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Carifree Consulatation

Hello, I’m Dr. Shindler.

Please take a few moments to read this article as it will explain a new program we are offering that will reduce the likelihood of getting cavities by up to 85% and enable you to remain cavity free for life.

This is made possible by a new understating of how the process of tooth decay occurs. A little background scientific information is necessary which I will keep as simple as possible.

The most important is that we know now that caries is a bio film disease. There are many types of bio film, but in the mouth it is the coating made up of plaque, saliva, minerals, organic debris as well as healthy and unhealthy bacteria.

Secondly we need to understand acidity and alkalinity. This is a scale measured by the pH number. Extremely acidic has pH value of 1, extremely alkaline is pH 14 and pH 7 is neutral.

The 3rd element is buffering. Buffering is the ability of a solution to resist large changes of pH value when acid or alkaline is applied. In our mouths, saliva provides this critical function.

So, how does the disease process of caries work? For years we have been taught that it is caused by sugar. In fact this is only partly true. What happens is that harmful bacteria in the plaque biofilm metabolize the sugar forming acids; causing the pH of the biofilm to drop.

In a healthy state, there is a balance between demineralization and remineralization of the tooth surface. This occurs at a slightly alkaline pH. When the pH of the biofilm drops below 5.5 and stays therefore a prolonged period, the teeth demineralize. If this is left untreated, the surface breaks down and eventually a full blown cavity occurs. However, in the early stages, if we return the biofilm to a healthy state, remineralization can occur.

In our office, we now have a very sophisticated screening device to accurately measure the state of health of a patient’s biofilm.

Historically, dentists have treated caries using a surgical model. We find decay, we drill it out and we fill the hole. In light of our new understanding of the disease, this does not make sense. We need to change to a medical model in which we diagnose and treat the cause as well as the symptoms. As Dr Ken Kutsh, a leading expert in dental caries says “If the roof of your house fell in because of termite damage, would you call in for a contractor to put in a new roof or would you first call an exterminator?

What we need to do is assess each patients risk factors and protective factors to be able to develop an individualized plan to prevent dental caries. In many cases, brushing and flossing alone is not sufficient. Certainly, the reduction in plaque load is beneficial, but the nature of the bio film and pH dysfunction is not altered.

It is also important to note that the disease is transmissible. Studies have shown that, just by treating mothers for 2 years prior to tooth eruption in their infants, the children were 40-85% less likely to develop cavities.


What are our risk factors?

Without a doubt, saliva is the most important. There are over 400 medications that cause a decrease in salivary flow. This is of tremendous concern for adult and elderly patients.

Another is the frequency (more that the amount) of eating refined carbohydrates. – Take note that many diet sodas and energy drinks have very low pH values. Diabetics are also more prone. A comprehensive risk assessment is part of the protocol of our caries prevention program.

The treatment consists of products that raise the pH of the bio film enabling remineralization of the tooth surface as well as encouraging healthy bacteria to colonize the bio film.

An extremely important part is the use of xylitol products which is our miracle drug in preventing decay.


A little history lesson:

During World War II in Finland the ports were blockaded and sugar could not be imported. The government built a factory to extract xylitol from birch tree bark instead. After the war ended it became cheaper to import regular sugar. Years later dentists noticed that children whose teeth erupted during that time, had fewer cavities that those whose teeth erupted before or after.

Subsequently many studies were done. These showed that just by using xylitol 4-5 times a day plaque levels were reduced by 50%. More extensive studies confirmed that after 1 year of use, an 85% reduction in cavities was observed.

Xylitol is a sugar that has 5 carbon molecules instead of 4. Because of this, plaque bacteria cannot metabolize it to produce acid. This prevents the drop in pH necessary for cavities to occur.

Xylitol is low glycemic and does not trigger an insulin response and so is suitable for diabetics or anyone seeking a healthy lifestyle.

We hope you find this information helpful and please view the short video from Carie-Free on my website for a very well done presentation on the subject additional information.


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