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Browsing 23 posts in tooth decay.

One reason to avoid sealants

Sealants. Sold to dentists and patients alike as the cutting edge of minimally invasive and preventive dentistry. The concept was “close those grooves” and you’d save that tooth from getting cavities. The problem is that if the grooves aren’t really explored and cleaned out, under high magnification, then decay can be left accidentally.

In many cases, sealants were being placed by hygienists and dental assistants who aren’t able to diagnose or remove decay. There is a certain mindset that sealants can be placed with no numbing and very little trouble. A lot of these sealants (research suggests 92% after 10 years) are failing, and the result can be big dental problems in the future!

I’ve written about these decay prone grooves in the past. I think that a lot of dental problems in adults come from undertreating these grooves and missing this hidden decay.

Do you have groovy teeth? Or do you not even know? If you’d like to know, we’d love help out! In fact, we’d like to be your Saginaw dentist! Feel free to call the office at (989) 799-9133, request an appointment online or email me at You definitely should have a groovy life, but we’d less groovy teeth!

Warning Labels for Pop

You’ve probably seen it in the news. The FDA will require graphic new warning labels on cigarettes starting in September of 2012.

The labels will be large, covering a large part of the pack of cigarettes. They’ll also be pretty gory. You can see all of the new designs at the FDA’s website.

Some are pretty sure they’ll help reduce smoking. Others are a bit skeptical.

I don’t think that these labels are actually meant to educate smokers about the health risks of cigarettes. Everyone knows that cigarettes are horrible for you in many different ways. What the gruesome photos are meant to do is remind you that you’re making a poor decision right at the time you’re making the decision (when you’re going for a cigarette). Will it help? I’m not sure,but I expect the new regulation will trigger a boom in cigarette case sales.

Dentistry’s version of “everyone knows it’s bad for you but does it anyway” is pop. Or soda for those of you in the northeast. Coke, Pepsi, Mountain Dew, Sun Drop. All that stuff is a double whammy for teeth. The acid in it causes the pH in your mouth to drop, which makes cavities. The sugar in it causes the bugs in your mouth to create acid, which lowers your mouth’s pH, which makes cavities.

Just like cigarettes, there’s no redeeming value to pop, except that people like to drink it.

So why not require a label on each and every soda can that reminds the drinker that they’re making a terrible choice every time they choose to have a pop?

I suggest this:

or perhaps…

Admit it. You might put down the Mountain Dew if you saw this.


Kissing-3 You just had your teeth cleaned.  The doctor is about to examine your teeth and you're crossing your fingers.   The mantra "don't find anything" runs through your head over and over again.  It's a roll of the dice.  Will he find cavities or not?

Most patients think of cavities as an occasional inconvenience that their dentist finds.  A random stroke of bad luck that means another appointment or two with the doctor.  But really tooth decay or dental caries is a disease that is spread similarly to the common cold.  

Tooth decay bugs are spread by oral transmission.  Basically we mean direct contact (kissing) or indirect contact (sharing a glass or spoon).  If you swap saliva in some way, you're sharing cavity bugs.  I know, I know…it's gross.  But let's face it, we human beings tend to kiss on each other (and our babies) and sometimes share glasses or silverware.  We need to be careful who we're sharing with!  Does that new boyfriend you're kissing have any cavities that need attention?  Are you spreading your cavity bugs to that newborn baby?  

In a previous post I described a cavity as a hole in the tooth created by the acid waste products of bacteria.  That much is true, but we're not talking about a clean and sterile hole in the tooth.  This hole is actually a perfect place for cavity causing (acid loving) bugs to live and reproduce.  Each cavity is actually a nidus (or nest) of infection.  

 So after you've thoroughly brushed and flossed your teeth or even after a cleaning by your dental hygienist when all the surface plaque and bacteria has been removed an unrestored cavity is a hideout for cavity bugs.  These bad bugs can reinfect your clean mouth in a matter of hours.  

What I'm saying is…you really shouldn't wait to take care of tooth decay.  It isn't as simple as just fixing the hole that's there.  That hole is a bacterial hideout of the worst kind that's waiting to reinfect your clean mouth and infect the people who are closest to you.  

Now that I've sufficiently grossed you out doesn't that make you want to have a dentist make sure you don't have any bacterial nests lurking in your teeth?  I'd be happy to help you toward a clean bill of dental health!  If you have any questions or would like to make an appointment email me at or call the office at (989) 799-9133 and we'll take a look right away!

