Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

In teeth we have a masterpiece of creative genius. They have a beautiful color, a firmness without being cemented in, and an accuracy that enables one to trap a tiny sesame seed between two points and crush it, a task the fingers would find difficult to accomplish. Even the jaws are ideally arranged to hold the teeth firmly in response to pressure stimulation. The beauty and utility of the teeth constitute one of the wonders of the body.

The most common cause of loss of teeth before the age of 25 is dental caries and the commonest cause after 25 is periodontal disease (pyorrhea, a degeneration of the gums and tooth socket). Both of these are related to diet.

Dental caries can best be treated by starting before the child is born with a good, simple diet for the mother consisting principally of fruits and whole grains for breakfast and vegetables and whole grains for dinner, all other things being taken sparingly, especially sweets and fatty foods which are laden with empty calories.

Readily available and fermentable sugars are especially injurious to the teeth and no child should be trained to like them. It is quite possible to train a child to enjoy being on a simple diet from infancy up, if a little trouble is used to avoid the sweet beverages including fruit juices, desserts, and snack foods. Sweets are not essential for children, and they will never know that they are supposed to like sweets if the sweetest thing that they are accustomed to having is a banana. Parents should not eat sweets in front of them, nor otherwise allow them to know that sweets are the expected food of children. In countries of the world where sweets are never used children grow up having a taste for natural sweets, and never miss the sugary things that our society feels are essential to the enjoyment of life.

Switching quickly back and forth from hot to cold foods is not good for the teeth, as microscopic cracks in the surface may be caused. Even if the teeth were not involved, the use of very hot or very cold drinks is not good for the stomach. The worst habit of all is that of crushing ice with the teeth. Cracks enlarge over the years and teeth may become quite brittle. Fillings are affected, since fillings pull away from the tooth and saliva seeps into the newly opened spaces carrying germs and food with it.

Similarly, children should not be allowed to eat between meals. From the ages of one to three a child should be trained to eat no more than three meals a day and should never be given between-meals feedings. It should be as strange and unusual to take food between meals as to take some strange or foreign food or alcoholic beverages and drugs. A child taught in this way from infancy up has no difficulty accepting these matters. It has been shown that the number of caries a child has is determined directly by the number of times he eats during the day. Sweet beverages and milk as well as "junk foods" contribute to the number of caries-producing risks the child experiences. Water is the preferred beverage as it cleanses the blood better than any other beverages, and is especially important in helping to produce a large quantity of cleansing saliva which reduces tooth decay.

In adults the most common cause of tooth loss is periodontal disease. Again a large part of the problem is diet, and the same simple diet recommended for children to prevent caries will also prevent periodontal disease in adults. Lots of raw fruits for breakfast, plenty of raw vegetables for dinner, and a small supper consisting of whole grain bread or whole grain cereal (not that shaken from a box but cooked in the kitchen), with some natural fruits or some dried stewed fruit or canned fruit without sugar is sufficient for a supper meal. Do not forget that milk contains milk sugar and tends to cling to the teeth and the gums when taken between meals or at the end of a meal.

A very thin film of gingiva grows down from the margin of the gums and forms a veil over the depression between the tooth and gum, protecting the deep groove between the teeth and the socket from getting food or germs in it. The use of a hard bristle brush can permanently injure these delicate veils, and may even destroy them entirely.

For periodontal disease, faithful use of dental floss, massaging the gums with the fingers, keeping a charcoal tablet in the mouth almost constantly when treating the inflamed gum, and the use of hot mouthwashes using only hot water at about 110° F. can be effective in gradually eliminating pyorrhea, provided one is vigorous and persistent in the treatment.

To cleanse the teeth, two things are needed: a soft bristle, small toothbrush and some dental floss, the unwaxed being better than the waxed. The proper motion for brushing the teeth is back and forth (not up and down as was taught 25 years ago) in a small jiggling motion, the soft bristles being directed in a 45-degree angle toward the gum margin. The upper teeth are first brushed, and then the lower. Toothpaste is not essential, but may be used in small quantities. If a large quantity is used the foaming action is actually retarded and less removal of food particles is possible. A small lump of toothpaste about the size of a rice grain is generally all that is needed. Use dental floss for each tooth, tilting the floss first against one tooth and then against its neighbor until it is "squeaky clean." If fruit stains get on the teeth, these may be removed by charcoal tablets or powdered charcoal used with a toothbrush. Tablets may be allowed to dissolve in the mouth, and distributed by the tongue across the teeth. Good functioning teeth are a strong adjunct to good health throughout life.

For temporary relief of a toothache, a poultice made of common chickweed, or a bag of wet goldenseal tea leaves already used once to make a cup of tea (fresh is too strong), can be applied directly to the tooth beside the inside of the jaw and the affected tooth. Often a toothache can be relieved by such a simple measure in a matter of a few minutes.

No discussion of dental disease is complete without mentioning halitosis. The most common cause of bad breath is decaying food matter either between the teeth or in the nasopharynx. If the teeth are cleaned frequently with the method mentioned above, the offensive breath may be eliminated entirely by just such treatment. The elimination of pyorrhea or postnasal drip, or properly cleaning removable dentures or prosthetic appliances will go far toward eliminating bad breath. Vigorous brushing of the tongue will remove much mouth odor. To drink plenty of water helps to cleanse the teeth and to provide a vehicle to remove odors from the mouth. Periods of emotional stress can cause an offensive breath. Remember that "exercise neutralizes stress."