Oct
Patients often ask,“What type of toothpaste or mouthwash should I use?” My thought is always, “What is the pH level of your saliva?” In contrast to toothpastes and rinses, saliva is what teeth are bathing in every second of the day. It is the saliva that plays the lead role in maintaining a healthy acid/alkaline balance keeping teeth and gums healthy. Products can play important supporting roles by providing extra sources of dissolved minerals like calcium and phosphorus in times of need. High oral acidity, which is measured in pH units, is a leading cause of tooth destruction, pain, and sometimes tooth loss in the forms of tooth decay, dentin sensitivity, and poor healing environment.
Causes of high oral acidity include, eating a high carbohydrate diet, having a high level of oral “bugs” (whose waste products are acidic), low salivary quality, and low salivary flow. Low salivary flow can be caused by hormonal changes, and is a common “side effect” of over 400 prescription and over-the-counter dugs.
High oral acidity vs Neutral or Low oral acidity
High acidity ____________________Neutral__________________Low acidity
Demineralization – – – – – – – – Buffering+ + + + + + Remineralization
Tooth enamel is the hardest substance our body creates. It is hard because it is mostly mineral, and like any mineral is very susceptible to having it’s surface damaged when in an acidic environment. The damage is called demineralization. Repairing the damage is called remineralization. Buffering is like “bumpering”; it absorbs the shock, and provides a safety cushion by changing an acidic environment to neutral. Luckily, saliva which is actually a very complex liquid has both a buffering system to neutralize, and dissolved minerals to repair tooth damage.
Dentin, the second layer of our teeth, makes up the outer covering of tooth roots and is especially vulnerable to oral acidity. This is because unlike hard mineral enamel, dentin is an organized structure of mineral supporting “organic” material. This is not the organic as in broccoli, but organic as in livings cells like nerve tissue. Imagine a big handful of drinking straws filled with something softer such as cooked egg white.
The straws represent the mineral support scaffolding for the nerve “egg white”. At the “cut” ends are the nerves extending right to the outside surface of the tooth. Ok, this is simplified, but those folks experiencing the piercing discomfort of cold sensitivity know that exposed roots are painful.
Dentin is much more likely to decay than enamel under the same conditions because of it’s “softness.” With time, and low oral acidity, the saliva remineralizes the dentin surface plugging up the end of the straws, placing a physical barrier between temperature and the nerve, and slowing tooth decay.
Neutral or low oral acidity, along with saliva (quantity and quality), low presence of “bugs”(good oral hygiene, and good diet, are immensely important factors in oral health. Tooth pastes and oral rinses, even your dentist or hygienist cannot produce the fantastic results of these interconnected factors when well balanced.
– Cynthia C. Copeland, DDS, DIBDM, AIAOMT