Changing Your Relationship with Your Dentist
The doctor of the future will give no medication, but
will interest his patients in the care of the human
frame, diet, and in the cause and prevention of disease.
—Thomas Edison
Sometimes the truth is painful. Certain observations throughout history have illustrated unexpected flaws in some generally accepted facts of that era. The problem is that often the messengers of these findings caused commotion and were viewed as defiant or disrespectful simply because the new concept conflicted with the accepted mantra of that time. For example, Copernicus was a mathematician and astronomer in the 1500s who was convinced that the sun, not Earth, was at the center of the universe. His ideas were contrary to the accepted opinions of that time, and so he was hesitant to publish his findings for fear of rejection and retaliation.
My hero is Dr. Ignaz Semmelweis, a physician in the mid-nineteenth century who championed hand washing for doctors, certain it was a simple way to save women from death and horrible infection during childbirth. Dr. Semmelweis was ridiculed, ousted by his peers, and eventually confined to a mental asylum, where he died in a straightjacket at the age of forty-seven. Dr. Semmelweis’s hand washing strategies offended doctors who held different opinions about disease. He was also unable to visibly illustrate the problem he described, because it was invisible. So he stood alone. The saddest part of the story is that, just fifteen years after his death, microscopes became available and were able to show that the “invisible problem” on the doctors’ hands were germs, transferred from autopsy cadavers to birthing women.
POSTPONING DENTAL TREATMENT
Before you run to share the strategies in this book with your dentist, you must realize that the idea you can maintain your own oral health is radical thinking. I know dentists who do not believe cavities or gum disease can reverse or heal naturally, and most hang their practice philosophies on the belief you need to floss and have cleanings every six months. This is why I encourage people to share their stories with one another so that others can gain confidence and escape the expenses and discomfort of avoidable treatments. Before you agree to dental treatments, I suggest you ask if it is possible for you to postpone treatment for a little while— possibly until your next appointment. The idea is to use this delay to implement the healing strategies outlined in this book and specifically in the next chapter.
A cavity normally takes at least a year to form, but it can often be reversed in a matter of months. When it comes to self-care, most professionals think it does not matter which toothpaste or rinse you use. Some have heard Listerine or fluoride are problems, and yet other professionals prescribe stronger versions of these. With such a variety of opinions, whom do you believe?
I often share the story of Helen Rumbelow, the British reporter who wanted flossing advice but tried my system, without flossing, until her next appointment. She kept her changes private as she sat in the dental chair, amused to hear this third-party endorsement of her improved oral health, despite the warnings her dentist’s office had given.
Like Helen, why not try to amaze your dentist with improved mouth health by using the strategies of my Complete Mouth Care System? Be aware, your dentist may not understand this system of care and may not have any faith in these products, my methodology, or my recommendations. Note that the American Dental Association (ADA) holds the intellectual property on a number of oral care products and has a vested interest in training people to use and believe in them. The other concern is that dentists are frequently gifted samples of products to share with patients at the end of their visits. A free gift is not necessarily a good product, and many appear to have the potential to upset your mouth health. One of my clients was persuaded by a free sample to relinquish her loyalty to the original Crest toothpaste that I recommend.This paste had protected her teeth successfully for twenty years, but she switched to one her dentist gave her in a sample gift bag and was horrified when she began developing staining, cavities, bad breath, sensitive teeth, and finally a dry mouth.
Despite the problems of convincing a disbelieving dentist, I will never recommend that you avoid going to see your dentist. You need a dentist to be the evaluator of your progress, to judge how your daily care system is working, and to step in when actual dental work is necessary.
Two pivotal risk factors, acidity and dry mouth, can ruin any healthy mouth. If you have these conditions, try to figure out how they can be controlled to turn your mouth health around. If you have a cavity in a groove on the biting surface of a molar, for example, consider making changes to protect your teeth from acid damage and mouth dryness. Then, use my suggested oral care protocol in the next chapter to prevent this cavity from progressing. With good strategies, you can often mineralize and rebuild the tooth, so the entire cavity will reverse and disappear.
