I am writing about the Amesbury Archer. Lived about 2400 BC. Had an injured kneecap that was constantly infected, used a stick to walk in pain for years. What killed him? A tooth abcess. Big hole in his jaw. His tooth was broken, maybe from cracking a nut.

The poor chap. His bone was probably bacterially infected. As soon as damage occurred, the bacteria would have found their way in. The water was so unhealthy in those days, too. (Apparently, the Egyptian mummies reveal pervasive bacterial and parasitical damage.)

The paleo diet people place a lot of weight on the increase in dental problems after the arrival of agriculture. I think there is something in it, though they overlook the fact that some paleolithic skeletons have been found with tooth damage too. The Amesbury Archer was chewing through a lot of rough cereals; and I would not be surprised if his abscess started when something such as a seed or, as you say, a nut got jammed into his broken tooth, causing inflammation and stopping pus from escaping. One thing I have noticed is that if get a spot of tooth soreness, it is usually from a piece of food catching somewhere. As soon as I brush, the pain goes again--presumably because I have brushed out the obstruction.

The Amesbury Archer probably did not brush his teeth, in which case lots of plaque would have grown up on his teeth, promoting bacteria. Even though he lived in the days before refined sugar, carbs can cause the same damage if they spend long enough on the teeth.

It is fascinating, I must say.

Mouth Piece 13. Three friends: Vitamin C, walnuts, and coconut

I have tried only a few of the various foods and nutrients recommended for gums and teeth. That so many different things help does not surprise me, since I now believe good oral health is the default state. To undermine it, we have to go out of our way in eating badly. Nevertheless, I will mention three stars that have had a wow effect for me.

1. Vitamin C

The same week I looked in my mouth with a mirror and desk light, I had a delightful shock.

As one of my experiments with nutritional and herbal supplements, I had decided to try a course of Vitamin C tablets. These are rather cheap and unglamorous now--a little out of fashion. But I remember the Vitamin C craze of the 1980s, when the theories of Nobel laureate Linus Pauling, who wrote Vitamin C and the Common Cold, ruled the popular press. Pauling advocated Vitamin C as the key to health--and by the bucketful. I was easily influenced by the papers in those days, so I bought a bottle.

My experiment with the elixir, however, was brief. A teaspoon of Vitamin C powder went through me like a dose of salts—which indeed it was. So I binned the rest and passed on to other fads. How sensitive my digestive system must have been then compared to its brutalised condition today, when I can knock back a whole bag of prunes without so much as a flutter in the gastrointestinal dovecote. Anyway, decades passed, and here I was taking a brace of Vitamin C pills one morning and another after tea and thinking no more of it.

When I cleaned my teeth that night and spat no blood out with my toothpaste, you could have knocked me over with a feather. My eyes almost popped out of my head. My toothpaste spit had always been pink, including as a child. Even on my new healthy diet I still spat blood. I did so even when, for one experiment, I ate my way through competition levels of fruit for a week, like a mountain gorilla. I always knew blood in the spit is a bad sign but not what to do about it. I had got so used to it that I did no notice it. And now, there it was, gone!

That was was my moment on the road to Damascus. Since then I take two or three Vitamin C pills a day, and not a drop of blood has emerged in that time from my gums. Which thrills me, because if those pills are doing good to my gums, they must be doing good to my whole body. Perhaps they have contributed to the improvements in my arthritis, too--but that is for another post.

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There is no mystery why Vitamin C benefits gums. It is essential in the formation and maintenance of collagen. Ascorbic acid was discovered after limes were observed to cure scurvy in sailors—the first sign of which was loose gums. Captain Cook made his men eat boiled cabbage each day, for which they understandably hated him, and he never lost a man to scurvy. It was similar at my boarding school, where we were served enough cabbage to put one off it for life. I do buy cabbages sometimes, out of nutritional piety, but eating them is another matter. Still, they make good compost.

Collagen is remarkable stuff. I think of it as the glue that keeps the different bits of me stuck together. (The word derives from “kolla”, which is Greek for glue, so I imagine myself a walking collage.) Apparently, a quarter to a third of the protein in our bodies is collagen. To quote Telly Savalas, that is a whole lot of sauerkraut.

Vitamin C promotes collagen synthesis, which helps wounds heal. I remember reading about Anson’s voyage round the world, during which his crew were so stricken with scurvy that old wounds reopened, and previously broken bones unset, even after decades. At sea for months, all his men dreamed of was fruit. I bet they would have killed for a fresh cabbage.

