oral fitness and dental hygiene

A New Approach to Better Oral HealthBy Steven J. Edwards, DDS, BA BiologyWho needs another problem, especially a darn dental problem? Yet, most people have dental problems,including those who visit the dentist regularly. Hmmm Whats up with that?But, did you know that you canEASILYprevent 80% of most common dental problemswithout a dentistand even in your sleep? Imagine what it would feel like to have no dental worries. To be in charge of your oral health. To have your teeth and gums on a healthy autopilot no matter what you eat or drink. To save money and avoid expensive dental bills. And to have good checkups whether you visit the dentist once or twice a year, or even once every 5 or 10 years like me. Well, its true and I can help you.Sounds weird, I know. But not only is it possible, good oral health is essential for your overall health, because dental problems are linked to several medical problems, the most important include: Diabetes Heart disease Stroke Pneumonia Alzheimers Erectile dysfunction And every couple years new links are discoveredTherefore, you cannot be totally healthy without good oral health.Even though most dental problems are easy to prevent, according to the Centers for Disease Control and the American Dental Association: Dental problems in general are the 2ndmost common human affliction (after the common cold) Tooth decay in America is rampant among children and the elderly Tooth decay is the most common chronic disease from age 6 to 19 90% of people over age 20 have some degree of tooth decay 80% of American adults have gum problems ranging from gingivitis to severe gum disease Dental problems are a silent epidemic in America despite the facts that: 80% of most common dental problems (cavities and gum disease) areeasilypreventable 64% of Americas communal water supplies are fluoridated 57% of Americans have dental insurance About 55% of Americans visit a dentist regularly in good economic times About 40% visit a dentist in bad economic times America has 190,000 practicing dentists for 321 million people Thats 1 dentist per 1,689 people It takes at least 2,000 active patients to keep a dental office busyNow, you may ask, if the above is true, then why are dental problems so rampant? What else can we do? And what are all the dentists doing anyway?Actually, most dentists are just fixing stuff every day. Few dentists do anytrueprevention. I definetrueprevention as education and helping people help themselves.To be fair, most patients who come to the dentist just want to be fixed up and get the heck out of the office, so its not all dentists fault that they dont teach prevention. Besides, prevention doesnt make money. Also, dentists are not evenly spaced across the country. Some rural areas, Indian reservations, and small towns have no dentists, while other regions have an overabundance of dentists. Everyone blames dental problems on sugar, fast food, too much fluoride, lack of fluoride, genetics, lack of insurance, lousy insurance reimbursement rates, bad public assistance programs, scarcity of dentists in rural and poor areas, uneven dentist distributions, poverty, etc., etc., blah, blah, blah.Nevertheless, I have seen similar rates of decay and gum disease in fluoridated and non-fluoridated areas, in different countries where you can even buy fluoridated chewing gum, in the insured and uninsured, and in wealthy and poor areas. Why? Because people are the same everywhere. Everyone puts off stuff until it hurts. Everyone does the least possible thing to get by. Rich people are too busy jet-setting around, making deals, golfing, sailing, spending money, investing money, too busy to brush or floss, they rarely use their insurance fully, and often they are even more cheapskate about their teeth than average people because frugality is one factor of their wealth philosophy. Poor people cant afford anything anyway, let alone dental care. And the middle class is too busy working their butts off, managing kids, soccer, camp, scouts, etc. Plus, everyone consumes sugar, fast food, sodas, and junk food. Even athletes suffer decay from eating nutrition bars, getting dry mouth while exercising, and drinking sports drinks. Worse, few people brush properly and they actually damage their teeth and gums from brushing. And 80% of Americans absolutely guarantee their own dental problems because only 20% of us floss or clean between our teeth.But the #1 reason for rampant dental problems is: Misunderstanding of the true causes of dental problemsand failure to use effective prevention strategies and productsWe will never control dental problems with more water fluoridation, more insurance programs, more charities, lower fees, less sugar and junk food, and more dental professionals. In fact, I wager that dental problems would still be rampant even if all 190,000 U. S. dentists were evenly distributed and worked for free, because moretreatmentof symptoms is not the answer.More and bettertruepreventionis the answer.Helping people help themselvesis the answer. But to do this, we need a different perspective and understanding of dental problems.Everyone thinks that sugar causes decay and that dentists are the center of the dental universe. This is wrong and is as backward as thinking that Earth is the center of the universe.The truth is thatyouand themicrobesand thefoodsthat feed them are the center of the dental universe. Control the microbes, and you control the diseases. And I can help you.Decay and Gum Disease are contagious microbial InfectionsMost people, including many dental professionals, dont address, nor even fully understand the fact thatdecay and gum disease are actually contagious, transmissible, microbial infections.This means that if you harbor enough of certain pathogenic dental germs, you can suffer dental diseases and infect others. Conversely, if you dont have enough of the germs, your risk of suffering dental diseases and infecting others is low or zero. Period. End of story.For example, consider Tuberculosis. You are currently alive because either you harbor zero Mycobacterium tuberculosis bacteria, or if you do have the bacteria in you, they are not in significant numbers to cause you any obvious problems or kill you. By the same token, people will suffer decay and gum disease,or not, depending upon the quantity and types of bacteria inhabiting their body,or not.Therefore, the solution to our most common dental diseases (decay and gum disease) is the control of our oral microbes. In other words its oralprobiotics,prebiotics,plusOral Fitnessversuspathobiotics. The internationally endorsed definition ofprobioticsis live microorganisms(or sometimes killed or merely attenuated microorganisms)that, when administered in adequate amounts, confer a health benefit on the host. Prebioticsare defined asnon-digestible food ingredients or chemicals that stimulate the growth and/or activity of probiotic commensal organisms (bacteria and fungi) to beneficially affect the health and well-being of the host. In other words the foods that probiotics prefer to eat. Interestingly, prebiotics are generally the types of foods weshouldeat more of, but we dont eat enough of. As a result, our Western Diet tends to feed our bacteria (and our bodies) with some of the wrong types of food (sodas, junk food, fast foods, sugar) thus selecting for and supporting a number of pathobiotic organisms that cause us problems. Oral Fitnessis the application of physical fitness concepts to oral health. (By the end of April 2015 I will have an online Oral Fitness course with videos, podcasts, and graphics because the subject is too involved for this paper.) Pathobioticsareorganisms that cause us problems. I call them pathobiotics because sometimes they may actually be good microbes that have just overgrown, as opposed to pathogens, which are always bad.For you to suffer dental problems, you need all four of the following factors:1. A proper substrate or environment (tooth, root, gums, connective tissue, etc.) This is the easiest factor to control because to suffer gum disease you need a tooth root and gum crevice for the bugs to infect. Obviously, you cannot suffer cavities if your teeth are removed. Although this is the easiest factor, it is the least desirable.2. Time (frequency of exposures and length of exposures) This is the 2ndeasiest factor to control. If you were to limit all of your sugar intake to just once a day and then brush, floss, and rinse immediately after, you would definitelyloweryour risk ofdecay and gum disease. The worst things are to continually sip soft drinks intermittently throughout the day (frequent short exposures), or snack on candies throughout the day (frequent longer exposures), or worst of all continually chew sticky, gooey stuff like gummy bears or stuff that turns sticky and embeds in your teeth, like pretzels and chips (gooey, sticky foods are like tooth bombs). Sticky stuff basically coats your teeth almost permanently and feeds the microbes almost forever.3. Adequate numbers of the causative pathobiotic microbes (bacteria, fungi, and protozoa) This is the 3rdeasiest factor to control because most people do only a fair to poor job of oral hygiene. Oral hygiene controls the bugs somewhat. Oral Fitness is better. If you dont have the gum disease or cavity microbes in you, then it is impossible to suffer decay and gum disease. Period. Because, decay and gum disease are microbial diseases.