Oral Hygiene Question

Not a dentist, but I worked for a small dental company for several years that made biodegradable periodontal implants. We employed several dentists and the scuttlebut around the office was that physical brushing of the teeth and tongue is more effective with oral hygiene and bacterial control than simply swishing mouthwash around. Even more effective are oral irrigators like the WaterPik device. On long trips I carry a sawed-off toothbrush and a small bottle of essential oil antibacterial blend (cinnamon, cumin, clove, various citrus and other oils) for oral hygiene and for any cuts I might get.

Lester, that interesting.

I use a little charcoal, chewed up to brush with,  and salt,  now I’m wondering about essential oils from chewed up pine needles, which are already beneficial due to their vitamin C content.

I am no dentist, but I have had problems.

Brushing at least once per day is important.

Fluoride really works best from the *inside*. And really, only when teeth are developing. You can get some high potency tooth paste from your dentist (prescription) that will help. Use only a small amount, like a drop on your tooth brush.

Don’t worry about bacteria. Your body is designed to handle that. Bad breath usually indicates another problem with gums/teeth. Your body will handle all sorts of bacteria entering through your mouth and nose. It is the first and most potent line of defense against disease.

Rinsing out with plain old water is the best. Don’t use anything that can be used as a food by these critters. Salt, baking soda, etc, all tend to lessen the concentration in your mouth. There is no good substitute for brushing, though. A half shot of 25-30% alcohol helps a bit, but, is not really necessary. IFF you have an open wound/sore/other problem, it can help more, though.

Thanks for the suggestions, guys. I generally brush twice and floss once (at night) whether on the trail or otherwise. Edgar, I never heard of charcoal being used for brushing teeth. What is the benefit?

It seems that a salt rinse may be a lightweight and practical replacement for mouthwash. Apparently, it temporarily increases the pH of the mouth. Many bacteria prefer a more acidic environment to survive, so raising the pH, particular in the harder-to-reach spots between/below teeth, will curb the populations of harmful bacteria. Perhaps not as effectively as mouthwash. I guess a more pronounced increase in pH could be achieved with baking soda.

When it comes to oral bacteria, the body does not works as effectively on its own as it does with some help — people have much better oral health in current times than in bygone eras before the advent of modern dental care. Though I agree with James’ point that bad breath is usually a sign of some other underlying problem, but I’m just talking about day-to-day maintenance.

Lester, good point about the Waterpik. I’ve never had one but I’ve heard it’s more effective by far than flossing. Of course, it’s not feasible for trail or travel, but I have come across a cap for a bottle that has an angled, pointed spout. Used with a squeezable bottle/bag like those that many of us carry about, it might offer a good substitute, if one could squeeze with enough pressure to make it worthwhile. Might make a right mess of things, though. haha

Not a dentist.

I eat bars during the day. (and chips, and party mix, etc.)  They are loaded into my hipbelt pockets.

And a toothbrush is in there permanently.  So I eat, brush, and then swish water throughout the day.

My mouth is better cared for on the trail than at home.

YMMV

I was a dentist in my first career.  Let me go thru the list based on science.  First thing to understand is that plaque is the enemy. It causes periodontal disease and when combined with sugar, causes tooth decay from acid production.  The best way to get rid of plaque is brush and floss, flossing being more important.  The sugar can be most any kind and the bacteria in the plaque that turn sugar into acid are not partial to glucose, sucrose, high fructose, natural, organic, fruits, etc. No plaque, almost no dental and oral pathology. Smoking is another really, really bad thing for oral health for about 20 reasons. Chewing tobacco is only one “really” bad on that scale.  I hope that does not apply to anyone here, especially on the trail.

