My Retainer’s Journey

I had braces as a teenager and following treatment got a shiny, new retainer that I was supposed to wear every night. After wearing it for a while, my shiny new retainer was no longer so nice or shiny. It was dull, stinky, crusty. Eventually I stopped wearing my retainer (don’t be like me… keep wearing your retainer!). Several years later, I opened a Christmas present from my mom and inside was my disgusting old retainer! Sending it back and forth every year became a running gag.

Even though we knew the retainer was coming, it was still always a shock to open the present and find it! It was so disgusting that it was impossible not to be surprised. I know a lot of people with retainers and other dental appliances such as nightguards or dentures eventually find themselves in this same situation. Once shiny, new appliances now are crusty, stinky, and dull. They get like that even though you may have tried to keep them clean. Who wants to wear something that looks and smells like this! Most people don’t think about their dental appliance needing regular cleaning just like the rest of their mouth.

Your mouth is a tough place for an appliance to hang out. It gets beat up by your teeth, there is constant moisture, food particles floating around, and bacteria looking for a place to settle in. It is no wonder that retainers and other appliances eventually turn disgusting.

There is hope for your retainer, nightguard, mouthguard, or dentures! The secret? You’ve got to clean it!… I would say you need to clean it just like you need to clean your teeth but there is a really big difference here that you need to understand.

Teeth get cleaned with toothpaste and floss. Dental appliances NEVER get cleaned with toothpaste.

If it is good enough for your teeth then why is it bad for your dental appliances? To understand this, you need to know what teeth are made of vs what dental appliances are made of. The outer portion of teeth are made up of the hardest substance in the body, enamel. Enamel is the hardest material found in any biological system by far, much harder than bone. It is harder than steel (but much more brittle and can chip somewhat easily). Dental appliances are usually some combination of metal parts and an acrylic or plastic material. These materials are not nearly as hard as enamel and scratch much more easily. Toothpaste, because it is made to clean teeth, is highly abrasive (like sandpaper) and will scratch most materials other than enamel. Imagine if you took fine sandpaper and rubbed it all over your dental appliance. You’ll end up with a lot of micro-scratches and a dull surface.

On a microscopic level, you’ve taken something that is highly polished and smooth and then put all sorts of nooks and crannys in it. Not only does this dull the surface but it also creates areas that bacteria can easily attach to. As this biofilm builds up, it creates a hard accumulation similar to what builds up on your teeth (tartar or calculus). Once this builds up on your appliance, it makes it much harder to clean. We’ll go over how to fix this in the Nuclear Cleaning Method.

Dental Appliance Cleaning Methods

I’m going to go through the methods in order from least effective to most. In general, the further on we go, the more effective it will be but you’ll end up spending a bit more money on supplies or equipment.

#1: Soap and Water Method / Routine Cleaning

Yes, this is as easy as it sounds. You need soap, water, and a soft bristled toothbrush. Get some nice suds going and brush your dental appliance all over until it looks and feels clean. This method works best if used consistently each week to keep your dental appliance clean from the start. It doesn’t work as well once your appliance has already gotten scratched, dirty, and covered in build-up.

#2: Soak Method

My hygienist came to me a couple of weeks ago and said “I finally did it! My retainer is clean again!” She has an Invisalign retainer that had turned a beautiful shade of orange (different people turn their appliances different colors… some colors we’re not sure how they show up). She’d tried soap and water, she’d tried putting it in an ultrasonic cleaner in mouthwash. None of these things had worked.

She soaked it overnight in denture cleaner. The staining was finally gone and it looked like new. For appliances that have a lot of staining, this can be a really good option to remove the staining and make it smell like new. Denture cleaner isn’t just for dentures, it is also great for any dental appliance including retainers, nightguards, mouthguards, or snoring/sleep apnea appliances.

I personally like Efferdent tablets but most brands of denture cleaner will work just as well. Click the picture below for a link to this product on Amazon.

#3: The Ultrasonic Method

If you’ve tried the last couple of methods and are still having problems, it is time to bring in the big guns. You need an ultrasonic cleaner.

Ultrasonic cleaners work by vibrating at an extremely high frequency. This vibration is highly effective at removing debris on appliances. It also works great to clean jewelry or coins.

To work the ultrasonic cleaner most effectively there are a couple of steps you’ll need to take. Fill the tank on the cleaner with distilled water (or whatever the manufacturer recommends). Then place your dental appliance in a ziplock baggie and fill it with Listerine or other dental mouthwash. Place the ziplock baggie in the cleaner and turn it on. A good 10 minutes or so is usually required for adequate cleaning. Sometimes after cleaning you’ll still need to brush the appliance off to remove the residual debris. It should be a lot easier to remove after running through the ultrasonic cleaner.

#4: The NUCLEAR Method

If you’ve used all the previous methods are are still struggling to get all the build-up off, there is one last thing you can try at home. It is the secret ingredient that many high volume denture offices know about but don’t generally tell you. That secret ingredient is CLR (Calcium Lime Rust). It is a high strength cleaner that is typically used to clean, you guessed it, calcium, lime, and rust that has built up in bathrooms and other household areas. Most people wouldn’t ever think to use this on their dental appliance.

The reason why this works so well? That heavy white or yellow build-up you get on many dental appliances is generally a calcium heavy type of build-up.  You need something that attacks this directly.

You’ll need to have an ultrasonic cleaner as recommended in the previous post and instead of using mouthwash in the ziplock baggie, use the CLR instead. Run it for about 10 minutes and the build-up will dissolve and fall off.

Once your appliance is clean, it is really important that you clean off the CLR really well. Rinse the appliance for at least a minute and then soak in mouthwash for another minute. This will make sure that you’ve cleaned all the harsh chemicals off your appliance. Almost all dental appliances are non-porous, meaning they don’t soak up any type of liquids. As long as you make sure all the residue is off the outer surface, you don’t have to worry about any harmful exposure as a result of using it as a cleaner.

