Mouth Care Comes Clean

Breakthrough Strategies to Stop Cavities and Heal Gum Disease Naturally

Ellie Phillips DDS

• Publisher: River Grove Books
• ISBN:
  9781632990952
• Topic: Medicine
• Subtopic: Oral Health & Surgery

Enjoy the Mouth Health You Deserve! ?Dr. Ellie challenges the traditional dental mantra that tells us to “brush and floss” because she believes it is dangerous advice and ineffective in light of our understanding that cavities and gum disease are bacterial infections. Oral health depends on the development of a bacterial balance in the mouth, and this cannot be achieved with a length of floss, by over-zealous cleaning, or indiscriminate killing of mouth bacteria.  Our mouth ecology develops early in life as bacteria transfer between parents and their babies. This exchange is important and continues throughout life as family and friends kiss, talk, or simply share food. Today we know that harmful mouth bacteria can impact our general health and that some are implicated in chronic inflammatory conditions. A healthy mouth will give you a brighter smile and provide special protection from cavities, gum disease, bad breath, sensitivity, and enamel erosion to ultimately limit your need for dental treatments—including cleanings, fillings, sealants, root canals, crowns, implants, and extractions. In this groundbreaking book, Dr. Ellie shares her easy-to-follow strategies that put oral health under your control. She reveals how to: •  Stop and reverse cavities and gum disease
•  Use diet and digestive health to influence saliva quality and promote tooth and gum healing
•  Enjoy xylitol  to control acidic damage and sensitivity 
•  End the discomfort of dry mouth and gum recession
•  Avoid damage caused by flossing 
•  Evaluate sealants and their potential dangers
•  Learn the dangers of artificial whitening and how to naturally whiten your teeth Mouth Care Comes Clean can empower you and lead you to a new level of oral health. The strategies are simple but they can miraculously transform mouth health. 

CHAPTER 1

The Evolution of Dentistry

Do nothing, say nothing, and be nothing,
and you’ll never be criticized.

—Elbert Hubbard

In the early 1900s, there were many physicians and dentists who believed that diet and nutrition were the keys to oral and general health and that teeth had an impact on whole-body health. From this conviction grew the idea that it was vital to rid the mouth of infected teeth, and this concept is in close alignment with our understanding today. Unfortunately, this observation of how mouth health affects bodily health was often abused and used as a scapegoat by physicians when they were searching to explain or find a reason for an intangible health problem.

The result was that health-care providers recommended many unnecessary extractions in a vain effort to solve unrelated medical problems or improve general health. This scenario led to many perfectly good or savable teeth being sacrificed. The term focus of infection was used to describe the suspicious dental source that appeared to be related to these health problems, and in this era, there was no understanding about bacteria or any way to X-ray teeth. Gradually, the focus of infection became a rejected and despised idea, as it was seen as a form of medical quackery. This explains why filling damaged teeth was suddenly embraced as a more professional, lucrative, and glamorous kind of dentistry.

Ironically, at this exact period, a silver-mercury-amalgam filling material emerged in America just as extractions began to become less desirable. The pendulum quickly swung in this new direction, and dentists were soon in the business of saving every damaged tooth possible with this new filling material from France. As this transition occurred, medicine and dentistry rapidly split into separated disciplines and continued to divide further as medical and dental specialties were formed. These subspecialties created the false impression that parts of the body, and definitely teeth, were somehow disconnected from the rest of the body and in no way an influence on whole-body health.

THE AMERICAN DENTAL ASSOCIATION

Looking back, it appears obvious why super-specialized doctors and dentists became myopic as they focused their attention on small and specific parts of the human anatomy, as if those were separated from the rest of the body. These changes took dentistry far away from the science of medicine, and in the mid-twentieth century, a group of powerful restoration-focused dentists became galvanized into a new organization called the American Dental Association (ADA).

