Do I REALLY Have to Brush My Teeth?
his blog is at risk of becoming a way for me to scientifically justify my most uncivilized tendencies. I think I may soon look at the pros and cons of picking scabs and infrequent bathing. Here, I try to answer a question I've been asking since having teeth enough to talk..."Do I have to brush my teeth?"
I've been somewhat curious about teeth brushing and other aspects of oral hygeine for a while--mostly because I, like most children, HATE doing it. Why do we need to brush/floss everyday and get a professional cleaning every 6 months? Seems nature would've equipped us with everything we'd need to keep a mouthful of healthy chompers...and if that's true, it'd mean we're now doing something destructive to our teeth which necessitates such meticulous remediation...and if that's true, perhaps removing those destructive behaviors could reduce/eliminate the need for said remediation--or at least greatly reduce the risk of an unhealthy oral cavity under either circumstance.
I've been somewhat curious about teeth brushing and other aspects of oral hygeine for a while--mostly because I, like most children, HATE doing it. Why do we need to brush/floss everyday and get a professional cleaning every 6 months? Seems nature would've equipped us with everything we'd need to keep a mouthful of healthy chompers...and if that's true, it'd mean we're now doing something destructive to our teeth which necessitates such meticulous remediation...and if that's true, perhaps removing those destructive behaviors could reduce/eliminate the need for said remediation--or at least greatly reduce the risk of an unhealthy oral cavity under either circumstance.
7. Cementum 8. Crown 9. Cusp 10. Sulcus 11. Neck 12. Root
13. Furcation 14. Root apex 15. Apical foramen 16. Gingival sulcus
17. Periodontium 18. Gingiva: 19. free or interdental 20. marginal 21. alveolar
22. Periodontal ligament 23. Alveolar bone 24. Vessels and nerves:
25. dental 26. periodontal 27. alveolar through channe.
Tooth Structure
If you look at the figure to the right, you can see that tooth anatomy is...well, complex. For our purposes, though, it suffices to know that a tooth is basically a core of nerves encased by two distinct mineralized layers--dentin (which is innermost) and enamel (which is the hard, white covering of teeth)--of which half protrudes from the gums.
"Tooth decay" or "dental cavities/caries" refers to the eroding of the mineralized portion of teeth. We'll next discuss how this occurs. It's worth knowing that the processes by which dental caries develops can also cause gum disease.
"Tooth decay" or "dental cavities/caries" refers to the eroding of the mineralized portion of teeth. We'll next discuss how this occurs. It's worth knowing that the processes by which dental caries develops can also cause gum disease.
Tooth Decay
The demineralization of tooth decay is caused by contact with acid--first eroding the shiny-white enamel and exposing the dull-white dentin before marching towards the nerve (ouch!). Conversely, when acid is low, minerals (calcium, phosphate, and fluoride) present in food and hard/fluoridated water and saliva are adsorbed to (re)mineralize teeth; however, lost enamel cannot be regrown. Saliva additionally neutralizes oral acid; people with poor saliva flow, usually due to age or as a side effect of medication, are at increased risk of tooth decay.
Acidic foods (like citrus or soda) or regurgitation of gastric acid from the stomach (from heartburn or vomiting), then, contribute to this demineralization and can ultimately result in cavities. The most prevalent source of tooth-demineralizing acid, though, is bacteria.
The demineralization of tooth decay is caused by contact with acid--first eroding the shiny-white enamel and exposing the dull-white dentin before marching towards the nerve (ouch!). Conversely, when acid is low, minerals (calcium, phosphate, and fluoride) present in food and hard/fluoridated water and saliva are adsorbed to (re)mineralize teeth; however, lost enamel cannot be regrown. Saliva additionally neutralizes oral acid; people with poor saliva flow, usually due to age or as a side effect of medication, are at increased risk of tooth decay.
Acidic foods (like citrus or soda) or regurgitation of gastric acid from the stomach (from heartburn or vomiting), then, contribute to this demineralization and can ultimately result in cavities. The most prevalent source of tooth-demineralizing acid, though, is bacteria.
(A) A small spot of decay (B) Radiograph shows region of extensive demineralization (C) Cavity present in tooth from decay (D) Decay of tooth removed.
