5 ways to preserve your teeth as you age

By Dr. Michael Apa, Special to CNN

For all intents and purposes, we really get only one shot to take care of our teeth.

The good news is, science and research have taken a front seat in dental education, making today's dentist savvy on "prevention" dentistry rather than the "drill, fill and bill" mentality of decades ago.

Things like adhesive dentistry, recalcification and dental implants have given dentists more options. But for many patients, it's a lot of information to process.

Here are five ways you can ensure that you hang on to your teeth as you age:

Educate yourself on dental care

Dentistry today has taken a much more conservative approach. But it can be hard to know what your options are. Here are some key points that you should know about dental treatment.

• Small cavities may be recalcified. Strong doses of fluoride, or something called MI Paste, applied directly to small cavities can actually recalcify or rebuild the enamel, removing the need for a filling.

That said, the key to recalcification is early detection. Regular dental visits are crucial to early detection.

• Fillings, crowns or any dental restoration should be replaced or heavily scrutinized every eight years.

Some patients are of the "if it ain't broke, don't fix it" era. But the reasoning behind this advice is to eliminate the spread of recurrent cavities that lurk under dental restorations.

The longer you wait to replace dental restorations, the more problems you can run into. If the decay spreads undetected, it may eat up too much healthy tooth structure and need the support of a crown or reach the nerve and need a root canal.

• Make sure your children are getting fluoride treatments until at least the age of 15. Kids, especially, consume a lot of sugar, which breaks down into a biproduct of acid that erodes teeth, quickly causing cavities. Fluoride is a great treatment in rebuilding enamel and neutralizing those acids.

Use an electric toothbrush

In dentistry, the electric toothbrush has been one of the biggest advances in home dental care. Ninety-nine percent of patients don't really know how to brush with a manual brush and, more important, don't brush for the full two minutes needed.

Electric toothbrushes remove the confusion and have a timer to ensure that the full brushing is done at each session. Improper brushing can lead to plaque buildup, swollen gums, cavities and overall poor oral health. The sonic brushes remove plaque and get into hard-to-reach places like in between teeth and under the gums to ensure a healthy mouth.

If you grind or clench, wear a night guard

Grinders can wear away a millimeter of tooth structure per year if undiagnosed. Clenchers may not see any immediate signs of wear on their teeth, but the pressure that clenching puts on your teeth is destructive. It slowly breaks down the supporting bone around the teeth, leading to gum recession, bone loss and inevitably tooth loss.

If you feel that you may fall into either of these categories, you should be wearing a night guard. It may not be sexy, but it's much sexier than missing teeth.

Know what oral hygiene regimen is right for you

Today, there has been a lot of money and research into better oral care products. But understand that there is an actual regimen of toothpaste, mouth rinse and "extra-care" products that's right for you.

The first step is defining what "type" of patient you are. I like to break it down into four basic types: cavity-prone, sensitive, stainers and those with bad gums.

You can ask your dentist which category you fall into. Each product in the sea of dental products in the drugstore has key ingredients tailored for each category of patient. Using the right oral care products can make a big difference in the longevity of your teeth.

Choose the right dentist

Fortunately -- or unfortunately -- your dentist has a lot to do with the preservation of your teeth. Make sure your dentist is up on all current research and his office is updated and state-of-the-art, but most important, make sure your dentist is taking time and looking after you. It sounds simple, but it's probably the most important item on your checklist.

Prehistoric Teeth Healthier Than Ours

Prehistoric humans didn't have toothbrushes. They didn't have floss or toothpaste, and they certainly didn't have Listerine. Yet somehow, their mouths were a lot healthier than ours are today.

"Hunter-gatherers had really good teeth," says Alan Cooper, director of the Australian Centre for Ancient DNA. "[But] as soon as you get to farming populations, you see this massive change. Huge amounts of gum disease. And cavities start cropping up."

And thousands of years later, we're still waging, and often losing, our war against oral disease.

Our changing diets are largely to blame.

In a study published in the latest Nature Genetics, Cooper and his research team looked at calcified plaque on ancient teeth from 34 prehistoric human skeletons. What they found was that as our diets changed over time — shifting from meat, vegetables and nuts to carbohydrates and sugar — so too did the composition of bacteria in our mouths.

Not all oral bacteria are bad. In fact, many of these microbes help us by protecting against more dangerous pathogens.

However, the researchers found that as prehistoric humans transitioned from hunting and gathering to farming, certain types of disease-causing bacteria that were particularly efficient at using carbohydrates started to win out over other types of "friendly" bacteria in human mouths. The addition of processed flour and sugar during the Industrial Revolution only made matters worse.