#5: The Professional Method

Finally, if nothing else has worked, it means that the surface of your appliance is beyond any type of regular cleaning. Nothing you do is going to help this. It is time to take it to your dentist to see if the appliance can be professionally cleaned and polished (by removing a small portion of the outer surface with abrasive polishers) or if you need to have a new appliance made.

Have you found any other methods that work well to clean your dental appliances? Let us know in the comments below!

For the first 23 years of my life, I too had a phenomenally bad gag reflex. Brushing my teeth in the morning?… Near impossible without losing my breakfast. Trying to swallow pills?… Hope they aren’t too big! Fluoride trays at the dentist?… They hid me in a back room and the rest of the office could still hear me gagging. Dental impressions?… I’m not sure how they managed these.

Then a crazy thing happened… I found that gagging could be controlled! Since then, it hasn’t been a problem for me. We’ll get to how I did this in just a bit.

What Causes Gagging?

Gagging is a protective reflex that your body has so that you don’t let food or other objects down your pharynx (windpipe). Food or other objects going down your pharynx into your lungs isn’t good. Gagging protects you from doing this. It is when this reflex is overactive that it can cause a problem with everyday activities.

There is a physical component as a mental component to gagging. First the physical component…You have a variety of touch receptors in your mouth located on the roof of your mouth, tongue, and back of your throat. Touch a certain area and it sends a signal to your central nervous system which immediately sends a signal back for muscles in the area to contract (the actually act of gagging). People have varying levels of sensitivity to how much it takes to cause this reflex.

On top of this reflex, you have a mental component that can make your gag reflex hyperactive. Ever wondered how you can just look at something and you’ll feel the familiar gag feeling coming on? Thoughts can literally turn on the gag reflex.

Your gag reflex is a complicated mix of these two factors. They both have to be addressed in order to really reduce your gag reflex. The good news is that it can be done!…

Short Term Gag Reflex Fixes:

• Controlled breathing – If you feel your gag reflex coming on, close your eyes, and take several deep breaths through your nose. This action relaxes your whole body including your gag reflex. Panicking always makes it worse. I found that this was the most helpful way to relieve my oncoming gag reflex early on.
• Sitting up – If you’re at the dentist and laying back, especially during dental impressions, ask if they can sit you up. Not only does it keep excess material from going down your throat, but it also seems to calm most people down.
• Distraction – While doing your controlled breathing,  think of something, anything other than what is currently happening. Go to your happy place. Pinch yourself. Listen to music. Watch TV. Anything that will make you think of something else. This will significantly help with the mental part of your gag reflex.
• Topical or injected anesthetics – If you’re having a really tough time at the dentist, they usually have a topical anesthetic spray that will numb your tongue and back of your throat. It tastes horrific but is helpful in reducing the physical sensations that trigger your gag reflex. In especially bad situations your dentist can inject anesthetic to get you even more numb.
• Sedation – For some people, none of the previous tips are enough to overcome their hyperactive gag reflex. In these rare cases, some level of sedation can be helpful in reducing the gag reflex. Sedation can range from an extremely mild sedative all the way to heavy sedation where you won’t remember a thing.
• Salt on your tongue – Many people like to put salt on their tongue to help with gagging. We’re not sure exactly why this is helpful. It could be distracting or it may change the sensation on the tongue. Either way, it definitely can’t hurt.
• Acupuncture – There have been a couple of interesting studies on acupuncture as a way to reduce the gag reflex. It is thought to help but in most cases there isn’t anyone available who knows enough about acupuncture for this to be a good way to reduce your gag reflex.
• Pressure points – Similar to acupuncture but a bit easier is the concept of pressure points. The most common pressure point for gagging is on the inside of the wrist.

How To Stop Gagging Forever:

Ever wondered how a sword swallower could possibly do what they do? I always wondered that too seeing that I couldn’t get a finger within an inch of the back of my mouth before I started gagging. Sword swallowers learned a trick that just about anyone can use to overcome their gag reflex. It can take some time but I think it is worth it.

So what happened when I was 23 that changed my gag reflex? I can’t take a whole lot of credit for actually coming up with this myself… it was more thrust on me involuntarily. I had started dental school and one of the fun things that dental students get to do is take dental impressions on each other. Repeatedly. And then do some more. And some more. Until we get really good at them. When I heard about this, I didn’t think I was going to make it. I couldn’t brush my teeth in the morning successfully and I was supposed to sit through dozens of impressions?

Well, I didn’t have much of a choice so we got started. My partner took the first impression and I predictably about lost my lunch. The next impression, I sat up, breathed through my nose, tried to go to my happy place, and relax. It was a little easier. We took about twelve dental impressions on each other that day. Each one got a little easier. By the end, it didn’t bother me at all.

Since that day, life has been easier. My gag reflex is normal. I can’t swallow swords but I can brush my teeth, swallow pills, and make it through dental appointments with ease. The only time I gag is if something touches the absolute back of my throat (that’s considered normal for most people). You can do this too. Now I’m not recommending getting twelve dental impressions done in a row but the process is similar. This process is called desensitization and it is highly effective for permanently improving your gag reflex.

The Solution – Densensitization

I didn’t know it at the time, but when we were taking those dental impressions we were progressively desensitizing my gag reflex. You can do this too. First, you’ll need to find what spots cause your gag reflex to be most sensitive. For most people these areas are the roof of the mouth (beyond a certain point), the back and side of the tongue, and the back of your throat.

Now for the fun part.

You’re going to have to stimulate your gag reflex repeatedly. Take a toothbrush and touch the area that gives you fits. Try to keep it there as long as possible without causing yourself to vomit. Rest a minute, and then go again. Try to keep the toothbrush there longer. If you’re having gagging issues with dentures, use them to do the same thing. The goal is to progressively increase the amount of time and pressure you can tolerate. It may take several weeks but eventually you’ll get to a point where your gag reflex isn’t so hyperactive. I recommend doing this 5-10 times a day for several minutes at a time.

Desensitizing my gag reflex was life changing. I never thought it could happen but it did. You can do it too! Stick with it and you’ll get there.

Why Do Children Grind Their Teeth?