(I have to repeat this several times for the concept to sink in, since few people associate the word infection with decay and gum disease. Its weird, but when I tell people they have a cavity, they are not as worried as when I tell them they have an infection, yet cavities are microbial infections of teeth.)However, in reality, your mouth has 6 billion microbes, and some of themwill bedental pathobiotics. But, it takes one million Colony Forming Units (CFU) of Streptococcus mutans per milliliter of saliva to begin having dental caries activity. Therefore, keep the bugs below that limit and you can almost forget about decay. Nowadays, you can add dental probiotics to your mouth and alter your oral microbiota on demandand lower your pathobiotic count, instead of crossing your fingers and hoping for salvation.4. Food (the foods that the pathobiotics prefer to eat) This is the hardest factor to control As stated before, cavity and gum disease microbes do not eat only sugar they also eat mucin, proteins, collagen, amino acids, starches, and even the remains of dead skin cells from your cheeks and the remains of other bugs in your mouth. And dont forget the nucleus-sucking, parasitic Entamoeba gingivalis that destroys your white blood cells that your body sends to fight gum disease! Also, you must eat. Therefore, you should eat as much as possible the foods that are beneficial to you and your probiotic microbes, which means avoiding sucrose and other simple sugars, eating more fresh fruits and vegetables, eating fiber (soluble and insoluble), and following an accepted diet, such as an anti-inflammatory diet or low glycemic diet.If you are missing any one or more of the above factors, your decay and gum disease risk will be minimal or zilch. However, you can trulyeliminate only one factor teeth. The rest are challenging to eliminate or control. Most people would like to keep their teeth, so the usual advice is to brush and avoid sweets, because thats about the simplest thing you can say that will provide some benefits without causing confusion to people. Yet it is not a good enough approach.For example, our western diet consists of too many simple carbohydrates such as sugars, high fructose corn syrup, processed starches, fast foods, junk foods, and sodas. These foods select for and support the types of pathobiotic organisms that result in cavities, diabetes, and intestinal problems. (This is also why we are just about the fattest nation on the planet.)If instead we regularly consumed high quantities of prebiotic non-digestible fibers, resistant starches, fructooligosaccharides (inulin), and other more complex carbohydrates, our bodies would eventually select for and support more probiotic organisms in our mouths and guts than pathobiotic organisms. Better yet, if we intentionally added specific probioticsplusprebiotics to our diet, we could immediately increase our probiotic load without waiting for it to haphazardly occur,andwe could maintain the organisms better.Good sources of prebiotics include raw and cooked: chicory root Jerusalem artichoke dandelion greens garlic leek onion jicama asparagus and other dietary functional fibers including non-starch polysaccharides such as: arabinoxylans cellulose resistant starches resistant dextrins inulin lignin waxes chitins pectins beta-glucansIf this sounds too confusing, you can simply buy a bottle of Now FoodsFiber-3or KlairesBiotagenpowder and mix it into smoothies, yogurt, or kefir.Below is a shortened excerpt from Klaire Labs, a well-known and respected probiotic company:Unfortunately modern Western diets often lack friendly bacteria that help optimize digestion, support immune system function, aid in production of vitamins, and defend against potentially harmful bacteria. Stress, disease, aging, exposure to toxins, or use of antibiotics and certain medications can reduce the numbers of beneficial bacteria and set the stage for digestive disorders, impaired immune function, increased allergic sensitivity, and inflammation. Probiotics help replenish and maintain the essential gastrointestinal microflora missing from the diet or disrupted by antibiotic therapy or other factors. By blending together various bacterial strains that normally predominate in the small intestine and colon, comprehensive benefits for the healthy function of the entire gastrointestinal tract can be obtained. Probiotics should be used on a daily basis by children or adults to support gastrointestinal and immune function and provide probiotic support for those with intestinal dysbiosis, increased intestinal permeability (leaky gut), viral and bacterial gastroenteritis, food allergies, eczema, or gastrointestinal complaints such as diarrhea, constipation or abdominal pain. Long-term probiotic supplementation can play an important role in restoring and maintaining a healthy, balanced gastrointestinal microflora.Whats interesting is that one can apply the above same concepts of gut health to oral health, because the mouth is the origin of the digestive tract. The mouth is just a different gut niche than the stomach, small intestine, large intestine, or colon. In addition, certain digestive maladies such as leaky gut syndrome and ulcerative colitis seem similar to gum disease. With gum disease, gum tissue epithelial lining and connective tissue can become ulcerated like intestinal lining, thus leaking bacteria and other substances through the gums into the bloodstream to cause systemic problems. Therefore, if certain microbes can improve leaky gut, then it should be possible to improve leaky gums. And it is possible!Furthermore, many toothpastes and mouth rinses are broad-spectrum dental germ killers. Some dental experts suggest that our constant use of dental germicides such as fluoride, triclosan, peroxide, sodium lauryl sulfate, cetylpyridinium chloride, essential oils, and chlorhexidine takes a toll on our good oral microbes similar to taking antibiotics and altering our gut microbiota. Although most mouthwashes and toothpastes last only about 15 minutes in the mouth, chlorhexidine, cetylpyridinium chloride, and triclosan with copolymer can kill microbes for up to 12 hours. Such long-term germ-killing is questionable because, like hardy weeds and delicate flowers, many pathobiotics are hardier than probiotics. Thus, we are indiscriminately killing many good dental germs along with some bad dental germs, which allows the surviving bad germs to eventually overpopulate. Furthermore, few if any of us supplement with specific dental probiotics, other than possibly eating yogurt with active cultures. This means that repopulation of good bugs in our mouth occurs haphazardly at best, or probably very little. And worse, we eat foods that support the bad microbes, but we rarely eat foods that support the good microbes. In fact, physicians recommend taking probiotics and prebiotics while you take antibiotics, and for at least two weeks longer to try to repopulate your gut with good bacteria and prevent the bad ones from taking over.Therefore, just like taking gut probiotics for better intestinal health, it makes sense to consider taking dental probiotics for oral health. Consider that you are not taking antibiotics twice a day for most of your life, but you probably brush your teeth and use a mouthwash twice a day most of your life. Therefore, it is probably even more important for oral health to take dental probiotics regularly. Luckily, many gut probiotics are actually dental probiotics too. Yet, you eat them instead of letting them linger in your mouth. In other words, you eat yogurt, but you dont usually squish it between your teeth and use it like a mouthwash. Thus, there is a need for specific dental probiotic delivery systems, such as tablets, powders, and rinses. So, the trick with dental probiotics is to dissolve them slowly in the mouth instead of swallowing them quickly, because you want your dental probiotics to take hold and colonize your mouth. Once they are in your gut, they are not doing anything for your mouth. Along with the probiotics, it makes sense to eat prebiotics in order to support the probiotic organisms, while avoiding foods that support the pathobiotics.On the next few pages is a short list of important probiotic organisms that confer oral health benefits. You can obtain all these probiotics and more by shopping online or at your local health food store, and/or eating fermented foods such as kefir, yogurt, sauerkraut, kimchi, and kombucha. For more information, just Google probiotics for oral health, or visit:Great Oral Health,Oragenics,Klaire Labs.ProbioticsTargetsPathobiotics affected

