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We often hear phrases like “Oral health is a window to your overall health,” but we rarely if ever find anyone who will talk about it. There are plenty of people out there who will talk to you about the benefits of protein, or the ways you can increase your VO2 max. Lots of people who have never worked in any healthcare setting could tell you the basics of diabetes or various cancers. Nearly everyone could tell you the dangers of excess sun exposure or eating too much. But I don’t think I’ve ever had an educated conversation about oral health with anyone who didn’t work in a dental office. If oral health is as important as the experts say it is, that is a problem.
That problem has consequences. The only thing that pretty much everyone could tell you about oral health is that you’re supposed to brush your teeth twice a day and floss. That is good guidance, it works most of the time for most people, but I’m sure there has been some point in your life where you’ve heard someone claim they’ve been doing everything right when it comes to brushing and flossing but they go to the dentist to discover that they have five cavities, maybe it has even happened to you. This is frustrating, this could cause people say things like, “What is the point of brushing and flossing if I’m just going to end up with cavities anyways?” or, “Why would I want to go to the dentist if he is just going to tell me I’m doing everything wrong?”
If these people understood the science of how tooth decay happens and how it is prevented and repaired I don’t think they’d have that same frustration and I think they’d be doing a little bit more than just brushing twice a day and flossing. About a year ago I researched the science behind all of it and I was shocked at how simple it was. It’s so simple a child could understand it. I’ll now explain it to you simply with minimal unnecessary jargon. I will also outline the protocol I have developed to keep my teeth healthy.
What causes our teeth do decay? Acid. As our teeth our exposed to acid they break down. If the strong outer layer of a tooth breaks down far enough its weaker inner layer will be exposed which will result in tooth sensitivity and pain. If enough of that inner layer decays the tooth will die and will need to be removed if a root canal surgery or some other intervention doesn’t take place. Ultimately if we want to prevent tooth decay we need to minimize acid exposure.
Where does that acid come from? Eating. Every time you eat the acid level in your mouth rises. This is because many of the things we eat are acidic but also because the bacteria in our mouth will feed on the sugars contained in our food and excrete acid as waste. Foods and drinks with a high acid or sugar content will obviously be more harmful to our teeth than other choices. Without intervention our mouths will remain in this acidic state where our teeth will slowly be breaking down for about an hour after eating (or drinking something other than water). The mouth of someone who is constantly snacking will be in this acidic state all day meaning their teeth will be decaying all day, this is how someone who brushes their teeth twice a day could still end up with cavities.
How do we get rid of the acid? Brushing your teeth right after you eat is one way to neutralize the acid but that is not at all practical. What I do instead is take advantage of a chemical known as xylitol which is a natural zero calorie sweetener. After I eat something I will chew a piece of xylitol sweetened gum, this does two things. First it causes me to drool which will dilute the acid in my mouth bringing its overall acidity back down to a level where my teeth are not at risk of decay. Second, the bacteria in my mouth that would usually be converting sugars into acid will begin to eat the xylitol instead of those sugars, these bacteria will not be able to digest the xylitol and will not produce any new acid. So to put it simply chewing xylitol sweetened gum after eating will flush out the acid in your mouth and will prevent new acid from being produced. If you decide to start doing this make sure whatever gum you chew is only sweetened with xylitol or you will just be feeding the bacteria more sugar to turn into acid to destroy our teeth.
How do we repair teeth? Brush them. But it isn’t the act of brushing that does it, it is the chemicals in your toothpaste. Fluoride is the most common active ingredient in toothpaste. There are two things you should know about fluoride, the first and most important is that it works. As you brush your teeth the fluoride molecules in your toothpaste will combine with calcium and phosphate ions in your mouth to create fluorapatite which is incredibly similar to the hydroxyapatite that our teeth are naturally made of. This fluorapatite will replace the hydroxyapatite in the ares of our teeth where it has decayed away.
The other thing to know about fluoride is that it is toxic, you’ll notice the directions on tubes of fluoridated toothpaste tell you not to swallow it and many even direct you to contact poison control if you do. Excess fluoride consumption will cause skeletal fluorosis which makes our bones brittle. Research has also linked fluoride to thyroid issues and many people have claimed it is linked to all sorts of other diseases. The important thing to remember is (as it is with all things) the danger is in the dosage. Some people claim you could eat a tablespoon of toothpaste and be fine, others say there is no such thing as a safe dose of fluoride for human consumption, the truth is probably somewhere in the middle of those two extremes. It is important to recognize that billions of people around the world brush their teeth with fluoride every day and seem to be fine, but I still don’t feel comfortable brushing my teeth with something I’m not supposed to swallow.
Is there an effective alternative to fluoride? Yes. Toothpaste with a 10% concentration of nano-hydroxyapatite has been proven to be just as effective as fluoridated toothpaste at repairing teeth, and unlike fluoridated toothpaste it is perfectly safe to swallow. Nano-hydroxyapatite does the exact same thing to your teeth that fluoride does. Do not waste your money on a toothpaste that does not contain either fluoride or a 10% concentration of nano-hydroxyapatite.
Whether you choose a fluoride toothpaste or one with nano-hydroxyapatite the chemicals need time to rebuild your teeth. We all know we are supposed to brush for two minutes but that still isn’t enough time. Once you’ve brushed for two minutes don’t immediately rinse out your mouth, you can spit out any excess foam but leave some of it on your teeth for at least five minutes so that you can get the maximum benefit from your toothpaste.
And that is really all you need to know in order to develop and maintain good dental hygiene habits and to understand why brushing twice a day might not be enough for you.
Let’s recap: Tooth decay is caused by acid, that acid comes from your food and could remain in your mouth for an hour after we’ve finished eating. The acid can be neutralized by chewing a xylitol sweetened gum. You should avoid snacking to minimize the amount of time your teeth are exposed to harmful acid. Brushing your teeth with either a fluoride or 10% nano-hydroxyapatite toothpaste will repair your teeth, give those chemicals enough time to work.
It’s really that simple, a child could understand all of this. Could you make this more complex by adding a bunch of jargon and more precise language? Yes, but that wouldn’t be very productive, most people don’t care what the difference between plaque and tartar is and they don’t need to know as long as they can keep it off their teeth.
I was never that great at doing the things that the dentists tell us to do just because that’s what they say we need to do and I’ve had fairly poor oral health because of that. A year ago I was experiencing some fairly serious tooth sensitivity issues and obvious signs of gum disease which caused me to look into all of this to see what I could do to fix it. After I gained an understanding of this simple science I was able to develop the habits necessary to properly care for my teeth. My tooth sensitivity and gum problems were soon gone and a year later my teeth have never been stronger.
The dental industry had done a great job at telling people what to do, the guidance they give works for most people most of the time. But there are lots of people out there like me who need to be told more than just what they need to do. And there are plenty of people who will become frustrated when what the dentist says to do doesn’t seem to work. The dental industry would be doing the world a huge favor if they could simply and effectively explain the whys and hows behind everything like I have here. People like me who don’t respond well to just being told what to do respond a lot better when we understand why and the people for whom the standard advice isn’t enough will be a lot less frustrated when they understand why.
If oral health really is as important as they say it is we should probably know a bit more about it.