Beyond the Dental Essentials: Enhancing Your Hygiene Routine

You don’t need more than the essentials for a healthy dental routine

Last week we talked about the importance of the dental hygiene essentials: brushing and flossing. You truly don’t need more than this for a healthy smile! However, there may be auxiliary dental care products and practices that you want to incorporate in your routine. In looking beyond the two essentials, we will explore things like mouthwash, oil pulling, and tongue scraping along with various types of whitening treatments.

Mouthwash: does it really help bad breath?

I never liked using mouthwash. As a kid it always seemed like a “cool” thing to have. It felt like this extra special step that adults had in their dental hygiene routine. As I grew older I would occasionally incorporate mouthwash because it seemed like I was supposed to, but I never liked it much.

Bacteria in the mouth causes bad breath. As we learned in the dental essentials post from last week, bacteria is removed only by mechanical actions like brushing and flossing. Mouthwashes typically contain alcohol as an ingredient (acetaldehyde or ethyl alcohol) which dries out your mouth. The saliva naturally present in your mouth helps to keep your mouth bacteria in balance. When your mouth becomes dry it allows the bacteria to get out of balance. Typically in this scenario it’s more bad bacteria growing, which causes worse-smelling breath. While mouthwash is typically marketed as a product to freshen your breath, the ingredients may cause it to do the opposite.

Mouthwash can also contain other ingredients like artificial colors, parabens, PEGs, etc. Since you’re spitting out mouthwash these are less of a concern, but there can still be residuals that linger around. If you really love using mouthwash and are looking for a cleaner option, I’d look into Lumineux. A study was done on thirty people with severe halitosis, the technical name for bad breath. The study group used Lumineux’s mouthwash for 2 weeks. The study found a 50-60% reduction in halitosis at the end of the 2 weeks. Lumineux’s ingredients do not include any alcohol to avoid the issues mentioned above and don’t include any ingredients of concern from my perspective. While the study completed wasn’t the most robust, it still indicates a likely improvement overall.

Oil pulling: can it really whiten your teeth?

Oil pulling originated a long time ago as part of an ancient Ayurveda practice. Ayurveda is a holistic and natural medicinal philosophy developed approximately 3000-5000 years ago in India. Recently some aspects of Ayurveda have resurfaced in Western cultures, one instance being oil pulling. The first time I heard of oil pulling, I had understood it was primarily a natural method used for teeth whitening. Obviously since the practice originated so many years ago, whitening was not the original intent!

Oil pulling is believed to be beneficial to oral health, and thus overall well-being. This is particularly true if you use coconut oil for oil pulling. Coconut oil is anti-inflammatory, so it can reduce gum inflammation and can help prevent bacteria growth. Some short-term studies have even found a reduction in the plaque known to cause gingivitis after consistent oil pulling. While it is not a great whitening method, it is believed to be able to remove some stains from the teeth.

If you want to try oil pulling, you can use coconut or sesame oil, per the ancient tradition. Put about one tablespoon in your mouth and swish it around for up to 20 minutes. If this is your first time oil pulling, it might be easier to start with a shorter timeframe and work your way up. Also, make sure to spit the used oil in the trash can. Coconut oil specifically is a solid at room temperature, and it can clog pipes once it hardens.

I have tried oil pulling a handful of times with coconut oil, but never consistently enough to see if it was beneficial. The feeling of swishing around oil was really strange to me, and I could never do it more than a few minutes!

Tongue scraping: do you need a special tongue scraper?

I think as kids we were all taught to brush our tongues when we were brushing our teeth. How many of us actually did it though? I rarely did because it seemed weird… Well, just like bacteria can build up on the teeth, the same types of bacteria will also build up on the tongue. This means bacteria buildup on your tongue can also contribute to tooth decay and other diseases. Removing all of this buildup should also help conquer bad breath as well!

Do you need to buy a special tongue scraper to get rid of tongue bacteria? No! You can of course brush your tongue with your toothbrush to help with removing the buildup, just as we were told as kids. If having an “official” tongue scraper will help make sure you clean your tongue, maybe it’s worth it for you. If you want a tongue scraper, I would recommend getting a stainless steel option. This way you can clean and reuse it rather than using single-use plastic tongue scrapers.

Teeth whitening: does it only have an aesthetic purpose?

I know I wish my teeth were whiter! Whiter teeth can have a direct impact on how confident we feel when we smile. The primary desire for whiter teeth is purely aesthetic. However, depending on the type of whitening agent you use, it could have negative effects on your teeth which is why it’s important to discuss here.

