Regarding tooth enamel. Please tell us more. Can we rebuild it?

Yes, it's possible. We rebuild it every day, or at least replace it, with bonded porcelain, space-age lab-processed resins, etc. The new stuff has nearly the same coefficient of thermal expansion and the same abrasivity and flexural properties as enamel. Like cloned enamel. Except it doesn't have enamel rods nor interprismatic substance and the fluids from within the tooth don't flow through it as in enamel. If you mean can the tooth or the body rebuild natural, autogenous enamel as part of the body's self-repairing capabilities, I've never seen nor read of it happening. The cells that originally created the enamel (ameloblasts) disappear after the last of the enamel's formed, and I've never heard of them reappearing, although I don't really know why it couldn't happen. I suspect that if our government doesn't completely paralyze those people capable of discovering new information and developing new technology, we'll probably have cloned enamel through genetic engineering within twenty years.

Teeth CAN "remineralize" without intervention from a dentist. Back in the 70's before I'd discovered NH, we used to help folks avoid sucrose and disrupt their plaque. Just with those two factors alone, we saw cavities REVERSE. The carious (decay) process stopped and the soft, rotting areas became hard (remineralization = "arrested caries"). The holes in teeth didn't fill in, but the disease process stopped, and the mouth was healthy. The remineralized dentin and enamel was not pretty. It was usually black or dark brown, but the destruction had stopped. How? Why? Methinkst two mechanisms:

1. Eliminating the sucrose stopped the most efficient food supply for the bacteria in the plaque that produce the toxins that cause gum disease and caries; and,

2. Eliminating the sucrose may have been enough to detox the body enough to reverse the harmful sick INWARD movements of fluid from the mouth toward the center (pulp) of the teeth and restore the healthful OUTWARD flow of that fluid, making further decay impossible.

Reliable research shows that with "normal" use of the mouth, enamel wears at about 10 microns per year. It's about 1.5 mm (1,500 microns) thick, so would take about 150 years to wear the enamel off the teeth. I don't remember the numbers, but would guess that 2-3 microns of enamel might be lost at each "tooth cleaning", depending on the abrasivity of the stuff used by the hygienist. I'm not convinced of any benefit of that abrasive polishing and we do it only on the insistence of people who want it to remove surface stains (approximately 97.4% of everyone seeing the hygienist). If you're concerned with losing your enamel, a far more significant consideration is "parafunctional habits". A person can do ten years worth of wear of enamel on the biting surfaces of the teeth in one night of grinding the teeth while sleeping (bruxing). Clenching combined with lateral (sideways) forces is probably even worse, causing the loss of enamel (abfraction) and recession of the gums at the necks of the teeth.

Solution: eliminate those sleep habits, "the nightly grind", with whatever "emotional poise" is and keep "LIPS TOGETHER, TEETH APART" anytime you're not swallowing (the teeth don't actually contact each other during chewing!), especially during sleep. If you can't keep teeth apart while sleeping by sleeping in serenity or with your tongue hanging out or an old sock in your mouth, your dentist will gladly build you a removable appliance to protect your enamel during sleep, for a fee.

I've been lucky during my lifetime and haven't had to deal with dental implants, crowns, and so on. Would you say a few words about such things, please.

Regarding implants, the modern concept is to attempt osseo-integration of ANY implants placed in the jaw bones. I've placed various implants for nearly 20 years, although lately I have delegated the surgical phase to oral surgeons and periodontists and am not aware of any implant system less invasive, less expensive and less difficult than the modern root-form osseo-integrated fixtures. They have a quarter-century track record of success and are easier to place than teeth are to remove.

"Crowns, and so on" covers a lot of territory! Basically, if a tooth is fractured, it requires SOMETHING strong enough to cover the biting surface to hold it together (a circumferential restoration) if it's going to last many years. This usually means a lab-processed onlay or crown. If it has other damage, like cavities, but the biting surface is intact, then tooth-colored bonded composite restorations may be the way to go. They're the most conservative of the remaining tooth structure and we won't know for years how deadly they are!

Please comment on some of the popular mechanisms for "solving" all our dental problems. Rotadent? Interplak? WaterPik? SoniCare? Sonix, etc.

Rotadent. A well constructed instrument, a bit slow unless there's a special need for it and the enforced multi-level dentist-only marketing is a bit odious to me.

Interplak. Probably the best and most proven of the electrical bristle-wigglers. I've used one since '89. While it doesn't do a better job than a good manual BHP blotting brush, it's about three times quicker.

WaterPik? I suggest brush/floss first, then insert water jet (intraorally!), turn it on, keep lips lightly together, lean over a basin or bucket so your lips are the lowest point of your head. It won't remove firmly adherent plaque, that takes a mechanical rubbing action. It DOES remove the loose 20% of the SURFACE of plaque, which happens to contain 90% of the actively growing colonies which produce the acids and toxins that waste your teeth and gums. CAUTION: keep the jet perpendicular to the surfaces of the teeth (parallel to the biting surface) DO NOT blast it down into the pockets beneath the gums. If they're sick, you can inject bacteria & toxins beyond the attachment barrier & into your circulating blood.

SoniCare. The latest electric brushes vibrate their bristles at millions of cycles per second and in theory sound great for disrupting plaque. The studies look good. I've been using one as a trial for a few months and don't notice any difference.

Sonex. Haven't tried it yet, but I suspect it may be a better deal 'cause the manufacturer is a big reliable company. I had the opportunity to speak with technical reps from all these companies & a lot more at the 10/94 ADA convention in New Orleans just before meeting your illustrious editor/publisher.

I know several H&B subscribers who use the PHB toothbrush, including you. Please fill everyone else in on this fine product. [For ordering information, call 619/756-9528]

Periodontal Health Brush. Yes, the finest preventive dental product ever created (if used with the correct "blotting" technique and replaced in its cap after each use). I've used this brush in my mouth since 1972 and have given thousands of them to clients. Most soft brushes wear out in about two weeks if used properly because the bristles flare out and friz up. PHB supplies a cap in which to house the head of the brush between uses. The cap reshapes the bristles. We've studied the bristles under dissecting microscope after several years of use -- still softly rounded as when new. Toothbrush salesmen visiting this office don't care for this demonstration, especially when we show them video pix taken through the scope comparing THEIR brushes with a 3-year old PHB.

Won't you end up with stained teeth from not using toothpaste? Yes, probably. I have!

What else could one use?

Well, calcium carbonate comes to mind as a pretty mild abrasive which is probably OK to use occasionally if stains on teeth bother you. I've experimented with NO abrasive, NO toothpastes, just blotting with PHB since 1972. Results: extremely healthy teeth, but darkly stained (I may soon make before and after pix of this stain prior to bleaching). Calcium carbonate is available in many toothpastes.
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