Cavity-Causing Oral Bacteria
Your mouth (and entire body) are full of germs--some good, some bad. In regards to the "bad" bacteria that can cause cavities, we are referring to those bacteria which can create acid. Not all oral bacteria create acid, though--and some actually neutralize acid.Those bacteria that do create acid do not do so constitutively; rather, they can only create acid from sugar...which is why sugar rots your teeth.
The Role of Carbohydrate & Sugar in Producing Acid
Technically speaking, a carbohydrate is a molecule that has equal parts carbon atoms (hence “carbo-”) and water equivalents (H2O, Hydrogen and Oxygen; hence “-hydrate”). There are 3 nutritionally relevant carbohydrate molecules: fructose, galactose, and glucose. Fructose is found in things that taste sweet, galactose is found in dairy, and glucose is practically found in any food that contains carbohydrate. Carbohydrate foods can be classified as either “simple sugars,” or “complex starches.” Simple sugars are either 1 or 2 bonded carbohydrate molecules, and are found in foods like fruit, milk, soft drinks, and sweets; complex starches are made of hundreds to thousands of bonded carbohydrate molecules, and are found in grain-/grain-like products and root vegetables.
After putting sugar in your mouth, the bad bacteria consume some it and generate tooth-demineralizing acid through a process called "fermentation"...which persists for several hours. Though each carbohydrate-type molecule can be fermented, fructose most abundantly results in acid generation. Because starch is basically a long chain of sugar (glucose) which is partially broken down into individual molecules by enzymes in the mouth, there is justifiable concern that even non-sugary-sweet starches--especially those that are "puffed" or "instantized"--can serve as acid-generating bacterial substrate.
The cariogenicity of carbohydrate, whether sugar or starch, is increased with its propensity to be retained in the mouth; in other words, the longer sugar is in your mouth, the more likely it is to be fermented. Sugary foods that are sticky (like caramel, jelly beans, or toffee) or sucked on (like breath mints, hard candy, icicles, or lollipops), or clumpable starchy foods (like flour-based, baked, or fried products) increase the exposure time of your oral bacteria to fermentable sugars--and thus increase their production of tooth-demineralizing acid. Conversely, non-sticky/quickly swallowed foods containing sugar (such as from fruit) and less clumpable forms of starch (as from root vegetables) are less likely to be retained, and thus fermented, in your mouth.
Other Roles of Sugar in Promoting Tooth Decay
Besides fermentation, carbohydrate promotes tooth decay in several other ways:
*Selection Pressures: By eating a consistently high-carbohydrate diet, you selectively feed the acid-producing bacteria, increasing their numbers and potency. Plaque, the yellowish film that develops on and around teeth, is actually colonies of bacteria; imagine how much demineralizing acid an entire colony of bad bacteria can produce if you've eaten in such a way to selectively facilitate their growth. The demineralization caused by plaque is made worse because it can forms a saliva-proof barrier over the disintegrating tooth, preventing remineralization from occurring. In time, plaque itself can become mineralized similarly to your teeth i.e. "tartar" or "calculus" buildup; this plaque mineralization kills the bacteria of the plaque, but creates a new surface for more germs to grow atop; tartar, then, can extend past the gum line, serving as a platform for bad bacteria to damage other areas including your gums. Tartar is difficult to remove with normal brushing and generally requires a professional cleaning.
*Suitable Surfaces: In order for bacteria/plaque to take hold, it must first have a suitably sticky surface on which to set up shop. Sugar provides just such a adhesive on which plaque can form.
*Fermentation Reserves: As you already know, some of the sugar you put in your mouth will be fermented by bad bacteria; further, some of it will be used to create suitable environments for colony growth. But there is yet another function to which these bacteria put sugar to use--storing it to ferment later. This means you might have near round-the-clock acid production taking place, even during periods in which you haven't consumed any carbohydrate.
Oral Hygiene, and Why I Don't Care
Don't get me wrong here--I'm not suggesting anybody stop tending to their teeth; I'm only indulging in reasons why I do so.
Let's start by stating the obvious effect of brushing, flossing, and using mouthwash: the removal of the germs and residual foodstuff in your oral cavity, which prevents the creation of tooth-demineralizing acid. But remember that for acid to be produced, a few things to be in place: the presence of bad bacteria and carbohydrate (especially sugar and refined starches); furthermore, the presence of bad bacteria is contingent on chronic consumption of such foods. Once these bad bacteria are present, more frequent consumption of these foods will result in more demineralization.