The ADA taught and encouraged its members to save as many decay-damaged teeth as possible, using their newly available silver amalgam material. The dental-restoration era blossomed, and there was a surge in the numbers of companies and laboratories creating all kinds of new filling materials, crowns, bridges, and precision attachments that could camouflage tooth damage and fix teeth to avoid extractions. The dental-material companies flourished and supported the ADA in its growth, as everyone worked to repair severely broken, damaged, and infected teeth. Dentists became ever more skillful in their ability to help patients restore and retain their teeth—even dead ones—patching them up and masking infection, so the tooth could survive for years and sometimes for a patient’s lifetime.

We understand the excitement this generated in dental circles and how happy patients were to save their teeth, especially when the restored teeth were shades brighter than their old natural ones. In hindsight, of course, we know that most of these fabricated smiles looked shiny and white at first glance, but under the surface, things were different: Rotting dental problems often existed around the tooth roots, and almost all these mouths remained infected. We can only wonder about the impact these good-looking restorations had on the general health of these patients, who sported teeth covered by fake crowns and roots stuffed full of plastics and pastes.

Besides the potential damage caused by the various toxic materials that have been used in dentistry over the past hundred years, even more damage may have been caused by harmful bacteria that were ignored in these patients’ mouths. Mouth acidity is a powerful risk factor that promotes unhealthy mouth bacteria. This was also the era when fast food, soda, snacking, and processed foods became popular, and these things probably compounded the perfect-storm conditions for poor mouth health. Underlying dental infections continued to be ignored, and as long as teeth looked good, everyone was happy. The sad part of this story is that cavity- and gum disease-causing bacteria in these patients’ mouths were unwittingly transferred to other people in their circle of family or friends, which may be why so many families in the United States today have experienced massive dental problems and a heavy burden of dental expenses.

A NEW FOCUS

Dentistry continued to focus on skills to beautify teeth and methods to repair dental damage throughout the 1980s, and this became reflected in the way dentists were being trained. When I was a student in the 1960s, our conversations at dental school were usually about how to stop or prevent cavities and gum disease. Two decades later, popular topics were about techniques or materials that could turn ugly teeth into a beautiful smile and which innovative products and evolving materials could help speed or simplify this process.

In the 1980s, TV shows promoted dental makeovers, sponsored by companies with a vested interest in igniting a hunger for this exciting form of cosmetic dentistry. Complete mouth rehabilitation was a moneymaker for everyone—product companies, dental associations, and dentists. Even when the makeovers were excruciatingly expensive, the public was mesmerized by the idea of younger-looking teeth and bigger, whiter smiles.

Financing and marketing companies were next to enter the dental arena, with many incentives for a patient to act now and pay later. This was the instant dentistry people wanted—crowns, veneers, and a mouth of the whitest possible teeth, even if they were porcelain, completely fake and often unnecessary. Fueled by demand, cosmetic dentistry exploded, totally ignoring any of the underlying diseases that caused the original disfigurement or dental problems. Dentistry paid little or no attention to the imbalance in patients’ mouths, often fueled by acidity, poor diet, or legions of harmful bacteria. These underlying problems were forgotten or ignored in the excitement of a “smile presentation.” This presentation was a glamorous ceremony that often occurred in a dental office after the final crowns were fitted, frequently with a semiprofessional photo session for the patient, as he or she smiled wide to show this incredible new makeover. As long as the teeth looked good, dentist and patient were ecstatic.

There was a similar emphasis on perfect-looking teeth for children. Concern shifted away from the mundane education of parents about nutrition, transmissible bacteria, and the real cause of cavities to the new goals of rebuilding teeth with crowns, often at great expense and sadly putting children’s lives at risk under general anesthesia. You can fix and fill every tooth in someone’s head, but harmful bacteria will remain and continue attacking more teeth to cause additional problems in the future. Teeth become damaged in babies and adults when unhealthy mouth bacteria exist within an infected mouth ecology. Without an effective whole-body health strategy, these harmful bacteria will continue to live in the mouth even after pretty crowns have fixed the damage, and they will eventually go on to cause more cavities in other teeth. There may be arguments for and against the fixing of baby teeth, but there should be no excuse for allowing this awful disease to live in a child’s mouth when the antidote is simple, easy, and effective.

