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It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization. 

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

If you wear braces, you want to be especially careful about excess demineralization. Because it can be hard to brush and floss effectively with braces, white spots and discolored patches are a common concern for those with braces, especially on the enamel around brackets.  

Talk to Dr. Dennis Johnson at our Columbus, OH office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization when you have braces. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.

Xylitol is a naturally occurring sweetener found in tree bark, plants, fruits, and vegetables. The human body also produces it in small amounts. It looks and tastes like sugar, so as part of a health regimen, most people require no willpower to use it.

Xylitol is safe (approved by the World Health Organization) because only a small amount is needed for health benefits. With a glycemic index of seven, it is safe for diabetics. It has less than three calories per gram and 40% fewer calories than other carbohydrates. If eaten in extremely large amounts too quickly, it has a laxative effect in humans.

Tooth decay happens when bacteria in your mouth consume the sugars you eat. When you eat food that contains ordinary sugar, it gives energy to the bacteria on your teeth, allowing them to multiply and start making acids that destroy the enamel on the teeth.

Since xylitol is a natural sweetener derived from the fibrous parts of plants, it does not break down like sugar, so it helps maintain a neutral pH level in the mouth. Xylitol also prevents bacteria from sticking to the teeth because they are unable to digest it. That is how it protects the teeth from cavities.

With xylitol, the acid attack is diminished. With less bacteria and acid, your teeth stay healthier. The frequency of xylitol ingestion is important: aim for five grams a day, or one gram every three hours.

Studies of xylitol use as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new cavities. It has also stopped and even reversed some existing cavities. This effect is long lasting and possibly permanent. Low cavity rates persist even years after the trials have been completed.

Xylitol needs to be one of the first ingredients in a product to be effective. It is convenient and easy to use. You can find it in health food stores and specialty grocery stores. Xylitol can be delivered to your teeth in chewing gum, tablets, or even candy and mints.

It also comes in toothpaste, mouth rinse, baby oral wipes, gel and pacifiers, nasal wash, dry mouth spray, a granulated form for cooking, granulated packets to add to drinks, and commercially prepared foods. It can replace sugar on a one-to-one ratio.

Sweet rewards in xylitol are good for the body and the teeth! If you have specific questions please feel free to contact Johnson Orthodontics. We look forward to seeing you soon!

The alarm sounds in the morning, you wake up and realize "I forgot to wear my retainer!"

If this only happened once, don't panic. Missing one night with a retainer is unlikely to cause significant teeth movement. However, if it has happened often, give our Columbus, OH office a call to make sure your teeth haven’t shifted position.

Here are some tips from Dr. Dennis Johnson to help you remember your retainer:

1. Write down the instructions we give you for wearing the retainer, whether you should wear it all day or at night, or just a few times a week. Writing things out like this helps set the schedule in your memory.

2. Clean the retainer when you take it out each time. If you don’t you may not have time when you’re rushing to get to work or school to clean it properly and may be tempted not to wear it.

3. Put a note on your mirror or in your purse or wallet reminding you to wear your retainer.

4. Set an alarm on your mobile phone to remind you when it’s time to put the retainer in. If you have email with a calendar you can set up daily reminders, too.

5. Always put the retainer in its case when you take it out to eat or sleep. You’ll reduce your risk for losing it or accidentally throwing it away.

6. If you don’t have to wear the retainer every day, you can use some recurring events to help you remember. With this system for example, watching your favorite weekly TV show, laundry day, or family pizza night can all serve as reminders that you should put in your retainer.

7. Don’t be shy about asking for help if you’re forgetful. Assure your spouse, parents, siblings, or roommates that you won’t consider if nagging if they remind you to wear your retainer.

8. Surf online for examples of how teeth can shift when retainers are not properly used. Those stories can serve as timely warning not to let the same thing happen to you!

Remember, you can always call our Columbus, OH office if you feel your retainer is uncomfortable or painful. We'll work with you to protect your smile!

Did you know that even in ancient times, people wanted to improve the look and function of their smiles? Johnson Orthodontics thinks of modern orthodontic appliances as sleek, efficient technology, but this was not always so! Take a look at the highlights in the evolution of braces.

Ancient Times: From Greece to Rome

• According to The Angle Orthodontist, Aristotle and Hippocrates first thought about methods for straightening teeth between 400 and 300 BC.
• The Etruscans, in what we now know as Italy, buried their dead with appliances that maintained spaces and prevented collapse of their teeth and jaws during life. Archaeologists have discovered mummified remains in various locations that have metal bands wrapped around the teeth.
• A Roman tomb has also been discovered in which the teeth were bound with gold wire, including documentation on the wire’s use as a dental device.

18th Century: A French Development

• The French dentist Pierre Fauchard is acknowledged as the father of modern dentistry. In 1728 he published a book that described various methods for straightening teeth. Fauchard also used a device known as a “blandeau” to widen the upper palate.
• Louis Bourdet was another French dentist who published a book in 1754 that discussed tooth alignment. Bourdet further refined the blandeau and was the first dentist to extract bicuspids, or the premolar teeth between canines and molars, for the purpose of reducing tooth crowding.

19th Century: Orthodontics Defined

• Orthodontics started to become a separate dental specialty during the early 19th century. The first wire crib was used in 1819, marking the beginning of modern orthodontics.
• During this period, gold, platinum, silver, steel, gum rubber, vulcanite, and occasionally wood, ivory, zinc, and copper were used — as was brass in the form of loops, hooks, spurs, and ligatures.
• Edward Maynard first used gum elastics in 1843 and E. J. Tucker began making rubber bands for braces in 1850.
• Norman W. Kingsley published the first paper on modern orthodontics in 1858 and J. N. Farrar was the first dentist to recommend the use of force over timed intervals to straighten teeth.

20th Century: New Materials Abound

• Edward Angle developed the first classification systems for malocclusions (misaligned teeth) during the early 20th century in the United States, and it is still in use today. Angle founded the American Society of Orthodontia in 1901, which was renamed the American Association of Orthodontists in the 1930s.
• By the 1960s, gold was universally abandoned in favor of stainless steel.
• Lingual braces were the “invisible” braces of choice until the early 1980s, when tooth-colored aesthetic brackets made from single-crystal sapphire and ceramics became popular

Today

As we arrive in the present, you need only look at your own braces to see how far we’ve come. Your treatment plan was probably created with a 3D digital model, and we’ve likely used a computerized process to customize your archwires. Perhaps you have clear aligners, self-ligating brackets, or highly resilient ceramic brackets with heat-activated wires.

Orthodontics has come a long way from the days of Aristotle, and even the bulky wrap-around braces of just 60 years ago. Regardless of your specific treatment plan, the development of high-tech materials and methods has made it possible for your orthodontic experience to be as effective, efficient, and comfortable as possible. Call our office in Columbus, OH to schedule your first orthodontic consultation!