by David Lewis
Did you know that you can have really
awesome teeth by loading your mouth with sugar after brushing
for just 2 minutes in the morning? I was shocked, but when I dug into
the details, it started to make a lot of sense. Now, I want to share
this well-kept secret with you. Why more dentists don't recommend
this approach, I may never know.
Following Directions
In another life, I was a salesman. I
used to sell home remodeling goods. I was a pretty good salesman -
one of the best in my office. My boss was a master salesman.
Seriously, he could sell bubblegum to the lockjaw ward in Bellevue.
One of the things he used to stress all of the time was how to
correctly bake a cake. Since both he and I were following the Atkins
diet at that time, how the hell would baking a cake be of any use to
us?
As
it turns out, knowing how to bake a cake can prevent you from making
some pretty serious mistakes in life. Let me explain. If you have
flour, butter, eggs, water, vanilla, yeast, and sugar, and maybe some
cream cheese, you have all of the ingredients necessary for a good
basic cake. It will taste great (if you like cake), and it will do
exactly what it's supposed to do in the oven. The second you decide
to forgo the eggs, however, you don't have a cake. You have a mess.
It's
all about following instructions. When my boss would talk about following instructions, it was because he wanted all of his salesmen to follow a proven sales formula that the company had put together. It worked. When we changed it, our closing ratio dropped like a stone (we didn't sell as much). Lesson learned: don't mess with the system.
In the paleo community, we mess with "the system" all of the time. We have a
tendency to want to "break the rules" and not follow instructions when it comes to conventional wisdom. Many times, that
turns out to be a good idea, but that's because "the system" is bad. So, not following the system produces good results - usually.
So-called conventional wisdom hasn't
given us good and simple solutions to the problems of obesity, heart
disease, chronic pain, and inflammation. Instead, it's given us
various crutches and band-aide solutions, like permanent medication,
that mask the underlying problem instead of solving it. Sometimes,
invasive surgery is needed to halt the progress of a certain health
problem. Sometimes, this is a good thing, and it saves a person's
life. Yet, even in these cases, the cause of the problem is never
addressed.
When
it comes to oral health, I've read about many different so-called
"paleo solutions." I've tried many different things like
SLS-free toothpaste, fluoride-free toothpaste, baking soda, salt (as
toothpaste), Dr. Bronners soap (as toothpaste), and even no
toothpaste (inspired by the idea of the now-popular "no-poo"
approach to showering). I've not had permanent and total success with
any of these approaches. After a recent visit to the dentist, and a
couple of late night Google sessions, I think I've finally discovered
the ultimate protocol for awesome oral health. While sometimes it's a
good idea to hack-and-slash your way to success, I think this is one
instance where following existing instructions from an experienced
dentist is a must. If you don't, you might not get a "cake."
You might just end up with a mess on your hands.
If
you have any oral health issues, I hope this method helps you.
Because I am not a doctor, I cannot make any medical claims or make
an official recommendation to use this protocol. However, I will
provide resources and links to the information I've discovered so
that you can verify the information I'm about to present and act on
it in a manner that you think is appropriate. Use your own judgment,
and you'll be fine (as long as you have a normally functioning brain
and are an honest thinker).
Before
I present this protocol, I want to stress something that I think
doesn't get stressed enough: we are not "paleo" in the
literal sense. This blog is called "modern paleo." I take
this to mean that we don't have to live in caves, eat bugs, and use
chew-sticks.
We can, and probably should, revel in the progress that
technology has brought us. We can live in climate-controlled homes,
eat prime-cuts of our favorite meats, and use toothbrushes and
mouthwash in an intelligent manner to treat existing acute problems. We can get the benefits of
"paleo" without a return to the primitive state from whence
we came. I think this protocol is an example of intelligently using modern technology and our current understanding of biology in the context of oral health to fix an existing health issue.
Some
Thoughts On Why Teeth and Gums Go Bad
It's
amazing that in our modern world, we still battle with gum disease,
inflamed gums, canker sores, loose teeth, calculus, dental carries,
and a host of other weird oral issues. The normal state of human
beings isn't sickness. It's health. You have to hold this view to get
a sense of why going to the dentist every three or six months to get
our teeth cleaned is absolutely insane. If you chip a tooth, or need
your teeth aligned, that's one thing. A dentist is invaluable for
acute oral problems.