MONITORING YOUR ORAL CARE PRODUCTS
Be aware of the importance of the oral care products you select. If you have dental problems, consider that the products you are using may not be helping you, and perhaps you should discard them. On the other hand, once you have found a way to enjoy sustainable mouth health and avoid dental problems and no longer need cleanings or treatments, stay loyal to your program. I know people who have faithfully used products that made their teeth sensitive, or they developed calculus and plaque, or they continued to endure unhealthy gums and weak enamel, yet they continued to use the same oral care products, because they had once been recommended to them.
These people were incredulous to discover that a small switch in toothpaste or the addition of rinses could quickly change their dental health. If your teeth are not getting stronger, change your toothpaste, and find a more effective system. Everyone should expect their mouth to feel clean and comfortable, and their teeth should feel shiny, glossy, smooth, and slippery. If your teeth feel dry and sandy or rough and dirty, change what you are using, no matter how recommended, natural, or endorsed this product may be. Two months on a good protocol should improve your oral health, so you will feel confident and make a good impression at your next professional visit.
It’s important to be enthusiastic about mouth health, and I believe when someone makes changes, they should be encouraged by seeing and feeling positive results. No one wants to limit favorite foods or conscientiously clean their teeth unless the outcome is successful. I feel sorry for people who are told to drink through straws or use peroxide trays on their teeth every night in efforts to control staining or fight gum disease. Dental issues happen whenever you upset the delicate bacterial balance in your mouth. You will know your ecosystem is out of balance if your teeth are sensitive or if they seem vulnerable to cavities, staining, erosion, or fractures. Regular use of the products I recommend in chapter 9, however, should stop these problems, even for someone who has sensitive teeth or a dry, acidic mouth.
A FEW PRECAUTIONS
Earlier in this book, we discussed transfer of bacteria within families. This is an often overlooked concern outside the family circle for anyone who is dating. Teens, young adults, and even seniors should be warned that oral pathogens transfer—no matter your age group—and statistics show that over 50 percent of the population have periodontal disease bacteria, which transfer from one person to another. Other often unrecognized sources of bacterial transfer are shared office phones and the use of contaminated musical instruments. Woodwind and brass instruments can harbor bacteria for weeks after use, leaving them potential reservoirs to transmit disease to others. Research shows woodwind instruments become more contaminated than brass, and clarinets, for some reason, may be the most susceptible.
Today, more dentists are talking to their patients about bacterial transfer, but perhaps we also need to be concerned about bacteria that hang in the air above dental chairs. In the 1980s, I was involved in research on bacterial transfer in dental offices. A few years later, dental offices were instructed to undergo complete overhauls of their sterilization techniques. For the first time, dentists began to wear gloves and masks and use disposable instruments for surgery and injections. These new mandatory guidelines were only instigated after patients were infected during dental treatment.
We cannot see infection in the air or on surfaces, so I believe we need to continue to be vigilant about transfer of disease on dental equipment, in water lines, and through splatter in the air of dental offices. Few people talk about the risk of patient-to-patient transfer, or the potential for inoculating decay from one tooth to another with a spiky dental probe, or the possible movement of pathogens from one infected pocket to another as periodontal assessments are performed. We know dental masks and eyewear are unable to completely protect dentists from splatter sprayed from a patient’s mouth during treatment, but what about the risk for a patient?
A Michigan study tested eye shield protection in 1984, using a phantom patient and red dye, and it clearly illustrated how splatter from a patient’s mouth sprayed as the drill touched teeth at speeds from 180,000 rpm to 500,000 rpm. Debris was found to travel up to 50 mph, with pieces of filling, tooth, calculus, and, potentially, bacteria hurled into the air with saliva and blood. This should give you pause as you lie horizontal with your mouth open and your nose, eyes, and skin exposed. If you are a parent, have you considered the consequences for a child with a healthy mouth who is next in line after someone with poor oral health?
