Bite Point

The Bottle Project

On a recent trip to California- my first, and on which I met the redoutable writer Tom Bentley in person- I was astonished when my wife said, "Hey Rick, look at this bottle!"

It wasn't plastic!

It was made from plant material, not petroleum.  This will change the whole game.  Plastics in our garbage stream are especially problematic since they never really go away, they just degrade into smaller and smaller pieces.

For more, have a look at my previous post:
http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2011/05/plastic-versus-plant-based-beverage-bottles.html

After admiring this simple consumer product for a few weeks- come on, you would too- I decided to start The Bottle Project.  I've placed two bottles into my garden, a conventional plastic one and this new plant-based bottle.  I'm going to take a picture once a week until one biodegrades completely.  Exposed to whatever elements Pennsylvania throws at them, we shall see in a most Visceral way what happens to each material, and at what rate.  Half of each bottle is in the dirt, exposed to soil microorganisms.  Half is exposed to sunlight.

Don't worry, I won't post each and every picture here.  But from time to time I will update you all on this important change in our consumer culture.

May the best bottle win!

 

Our Caries Clock- Avoiding Cavities

Some time ago, we posted our magnificent Caries Clock for anyone to use in order to educate themselves and their families about how to avoid getting cavities:

http://www.smilephiladelphian.com/clock/Caries.php

Tooth decay is certainly one of the most common diseases in humans.  Worldwide, most children and an estimated ninety percent of adults have experienced tooth decay, or dental caries.  This is upwards of 6 billion people.

Some of the effects of dental caries are:

-Soft spots in teeth, loss of softened tooth structure as it breaks off or is removed during repair.

-Pain. 

-Infection if the decay progresses into the center of the tooth, the living dental pulp.

-Endondontic (root canal) treatment can eliminate this pain and infection if the tooth is still intact enough to be restorable.

-Esthetic challenges, as many cavities are visible when a person smiles; also gaps show when teeth are lost due to cavities.

-Loss of time from productive work as teeth and possibly infections related to decayes teeth are treated.

-Emotional trauma expecially in children from the treatment of what is by definition a complex and sensitive medical problem.

-Cost.  Tremendous cost can be incurred in treating extensive decay and it's all preventable.

We need three things for a cavity to occur in a tooth.  We need the person, who has to have teeth, we need simple sugars, and we need a particular germ.  Unlike gum disease with its many possible causitive germs, with cavities there are only two main bad guys.  There is primarily Streptococcus mutans, and there is Lactobacillus acidophilus who is kind of like Best Supporting Actor here.  I know, I know, they should name them something a lot simpler, like Elmo and Big Bird or Hall and Oates.  But they don't...  Something involving Latin taxonomies and large quantities of micro-brewed beers at scientific conferences.

What happens is actually pretty simple.  Any time we ingest simple sugars in either liquid or solid form- any time, any sugar- Herr Mutans, in particular, steals some of it from us.  The millions of germs in our mouths (Gack!) grab on to this food like starved football players after practice.  The problem is that Strep mutans happens to kick out insane levels of acid waste products when it metabolizes sugars.  The next problem is that the more we feed sugar to these little beasties, the more of them there are- giving them just what they want increases their population in the plaque in our mouths.  The acid eats into the teeth, both in the grooves on top and on the smooth sides.  Cavities result.  Then, the more cavities there are, the more Strep mutans there is in all those holes... It's a snowball rolling down hill at that point.

Our defenses:

-Keep the plaque in our mouths down to a minimum.  Brushing thoroughly, flossing, using Soft Pics if you don't like floss- all keep the numbers down on Strep mutans and for that matter everyone else in there too.  Fringe benefit- better breath.

-Fluorides strengthen the enamel against this form of acid attack.  Topical fluoride in toothpaste is appropriate for adults whose teeth have already grown.  Not all water supplies have fluoride, so for kids with their teeth still forming a careful check is needed to ensure that they are getting the optimal levels.

-Eating with some regard to frequency of carbohydrate intake is important, and is what our Caries Clock is all about.  We can snack, we can have our chocolate- we just shouldn't have it too darned often.