I do not say I now agree with Pauling that downing vast quantities of Vitamin C every day is necessary for health—though it did him no harm, as the old boy lived to his 90s. My two or three 500g pills are more than the government recommends but hardly a megadose. Nonetheless, I was surprised to read how little Vitamin C most people get. Even a healthy diet, containing green vegetables, fruit, etc., might yield only 100mg a day. Compared to that, the western processed diet is a recipe for poor gum health. Thank goodness at least for the Vitamin C in fries.

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2. Walnuts (essential polyunsaturated fats)

A second dental revelation came not long after I lost my weight and moved into maintenance. I had noticed my teeth slightly starting to hurt again in the areas around the three teeth that troubled me over the years—the three amigos, as I call them. It surprised and dismayed me, since by then I believed my new diet had made mouth pain a thing of the past. So I searched in my food journal for a clue to the cause.

I discovered that the period when my mouth started hurting again coincided with an experimental all-meat diet (documented earlier in the thread). But meat was certainly not to blame, because I had previously eaten a meat-heavy, low-carb diet for many months without so much as a twinge in the gnashers. So I checked the foods I omitted during that carnivorous fortnight. It took me some time to spot—though it stared me in the face--that the absence of my midday walnut snack was suspect-in-chief.

Sure enough, the instant I resumed eating walnuts, my tooth pains vanished. To test the correlation, over the following months I experimented to see if I could turn the pains back on by giving up nuts again. I could. The correlation was clear.

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I have not read any research that directly associates walnuts with the easing of tooth or gum pain; but I now have a theory about what happens. Walnuts (and nuts in general, though walnuts are the champions) contain essential polyunsaturated fats, which are known to play a key anti-inflammatory role in the body. Walnuts, for example, boast a high amount of Omega-6 and Omega-3 oils. Therefore, I propose, eating them soothes tooth and gum inflammation.

Some technical problems attach to this theory, though. First, it is often suggested that O-6 oils might actually be pro-inflammatory, especially when eaten in a high proportion to O-3 oils. In nuts, the ratio between the two, even in walnuts (the nuts with the most O-3s), heavily favours O-6s, the supposedly dodgy fats. Another technical problem is that the O-3 oil in nuts, which takes the form of alpha-Linolenic acid, must be converted to the forms DHA and EPA in order to become anti-inflammatory. And some experts suggest the body cannot convert enough of it that way to make very much difference. Vegetarians, who eat flaxseed for its O-3 oil, are for this reason often told they can forget scoring significant amounts of DHA or EPA by this route.

So that is all very bothersome. But I have to say I do not find the debate on these points either consistent or coherent. What I do find is that nuts stop my teeth and gums from hurting. And at least some support for this exists in the science. For example, I have come across more than a little research suggesting that O-3 oils from plants can indeed stop gum pain. I have not, I admit, found any research about walnuts and tooth care; but I have read positive research on flaxseed oil and oral care, which, since the O-3 oils in flaxseed and walnuts are similar, leads me to deduce that the oil in walnuts might indeed be anti-inflammatory to the mouth in the same way.

Overall, the research on Omega-3 and Omega-6 supports their use against gum disease. I was going to quote a series of studies to that effect, but a good recent review of studies sums them all up:

"Proper nutrition plays a vital role in the well-being of a person. Omega-3 fatty acids have a proven role in resolving inflammation in both in vitro and in vivo studies. The overall existing research results on dietary omega-3 fatty acids in the periodontal disease scenario are promising." (Peeran, et al, “Therapeutic role of dietary omega-3 fatty acids in periodontal disease”, Univ Res J Dent, 2014)

Another good summary of the research is T E Van Dyke's, “The management of inflammation in periodontal disease” (Journal of Periodontology, 2008), which analyses the nature of gum inflammation and the role of Omega-3 and Omega-6 polyunsaturated acids in resolving it.

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I have three hunches how that might work via nuts. One is that even a tiny amount of converted O-3 from nuts could have a high impact. After all, the point of an essential dietary fat is that the body needs very little of it (if it needed a lot, it would surely make it itself, as it does other types of fats). Another is that the alpha-Linolenic acid in nuts might have an anti-inflammatory effect of its own, whether converted to DHA and EPA or not. The third is that the ratio between O-6 and O-3 oils in nuts could be irrelevant, because unprocessed O-6 oils are benevolent anyway. (That is an unfashionable theory, now that the denatured O-6 oils in processed foods are rightly demonised; but there is evidence for it.) In which case, all the fats in nuts might help sooth sore gums, including the various complexes of Vitamin E. And they probably work in synergy with each other.

