Unless you’ve had a dentist take the time to show you how to correctly brush and floss your teeth (and a mom who is a dental assistant, hi mom!), you are likely doing it wrong.
This interview will tell you everything that you were never told about how to properly take care of your teeth and gums.
For this first blog interview, in my new Expert Interview series, I’d like to introduce you to Dr. Caryn Guba. Dr. Caryn is a general and cosmetic holistic dentist in Indianapolis, Indiana and she has been my dentist since I was a teenager.
It is shocking to me the number of people who take excellent care of their health, but who neglect to see the relationship between their oral hygiene and their overall health and longevity.
And if you have children you will definitely want to pay extra attention to the information on when to start brushing baby teeth, when to take your child for their first dental visit, and if you should consider using fluoride.
So without further ado…
[Dr. Alexis] What does it mean to be a holistic dentist and how did you get into this type of dentistry?
[Dr. Caryn] To be a holistic, or a biological, dentist means taking a biocompatible approach. By using the term holistic, we are not attempting to stake out a new specialty for dentistry, but to describe an attitude that can apply to all facets of a dental practice and to healthcare in general. We strive to use the safest, least toxic dentistry. I often work in collaboration with other integrative practitioners to uncover the underlying cause of health problems. We try to practice as naturally and as conservatively as possible, while still giving the patient a healthy, long-lasting, and cosmetic result. Optimal dental health is a prerequisite for overall health and well-being.
I became interested in holistic dentistry while I was searching for solutions for my chronic headaches. I studied massage and reflexology and started incorporating them into my dental practice. I continued to learn more about pain and trigger points and studied with Dr. Janet Travell who actually “wrote the book” on trigger point therapy and pain management. I also studied occlusion and TMJ therapy over the next few years because I was trying to learn everything I could about headaches and pain management.
Around this time I also discovered the International Academy of Oral Medicine and Toxicology (IAOMT). After the first meeting I became a member. The meeting made me realize all of the things that I still needed to learn. I then enrolled in Capital University’s two-year program in Washington, DC, which was the first integrative medicine training available to dentists. With my evidence-based knowledge of the dangers of mercury toxicity, I had my fillings removed using the methods recommended by the IAOMT. This had such a big impact on me that I knew I would never use mercury fillings in my practice.
[Dr. Alexis] Is there a online directory or professional credentials to look for when seeking out a holistic dentist?
[Dr. Caryn] The International Academy of Oral Medicine and Toxicology (IAOMT) is where many biological dentists get their standards and education for a holistic practice. The Academy promotes scientific research relating to the biocompatibility of dental materials to make sure they are safe for the patient. The International Academy of Biologic Dentistry and Medicine (IABDM) promotes individualized testing for the biocompatibility of dental materials, and the integration of therapies such as Chinese Medicine and energy medicine into a dental practice.
[Dr. Alexis] How often should someone really go see the dentist each year? What can happen if you don’t?
[Dr. Caryn] Everyone is different and your personal needs depend on the way that you choose to take care of your teeth on a daily basis. Your mouth is also affected by your dietary choices and stress level, just like the rest of your body. Without regular dental exams you cannot be proactive in diagnosing and preventing the worsening of dental disease. Dental disease, both caries (cavities) and periodontal disease (gum disease), is not painful until it is extremely serious. Eighty percent of the population has some form of periodontal disease. This means that bacteria are residing under the gums and causing disease. Studies from peer reviewed medical journals have shown that bacteria may also travel through the blood stream to distant parts of the the body, and at the very least, these are significant risk factors for systemic diseases, such as cardiovascular, diabetes and stroke.
[Dr. Alexis] How important is daily dental hygiene to a person’s overall health?
[Dr. Caryn] Without proper daily dental hygiene the bacteria in the mouth multiply and can cause gingivitis (inflammation of the gums) which over a period of time leads to periodontitis (gum disease). Gum disease leads to tooth loss and is a risk factor for many other health conditions, such as cardiovascular disease, premature and low birth weight babies, and diabetes.