Bifidobacterium bifidum

Gums

Staphylococcus aureus

Bifidobacterium breve

Gums


Bifidobacterium infantis

Gums


Bifidobacterium longum

Decay

Streptococcus mutans

Gums

Porphyromonas gingivalis


Lactobacillus acidophilus

Gums


Prevotella intermedia


Lactobacillus bulgaricus

decay


gums


Lactobacillus casei

gums


Lactobacillus gasseri

gums




Lactobacillus paracasei

decay


gums




Streptococcus salivarius

Streptococcus sanguinis

Lactobacillus plantarum

decay


gums



Lactobacillus rhamnosus

decay


gums




Streptococcus salivarius

Streptococcus sanguinis

Lactobacillus salivarius

decay


gums




Pediococcus acidilactici

gums


Saccharomyces boulardii

biofilm

Blastocystis hominis

Candida albicans

Clostridium difficile

Entamoeba histolytica

Escherichia coli

Giardia lamblia

Helicobacter pylori

Hemolytic Aeromonas

Salmonella typhimurium

Vibrio cholerae

Yersinia enterocolitica

Streptococcus salivarius K-12

decay


Streptococcus sanguinis M-18

biofilm + decay


Streptococcus thermophilus

decay


gums


The true dental situation:1. Your mouth contains about 6 billion microbes composed of at least 700 different types of viruses, bacteria, fungi, and protozoa. Some are pathogenic but most are beneficial, thank goodness.2. Luckily, only about four types of bacteria (Streptococcus mutans, Actinomyces, Nocardia, and Lactobacillus acidophilus) plus a fungus (Candida albicans) seem to cause any significant dental decay. Furthermore, these microbes are facultative anaerobes (able to live with or without oxygen) often living on surfaces exposed to oxygen. Dental decay is fairly easy to control because of the few types of microbes involved and the ease of reaching them.3. However, about 60 types of bacteria and protozoa cause gum disease. The worst ones are generally strict anaerobes (die in the presence of oxygen) and prefer to live in deep crevices. Therefore, gum disease is harder to control because there are so many types of bugs and because of where they live. Gum disease always starts on the surface and morphs and matures into organisms that burrow under the gums. Luckily, if you can control the surface microbes, you can eventually control the subsurface microbes, because the subsurface microbes survival depends somewhat on byproducts from their surface co-microbes.4. Our oral microbes live in various niches:1. On exposed tooth surfaces2. In tooth cracks, grooves and pits, and even under fillings and crowns3. On the tongue, cheeks, mucosa, roof of the mouth4. In shallow crevices between gums and teeth5. Deep in connective tissue between gums, jawbone and teeth6. Even in the epithelial lining and your own body cells lining the supporting connective tissue for your teeth roots7. Worst of all, some of them can infiltrate damaged blood vessels in your gums and circulate throughout your body, landing on heart valves, artificial joints, and causing blood clots.So, how do we get these microbes? Where do they come from?1. Microbes are the oldest and most ubiquitous life forms on Earth. They are everywhere, from two miles deep inside solid rock, to the upper atmosphere just floating around in air. Some have even survived 1 years of exposure to space outside the International Space Station! http://www.popsci.com/technology/article/2010-08/bacteria-survive-553-day-exposure-exterior-iss2. Our mothers pass the first organisms to us immediately during birth, then via nursing with colostrum for the first week or so. Then we get them via kissing, feeding, playing, sticking everything in our mouth as a kid, etc.3. Within weeks we are populated with billions of microbes from air, dirt, everything we touch and eat, and whoever we spend time with and play with.4. By age three our microbiota (total colonies of organisms) reaches and stays at about 100 trillion organisms in and on our bodies. This is ten times the number of our own somatic cells. All these organisms contain about 200 times the amount of our own genetic material, so some scientists believe we should consider our microbiota like another organ, or maybe even another entity. It almost seems as if humans have evolved to house and transport these microbes in a symbiotic relationship. In fact, our mitochondria (the powerhouse or energy supplier) of our own cells have their own DNA and may have once been separate organisms that somehow became incorporated as endosymbionts within our own cells eons ago. http://en.wikipedia.org/wiki/Symbiogenesis5. Normally, the microbes that inhabit us multiply until they reach an equilibrium determined by their environment, available food, host responses, chemical signaling among one another, and dozens of other limiting factors, otherwise, we would probably be devoured within a few hours. I estimate that if you started with onlyonebacterium in your mouth at night, and if it could multiply without any limitations, by morning your mouth, nose, and sinuses would contain 281 trillion cells weighing about 21 pounds, and you would be suffocated. Therefore, it is not in the microbes interest to kill us (at least that fast), but rather, they tend to use us for as long as possible, until some day that our immune systems break down, or we get too old, or suffer other complications that allow them to overwhelm us. In fact, our existence is just a temporary victory over all the bugs that inhabit us.6. Some microbes are permanent residents in and on us. Others are just passing through, staying awhile, and sometimes colonizing for good if consumed often enough, or until eradicated with antibiotics. Our microbial makeup changes throughout our life depending upon our age, hormones, diet, stress, disease, antibiotic usage, significant others, where we live, etc.7. Most bacteria, good or bad, have tiny fibers (flagellae and pili) sticking out from their cell membranes. These fibers act as little arms, legs, propellers, and feelersto enable them to crawl, swim, claw, squeeze, and ooze their way into their preferred niches. Once installed into their niches, the external fibers act like Velcro hooks attaching the microbes to each other, biofilm, tooth, root, skin, intestinal lining, and even to communicate with, or kill each other.8. Occasionally certain microbes may overgrow or crowd out others to gain an advantage, which sometimes ends up causing us humans to suffer inflammation or disease. This overgrowth can happen if our immunity is compromised due to stress, overwork, inadequate sleep, improper nutrition, genetic problems, antibiotic therapy, accidents, and many other situations.9. Gum disease is caused by at least 60 different types of microbes. It starts as inflammation at the external-most gum/tooth interface due to microbial infiltration from overgrown and undisturbed dental plaque due to poor or ineffective oral hygiene. From there it spreads into the gum crevices and eventually into the connective tissues between the tooth roots and bone.10. Most people have no concept of the microbial world and the tiny sizes and distances involved. To give you an idea, most bacteria are so small that six billion (the entire human population of Earth) live just in your mouth. The average size of a bacterium is about one micron in diameter. A micron is one thousandth of a millimeter. Therefore, if you laid a thousand bacteria end to end, the distance covered would be one millimeter which would be the length of this dash (or 0.0394 inches) when viewing this page at 100% magnification. Likewise, if you laid a thousand humans (5.28 feet tall) end to end, the distance covered would be a mile (5,280 feet). Therefore, to a bacterium, one millimeter is equal to a mile, in human terms. Thus, if you have a gum pocket of 5 millimeters deep, this would equal the depth of the Mariana Trench, the deepest oceanic spot on earth and one of the hardest places to reach! More people have been on the moon than to the bottom of the Mariana Trench, and its almost just as hard to clean teeth beyond 5 mm. I hope you can start to visualize how many bacteria inhabit only your mouth and how hard they can be to find and kill with traditional means.11. These microbes crawl, squeeze, and claw their way into the crevices between gum and tooth as deeply into the crevices as possible, and even into the actual gum tissues lining the crevices. (These include beneficial bacteria, pathobiotic bacteria, pathogenic bacteria, and even parasitic protozoa such as amoebas.)12. Along their journey, the gum disease microbes consume mostly protein, collagen, mucus, dead cell byproducts, and body fluids. They excrete and secrete hydrogen sulfide gas, ammonia, amines, toxins, enzymes, antigens, phenolic compounds, metabolic byproducts, and even hydrogen peroxide and alcohol. Their exudates affect other bacteria as well as your bodys connective tissues, blood vessels, and bone, and cause inflammatory responses in your body.Notice I didnt mention sugar. There is the common misconception that sugar causes most dental problems. This is untrue.Microbes cause dental problems. Sugar and other simple carbohydrates are the main foods fordecay microbes, although they can eat mucin, amino acids, and proteins if necessary. Proteins, collagen and amino acids are the main foods forgum disease microbes. This is why you cannot gain total control over decay and gum disease by trying to avoid sweets because the darn germs can eat other foods too. This does not mean you can eat all the sweets you want. It means that your most promising preventive dental choice would be to control the bacteria. You can do this by pitting beneficial probiotic bacteria against detrimental pathobiotic bacteria and let the bugs fight each other. In the meantime, you can feed your probiotics with the foods they prefer meaning complex carbohydrates, fiber, fresh fruits and vegetables, and following diets such as the Anti-inflammatory diet, Paleo diet, Low Glycemic diet, or Mediterranean diet.13. The entire situation in your mouth is like a horror movie taking place in a prehistoric jungle with all kinds of good and bad carnivorous bugs, plants, and beasts lurking everywhere, fighting amongst themselves and fighting you, or in the case of beneficial bacteria even sometimes helping you