Keeping Your Teeth Healthy

Teeth are mineral structures

Clench your teeth together and you can feel how hard they are. If you clench into them a little further, you will feel a slight deepening of your bite. This is because your teeth have a periodontal ligament that suspends them to bone. In the oral cavity you have specialised epithelium that creates oral mucosa and gingival structures that are often referred to as gums.

Teeth are unique, in that, there is nowhere else in your body that you have such mineral structures meeting soft tissues. In fact, the junction between your teeth and your gums is so important in the general health and well-being of your entire body. This is because if the gums are inflamed and bleeding, they can provide a pathway from the end capillaries (small blood vessels) such that bacteria can enter your blood stream. Did you know that Cardiovascular plaques that cause cardiovascular accidents, such as heart attacks, contain remnants of oral bacteria? Poor oral health is a risk for factor for many other diseases too, including diabetes.

Oral health is so important to general health that studies have shown that flossing your teeth daily can add 7 years to your life. 

When we eat and drink generally there is an acidic challenge that is created. This means that your enamel wants to demineralise. Which means that the minerals such as calcium and phosphate want to leave your tooth structure. As a mechanism to help neutralise such exposures our bodies produce saliva. Saliva helps us to enjoy and provides ease in daily activities such as talking, eating, swallowing, kissing and laughing. It also helps to initiate digestion, and emulsify our foods, but most importantly it brings an abundance of minerals to the teeth to keep them strong. Even as we start to think about food, or about kissing our loved one, our body starts to ramp up saliva production, by means of our autonomic nervous system.

Like I mentioned before when we eat there is an acidic reaction that occurs in our enamel and dentine which wants to ‘dissolve’ your teeth so to speak. This process is called demineralisation. Saliva works by bringing the minerals back to the enamel and dentine to remineralise the tooth structure. This process is called remineralisation. Saliva is so important for buffering the teeth back to a more neutral ph. level of 6.8-7.2. And that process of buffering can take up to 15-20 minutes to occur. In order to encourage that process you can clear the mouth with water and use dairy products such as milk and cheese.

If we snack too often the teeth are not able to remineralise. The teeth loose more and more minerals, and more and more plaque forms about the teeth. The plaque which is a bacterial layer creates acids which further soften the teeth. As the demineralisation occurs decalcification marks, and white spot lesions can often be seen on the teeth . Acidic exposures and high sugar diets contribute to dental decay. The plaques become more cariogenic meaning the risk of decay becomes established. Once bacteria are sufficiently active in the dentine, caries occurs. This is the technical term for decay.  Once into the dentine the decay will generally progress.

There are many ways to mitigate the risks.

Excellent oral home care is the basis. Consider using an electric toothbrush and using it for a minimum of twice a day, for a minimum of 2 minutes at a time. If you have the opportunity to do an additional brush, then I would suggest that especially if you snack a lot and have a dry mouth.

Which brings us to the topic of frequency of eating. The more often we eat or drink, then generally the more period of time our teeth are exposed to dietary acids.

So, avoid snacking 

For every 5 eating episodes, including drinks with a fermentable carbohydrate then consider brushing twice daily. This is a 5 in 2 rule. If you snack more than you should brush more. Further to this, we want to keep the teeth away from abrasion risk. Abrasion occurs when after an acidic exposure we brush our teeth too soon. A classic example of this may be in the evening when you may be enjoying a glass of wine, or kombucha, beer or champagne.

You might have been sipping slowly on that special drink for an extended period of time savouring it, and often the sipping slowly may endure for hours at a time! This inadvertently puts the teeth under an extended acidic challenge. Now I’m not advocating to skull your wine, but it is important to realise that for the period you sip your wine your teeth are going to be under that acidic challenge for that entire time. It’s important not to brush the teeth straight away, and to wait at-least 20 minutes for your saliva to neutralise. And then brush!

So, when it comes to drinking alcoholic drinks, juices, fermented teas, carbonated beverages, sweetened drinks including flavoured milk, or tea or coffee sweetened with honey and sugar,  mouth will be in a state of constant acidic challenge for as long as that drink lasts! Non-dairy milk can also have high levels of sugar so be careful with those alternatives too.

A lot of people tell me they drink water, and then tell me about their soda stream! This can be a real problem for the teeth and a risk factor for demineralisation. It is incongruous to many people that the soda stream is a problem because physically you feel you are drinking water as you fill the bottle from your tap. However, the moment it becomes carbonated a carbonic acid shift occurs making it unfavourable for the teeth.

The best advice is to keep hydrated as much as possible with flat water 

Sometimes despite drinking lots of water the body can still suffer from a dry mouth. And especially when exercising the mouth can become very dry at times. It is important to rehydrate with water and, appropriate at times to replenish with electrolytes, depending on how much you have sweated.  Sometimes people will use gels and chews to replenish the body during extended exercise, such as long runs, cycling and hiking. While this is important keep in mind that the retentive nature of sticky gels and chews, which contain sugars, can have a nasty effect on the teeth especially if using when your mouth is already in a dry state.

Saliva production is primarily driven by our autonomic system, so stress, dehydration, and medications, can contribute to decreases in saliva production.  Medical conditions such as conditions of autoimmune origin can also cause dry mouth. This factor of saliva being controlled by primarily by our autonomic system explains why when we are nervous our mouth becomes dry. Or if we are sick and vomiting, why our bodies naturally produce a lot more saliva to help protect the teeth from the strong stomach acids.

Our bodies are truly amazing. They are always working to keep us alive and keep our homeostasis intact. Our saliva production can reflect the state of our general well-being and state of health. And optimising our oral hygiene practices is so important for the health of our teeth but also of our entire body!

Managing stress and having mind body awareness which includes noticing the sensations in our mouth and about our teeth is a good skill to develop in terms of neurological health and wellness. Cultivating an awareness of what ‘healthy feels like in my mouth’ and what is ‘not feeling healthy’ feels like is also a good practice. Looking in the mirror and inspecting the teeth after and during flossing and brushing is also a good habit. You can see a lot if you take the time to inspect and become familiar with your own mouth. Sometimes people can entirely disengage or dissociate from their teeth and mouth, even though it’s part of their body. Whilst that is an extreme example it does happen.

Often people will say ‘I don’t have time to brush twice a day or to floss!’ I always say flossing is like giving each of your teeth a gentle hug. Take the time attending to your teeth and they will go the distance in looking after you. Brushing and flossing is an essential practice for self-nurture and optimising health.

We prioritise the things that are important to us!

Brushing twice a day for two minutes each time, with a fluoride containing toothpaste, and flossing daily is the basics of a home care routine.

And given we have just one body and one life it makes perfect sense to me to look after our teeth as tenderly as we look after anything we love!

Happy brushing and flossing everyone.

Dr Janet Daniels