NOTE: Be sure to read the disclaimer at the end of this article. This is an old article revived because people still search for it. It hasn’t been updated in years. I also haven’t been to a dentist in years. The concepts below are still useful, but as I said, read the disclaimer at the end of this article.
Tooth Health: Cure for Cavities
Created 1/24/2002 – Updates 4/13/2007
Ten cavities?! That’s what I had a few years ago. I consulted Google, created this page and then I healed five cavities. Amazing!
Do cavities in teeth heal? Yes, they really do. I had two of my ten cavities filled. I then gave up refined sugar and did some other things below. A few years later I had only three cavities. I had these filled by a laser dentist. (No needles!) Assuming competent dentists read my X-rays correctly at the start and finish, I healed five of them.
I remained cavity free as of 4-13-2007. I believe most of you can be too. Note: I’m a science writer and researcher, not a dentist, but a few dentists from around the world have written to say this article is a useful review. Read on and then go heal your teeth. Updates or corrections welcome, leave a comment. Please check the sources (numbers) and confirm facts yourself.
1. A bacterial disease | 2. What is s. mutans? | 3. Evidence s. mutans Causes Cavities | 4. How s mutans causes cavities | 5. Fluoride | 6. Growing on your toothbrush | 7. My S Mutans Test Results | 8. Mouth wash | 9. Hiding inside your teeth | 10. Bacteria are Inside Gum Crevices | 11. Acid reflux | 12. Killer toothpaste | 13. Vaccine | 14.Tobacco? | 15. Status of CaroRx | 16. Status of Cavity Inoculation | 17. (re)Population Problem | 18. Salivary Flow | 19. Remineralization: Teeth Do Heal! | 20. Stop the Acid! | 21. Re growing Teeth | 22. Recaldent | 23. Xylotol | 24. X-Rays (Radiographs) | 25. Dental Cleanings | 26. Poking Around | 27. Changing Your Mouth Bacteria | 28. The Solution | 29. Giving up Sugar Results | 30. Things You Should Do | 31. Laser Dentistry | 32.References
A Bacterial Disease
The biggest secret I learned is this: Dental cavities are primarily the result of a communicable disease spread through the transmission of bacteria!
“I have been working in dentistry for 27 years and I have no idea what you are talking about.” – dental receptionist when asked if her office will test for S. mutans.
One certain cause of cavities is the bacteria named mutans streptococci. (1) According to the dental school at UCLA, if the percentage of S. mutans in plaque is in the range 2-10%, a person’s risk for cavities is high. If S. mutans can be reduced to 0.1% cavity risk is low. (2)
What is s mutans?
S. mutans is actually a group of seven closely related bacteria. (3) According to another source, S. mutans comprises thousands of different strains. (4) The photo below is from tokushima-u.ac.jp:
Evidence that s. mutans Causes Cavities
The evidence includes:
1. A significant correlation between S. mutans counts in saliva and plaque and the incidence of caries.
2. The correlation of S. mutans counts and the progression of tooth decay.
3. S. mutans can be isolated from the tooth surface before initiation of a cavity.
4. Infection of experimental animals with S. mutans produces high incidence of caries.
5. Immunization of experimental animals with S. mutans significantly reduces the incidence of caries. (What?! You can immunize animals against cavities? Why not humans? Read on.)
6. S. mutans produces copious amounts of extra cellular polysaccharide, a key component of plaque.
7. S. mutans metabolism of sucrose rapidly produces an organic acid which de mineralizes tooth enamel. (3,6,7) (Acid production occurs about 5 minutes after you eat sugar.)
How S. Mutans (and company) Cause Cavities
The “fuzzy” feeling felt on poorly brushed teeth is an accumulation of bacteria. (8) There are many species of bacteria in your mouth (and throughout your digestive system ) at all times. Some are helpful and even essential to our health. We now know that some types of bacteria in your mouth form plaque and cause cavities.
The S. mutans bacteria is facultative, that is, it can live with or without oxygen. (9) When the cells at the bottom of the plaque run out of oxygen, they switch from aerobic respiration (using oxygen) to the fermentation (10) of fructose, producing lactic acid (11) which eventually breaks down teeth and causes cavities.
The S. mutans, gordonii, and salivarius bacteria all ferment sugars to get energy for reproduction. S. mutans breaks sucrose (a sugar)(12) into glucose (13) and fructose (14), and ferments fructose for energy. S. gordonii ferments both sucrose and high fructose corn syrup. (15) S. salivarius can ferment glucose, sucrose, and usually lactose.
Glucose is polymerized (16)(joined into large molecules) into an extra cellular (outside the bacteria) dextran capsule (17) (protective layer) which cements the bacteria to the tooth enamel. The capsule is 300 to 500 cells thick and is the matrix of dental plaque. (18)
Shortly after you brush, a pellicle (thin protein film from saliva) forms on your teeth and the sticky dextran capsule of S. mutans sticks to this. Other microorganisms colonize the accumulations of dextran. Dental plaque forms primarily from S. mutans and filamentous Actinomyces, although it is estimated plaque contains up to 400 distinct bacterial species. (19) Lactic acid from carbohydrate (sugar) fermentation destroys tooth enamel at the site of the plaque. (20)
Fluoride fights cavities in part by decreasing demineralization (21) and increasing remineralization. (22) (also see below) The element fluorine (23), the most chemically reactive of the halogens (24), will bind almost any other element to form a fluoride. (“ide” on the end means there is an ionic compound (25) of two elements (26). So, there are different fluorides depending on what other element binds with fluorine.) Think of fluorine as super sticky dust that grabs everything nearby. It helps glue minerals into your teeth and to keep them there. So far, so good!
Fluorine’s reactive property also causes it to inhibit the function of some enzymes (like enolase (27)) essential to bacteria’s ability to produce acid. Acid from bacteria causes loss of minerals from the tooth and eventually a hole or cavity, so stopping the acid production sounds nice as well … until you realize that we humans have enzymes too.
