Your mouth is like a cave. It is dark, wet, and full of bacteria! Two important processes are happening. One is the laying down of calcium carboxylate (like stalactites) which forms rough surfaces on your teeth that can become "thorns" or "rocks" that hide bacteria, irritate the gingiva, and destroy the bone. The other process has to do with the bacteria hiding in all the places that you do not clean. The more you feed the "little beasts" (the bad bacteria) sugar, and other foods that are converted into sugar in the mouth, the more bacteria that you will have and hence the more waste product produced. Note that bacteria do not eat teeth, they just dissolve teeth with acids that they produce as a waste product. In essence bacteria are going to the bathroom in your mouth (hence the phrase "toilet mouth"). As you eat, the bacteria are metabolizing the same food and producing acids. One bacteria will divide into two bacteria in 30 minutes. Thus if you do not brush your teeth after eating......and you have 1 million of them...you will have 2 million soon after eating that nice sweet snack. That is why it is very important to remove decay and other food traps that harvest bacteria and acid.
Ironically the saliva in your mouth is the main defense that you have against bacteria. The saliva not only washes the food, acid, and bacteria away but it also carries bacteria eating cells that destroy and neutralize bacteria. Thus if you smoke or have diminished saliva due to pharmaceutical drugs etc. you will have more tooth decay! Smoking is one of the major causes of periodontal disease and other serious problems in the mouth such as cancer. Recent research shows that periodontal disease also introduces certain enzymes into the blood stream that weaken blood vessels in the heart causing heart attacks. Chewing gum can help produce saliva and control bacteria but it can also do damage to the joint or the TMJ. So ease up on the gum.
Flossing and Brushing with a soft toothbrush are your two best weapons to fight the bacteria. The less bacteria you have the less the mouth odor, the less the decay, and the less the potential for infections in the gingiva. Over brushing is a big problem and can lead to severe wear called recession. When flossing move the floss up and down along the curve of the tooth on either side. Causes of fracture, wear, and nerve withdraw point primarily to the chewing of ice and bruxing. To lessen wear stop any compulsive actions and decrease the consumption of caffeine and other stimulants.
Other Consumer Warnings: 1) The Sonicare Toothbrush is not safe for children and the handicapped to use. The Sonicare can also be damaging in the hands of an adult who might be compulsive. It will cause abrasion and wear to both the tooth and the supporting gingiva and bone. Like a hard tooth brush it causes recession & stripping.
2) Do not buy over the counter nightguards. These "Walmart" style appliances can cause major problems for both teeth and the TMJ. Recently I saw a patient with unexplained pain in all her lower teeth. She had wear on the incisal of her teeth from grinding and so felt compelled to have all these lower teeth veneered or crowned...thinking that her pain would then go away. She had received a treatment plan for thousands of dollars and would have had all this unnecessary work done, if I had not asked her the simple question concerning the nightguard that she had purchased. Her over the counter nightguard was soft and not hard like the ones required. We offer easy to wear thin nightguards for less than half the charge that many dentist charge. These hard yet confortable nightguards allow the jaw to slide and do not brake the lower teeth against the upper. This "braking" is what causes the pain in the weaker and smaller lower anterior teeth.
3) Trident makes many types of chewing gum but there is one in particular that is very good for children. The gum with Xilitol helps to build stronger bones and does not cause tooth decay. Normally Xilitol is more expensive than other sweeteners, Trident offers this great gum at the same price!!
4) Listerine has alcohol in it and so dries out the teeth and gingiva. Use mouthrinses that do not dry out the mouth. A dry mouth allows tooth decay and gum disease to proliferate. Moisture and saliva is important for bacteria fighting agents to work properly and for the vitality of teeth and gingiva.
New Developments: There is now new evidence that periodontis and swollen inflamed gum tissue is related not only to heart disease but also to pneumonia and pancreatitis. My aunt who has had pneumonia multiple times is in a nursing home. I checked her teeth and found that the staff was not brushing her teeth despite the fact that I had pursued the issue many times before and had her on a strong anti-bacteria mouth rinse. I sat some of the staff down along side her and showed them the "gunk" around her back teeth and told them that the bacteria clinging to those teeth was helping to cause her pneumonia. After properly brushing her teeth for her, her appetite returned and she began to eat more!!! If you have anyone in any kind of rehab center etc., take a mouth mirror and check the back teeth!