It may be time for better air quality control in dental offices and systems for healthy mouths to be examined in a separate room from the operatory where cavities and periodontal disease are treated. In the interim, here are three simple things anyone can do to limit their risk of exposure. And even if these steps are not essential, it may be smart to be cautious:
1.Schedule a dental appointment as early in the day and week as possible, ideally after a long weekend when the office air will have settled. Avoid Friday afternoon when office air may be fogged with bacteria.
2.Boost your immune system with a healthy diet and probiotics for several weeks before an appointment.
3.If you are an adult, you may want to prepare your mouth with my Complete Mouth Care System immediately before an appointment and chew a Zellie’s mint or gum as you exit the dental office.
CAMBRA
If you want to talk with your dentist about reversing cavities, you need to know about something called CAMBRA. These initials stand for caries management by risk assessment. In 2010, when my first book, Kiss Your Dentist Goodbye, was published, CAMBRA was a new idea, and my book was written to explain this concept and why some people are at greater risk for dental problems. In addition, I explain how to overcome these risk factors and control cavities and gum disease to make dental problems stop.
The CAMBRA concept has now emerged more fully and has been incorporated into many dental office protocols. My introduction to CAMBRA science was decades ago through the teaching of Dr. John Featherstone, who is now the dean and professor at the School of Dentistry at the University of California, San Francisco. Dr. Kim Kutch is another dentist who has also worked tirelessly for many years to teach CAMBRA and explain how patients can avoid fillings and reverse cavities.
A CAMBRA dentist may ask a lot of questions about your diet, acid reflux, and habits that could be affecting your oral health. They will search for the source of acidity in your mouth and may measure acid-producing bacteria. All CAMBRA programs that I know center on the use of xylitol, and many have similarities with my Complete Mouth Care System. I am glad the idea of CAMBRA has raised awareness about natural tooth repair and mineralization, but not all CAMBRA home care suggestions are the same. My belief is that many CAMBRA protocols were developed before dentists understood the role of healthy bacteria and the importance of a healthy microbiome, which is easily damaged by strong fluoride, strong antiseptics, or the use of antibiotics. Much as I support the concept, the following is a list of my personal concerns about CAMBRA:
•CAMBRA testing currently does not measure either healthy bacteria or gum-disease pathogens. CAMBRA testing measures cavity-forming bacteria found in plaque. I prefer strategies that consider the mouth’s complete ecosystem and strategies that develop long-term and sustainable tooth and gum health.
•CAMBRA programs sometimes suggest a prerinse of bleach, which can eradicate harmful bacteria, but it will also eradicate healthy bacteria. I prefer a prerinse with chlorine dioxide, because it is does not kill healthy bacteria. The released oxygen from chlorine dioxide disturbs anaerobic pathogens but does no harm to the healthy oral ecology.
•Most CAMBRA systems provide stronger fluoride in their pastes and rinses, which I believe can damage healthy mouth bacteria. Stannous fluoride is often the fluoride preferred by CAMBRA dentists, whereas I recommend only sodium fluoride products. Stannous fluoride can cause staining and upset the mouth’s ecology and the delicate mouth tissues.
Hopefully, you will find a dentist who believes in reversing cavities and gum disease and who will be excited to help you end dental problems and improve your oral health without unnecessary treatments. You want to find a dentist who does not see themselves as a fixer of damage but someone who is happy and passionate to be your dental health coach and advisor.
Insurance companies may eventually reward this kind of dentist who is motivated by early detection and wants to help you avoid dental problems. Medical insurance companies know about the close links between mouth health and general health and how chronic systemic health problems may be reduced with improved oral health. United Concordia, a dental insurance company, has recently developed teams of Oral Wellness Consultants whose job is to explain the oral-systemic connection to patients and guide them to dental professionals who understand this link. Unless recommended ideas for oral care are able to truly improve mouth health, we will never fully recognize the whole-body benefit that a healthy mouth can bring.