“There is plenty of evidence to indicate that fluorine in the amount of 1 ppm or slightly more interferes with enzyme systems and these enzyme systems are involved in the growth of bones, in the functioning of nerve tissue and so forth…” (Dr. Robert S. Harris, (Ph.D.), Director of Nutritional Biochemistry Laboratories, Massachusetts Institute of Technology.) – fluoridedebate.com (28)
I had frequent treatments as a kid. I still recall eating red fluoride pills (29). Am I now being overly cautious by avoiding fluoride? Perhaps I am jeopardizing the health of my teeth as some dentists claim, but based on my research my personal choice has been to avoid it. I’ve avoided it for years due to claims of weakened bones (30), a lowered IQ (31), cancer (32), thyroid dysfunction (33), anemia (34), liver disease (35 ), heart disease (36), Down’s syndrome (37), and others. Many hold that fluoride is a politically protected poisonous industrial waste. I’ve also read that fluoride is a byproduct of atomic bomb production. (38) Documents obtained by researchers seem to support the claim that it was sold to the public as beneficial to teeth with bogus studies in order to protect early interests in its use.
Believe this part or not, but my personal experience is that I healed five cavities without fluoride. No matter where you stand on the fluoride debate, it seems most reasonable to focus on the cause of cavities, the microscopic tooth eating beastliest themselves.
Bacteria Are GROWING on Your Tooth Brush!
A clean mouth is very important because germs that cause disease enter your bloodstream through tears in your gums. (39) USA Today reported that your toothbrush may be “the most serious threat to your everyday health”.
A study used an electron microscope to view the bacteria on toothbrushes. Those rinsed with sterile tap water saw bacterial growth, but those dipped in 0.12% chore glaucoma; or 1% sodium hypochlorite (bleach) had no growth. (40) Obviously, STEP 1 in getting rid of cavities should be to kill the gunk on your toothbrush. Chlorhexidine may only be available a dentist’s prescription. I was prescribed some, but did not find it necessary to heal my cavities.
The Purebrush Antibacterial Toothbrush Sanitizer uses ultraviolet light to kill bacteria as well as viruses and yeasts. (41,42) It is currently on sale without a prescription for $69.95 after tax. It ships in 3-5 business days. I used this device for several months before going to the University of California, San Francisco Dental School for S. mutans tests, but still had the bacteria. ( Possible reasons detailed below.) A more expensive toothbrush steamer at germterminator.com (43) claims to kill germs, but the test results they sent me show germ killing happens at steaming times longer than the system they sell actually uses. It may just be cheaper to boil your toothbrush in salt water every few days! Bring water to a full rolling boil for at least 1 minute to kill most infectious organisms. Also, you should buy a new tooth brush at least once a month.
My S. Mutans Test Results
Dr. White from UCSF wrote on June 18, 2002 that my s. mutans level was “high”, and lactobacillus low.
“S mutans 97,000 CFU High
Lactobacillus 310 CFU Low”
CFU = colony forming units. A Japanese article ( 44 ) showed that I was actually in the Low area according to the scale for that test. (Did my UV toothbrush holder help?) I finally had time to write for clarification 4 months later. “Is that 97,000 CFU per ml saliva?” Yes. On 10-2-02 Dr. White wrote “Your goal is to get to 10,000 CFU per ml of saliva Strep mutans to decrease your bacterial challenge!”
Colony forming units (CFU) S. mutans/ml saliva Class 0-1 <100,000 Class 2 100,000 <CFU/ml <1,000,000 Class 3 >1,000,000 CFU/ml
High or low, I was obviously not killing all the s mutans the bacteria in my mouth, even if I was killing them on my toothbrush.
What About Mouthwash?
One dentist I asked said mouthwash “kills germs” but said it didn’t reduce cavities. This did not make sense to me. If by “germs” they mean s. mutans, then cavities should be reduced by the use of mouthwash, right? According to one study: Rinsing with 20 ml of Listerine Antiseptic for 30 seconds twice per day for 11 days produced respective reductions of 69.9% and 75.4% in total recoverable streptococci and in S. mutans in plaque, and corresponding reductions of 50.8% and 39.2% in saliva. ( 45 )
The drug company, Pfizer, has been told by a federal judge that their advertising which claims Listerine is just as effective at fighting plaque and gingivitis as the use of dental floss is misleading. McNeil-PPC, a unit of Johnson & Johnson, sued Pfizer saying the ads were a threat to dental floss sales. ( 46 )
Recommendation: Use both mouthwash and floss. My choice for floss is Eco-dent with essential oils found in mouthwash. The active ingredients of Listerine are called essential oils and they include Thymol 0.064% (kills fungus 47 ), Eucalypol 0.092%, Methyl Salicylate 0.060% and Menthol 0.042%. Tests at Weber State University by Dr. Gary Young found certain essential oils kill 99.96% of airborne bacteria, although some say Young’s knowledge of basic science is lacking. ( 161 )
For a while I was using Biotene mouthwash. I previously used Listerine mouthwash daily and I still had high counts, however.
Bacteria are Inside Teeth, Hiding from Mouthwash
The dentists I consulted said bacteria that cause cavities are INSIDE teeth, under the surface. Mouthwash can’t reach them. Interesting. Another said that bacteria can not be inside the teeth in the microtubules, otherwise they would infect the root.
We saw above that plaque is 300 to 500 cells thick with s. Mutans. How does this layer interact with the tooth surface? How big are s. mutans bacteria? How do they hide from the active ingredients in mouthwash?
In healthy enamel strands are 100,000 by 50 by 25 nanometers. (49) Each green bundle (artificially collored in the photo for clarity) below is made up of many enamel strands and each bundle is about 5 micrometers (microns) in diameter (50) or about five times as wide as a single s mutans bacteria.