I arrived at these hunches on the simple and, I suppose, not very reliable basis that I can feel the effect. When my diet includes nuts, not only is my mouth pain free, but the troublesome areas round my problem teeth feel numb to my tongue. It is a peculiarly lovely feeling, akin to that from a painkilling drug. In the circumstances, I am not easily persuaded that the O-3 oils in nuts do not affect my gums or that the O-6 oils in nuts will make my teeth hurt. Harmful though industrially treated polyunsaturated margarines and cooking oils undoubtedly are, no evidence associates eating raw nuts with poor health outcomes--in fact, the contrary.

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3. Coconut

I recently ran out of nuts for a while, and the little residual niggles and aches around my three bad teeth slowly returned. I had a food delivery ordered for the following week, but in the meantime I decided to finish off some very old desiccated coconut from a jar at the back of a cupboard.

I have read a lot about the wonders of coconut oil, which I use in cooking now and then. But I was never sure how to rate coconut compared to the regular tree nuts I eat, and so I never classed it with them or ate it very much. Anyway, I can report that my tooth pains went away fairly smartly after eating the coconut. In all respects, the effect was the same as if I had eaten my walnuts or mixed nuts as usual.

Some evidence supports the benefit of coconut to oral health. For example:

"The husk fibers of coconut (Cocos nucifera) are reported to be used by people of rural areas of South India for daily cleaning their teeth. […] Inhibitory action against cariogenic bacteria exhibited by aqueous extract of coconut husk indicate presence of highly effective active compounds in these extracts, which can be identified and incorporated into modern oral care systems for controlling dental caries." (Cyriac, et al, “Antimicrobial properties of coconut husk aqueous extract on cariogenic bacteria”, Arch Med Health Sci, 2013)

Damien Brady’s research group at Athlone College of Technology found that both coconut oil and dairy milk have an anti-bacterial action in the mouth, according to a report to the conference of the Society for General Microbiology in 2012.

So I will add coconut to nuts as a pain reliever for my teeth. But perhaps all natural fats are good for the teeth and gums--certainly dairy fats are associated with good dental health, as Brady confirmed. Weston Price, I recall, had success reversing tooth decay with butter oil.

Finally, I have read a lot online—in very unscientific anecdotal reports—of the benefit of oil pulling, a practice in which you swish one oil or another round your mouth for ten minutes, with beneficial effects on the teeth and gums. Since I believe nuts, essential omega oils, and now coconut to be helpful in that respect, I can well believe it works. Nothing will persuade me, however, to take up so unpleasant and tedious a practice. If oils be healthy for our mouths, I see no reason they should not be so when eaten, mixing into the saliva as one chews. So, no swishing for me.

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To sum up this post, I return to my refrain that the key to oral health is a varied diet of real food. Any healthy, varied diet, I suspect, will do—low-carb, high-carb, Paleo, whatever—so long as it cuts out refined sugar, refined oils, and the processed foods made with them. One could debate forever which nutrients in such a diet help most. Personally, in the event of mouth problems, I would turn first to my two big hitters: Vitamin C and unrefined oils. Supplement the first, eat both in food. But everyone is different, and many other substances are mouth friendly too. Whatever—none of this seems to me rocket science.


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Plinge, it may not be rocket science, but may really help someone else. I love me my nuts and have even found my favorite bedtime snack is a tbs coconut oil, 1/4 c unsweetened, shredded coconut, and one ounce almonds or other nut.

I am so glad you found what eases your mouth pain.

I tried pulling ONCE ond only once.

Really interesting - will try adding in vit C and walnuts - I could certainly use some additional anti-inflammatory assistance!

Wayhey! Teresa! Thought I might not see you here again. Hope you are well.

I should have said 500mg Vit C pills, not 500g! :O

I hope to get to arthritis one day, which I know you also suffer from. Mine is so improved, but I cannot say I exactly know why. It is about 5000 times more difficult to understand than teeth.

Was this when your husband was away?

ONLY JOKING!

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I am going to order a shedload of desiccated coconut soon, from the same bargain place I get my dried fruit, and am going to have it maybe everyday. I was a bit stuck for how to use coconut, because I find the coconut oil a bit awkward to cook with compared with butter or olive oil. But some coconut stirred in with my daily fruit and cream or oats is a treat. Desiccation, I suppose, is a form of processing, but by all accounts it does not reduce the nutrients.

Hope you are doing fine, Arlene!

Yep, he was away! He missed my one time only, can't talk for ten mins 'cause my mouth was full of coconut oil swishing between my teeth. ROFLOL!!!