DENTISTRY TODAY

The problem with traditional “dental prevention” is that it embraces aggressive mechanical techniques and products that are designed to strip or kill mouth bacteria. Most antiseptic rinses and antibiotics do not discriminate between good and bad bacteria and generally end up killing both. Hygienist cleanings will mechanically remove debris and temporarily lighten the disease burden in an unhealthy mouth, but sustainable mouth health is only achieved with a kinder, gentler, and more natural approach that supports healthy bacteria and encourages them to thrive. If we nurture the hundreds of good bacteria in our mouth, they will create and build a healthy ecology that can protect our teeth and gums from physical, chemical, and thermal damage and from disease.

You may be shocked that the ADA’s recommendation for six-month professional cleanings and daily flossing has never been shown to change mouth health from a bacterial standpoint. My belief is that inappropriate treatments and products can do more harm than good to your mouth either by masking the underlying problems or by causing a bacterial disturbance—or dysbiosis—to a healthy mouth ecology. Hygienists are trained in protocols designed to reduce infection, but this does nothing to improve a mouth’s underlying ecology. This is why I believe dentistry needs a new approach to help interested patients prevent and reverse gum disease and cavities. Most dentists think it is pure luck if you enjoy a lifetime of oral health without fillings and gum disease. This is why deteriorating oral health is frequently accepted as normal and is seen as an acceptable and regular part of aging, since dentists see this kind of infection and damage in 95 percent of US adults over age sixty-five. By the time you finish this book, I hope you will believe that sustainable oral health is not only achievable but is vital to minimize your risk for chronic general health problems.

Dental Marketing

Ultimate oral health is so precious that it must be protected, which is why I believe it is necessary to question some accepted dental treatments and find out if they upset a healthy mouth and tip it out of balance. Obviously, the idea of less treatment is unlikely to be readily promoted in dental offices, so it is important for you to have a good understanding of what you may wish to have done, or avoid having done, when you are in the dentist’s chair. Many dental-marketing companies have enthusiastic partnerships with dental offices. Marketers have a traditional understanding of mouth health, compounded by a goal of helping dentists sell more of the products and services they believe are a benefit to you and a source of income for the dental offices. Recall visits are always an exciting priority for marketers. To them, these visits are the perfect way to boost your health and the dentist’s income as a win-win for everyone. These marketing companies encourage a keen focus on the efficiency of scheduling recall visits, which is why you receive so many text messages to remind you about the necessity for your recall visit.

The difficulty is that science does not support six-month professional cleanings as a benefit for a healthy mouth. Frequent cleanings could weaken teeth, thin your enamel, and cause sensitivity by the removal of a vital protein layer, which may leave your mouth more vulnerable to damage and cavity bacteria. A study published in the Journal of Dental Research in 2013, “Patient Stratification for Preventive Care in Dentistry,” was carried out by researchers at the University of Michigan Medical School of Dentistry and showed no difference in tooth-loss rates over sixteen years with differing intervals between cleanings for low-risk patients. This is no surprise when you understand that cleanings do not improve the ecosystem of the mouth or change the composition of the mouth’s resident bacteria.

The study did show that more frequent cleanings helped patients who were at high risk, and this makes sense, as the burden of infection was temporarily lightened—but it was not taken away. A news release by the ADA was published on June 10, 2013, in light of this study, and recommended that, to maintain optimal oral health, regular dental visits should be at intervals determined by a dentist and that their frequency should be tailored and personalized to accommodate the current oral-health status and health history of each patient.

When we feel we are a target of aggressive marketing, it is easy to incorrectly assume that dentists are motivated by money, but we know even ethical and caring dentists can become victims of money-centered sales systems. This is why it’s important to be empowered with some dental science yourself and to have enough facts to decide which treatments to accept, which to refuse, and which ones to talk over with a trusted advisor before agreeing to treatment or prepaying for work to be done.

