Tuesday, January 27, 2015

Swish, Swish, and Oil Pulling

I like to peruse the dental supply sections of different drugstores.  Call it a hobby of mine, (I do have many other hobbies ;) )  but I need to know what's available, who's selling it, and where my patients can purchase it.  One day while looking over supplies, I noticed this little old lady, truly the great- grandmother type, trudge up to the mouthwash section of the aisle and look for a long while at all the options.  My heart broke for her.  She was looking for a cure for her bad breath.  I knew she was not going to find it there.  She then picked the gallon size jug of storebrand essential oils and trudged off. That bottle was as big as she was.  And, unfortunately for her, was not going to fix what was really the problem.  So, let's talk about mouthwash.  What it does, why use it, or why not.

Mouthwash
Or your salvation :) 
You spend your time and money, just like great-grandmother, going to the store, to get mouthwash. What's your goal?  What are you expecting rinses to do for you?

Make you more kissable
Clean your teeth
Take over the job of brushing and flossing
Kill bacteria
"Kill the germs that cause bad breath"
Remineralize your teeth
Stop cavities
Make your breath minty
Re-moisturize your mouth

That's a lot to ask of something you use for about 30 to maybe 60 seconds once or twice a day.  Most mouthwash is totally cosmetic and can only do one thing- give you minty breath.  If that's what you want, swish to your heart's content.  Personally, I'm not the biggest mint fan so I never really got into the whole mouthwash thing.  Instead, I want everything I recommend to either disinfect, disperse, disorganize, change the bacterial oral flora, re-moisturize the dry oral tissues, or remineralize teeth in your mouth.  In other words, be therapeutic.  There are some over the counter (OTC) therapeutic rinses,  most are prescription.

First, Why am I down on most OTC mouthwash?
It's because of the pH.  Many are alcohol based-  pure ethanol, that's the ingredient that activates the essential oils such as thymol, eucalyptol, menthol, and methyl salicylate.  By activate, I mean make them antiseptic.  The alcohol triggers the antiseptic properties of these ingredients.  An antiseptic agent can either kill bacteria, or at least be bactericidal and make it so the bacteria can't make more bacteria babies.  This is good.  However, where I have issue is that the alcohol lowers the pH of your mouth and makes your mouth very acidic.  When the pH of your mouth drops below 5.5, the minerals come out of your teeth, and the tooth decay process starts.  We call that demineralization.  Soda pop, juice, and wine do that to your teeth.  So does mouthwash.  It happens every time you eat or drink anything acidic.  Remineralization occurs when your saliva puts these minerals back in your teeth, where they belong.  Read my post: Tooth Decay, What's pH got to do with it?  for more information on pH and tooth decay.  For today's purpose just know that anything I recommend using will have a pH that is neutral i.e. 7 or is basic: 7.1 or greater.  Most OTC mouthwash is acidic.  And, most folks have dry mouth at night.  That's called xerostomia, and there's little or no saliva especially at night for many people.  What's the last thing you do before bed?  You brush your teeth and use mouthwash.  When you hit that pillow, your salivary glands say good night too.  You have an acidic environment all night, not enough saliva to return the pH to neutral.  Too often, I see senior citizens with root decay.  They promise me they aren't eating candy, or juice and only drink water, yet, yikes, there's a ton of tooth decay.  Then I ask them what mouthwash they're using.  Proudly, they tell me they use mouthwash daily, and nightly.  (The acidic kind, unfortunately.)   And then I see decay under their crowns, and along the gumline on the delicate root surfaces.  The bottom line, watch pH of everything you put in your mouth. If you have a rinse you love, call the company and ask them what the pH of their product is, if it's below 7.0 think again.   More on what I do recommend shortly.

Making you Kissable, and Cleaning your Teeth.
The main reason folks use mouthwash is to "freshen their breath"  and to cure bad breath, or as we refer to it- halitosis, all in 30 seconds.  Sorry, not going to happen.  Remember, plaque is sticky, sticky, sticky.  It needs to be physically removed from your teeth, gums, and the back of your tongue.  Bad breath germs live in the deep follicles on the back part of your tongue.  That's never going to be touched by your daily swish.  Brushing, flossing, cleaning in-between your teeth, scraping your tongue, that's how to make your mouth cleaner, healthier and smell better.  Mouthwash will make you mintier.  Minty bad breath is not, however, more pleasant.   Read my post on It's all about the Plaque  and then read my post Addressing Kissability.

Killing Bacteria - Maybe.  I did my own experiment to see how effective OTC mouthwash was at killing bacteria.  I took a plaque sample from one pocket, did a control slide with saline solution and then another with mouthwash that proclaims it kills the germs that cause bad breath.  All day I compared the two slides on my microscope, and to me, there was no reduction in bacterial activity on the mouthwash slide.  Not sure what it kills but nothing on that slide was dead or even remotely slower.   It's probably time to update that experiment with the newer rinses I have listed below.  If swishing with mouthwash prevented gum disease, then there should be NO gum disease, anywhere.  Television commercials have convinced everyone that's all you need to do.  Yet, 80% of the US population has some form of gum disease.  Hmmm, makes me wonder, and you should too...