I am really done well. I swear, a switch went off in my head one day and I said, I have done all I can to know me.... I know what works for me, I do not need the body of a super model, my glucose is under control , I do NOT need to count anymore, I do not need my scale every day if ever and my pants fit.

My daughter is a Weston Price nutritionist(well in two more months) and has pronounced me fit and healthy. Except I won't give up my over-indulgence of my morning coffee and cream. Otherwise she says I know as much as she does! Now that is a wonder to my ears!

Pass me my nuts, please. Raw Walnuts, almonds and macs please. I want to mix them with my lovely coconut for a snack.

So good to hear from you, Plinge!

And you. I am going to be more regular around here. So so much I want to write about.

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I know that feeling of a switch going off. With me it was that thing where I realised that slightly undereating most days solved everything. I have not looked back since then. Maintenance takes care of itself. There is no edge to it any more.

I am applying it to my finances too, underspending. And to my life in general--living a simpler life...moving back from the edge of everything. All this came from that one switch moment.

I have always said that one day I would, like you, stop counting--but it still really fascinates me. I love keeping my records. I do not physically measure food much these days, though, because I know the amounts of things off by heart and am a guess-the-weight-of-the-nuts champion.

Mouthpiece 14. Dental self-help

I learned how to scrape the tartar out of my gum line by watching YouTube videos and seeing what dentists and hygienists get up to. I noticed that much of what they get up to is not very sophisticated—namely small-scale spackling and carpentry, plus a deal of picking and scraping. It occurred to me that the picking and scraping is something I can reasonably do for myself.

Hygienists, for example, do a horrible-sounding thing called root planing. It might better be called root scraping, since literally planing the teeth would damage them. The hygienist pokes a curved tool into the gap between tooth and gum and scrapes out any debris--mainly plaque, tartar, and food particles. After that, the area is rinsed and good to go till the pocket fills back up. Which it will do soon enough for people who eat sugary food but not for people who eat a healthy diet and brush their teeth. For someone with gum disease, root planing will stave off inflammation only in the short term.

In periodontal disease, typical intervention procedures such as root planing boast some success in removing etiologic agents associated with inflammation, thereby helping arrest periodontal disease. However, such procedures do not offer the necessary resolution of inflammation to restore tissue homeostasis. (Van Dyke, “The management of inflammation in periodontal disease,” J. Periodontal, 2008)

I watched the videos intently to see if there were any special manoeuvres involved; but, no, scraping is a pretty crude job, akin to deep cleaning behind a radiator or between the keys of a keyboard. Like Yosser in Boys From the Black Stuff, I thought, “I can do that”.

So I bought one of those curve-headed tools and had a go. It is not the most alluring job in the world, but it is easy. And what surprised me from the start is that it does not feel particularly unpleasant, nor does it hurt. Healthy gums are relatively resistant to pain and surface damage and do not seem to mind being poked. Even if you scratch or prick them, they do not bleed. It is the opposite with unhealthy gums, of course. I prefer scraping to flossing now, because I feel I know what I am doing.

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I always thought that to achieve a clean mouth I must put in serious elbow work at the tooth face—protracted brushing, flossing, mouth washing—as well as regularly visiting the dentist. In fact, ever since I transformed my oral health by diet, I spend much less time on my teeth.

My previous routine:

Brushing three times a day and after eating. (Before bedtime I would try to brush non-stop for at least five minutes.)

Use of strong Listerine mouthwash to prevent bad breath.

Use of other mouthwashes, potions, and gels on occasion for toothache, mouth ulcers (such as Oraldene, Bonjela, TCP, Anbesol, Oil of Cloves, bla bla bla), etc., which made me the chemist’s best friend.

Use of whitening toothpastes, sensitivity toothpastes, et al.

Painkillers.

Flossing daily with dental floss or dental tape.


My present routine:

Brushing with a soft brush briefly twice each day.

Use of either Oral-B Pro-Expert toothpaste or Arm & Hammer baking soda toothpaste.

Drinking green tea with meals.

Occasional use of a toothpick after meals.

Chewing dental gum after most meals and snacks.

Occasional scraping of gum line, maybe once every three months.

Very occasional use of a mouthwash of sodium bicarbonate and water.

(I suspect I could get away with even less. But psychological factors play a part—the wish for clean-looking teeth, the pleasure of a fresh feel in the mouth.)

At first glance, my new regime might look as effortful as the first, but in practice it is not. A drop of green tea, some momentary toothpick action, a brief chew of some gum—these are part of my meal ritual now, at least when I am alone. They are instinctive, and I enjoy them.

