Tooth Decay (Holistic)

About This Condition

Keep that smile on your face by protecting and strengthening your teeth and gums. According to research or other evidence, the following self-care steps may be helpful.
  • Discover xylitol

    Chew gum containing xylitol to reduce the activity of cavity-causing bacteria

  • Battle the bad bugs

    Inhibit cavity-causing bacteria by adding lactobacillus GG to children’s milk

  • Pass up sticky sweets

    Cut down on cavity-causing bacteria by avoiding sugary foods that stick to your teeth or stay in the mouth for a long time

About

About This Condition

Tooth decay is the gradual breakdown of the tooth, beginning with the enamel surface and eventually progressing to the inner pulp.

Tooth decay is caused by acids produced by certain mouth bacteria in dental plaque. Factors that affect this process include oral hygiene, diet, meal frequency, saliva production, and heredity. Teeth with significant decay are said to have caries, or cavities.

Symptoms

People with tooth decay may have tooth pain, including sensitivity to cold food and drinks.

Healthy Lifestyle Tips

The ADA recommends regular tooth brushing—daily brushing, ideally after each meal.1 Although thorough brushing varies from person to person, five to ten strokes in each area should be adequate.2 Toothpastes containing 1,000 to 2,500 ppm (1 to 2.5 mg per gram) of fluoride have been shown to reduce caries risk.3

A recent population survey found blood lead levels were associated with the amount of dental caries in children and adults. The authors estimated that lead exposure is responsible for roughly 10% of dental caries in young Americans.4 For this and other health reasons, known and potential sources of lead exposure should be avoided. Common sources of lead exposure may include paint, foods grown near roadways, and water from lead pipes.5

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

RecommendationWhy
Choose whole grains and unprocessed foods
A diet high in whole grains and low in processed foods is a healthful choice that probably helps defend against tooth decay.

It has been noted for over 50 years that the incidence of tooth decay is low in people of traditional rural societies, such as Eskimos and African Bantus. However, the incidence of cavities increases as their diets begin to include more “westernized” processed foods. Although many different factors have been implicated in this observation, including refined flours, inactivation of vitamins by heating foods, and sugar intake, no single agent has been found responsible. Nevertheless, a diet high in whole grains and low in processed foods is a healthful choice that probably helps defend against tooth decay.

Pass up sticky sweets
Cut down on cavity-causing bacteria by avoiding sugary foods that stick to your teeth or stay in the mouth for a long time.

Sugar, especially sucrose (table sugar), appears to be required by the oral bacteria for the production of tooth decay. This finding has caused sugar to be widely blamed in the popular press as the primary cause of dental caries. However, caries incidence has recently declined in a time of increasing sugar intake. This has led to a reevaluation of caries causation, and sugar is now understood to be only one of the factors in the development of tooth decay. Nearly as important as the total amount of sugar intake seems to be the consistency of the sugary foods and the length of time they are in contact with the teeth. Dry and sticky foods tend to stay in contact longer, causing more plaque formation. Still, reduction of total dietary sugar is probably the most accepted dietary recommendation for the prevention of dental caries.

Supplements

What Are Star Ratings?
SupplementWhy
3 Stars
Probiotics
Add 5 to 10 x 105 CFU per ml to milk or formula
Supplementing with probiotics may inhibit cavity-causing bacteria.

In a double-blind study of children aged 1 to 6 years, supplementation with Lactobacillus GG five days a week in milk for seven months reduced the incidence of cavities by 49%, compared with unsupplemented milk. The amount of Lactobacillus added to the milk was 5 to 10 x 105 CFU per ml.

In another study, supplementing with Lactobacillus reuteri strain ATCC 55730 (derived from breast milk) significantly decreased the number of children who had dental cavities at 9 years of age. The probiotic was given in the amount of 108 colony-forming units per day to the mother during the last 4 weeks of pregnancy, and then to the infant in the same daily amount during the first year of life.
3 Stars
Xylitol
Chew gum containing xylitol regularly
Chewing gum with xylitol, a sugar substitute, may reduce the activity of cavity-causing bacteria.

Certain sugar substitutes appear to have anti-caries benefits beyond that of reducing sugar intake. Children chewing gum containing either xylitol or sorbitol for five minutes five times daily for two years had large reductions in caries risk compared with those not chewing gum. Sorbitol is only slowly used by oral bacteria, and it produces less caries than sucrose.