Dry Mouth- the commercials will all tell you that's solved with OTC rinse.  Not so.  Instead, check out my post on Elixir fixer for your dry mouth.   I have a list of products that may well work better for you.

Remineralize Teeth/Stop Cavities- You need to find out the reason there's new decay before you can select the proper treatment.  Is it because of an increase in soda pop, juice, dry mouth, sticky candy stash, mouth breathing, new dental appliances, new medication?  That's where your dental team can help sleuth out the cause.  Then, select the proper rinse to aid you.  If you have had one new cavity in the last year, there's a 60% chance of another in nine months.  Don't wait, it is time to prevent any new disease.

Recommendations:
There are some rinses I do recommend to help my patients get healthier mouths.
Killing bacteria:
               CloSYS- chlorine dioxide pH balanced and effective at killing bacteria. I like what I read
               about this product.   I need to do my own experiment. For now, this may be my favorite
                OTC rinse.

               Any mouth rinse with Xylitol - read my post on Mouth Magic to learn all about xylitol.

               Carifree Treatment rinse or Carifree Maintenance rinse. This is a research based set of
               rinses and do stop tooth decay bacteria. Check out the Carifree website- lots of great                            information there.  Kill decay bacteria and remineralize teeth - YES!
Preventive:
               ACT mouthrinse for fluoride and remineralizing your teeth- good preventive rinse for                         maintaining  healthy tooth structure.  Good for children as well, as long as they can swish                   and spit.
Bad Breath:
               Smart Mouth - for bad breath - easy to find at your local drugstore- not sure how effective
              this is but worth trying.

               Oravital for bad breath - more involved and requires your dental office to participate.  They
               require a plaque sample and analyze it for the source of your bad breath.  In order to "fix"
               the breath problem, you first need to find the source.  Is it caused by tooth decay, gum
              disease, dental appliances soaking up mouth odors (great-grandmother's problem above),
               coated tongue, mouth breathing or sinus? Find the source then you can fix the problem.
Other thoughts:
               Killing pathogens that cause gum disease- see your favorite dental hygienists.  They can
              analyze your gum disease bacteria and recommend the right products for you.  No swish
              will get to where the pathogens live.   You gotta go where they live to get'em out.



Oil Pulling-  Again, I wish it were so, but oil pulling will not replace brushing, flossing and cleaning in between your teeth.  I have done some research on oil pulling.  You still need to remove the plaque.  If you are willing to swish with anything for 20 minutes, okay, but you still need to remove the plaque.  That's in the fine print after the swishing instructions. That's where the bacteria, fungi and pathogens live.  Swishing with oil for 20 minutes does not get into the areas the bacteria live- I.E. below the gum line and in-between the teeth.   If you are willing to swish for that long, let's do some good.  Use the products above that I have research on that are proven to "do something".  Instead, invest that 20 minutes or even five minutes just getting all the plaque off.
I had a patient who was doing oil pulling and I did a microscope slide on her (click to check out my post on the microscope world).  The bacteria deep under the gumline was still VERY active and untouched by any swishing she was doing.  Wish I had video of it to show you.
My other concerns with oil pulling- Exogenous Lipoid Pneumonia- there is evidence that people are inhaling the oil from oil pulling into their lungs and causing pneumonia.  Please tell your physician if you are oil pulling.   And, minor detail, but don't spit the oil into the sink- it could clog your pipes.
As with any "natural product" it is not entirely without risks attached.  Dr. Andrew Weil says that oil pulling does not "cure" any illness or improve your overall health.  Still, more research into oral oil pulling needs to be done before I can recommend it.

To rinse and swish or not, that is the question.  The answer is- what's your goal?  Then, find the correct products to do the job you want.  

Funny dental joke for the computer techs!
My kind of website!

If you have more questions about anything I post, please email me at TopGums4u@msn.com.  I appreciate your comments. Anytime there's a highlighted word, click on it, it links to research, information, and/or my sources.
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A beautiful smile speaks for itself,
Barbara









2 comments:

  1. Livionix dental gel has some interesting research for it too. I just started trying it yesterday so can't report much as of yet but might be worth checking into.

    ReplyDelete
    Replies
    1. Good Morning!
      Thanks for checking out my blog and for your comment. I have information on Livionex on my blog entitled "Creating a Healthy Mouth - Tooth Paste II". There's even a discount code. I've been using it since January and love how smooth and clean my teeth feel all day. It truly does make a difference! Glad you are trying new things. It's so easy to stay in a rut, even if that rut does not really work so well. That's why I do this blog- get people products and answers so they can be healthy! Keep smiling,
      Barbara

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