Above is an electron micrograph of enamel crystals organized in bundles called prisms. These extremely long and parallel organized hydroxyapatite (51) crystals are often organized perpendicular to each other. The figure is colorized to show the organization. (52) You can see that from the perspective of a bacteria, the surface is rough and there may be many places to hide. It seems evident from this photo, however, that bacteria would not be able to penetrate healthy enamel unless they break it down first.
Remaining questions about mouthwash: 1. How exactly does it kill bacteria? How effective is it at killing s mutans? 2. As they get into your teeth, do the bacteria leave behind any kind of barrier to keep the mouthwash out?
Bacteria are Inside Gum Crevices
One s. mutans bacteria about 1 micron in diameter, about 1/5th the size of a human red blood cell. Unfortunately, “There are more Strep Mutans bacteria in a single drop of dental plaque than there are humans on earth.” One micron (53) (also called a micrometer) is one thousandth of a millimeter. (54) Since normal pockets where your gums overlap your teeth are 1 to 4 millimeters deep, gobs of bacteria can and do hide in your gum pockets.
“The electric toothbrushes, Sonicare and the Oral-B Braun 3-D claim to clean up to 2 or 3 millimeters past the bristle tips, or about 3.5 or 4.5 millimeters (55) into gum crevices, although this is debatable.”
For various reasons, for example, hiatal hernia, some people suffer from stomach acid rising during the night. According to Dr. White at UCSF, acid reflux “diminishes protective factors” but has a different pattern of demineralization than caries (cavities caused by bacteria). A clinical exam at UCSF by Dr. White can determine if stomach acid is the cause of cavities.
By the way, I’ve fixed my acid problem by eating better, exercising, loosening my belt and sleeping slightly propped up. The acid reflux drugs I tried were terrible. A better diet and exercise was the key. Also, I did NOT have to give up spicy foods. I love them and I still eat them almost daily. It seems that giving up sugar to fix my cavity problem also fixed my stomach acid problem.
Now that we know the goal is to kill the bacteria that cause cavities, why not use a toothpaste that has anti microbial agents (56)? Human saliva contains anti-microbial proteins and peptides such as lactoferrin (57), lactoperoxidase (58) and lysozyme (59). Lactoferrin (LF) is an iron binding glycoprotein; a natural component of many body fluids such as tears, blood, milk and saliva. It is an important part of your defense system against invading microorganisms because of its wide anti-microbial properties. The question is, does it kill s. mutans? Some research I found says LF kills s. mutans only when oxygen is present. (60,61)
At pure-milk-calcium.com (62) I found a toothpaste with lactoferrin selling for about $5 per tube plus $5 shipping. The site is run by an independent rep who sells for a company in Quebec Canada, but there is no problem with US sales. The toothpaste was originally created by an oral surgeon. On 5-24-02 I ordered a few tubes and sent a request for any studies relating to lactoferrin’s action on s. mutans, lactobacillus, and Actinomyces viscosus.
The salesman has only been using the toothpaste for 3 months. The salesman had said his son’s stomach problems went away when he started using the toothpaste. My experience was the opposite. I tried this, but stopped when I had a sick stomach after using it.
For a while I was using Kiss My Face organic Whitening Toothpaste. I still use Eco-DenT (63) “Daily Care” Tooth Powder.
Tooth Decay Vaccine?
Successful trials with human subjects have been conducted. For example, a Fall 1999 article from the University of Alabama at Birmingham states: “Microbiologist Suzanne Michalek, Ph.D. (64), and pediatric dentist Noel Childers, D.D.S., Ph.D., have developed an anti cavity vaccine that is being administered to volunteers in a nasal spray rather than in a hypodermic needle. (65)
In Winter 2005, Dr. Michaleck replied to an email request for an update, saying “Regarding our study, we had very encouraging results that the vaccine significantly delayed the re colonization of the bacterium that causes tooth decay. We are very excited about our findings and are continuing our studies.”
In response to follow up questions: “We have been doing human trial studies with our various vaccine candidates. … The delayed colonization was months without a boost.”
The Dr. was unable to provide more details because the technology will be patented, but included references for her earlier publications. (66,67,68)
Another human vaccine that delayed bacterial repopulation by years and looked promising may be even further along.
“British scientists say they’ve developed a vaccine to prevent tooth decay by eliminating bacteria from the mouth, according to reports from CNN. The American Dental Association’s (ADA) Division of Science believes that the initial research results appear promising in the ongoing fight against tooth decay. The ADA looks forward to additional long-term studies that validate the results as reported. The new vaccine is a plant-based substance that is painted on teeth and allegedly produces antibodies that prevent harmful bacteria (streptococcus mutans) from sticking to teeth and causing cavities.
The vaccine was developed by California-based Planet Biotechnology (69) and tested at Guy’s Hospital in London, CNN reports. The tasteless, colorless vaccine was tested on people during a four-month trial. Volunteers received the vaccine twice a week for three weeks for a total of six applications. According to the researchers, a mouth rinse was first used to reduce the levels of bacteria in the volunteers to zero.
Then they applied a control, or placebo (70) solution to some patients and the vaccine to others. Within two months, the bacteria returned to the mouths of the control group while those who received the vaccine were reportedly protected for up to four months. Dr. Julian Ma and Professor Tom Lecher led the team of researchers at Guys Hospital dental school where the testing took place. The scientific trials are reported in the May issue of Nature Medicine. ADA scientists are looking forward to examining and validating the results from this as well as larger clinical trials.
The ADA science staff adds that a variety of research endeavors have been underway to explore the possibility of developing a caries vaccine for more than 20 years. The Association is hopeful that a safe, effective vaccine can be developed for the public. The company is hoping to have the vaccine available for consumers in 2001 or 2002, according to news reports.” (71,72)
Status of Cavity Inoculation
Will we ever see a product? The answer years ago was, “a few more years.” In 2005 the answer was, “In a few years.” Well, it’s 2007 … we’re still waiting.