Here's a neat graph of the acid curve over time:

Sucrose is a common simple sugar, it's table sugar actually, and pH is a measure of acidity.  (Just in case you've protected your psyche by blanking out all memories of high school chemistry class.)  As you can see from the graph, your teeth need time to rest after an "acid attack".

And watch out for what really contains carbohydrates.  People always seem to be aware of the risk from sodas but not from sports drinks.  If it's liquid and tastes really sweet and there's any other ingredient besides sucralose or aspartame in there, it can cause cavities:

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2009/12/how-sweet-it-is.html

So can otherwise healthy foods like raisins and dates and most fruit.  These are excellent things to be eating- just don't graze.  And try to clean your mouth after you're finished.

The worst thing you can do for your teeth- and your pancreas, for that matter- is to "graze" on refined sugars all day long.  Eat, then give your mouth time to rest.

Mr. mutans will be very angry about this, but that's his problem.

Gatorade- Open. Gulp. Repeat.

Ah, Gatorade.  There you go again...

Those of us who are of a certain age can well remember "There you go again":

http://www.youtube.com/watch?v=t3GnWTy8Ebg

In this instance, the Gatorade folks have devised a remarkable slogan: "Open. Gulp. Repeat".  Oh my.  Where do I even start on this one?

(Notice where I noticed it- pumping that other culturally charged liquid, gasoline...)

-By "open", I suppose they mean both the bottle and the mouth.  So far, so good.

-"Gulp".  Which means "Gulp 14 grams, 7 teaspoons of refined sugar, 125 calories."

-Repeat.  This is the dodgy part for us dentists, as repeating small intakes of refined carbohydrates over a period of time is by far the biggest risk factor for getting cavities:

http://www.smilephiladelphian.com/Clock/Caries.html

Bottom line: the Repeat part leads to tooth decay, and the Gulp part increases the chances that you'll end up with Type II Diabetes.  No kidding.  Human beings don't do well when we shock our insulin system too hard and too often.  We simply weren't designed for it.

Yes, Gatorade replaces lost electrolytes.  Yet just so you know, it takes about 2 hours of hard exercise, I mean pedal to the metal, to lose enough electrolytes in sweat to warrant replacement in a healthy young athlete.  And at that point the sugars will be useful too, especially if the event isn't over yet.  I'm thinking swim meet with multiple heats, cycling a century, running the Iditarod.  That kind of thing.  In these cases, go for it.

When you're exercising for under an hour though, or playing a sport like softball where the action is intermittent, please consider water.  Your pancreas and your teeth will thank you.

*More on "Vitamin G":

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2010/02/2010-super-bowl-gatorade-shower.html

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2009/12/gatorade-selling-the-sizzle-not-the-slake.html

New Decay Preventing Strategy- Pro-t-action

Ever notice how some football tackles involve lots of defensive players just overwhelming the guy with the ball?  I've always found these to be one of the more interesting parts of the game.  There's usually nothing malicious about it- they're all just caught up in the moment, and they just keep glomming onto the ball carrier:

 

Well, BASF corporation is developing a new tooth decay preventive strategy that, on a microscopic level, looks an awful lot like a mass football tackle.  Or a rugby scrum, if you're from that side of The Pond.

As I reviewed back in 4/4//2009 in "The Resurgece of Dental Caries", there is one particular germ, Strep mutans, which lives in our mouths and eats some of the sugar that we eat and, as it does so, kicks out a tremendous amount of acid as a byproduct.  This acid can then decay our teeth if we are exposed to it too frequently. 

(See our "Caries Clock" @ http://www.smilephiladelphian.com/Clock/Caries.html )

For years dental researchers have tried to thwart the destructive plans of this single-mindedly nasty germ.  One approach from a few years back was to genetically engineer a strain that wouldn't produce so much acid, and then innoculate patient's mouths with this less damaging version of the Strep.  When that was being tried, my first question was, "How are they going to ensure that the less virulent strain out-competes the wild strain, and takes over in the patient's mouth?"  There are also the vast concerns about introducing genetically altered strains of bacteria into the world when we are really not yet fully able to predict the consequences of such manipulations.

