| Introduction
In the September
2006 issue of the
AARP
Bulletin,
Carole Fleck describes
the problems many
older persons experience
in finding affordable
dental care. She
attributes their
dental health problems
either to lack of
insurance or the
inability to pay
for services. She
does not mention
that dental health
depends almost entirely
on the self-care
one uses to control
oral
infections, not on
the fillings, crowns,
bridges, root canals,
etc. that are used
to treat diseased
teeth.
The “50+
Americans” who
go to a dentist or
hygienist on a regular
basis should be receiving
hands-on oral hygiene
instructions that
will prevent and
arrest tooth-destructive
diseases. Unfortunately,
this does not happen
in most dental practices.
Thus, a great need
exists for the costly
reparative services
Ms. Fleck writes
about.
Comprehensive dental
care should put infection
control first and
appropriate restorative
services after that.
Providing large sums
money for “fixing” teeth
will not lead to
better dental health
unless a change occurs
in the orientation
of most dentists
in practice today.
They should be teaching
prevention by educating
patients on how to
take control of their
own oral health.
My letter to the
editor of the AARP
Bulletin follows.
Dr.
Keyes Letter
September 19, 2006
Mr. James S Toedtman,
Editor
AARP Bulletin
601 E St. NW
Washington, DC 20049
Dear Mr. Toedtman,
I am Dr. Paul H.
Keyes, a dentist
who served in the
U.S. Public Health
Service from 1955
to 1981. I was stationed
in the National Institute
for Dental Research
where I spent 20
years in the laboratory
working with colleagues
on bacterial cofactors
associated with dental
caries and periodontal
diseases. From 1975
to 1981, I worked
in the dental clinic
in the NIH Clinical
Center. While there,
I spent most of my
time using conservative
non-surgical anti-infective
measures in the treatment
of patients with
advanced periodontal
infections. Some
of these patients
had been previously
treated once or twice
with surgery. I am
the clinician who
has advocated the
combination of baking
soda and hydrogen
peroxide as a bactericidal
dentifrice. Many
baking soda dentifrices
on the market today
are there because
of my recommendations.
My work received
considerable attention
20 years ago and
was written up in “Modern
Maturity,” “Reader’s
Digest,” “People”, “Saturday
Evening Post”,
etc. You can find
my website at drpaulhkeyes.com.
Throughout my professional
career, I have been
especially interested
in prevention.
As you know, on
the front page of
the latest issue
if the AARP Bulletin there
is a picture of a
man with his hands
covering his mouth
and the question, “Why
Isn’t This
Man Smiling.”
Apparently he isn’t
smiling because his
teeth have been severely
damaged by tooth
decay and/or periodontal
(gum) disease. Unfortunately,
this has occurred
because his dental
self-care has not
prevented and intercepted
the tooth-destructive
bacterial infections
that have damaged
his teeth. It has
not occurred because
he has not received
adequate restorative
dentistry. The same
can be said for the
mother of three who,
mentioned by the
author of this article,
Carole Fleck, needs
restorative services
that would cost thousands
of dollars. Fixing
dentitions damaged
by tooth-destructive
infections without
first arresting them
would be like repairing
a house damaged by
termites without
first eradicating
the termites.
Tooth decay and
periodontal diseases
are caused by contagious
infections induced
by microorganisms
transmitted from
mouth to mouth largely
by saliva while kissing.
What happens to these
microorganisms depends
on the conditions
in one’s mouth after
they are acquired.
Persons, who consume
products that leave
sugar-residues around
their teeth, put
themselves at risk
of cavities caused
by Streptococcus
mutans. Acid produced
by this bacterium,
as it metabolizes
sugar, is the primary
cause of tooth decay.
Research in Sweden
has shown that this
bacterium can be
passed from the mouths
of mothers to the
mouths of their children.
One can prevent tooth
decay by not consuming,
or removing soon
after ingesting them,
substances that contain
sugar. Fluoride in
drinking water and
dentifrices helps
to make the teeth
more resistant to
decay-producing acids.
Destructive periodontal
infections are caused
by pathogenic germ-life,
now called bacterial
biofilms, that grows
on the necks and
roots of one’s teeth.
These are complex
microbial infections.
Several different
types of bacteria
contribute to the
inflammation that
destroys the tissues
and bone that attach
the teeth to one’s
jaws. Clinical observations
and anecdotal data
reveal that these
infections can be
largely prevented
by measures as simple
as careful tooth-brushing
with salt and/or
soda.
So, why is there
a “50+ America’s
growing dental epidemic”?
It exists because
persons have not
taken proper care
of themselves, not
because they have
not had adequate
restorative dentistry.
There are two possible
reasons for this
very unfortunate
situation: carelessness
or ignorance - and
by that I mean lack
of know-how. All
too many persons
have not received
the information and
guidance they need
to prevent “dentopathic” infections.
Excellent dental
health can be attained
with two relatively
simple measures:
keeping sugar residues
in one’s mouth at
very low levels and
by carefully brushing
one’s teeth for few
minutes a day with
an antibacterial
solution or dentifrice.
Salt and/or soda
have an excellent
antibacterial potential
after they go into
solution in one’s
mouth.
Unfortunately the
dental profession
at large has not
done a very good
job in promoting
dental health. The
teaching of preventive
dentistry has been
sadly lacking in
dental education.
Far too much emphasis
has been on cosmetic
and restorative services,
but that is where
the money is. Dental
hygienists have been
far more interested
in preserving dental
health than most
dentists. Perhaps
in the future they
will be able to provide
their services without
so many of the restrictions
they now experience
in many dental offices.
“America’s
growing dental epidemic” is
not unlike the AIDS
epidemic. It is caused
by contagious infections.
Effective control
can only be attained
by the use of effective
preventive measures.
Comprehensive care
is needed for all
infected persons.
For dental patients,
resources are badly
needed for providing
anti-infective treatment
and appropriate restorative
measures for persons
willing and able
to use self-care
that will help to
control existing
and future infections.
Americans who have
computers can find
valuable information
on prevention by
searching for dental
health on the Internet.
Sincerely,
Dr. Paul H. Keyes
301-229-0730
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