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Brush and Floss

Back when I was a kid, elementary schools did a thing I don’t think they do much anymore.  About once a year, they had a dental hygienist come in and show us how to properly brush and floss our teeth.

It was pretty fun. The hygienist (back then, it was always a she) had this big set of plastic fake teeth she’d use to demonstrate proper technique. After the demo, we’d each be given a little kit with a new toothbrush, a mini tube of paste, and a tiny package of dental floss (courtesy, I assume, of some corporate sponsor intent on building its next generation of loyal consumers), and we were instructed to do our best.

Next, we’d be given a little red tablet to dissolve in our mouths and swish around. The dark-red dye from the tablet (I shudder now thinking about what kinds of chemicals it contained) would stick to the remaining plaque residue in our mouths, showing where our cleaning efforts had been subpar.

Predictably, most of us had bucked the hygienist and largely ignored our difficult-to-reach surfaces. It provided a great, highly memorable gross-out experience for the whole class.

These days we have an astonishing array of high-end, sonic-electric toothbrushes; high-definition, nanoscience whitening toothpastes; stretchy microfiber flosses; tartar-control mouthwashes; and stain-removing strips, gels, and apparatuses of all kinds.

And yet, I’ll bet that if you gave most of us adults a little red tablet to swish around after our standard daily dental-hygiene regimen, you’d find that even our grown-up efforts are leaving a fair bit to be desired.

There’s a reason for this: No matter how much mass-media emphasis we place on the value of sparkling white teeth, minty-fresh breath, and high-end dental accessories, most of us still don’t really grasp the deeper importance of properly caring for our mouths.

Sure, we run a brush around in there a couple of times a day. We floss when we think of it. But we tend to skimp on these efforts when we are busy or tired — which is most of the time.

Ultimately, we just don’t invest much care in the simple, daily rituals that keep our mouths clean, healthy, and resilient. In part, perhaps, because we don’t fully appreciate the many ways in which our mouths both reflect and dictate the health of our entire bodies.

True fact: Many of the problems that show up in the mouth — from cavities and bad breath to weird tongue coatings and canker sores — are indicators of larger imbalances, deficiencies, and infections elsewhere in the body. The mouth is just one of many places where the symptoms happen to appear.

Similarly, many of the problems located in the mouth, like decayed or missing teeth and diseased gums, have significant negative downstream influences on other areas of the body.

The inflammation caused by periodontal disease, for example, can cause body-wide inflammation, triggering a resultant rise in cholesterol levels and immune-system activity while raising risks for atherosclerosis and heart disease. Gum disease is also a strong predictor of type 2 diabetes.

It’s not always clear whether an individual’s poor health and lifestyle habits led to a messed-up mouth, or whether poor oral health contributed to the messed-up state of his or her body. But two things are pretty evident: If you want to evaluate the state of your health, looking at (and smelling) your mouth is not a bad place to start. And if you want your body to be healthy, taking responsible care of your mouth is absolutely essential.

With that in mind, I’ll offer up my top five suggestions for a healthy mouth:

1) Make your body a temple. Most of us learned as kids that sweets and soda were bad for our teeth (because they encouraged dental plaque), but we were never taught about the important role whole-food nutrition plays in creating and maintaining healthy teeth and gums. The same things that create a healthy body create a healthy mouth, so making fresh whole foods and filtered water the basis of your diet is a powerful strategy for improving oral health. So is avoiding tobacco products, excessive alcohol, and soft drinks (look up “Mountain Dew mouth” if you don’t believe me). The other key: getting enough sleep. A study published in the Journal of Periodontology showed that lack of sleep was second only to smoking as a factor influencing the progression of periodontal disease.

2) Clean with care. Something like 40 percent of our teeth’s surfaces aren’t within reach of a toothbrush. And some of the nastiest bits that get caught between them can’t be gotten out except by careful flossing.

A really good electric toothbrush can help remove the stuff most manual brushing misses — if you use it properly. That means holding the brush stationary, in contact with a single small stretch of gumline, for a count of five before moving on to the next area.

Oil pulling (swishing coconut oil around in your mouth for several minutes and then spitting it out) is another good strategy. So is tongue cleaning. In one research study, using a tongue-scraping tool reduced smelly, sulfur-laden residues at the back of the tongue almost twice as well as brushing the area with a toothbrush. But even if you do all this, floss, too.

3) Rethink your oral-care products. Many long-trusted, brand-name products are full of industrial chemicals many health seekers would rather avoid, and some (like alcohol-based, germ-killing mouthwashes) can wreak havoc with the mouth’s delicate environment, drying out tissues and obliterating the good flora on which a healthy microbiome depends. I won’t even address the thornier debate about fluoride here, but suffice it to say, if you haven’t read up on concerns about conventional dental-care products recently, you might want to. And if you are still loyal to the brands your mom used, you might want to branch out or even start making your own simple products at home.

4) Address the root causes of bad breath. Often, halitosis starts with gum disease, but other common causes include digestive troubles, sinus or lung infection, yeast overgrowth, and other microbiome imbalances. If good, daily oral hygiene (see above) isn’t helping, consider looking for alternative explanations, including those outside your mouth. Remember, your mouth is just one end of a very long and biologically complex tube.

5) Consider consulting a holistic or integrative dentist. These dentists typically have significant additional training beyond dental school, and they see the mouth, jaws, throat, sinuses, and cranium within a larger, whole-person perspective. As a result, they often take a more multifactorial, nuanced approach to resolving dental challenges, and they look to the mouth as an indicator and driver of general well-being. For a good article on the field of holistic dentistry (and its critics), see Revolutionary Reading, below.

If all that seems like too much to take on, consider this: Reliably performing a good oral-hygiene ritual each morning and night is one of those self-regulatory “foundational habits” that is likely to predispose you to other healthy choices throughout the day. And if you’re skimping on this essential element of self-care, it’s worth asking: Where else am I undermining my health goals by not taking care of the fundamentals first? Just something to ponder while you are happily brushing, flossing, and tongue cleaning later on tonight.

Revolutionary Reading

A Different Kind of Dentistry” — What makes holistic dentists different, and why their popularity is growing.

The Mouth–Body Connection” — How oral health influences whole-body health — and vice versa.

Your Microbiome: The Ecosystem Inside” — The trillions of nonhuman organisms in your body (bacteria, yeasts, fungi) can make or break your health.

What Your Body Is Trying to Tell You, Part 2” — A head-to-toe guide to decoding some of your body’s mysterious symptoms.

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