Dr. Tom Ferguson is the regular author of the Medical Self Care column.
A staggering proportion of Americans lose their teeth. Every year, in fact, dentists extract over 60 million precious ivory "choppers" from mouths all across the country. And at last count, one in every eight Americans was completely toothless!
Worse yet, the problem remains widespread despite decades of holding educational dental hygiene programs in U.S. schools. In fact, many people still know little or nothing about why tooth loss occurs. And in a lot of cases, what they do know is heavily shrouded in myth.
Myth 1: Only old people lose their teeth.
It is true that nine out of ten Americans over 60 no longer have any teeth, but this fact doesn't mean that such loss is an unavoidable aspect of aging or that younger people are immune to the problem! Statistically speaking, by the time you turn 35, there's a 30% chance that all of your pearly whites will have been removed!
Myth 2: Tooth decay is the major cause of tooth loss.
Wrong. The average American loses "only" six to ten teeth to cavities. The rest are destroyed by gum disease, which causes 90% of all tooth loss after age 40.
And just what is gum disease? Well, unlike tooth decay, this malady (also known as pyorrhea or periodontal disease) attacks the support system of your teeth rather than the choppers themselves. It typically begins with an inflammation of the gums, and then spreads to the ligaments and bones that hold the teeth in place. Once these structural components begin to weaken, the teeth loosen and eventually fall out.
Periodontal disease develops in two stages. The first, called mild gingivitis, is characterized by redness and swelling of the gums, plus localized bleeding when — for example — you simply work a toothpick between your teeth. If detected early, this stage is relatively easy to cure. But if left unchecked, it progresses into stage two, periodontitis, a more serious condition with the following symptoms:  increased redness and swelling of the gums,  bleeding, even after gentle brushing,  persistent bad breath,  a buildup of calculus, or tartar, along the gumline,  a feeling that your teeth are drifting out of position, and  receding gums.
If you have any of these symptoms, you should consult a dentist immediately. In most cases (depending, of course, upon the extent of the problem), the doctor will first try to rid your mouth of a sticky, villainous substance called plaque: a more or less transparent film consisting of bacteria and decomposed food particles-that is the principle cause of gum disease. The material accumulates on the surface of teeth, usually in such hard-to-brush places as the spaces near and just behind the gums. If it's not washed or scraped away within 24 to 36 hours, it hardens into calculus, which irritates the gums and protects the bacteria living in plaque from being easily removed.
Then as time goes by, these bacteria give off toxins that infect the gums and cause them to pull away slightly from the teeth. In the space (or pocket) left behind, food particles and pus build up, making it easier for the microbes to dig deeper and attack their ultimate target: the bony structure surrounding the roots of the teeth.
Prevention’s the Key
The most effective way to fight gum disease — and to keep all your teeth — is to mechanically remove as much plaque from your mouth as possible every day. And the best tool to use for the job is a toothbrush, preferably one with soft or medium, rounded bristles, a flat brushing surface, and a head small enough to reach into every corner of your mouth.
Most dentists recommend brushing with short, horizontal strokes. Hold the instrument sideways at a 45° angle so the bristles can explore the area between your teeth and gums, and brush gently back and forth on both sides of each tooth.
The next step is to floss your teeth. Wind one end of an 18-inch strand of dental floss around the upper joint of your left middle finger, and the other around your right middle finger, leaving several inches of string stretched between your hands. Now, guiding the strand by holding it with your thumbs and forefingers, slide a small section (about an inch and a half) slowly between two teeth, loop the floss into a Cshape around one chopper, and gently scrape the area of the tooth under the gum. Repeat the procedure on the rest of your teeth. The process might take you 15 or 20 minutes the first few times you try it, but with practice you should be able to finish it in three to five minutes.
To find out if your tooth-cleaning program is effective, you might want to use "disclosing tablets" for a few weeks. These chewable pills, which can be purchased at most pharmacies, contain safe vegetable dyes that stain areas of the teeth where plaque has accumulated (brushing and flossing will remove the stain). By chewing one before and after a teeth-cleaning session, you can see how much plaque your brushing removes and also pinpoint areas that you're not scrubbing adequately.
Furthermore, if your gums are bleeding or you notice any other symptoms of periodontal disease, Dr. Thomas McGuire, author of The Tooth Trip (Random House, $6.95), recommends cleansing your mouth with two easily obtained solutions.
Make the first rinse with one ounce of hydrogen peroxide and one ounce of water that's as hot as you can stand. Slosh the liquid around in your mouth for 15 to 20 seconds, and then spit it out. The mixture will penetrate deep into infected areas, destroying many germs and bringing much needed oxygen to the damaged cells.
After the initial rinse, wait five minutes and then repeat the process with a solution of one-half teaspoon of salt and a half a glass of water. The salt not only kills germs, it also shrinks the gums, reducing the bacteria's "theater of operations".
McGuire suggests using both rinses four times a day for three days if the disease is in stage one and for five days if it's in stage two. After that period is up, your gums should have improved enough to allow you to eliminate the peroxide rinse and use only the salt solution, say, once every other day for a few more weeks.
To supplement this program — according to McGuire — you might reduce the proportion of refined foods in your diet. Plaque bacteria thrive on sugar in all forms, including honey, as well as on such easy-to-digest carbohydrates as pasta and white bread. You should cut down your consumption of these items, therefore, and replace them with raw fibrous fruits and vegetables such as celery, carrots, and apples — all of which function as natural cleansing agents when you chew them. (Keep in mind, too, that smoking, stress, and the use of oral contraceptives also diminish your body's resistance to gum disease.)
The Hunza people of West Pakistan provide good examples of just how important proper diet can be to dental health. Instead of processed sweets, the citizens of this small region eat only fresh foods, drink pure natural mineral water, and scrub their teeth with twigs that they first chew into the shape of a brush. As a result of these practices, dental disease (as well as most other maladies of civilization) is virtually unknown to the Hunzas.
Finally, keep in mind that the Pennsylvania Insurance Department Guide conducted a study of modern dental practices and concluded that "probably 6 million teeth are removed each year that should have been saved through other treatment."
Hugh J. Delehanty, guest writer for this installment of Dr. Tom Ferguson’s regular column, is a frequent contributor to Ferguson’s quarterly journal
Could some of those choppers be yours? Well, you can keep your teeth throughout life. The key is simply to take care of them.