“Chew On That”

Recently, I was reading an article about chewing licorice gum for your digestive complaints and was reminded that I wanted to update the information on anti-carious items you can easily incorporate in to your day, one simple way being chewing gum. Anti-carious simply means that a substance has inhibitory properties when used in the oral cavity. In other words it can stop decay (caries) in its tracks. Let me start by giving you some basic background on how decay occurs.

Every time you eat or eat/drink sugar laden foods you decrease the pH of your mouth to a point where the bacteria that cause decay (cavities) thrive. To put it simply the bacteria feed on the sugars and get all sticky and glue themselves to the surface of your tooth called enamel (enamel is the outer layer of every tooth and is 3 mm thick). These bacteria that are now attached to your tooth actually defecate on your tooth surface (yes, that is right they poop on your tooth surface) and their excrement is laden with acids and those acids are detrimental to the enamel. About 15 minutes after you eat or drink the pH of your mouth will return to a more normal basic pH of 7 but if you then have one more sip of soda or eat a piece of candy your pH returns to an acid state and some people keep their mouths constantly acidic by sipping soda all day or sticking one more piece of red licorice in their mouth all day.

Just imagine now that you have this acid factory going on in your mouth, it is rather like an atomic bomb of decay. If you don’t brush thoroughly every 24 hours the layer of sticky acidic plaque gets thicker and more viscous and more difficult to remove with just a toothbrush often resulting in a need for a hygienist’s instruments to remove the now hard layer of calculus (not just a math term, it is Latin for tartar) but in the meantime the bacteria are laboring away in an attempt to eat your tooth away.

By the way, if you were to put that plaque (the sticky substance that is on your teeth and needs to be brushed off) under an electron microscope you will see thousands of microscopic bugs moving around and each one of those bugs produces acidic waste that they spew on your teeth and the acid eats away the enamel. If you leave this acidic plaque on your teeth it will destroy the enamel and eat in to the dentin of your tooth. Once it is in the dentinal portion of the tooth it spreads like wildfire because dentin is soft, much softer and more porous than enamel, and it is easily destroyed.

We fast forward to your six month preventive care appointment at the dentist. She is “picking ” away at your teeth and she says to her dental hygienist “Let’s watch number 21 occlusal” (listen to them they will say things like that). That  simply means that there is some decalcification (white chalky areas) on the enamel chewing or flat surface of a back tooth. It hasn’t etched the enamel enough to drill out the sticky part but it is on its way in to the dentin and they want to keep their eye on this area, so it is recorded in your chart and watched with eagle eyes. These white chalky areas can be remineralized and the decay stopped dead in its tracks with proper care.

Or let’s say you look at your teeth and you see chalky white spots on a flat vertical surface (called facial or buccal) of your front tooth. Those are also areas (“watch” areas) where you have left bacterial plaque and the bugs are working hard at destroying your tooth and you will soon need a “filling” which simply means the dentist will remove the soft decayed bacteria laden portion of your tooth leaving a cavity that needs to be filled with a plastic tooth colored or silver amalgam filling to keep it from decaying again.

Children are notorious for presenting with white chalky areas on almost any tooth surface and while the first time they come in and we find “watch” areas they may not have a cavity or need a filling they are dangerously close. If their oral hygiene cannot be improved the next time they come they will most assuredly be returning to have the dentist remove the decay and leave in its place silver amalgam or a composite of tooth colored plastic. The same is true of an adult, if there are watch areas there are things the person can do to halt the decay but it requires better oral hygiene and other useful adjuncts.

That segues nicely to what you can “chew on” to halt the progress of all those nasty bugs hanging in your mouth. I have in a previous blog entry discussed Xylitol a natural sweetener traditionally made from birch bark (although now made from corn in China by many manufacturers). One of its many beneficial properties is that it disables the bacteria that cause decay, it destroys them and thus their ability to cause decay is foiled. Xylitol can be found in mouthwash, mints and gum. Global Sweets is a good online source of birch tree sourced Xylitol which is unquestionably the best Xylitol and the superior Xylitol products. However, if you aren’t an online shopper there are several products you can pick up at your local Target, Walgreens, CVS store and in today’s world where simpler is always viewed as better what could be easier?

When you shop for Xylitol containing products the one thing you need to look for is that Xylitol is the first ingredient listed not sorbitol, mannitol etc. The ability to deter decay is directly proportional to the amount of Xylitol added to a product, so if it is listed as the third or fourth ingredient as it is in Trident sugar free gum it is doing you very little good. Look for Xylitol to be the first ingredient as it is in Ice Breakers Ice Cube (IBIC) gum. IBIC gum is available in several flavors, so every palate can be sated. I don’t really want to encourage gum chewing but if you have an insatiable need for sugary soda or one more piece of red licorice chewing a piece of Xylitol sweetened gum for 5 minutes afterwards will neutralize acid and halt the production of those hard working cavity bugs. If you are at work and cannot brush after eating lunch chewing a piece of Xylitol sweetened gum for a few minutes will not only make your mouth feel fresher it will help prevent decay.

Altoid peppermint and cinnamon gum also list Xylitol as the first ingredient and it comes in these cute useful little tins that once empty can hold your daily supplements or jewelry if you are traveling. However, if you look at the list of obnoxious ingredients those gums contain it would be better to risk decay than chew on the chemicals. Spry gum and mints are a tasty option but again they are difficult to find as are XyliChew products. One might be better off using Biotene mouthwash or gum which is found in the dental section of your convenience store and does contain Xylitol not to mention enzymes known to inhibit decay and periodontitis. It is primarily recommended for people with xerostomia (dry mouth) but its gentle flavor and Xylitol content make it okay for everyone to use.

As a dental hygienist I think everyone could benefit from putting some Xylitol in their mouth once in a 24 hour period perhaps the best time would be right before you go to bed.  When you sleep your salivary flow slows and no longer has the decay preventive action it does during the day. If you brush your teeth and then coat your tooth surfaces with Xylitol before you go to bed you are adding a coat of armor that the cavity bugs will have trouble penetrating and hopefully keep you out of the dentist’s chair now and forever. Chew on that.

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