Over the past ten years I have repeatedly had problems with caries and inflamed gums. My dentists always gave general advise on dental care and filled carious lesions with a steady hand. I became very good at following the recommended hygiene procedures, yet the problems persisted. Though my issues are not particularly serious and in no way uncommon to our times, I decided that if I wanted long-term improvements to my dental health, I would need to understand the contributing factors for myself.

I am making this website to share a summary of my research and conclusions.

Some basic information about oral health as a question of ecology

1. Your mouth is home to a wide range of microorganisms.
2. The name for your mouth as an environment and all of the microorganisms inside of it is microbiome.
3. Everbody has a slightly different microbiome. Your microbiome depends on your physical features, your personal history and your lifestyle habits.
4. Some microorganisms are advantageous or harmless to your dental health, while others can cause disease -- we call the latter pathogenic.
5. Your microbiome is relatively stable as long as the environmental factors are stable.
6. When an imbalance arises in your mouth and pathogenic microorganisms become widespread, they can damage your teeth and oral tissues.
7. Ill oral health is therefore first and foremost an ecological problem.
8. Because your teeth do not shed cells from their surface, microorganisms can attach to them and build tiny communities called biofilm or dental plaque.
9. Caries happens when microbial metabolism creates an acidic environment in which the protective layer of your teeth dissolves.
10. The prime suspect in caries is a sugar-loving bacteria named Streptococcus mutans.

Some basic information about acid, erosion and caries

1. The protective mineral layer around your teeth, the enamel, can be demineralized, i.e. damaged, by acid.
2. When externally introduced acids eat away at large surface areas of enamel, this is erosion. Possible reasons may be acid reflux or overly generous consumption of acidic beverages such as wine or citrus fruit juice.
3. When acid is produced within the dental plaque on a tooth's surface, this localised damage is called caries.
4. After consumption of sugar, or fermentable carbohydrates more generally, the acidity within plaque is known to increase sharply. It will be brought back down over around a thirty minute time window as saliva does its job. This time window of acidity is when caries lesions progress.

Some basic ideas for maintaining oral health

1. Consume little sugar to avoid making your mouth an attractive feeding ground for S. mutans.
2. Eat at only a few occasions each day, ideally three or less, to avoid repeated feeding.
3. The role of starches is not completely understood, but it seems that certain kinds of starches can cause similar problems as sugar. This is mostly because of two factors: they can stick to your teeth and they can be broken down into sugar. As a rule of thumb, anything that is particularly bad for diabetics is likely also bad for your oral health.
4. Your saliva is your body's most important tool for keeping your mouth healthy. After eating you want plenty of non-acidic saliva around your teeth.
5. By brushing your teeth you can mechanically remove a huge amount of microorganisms, including those that are likely to cause problems.
6. Brushing your teeth is the most consistently advised measure against damage to teeth and gums. Most cultures today advice to brush two or three times a day.
7. The best time to brush your teeth is before having a meal. Your goal is to remove microorganisms, not leftover food. If you brush after eating, you will cause two problems:

   • You will feed more microorganisms, who will rapidly metabolise the nutrients in your mouth.
   • You will brush your freshly softened teeth and contribute to demineralization.

   The problem with this advice is that it is based on theory, there seem to be no great studies confirming it empirically.
8. It is helpful to end your meal with food that leaves your mouth in a good state. Many kinds of cheese help increase saliva flow, provide calcium for remineralization and help create a slightly alkaline environment.
9. It is still a good idea to remove leftover food from your mouth. Rinsing your mouth with water is a good idea, as is the use of sugar-free chewing gum.
10. The dangers of our modern diets can be counterbalanced by fluoride. Most toothpaste today contains fluoride, which is used to rebuild your teeth's enamel layer.