Your dental health is an important component of your physical health. From my perspective as a physician, oral health is a frequently underappreciated aspect that can have a profound impact in your physical health. Root canals and cavities can have a significant systemic influence.
Your mouth is like a window to your health, where the health of the soft tissues as well as your teeth is a reflection of what's going on in the rest of your body.
Although people tend to resist this truth, your diet is overall more important for dental and oral health than the actual cleaning of your teeth…And it starts from birth.
The Importance of Diet During Infancy
You may have heard of "bottle caries," which typically affects the front teeth. This can occur when your child is allowed to suckle on a bottle of formula or juice during the night. This exposes your child's developing teeth to the drink for an extended period of time. As the formula, milk, or juice ferments in your baby's mouth, it causes the teeth to rot.
"No amount of fluoride will prevent bottle caries," Dr. Osmunson says. "That's a hundred percent diet. Don't put your baby to bed with a bottle of juice or milk and leave the bottle for long periods of time. Water is OK."
Diet can truly make or break your child's dental health, especially during her first six to nine months.
"Some infants will nurse for three, four, and five years, which I don't find to be that much of a problem. Mother's milk is wonderful. If a mother and a child want to nurse that long, I don't have any problems. Talk to your pediatrician. It's a wonderful source of nutrition.
Bottles are a little bit more of a problem because of the juices we tend to put in, the sugars that are in it. Milk or juice sitting in the mouth during sleep is a problem"
Caring for Your Child's Teeth During Childhood
As your child grows, sticky foods can become a problem, especially chewy candies and even vitamin gummies.
"The back teeth have deep grooves… When you look at them under a microscope, those grooves go way down, so it's impossible to clean your teeth—just impossible. You can do it 24 hours a day and you would never get down these grooves," Dr. Osmunson explains.
"The toothbrush bristle is much too big to get down there. You have to rely on your body's resistance in order to prevent cavities in these deep grooves! If you eat something sticky like a raisin, it will stick into those grooves and be very difficult to get out…
In my office, for preventive purposes, I like to use a little air abrasion, or a tiny Fissurotomy burr to make sure those grooves are very clean, and then I'll add a tiny bit of a sealant or filling material so that they don't get decay in the grooves. I think that's a very important preventive measure."
If you do this, however, you'll want to make sure your dentist uses BPA-free sealant, to avoid any potential health risks inherent with the BPA. (Products such as Voco Grandio and Heraeus-Kulzer Venus Diamond.)
Proper Mouth and Dental Development
This may sound obvious, but it's actually a very common problem: your mouth must be big enough for your tongue to fit properly. The opening of your mouth; the height and the width must be sufficient. When your mouth is too small, it can trigger a cascade of health problems, from breathing problems, including sleep apnea, to headaches.
What causes this underdevelopment?
Any type of breathing problem can set this vicious cycle into motion. Allergies, for example, may cause chronic stuffy nose, and if your child cannot breathe comfortably through his nose, he'll start breathing through his mouth, causing his mouth to under-develop.
"[T]he tongue is that force on the inside that's going to develop the mouth. If you can get the child to be able to breathe through their nose comfortably, then their mouth will develop properly."
Mouth-breathing, therefore, is one early sign that your child may be experiencing some trouble that could lead to improper jaw positioning or oral development. Thumb-sucking is another. Pretty much any time a child (or adult for that matter) says that it "feels better" to have something between their teeth, it can be a sign that their mouth is out of alignment and/or they're struggling to breathe properly.
Because of the future ramifications of chronic mouth-breathing, it's important to make sure you address any potential allergies.
"We have to make sure that they can breathe through their nose easily, and that they do breathe through their nose, by correcting that habit of mouth breathing.
You'll see many times where people, as they're older, their chin and jaw will recede way back, where the proper position of the tongue never developed the jaw properly.… You can go up to that person and say, "How are your migraines doing these days, how is your TMJ?" Most of the time they will have or have had serious headaches, clicking, popping or other TMJ symptoms until, or if, their joints or teeth have adapted, if they ever do. Their mouth is not developed to a good position for proper function.
In the past, a lot of times, we would break the jaw and bring it forward. That's almost never necessary, however. We know how to correct that now by developing the mouth size, even in adults."
Early Diagnosis Can Prevent Lifelong Problems
Your dentist can play an important role in making sure your child's mouth develops properly. But diet is paramount for proper development as well. The standard American diet (SAD) tends to lead to poorly developed mouths with crowded teeth—a phenomenon rarely seen in indigenous cultures. This is primarily caused by lack of proper nutrition.