One thing I would not do now is brush my teeth straight after eating. To my surprise, I read that this might damage the enamel, which then is in a state of turnover from the temporary acidity caused by the meal. The teeth need time to re-harden before being brushed.

When I first discovered what I now know about teeth, I vowed my oral health should never relapse again, and so I initially embarked on an elaborate maintenance routine based on my new discoveries. But I have found that so long as I avoid sugary and processed food, little vigilance is actually required. The system looks after itself.

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I read plenty before coming up with my present practices. Information about the role of saliva led me to the sodium bicarbonate toothpaste and mouthwash. But I doubt they add much to the pH of my mouth, which is now naturally neutral as a result of my eating habits. Information about the way teeth remineralise led me to using the Oral-B toothpaste, which includes stannous fluoride as well as the usual sodium fluoride. Again, my saliva probably needs no help from fluoride in sealing dentin and remineralising teeth, but I think the toothpaste at least does no harm.

Of course, there are many who argue against the use of fluoride for human consumption; but, having assessed the debate, I am not convinced by the anti-fluoride position. Yes, it is prudent for pregnant women and infants to avoid fluoride, but I can find no evidence that fluoride is harmful to a fully grown male. Nevertheless, it is not essential to tooth care and can certainly be done without. The fact that fluoride helps remineralise teeth and seal dentin tubules seems to be one of those happy accidents that nature sometimes throws up, such as the fact that cow’s milk is chemically similar enough to human milk to do some of the same work. But that does not make fluoride essential.

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I mentioned that I do not floss any more. I gave it up after years of unconvincing results. First of all, I found it a messy and awkward chore to do, particularly in the extreme corners of my mouth. Tape would snap, my fingers hurt, the dispenser malfunction. Worst of all, if I was not careful, floss drew blood when rubbed against my gums—and that, I now see, must only have invited bacteria and infection into them. The argument for flossing is that it removes plaque from the tight areas between the teeth. But the value of that depends on the state of the mouth in the first place. By avoiding sugar and processed food, I now defeat plaque in advance. If you do not want snow in your hallway, first close the front door.

One does need some way to remove solid particles jammed into the nooks and crannies of the teeth. That is where my pick comes in. I bought a few dental tools—for example a flat-headed scraper with a chiselled edge and the curve-headed tool that I use for cleaning out gum pockets. The one I use after meals has just the right head for doing much of the work I was trying to do with floss. It might not get right into the tight areas between teeth, but it runs up and down the groove neatly and pokes effectively into the gaps that occur (for a raddled man of my age) at the base of teeth. It works particularly well for pieces of meat, seed, nuts, oats, vegetable shreds, and the like. Unexpectedly, I find this postprandial poking strangely enjoyable. Picks were used as a matter of course in history; rare is the archaeological dig that does not turn up toothpicks and pick holders. I have some nineteenth-century Chinese pick holders as ornaments.

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The other thing I do after most meals is chew a stick or two of dental gum. Again, I find this an enjoyable coda to the meal. (I recommend it as a psychological help against overeating too, because it intervenes against the impulse to eat afters—once the gum cleans your teeth you do not want to undo the work.) Gum also beats brushing for convenience, because you can use it on the run, whereas brushing requires water and a sink. And gum is tactile as well as cleansing; it plucks out food particles remarkably well.

I was surprised, to say the least, that I took to gum, because I have never been a gum chewer, as I think gum chewing an ugly-looking habit. My parents forbade gum, and my boarding school banned it; therefore I grew up with a prejudice against gum chewing, as if it were a moral defect. I still consider it ill-mannered to chew gum while talking, so I do not chew it in company. Also, I chew it only briefly, for no more than 20 minutes, usually when I am doing the dishes or other post-meal tasks.

There are many dental gums on the market. The type I chew contains xylitol. I buy Miradent, which has a high percentage of xylitol, but Orbit, a commercial Wrigleys product, contains some and is sold at most kiosks. I expect any sugar-free gum has a beneficial effect on the teeth; but I settled on xylitol gum because I have been impressed by the science behind xylitol. It is one of a group of substances called polyols, several of which been found helpful for tooth care. For example, this review of data from 14 studies concluded:

Although research gaps exist, particularly on optimal dosing and relative polyol efficacy, research evidence supports using polyol-containing chewing gum as part of normal oral hygiene to prevent dental caries. (Deshpande & Jadad, “The impact of polyol-containing chewing gums on dental caries: a systematic review of original randomized controlled trials and observational studies”, J Am Dent Assoc, 2008)

They found that xylitol was the most effective polyol, followed by a xylitol-sorbitol mix, and then, quite a way behind, sorbitol (a sorbitol-mannitol mix was not so effective).

