Tag Archives: teeth

Losing Your Teeth Is a Choice

When I saw the headline in my Google Alerts – “Reality Bites When Your Teeth Turn 45” – I just had to click the link and find out what this moaning was all about.

It was an op-ed piece in the Sydney (AU) Morning Herald – an attempt to write humorously about the physical changes that come with “old age.”

Birthday euphoria associated with my 45th last week vanished pretty quickly as the next morning, brimming with good resolutions in the dental hygiene line, I flossed my teeth with vigour. To my horror, half a tooth fell out. This sent me into a morose tailspin. So, this is what happens once you cross the 45-year-old line – your teeth fall out. I decided to abandon immediately all the healthy living birthday resolutions, such as flossing, as they obviously only usher on the inevitable at speed – and instead focus on the fun ones centred on wine, chocolate and wild partying.

Because, of course, when you have a health problem – and yes, losing part or all of a tooth you’re not supposed to lose is a health problem – you don’t want to do something to keep it from getting worse. You abandon all hope – because, so suggests the writer, it’s just a normal part of aging.

That’s the subtext. And if the writer actually and seriously believes it, well, that’s just sad.

For starters, 45 is not old by any stretch of the imagination. Yes, the body is aging, changing, slowing down. But it’s hardly falling apart – unless you’ve not taken very good care of it. And maybe that’s the case with the writer. After all, according to her article, after visiting the dentist about the tooth damage, she proceeded to eat a chewy sweet, even as she says she knew it was risky (and lost another tooth in the process).

The crux of the matter: Tooth loss is not an inevitable part of the aging process. Apart from accidents, the only time we usually lose adult teeth is when we don’t take care of them: when we eat poorly, don’t brush and floss regularly, don’t see the dentist regularly; when we smoke, take drugs (legal and illegal), drink too much, don’t exercise. Such things harm our teeth and gums, making them vulnerable to decay and disease.

Teeth don’t normally fracture on their own either. Non-accident related fractures usually result from behaviors such as chewing ice or other hard objects, or habits such as clenching and grinding. Under normal conditions and with proper care, most people’s teeth will stay intact and in their mouths for their lifetime. Only when something goes wrong might they fall out, crack or break.

The main change healthy but aging teeth experience is darkening from a lifetime of staining and normal wear and tear. This problem is easily solved by whitening or doing things to create the illusion of brightness. For instance, women can use lipstick with blue tones to create the impression that their smile is whiter.

But almost never is damage to or loss of the teeth a byproduct of aging. It’s a byproduct of the choices we make. “Getting old” is just when your choices start catching up with you.

Image by xcode, via Flickr


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What Does a Smile Say?

The human smile sets us at ease. People who don’t smile openly are considered unapproachable, unlikeable and even dangerous. Yet the same expression by an animal signals danger.

Why does it signal safety when we humans smile? Charles Martin DDS, of the Richmond Smile Center, decided to find out.

Smiling, as it turns out, is related to sound, according to research by John J. Ohala, Professor Emeritus in the Department of Linguistics at the University of California, Berkeley. Ohala discovered that words sound better to humans when accompanied by a smile.

A smile gives the speaker’s voice a higher pitch. Humans associate lower-pitched voices – like those of larger, more threatening animals – with danger, while higher voices are typically found in smaller animals. Over time, the visual cue of a wide smile has become connected with the sound of a higher pitched voice. Therefore, a smile conveys an absence of danger.

“We see an example of this in babies,” Dr. Martin explained. “Babies respond more favorably to female voices, which are higher pitched than deeper, louder male voices. That’s why we see grown men instinctively change their voices when speaking to babies.”

Though adults don’t respond as strongly to higher voices and smiles, we do tend to gravitate toward a smile. In fact, the sound of a voice accompanied by a smile is now so firmly ingrained in the human subconscious as safe and cheerful that a smile alone can make us feel good about someone.

“Showing our teeth through smiling tells people we’re friendly and makes them comfortable being around us,” said Dr. Martin. “How does the world view us if we refuse to smile, even if that refusal is simply due to being self-conscious about a less than perfect smile? A smile, or lack thereof, sends a very distinct message to other people.”

Adapted from a Richmond Smile Center media release, via PRNewswire.

Image by Jen Marquez, via Flickr

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Gum Disease & Cancer, Cancer & Smoking, Smoking & Tooth Loss

Over the past year or so, there’s been a lot more talk in conventional dental circles about the relationship between oral health and physical health, much of it focusing on the demonstrated links between periodontal (gum) disease and inflammatory conditions such as heart disease, diabetes and Alzheimer’s. One of the links we’ve heard less about – at least in the popular media – is that between oral health and cancer.

