Question: The sharp dental explorer sticks to a tooth, and the dentist says, ÒIt is soft. I'll drill." Do you wish to comment after you read the following letter by a dentist to the Journal of the American Dental Assn. published in 1992: The letter, 'Sealants' (August) by Dr. Donald W. Kohn contained an omission. The second paragraph should read: Dr. Eames and I can certainly agree that it gets down to integrity and that other great unquantifiable, clinical judgment. Yet, in my pediatric dental practice, when the explorer sticks in the deep, narrow pits and fissures of a recently erupted molar in a mouth relatively free from proximal decay, I will generally recommend sealants. Not only are the research and clinical experience there to justify this recommendation, but so are the children who have been spared the discomfort, loss of sound natural tooth structure and expense that traditional restoration entails."

Answer: I agree completely. That's been my recommendation since the mid 70's.

Question: Should we spend time cleaning the tongue and mouth of bacteria inasmuch as the bacteria transfers to the teeth?

Answer: I do it 'cause I like it, much as I scrub the outside of my bod daily for the same reason. "Should" depends on what you're trying to accomplish. I'm not convinced that it's necessary to clean your tongue or your neck very regularly to achieve/maintain optimum health, Ôtho some of us feel better if we do those things.

Question: Do you recommend a particular mouth rinse, and if so, on what basis?

Answer: No, not for healthy people. I've recommended various peroxides, fluorides, antimicrobials very rarely in very serious cases when there's zero understanding of health and a high risk of a condition becoming life-threatening soon.

Question: Is a recently graduated dentist more like or less likely to use conservative measures, such as to do narrower preparations to receive fillings? (See ÒInitial Preparation" JADA 11-92, p. 72, col. 3 bottom)

Answer: I would not use Òyears since graduation" as a predictor of knowledge nor correctness of dental philosophy. I wouldn't count on a recent graduate being up to date. Dental schools once taught current dentistry. Then governments started protecting y'all and licensing dentists. Now the schools teach how to pass the state board exams. And I wouldn't count on the average oldphardt dentist on being up to date, either, most of us lose interest in study shortly after graduation. Government-controlled schools teach COMPLIANCE, not THINKING.

Question: What do the manufacturers tell dentists now, in 1994, as to how long on average a newly made composite filling will give good service in a posterior tooth? Also, what about good service time for sealants?

Answer: I dunno. Haven't paid much attention to manufacturer's claim on this sort of issue for decades. Longevity of the current materials is pretty good. They'll last for centuries. If they're put into a mouth, longevity is more accurately predicted by the location on the tooth, how much lateral and occlusal forces are placed on it, how much of the tooth is still left to support it, what techniques and how meticulous was the placement and the lifestyle & dental, mental and general health of the owner of the tooth.

Question: Are these materials (composites and sealants) dated? What is their shelf life?

Answer: Yes, most of 'em are dated. Dunno the shelf life. In 23 years of use NO ONE's EVER asked and the issue doesn't arise Ôcause the materials are evolving so fast that we're constantly updating to newer materials before the ones we're using today have time to age. My dad founded a dental manufacturing company in the late 30's and operated it and a large dental supply company Ôtil he sold them in Ô72. I still have some of the methylmethacrylate polymers he was formulating and supplying to dentists in the 60's and their physical properties are not noticeably different after 30 years of shelf life. Most of the present composites are bis-GMA or urethane derivatives and newer, improved exotic systems are developing daily. Exciting stuff! Better living thru better toxins! ;-)

Question: On a periodic check-up visit to the dentist no pain is felt, but the dentist says root canal therapy is necessary to save the tooth. When a tooth's pulp, containing nerves, becomes infected, will such decay always cause pain?

Answer: No.

Question: Can a restoration extend into the pulp chamber without necessity of root canal therapy? Please explain.

Answer: Yes, considerable research (20 years worth in Japan) demonstrates that if the dental pulp is exposed, is relatively healthy and owned by a relatively healthy human and the wound is Òcleaned" and the defect Òsealed" the pulp may survive and no root canal treatment is necessary. I always give these pulps a chance to heal if their informed owner consents. Often that makes me the bad guy when the pulp dies and the pulp blows up weeks or years later.

Question: How frequently is elective root canal therapy performed on the basis of patients' ability to pay?

Answer: That question could mean at least 45 completely different things, and I don't know which one(s) of Ôem you mean. If the question implies that some people ("patients") should have the power to force other people ("health care providers") to "help" them with against their will, I disagree with your premise. If it implies that many dentists are dishonest, I suspect that about the same percentage of dentists are dishonest as are members of other professions, excepting the criminal professions like rapists, lawyers & government agents.

Question: Please read the following excerpt from the ÒInitial Preparations" article in JADA, Nov. 1992, page 71, column 1, and tell us if visible but small carious areas should be sealed to avoid drilling and filling, and cost to the patient: ÒIf a small area of caries at the base of a fissure is inadvertently sealed, it will not expand unless the seal is lost. Bacteria sealed in carious lesions have been shown repeatedly to diminish, and many sealed carious areas become sterile without a few years."

Answer: I agree completely. That's been my recommendation since the mid 70's. Cost varies from $5 to $50/tooth, depending on how much the government has interfered with the marketplace.

Question: An advertisement I submit directed to dentists, states that new composite can be easily bonded to an existing composite restoration by applying that company's bonding product. Please tell us if such Òpatch" to worn, existing composites and amalgams is durable, less expensive to the patient, and should be requested by the patient.