2005: “PLANET has secured a leading European development and marketing partner for CaroRx(tm) and plans to create revenues from the sale of this product within 3 years.” (73)
On 5/23/2002 I asked Dr. White at the University of California, San Francisco Dental School about a cavity vaccine and he said:
“We haven’t had any luck in doing so because everybody repopulates. The best therapy we have is, what you’re going to get.”
What I was given to take was a high dose of fluoride and chlorhexidine gluconate. I postponed these treatments until I could get the results of my saliva’s bacterial counts and fluoride concentration tests. My sixth sense told me to avoid chlorhexidine and I’m glad I never did use it because a 2004 study (162) shows it causes DNA damage. It is especially bad for your kidney cells and white blood cells.
On 12/17/2002 I finally got the fluoride results from the Dr.’s busy assistant. Fluoride 34 (Med 0.03-0.08 ppm). I asked if this means .03 to .08 ppm of fluoride per ml of saliva, but as of 1/7/2002 I’d had no reply.
As of March 2005, I had not used the fluoride, chlorhexidine nor any vaccines and I was 100% cavity free. Some day we may have vaccines. Some day we may be able to eat sugar with no ill effects. But to heal your cavities starting right now, follow the tips below. You too can kill off your own personal collection of tooth eating micro-monsters with healthy things like honey, wasabi and cashews!
The (re)Population Problem
From where are the bacteria repopulating? Are they just all over in food?
“Yes, ah, they usually (repopulate) from kissing their spouse, trading toothbrushes, like that and from the oral pharinx. Can’t sterilize. So its an ecological experiment. It’s ecology, not eradication. Can’t eradicate it.”
Well immunization means the production of antibodies, right?
“Right. We did anti-body experiments and it didn’t work any better. We’re still not there yet. In the future, may be, but we’re not there yet.”
So it does work in animals, but only because you can isolate the animal from getting repopulated?
Dr White: “Correct. Yup. Not humans unfortunately. ”
If it did work, would a caries vaccine cause a loss of millions of dollars for dentists everywhere who fill cavities? I didn’t ask this question.
Good salivary flow is an important part of preventing cavities. Dry mouth, for example, from dental x-rays, causes cavity causing bacteria to increase in numbers above non-cavity causing bacteria. (150) Avoiding dry mouth is a reason dentists recommend chewing sugarless gum. According to Dr. White: “When I look at your salivary function, you’ve got normal wet saliva and you were able to spit 3 ml in less than 5 minutes so that’s not an issue.” The reason saliva is important is that teeth are not solid. Teeth are a protein matrix, a structure with calcium and other minerals filling the holes. Acid takes away these minerals (demineralization) (21) and eventually breaks down the matrix itself, causing cavities. Saliva delivers calcium and other minerals to be deposited in the matrix (remineralization) ( 22 ) and rebuilds your teeth!
Remineralization: Teeth Do Heal!
As long as you remove the infection and stress, bones heal. In fact, after a bone heals it may even be stronger than the original. (74) Do teeth heal? Yes.
A cavity is a hole in your tooth’s enamel. Enamel is the hardest and most mineralized substance in your body. (75) Minerals such as calcium are constantly entering and leaving your teeth. Before a hole forms, there is a constant battle between demineralization and remineralization. Saliva is supersaturated (76) with calcium as well as phosphate (77) at pH 7 (78) and it deposits minerals in the porous enamel areas demineralized by acids. This process is known as remineralization.
Remineralization is a dynamic balance:
calcium hydroxyapatite (teeth) + acid <> calcium phosphate and water
According to my (former) dentist, once the protein matrix has failed, a hole in a tooth will not fill in. This statement is confusing to me because there isn’t much protein matrix in adult tooth enamel. During the formation of enamel, nearly all of the protein matrix (mostly amelogenin (79) proteins) is removed before final mineralization when teeth form. “More than 98 percent of tooth enamel consists of carbonated calcium hydroxy-apatite,” according to CCMB research professor A.G. Fincham. “Essentially, your teeth are made of rock.” (80) What are the real limits of remineralization (81)? How much enamel can be destroyed and still re-grow?
I gave up sugar drinks on 1/24/02, the day I was diagnosed with 10 cavities and the day started this article. I had an ugly cavity on a crooked front tooth. I could clearly see the hole. I could feel the hole with my fingernail. In fact, my dentist poked a metal poker into the cavity causing me to ask about the spread of bacteria. On 5/30/02, 5 months later, there was still discoloration under the tooth, but the hole seemed to be sealing. I still decided to have it filled for cosmetic reasons. My dentist commented that it had not gotten any worse since she last looked at it 5 months ago.
One thing is certain, filling cavities does not stop the bacteria that cause cavities.
Stop the Acid!
Acid in saliva will cause minerals in teeth to dissolve out into your saliva. Adding alkali will cause minerals to deposit into and onto teeth. You can neutralize acids formed in plaque using baking soda, but timing is essential. Fitmouth (82) recommends that you neutralize or dilute plaque acids within 10 minutes of eating and for at least 20 minutes afterwards, matching the amount of time you ate with the time you swish a backing soda solution in your mouth. I never did anything that drastic, but it makes some sense. Try it and let me know, but be sure to spit! Don’t drink the baking soda solution. Eating or drinking too much sodium is not healthy.
“As a buffer, Baking Soda tends to cause acid solutions to become more basic and to cause basic solutions to become more acid, bringing both solutions to a stable pH around 8.1 (slightly basic) on the pH scale.”
Quote was from armandhammer, page now removed. Closest match here: (83)
Mix 1 tsp of baking soda in a half glass of water and swoosh and rinse with it. This will alkalize your mouth. Avoid baking soda toothpastes that contain peroxides which can irritate and damage gum tissue and can be dangerous.