Perhaps
you didn't get the nutrients you needed as a child to grow and
develop properly. Maybe there is a genetic disorder that prevented
your jaw from developing properly so that all of your teeth fit in
your mouth without crowding. A dentist can help correct these
problems and can do something that is just impossible or impractical
for you to do on your own.
Outside
of physical deformities, however, the evidence I've seen so far
suggests that oral bacteria are the driving force behind why human
beings "need" to visit a dentist for regular cleanings.
According to Dr. Ellie Phillips, the bacteria responsible for gum
disease and bad breath thrive in an acidic and dry mouth. These
bacteria produce acid that wears away tooth enamel. Once this enamel,
which is a living membrane, is weakened and demineralized from
bacterial acids, all manner of oral health problems can spring up.
These oral problems don't stay confined to the mouth, either.
If
enough of these harmful bacteria are present in your mouth, they will
make their way to other parts of your body. Even the simple act of
eating, when you have a bad bacterial load in your mouth, could
potentially contribute to new or existing health problems that are
seemingly unrelated to oral health problems. If you have cavities,
gum disease, bad breath, or any other oral issues, it may be time to
take a very serious look at how you're caring for your teeth.
If
you can fix your existing problems, you can potentially reduce (or
eliminate) routine dental visits. I say potentially because much of
this is going to depend on your diet, current health, and whether you
have other health issues that need to be sorted out. Ideally, if
you're not dealing with chronic bad oral health, then it would be
natural to assume your reliance on a dentist for regular cleanings
should decrease over time. The problem, as I see it, is that people
have the mistaken idea that bad oral health is normal and that they
need a dentist to continually scrape, pick, brush, floss, and polish
their teeth every three to six months because human beings are
inherently prone to bad oral health. I question that premise and
propose an alternative approach.
Why
I Tried This Protocol
I
recently went to the dentist because of a strange film building up on
my teeth. I hadn't noticed because it was mostly on the backside of
my top front teeth and I never thought to look. Consequently, I had
no idea how long this had been there. Calculus hasn't been a major
problem for me for many years. I attribute this, in part, to the Atkins diet
I've been on since age 18. Maybe that had something to do with it, but I'm not certain. Still, throughout the years, I've always
had to rely on regular cleanings at the dentist's office because my
teeth would eventually show plaque formation. The dentist always told
me I had good, strong, teeth but I was unsatisfied with the calculus
buildup. When I went paleo, I thought the problem would resolve on
its own. It didn't.
I
eventually broke down and started using a simple set of dental
scalers, available from most grocery stores, to carefully pick away
anything that had calcified on my teeth between dental visits. Yes,
it bugged me that much. After sifting through a few good paleo blogs,
I discovered some people were using high vitamin butter oil and
fermented cod liver oil from a company called "Green Pastures"
to improve oral health. When I first tried butter oil and fermented
cod liver oil, I noticed that the normal plaque/calculus formation on
my teeth slowed down but it didn't stop. Rats.
I
went to the dentist once again to have a cleaning, this time
explaining this new-found biofilm issue. It was a greyish/blackish
film that I could scrape off with a scaler, but it was really sticky
and honestly a bit gross. Brushing didn't do anything to it. I didn't
think I had poor hygiene, but obviously I was doing something wrong.
My dental hygienist informed me that it was some kind of staining or
plaque or something and went to work on it. Problem solved! Or so I
thought.
After
my last cleaning, I did notice a positive effect: no calculus
formation after a week. None. Not even a hint of it. However, the
strange gray biofilm started to return - with a vengeance. It almost
seemed like it was worse than before. Now, instead of covering just
the backside of my teeth, it was starting to cover the front of my teeth.
Brushing wasn't working - not even brushing twice a day. I was
developing a thin gray film everywhere and my teeth started to look
dull. GROSS! Also, I just went to the dentist. Something was
seriously wrong with this picture. I had to do something, and quick.
