The terror of the dentist's office, that buzzing nemesis that sends a chill through your very marrow even before it actually starts making its way there in person - the dentist's drill - may soon be little more than a relic. Whereas the fearful drill is now actually a part of the dentist's chair itself, in years to come the dentist may have to roll the monster out of the closet and wipe the dust off before putting it to occasional use.
Sound like a PREVENTION editor's typewriter dream? (We don't smoke pipes around here.) Actually, the fact that you could think of such a thing as a dream bears out what one of the dentists we talked to said. Robert O. Nara, D.D.S., from Houghton, Michigan,* told us, "People almost universally believe the untruth that dental disease is inevitable. The dental profession itself views disease as something to be supressed but not effectively prevented." And when Dr. Nara says prevention, he's not talking about the TV commercial's brand of prevention.
"On TV you see this kid coming home from the dentist's office bragging that he only had one cavity this time. Then the commercial recommends that you see your dentist twice a year. Well, figure it out: If the kid has 'only' one cavity at every checkup, and he goes twice a year from age six to 21, by the time he's 21 he'll have had 32 teeth filled! That's prevention?
That's not preventing anything. It's just superficially controlling it a bit," he maintains.
O.K., so prevention is something you expect to be talked about in this magazine. Preventing dental disease is, of course, the sure way of keeping the drill out of your mouth. But there's more good news: "Doctors, dentists and other people have no trouble understanding other physical healing processes. Broken bones knit, cut tissues heal, hair and fingernails grow back after being cut. The body restores itself naturally. Why can't the same thing happen with teeth?
That's quite a question and Dr. Nara wouldn't have asked it unless he had a good answer. Apparently, the same thing can happen to teeth.
Erling Johansen, D.M.D., Ph.D., a dental researcher at the University of Rochester, also told PREVENTION that teeth can heal themselves. "The extent of remineralization depends on the location of the cavity. If the cavity is in an area where the saliva has access to it - and if you have sufficient saliva - that cavity can be hardened. The cavity won't progress any further. If the person decides he or she wants it filled for aesthetic reasons, you can just touch it up a bit. The drilling is much simpler, then."
Well, that's the good news: Your trips to the dentist don't have to make you feel that enough oil to solve the energy crisis has been discovered somewhere in your jaw. But we did say there was some bad news, too. Here it is: There's no miraculous treatment or pill newly discovered that's going to prevent dental disease that's already there. There's no magic here - other than the magic of your body's natural healing powers.
Fortunately, there's more good news than bad. After we got the good news and the bad news from the dentists we talked to, we didn't let them get off that easy. we asked them how we could all make that good news part of our dental future.
"Then, especially if the person has a lot of problems, we do a blood analysis, and I go over the test results with the person. We look at calcium, phosphorus, glucose, cholesterol, triglycerides and show what elements are high and which are low. Then I tell them what they can do with their diet and carbohydrate metabolism."
Dr. Knapp, by the way, also teaches nutrition at nearby Volunteer State Community College. and he has a good reason to believe in the nutritional-preventive approach to dentistry. "I started getting into this about two years ago. My son was hyperactive. He had rapant tooth decay and here his father was a dentist! We took a hair analysis and found that his sodium was just out-of-this-world high. And a lot of other things were high. So we got off the salt, got off the lunch meat, got off the preservatives. We got off the junk food and the sugar. But he still had cavities. Then we suspected he might be allergic to homogenized milk. Got him off the milk and he hasn't had a cavity since. and he's not hyperactive anymore. He went from just barely passing kindergarten to making A's and B's now."
Just like he took Junk food out of his family's life, Dr. Knapp recomments that his patients do the same. "I try to get them to take the soft, high-carbohydrate foods out of the diet. Thjese foods get impacted and cling to the teeth and cause decay. Detergent foods that require vigorous chewing stimulate the gums, clean the teeth and inhibit the formation of plaque. Sugar, alcohol and caffeine must go. With these three things in the diet, it's impossible to get the blood elements in balance.