To prevent lifelong problems, the solution is to identify improper development of the mouth early on and implement an intervention strategy. If allergies are ruled out, check your child's tonsils. If by the age of five your child still has very large tonsils and has trouble breathing or snores at night, having the tonsils removed is a warranted alternative according to Dr. Osmunson.
"Large tonsils, adnoids or frequent snoring in children are absolute indications that the lower third of the face is not developing properly and airway problems should be diagnosed," he says. "We've got to get that child air."
If it's caught later, during adolescence, it's important to not remove the bicuspids when doing braces. Instead, you want to expand the arch and allow the jaws to come forward to allow the condyles to develop properly. (The condyle is the "knobby" protrusion at the top of your mandible, the joint.)
This can be done using functional orthodontics.
Dr. Osmunson also recommends finding a dentist who has some neuromuscular training, as they can be of greater help to correct the positioning of your jaw. Craniosacral adjustments can also help adjust your head, which can completely change your dental occlusion and bite.
How to Properly Care for Your Child's Teeth and Gums
Daily brushing and flossing is very important. However, how you brush makes all the difference. A mouthful of foamy toothpaste might make it taste clean, but that doesn't mean it is.
It's the mechanical rubbing, and your accuracy in covering all of the 120 plus surfaces of your teeth that ensures cleanliness. Ideally, you'll want to spend about two to three minutes gently brushing all the surfaces of your teeth, twice a day.
You don't need to scrub hard, however. In fact, brushing too hard can result in gum recession. It can also damage your enamel and cause abfractions, groves in the teeth.You also only need a very small amount of non-fluoridated toothpaste—about the size of a pea.
For a demonstration of proper brushing technique, please watch the video above.
Selecting the Ideal Toothbrush
There are countless options available when it comes to toothbrushes. Which one is the best? Does the design, the hardness of the bristles, and the frequency at which you replace the toothbrush even matter?
"There is a tendency for the toothbrush to be pushed too hard under the teeth, so the softer the toothbrush the better—unless you're like my mother who is 90 years old, she could use a hard brush," Dr. Osmunson says.
As for how often you need to replace your toothbrush, Dr. Osmunson recommends replacing it about every two to three months.
"Once it starts to fray, then it's going to be less effective. A lot of dentists will have two or three toothbrushes that they rotate. It allows the toothbrush to dry out, and the bacteria to dry off," he says.
What about electric toothbrushes?
According to Dr. Osmunson they are great if you're disabled, but he believes most able-bodied people can do just as well with a regular toothbrush. Sonic toothbrushes do tend to break up plaque better than regular electric toothbrushes, but in general, he doesn't think they're worth the exorbitant price tag. Neither do I.
The Importance of Flossing
Flossing is perhaps even more important than brushing because it removes the bacteria that are the precursors of plaque. And while your cheek does a certain amount of rubbing along the outside of your teeth, and your tongue rubs them on the inside, nothing gets in between your teeth besides food. Hence these become prime areas for decay.
For a demonstration of proper flossing technique, please watch the video above.
It's important to wrap the floss around the tooth and scrub it by moving the floss up and down, and back and forth. If you have wider spaces between your teeth, use Super Floss, which is thicker.
While flossing you can also get telltale signs of potential health problems. For example, bleeding gums is a warning sign that you have bacteria in your mouth causing damage, which can easily spread through your blood stream and cause chronic inflammation elsewhere in your body.
The answer is to gently floss and brush more often, until your gums no longer bleed from brushing or flossing. If bleeding persists longer than a week, see a dentist.
Keep in mind that a Water Pik cannot replace flossing. These types of irrigation tools can also be hard on your gums. The truth is, if you brush and floss, you have no need for a Water Pik. It can however be beneficial if you have braces, for example.
Preventing Tooth Decay Naturally
When it comes to oral hygiene and preventing cavities, drinking fluoridated water and brushing your teeth with fluoridated toothpaste is not the answer because fluoride is more toxic than lead. Rather it's about your diet, and about proper dental care: brushing and flossing.
By avoiding sugars and processed foods, you prevent the proliferation of the bacteria that cause decay in the first place. Following up with twice daily brushing and flossing, along with regular cleanings with your natural dentist, will ensure that your teeth and gums stay healthy naturally.