in their own primitive ways.14. One especially bad pathogenic microbe, the parasitic amoeba Entamoeba gingivalis found in 95% of people with gum disease is like a monster out of a horror movie. Like a vampire or a spider, Entamoeba gingivalis punctures the white blood cells that your body sends out to fight disease, and devours their nuclei. The damaged, lifeless, white cell bodies ooze out their cellular contents and decompose, thus feeding surrounding bacteria, which release bacterial toxins into your gums. Horrible! If you want to read a terrifyingly fun book about the microscopic world, read Micro by Michael Crichton (Jurassic Park author) its kind of like a Jurassic Park of insects.15. Advanced gum disease occurs in places too far under the gums for you to reach with any toothbrush, floss, pick, or irrigator. No matter how hard you try, about the deepest you can clean under your gums is 2.5 mm, even with the best electric, sonic, ultrasonic, and ionic toothbrushes perfectly aimed into the gums and using the best brushing techniques. Therefore, if you have a gum pocket that is only 5 mm deep, that means two and a half miles of microbial crud, biofilm, and microbes remain totally unaffected despite your own best Oral Fitness efforts with the best equipment and dentifrices on the planet.16. This the main reason why gum disease is such a stubborn problem to fight. You simply can never really get to the root of the problem because you at home can never clean deeper than 2.5 mm. Furthermore, what good is it to have your teeth professionally deep cleaned 4 days per year, when for the other 361 days your teeth are virtually wallowing in a cesspool of microbial biofilm and toxins? Would four showers per year be of much benefit to you? And worst of all, studies show that professional dental scaling done by expert dental hygienists is ineffective beyond 7 mm.17. As for dental decay, fewer microbes are involved only about four main ones and just one of them is really bad Streptococcus mutans. A count of one million Colony Forming Units (CFU) of Streptococcus mutans per milliliter of saliva is associated with potential caries activity. Fewer than one million, and you may be cavity-free, or at least have a very low decay rate. So, you see, you could have decay bacteria residing in your mouth for a long time and not suffer any decay until their numbers get out of whack, and then, presto you have a cavity after being cavity-free for a few years.18. Decay bacteria are aerobes and facultative anaerobes (meaning they can survive with or without oxygen if necessary). They prefer to live within biofilm on exposed surfaces and they dont burrow deep under the gums; however, they can burrow deep into teeth.19. Dental decay bacteria prefer to eat simple sugars, and starches, but most people dont know the bugs can eat proteins and mucus if necessary. When they eat simple carbohydrates, the decay bacteria excrete various metabolites and acids, including lactic acid, acetic acid, butyric acid, and propionic acid. These acids dissolve the inorganic minerals from our teeth until reaching some organic tissues that the bacteria can digest. Then the bugs turn on their digestive juices and digest the organic tooth matrix until reaching too much mineralization to digest, whereupon their acidic exudates dissolve more mineral, until reaching more organic matrix, repeating this cycle until eventually reaching the pulps of the teeth, entering the root chambers, extruding out the tips of the roots into the jawbone, and causing abscesses.20. Now, I ask you, are teeth sweet? Is enamel sweet? Is the dental pulp sweet? Is bone sweet? No to all. Therefore, does it make sense to say that sugar and sweetscausedecay? No. The decay microbes can eat your teeth whether or not you eat sugar. They just dissolve your teeth faster when you eat sugar. And by the way, not all sweets are food for decay bacteria. For example, xylitol, stevia, erythritol, and inulin are all sweet, but are not useful foods for decay bacteria. In fact, xylitol is really interesting because decay bacteria can actually eat xylitol, but they cannot make acid nor plaque from it, and they cant metabolize all of it, so some of the xylitol remains in their system and builds up until eventually bursting the cells. Therefore, xylitol is one sweet that everyone should use if they wish to reduce dental plaque and fight dental decay. Thus, if you were to avoid sweets, you would be avoiding at least one sweet that could actually help you prevent decay, yet few people know this, and surprisingly, not many dentists are knowledgeable about xylitol either.21. It turns out that our modern western diet of chips, candy, Twinkies, fast foods, sodas, sugar, junk food, snacks, cakes, candies, desserts, promotes the growth of cavity and gum disease bacteria 22. Its hard not to eat these types of food because they taste good, are easy to keep, store, and eat, and are so ubiquitous.23. To change our oral bacteria, we would have to change our diets drastically and eat lots of raw garlic, raw onions, raw leeks, lentils, beans, sauerkraut, kimchi, cabbage, kale, and all the other stuff that is a pain in the neck to wash, peel, prepare, and then deal with the aftermath of garlic/onion breath, possible gas and bloating, etc.24. Nevertheless, it would be good to at least try to eat a Mediterranean diet, or a low glycemic diet for diabetics, or an anti-inflammatory diet and incorporate some fermented foods and probiotics as well.The problems with oral health:1. It is impossible to remove all dental plaque from teeth and gums, even after the most incredible professional deep cleaning, polishing and irrigation by the worlds greatest dental hygienist. Even products such as Listerine that say, Kills 99% of germs, are misleading because, they dont say which germs are killed, where, and for how long. Maybe Listerine kills 99% of germs on a few surfaces for 10 minutes, but thats only one generation of germs. In the next 10 minutes, other germs nearby can double in number and eventually repopulate. You cannot easily kill germs that reside within dental plaque, unless you try to destroy the plaque first with special products and procedures. Dental plaque is a complicated biofilm structure with channels to provide nutrients, eliminate wastes, and flush out antagonists, antibiotics, and antimicrobials. In fact, you might think of dental plaque as sort-of a colonial organism like a jellyfish or a slime mold, as the plaque sort of takes on a life of its own, along with the lives of the cells that inhabit it and produce it. Also, the microbes within dental plaque operate as if in an interconnected continuum, which is different from when they are free-swimming planktonic organisms. Sort-of like theBorgof the microbial world. Weird!2. Nevertheless, imagine if you can, that your teeth and gums are perfectly 100% clean of microbes, scum, tartar, etc., and only pure teeth surfaces and gum epithelium exist.3. The first thing that happens is that mucus-filled saliva washes over the teeth and gums, and instantly a viscous mucoprotein called mucin attaches to your teeth and gums, forming the first foothold for microbes to begin attaching to your teeth and gums. These initial microbes reside on your cheeks, top and back of your tongue, under your tongue, in your sinuses and throat, and even in the air you breathe, the food you eat, and who you kiss, etc. You cannot escape the microbes. Resistance is futile. (However, with help, you can avoid assimilation.)4. Within 9 hours after a dental scaling, cleaning, or whatever, dental plaque has already formed and continues increasing relentlessly on surfaces and even into the crevices between the teeth and gum tissues.5. By day 2, plaque begins to mineralize and harden into tartar, while new plaque keeps growing onto old, hardened and hardening plaque in a never ending cycle.6. Meanwhile, gum disease starts, obviously, at the surface of the gum and tooth as dental plaque, which invades the first 1 3 millimeters of the gingiva.7. At the initial stage of gingivitis, the disease is just an inflammation of the gingiva and can be reversed with proper Oral Fitness.8. However, sometime between months one and three, the gum disease microbes crawl deep into the gum/teeth crevices and begin making craters and hiding places under the gums where toothpaste, mouthwash, floss, brush bristles, picks, and irrigators cannot reach.9. Once the microbes advance beyond 2.5 mm under your gums, it is impossible to reach the bugs with ordinary home care devices, because you cannot clean your own teeth deeper than 1.5 mm unless you hold your toothbrush exactly perfectly at 45 degrees to the teeth. And even if you brush perfectly at 45 degrees on every tooth surface, you cannot clean deeper than 2.5 mm no matter what you do, even if you use a sonic or ultrasonic toothbrush.10. Also, once a cavity in a tooth reaches beyond 80 microns (the thickness of one or two human hairs), the cavity cannot ordinarily be remineralized and will nearly always proceed to frank decay and will need a filling.11. So, how can you affect the nasty microbes that live so deeply under the gums or burrowed into teeth, or residing in biofilm?12. With probiotic replacement, thats how. Why not regularly send billions of known beneficial gum microbes deep into the gums, plaque, and teeth to crowd out the pathogens. Heres how:Materials needed:(You can obtain some of the products below on ourshopping site.)All of the products and concepts below are designed to: Penetrate dental plaque Kill pathobiotics and pathogens within dental plaque Preserve, replenish, and grow probiotics in favor of pathobiotics and pathogens Feed the probiotics Make things as easy, simple, automatic, convenient, no-brainer, safe and effective as possible Be as cost-effective and/or economical as possible, yet as valuable as possible Be alcohol-free, sodium lauryl sulfate-free, toxin-free, fluoride-free (although I believe fluoride is still useful for many people, yet many other people are against fluoride) Prevent canker sores and be easy on the mucosa Fight dry-mouth1. CloSys mouth rinse Get the largest bottle. CloSys rinse comes with a tiny