[Dr. Alexis] How do you explain to patients the best way to brush their teeth? Do you suggest certain toothpaste or toothbrushes?
[Dr. Caryn] The best way to brush is to make sure you are using more of a massaging and circular motion rather than a scrubbing motion. It is always easier to show than to try to explain it.
Brush twice a day minimum for proper daily oral hygiene. Eating organic is recommended as often as possible but this does not reduce the need for proper oral hygiene. I recommend an extra soft toothbrush because most people still brush too hard. With an extra soft brush it is much more difficult to cause damage. Years of vigorous over-brushing can cause damage to the gums. Flossing once a day is optimal but it is something that most people refuse to add into their routine. I have seen an improvement in patients’ oral health with just implementing flossing twice a week. Again, easier to show the proper technique!
[ Update to article: June 6, 2018
Maybe you have heard that there is controversy regarding the recommendation to floss daily? Flossing has been under debate by medical professionals and researchers since studies came out in 2008. In 2016 the Associated Press published an article stating that the medical benefits of flossing are unproven. Despite this information, I side with many dentists on this one and still recommend flossing.
Here is a very thorough review of the what we know by Kelli Gardener from Groom and Style blog – Do We Really Need to Floss. ]
A Waterpik is a great tool to add to your oral hygiene routine. The Waterpik, even without flossing, can remove most bacteria from under the gums and between the teeth. Studies have shown up to 99% reduction in bacteria.
I also like my patients who have active gum disease to add a concentrated herbal mouth rinse to the water well of the Waterpik. This allows antibacterial herbs to enter the infected areas. I also recommend the Tooth and Gum Tonic and the Dental Herb Company tooth paste for most people with gum disease.
For people with healthy gums needing an everyday toothpaste I recommend Earthpaste made with non-GMO xylitol. At certain doses xylitol has been shown to prevent tooth decay, decrease tooth sensitivity, decrease dry mouth, and can remineralize small cavities. I have been recommending the same Earthpaste for children. The flavors are very mild and they have no artificial coloring and no glycerine. New research shows that when glycerine is applied to teeth they remain coated and slick but unable to naturally remineralize. This can make them more prone to cavities.
Lastly, and probably my most favorite, is the Nimbus toothbrush. Unfortunately you cannot get these at the drug store yet, they must be purchased on Amazon but they are the BEST!
[Dr. Alexis ] When should a parent start to brush their child’s teeth?
[Dr. Caryn] Parents are encouraged to start brushing their child’s teeth as soon as they first appear. Initially this should be with plain water. If the child is very young and you cannot use a toothbrush, a wet washcloth is fine. We encourage children to brush their own teeth as soon as the parent feels that they are able, but the parent should always follow-up with a thorough brushing of the child’s teeth right after.
[Dr. Alexis note] To keep your child brushing for the recommended two minutes try the Firefly light-up toothbrush.
[Dr. Alexis] When should a child make their first visit to the dentist?
[Dr. Caryn] Decay can occur as soon as teeth appear in the mouth. I suggest that parents bring their children into our office as early as possible so they start getting used to the dental environment. We find this reduces anxiety and stress with future dental visits.
[Dr. Alexis] What are your thoughts on root canals? I hear from much of the online chatter that they can create long-term infections and long-term health problems?
[Dr. Caryn] For approximately 100 years, this subject has been chattered about. This all comes from Dr. Weston Price’s research from the 1920’s. His theory, that it is difficult to remove all of the bacteria from inside a tooth, is correct. It is difficult, if not impossible, to remove all of the bacteria from the canal of the tooth. He believed that all root-filled teeth were infected and they contribute to many general health problems. He also claimed to show that root canal treated teeth harbor bacteria. But, it is important to note that Dr. Price’s work has never been reproduced.
