In 2001, raw foodist Frederick Patenaude got some alarming news from his dentist – after 3 years of exclusive raw food diet, he had developed 19 cavities. Determined not to undermine his dental health any further, he avoided eating any dried fruit, raw ‘junk food’ and flossed and brushed after most meals. Two years later he went to see a dentist again – this time 20 new cavities had appeared!
The advice of his dentist simply had not worked. It was then that he researched and discovered a book by Robert Nara DDS, an accomplished dentist who had founded a preventative dentistry organization in the United States called Oramedics International. The book was called Money by the Mouthful. Robert Nara was highly critical of mainstream dentistry, believing it to be primarily concerned with the lucrative business of repairing diseased teeth, rather than teaching how to prevent dental problems. Frederick followed Dr Nara’s advice and in 9 months time after a dental check-up, there were no cavities.
Quoting directly from Dr Nara:
‘In 30 years of practicing dentistry, I’ve learned that there are some amazing factors about getting cavities and having gum problems that the public does not know. When people ‘get with it’ by daily eliminating the cause… the body heals itself. The body regrows new healthy gums, calcium and phosphorus are deposited in areas of soft enamel and dentin, thus healing cavities. This is not so amazing to the many folks who already know, that given the chance… the body heals itself. This includes all tissues. Cavities can be made to heal, new bone will grow around the necks of loose teeth, and brand new gums will grow to replace diseased and receded gums’.
What did Frederick do different? Firstly, it is necessary to understand exactly what it is that causes dental disease and why. The ‘cause’ is the establishment of bacterial colonies in the mouth, consisting primarily of Streptoccocus Mutans and Lactobacillus Acidophilus, though other bacteria can be present when disease spreads to the gums (1). Lactobacillus Acidophilus has a positive role to play in the gut, and neither of these bacteria are particularly harmful in a free-floating state in the mouth, but if colonies are formed then the disease and decay process begins. The bacteria ingest their nutrients from food debris, food particles and sugars in your mouth and they secrete their own waste products. One of these wastes is called dextran. It is an invisible product that deposits on the tooth surface, leaving a film called plaque. You can’t see plaque unless it has built up many layers thick – then it will be visible as an off-white or yellowish film on the teeth. In this shielded, oxygen free environment, bacterial colonies have formed and secrete acids amongst their waste products, which eat away at the tooth enamel. Once this penetrates to deeper layers of dentin, the dentin becomes infected and decays, sometimes all the way to the pulp and beyond into nerve tissue, which causes toothache.
As bacterial colonies continue unchecked, the disease process can spread to the gums and the connective tissue that holds our teeth in place. Plaque also deposits on and between the teeth, near the gum line. As the periodontal ligaments that hold the teeth in place are progressively undermined, the tooth gets looser in its socket. This process is accompanied by inflammation and is called periodontitis. In dentistry it is often assumed that dentures are an inevitable consequence of ageing, as periodontitis affects up to 50% of the population. This is completely untrue and perfect teeth, according to Dr Nara, are possible for life.
The conventional advice of ‘brush after meals, use floss, avoid sweets, and see your dentist twice a year’, didn’t work for Frederick. Although this is helpful and positive advice, it ignores some critical factors that are essential to our oral health.
Alkaline saliva is critical. It is acids in the mouth that destroy enamel, present already in saliva or produced by bacteria. Acid loving bacteria thrive in acidic saliva and feed of sugars and starches in the diet. Ingesting any food which the mouth can rapidly convert to sugar will almost instantly cause high acid production, particularly if there is established dental plaque in the mouth, recalling plaque is a dextran rich bacterial biofilm. This includes starchy foods such as bread or grain based products, whether white or wholemeal. While the increase in acid is enormous and instantaneous, as bacteria quickly metabolise and thrive on this starchy carbohydrate, it takes a long time for the production to taper off, as long as 20 minutes for bread, after the initial contact with food. If you already have dental disease, especially don’t eat food bars containing sugar, chocolate or any starchy ingredients that result in prolonged contact time in the mouth, or which slowly melt in the mouth, or which might stick to the teeth afterwards. This includes superfood smoothies made from ‘healthy’ berries, such as regularly consumed by Frederick on his raw food diet, or any drink with sugar in it that is slowly sipped. Part of the solution to his ongoing problems with cavities was to consume the smoothies through a straw!
Where oral hygiene is very poor and where the diet is rich in refined carbohydrate, dental decay can result within months of tooth eruption in children. ‘Baby bottle rot’ is a pattern of decay found in young children with their baby teeth. The decay usually results when children are allowed to fall asleep with sweetened liquids in their bottles, or through feeding children sweetened liquids multiple times during the day. It is not the amount of sugar ingested but the frequency of sugar ingestion that is the most important factor in the causation of tooth decay.
Raw food vegans are also often guilty of food ‘grazing’ and tend to eat high carbohydrate foods on a more regular basis, possibly due to the relatively poor protein levels of most raw foods. This results in a prolonged exposure of sugars in food to bacteria in the mouth. This also often includes acidic fruits. Anything that sticks to the teeth should be immediately followed by brushing and rinsing, particularly if there is a recent history of dental disease. This goes for acidic foods too, except brushing should be delayed. Acidic fruit juices and fruits can also attack enamel if used too often. Rinse mouth with water after eating acid fruits. Avoid these if there is already dental disease. Rinse and floss, but wait ½ hour to brush after eating acidic foods so as not to brush away enamel in a softened state.