Xylitol on its own looks and tastes just like sugar. It makes a good sugar substitute for anyone who cannot do without Mr Pure White & Deadly in their life. I buy it for my mum, who is diabetic. I should say, however, that it is not a diet sugar; it has the same calories as other sugar. I keep a jar of it in the kitchen, but I never use it, having cured myself of wanting added sugar in anything.

Experts argue about whether xylitol heals tooth rot and gum disease or merely prevents them by replacing sugar. From what I have read, it does a bit of both. The fact that it has a different chemical structure from sucrose means the bacteria cannot recognise it and use it to create plaque. Either way, the result is reduced plaque. For that reason, xylitol has also been associated with improved gum health.

Xylitol changes the adhesive and cohesive qualities of plaque, leading to decreased plaque. This character is not shared by other sugar alcohols (Maguire & Rugg-Gunn, “Xylitol and caries prevention—is it a magic bullet?”, British Dental Journal, 2003)

In one lab experiment, the scientists chopped up bits of damaged teeth and dropped them in various solutions to see what happened. They found that teeth remineralised in a solution containing fluoride and did so even better in a solution containing fluoride and xylitol. (Sano et al, “Effect of a xylitol and fluoride containing toothpaste on the remineralisation of human enamel in vitro”, J Oral Sci, 2007.)

When I began my drive to keep my teeth nice, I expect I overdid the xylitol. Not only did I chew several sticks of xylitol gum at a time, but I alternated a xylitol toothpaste with a baking soda one. As my faith grew in the power of a good diet to ensure healthy saliva, I decided that was overkill—like cleaning the bathroom sink every day when it is already clean. And so now I usually chew one stick of xylitol gum at a time and do not bother with xylitol toothpaste any more. There is more than one way to skin a cat, but you do not need to do all of them.

Chewing any sugar-free gum will probably improve oral health, simply by stimulating saliva. A problem with processed food is that it does not require much chewing, which reduces the amount of saliva. Chewing gum vastly increases saliva turnover, maybe tenfold.

Another group of researchers mounted a study in which children in different schools chewed different gums for three years. One of the schools chewed straight sugar-free gum, others chewed gums with sorbitol, xylitol, or other additives. All the gum-chewing schools experienced less tooth damage than a control school where no gum was chewed. But the school that chewed a sugar-free gum without any special tooth-protective additives did just as well as the ones with xylitol, sorbitol, etc., in the gum. So the experiment appears to show that gum chewing is good for the teeth in itself. (See Machiulskiene et al, “Caries preventive effect of sugar-substituted chewing gum,” Community Dentistry and Oral Epidemiology, 2001.) This reminds me of the finding that chocolate milk is as good for the teeth as plain milk. Such studies make me think the requirements for a healthy mouth are so broad that finessing the matter might be beside the point. If saliva pH is good, the mouth will be fine, no matter how it got that way. It seems straightforward.

Stimulation of saliva increases the level of bicarbonate ions in the oral cavity, which raises the pH to neutralise acids from the metabolism of fermentable carbohydrates. The concentration of calcium and phosphate ions is increased in supersaturated salivary fluid, promoting tooth remineralisation. Mastication allows for clearance of fermentable carbohydrate from the oral cavity. Under certain conditions, chewing sugarless gum after acidogenic exposure can promote oral health, producing an environment that favours tooth remineralisation and facilitates clearance of fermentable carbohydrate. (Doniger, “Saliva, chewing gum, and oral health”, Dentistry Today, 2004)

I think it possible that even sugary gum is not as bad as might be imagined, so long as the gum is chewed for sufficient time. I remember kids on my street chewing gum all day when I was a boy. I thought it gross because they did so for hours after the gum lost its flavour. But it meant they were effectively chewing a sugar-free gum for hours, giving their mouths a good workout with a high turnover of saliva, counteracting the original increase in acidity caused by the sugar.

The considerable volume of literature on the dental effects of chewing gum attests to the effective salivary stimulation it provides. The habitual use of chewing gum, especially if it contains xylitol and/or Recaldent [a milk protein product], effectively improves plaque pH and eliminates caries risk when chewed after meals and snacks for at least 20 minutes. (Manikandan et al, “Oral health: role of chewing gum”, Brunei Int Med, 2011)

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One remarkable effect my new diet has had on my oral confidence is that I no longer worry about bad breath. Even now I am not sure how often I really had bad breath—no one ever told me—but I was so concerned to avoid it that I became not only an obsessive toothbrusher but also a constant user of mouthwashes, particularly Listerine.

