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A reason to grin

Although you may religiously employ the old standbys—toothbrush, paste, and floss—to maintain healthy teeth and gums, you may not realize that your daily oral regimen also affects your body's total well-being, possibly even helping prevent heart disease.

Oral health care means more than preventing cavities and polishing your pearly whites; the way in which you treat your mouth can have far-reaching physical consequences. Although you may religiously employ the old standbys—toothbrush, paste, and floss—to maintain healthy teeth and gums, you may not realize that your daily oral regimen also affects your body's total well-being, possibly even helping prevent heart disease.

In any case, good brushing and flossing habits alone aren't enough to protect your teeth and gums—you also need a sound diet and lifestyle. "The best regimen for oral health is systemic health," says Philip Memoli, DMD, dean of the Berkeley Heights, New Jersey-based Institute of Natural Dentistry. "The mouth is a reflection of your overall health. If there's a problem with your body, oral disease presents itself, be it through tooth decay or gum disease."

Your smile, it appears, reveals to the world much more than your mood. Here are some tips to help you make your mouth the best it can be.

Gum Mayhem
So what can go wrong inside your mouth—other than getting an occasional cavity or having a severe case of halitosis? One major oral offender is periodontal disease, or gum disease, an infection caused by bacteria that accumulate between the teeth and gums. Be extra-vigilant about preventing this problem: It's the major cause of tooth loss in adults.

Your daily routine should include a regular toothbrush, a stimulator toothbrush, a tongue cleaner, and floss. Periodontal disease begins when the bacteria in plaque cause the gums to become inflamed. Bacterial toxins irritate the gums and trigger a chronic inflammatory response leading to tissue and bone destruction. Gums then separate from the teeth, forming pockets where infections begin. According to the American Academy of Periodontology (AAP), periodontal bacteria can enter the bloodstream and travel beyond the mouth to major organs and begin new infections. This may even contribute to heart disease and increase the risk of stroke. Although genetics influence a person's predisposition to periodontal disease, other risk factors include hormonal changes, stress, and smoking (Journal of Periodontology 1999, vol. 70, no. 7; 2000, vol. 71, no. 5). Luckily, there are ways to reduce your chances of developing gum disease, mainly through diet and proper mouth cleaning.

Diet Matters
One of the best ways to protect your mouth is to take a whole-body approach to oral health care. A well-rounded, nutritious diet is a great place to start. Both calcium and vitamin C, for example, support robust teeth and gums, according to the AAP. Conversely, an unbalanced diet with too much sugar and processed foods increases the risk for tooth and gum problems. A poor diet, cautions Memoli, weakens the immune system, which can cause tooth decay, receding gums, and jaw bone loss. Memoli recommends a diet rich in fruits and vegetables, with some protein to help sustain the immune system.

By making his patients aware of their diets, Dick Thom, DDS, ND, of Natural Choices Health Clinic in Beaverton, Oregon, sees improvements not only in oral health, but also in whole-body wellness. Thom makes similar dietary recommendations, emphasizing whole foods and minimizing saturated fats and processed foods. Drinking plenty of water, he adds, not only keeps tissues lubricated but reduces bad breath, tooth decay, and infection. One more reason to get your eight to ten daily glasses.

Tools Of The Trade
Keeping your mouth clean, however, is still the most important way to prevent mouth disease. And here's the good news: "If you 'disorganize' plaque within a 24-hour period," says Thom, "you'll keep the incidence of tooth decay and periodontal disease to a pretty minimal level." He recommends your daily routine include a regular toothbrush (electric toothbrushes aren't necessary), a stimulator toothbrush (also called a sulcus brush), a tongue cleaner, and floss. A stimulator toothbrush has two rows of bristles and is typically used without toothpaste to massage the gums, which Thom says improves blood and lymphatic circulation, thereby removing waste products.

Toothbrush designs vary widely, from the I-forgot-to-pack-my-toothbrush $2 specials to various ergonomically-shaped brushes—some with unique flexing capabilities and bristle differentiations only marketers can appreciate. Dentists agree that the right toothbrush is the one you enjoy using so you'll brush longer and more frequently. Try different shapes and switch often to see what feels best to you. After all, Thom says, most people don't replace their toothbrushes often enough. (Replace yours when the bristles begin to fray; this could be every few weeks to every few months.) The pros say to opt for soft bristles and go easy on your teeth and gums. "People tend to act like they're scrubbing the floor when they brush their teeth," says Thom. "You don't need to brush hard."

Choosing a toothpaste is another personal decision, most likely driven by flavor and texture. Many natural toothpastes feature nonabrasive vegetable fibers in lieu of the sand and chalk found in some other brands. Some are saccharine- and sugar-free. Natural toothpaste ingredients also often include herbs that are astringent, antibacterial, and soothing, plus essential oils to add flavor. Toothpaste purists can even mix a batch themselves (see "Make Your Own"). Many dentists who espouse natural oral care recommend avoiding toothpastes with fluoride and sodium laurel sulfate—ingredients that some believe are toxic. But Thom says the extremely small amounts people are exposed to from toothpaste aren't worth worrying about. "People are exposed to a lot of other additives in the food they eat compared with what they're getting in toothpaste," he says. "I'm more interested that they brush their teeth, period."

Surprisingly, Thom says toothpaste is optional, though using it does help people to brush longer—something we could all stand to do. Turns out, most people brush for less than a minute when it might take three or four to clean teeth thoroughly. If you're speeding through the process, consider setting a timer or brushing for the length of a song to stay motivated. Brush after every meal if possible, twice a day minimum, plus clean your tongue and floss your teeth daily.

Although the benefits of breath-freshening toothpastes are often touted in commercials, researchers have shown that 90 percent of bad breath is from bacteria on the tongue, not the teeth (Journal of the American Dental Association, 1998, vol. 129, no. 11). To combat this, dentists recommend scrapers and tongue brushes, which are specifically designed to remove bacteria from the tongue's crevices. These tools are also less likely to trigger the gag reflex, which toothbrushes often do. Tongue brushes can be used alone or with toothpaste.

Myriad kinds of flosses and rinses stand in colorful array on supermarket shelves. Natural choices include infused flosses made with essential oils and enzymes that help eliminate plaque, reduce tooth decay, and freshen breath. Mouth rinses enhanced with anti-inflammatory and antibacterial herbs, such as echinacea (Echinacea spp), goldenseal (Hydrastis canadensis), and tea tree (Melaleuca spp), are also available. If you can't find one that suits your tastes, try making your own (see recipe). Soothing aloe vera and astringent witch hazel (Hamamelis virginiana) are nice additions to some mouth rinses, but avoid rinses containing alcohol, which can dry sensitive mouth tissues (Acta Odontologica Scandinavica, 1993, vol. 51, no. 1).

No matter how tedious they may seem, daily brushing, flossing, tongue cleaning, and mouth rinsing do help prevent gum and maybe even heart disease. Likewise, a healthy diet helps maintain a healthy mouth. So take care of your teeth—and simultaneously take a bite out of other serious health risks.

Dena Nishek, a freelance writer and editor, has renewed her vow to floss daily.


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