| Why
Use a Dentifrice?
Many years ago,
in a terrible decision, the Council on Dental Therapeutic of the ADA said
the sole purpose
of a dentifrice was
to aid in the removal
of food particles
from tooth surfaces.
The council objected
to the inclusion
of antibacterial
agents in toothpastes.
At that time (1930s)
some manufacturers
were adding antibacterial
agents to the dentifrices
they were producing. “Kolynos,” for
instance, contained thymol, if my memory serves me, and it was to be used
on a dry brush.
In my in vitro
testing of the
ingredients in
this product when
I was at the National
Institutes of Health
(NIH), I found
that this formulation
had a very good
antibacterial potential.
In my opinion the
advertisements
for this toothpaste
were the best I
have ever seen.
I may still have
some of the photographs
of some of these
advertisements
that I used to
show when I was
giving lectures.
After the council’s
ruling the JADA no longer carried these excellently focused ads for a very
good product for its time.
I mention this
because the primary dental health benefits attained by using a dentifrice
are derived from
its potential to
do the following: to disorganize, disperse,
detoxify, and thereby decontaminate the pathogenic bacterial biofilms that colonize
tooth-surfaces and gingival crevices. The mechanical action of brushing,
flossing, tooth-picking, mouth-rinsing, and conventional irrigation can reduce
bacterial biofilms somewhat, but these methods have no bactericidal action per
se. If a person’s mouth has not been contaminated with pathogenic microorganisms,
intensive self-care measures are not necessary. However, since reliable
methods for assessing bacterial risk factors in the mouth are not readily available,
it seems prudent to use a self-care regimen that has a reliable anti-infective
potential. The pathogenic bacteria that colonize one's teeth are acquired largely
by the transfer of contaminated saliva from another person’s mouth
usually by kissing. Adequate usage of the products listed below will kill
many of these microorganisms, if they have been transferred.
The secondary benefits
are cosmetic: to remove stains from tooth surfaces – to keep tooth
surfaces white – pleasing to the eyes. Unfortunately these benefits
are the ones most highly advertised. To find a good example of this with
audio accompaniment bring up the web site on Kolynos dentifice.
Somehow the manufacturers got off track.
Over the centuries
by trying different substances for “tooth-cleaning” people
have found some that have made their teeth and gums look and feel better. Some very beneficial combinations have been formulated without any understanding
of the therapeutic properties of the ingredients used.
In the material
that follows I have
tried to provide
a little insight
into the therapeutic
potential of some
of these substances. Properly used they
equal and often surpass
the formulations
found in many commercial
dentifrices. They many not be as tasty or as convenient to use, but
they can be far superior
therapeutically.
SODIUM
BICARBONATE (BAKING
SODA)
A product
used for many years
by itself or in
combination with
other ingredients
has several excellent
properties. As
a soft crystalline
substance that
dissolves readily,
it has a mild abrasive
potential. In solution
it will kill on
contact all of
the motile microorganisms
associated with periodontal infections, e.g. spirochetes, motile
rods, etc. It will also kill other disease related bacteria. It will also neutralize and detoxify the bacterial acids and
toxins that form in plaques (bacterial biofilms). I would put
this inexpensive, readily available, product at the very top
of the list of potentially beneficial dentifrice-ingredients.
SODIUM CHLORIDE (TABLE SALT)
Like
baking soda, salt has been used for many years as a dentifrice,
alone or in combination. When used alone it is rather stingy
and unless milled, rather grainy. It is not highly abrasive,
contrary to some opinions. In solution at higher concentrations
it will kill on contact all motile microorganisms associated
with periodontal infections. However, its antibacterial potential,
while good, is not as powerful as that of sodium bicarbonate,
and it will not detoxify bacterial byproducts. In higher concentrations
it will reduce edema in the gingival tissues and stimulate
circulation.
GLYCERIN
Glycerin
has an antibacterial potential, which is not well recognized. When living bacterial dental plaque is examined with
a phase contrast
microscope, all of
the motile microorganisms
(spirochetes, amoebae,
motile rods, tricohmonads,
etc) can be seen
actively moving about. If a drop of glycerin
is add to the solution
in which the bacterial are living, all motility instantly
ceases. In the scientific literature some of the antibacterial
properties of glycerin have been described.