capsule of mint flavor to add if you like. CloSys is marketed as chlorine dioxide. Chlorine dioxide (Cl O2) actually penetrates dental microbial biofilm (plaque) and kills many plaque organisms. To be clear, and to prevent certain haters from taking issue with me, CloSys is technically stabilized sodium chlorite (Na Cl O2), not chlorine dioxide. Chlorine dioxide is actually a gas that is difficult to store and use easily. In order to create the gas, you must always mix two components and then use them within a day or two before the gas degrades and dissipates. This is problematic and a hassle when trying to create a simple preventive program. Furthermore, chlorine dioxide gas penetrates dental plaque and kills some bacteriabut then reacts with dental plaque and turns into sodium chloritewithin dental plaque. The resultant stored sodium chlorite inside the plaque turns into chlorine dioxide gas when dental plaque becomes acidified by your pathobiotic microbes, such as when eating sugary foods or drinking sugary, acidic beverages. Therefore, a simpler and easier way to accomplish about the same results as using true chlorine dioxide is to just rinse with sodium chlorite which will penetrate the plaque and sit there until the plaque becomes acidic and turn into chlorine dioxide. Similar results just easier and simpler.2. CloSys toothpaste3. Livionex toothpaste As an alternative to CloSys toothpaste. Or instead of CloSys toothpaste. Or, better yet, in addition to CloSys toothpaste. This is an amazing toothpaste that absolutely destroys dental plaque at least 2.5 x better than any other toothpaste. Plus, it is nontoxic and made of ingestible ingredients. I believe Livionex is a significant advance in nontoxic, safe, plaque-reducing toothpastes If you were to alternate CloSys and Livionex, I dont see how dental plaque could stand a chance of growing to any significant amount. In fact, although Livionex has a slightly runny consistency, this is sort of an advantage, because: you can squirt Livionex into your AirFloss or Waterpik and shoot it between your teeth for extra benefits you can floss Livionex between your teeth because it acts almost as a lubricant for floss4. Two small silicone medicament travel bottles (Bed Bath and Beyond, CVS) One bottle for CloSys and one for xylitol. I like things handy. If I have to remove a lid, put the lid somewhere, find a glass, pour a little into a glass, replace the lid, use the glass, put the glass back Im already tired. I would rather pour some stuff into a squirt bottle to use for a week or two and just flip the top of the squirt bottle and squirt some into my mouth, flip the top closed, and put the squirt bottle back.5. Sonicare Flex Care electric toothbrush Dislodges dental plaque and microbes even in shallow gum pockets and somewhat between teeth if held correctly. Cleans gum lines 1 mm past the tips of the bristles by sonically agitating fluids in the gum crevices. You need not scrub your teeth just aim the bristles 45 degrees into the gums and let the brush do its job. What could be easier than that?6. BreathRX tongue scraper The tongue surface area is larger than the entire palate. Hundreds of millions of microbes live on the tongue. The tongue is a huge reservoir for bacteria. Therefore, tongue-scraping is essential for bacteria control, bad breath control, as well as for repopulation with probiotics. Whats the point of brushing your teeth but never removing the crud that builds up on your tongue? Did you ever move into a carpeted apartment formerly occupied by a smoker or a pet-owner with pet pee and odors embedded into the carpet? Thats your tongue surface.7. Interdental cleaning is absolutely essential to oral health. Unless genetically gifted, whosoever does not regularly clean interdentally might as well permanently forget about ever obtaining any semblance of good oral health. Thats a fact. I have a saying similar to famous football coach, Vince Lombardi: Show me a person who fails to clean between their teeth and Ill show you a dental failure. Sorry, but its true. When I tell people I actually floss twice a day, most people look at me like Im a Martian. I dont get it. Why wouldnt anyone floss twice a day unless they gag or are paralyzed or disabled. If you could look over my shoulder every workday and see what I see, you would definitely floss at least once a day. Glide floss because it is Teflon and goes between teeth easier than any other floss and resists shredding and breaking. This works well when flossing toothpaste between teeth especially Livionex. Sonicare AirFloss (or a Waterpik) because 80% of people dont floss, cant floss, or dont floss correctly, or name the excuse. Besides, the AirFloss mixes air and water or mouthwash to blast bacteria, plaque and food from between teeth. Remember that gum disease bacteria are anaerobes. They hate oxygen. That is why they burrow like parasites under the gums. So, hitting these bastards every day with an oxygenated spray can make life miserable for them and reduce their growth. You can squirt the CloSys mouth rinse or xylitol solution into your AirFloss and blast that between your teeth as an irrigant.8. Xylo-Sweet xylitol granules 3 to 5 pound bag Spoon a couple spoonfuls of Xylo-Sweet into your Go-Toob squirt bottle and fill the bottle with tap water, and presto you have a couple-week supply of squirtable xylitol. Twice a day squirt some xylitol/water solution into your mouth and swish it around for at least a minute. You dont need to swallow it because it does no good for teeth once its in the gut. Do it while showering, getting ready for work, bed, etc. Xylitol has a long and proven history of killing Streptococcus mutans (the main cavity bacterium) and other unfriendly oral microbes as well. Another benefit is that it can stimulate saliva formation for some people with diminishedsaliva flow. It seems that some beneficial bacteria can tolerate xylitol exposure more than many of the bad ones; therefore, regular, timed exposures throughout the day can eventually destroy Streptococcus mutans (S. mutans) and select for more beneficial oral microbes. The problem is that you have to use at least a gram of it multiple times every day like 7-10 times a day to be truly effective, which means morning, after snack, lunch, after snack, dinner, after snack, before bed. It has been shown that using 7-10 grams of xylitol every single day without fail for six months straight could dramatically inhibitS. mutans for up to 2 years by promoting the growth of good oral bacteria instead of bad ones. (And just to be absolutely certain, I would add specific, known dental probiotics instead of twiddling my finders and waiting for the good guys to come on board by themselves.) Until about the last 5 years, research on xylitol was performed without subjects taking additional probiotics. Yet, despite the subjects not taking any probiotics, merely using xylitol every day managed to allow good bacteria to gain a foothold against the stronger bad bacteria just by chance. Now, I notice that many probiotic supplements contain some xylitol. So, imagine how much better and faster you could improve if you were to supplement your oral microbiota daily with known strains of specific beneficial organisms while also killing the bad ones.9. Xylitol chewing gum Chewing xylitol gum throughout the day will do the following: Break up newly formed dental plaque Stimulate saliva flow to neutralize dental plaque acids Dislodge food particles Coat the teeth in xylitol for about 15 minutes at a time Helps achieve the 7-10 xylitol doses per day needed to begin destroying Strep mutans dental decay bacteria10. Probiotics Great Oral Health dental probiotics Oragenics Evora Plus or Evora Pro dental probiotics Instead of waiting for some good bacteria to haphazardly take their time and grow, the idea is to forcibly repopulate the mouth several times daily with specific bacteria that are already proven to be beneficial. This is a relatively new subject and needs more research, but it is very promising, and I believe this is where much of preventive dental treatment will soon be heading. People are tired of hearing about communal water fluoridation and other toxins in our environment. Lets minimizethese toxins and let the bugs duke it out among themselves. After all, theyve been battling each othernaturally for billions of years and they have developed ingenious offensive and defensive strategies that we are unable to replicate so far other than to create antibiotics. But look where the double-edged sword of antibiotics have gotten us drug-resistant superbugs, overgrowth of bad bugs, etc. Oragenics Evora Plus three types of bacteria two for gums and breath, and one for decay Great Oral Health probiotics seven types of bacteria with various functions for gums, breath and decay You dont need to eat the probiotics you can just dissolve them or chew them and swish them around and then spit out. The probiotics are simply live bacteria that you would eat when you eat yogurt with live cultures, sauerkraut, kimchi, buttermilk, kefir, certain cheeses, kombucha, etc.Technique and Rationales:1. Fill one small silicone squirt bottle with CloSys mouth rinse, and then set it aside for future use.2. Spoon two teaspoons of Xylo-Sweet xylitol granules into the other silicone medicament squirt bottle and fill it the rest of the way with tap water, then set it aside for future use.3. Put a small glob of CloSys toothpaste into your mouth and squish and swish it around real well before brushing. Or substitute Livionex toothpaste everywhere you see CloSys toothpaste.4. Use the Glide Floss to floss the toothpaste between your teeth and under your gums. Whoever does not floss daily or use some sort of device or method to clean between the teeth daily might as well permanently forget about having good oral health. Thats a fact. Forgive me, but I have another saying, Floss is dental butt-wipe. So, imagine how it would be if you rarely used toilet tissue. Now imagine the bugs in the cracks of your teeth and gums. Sorry, but sometimes it takes some weird visuals to get my points across. I was able to quit smoking by imagining myself putting my head over a smoking trash can. To this day, any time I get the urge for a cigarette, I visualize my head over a smoking trash can and I actually feel like coughing. When I talk to my wife about the 100 trillion microbes that inhabit us, she starts getting itchy. Visuals can be powerful motivators.5. Spit out the excess and then put another glob of CloSys toothpaste into your mouth and squish and swish that one around too.6. Brush with CloSys toothpaste first to remove as much dental plaque as possible before rinsing. This way, having already flossed and brushed, there will be less plaque for the CloSys rinse to have to penetrate. Remember, it is virtually impossible to remove all dental plaque, even with Livionex. Therefore, because some plaque will always remain, the CloSys rinse can penetrate it and store the sodium chlorite until necessary. Genius.7. Rinse out the toothpaste foam with the CloSys mouth rinse.8. Squirt some CloSys mouth rinse from the silicone squirt bottle into the AirFloss reservoir and irrigate your teeth and gums with the AirFloss. Remember floss or irrigate daily the teeth you want to keep. Whoever does not do some sort of interdental cleaning every day might as well take every cent spent on dental care, toothpaste, etc., and flush it down the toilet.