The Most Common Chronic Disease....

Unpacking Truth

Is TOOTH DECAY!!

Tooth decay continues to plague humans in a way that was not as common hundreds of years ago.  Archaeological data from the medieval period (1500s) show that an average of only 20 percent of teeth show any sign of decay.  This is in stark contrast to 90% of adults (aged 20-64) who have suffered from this chronic condition today. 

What could be different in this 500 year period??  We have far better technology and access to dental care.  We have the electric toothbrushes, dental floss and a myriad of rinses and potions to clean our mouths.  We have fluoride in everything dental (you know how I feel about this!).  The answer is SUGAR.  In the 1800s we consumed less than 18lbs/ year.  Contrast that with the current consumption hovering between 150-180lbs/year.  This has strongly impacted the growing rate of obesity, diabetes and heart disease afflicting more than 50% of the American population.  Additionally, we've seen a dramatic increase in tooth decay with little progress in the last quarter century at decreasing its prevalence.

I would love to encourage each of you to cut out sugar as much as possible.  I would also suggest that you start reading food labels and focus on minimizing processed foods from your diet.  Most providers are singing this same song so the purpose of my post is not to beat you with this same message.  My goal is to introduce a simple ingredient that might help you mitigate the formation of cavities.  An ingredient that also decreases the bacterial load that leads to gum disease and bad breath.  Likely you have heard of xylitol, but you may not know that beyond being a non-caloric natural sweetener, it helps to stimulate salivary production, it has antibacterial properties that limit the formation of the plaques causing gum disease and it can help stimulate salivary production.  Your saliva is your body's natural defense but age and prescription drugs have the common side effect of causing dry mouth.  Lack of saliva is a huge contributing factor to dental decay seen after the age of 60.

Xylitol is a naturally occurring five carbon sugar. It is found naturally in fruits, vegetable and berries. It has been broadly studied over the past 40 years for its benefit at reducing tooth decay. Currently, more than 35 countries have approved the use of xylitol in foods, pharmaceuticals, and oral health products. The most common product to use xylitol is chewing gum.

Chewing sugarless gum sweetened with xylitol is a simple way to introduce the recommended dosing of 6-10g/day for dental cavity prevention.  One chewing tab of PUR gum (the one I love) has 2g of xylitol.  For those who cannot chew gum because of TMJ issues, xylitol based hard candies are available.  Xylitol is safe for children and studies have shown as much as a 59% decrease in cavities was observed in children who chewed sugarless gum (sweetened with xylitol) daily. Another not well advertised advantage of chewing sugarless gum is to avoid the afternoon snack or to bypass dessert after a meal by popping a piece of gum instead.

For patients with dry mouth, who wake up at night feeling their cheeks, tongue and lips plastered to their teeth, Xylimelts may be an excellent way to moisturize while you sleep. They can also help to minimize the increased risk of tooth decay associated with low nighttime salivary flow.  Dry mouth is a complicated experience and I encourage you to be willing to try different products and find what works best for you. 

I have mentioned this previously but I am huge fan of the Risewell oral rinse containing xylitol. This is now the product that I am recommending to patients.  Their naturally created dental floss infused with hydroxyapatite actually feels like it is cleaning your teeth unlike the synthetic products that my profession has been pushing for decades. I encourage you to try them if you are not currently using products that contain these ingredients.

In closing, I must advocate that the VERY BEST way to have a healthy mouth is to eat a healthy diet. Proper oral hygiene including brushing, flossing, tongue scraping and an oral rinse is a strong second. But when you’re looking for another tool in your toolbox to fight tooth decay, consider xylitol based products in your health journey.