Teeth, Floss ’em or Lose ’em

I had a comment last week regarding caring for one’s teeth when it appears you are losing ground. I think there are many answers out there but without quoting any books, or interviewing other dental personnel I thought I would outline some possible treatment plans that this dental hygienist with 34 years of experience might advise a patient to consider.

Picture this, you are the patient in the dental chair in a somewhat progressive dental office where the thinking is forward, the room modern (but no televisions on the ceiling). A hygienist looms over you with mask, gloves and goggles hiding her face but her voice is confident and reassuring.

“Morning Marjorie, how are you? Are you having any issues with your teeth?” “Not really” Marjorie says holding her hand against her jaw, “but I have had this dull achy feeling now and then. It might be worse when I eat something cold. Oh, and this tooth”  she says pointing to her upper right canine (#6) ” feels slightly loose”.

Hmm, okay, how about any chewing sensitivity? “No, not really but sometimes when I chew my jaw aches right here” she points to the right angle of her jaw “and right here” rubbing her right TMJ.

Are your teeth cold sensitive in the morning or all day? When they are cold sensitive does it go away or do you have to take pain killers for the pain? In other words does any pain you perceive linger? “Well, they hurt immediately with ice cream ( Don’t eat it then, the humorous hygienist says, and is the only one  laughing) but the pain goes away as soon as the cold is out of my mouth. It does hurt more in the morning as my teeth feel really sensitive to everything. Sometimes it just hurts to brush or if I put my fingernail right here (don’t put your fingernail right there) but it never lingers and I never take pain killers for the sensitivity. You meant like taking Ibuprofen or aspirin, right?  Yes. No nothing like that. Kris, I’m really afraid I will eventually lose my teeth and I don’t know what to do.

I don’t think things are as hopeless as you think Marjorie but I would recommend taking some proactive measures. I think you are grinding your teeth. You grind all night which causes your teeth and the angle of your jaw to hurt in the morning. The loose tooth on the upper right is also indicative of grinding. I think, and we will discuss this with the dentist, that you need a nightguard to protect your teeth at a very vulnerable time, when you sleep and are totally unaware that you are grinding. Grinding causes loss of tooth attachment and will also present itself as receding gums (gingiva). When the gums recede, and then you brush them too aggressively you actually wear away the tooth, digging a ditch in to the marginal gingival area and weakening them. If done to extreme grinding can irritate the tooth so badly the nerve dies and then you need a root canal procedure or extraction.

“Well, what if I don’t think I can wear a nightguard? And how should I brush my teeth? What about toothpaste? Is that too abrasive if I have exposed roots?”

I think you will need to try the night guard, we could even get you started with one that takes only your two front teeth out of occlusion (bite) but that is not a long term solution as it will skew your bite and then the TMJ issue will become more pronounced. I recommend the Braun Oral-B for brushing as it has been proven to remove plaque better and be less abrasive than a normal hand held brush and if you are going to use toothpaste I would try one like Crest Pro Health. It has stannous fluoride which may stain the teeth but the fluoride may help with the sensitivity and protect against decay. I personally do not like toothpaste but that is my choice and not one I feel I can foist on patients.

You need to reduce the acidic environment in your mouth and adding xylitol to your diet or with gum (only for 5 minutes at a time) or a  mouth rinse like Biotene with xylitol (not crazy about the chemical additives but it is easily available) can help destroy the bacteria that might be destroying your teeth. Flossing, our all time favorite, still seems the best way to clean in between your teeth and I don’t care what type you use, so long as you use it once every 24 hours.

As for diet there are some bodies of thought that even reducing whole grains will help with the acid as whole grains, even soaked whole grains have phytic acid and could present a problem to the compromised mouth. No soda period, enough said about that and juice of any kind is really no better. Chewy candy like licorice is like decay on a stick and I have seen it wreak havoc in an older person’s mouth. Things you should eat are dark green leafy vegetables and lean meats for the protein to keep the ligaments that hold your teeth in place strong.

I would add some supplements mostly to build bone as gum recession is a sure sign of bone loss. A K vitamin complex is showing remarkable ability to help remineralize bone. Almost all people are low in magnesium and Jigsaw makes a good slow release magnesium and Ionic Fizz tastes good as well as supplies you with necessary bone building nutrients. Vitamin D is essential for building bone and I like Healthy Origins as the price is right and the pills are small and easy to take. Add to this a good all round multi which has ample B &C vitamins for gingival health and you should have most of your bases covered.

“Gosh, I kind of feel overwhelmed is there anything I could read that would help me understand better? I am a visual learner and find it easier if there is something I can refer to.

I can give you several book suggestions to read on the subject all of which take a different point of view but all have a natural approach. I have had “Kiss Your Dentist Good-bye” by Ellie Phillips recommended. Ramiel Nagel has written a book called “Cure Tooth Decay: Heal and Prevent Cavities with Nutrition and friends of mine really liked the “The Perfect Prescription” . Personally I like the title of “Good Teeth Birth to Death” as who doesn’t want to keep their teeth until they die?

Okay, so we will clean your teeth today and take a panorex. On the panorex we can see if you are experiencing bone loss as the jaw will appear rather translucent instead of opaque as well as check for cysts and or tumors that could also cause your teeth to hurt or feel loose. I would recommend a routine cleaning every 3-4 months to keep bacterial plaque to a minimum and in one year we will reevaluate the health of your mouth to see if there is more we can be doing to help you save your teeth.

All right now Marjorie, if that all makes sense I say let the fun begin.

It is a bit stilted but you get the idea. There are so many things you can do to save your teeth beyond the usual floss ’em or lose ’em. I heartily recommend starting today with just one thing if that is all you can do, even if that one thing is flossing every day for 10 days, and from there the recovery begins.

Here’s to keeping your teeth a lifetime,

Kris

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2 responses to this post.

  1. Posted by QuercusMax on 7:48 at Wednesday, January 19, 2011

    I hate to floss, mostly because I really dislike using conventional string floss where you have to wind it around your fingers until it cuts off your circulation, and then get your fingers covered with saliva. But ever since I started using floss picks (short individual pieces of floss mounted on a wishbone-shaped plastic handle), I floss frequently. There are several brands and styles, some of which are better than others.

    Reply

    • HI QM, floss piks are great devices and I highly recommend them. After 20 years (yes it took me 20 years) of marriage and trying to convince my spousal unit to floss I met with success thanks to floss piks. We buy them by the bag at Target and he uses them almost every night. I think my SU even likes doing it now and that is a mark of true success.

      Reply

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