On chewing gum

Chewing gum can be good for your teeth.  It also can be bad for your teeth and your jaw joint.  Chewing gum will stimulate saliva, which is the major natural defense your teeth have against cavities.

There are two rules that I have for chewing gum.  Two and a half, really.  They are simple and they are to be followed.  Failure to follow them may cause this Saginaw dentist to hunt you down, call you silly names and revoke your license to chew.

  1. Chew sugarless gum.  Preferably containing xylitol.  There are so many foods and drinks that have an insane amount of sugar in them and many of these don’t have good sugarless options.  There are a ton of really good sugarless gums.  They’ll stimulate saliva flow after meals and make your mouth feel fresh but they don’t give cavity bugs anything to eat.  Win-win.
  2. Chew for 5 minutes or when the flavor is gone, whichever is shorter.  The hard core gum chewers hate this.  Your jaw joints suffer wear and tear like any other joints.  I recommend that you don’t overuse them.  I would compare gum chewing all day long with cracking your knuckles.  It’s a kind of nervous habit.  My evidence is completely anecdotal, but patients that are heavy gum chewers often have a “jaw pop.”  It doesn’t necessarily lead to problems or pathology, but it can be annoying.  So don’t chew too long.

2.5. If you have braces or an orthodontic appliance, don’t chew gum.

These are the rules.  You know the consequences.  Chew wisely.

Questions?  Comments?  Do hard core gum chewers want to send me angry emails?  Email me at:  I return all of my own email and would be happy to answer questions!

By the time it hurts, it’s expensive or “why I wish cavities hurt more”

Extra-extra-paper I can see the headline now: “Saginaw dentist wishes cavities hurt more!”  Film at 11.

Let’s get this out of the way right away.  I don’t want patients to have more pain with their teeth.  It’s just that most cavities don’t hurt.  Patients hardly ever feel a cavity.  Most of the time a cavity becomes noticeable when food gets caught in it.  By the time it hurts there’s probably been irreversible damage to the pulp (nerve and blood vessel deep inside the tooth).

Another painless dental problem is periodontal disease or “gum disease.”  A combination of bacterial toxins and immune system reactions can cause a patient to lose the bone support surrounding their teeth.  Over time this causes a chronic inflammation in the gums and can, over time, cause tooth loss.  It sounds horribly painful when I describe it like that.  But it’s actually painless.

In moderation, pain will cause us to withdraw from a harmful stimulus.  For instance, you yank your hand away from the hot stove.  The pain of a burn, or even a potential burn, causes a quick response which actually helps you avoid more serious injury.

We don’t have that with long term, slow moving dental diseases like tooth decay and gum disease.  And it’s kind of too bad.

More headlines…this one says, “Saginaw dentist thinks it’s too bad that gum disease and cavities aren’t more painful.

It’s just that by the time something is painful we’ve probably added acute inflammation and often infection into the mix.  This makes treatment more expensive and less predictable.  So if you could feel a cavity earlier, maybe we could fix it when it’s cheaper and less expensive to fix.  That’s all I’m saying.  Really.

Dentists don’t really need much help getting bad press.  So I should probably stop while I’m ahead!

Questions, comments or complaints with this post?  Do you want to make an appointment with Saginaw’s premiere blogging dentist? (Me.  I mean me! 😉 )  Call the office at (989) 799-9133 or email me at  I’d love to hear from you!

A groovy video

I was recently searching on Youtube for a video that explains tooth grooves well.  I came across this one.  It's not a bad description, but I think it gets the whole "sealant" concept wrong.  

I almost never place a sealant any more.  I've replaced way too many of them that have a hidden (but large!) cavity underneath them.  The problem is that often the deep and bacteria-laden groove is still there.  I've told a lot of patients that they have "groovy" teeth.  Unfortunately for those who watch Brady Bunch reruns I don't mean "really cool" or "incredibly hip" when I'm referring to groovy teeth.  I mean that these deep grooves make for greater risk of cavities and other dental troubles.  

Keep checking back to for more discussion about risk factors for tooth decay and what you can do about them!  It's going to be my main focus in 2011!

Happy Halloween!

ARRRG Kathy, our office manager, just wanted you to know that we "arrr" here for you when you need us!

Also, we'd like you to review some of our previous posts prior to digging into all of your Halloween "booty."

Brush first, then floss? Floss first, then brush?

So which comes first, the chicken or the egg?  I’ve heard arguments from knowledgeable people for one or the other.  So which is it?