In years past, it was thought that children who ground their teeth and snored would grow out of it eventually. And the conventional wisdom was in some small way right. After a certain age, a good number of these kids did seem to stop these behaviors (we’ll get to why in just a bit). What many doctors didn’t realize is that in the intervening time, there could be some significant health issues that developed as a result of what is known as sleep disordered breathing (SDB).

What we are starting to learn now is that children who grind their teeth and snore often have sleep disordered breathing. This is a condition in which their body isn’t getting enough oxygen as they sleep during the night. In order to get more oxygen, their body wakes them up to take a breath. They are back asleep almost immediately, never remembering all these awakenings. This can happen dozens of times an hour, all night long.

You might be thinking, “That only happens in overweight, middle aged men, right?”. That is what everyone used to think too. We are finding out that sleep disordered breathing is a problem for a lot of people, not just overweight middle aged men. It affects everyone from very young children, to skinny young mothers, to the very elderly.

Back to the grinding part. We believe that the grinding is a result of the sleep disordered breathing. The grinding may help them wake up enough to breath correctly. It is no longer thought that stress or anxiety leads to nighttime grinding in children. It may possibly lead to daytime grinding, but not nighttime.

What Causes Snoring In Kids?

Snoring itself is a result of air moving through tissues that aren’t quite large enough causing loud vibrations. It can be loud enough to wake up people asleep several rooms away. Yes, even in kids it can be loud enough to wake the dead. Even if it isn’t loud, it can still mean that there is an issue.

There are a lot of different areas that the snoring can originate from in children. These include the nose, tongue, palate, or tonsils. Knowing what area/s the snoring is originating from can help to know how to treat it.

Snoring can be chronic (happening consistently) or acute (limited duration). Chronic snoring is usually a result of over-enlarged tissues (especially tonsils and adenoids). Being overweight is a major risk factor for chronic snoring in children. Acute snoring is more often related to allergies and colds and will often go away once the source is removed.

As we discussed just a bit ago, a lot of kids do grow out of snoring. Many times as they grow, their tonsils and adenoids shrink in size as compared to the airway. This shrinking can be enough to open their airway to a healthy level. So if this is the case, why do we need to treat children for sleep snoring. It’ll just go away with time right? The major problem is what happens in the meantime by not treating it. What we are finding out now is that it can cause some major behavioral and mood disorders and possibly affect their overall growth.

If your child is snoring often enough that you notice, I highly recommend you have an evaluation done by your dentist and ENT for some of the risk factors we’ll go over in just a bit.

What Are The Dangers of Disordered Sleep in Children?

Sleep disordered breathing has been linked to a variety of different developmental issues with children. These include:

• Mood disorders. How grumpy and unhappy would you be if you got poor sleep every night?
• Behavior disorders, with a particular emphasis on disorders similar to ADHD
• Poor academic performance
• Poor growth
• Higher incidence of poor jaw development (leading to the need for braces later on)

In adults with sleep disordered breathing, such as obstructive sleep apnea, we know that they develop major health issues such as high blood pressure, diabetes, heart disease, stroke, and mental deterioration at a much higher rate than the regular population. Their lifespan is reduced by 5-10 years, easily.

If this is what happens to adults with sleep disordered breathing, what do you think it does to children as they developing? Unfortunately, we don’t have the answers to this yet, but we do know that it has been correlated with poor outcomes for certain measures of behavior and development.

What Are Some of the Warning Signs For A Sleep Disorder?

• Snoring
• Grinding teeth at night
• Excessive daytime sleepiness
• Large tonsils
• Overweight for their age
• Overactive behavior (inadequate sleep can cause a paradoxical effect where the child exhibits even more overactive behavior)
• Mouth Breathing (open mouth at rest, sleeping with their mouth open) – Your dentist will also notice very specific dental symptoms related to mouth breathing. The gum tissues in a person who breathes through their mouth tend to be extremely red and irritated on the top, front teeth.
• Unusual stress or anxiety
• Consistent bed-wetting

How Do We Treat Sleep Disordered Breathing In Children?

As opposed to adults, treating sleep disordered breathing in children is pretty straightforward. In most children, removing the tonsils and adenoids opens up the airway enough to allow proper air flow.

For children who have a narrow palate structure, they may also need early intervention by a qualified orthodontist. In most of these cases the orthodontist will place a palatal expander, which is a device that is fixed in place and slowly widens their upper arch of teeth. This treatment must be done early on, while the child is still growing, usually around age 7-9, in order to achieve the best effects.

Some children who are overweight, may also need help in losing the additional weight to fully treat their issues with sleep disordered breathing. Being overweight makes it so that their is additional tissue in the airway, blocking adequate airflow.

If your child suffers from frequent colds or allergies, it may be helpful to start on maintenance medications to keep them from becoming an issue. These include medications such as antihistamines for allergies (Claritin, Zyrtec, etc).

Why I Care About This Subject

I’m passionate about this subject, not only because I’m a dentist, but because I have four kids of my own. At the time of this writing, one of my children had his tonsils and adenoids out just months ago. He had many of the classic symptoms of sleep disordered breathing. His twin brother was constantly up because of his brother’s snoring. The snoring has stopped and he appears to get far better sleep than he used to. My only regret is that we didn’t have the surgery done sooner.

In all cases I recommend waiting for the numbing agent to wear off before eating anything that you have to chew. Chewing with a numb mouth is an easy way to chew up your cheek or tongue. In most cases the numbness should wear off within 2-3 hours after leaving the dentist. In some cases (usually for bottom teeth) you may be numb up to 4-5 hours after. That doesn’t mean you can’t eat anything. Try eating food that you don’t have to chew. I recommend mashed potatoes or a milkshake. You can drink most things that you feel comfortable with. The only exception are really hot beverages as these could burn the numb area without you knowing it.

Once the numbness wears off, it depends on what you had done as to what you should eat.

Amalgam / Silver fillings:

These type of fillings have a hard initial set within 3-5 minutes after being placed but don’t fully set for about 24 hours after placement. Stay away from anything especially hard with these types of fillings for at least that first 24 hours. After 24 hours you can return to a normal diet.

White fillings:

White fillings are fully set before you leave the dentist. You can eat a normal diet as soon as the numbness wears off.

