Most people think of tooth decay as an inevitable aspect of aging. According to the Centers for Disease Control and Prevention, 3 in 4 people in the United States have dental restorations, 1 in 5 people have untreated cavities, and nearly 1 in 4 adults aged 65 years and older have no teeth left at all.1 Poor dental health may be common, but it’s not necessarily a normal part of getting older.
What are cavities?
Cavities are a bacterial infection of the teeth. They start as soft spots of decay in the hard outer layer of teeth called enamel. On a microscopic level, healthy enamel is made of large crystals that are packed tightly together. This gives teeth a hard, smooth, shiny surface that reflects light and makes them appear white. When the crystals that make up tooth enamel contain fewer minerals, or they are not packed tightly together, or when enamel has been damaged by an acidic environment, the surface of the tooth is soft and porous and it absorbs light rather than reflects it. When light is absorbed, teeth look dull because the underlying layer of dentin shows through, giving them a dark or yellowish hue. As the decay of enamel progresses, cracks and holes form in the surface of the tooth which allow bacteria to travel deep inside where they can cause pain, inflammation, and tooth loss, if left untreated.
Encouraging Innate Healing
Encouraging the natural repair of teeth prevents cavities from forming and helps heal early stages of decay, as long as the surface of the tooth is intact. Once the protective outer layer becomes broken, whether it’s a result of advanced decay or drilling by a dentist, the structure of the tooth is permanently damaged and healing becomes very difficult and often impossible. But as long as the outer layer remains intact, teeth can heal themselves under the right conditions. This requires protective mouth bacteria, sufficient saliva, a mineral-rich environment, a neutral pH, and good oral hygiene. These 5 factors are the keys to cavity prevention and natural healing for teeth.
Protective Mouth Bacteria
Our bodies harbor 10 times more bacterial cells than human cells and they’re an important part of our natural defense. Most of these bacteria live on mucus membranes like the one lining our mouth, and they protect us from disease-causing bacteria like the ones that produce acid which can be damaging to teeth. Antimicrobial agents, like menthol used in an oral rinse, can inhibit the growth of acid-producing bacteria without harming protective bacteria. Studies show that menthol can also reduce existing plaque and prevent the formation of new plaque.2
Diet also plays a role in the composition of mouth bacteria. Research studies show that the consumption of refined carbohydrates—like sweetened beverages and sweet and starchy foods—promotes the growth of acid-producing bacteria in the mouth and the progression of tooth decay.3 One exception is xylitol, a naturally sweet compound found in birch trees, berries, mushrooms, corn husks, and oats. Xylitol has been shown to promote healthy changes in the composition of mouth bacteria,4 reduce dental plaque and acid production,4 stabilize decay,5 harden teeth,5 and heal cavities.5 Studies showing benefits used 6 or more grams of xylitol each day, sometimes in the form of gum chewed for five minutes at least 3 times each day.
Saliva helps keep teeth clean by removing food debris from tooth surfaces, neutralizing mouth acidity, and acting as a reservoir for the minerals our teeth need to build strong enamel. Several factors can contribute to a dry mouth including stress, certain prescription medications, nasal congestion from allergies and sinus or upper respiratory infections, and activities that increase air exchange through the mouth like singing, exercise, dental hardware, intubation, and continuous talking associated with teaching, public speaking, and performing.
If your mouth lacks sufficient saliva, modify the factors you can. Also, be sure to drink plenty of filtered tap water, especially when you exercise (unless you have kidney problems or your doctor has told you to limit fluid intake).
A Mineral-Rich Environment
Enamel is made up of minerals found in saliva that combine to form crystals. In an alkaline environment, minerals from saliva are added to the framework of teeth, making them stronger and more resistant to weakness, sensitivity, and decay. In an acidic environment, minerals are released from the framework, making the enamel weaker, more porous, and more prone to decay and discoloration.
Minerals in saliva come primarily from the foods that we chew. The best sources of 2 very important minerals—calcium and phosphorous—include dairy products, eggs, seafood and fish (especially those with soft bones that you eat like canned wild salmon and sardines), meat, bone broth, beans, tofu, nuts, and cooked green vegetables like spinach, collard greens, and turnip greens.
When one mineral in particular—fluoride—is present in saliva, mineral crystals form more quickly, they’re larger and packed more tightly together, and they have a more perfect shape. This makes teeth stronger, smoother, and shinier. When fluoride is not available, teeth can still incorporate minerals from saliva but it happens at a slower rate and the crystals are smaller and less perfect. Because fluoride has a topical effect on teeth, brushing and rinsing with it are effective but drinking it is not. Look for toothpastes and low-dilution (0.05%) oral rinses that contain sodium fluoride. You only need a small amount but it should be kept in contact with teeth as long as possible.
