Nearly one-third of American men ages 35 to 44, and one quarter of American women in the same age range, have untreated dental decay, according to an American Dental Association (ADA) survey.
Close to half of all men and and about 57 percent of all women brush their teeth twice a day as recommended. The two sets of statistics are undoubtedly related.
Before fluoride was found to help prevent cavities in the 1950s, people of previous generations accepted them as a fact of life. The Three Stooges developed an entire short film around the subject. Hilarious, yet painful to watch. But there are children today who have no cavities thanks to fluoride and dental sealants.
In many adults, that fatalistic view of developing cavities still exists. They tolerate them for far too long, or don’t maintain a regular schedule of dental checkups that can now catch cavities so early they can actually be reversed.
Once the acid released by bacteria dissolves the tooth enamel — the hardest substance in the body – and the softer inner layer called dentin, the living pulp of your tooth will die. Then, the only way of keeping the tooth is root canal therapy, which is far more expensive than checkups every six months.
When you brush your teeth twice a day, generally in the morning and before you go to bed, you are removing a sticky film called plaque. Scientists now know plaque is an interconnected community of bacteria and other microorganisms called a biofilm.
The biofilm also tends to thrive at certain sites in the mouth, those that are susceptible to bacterial growth. If it spreads too much, another result of neglect is periodontal (gum) disease, which forms pockets of bacteria between the teeth and gums. That triggers an immune response that can destroy the soft tissue, even the bone that holds your teeth in place.
At this point you will also likely develop intolerable bad breath, known as halitosis, which 65 percent of the population may have. This can affect your work, social interactions – a lot of factors that constitute the positive aspects of your life.
Having white teeth is the least of your concerns. Although, many Americans have become so hung up on tooth whiteness as a beauty statement, that their teeth look like a picket fence or a string of Chiclets.
Enough already. People have needed root canal therapy because they had their teeth bleached so much, their enamel was destroyed.
For some, apparently, unnatural whiteness is more important than basic oral health, which is a process in reverse. There’s a well-known term for that: Concentrate on health and beauty will follow.
Oral hygiene basics include a brush with soft, polished bristles and rounded ends. Its shape should simply allow you to reach every tooth. Hard bristles can erode your gums.
Brushes should be replaced every three to four months or earlier if bristles are frayed or splayed. Old brushes can’t do an adequate job and may retain harmful bacteria.
Electric and newer sonic toothbrushes are fine as well when used properly; improper use of an electric brush can gum problems and loss of tooth enamel. The key is to brush with a fluoride toothpaste for at least 2 minutes twice a day. If you think you don’t have time, think about whether you have time to lose your teeth.
The statistics on flossing are worse than for tooth brushing. One-third of Americans floss less than daily; more than 18 percent don't floss at all. The ADA says you should floss every day to remove food debris and plaque from between the teeth and below the gum line where a toothbrush can’t go.
Researchers have found that development of gingivitis (gum inflammation) and periodontal disease is highly individual, meaning you may not floss and still won’t develop either one. But science also tells us that removing the debris minimizes the chances of an inflammatory reaction. So why gamble? You can floss while you watch television.
Use a tongue scraper. No kidding. You may not know what a tongue scraper is; most people don’t. But it’s important because the uneven surface of the tongue is a great place for bacteria, food debris and fungi to live. The bacteria and fungi on your tongue are related to many common oral and general health problems and are a leading cause of bad breath.
Many of you have been to complimentary alternative medicine (CAM) practitioners, who used to be known simply as doctors who practiced ancient Eastern medicine. So you know that the first thing they want to see is your tongue. It tells them more than you know.
Judging by the surveys on at-home dental hygiene, you need to know more as well.
In between brushing, consider chewing sugarless gum. Chewing naturally stimulates salivary flow, and stimulated saliva contains more of the proteins that keep the mouth in balance by holding potentially harmful bacteria in check.
Begin and maintain regular dental visits and cleanings. Millions of people do not see a dentist regularly, even when they have one.
Regular dental exams and cleanings can prevent or catch oral cancer in an early stage, prevent gum disease, keep your teeth where they belong, find dental problems early, affirm or correct your at-home hygiene, and preserve a naturally attractive smile without cosmetic makeovers that will eventually have to be done again – and again.
June 03, 2015
Christopher Nystuen, MD, MBA