Xylitol gum was associated with a slightly greater risk reduction than sorbitol gum. Bacteria in the mouth do not ferment xylitol, so they cannot produce the acids that cause tooth decay from xylitol. A double-blind study found 100% xylitol-sweetened gum was superior to gum containing lesser amounts or no xylitol. Another study found xylitol-containing gums gave long-term protection against caries while sorbitol-only gum did not.

Other research has confirmed the anti-caries benefits of xylitol in various forms, including gum, chewable lozenges, toothpastes, mouthwashes, and syrups. Mothers typically transmit one of the decay-causing bacteria to their infant children, but a double-blind trial found that the children of mothers who regularly chewed xylitol-containing gum for 21 months, starting 3 months after delivery, had a greatly reduced risk of acquiring these bacteria, and also had 70% less tooth decay.

2 Stars
Fish Oil
3 tsp per day of cod liver oil
One trial showed that children given cod liver oil for an entire school year had over 50% fewer new cavities.

One older controlled trial found that children given 3 teaspoons of cod liver oil per day (containing roughly 800 IU of vitamin D) for an entire school year had over 50% fewer new cavities. These promising results have not been followed up with modern placebo-controlled trials.

2 Stars
Neem
1 gram of leaf extract in gel applied to teeth twice per day
Neem leaf extract has been shown to reduce plaque and bacteria levels in the mouth.

In a double-blind trial, 1 gram of neem leaf extract in gel twice per day was more effective than chlorhexidine or placebo gel at reducing plaque and bacteria levels in the mouth in 36 Indian adults. A similar trial found neem gel superior to placebo and equally effective as chlorhexidine at reducing plaque and bacteria levels in the mouth. These promising early studies should be followed by studies regarding prevention of cavities and relief from gingivitis or periodontal disease.

2 Stars
Vitamin B6
For adults: 20 mg per day in capsules or lozenges; for children: 9 mg daily
Vitamin B6 appears to increase growth of beneficial mouth bacteria and decrease growth of cavity-causing bacteria.

Test tube studies show that vitamin B6 increases growth of beneficial mouth bacteria and decreases growth of cavity-causing bacteria. A double-blind study found that pregnant women who supplemented with 20 mg per day of vitamin B6 had significantly fewer new caries and fillings during pregnancy. Lozenges containing vitamin B6 were more effective than capsules in this study, suggesting an important topical effect. Another double-blind study gave children oral lozenges containing 3 mg of vitamin B6 three times per day for eight months, but reported only insignificant reductions in new cavities.

1 Star
Sorbitol
Add 5 to 10 x 10e5 CFU per ml to milk or formula
Chewing gum with sorbitol, a sugar substitute, may reduce the activity of cavity-causing bacteria.
Certain sugar substitutes appear to have anti-caries benefits beyond that of reducing sugar intake. Children chewing gum containing either xylitol or sorbitol for five minutes five times daily for two years had large reductions in caries risk compared with those not chewing gum. Sorbitol is only slowly used by oral bacteria, and it produces less caries than sucrose. Xylitol gum was associated with a slightly greater risk reduction than sorbitol gum.
1 Star
Strontium
Refer to label instructions
Communities with strontium in their water supply appear to have a reduced risk of dental caries.

Levels of strontium in the water supply have been shown to correlate with the risk of dental caries in communities with similar fluoride levels. Compared with children with fewer cavities, enamel samples from children with high numbers of caries have been found to contain significantly less strontium. However, supplementation with strontium has not yet been studied as tooth decay prevention.

References

1. Fure S, Gahnberg L, Birkhed D. A comparison of four home-care fluoride programs on the caries incidence in the elderly. Gerodontology 1998;15(2):51-60.

2. Petersson LG, Svanholm I, Andersson H, Magnusson K. Approximal caries development following intensive fluoride mouthrinsing in teenagers. A 3-year radiographic study. Eur J Oral Sci 1998;106:1048-51.

3. Driscoll WS, Nowjack-Raymer R, Selwitz RH, et al. A comparison of the caries-preventive effects of fluoride mouthrinsing, fluoride tablets, and both procedures combined: final results after eight years. J Public Health Dent 1992;52:111-6.

4. Ellwood RP, Blinkhorn AS, Davies RM. Fluoride: how to maximize the benefits and minimize the risks. Dent Update 1998;25:365-72.

5. DePaola DP, Faine MP, Palmer CA. Nutrition in relation to dental medicine. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkens, 1999, 1110-2.

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