October 4, 2010

New Ways to Fight Cavities

One of my patients once told me there is nothing certain in life but death, taxes, and cavities.  Tooth decay has been a problem in human life since creation, and for various reasons, some people are more susceptible than others. There are many wives tales out there that try to explain why people suddenly get cavities and a few of my favorites are: “In my pregnancy my baby just sucked the calcium out my teeth”,  “I lost a tooth for every child”, “Soft teeth run in my family”,  and “I didn’t have any cavities until I went to that dentist”.  Of course, all of these are not true and the latter is like saying I didn’t have cancer until I went to the doctors office, even though you went to the doctor to check out your lump.

Today, modern dentistry knows why people get cavities and tries to help prevent them by educating the public.  For instance, we know that you have to have four factors come together to have a cavity: You have to have a tooth, table sugar (sucrose), bacteria (Streptococcus mutans), and time. In other words, you have to have enough time for the bacteria to eat the sugar to make waste products that harms the teeth.  If you take away any one of these above factors you cannot have a dental cavity (caries).  This is why dentists and dental hygienists have preached over the years to brush and floss your teeth twice a day (time), and to eat sugar-free products (sucrose), or you will have decay (tooth).

Exciting new remedies, break-throughs in bacteriology, along with advancements in fluoride technologies are leading the way to suppressing the prevalence of cavities in the general population of humans around the world.

Xylitol vs Sucrose (table sugar)

There is a massive amount of information being put on the internet about the use of xylitol sugar and the prevention of dental caries.  This is why I tell my patients about xylitol at the chair side so they can understand the importance of using this alternative sugar source in their families daily diet.

Cavities really revved up after human civilization figured out how to mass produce sugar (sucrose) from sugar cane, sugar beat, maple trees and other sources.  Before that in the archeological records caries were not that common.  People instead wore their teeth down from the course diet of grains, fruits, nuts, meats, and many of these food were contaminated with dirt, sand and ground up stone that got in there food during the processing.  Sucrose in our modern diets has become a major health problem, especially in America.  Overweight children and adults, diabetes mellitus, and dental caries are just a few of those problems.  If you were to stretch the definition of poison, you could say that sucrose was actually poisoning us.  Poisoning us to a point that several whole industries have sprung up to try and cope with the problem.  One industry is the sugar substitute market.  Artificial sweeteners and natural sugar substitutes are all the craze. Everyone wants to put something fake on their food to cut down on their natural sugar intake.  I have to admit I like Splenda just because it tastes a lot like natural sugar.  It is actually made from a natural sugar, sucrose.  Splenda is made by chemically changing the sucrose molecule by jamming on 3 chlorine atoms.  Chlorine is in a chemical group called halides which include iodine, and bromine.  The process of working with the chlorine and sugar is not a “Clean” chemical process.  The way I understand it is this process makes a lot of other products as contaminates that we are not really sure what affect they have in our bodies.  No really long term studies have been done on these chemicals or Splenda for that matter.  But since the sugar industry is supplying the sugar for the manufacturing of Splenda, they are not that interested in performing studies to prove harm, like they did with their competitors like cyclamate, and saccharin.  For this reason I try to stay away from Splenda.

Xylitol on the other hand is a natural sugar and not a substitute.  It is tapped out of the birch tree like one would tap a maple tree and about 20 grams a day of xylitol is made in our bodies every day as a primary sugar that shows up in wound healing.  Our bodies make this sugar so it doesn’t have to absorb it from our gut. Sucrose has a diabetic index of 100 and xylitol has an index of only 7.  This means it is safe for diabetics to use in their diet, and xylitol doesn’t become involved in the insulin pathways.  Because it is not absorbed at a high rate it not only doesn’t contribute to weight gain, but it doesn’t contribute to our overall carbon load inside our bodies.  Many people do not know that one of the major ways we get rid of metabolized carbohydrates is through the lungs as CO2.  There is a simple chemical formula medical doctors use involving CO2 and blood pH called the Henderson-Hasselbalch equation which basically says that as the CO2 increases in the body the pH of the blood gets more acidic.  This is important because as your blood gets more acidic the bodily functions do not work as well as they should.  One example is that bones do not hold calcium as well and as you know osteoporosis is becoming very common in our elderly populations.

In the normal flora of bacterial found in human beings mouth is a bacteria called Streptococcus mutans.  It was normally found in the mouth in small amounts and feeds almost exclusively on sucrose, a natural sugar found in small quantities in various natural foods.  Now here comes the problem, as soon as we started to increase sucrose in our diets, so increases the numbers of S. mutans.  In this way, increasing the sucrose in our diets is just like throwing fertilizer on grass.  We call this increase in growth a super-infection because the bacteria is growing at a much high rate in the mouth than it would normally grow with an all natural diet.  This bacteria is a very simple little creature that has receptors on its outer wall that brings into its body carbohydrates (sugars).  Once the sugar is inside the body of the bacteria, it breaks down the sugar and pops out the wastes in the form of products that make plaque.  Adding as little as 6.5 grams of xylitol sugar to your diet throughout the day has been shown in studies to crash the population of S. mutans in your mouth.  Let me tell you how that happens.  Remember the bacteria are simple little creatures.  When they bring in the carbohydrate xylitol into their bodies they cannot figure out how to break it down.  This is a bigger problem than you can imagine for the bacteria.  They are so simple they cannot get rid of a carbohydrate, and after 5-6 weeks of using the xylitol daily the S. mutans can no longer hold any more xylitol and therefor cannot eat any more carbohydrates and the simply stave to death.  Once this happens the population of bacterial that are responsible for the plaque is gone and you cannot get cavities.

The jest of this story is to eat at least 6.5 grams of xylitol throughout the day for 5-6 weeks.  Doing this is surprisingly easy because xylitol is coming in more forms than ever. Chewing gum, mints, granular by the pound, mouthwash, candies, toothpaste, and even nasal spray.  Put in you coffee, tea, water, eat a mint after each meal and before you go to bed.  At our office we advocate that at night before you go to bed brush and floss like regular, rinse with a non-alcoholic mouthwash, and the load your mouth up with xylitol sugar and go to bed.  This protocol will actually help to remineralize incipient caries in your mouth.


Based on more than 30 years of research we now have a new way to prevent tooth decay and it will be sold in the neighborhood grocery stores soon.  It is called EvoraPro and was invented in Gainesville, Florida (Go Gators!).  It contains genetically engineered relatives of S. mutans called S. uberis KJ2, S. oralis KJ3 and S. rattus JH145.  And of course, the mints are flavored with you guessed it, xylitol.  One mint contains 100 million colony forming units of good bacteria to inhabit your mouth and push out the bad bacteria.  Not only does this product help with fighting cavities, but it also helps with periodontal disease.  By controlling periodontal disease causing bacteria that could cause bad breath it becomes a very affective breath freshener.  The pediatric product is called ProBiora.

Got a pet with bad breath?  There’s a product for them, too!  Xylitol free, of course.