If you're familiar with the rest of my website, you'll recognize that I advocate for (and practice) 2 things which would negate the causative factors of tooth decay: infrequent eating, which decreases the exposure time to acid-producing substrate and allows lots of time for salivary remineralization, and low-carbohydrate nutrition, which selects for good bacteria and prevents any bad bacteria from creating acid. As such, I do not personally concern myself with the consequences of not brushing/flossing. But I am concerned with the possible consequences of following these practices.
Let me explain. Bacteria are not only present in our mouths, they exist all over the body. The bacteria which inhabit our guts, for example, do some very important things for us and our health...so long as those germs are mostly good; to have mostly bad bacteria in your gut can cause several problems. Have you ever had a case of diarrhea after taking antibiotics? This is caused because these medications generally kill bacteria indiscriminately; all of the good bacteria in your gut, then can be wiped out, possibly allowing bad germs to take over. While I have no direct evidence that something like this can/does happen in the mouth after brushing, the possibility doesn't seem very far fetched; perhaps standard oral hygiene practices clear the way for bad germs to set up shop :
Of course, you could argue that's why you should brush and floss after eating, to get rid of bad germs and food particles--who cares if you're wiping out good germs because you should be brushing/flossing frequently enough to get rid of all germs. Fair enough. But being the lazy boor and contrarian I am, I would point out that brushing too hard can also strip away enamel and gum tissue--I could simply brush softer, but come on...I'm not gonna remember that!
Rather than brushing, I may choose to follow my meal (especially one containing carbohydrate) with some roughage, which has been found to exert gentle brushing actions while chewing, some cheese, which also exerts a brushing action while additionally neutralizing pH and introducing calcium and phosphorus for remineralization, or a water swish-and-gargle. That seems more my style. Xylitol-containing gum (sugar-free) also helps to clean teeth, though I would not personally use this for reasons discussed.
So there you have it, the reasons I don't care about brushing and flossing. I hope this article has been at least interesting, informational, and possibly entertaining--though I hesitate to hope instructional.
Cavity-Causing Oral Bacteria
Your mouth (and entire body) are full of germs--some good, some bad. In regards to the "bad" bacteria that can cause cavities, we are referring to those bacteria which can create acid. Not all oral bacteria create acid, though--and some actually neutralize acid.Those bacteria that do create acid do not do so constitutively; rather, they can only create acid from sugar...which is why sugar rots your teeth.
The Role of Carbohydrate & Sugar in Producing Acid
Technically speaking, a carbohydrate is a molecule that has equal parts carbon atoms (hence “carbo-”) and water equivalents (H2O, Hydrogen and Oxygen; hence “-hydrate”). There are 3 nutritionally relevant carbohydrate molecules: fructose, galactose, and glucose. Fructose is found in things that taste sweet, galactose is found in dairy, and glucose is practically found in any food that contains carbohydrate. Carbohydrate foods can be classified as either “simple sugars,” or “complex starches.” Simple sugars are either 1 or 2 bonded carbohydrate molecules, and are found in foods like fruit, milk, soft drinks, and sweets; complex starches are made of hundreds to thousands of bonded carbohydrate molecules, and are found in grain-/grain-like products and root vegetables.
After putting sugar in your mouth, the bad bacteria consume some it and generate tooth-demineralizing acid through a process called "fermentation"...which persists for several hours. Though each carbohydrate-type molecule can be fermented, fructose most abundantly results in acid generation. Because starch is basically a long chain of sugar (glucose) which is partially broken down into individual molecules by enzymes in the mouth, there is justifiable concern that even non-sugary-sweet starches--especially those that are "puffed" or "instantized"--can serve as acid-generating bacterial substrate.
The cariogenicity of carbohydrate, whether sugar or starch, is increased with its propensity to be retained in the mouth; in other words, the longer sugar is in your mouth, the more likely it is to be fermented. Sugary foods that are sticky (like caramel, jelly beans, or toffee) or sucked on (like breath mints, hard candy, icicles, or lollipops), or clumpable starchy foods (like flour-based, baked, or fried products) increase the exposure time of your oral bacteria to fermentable sugars--and thus increase their production of tooth-demineralizing acid. Conversely, non-sticky/quickly swallowed foods containing sugar (such as from fruit) and less clumpable forms of starch (as from root vegetables) are less likely to be retained, and thus fermented, in your mouth.