Re growing Teeth?
One team has successfully synthesized tooth enamel (84). Ameloblasts are spherical cells about 1/500th the size of a red blood cell (18 to 20 nanometers in diameter) which in embryonic tooth buds secrete amelogenin (79) proteins. Amelogenins self-assemble and form an extra cellular matrix within which inorganic crystals of mineral form.
“Materials now used to fill cavities all have some drawbacks. For example, porcelain is very hard, which helps it last but also causes wear on teeth that come into contact with one that’s been filled.
… Enamel is special — the cells in the mature enamel are already dead, unlike bone or skin. Mature enamel is pure chemicals, so we think there might be a pure chemical way to create enamel,” Chen said.
… Clarkson believes it’s possible they could have an enamel-like composite within a year, and produce crowns suitable for repairing decayed teeth within about four years. Perhaps even before crowns, they could produce thin films that could act as a sort of enamel bandage over a cavity that’s just begun. (84)
Calcium is an element that can be bound to other atoms to make different compounds. To get calcium in a form you can use, try Trident gum with ReCaldent (85). At one point during my consultation, Dr. White of UCSF Dental School said, “We can’t do much about the protein and calcium phosphates in your saliva, but we can increase the fluoride in your saliva.” When asked if the ReCaldent helps, Dr. White said, “Yeah, there’s Xylotol right there” on the paper with different risk factors and protective factors he gave me. Xylotol is just a non sugar sweetener. It gives you something sweet that bacteria can’t eat. The Dr’s answer about Xylotol didn’t address the question about ReCaldent exactly. According to its makers, ReCaldent adds calcium to your saliva, thereby increasing remineralization.
“Strep Mutans cannot metabolize Xylotol, which is a type of sugar alcohol that is used as a sweetener. In fact Xylotol actually seems to damage Strep Mutans.” (86)
I found references to Xylotol tolerant S. mutans, however. (87) When exposed to Xylotol, some bacteria become more tolerant and one study showed that “Xylotol-containing snacks and candy did not reduce S. mutans levels.” (88)
Are there any risks of Xylotol? Yes, some. More than 60 grams per day can be hazardous for diabetics. According to one site, diabetics should be careful. Large amounts of Xylotol cause the liver to “convert the excess to glucose, simple sugar, and if enough insulin is not produced to handle the increase in glucose, high blood sugar and the associated risk factors are imminent.” (89)
I found an interesting comment on one page (90) that said X-rays show only cavities that are one to two years old. The most modern method may be the use of high-intensity light to measure loss of calcium or phosphate from a tooth.
Here you can see a radiograph of one of my own cavities from Sept 20, 2001. In the picture, all the very white on top are previous fillings. The black indentation underneath the white point is where the bacteria have eaten into my tooth. Reading x-rays is difficult but this example is pretty easy to see. A larger x-ray of the whole area is below. (How many web pages give you an actual x-ray of the webmaster’s teeth? Only here baby.)
Before you actually have a cavity, you can see where the minerals of the tooth have started to disappear. These areas can be re mineralized with enhanced salivary flow. In fact, about 60% of caries extending just into the dentin have not “cavitated” (broken through showing a hole) on the surface. (91)
The year before I had my diagnosis of 10 cavities, I had stepped up my dental cleanings to once every 3 months. The situation in my case got much worse with the regular cleanings. According to DR. ROBERT O. NARA, D.D.S. speaking at Total Health ’87, every time you have your teeth cleaned, you lose about 2 to 3 microns of your enamel. “Even in dental professional literature, they state that there is probably some damage to the root surfaces when they scrape with these scalers.” (92) In other words, one wonders if the cleaning process drums up extra business for dentists by weakening teeth and eventually allowing more cavities. What seems to be the cure, is actually the cause? On 10/1/02, I called my dentist to cancel all future cleanings until my dentist could show me a published peer-reviewed study where cleanings were effective in preventing cavities. On 5/30/03, I had a reply, but not the kind I expected!
According to this Boston Globe article, “in actuality, there’s so little evidence on the right interval for cleaning that the authors of a 1994 study in the Journal of Dental Education concluded it may be time to call all clinical dogma regarding treatment of adult periodontitis into question.” (93)
My previous dentist felt it is “important to develop a sound program of routine dental care” (cleanings). But what about all the people who never go to dentists and who never get cavities? Is it important for them too? Or just for people at risk for cavities? Could it be that some “sound” dental programs actually spread s. mutans and weaken the protective coating on your teeth? Could my dentist find no research to support the efficacy of dental cleanings in reducing cavities? Perhaps it was much easier to get rid of a trouble patient than to face the possibility that a long held cure was actually part of the cause. My previous dentist did confess frustration at an inability to get a handle on my caries problem. ( At the time, however, I was drinking lemonade for dinner every night, sweetened juice for breakfast, and soda for lunch. )
2-22-2005: Above is a photo I found of a guy with REALLY bad calculus (that’s not me!). My dentist today said tarter (calculus) is composed of mineral encrusted dried plaque. It is mostly dead bacteria, not live bacteria. The minerals in tarter come not from your teeth, but from your saliva. Tarter is not pre-tooth decay.
So, I asked: Does removing calculus allow saliva to re-mineralize teeth better?”
His answer: No, you don’t remove it to protect teeth. You won’t get cavities where there is calculus. The calculus protects the teeth from getting cavities, but dentists remove it to protect your gums. Calculus allows the growth of micro-organisms that can lead to gum disease. He said he is careful not to scrape unless it is needed. That made sense, so, I went ahead and got a cleaning today.
9-6-2005: I have had some sensitivity in one tooth since that cleaning, but an X-ray showed no cavity.
