New research in cariology--the study of tooth decay, cavities--is impressive.
Here's the essential thing: While it is still certainly true that the germ Strep mutans metabolizes the sugars we eat and drink, and creates acid metabolic byproducts that decay our teeth, what drives the entire process is acidic saliva. What I mean is, some of us have lower pH (more acidic) saliva than others.
Correcting this condition, meaning raising the average oral pH, if it were possible, would do several useful things:
*Decrease acidity, and thus decrease caries (cavities),tooth erosion and abfractions.
*Down-regulate the various sugar-metabolizing, acid-producing oral bacteria.
*Up-regulate the various protein-metabolizing, non-acid-producing oral bacteria. Which are beneficial to have about.
As usual, both diet and genetics have a role in this salivary pH issue. And while it can be changed with diet, I'm not sure we even know precisely what diet would be best, and of course that might conflict with something else medical for the person. Fortunately there are other ways to manage low salivary pH. Most involve the amino acid arginine, which does the beneficial things I mention above. So one could eat arginine-rich foods.
I believe I have acidic saliva to an extent, and I'll explain why. I just don't get caries because:
*My frequency of eating & drinking refined carbs is infrequent throughout the day,
*My main carb of choice is chocolate, which dissolves away quickly and is not all that cariogenic, and
*I'm constantly flossing and brushing and so on. There wouldn't be any caries if there were no plaque germs at all, right? So less plaque is less risk.
The reason I assert that I have acidic saliva (I plan to test it soon) is that I tried the baking soda test. First, you taste some water. I love how water tastes when I'm thirsty, but otherwise, not so much. And at home we drink tap water, filtered with a Brita filter in the fridge. So it's cold and clean, but I often feel like I'm forcing it. Now, I took a cup of hot water and mixed in as much baking soda (sodium bicarbonanate, a very basic/alkaline substance) as would dissolve, and then some. Then I took a swig of the supernatant liquid and rinsed for 30 seconds. After spitting it out, I took a deep breath and noted a series of odd odors; this was the protein-metabolizing bacteria coming into play. Then here's the test: I drank some water. It tasted sweet, pure, amazing, like it had come out of an Alpine spring! That's how people with high oral pH perceive water all the time. Me, I don't dislike water, but water never tasted like this before!
So now we see that I have to consider raising my own oral pH.
Also, a note regarding fluoride. Certainly fluoride protects against caries by strengthening the mineral structure of our enamel, as we learned. However, fluoride minimizes the effects of acid demineralization. Altering the oral pH helps treat the cause, a much more useful thing to do.
There are two new preventive oral care products I recommend highly.
The first are Basic Bites. What they do is use arginine and other ingredients to raise our oral pH for hours at a time. The baking soda only does it for half an hour or so. The idea is to have a Basic Bite once or twice a day.
I did a little experiment on myself. I tested the pH of my saliva and found it to be 6. This is dangerously on the acidic side!
I then chewed a delicious Basic Bite. I mean, these things are good. Even better, the Basic Bite raised my pH to 8: nice and alkaline.
Very low risk for cavities. Not that I ever had many cavities, but that's because I clean my teeth well and enjoy sweet food and drink in moderation. Having acidic saliva means I'm naturally at risk for cavities, and that I had to behave that way to avoid them.
The second is Synedent. This is a remarkable and unique rinse.
What apparently happened is that about a decade ago, a researcher noticed that, unique so far among all land and aquatic animals studied, shrimp absolutely do not form a biofilm on their exoskeletons. Bacteria can "land" there, but they cannot stick and form colonies and weave the polysaccharide nets that we now term a biofilm. Why this would be from an evolutionary standpoint is hard to say. However the U.S. military got very interested in this and developed a battlefield wound spray, so that wounds would not get infected during and after treatment. That's a lot better than waiting for infection to start and then using antibiotics!
They released the research to civilian companies recently and Synedent is an oral rinse that resulted. The idea is that it disrupts the formation of biofilm around the teeth, on the tongue and cheeks and so on.
Now, this is anecdotal and a sample size of one, but I started using Synedent a few weeks ago after a prophy and lo and behold--I do not have any noticeable plaque or calculus forming. None at all. And this is especially striking because I tend to form a lot of supragingival light calculus in the lower anterior. I attribute this to not drinking enough water at work and then eating chocolate at lunch. Not for lunch, mind you! But at lunch, yes. Now? No calculus at all.
Thus, for anyone who has had an issue with cavities I would recommend both Basic Bites and Synedent. You order both online from their websites. And floss, and modulate your carbohydrate frequency, and use some fluoride product; toothpaste is fine.