"Some people may have a gum problem. Sometimes it's related to stress. You'd be surprised what can come about because of stress. We've had a lot of cases of gum disease that had no plaque at all. We found out that the person wasn't eating enough, wasn't getting enough sleep, and was under a lot of stress. There's a lot of gingivitis among people taking exams in college, and among people getting a divorce."
"You know, periodontal disease - disease of the gums - is the major source of tooth loss in people over 40. so we have to pay special attention to the health of the gums. Cyanosis - easily bleeding gums - is something that has to be taken care of right away. As far as supplements go, I get them on B complex and C. But it's most important to find out the diet and take a long health history to make sure there are no systemic problems like diabetes or hypoglycemia.
"Teeth can also be lost if the part of the jaw holding them in, the aveolar ridge, deteriorates. Usually, people who have periodontal disease have what is called a periodontal profile, which shows up on hair and blood analysis. They're low in zinc, iron, copper, potassium, magnesium and manganese. If I find this to be the case, I put them on a supplement and check them again later on, to see if the minerals are balanced yet. I also work on their diet because they should get their minerals from their food.
"Bruxism, or teeth grinding, also responds to nutritional therapy. A woman came in here who had taken her son all over the place looking for some help. He had head X-rays and orthodontic advice, but he was still grinding his teeth smooth, keeping the whole house awake at night. And he would wake up tired, too, in the morning. I put this child on B complex and dolomite, one tablet of each one hour before bed. the bruxism was gone that very night."
Dr. Johansen cautioned against being lulled into thinking that sugarless gum is really devoid of tooth-decaying sugar. "Sugarless gum isn't sugarless. It' is sucroseless. If you look at the label, you will see that it says, on most of them, 60 percent carbohydrates. That can be just as bad as sugar. The bacteria that cause decay can survive and multiply on those carbohydrates."
And those bacteria are the reason why a good diet isn't quite enough to keep your teeth in one piece - and in your mouth - for as long as you need them. You have to keep them clean. Unfortunately, as Dr. Nara commented, "Most people keep their underarms cleaner than their mouths."
Dr. Johansen told us, "You have to keep after your teeth. I always say to my male patients, just because you shaved yesterday doesn't mean you don't have to shave today. You have to keep at it every day. the main thing is to keep the bacteria from growing on the teeth. and that's done by brushing. You should brush your teeth at least after breakfast and after supper. You should brush right after you eat, too. and you should floss your teeth once a day."
Dr. Nara has similar advice. "You can't allow the bacteria to become attached to the teeth. You have to keep them what we call 'free floating.' That's done by using a brush to clean your teeth. It's a matter of oral cleanliness. You're not going to find healing in a mouth that's laden with plaque. Plaque is a combination of food particles and bacteria. If it's on the teeth too long, calcium precipitates out of the saliva and it gets hard. You can remove plaque from your teeth before it calcifies by simply brushing.
Finally, Dr. Knapp told us a little more about keeping the teeth clean: "If you brush your teeth and you feel a tingling afterwards on the gums, that doesn't mean that you've gotten them extra clean. It means you may have damaged some cells. When you wash your arm, it doesn't tingle afterwards, does it? This is the sort of common sense thing that people don't think about. If you start to floss, you should do it correctly. Use unwaxed floss so the floss will spread out. Use the floss like a shoeshine rag across the teeth. Flossing and brushing should control plaque.
"Also, a lot of toothpaste has chemicals in it. I tell my patients, if you can't pronounce it, don't put it in your body. If you look at a tube of toothpaste, you'll sometimes see artificial sugars listed, too. These artificial sugars have been shown in some studies to cause changes in the tissue cells, and to slow down healing as much as sugar can and possibly more. We tell them to avoid toothpaste - to use baking soda, salt or just plain water."
By far, that was probably the most pleasant visit with a dentist any of us has ever had, not to mention the most pleasant visit with three dentists! Of course, these are three dentists practicing what appears to be a dentistry of the future, a dentistry that is concerned with healing rather than drilling. Naturally, you don't have to wait until your dentist becomes more interested in preventing tooth decay than treating it. They're your teeth! Take care of them and the dentistry of the future will be yours. Today.