As people get older (the 50's & 60's and beyond), cancer treatments, artificial joints, diabetes, or a lifetime of tobacco or alcohol use can all affect oral health.

Good mouth-care habits, a decent diet, fluoride, and regular professional preventive dental care can save you from unnecessary pain, inconvenience, permanently altered teeth, and save you thousands of dollars. Would you like to know how to have a strong and healthy smile for life, no dental insurance needed? Read on!

1. Brush teeth well with a fluoride toothpaste after every meal, snack, and sugary drink. Get all 3 sides: tongue-side, cheek-side, and the biting surface. Brush all the way down to the gums. Get back teeth and front teeth under the lips. Brush the tongue. ALWAYS BRUSH BEFORE SLEEPING-and have only water to drink after the last brushing of the day. Can’t brush that often? There are some other options: a) Chew a sugar-free gum, ideally one sweetened with Xylitol, a natural decay-fighting sweetener. b) At least rinse with water to neutralize acids and rinse out food. c) “Grazing” = lots of little snacks. That means your teeth are bathed in acid constantly throughout the day (There are 20 minutes of acid production by your oral bacteria every time you put carbohydrates in your mouth). Cutting back on the number of times per day you have food/sugary drinks in your mouth can save your smile!
2. Floss between any teeth that touch one time per day, ideally before bed. Brushing is mainly for your teeth; flossing is for your gums. Healthy gums don’t bleed. Smell your floss after you use it: do you really want to leave that stuff in your mouth to smell like that? Do you want to kiss a mouth that has that stuff in it? Think about it...By the way, cavities and gum disease are caused by a bacterial infection: if you’re exchanging saliva with a mouth that has decay/gum problems, you’re putting yourself at risk for “catching” that person’s dental problems. Ask your dentist for specific prevention tips if you have an infected partner. Also, gum disease/dental bone loss runs in families (problems usually start to crop up in a person’s mid-30’s). Know your family’s dental history and whether you are at an increased risk for dental problems as you get older. Hard to floss? Try Reach Access flosser (on an easy-to-handle toothbrush-style handle) Won’t floss? Try FlossSticks, BrushPicks, or toothpicks to get in-between teeth. Get a Hydrofloss or Waterpik oral irrigator and flush out the gunk (bacteria, food, inflammatory mediators, you know: gunk!) with water.
3. Xylitol - Chew xylitol gum, use xylitol in toothpaste/mouthrinse/mints, or as a sweetener. Selecting a xylitol product: Xylitol should be listed as the primary sweetener (listed first on the label). 100% xylitol-sweetened, chewable or suckable products are the best. Crystalline xylitol can be sprinkled on cereal, mixed with drinking water, used in salad dressings, or cooking/baking. Xylitol = less plaque, less acid, and less decay-causing bacteria. Xylitol is particularly effective when used with fluoride. Chewing gum 5 times (3 minimum) per day has been shown in studies to significantly reduce bacterial colonization of the mouth. For maximum benefit, use any combination of xylitol products 5 times per day.
4. Fluoride - makes enamel/teeth more resistant to acid attack. Use a toothpaste with fluoride for extra protection, and use a mouth rinse with fluoride like ACT. Xylitol prevents bacteria from making acid that eats away tooth enamel, and fluoride protects the enamel from any small amount of acid that does get produced. Prescription strength fluoride toothpastes and rinses are available for patients at high risk of decay.
5. Drink water - not juice, soda, coffee with sugar, or Gatorade-type power drinks. It’s all liquid sugar. If you must, drink diet or use a sugar substitute. In addition to xylitol, Stevia is a great natural sweetener available at health food stores (liquid or powder) that is great in tea/coffee and doesn’t promote tooth decay.
6. Simple Carbohydrates= SUGAR! A lot of “natural” things have sugar too. Glucose, fructose, corn syrup, cane sugar, honey, and maple syrup are all types of sugars. The more often you eat and drink, the longer the teeth are sitting in bacterial acid and getting dissolved. Coke, coffee with sugar, and yes, beer: they’re all carbs!! Watch out! Many common medicines contain sugar: cough drops, cough medicines, vitamins, and TUMS, for example. Remember to brush with fluoride or xylitol toothpaste after using. Look for a sugar-free version, e.g. N’ICE cough drops are sugar-free. Avoid frequent use of Altoids and other sugar-containing mints. If you have a breath problem, see your dentist now! Sweets are treats: enjoy them in moderation and brush afterwards. Living on candy bars and ice cream will take a toll not only on your teeth, but also on your body. Sooner or later, you will pay the price: tooth decay, overweight, Type II diabetes, heart and artery problems.
7. Don’t use tobacco in any form. Dip/chew rots your teeth (it has sugar!!); cigarettes rot your mouth, throat, and lungs. Both habits are killers. Get help now to plan a good “quit date,” a goal to reach.
8. Wear your mouth guard for sports - a professionally made guard fits well, works better than a stock guard, and is easy to breathe and speak with. But wear something! Elbow and head contact can cause a lot of damage; concussions (due to trauma to the chin/falls) can actually be prevented or lessened by mouth guard use. Also think about using a mouth guard for soccer, Ultimate Frisbee, mountain biking, horseback riding, and ice skating in addition to the obvious football, ice hockey, basketball, field hockey, and lacrosse.
9. As you get older, things can change. Check in regularly with your dentist and let her know if you have:
   

