The Center for Disease Control (CDC) defines dental cavities or “caries” as the “result of bacteria on teeth that breakdown foods and produce acid that destroys tooth enamel and results in tooth decay”.

I see the result of sugar and poor diet on teeth every day. This coupled with inadequate oral hygeine/home care is the difference between dental health and decay.  When I see the effects on the oral cavity, it makes me wonder what sugar, processed foods, and improper diet does to the body as a whole in terms of acidity, plaque in the arteries, inability to detoxify, and breakdown of the organs and immune systems.  It is a humbling thought.

The acid stays present on the teeth because of either poor brushing and flossing habits (oral hygiene) and/or the presence of too much acidity in the saliva, which feeds the decay-causing bacteria and causes it to flourish.  Children from age 6 until adolescence are at risk for cavities because their constant exposure to sweets, whether in the form of all-too-prevalent candy or ‘good-for-you’ fruit juices, which  contain a high degree of fructose.  While fructose is a natural sugar, it is still a sweet and will feed the bacteria that causes tooth decay.  My youngest patient is currently two years old and has cavities.

In my holistic dental practice, I strongly espouse the basics. What you do every day to maintain the health of the mouth pays dividends on many levels.  Keeping your mouth and gums bacteria free and thus inflammation free has become recognized as having a role in the health of your heart and blood vessels.  Brushing and flossing really are important.  Yes often it is inconvenient, but once a day is all you need to maintain your teeth in a healthy state.  If you have trouble with inflammation, maybe twice a day with regular cleanings will be necessary.

If you have bleeding gums when you brush or when you have cleanings done at the dental office, or if you have pocketing over 3 millimeters when measured by your dentist, then more than the basics may be necessary.  Often deep cleanings or root planing is recommended.  However, I have found that bringing the inflammation down first is more effective than just deep cleanings.  I have spoken about the holistic gel treatment I do in my dental practice in previous posts.  What I haven’t spoken about is the overall effect it has on the health of the mouth.

Basically, less bacteria and less inflammation leads to less plaque and less decay.  Really healthy gums means healthier teeth.  The two go hand in hand.  With this foundation, good home care and a good holistic dentist who is focused on the preservation of your teeth, you will have your teeth for a lifetime.

I’ve been talking a lot lately about gum disease as it is so foundational for the health of your mouth and your body. I am going talk about gum surgery today and when it should be used. First of all, surgery should not be the first option, but when it is necessary, it can and often does save teeth. That is because gum or periodontal surgery has come a long way over the years.

There are techniques including bone grafting techniques that have evolved over the years. The types of things that can be done and the results possible are quite impressive. It of course depends on the knowledge and skill of the practitioner and the healing capacity of the body.  The main difference is that instead of cutting gums back to where the bone is, often times bone can be added to support and strengthen the teeth.

Lasers can also play a role in gum surgery at the periodontal office. Instead of using a knife the periodontist can sometimes use a laser to cut tissue and coagulate the blood. The main advantage of this technique is that often there is recovery and healing that leaves the tissue and bone levels better than before. In other words there is more  bone and gum attachment after the healing is complete.

While it is not faster than traditional surgery, the results can be as good or sometimes better. Although not applicable in every situation, laser surgery definitely has its place. Most periodontists in San Diego charge around $1,000 per quadrant and there are four quadrants in the mouth. Unfortunately, the treatment needs to be completed within a 2-3 week period, so it is not something that can be done over time.

I have found that most patients first want to try the conservative and non-surgical approaches first. I have had good luck in my office with patients who will do the necessary home care required to reverse gum disease.

I wanted to start a discussion of just what lasers can do for gum health. There is a lot of information currently available about gum disease and overall health.  Research has found that with gum disease, coronary artery disease is almost twice as likely to occur. Coronary artery disease results in a thickening of the walls of the coronary arteries. It may be that bacteria that causes gum disease enters the blood stream and increases clot formation in blood vessels.

Even though up to 80% of the population suffers from some form of gum disease, it is not always apparent or obvious. This is because it rarely hurts until the damage becomes quite advanced. The common warning signs of gum disease include gums that bleed when brushing or flossing, swollen or tender gums, red gums, and spaces that develop between teeth. Other warning signs include bad breath or bad taste, long teeth from extreme gum recession and/or a change in your bite.

What can be done about this common problem and how can we maintain our teeth and gums so that we keep them healthy for life? As a holistic dentist practicing in San Diego, I have years of experience treating gum problems.  I have found that there are basically three levels of care that work in conjunction to improve gum health. I first remove the plaque and hard deposits that cause bacteria buildup and gum inflammation. I then use natural products in the office and recommend other products for home use to continue to lower inflammation and promote healing of the gums. I then use laser gum treatment to stimulate the gums and eliminate the pocketing that promotes gum disease.