Once I saw inside my mouth and found it good, I switched from these expensive chemical concoctions to a simple mouthwash of sodium bicarbonate and water, to neutralise the pH of the mouth, thus killing the bacteria that cause mouth odours. But I soon asked myself if that were necessary, given that my diet and gum chewing produced that result anyway, not to mention my sodium bicarbonate toothpaste or Oral B, which contains neutralising pH buffers. As with the fact that I have more or less given up using deodorants (I just carry a roll-on with me when I travel), the decision to stop using mouthwashes and breath fresheners was instinctive. I just sensed they were not needed any more. My poo and urine hardly smell these days, either.

Apart from a brief acidity after meals, a good mouth pH should sustain itself all day. It does not wear off. On the other hand, if the mouth is full of plaque, and one is eating processed, sugary food all the time, even the strongest mouthwash will give only a brief freshening effect before the mouth acidifies again, with renewed potential for bad breath. I still have half a bottle of Listerine in the house somewhere, which I shall turn to if ever I need to strip paint.

A big yes to gum preforming many tasks, one big one for me, easing that after dinner craving for sweet.

Very good observagtions here. I am going to add a bit of Bsoda to my nightly routine. I take powdered mag at night, so will add Bsoda and then swish and swallow.

Yes, I have a magnesium pill in the evening.

If I swallow baking soda it can be very powerful, so I would not take more than half a level teaspoon myself. Its power comes from the fact the whole body runs on carbonate balance. I consider it one of the big players, up there with oxygen, water, salt, and potassium.

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I did not plan it on purpose, but my after meal ritual of finishing my green tea, chewing some gum, washing up, and then having an enormous coffee and cream, takes so much time that it bridges the danger zone when in the past I might have eaten some more food. You are right, that sweetness in the gum fulfils an urge for the sweet at that moment.

Thanks Plinge. I will use 1/4tsp of Bsoda. That should be plenty to clear my mouth.

Mouth Piece 15. Dental products

A friend of mine has bad teeth, and he swears by Listerine. “The strong stuff”, he calls it. “You can tell it packs a punch.” But why should a mouthwash pack a punch? The stinging sensation, in my opinion, is purely cosmetic. I have read that the Listerine “bite” serves no chemical purpose and is there just to impress users that something so strong must be doing some good. Is the bite no more than a psychological trick?

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Various studies cast doubt on the effectiveness, and even on the safety, of the mouthwashes sold to the public.

The results indicate that the use of some mouthrinses could predispose to excessive tooth substance loss and dentine hypersensitivity, particularly if used prior to toothbrushing. There is a need to determine whether the intermittent use of some mouthrinses produces cumulative effects on dentine. (Addy et al, “Dentine hypersensitivity—effects of some proprietary mouthwashes on the dentine smear layer: a SEM study”, Journal of Dentistry, 1991)

Alarmingly, I have discovered that most mouthwashes, far from making the mouth pH neutral, actually make it more acidic.

The study sample was composed of 10 commercial brands of mouthwashes based on different active ingredients: Cepacol(R), Clinerize(R), Equate(R), Listerine Cool Citrus(R), Oral-B(R), Periogard(R), Peroxyl(R), Plax Overnight(R), Prevident 220(R) and Sanifill(R). The experiments were performed in triplicate. […] pH values ranged from 3.56 (Peroxyl(R)) to 7.43 (Cepacol(R)) and three mouthwashes presented pHs below 5.5. The titratable acidity values ranged from 0.007 (Periograd(R)) to 0.530 (Prevident(R)). Oral B(R) and Clinerize(R) presented the lowest (4.7%) and the highest (23.70%) TSSC, respectively. Some of the mouthwashes evaluated in this study presented low endogenous pH, even below the critical value for enamel dissolution (pH<5.5), high titratable acidity and high TSSC, and may be potentially erosive to the dental tissues if not properly used. (Cavalcanti, et al, “Endogenous pH, Titratable Acidity and Total Soluble Solid Content of Mouthwashes Available in the Brazilian Market”, European Journal of Dentistry, 2010)

Various online calculations—it is not a difficult test—of the pH of commercial mouthwashes show most of them to be well in the acidic range. Unsurprisingly, scientific reports question the value of these products for tooth care.

Based on the study in situ, it is recommended that low pH mouthrinses should not be considered for long term or continuous use and never as pre-brushing rinses. (Pontefract et al, “The erosive effects of some mouthrinses on enamel. A study in situ,” J Clin Periodontol, 2002)

*

The main ingredients in Listerine are essential oils, which are certainly good for the mouth, and alcohol, which is certainly not. Alcohol is bad news for the mouth.