HYDROGEN PEROXIDE
When
hydrogen peroxide comes into contact with dentobacterial
plaques, it breaks down very rapidly into oxygen and
water. This breakdown, which causes the foaming action,
is caused by an enzyme (catalase). This foaming action
does two things: It helps to disorganize and disperse
the bacterial biofilms growing on tooth surfaces, and
it reveals places where bacteria are located. When used
as an ingredient in dentifrices, it has little, if any,
bactericidal action. It breaks down too rapidly.
VINEGAR
Vinegar
is another product that has been used for dental
hygiene for many
years. A half strength
solution of vinegar
(apple cider for
taste) will pickle
all of the motile
bacteria mentioned
above, and it will
help to dissolve
deposits of calculus. For persons whose
dental hygiene does
not reduce the buildup
of bacterial plaques
adequately, some
of this buildup may
harden into calculus. Brushing several
time a week with
a vinegar solution
can help to prevent
calculus formation.
CRANBERRY JUICE
Unsweetened
cranberry juice can be used as mouthwash and
as a solution for
brushing one's teeth.
It will kill all
motile bacteria on
contact and help
to disintegrate plaques.
Since it is somewhat
acidic, probably
it should not be
used more then a
few times a week.
It is pleasant to
use and can be swallowed.
This juice can be
used as a rinse and
then swallowed. Brushing
the teeth with cranberry
juice leaves the
teeth and mouth feeling
very fresh and clean.
After brushing one
can rinse again and
expectorate or swallow
the juice. For the
care of handicapped
persons who cannot manage conventional oral
hygiene measures,
this could be a pleasant
solution for caregivers
to use. It is tasty
and can be swallowed.
NEUTROGENA
SOAP (UNSCENTED)
About
25 years ago a dentist on
the
West Coast called my attention to the
use
of unscented Neutrogena
soap as an ingredient in
a
homemade dentifrice. When a solution of this
soap comes into contact with the motile microorganisms
in
plaques all motility ceases rapidly. To
use,
rub dry or moisten bristles over a bar
of
this soap. The unscented type
tastes soapy. The scented
tastes
awful.
WEAK
SOLUTION OF SODIUM
HYPOCHLORITE (E.G. ,
CLOROX)
One
teaspoon in a pint of water provides
a very powerful
irrigation solution
(DO NOT
INGEST). The
taste is very
unpleasant, but
it can
be very beneficial
in the maintenance-regimen
for persons
who have been
treated for periodontal
diseases. Brushing
the teeth
with baking soda
after using this
solution will
rapidly
neutralize its
taste. Then one
can rinse with
a pleasant tasting
mouthwash.
There are numerous
ways the ingredients
mentioned above
may be used alone
or in combination. With their antibacterial
potentials they
can be very beneficial
therapeutically,
if properly applied
to tooth surfaces and gingival crevices. They will help to
control the bacterial
populations that
cannot be removed
mechanically with
irrigation, brushing,
flossing, or tooth
picking.
A
Very Powerful Antibacterial Combination
Add glycerin to
baking soda to form a pasty mixture that can be applied to a toothbrush with
a spoon or other instrument.
- Put a capful
of hydrogen peroxide in a tumbler.
- Moisten bristles
of toothbrush (mulitufted) by dipping in peroxide
- Rub moistened
bristles over cake of unscented Neutrogena soap
- Cover bristles
with soda-glycerin mixture.
- While watching
in a mirror brush cheek-sides and tongue-sides of teeth
- Redip brush
in peroxide as needed
- Work mixture
between teeth with a flat toothpick or Butler stimulator
- A few drops
of wintergreen oil could be added to the glycerin-soda mixture for flavor
Over the years
when I was lecturing, I asked thousands of dentists and hygienists to raise
their hands if they
had ever seen destructive
periodontal disease
in person who had
regularly brushed with salt and/or soda. I have never seen a hand! And
although I have not seen many such cases, the periodontal health in these patients
has always been excellent. I have photographs of a lady who was 95 at the
time I saw her. She lived to be over 100.
Regards,
Dr. Paul H. Keyes
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