I
discovered the solution to my problem, I still have no calculus
buildup after several weeks of using this new protocol, and the
biofilm is almost totally gone. My teeth are as bright as the day I
had them cleaned by the dental hygienist, and I have reason to
believe they will become stronger and brighter over the nest six
months to a year.
How
To Fix Dental Problems - The Basic Theory
Your
mouth has a pH that it likes. When you move below a pH of 6.5, damage
starts to occur. Your mouth doesn't like an acidic environment. Below
5.5, serious damage to tooth enamel can occur. To fix this situation,
you have to introduce something that will have an alkalizing effect
in your mouth. This should take away the pleasant environment for bad
bugs. I think the basic principle that makes this protocol work is:
an alkaline environment in your mouth promotes oral health. To that
end, you must do what you can to help your body out by promoting good
alkalinity in your mouth.
The
Protocol
This
is not my protocol. Full credit goes to Dr. Ellie Phillips. She has
35 years experience as a dentist (yes, she's a DDS and she is
advocating a DIY approach to help you reduce your reliance on
dentists - though she rightfully does not attack or denigrate the
dental profession). Here is the protocol in its basic form, with my
comments added:
What
you need:
CloSYS™
mouthwash. This is available at Walgreen’s. I could not find it
anywhere else.
Crest®
Original Paste. Yes, regular paste. Don't get fancy with this. No
whitening agents, tartar control additives, stannous fluoride,
sodium monofluorophosphate, or triclosan. More on this in a moment.
Listerine®
- the original. Again, stop being a fancy-pants. Original, mint, or
vanilla flavor if you must. Just get something with the ADA seal of
approval. No plaque, tartar control, or whitening agents.
ACT®
Anticavity Fluoride - again. The original. You want that fancy ACT
Restore, don't you? Stop it. Stop it I say. Stop trying to hack this
protocol. You're eliminating the eggs in this cake, and you're going
to make a mess.
Xylitol.
Yes Sugar! OK, technically, it's a sugar alcohol but it's a crucial
part of the protocol. Skip this, and you won't get the benefits
promised by Phillips. You can purchase xylitol from Dr. Phillips,
but granular xylitol works just as well and is also recommended by
her. I use pure granular xylitol.
A
good toothbrush. I use SoniCare. This is where I deviate from the
protocol and I think it's OK. Dr. Phillips recommends her own
house-brand of medium-soft toothbrush. I wasn't about to ditch my
$70 toothbrush, and the SoniCare has done an excellent job. In the
end, I think her point is to get a good quality toothbrush. If I
find out I'm wrong, I'm obviously going to ditch my brush and go
with a good medium-soft regular toothbrush.
Extras:
Floss.
I use Oral B. That's just what I like. I don't know if this makes a
difference or not. I suspect not.
Tongue
Scraper. Not necessary, but I find it helps with cleaning. I got mine from Life Extension Foundation.
Simple
scaling tools. Again, not necessary. I don't use them anymore since I haven't had any calculus buildup. However, it's neat to gently inspect my teeth and confirm once in a while. If you have serious buildup, these might be worth looking into if, and only if, you're very, very, careful with them. No scraping your gums or going crazy on your teeth. If you go crazy, you void the warranty.
I
don't think my addition of the floss and SoniCare will make a
difference in the long-term. These are superficial deviations to the
basic protocol and do not - to the best of my knowledge - contradict
the principle that makes it work. However, again, if I'm wrong I'll
get a regular brush. I've been wrong before, and I may be wrong this
time. So far, I don't think my brush and floss are having a negative
impact. I have noticed results exactly as Dr. Phillips predicts for
her patients. What I won't do, however, is make substantial changes
to her protocol because the ingredients in various toothpastes and
mouthwashes can have negative side-effects. For example, Dr. Phillips
notes that:
COLGATE TOTAL contains Triclosan - which reacts with
chlorine in tap water to form chloroform.
http://www.ncbi.nlm.nih.gov/pubmed/15926568
You may also want to
read more about Triclosan before you put any more of this toothpaste
in your mouth! http://en.wikipedia.org/wiki/Triclosan
I suggest Crest Cavity Protection toothpaste. Obviously I do
NOT recommend Colgate Total. If you want to experience the improvements and helpful changes
from the System, you should use the Zellies Complete Mouth Care
System EXACTLY as is recommend.