A Neutral pH
A healthy mouth has a neutral or slightly alkaline pH. When the pH is acidic and drops below 6, tooth enamel can dissolve. You can test your mouth pH using litmus paper, which you can also use to test the pH of drinking water and other beverages. Look for litmus paper with a pH range of 5 to 8 and a color chart for comparison, then put the paper in contact with any liquid and match the color change to the chart.
If your saliva is acidic, avoid acidic foods and beverages like vinegar, citrus fruit, lemonade, fruit juice, fruit punch, tomato juice, sports drinks, regular and diet sodas, fruit teas, coffee, wine, and acidic water. Consume more alkaline foods and beverages like almonds, apples, asparagus, bananas, broccoli, celery, nuts, pineapple, raw vegetables, cheese and yogurt, especially at the end of meals.
Good Oral Hygiene
Professional cleanings can remove hardened plaque that may be infected with acid-producing bacteria, but they don’t make teeth stronger or cause long-term changes in mouth chemistry. For a healthy mouth, practicing good oral hygiene is essential.
Start by rinsing your mouth with pH-neutral tap water or an oral rinse with a neutral pH because brushing teeth in an acidic environment is more likely to damage enamel. Before you brush, floss your teeth, which can reduce the risk of gingivitis, an inflammation of the gums.6 Use a toothbrush with soft, rounded bristles to remove surface debris from your teeth and massage your gums. Avoid toothpastes with abrasive ingredients like baking soda and products designed for whitening, plaque control, or tartar control, which can contain irritating ingredients. If your toothpaste contains fluoride, before you spit it out, swish a small sip of water around your mouth to make sure that the fluoride comes into contact with all tooth surfaces. Finish with a menthol-containing oral rinse, swishing it around your mouth for 30 seconds or more. Because toothbrushes can act as reservoirs for acid-producing bacteria, use a small amount of rinse to cleanse your brush as well. Keep your toothbrush clean and disinfected by storing it away from other toothbrushes, with the head up, where the bristles can dry completely before the next use.
1 National Center for Health Statistics. Selected Oral Health Indicators in the United States, 2005–2008. NCHS Data Brief No. 96, May 2012. [Web page]. CDC website. https://www.cdc.gov/nchs/data/databriefs/db96.htm. Accessed April 1, 2018.
2 Featherstone JD. The science and practice of caries prevention. Journal of the American Dental Association. 2000;131(7):887-99. https://www.ncbi.nlm.nih.gov/pubmed/10916327
3 Marsh PD. Microbiological aspects of the chemical control of plaque and gingivitis. Journal of Dental Research. 1992;71(7):1431-8. https://www.ncbi.nlm.nih.gov/pubmed/1629460
4Holgerson PL, Sjöström I, Stecksén-Blicks C, and Twetman S. Dental plaque formation and salivary mutans streptococci in schoolchildren after use of xylitol-containing chewing gum. International Journal of Paediatric Dentistry. 2007;17(2):79-85. https://www.ncbi.nlm.nih.gov/pubmed/17263856
5 Mäkinen KK, Mäkinen PL, Pape HR Jr, Allen P, Bennett CA, Isokangas PJ, and Isotupa KP. Stabilisation of rampant caries: polyol gums and arrest of dentine caries in two long-term cohort studies in young subjects. International Dental Journal. 1995;45(1 Suppl 1):93-107. https://www.ncbi.nlm.nih.gov/pubmed/7607749
6 Sambunjak D, Nickerson JW, Poklepovic T, Johnson TM, Imai P, Tugwell P, and Worthington HV. Flossing to reduce gum disease and tooth decay. [Web page]. Cochrane Database of Systematic Reviews. http://www.cochrane.org/CD008829/ORAL_flossing-to-reduce-gum-disease-and-tooth-decay. Accessed April 1, 2018.
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Sarah Cimperman, ND is the author of the new book, The Prediabetes Detox: A Whole-Body Program to Balance Your Blood Sugar, Increase Energy, and Reduce Sugar Cravings. She graduated from NCNM in 2002 and has a private practice in New York City. Her expertise has been featured on Fox News and Huffington Post and in Natural Health magazine, Whole Living magazine, and the Well Being Journal, among other publications. Dr. Cimperman also writes two blogs, A Different Kind Of Doctor and The Naturopathic Gourmet.