A little over a year ago, a study published in Cancer Epidemiology, Biomarkers & Prevention cast some light on this relationship, looking to the effect of chronic periodontitis on head and neck squamous cell carcinoma (HNSCC). As gum disease in its most severe form leads to bone loss in the jaw, researchers measured the amount of alveolar bone loss. (This is the bone that secures the teeth in their sockets.) Even after adjusting for factors such as smoking, alcohol use and missing teeth, they found that for each additional millimeter of bone loss, an individual’s risk of developing HNSCC increased by more than four fold, with the strongest association occurring in the oral cavity. The scientists concluded that chronic gum disease may well be an independent risk factor for HNSCC. Smoking may raise the risk even more, considering that it aggravates alveolar bone loss.

Because the alveolar bone is the fundamental structure that keeps teeth in the mouth, as it erodes, the individual becomes more susceptible to losing their teeth. There’s simply not enough bone to hold them in place. This is something we’ve known about for some time, but there’s continued interest in understanding the progress of gum disease, as well as the impact of risk factors such as smoking even after the the person has quit.

Along these lines, a sobering study was just published in the Journal of the American Dental Association, in which researchers looked at the long term effects of smoking and tooth loss among older adults. Unsurprisingly, current and former smokers both showed a much higher rate of tooth loss than those who had never smoked. Surprisingly, though risk declined significantly once individuals quit smoking, their risk remained elevated even after 30 smoke-free years.

For those who still think smoking makes you look cool or sexy, you might want to think about how cool you’d look without teeth or how sexy when taking out dentures each night before going to bed.

Yet another reason to quit the smokes – or never start in the first place.


Image via foldedspace


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Why Tongue Piercings Aren’t So Cool for Your Teeth & Gums

Most fashion trends seem to come and go pretty quickly, but not tongue piercing…much to the dismay of parents and dentists.

Yes, dentists.




For tongue piercing can cause a number of dental problems, starting with infection, which can spread to other parts of the body via the bloodstream. Occasionally, such an infection can spread to the brain, killing the patient.

More common are gum problems and broken teeth caused by the habit of playing with the piercing – flicking the tongue around the oral cavity, hitting both teeth and gums. This repeated trauma can damage the periodontal tissues and crack or break the teeth.

Recently, a case report surfaced that illustrates another potential risk of the playing habit: orthordontic problems.




The study, published in the Journal of Clinical Orthodontics, described the case of a 26 year old woman who repeatedly played her piercing against her upper front teeth. By the end of 7 years of pushing the stud up and against her front teeth, a significant diastema – a gap between her front teeth – had formed where none was before.

As the study’s lead author, Sawsan Tabbaa, DDS, describes it,

The barbell is never removed because the tongue is so vascular that leaving the stud out can result in healing of the opening in the tongue…so it makes perfect sense that constant pushing of the stud against the teeth – every day with no break – will move them or drive them apart.

Thanks to orthodontic treatment, the patient’s smile was restored to its original, non-gappy look.


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Nutrition & Your Amazing, Self-Healing Teeth

When people ask how I became a holistic dentist, I like to tell them that I was born into it. My mother was committed to natural health and holistic living, so that was the environment I grew up in. Eating a nutrient-rich, whole foods diet, getting plenty of physical activity, balancing work and play – these were the norm. It was only natural, then, that holism would inform my work as a dentist.

So I practice what I preach (and what was preached to me), so to speak, and encourage my staff to do the same. After taking a recent nutrition seminar, for instance, all of us in the office adopted the detox diet we’d learned about. No, detox isn’t just for those who show symptoms of illness. After all, we live in a toxic world. Even if you make all the best, most healthful choices, you’re still exposed each day to countless pollutants through each breath you take. We can all benefit from detoxing now and again, coming away, as my staff and I did, with renewed energy and a heightened sense of physical well-being.

Once upon a time, many used to think that nutrition was beyond the scope of dentistry. Only holistic and biological dentists commonly offered nutritional counseling as we helped chronically ill patients heal from the effects of mercury fillings or other toxic dental materials, focal infections or cavitations. But as many conventional dentists are finally starting to see, nutritional counseling and support can and do play a part in general dental health, as well. And it’s not just about avoiding sugar so you don’t get cavities. It’s also about how key nutrients such as minerals, antioxidants and Vitamin D support strong teeth and healthy gums and bone.