It will be more exciting when insurance companies create enough motivation for dentists to use measuring equipment like the Inspektor Research Systems light technology. These devices measure changes in enamel strength, which can be pivotal in detecting potential weakness early to give you enough time to take action and avoid a filling. By measuring tooth hardness with the precision of these systems, your dentist can check for changes in your teeth’s mineralization and determine if your teeth are getting stronger and healthier.
A company called Oral DNA has a test called MyPerioPath®, which measures the levels of periodontal bacteria in your saliva. This can alert you if harmful periodontal pathogens are at an unhealthy level, indicating the probability that they are breeding in gum pockets around your teeth. With Oral DNA testing, you’ll swish saline in your mouth and then spit the liquid into a test tube. The sample is sent for analysis, and the periodontal bacteria are identified, measured, and displayed as a graph showing levels of specific pathogens that are implicated in gum disease.
Oral DNA testing can identify eleven kinds of bacteria that are causes for concern and give the level of each compared with a black line, considered the generally accepted safe level, for every kind. Any measurement above this line indicates a problem, since these bacteria have been implicated in various health conditions, and some have been associated with chronic inflammation and its health consequences.
Some bacterial testing involves the insertion of a toothpick-shaped piece of absorbent paper into gum pockets around teeth. The paper soaks up fluids and bacteria from the area, and then it is viewed under a microscope to look for harmful bacteria. The problem with this kind of testing is that some harmful bacteria are normal residents of our mouth, and providing their numbers are low, they pose no problem. Concern should arise when harmful bacteria multiply rapidly, and this can be seen in saliva samples. Because of its limited view, samples gathered from a single pocket could cause unnecessary concern.
There is a still a lot to learn about mouth bacteria, but we already have sufficient information to know that we cannot continue to follow old dental mantras. I suggest everyone takes a salivary mouth test for periodontal pathogens along with an oral cancer screening, at least every couple of years. If you have active gum disease, I believe you should consider testing immediately and then monitor your oral health until it is satisfactory and remains stable. For the latest information about salivary testing, please visit my website at www.DrEllie.com.
BECOMING DENTALLy EMPOWERED
To become dentally empowered, I suggest you begin preparing your mouth before your next appointment. If you improve your oral ecosystem before a cleaning, you will be able to imagine as you leave the dental chair and pay your bill that healthy bacteria will be ready to populate your teeth and become the main protectors of your mouth. Changing the mouth’s ecosystem is a process that takes time (2–6 months) and requires the progressive reduction of harmful microbes alongside the protection and promotion of beneficial ones.
With healthy bacteria in your mouth, you should be able to extend the time intervals between cleanings, which can translate into stronger teeth and improved oral health. Remember, you cannot simply stop having cleanings and hope that your mouth is healthy. Ultimate oral health demands healthy bacteria and daily care that protect your teeth from the harmful consequences of infected plaque, calculus, and gum infections. Your journey to this place is progressive, and although you can take the first steps today, it may be a year or more before your dentist agrees that you no longer need frequent cleanings to maintain mouth health.
There are currently a lot of studies looking at saliva. Healthy, alkaline saliva promotes bacteria that do not produce acids, and it can control undesirable bacteria in various ways and make certain ones inactive. For example, salivary glands accumulate nitrate from the blood and secrete it into the saliva that washes the mouth. Certain mouth bacteria are able to process salivary nitrate (NO3-) and turn it into nitrite (NO2-). When nitrite comes into contact with acid-producing bacteria, the nitrite becomes a substance that is toxic to them, and this helps eliminate some of the harmful oral bacteria, especially those that cause cavities.