This protocol offered at my holistic dental office is one that almost any patient can do because it is less painful than most of the other options and less expensive as well.  Compared with surgery, it is a lot less painful and less expensive. With this approach to gum treatment, I have found that patients can go from moderate gum disease, with 4-6 mm pocketing, to a healthy 2-3 mm pocket range. Quite a difference for them, and they are very happy they were able to avoid surgery. Surgery is always an option, but wouldn’t you rather try the conservative approach to treat gum pain and periodontal disease first?

If you are local to San Diego, we will be happy to answer your questions to see if holistic dentistry may be the right approach for you.

As a follow up to yesterday, I am going to outline what I have found works best in my holistic dental practice to treat periodontal disease. I see a lot of health conscious people in my practice, but when it comes down to it, who isn’t interested in being healthier? It is just a matter of education and presenting the right choices and options.

There have been quite a few patients I have seen with bleeding gums and sore gums that had gingivitis or gum disease. They had been told they needed gum surgery and came to me as a last resort, to see how I could help them avoid this expensive and painful treatment. If you know someone who has had gum surgery, they will tell you that they will never do it again. It is not fun.

 What I have found works best is to first lower the inflammation in the gums, because on a simple level gum disease is an inflammatory process that usually goes unchecked for months and years. To do this I use special rinses in the office and a gel treatment that both feeds the gums directly and lowers inflammation by safely removing and killing bacteria. I also have patients do specific things at home to accomplish the same thing. These are things that anyone can do. They are not hard but very necessary to cause healing to take place. This is one of the approaches I employ in my San Diego holistic dental practice.

Once the inflammation and resulting pain has improved, I find that everything goes better from that point on. Deep cleanings and other treatment go easier, are less painful and have a more dramatic effect on the improvement of the gums. In other words once the inflammation is down and the right home care is in place, the amount of treatment necessary to heal gum disease tends to be much less. 

So back to actual cases; after the gel treatment I did an overall cleaning and a fine cleaning 2-3 weeks later to follow up. How gum disease is categorized is by measuring the gap between the tooth and gum. If it is between 4-6 mm then you have moderate gum disease. What happens in almost every case in my office is that most of the pocketing resolves with simple cleanings. However, there are usually areas that are more resistant and need more treatment. That is when I either do deep cleaning or laser periodontal treatment.

By this time there has already been a significant improvement in the overall health and pocketing of the gums. This makes the deep cleanings and laser treatment simpler, cheaper and more effective as well. Also, if the gums aren’t all inflamed and sensitive, it won’t hurt as much. It can make a significant difference. 

Basically the approach is to progress from the simple to the more complex, building on the success and improvement already achieved. The difference is that most offices treating periodontitis start with deep cleanings, and we employ it at the end when it will have a much greater impact on the healing of the gums.

The results I have seen using the approach described above is that patients who were facing gum surgery totally healed and their pockets improved from 4-6 mm to 2-3 mm which is considered normal. They are happy to say the least, as they did not have to face expensive and painful surgery. I am always amazed at the healing capacity of the body, even the gums. As always, the earlier you treat gum problems the better.

A study just came out concluding that 1 in 4 children under the age of 11 have never seen a child dentist. This is in California where dental education is higher than many other areas in this country and worldwide. In addition, many of these children were covered under insurance or Medicaid, so lack of insurance and cost should not have been a deterrent.

Researchers from UCLA and from the California HealthCare Foundation found that underprivilaged kids were less likely to have visited a childrens dentist in the previous six months – or even in their entire lifetime. Also, Latino and African American kids saw a pediatric dentist less, even when they had the same insurance. One solution was to raise re-imbursement to Medicaid dentists and increase the network of dentists.                                                 

According to the study, 54% of the kids who had insurance, 27% of the publicly insured kids and only 12% of the kids without insurance saw the kid dentist within the last 6 months. These numbers are not good. According to Dr. Pourat from UCLA, “Having insurance isn’t always enough, we need to address the other barriers that keep children from getting the help they need.”

As a holistic dentist this is of special concern to me because I know good habits are hard to come by. If our children get used to going to a pediatric dental office, especially a pediatric dentist they like and learn to trust, they are so much better off than waiting till something bad happens or they are in pain and have to go under stressful conditions. In addition their dental health will be better and their home care habits will be instilled early and correctly. 

Basically, good habits once instilled never seem to leave you and good health is best supported through taking consistent action throughout life, not just when the need arises or worse yet an emergency. 

Please, start taking your kids to the children friendly dental office as early as possible. Usually the best time to start is when they are 4-5 depending on the child. If there is something that needs addressing before, by all means bring them. We view pediatric dentistry as truly important for children to accept and get used to.

If you are looking for a San Diego kid friendly dentist who focuses on biocompatible materials for their teeth feel free to call our office. We have a kid area with puzzles, things to draw with and toys. Kids seem to love coming to our practice and we really enjoy them as well. By starting early, your kids will benefit their entire lifetimes.