Diet
- Eliminate dietary sugar (e.g., sucrose, glucose, and fructose) intake between meals, both in terms of snacks and beverages. Purchase “sugar-free” snacks and candies (not “sugarless,” which often contain “less” sugar rather than no sugar!). These sugar-free snacks contain sweetening agents that do not cause dental caries, such as xylitol, sorbitol, saccharin, aspartame, or sucralose.
- There is evidence that the use of a xylitol-containing gum or candy four to five times a day for 5 minutes after meals and snacks can reduce caries-producing bacteria and that xylitol increases saliva production. Aspartame, on the other hand, tends to dry the mouth.
- Do not sip on carbonated beverages (e.g. a can of soda) between meals. The acidity of the beverage cannot be buffered without food and this prolonged fermentable carbohydrate and acidity in the mouth promotes dental decay. Should you drink, drink quickly (including juices). Try to consume juices that are fortified with calcium and fluoride and rinse with water afterwards.
- Avoid alcohol and caffeine since these beverages are acidic and can promote caries.
Stop smoking since it can aggravate dryness of the mouth.
Dental hygiene
- Practice scrupulous oral hygiene. Brush and floss regularly and use fluoride daily. Your teeth should be cleansed at least twice daily using a soft bristled electric toothbrush and mildly flavored (avoid strong minty flavor) low-abrasive toothpaste. Choose “dry mouth” toothpastes. They do not contain sodium lauryl sulfate, a chemical in most regular toothpastes which may contribute to the formation of canker sores. Avoid whitening, tartar control, or smokers toothpastes since these contain abrasives.
- For the first 30 seconds, use the dry brush and brush the lingual (inside) surface of your teeth, then moisten toothbrush and apply a dry mouth toothpaste (e.g. Biotene, Pronamel, CloSYS, Orajel, Sensodyne) and brush for 1.5 minutes.
- Floss between all adjoining teeth at least once daily to remove dental plaque.
- Carry a travel toothbrush and toothpaste with you to work and brush after meals and snacks.
- Do not brush immediately after consuming acidic beverages or food (lot of food and fruits, including salad dressings, are acidic). Instead rinse mouth with plain water or low fluoride containing rinse (e.g. ACT) and brush after half an hour.
- If you are at low-to-moderate risk of caries, you should use a 0.05% sodium fluoride mouth rinse (available over the counter, such as ACT or Colgate Fluorigard) for 1-2 min. daily, before sleep. Hold the sodium fluoride rinse in your mouth for at least one minute before expectorating. If you are at high risk of caries, your dentist or physician should prescribe 1.1% neutral sodium fluoride toothpaste (such as Prevident 5000 or SF 5000) to be used once daily in place of your regular toothpaste. Prescription fluoride toothpastes can be applied with a toothbrush and left in place for two to three minutes before expectorating. Do not swallow the prescription fluoride toothpaste. If dental caries develop in spite of daily use of topical fluoride, a soft acrylic carrier can be constructed for nighttime use of fluoride gels.
- Visit your General Dentist every 3 months for cleanings and any dental treatments
Sonicare toothbrush 3 times a day
- Place the head of the toothbrush on each tooth for 10 seconds. Be sure to brush both the front and back of the tooth. Lift and go to the next tooth. Be sure not to put a lot pf pressure on the tooth or the gums as this may cause recession.
- Brush your tongue for 1 minute. Brush the tongue in strokes from back to front.
Prescription Strength Fluoride Toothpaste (e.g. Prevident 5000)
- Brush with at least once a day (at night), spit but do not rinse after brushing OR brush with regular toothpaste and apply a dime/pea size amount on the finger/Q-tip and directly apply to your teeth.
At other times of the day, consider mixing equal parts Tom’s Rapid Relief Sensitive (fluoride-free) toothpaste with your favorite over-the-counter fluoride-containing toothpaste. The Tom’s product contains 8% arginine bicarbonate/calcium carbonate, which helps neutralize the pH on the dental surface. This promotes deposition of calcium and phosphorus into open dentinal tubules, thereby decreased dental sensitivity and protecting the dental surface from erosion. Spit but do not rinse after brushing.
MI Paste Plus (Topical creme with calcium and phosphate)
- Use before bed, 30 minutes after prescription fluoride toothpaste
- Put a dime/pea size on finger or Q-tip
- Rub around teeth and all around inside of mouth/tongue
Use BioSal, SalivaMax, Caphosol Rinse, NeutraSal or Baking Soda Rinse 3 times a day
- BioSal, SalivaMax, Caphosol and NeutraSal are each supersaturated calcium phosphate rinses that help relieve dry mouth and associated mucositis (inflammation of the oral lining). Use as directed on box.
- Baking soda rinse can be made by mixing 1 tsp of baking soda and pinch of salt in 8 oz of water. Rinse your mouth with it and then spit out.
Denture Care
- Take your dentures and other dental appliance out before going to sleep and disinfect them overnight in a commercially-available denture cleanser (e.g. Polident) or water. Dishwashing liquid and water can also be used for cleaning along with gentle brushing with a soft-bristled toothbrush. Whichever method, rinse thoroughly in water before re-inserting in the morning. Avoid using toothpaste on dentures as it is abrasive to denture teeth. Night guards, however, can be inserted before bed. They can be cleaned with water and a toothbrush, but do not use a denture cleanser. They do not need to be stored in water when not in use. To remove concretions from the denture/appliance, place them in full strength white vinegar for at least 10 minutes, and brush gently to remove the mineralized material. Repeat as needed until the denture surface is clean and smooth.
- Wash your denture cup on the top rack of your dishwasher once a week.
