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Things you should Know about Dental Hygiene


Things you should Know about Dental Hygiene

Things you should Know about Dental Hygiene

Everyone “knows” that brushing and flossing prevents cavities, except when it doesn’t. There are peoples throughout the world who have never brushed and flossed and never got a cavity.

The four factors are 1. saliva: do you have it, 2. pH or acidity of the areas in and around the teeth, 3. diet = sugar and carbohydrates, and 4. BACTERIA.

It has always seemed obvious that the removal of bacterial plaques/biofilms from tooth surfaces would remove bacteria, and bacteria cause cavities, right? True, but which bacteria? It is impossible to remove them all (1,500 different species) that grow right back.

It has always seemed obvious that the removal of bacterial plaques/biofilms from tooth surfaces would remove bacteria, and bacteria cause cavities, right? True, but which bacteria? It is impossible to remove them all (1,500 different species) that grow right back.

If you don’t brush, your gums will bleed at the gum-line. If you don’t floss, you get bleeding between the teeth. But this has nothing to do with decay/cavities. This is gingivitis, the precursor of some types of periodontal disease.

The major culprit is Streptococcus mutans, which has 39 different strains at the last count, some worse than others. Some do nothing, and some cause rampant cavities. To stop cavities, you must change the bacterial population mix.

Fluoridated toothpastes have been shown in the last 65 years to reduce cavities in school-age children by 13.5%. This sounds good until you see what it means; in 1953 the average number in a child’s mouth was 3.7, now it’s 3.2. The old 1953 Crest TV add showed a child returning from the dentist yelling, “Look, Mom, no cavities!”, when what he meant was, “Look, Mom, only three cavities!”

So…what can you actually do? Fluoride treatments at the dentist last about three days. The dentist can apply fluoride varnish, which is better, but the results are not satisfying.

A dependents dental clinic at a Navy base in San Diego had no interest in replacing fillings over and over in the childrens’ mouths. They didn’t have enough dentists. Some kids never brushed and didn’t have cavities; some had immaculate mouths and they were out of control. They tried having them rinse with a prescription mouth rinse called Peridex (0.12% chlorhexidine) and it worked!!!, but only 2/3rds of the time. What was going on. Why didn’t it work all the time? Well it seems that it knocked out 34 out of the 39 strains of Staphylococcus mutans bacteria. Yeah!!! The other five strains happened to be the most aggressive of the lot. Boo! It made things worse for some kids. Also, Peridex stains the teeth brown, so, not so good.

Then they tried Betadine, an iodine containing disinfectant. It didn’t work. Then they tried laundry bleach, and they hit the jackpot.

For additional information and verification Google CAMBRA Caries Management By Risk Analysis. They will talk about testing the saliva and many other things. I tested saliva in 1970 and it didn’t always match what I saw in the mouths.

  1. Keep brushing and flossing.
  2. Have all of your cavities taken care of.
  3. Mix two teaspoons of laundry bleach in one quart of water. Rinse with one ounce, once a week only, for one minute. Do this for 8 weeks after the last filling is placed. Start now. (tastes terrible, but it’s worth it).
  4. Start chewing gum with xylitol sugar in it, three times a day (Orbit, Mentos, etc.) Any chewing gum that has xylitol listed as the first ingredient. Some will argue that the amount of xylitol is important, since this will determine whether it is bacteriostatic, or bacteriocidal. It turns out that it doesn’t matter since the outcome is the same; bacterial population mixture control.

If you have a WaterPik with a reservoir you can use the bleach solution in that once a week. This also provides great results if you have periodontitis (diseased gums). Do not substitute this for regular dental follow-ups.

Periodontal disease is not all the same. There are various forms of adult chronic periodontitis manifested by the types of calculus (tartar) that forms above and below the gum. Some are thin, some are thick, some are nodular, some are white, some are brown, some black, some are green, some are soft, some are hard. Some types are easy to remove, and others are tenacious. What this means is that they are all formed in different ways by different bacteria or combinations thereof.

The rate of destruction of bone also varies from individual to individual dependent on their health (diabetes especially) and unknown factors.

The treatment is periodic scaling under the gums, followed with 10 days of 20mg of doxycycline twice a day to knock down the inflammation that complicates healing.

Then rinse or irrigate with the dilute bleach solution (two tsp per quart of water) once a week. I first learned about this from…wait for it…a patient. I diagnosed possible surgery after deep scaling his sub-gingival calculus. He said, “Doc, let me show you something in a week”. He returned, and all of his sub-gingival calculus was now above the gum; his inflamed gum shrunk to a health level. He said an older dentist told him about this in 1970, who learned it from an even older dentist. He said he felt stupid for not continuing the bleach rinses. The did taste awful.

There is another type of gum disease that most dentists don’t know about that conventional treatment cannot treat. The patient just keeps getting worse and worse, loses teeth, and the dentist just scratches his head. Aggressive periodontitis is caused by one particular bacteria and occurs in about 4% to 7% of young adults. It is rapid, and I have seen 22 year olds with the back teeth very loose, called “floaters”, with no other treatment except the extraction of all the back teeth. Sometimes it’s also the front teeth. Another name for it is “poor man’s periodontitis”. It runs in families because of cross contamination; kissing is one way.

It is easily diagnosed by the distinctive smell. Regular periodontitis smells to me like mothballs and cedar. Aggressive periodontitis smells the same as the bottom of a dumpster in the produce portion of a market. The dentist has to take his mask off to do this.

The good news is that aggressive periodontitis is easily treated with the antibiotic doxycycline after scaling (higher dose, 5X, than mentioned before). And in many cases, the bone may grow back. Because it is fast, it has to be caught early.

There, I bet you didn’t know that.

It is also susceptible to control with the dilute bleach solution.

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