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Dental care for MMers – Part I

The average adult ends up with 32 little bone-like things in their mouth that they have to take care of. If care is not taken, each of these teeth can potentially bring a large bill totaling thousands, in an attempt to save, re-save and eventually replace the tooth. Multiply that by 32 and you have a nice total sum to consider.

Repairing problems with teeth and the mouth also takes time out of your life. It could lead to parts of the day off work, or even a number of days if severe problems occur. Pain associated with tooth problems is also a factor you need to consider. Dental pain can potentially be quite a severe, overshadowing your days or preventing sleep. Finally, by eventually losing teeth, you will lose proper function when eating. In this case, you don’t really know what you had until it has gone. To gain an appreciation, ask an older person with partial or full dentures how fun it is to use their fake teeth, and how well they work.

Hopefully this gives you a little incentive to care for your teeth. The good news is: in this day and age, good home care can obviate the need for this large bill, time, pain, and function hassles, and you can potentially maintain all your teeth without the need of significant repair for your whole lifetime.

In this article I will discuss how to achieve a good standard of care, the issues that people face regarding their teeth, and address specific concerns for the bodybuilder/supplement enthusiast.

The basics

How to brush and floss:

For correct brushing and flossing I refer you to the ADA animations :http://www.ada.org/public/games/animation/interface.asp

Points to remember when brushing:

  • Angle the bristles into the teeth and gums so they can clean along the gum line, which is where most of problem plaque accumulates and can lead to cavities or gum disease.
  • Keep the word “vibration” in your mind while you brush. You only need a gentle vibration (wiggle side to side) on each tooth, then move to the next tooth and vibrate again.
  • Brush one tooth at a time, then move to the next tooth, donÕt just go across all teeth in big sweeps.
  • Don’t forget to clean the chewing surfaces (the top surfaces) of your teeth.

Points to remember when flossing:

  • Each space that you floss has two teeth that make up each side of the space. The space essentially looks like this Ò) (Ò. You need to clean one at a time. To do this, curve the floss around the single tooth and move down the tooth to the neck of the tooth gently. Move it down to a point where you feel a little resistance. Never move down to a point of pain, as you can actually cause damage with vigorous flossing. Move the floss up the tooth to remove the plaque. Repeat the flossing of that one side of the tooth. Then move on to the tooth next to it. Carry out the same procedure.
  • Don’t worry if your gums bleed. If you haven’t been flossing , you have some form of gum disease, gingivitis. Once you start flossing, the bleeding just indicates that more flossing needs to be done. If, however, you are flossing every day and the gums still bleed after a week of flossing, go see your dentist.

Problem 1: Dental caries a.k.a holes, cavities, decay

According to current research, there are five main factors that determine caries formation and progression. These factors are: caries is a bacterial disease, caries is modified by saliva constituents, caries is modified by fluoride, caries is dependent on dietary fermentable carbohydrates, caries is driven by frequency of eating (1).

What do you basically need to achieve caries?

Tooth: birth gave you this.
Plaque: microorganisms. Usually first passed on by your mother during those kisses in the early years.
Sugars: fermentable carbohydrates. What you eat each day.
Time: a cavity doesn’t happen overnight.

What can you address?

Plaque and sugars.

Plaque and microorganisms: Once you have been infected with microorganisms that cause dental decay you really can’t get rid of them. You can reduce the amount of total microorganisms and plaque in your mouth and on your teeth, but you wonÕt be able to rid them forever. This is where brushing and flossing come in. Brushing and flossing disrupts the plaque that attaches to your teeth and stops their multiplication. Simply, when microorganisms on the teeth are left on the surface of a tooth and are not disrupted by brushing, they, over time, join forces and work as a team in that particular site, and the longer they are left to work as a team, the more potent damage they can cause. This is why dentists advise you to brush your teeth at least 2 times a day.

Sugars (carbohydrates): This is a big factor you can address. Sugars/carbohydrates feed the plaque/microorganisms and the plaque produce the acids that cause decay of your teeth. Fortunately, many of you may have already been reducing risks of dental decay by the way you control and choose your food. Low carbohydrate diets many bodybuilders and dieters subscribe to are positive in regards to dental health. Even the concept of a refeed aligns with the recommended strategies to reduce decay.

