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78 – A Vulture Boards an Airplane

Hi there. You are listening to The Perio Patient Podcast, a podcast for my patients anyone else who cares to listen.

My name is Dr. Ben Young, and I am a practicing periodontist in San Antonio, Texas. Welcome if this is your first time. What I talk about here has to do with periodontal disease which can be very broad or narrow in scope. In many ways it is an excuse to just say hi and to put the thought into your mind that is easy to forget due to the many more urgent distractions of life that your health is important and that your best way to manage it is to do the little necessary things every day. Health has a lot to do with routine and routines when established become healthy habit patterns.

If someone is out of shape or wants to improve general health – is the best idea to go out and run a marathon – the idea being that it would be a quick way to make up for lost exercise time? Of course not. It isn’t how the body operates. Instead, its by incremental changes that health improves – and what often hinders improvement when the level or intensity is low is that it messes with our thinking.

It’s easy to think I’m not doing anything useful when I just do a little bit at time. For this reason, we seek feedback loops that then are used as indicators that we have done enough today. The problem when it comes to brushing and flossing is that intensity of effort can cause recession of gums and even the loss of tooth structure rubbed away by excessive use of toothpaste on the toothbrush. And advertisers don’t help when they show the amount of toothpaste they hope you use to be greater in length than the bristles of the brush. This amount results in foaming at the mouth. People who brush with this amount of toothpaste have to stand over a sink because if they don’t they will have toothpaste foam dropping on the bathroom floor. Also, when people use this much toothpaste, they also seem to scrub at the same intensity as they would polishing their shoes.

So what are the problems? First if they have thin gums, these gums can be injured and recede, exposing the root dentin – this makes the teeth look longer. It also ads to sensitivity.

Also the toothpaste can abrade away the enamel, which is an insulating layer over the dentin that supports it and sits between the enamel and the pulp containing a nerve that really doesn’t like hot and cold. This means as the enamel goes away after years of intense brushing with a lot of toothpaste, a lot of the insulation between the oral cavity where cold ice cream and hot coffee are introduced to the digestive system and the pulp that is looking for an opportunity to tell you its there.

Finally, toothpaste is promoted as helping whiten the teeth. This is nice, but how does it do this? Generally the answer is it cleans off the outer layer of enamel that has dulled exposing new whiter enamel behind it. And this works for awhile until the dentin behind the enamel begins to show through. Dentin is yellower than enamel, which means that your teeth will turn a yellower duller color and be more sensitive to temperatures to boot.

So what do you do to have white teeth? First, avoid too much toothpaste, use it for flavor. Second, don’t get decay, which means control sugar intake and frequently gently clean with floss and soft bristle brush and minimal toothpaste. Do you need fluoride? Ask your dentist.

What about Waterpiks? They do not replace brushing and flossing. My concern with Waterpiks has to do with intensity once again. It is working over the gums by too high a pulse and shooting bacteria down into pockets. The benefit of Waterpiks is to irrigate away food, especially under bridges or around brackets and braces when someone is having their teeth straightened.

What if there is a place in your mouth where floss doesn’t work? Come see me or your other dentist to look at this. It may be that we can come up with a way to make sure this area does not end up with tooth decay or periodontal disease problems.

That’s all I have for you today. If you have any questions or concerns, please let me know. You can comment to a podcast or send a message through my website.

Finally. Thank you to someone who said they liked my corny jokes at the end of podcasts. I will have one at the end of this one – just for you.

This has been the Perio Patient Podcast and I am still, as far as I can tell, Ben Young. Thanks for listening.

A vulture boards an airplane, carrying two dead raccoons.
The stewardess looks at him and says,
‘I’m sorry, sir, only one carrion allowed per passenger.’