(Actually, if you make a serious attempt to follow the steps in this program, you could take a day off from interdental cleaning here and there. Just like with exercise, you need a day off once or twice a week, and you need a food cheat day once a week but these concepts are part of my Oral Fitness challenge program on myUDEMY training website where I can get into more detail.)9. Spit out the CloSys mouth rinse and then squirt some Xylo-Sweet/water mix into your mouth and swish that around for a while at least a minute or so. Try this while getting ready for work, shopping, bed, whatever.10. Spit out the Xylo-Sweet/water11. Use the tongue scraper to scrape your tongue at least 4 times top, left, right, and then top again.12. Wait 30 minutes if possible, then dissolve a probiotic tablet slowly in your mouth. Swish and squish the probiotics around and between the teeth occasionally. You could swallow the probiotic residue, but during pregnancy, there is some slight possibility of altering the bacteria in your gut, and maybe having gas or bloating, like if you ate beans. This will not happen if you merely squish, swish, and spit. For one hour after using probiotics do not eat, drink, brush, rinse, or use any xylitol products or you will reduce the probiotic benefit.13. For the first 30 days, use two probiotic tablets per 24 hours one probiotic tablet in the morning and one at night.14. After 30 days, use one probiotic tablet per 24 hours preferably at night before bedtime, and let it work while sleeping. Always let them dissolve slowly, as the probiotics do no good for your teeth when they are in your gut.15. During the day, carry xylitol gum with you at all times, everywhere, and chew it immediately after every meal, snack, drink, soda, gummy bear, coffee, or anything and everything you might eat. Consider the xylitol gum as if it were one last bit of food with every other food you eat, drink, etc. If you do this at least 5 times per day for at least 6 months, PLUS all the other stuff listed above, you will drastically limitthe dental decay bacteria and gum disease bacteria in your mouth, AND, you will have a good chance not to transmit your decay bacteria to your loved ones!Probiotic ChoicesEvora Plus Mild mint flavor 30 tablets/bottle $16 $20 per bottle of 30 tablets 300 Million bacteria total per tablet Dose: 1x/day evening, 30 min after oral hygiene Contains 100 million each of: Streptococcus rattus JH145 excretes alcohol instead of acid, so it is incapable of causing decay fights S. mutans via lantibiotics Lantibiotics are a class ofpeptideantibiotics (bacteriocins) produced by manyGram-positive bacteriasuch asStreptococcusandStreptomycesto attack other Gram-positive bacteria. Microbes always must fight for space and resources, so they have evolved methods of signaling, inhibiting, and killing other microbes. For example, a type of mold called Penicillium notatum produces the antibiotic Penicillin, which kills certain types of bacteria. We already have billions of bacteria in our mouths, all excreting innumerable acids, toxins, and other compounds, so this is nothing new. However, instead of leaving things to chance, we might as well install some bacteria that we know are beneficial bacteria and that are found in people who have good oral health. We might as well let the good bugs fight it out with the bad bugs like they have been doing all along for eons. Results: S. mutans (cavity bacterium) levels reduced after one month Streptococcus oralis KJ3 produces H2O2, (hydrogen peroxide) fights bad breath and gum problems whitens teeth Results reduced gum inflammation, shallower gumpocket depths within three months Streptococcus uberis KJ2 produces H2O2, (hydrogen peroxide) fights bad breath and gum problems whitens teeth Results reduced gum inflammation, shallower gumpocket depths within three months Remember that most gum disease bacteria are anaerobic (hate oxygen), and that 2H2O2breaks down into 2H20 + O2, which is just water andOXYGEN.Great Oral Health probiotics Two flavors: mint and strawberry/vanilla 60 tablets $25/60 tabs 3Billiontotal bacteria per tablet Dose: two per day for the first month, then one per day in evening thereafter, 30 minutes after oral hygiene 7 types of bacteria1. Streptococcus salivarius (BLIS K-12) inhibits S. mutans2. Streptococcus salivarius (BLIS M-18) inhibits S. mutans3. Streptococcus thermophilus a subspecies of S salivarius4. Lactobacillus acidophilus inhibits periodontal bacteria, fights gum inflammation5. Lactobacillus salivarius reduces gum pocket depth, fights periodontal bacteria6. Lactobacillus paracasei reduces S. mutans after 2 weeks7. Lactobacillus reuteri reduces crevicular (gum) fluid, reduces gum inflammation and fights rotavirus (a type of diarrhea virus) For an excellent explanation, click this link toGreat Oral Health, and see the graphic below:Summary:Our current lifestyle, diets, stress, antibiotics, toxins, food preservatives, processed foods, etc. seem to be capable of affecting our microbiota (microbial inhabitants of our bodies) in such a way as to tip the delicate balance toward relatively unfriendly microbes than are capable of surviving harsh environments. It is estimated that as long as you have about 85% beneficial microbes overpopulating the bad ones, you will have improved health in your gut, mouth, respiratory tract, etc. However, for many of us, this 85%/15% ratio becomes distorted, and the result is disease.By studying the microbiota of healthy people, we can determine many types of beneficial bacteria, just like when we discover pathogenic bacteria from sick people. Therefore, armed with knowledge of good bacteria (probiotics) we can purposefully try to repopulate our mouths, guts, etc. with good microbes. And then we can try to maintain an environment that supports them.Unfortunately, it turns out that many of the beneficial microbes are a bit sensitive. They have a hard time living in the stresses, diets, and other issues I listed above. Also, many probiotics are not indigenous microbes that stay with us permanently, thus we always need to replenish them. And since the above-mentioned situations tend to select for hardier, and often times, harmful microbes, it is easier for many harmful microbes to carve out their niches within us and defend them vigilantly.As a result, the beneficial bacteria need to continually be re-introduced until they can gain a decent foothold. And even then, they can eventually succumb after a while. So it may be that, unless our lives change, our stresses dissipate, our diets revert back to mostly salads, fruits, nuts, and fermented foods such a sauerkraut and kombucha, or whatever the heck we ate thousands of years ago when we had to hunt and forage and exercise, etc., then we will probably have to supplement with probiotics.Another reason for probiotics for gum health is that at home, we cannot brush, nor floss, nor irrigate deeper than about 1.5 2.5 millimeters under the gums. So, the bad bugs in gum pockets of 4 mm+ are relatively unaffected by whatever we do at home. Since home care is 95% or so of the oral health battle, then we are failing unless we figure out a better way. Sure, as a dentist, I can inject Doxycycline or Minocycline antibiotics into the gum crevices, but these products last only 30 days at the most, and they cost at least $65 per site of injection! Many times it is money flushed down the drain. However, if you could repopulate your gums with beneficial gum bacteria that automatically crawl and swim and claw their way down into the pockets naturally, and then let the bacteria duke it out among themselves, and then keep re-populating, and keep hassling the bad bugs with the good ones, every day, then there is a very good chance you will see positive results. And if you keep it up, it should really help.Since I have been studying probiotics, I have changed my diet a little, so as to include some fermented foods that already have beneficial bacteria living in them: sauerkraut, kimchi, kombucha, yogurt with active cultures, certain cheeses, etc. Also, it turns out that we should eat more PRE-biotics meaning, fiber and complex carbohydrates that the beneficial bacteria like to digest which means lots of vegetables and fiber.So the result of studying probiotics is that I am eating healthier, not only for me, but for my bugs that inhabit me, and I can say that I have noticed a few percent better feeling when I actually do eat more of what I should eat but damn, those chips taste good, and the chocolate-covered almonds too. The cool thing is that by following my Oral Fitness concepts and using probiotics, I never worry one iota about whatever I eat or drink, because I know the truth about oral health and what ruins teeth and gums, and how to prevent dental problems about 47 X better than anyone else. And you can too.- See more at: http://www.oralfitnessexpert.com/a-new-approach-to-oral-health/#sthash.7LyCsX6b.dpuf

