Category Archives: Oral Health

No Time to Eat Well? 8 Time-Making Tips

Regular readers here know about Dr. Weston Price and his important research on the relationship between diet and dental conditions. (Not familiar? I give a quick overview at the start of this video.) It was Dr. Price, of course, who showed that when people shifted from their traditional diets to a Western one, high in white flour and sugar, dental problems followed – problems such as cavities, narrowed arches and crooked, crowded teeth.

Archaeological and anthropological research has also suggested that the rise of agriculture and the accompanying shift to grain-based diets had a negative impact on health. Now a new study shows that this may be due to broader effects of this change. Based on her analysis of more than 300 skulls from 11 different populations, anthropologist Noreen von Cramon-Taubadel concluded that

the changes in human skulls are more likely driven by the decreasing bite forces required to chew the processed foods eaten once humans switch to growing different types of cereals, milking and herding animals about 10,000 years ago.

“As you are growing up… the amount that you are chewing, and the pressure that your chewing muscles and bone [are] under, will affect the way that the lower jaw is growing,” explained Dr von Cramon-Taubadel.

She thinks that the shorter jaws of farmers meant that they have less space for their teeth relative to hunter-gatherers, whose jaws are longer.

The study abstract is available here.

The problem with crowded teeth, of course, is more than just aesthetic. They can be harder to clean well, raising the risk of tooth decay and gum disease. They can throw off the bite and contribute to improper oral and facial function and/or habits that can lead to pain and other problems. They’re also more vulnerable to uneven tooth wear and breakage.

As ever, good dental health, like good physical health, depends on eating well. Yet for many, this isn’t always easy – especially with the economy still so bad and budgets tight. But “challenging” doesn’t mean “impossible,” as shown by projects such as 100 Days of Real Food on a Budget ($125 a week for a family of 4). More recently, a group of three bloggers – Sherrie Flick, Cory Van Horn and Hal B. Klein – did a variation on the Food Stamp Challenge, in which participants commit for a week of living on the average food stamp allotment of $4.50 per day. These bloggers challenged themselves to eat a healthy, varied meals on just $35 a week, supplemented by any food they grew themselves or bartered for.

One particularly striking aspect of their reflections was their observation that the food itself was just a small part of the challenge. As Flick writes,

The idea of bartering led to a discussion about the importance of community and friendship in food circles. It’s much easier to eat cheaply if you’re joining together with others.

We also talked about cooking skills—how knowing how to cook, how to garden and prepare food efficiently is one key to avoiding processed foods. We talked about time versus money. How, for me, having a non-traditional work schedule lends itself to, say, baking bread on a Monday morning.

For many of us, regardless of budget, the biggest obstacles are often time and energy. Affordable convenience wins out. Yet, as Edward Stanley wrote in The Conduct of Life, “Those who think they have no time for healthy eating will sooner or later find time for illness.”

So here are few tips for ensuring you eat well even if you have “no time” for it:

  1. Keep it simple
    Who says you have to cook fancy recipes for every meal? It only takes 15 to 20 minutes to put together a tasty dinner of pasta and green salad, or meat, steamed vegetables and salad. Baked or roasted foods can be put in the oven to cook while you take care of other chores.
  2. When you want something fancier, know where to look
    Lots of recipe websites have sections of nothing but “quick and easy” recipes and meal ideas, such as these at and
  3. One word: crockpot
    It doesn’t get much easier than throwing ingredients into a crockpot and leaving it to cook. And don’t think it’s just about soups and stews either. Sites like Slow & Simple offer a wealth of ideas for delicious crockpot/slow cooker meals.
  4. Cook less by cooking more
    On the weekends or other off days, cook larger-than-usual meals and freeze the extra. Voila! Instant TV dinners! If you cook steaks or other meat, cook a little more than you need for your meal and use the rest for a quick and easy hash or stirfry on the next day.
  5. Plan and shop ahead
    Make a list, check it twice and keep a pantry well-stocked with basics. If you stock it with a lot of processed stuff “just in case” you don’t feel like cooking, you’re apt to not feel like cooking a lot more often. Clean, cut and store veggies as soon as you bring them home. It’s less work down the road (and handy for snacking, too!)
  6. Keep healthy snacks at hand
    When we’re on the go, it’s all too easy to default to vending machine and convenience store nosh – most of which is highly processed and loaded with sugars, salt and unhealthy fats. Keep things like fresh fruit, nuts and jerky at the ready.
  7. Eat out…of a brown paper bag
    Or any other device for carrying your homemade lunch with you. If you’re not a morning person, why not make lunch the night before – even while you’re cooking dinner? A sandwich takes just a few minutes to make. If you make a point of cooking more than you need, those extras/leftovers can make fine lunches, too.
  8. Commit
    Decide on your preferred mealtimes and stick to them, even setting an alarm if you need a reminder. Just as you make time for those activities that mean a lot to you, you can make time for eating well. Being the foundation for good health – dental and systemic – it’s certainly deserving of all the commitment you can give it.

