinent, to properly manage your treatment and prevention program.

Protect your Teeth- Dental protection includes the obvious, such as wearing mouth guards for sports. Less obvious ways to protect your teeth from trauma include always wearing a seatbelt, never use your teeth as tools, and wearing a night guard if bruxism is evident.

Tooth Decay (Caries) and Cavity Prevention ....NIH website, very informative

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Last modified: February 17, 2009