These strategies are:

  • Reduce the amount of carbohydrates/sugars you eat.
  • Any lower carbohydrate diet achieves this.
  • Reduce the frequency of carbohydrate ingestion. This means you eat less carbohydrates every day. For example, you donÕt eat carbohydrates at each meal, and not all of your snack meals have carbohydrates in them. Leaving the carbohydrates to a post workout shake and not having them spread throughout the day reduces the frequency of intake. Also, having all of your carbohydrates in the evening during your reefed/cheat meal reduces the frequency of carbohydrates to one. Essentially, all lower carbohydrate diets, or the targeted use of carbohydrate diets e.g. CKD, TKD, IF, carbohydrate cycling, all reduce the risk of decay.
  • Address the type of sugars/carbohydrates. Stickier sugars and carbohydrates can attach better to your teeth compared with carbohydrates that are in a drink. As they can attach better, these carbohydrates can stay in contact with your teeth for longer, and the microorganisms can use them for longer and essentially multiply and thrive better. Therefore, opt for less sticky carbohydrate substances.

What are teeth made from and how does decay and loss of tooth substance occur?

Simply, plaque/microorganisms feed on sugars/carbohydrates and as a byproduct of utilizing the carbohydrates to keep alive and thrive, the microorganisms produce acids.

Acids cause demineralization of the teeth. The minerals/inorganic compounds that make up the tooth are namely calcium, phosphate, carbonate, magnesium and sodium.2 Acids essentially remove these compounds from the organic substructure of the tooth, and you can think of this as dissolving the tooth surface away.

The good news is demineralization is reversible. After acids have demineralized teeth, your saliva, if it has a good level of minerals and can buffer the acids, can replace the minerals lost due to the acid. Demineralization and remineralization continue to occur back and forth during the lifetime of the tooth. Certain dietary foods and products, which I address later, can tip the balance in your favor and enhance remineralization, and decrease the amount of demineralization over time. If you however, let acids continue to demineralize your teeth, then, over time, the tooth structure will be lost because the organic substructure will be soft enough to be removed by eating, or brushing, or scraping.

Fluoride

The declining levels of tooth decay have been mainly attributed to the addition of fluoride to the public water supply. Systemic fluoride within the body of a child has made developing teeth stronger and more resistant to acids, and also has changed the shapes of developing teeth to make them less prone to decay.

Topical fluoride (fluoride in contact with the surface of the tooth) is the form that is most important to people that already have their adult teeth developed and in place. Fluoride has antibacterial properties, reduces the adhesion of plaque to teeth, and also. if incorporated as a mineral into the surface structure of the tooth, reduces the dissolvability of the tooth.

A potential issue that some have noticed these days is the prevalence of bottled and filtered waters. The more children and adults drink water which has had the fluoride reduced or removed (e.g. from bottles or certain water filter systems), the less fluoride-based protection you get. If you are an adult, you donÕt need systemic fluoride for your dental health. So if you want to reduce your fluoride intake systemically, or you prefer bottled water, then I would suggest periodically supplementing your topical fluoride exposure by using a fluoride rinse, or just simply putting some fluoride toothpaste in your mouth and leaving it there.

Caries is modified by saliva constituents: this will be addressed in: CPP-ACP: your special partner.

Problem 2: Erosion

Caries/dental decay was the main problem focused upon in the past. As fluoride has been added to water supplies and the general dental education of the public has improved over the years, dental decay has reduced.

Nowadays, a growing issue is the issue of erosion. Erosion is simply, loss of tooth structure due to acids dissolving your teeth. With dental decay, the acid is produced by the plaque/microorganisms, however erosive loss of tooth structure is due to external acids we consume in the form of foods and beverages and internal acids which come about when people have reflux, regurgitate their food, as in the case with bulimics. Apparently, we as a society are consuming more acidic foods and beverages, and we are losing tooth structure as a consequence. Bulimia is also an issue in our present age of obsession with slimness and one in which both females and males deal with.

Next week: What can we do about it?

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