This
is why you can't go monkeying around with the protocol's ingredients
in a substantial way. Some of the ingredients in some of the popular
dental products out there actually promote a more acidic mouth - they
contradict the basic principle of the protocol. That's not going to
give you the results you want.
What
about seemingly harmless additions, like adding baking soda? Doesn't
baking soda help? It promotes alkalinity. However, according to
Phillips:
There may be a couple of natural
products that can stop cavities – but they often cause gums to
recede (especially if they contain baking soda or
peroxide) and rarely help your teeth get
healthier.
and
Baking soda can cause gums to
recede. Peroxide and whitening products can damage the gums and teeth
and also cause mercury to be released from silver fillings.
If you need to whiten your teeth – use the Zellies Complete Mouth
Care System for at least 6-12 months and see if this can improve the
color of your teeth.
In
the case of baking soda, I don't think it's the alkalinity that's the
problem. I think it's the extreme abrasiveness that's the problem. As
for peroxide, it's a powerful oxidizer so it's not surprising that
it's harsh a person's gums and teeth.
Step
1 - Rinse your mouth with CloSYS, using two capfuls of the wash.
Swish for a minute, then spit. CloSYS comes with a mint dropper, and
the company is awesome about allowing you to control what goes into
the basic mouthwash formula. They don't add anything. It tastes sort
of like lightly chlorinated water. Don't use the mint flavoring. Dr.
Phillips claims this reduces the effectiveness of the wash. The
purpose of this wash is to bring your mouth into a more neutral or
alkaline state before you start brushing. Brushing your teeth while
your mouth is acidic is bad joojoo. It can wear away your gums. Who
knew?
Step
2 - Do not rinse your mouth out with tap water, or any water for that
matter. You just made your mouth more alkaline. It's time to brush.
Put a little toothpaste on your brush and go to town. Don't forget to
brush the backside of your toofers. Hit the molars and your gums good
but don't brush so hard that you destroy your gums. A gentle massage
and scrub - just enough to remove foodstuff and existing bacteria -
should do the trick.SoniCare shuts off after 2 minutes. I think 2 minutes is the generally accepted amount of time you should brush. I'm going to stick with that unless or until I hear otherwise.
Step
3 - Spit out the toothpaste when you're done but DO NOT RINSE THE
PASTE OUT OF YOUR MOUTH. You want some residual paste in your mouth.
It will protect your gums and teeth from the harsh alcohol in the
Listerine. Listerine will kill weak bacteria in your mouth, but the
alcohol has a drying effect on your mouth - not good. However, the
paste has a protective effect on your gums and teeth, making the
Listerine safe to use - good. Hey, it sounds odd, but Phillips has
perfected this over years. So, swish some Listerine around in your mouth according to the directions on the bottle. Thirty seconds should be good. When you're done, spit and refill the cup with a little more Listerine. Soak the bristles of your toothbrush in the Listerine for 30 seconds or so to kill any bacteria on the brush.
Step
4 - Do not rinse the Listerine out of your mouth with water. Fill the
ACT plastic cup with the recommended amount of wash and swish this
around in your mouth for about a minute. Spit. Do not wash your mouth
out after the fluoride rinse. I know you want to, but it's essential
to leave the fluoride on your teeth to help promote mineralization.
It flies in the face of what some dude, who isn't a dentist and
didn't spend 35 years working on people's teeth, on some paleo blog
told you about fluoride For the time being, forget The Dude. This
isn't the Big Lebowski and you're not getting advice on how to become
a better bowler. You're trying to improve your oral health. Trust the
dentist.
Step
5 - Chew on some sugar. OK, this is honestly my favorite part. Dr.
Phillips recommends between 6 and 10 grams of xylitol per day. That's
about 2 to 3 teaspoons of xylitol per day. You can chew it or put it
in some water and sip it throughout the day (that's what I do).