Crown appointment with a temporary crown placed:

Most dentists still do crowns in two appointments. During the first appointment, the tooth is prepared for the crown and a temporary crown is placed and cemented with a temporary cement. Both the temporary crown and temporary cement are far weaker than their permanent counterparts. You’ll want to avoid anything sticky or especially hard while you have the temporary on. The major culprits for these crowns coming off are things like gum and candy. If the temporary crown does come off, make sure to get back to your dentist quickly to have it recemented.

Same day crowns:

Some dentists have technology in their office that allows them to create your crown the same day that the tooth is prepared. You go home with the permanent crown already on the tooth. Most of these crowns are bonded directly to your tooth and this bond is fully set by the time you go home. You can eat normally as soon as the numbness wears off.

Extractions:

If you had an extraction or several done, you’ll need to be a bit more careful with what you eat. For the first several days you’ll want to avoid any especially hot beverages. Hot beverages can dissolve the clot in the socket and give you a dry socket (not fun!). No straws should be used for drinking beverages for at least a week. For food you’ll want to avoid anything spicy or acidic (like orange juice) for the first couple of days. They can sting or burn  quite a bit. You’ll also want to avoid hard or sharp foods that may reinjure the area. Tortilla chips are one of the major culprits here. A somewhat soft diet for the first couple of days to a week or so can help the area heal more quickly.

Root Canal:

Root canals are probably the most tricky out of all of them. A tooth with a root canal is significantly weakened and more likely to fracture if force is put on it the wrong direction. Long term, most teeth that get a root canal should get a crown quickly after the root canal has been completed. Most of the time, a temporary filling is placed in the tooth until the crown can be done. I highly recommend avoiding hard foods on that tooth until the permanent filling or crown has been done. It is always sad when someone spends a lot of money on a root canal only to break the tooth shortly afterward and lose it anyway.

Teeth that have had root canals are also likely to have some biting soreness for a couple of days up to several weeks following treatment. Staying to a relatively soft diet can reduce the trauma to the tooth and allow it to heal more quickly.

With the rise in the number of people being treated by Invisalign, there has been a similar (huge!) increase in the number of people who have questions about how the process works, how to maximize its effectiveness, and deal with any major and minor problems that can come up with it.

Yes, when cavities are small you absolutely can reverse them. I’ll show you when and how…

First, let’s talk about what cavities can be reversed and which ones cannot. Cavities aren’t some yes or no state your tooth is in. Cavities start microscopically small with minerals being lost from your teeth, progress to larger demineralized areas, and eventually the outer tooth structure starts to visibly break apart. This process occurs over months to years. Dentists typically fill a cavity once it has broken through the surface of the tooth or has spread far enough under the surface that the outer surface will eventually break down.

Teeth that are only demineralized, without significant breakdown of the inner or outer structure of the teeth can be reversed.

Teeth that have irreversible structural damage (aka a hole or “cavity” in them) cannot be reversed. They need professional intervention in the form of a dentist at that point.

Many other articles will tell you that you can naturally heal all cavities on your own with some mixture of diet change, essential oils, and natural products.  Unfortunately I’ve found that the vast majority of people writing these articles don’t really understand how teeth work and tend to have some claims that just aren’t true. I’m a practicing dentist and I’ve studied the scientific research on what actually works to heal teeth. Let’s jump into that now…

We’ve got to fix multiple problems in order to reverse cavities…

Stop the demineralization process

This is the big one. If we can stop the factors that are actively removing minerals from your teeth then your body can usually start the healing process. Demineralization happens when a tooth is exposed to acid. Acids come from a variety of sources such as sodas, most flavored drinks, citrus fruits, bacteria that feed on sugar and carbohydrates, and conditions that cause excess vomiting, .

• Sodas and flavored drinks – These are some of the biggest offenders. Most people I talk to with many cavities have a problem in this area. Cutting these out of your diet entirely will make a massive difference in developing cavities.
• Citrus fruits – For most people, they don’t eat enough of these fruits to make a major difference but some people snack on them all day, long enough to literally dissolve all the enamel off their teeth. I’ve seen people who’ve done this. Everything in moderation. Don’t suck on lemons all day!
• Bacteria that feed on sugar and carbohydrates – There is a reason that sugar and carbohydrates are so highly related to cavities. Bacteria in your mouth sit on your teeth and feed on this sugar (or foods that break down into sugars). As a byproduct they create acid which starts to break down your tooth structure. This process can continue until they literally break down the entire tooth. Brushing and flossing will also help to remove these bacteria from the surface of your teeth and slow this process down.
• Conditions that cause excess vomiting – These include things like bulimia or hyperemesis gravidarum while pregnant. You can’t usually stop this but you should rinse your mouth out with water after each vomiting session (if possible). You’ll also need to aggressively try to stop any other sources of acid in your mouth (see above) and work on getting those minerals back.

Xylitol

Xylitol is an interesting and relatively new chemical. I have other articles on here that talk about it in more depth. Basically, xylitol makes it so that the bacteria in your mouth are inhibited and struggle to actively grow and produce acid. This causes a reduction in cavities.

Add minerals back

Your tooth enamel is composed primarily of hydroxyapatite, which is a hard crystalline material based around calcium. Your body can also substitute fluoride in place of the calcium to create fluroapatite which ends up being more resistant to decay than the original hydroxyapatite.

Fluoride

Most dentists focus on getting fluoride to your teeth in order to remineralize these small areas so that they don’t turn into decay. People who have no exposure to fluoride in either water supplies, toothpaste, or other applications have much higher rates of decay. It is that important. If you don’t like the idea of any exposure to fluoride, you’re really going to struggle to remineralize those areas of decay. For a middle ground on the fluoride issue, check out my article where I explain my stance on fluoride in the water supply vs topical applications like toothpaste.

If you didn’t read that last article, I’ll cut to the chase here. I don’t particularly care if you are drinking fluoridated water. I do care if you are using fluoride toothpaste and having professional fluoride treatments. These types of treatments get fluoride to your teeth with minimal overall exposure to your body (unlike fluoride in water supplies).