TOOTH DECAY: what causes it? Contrary to popular thought sugar does not cause tooth decay. What causes tooth decay is bacteria and the acid they produce. The bacteria does not eat the tooth. It is the waste product (the acid) that they produce that dissolves the enamel and causes the decay. In essence the bacteria eat the sugar and then they "go to the bathroom" in your mouth. That is what also helps to create the bad breath. Thus anything that helps produce bacteria is harmful not only to the teeth but also to the bone and the gums. These factors include 1) intake of sugar (sucrose..which is found in fruit) and carbohydrates (specifically starch) 2) a dry mouth which prevents the bacteria killing saliva from protecting the tissues 3) smoking which kills the good bacteria eating cells in saliva 4) acids which help promote bacteria growth and etching of the teeth 5) food traps including rotated teeth, holes in teeth, old fillings, poorly made crowns, unfilled decayed areas, spaces, periodontal disease, swollen gums, pockets in the bone, spaces between teeth etc. 6) a poor diet which decreases your bodies resistance to disease and ability to create new cells and fight bacteria 7) other bad habits such as placing objects etc. in the mouth and 8) not brushing and flossing your teeth and not seeing a dentist 2 X per year in order to remove hard plague on teeth called "calculus".
Did you know that the more you brush your teeth the yellower they will become...
How is that? Yes, as you over brush you will remove more and more of your whiter enamel thus exposing the more yellow dentin underneath. So do not use a hard toothbrush and do not go back and forth more than once. Do not use a timer when you brush nor teach your kids to do that....it only creates an obsessive compulsive behavior that leads to serious recession. Be careful in using any sonic brushes...they can cause serious damage to enamel, dentin, and to gum tissue!
In Texas: and maybe elsewhere, dentistry is changing...unfortunately often for the worse. When I tested in for dental school 30 years ago I had to prove my hand-to- eye dexterity and my spacial- relation abilities. We had to look at a drawing and then using our best understanding of the 3 dimensional presentation, we had to carve it out on a piece of regular chalk. If the piece was dropped and broke the whole test was scrapped and you had to retake it. It was a very good test to see how you could use your hands under pressure in a challenging scientific and artistic manner. This test is no longer necessary and so many dentists are graduating who cannot visualize parallelism which is necessary for properly constructing crowns, veneers, bridges, and partials!
In today's dentistry too much emphasis is being placed on selling and marketing dentistry. It is unfortunate, for in my own practice I have seen many friends and friends of friends who have been told that they need hundreds and sometimes thousands of dollars worth of dentistry when in essence they need very little or in some cases none! For instance there is a "Scientology" dentist down the road who has been telling almost every patient who walks in that they need scaling and root planning ( for which they charge $900 ) when in essence most only need a regular cleaning (which is $59 and is usually paid 100% by insurance). There is another practice not too far away where patients are being scared into removing all their metal fillings (they are being told that they will develop Alzheimer's if they do not). Another dentist is doing crowns in a pyramid shape which means all his crowns will fall off and you will have to constantly recement them. About 50% of the crowns that I see in the mouths of patients have either open margins (the fit at the gum level is off), shoulders (crowns are too bulky thus trapping food), or have open margins ( allowing food to be trapped in between them). Since I am a perfectionist when it comes to a persons health, I will not allow a crown to be cemented in that does not fit properly! We are here to serve in the health field....we are not just another business!!!!!!
Smoking is one of the main causes of periodontal disease. The nicotine and the heat from smoking causes dry mouth syndrome and helps to kill good bacteria fighting cells normally found in saliva. Smoking and many new drugs that cause dry mouth or decreased salivation cause teeth to dry out like coral out of the ocean, making teeth more brittle and prone to decay. Recent studies also show a correlation between periodontal disease and heart disease!!!!!!!!