Phillips recommends dosing yourself with xylitol throughout the day
when you're not eating. Be careful with how fast you consume xylitol. Some people notice some intestinal discomfort if they eat too much too quickly. Slow and steady throughout the day is suggested as the best way. I put 2 to 3 teaspoons in a cup of water and sip on it throughout the day. Why does xylitol work? Phillips says:
When xylitol dissolves in your
mouth, it makes a sweet sugary solution that is alkaline, the
opposite of damaging acidic. Studies show that eating two teaspoons
of xylitol each day (6-10 grams) for 5 weeks will remove harmful
germs from plaque on your teeth and in 6 months 95% of these germs
will be removed from your mouth.
From
what I've read outside of Dr Phillips' site, it appears that
Streptococcus mutans is to blame for bad oral health. This bacteria
lives on carbohydrates. It makes sense that a paleo diet would
promote good oral health, but only if you are eating no or low carb.
Even on a low carb diet, you might still be getting enough sugar to
feed the bacteria. The theory is that Streptococcus mutans will try
to metabolize the xylitol in your mouth, but it will be unsuccessful
because xylitol inhibits an enzyme that S mutans needs to metabolize
sugar. In essence, you are apparently starving the bad bacteria to
death. Since you're addressing the root cause of many oral diseases,
you should notice an improvement in oral health. Perhaps someone more
scientifically inclined can elaborate on the exact mechanism involved
here.
Step 6 - Brush your teeth using
steps 1 through 4, once in the morning and once at night. No need to
chew xylitol at night, but it probably won't hurt.
Intelligent
Additions
If
you understand the principles underlying the protocol, you'll see
that making additions to it isn't necessarily a bad thing. To
continue the cake analogy, it's sort of like adding chocolate to a
vanilla cake or lemon zest to the basic cake recipe. You're taking
the recipe that works well and adding to it without contradicting the
basic principles of what makes it work.
I've
made what I think are intelligent additions to Dr. Phillips protocol.
Not because I think the protocol is bad, but because I think a
"paleo" template could prove helpful and makes sense given
what the protocol is trying to do.
To
that end, I've added ghee, made from cows raised on pasture, to my
diet. Right now, my preferred choice is Purity Farms. They've
graciously provided a copy of an assay done on their product. It
contains a good amount of vitamin k2, which has shown to direct
calcium out of soft tissue and into bones - presumably this includes
teeth.
A teaspoon of this stuff provides almost 100mcg of k2. That's a decent amount according to what I've read. If you think you need more, by all means eat more ghee. From
what I've been able to dig up, it also appears that ghee is rich in
butyrates
and caprylates, short-chain fats that have an alkalizing effect
(maybe someone with a good background in the appropriate science can
confirm this). This would make sense since the claim to fame for ghee
and butter oil is its ability to help promote tooth mineralization.
Hats off to my Indian ancestors for discovering how to refine butter
this way. They've unknowingly turned acid-promoting dairy into
something that may promote good oral health. I take a teaspoon of
this stuff every morning, massage it into my gums and teeth with my
tongue, swallow it, and revel in the delicious intense buttery taste
without suffering any of the ill effects of casein or lactose since
good quality ghee will have these almost totally (or totally) removed
from the final product. The best part? Purity Farms ghee costs a mere
$10 or so at my local Whole Foods store for a 13.xx oz jar. It's a
bit cheaper on Amazon.com, but I think it might come out even when
you figure in shipping charges. If you use a teaspoon a day, it's
going to last you almost two months. Not bad.
If you really want to
thumb your nose at conventional wisdom, take a teaspoon of ghee and
then immediately take a teaspoon of xylitol. Butter. Sugar. Chomp it
around in your mouth and push it into every corner you can find with
your tongue. Let it sit there for a minute. Swish it around in your
mouth. I know it feels wrong, but it's not.
I
also take a vitamin D supplement from Life Extension Foundation
(liquid). Up until recently, I was taking fermented cod liver oil
from Green Pastures. I have tentatively decided to switch to liver
after hypothesizing that I can grind up liver, mix it into hamburger,
and eat it without barfing. Just one ounce of beef liver provides a
truly wicked amount of vitamin A and is somewhat cheaper than
purchasing the Green Pastures cod liver oil. Finally, I periodically
drink bone broth made from marrow bones and whatever else I can find
with the thought that this will provide a good source of raw
materials that my body needs to keep my teeth and other bones
healthy.
