The Basics of Dental and Oral Health

Dr. Andrew Huberman, has a popular podcast Huberman Lab that talks about protocols and tools for health. On a recent episode he discussed oral health and the protocols and tools for optimal oral health.

I was trained and work here in Canada and I found the podcast provided good evidence-based information. It’s a great start for any non-dental person.

Visiting a dental professional is always a good idea, they can review the best practices, and complete a visual and radiographic exam to determine the current level of oral health and recommend next steps. An important part of visiting a dentist is for an oral cancer screen both in the mouth and outside the mouth. We have identified suspicious findings that once checked by an oncologist turned out to be early signs of cancer. None of the patients had pain or noticed anything out of the ordinary.

The easiest habits to adopt to begin the journey of good oral health starts with brushing twice with fluoride toothpaste and flossing once, daily. Most people use a commercially available toothpaste that has fluoride for daily use. If you cannot tolerate these toothpastes, please discuss with a dental provider. One note, sodium lauryl sulfate is a tissue irritant for some people, and is found in a lot of toothpastes (and shampoos, soaps). If you are sensitive and prone to canker sores then a commercially available option is Pronamel. Electric toothbrushes (soft bristles) are better than regular toothbrushes, and flossing is 100% better than not flossing.

There are a few supplemental options to add including water flossing (e.g. by Waterpik) and although it is beneficial it is not a replacement of string floss. The best analogy is would you do the dishes with only the water from the faucet, or would you scrub the dishes? The best answer is to do both.

Mouthrinse or mouthwash. Daily use is not recommended as it can disrupt the already healthy oral microbiome (as Huberman mentions during the podcast). It’s akin to taking a painkiller, when you don’t even have noticeable pain.

Dry mouth is a major issue for most people because it can lead to increased risk of cavities and gum/periodontal disease. Dry mouth (xerostomia) can occur for a number of reasons, mouth breathing, radiation-affected salivary glands, and medication-related dry mouth are common examples. Dry mouth is a problem because there is reduced saliva, and saliva is the only way teeth are protected from cavities. For each of the causes of xerostomia, there are different approaches to help however a few things you can do are to drink more water, try a saliva-substitute such as Biotene, or a saliva-stimulating lozenge such as Xylimelts. You can also see if there are steps you can take to reduce the number and dosage of your medications as well, discuss this with your family doctor.

What we eat is important for our oral health as well. Teeth are directly affected by hard foods, refined sugar, and acidic foods. Even the timing of when we eat can affect our teeth. Cavities form at an acid concentration of approximately pH 5-5.5 in saliva. During the day when we’re not eating, saliva pH is approximately 6.5-7. As a result, when we eat our saliva pH can drop below 5.5 and demineralization can occur of the teeth. If there are more demineralization phases during the day, and for longer periods of time, it stands to reason the risk of cavities would also increase. In order to buffer this change in acidity, drinking water can literally buffer this change along with rinsing the teeth and gums of food debris and bacteria. On the mindset side, it’s important to address these food items when you’re at the store and considering purchasing processed foods, making the change at that level will make a big difference.

Last thing is that cavities and gum/periodontal disease are signs and symptoms that should cue you in that something is not normal. When teeth get cavities for example, it has limited ability to fight it off, whereas our bodies are more resilient against diabetes. A common example are kids who often get processed foods and drinks, don’t get diabetes in their teenage years, yet they tend to get a lot of cavities early on. What happens to the teeth and gums are foreshadowing other diseases in adulthood.

There’s so much more to oral health and dentistry than we’ve talked about it so far and I hope there will be future discussions about oral health! I’m also glad to hear that Huberman has added oral health and gut microbiome to his pillars of health!

Caring for you and your smile,

Dr. David Pham