WHAT IS ORAL FITNESSAND HOW DOES IT WORK?

The physical fitness concepts applied to oral care include nutrition, supplementation, exercise physiology, ergonomics, ranges of motion, paths of motion, injury prevention, disabilities, cognition problems, and more.If we could distill these concepts into an OF equation, then it would be written as follows: OF=M+N+S+Pr+Oc+Pt+Pc.OF=Oral Fitness(1) M=Motivation(2) N=Nutrition(3) S=Supplementation(4) Pr=PerioRobics (improving periodontal circulation and fighting stagnation)(5) Oc=OraCise (exercise physiology, ergonomics, paths of motion, etc)(6) Pt=Personal training(7) Pc=Professional careVery simply, the basic physical fitness targets are the following: muscle, fat, heart, and circulatory systems.Physical fitness basically focuses on 5 actions: safely building muscle, preventing muscle loss, safely burning fat, preventing fat accumulation, and enhancing cardiac/aerobic/circulatory performance.Analogously, the basic OF targets are the following: enamel, dentin, and alveolar bone; plaque, tartar, and pathogenic microbes; and crevicular fluid flow, periodontal blood circulation, and saliva flow.OF also focuses on the following 5 actions:1) building, remineralizing, and maintaining hard dental structures;2) preventing demineralization and loss of hard structures;3) safely "melting" or "burning" plaque, tartar, and pathogens;4) safely preventing accumulation of plaque, tartar, and pathogens; and5) enhancing periodontal, crevicular, and salivary circulation.Organizing OF into an equation with multiple variables, target tissues, and actions allows it to become essentially digital. Also, by including other actions or goals such as desensitizing teeth, freshening breath, and fighting dry mouth syndrome, one could customize the OF equation into hundreds of permutations for a tremendous improvement over standard "analog" oral hygiene. In addition, the oral environment safely becomes clean by default when focusing on oral fitness instead of hygiene. In fact, standard oral hygiene alone can damage teeth and periodontium (eg, overzealous brushing and brushing too soon after acidogenic meals). What's more, even physical fitness without oral fitness can damage teeth. How? Dehydration during exercise and multiple feedings throughout the day become multiple cavity attacks for most people. Therefore, people absolutely need oral fitness training to protect their dentition.In other words, a person performing standard oral hygiene is like an untrained person supposedly exercising at a gym, merely moving weights around, oblivious to any sort of fitness program, ignorant of nutrition and supplementation, suffering injuries, failing to achieve desired results, stagnating, and hitting a wall or impassable plateau. This describes virtually everyone in America. No wonder our country's periodontal disease rate of about 75% is approximately the obesity rate of 66%- because very few people understand fitness,physical and oral, and most healthy people can simply thank their genetics or just dumb luck. Just as a fitness trainer helps a bodybuilder break a plateau, we need to help our patients safely blast past the plateau at which they have been stuck since the days of "Look, Ma!No cavities!"WHAT IS AN ORALFITNESS PROGRAM?