On the basis of this review, we believe that there is now sufficient evidence to accept the proposition that alcohol-containing mouthwashes contribute to the increased risk of development of oral cancer and further feel that it is inadvisable for oral healthcare professionals to recommend the long-term use of alcohol-containing mouthwashes. (McCullough & Farah, “The role of alcohol in oral carcinogenesis with particular reference to alcohol-containing mouthwashes,” Australian Dental Journal, 2008)

Mouthwashes are full of strange-sounding chemicals. Some, such as Periogard, contain chlorhexidine.

When rinsing with 0.2 and 0.1 % chlorhexidine gluconate and acetate, some desquamations and soreness in the oral mucosa were observed. Twelve per cent of the tooth surfaces and 62 % of the silicate fillings were discolored, while 36 % of the test persons developed discolored tongues in the experimental period. Because of the side effects, there are some objections to uncritical use of chlorhexidine in preventive dentistry. A close control is necessary; and until more information is gained, the use of chlorhexidine mouth washes is recommended for short periods only. (Flötra et al, ” Side effects of chlorhexidine mouth washes”, European Journal of Oral Sciences, 1971)

*

Simple science tells me that though acidic mouthwashes might chemically kill odours for a few minutes, they will encourage the growth of bad odours after that. The catch follows the pattern of many commercial products—not just dental ones—which fill a short term need while ensuring a repeated need for the product. Spotting the frequency of this pattern has been a depressing revelation. It pervades the mouth care industry, for obvious reasons.

*

It is by no means certain, in my opinion, even that toothpastes are of long-term value to the teeth. The chief benefit of cleaning the teeth with toothpaste is the action of the brush in removing plaque and particles of food. The chief chemical benefit of the toothpaste itself lies in the neutralising effect of the pH buffers in it—such ingredients as baking soda or sodium hydroxide—and in the application of substances such as fluoride, xylitol, or eucalyptus to the surfaces of the teeth. But most toothpastes try to be jacks of all trades. They include chemicals to mend damage, prevent damage, whiten the teeth, freshen the breath, abrade the enamel, support the gum, etc. Some of these functions may contradict each other. For example, any additive that whitens teeth by stripping away their stained surfaces damages the protective coating of the enamel.

The abrasives contained in toothpaste are designed to remove the surface of the teeth, so a vigorous brushing regime might undermine a tooth’s protective film over time, allowing more acid penetration and staining. The peroxides contained in whitening toothpaste could potentially irritate and damage gum tissue, though the amount legally allowed is probably too low to have any effect at all, whitening or otherwise. (Most unbiased reports on whitening toothpastes suggest, unsurprisingly, that they fail to whiten teeth in the slightest.)

Toothbrushes tend to harbour bacteria and reintroduce them into the mouth. Arguably, one is better off not brushing at all than using a dirty toothbrush. Using a dirty toothbrush to clean one’s teeth is illogical, but most of us do it. I am not a hygiene obsessive; but a moment’s thought tells me how counterproductive this practice is. As is rinsing one’s mouth straight after teeth cleaning, which instantly dilutes any substances in the toothpaste designed to act by contact with the enamel. (Such chemical reactions need time.) So now, at least, I make sure to spit, not rinse—though I have yet to join the boil-your-brush brigade (life is too short).

I have also abandoned my old routine of cleaning my teeth on rising, followed by drinking my morning coffee—another ludicrous, self-defeating pantomime I carried on for decades. Nothing now seems more pointless than cleaning my teeth before going to bed and then cleaning them again when I get out of bed. Short of being punched by a ghost, nothing bad can happen to my teeth overnight. (Even if one falls out, a fairy should leave me a sixpence.)

In sum, I am putting more thought into the toothpastes I use and the way I use them. But I am still not convinced they do that much good. The toothcare industry looks to me like an entirely fabricated world of products and commercially sponsored advice that has little to do with the requirements of nature. Its chief function, it seems, is to counteract the equally fabricated world of modern foods and commercially stimulated eating behaviours, to which it has become an obligatory adjunct, like the cart that gathered the corpses during a plague.

*

As for floss, do not get me going! The infernal stuff was making my gums bleed, so good riddance.*

*The last time I used dental tape was to wad a dripping tap, a job it does admirably with the assistance of candle wax.

My dentist told me years ago that toothpaste is really not necessary; brushing alone is sufficient. I admit to using toothpaste still, but mostly because brushing without leaves a funny taste in my mouth.