“Chew On That”

Recently, I was reading an article about chewing licorice gum for your digestive complaints and was reminded that I wanted to update the information on anti-carious items you can easily incorporate in to your day, one simple way being chewing gum. Anti-carious simply means that a substance has inhibitory properties when used in the oral cavity. In other words it can stop decay (caries) in its tracks. Let me start by giving you some basic background on how decay occurs.

Every time you eat or eat/drink sugar laden foods you decrease the pH of your mouth to a point where the bacteria that cause decay (cavities) thrive. To put it simply the bacteria feed on the sugars and get all sticky and glue themselves to the surface of your tooth called enamel (enamel is the outer layer of every tooth and is 3 mm thick). These bacteria that are now attached to your tooth actually defecate on your tooth surface (yes, that is right they poop on your tooth surface) and their excrement is laden with acids and those acids are detrimental to the enamel. About 15 minutes after you eat or drink the pH of your mouth will return to a more normal basic pH of 7 but if you then have one more sip of soda or eat a piece of candy your pH returns to an acid state and some people keep their mouths constantly acidic by sipping soda all day or sticking one more piece of red licorice in their mouth all day.

Just imagine now that you have this acid factory going on in your mouth, it is rather like an atomic bomb of decay. If you don’t brush thoroughly every 24 hours the layer of sticky acidic plaque gets thicker and more viscous and more difficult to remove with just a toothbrush often resulting in a need for a hygienist’s instruments to remove the now hard layer of calculus (not just a math term, it is Latin for tartar) but in the meantime the bacteria are laboring away in an attempt to eat your tooth away.

By the way, if you were to put that plaque (the sticky substance that is on your teeth and needs to be brushed off) under an electron microscope you will see thousands of microscopic bugs moving around and each one of those bugs produces acidic waste that they spew on your teeth and the acid eats away the enamel. If you leave this acidic plaque on your teeth it will destroy the enamel and eat in to the dentin of your tooth. Once it is in the dentinal portion of the tooth it spreads like wildfire because dentin is soft, much softer and more porous than enamel, and it is easily destroyed.

We fast forward to your six month preventive care appointment at the dentist. She is “picking ” away at your teeth and she says to her dental hygienist “Let’s watch number 21 occlusal” (listen to them they will say things like that). That  simply means that there is some decalcification (white chalky areas) on the enamel chewing or flat surface of a back tooth. It hasn’t etched the enamel enough to drill out the sticky part but it is on its way in to the dentin and they want to keep their eye on this area, so it is recorded in your chart and watched with eagle eyes. These white chalky areas can be remineralized and the decay stopped dead in its tracks with proper care.

Or let’s say you look at your teeth and you see chalky white spots on a flat vertical surface (called facial or buccal) of your front tooth. Those are also areas (“watch” areas) where you have left bacterial plaque and the bugs are working hard at destroying your tooth and you will soon need a “filling” which simply means the dentist will remove the soft decayed bacteria laden portion of your tooth leaving a cavity that needs to be filled with a plastic tooth colored or silver amalgam filling to keep it from decaying again.

Children are notorious for presenting with white chalky areas on almost any tooth surface and while the first time they come in and we find “watch” areas they may not have a cavity or need a filling they are dangerously close. If their oral hygiene cannot be improved the next time they come they will most assuredly be returning to have the dentist remove the decay and leave in its place silver amalgam or a composite of tooth colored plastic. The same is true of an adult, if there are watch areas there are things the person can do to halt the decay but it requires better oral hygiene and other useful adjuncts.

That segues nicely to what you can “chew on” to halt the progress of all those nasty bugs hanging in your mouth. I have in a previous blog entry discussed Xylitol a natural sweetener traditionally made from birch bark (although now made from corn in China by many manufacturers). One of its many beneficial properties is that it disables the bacteria that cause decay, it destroys them and thus their ability to cause decay is foiled. Xylitol can be found in mouthwash, mints and gum. Global Sweets is a good online source of birch tree sourced Xylitol which is unquestionably the best Xylitol and the superior Xylitol products. However, if you aren’t an online shopper there are several products you can pick up at your local Target, Walgreens, CVS store and in today’s world where simpler is always viewed as better what could be easier?

When you shop for Xylitol containing products the one thing you need to look for is that Xylitol is the first ingredient listed not sorbitol, mannitol etc. The ability to deter decay is directly proportional to the amount of Xylitol added to a product, so if it is listed as the third or fourth ingredient as it is in Trident sugar free gum it is doing you very little good. Look for Xylitol to be the first ingredient as it is in Ice Breakers Ice Cube (IBIC) gum. IBIC gum is available in several flavors, so every palate can be sated. I don’t really want to encourage gum chewing but if you have an insatiable need for sugary soda or one more piece of red licorice chewing a piece of Xylitol sweetened gum for 5 minutes afterwards will neutralize acid and halt the production of those hard working cavity bugs. If you are at work and cannot brush after eating lunch chewing a piece of Xylitol sweetened gum for a few minutes will not only make your mouth feel fresher it will help prevent decay.

Altoid peppermint and cinnamon gum also list Xylitol as the first ingredient and it comes in these cute useful little tins that once empty can hold your daily supplements or jewelry if you are traveling. However, if you look at the list of obnoxious ingredients those gums contain it would be better to risk decay than chew on the chemicals. Spry gum and mints are a tasty option but again they are difficult to find as are XyliChew products. One might be better off using Biotene mouthwash or gum which is found in the dental section of your convenience store and does contain Xylitol not to mention enzymes known to inhibit decay and periodontitis. It is primarily recommended for people with xerostomia (dry mouth) but its gentle flavor and Xylitol content make it okay for everyone to use.

