Wednesday, March 18, 2009

ADA's Dirty Secret--Tooth Decay is not only preventable, its curable!

What causes tooth decay.
Dental cavities are caused by a bacterial infection called Streptococcus mutans. S. mutans is not present at birth but is usually acquired by children in early childhood or infancy, many before tooth eruption.

How we are exposed.
Human beings get infected by the most innocent of sources, the mother's first kisses.
Adults may have a high concentration of S. mutans in their mouths. Bacteria can be transmitted from a parent or another intimate caregiver to an infant or child via saliva, for example, by allowing infants or children to put their fingers in the parent’s mouth and then into their own mouths, testing the temperature of a bottle with the mouth, sharing forks and spoons, and “cleaning” a pacifier or a bottle nipple that has fallen by sucking on it before giving it back to the infant or child.

Even if an infant or child is already infected with S. mutans, transmission can increase the concentration of bacteria in the infant’s or child’s mouth, increasing the likelihood of tooth decay or resulting in more severe decay. Therefore, it is important that parents and other intimate caregivers practice good oral hygiene and avoid behaviors that could transmit S. mutans to an infant or child. (source)

Other problems caused by Streptococcus mutans.
S. mutans is manageable and considered by dentists to be natural when confined to the oral cavity but is a serious infection when the bacteria migrates to any other part of the body. Infection of the heart valve by S. mutans is a life threatening disease that can be initiated by improper procedures at the dentist's office. All people with pre-existing heart valve problems such as mitral valve prolapse are encouraged to take antibiotics such as
Amoxicillin or Clindamycin prior to dental work to prevent the S mutans infection from traveling in the bloodstream and affecting the heart. (Guidelines have recently changed, so consult your doctor and/or dentist before getting any dental work done.
People with prosthetic joints may also be recommended to take antibiotic premedication prior to dental work to prevent S. mutans from migrating to the joints and causing or compounding rheumatoid arthritis.

Treatments for Streptococcus mutans infection.
In 1983, I Zickert, C G Emilson, and B Krasse authored a study on "Correlation of level and duration of Streptococcus mutans infection with incidence of dental caries." The study showed "the value of antimicrobial treatment in the prevention of caries."(source)

In 1975, R T Evans, F G Emmings, and R J Genco showed that a vaccine(composed of dead cells) to S. Mutans prevented infection by S. mutans in the oral cavities of monkeys--study has not been reproduced on humans. (source)

Other Citations
http://www.mchoralhealth.org/openwide/mod1_0.htm specializing in "Oral Health Training For Health Professionals"

----------------------------------------
Economics of treatment verses cure.
Dental cary repair represents a large portion of any dentist's business and is the largest portion of any dental office's income. The cost of actually filling a cavity is nearly insignificant compared to the average cost of a visit to the dental office, so there is a strong resistance to changing the way people are treated for tooth decay.
Today, it is common for a patient to be belittled for their failure to brush and floss "enough". There is no specific guideline for how often or how long to brush and floss but "3 times a day" is a typical recommendation. Truth is that no matter how much you brush, as soon as you get a cavity, "you haven't brushed enough", "you haven't flossed enough," or you "haven't done it correctly." Dentists use this argument to put the blame on the patient rather than mentioning the true cause of caries, S. mutans, and how to slow the infection or kill it for good. Why? Because it is not good for the bottom line to tell a patient, "You can prevent future cavities by taking a vaccine or antibiotic and then rinse your mouth with an antibacterial on a regular basis." But, it is very good for the bottom line to blame the patient and then continue to fill cavities with $5.00 worth of materials and charge $250 for the service.
One of the reasons why this has worked out so well for Dentists(who make nearly as much doctors with about half the education and no late night emergency calls) is that when people are having a toothache, they will pay anything they have to make it stop. The ADA also has a very powerful Lobby in Washington DC that has exempted them from price controls on services and exemption from providing emergency medical treatment to anyone who needs it.
----------------------------------------

Slowing the effects of S. Mutans:
Until dentists are willing to prescribe a routine of
Amoxicillin or Clindamycin to kill the bacteria at its source or rally behind a vaccine(and effectively kill off 50% or more of their business) there are a few natural products that kill or slow the growth of S. mutans. One of the most effective is peppermint oil which is why so many tooth pastes taste like peppermint--unfortunately most modern toothpastes use artificial flavor so this benefit has been lost.
Other antibacterials:
Licorice contains glycyrrhizin, the power behind cavity prevention. Cavities are a result of lingering bacteria in the mouth- the main condition rooted in bacteria production is delayed and prevented by licorice.
Only 15 milligrams of licorice powder eliminates 99.9 percent of Streptococcus mutans, a common bacterium that could release harmful cavity-causing acids.
Before cavities appear, bacteria in the mouth produce acids that create holes in the top layer of the teeth. Streptococcus mutans is particularly harmful and causes a large percentage of these holes.
Importantly, the extract does not kill the other bacteria in the mouth necessary for good oral health.