   a) Dry mouth—(often due to high blood pressure and anti-anxiety/anti-depression medications, or other medical conditions) puts you at risk for cavities; fluorides and calcium/phosphate pastes and rinses can help.
   b) Recession of the gums—(“long in the tooth”) means a higher risk of cavities on the softer, more vulnerable root surfaces; a possible sign of gum disease.
   c) Red or white spots in the mouth that don’t heal within two weeks, or that bleed. Oral cancer can be deadly and must be caught early. “Dippers”—check the inside of your lip/cheek where you hold the dip (the sugar in the dip helps make cavities, too.) Smoking and chewing tobacco are risk factors; adding alcohol greatly increases the risk. HPV (human papilloma virus), linked to cervical cancer, is also linked to a rise in oral cancers in young, non-smoking women in their 30’s and 40’s. The HPV incidence is rising and many men and women don’t even know they are infected. Mouth tissues are very similar to cervical tissues, and the sexually transmitted disease can be passed to a partner during oral sex as well as sexual intercourse. Ask your dentist to do an oral cancer exam at your maintenance visits.
   d) Clenching or grinding, headaches—possible misfit of the upper and lower teeth can wear or break teeth. Many people don’t realize that a bad bite can cause wear and damage to their teeth, as well as jaw pain and headaches.
   e) Heavy snoring—possible sleep apnea, increased risk of strokes.
   f) Pain when biting—possible cracked tooth or filling.
   g) Bleeding gums—possible gum disease.
   h) Sensitivity to cold air or hot liquids—could be recession of the gums or possible nerve damage
   i) Diabetes—increases your risk of gum disease
   j) If you use tobacco (smoked or smokeless) and alcohol—increases oral cancer risk, dries the mouth and increases cavity risk.
   k) Avoid altoids, mints, hard candies, and beware of chewable vitamins with sugar—use a sugar-free alternative, limit usage, and/or brush afterwards.
   l) Avoid sipping sugar-filled liquids for long periods at your desk or driving on a regular basis—doing so increases your cavity risk.

10. Go for a professional cleaning and check-up (with x-rays as needed) AT LEAST once a year. This will cost you less than $200 per year, and you don’t need insurance. Even when money is tight, make checkups and maintenance a priority. Budget for it and pay out of pocket, just like buying gas, paying for car insurance, changing the oil, getting a tune-up, and rotating the tires on your car. Nothing is more expensive or uncomfortable than waiting until it hurts (like a blown-out tire). If you only go to the dentist for emergencies or problems, you’re cheating yourself of good health. Teeth are made to last for a lifetime, with good care, diet, and professional maintenance. Also: Did you know that your saliva can be tested to find out if you are at greater risk of getting new cavities? Request a CariScreen from your dentist.

Bonus tip! Need dental care supplies or advice that you can't get at your local pharmacy or supermarket?

• Go to Toothpix Store in Thorne’s Marketplace in Northampton: www.toothpixstore.com or 413-587-0359, and ask owner Evelyn for her knowledgeable assistance.
• You can also go to www.strongandhealthysmiles.com and look under “Patient Education” or the “Smile Link Newsletter” for more preventive and treatment information.
• Like to read/have a fun and informative reference book? The 199 page book I Hate Dentists! The Feel-Good Guide to Going to the Dentist by Dr. Mac Lee, Joleen Jackson & Vicki Aydette is available at our office for $25, or at 800-746-5486, www.ihatedentists.com, or www.amazon.com.
• Information on xylitol is available at www.xylitol.com, and products with xylitol including toothpaste, rinse, gum, and mints are available at www.sprydental.com.
• If you don’t like mint flavors or are looking for alternative toothpastes, check out www.tomsofmaine.com or www.tannerstastypaste.com.