BASF's approach, named pro-t-action, seems to take advantage of the more natural antagonisms between different bacteria.  Just like the Philadelphia Eagles and the Dallas Cowboys have a famous sports rivalry, germs compete against each other too. But instead of title wins, they are after resources in their environment.  Over thousands of years (and with generation times of as little as 20 minutes) they have developed offensive and defensive strategies that would make any football coach green with envy.

It turns out that a germ called Lactobacillus paracasei has developed a protein (probably back when our ancestors were trying to figure out how to walk on two feet, not four) that has the ability to:

-Target Strep mutans,

-Bind to them, and then,

-Clump them together, just like football's mass tackle or rugby's scrum:

A lot more germs clump together than there are players in the entire NFL, however, and once they do this, the normal actions of chewing and swallowing simply flush the clusters of them out of the mouth.  Other germs besides Strep mutans are not affected, since these antagonisms are very specific.  Also, not all of the Strep mutans would be washed out of the mouth, but most of them would be, and this may prove to be sufficient to stop the process of tooth decay in the human mouth. 

Unless you drink too much Gatorade- any system can be overwhelmed...

BASF has details (dry corporate ones, but details nonetheless) here:

http://www2.basf.us/corporate/news_2009/news_release_2009_00080.htm

We'll keep you posted as this concept is developed further.

What does "sweet" really mean, sugah?

Our "Caries Clock" is ready!  It's a graphic representation of how our daily eating and drinking habits can lead to cavities if we take in sugary foods and liquids too frequently.

It's here:

http://www.smilephiladelphian.com/Clock/Caries.html

 
"Caries" is the technical word for "cavities"; it just seemed to us that "Caries Clock" sounded snazzier than "Cavity Clock".

I would really like to review what types of foods are worse than others in terms of leading to tooth decay.  This is difficult though.  Supposedly there was work being done on a "Cariogenic Index" or cavity-causing rating system for common foods.  I cannot find any such thing at the moment.  I thought that some European countries had made that a part of their food labeling back in the 90's.  I'll keep looking and asking.

Essentially, if something (liquid or solid) tastes sweet, and if it has refined sugars as part of its substance, then it has a high potential for causing cavities.  So we're talking a range of foods all the way from candy to Twinkies to soda and sports drinks to tea with honey in it to ketchup to granola cereals to fruits of all kinds to raisins- it's a big range.  Many of the final foods that I listed are very healthy for us.  Yet as a separate issue they can cause cavities if eaten too often throughout the day on a regular basis. 

 

Fruit juices provide an excellent example with which we can learn some of the principles involved in thinking about sugars and our health.  Let's take a minute and examine them.  Fruit juices contain a number of simple sugars, especially fructose.  Fructose is a sugar found all over the place in nature.  (The most common sugars are fructose, sucrose (table sugar) and glucose.  There are many though.  These are different than high fructose corn syrup, which is controversial because the corn industry is powerful and has been responsible for putting it into everything.  And corn syrup has a lot of calories per gram.)

 

http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/C/Carbohydrates.html

 

So fruit juices contain many valuable nutrients and vitamins.  The negative aspects are that they do have calories, they do have these simple sugars that can cause cavities if taken with too much frequency, and if ingested quickly with no exercise following they might add to Type II Diabetes risk because they shock our insulin system.  So- my interpretation of the science is as follows:

 

-Fruit juices provide essential vitamins and nutrients;

-To avoid cavities they should not be sipped at over long periods of time;

-To avoid increasing diabetes risk they should not be ingested quickly too often without being followed by at least moderate exercise, and;

-To avoid weight gain their calories should be considered as balanced against exercise and overall calorie intake for the day.

 

Finally, the less high fructose corn syrup added, the better.

 

Keep these principles in mind for all foods that contain simple sugars and you will minimize your risk of diabetes, weight gain and tooth decay, and yet can still enjoy the wonderful range of fruits, vegetables, sauces and desserts which we have access to these days.

 

I mean, I love chocolate...