Now that we know bacteria is the cause of cavities, have you ever wondered why dentists take a pointy metal object and poke INTO the cavity in your tooth? Are they purposefully or accidentally pushing the bacteria deeper into your tooth?! According to Dr. White, “Nyah. Nyah. They go pretty deep just on their very own. They’re pretty small and they’re fine at migrating.” (Nyah? Is that a hybrid of no and yeah? Hmm.)
Know Your Enemy: Streptococcus mutans
Scientists can get S. mutans (94) for experiments. It is shipped freeze-dried and grown on Trypticase soy agar (95) with 5% defibrinated sheep blood.
We are well on the way to knowing exactly what makes these little tooth decay beasts tick. For at least one strain, the entire genetic code has been determined. “The genome of S. mutans UA159, a serotype c strain, has been completely sequenced and is composed of 2,030,936 base pairs. .. The genome analysis provides further insight into how S. mutans has adapted to surviving the oral environment through resource acquisition, defense against host factors, and use of gene products that maintain its niche against microbial competitors.” (96)
The genus Streptococcus (derived from the Greek streptos, twisted: kokkos, a bunch of grapes) is a genus of non-motile ( they don’t move on their own ), non-spore forming, aerobic to facultatively anaerobic bacteria. (97) The genus is comprised of Gram-positive, microaerophilic cocci (round), which occur in chains or pairs. – (98,99,100) S. mutans LOVES carbohydrates (darn, so do I) — so much that it stores its own carbohydrates in its cells for time when you don’t feed it carbohydrates and when it becomes “buried” in plaque and is unable to easily get them from your diet. How long can s. mutans survive without sugar or starch? Unfortunately, almost all bacteria can become dormant when starved, start to grow again very quickly once nutrients are available. Again, what is its life cycle? What radiation (light, heat, etc.) is harmless to you but deadly to s. mutans?
According to the dentalcomfortzone (101) antibiotics can cause dangerous allergic reactions as well as produce resistance strains of bacteria. Some research according to the site states that more people “got sick and died from taking the antibiotics prior to dental treatment” than were helped by taking antibiotics to avoid heart disease (subacute bacterial endocarditis (102)) caused by bacteria from teeth. Streptococcal infections with most strains still sensitive to penicillin and erythromycin (103) but this doesn’t seem worth the risk.
Cavity Vaccine Patents
Take a look at US Patent US04150116 (104), titled Immunization against dental caries with glucosyltransferase antigens. This is from April 17, 1979. How about US05352446 (105), or this US04324782 (106) which says you can eat s. mutans and gain cavity immunity. Were any of these ever tested in clinical trials?
Kissing and Cavities
I did a double-take when I read that Heidi K. Hausauer, DDS, FAGD (510) 538-3334 spokesperson from the The Academy of General Dentistry (107) recommends kissing to prevent cavities “because it stimulates saliva production, which helps reduce the incidence of decay.” There is no mention in the article (108) of bacteria or the fact that caries is a transmissible disease.
“The mission of the Academy of General Dentistry is to serve the needs and represent the interests of general dentists, to promote the oral health of the public, and to foster continued proficiency of general dentists through quality continuing dental education in order to better serve the public.”
Is oral health secondary to the first part of the mission: represent the dentists? Does that mean drumming up more business by causing the spread of cavity causing bacteria? It seems so. A similar story was run by CNN (109), February 14, 1999. The statement about kissing reducing cavities is at odds with this fact: “The bacteria that cause cavities may be transmissible through saliva, according to a study published in the Journal of the American Dental Association.” (110,111,112)
Mothers can transmit the cavity causing bacteria by kissing their babies mouths. One “study chose first-time mothers who had high counts of S. mutans in their saliva. Half of these mothers underwent specific programs to significantly reduce the amount of S. mutans in their saliva. Out of the 28 mothers which were successfully treated, only three of their children (at three years old) were infected with S. mutans. As both groups of children got older, the number of infected children increased, but the number of infected children from the successfully treated mothers was significantly less than those of the untreated mothers. ” (113)
Kissing between spouses passes the bacteria back and forth, but people should know that if you don’t have cavities, you can get them from kissing someone who does. Then again, perhaps if you have cavities you can change your mouth’s bacteria by kissing someone who doesn’t …
9/6/2005 Update: After about a year of great kisses with my girlfriend who had a few cavities, I did not get them again myself! I suspect my diet nearly free of processed sugar is the key. She still eats sugar. 😉
Changing Your Mouth Bacteria
We all know people who never get cavities. We’ve also heard that kissing can help prevent cavities. Why might this be? Dr. White at UCLA told me that dental cavities are a complex problem dealing with the bacterial ecology.
Here is one idea that might turn out to be the key: There is competition between the cariogenic bacterium, Streptococcus mutans, and the non cavity causing Streptococcus sanguis. (114) “The higher the initial population, the easier it became predominant, or the harder it was eliminated from the mixed population.” Adding S. sanguis to your mouth is not the answer, in fact, it could kill you. S. sanguis binds to oral surfaces and allows other bacteria to attach. “Furthermore, S. sanguis (115) has been long recognized as a leading cause of bacterial endocarditis, a disease of high morbidity which is fatal if untreated.” Is there some other “good bacteria” that people with no cavities have?
It seems so … “S. mutans comprises thousands of different strains, some more harmful than others, which partly explains why some people have more, or more severe, cavities than others.” (116) The solution may be to target individual strains.
The (Sugar) Solution
To have cavities, you need BOTH sugar and bacteria. Animals kept in sterile environments will NOT develop caries if they are fed sugar. (117) I couldn’t get rid of the little tooth eating monsters, so I gave up refined sugar (including soda drinks and fruit drinks) on 1/24/2002 when I was diagnosed with 10 cavities. I had a few weeks of full body cravings and withdrawal symptoms for three weeks, but after that, I actually lost my taste for the stuff. I do eat fresh fruit (118). The natural sugars mostly stay in the cells of fruit as you eat it so your teeth get less. I’m still getting sucrose and starch every day from my food, possibly enough to keep the s. mutans alive. I did have two cavities filled because they were on my front teeth. I had some sensitivity and visible discoloration on two teeth other teeth, but the sensitivity went away. (Footnote: I read that Mr. Bush also gave up sugar (119) in March 2003. )
Once sucrose was introduced to Europe from the Middle East, European teeth started to decay. (120) The average American ate 4 lbs/sugar per year 100 years ago. Today, that figure is 106 lbs/yr. In addition to tooth decay, the World Health Organization also links sugar to cardiovascular diseases, hyperactivity and obesity.