A physical fitness program must have at least 7 components: motivation, nutrition, supplementation, aerobics, resistance, personal training, and professional care.The table shows the 7 components of a physical fitness program on the left side and an oral fitness program on the right side, with shared concepts in the middle. It also shows the relative importance of certain aspects. (PerioRobics and OraCise are explained below.)THE 7 COMPONENTS OF AN ORAL FITNESS PROGRAM(1) MotivationWithout motivation, nothing happens. Find hot buttons, turn-ons, pressure points, fears, needs, or wants such as whiter teeth, fresher breath, more confidence, less pain, monetary savings, etc. The basic desires of sex and money are brooding in there somewhere, so look for tasteful ways to capitalize on those aspects (like fresh breath for 4 hours on a date, fresh breath in the morning, more sales, better job).(2) NutritionThis is such a huge and important subject that improperly following just this one component can destroy a fitness plan, even if everything else is followed correctly. Nutrition involves calories in and out, proteins, fats, carbohydrates, metabolic rates, timing of foods, and tons more. Dr. Atkins was basically correct regarding avoidance of simple and high glycemic carbohydrates. A diabetic diet would be good for teeth as well.(3) SupplementationOF supplements include many of the physical fitness supplements of vitamins, minerals, and herbs, plus fluoride, chlorhexidine, triclosan, sanguinarine, stabilized chlorine dioxide, iodine, baking soda, casein phosphopeptide, green tea, coffee, urea peroxide, essential oils, zinc citrate, coenzyme Q-10, antibiotics, anti-inflammatories, and more.(4) PerioRobicsPerioRobics is the concept of enhancing the circulation of periodontal blood, lymph, crevicular fluid, the agitation of plaque, and disruption of tartar-anything to do with causing turbulence and preventing stagnation: flossing, water jets, sonic vibration, ultrasonics, squishing and swishing, etc.(5) OraCiseOraCise is the application of resistance training techniques to oral hygiene. This means following proper paths of motion and ranges of motion of the exercise implements (brush, flosser, tongue scraper,toothpick, proxabrush, etc); following an organized program; applying ergonomics, safety, and injury avoidance; considering disabilities and cognitive problems; etc.(6) Personal TrainingOF personal training is what the hygienist should do instead of teaching oral hygiene. It is nonconfrontational, fun, interesting, and not insulting, unlike ordinary hygiene instructions.(7) Professional CareThis is dental diagnosis, treatment planning, guidance, coaching, follow-through, surgical intervention, restorative treatment, etc. Patients sometimes need a skilled professional to intervene and restore things back to as normal as possible. Coaching means we are on the same team as the players (patients). We have a common adversary (plaque). Coaches command respect and earn love from their team."TEETH FIRST": A SAMPLE ORAL FITNESS ROUTINEIn "Teeth First," the teeth take priority over the body. Flossing comes before showering. Brushing precedes washing the body. Fluoride outranks shampoo and conditioner. I hope that future articles will allow more elaboration; however, suffice it to know that every OF aspect has a specific purpose and scientific rationale over and above any product name. Names of products are not to be construed as endorsements, and all products are picked for dozens of reasons that include such parameters as fun, ease of use, simplicity, convenience, cost, drama, safety, effectiveness, substantivity, etc.The following materials are needed for "Teeth First": bathroom sink, shower, shower caddy, Glide floss, Colgate Total toothpaste, Oral-B Cross Action manual toothbrush, Act fluoride, tongue scraper, and Trident Advantage gum with Recaldent.Method(1) Before showering, think"Teeth First" and stand in front of the bathroom sink while squishing and swishing a glob of toothpaste between the teeth.(2) Squish and floss all the toothpaste between the teeth. Flossing first with toothpaste dredges out plaque to be brushed away and replaces plaque between teeth with toothpaste between teeth. Squishing toothpaste can also prevent toothbrush abrasion.(3) Step over to the shower and think "Teeth First." Grab your brush from the shower caddy and brush while the shower warms up.(4) Continue brushing in the shower while wetting down.(5) Continue squishing and swishing toothpaste while soaping up the body.(6) Gargle and spit out before shampooing hair.(7) Think "Teeth First" and apply Act fluoride to the teeth before shampooing.(8) Squish and swish Act fluoride vigorously while shampooing and conditioning hair. Extensive fluoride soaking leaves teeth electronegatively primed to absorb maximum calcium ions from Trident gum in a later step.(9) After rinsing off the hair conditioner, spit out the Act fluoride.(10) Scrape the tongue well before ending the shower.(11) After exiting the shower, think "Teeth First" and chew a piece of Trident Advantage Recaldent gum for 20 minutes to form an extra calcium-fluoride shield of protection that may last up to 3 days.(12) Keep Trident gum handy for snacks and between meals and to maintain plaque in an alkaline condition and remineralize teeth as long and as often as possible.SUMMARY, ORAL FITNESS CYCLE OF GROWTH, AND THE ORAL THEORYOF EVERYTHING

Americais the fattest nation on earth and getting fatter. Food, fatness, and lack of fitness are killing us. Because food passes through the oral cavity, obesity and dental problems are intricately connected. Obesity is linked to myriad systemic problems. Dental problems are linked to several serious systemic problems, too. Physical fitness improves health but can damage oral structures. Oral hygiene can damage oral structures as well. OF blends the best qualities of both and safely improves physical fitness and oral health. OF is fun, interesting, and unique (as opposed to oral hygiene instructions). OF reduces stress and prevents arguments. Patients appreciate learning new things that will benefit them immediately (eg, fresher breath in the morning, less sensitive teeth in 5 days).OF generates a dental practice cycle of growth. Nobody cares how much you know until they know how much you care; therefore, teaching OF establishes your care for patients like a coach cares for the team. Care engenders trust. Trust facilitates patients listening, learning, and accepting your diagnoses and treatment plans. Educatedpatients make better decisions about their healthcare and buy more of your services. Increased trust generally means patients like you more, and friendly patients are less apt to sue. OF puts the onus on patients and blows away urban legends because it scientifically proves that patients are responsible for their oral health and the longevity of their restorations, which further reduces your liability.OF is a customer service that demonstrates to skeptical patients that you are not in the profession just to earn a quick buck, because OF is the only thing you truly do for your patients as opposed to everything else that you do to your patients. And therein rests one of the most important, yet subtle impressions that patients subliminally perceive. Trusting, happy, educated patients refer more often and refer more quality people resembling themselves. OF's newness and uniqueness create a niche for you. Having something new to discuss about your practice creates marketing potential and makes you appear better and more knowledgeable than the average professional. The good referrals grow. Production and collections improve. Goodwill increases. Practice value increases. Overhead decreases. Advertising and marketing budgets shrink from word-of-mouth referrals. Referrals allow the whole process to cycle continuously. Dentistry as a whole gets busier.People visit dentists more frequently than they visit physicians. Therefore, OF offers dental professionals unique opportunities to improve our country's overall health and fitness while positively affecting dental practices. OF could just be the oral theory of everything.

oral fitness and dental hygiene

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