Image by pha10019, via Flickr


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The Need to Talk About Oral Cancer

The British Dental Health Foundation recently distributed some interesting UK survey results on oral cancer. Reading their media release, I wondered: Would US survey results be similar?

What they found:

  • 88% of the public would like to be checked for oral cancer at their dental appointments.
  • 89% of dentists check for signs of oral cancer.
  • 68% use tools like VELscope to check for cancer.

More, every dentist surveyed – 100%! – said that they consider it their role to promote oral cancer awareness. And yet the BDHF found that

  • 84% of dentists do not explain the risks and symptoms of mouth cancer to their patients.
  • Almost half – 43% – do not provide oral cancer educational material to patients.

How do you effectively “promote awareness” then?

Earlier this year, I wrote about the sharp increase in oral cancer rates:

Once upon a time, oral cancer was a disease limited largely to tobacco users and heavy drinkers. For all others, the risks were thought to be very low, and the rate of disease remained fairly steady.

And then it started going up. And fast.

How fast?

Between 1974 and 2007, cases of white men with oral cancer shot up by 225%.

At the same time, there was a five fold increase in young adults with oral cancer.

Incidence has especially skyrocketed for women. In 1950, for every 6 men who developed oral cancer, only one woman did. Today, that ratio has narrowed to 2 : 1.

Clearly, oral cancer is something we need to be talking about, dentists and patients alike. So it’s no surprise that the BDHF’s media release about this survey focused so sharply on the need for better communication.

Chief Executive of the Foundation, Dr Nigel Carter…said: “Good communication in healthcare is vital for both the professional and the patient. In dentistry it allows the dentist to explain certain procedures, which can often be very technically-minded. The patient can then come back with any further questions they may have about the treatment, what is involved and what may happen afterwards. If either of these roles is ineffective then it can lead to a failure of communication.”

“Mouth cancer cases are increasing at a phenomenal rate due to choices in lifestyle such as smoking and alcohol. The disease, its symptoms and risk factors need to be discussed honestly and openly more often and there’s no better place to start than at a dental check-up.

“Knowing the risks and learning how to self-examine are key when it comes to the early detection of mouth cancer, where it can dramatically improve survival rates to 90 per cent. Without early detection, half will die – it really is a silent killer.”

If you’re not sure your dentist checks for cancer at your regular appointments, just ask. Ask your dentist to explain the procedures and what he or she looking for. Talk with him or her about any risk factors you may have and preventive steps you can take.

I can’t speak for all dentists, of course, but as a dentist, it’s important to me that you understand what we’re doing and why we’re doing it, as well as what you can do to gain and sustain more optimal oral health in general. After all, dentists are doctors, too – physicians whose specialty involves the teeth and oral cavity. You know how the word “doctor” came about? The English word comes from the Latin word docere, which means “to show, teach or cause to know.”

Teaching is part of our job.

To learn more about key risks and symptoms of oral cancer – as well as why we’re seeing so much more of it these days – see my earlier post, “The Oral Cancer Pandemic & How You Can Keep Yourself Safe.”


Filed under Oral Health

Exercise: Good for Muscles, Heart, Lungs & Yes, Teeth & Gums, Too!

If you’re unfamiliar with holistic approaches to health, you might be surprised by the fact that what’s good for general health is also good for your teeth and gums. Conventional wisdom says dentistry and medicine are two separate fields, not specializations within a single, broad field. So you see a dentist for your teeth and a physician for the rest of your body, as though one had nothing to do with the other.

Funny – how easily we can forget that the mouth is connected with the rest of the body!