The main argument for “floss first, then brush” is that flossing is nasty.  It’s very important, but kind of gross.  Even in the cleanest mouth, the bacteria that you find under your gum line (known as “anaerobes“) is pretty smelly.  You get stuff on your hands, you get stuff on the mirror and in general, it’s messy.  So if you floss first, then you can brush the nastiness away.

With that said, I’m a strong proponent of “brush first, then floss.”  When you brush with toothpaste, you’re removing the bulk of the plaque on the teeth as well as placing fluoride on the teeth.  This fluoride helps to remineralize spots on the teeth where cavities have started.  However, you can’t really get your brush in the spots between teeth.  This is where the flossing comes in.  When you floss after you brush, you can force the topical fluoride left behind after brushing into the “in-between” spots.  In this way, you’re getting the most benefit of the fluoride from your toothpaste.


So what’s the solution for the nastiness of flossing?  My new favorite dental health product: ACT Total Care Mouthwash.  I can see the headlines now: “Saginaw Dentist Shills for Big Pharma.”  What I like about this stuff is that it tastes really good, like a mouthwash, but also delivers an “over the counter” dose of fluoride as well.  There are probably other brands that have both a fresh, minty finish as well as fluoride, but I haven’t seen them yet.

So try both out.  See what you think and let me know at  Honestly, if you’re one of the few people who floss each and every day, I don’t really care when you do it…just keep doing it!

Why so dry? Dry mouth and what you can do about it.

Dry  One of the main causes of tooth decay is dry mouth (also known as xerostomia) caused by low saliva flow.  The saliva in your mouth is your main natural defense against cavities and tooth decay.

What causes dry mouth?  There can be many causes but usually it's a combination of these:

  • medications
    • more than 400 medications have dry mouth as a side effect and the number keeps growing
    • blood pressure medications and antidepressant medications are known for their dry mouth side effects
  • disease
    •  Diabetes, HIV/AIDS and Sjogren's syndrome are known to reduce salivary flow significantly
  • cancer treatment
    • radiation therapy of the head and neck can damage the salivary glands reducing salivary flow to almost nothing 
    • chemotherapy drugs can cause saliva to become much thicker causing the mouth to feel uncomfortably dry
  • nerve damage
    • injury to the nerves of the head and neck can limit the signals going to the salivary glands which tell them to produce saliva 
  • diet
    • foods containing caffeine can reduce salivary flow
    • salty foods can make the mouth feel particularly dry 
  • tobacco use
    • the smoke from cigarettes has a drying effect in the mouth
    • the nicotine from tobacco reduces salivary flow 

What can you do about dry mouth?  Treatments are tailored to the cause of xerostomia when it can be diagnosed.  

  • xerostomia that's caused by a medication can sometimes be helped by changing the medication or changing the dosage.  This would need to be done by the prescribing physician.
  • for salivary glands that are damaged or not functioning completely there are some medications that can help stimulate salivary flow.
  • there are some salivary substitutes that can be helpful.
  • sleep with a humidifier
  • chew sugarless gum or mints (preferably sweetened with xylitol) to help stimulate salivary flow
  • sip on water throughout the day and particularly at meals
  • brush and floss regularly
  • don't smoke or chew tobacco (one more excellent reason not to!)

Dry mouth is very common.  Make sure to let your doctor and dentist know that you're experiencing it because there are things that can be done!  If you have dry mouth and are looking for some help feel free to drop me an email at or call the office at (989) 799-9133.  We'd be happy to help!

Attention gum chewers…

This is what you should be chewing.


Before I’m accused of being a corporate shill for Hershey’s (I can see the headlines: “Saginaw Dentist Sells Out to Chocolate Company!”) let me explain.

It seems that Ice Breakers Ice Cubes are the only gum sweetened with xylitol that can be found easily in stores. There are a ton of xylitol gums out there, but I just haven’t seen them around.  If anyone else has, please feel free to comment and prove me wrong.

Why should you care?  Because xylitol is proven to be good for teeth.  Specifically, xylitol cannot be broken down by the bad bacteria found in your mouth in the same way that regular sugars are.  Which means that xylitol cannot be used to create acid by those bacteria, which means that this acid can’t attack your teeth and cause cavities.

Even better is the fact that xylitol is taken up by the bad bacteria and they can’t do anything with it.  For lack of a better description…it kind of constipates them!  Over time, using a xylitol gum can actually change the make up of the bacteria in your mouth.  It actually gives the advantage to the “less bad” bacteria!  Cool stuff.

So all the gum chewers out there need to go out and try some xylitol gum.  Check the ingredients on the box and try it out.  Your teeth will love you for it!

If you have any questions or comments please feel free to email me at  We would love to hear from you!

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