With all the medical and scientific advancements of the past 20-30 years, you’d assume that our mouths are surely healthier than they’ve ever been. And you’d be wrong.
The oral healthcare market is a massive $30 billion industry and it’s mainly concerned with maintaining the status quo. All the promises you read on oral health product labels (“tartar control,” “plaque fighting,” “healthy gums," “complete oral health”) they’ve been more about marketing than results.
Luckily, you don’t have to continue putting inferior ingredients into the mouths and bodies of yourself and your children. There are now safe, effective, and fun alternatives. But before you explore your options, there is a need to set the record straight on a few mouth care beliefs. In this series, we debunk popular myths about dental health that you’ve probably believed your entire life.
Once you learn the truth about what works, what doesn’t, and what the oral care manufacturers don’t want you to know, you will be armed with the tools to make the right choices for a happy, healthy, and successful life for your loved ones.
Let’s dive in, starting with one of the biggest myths: Cavities are no big deal.
Dental caries, the disease that causes cavities, is the most common chronic disease in children. Childhood tooth decay is four times more common than early childhood obesity, five times more common than asthma, and twenty times more common than diabetes. Cavities are so common that they’re considered normal — but that’s just it. They’re not normal.
By third grade, more than 50 percent of children have had cavities, and nearly one-fifth have untreated decay. Plus, children in California miss 874,000 days of school every single year due to dental problems. Sadly, adolescents aren’t any better off. Fifty-nine percent have had cavities in their permanent teeth, and 20 percent have untreated decay.
Dentist and founder of SuperMouth™, Dr. Kami Hoss, had a patient named Laura, who never missed an appointment. However, a few years ago, she missed several appointments back-to-back. When she finally came in for a visit, Dr. Hoss asked her if everything was okay. She burst into tears and told him she was going through a tough divorce. After the difficult experience, she had decided to move in with her family in another state to get back on her feet. When she returned to his office a few years later, her mouth was a mess. She had several major cavities and the enamel on her teeth had eroded away so badly that she needed a near full mouth reconstruction. She told Dr. Hoss that the stress of her divorce and the pressures of being a single mom had caused her to develop acid reflux. She had treated the discomfort with a constant supply of medications, all while sipping on a steady stream of acidic and sugary drinks like coffee and soda. Laura was devastated and shocked that she had developed so many oral health issues. After all, she had always been cautious of sweets. Additionally, she brushed routinely using a very popular toothpaste specifically marketed to be anti-cavity. What went wrong? If you ask the average person, “How do you get cavities?” they’ll probably say, “By eating a lot of sugar and not brushing my teeth.”
But if it were that simple, dental caries (or cavities) wouldn’t be the number one disease in the world and this article would be a lot shorter. It turns out, dental caries is a complex process and requires a deeper understanding of all the risk factors involved.
Mouth Microbiomes - Your Mouth’s Natural Defenses
Our mouths are filled with good and bad bacteria called microbiomes. Everyone has a unique oral microbiome similar to a fingerprint, but it’s important to note that, unlike fingerprints, our oral microbiome balance can change over time, for better or worse. Think of your mouth as a garden and your oral microbiome as the beautiful flowers, plants, and vegetables that grow inside the garden. To keep everything healthy, you water your garden daily, cut and trim branches, and add nutrients to the soil when necessary. But what happens if there is an issue? What if a weed grows or one of the plants catches a disease? You’d probably selectively take out the weeds or use medicine for that diseased plant and continue taking care of your overall garden. You probably wouldn’t throw weed killer on all of your plants. And what happens if you leave town for a few weeks and forget to have someone take care of your garden? When you come back, the weeds may have overgrown and taken over, and diseases may have spread, destroying your crops. This happens in your mouth too. How well you brush or floss will determine the quantity and quality of your oral microbes, and what you eat or drink and how frequently you do that will favor either the helpful microbes or the harmful ones. Additionally, the oral care products you use can dramatically impact the health of your mouth and ultimately the health of your entire body.
How Cavities Form
Your oral bacteria form a sticky film called “plaque” or “dental biofilm” to attach themselves to the enamel of your teeth. Cavities occur when there is an imbalance of the oral bacterial population and a malfunction of the biofilm. The enamel goes through constant demineralization (losing minerals) and remineralization (gaining minerals) cycles throughout the day. Just about every time you eat or drink, the pH of your saliva drops and becomes acidic thanks to the enzymes that start the digestion of food as well as from the foods themselves. This acidic environment favors the “bad” bacteria. These bacteria digest the food and excrete acid themselves, creating a vicious cycle. The pH of saliva is normally neutral (6.7–7.3) at rest and slightly alkaline when stimulated, but once it becomes acidic and reaches around pH 5.5, some of the hydroxyapatite minerals in the enamel dissolve away from the enamel into the biofilm. When everything is functioning correctly, after about 15–30 minutes, the saliva reverses the pH and bathes the teeth with minerals, which are then absorbed into the teeth.9 In a healthy mouth, there is a balance between the demineralization and remineralization of the enamel, and the teeth stay healthy. But if there is a breakdown in that process—for example, if there is too much sugar in the diet or the person is eating and drinking too frequently—the saliva can’t put the minerals back fast enough to protect the enamel. If this continues for a long time, the prolonged low pH will cause the oral microbiome balance to shift from healthy to unhealthy and oral disease will take over.
The Role of Infamous Sugar
Ah, sugar. You didn’t think you were going to read an article about the mouth written by a dentist without delving into the problem of sugar, did you? Yes, we all know that refined sugar is bad. In fact, sugar being bad and veggies being good is pretty much all we can agree upon in the medical community. Still, sugar is everywhere. From baby formula, to condiments, to juice, to birthday cakes—the average American consumes more than 150 pounds of sugar every year.10 That’s like eating an entire person made of sugar! Even some well-meaning doctors give lollipops to children after their medical visits, although thankfully that trend has been waning. Why is sugar so hard on teeth? Excessive sugar intake can shift the balance of the oral pH from alkaline to acidic, causing a predominance of bacteria that metabolize simple carbohydrates. These bacteria then release acids that eat away at enamel and cause tooth decay.
But sugar isn’t the only culprit responsible for tooth decay. Discover seven surprising contributors to cavities here.