Your tooth structure contains the outer enamel which is primarily made up of hydroxyapatite, and the internal structure called dentin which is made up of hydroxyapatite among other tissues. The dentin is the living part of your tooth that ages, just like anything else in your body. When dentin ages, it turns yellow. The enamel is essentially translucent and reflects the color of the dentin. However, the enamel surface can also get stained. This is primarily from food and drink like coffee, tea, berries, wine, or any food/drink with a strong pigment. Whitening treatments that target changing the color of the enamel or dentin are intrinsic whitening methods. Treatments that target removing stains from the outer surface of the enamel are extrinsic whitening methods. We can also look at preventative methods to help keep your teeth white.

The easiest teeth whitening method… prevent yellowing!

There are a few different preventative methods. One is to protect your teeth from damage, which will prevent premature aging of the dentin. Remember, dentin turns yellow as it ages. Some activities that can cause premature aging are grinding your teeth at night or from impact when playing sports. It’s important to protect against these factors to prevent yellowing. Taking care of your overall health by eating nutrient dense foods and avoiding tobacco will also prevent premature aging. Taking good care of your oral health by scheduling regular cleanings at the dentist, as well as brushing and flossing on your own, will help prevent premature aging as well.

Some of the yellow color on your teeth is likely from foods and beverages that have stained your tooth enamel. Avoiding consuming some of these foods and beverages that cause tooth stains will prevent the need for whitening treatments. Foods and beverages known to cause staining are red wine, berries, black tea, turmeric, balsamic vinegar, coffee, or anything with a strong pigment.

Intrinsic whitening methods

Common intrinsic methods for teeth whitening include using hydroxyapatite toothpaste, custom whitening trays, and peroxide-based whitening strips. Hydroxyapatite toothpaste can be considered an intrinsic whitening method because the structure of hydroxyapatite allows it to penetrate your tooth. Hydroxyapatite can help rebuild and strengthen your enamel to prevent aging and thus prevent yellowing.

Custom whitening trays and whitening strips are similar as they both rely on peroxide. Custom trays must be fitted by your dentist then applied at home with a purchased whitening gel. Whitening strips can be bought at any pharmacy store to be applied at home. Peroxide has been demonstrated to be effective at whitening teeth intrinsically, but there are concerns to be aware of. Using whitening treatments with a high percentage of peroxide in the formulation, or using peroxide treatments frequently, can lead to significant tooth sensitivity. Additionally, gum and tissue exposure to peroxide can be damaging. A trusted holistic dentist, Ask the Dentist, recommends not to use more than a 10% peroxide concentration. He also recommends no more than once a year treatments for custom peroxide trays and no more than once every 3-5 years for whitening strips. Custom trays protect the gums from being exposed to peroxide whereas there is no protection with whitening strips.

Extrinsic whitening methods

Common extrinsic methods for teeth whitening include using abrasive whitening toothpastes, electric toothbrushes, and non-peroxide whitening strips. When using an abrasive whitening toothpaste, it’s important to consider how hard the abrasive is. It can be difficult to balance finding an abrasive strong enough to remove staining without damaging the teeth. Some common softer abrasives in whitening toothpastes are activated charcoal, sodium bicarbonate, and calcium carbonate. Medium abrasives are calcium pyrophosphate, hydroxyapatite, and hydrated silicas. Hard abrasives are alumina and perlite. Since your tooth enamel is primarily hydroxyapatite, it is best to avoid abrasives harder than this as there is significant risk of damaging your enamel.

We’ve already talked about electric toothbrushes in our dental essentials post from last week. In addition to the other benefits we discussed, they are more effective at removing staining, particularly those with oscillating heads. Whitening toothpastes in combination with electric toothbrushes are effective at changing the shade of the tooth. Since this is stain removal (extrinsic) only it is less effective than peroxide-based whitening strips.

The last extrinsic method is whitening strips that are not peroxide based, like Lumineux. Lumineux uses dead sea salt and essential oils to remove surface stains. Results from one study that compared Lumineux strips to a standard peroxide strip to a placebo strip indicate that there was no significant difference in whitening effect between the Lumineux and peroxide strips over the 14 day study. Additionally, more participants reported tooth or tissue sensitivity when using the peroxide based strips. Another finding was that teeth were significantly more lustrous after using the Lumineux strips as compared to the peroxide strips.

My dental hygiene routine

In all transparency, I could do a better job taking care of my oral health. My current essentials that I never skip are brushing my teeth twice a day with my electric toothbrush (with an oscillating head to prevent gum damage) and using my nano-hydroxyapatite toothpaste bits from BITE. I also prioritize regular dentist visits twice per year. I use my WaterPik every day before brushing my teeth at night, but use BITE’s compostable floss approximately once to five times per week, depending on the week. Since I am not very good at remembering to clean my tongue while brushing, I may look into buying a stainless steel tongue scraper soon. And lastly, it has been on my list for a while now to try Lumineux’s whitening strips! Let me know if you are going to change up your dental hygiene routine based on what you learned in the comments below.

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