"What you've really created is an ecosystem which is very low in diversity and full of opportunistic pathogens that have jumped in to utilize the resources which are now free," Cooper says.

And that's a problem, because the dominance of harmful bacteria means that our mouths are basically in a constant state of disease.

"You're walking around with a permanent immune response, which is not a good thing," says Cooper. "It causes problems all over the place."

In addition to oral disease, those problems may include diabetes, obesity and even heart disease.

According to Cooper, bacteria make up approximately 90 percent of the cells in our bodies. He believes that we focus too much on ourselves and not enough on this so-called microbiome.

"We brush our teeth and we floss, and we think that we've got good oral hygiene. But [we're] completely failing to deal with the underlying problem," he says. "Ten years from now, I think we're going to find that the whole microbiome is a key part of what you get monitored for and treated for."

As for right now, Cooper suggests that one way to help return your microbiome to a healthier, more balanced state might be to cut out all of those processed carbs and start eating like our ancestors.

 This Is What Happens In Your Body When You Drink a Cola (Coke, Pepsi, RC, etc.) 

10 minutes: 10 teaspoons of sugar hit your system. (100% of your recommended daily intake.) You don’t immediately vomit from the overwhelming sweetness because phosphoric acid cuts the flavor, allowing you to keep it down.

20 minutes: Your blood sugar spikes, causing an insulin burst. Your liver responds to this by turning any sugar it can get its hands on into fat. (And there’s plenty of that at this particular moment.)

40 minutes: Caffeine absorption is complete. Your pupils dilate; your blood pressure rises; as a response, your liver dumps more sugar into your bloodstream. The adenosine receptors in your brain are now blocked, preventing drowsiness.

45 minutes: Your body ups your dopamine production, stimulating the pleasure centers of your brain. This is physically the same way heroin works, by the way.

> 60 minutes: The phosphoric acid binds calcium, magnesium, and zinc in your lower intestine, providing a further boost in metabolism. This is compounded by high doses of sugar and artificial sweeteners also increasing the urinary excretion of calcium.

> 60 minutes: The caffeine’s diuretic properties come into play. (It makes you have to pee.) It is now assured that you’ll evacuate the bonded calcium, magnesium, and zinc that was headed to your bones as well as sodium, electrolytes, and water.

> 60 minutes: As the rave inside you dies down, you’ll start to have a sugar crash. You may become irritable and/or sluggish. You’ve also now, literally, evacuated all the water that was in the Coke. But not before infusing it with valuable nutrients your body could have used for things like hydrating your system, or building strong bones and teeth.
If you can’t completely remove soft drinks from your diet then make sure you drink it in moderation.

Swishing With Oil for Oral Health: Not Recommended

Oil pulling—the Ayurvedic practice of swishing oil in your mouth—may not be bad for you, but there's little evidence that it cleans teeth and none that it can cure anything else.

(from The Atlantic)

The Internet’s new quasi-health obsession is actually very old. Oil pulling—swishing oil  (coconut and sesame seem popular, preferably unrefined) around in your mouth for 10 to 20 minutes—is an oral health practice that has been done in India for years and years. It’s mentioned in the Charaka Samhita, one of the key texts of the Indian traditional medicine known as Ayurveda.

It’s also mentioned by kooky celebrity darling Shailene Woodley, star of the upcoming films Divergent and The Fault in Our Stars, in an interview for beauty website Into the Gloss. In between recommending eating clay to “clean heavy metals out of your body” and extolling the virtues of getting sunlight on your nether regions, the natural medicine enthusiast says:

You can do something called ‘oil pulling’ where you swish coconut or sesame oil in your mouth when you wake up and spit it out. It’s amazing! It really makes your teeth whiter, because the plaque on your teeth is not water soluble, it’s fat-soluble. So the lipids have to dissolve in fats, which is why oil works in your mouth.

But Robert J. Collins, a clinical professor at the University of Pennsylvania School of Dental Medicine says there is no evidence that plaque is fat-soluble.

“Even if it was, it doesn’t mean that it would disrupt the plaque,” he says. “We’re learning more every year how sophisticated those colonies are.” The only things we know of that work to remove plaque are chemical (like Listerine) or mechanical (the tooth-scraping you go through at the dentist’s office).

