Medicine For People!

January 2019: Be Proactive about your Mouth and Teeth

Teaching Oral Health
By Latrobebohs - Own work, CC BY-SA 4.0

Be Proactive about your Mouth and Teeth


Warding Off Dental Decay

  • Fluoride
  • Silver Diamine Fluoride

Dental Diagnosis

  • Bleeding
  • Sensitive Teeth
  • Dry Mouth
  • Mouth odor

Dental Score

This is the third of a series of newsletters about care of your teeth. The ability to chew your food is as important to your health as is the quality of your digestion and the bacteria in your colon.

Now, of course Nature's way is the best, so some people are tempted not to intervene. And if you lived in a primitive situation, safe from the temptations of cheese and chocolate bars, you might well make it many years with healthy teeth. But if you are going to give in to the temptations of our modern world, then you need to attend to your teeth if you want to keep 'em.

Here are our previous newsletters on this topic.

Executive Summary

Your teeth are an important part of your gastrointestinal tract. When you suspect trouble, you gain nothing by waiting. Here are some tools you may find useful:

Warding Off Dental Decay


Yes, I know all the arguments against fluoride. They make for high drama and are spurious.

Chewing exerts tremendous forces on your teeth, forces resisted by the extremely tough enamel coating. Dental enamel is diamond hard (Well, almost. Dental drills coated with diamond powder will get through the stuff.). The acidic nature of the modern diet leaches vital minerals out of this enamel coating. Fluoride strengthens the enamel and helps it resist decay. Cavities are dramatically reduced.

Fluoride, while always present in the teeth of animals such as the shark, becomes a part of human teeth only when our environment gives it to us. This naturally occurs in many areas of the country that have fluoride in the ground water. People in these areas incorporate the fluoride into the teeth as the teeth develop. They have much less tooth decay.

The benefit far overwhelms any conceivable downside. Dental fluoride is most important in the latter two trimesters of pregnancy and the first few years of life, but can help you at any age.

Silver Diamine Fluoride

Plain old fluoride works as a preventive. When biofilm starts tearing apart the enamel and causing cavities, you need more oomph. A substance called silver diamine fluoride[1] can combine with the damaged enamel to restore its integrity. The silver inhibits the formation of biofilm, and the fluoride protects you from further demineralization of your teeth. This is a chemical way to stop dental decay. Currently, this is available only from a dentist.

Stained Teeth photo courtesy of Daniel Raether, D.D.S.

Photo courtesy of Daniel Raether, D.D.S.

As you see in this photo, the silver in this substance stains the teeth. At some point we may find a remedy that does not do this. In 2019, however, the no-drill choice is between a decayed and disappearing tooth and one that is stained like the teeth above. Sorry!

Dental Diagnosis


If your gums bleed without being traumatized, they are in trouble. Diseased gums lead to missing teeth. No newsletter will help you with this – a good place to start would be your dental hygienist.

Sensitive Teeth

If you have a sensitive tooth, you need to have your dentist check it out. Not all sensitive teeth, however, result from dental disease. Measures to diminish the sensitivity include baking soda and water, xylitol mouthwash, and prescription fluoride gels.

Dry Mouth

If your mouth feels dry, then it is. Sometimes caffeine or a prescription medication can cause dry mouth. When your mouth is dry, it is easier for biofilm to accumulate on your teeth. You can help yourself by rinsing up to five or six times a day with baking soda, nonalcoholic mouth rinse or xylitol mouthwash. Fluoride as a prescription solution or gel can reduce your chances of tooth decay resulting from dry mouth.

Mouth odor

Mouth odor is often caused by bacteria. Careful cleaning at home, dental care and professional dental hygiene can help.

Dental Score

An online assessment of your own dental health is available at[2].

Summary of Care for Your Teeth

  • Clean 'em Right
  • Use 'em Right
  • Avoid Sugar
  • Drink Water
  • Minimize Snacks
  • Let Your Dietary Choices be Determined from Within
  • Swish for a Healthier Mouth
  • Remember Fluoride and Silver Diamine Fluoride


[1] Silver diamine fluoride can also be spelled silver diammine fluoride.

[2] There is an identical site at



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Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.