A big piece of the wear on teeth and gums is nutrition and stress. The biggest problems that I see include:
We end up consulting with individuals on how they can modify their diet and habits and how they can take care of their teeth to keep them from decaying and melting away as their saliva becomes less and their stomach acid becomes more. The lack of saliva also causes teeth sensitivity to hot and cold.
I recommend the patch or Nicorette brand chewing gum to help them stop smoking. I also recommend the e-cigs if they can’t stop the smoking.
A huge problem with our society is acid-reflux; stomach acid coming up during the night that practically melts teeth. I even see this problem with kids. The cause of acid reflux is diet (caffeine, spicy foods, eating before you go to bed) and stress.
Acid reflux and stomach acid are both commonly exacerbated by caffeine. The caffeine tightens skeletal muscle but relaxes smooth muscle. The sphincter from the esophagus to the stomach is smooth muscle. The caffeine also stimulates stomach acid production and opens up the sphincter to the stomach which allows the stomach acid to get into the mouth.
For people who have severe acid erosion, we recommend they get down to only one cup of caffeinated beverage in the morning.
Caffeine has a half life of 5 hours and is longer in people over the age of 40 years. If you have two cups of coffee at 8 am, half of the caffeine you had in the morning will be in your system at 1 pm, then half of that will be in your system at 6pm and when you go to bed at night the caffeine remaining in your system can cause the acid reflux.
An average 8-ounce cup of coffee contains 95 milligrams of caffeine. With the example above, you will have around 24 milligrams of caffeine in your system when you go to bed. That assumes that you have no other caffeine drinks during the day. If you have only one cup in the morning, you would have about 12 milligrams at bed time.
People who follow the advice to reduce their caffeine intake may go through a withdrawal period with headaches and muscle pains when they stop drinking caffeinated beverages but invariably, the erosion of their teeth slows down and they often find they sleep better and stop having headaches.
Half my patients over the age of 60 have significantly less saliva than they had when they were in their 20s and 30s. Part of that is medication, part of that is that our salivary glands don’t work as well when we get older. Saliva is a huge protector of the teeth in that it neutralizes acids that can erode the teeth.
Saliva inhibits demineralization of the tooth surface and promotes remineralization.
That means that when acids try to dissolve the outer layer of your teeth (the enamel), your saliva is right there, super-saturated with extra calcium and phosphate to prevent the acid from demineralizing your teeth.
When the acid is so strong that it does demineralize the tooth, your saliva will neutralize the acid as soon as possible, and then replace the lost tooth with calcium and phosphate.
I have patients in their 80s, 90s and even 100s who have lost the protection of their saliva so they end up with more cavities and more acid erosion from their stomach acid.
Smoking and chewing tobacco are still significant problems with mouth and teeth health.
The problems with smoking with gum disease and with tooth decay comes from the heat and the smoke (which contains the particulates) and the fact that cigarette smoke is almost a perfect desiccant. Cigarette smoke removes moisture from the mouth which compounds the problem of losing saliva as we get older.
If you watch the smoke from a cigarette burning on its own, it comes out blue. The tiny ash particles are a microscopic, 20-micron size. The ash particles reflect the high end of the visible color spectrum which is blue. Billions of those particles are coming out of the smoke, all reflecting blue.
The smoker inhales and upon exhalation, every one of those billions of particles now reflect white since the smoke has extracted moisture out of the lungs, trachea and the mouth. The smoke removes the last protective layer from the mucous membranes and has left the ash and tar which embeds into the lungs.
I love to help problem solve with cigarette smokers since so many of them want to quit smoking. I often recommend the patch or Nicorette brand chewing gum to help them stop smoking. I also recommend the e-cigs if they can’t stop the smoking.
I had one patient who smoked 3 packs a day and on his own, he transitioned to an e-cig. He always flossed, always brushed, but because of the cigarette smoke, his gums and teeth were not healthy. He still smokes the equivalent of 3 packs a day but bleached his teeth and started getting healthy gums.
There has not been a lot of research on the e-cigs. However, I know cigarettes are going to create problems with my patient’s gums and health. I also know the e-cigs don’t desiccate. The ingredient that is inhaled is nicotine dissolved in water. The mist that is exhaled is the mist, the water, that the nicotine is in. There is no temperature change so the heat is not going into the lungs. There is no smoke and there is no tar. I’ve seen positive results with smokers’ gums and teeth when they switch to e-cigs.
Chewing tobacco is known to be a cause of oral cancer.