Cinnamon EO is antibacterial, anti-fungal, anti-infectious, anti-inflammatory, antimicrobial, antiviral and astringent.

Peppermint EO is antibacterial, analgesic, and antiseptic.

Spearmint EO is antibacterial, anti-catarrhal, anti-fungal, anti-inflammatory, and antiseptic.

Citrus EO is antibacterial, anti-depressant, antiseptic, antiviral, astringent, and restorative.

Ginger EO is antibacterial and antiseptic.

Brush to Clean and Kill
Learn how to brush your teeth and kill S. mutans at the same time.

39 comments:

Ryan said...

What about all the antibacterial mouthwashes on the market?

VicinSea said...

That would be dependent on what the mouthwash contained to kill bacteria--alcohol based mouthwash probably does more harm than good--S mutans is only minimally affected by alcohol and the drying caused by alcohol may actually favor the bacteria.

Non-alcoholic mouthrinse containing Chlorhexidine gluconate 0.12% has shown to be pretty effective against several oral bacterium (See: http://www.llu.edu/llu/dentistry/biomat/stephens/stephnsresh.html)

Emma said...

Prescribing oral antibiotics will not kill bacteria present in the plaque biofilm. Minimal amounts are secreted in the saliva, and there is no blood supply to the biofilm to deliver the antibiotic. To suggest this should be routine practice is grossly irresponsible given the potential adverse affects of antibiotics, particularly relating to penicillin allergy, and the growing problem of antibiotic resistant bacteria.

As a dentist, I would welcome more research into a caries vaccine. Anything that can help my patients reduce their caries risk is a bonus. The reality in Australia at the moment though is that caries is not as a large a problem as it used to be, and we are instead spending more time treating periodontal disease in older patients who are retaining their teeth for longer, and treating tooth wear from bruxism and erosion.

dzyns said...

and erosion that could be helped by mouth guards because of clenching and grinding. . .but my dentist did not recommend it. . .I figured it out and have saved myself over a year of pain and mouth/tongue sores.

and don't bother with the 'dental guards' they cost big bucks. . .go to the sports dept. .great mouth guards there, very reasonable.

TJ said...

I was stumbling and came across this post, which is filled with such ignorance that I feel that I must comment.

You should know that the human body is a very delicate ecosystem. Your body at any given moment actually contains MORE bacterial cells than human cells (roughtly 10^14 vs. 10^13, which is actually a hell of a lot more). The reason there are so many is because most of them are actually helpful. Truth to the matter is, we don't even know all the species of bacteria that live in us and what they do, it is an emerging line of research.

The same holds true for your mouth, S. mutans, which you correctly identified as the caries causing species, even has different strains of it that don't cause caries. The
deciding factors being what kind of acid they produce (lactic causing decay, acetic not) The bacteria that don't cause caries (read as: good bacteria) actually form a layer over your tooth like a raincoat that protects your teeth from the more harmful secretions of S. Mutans.

Being put on broad spectrum antibiotics like Amox or Penicillin can be likened to trying to kill a gnat surrounded with glasses with a sledgehammer. Sure, you may kill the gnat, but you're also harming all of the other things around it. Plus, as Emma has said, the antibiotics are secreted by your salivary glands in an minimal amount, reducing the effect to nearly nil.

A more appropriate treatment for patients with severe caries that seem independent of tooth brushing is Chlorohexidine mouthwash which is a very powerful antimicrobial agent. After about a ten day treatment with this, monoclonal antibody is topically applied to the tooth and this has been shown in studies to reduce S. Mutans populations for nearly 2 years.

To say that there is no interest in developing a caries vaccine is a gross misunderstanding of the situation. This is an extremely active area of research in all oral biology departments across the US but producing a vaccine is not exactly a cut and dry thing, else we'd have vaccines for just about everything that ails us. I don't know the details of it, so i won't speak as an authority, but I can assure you that it is a very long and arduous process.

Some people are just naturally more prone to caries because of the ratios of the inhabiting bacteria in their mouth favors the caries causing strains. However, a MUCH bigger factor determining caries risk is the diet of the patient.