Nitrates generally reach saliva through the absorption of nitrates from our diet, and they are found in a wide assortment of green leafy vegetables and in beets. The more nitrates in saliva, the more saliva will be able to promote and aid the bacteria that use nitrate (denitrifying bacteria). When denitrifying bacteria are plentiful, they will help to control cavity-causing bacteria and help promote mouth health. Humans lack the nitrate reductase enzyme necessary to turn nitrates into nitrites, so we depend on oral bacteria for this benefit. Furthermore, any nitrite we swallow in our saliva reacts with gastric acids in our stomach to create nitric oxide, which can inactivate potential pathogens in the stomach and will also exert positive vasodilatory effects on our circulation and breathing. It appears that today only 10 percent of the US population has healthy, mineral-dense saliva and the nitrate-reducing bacteria that can naturally protect us in these ways.
Some of these healthy denitrifying bacteria are harmed by oral care products like bleach or the strong antiseptic rinse chlorhexidine, which is a often recommended for gum disease. A Swedish study by Joel Petersson et al. examined rats that had been fed a super nitrate-rich diet. Some of these rats had their mouths sprayed with an antibacterial spray, which damaged their oral bacteria, including the denitrifying bacteria. Then, the rats were given a compound known to cause mouth ulcers. Only the rats whose mouths had been sprayed with the special antibacterial compound developed mouth ulcers. Petersson suggests that the spray killed the denitrifying mouth bacteria, and without these bacteria, the rats lacked the protection that the nitrate-nitrite and nitricoxide effect offers to the skin of the mouth. Without the protection normally offered by healthy bacteria, the antibacterial compound was able to cause ulcerations. This shows the value of a healthy mouth ecology and illustrates why people who experience mouth ulcers should look at ways they can nurture more denitrifying bacteria in their mouths. Generally my advice is to begin with regular use of xylitol after meals and drinks, give thoughtful choice to your selection of oral care products, stop tongue scraping or too frequent mouth cleaning, and enjoy a diet that supports salivary health. This would ideally be a diet that includes plenty of green leafy vegetables, beets, mushrooms, garlic, yogurt, butter, and pomegranate juice.
Remember that you dilute your saliva by sipping anything, and this will dilute the protective benefits of saliva. If this is difficult to imagine, consider what would happen if saliva were the same consistency as water. The crystals of tooth enamel would dissolve into the water in the same way that bath salt crystals dissolve in bath water. The benefits of saliva are enhanced when we make teeth more accepting of saliva’s minerals. This is achieved with a solution of 0.05 percent sodium fluoride as a rinse used twice per day. The benefit is created as minerals from saliva become attracted to the tooth surface, where they enter and strengthen the enamel.
TALKING WITH YOUR DENTIST
If you visit your dentist every year, you can use this opportunity to talk and ask questions about changes in your mouth, good or bad. If you begin with poor oral health, you should see improvements quickly, and bleeding gums should heal and disappear if you have been massaging your gums and working to improve your digestive and immune health. My strategies are useful for people fighting cavities and gum disease, but they are also useful for people who have fillings, crowns, bridges, implants, or otherwise damaged teeth, especially as they age or begin to take medications that dry the mouth.
People with good teeth will find that my strategies enhance and safeguard their teeth. Shiny teeth become shinier, healthy gums look better, and teeth feel cleaner. Some people are afraid to tell their dentist about their new approach to oral health. Most biologic dentists are adamant that fluoride should never be used, yet they often witness teeth that fracture or have problems that lead to root canals, crowns, bite guards (which are plastic), fillings (which often contain BPA), or the need for artificial whitening. If you are on a downward spiral of treatments, at least consider changing your home care, and remember that the most biologic and natural dentistry is no dentistry at all.
The need for ongoing dental treatments should be a reality check for anyone who is working hard to care for their teeth. You deserve to enjoy sustainable oral health without ongoing treatments. Remember that our understanding of oral health has changed radically in the past ten years, and these new concepts about oral health have exciting implications and should offer great hope to everyone. Why be intimidated? Why not give my strategies a try for a few weeks, even if they fly in the face of something like flossing, which may have been recommended to you but has never worked? I hope you surprise yourself and discover there really is a way to enjoy ultimate oral health and that many of these positive changes will happen easily and relatively quickly.
