Monthly Archives: February 2015

4 Easy Tricks to Get Your Kids CAVITY-FREE for Life (and #2 will reverse small cavities!)

Before National Children’s Dental Health Month comes to an end, I want to shout this advice from the rooftops.  Cavities are NOT a necessary evil…not in baby teeth and not in permanent teeth.  New science gives us the ability to reverse cavities, make enamel harder in genetically soft teeth, and prevent nearly ALL cavities for kids and adults alike.  I’m so passionate about this subject that I shake when I speak about it.  So you can imagine how I must get when…

I was talking to a mom-friend of mine last week.  Her son just found out he had a cavity, and she was stressed out.  So she said to me, “all kids get cavities, right?  I mean, cavities in baby teeth is no big deal…that’s why we get a first set of teeth that falls out, right?”

FALSE! FALSE! FAAAAAAAALLLLLLLLLSE!

As a parent, you hate hearing that the dentist found cavities in your kids teeth.  Still, it soothes you to think, “at least they’re baby teeth that will eventually fall out.”  But that doesn’t soothe the expense OR the fact that your kid is going to have to undergo an unpleasant procedure.  Funny…after that procedure, what do we do to soothe our kid?  Give him a lollipop, of course!  (Seriously, y’all…you wouldn’t do that, right?  At least not until I tell you below which lollipops help reverse cavities…)

Take it from a mom who is a dentist.  It doesn’t have to be this way.  Even if your child inherited your “soft teeth”, here are 4 easy things you can do to minimize and even erase cavities from your child’s life (and they will work for your teeth too!).

  1. Toothbrushes: Any Kind and Everywhere. From the section in the dollar store to the entire long aisle in the drugstore, there are a zillion toothbrushes to choose from. And, I’m here to tell you that aside from choosing soft bristles* it truly doesn’t matter what kind you choose.
    toothbrushes

    Your best bet is to let your kid choose — make it a fun reward in the store — and when it comes down to the favorite 2 or 3 and it’s hard to decide, surprise your kid and buy all 3!  Then, when you get home put one toothbrush (along with a toothpaste that he or she really likes) near every sink in the house.  If you’re a little OCD like me, throw the brush/paste combo in a ziplock and keep it in the cabinet or drawer nearest the sink.  Proximity is half the battle.
    When Sammie and Oscar invade my bathroom, or when I’m working in the kitchen, I can get them to quickly brush.  Even if they tell me they already brushed today, I can say, “That’s great!  Now go ahead and do a quickie-brush while you’re right here.”
    Note:  The most important time of the whole day to brush is right before bed.  If your kid likes brushing, encourage them to add in flossing.  Try Gum Chucks:  cool flossers that make it easy for kids (and adults!)

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    **Side note on the soft bristles: One of the smartest dentists in the world, John Kois, ran several experiments using soft, medium and hard-bristled brushes and found that the bristles don’t harm your teeth. What does harm your enamel is the abrasivity (RDA) of your toothpaste. Use only toothpastes with RDA of 70 or less.**

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  2. Xylitol: The miracle gum. (This font won’t show you, but this is when I really start shaking with excitement.) Xylitol is an all-natural sugar substitute that looks like sugar and tastes like sugar, but doesn’t act like sugar. In fact, xylitol behaves opposite to sugar’s bad behaviors. It has one-third the calories, a low glycemic index, and helps to remineralize tooth enamel. That’s right, it can help your enamel re-grow! So it prevents and even reverses cavities. You can find it in gum, candy, mints, mouth spray, and in granular form. (side note: choose 100% xylitol products because the gum in the store that has xylitol in it may also have another sweetener like malitol, sucralose, or aspartame that can counteract the healthy xylitol benefits)
    Xylitol
    When Sammie and Oscar were toddlers, I started giving them xylitol candy, and I sprinkled plain xylitol on their fruits and called it candy dust. And, once they were beyond choking hazard age, I taught them how to chew gum and encouraged them to chew xylitol gum all day long. I buy vats of the gum on Amazon and keep it out on the counter where they can grab a piece anytime. I make sure they’re chomping on it when we read bedtime stories. And, the very last thing after they brush their teeth before bed is pump in a few shots of xylitol mouth spray. I remember nights when they were both babies, and after a long hectic day I tucked them in bed only then remembering I hadn’t brushed their teeth. So, I woke them and brushed their teeth… right? No way! Those nights I whispered that we forgot the “candy spray,” and in their sleep they’d open wide and I pumped in several shots of tasty xylitol spray. I honestly believe we could eliminate most cavities if we substituted xylitol for every sugar or syrup available in food and drink.

    Any negatives on xylitol? Two that I can think of:
    • It’s expensive. I believe if we get the word out and create a demand, then production will increase and price will go down. In the meantime, expensive lollipops, gum, and candy dust are WAY cheaper than unpleasant filling appointments at the dentist’s office!
    • Just like healthy favorite dark chocolate, xylitol will hurt your pets. Keep Fido away from the vat-o-xylitol-gum.