Even physical exercise – or the lack of it – affects more that just our muscles, lungs and heart. Those are just the three areas where we feel it most. While we might get a “runner’s high,” we don’t really feel exercise in our brains, even as exercise has been shown to keep the brain fit and improve thinking. Likewise, we don’t feel exercise in our teeth and gums, but there are, in fact, established links between physical fitness and oral health.

For instance, check out the 2005 Journal of Dentistry study, which found that regular exercise lowers the risk of periodontitis (gum disease):

  • Never-smokers who exercised regularly “were about 54% less likely to have periodontitis” than those who didn’t exercise.
  • Former smokers who exercised regularly had a 74% lower risk.

Unsurprisingly, exercise did nothing to lower the risk of gum disease for smokers.

We see similar results when obesity is factored into the equation. For instance, one paper published last year in the Journal of Periodontology found that those with the lowest body mass index (BMI) and highest measure of physical fitness – gauged by percent body fat and maximum oxygen consumption – were less at risk for periodontal disease than other study subjects. “This study suggests,” wrote the research team, “that obesity and physical fitness may have some interactive effect on periodontal health status.”

In fact, there are three positive factors – “health-enhancing behaviors” – that have been shown repeatedly to reduce the risk of gum disease. They’re spelled out in the abstract of one last study I’d like to draw your attention to, also from the Journal of Periodontology:

After controlling for age, gender, race\ethnicity, cigarette smoking, other tobacco products, education, diabetes, poverty index, census region, acculturation, vitamin use, time since the last dental visit, dental calculus, and gingival bleeding, a 1-unit increase in the number of the three health-enhancing behaviors was associated with a 16% reduction in the prevalence of periodontitis (odds ratio [OR] = 0.84; 95% confidence interval [CI]: 0.77 to 0.93). Individuals who maintained normal weight, engaged in the recommended level of exercise, and had a high-quality diet were 40% less likely to have periodontitis compared to individuals who maintained none of these health-enhancing behaviors. [emphasis added]

So what are you waiting for? Get out there and get moving!

Images by Mait Jüriado and BBluesman, via Flickr


Filed under Dental Health, Oral Health

The Oral Cancer Pandemic & How You Can Keep Yourself Safe

Once upon a time, oral cancer was a disease limited largely to tobacco users and heavy drinkers. For all others, the risks were thought to be very low, and the rate of disease remained fairly steady.

And then it started going up. And fast.

How fast?

Between 1974 and 2007, cases of white men with oral cancer shot up by 225%.

At the same time, there was a five fold increase in young adults with oral cancer.

Incidence has especially skyrocketed for women. In 1950, for every 6 men who developed oral cancer, only one woman did. Today, that ratio has narrowed to 2 : 1.

What happened?

HPV – human papilloma virus. This sexually transmitted virus, most known for causing cervical cancer, is now a major cause of oral cancer. Over half of us are at risk for contracting HPV at some point in our lives.

Perhaps you saw the recent episode of Dr. Oz dealing with these issues. If you missed it, you can watch it here – and I highly recommend that you do. He gives an excellent, plain-language overview of the issue, including discussion of warning signs/early symptoms and demonstrations of the different exams your dentist should perform so that if you do develop cancer, it can be caught and treated as early as possible.

As a rule, I screen each of my adult patients for cancer once a year using a tool called VELscope. This technology lets us look beneath the mouth’s soft tissues for lesions and abnormal growths that may indicate beginning oral cancers. VELscope testing is completely non-invasive and painless. We just aim a blue excitation light at the tissues and see how they respond: healthy areas appear fluorescent and problem areas, dark. I’ve used this device in my practice for several years now – not as an “extra” but as an essential.

If VELscope detects a problem, the next thing we do is an oral CDX brush test, which Dr. Oz’s guest dentist describes as a “pap smear for the mouth.” This procedure, too, is non-invasive and painless. We merely use a special brush to take a sample of cells from the problem area(s), save them on a slide and send them to a lab for analysis.

You can see these early detection methods demonstrated in Part 4 and Part 5 of the Dr. Oz video – screening tools that help save lives by letting us find the cancer early enough for effective treatment.

Of course, the best course of action is to prevent the cancer from occurring in the first place. Key things you can do to lower your risk:

  • Be sure your dentist gives you an oral cancer screening at least once a year if not at every visit. If he or she doesn’t – or if you’re not sure – ask for one.
  • Limit alcohol use.
  • If you smoke or chew tobacco, quit. (And if you don’t, don’t start.)
  • Practice safer sex. Always use condoms and/or dental dams, or completely abstain from oral sex.