To understand this, one must first know that bacteria use sugars as fuel. This is the reason why soda is so bad for your teeth, not only does the carbonic acid lower the pH of your mouth, the sugar in the soda fuels the bacteria to produce lactic acid, which lowers the pH of your mouth even further. Low pH is the ideal environment for S. Mutans so you can see where this will cause a problem. The other factor is length of exposure. Obviously the longer the bacteria are presented with sugar, the longer they will produce the acid and lowering the pH of the mouth for a longer period of time. For this reason, from a dentists perspective, it is better for you to chug a 2L of coke vs. sip on it all day.

Most interesting, however, is the fact that your mouth contains salivary amylase. Amylases takes starches (like potatoes) and convert them to simple sugars. If you had read my previous paragraph you can see that this is a very bad thing for your teeth. So don't snack on those potato chips. It for these reasons that with people with severe caries also undergo a nutrition sampling with their dentist to help them become more aware of how their habits affect their teeth. To say that a dentist merely blames the patient's brushing habits is a severe misunderstanding the causation factors and a dentists understanding of them.

"[dentists] make nearly as much doctors with about half the education"

As person who is going through dental school right now, this statement made me cringe. Dentistry is a specialty of medicine and this is the way that every dental school in the US treats it. While dental school is 4 years long and med school is 4 years long + residency, the reason for this is because dental students accomplish in 4 years what it takes about 7 for a medical student to do (school plus surgery residency). We not only need to take ALL of the same classes as the med students, we need to train ourselves to be able to work on the minute scale of dentistry, where .25 mm too far in any direction can cause damage. This includes spending 2 years in a practice lab on fake teeth before you even get to touch a real person. After that, you spend 2 years in the clinic practicing on patients under close supervision of professors. My medical student counterparts have about 20 hours less class time a week than me, which is a lot considering just how much you need to study in order to master the information (read as:every moment you are not in the lab or class).

You may ask why do dentists need to learn all of this information, they're just working on the mouth. Believe it or not, the mouth is actually connected to a human, many times with medical problems and medications. You need to understand how these processes affect the oral cavity in order to make sure to not hurt the patient. Just like a hand surgeon needs to learn about the entire body even though he just does surgeries on the hand, a dentist must have the same training.

please before presenting yourself as an authority on a subject, first do the proper research and have a basic understanding of which you are writing about.

Throckmorton said...

My comments in bold like this. I am a Buffalo, NY area general dentist who wants to respond thusly:
----------------------------------------
Economics of treatment verses cure.
Dental cary repair represents a large portion of any dentist's business and is the largest portion of any dental office's income.

No longer true for most modern dental offices.

The cost of actually filling a cavity is nearly insignificant compared to the average cost of a visit to the dental office, so there is a strong resistance to changing the way people are treated for tooth decay.

Wrong. A filling isn't a treatment for tooth decay - it is a treatment for a cavity that was caused by tooth decay. Proper brushing and flossing is a treatment for tooth decay. You must control the development of bacterial plaque on your teeth. The "oils" below do not do this alone.

Today, it is common for a patient to be belittled for their failure to brush and floss "enough".

Your dentist is a jerk. Behind the times. Not a people person. Don't judge us all because you were belittled by one idiot.

There is no specific guideline for how often or how long to brush and floss but "3 times a day" is a typical recommendation.

There are specific guidelines. Ask your dentist for specific guidelines. We all know them.

Truth is that no matter how much you brush, as soon as you get a cavity, "you haven't brushed enough", "you haven't flossed enough," or you "haven't done it correctly."
If a dentist ever said this to you without then correcting your brushing and flossing routine, he is a jerk. Switch dentists until you find one that will show you how to brush and floss correctly. Specific instructions. It won't be hard to find a dentist who will do this. We all know exactly what you must do. The answer is not special essential oils alone.

Dentists use this argument to put the blame on the patient rather than mentioning the true cause of caries, S. mutans, and how to slow the infection or kill it for good.
Wrong

Why? Because it is not good for the bottom line to tell a patient, "You can prevent future cavities by taking a vaccine or antibiotic and then rinse your mouth with an antibacterial on a regular basis." WRONG. It would be very lucrative to say the above statement to patients, because then they would get more cavities. Dentists don't want you to get more cavities. Really.
VicinSea's statement above is wrong. There are (as of march 2009) no vaccines nor antibiotics that fight tooth decay. Nothing works as well as correct brushing and flossing. Brushing and flossing is cheap, effective, available to everyone, and nobody is allergic to it.


But, it is very good for the bottom line to blame the patient and then continue to fill cavities with $5.00 worth of materials and charge $250 for the service.
Service. You said it right there. Service. You are not buying $5 worth of material for $250. You are buying a service. Do you understand this?