  3. Sealants: Consider sealants to be a coat of armor preventing cavities from growing in the deep crevices of back teeth. The deep grooves of molars and premolars are excellent hiding places for cavity-causing bacteria. The bacteria stay in the groove for a long time and destroy the enamel causing a cavity that decays and eventually destroys the tooth. Many of these grooves are deep and also smaller than one toothbrush bristle. That means that brushing can not remove the bacteria or debris from the grooves.
    Sealants
    When we place sealants, we use a special cleaner to completely clean out the deep grooves, and then we flow a protective resin to fill the groove. The bacteria can’t get back into the groove, and this specific kind of cavity is prevented.
    I recommend sealants for all teeth with grooves (molars and pre-molars/bicuspids and even the backs of your front teeth if your front teeth are super groovy). I even recommend sealants for baby teeth if possible. However, most dental insurance will pay only for sealants in permanent molars and only in children (not adults)…but don’t get me started on my soap box of insurance companies dictating what’s best for your health!
  4. The Great Fluoride Debate: This disagreement is decades long and started over the US government’s decision to fluoridate the public water supply. This debate has stayed fresh in dentistry as fluoride is one of our greatest tools in cavity prevention and in strengthening teeth.
    Dentist’s argument: Simply put, when the fluoride ion is taken up by enamel and used in enamel’s crystalline structure, the enamel becomes much stronger and less likely to decay. The amount of fluoride in drinking water and toothpaste is an incredibly small and incredibly safe amount.
    Anti-fluoridationist’s argument: At higher doses, fluoride is a poison. The activists consider the government’s decision to fluoridate the water supply to be an unethical form of mass-medication.
    Where do I stand? I can see both sides. Before the fluoridation of water, the number one reason kids missed school was a toothache or tooth infection/abscess. Those numbers dropped significantly after a trace amount of fluoride was to drinking water. Interestingly, during the last 2 decades where bottled water (no fluoride) has become more popular than tap water to drink, the incidence of tooth decay is going up. If you’re drinking only bottled water, the dental science tells me that you should at least be getting fluoride in your toothpaste.
    What about fluoride treatments at the dentist? These treatments use higher concentrations of fluoride, and science shows that they result in stronger uptake of fluoride in the enamel crystal — which means stronger enamel. If your child has (or you have) soft teeth that are cavity-prone, it’s a good idea to use the fluoride treatment. If your child has never had a cavity before (and you’re practicing the other 3 pieces of advice above), then you’re probably okay to limit the fluoride treatment (maybe just once per year instead of twice).
    Current Events: For cavity-prone children and adults, there are newer, safer products (like CariFree and Enamelon) on the market. An, even though the anti-fluoridationists hate these products, if you have soft teeth and cavities and you want to reverse small cavities and eventually become completely cavity-free, these products will help you do that.
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    **UPDATE for anti-fluoridationists! As I was working on this piece, I just received notice from a dentist friend of mine that he has completed his tooth powder that has natural ingredients, xylitol, and no fluoride. I’ll be testing it soon, and I will keep everyone posted on our findings.**[/box]

I’ve been in this profession long enough to realize that when there are strong debates like these, it’s unwise to pick just one side. In dentistry and all of healthcare for that matter, it’s important to first consider each individual and his/her risk factors and his/her personal concerns, and only then decide what treatment is most ideal.

There you have it:4 tried and true action steps to prevent and reverse tooth decay.

The Most Affordable Dental Care is at Your Fingertips: a message especially aimed at my 20-40 year old readers

90Every week I hear someone mention how dentistry is very expensive, and I don’t disagree, it certainly can be. Moreover, it can be one of the smallest investments in your healthcare budget if you’re doing the right things at home. I also hear the gamut of reasoning behind why a patient thinks their suffering from dental problems: “my parents had gum disease so I do too,” “when I was pregnant I lost all my calcium and my teeth fell apart,” “I have bad genetics,” “my grandparents were in dentures by the time they were 30 so I guess I will be too,” and “my parents never took me to the dentist so now I’m having to deal with all the problems.”


30 What I rarely hear is, “I know why my mouth is unhealthy; I’ve neglected to take care of it.” Don’t get me wrong, every now and again I meet someone who’s brave enough to own up to their less-than- stellar home care habits, or what I like to call “low-giene.” And if you’re one of the folks that have said or thought one of the statements I previously mentioned, most of those CAN play a FACTOR (the pregnancy one has pretty much been resoundingly refuted though). The reason I emphasize that is because sure, genetics can absolutely play a role, but it’s usually one part of the puzzle and can only really be blamed as the actual cause in extreme cases. Most people don’t realize how much control they have over their own dental fate (or maybe they don’t want to take ownership), but even someone whose whole family has had periodontal disease doesn’t have to suffer the same fate as their ancestors. If they do have similar problems, the reason is much more likely that if their parents never took care of their own teeth, they probably didn’t teach the best habits to their kids…or perhaps they never built value into having a healthy mouth. Regardless, you have the ability to trump genetics, prove your parents wrong, and have a healthy mouth for a lifetime if you commit to it.