X-RAYS
When I was a child, there were X-ray machines in shoe stores. As we were fitted for a pair of shoes, it was customary to stand in this machine, so the store clerk could take an X-ray of your shoes to check if your toes had adequate room for growth. There was no protection from the X-rays, and because my father had bad feet, he lovingly insisted that my brother and I had lots of pictures taken to avoid ill-fitting shoes. I cringe when I think how many X-rays I experienced as a preteen child. No one knew of any dangers, but when they did, these machines rapidly vanished forever. There are now studies that say X-rays can be harmful and may damage living tissue and promote cancer, yet they continue to be taken regularly in dental offices, sometimes as often as every six months.
In September 2012, the journal Cancer published a study showing an association between dental X-rays and meningioma, a common brain tumor. The results were challenged by the ADA, but that same year, the organization created guidelines to limit a patient’s exposure to radiation and avoid unnecessary risk from its long-term effects. I have already mentioned how great it would be for more dentists to use equipment capable of measuring small changes in enamel strength.This equipment was introduced years ago and has been used in other countries for over a decade. The benefit is that the measurements tell you about changes in your tooth strength, which allows you to know if your teeth are getting stronger or weaker. This test involves no radiation, because the measurements are by light reflection. The equipment would be able to give us preventive warnings about areas where enamel is softening, without the need for routine bitewing X-rays, the kind that are part of almost every dental checkup appointment today. Unfortunately, the dental industries associated with all the expensive X-ray equipment will continue to lobby and likely block this new technology to keep it away for as long as possible.
Dental X-rays can be divided into two groups: those taken for preventive screening purposes and those used to investigate a specific problem or injury. X-rays taken for screening are used to ensure everything is healthy, and they allow your dentist to evaluate unerupted teeth and the health of bone and roots below the gumline. If you have an unhealthy mouth, plaque and calculus, cavities and fillings, root canals, crowns, implants, bleeding gums, or periodontal pocketing, you will need diagnostic X-rays often, even as much as every six months. If you have a healthy mouth with pristine teeth, a dentist can be quite confident of your mouth health with far fewer X-rays.
With healthy gums and pristine teeth, the need for X-rays to check deeper should be adequate at three- to five-year intervals. Over fifty years, this extension of the time interval from six months to five years could save you over one hundred potentially unnecessary exposures. When all the crevices of molar teeth have been filled by sealants or covered with fillings or dental crowns, this prevents the dentist from being able to visually judge the health of your mouth, as the molar grooves have been eliminated. As a general rule of thumb, pristine teeth will need the fewest X-rays, and this is one reason I strongly oppose the use of sealants, as they increase the need for frequent X-ray assessment for the rest of your life.
LESS IS MORE
Most people have been conditioned to believe that the more cleanings they have, the better their teeth will be. Companies with a vested interest have encouraged this promotion, aided by the insurance industry and marketers who have created dental software and services to promote dental recalls. The idea of regular cleanings is the darling of business consultants who have encouraged dentists to adopt a business idea called the hygiene model of dental practice. These dental offices have one or more dental hygienists, who generate a substantial core income from recall cleanings, usually performed before the dentist has examined the patient or anyone has determined if a cleaning is even necessary. A cleaning can remove discolored and infected biofilm (the material that is called plaque) from teeth in an infected mouth, but a dental cleaning has no power or ability to naturally improve or whiten the actual color of healthy teeth. To review this important point: the color or whiteness of teeth is an illusion that is created as light reflects off enamel prisms on the smooth outer surface of healthy enamel, which is covered by a protective protein film.
