Brushing Off Gingivitis? - Ask Dr. Weil

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Gingivitis is an early stage of gum disease, an infection of the tissues that surround and support the teeth. The cause is plaque, a sticky film of bacteria that forms on teeth and creates an environment that can damage gums. The bacteria also form acids from starchy foods, which can lead to tooth decay.

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Studies suggest that some 30 percent of the population is genetically susceptible to gum disease, and stress may also be a factor. Certain drugs, including birth control pills, anti-depressants, and some heart medicines may increase your risk as well.

With gingivitis, gums become red, swollen and tender and bleed easily. Fortunately, with proper care, you can reverse the disease process and prevent further damage both to the gums and, more importantly, to the bones that support your teeth. Here's how:

If you smoke, quit. Smoking is one of the most significant risks in the development and progression of gum diseases and can lower the chances of successful treatment. Smoking interferes with healing by restricting blood flow, making smokers less likely to respond to treatment and more likely to lose teeth.

Take 100 mg of coenzyme Q10 daily. I also suggest taking a calcium supplement daily (500 to 700 mg divided into two or three doses) and a multivitamin/mineral supplement that contains antioxidant vitamins C, E and the mineral selenium.

Be sure to brush your teeth twice a day and floss once a day. I recommend using a natural toothpaste containing myrrh (a natural antibacterial) or chlorine dioxide. I also suggest making a paste of baking soda and hydrogen peroxide and massaging it into your gums once a day. Leave it on for a few minutes, and then rinse your mouth with water.

Be sure to get a dental check up every six months, and ask your dentist if you should consult a periodontist, a specialist in gum diseases.

Andrew Weil, M.D.

Can Bad Teeth Kill You? - Ask Dr. Weil

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Unfortunately, it is. A recent study published in the Journal of Endodontics showed that deaths from dental infections are not as unusual as they once were, and that in recent years an increasing number of Americans have ended up in the hospital with serious dental infections that could have been prevented. It isn't known whether these patients sought care at hospitals rather than dental clinics because they couldn't afford care or whether they had dental treatment that led to complications. Other recent reports revealed that dental problems comprise hundreds of thousands of visits to emergency rooms every year.

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The most common infections that turn up in emergency departments are what are known as periapical abscesses, which affect the tip of a tooth's root due to untreated decay. These can be effectively prevented with root canal procedures in the dentist's office, but once they set in they can progress rapidly. The study, which covered the years from 2000 through 2008, found that a total of 61,439 hospitalizations were primarily due to these abscesses, which can cause facial swelling and breathing problems. These cases increased by more than 40 percent, from 5,757 in 2000 to 8,141 in 2008. During these eight years, a total of 66 patients died in the hospital as a result.

The number of people who come to hospitals (as opposed to being admitted) with dental problems, including abscesses, is shockingly high, according to a 2012 report from the Pew Charitable Trusts. It estimated that preventable dental conditions were the primary reason for 830,590 emergency room visits in 2009 alone — a 16 percent increase from 2006.

According to the Pew report, these hospital visits stem from the problems disadvantaged people have getting preventive care from dentists and other providers. "In 2009, 56 percent of Medicaid-enrolled children did not receive dental care - not even a routine exam. The access problem is driven by multiple factors, including a shortage of dentists in many areas of the U.S. and the fact that many dentists do not accept Medicaid-enrolled children," the report found.

"The fact that so many Americans go to hospitals for dental care shows the delivery system is failing," says Shelly Gehshan, director of the Pew Children's Dental Campaign. "The care provided in an ER is much more expensive, and it generally doesn't solve dental problems. Most hospital ERs are not staffed with dentists and the medical personnel who work there are not trained to treat the underlying problems of patients with untreated dental issues."

Overall, this is a pretty sad situation that our society should be addressing but, so far, is not.

Andrew Weil, M.D.

A Threat From the Zinc in Denture Adhesive? - Ask Dr. Weil

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Yes, I am aware of this problem. Concerns about zinc in denture adhesives surfaced in 2008 with publication of a study in the journal Neurology by researchers at Texas Southwestern Medical School. They reported on four patients who were found to have abnormally high zinc levels in their blood; all told their doctors that they had been using very large amounts of denture cream, the adhesive that holds dentures in place. The products that were implicated were Fixodent, from Procter & Gamble, and three types of Poligrip from GlaxoSmithKline. All contained small amounts of zinc.

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The Texas study was widely reported and featured on the ABC news program 20/20 along with patients who suffered severe neurological damage as a result of using excessive amounts of denture adhesive. After this study was published, a physician at Vanderbilt University determined that 11 patients who had low copper levels and had developed crippling disabilities were also using too much denture adhesive. Reportedly, one death has been linked to overuse of these products.

Some of these patients reported that their problems began with numbness and tingling in their fingers and toes and eventually progressed to crippling nerve damage. Some ended up in wheelchairs or now need canes to walk. A number of similarly affected patients have since come forward and joined a class action suit against Procter & Gamble. (GlaxoSmithKlein has settled cases brought against it and announced in early 2010 that it would no longer distribute the three Poligrip products. It introduced reformulated zinc-free products  in the spring of 2010.)