Saliva

Your body will also naturally try to add minerals back to your teeth. Your saliva is a natural source of calcium and you need proper saliva flow to wash bacteria away and add minerals back. It isn’t unusual for people with dry mouth (such as those on a lot of medications) to struggle with cavities. Make sure you are getting good calcium sources in your diet so that your body has enough. Chewing sugar free gum is one great way to stimulate saliva flow and reduce your risk for cavities.

Things That Don’t Work To Reverse Cavities:

• Oil Pulling – I’ve written another article about this. It doesn’t work and is a waste of time. Essential oils may be natural but they don’t cure cavities.
• Homemade remineralizing solutions
• Adding Fat Soluble vitamins to your diet (A and D are commonly cited)

Let’s Recap What We Need to Do to Reverse Cavities:

• Avoid soda and flavored drinks.
• Don’t eat acidic foods or drinks all day.
• Minimize the exposure your teeth get to sugars and carbohydrates (I recommend a quality diet of some combination of whole foods that includes fruits, vegetables, lean meats, good fats, and small amounts of whole grains – It is good for your teeth and your overall health).
• If you do eat sugar or carbs, include it with a meal and don’t snack on it throughout the day. Remember we are trying to have as little exposure to your teeth as possible.
• Brush and floss twice a day.
• Consider using a xylitol product, especially as chewing gum.
• Use a topical fluoride containing product such as fluoride toothpaste.

It’s not magic but it does work. It doesn’t take big changes to make a significant difference in how your teeth are taking up and losing minerals.

“What will it do to your teeth??”

I know. I know. It’s probably not the first question that comes to most people’s minds. I think it is a really important one though. A healthy set of teeth is important for eating and chewing as well as overall health. Many people are starting to realize that your mouth is a window into the health of the rest of your body. A great diet should be healthy for your teeth as well as for the rest of your body. Figuring out that part… Not so easy, but I’ve got you covered!

I’m going to go through all the major diets out there, and rank them according to how tooth friendly they are (This doesn’t take into account if the diet is effective for anything else… just how “safe” it is for your teeth). These rankings are my subjective ratings on the diets based on how I think the average person would use the diet.

One last piece of advice before we get into the rankings….

Almost any diet can be made “teeth healthy” if you understand and follow the basic rules about how to eat for healthy teeth (sign up for our email list on our home page for a free, detailed PDF on how to do this!). The problem is that people don’t usually understand how the process works, what foods can actually cause cavities, and how to avoid it.

Diets with a Tooth Score of 0-2 will be very challenging to follow as is and not develop cavities long term.

Diets with a Tooth Score of 3 can be made teeth healthy if you watch what and how you’re eating.

Diets with a Tooth Score of 4-5 will typically be quite teeth healthy without much modification.

Abs Diet

This diet recommends six meals a day, each meal containing at least two of it’s twelve superfoods (Almonds/Other Nuts, Beans, Spinach/Green Veggies, Dairy, Instant Oatmeal, Eggs, Turkey/Lean Meats, Peanut Butter, Olive Oil, Whole Grain Breads and Cereals, Whey Protein Powder, and Berries. Smoothies are a highly recommended way to get many of these meals in.

Pros: It recommends limiting refined carbohydrates and sugar.

Cons: It keeps you eating all throughout the day. Whole grain breads and cereals can still cause cavities. Sipping on smoothies, especially if they are berry heavy, is a good way to get cavities.

Tooth Score: 2/5. The constant eating is the biggest risk factor with this diet.

Anti-Inflammatory Diet

This diet is a relatively complicated one to follow! Here are the basic rules… 1) Eat as much fresh food as possible 2) Avoid processed foods and sugars 3)Get 40-50% of your calories from carbs, 30% from fat, and 20-30% from protein 4)Eat whole grains 5) Eat pasta in moderation 6) Avoid high fructose corn syrup 7) Reduce your intake of saturated fats 8)Eat more vegetable based protein than animal based protein other than fish 9)Eat fruits and vegetables from the entire color spectrum and 10) Drink water

Pros: It recommends you limit most refined carbohydrates, sugar, and high fructose corn syrup. These are the biggest contributors to tooth decay.

Cons: It can be complicated to follow and know if you’re doing right.

Tooth Score: 4/5. It cuts out the vast majority of foods that are known to cause cavities.

Atkins Diet

The Atkins diet is one of the most popular low carb diets out there. It has you cut out almost all starchy and sugary carb foods including candy, cookies, chips, potatoes, pasta, bread, and sugary drinks.

Pros: It cuts out almost all carbs and sugars which are the biggest contributors to tooth decay.

Cons: None for your teeth.

Tooth Score: 5/5. By cutting out almost all carbs (except those you get from vegetables) you reduce your risk for cavities drastically.

Biggest Loser Diet

The Biggest Loser Diet, popularized by the reality television show, focuses on small portions of food eaten in 5-6 meals throughout the day. It emphasizes weight loss which is achieved by eating fewer calories. The recommended foods for this diet include lean proteins such as turkey or chicken, low fat dairy, whole grains, fruits, vegetables, beans and nuts.

Pros: It cuts out refined carbohydrates.

Cons: You are eating more frequently and still have a good number of sugars and carbs in your diet from grains and fruits.

Tooth Score: 2/5. The combination of eating frequently and carbs isn’t usually a good one for your teeth. Limiting how often you eat grains and fruits will help lessen the impact on your teeth.

DASH Diet

The DASH diet was originally created as a diet to help keep blood pressure in check. It has since been rated by several publications as one of the best overall diets to follow. It is similar to and often called the Americanized version of the Mediterranean diet. It recommends eating the following servings of food each day (on a 2000 calorie diet): 7-8 servings of whole grains, 4-5 servings of fruit, 4-5 servings of vegetables, 2-3 servings of low fat or non-fat dairy, 2 or less servings of lean meats, fish, or poultry, 4-5 servings per week of nuts, seeds, and legumes, and limited consumption of fats and sweets. It also recommends keeping sodium intake very low

Pros: Great for your overall health

Cons: It has a large proportion of your food coming from grain and grain products as well as fruits. All of these can contribute to cavities if eaten too frequently.