The Treatment Ladder

Dentists have gained a well-deserved reputation for being some of the nicest and most trusted professionals in the world, but most dentists know there have been dramatic changes to the way students are being trained recently and in the way modern dentistry operates. Dentists often graduate with a heavy burden of student debt on their shoulders and enter the workplace without experience and with no time to question their dental training. Compounding matters, the dental business has become more challenging today, and it is harder for an independent dental office to grow in the crowded dental-services marketplace.

This explains why corporate dental franchises have become dominant and a major employer of new dental graduates. Businesspeople usually lead these corporate dental chains, and this has changed the landscape of dentistry in various ways. Certainly, these corporate offices are convenient, but, just like franchised food, there are unfortunate side effects that the average consumer does not always recognize.

For example, it may surprise you to know that many corporate offices begin each morning in a “huddle.” Because costs are attached to every type of dental procedure, it is often part of the process for these businesses to coordinate with dental insurance plans and maximize their income and the profitability generated by specific treatments. The office team is taught strategies to guide you “up the ladder” of treatment options, often pushing you toward whitening, a bite guard, or an upsell to cosmetic straightening, crowns, or veneers. As you hear the suggestions from various staff members, you may begin to believe your teeth really need to be whiter or straighter. Staff may even try to persuade you to get treatment before a special offer expires. If you feel a sense of urgency in the pitch, my advice is to beware!

Sometimes, these tactics are targeted toward you when your treatment plan was never finalized. The team’s goal is to persuade you to complete treatment, hopefully that will benefit your teeth. In some situations, a front manager will start a conversation to uncover ideas that could maximize acceptance and learn about your dreams or fears, such as an upcoming wedding or an event that could be used for motivation by the treatment coordinator.

In the worst situations, these sales pitches are choreographed ahead of time, and words are specifically chosen to drive acceptance. This effort is obviously acceptable if the end goal is to improve your oral health through honest education, but it is totally unacceptable if it is used to generate treatment, or if less expensive options exist, or if you can reverse these problems simply by improving your home care.

Fillings: Never-Ending Maintenance

Traditional dental care that works to fix cavities and clean teeth has no ability to control mouth bacteria with these treatments. The infection that causes the tooth and gum damage will remain after these treatments, and it will continue to attack your teeth even after all the cavities have been filled. Dentists can restore your teeth to function, but they have no power to change an infected mouth. This is why most fillings become reinfected in about ten years and need constant replacement and repairs that usually become larger and more complicated every time.

Cavities rarely occur on a single tooth, because the bacteria that cause them are everywhere in the mouth and attack all the teeth at the same time. This means that four teeth in mirror positions in each jaw will usually develop cavities within a short time period or even simultaneously. With correct care, a cavity can be stopped and reversed, heal naturally, and never need a filling.

The methods that I teach to reverse a cavity will adjust the health of your entire mouth and improve the health of all your teeth, everywhere. Deciding to fill a cavity that can be reversed has financial ramifications far greater than most people would expect or calculate. For example, similar teeth are usually damaged simultaneously in other places in the mouth. A small filling will need ongoing repairs, which weaken the tooth structure at each replacement and can potentially lead to the need for a root canal or crown.

One small filling that costs only a few hundred dollars and that may have been “covered” by insurance can create escalating expenses that propel the cost into thousands of dollars as the filling needs constant repair and the tooth structure deteriorates over time. Remember, dental disease is preventable, and cavities in the early stages are completely reversible. Think about how much money, time, and aggravation an effective strategy could save you over your lifetime if you decided to reverse the first small filling.

The anatomical locations where cavities occur are places on a tooth surface that have vulnerability to bacterial attack. The most susceptible areas of the most vulnerable teeth will succumb first, and the sequential decay pattern in the mouth is usually predictable, dictated by the relative susceptibilities of different tooth surfaces. This means an experienced dentist will know where to expect a cavity first, next, and so on. This is also why similar teeth usually have cavities at the same time and in similar locations on their surfaces.

Imagine a filling is placed in a child’s molar at age six, and this filling needs to be replaced in ten years. Let’s assume the cost of one filling is $200 for the first treatment. Now multiply this cost by four ...