New Solutions to Old Problems

Dominic Bosco / Prevention Magazine

Drilling may be on the way out

-at least out of your family's lifeif you heed the words of these dentists
PREVENTION has been talking to some dentists, and we have some good news and
some bad news. We're going to give you the good news first.
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 yopu 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 sae 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.

How Does A Tooth Heal?

Dr. Nara told us just how much healing could be expected from a tooth: "It ranges from
some little pinpoint cavities here and there all the way to a tooth that's rotted right off at
the gum line, you're not going to grow a whole new crown on it. The little ones will
heal, remineralize up to about two millimeters deep. What will happen in a tooth that is
severely decayed is that the stump will firm up. Instead of being soft and mushy, it
develops a leathery consistency. A healed tooth will remain resistant to decay as long as
the oral conditions are beneficial."
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.

Nutrition Very Important

As you might expect, nutrition plays a big part in keeping your teeth healthy. In fact,
checking out a person's nutritional state is the first thing Joel Knapp, D.D.S., of
Hendersonville, Tennessee, does. "First, I take a blood pressure reading to get an idea of
the condition of the blood vessels. A different dental treatment has to be worked out for
someone with high blood pressure. I take a health history and get information on
digestion, allergies, previous illnesses, the person's personality and fears regarding
dental treatment - and diet.
"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."

Using Vitamins
Dr. Knapp treats these problems with good nutrition rather than his drill. "Basically, I
try to get them on a good, well-balanced diet, with vitamin supplementation - mainly
multivitamins. In most cases the patients need to take vitamin C and vitamin E, and
maybe some A and D. For the people with stress problems, I get them on vitamin B
complex, C and E. I get them to eat a high protein diet, low carbohydrates - and
wonderful things happen.
"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."

Calcium vs. Sugar

Drs. Nara and Johansen have their nutritional dos and don'ts, too. In order for the teeth
to heal or remain healthy, Dr. Nara explained, "A person has to have sufficient calcium
in his system so that the saliva contains a fair amount of calcium. A person who is on an
extremely low-calcium diet would not get any remineralization, and the saliva would
not be such as to prevent decay."
Dr. Johansen cautioned against being lulled into thinking that sugarless gum is really
devoid of tooth-decaying sugar. "Sugarless gum isn'tsugarless. 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 brakfast
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.

Use the Right Brush

"You have to use the right kind of brush. A lot of people are brushing with a cheap
brush. You can go to the drugstore and pick up a brush for 25 cents. A cheapie. A good
brush these days is going to cost you at least a dollar. The reason a lot of people are not
cleaning their teeth better is that they're using an inferior instrument. We start off by
giving them a fairly soft brush, with rounded tips."

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.

Reprinted from PREVENTION, October, 1978