ALKALINE MINERALS AND SIALIN
Healthy ‘alkaline’ saliva on the other hand, is vital to oral health. It helps wash the teeth clean and bathes them in bicarbonate, neutralising mouth acids. It contains nitrogenous substrates such as Sialin that are metabolized by the oral bacteria, into compounds that neutralize the acid that the bacteria generate during carbohydrate breakdown. Sialin actually ‘programs’ bacteria to stop making acid. Calcium and phosphate ions present in saliva gives the tooth enamel a constant ‘bath’ of the very elements which make up tooth enamel. These minerals present in ionic form result in a form of ion exchange where lost minerals in teeth are replaced. It should be noted that fluoride is not normally found in saliva and does not constitute a natural, or necessary structural element of the teeth. Saliva also contains calcium phosphate in an amorphous form that can infiltrate the plaque biofilm and work from within to repair the enamel. It is this availability of the building blocks in healthy saliva which can result in the absence of disease and in the healing of early carious lesions, or small chips or cracks in the teeth.
An ideal alkaline salivary pH is 7.4, the same pH as found in blood, which can be achieved over time through an alkaline diet, or by using alkalising minerals or powders. If the saliva remains acidic despite these interventions, it can be due to chronic stress, infection or food intolerance. If you have acidic saliva, it will also erode amalgam fillings, increasing the outgassing of neurotoxic mercury, which is both swallowed and absorbed through the lungs. Acidic saliva is often indicative of systemic acidity which may be linked to other chronic inflammatory disease, and which can be cross checked by measuring urinary pH. Please refer to my report on Salivary and Urine pH Testing, for an exploration of the science behind the subject of acid/alkaline diet.
Apart from dietary interventions and optimising pH of saliva, the fight against oral bacteria has to do mainly with two things: the correct method of brushing the teeth and using dental floss and preferably tape. Your dentist or dental hygienist should advise you of correct methods of cleaning. If they haven’t already done so, you need to ask. The areas between adjacent teeth, the pits and fissures of the molars, are plaque-laden areas which are shielded from natural chewing and saliva-washing action so brushing and flossing are an essential part of dental hygiene, particularly with exposure to a carbohydrate-rich, modern Western diet.
Research however has proved absolutely that if the teeth are cleaned professionally every two weeks, without any daily maintenance, there is no further disease or decay activity. That is, once the plaque which contains colonies of bacteria has been thoroughly removed, it doesn’t matter nearly as much how often you brush, as it does how well you do it. It’s almost impossible to do a good brushing job in less than 2 minutes. For prevention it’s recommended to brush for a total of 5 minutes, after the evening meal. Plaque takes 24 hours to harden so best to brush at least once daily, more often if you have dental disease. If you are a ‘mouth breather’ while asleep at night, this dries out saliva and increases activity of mouth bacteria. A good brush before retiring will lower risk of colony growth. If your oral hygiene is presently not good, you’d be better off with a soft-bristle brush, in order not to damage gums and invite infection. Otherwise a medium-bristle is o.k. Receding gums are often the result of hard brushing, so massage the teeth rather than scrub. Also floss carefully for a few minutes at least, and/or use Piksters and rinse after each meal. If you don’t brush your teeth and rinse your mouth sometime within about fifteen minutes after you’ve eaten, you’re too late. However if you don’t have dental disease you can safely brush when you get around to it, with no fear of decay.
Mouth washes are another useful intervention with the intention of killing off mouth bacteria, which if unchecked can also promote ear, nose and throat infections. Many commercial mouth washes, though effective, are very toxic and can be absorbed through the oral mucosa. This includes fluoride rinses, toxic to both bacteria and humans. An alternative is Xylitol, which can be used as a mouthwash, also in toothpastes, or in gum or mint form. Frederick Patenaude suggests that 6 -10 grams/day of Xylitol consumed as gums or mints will eliminate bacteria from dental plaque in about 5 weeks. The bacteria try to use Xylitol as a source of energy, but can’t and die. Xylitol also raises mouth pH, helps saliva flow and reduces adherence of bacteria to oral (and urinary) mucosa. Dr Nara promotes fluoride rinses if serious dental disease is present. To be effective, these rinses have to be prescribed by a dentist in a higher fluoride concentration, for short term use only. Over- the- counter ones are too weak in this application.
An effective alternative, though more time consuming, is the Ayurvedic practise of Oil Pulling, which also promotes saliva flow and natural tooth repair. A teaspoon of coconut or sesame oil is swilled around in the mouth after brushing teeth, ideally following the evening meal. This is performed vigorously for a period of 15 minutes, while watching T.V. or reading seems to work o.k. The oil weakens plaque and binds to bacterial cell wall membranes, ‘trapping’ bacteria, while copious amounts of bicarbonate and mineral rich saliva is produced in the washing action. It is then appropriately discarded, never swallowed. This also whitens the teeth, as the plaque film is gradually removed. Ideally it could be used on a less frequent basis as part of a prevention strategy, after a thorough clean by the dental hygienist. The more alkaline the saliva, the greater the benefit with this technique. If the saliva is very acidic (below pH 6.0), it might be advisable to change the diet and use alkalising powders to raise pH before regular Oil Pulling. Dental enamel begins to demineralize at a pH of 5.5.
If you need guidance in the treatment of this or any other condition, please make an appointment with one of our practitioners.
This article is for information purposes only. Please refer to our Medical Disclaimer policy for more information. The opinions expressed here represents the author’s and not necessarily those of Realize Health. In addition, thoughts and opinions change from time to time due to updates in research and as a necessary consequence of having an open mind. Views expressed in out-of-date posts may not be the same to those we hold today.
Robert O. Nara D.D.S. , Steven A. Mariner : Book – Money by the Mouthful
Robert O. Nara D.D.S : Book – How to become Dentally Self-sufficient
Judith Blaine, Michel Chonchol, Moshe Levi : Renal Control of Calcium, Phosphate and Magnesium Homeostasis. Clinical Journal of the American Society of Nephrology, October 2014