39I’m not expecting you to become a daily flosser either. Please believe I’d LOVE it if you were, but I know for a fact that most of Americans floss a couple times a month at most, and that’s usually to get the pesky piece of popcorn or steak sandwich out from between some teeth. That, or they’ve got a dental appointment in the next few days and they think flossing in the 48 hours leading up to a cleaning will fool the hygienist. It doesn’t, I promise. However, if you tried flossing about 3 times a week for 2 or 3 weeks I bet you’d fool some of us. That’s because gingivitis (puffy, tender, gums that bleed easily) is a very reversible condition. The inflammation in your gums is your body’s way of trying to fight back from all the plaque and buildup that accumulates daily. If you floss just a few times a week, that allows your body to get that inflammation under control, and you’ll find that pretty quickly it won’t hurt to floss, there won’t be blood in the sink, the floss won’t smell terrible, and it’ll actually start to feel good. Yeah, I said it, flossing can FEEL GOOD. You know how a massage feels nice to a healthy body but would hurt like crazy to a swollen limb or joint…well, the same goes for flossing on some inflamed gums. The nice part here though is that the massage that floss provides removes the offending agent (plaque) and therefore gets rid of the inflammation—you’re actually massaging your gums to health. So keep this in mind: if there is blood in the sink after flossing or brushing THAT IS NOT OK–it means there is some serious inflammation at a minimum. Would you be ok with any other part of you that bled if you just pushed on it a little? Heck no, you’d go see a doctor about it.


47But often I find that a major part of the problem is that I’m having this talk with a younger portion of our patients. I don’t mean kids and teenagers, I mean 20 and 30 somethings, and there are a number of reasons for this. For one, some of us cling to a bit of the invincibility-mentality that most of us went through as teenagers. “Bleeding gums aren’t a big deal,” “I’ve never had a cavity,” “nothing hurts,” “yes I have a bite guard, but no I don’t wear it,” etc. I hear this from young people because it’s a SLOW process. Enamel is the hardest substance in our body. It’s incredibly dense, and it takes YEARS for a cavity to dissolve it (bacteria turn sugars you eat into acid and use it to burrow through the teeth). Enamel also doesn’t have feeling; if it did, every hot, cold, or hard thing would hurt our teeth. However, the next layer of tooth is called dentin, and it’s very sensitive and very soft compared to enamel. So you can have a cavity and it will not feel like anything until it’s dissolved its way through the enamel and gotten to dentin–that’s about 25% of the thickness of the tooth! And when it does make it to dentin, things really escalate–it hurts, especially with cold or sweet foods, and the speed at which the cavity grows ramps up because dentin is so soft. So when I hear, “it doesn’t hurt so I’ll wait to do anything about it until it does,” it can be very frustrating. If you fix it before it gets that far, not only is that minimally invasive to your tooth (they’re not that big, you don’t want to have any more removed than necessary) but it’s minimally invasive to your wallet. If you were told you need a filling for a couple hundred bucks, that’s a bummer. If you wait and let the cavity expand, that little $200 filling can rapidly escalate into the thousands as more and bigger procedures are needed to fix the tooth. My younger patients haven’t had to go through these major expenses yet, so they’re skeptical. What they don’t realize is they have the repercussions of decades of low-giene habits accumulating. Think about this: every tooth has the same born-on date, the same manufacturer, are made of the same material, and have been exposed to the same environment. If one tooth is sensitive or having issues, there is an excellent chance you have about 27 other teeth that may be on the brink of the same problem. If you have a $200 filling on all 28 teeth (I see this more than you’d think), that’s $5,600. Let that worsen to the point of $2,000 per tooth (I’ve absolutely seen this too) we’re talking $56,000. I don’t know about you, but as a 20 something I may have felt invincible, but my bank account didn’t (still doesn’t, actually) and $56,000 would have been unfathomable to me. THAT’s how people end up in dentures before their kids hit college age.


145The same applies if you’ve been told you’re a clencher or grinder. Most of us are, especially when we have stressful episodes at work, home, whatever. If you’ve been told you need a bite guard, it’s because we can see the wear that you can’t feel yet. After decades of beating on your teeth while you’re asleep (you can bite much harder in your sleep than you can awake because your safety reflexes are turned off) they form little hairline cracks. Just like the little crack in your windshield, it’s tiny and a non-event…until it isn’t. When you hit that pothole (or almond) and that crack all of a sudden runs the length of your windshield, you have to get a new windshield. Guess what, the same is often true for your tooth. Cracks can go vertically or horizontally. Vertically, there’s no saving it and that tooth has to come out and will need to be replaced with an implant or bridge. Horizontally we can sometimes save them with crowns and root canals but the tooth is vulnerable forever. Again, these are expensive repercussions that can easily be prevented with a bite guard. Make sure you use one made by a dentist though–if they aren’t calibrated they can introduce more problems than they prevent, but that’s fodder for another blog. I know this probably sounds like I’m trying to talk myself out of a job, but I have a feeling there will always be people who are lazy about flossing, disregard the advice of their dentists, chomp on almonds, and practice the dark arts of low-giene…but you can’t say I didn’t try to warn you. And if you ever complain to me about the cost of dentistry, be ready to hear my response of, “You know what’s a much more affordable option? Floss.”

-Andrew S. Currie, DMD, MS