Also be aware of these warning signs and contact your dentist immediately if you develop one or more of them:

  • A white or red patch in your mouth, or a sore that doesn’t heal within two weeks
  • Sore throat or ear pain, typically on just one side of the head, that doesn’t go away within two weeks
  • A lump in your neck
  • Voice changes or hoarseness that last more than a week

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Oral Health & School Performance – Yes, There’s a Connection

The same day that the Pew Chartiable Trust’s latest report on children’s dental health made the news, I happened upon a news item about a heated budget battle in North Carolina.

Since 1967, Guilford County has had a dental hygienist working in its schools. Now the county Health Director has proposed axing that position to save $25,000 per year – a miniscule amount in a budget that runs in the hundreds of millions. One Commissioner – Paul Gibson – passionately argued against the cut, calling the proposal “short-sighted.”

Gibson said having a dental worker in the schools examining kids’ mouths – and drawing parental attention to problems through a letter home – clearly made sense.

“It’s a great service,” Gibson said. “For $25,000, I think it’s well worth having that person stay where she is and go look into people’s mouths.”

Gibson said most of the commissioners were no doubt familiar with the fact that, not long ago, a young boy in Maryland died because he didn’t get care for an abscessed tooth. Gibson said he didn’t want to see something like that happen in Guilford County.

You can read about the Maryland boy, Deamonte Driver, here.

“Short-sighted.” Gibson’s comment brought to mind a study I happened across earlier this year in the American Journal of Public Health, “Impact of Poor Oral Health on Children’s School Attendance and Performance.” Analyzing data on more than 2000 students, the research team found that not only were those with poor oral health three times more likely to miss school because of dental pain, they also did worse academically. Those who missed school to get their teeth cleaned and examined, however, showed no drop in performance.

Missing school wasn’t the key. Dental problems were. Thus, the authors concluded,

These findings suggest that improving children’s oral health status may be a vehicle to enhancing their educational experience.

In this light, $25,000 for a school-based hygienist seems a totally reasonable investment.

As for the Pew report? California rated a C, ranking in the bottom half of the nation, as might be expected for a state in which more than half of all kindergarteners have a history of tooth decay (71% of third graders) and one in 5 kids under 12 has never even seen a dentist. While a biological dentist might question some of the measures used in the Pew study – for instance, sealant use and fluoridation – it is clear that we can and need to do better when it comes to kids’ oral health.

Image by B Tal, via Flickr

Note: I’ll be taking a short break from blogging – back to the regular schedule on June 17. – Dr. E

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Teeth Sensitive? Don’t Look Now, but Your Dentin May Be Showing

“Your teeth are crystals, just like rocks,” explained Dr. Linda Niessen. “You know you erode rocks from water and rain; you can erode the teeth from these acidic drinks.”

The “acidic drinks” being blamed here for rising rates of dental sensitivity following tooth erosion are sports drinks like Gatorade, which some people think of as healthier than soda. In fact, they’re just another kind of soft drink, as are many sugar-laden energy drinks, juice-based drinks and teas.

It’s no surprise that we see more tooth erosion these days. The increase has paralleled the monumental rise in soft drink consumption and accelerated after the introduction of energy drinks – which may be even worse for teeth than soda – and popularization of sports drinks among non-athletes. Since the late 70s, “soft drink consumption in the United States has doubled for females and tripled for males. The highest consumption is in the males between the ages of 12 – 29; they average 1/2 gallon a day or 160 gallons a year.” Here in California (PDF), nearly half of all children aged 2 to 11 drink at least one soft drink a day, as do more than 60% of teens and 24% of adults.

Eroded teeth are necessarily sensitive teeth. The dentin – the layer of tissue between the tough enamel and the delicate pulp – is no longer protected. Cold air or liquid touching it may send shockwaves of pain through the tooth and into the jaw, or hot liquids or foods may cause discomfort.

Eroded teeth are also more prone to deep decay, since pathogenic oral microbes (“bad germs”) have easier access to the delicate tissues inside the tooth. Helping the decay process along are the continual sugar baths they get from soft drinks. Not only do the sugars feed the bacteria that cause decay, they also reverse the flow of fluids in the tooth so that microbes and their acidic waste products are pulled into it rather than repelled. (Read more about your teeth’s natural defenses against decay.)