Question: Those repairs can be durable, long-lasting and cost-effective, depending on the location on the tooth, how much lateral and occlusal forces are placed on it, how much of the tooth is still left to support it, what techniques and how meticulous was the placement and the dental and general health of the owner of the tooth. I'd recommend relying on your dentist's advice on each individual case, assuming you trust your dentist. If you don't trust the dentist, I wouldn't advise letting her/him provide ANY care for you. Find one you do trust.

Question: This is true and took place this year: One dentist using the unaided eye finds six Òcavities" in a prospective patient and states they must all be treated. A second dentist looking at the same teeth (hopefully with normal vision!) finds no cavities and prescribes only scaling by the dental hygienist in his office.

How common is differing diagnosis among dentists, assuming good faith? Can you cite a published study on this?

Answer: VERY common. Happens rather frequently even with the three dentists who Òpractice" in my office (I'm generally the one who recommends minimal treatment 'cause that's what I'd prefer for MY mouth; the others recommend more therapy probably Ôcause that's what they'd want in THEIR mouths in the same circumstance). Diagnosis and treatment recommendations are largely determined by the belief system of the doctor. Find one that is in synch with YOUR belief system and CO-treatment plan your Òcase" with him/her. Differing diagnoses and plans are an advantage of more than one opinion. Any dental library can cite studies on most anything, including this. I can't.

Question: What can cause a tiny brown spot on the occlusal surface of a tooth?

Answer: Stain from foods, drugs, etc., plus a defect to retain the stain.

Question: In his book Nutrition and Physical Degeneration, Weston Price informs us that remineralization is deposited by the saliva in carious teeth of primitives, arresting decay and keeping such teeth functional without benefit of dentists. He does not state how common this natural process of restoration is. If you have examined archeological specimens or primitives teeth, can you tell us your finds with respect to remineralization?

Answer: Yes, if I do such examination, I'll report my findings. In the meantime, I've seen that remineralization occur in living humans who change to more healthful lifestyles frequently.

Question: Have you come across any article in the dental literature which states that remineralization does take place when conditions are receptive, in human or animal teeth?

Answer: Yes.

Question: What procedure would you recommend for someone who hasn't visited a dentist for several years and is experiencing either real or perceived problems with his/her teeth?

Answer: My suggestion: Find a dentist you trust, get a comprehensive, COMPLETE oral examination, discuss with her/him your present level of dental health, what level you wanna achieve, evaluate his/her recommendations, follow Ôem or not and perhaps return for re-evaluation in a few months. I've ALWAYS felt that the LEAST dental/medical treatment you have and still attain/maintain Optimal Health &Mac220; the better. Another possible excuse for seeing a dentist is for correction of increasingly popular birth defects, poorly developed malformed jaws, faulty occlusion, misaligned teeth, etc. that I feel are caused by NOT choosing NH ancestors. These developmental defects, once created, don't repair in adults. They need help from orthodontists and restorative dentists if they're to be corrected. (Lateral forces on teeth from parafunctional habits clenching/bruxing, etc. and neuromuscular imbalances plus osteoporotic tendencies are probably as important as plaque in advanced periodontal disease and few dentists have an understanding in those areas.)

Question: If cavities are found, how are they best dealt with?

Answer: With as little "treatment" as possible to attain/maintain Optimum Dental Health. Specifically, if the Òcavities" are small and not growing and you're living hygienically, perhaps just keep Ôem as clean as possible and get Ôem checked in a few months and decide if ya wanna continue that way or have some conservative "treatment". If we're not poisoning our bodies, they DO heal and small defects in teeth DO remineralize when sucrose and other toxins are avoided. If ya don't wanna take a chance "waiting and watching" small carious lesions, the next most conservative step is to "seal" them with bonded composite resin (with or without cleaning the deep grooves with rotary diamond instruments). If the holes in the teeth are too big for "sealants," but the teeth are still sound and not cracked, I'd recommend removing the decayed areas and replacing the missing parts with bonded tooth colored composite materials. Once teeth are cracked (as are at least half of teeth that were filled" with mercury/ silver materials the zinc and mercury phases of these materials react with your saliva, expand and help fracture the teethGREAT for biz!) they need to be re-built with gold or tooth-colored onlays and crowns to prevent their further destruction and/or loss. Those years of non-NH lifestyle were VERY expensive. :-(

Question: Anything else?

Answer: Yes, much else. Very much else. But there must be more to life than Dental Health, yes?

Now that I've answered questions, would you ask your readers to answer some for me?

I'm most interested in the "Natural Hygiene-Dental Connection". Dentists as a group are not quite as establishment-oriented as physicians. Our profession mostly repairs mechanical defects caused by disease and trauma; we rarely actually Òtreat" disease with drugs, radiation, surgery, as do physicians. Probably we Òtreat" about 10-20% of our time whereas MD's Òtreat" probably 90% of their time. Therefore more dentists are interested in prevention, nutrition and alternative concepts than physicians.

As usual, we've exhausted the space before we've exhausted the fascinating material. If you find Bob's style and writing to be as informative and fun as I do, you'll definitely want to check out the Natural Hygiene Many to Many, where those of us who subscribe pick Dr. Wynman's brain every other month with our questions about dental health as well as any other subject that comes to mind. I wholeheartedly encourage you to send an $8.00 check (or International Money Order) made out to Bob Avery, 1930 Washtenaw Ave., Ann Arbor, MI 48104-3655, 313-769-1598 to receive a sample copy of his wonderful Natural Health Many to Many Newsletter. You'll receive close to 200 pages of fabulous Natural Hygiene information from individuals who are living the lifestyle and sharing what they're learning about it with others. THE END.