Monday, March 22, 2010

The Dental Conspiracy

When I was growing up, I found my oral health didn't seem to be connected to my oral care. The more I brushed and flossed, the more cavities I got. When I brushed and flossed less, I got fewer, or no cavities.  When I was in college I never went to the dentist, and I was pretty slack about brushing and flossing. When I was in university, I went to the dentist. I expected to have 17 cavities, 5 extractions, and 2 root canals. Instead, the dentist said "Well, you have no cavities, but you need to brush and floss more." So I did.  Diligently.

Two years later, once I had my job with dental benefits, I went to the dentist again. For the first time in my life I was confident I would have a good check-up. I had brushed twice every day. I flossed more than I ever had before. When I would drink sugary drinks, I would immediately chase them down with water. Take a sip of Pepsi, then a sip of water.

The dentist took a look, and some X-Rays and said "You have two cavities."

WHAT?! That doesn't make sense! I neglect my teeth, I'm fine. I take care of them and I get two cavities?!  I suspected a dental conspiracy. I looked around the Internet for evidence to support my theory and couldn't find much. But, I did find an awful lot of information, which I will share with you now in the form of myths and facts.
Sugar causes cavities
It doesn't. Acid causes cavities. Acid slowly dissolves the minerals in your enamel. Eventually, your enamel becomes weak and worn away, and a hole appears. That's a cavity. A certain strain of bacteria uses sugar to replicate and create acid. Acid can also come in the form of acidic food (like oranges and lemons), acidic drinks, or your saliva could be acidic.
The only way to fix cavities is to have them filled
This is mostly true.  The truth is that your saliva has minerals in it that strengthens tooth enamel. But, the more acidic your mouth is, the longer that process will take. In fact, if your mouth is acidic enough, or for much of the time, the cavity will grow faster than the minerals will be replenished. If you put your mouth into a non-acidic condition, you can remineralize your teeth with your saliva.  However, with a full-on cavity (a hole, as opposed to weak teeth), I doubt there's any substitute for a filling.
Fluoride in our water prevents cavities
If this were the case then cavities would only be found in areas without water fluoridation.  (Sault Ste. Marie, during my time there, did not fluoridate their water, yet even without much brushing or flossing, I had no cavities.) It's true that fluoride, in very small doses, can help teeth remineralize. In order for fluoride to work on your teeth, it needs to be in contact with your teeth. Fluoride in a mouth wash, or in toothpaste will help, but in drinking water, it won't do much once you've swallowed the water. Fluoride is an industrial byproduct. In the bloodstream it can be extremely harmful to people and animals. It's true that cities keep fluoride levels low enough not to harm most people. But if you drink more water than most, you may consume more fluoride than is harmless to you. The bottom line is this: A dilute fluoride rinse (0.05% Sodium Fluoride) in a mouth wash is good for your teeth. Due to the nature of fluoride, a stronger concentration is not necessarily better than a weaker one. Stick with a 0.05% sodium fluoride mouth wash - so I've read.
Sugar-Free gum is good for your teeth
That depends. It's true only if your sugar-free gum has the right sweetener in it. It probably doesn't. It probably has sorbitol, manitol, aspertame, and/or maltitol in it. None of those are good for you. Most sugar-free gums use sorbitol as the main sweetener. The bad bacteria in your mouth quickly learn how to use sorbitol instead of sugar. These sweeteners can cause gastro-intestinal problems. The sweetener you want to look for is xylitol. Xylitol is an all-natural sweetener that the bad bacteria in your mouth never learn to use, even after years of exposure. Xylitol also makes your mouth alkaline, so your saliva can remineralize your teeth. Look for Xylitol gum at your local health food stores.
Xylitol will give you diarrhea
It's true that in large quantities xylitol will give approximately one third of the population loose stools until their system becomes used to it. But, for dental purposes, you only need about 6.5 grams to 10 grams a day. You don't even need to swallow it. You can chew xylitol gum.
If Xylitol were so great, why don't we hear more about it?
Good question. I've found that some dentists are somewhat aware of the existence of xylitol as a molecule, but are unaware of it's dental benefits. Either that, or they don't want you to know too much. It could really cut down a dentist's business.  :) The only downside to xylitol I can find is that it's expensive compared to other sweeteners. It's also not appropriate for all types of baking.
Sealants will help protect my molars from cavities
They will as long as they were applied correctly, and they stay on perfectly. Once they start wearing down, cavities can form beneath them that can't be seen with the naked eye. Besides, sealants don't fix the problem. They're a band-aid solution, except it's like putting on a band-aid before even getting a cut. Wouldn't it be better to fix the problem (ie: bacteria and acidic saliva)?
It's a good idea to take dental advice from a computer programmer.
It's not. Don't do it. (BTW: I'm a computer programmer, darn it, not a dentist!) It's better to take dental advice from a dentist. This dentist maintains a blog where she answers people's questions. It's really quite informative. She wrote a book called Kiss Your Dentist Goodbye where she explains things more fully. She has come up with an easy system you can use to keep your teeth healthy and shiny. You can buy the products from her site, but you can buy them elsewhere with no profit to her.

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