The best hygiene is floss and a brush. Electric toothbrushes are in improvement, but not enough to warrant taking it on the trail. Toothpaste is not required on a week or two trip.  It does little to remove plaque.  Topical fluoride helps over a long haul, not worth the weight for a short trip. Chlorhexidine (Peridex) mouthwash is about the only mouthwash worth anything.  Alcohols are linked to oral cancer, eg. Scope types. Salt is an old remedy that is probably just a feel good therapy.  Easy on the trail, however. Charcoal, essential oils, pine nuts, Vit C might feel good and are probably ok to use in low doses, but offer little science based therapeutic advantage. With saliva as a very good chemical buffer, trying to change the mouth pH to the point of inhibiting bacteria proliferation is about impossible. Water piks are pretty useless. They remove large food particles, but not the important plaque. That requires more mechanical pressure than a water pik can deliver.  Reducing the time exposure of sugar in your mouth lessens the time of low pH and reduces decay. In other words, assuming the same amount of sugar, eating a sugar cube is far less harmful than sucking on a sucker or hard candy over a longer time period. So, eat sugar quickly and less often during the day. Swishing water after sugar intake can be helpful in speeding the removal of sugar from the saliva and decreasing time of exposure of the sugar to the bacteria. I spend a week every year on the trail with old dentist buddies. We never talk about it, but we all do the same.  No mouthwash. Nothing fancy.  Floss twice a day and brush twice a day without toothpaste.  Done.  If I was stranded on a deserted island and had one thing to choose for oral hygiene, I would take floss and no tobacco.

Thanks for the detailed and actionable info, Arthur.

Arthur, Thanks You! I would also point out that many tooth-pastes are actually an abrasive compound, some sort of soap/detergent and a flavour.

Good point James. The hygienist or dentist will use pumice to clean teeth but only a couple of times per year.  Good for stain removal and removing fine calculus from teeth after it has been mechanically scraped if off.  Using abrasives every day is a good way to erode enamel and even worse, any softer exposed root surfaces.  BTW, calculus is not a college math course here!  It is the hard, calcium buildup created when plaque is not removed regularly. That is tied into periodontal disease, another whole issue that is mostly prevented again, by floss.

good info Arthur and others

baking soda wold neutralize acid, maybe use that as toothpaste or gargle

how often should you go to dentist – 1 year, 6 months, 4 months?  Especially if you have periodontal disease?  Are there controlled studies on various tooth procedures, like do people keep their teeth longer if they go to dentist more often?.

My dentist said to use waterpik.  I have noticed dislodged food particles but wondered if that made much difference to plaque…

Jerry, Baking soda will neutralize acid generally in the mouth for a very short time. With the buffering ability of saliva, it is probably not effective after a few minutes.  The other issue is that the acid production by bacteria using sugars as well as the toxins produced by the bacteria that cause periodontal disease is very localized in the nooks and crannies of the teeth and deep in the normal pockets around the teeth. Baking soda is hard to get there and would only last a short time.  The body’s saliva does a better job.  Probably getting dehydrated and walking around with little saliva is more harmful that the benefit of baking soda.  No science in that last statement, only my off handed theory.

Water piks cannot generate enough pressure to adequately remove plaque and cannot get to places that floss can.  Better than nothing, but not by much.

There are million studies out there on variables of keeping your teeth.  I am out of the research stuff for years, so I cannot rank these accurately, but here are the major ones.   Systemic fluoride growing up is close to number one.  Cities like Portland, Tucson, San Jose and others are a dentist’s annuity.  Don’t smoke or use tobacco.  Avoid refined sugars over long periods. Eat or drink your sugar fast if you have to consume it.  Floss properly and brush every day preferably 2x per day.  Adding topical Fluoride in a toothpaste is very good, but farther down the line.  Notice I haven’t said go to the dentist yet. Wear a mouth guard if involved in even minor contact sports if you like your front teeth.

Personally, I go to the dentist every 6 months. I did not grow up with Fluoride, unfortunately. Not in the lucky sperm club either.  I get bitewing x-rays every year.  Minimal radiation / benefit ratio is very good.  Where does the dentist fit in?  Kind of like getting a physical.  if you are part of the lucky sperm club, you can live to be 100 and never see a doctor.  But, if you have high blood pressure, genetic hyperlipidemia, etc, etc, and don’t know or treat it, well……..     Periodontal disease and tooth decay usually cause symptoms very late in the disease course. Be sure to have the dentist teach you how to floss properly with you showing them how you do it to be sure you have the correct technique.