Other Roles of Sugar in Promoting Tooth Decay
Besides fermentation, carbohydrate promotes tooth decay in several other ways:
*Selection Pressures: By eating a consistently high-carbohydrate diet, you selectively feed the acid-producing bacteria, increasing their numbers and potency. Plaque, the yellowish film that develops on and around teeth, is actually colonies of bacteria; imagine how much demineralizing acid an entire colony of bad bacteria can produce if you've eaten in such a way to selectively facilitate their growth. The demineralization caused by plaque is made worse because it can forms a saliva-proof barrier over the disintegrating tooth, preventing remineralization from occurring. In time, plaque itself can become mineralized similarly to your teeth i.e. "tartar" or "calculus" buildup; this plaque mineralization kills the bacteria of the plaque, but creates a new surface for more germs to grow atop; tartar, then, can extend past the gum line, serving as a platform for bad bacteria to damage other areas including your gums. Tartar is difficult to remove with normal brushing and generally requires a professional cleaning.
*Suitable Surfaces: In order for bacteria/plaque to take hold, it must first have a suitably sticky surface on which to set up shop. Sugar provides just such a adhesive on which plaque can form.
*Fermentation Reserves: As you already know, some of the sugar you put in your mouth will be fermented by bad bacteria; further, some of it will be used to create suitable environments for colony growth. But there is yet another function to which these bacteria put sugar to use--storing it to ferment later. This means you might have near round-the-clock acid production taking place, even during periods in which you haven't consumed any carbohydrate.
Oral Hygiene, and Why I Don't Care
Don't get me wrong here--I'm not suggesting anybody stop tending to their teeth; I'm only indulging in reasons why I do so.
Let's start by stating the obvious effect of brushing, flossing, and using mouthwash: the removal of the germs and residual foodstuff in your oral cavity, which prevents the creation of tooth-demineralizing acid. But remember that for acid to be produced, a few things to be in place: the presence of bad bacteria and carbohydrate (especially sugar and refined starches); furthermore, the presence of bad bacteria is contingent on chronic consumption of such foods. Once these bad bacteria are present, more frequent consumption of these foods will result in more demineralization.
If you're familiar with the rest of my website, you'll recognize that I advocate for (and practice) 2 things which would negate the causative factors of tooth decay: infrequent eating, which decreases the exposure time to acid-producing substrate and allows lots of time for salivary remineralization, and low-carbohydrate nutrition, which selects for good bacteria and prevents any bad bacteria from creating acid. As such, I do not personally concern myself with the consequences of not brushing/flossing. But I am concerned with the possible consequences of following these practices.
Let me explain. Bacteria are not only present in our mouths, they exist all over the body. The bacteria which inhabit our guts, for example, do some very important things for us and our health...so long as those germs are mostly good; to have mostly bad bacteria in your gut can cause several problems. Have you ever had a case of diarrhea after taking antibiotics? This is caused because these medications generally kill bacteria indiscriminately; all of the good bacteria in your gut, then can be wiped out, possibly allowing bad germs to take over. While I have no direct evidence that something like this can/does happen in the mouth after brushing, the possibility doesn't seem very far fetched; perhaps standard oral hygiene practices clear the way for bad germs to set up shop :
Of course, you could argue that's why you should brush and floss after eating, to get rid of bad germs and food particles--who cares if you're wiping out good germs because you should be brushing/flossing frequently enough to get rid of all germs. Fair enough. But being the lazy boor and contrarian I am, I would point out that brushing too hard can also strip away enamel and gum tissue--I could simply brush softer, but come on...I'm not gonna remember that!
Rather than brushing, I may choose to follow my meal (especially one containing carbohydrate) with some roughage, which has been found to exert gentle brushing actions while chewing, some cheese, which also exerts a brushing action while additionally neutralizing pH and introducing calcium and phosphorus for remineralization, or a water swish-and-gargle. That seems more my style. Xylitol-containing gum (sugar-free) also helps to clean teeth, though I would not personally use this for reasons discussed.
So there you have it, the reasons I don't care about brushing and flossing. I hope this article has been at least interesting, informational, and possibly entertaining--though I hesitate to hope instructional.
Tag: carbohydrate, decay, infrequent eating, intermittent fasting, sugar, teeth, tooth decay,