Of course, when it comes to tooth erosion, soft drinks aren’t the only culprit – just a common one. For instance, stress can be a factor, often leading to grinding, clenching and other behaviors that weaken enamel over time. They also contribute to gum recession, where exposed tooth root also means more tooth sensitivity. (Chronic stress is also a drag on your immune system, making your body less resilient, more prone to disease and dysfunction.)

Another factor – often overlooked – is the effect of pharmaceutical drugs. (The skyrocketing rate of prescription drug use likewise parallels the rise in soft drink consumption.) As I mentioned before, dry mouth is a common “side effect” of drugs as varied as antidepressants, anti-anxiety medications, antihistamines and muscle relaxants.

Dry mouth may not sound like anything too serious, but it’s got some significant dental implications, raising the risk of caries (cavities), tooth erosion and periodontal disease. This is because one of the functions of saliva is to wash away the microbes that make up dental biofilm (plaque) and food particles that feed them. Saliva is also a source of the calcium and phosophate particles that help keep tooth enamel strong. The less saliva, the more conditions favor decay and other tooth damage.

If dry mouth is an issue, there are remedies so you don’t put your teeth and gums at risk. In my office, for instance, we have products that can help, such as GC Dry Mouth Gel and the Dental Herb Company’s Tooth and Gums Tonic. But even just drinking more water can help relieve dry mouth, as can eating more foods that require chewing, especially foods like crunchy vegetables.

If grinding and clenching are a problem, your dentist can provide you with a splint to cushion and protect your teeth – as well as reduce the amount of associated pain you may be experiencing. (Neck, head, face, shoulder and back pain are all common, cascading effects of clenching and grinding.)

And, of course, moderating or eliminating soft drinks from your diet will also lower the risk of tooth erosion and sensitivity.

And if the damage is already done? Above all, see your dentist, so he or she can assess the situation, offer solutions and help you decide on the best course of action for fixing your teeth. In the interim, avoid stimuli that aggravate the pain and, when cleaning your teeth, use a very soft toothbrush and toothpaste formulated for sensitive teeth.

Image by stuartpilbrow, via Flickr

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Filed under Dental Health, Diet & Nutrition, Oral Health

What’s Ozone Therapy & How Is It Used in Dentistry?

If you’ve read much about “alternative medicine,” you may have run across discussion of something called “ozone therapy.” But what’s that?

The word “ozone” might make you think of pollution. We’ve all heard of the “hole” in the ozone layer caused by CFCs and other toxins. Maybe you’ve read that ozone is found in smog or know a little about its industrial uses, many of which tap into ozone’s disinfecting properties (including use as a pesticide, bacteriacide and fungicide).

Ozone also has a significant history in medical treatment, as well. According to Dr. K.W. Donsback,

Ozone therapy was used medically by Nikola Tesla in 1900. It has been in continual use for over 50 years in Europe and the USA, but due to our legal pressures, ozone is presently only widely used [as an orthodox treatment in Germany, Russia and Cuba]. When the proper protocols are followed, ozone has been proven effective in the treatment and possibly the elimination of over 40 common diseases.

Ozone therapies are among the safest therapies ever used. One European study of over 5.5 million treatments showed a side effect rate of .0007%, probably among the lowest of any therapy known. Side effects (like fever and weakness) are minor and temporary.

Ozone therapy also has a place in dental practice, although its use remains uncommon here in the US, owing to opposition from the dental/medical establishment. Among those dentists who do use it for oral healing and health, there are five main applications :

  1. Ozonated water may be used as a gargle or rinse to treat oral abscesses, gum problems, sore throats and ulcerations. It may also be used for irrigation.
  2. Ozone gas may be used as a preventive measure against tooth decay and periodontal disease.This is done by fitting a custom tray over the patient’s teeth and gums, and letting ozone into the tray for a short while.
  3. Teeth that might otherwise be subject to a root canal or extraction may be treated by washing an exposed nerve first with ozonated water, then with ozone gas.
  4. Ozone may be used as a disinfectant before a root canal or restorative dentistry is done. Ozonated water and gas can get through the walls of the tiny dentinal tubules, killing harmful bacteria that have taken up residence in these hard-to-reach, hard-to-clean places.
  5. Temporomandibular joint pain may be treated with ozone, where gas injected right into the TMJ can kill harmful microbes, as well as reduce inflammation and spur the growth of new cartilage.

Learn more about dental uses of ozone:

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