Are You Cavity Prone?
Research has recently shown an amazing difference in the biological ecosystems between a healthy, disease-free mouth and one with lots of cavities. A healthy mouth averages 145 different types of germs versus only 95 when cavities are present. I frequently tell my patients that a healthy mouth is like a rain forest with lots of living plants and animals, and a cavity-prone mouth is like a desert. Unfortunately it’s the ”cacti” which cause decay. Apparently, the greater varieties of germs compete with the bad bacteria, thereby reducing their ability to destroy your teeth. Our goal is to figure out the reasons for the difference!
While fluoride has been very helpful in reducing the incidence of tooth decay (caries, or cavities) it certainly has not eliminated it. It helps by strengthening the enamel, making it more resistant to the acids produced by the bad (or cavity-causing) bacteria, mostly Strep Mutans, but it fails to significantly change the type of bacteria in a patient’s mouth.
We obviously continue to emphasize the importance of excellent home care, to reduce the overall volume of bacteria, and dietary control of sugar to reduce the energy source necessary to produce acid. The new cavity-prevention strategies suggested here are for the 15-20% of our patients where the disease is out of control and all conventional efforts have failed. Our objective is to actually reduce or eliminate the presence of these bacteria, the IDEAL CAVITY PREVENTION!
1. Brush TWICE DAILY with baking soda. We know that the bad bacteria LOVE acid! They LIVE in it. We also know that as the pH of a patient’s mouth drops (meaning increased acidity), the percentage of bad bacteria significantly increases. Baking soda (sodium bicarbonate) is a powerful acid neutralizer and works to deprive the germs from their ideal environment.
We recommend filling a shot glass with the baking soda and dipping your wetted toothbrush (preferably a Sonicare) into it. Should the taste be an issue, first apply your favorite toothpaste.
2. Chew TWO PIECES OF ICEBREAKERS ICE CUBES GUM Three Times a Day. This has the ideal concentration of xylitol, a natural sugar with only 40% of the calories, which has been shown to significantly reduce the percentage of Strep Mutan colonies on teeth. These bacteria eat glucose, fructose and sucrose and very efficiently produce high levels of acids over and over. Xylitol, however, can be consumed but not metabolized, leaving them bloated, constipated and unable to eat the other sugars. Studies have shown as much as an 80% reduction in Strep Mutan colonies. CHEW ON!
For more information, check out www.dentist.net/xylitol-teeth.asp
*Note: a small percentage of patients can develop digestive problems, and it needs to be kept away from all dogs as this can make them dangerously sick.
3. Try MI PASTE. MI paste is a product that helps in two ways. First, it helps create a more stable neutral environment in your mouth, thus inhibiting the growth of the bad germs. Second, while fluoride only helps reduce the demineralization of the enamel, MI paste actually creates a chemical environment that permits the remineralization of both the enamel and dentin with calcium and phosphate. This product has the ability to help the teeth repair themselves. It’s like vitamins for your teeth.
Try applying a “dab” to your finger after brushing at night and swipe it around your top and bottom teeth. If you have any bite splints, retainers or trays, wear them as well.
*Note: Not everyone in the dental community is convinced there is an adequate body of valid clinical trials to make the claim that it is effective at remineralization on all patients. Some feel that with normal saliva quality and volume there is already enough calcium and phosphate present. I personally feel that when nothing else has worked on our highly decay-prone patients, there is enough evidence to give this a try. For more information, check out: www.gcamerica.com/products/preventive/MIPaste/
4. Every Three months, Suck on ONE GYLIC LOLLIPOP IN MORNING AND AGAIN AT NIGHT For Ten Days. It contains licorice root, which has a natural anti-microbial affect that disables the germs that cause cavities and periodontal disease. Research conducted by Delta Dental of Michigan supports the company’s claims that this reduces decay. Go to www.drjohns.com for more information or to order. We also stock glycolic lollipops, so please contact the office for more information.
5. Increase the amount of ARGININE IN YOUR DIET by eating more spinach, soy, seafood and nuts. Arginine is an amino acid that reacts with any acids to produce ammonia, which rapidly raises the pH in the mouth for an extended period of time. Bad news for bad bacteria!
6. Try to Keep Your Mouth on the Moist Side. Patients with dry mouth symptoms have a particularly difficult challenge. Healthy saliva is your teeth’s best friend helping reduce acids naturally and ask as an excellent lubricant while eating. These symptoms often develop as a side effect to many medications, head and neck radiation therapy and simply aging. We have some suggestions:
- Nuvora is a company that makes a number of products under the brand name Salese. These contain sodium bicarbonate and xylitol which increase moisture and pH reducing the bad bacteria. For more information, visit www.nuvorainc.com or contact us.
- Pilocarpine is a drug that, when taken in pill form, significantly increases your body’s secretions, including saliva and sweat. Needless to say most patients are not too happy when sweating profusely.
To significantly reduce these negative side effects we can order prescription Pilocarpine lollipops which can be sucked on periodically during the day. This creates a topical effect on the salivary glands to increase flow without nearly as many side effects.
7. Control Sources of Additional Acids in the Mouth. Because cavity-causing bacteria are acid-producing machines, they thrive in that environment Recent studies have shown that even a small drop in pH (increasing acidity) results in significant increases in the percentage of Strep Mutans in plaque. My patients seem to understand when I give them my analogy: “If cacti are the cause of cavities, don’t move to Mexico.”
8. Seek Help for Bulimia and Gastric Esophageal Reflux Disease (GERD). For years, we felt these patients were prone to more cavities because of the acids softening the teeth. It should be obvious for what we have discussed here; the stomach acids create a perfect environment suitable for the acid-loving bacteria. While GERD patients can be helped with acid-reducing drugs such as Prilosec or Prevacid, bulimics pose a particularly challenging problem. The difficulties involved in curing or managing this disease is well known and every possible measure should be implemented to help them.
Try these new cavity-reducing strategies and let me know how they work for you. For more information on this or other dental topics, feel free to contact Northway Family Dentistry at 616.531.7480 (Grandville office) or 616.957.1190 (Cascade office).