“But Doc, I just have soft teeth…….”

Frequently, dentists hear the statement “Doc, I just have soft teeth.”  There are a few people who can honestly claim the diagnosis of “soft teeth.” A rare developmental abnormality called Amelogenesis Imperfecta – imperfect enamel formation- does cause fragile enamel. However, most all of the individuals who come to their dentist with self diagnosed “soft teeth” do not suffer from Amelogenesis Imperfecta. Rather, they suffer from a virtually completely preventable disease – tooth decay. The ability to prevent tooth decay comes down to understanding why teeth decay and then making the necessary wise choices to prevent the process from occurring.

Tooth enamel is actually the hardest substance in the entire human body – much harder than bones. The hardness comes from minerals – primarily calcium, phosphate and fluoride. The way that teeth become soft is from exposure to acids. Acids chemically remove the necessary minerals from enamel, leaving the surface porous and weak. This is the first stage of decay. Decayed teeth break and often become painful.

Controlling acid exposure and promoting an environment that strengthens rather than weakens enamel is critical to dental health. 

The Acid Challenge – A Short List

Common sources of acids are sodas, energy drinks, lemonade, Gatorade, gastric reflux, and the bacteria that live in the plaque that adheres to the enamel.

There are specific bacteria within dental plaque – the gooey white film that constantly is developing on teeth – that are a major source of acid. These bacteria are transmissible from person to person (this may be where the notion that one could inherit soft teeth came from) and are necessary for the formation of cavities. The waste products that these bacteria give off are highly acidic. Let me put this more bluntly: these nasty bacteria are simply “going to the bathroom” on your teeth 24/7. This is why your dentist and dental hygienist are so passionate about helping you to develop excellent brushing and flossing techniques.  You MUST evict these dirty little beggars daily if you are serious about dental health.

Dry mouth is another factor in dental disease. A person who suffers from dry mouth has several challenges: discomfort, extra sticky plaque that is difficult to remove and the loss of the body’s primary buffering defense against acid attack on the teeth.  Dry mouth can be a side effect of many common medications, it can result from radiation therapy in the head and neck area or from diseases of the immune system. 

Gastric reflux is another very real threat to dental health. Up to 75% of people who have gastric reflux do not have obvious symptoms. The stomach acid that enters the mouth at every reflux event is highly acidic and detrimental to dental health.

Acid Reduction Advice – A Longer List

Drink water – at least eight cups a day. Walk right past those fancy displays for energy drinks, sodas, Gatorade, lemonade etcetera…..they are specifically designed to take cash out of your wallet and put it in someone else’s wallet - and give you cavities as an ugly side effect of the cash transfer. Water helps to buffer your mouth’s pH. All other drinks decrease pH, making the oral environment acidic. This advice may be tough to swallow - but consider the choices: drinks and dentures vs. water and your own teeth.

Eat at mealtime. Every time you eat your mouth becomes acidic. So limit the number of acidic events in your day.

Eat spinach, soy, nuts and other foods high in the Arginine. This will help to cultivate healthy oral flora.

Eat food in the most natural state possible. For example, choose whole wheat bread over white bread, brown rice over white rice, eat a peach for dessert instead of a Little Debbie. The more highly refined or processed your food is, the more prolific your “bad bacteria” become.

Beware of dried fruit as it is a highly concentrated, sticky carbohydrate. Focus on fresh fruit.

Rinse with baking soda and water after meals to restore your oral pH.

Brush and floss meticulously every day. Ask your dental hygienist to check your technique. Consider a good quality electric toothbrush. Sonicare and OralB both make good products. These amazing inventions really do clean better than your traditional brush. Add baking soda to your toothpaste – place your favorite toothpaste on your brush and then just dip it in baking soda. If you are one of those people who WILL NOT floss your teeth, purchase a Water Flosser by Waterpik. While not the “gold standard” that flossing is, the Water Flosser is much better than doing nothing to clean between your teeth.

Give yourself an MI Paste treatment every night. MI Paste contains bioavailable calcium and phosphate to strengthen your enamel. Ask your dentist for MI Paste as it is not available over the counter.

Use Xylitol. This natural sweetener can be found in gum, toothpaste, mouthwash and five pound bags. Xylitol has the lowest glycemic index of any sweetener (good for diabetics) and has the wonderful effect of decreasing the presence of harmful bacteria in the mouth. This magnificent property seems to be the result of the unusual carbon structure of the Xylitol molecule. For best results use products sweetened only with Xylitol, rather than with a combination of other sweeteners. It is important to ingest at least 6 grams of Xylitol per day to gain a therapeutic effect.

Among commonly available gums, Ice Breakers Ice Cubes has the highest level of Xylitol, though it also contains other sweeteners. Chew two pieces three times per day. Products sweetened only with Xylitol can be found at Morning Glory, as well as most other health food stores. Your dentist probably carries certain Xylitol products and they are readily available on the internet. Check Xlear’s website.

If you suffer from dry mouth consult your dentist and physician immediately. Because dry mouth deprives your body of saliva, your natural first line of defense against decay, cavities start and progress rapidly.  A product line that many people with dry mouth find helpful is Biotene. Biotene products (mouthwash, toothpaste, saliva replacer) are available over the counter in most grocery and department store pharmacies. Xylitol are also helpful because Xylitol stimulates salivary function and helps to rid the mouth of harmful bacteria. If you take prescription medications, ask your physician about medication alternatives to decrease your dry mouth symptoms.

If you have a high decay rate even though you are “doing everything right” get evaluated for gastric reflux.

If you suffer from bulimia and the gastric reflux that it involves, get the help that you need. Not only can this save your teeth, it can save your life.

Track your salivary pH levels with litmus paper. When is your mouth basic, neutral or acidic?

Take responsibility for your dental success by becoming knowledgeable about dental health. Consult your dentist regularly for the information and care that will be most pertinent to your personal dental success. Banish the notion of “soft teeth.” Make the choices that will strengthen the hard enamel that you have!