Dental professionals are trained to have faith in regular cleanings and there are only a few of us voicing concerns about them, questioning if they can be detrimental to people with a healthy mouth. The concern is that a cleaning removes the hardest part of a tooth, a microscopically thin and vitally important layer on the outside of tooth enamel. As most dental practices in the United States were evolving into hygiene-model practices, the existence of this important enamel layer was not recognized. Recently, we have discovered that the outside protective layer is at least ten times thinner than previously thought and may be important to the health of your mouth because of the ionic charge that is carried on its surface.
This new understanding of the situation suggests that frequent cleanings could create sensitivity, disrupt healthy biofilm, and may even leave teeth more vulnerable to cavities and staining. Patients with a dry mouth lack saliva and may have great trouble replacing healthy biofilm after it has been stripped during a routine cleaning, since saliva proteins are the foundation for rebuilding biofilm. This means people with a dry mouth and less saliva could be particularly damaged by frequent cleanings and find that their teeth become ever more sensitive and progressively more at risk for cavities, stains, and fracture with each cleaning.
If you have a dry or acidic mouth, you should make every effort to adjust your mouth health before a cleaning, and remember to ask your dentist if you really need one. If you do need a cleaning, consider making every effort to establish healthy biofilm before your next cleaning. Your goal is to ideally create long intervals between cleanings and monitor if this helps you to decrease dental problems like sensitivity and tooth fractures.
Another group of patients who should be wary of cleanings are those who have titanium dental implants. With titanium in your jaw, you should be extremely judicious about the frequency of professional cleanings you receive. This is because there is a substantial risk that particles of metal can be scraped off your implant and get into your gum tissue, which could create a new health hazard. So, once you get to a place where you no longer need a regular cleaning, you should be able to keep your teeth and gums healthy by following my at-home protocol and having periodic check-ins with your dentist to assess the level of your oral health.
We also need to be concerned that frequent cleanings could open the door for a healthy mouth to become infected. Many years ago, some US Navy recruits were selected for a study because they had no plaque, healthy mouths, and were cavity-free. Half the group was given a professional dental cleaning, then all the recruits were told to rinse with a solution of cavity-forming S. mutans bacteria, the bacteria that infect biofilm and form plaque. Then the groups were tested for S. mutans salivary levels after the rinse. The outcome was that the group that had received a cleaning tested positive with high levels of S. mutans, whereas the group that did not have a cleaning did not appear to have become infected by the rinse. It appears that removing the protective layer of beneficial biofilm during the cleaning had allowed this group to become vulnerable and be contaminated by the plaque bacteria. This study was conducted over forty years ago and appears to have never been investigated further but was ignored, as if it never took place.
The majority of people in the United States, if tested, would probably find they do need a cleaning, because they have harmful plaque in their mouths, even many who are fastidious and believe that they take good care of their teeth. Cleanings are useful for people who don’t have good oral hygiene, who do not care, or who don’t want the responsibility of their own oral health. Please understand that, while I suggest you restrict unnecessary cleanings, I do believe everyone needs a dentist to monitor their oral health. This means we may not all need the same treatment. For example, patients who want to improve their own oral health will need different care from those who are happy to leave their oral health in the hands of their dentists and let their insurance pay for as much treatment as possible.
The first group needs effective advice, careful monitoring, and encouragement to reach their ultimate oral health status. Patients who do not want this responsibility will be served well by traditional dental care, which can treat almost every dental symptom as it occurs. For this second group, the dentist will look for problems at each routine examination and fix issues as they happen. In this way, patients can keep their teeth pain-free and looking good for as long as possible, and all they need to do is show up for their dental appointments and pay the bills.
This means that the most important question is whether or not you want to be responsible for your own mouth health. The time has come, in medicine and in dentistry, to recognize we have two kinds of patients: those who want the doctor or dentist to take care of them and those who want to be empowered, take responsibility for and learn about their health, and self-direct their journey for the best possible outcome. This latter group needs up-to-date, complete, and effective advice, regular monitoring, and encouragement to reach and enjoy optimal bodily and mouth health.