A Google search for “oil pulling” brings up more than two million results, many from the past few weeks. This late February post on the blog Fashionlush,received around 800 comments. The main claims being bandied about are that the practice cleans and whitens your teeth, helps with bad breath, and eases jaw pain. More dubious are the assertions that it cures diabetes, hangovers, acne, and all manner of other bodily ills. (A good rule to live by, I think, is not to trust anything that claims to get rid of “toxins,” especially if it does not specify what these toxins are. “We have these magic organs called kidneys and livers and [detoxifying] is what they do,” Collins says. “We don’t necessarily need to be swishing things around in our mouth.”)

There have been a handful of studies on the practice (published in Indian journals, it’s worth noting) that found it to be equally or nearly as effective as mouthwash in reducing halitosis, plaque-induced gingivitis, and the presence of streptococcus mutans, a bacteria that contributes to tooth decay. But these studies had very small sample sizes—20 people total—which makes them, Collins says, “one step away from case studies.”

When I contacted the American Dental Association, I was told it could not comment on the practice “because additional research is needed.” The organization pointed me to its statement on “unconventional dentistry,” which reads in part:

The ADA… supports those diagnostic and treatment approaches that allow both patient and dentist to make informed choices among safe and effective options. The provision of dental care should be based on sound scientific principles and demonstrated clinical safety and effectiveness.

Oil pulling is far from a sound scientific principle. Collins says that, in his opinion, there’s no harm in it (though if you swallow it, he posits you might have some gastrointestinal issues), but neither is there any solid evidence of benefits.

“From a public health point of view, we certainly do not want to encourage people to use things that, while they may be harmless, we have no evidence that they work,” Collins says. “It’s kind of like chiropractic. If somebody feels that they can go to the chiropractor, get a back adjustment, and it makes them feel better, I’m okay with that. If people start selling chiropractic as a mechanism to cure cancer then I have a problem with that.”

Basically, if you feel that swishing oil between your teeth for 20 minutes a day is a good use of your time, it probably can’t hurt you. But don’t use it as an alternative to brushing your teeth, and certainly don’t expect it to cure any real conditions. No matter what the movie stars say.

The strange reason diet soda makes you fat   

Calorie-free sweetness may confuse the brain into craving more sugar, research suggests.

 Want one reason for your beer belly? How about 100 quintillion? That's about how many bacteria live in your gut. And scientists now believe these bacteria can have a significant impact on your weight. 

Consuming high amounts of fructose (a type of sugar), artificial sweeteners, and sugar alcohols (another type of low-calorie sweetener) cause your gut bacteria to adapt in a way that interferes with your satiety signals and metabolism, according to a new paper in Obesity Reviews. (If you've noticed you've been feeling tired all the time and gaining weight, your metabolism may be slowing.) 

"An evolution of the gut flora to this new sweetener-rich environment has a potential to negatively impact our health," says Amanda Payne, Ph.D., lead author of the review. 

How does that happen? As bacteria in the gut process food, they give off byproducts called short-chain fatty acids. These can be beneficial and serve as energy in the body. But as the sweetener-adapted bacteria thrive and become more efficient at processing large amounts of high-fructose corn syrup, artificial sweeteners, and sugar alcohols, they also produce more and more short-chain fatty acids. (Not to imply that sugar is any better than artificial sweeteners. 

In those high amounts, Payne says, short-chain fatty acids decrease satiety signals. "This signaling may cause disruptions in our feeling full and hence prevent us from stopping to eat when we should," Payne says.

As if overeating isn't enough, the short-chain fatty acids also promote inflammation in the lining of the gut. Just how? Scientists aren't yet sure. But they do know that inflammation damages gut tissue and results in leaky gut syndrome. Pleasant as it sounds, it means bacteria leak through that damaged gut tissue into the blood stream and cause further inflammation there. That's a serious problem that can lead to insulin resistance and an increased risk for coronary artery disease, stroke, and type 2 diabetes. 

 Is This Sugar Making You Fat? 

This could partly explain the link researchers have found between drinking diet soda and being overweight. In one study, people who drank two or more diet sodas a day had five times the increase in waist circumference over a 10-year period compared to people who didn't drink any diet soda. There are a few explanations for the findings. Maybe people drink more diet soda because they're trying to lose weight. Calorie-free sweetness may also confuse the brain into craving more sugar. 

As for your gut, at this point it's not clear if one diet soda a day is less damaging to the gut flora than ten. "I will say from a personal perspective that I don't drink sodas--diet or regular--and I rarely eat processed foods, especially if they have high-fructose corn syrup listed on their label," Payne says. Your best bet is to consume products containing these sweeteners in moderation, and drink mostly water. For gut flora to thrive, eat a wide variety of fruits, vegetables, and whole grains.