As a dental hygienist I think everyone could benefit from putting some Xylitol in their mouth once in a 24 hour period perhaps the best time would be right before you go to bed.  When you sleep your salivary flow slows and no longer has the decay preventive action it does during the day. If you brush your teeth and then coat your tooth surfaces with Xylitol before you go to bed you are adding a coat of armor that the cavity bugs will have trouble penetrating and hopefully keep you out of the dentist’s chair now and forever. Chew on that.

Something smells corny

Thanks to a friend’s question last night I started researching Xylitol and to my surprise my favorite brand is made from corn and worse yet comes from a manufacturing plant in China. As I type my mouth is agape and I am appalled. It seems to me that anything made from cooked down corn be it from a corn cob or the kernels is potentially full of unbound glutamate and that means it is rich in excitotoxins and not good for anyone but can be downright dangerous to people who are sensitive to MSG.

Perhaps you didn’t know that Xylitol was traditionally from birch trees and is a naturally occurring sugar with 40% less calories than typical cane sugar and a much lower glycemic index (7) thus making it safe for diabetics. Because it has only 5 carbon atoms versus the normal 6 it inhibits bacterial growth and thus has been found valuable in dentistry to help stop rampant decay much like fluoride but much safer in my opinion. It has been used in Europe for decades but really only found some popularity in the USA in the last decade when it was promoted by companies like XClear at dental conventions and online as a nasal spray for chronic sinus infections. I think it is a great sweetener because it is useful in dentistry and it tastes great and looks just like sugar but lacks the calories of sugar. BUT, I have a problem with corn derived products.

Let me count the problems I have with it. Corn is one of the most genetically modified crops that American farmers grow. If you boil corn down you hydrolyze it and create free glutamate. Corn is a common allergen and corn crops if not rotated totally deplete the earth they are grown on and massive erosion occurs (I have experienced it with my own eyes). High Fructose Corn Syrup (HFCS) is in almost any packaged food you buy and is known to be a link in our food chain that may cause obesity and a host of other problems for the consumer. Even Ethanol production presents numerous problems not first of which is pollution of our air. Corn fed to animals creates meat that is unhealthy for human consumption and sickens animals who are ruminates and not meant to eat grains or corn. Did I say something smells corny? Well there is no way Xylitol needs to.

Xylitol is originally from birch trees and my sweetener will from now on be from birch trees. It will contain no excipients and it will not come from China. I highly recommend Xylitol as a sweetener.  I even use it in my morning tooth powder (baking soda, Xylitol and Celtic Sea Salt) because of its antibacterial qualities. However, do not buy the brands that are coming to us in giant poison filled containers from China. Look for “Made in the USA” and check its source to be sure it comes from organic birch trees and not the ubiquitous kernel or cob of corn.

Flossing Your Way to a Healthy Heart

Dental health is in the news again and being a dental professional I am always interested. This article came from Jenny Thompson of Health Science Institute (http://www.hsibaltimore.com) and has to do with periodontal disease and its apparent relationship to metabolic syndrome, a group of symptoms that put a person at greater risk of developing heart disease and type 2 diabetes. The article struck a chord with me because my spousal unit (SU) asked me to discuss flossing alternatives on my blog as he felt it was useful information. Flossing is only one component of good dental health and ridding your body of inflammation is the first thing a person needs to do to avoid heart disease and type 2 diabetes BUT if you are having trouble getting in to the floss “habit” read on.

As you can imagine it can be difficult to be espoused to a Nazi hygienist (or so my daughter called me one day) and for 25 years my SU really didn’t floss which resulted in the normal helpful advice that hygienists give anyone willing to listen. Apparently he never tired of my whining, bitching, cajoling, whatever adjective you want to use because he really did not attempt to develop “the” habit until he says I finally  mentioned alternative methods to floss his teeth. I don’t quite buy that in 25 years I never mentioned alternatives to the white finger method but that is another story. For the purpose of this article I will mention a couple of really successful methods that have worked for my family.

If you are a Target shopper they sell a product by DenTek called Floss Pik. These little wonders come in bags of 75 at a price that is affordable and probably varies by region. I like the Silk flossed ones with an “easy angle” my SU prefers the regular Floss-Piks. They each come with a toothpick end and a floss end and both ends serve a means. Toothpicks are useful for pushing food through when it is impacted, say, in an area where your teeth don’t meet perfectly thus forming an open contact. The floss cleans the spot where normally aligned teeth touch each other (contact area) and the subgingival (under the gums) area not attached to tooth or bone called the sulcus. No longer do you have to feel that lovely numb and tingling feeling brought on by floss wrapped ridiculously tight around your middle finger, you just grab a Floss-Pik and Bobs your uncle (as they say only in Britain so I am told).

But wait there is another adjunct that works wonders when flossing is recommended but you value your fingers too much to follow your hygienist’s advice. It is called the Reach Access flosser and it is the one I prefer and my daughter swears is the only reason she flosses. You can buy it at any retail store that sells dental products but I know Target sells it with the other floss. It has a long handle with a U-shaped end that holds a U-shaped device that has a piece of floss tightly stretched from end to end. This flossing U-shaped end snaps on the handle and away you go. You can read a book and floss, drive a car and floss (I did not say that) why you could even……..and floss.

I hope you all find this helpful advice and if nothing else you will know some key words to use the next time your hygienist brings up the oft discussed topic of flossing.