For the past seventy years, traditional dentistry has become a care system that caters to the patient who accepts the need for ongoing treatment, cleanings, repairs, and finally the replacement of their teeth after extractions. This system has grown to offer cosmetic reconstruction for damaged teeth and smiles, and finally it is starting to alert patients to the implications of periodontal disease. Unfortunately, if you decide that you want something more, if you want to be empowered and achieve the highest level of oral health possible and avoid disease and its consequences, your biggest problem will be finding a dentist who believes this is possible, who will encourage you, and who will agree that many treatments and cleanings are unnecessary. Initially, you may have to take it on yourself to prove the point with your own achievements. With correct care and nutrition, you should expect to quickly develop and enjoy a mouth free from plaque, calculus, and cavities and avoid any bleeding gums or periodontal disease.
SUPPORT FROM A WELLNESS DOCTOR AND A DENTIST
Many of the people who buy fancy toothpastes are shocked by my simple and unimpressive suggestions for daily tooth care. On the other hand, there are some who cannot believe I suggest products that contain fluoride as an ingredient. This is why it took a while for me to find my first holistic convert: Dr. Marlene Merritt, a dedicated wellness doctor, herbalist, and acupuncturist in Austin, Texas.
Dr. Merritt was gracious when we met, and she listened to my explanations about the impact of oral health on general health. We discussed all the strategies of my system at length, and eventually she was confident enough to try my system herself and suggest it to her office assistant, someone who had prepaid thousands of dollars for impending gum surgery to perform grafting, deep scaling, and periodontal therapy. For several weeks prior to this appointment, Dr. Merritt’s assistant diligently used my strategies and the Complete Mouth Care System. When the appointment time arrived, the office assistant sat in the dental chair and was stunned as her dentist described his amazement at her incredible mouth health improvements. He pronounced the treatment was no longer necessary and gave a complete refund.
This was the start of a long relationship with Dr. Merritt and many of her professional contacts in Austin, Texas. She has also introduced numerous practitioners to my method of oral care during her travels across America as she lectures about the many ways we can reduce our risk for chronic inflammation, diabetes, and Alzheimer’s.
DAILY HOME CARE
Daily home care is imperative for maintaining oral health. And if you are using the correct system, it should keep your teeth strong, plaque-free, and comfortable between dental visits. If this is not happening, then something is wrong with your daily care. People who experience soft or weak teeth, plaque buildup, or sensitivity should reconsider the products they use daily. My Complete Mouth Care System is a program that will help develop and maintain oral health and assist you in avoiding unnecessary dental treatments to enjoy ultimate oral health.
Anyone who brushes their teeth is spending money on products for daily use anyway, and often people assume expensive products are better than simple ones. On the other hand, homemade toothpaste can seem like a bargain, but it is not if it permits deterioration of tooth enamel, the eventual loss of fillings, gum recession, sensitivity, broken or dead teeth, and other problems that may lead to expensive root canals and crowns. Just because something is “natural” does not mean it is good for your teeth, and in the next chapter, I will share the dangers of many natural things like oil pulling, salt, baking soda, and hydrogen peroxide.
I often ask people how they rate the status of their mouth health. The responses I get indicate that most people have no idea what constitutes mouth health. Some people tell me they have great teeth, because they have white teeth or straight teeth, but I know they have plaque, acidic damage, gum recession, and are probably told to floss at every dental visit. Most people do not understand the signs of disease, and dental disease is painless and invisible, so how do you know if your mouth is healthy?
We can wish for better testing equipment, but for now, ask your dental team to explain what progress they see and if you are doing a good job caring for your teeth. Reducing your need for cleanings is an excellent sign that you are heading in a good direction. In the next chapter, you will learn about my Complete Mouth Care System, which has all the tools you need to begin a journey to improved oral health.