Winter is Coming, Keep Smiling

We are staring down winter folks. I pushed it out of my mind, convinced myself that it wouldn't return. And yet, despite all my "jedi mind tricks" and appeals to the universe, October has arrived. It could snow before we flip the calendar. SNOW PEOPLE!! Let's pull on our Sorels and tune up our snow-blowers and get through this together. We need each other's smiles over the next six months.

Not only is the weather going to get trying, we are facing down the dental and waistline guantlet. With a shotgun start on October 31st, piles of halloween cavity nuggets unfortunately transition very easily into "pumpkin pie" & "eggnog" season. Some of you might refer to this as autumn or fall. Either way, the sun is no longer bathing us in happiness so we seek out alternative savory and sweet sources. Seriously, I hope whoever invented eggnog received a Nobel Prize for their contributions to humanity.

Alright, I'm obviously making an over generalization with assuming you are all as weak as me when it comes to the holidays and the treats they offer. You are all amazing examples of self-control and are all very svelte I might add. But in anticipation of moments of weakness let's approach this holiday season a little smarter following a frank discussion on dental caries (aka cavities; aka tooth decay). 

What more can I teach you about tooth decay? You're going to say, "sugar rots your teeth. I already know that." I'm going to get down to the simple science behind the creation of a tooth cavity so that you can make a more informed approach to the holidays with respect to your oral health.

I'll respond to your earlier comment and tell you, "sugar does not cause tooth decay any more than gasoline alone gets you to point B." In other words, sugar needs a motor to harness its high-energy chemical bonds. Our mouths are filled with billions of little motors in the form of bacteria. Some of these bacteria are cariogenic and responsible for tooth decay. Mainly Streptococcus mutans and Lactobacilli. They ferment the available sugar and create lactic acid as a by-product, this is the direct cause of tooth decay: ACID!

Right now, as you read, your teeth are under attack. Bacteria are colonizing and creating a biofilm (plaque) on your tooth surface. Cariogenic bacteria thrive in an environment devoid of oxygen. The thicker the layer of plaque, the less oxygen available at the tooth surface, the more potent the bacteria, the more acid being produced, the greater the rate of tooth decay.

Now that we have established that acid is the direct cause of tooth decay, let's discuss the oral pH cycle. The pH scale is a logarithmic measure of acidity. To keep things brief, the lower the pH value, the more acidic something is. Our mouths have a physiologic resting pH of approximately 7.0, or neutral. After we eat food containing fermentable carbohydrates, the pH levels within plaque drops below 5.0 rapidly as bacteria convert the available sugar into acid. Demineralization (decay) of dental enamel occurs at a pH of 5.5 or less while remineralization (repair) occurs at pH levels above 5.5.

Saliva acts to neutralize the mouth and restore healthy pH levels, but this typically takes about 30 minutes. So everytime you eat, drink, snack, etc. your teeth experience demineralization from the first bite until 30 minutes following the last bite. This should get the wheels in your head turning, you've been informed, think about your morning coffee that you sip over the course of 2 hours. This equates to 2.5 hours of tooth demineralization. Even worse, sustained periods of high acidity will eliminate healthy bacteria resulting in a higher concentration of cariogenic bacteria, lower pH levels, and more rampant tooth decay.

Halloween is upon us. Our children gain access to a bag of candy that they will devour over the space of a few days. It is not only possible, but probable that they will have a sustained oral pH of 5.0 or less for days on end. Irreversible damage is inevitable. Thanksgiving is next, offering up bottomless supplies of pies, sweet potatoes, cranberry sauces, and cider that segue seamlessly into December's caramels, fudge, cookies, cocoa, etc. It doesn't end until midnight on New Year's.

My purpose is not to be a party pooper, but rather to inform and let the reader react accordingly. The day after halloween I'm going to exercise my right as a father to confiscate any and all Reese's Peanut Butter Cups and enjoy them...my way. During Thanksgiving, I fully intend on consuming my weight in pumpkin pie, and you already know my stance on eggnog. I take it personally every year as they remove it from the shelf, as if they are staging an eggnog intervention. "Don't judge me," I think, "I'm in complete control"...while they call security.

As I'm doing these things however, I'm going to be conscious of the microbiotic processes being carried out along the surfaces of my teeth, and I'm going to take measures to combat them. So I want to leave you with a few tips so your teeth will survive the holidays and be just as healthy (if not healthier) than going in.

Brush your teeth 3 times per day.
This disrupts the bacterial plaque reducing the amount of harmful bacteria and exposing them to Oxygen. Don't forget your gums, a common location for plaque accumulation.

Floss between teeth once per day.
This disrupts plaque between teeth, the most common location of tooth decay.

Use a fluoride rinse right before bedtime.
Topical fluoride greatly aids in the repair of damaged enamel and makes it much more resistant to acidic demineralization.

Rinse your mouth with water after snacking.
This will greatly dilute the acid in your mouth and raise the pH rapidly. If you want to go one step further, dissolve 1/2 teaspoon of baking soda in 8 oz. of water for a potent neutralizing mouth rinse, which is also great for fresh breath.

Chew sugar free gum.
This stimulates salivary flow which aids in acid neutralization.

Of course you all know to brush and floss, but I want you to think about what you are accomplishing now that you are an informed defender of your precious enamel. You are disturbing and removing the acidic plaque, allowing oxygen to incapacitate the cariogenic bacteria. I want you to think critically about the acid levels in your mouth. It should not come as a surprise that orange juice is just as destructive as soda to your teeth. 

A biochemist whose career was focused on metabolism and obesity once told me 10 years ago, "If you ran three miles every day, you could pretty much eat whatever you wanted and not gain weight." I've reflected on that a lot over the last decade. I don't run three miles a day, but I also don't get to eat whatever I want. Now you have a Dentist telling you, that if you brush and floss as you're supposed to, and rinse regularly, and see your Dentist and Hygienist every 6 months, you can pretty much eat what you want and avoid tooth decay. Assuming everything else is functioning properly and you are mindful of your mouth's pH cycle.

I wish you all the happiest of holidays, and I sincerely want you to enjoy all the indulgences that come your way. Thank You!

Read Winter is Coming, Keep Smiling by Dr. John F. Miller DDA in 406 Woman magazine.

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It Takes A Village