What’s more, not only does a good diet help prevent tooth decay. It can even reverse it once it’s begun.

It’s important to remember that your teeth aren’t just solid, static structures in your mouth. They’re living organs – just as your liver, lungs and heart are living organs. Under the hard enamel covering each tooth is the dentin. It consists of miles – yes, miles! – of microscopic tubules containing fluid and cellular structures. Below that is the pulp, which is made up of living connective tissue and odontoblasts – cells that create dentin. Both dentin and pulp are also rich in nerves, which is why your tooth will start to hurt when there’s deep decay or other damage.

Early in the 20th century, the great dental researcher Dr. Weston Price did some impressive research on the effects of diet on dental health. In studying various native populations around the world, he found that shifts from traditional diets to non-traditional Western diets rich in refined flour and sugar commonly led to oral changes such as smaller, narrower arches that led to the crowding of teeth. It also increased cavities. But it also worked the other way around. That is, he found that a diet rich in minerals and fat-soluble vitamins (A, D, E and K) and low in phytic acid promoted remineralization of the dentin, thereby reversing the course of tooth decay. (Phytic acid is main storage form of phosphorous. Its found in many plants, but humans can’t absorb it since we lack the enzyme needed to break it down.) As Dr. Price wrote in Nutrition and Physical Degeneration,

The chemical analysis of the saliva revealed a marked improvement which progressively increased. At the beginning of the test the average for the group showed a very low factor of safety, so low that we should expect tooth decay to be active. In six weeks, the average changed to a condition which we should expect would be accompanied by a cessation of tooth decay. The saliva factor of safety continued to improve for five months at which time the program was discontinued for the summer.

Several incidents of special interest occurred. Two different teachers came to me to inquire what had been done to make a particular child change from one of the poorest in the class in capacity to learn to one of the best. Dental caries is only one of the many expressions of our modern deficient nutritions.

Similar findings were published by Drs. Edward and May Mellanby. Stephan Guyenet at Whole Food Source offers a good discussion of their research:

When enamel is poorly formed and the diet isn’t adequate, enamel dissolves and decay sets in. Tooth decay is an opportunistic infection that takes advantage of poorly built or maintained teeth. If the diet remains inadequate, the tooth has to be filled or removed, or the person risks more serious complications.

Fortunately, a decaying or broken tooth has the ability to heal itself. Pulp contains cells called odontoblasts, which form new dentin if the diet is good. Here’s what Dr. Edward Mellanby had to say about his wife’s research on the subject. This is taken from Nutrition and Disease:

Since the days of John Hunter it has been known that when the enamel and dentine are injured by attrition or caries, teeth do not remain passive but respond to the injury by producing a reaction of the odontoblasts in the dental pulp in an area generally corresponding to the damaged tissue and resulting in a laying down of what is known as secondary dentine. In 1922 M. Mellanby proceeded to investigate this phenomenon under varying nutritional conditions and found that she could control the secondary dentine laid down in the teeth of animals as a reaction to attrition both in quality and quantity, independently of the original structure of the tooth. Thus, when a diet of high calci­fying qualities, ie., one rich in vitamin D, calcium and phosphorus was given to the dogs during the period of attrition, the new secondary dentine laid down was abundant and well formed whether the original structure of the teeth was good or bad. On the other hand, a diet rich in cereals and poor in vitamin D resulted in the production of secondary dentine either small in amount or poorly calcified, and this happened even if the primary dentine was well formed.

Thus, in dogs, the factors that affect tooth healing are the same factors that affect tooth development:

  1. The mineral content of the diet, particularly calcium and phosphorus
  2. The fat-soluble vitamin content of the diet, chiefly vitamin D
  3. The availability of minerals for absorption, determined largely by the diet’s phytic acid content (prevents mineral absorption)

They later replicated these findings in human subjects. As they wrote in their 1932 British Medical Journal study, also cited by Dr. Guyenet,

The hardening of carious areas that takes place in the teeth of children fed on diets of high calcifying value indicates the arrest of the active process and may result in “healing” of the infected area. As might be surmised, this phenomenon is accompanied by a laying down of a thick barrier of well-formed secondary denture… Summing up these results it will be clear that the clinical deductions made on the basis of the animal experiments have been justified, and that it is now known how to diminish the spread of caries and even to stop the active carious process in many affected teeth.

To learn more about the role of nutrition in dental health, see my previous article “Eating Well for Good Oral Health” and video “Feeding Your Teeth.”


