Three Steps to Achieving Proper Oral Health
(Well, 4, actually...)

Depending on whom you read, from 87% to 98% of all Americans have ‘Periodontal' disease.  Periodontal disease has been recently discovered to lead to risks of heart disease, diabetes, pregnancy problems (low birth weight and premature births), and respiratory disease.

We are dealing with one disease; considering that this one disease has various stages of development or 'decay'.  These stages may have names such as 'cavities', 'gingivitis', 'pyorrhea' or 'Riggs' Disease', etc.  Let's just consider that these are simply stages of the same 'one' disease, referred to as 'Periodontal' disease.

Periodontal disease is caused by the acidic waste by-products from varieties of bacteria and other microflora thriving on sugars created from food particles trapped between teeth.  The microbes are passed from mouth to mouth by kissing, sharing utensils, etc.  In other words, it's contagious.  Early symptoms occur when the bacterial infection spreads from the gum to the bone that supports the teeth.  The pathogens then cause small spaces or crevices to form between the gums and the teeth.  These crevices are called ‘pockets.’  The disease can progress for quite a while without you becoming aware of its advancement because, for the most part, the progression is painless.  When you notice an odor coming from one or more teeth, pain, blood or one or more teeth loosening, the disease is probably at an advanced stage.

There are four things you will want to do:

1.  Know/discern the current status of your oral health.  One way of checking is through microscopic Anti-Infective periodontal testing done at the dentist's office.  If your dentist doesn't do it, inquire about one he or she knows who does do it or call around yourself. Dr. Nara used to offer a saliva test, which would give readings on the levels of Strep Mutans and Lacto Bacillus.

Another way is to know how deep your periodontal pockets (the gaps between your teeth and the surrounding gum tissue) are.  Your hygienist will measure them with a probe right in the Dentist's office and log the depth measurements in millimeters on a chart representing your teeth.  Although this is not going to give you a detailed analysis of the level of microbes present, it will give you a general idea of how much the disease is advancing in your mouth and which areas of the mouth are most affected.  Have the measurements taken and ask for a copy of the chart.  Tape it up in your bathroom next to your mirror so you can have a reference to work with. This procedure is standard in many dental practices and if it isn’t ask for it.


Realize that the purpose for any sort of testing is the comparison of current results with results of subsequent periodic testing in order to get an idea of how well you are doing your job when you clean your teeth.  If you are doing a good job, you are beating the disease, avoiding root canals and will likely keep your teeth healthy for as long as you live.

If any of your pockets are deeper than 2 millimeters (mm), you should procure an oral irrigator.  Normal brushing and flossing cannot usually get deeper than 2mm into the periodontal pocket – and one has to be very thorough to achieve even that depth with a brush.  An oral irrigator is a good tool to have around and can be used even if your pockets are not currently threatened by decay.

Irrigators come in a variety of styles and models, but pay attention to the types of ‘tip’ attachments that come with the unit.  A ‘standard’ tip has a wide opening that will allow you to deliver water or a solution of baking soda and water (or other anti-microbial rinse) to areas in between the teeth and gums, but not too far into the pockets themselves, because of the width of the tip.  The narrower ‘sulcus’ tips are for irrigating pockets between 2mm and 4mm deep.  Beyond 4mm, you will need a cannulae tip, which allows the flow of solution to get deeper into a more affected area.  The Via-jet comes with a set of ‘sulcus tips’ and other units probably come with sulcus tips or have them available as options.

Finally, where the periodontal pockets are found to be deeper than 4mm, a sulcus tip may not do the job.  At this point you will need a special, narrower ‘cannulae’ tip in order to reach deeper into the pocket to deliver the solution when you irrigate.  This type of tip is available for the ViaJet PRO.

2. Fix/repair the problem.  If you have a large amount of decay present in the mouth currently, it would be wise to have the repair work done by a professional one last time, but make the decision to maintain a healthy oral environment from that point on.  If you have a condition where a tooth is cracked or so badly decayed it needs to be repaired or pulled, you should have the work done - but get into the mind set that you will never let things get so bad in the future.

3. If you have deep pockets or other manifestations of decay or infection your dentist may suggest 'periodontal' surgery.  I recommend that you insist on alternatives or locate a dentist willing to work with you on the alternatives.  By that, I mean you may be able to use oral irrigation therapy to kill off bacteria and remove the bacterial waste, which is causing the decay of the teeth, gums and connective tissue between the teeth and gums.  This is possible to do; although by your taking matters in your own hands - at home - means the dentist or the 'specialist' doesn't profit from it as much as when restorative work, surgery or prosthetic work is performed.  You may have to search a little until you locate a professional willing to work with you.  Teeth can remineralize, gums and connective tissue will grow back... but you need to keep the areas very clean and healthy for this to occur - so you need to...

4. Maintain a healthy oral environment.  Once you get things in good shape, keep them that way.  Eat healthy, nutritious foods.  Clean debris from the teeth; brush thoroughly for at least two minutes after each time you eat, floss daily and irrigate the teeth.  Brush your tongue, cheeks and roof of your mouth while doing your teeth. This will keep bacteria from spreading from those areas onto your clean teeth. A type of electronic toothbrush, which has been on the market for the last few years, emits transonic waves, which will actually strip the fibria from microbes, which helps keep them from attaching to the enamel of the tooth.  Two common units are from Braun and Sonicare.  There are probably others, but if you decide to purchase one of these, make sure that it isn’t simply an ‘electric’ toothbrush, where the head simply rotates or moves back and forth.  A good ‘transonic’ type electronic brush will cost on average of $100.

Make it a goal to become 'dentally self-sufficient' this year.  Periodontal disease progression can be painless so you may not even be aware of its presence.  Decide to keep all of your natural teeth in your mouth and your 'dental dollars' in your pocket.

- Tom Cornwell

Read 'Money by the Mouthful' and 'How to Become Dentally Self Sufficient!'

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