Giving Up Sugar Results
On 1/20/2004, two years after I was diagnosed with 10 cavities and gave up sugar, I had a full set of x-rays for all teeth.
GOOD NEWS: No new cavities in the two years! That’s huge because I had out of control cavities two years ago. I did this using non-fluoride toothpaste and without the chemical chlorhexidine.
BAD NEWS: The dentist who took the digital x-rays told me the 8 cavities I had two years ago are still there, but none of them had progressed much. I’m going to go ahead and get them filled.
BEST NEWS: After much stalling from the X-ray dentist, I finally got my own copy of my X-rays. On July 22, 2004, I took them to a new dentist, who confirmed only 3 cavities! This means in two years, 5 cavities vanished or healed.
I’ll update this after my next s. mutans test to see how reducing sugar has changed my bacterial count.
10/1/04 (photo from a NJ laser dentist) Had my first no Novocain experience with a dental laser in Sacramento today. Two cavities filled with no needles! The dentist usually puts the laser on the tooth for 90 seconds or so to numb it then he starts using it to remove material from the tooth.
Well, I did feel something. It was a little uncomfortable, but he eased up and went slower when I made a little noise. The pain was only a 3 to 4 on a scale of 1 to 10. The pain of the drilling was way less than the pain from the needle. After you are done, there is no more pain and you aren’t numb. You can hear the laser sparking, but there is no drilling vibration at all. There was only a very slight smell.
I had a little sensitivity when I ate a few hours later. All in all, this was the best, least painful experience I’ve ever had at a dentist! And by the way, 5 of the 10 cavities I had 2 years ago really did heal up since I stopped eating sugar.
If you have cavities that are pretty far along and you want to get them filled, this is the best way to go. In addition to the lack of pain and the quickness of recovery, the laser kills the bacteria. Zap! (Lasers these days are used for drilling cavities as well as for whitening teeth.)
Summary: Things That May Help You Heal Cavities
1. Floss at least three times a week, preferably daily.
2. Sterilize your toothbrush frequently. (Steam, UV, etc. See above. )
3. Get a tongue cleaner and scrape your tongue each morning after you brush your teeth. (ref)
4. Drink enough water.
5. Eat onions (raw are best) since they contain powerful antibacterial sulfur compounds and in a 1997 test tube study killed S. mutans. Then use parsley or mint leaves for your breath.
6. Drink Green tea (Camellia sinensis) which contains substances called catechins that kill mouth bacteria.
7. Get enough vitamin C. Kiwis have more than any other fruit. I currently take 3,000 mg of C each morning in a delicious shake.
8. Eat a tablespoon of sesame seeds to clean teeth and add 87 mg of calcium.
9. Eat wasabi since it contains isothiocyanates that inhibit the growth of cavity-causing bacteria.
10. Eat cashew nuts which have anacardic acids that kill bacteria like S. mutans [Himajima & Kubo 1991 p419]. These nuts have antibacterial, antidysenteric, anti microbial and antiseptic properties.
11. Eat grapes since they contain polyamides, a type of tannin that inhibits the growth of S. mutans. Buy organic to avoid pesticide residues.
12. Eat pure cocoa powder or raw chocolate without sugar, since it contains tannins known to prevent bacteria from attaching to the teeth.
13. Eat Sage honey and Tupelo honey which inhibit oral pathogenic bacteria.
14. Kiss people who never get cavities.
15. Take Culturelle ( Lactobacillus casei rhamnosus GG ) which produces an anti microbial agent that kills Streptococcus.
16. Rinse your mouth with a baking soda solution within 10 minutes after you eat.
17. Cook with cinnamon and oregano. ( 134 )
Good luck with your teeth!
(revised and renumbered 9/06/2005)
6. Microbiol Rev. 1980 Jun;44(2):331-84. Biology, immunology, and cariogenicity of Streptococcus mutans. Hamada S, Slade HD.
7. Loesche WJ. Role of Streptococcus mutans in human dental decay. Microbiol Rev1986: 50: 352 380.
9. nyu.edu – “The term ‘facultative’ is used to describe organisms which can grow in the presence or absence of oxygen – that is, they can generate ATP via respiration if oxygen is present or by fermentation if oxygen is absent or insufficient. Such organisms are usually referred to as ‘facultative anaerobes’.”
10. ohio-state.edu – Fermentation is defined as an energy releasing process that takes place only under anaerobic conditions. Fermentation is a process where enzymes produced by the bacteria control an anaerobic (non oxygen) breakdown of fructose as an energy source for growth.
“Plaque can be defined as a complex microbial community, with greater than 10^10 bacteria per milligram. It has been estimated that as many as 400 distinct bacterial species may be found in plaque. In addition to the bacterial cells, plaque contains a small number of epithelial cells, leukocytes, and macrophages. ”
40. Pediatr Dent 2000 Sep-Oct;22(5):381-4 Microbial contamination of toothbrushes and their decontamination. Nelson Filho P, Macari S, Faria G, Assed S, Ito IY.