I feel like I am moderating a “call the dentist” show!!  Glad to hopefully give back to this forum that has been to valuable to me.  Thanks

Arthur, thank you for taking the time to type all of that out. Lots of really good info. Sounds like I am already roughly on the right track (I had heard that more than one flossing per day may actually damage gums?), and that a salt or baking soda mouthwash will not be very useful. Nor a Waterpik, let alone some kind of improvised one. I had never thought about the effect of hydration on oral bacteria, via the natural effectiveness of saliva at controlling them, but what you have pointed out makes a lot of sense.

I do still find that my teeth/mouth feel(s) less thoroughly clean, and clean for a shorter time, when I omit either mouthwash or the electric toothbrush. Which is what prompted my enquiry in the first place. Interestingly, toothpaste doesn’t seem to matter as much in this regard — something you alluded to.

I have also heard or read somewhere that the pH of the mouth is lower after a meal, softening the enamel for around half an hour after eating, so that it’s generally advisable to avoid brushing immediately after eating. I usually try to follow this rule (as well as not eating for half an an hour after brushing, since doing so reduces the effect of the toothpaste). Is this worth bothering about, really? Sometimes it’s a little inconvenient to consider the timing.

Anyways, thanks again, great to get some real, professional advice!

This seems to be a bit off topic from backpacking light! but I will keep going.

The pH in the mouth as a whole changes very little anytime. Otherwise the mucosa would get angry and inflamed because it is not designed for that.    The pH changes drastically in the little pits and fissures of the teeth as well as in the pockets around the teeth and between the teeth within seconds of sugar exposure.  those places are hard for the saliva to reach in enough volume to neutralize the acids and toxins.  If you want perfect timing, it would a few minutes after you eat to allow all the bacterial nutrition to be depleted from the mouth so there is little new growth of bacteria until the next meal.  Then, brush and floss, right before you eat to get rid of plaque that produces the acid.   Theory, not real practical.

So, I brush and floss after breakfast and before bed.  I am not the most nutritious eater and I snack. (BOO).  I have perfect periodontal health but still suffer from the ravages of occasional cavities because of lack of Fluoride as a kid. My teeth were already formed by the time it came to my community.

Sorry, not sure how I missed your reply! Thank you very much for all the good info (I didn’t really understand your fifth sentence, though). You’re right, I guess I was straying a bit away from BPL topics with that last question. I think the previous information you gave does help all of us who are interested in doing so to refine what to include for oral hygiene when going UL. Thanks again

As I mentioned the “Geezer Post”, I often cary a plastic flask of 150 proof Lamb’s Navy Rum.

1. rinse mouth
2. swallow
3. wipe tears from eyes
4. do not attempt to speak for one minute

Arthur,

Thank you for taking the time to share your wisdom….love this community and love learning from the wealth of collective knowledge shared here.

Tony

I take this little 1/4 oz squeeze bottle of a product called “fresh breath plus” made by dr schultz. Website is herb doc. It is concentrated essential oils. At night I put 5 drops on my tongue, add a little water and swish for a minute or so, after brushing and flossing of course. It tastes great and makes my mouth feel super. Not sure if it’s therapeutic but makes for great breath. Cheers!

Very informative thread. Thank you all for this helpful info.

Floss is really ultralight. About 12-15 years back the hygienist at our dental practice casually asked my wife how many days per week she flossed and  obviously not  satisfied with the  answer very frankly observed that on the days she didn’t floss she might as well forego brushing as well. That got our attention! I  confirmed with several dentist friends the same basic information provided by Arthur; though I’m betting Arthur wouldn’t suggest we skip brushing. 1 carry floss, one of those really light brushes they handout at the front desk of the hotel when you’ve forgotten yours which I now do regularly 😉 and one of those little brush/pick thingies. It’s a  really light kit.

Ok, for you ultra-ultra-ultra light folks.  I tie a ~6 inch piece of floss into a circle.  Much easier to use. Try it.   And, rinse it off and reuse it!  Gross, but as long as you do not share it, no different that reusing your toothbrush. Take a second circle for backup.  Next, take a toothbrush and cut the bristles half way down.  Combined, probably saves a half a gram or two.  Third, have all your teeth removed, saving 100 grams and the need for floss or a brush. Most of that freeze dried “food” requires no teeth anyway. (Not kidding on the first concept)

I often take my electric toothbrush (54g won’t kill me) – principally as it encourages me to brush my teeth more than manually (so lazy!).