The Tools of (Dental) War
The cavity creeps are losing…
It is a sign of rationality for human beings to regularly profess that they do not know everything. I, for one, am careful never to pretend I know everything. Patients here at Spring Valley listen to me restate that regularly; my staff hear me chant that fact daily. But while I don’t know everything, I certainly do know some things. In fact, I know some things that others seem not to.
I earned my diploma at the SIU School of Dental Medicine in May of 1993. That means I’m about to complete my 25th year of calling myself a dentist. School was a tough gig; there’s no need to convince you of how much information was crammed into our heads while in that program. Suffice it to say, we learned a lot, cellular biology, human physiology, chemistry, and oh yeah, we learned some stuff about teeth and gums. But when a graduate of dental school leaves the training facility, that’s when his real education begins. Every day for the past 29 years, I’ve thought about teeth, not necessarily because I wanted to. Teeth have become my livelihood. And when you want to be good at what you do, the learning never stops.
Lately, I’ve been struck by the number of articles, especially online articles, sharing with readers the latest tips and tricks you can employ if you want to have healthy teeth and gums. I’m reading about scrubbing with charcoal, pulling coconut oil… and with each of these tips it strikes me that the writers really seem not to know that we have the answers, the real, honest to God answers to what causes problems with our teeth and gums. There are some tidbits that make me consider incorporating them into our regimen, and there are others that simply do not fit with anything we know. Experience counts for something, so let me share with you what I have observed over these past years.
Where mouths are concerned, bacteria are the root of all evil. Without bacteria, I’m not sure it would be possible to get a “cavity”. There are other, obscure ways our lives can injure our mouths, but decay would cease to exist without bacteria. We can even tell you some of the most damaging bacteria in mouths by their proper names. These bugs don’t eat our teeth. They eat what we eat and drink. They digest what we eat and drink. And as they digest that fuel for life, they produce waste, just like every other critter that eats. (Ever read the kids book, “Everyone Poops”? It’s a disgusting little kid’s book, but I digress…) Bacterial waste is noxious stuff, and it’s horribly acidic. It is this waste that dissolves the minerals out of our teeth. That’s why you seldom see decay start in places your lips or tongues rub. The bacteria are swept away in those places. We generally see decay start in the deepest grooves, at or below the gumline, or between teeth where they are least likely to get moved. The bacterial products are also treated like toxins by your soft tissue. A body gears up like it’s at war with the assaulting cavity bugs, but it’s a war your immune system cannot win without your attention and help. So how can you help your body defend itself against this relentless attack? Here again, I know some stuff. Let me share!
Limit the bacterial feedings. Remember, they eat what we eat. So for example, if we ate three times a day, and never ate or drank anything but water between meals, we could measure three spikes in acid assault per day. Your saliva tends to neutralize the acids on surfaces, but struggles to neutralize the acids at any depth. But let’s instead use the example of the teenager that takes his first job at a pizza joint. One of the perks of delivering pizzas seems to be the access to the soda machines. And when you have access to such liquids for hours, we observe that folks tend to sip on these drinks for hours. Now, instead of having three peaks of high acidity with each meal, we would measure hours of sustained acidic attack. Each time the bacteria are slowing down, they are dosed with fuel again and produce acid. That’s what they do. Limiting frequency and doses of food or drink also ensure minimal acid production.
One could also pay attention to the kinds of foods they eat. Foods that cling to teeth tend to elongate acid exposure. Foods that have carbohydrates or simple sugars are instantly turned to acid. Take a sugary, sticky food, (I’m thinking Skittles), and you have some long, drawn out acid exposure. Bad for teeth.
In addition to depriving bacteria their food sources, why not remove them? Make them go away. Use tools to physically knock them off the surfaces they want to stick to. Brush your teeth. Brushes are good for all flat areas, can get into the deep grooves on the chewing surfaces, and can do quite nicely sweeping the bacteria away all the way down to the limits of the gumline. A brush cannot get under the gumline. A brush cannot get between the teeth. To date, nothing has been found more effective for removing bacteria and food between the teeth than string floss. It isn’t a perfect tool, but there is no single tool better for between your teeth than floss. What do you do with those you cannot remove? You make them dead. Kill the bacteria you cannot remove. Listerine, Crest ProHealth, Hydrogen Peroxide…there are not a huge number of rinses known to effectively kill bugs, but those are a few. Remove what bugs you can, kill what bugs you can’t.
Other tools? Well, waterpiks have been around for years. For their pure bacteria removing ability, they are a second place to proper flossing. But because folks hate to floss, waterpik jets can be more effective than nothing for in-between surfaces. There is a reason water pics are quietly being rebranded as “water flossers”. They are a useful tool. Then, there are tooth picks. Tooth picks serve a purpose, but are close to useless in terms of removing bacteria, (similar to your tongue in terms of what they can’t touch). They fail moving anything beyond their physical reach. Proxy brushes are like tiny little bottle brushes for getting between teeth. Nothing replaces floss.
What about internet advice? Oh brother! I have heard some of the craziest advice ever, stated as the gospel truth. I don’t know how to generically help discern whether advice is credible or nonsensical. But I can tell you this: you know a guy. Or at Spring Valley, you know some guys. There is collective wisdom in experience among professionals. And the doctors at Spring Valley want you to know what we know. There are no secrets here. I’ve had 2 tiny cavities fixed at age 41. My wife has never had a cavity since we’ve known each other. I have two daughters that have never experienced dental work other than orthodontics.
The bottom line, as I see it, is that we already have the tools to defeat decay. Will there be positive developments in the future? Of course. Simpler, cheaper, more effective tools? Yes, please! We’ll never stop watching for something that will put us out of business, because if you think about it, that’s pretty much what we spend our days doing. We share all the secrets we know regarding how to prevent you from needing our services. We just need people to execute the plan! When we have an easier solution, or a more effective solution, you can rely on us to keep you in the know. But don’t be fooled, you too can certainly know all you need to do in order to win this war.
Lance P Martin, DMD