Tooth Score: 3/5. To make this diet more teeth healthy, limit grain products, fruits, and any sugary items to your specific mealtimes and don’t snack on them throughout the day.

Fast Diet (5:2)

The fast diet (the most popular of which is the 5:2 variety) is a diet in which you eat normally 5 days out of the week and the other two days you eat a very small number of calories (usually around 500 calories). The goal of this diet is to lose weight. It says you can pretty much eat what you want on your non-fast days. The major goal is calorie reduction.

Pros: One of the easier ones to follow.

Cons: There aren’t any recommendations about cutting out refined carbs and sugar.

Tooth Score: 1/5 if your 5 regular days are like the typical western diet (high in refined carbs, sugars, and sweet drinks). If you eat more healthy foods on your regular days this could be a reasonable diet for your teeth.

Fertility Diet

The Fertility Diet as the name suggests was created to help people get pregnant. Many cases of infertility are related to the woman not ovulating which this diet can help with. The rules include avoiding trans fats, using unsaturated vegetable oils, eating vegetable proteins instead of animal proteins, eating slow carbs such as whole grains, vegetables, and fruits, drinking whole milk, eating iron containing plants, and staying hydrated while avoiding sugary drinks.

Pros: It recommends avoiding refined carbohydrates and extra sugars.

Cons: It is recommended that some women gain weight on the diet to get to a more healthy BMI for fertility. It is easy to eat the wrong foods in order to do this (such as ice cream or too many carbs).

Tooth Score: 4/5. Overall a good diet as long as you watch how often you’re consuming carbs and fruits.

Flat Belly Diet

The Flat Belly Diet claims you can lose up to 15 lbs in a month with their system. For the first four days of the diet you can only eat 1200 calories and avoid all salt, processed foods, carbs, and gassy foods such as broccoli, onions, and beans. After the first four days you shoot for 1600 calories a day, eating a small meal/snack every four hours and sticking to a Mediterranean style diet. You also have to drink 2 liters of water a day that has been mixed with ginger root, cucumber, lemon, and mint leaves.

Pros: After the first four days, it sticks to a Mediterranean style diet, which is pretty tooth safe.

Cons: The water concoction isn’t great for your teeth (regular water would be much better) and eating all throughout the day is associated with a higher rate of developing cavities.

Tooth Score: 2/5. If you drink plain water instead of their “sassy water” and avoid most processed carbs and sugars, it’ll be much safer for your teeth.

Flexitarian Diet

The Flexitarian diet aims to have you add five new food groups to your diet without putting specific restrictions on what else you can eat: Plant proteins such as tofu, beans, nuts, eggs, or seeds, fruits and vegetables, whole grains, dairy, and sugar and spice. It also aims to reduce the calories you eat each day.

Pros: Relatively easy to follow.

Cons: Easy to justify eating too many carbs and sugar.

Tooth score: 2/5. While much healthier than the standard diet, it still allows a lot of cavity creating foods, which if eaten too frequently will definitely cause tooth decay.

Glycemic Index Diet

The Glycemic Index Diet attempts to get you to only eat foods that have a low glycemic index (eg. that don’t spike your blood sugar quickly such as refined carbohydrates, sugars, crackers, etc).

Pros: Many of the foods that have a high glycemic index are also cavity causing. Cutting them out will help.

Cons: Some of the moderate to low glycemic index foods can still cause cavities (such as fruits, pasta, or ice cream).

Tooth score 3/5. If you watch how often you eat those additional cavity causing foods, you can lessen the impact on your teeth.

Intermittent Fasting

Intermittent fasting is a pretty broad term that spans everything from the 5:2 fast diet to one meal a day to a whole variety of other diets. The one thing that binds them all together is the emphasis on extended periods of not eating / minimal eating.

Pros: Extended fast periods are good and safe for your teeth.

Cons: No guidance on what types of foods to eat.

Tooth score: 4/5. One of the biggest factors in developing cavities is the frequency with which you eat sugars and carbohydrates that cavity causing bacteria feed on. Intermittent fasting makes it so that you don’t eat them frequently, even if you do eat them.

Jenny Craig Diet

Many people love the Jenny Craig Diet because they make it easy. They send you pre-packaged meals and provide you with the meal plans so that you can stay on track. Portion size control is the biggest thing that they do for you.

Pros: By having pre-set meals and snacks you are able to avoid constant snacking throughout the day.

Cons: There are still a lot of refined carbohydrates and sugars in their meals, snacks, and desserts.

Tooth Score: 3/5.

Mayo Clinic Diet

The Mayo Clinic Diet focuses on eating according to their Healthy Food Pyramid which emphasizes eating a lot of fruits, vegetables, and in lesser amounts, “smart” carbohydrates such as whole grains. For the initial portion of the diet, they also recommend cutting out artificial sweeteners, alcohol, and all sugary items but are added back after losing the weight you’d like to lose.

Pros: It recommends cutting out refined carbohydrates and eat “smart ” carbohydrates such as you’ll find in whole grains, fruits, and vegetables.

Cons: Carbohydrates (with a picture of pasta) are still high on their list of foods to eat.

Tooth Score: 3/5

Mediterranean Diet

The Mediterranean Diet basically has four different categories of foods to eat… Eat regularly, Eat in Moderation, Eat Rarely, and Don’t Eat. Eat regularly includes fruits, vegetables, whole grain breads and pasta, nuts, beans, fish, and healthy oils such as olive oil. Eat in moderation includes eggs, dairy, and poultry. Eat rarely includes red meat. Don’t eat includes refined carbohydrates, processed foods, processed meats, and sugars.

Pros: It cuts out refined carbohydrates.

Cons: It still has a heavy emphasis on carbohydrates and fruits which can both cause cavities if eaten frequently.

Tooth Score: 3/5

MIND Diet

MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay (quite a mouthful!). The goal of the diet is to reduce your risk for developing Alzheimer’s disease. Studies have shown that it is effective in doing this if followed well. The foods it recommends eating are a combination of the Mediterranean and DASH diets, specifically the ones that are good for brain health. These include green leafy vegetables, other vegetables, berries, nuts, whole grains, fish, and poultry.