42. http://www.usatoday.com/life/health/doctor/lhdoc139.htm (defunct)
45. J Clin Periodontol 2000 Mar;27(3):157-61 Effect of an essential oil-containing antiseptic mouthrinse on plaque and salivary Streptococcus mutans levels. Fine DH, Furgang D, Barnett ML, Drew C, Steinberg L, Charles CH, Vincent JW
66. Childers NK, Tong G, Mitchell S, Kirk K, Russell MW, Michalek SM (1999). A controlled clinical study of the effect of nasal immunization with a Streptococcus mutans antigen alone or incorporated into liposomes on induction of immune responses. Infect. Immun. 67(299.9999223):618-623.
67. Childers NK, Tong G, Li F, Dasanayake AP, Kirk K, Michalek SM (2002). Humans immunized with Streptococcus mutans antigens by mucosal routes. J Dent Res 81(3699.018):48-52.
68. Li F, Michalek SM, Dasanayake AP, Li Y, Kirk K, Childers NK (2003). Intranasal immunization of humans with Streptococcus mutans antigens. Oral Microbiol Immunol 18(5):271-7.
73. Plant Cell Rep (2004) 22:711-720. http://www.springerlink.com/…43V50UEY1RAVF5KJ.pdf (PDF)
91. Caries Risk Assessment and Management in the Dental Office. Draft by W. Stephan Eakle, based on D1 course handout May 2002.
111. Newbrun, Ernest, “Preventing dental caries: breaking the chain of transmission” The Journal of the American Dental Association, June 1993, pp. 79-86
112. Slavkin HC, “First encounters: transmission of infectious oral diseases from mother to child” The Journal of the American Dental Association 128 (6), 1997, pp. 773-778.
113. Kohler et al., “Preventive measures in mothers influence the establishment of the bacterium Streptococcus mutans in their infants,” Archives of Oral Biology 28 (3), 1983, pp. 225-232).
120. Price, Weston. Nutrition and Physical Degeneration. See chapter 22, table 2, for a summary. See also Kennedy, How to Save Your Teeth, pp. 2-3.
121. hyperdictionary – Dextran is a polysaccharide (chain of simple sugars) composed of glucose (a type of simple sugar) monomers (units of a polymer, such as a polysaccharide), used as a means of storing food by bacteria and yeasts. When dextrans are formed out of sucrose (another type of sugar) by bacteria in the mouth, it makes dental plaque.
123. The estimation of more S. mutans in your mouth than S. sobrinus is based on the use of a MS-bacitracin plate, which inhibits S. sobrinus to a greater extent than S. mutans. Therefore, the actual incidence of S. sobrinus may be higher than currently supposed.
124. Tanzer JM &Clive J. Quantitative considerations in microbiological evaluations for caries: risks for type II errors resulting from use of MSB agar. Oral Microbiol Immunol1986: 1: 28 30.
133. http://home1.gte.net/res0k62m/fluoride.htm#price“There is dramatic evidence regarding the civilized diet’s pernicious influence on teeth, and especially refined sugar. Wherever Western civilization has made its appearance over the past several centuries, tooth decay and other health problems have followed in its wake. In the 1930s, Weston Price journeyed to earth’s last remaining ‘primitive’ civilizations. Price studied primitive civilizations and what happened to them when introduced to the ‘civilized’ diet. On the average, the ‘primitive’ peoples exposed to civilized diets experienced a 3500% (thirty-five times) increase in tooth decay, of the fourteen cultures he studied. Their dental arches also degenerated, leading to crowded teeth.”
134. http://www.crucible.org/oils_chemistry.htm“In 1985, Dr. Jean C. Lapraz said he couldn’t find bacteria or viruses that could live in the presence of the essential oils of cinnamon or oregano. He found many other oils displaying the same qualities.”
138. Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity http://jdr.iadrjournals.org/cgi/content/abstract/72/1/37
139. Poor oral health and coronary heart disease
140. Bacterial adhesion to oral tissues: a model for infectious diseases
150. Effect of radiation-induced xerostomia ( dry mouth ) on human oral microflora. Cariogenic microorganisms gained prominence at the expense of noncariogenic microorganisms in concert with the saliva shutdown. These changes occurred before the onset of clinical caries irrespective of whether or not a topical fluoride gel was used as a caries preventive.
151. Colonization of the human oral cavity by a Streptococcus mutans mutant producing increased bacteriocin. In two of the three subjects, total (indigenous plus JH1005) S. mutans levels were significantly decreased. The results provide additional support for the role of bacteriocin production as an ecological determinant in colonization by S. mutans.
152. Microbiological aspects of the chemical control of plaque and gingivitis. Antimicrobial agents, delivered either by mouthrinse or toothpaste, can be used to maintain plaque at levels compatible with oral health by (a) reducing existing plaque, (b) preventing the formation of new plaque, (c) selectively inhibiting those particular bacteria that are associated with disease, and (d) inhibiting the expression of virulence determinants.
153. PDF. A Caries Vaccine? Caries Res 2004;38:230-235.
155. http://www.forces.org/evidence/pharma/appendix.htm “Cavity fighter: Planet Biotechnology, a California firm, is growing antibodies in tobacco plants that could be used to fight tooth decay if used in toothpastes or mouthwashes. … Tobacco an ideal subject for genetic research,” Gail Gibson, Lexington (KY) Herald-Leader, 2/27/2000
156. JA Weintraub. Pit and fissure sealants in high-caries-risk individuals. J Dent Educ. 65(10): 1084-1090 2001. “There is good evidence that sealants can be used efficaciously and effectively in high-risk children as long as the sealant is retained. Sealants are more effective in preventing further caries and providing cost savings in a shorter time span if placed in children who have high rather than low caries risk.”
159. http://www.the-scientist.com/yr2003/jul/lcprofile1_030714.html Volume 17 | Issue 14 | 45 | Jul. 14, 2003
162. Chlorhexidine induces DNA damage in rat peripheral leukocytes and oral mucosal cells
DA Ribeiro, AP Bazo, CA da Silva Franchi, ME … – Journal of Periodontal Research, 2004 – Volume 39 Issue 5 Page 358
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