We now have new and improved materials, techniques and diagnostic equipment. However, not all root canals are done properly. The key in root canal therapy is to properly select cases that can be treated well. Specialists should be used for more complex cases. Infection is less common in well-treated root canal teeth, or root canals that are also treated with ozone gas. If someone has multiple health issues or is immunocompromised then we might look at extraction and a zirconia implant, versus a root canal.
[Dr. Alexis] If someone has old mercury fillings, should they always be removed? What is the best method for removal?
[Dr. Caryn] If you have silver fillings, you have mercury in your mouth. A large filling may contain as much mercury as a thermometer. Mercury vapor is colorless, odorless, and tasteless. If someone presents with multiple health issues, we usually recommend heavy metal toxicity testing first. If the old mercury filling is leaking or if there is decay underneath the old filling, we recommend the removal of it. My best suggestion is to have those who are concerned with old mercury fillings to seek advice from a physician knowledgable in mercury toxicity issues and a biological dentist.
We follow the IAOMT’s protocol for safe mercury removal of fillings. Here is the resource for that protocol.
[Dr. Alexis] Why do you think so many people are so fearful about going to the dentist? And how could that fear be reduced?
[Dr. Caryn] Most people hate EVERYTHING about going to the dentist. I think this comes from the fear of the drilling sounds and needles, the fear of someone in your personal space, and the feeling of not being in control. Unfortunately, this results in avoiding seeing the dentist for preventive maintenance and seeking out care only when in pain. And by that point, they are usually so anxious that is is difficult to make it a pleasant experience. Routine pain-free procedures under normal circumstances can become very painful for the anxious patient. There is research into this area of how to reduce the fear and anxious feelings associated with going to the dentist.
People that are fearful have usually neglected their dental health and they will have more problems. In my office we try our best to build a good rapport and trust with each patient before we start any procedures. I let them know that they really ARE in CONTROL and I WILL stop any time they need to rest or have any discomfort.
To make patients more comfortable we have oxygen therapy for patients to breath during the procedures so that there is not a smell during treatment, and headphones with music or television to help with the noise. We give each patient a warm neck wrap and blanket. And we have essential oil diffusers with calming aromas to create a comfortable atmosphere.
First and foremost, it is important to develop trust with the patient before you start any type of restorative work.
[Dr. Alexis] What is one big misconception that people have about going to the dentist?
[Dr. Caryn] Probably the biggest misconception is that dentists just fix and polish teeth and make pretty smiles. Oral diseases and toxic dentistry materials in a person’s mouth can have a significant impact on your overall health and longevity.
[Dr. Alexis] I routinely recommend against using fluoride, what are you thoughts on this?
[Dr. Caryn] We now understand that fluoride is a dangerous chemical that shows significant neurotoxicity. Two-thirds of Americans get fluoride in tap water and it is in all processed beverages including juices, coffee, beer and soups made with fluoridated water. Children today ingest much more fluoride than the children of previous generations due to increased consumption of processed foods, and fluoridated mouthwashes and toothpastes. In some cases we are giving our infants fluoride drops and then fluoride vitamins.
In 2010 the EPA placed fluoride on the list of developmental neurotoxicants with substantial evidence for the ability to harm a child’s developing brain and body. It sits alongside mercury, lead, and PCBs as a chemical known to be toxic to the developing brain. Currently in the US we are having an epidemic of neurodevelopmental brain diseases, which include ADHD, Autism Spectrum Disorder and learning disabilities.
The CDC and ADA both state that water fluoridation decreases the numbers of cavities in the average person by 25 percent. I do not feel that the benefit for your teeth outweighs the long-term health dangers. We have stopped using fluoride completely in my office because of these recent studies. We now strictly promote good nutrition, oral hygiene, xylitol, coconut oil and the use of ozone.
This short video from Our Daily Dose discusses the issues of fluoride safety further.
Thank you Dr. Caryn for all the oral hygiene and dentistry pearls of wisdom! Such important information that is always good to be reminded of on a regular basis.