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Tooth diagram by Ruth Lawson, Otago Polytechnic


Filed under Dental Health, Diet & Nutrition

Eating Well for Good Oral Health

In the 1930s, the great dental researcher Weston A. Price traveled the world, investigating the effects of diet on human dentition. From the Swiss Alps to the Peruvian Andes, from Africa to the South Seas, he found one commonality among all people he met: those who ate traditional diets made up of indigenous foods had healthy gums and nearly perfect teeth. Comparatively, those who ate highly processed, non-local foods – diets including refined flour and sugar – were much more likely to have crooked teeth, malocclusion (improper jaw alignment), caries (cavities) and gum disease. He published his findings as Nutrition and Physical Degeneration in 1939.

Sadly, all too few dentists have recognized the importance of Price’s work. They can’t state the obvious: what you eat affects not just your overall health but your dental health.

For instance, refined carbohydrates and starches contribute greatly to biofilm (plaque) build-up, tooth decay and periodontal disease. When broken down by enzymes in your saliva, these fermentable carbohydrates make a desirable meal for the microbes that live in your mouth. The environment grows acidic while the microbes thrive and colonize, intensifying acidity. If the biofilm they form isn’t regularly disturbed by brushing, flossing and other cleaning techniques, decay and gum disease are sure to follow.

If, on the other hand, you eat plenty of vegetables, fruits and other whole foods, you make the terrain less friendly to those microbes. Indeed, shifting to a less acidifying, more alkalinizing diet can go a long way toward enhancing your health.


mini true/Flickr


Broadly speaking, all foods can be classified as either acidifying or alkalinizing. One of the reasons why the Standard American Diet (SAD) is so notoriously unhealthy is precisely because it makes the body so acidic. Meats, grains, dairy, caffeine and sugar are the main culprits. Alkalinizing foods are needed to balance things out. These include:

  • Fruits and vegetables (except tomato), their juices and oils
  • Nuts and seeds (except peanuts, pecans, pistachios, walnuts, heazel, pine and soy nuts), their oils and butters
  • Herb and green teas
  • Mineral water
  • Sea salt, major herbs and spices
  • Molasses

Generally speaking, riper, fresher and less cooked produce is more alkalinizing, and organic is more so than industrial produce. Similarly, whole grains are less acidifying than refined grains, and whiter meats are less acidifying than darker ones.

You’ll note that this list contains few processed foods. This is because whole foods – foods as they occur in nature – are the foundation of a healthy diet. They may be processed into other foods of varying quality – everything from healthy, hearty whole grain breads to nutritionally empty Twinkies. While these days it would be extremely difficult, if not impossible, to follow a completely traditional, indigenous diet such as Dr. Price found ideal, we can benefit greatly by at least avoiding use of the most heavily processed foods. Hence, the oft-cited rule of thumb, of shopping the perimeter of the grocery store: produce, meats, dairy, bakery. When you venture into the center aisles for the more heavily processed foods, be sure to read the labels carefully – especially the ingredients. The fewer, the better.

Eating a wide variety of whole foods, with emphasis on alkalinizing foods, can help ensure that you’ll get all the vitamins, minerals and other nutrients that support strong teeth and healthy gums. While we need enough of all nutrients in oder to stay healthy, some are especially important to good dental health.

All are vital, but especially vitamins C and E. As anti-inflammatory agents, they support healthy gum tissue. They also make the terrain less acidic, slowing the growth of biofilm. Eating a wide variety of vegetables and fruits can help ensure you get enough of these nutrients. Nuts and whole grains are great sources of E, while citrus and cruciferous vegetables (e.g., broccoli, cauliflower, kale) are excellent sources of C.

Calcium, Magnesium, Zinc, Iron and Trace Minerals
Minerals support bone growth and maintenance. Good sources include meat, fish and dairy products, along with green leafy vegetables.

Vitamin D
D plays a role in maintaining strong teeth and gums. Luckily, our bodies can produce this vitamin with the help of sunlight. All it takes is ten to twenty minutes of exposure three times a week. Also, dairy products are often fortified with D.

Our body tissues are constantly breaking down, including the tissues in your mouth. Protein is needed to rebuild and maintain them. Good sources include meat, fish, dairy products, beans and nuts.

Along with taking regular exercise and making time for rest and rejuvenation, eating a varied, nutrient-dense diet is hands-down your best bet for supporting and enhancing your wellbeing. For as Hippocrates said well over 2300 years ago, “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.”


For more articles like this one, visit our library at drerwin.com.


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