Pros: It cuts out refined carbohydrates.

Cons: Like the two diets it is based on, a large proportion of calories still come from carbohydrates and fruits. This can cause cavities if eaten too frequently.

Tooth Score: 3/5.

Nutrisystem Diet

The Nutrisystem diet is similar to the Jenny Craig Diet in that you select from pre-packaged meals that are shipped to your house. It focuses on portion control and eating many small meals throughout the day. The meals shoot for 50% of your calories from carbohydrates, 25% from protein, and 25% from fat.

Pros: You have some flexibility in what meals you get.

Cons: A lot of meals have sugar or a lot of carbohydrates in them and it also recommends you eat frequently throughout the day.

Tooth Score: 2/5.  Too many carbohydrates too often can lead to cavities.

Ornish Diet

In the Ornish diet foods are broken up into five categories, Group 1 being the most healthy all the way to Group 5 which is the least healthy. Group 1 includes fruits, vegetables, beans, non-fat dairy, and whole grains. Group 2 includes avacados, nuts, seeds, and various oils such as canola or olive. Group 3 includes seafood and reduced fat dairy products. Group 4 includes poultry, whole fat dairy products, cookies, and cakes. Group 5 includes red meat, butter, fried foods, and other highly processed foods. The goal is to eat primarily from groups 1 and 2, occasionally from group 3, and infrequently from groups 4 and 5.

Pros: It cuts out most refined carbohydrates.

Cons: Depending on how you implement the diet you can end up with a lot of carb heavy meals.

Tooth Score 3/5

Paleo Diet

The goal of the Paleo diet is to eat like early humans used to eat. This can be quite variable so there are a good number of variations on this diet. Most practitioners of the Paleo diet recommend getting the vast majority of your calories from fruits, vegetables, nuts, and meat. Beans, sugars, and most carbohydrates, even whole grain, are a big no-no.

Pro: It cuts out most carbohydrates except for what you get from fruits and vegetables.

Cons: It’s unclear if this diet is actually healthy for the rest of your body (even though it is pretty good for your teeth)

Tooth Score: 5/5

Slim Fast Diet

You eat Slim Fast products as meal replacements. These primarily include shakes, meals bars, and snack bars. You also fix one 500 calorie meal a day. The primary goal of this diet is to lose weight, not to be a long term diet plan.

Pro: It is an easy diet to follow, if not very exciting.

Cons: Most of the products have sugar or carbs in them.

Tooth Score 1/5.

Slow Carb Diet

The Slow Carb Diet was popularized by Tim Ferris in his book, “The Four Hour Body”. Tim Ferris differentiates between “fast carbs” and “slow carbs”. Fast carbs are things like sugar and refined carbohydrates (such as white flour) that break down quickly into sugars. He specifically says to avoid anything white and starchy as well as fruits. Slow carbs are things like whole grains and vegetables that your body breaks down much more slowly. You basically cut out all “fast carbs” from your diet 6 out of the 7 days of the week. The 7th day is a cheat day and you can eat whatever you want. You also shouldn’t drink any calories so no sugary drinks allowed.

Pros: The diet really cuts out the vast majority of foods that cause cavities.

Cons: Most people go crazy on the cheat day, but it shouldn’t be too much of problem if eat the right things on the other days.

Tooth Score: 4/5

Smoothie or Juicing Diet

Several documentaries have extolled the virtues of a smoothie or juicing only diet for some period of time in order to lose weight. The most popular of these is “Fat, Sick, and Nearly Dead”. The basic idea is that you only make fruit and vegetable smoothies or juice for whatever period of time you need in order to lose your required amount of weight.

Pros: None that I can think of.

Cons: Drinks with sugar (such as almost every smoothie or juice) are terrible for your teeth, especially if you consume them frequently.

Tooth Score: 0/5. This is a dangerous one for your teeth.

South Beach Diet

The South Beach Diet is another low carb / right carb diet. It breaks up the diet into three separate phases. Phase 1 is the most restrictive and cuts out all carbohydrates except those with a very low glycemic index such as such as vegetables. This phase is very tooth friendly and intended to help you lose a lot of weight. Phase 2 lets you re-introduce some of those carbs back into your diet. It recommends only whole grains, fruits, whole wheat pasta, and sweet potatoes. This is moderately tooth friendly. Phase 3 is when you are at a stable weight and are just maintaining. It recommends you make good food choices based on your experiences in the first two phases. You can go back to phase 1 and 2 if you need to lose more weight.

Pros: Cuts out refined carbohydrates for the most part.

Cons: Once you’re at a stable weight, it is far less restrictive and you might start choosing foods that are bad for your teeth again.

Tooth Score 3/5. Depending on what phase you’re in, it can be either good or bad for your teeth.

Standard Western Diet

This isn’t so much a “diet” as it is the typical way many people eat today. It started in the United States and has since spread to most other parts of the world. There is a heavy emphasis on refined carbohydrates, meats, and sugary drinks. Fruits and vegetables are usually an afterthought. It is responsible for the skyrocketing rates of obesity, cancer, diabetes, heart disease, and many other diseases. As expected it is terrible for your teeth too.

Tooth Score: 0/5

TLC Diet

The TLC diet aims to lower your bad cholesterol levels and be heart healthy. It does this by reducing saturated fats in your diet. On this diet you’ll want to avoid most saturated fats including butter, whole fat dairy, and fatty meats. It also increases the amount of soluble fiber you consume. The recommended foods include fruits, vegetables, fish, skin off lean meats, bread, pasta, and other whole grains.

Pros: It is rated as a good diet for your heart.

Cons: There are a lot of recommended carbs in this diet. If you’re eating fruits, bread, and pasta too frequently you’ll likely develop cavities.

Tooth Score: 2/5

Traditional Asian Diet

This one spans a good variety of different diets prevalent in the area of Asia. Most of them are low fat and include large amounts of rice, vegetables, fruit, and fish. Red meat is very limited.