The
minerals in the bone broth should help in providing a mineral-rich
saliva. I suspect that the synergistic effect of vitamin A, vitamin
D, and vitamin k2 are going to promote mineralization - my body
should know what to do with what I give it.
Going forward, I plan on making some dietary tweaks that I've somehow missed over the years. You see, I've been eating "the Atkins way" since roughly 18 and, if you're not already familiar with the mentality of Atkins folks, the focus is always on carbohydrates. That's where I put the focus too. Low carb. That's what is beaten into you. The problem is that some carbs are good because they help your body achieve a more alkaline state. When I went paleo in 2009, I started eating more veggies, but I never focused on balancing out the acid load in my mouth. This might have promoted bad bacterial growth. Since I don't eat a lot of sugary foods, it does help explain why my teeth weren't terrible - just in need of some professional cleaning.
So, all of this makes me incredibly happy because I think another key to the puzzle of perfect health has been found: xylitol and a good brushing program to rapidly kill off bad bacteria and introduce beneficial bacteria in the short-term with the introduction of foods that promote an alkaline environment to balance the acid load inherent in a meat-heavy diet for the long-term. I'm not exactly sure whether or not I will need to maintain such a rigorous brushing and xylitol chewing regimen over the long term. For now, however, it has proven effective at killing off the nasty biofilm and helped to improve the brightness of my teeth so I'm going to continue with it for the foreseeable future.
If I can reliably and consistently confirm a good pH level, using pH paper, in my saliva then I may consider ditching the xylitol. Of course, I would have to confirm that my pH remains at a good level without the xylitol. If I can control this with good dietary habits, I will. Otherwise, xylitol supplementation will continue until or unless I can find a permanent solution. If the theory holds true, then low pH in my saliva should prevent the biofilm from returning. This would also mean a much less rigorous brushing regime is needed to keep teeth clean and to maintain good oral health. While it sounds awkward, there may come a day when little or no brushing is needed. At this point, I won't scare my friends and family. In other words, don't worry. I'm still brushing!
Conclusion
There
you have it. Even if you have some serious plaque built up on your
teeth, this protocol is supposed to knock it down and eventually
eliminate it. All I can say is that it's been less than five weeks,
and the protocol has already eliminated almost all of the annoying biofilm
that tried to take over my teeth. My teeth are visibly brighter, and
my mouth feels amazingly clean all day long. Here are some resources
you might find helpful:
About
Dr. Phillips:
http://www.drellie.com/Ellie-Phillips-DDS.php
Dr
Phillips' Protocol:
http://www.zellies.com/products-zellies-complete.html
About
Xylitol:
http://www.nature.com/bdj/journal/v194/n8/abs/4810022a.html
http://www.nature.com/bdj/journal/v212/n4/full/sj.bdj.2012.171.html
This
study seems to suggest that long-term use of xylitol may produce
resistant strains of bacteria. However, if you fix the problem, and
tune your diet, you might be able to reduce the acidity of your mouth
without having to rely on long-term use of xylitol. I still have
questions about this. In the short-term, it seems to promote good
oral health:
http://www.ncbi.nlm.nih.gov/pubmed/22218085
...and this study seems to contradict the previous one (unless I an not understanding something in the previous study). Xylitol is supposed to help with the reduction of S mutans responsible for plaque buildup:
http://www.ncbi.nlm.nih.gov/pubmed/7607748
This
study suggests that xylitol alone is not a silver bullet. If your
diet is not on point, and you're not using enough xylitol throughout
the day, you might only experience short-term positive results or no
significant results from the use of xylitol alone:
http://www.ncbi.nlm.nih.gov/pubmed/20415801
Diet
may prove to be the "missing link" to long-term oral
health, specifically, foods with lactobacilli. In other words,
certain fermented foods seems to promote good oral health in this
study:
http://www.ncbi.nlm.nih.gov/pubmed/19453574
Finally,
Dr. Phillips provides her own list of resources that claim xylitol
has a positive effect on oral health:
http://www.drellie.com/Resources.php
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