One of the reasons why this has worked out so well for Dentists(who make nearly as much doctors with about half the education and no late night emergency calls)

We make MORE than primary care physicians and much less than surgeons and specialists.
Dentists make late night emergency calls all the time. Did you even ask a dentist about this before you posted??


is that when people are having a toothache, they will pay anything they have to make it stop. The ADA also has a very powerful Lobby in Washington DC that has exempted them from price controls on services and exemption from providing emergency medical treatment to anyone who needs it.

What? I'm unsure what you are talking about here. Enlighten us. I am not exempted from providing emergency care. I don't even know what you mean by that. What price controls? If dentists are exempt from price controls, then who isn't?? Does the government tell physicians, lawyers, hairdressers, florists, carpet cleaners or anybody what they can charge for their service. NO. God bless america...

----------------------------------------

Slowing the effects of S. Mutans:
Until dentists are willing to prescribe a routine of Amoxicillin or Clindamycin to kill the bacteria at its source or rally behind a vaccine(and effectively kill off 50% or more of their business)

Oh Boy. Dentists are doctors. They are willing to do whatever is safe and effective to cure disease. Amox and Clinda are neither safe nor effective for the treatment of dental disease. This isn't self serving guesswork - they've been tried, and they failed to be even nearly as effective as a good home care routine. IF you know what you are talking about, then you must have access to scientific studies that support your claims. Please share.

there are a few natural products that kill or slow the growth of S. mutans.

Your oils may slow the growth of S. mutans. That's great, if true. BUT no oil is as effective as brushing and flossing. Removing the infection (brushing) is common sense medicine. When you advocate application of essential oils, you do the readers of your blog a disservice. They may think your oil replace brushing and flossing. It doesn't. It can't. It might help, but not replace.

One of the most effective is peppermint oil which is why so many tooth pastes taste like peppermint--unfortunately most modern toothpastes use artificial flavor so this benefit has been lost.
Other antibacterials:
Licorice contains glycyrrhizin, the power behind cavity prevention. Cavities are a result of lingering bacteria in the mouth- the main condition rooted in bacteria production is delayed and prevented by licorice.
Only 15 milligrams of licorice powder eliminates 99.9 percent of Streptococcus mutans, a common bacterium that could release harmful cavity-causing acids.
Before cavities appear, bacteria in the mouth produce acids that create holes in the top layer of the teeth. Streptococcus mutans is particularly harmful and causes a large percentage of these holes.
Importantly, the extract does not kill the other bacteria in the mouth necessary for good oral health.

Cinnamon EO is antibacterial, anti-fungal, anti-infectious, anti-inflammatory, antimicrobial, antiviral and astringent.

Peppermint EO is antibacterial, analgesic, and antiseptic.

Spearmint EO is antibacterial, anti-catarrhal, anti-fungal, anti-inflammatory, and antiseptic.

Citrus EO is antibacterial, anti-depressant, antiseptic, antiviral, astringent, and restorative.

Ginger EO is antibacterial and antiseptic.

Brush to Clean and Kill
Learn how to brush your teeth and kill S. mutans at the same time.

Your post claims Tooth Decay is curable AND that the ADA has kept this secret. This is standard old school conspiracy theory crap.

You claim the ADA and dentists are dishonest for financial gain. I claim that you are. You believe you can sell your "oils" by blogging lies about my fine profession of Dentistry. Open your mind, VicinSea. Do your research. Please try to allow for the fact that there may be people who know more about something than you do...

skeetshooter said...

damn...you got pwned by Throckmorton.

Watson said...

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Dr. David Cheng, DDS said...

It is true that dental tooth decay is curable, but only to a certain extent. When a cavity is very small, meaning it is only in the outer layer of the tooth, the cavity can remineralize or reverse if there is good dental hygiene. Once the cavity extends past the outer layer, the cavity cannot repair itself.
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djc251 said...

I just wanted to point out that Dentists go through just as much schooling as M.D.'s. The pre-dental education path is the same as that of a pre-med's. When you get to graduate school, you have to do the same amount of schooling as a general practitioner. Do your homework, particularly in microbiology.

Also, well said, TJ and Throckmorton :)

djc251 said...
This comment has been removed by the author.
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Timothy said...

My school-age kid, Jason has this great fear of going to the dentist that is why I'm so fortunate that our oral care specialist at the St Petersburg dentists clinic is so patient with my little boy. My son always complain of toothaches that is why I brought him to the clinic last week. Upon checking his mouth, the St Petersburg dentist saw that Jason's lower teeth is starting to show signs and symptoms of tooth decay. I sure am glad that the I brought my son to the dentist because they also taught my him how to properly brush his teeth.

Well, I certainly learned a lot from your post particularly what is tooth decay and what causes dental cavities. Thanks for the great help!

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my dentistas gave me some oral antibiotics and gargles to prevent this bacteria .makes my teeth white to.

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