Pros: It is typically considered a pretty healthy diet.

Cons: Rice, fruit, and noodles can definitely cause cavities, especially if combined with any added sugars.

Tooth Score: 2/5

Vegan Diet

A vegan diet aims to cut out all animals products. That means no butter, eggs, dairy, cheese, meats, or fish. Most people on a vegan diet eat large amounts of fruits, vegetables, nuts, beans, pasta, and bread.

Pros: A well done vegan diet (heavy on the vegetables, fruits, beans, and nuts can be really healthy).

Cons: It is easy to load up on carbs or sweets while on this diet since you have so many other restrictions.

Tooth Score: 2/5. I recently had a patient who had 15 cavities while eating a vegan diet. She was snacking on potato chips all day which led to the cavities. I’ve seen the same thing with fresh fruit heavy diets. You can make it more teeth healthy by eating more whole grains, limiting the frequency with which you have them (don’t snack on them!), and avoiding added sugars.

Vegetarian Diet

The vegetarian diet cuts out all meat products but other animal products such as dairy and eggs are OK for most people. There are a couple of different variations that allow different items. Most people eat a large amount of vegetables, fruits, cheese, nuts, beans, pasta, and bread.

Pros: A well done vegetarian diet can be really healthy.

Cons: As with the vegan diet it is easy to load up on way too many carbs and sugars.

Tooth Score: 2/5. To make this one more teeth healthy avoid eating carbs and extra sugars except at meal times.

Volumetrics Diet

The Volumetrics Diet is different than many of the other diets I’ve featured on here. Instead of focusing on food groups or calories, it recommends simply eating high volume, low calorie foods to keep you full without eating excess calories. Examples of these high volume, low calorie foods include fruits, vegetables, low fat dairy, whole grains, and lean meat.

Pros: It recommends cutting out refined carbohydrates.

Cons: You can still develop cavities if you are eating a lot of the fruits and grains too frequently.

Tooth Score: 3/5

Weight Watchers Diet

Weight Watchers works by using a SmartPoints system. You have a set number of points you can use each day. Foods that are healthy cost very few points while calorie heavy, non-nutritious foods cost a lot of points. No food is banned in this diet. The SmartPoints system aims to get you to eat low calorie and fillings foods such as fruits, vegetables, whole grains, and lean vegetables.

Pros: Most of their “good” foods are pretty healthy for your teeth.

Cons: You can eat small amounts of the “bad” foods on this diet and if you are doing it frequently throughout the day they can still cause cavities.

Tooth Score: 2/5

Zone Diet

This diet ends up being a relatively low carbohydrate diet. It allows you 3 meals a day a two snacks. Each meal is supposed to be 30% protein, 30% fat, and 40% non-starchy/non-sugary carbohydrates. High sugar fruits and vegetables are discouraged as well as bad fats like red meat and egg yolks. Most meals end up being about 1/4 lean meat, 2/3 good fruits and vegetables, and the rest good fats such as avocados, etc.

Pros: It cuts out most foods that cause cavities.

Cons: Not many from the perspective of your teeth.

Tooth Score: 5/5

Did I miss any major diet plans out there? Let me know in the comments below!

I recently go this question from a friend about a wisdom tooth extraction…

Question:

Answer:

The shock sensation she felt is a result of the needle grazing the nerve. It does happen occasionally and there isn’t a good way to prevent it because the injection is “blind” (we estimate where the nerve should be based on other landmarks and try to get as close as possible… sometimes we just hit it dead on). In rare situations it can cause some lasting nerve damage but most heal completely on their own. If all her sensation came back a couple of hours later then you don’t have to worry about nerve damage from that.

Nerve damage directly from the wisdom tooth extraction is a different matter. Lower wisdom have a tendency for the roots to be in close proximity to the mandibular nerve especially when fully formed. During the extraction you can get nerve damage from severing or damaging this nerve. One of the best ways to avoid this is to have a 3D conebeam CT scan done. Many oral surgeons have these now. It’ll give them a 3D reconstruction of the lower jaw so that they can see exactly where the nerve lies in relation to the tooth. If the nerve is wrapped up with the tooth sometimes they’ll cut the top of the wisdom tooth off and leave the roots in place. Success rates with this are really good and avoid the risk of nerve damage.

If there is a concern with the proximity of the nerve, I’d definitely have her see an oral surgeon and get the 3D scan done. Most oral surgeons do these all day, every day and are really good at it.

Hope that helps!

Question:

I went to my dentist for a cleaning, which I have every 6 months. I
had a crown put on a tooth that developed an abcess. This was done
approximately 12 years ago. On the visit today, 2/1/17, the dentist
said the filling in the crown needed to be replaced because of age,
but that he wanted to remove the crown and put a new crown on.

I asked if he could just replace the filling, and he in effect said
no.

I maintain that the filling in the crown is just like a filling in a
tooth and that he should replace it. There is no decay issue, and the
filling is about 12 years old and cracked.

Am I wrong in not having the entire crown replaced?

Answer:

I’d tend to agree with your dentist. If the old crown and filling are wearing out getting a new crown is your best option. A crown that has had a hole drilled through it is much much weaker and will tend to break more and more over time. Also, the fillings that are placed through that hole typically don’t seal the tooth as well as an intact crown. The primary reason why root canals fail is because there isn’t a good seal and bacteria gets down in there and causes it to become infected again. A new crown will seal that tooth much better! I know it can be expensive to get a new crown, but it really sounds like that is the best thing for the long term health of the tooth.

Hope this helps!

Dr. M

Question:

I had a root canal on my upper right premolar on 14 Feb 2017. This is my last appointment (third appointment). The pain has decreased gradually but I still can’t chew hard food. I still can’t brush this tooth with a normal force which means I brush it very softly. How long will the tooth become normal again? When can I use that tooth to chew hard food?
On the 2nd and 3rd appointment, the dentist put a file in and out of my tooth. When the file pushes too deep into the end of my root, it feels extremely painful. Do other patients feel this pain too?

The dentist did not put a crown for my tooth.

Thank you.

Answer: