There’s a Time for All Things…

…including time to take a little break from blogging, which we’ll be doing for the next few weeks. Regular posting will resume on Tuesday, June 16.

Meantime, we encourage you to check out our archive, as well as Dr. Verigin’s Biodental Library for even more articles, video and other resources on biological dental health and wellness.

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Eminently Quotable: Daniel H. Kress, MD

Kress quote on pharma

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And the Best Way to Clean between Your Teeth Is…

interproximal brushesYou hear it all the time: brush and floss, brush and floss…though as we’ve noted before, there’s actually not a lot of good evidence supporting the flossing part.

That doesn’t mean you don’t need to bother cleaning between your teeth. You do – well, unless you’re happy with only cleaning the 60% or so of total tooth surface that a toothbrush can reach. And with having a higher risk of caries and gum disease, natch.

No, the question is simply this: What’s the best tool for the job?

Several years ago, a meta-analysis in Evidence Based Dentistry concluded that interproximal “proxy” brushes win out over both floss and perio-aids. And now a new review in the Journal of Clinical Periodontology lends some further weight.

The authors looked at 6 systematic reviews: two each on floss and proxy brushes, one on woodsticks (toothpicks) and one on oral irrigators (like Waterpiks).

Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs [interdental brushes] in combination with toothbrushing reduce both plaque and gingivitis.

In sum, while all methods showed some efficacy, there was more substantial evidence for proxy brushes.

Or you could put it another way: Any kind of interdental cleaning is better than none at all – provided it’s done correctly and safely – but for best results, opt for those proxy brushes.

Image by Hondrej, via Wikimedia Commons

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Worst Ways of Saving Money #43: Avoid the Dentist

We’ve said it before: If you want to spend a lot of money on dental care, one of the best things you can do is avoid going to the dentist.

Now NASCAR driver Danica Patrick is making much the same point in a campaign for Aspen Dental. “Delaying dental visits for years,” she says (or, at least, is said to have said),

is similar to what happens when you don’t keep up maintenance on your car and then expect it to perform the way it should. You end up having higher costs to repair damage that could have been prevented with proper, regular maintenance.

Amen.

The campaign kicked off with a prank video that we have to admit is really fun – despite the commercial pitch for the super-corporate, decidedly non-biological Aspen Dental at the end – and pounds the “no bargain” point home:

Dental work only gets really expensive when you avoid seeing your dentist until something goes wrong. What you save in the short run, you lose in the long – not just in terms of oral health but overall health. The two, after all, are linked.

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Sugar: The Difference-Maker

Recently, we ran across a not-very-surprising-yet-kind-of-interesting study published earlier this year in Caries Research.

sugar cubes on spoonThe “no surprise” part is that it confirmed the role for sucrose – ordinary table sugar – in tooth decay. Evaluating a group of children over the course of 13 years, the researchers found that those with the highest sugar intake at 3 years old maintained high intake throughout the study, had higher counts of S. mutans and Lactobacilli in their saliva, and, thus, a higher risk of caries than those who ate less.

Kind-of-interesting thing, the first: The authors reported no differences in oral hygiene. Both groups shared similar toothbrushing habits. Sucrose intake was the obvious difference-maker.

Kind-of-interesting thing, the second: Sugar intake didn’t change much over the long-haul. Those who ate a lot of sugar early kept eating a lot; those who ate less consistently ate less. It pounds home just how strong a hold sugar can have over a person. We hesitate using the word “addiction” here – it’s just too problematic – yet plenty of those who have quit sugar will tell you just how hard it can be at the onset. Sugar makes the brain happy, after all – as it should, considering it’s the brain’s primary fuel. Going without makes the brain unhappy. It’s easier to just eat some more sugar instead of muddling through any period of feeling bad.

It’s also a good reminder of why it’s so important to instill and encourage healthy eating habits early: Those we pick up early tend to stick with us.

Kind-of-interesting thing, the third: The demarcation point for high sucrose/low sucrose intakes was 10% (i.e., those whose daily intake was more than 10% of their total calories were in the high group; those with less, in the low). That’s double the World Health Organization’s currently recommended consumption “target” for sugar. But as we noted before, recent research has shown that to prevent tooth decay, sugar consumption should be no more than 3%.

There is really every good reason to reduce the amount of added sugars we eat – and no really good reasons to stay the sugary course.

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Research Continues to Support Oil Pulling

Since oil pulling turned trendy last year, research has continued to show that it works – and that it works with a variety of different oils, though sesame, as noted before, has been the traditional go-to oil.

But it may be taking jars of coconut oila backseat to coconut oil, about which the news seems to get only better.

The latest comes courtesy of a study just published in the Nigerian Medical Journal, which evaluated the impact of coconut oil pulling on the oral health of young adults. All participants had been diagnosed with plaque induced gingivitis (mild gum disease). After just one week, there was “a statistically significant decrease in the plaque and gingival indices” of participants. That improvement continued through the rest of the 30 day testing period.

Of course, one thing this study can’t say is whether a different oil would bring different results. It was a preliminary study, after all. There was no control group. But the authors did speculate on how coconut oil in particular might work – and thus cast some light on one possibility for why it may work better than other oils.

Coconut oil has a high saponification value and is one of the most commonly used oil in making soaps. The soaps produced with coconut oil can lather well and have an increased cleansing action. The lauric acid in the coconut oil can easily react with sodium hydroxide in saliva during oil pulling to form sodium laureate, the main constituent of soap which might be responsible for the cleansing action and decreased plaque accumulation.

The significant reduction in gingivitis can be attributed to decreased plaque accumulation and the anti-inflammatory, emollient effect of coconut oil.

And there might be more. Earlier research – such as this study from 2012 – has shown that coconut oil has pronounced antimicrobial effect. A literature review published last year in IJSS Case Reports & Reviews offers a good summary of additional findings:

Recently, results from many studies revealed that the monolaurin, the monoglycerides of lauric acid from coconut oil had antimicrobial activity against various Gram-positive and Gram-negative organisms, including Escherichia vulneris, Enterobcater spp., Helicobacter pylori, Staphylococcus aureus, Candida spp., including Candida albicans, Candida glabrata, Candida tropicali, Candida parapsilosis, Candida stellatoidea and Candida krusei, as well as enveloped viruses. Though the exact antibacterial mechanism of the action of coconut oil is still unclear, it was hypothesized that monolaurin and other medium chain monoglycerides had the capacity to alter bacterial cell walls, penetrate and disrupt cell membranes, inhibit enzymes involved in energy production and nutrient transfer, leading to the death of the bacteria.

That said, while oil pulling is hardly a replacement for regular old brushing and flossing – let alone a cure for all ills, as some have claimed – it’s easy, inexpensive, and it can give a real boost to your home hygiene, especially if you’re in a constant battle with gum disease. We’ve seen patients really turn conditions around once they begin oil pulling.

Give it a try and see what you think! (Need the hows? Here you go!)

Image by Chiot’s Run, via Flickr

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Biological Terrain & the Development of Chronic Illness

View Dr. Rau’s complete lecture.

Learn more about the biological terrain and its role in illness and health.

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