We all need some zinc for good health, but when you get too much, you can deplete your copper stores, as the two minerals compete for absorption into the body. Small amounts of copper are essential for normal growth and health. Along with iron, copper is required for the formation of red blood cells; it also influences the functioning of the heart and arteries, helps prevent bone defects such as osteoporosis and osteoarthritis, and promotes development of healthy connective tissue. And, as in the cases of the excessive use of denture adhesives, when high zinc levels interfere with copper absorption, serious and irreversible neurological problems can develop.

The denture wearers who got into trouble were those whose dentures didn't fit properly. To keep them in place, these individuals used much more than the recommended amounts of denture adhesives, some going through a tube that should last six to eight weeks in just two days. Anyone doing this could be at risk for neurological damage. Fixodent remains on the market, but Procter & Gamble has added a warning label cautioning consumers to use the product only as directed and that excessive and prolonged use is associated with serious health problems.

Andrew Weil, M.D.

Gingival Overgrowth: Gums Growing Over Teeth? - Ask Dr. Weil

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The condition you describe is called gingival overgrowth or gingival hypertrophy. It usually is a reaction to pharmaceuticals, especially those drugs used to treat high blood pressure and prevent seizures. The immunosuppressant cyclosporine can also cause it. When drugs are the cause, the gum overgrowth is usually noticeable about a month after starting the medication.

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The advancing gums are usually red and inflamed, and the condition is often painful and disfiguring, as the gums tend to bleed and teeth may loosen. Chewing, eating, and speaking can become difficult, and patients have an increased risk of oral infections and gum disease.

I discussed your question with Sanford Newmark, M.D. , head of the Pediatric Integrative Neurodevelopmental Clinic at the Osher Center for Integrative Medicine at the University of California, San Francisco. He told me that the hormonal changes of puberty can also lead to gingival overgrowth, which he said is probably the cause in your daughte's case, if she is not on medication, given her age.

While the condition is likely to reverse itself once she is past puberty, Dr. Newmark suggests that you take your daughter to see a dentist, preferably a holistic or integrative one, because good dental hygiene can make a big difference.

Dr. Newmark also notes that severe vitamin C deficiency (scurvy) can be the cause of gingival overgrowth, but that is very rare in the United States today and unlikely to be your daughter's problem.

When a drug reaction is the cause of gingival overgrowth, getting off the drug responsible may halt its progress, but won’t necessarily reverse it, particularly if it has been going on for a long time. Antibiotics and antifungal medications may help, and a study published in the April 2011 issue of Neurology suggests that folic acid supplementation may lessen overgrowth caused by the antiseizure drug phenytoin (Dilantin).??? Treatment still involves good dental hygiene and possibly dental surgery.

Andrew Weil, M.D.

Best Cure for Bad Breath? - Ask Dr. Weil

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The most efficient way to eliminate bad breath is to find the cause and deal with that directly. Typically, bad breath stems from bacteria growing on food that accumulates between the teeth, on the tongue and around the gums. The obvious solution is brushing your teeth twice a day, flossing between your teeth daily and brushing your tongue as well as your teeth with your toothbrush or gum scraper, a special metal or plastic instrument you use once or twice a day. Mouthwashes may help, but often don't penetrate into the crevices of the tongue.

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Persistent bad breath (or a bad taste in the mouth) can be a warning sign of gum disease. A dental checkup can spot early signs of this problem, and your dentist can recommend treatment.

Insufficient secretion of saliva as a result of salivary gland problems, breathing through the mouth or taking one or more of a number of medications that make the mouth dry can also cause bad breath. The drugs that can be responsible include decongestants, diuretics and other blood pressure medications, antidepressants, antihistamines, muscle relaxants, drugs for urinary incontinence and drugs used to treat Parkinson's disease . If you take any of these regularly, ask your doctor or pharmacist to suggest an alternative.

Bad breath can also be a sign of thrush, postnasal drip, chronic bronchitis, a respiratory tract infection, diabetes, a gastrointestinal problem or liver or kidney disease. Before investigating these possible causes, see your dentist to determine whether or not your breath problem originates in your mouth.

Acidophilus is a general name for dried or liquid live cultures of lactobacillus bacteria that sour milk. They are considered "friendly" organisms in the intestinal tract. I've seen claims that these products can reduce bad breath, but I know of no scientific research to back this up. Similar products, such as Flora Balance, are unlikely to help either. Like acidophilus, they affect the colon and large intestine in the lower end of the digestive tract, while problems that cause bad breath are typically higher up (sinus problems, gum disease, oral cavity, tonsils, decaying food particles, infected teeth). Occasionally, bacterial overgrowth of the small intestine can result in bad breath. If no other cause can be found, a test for methane in the breath can determine if bacterial overgrowth is your problem.

Andrew Weil, M.D.

Are Dental Implants Safe? - Ask Dr. Weil

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Dental implants are an alternative to dentures for the replacement of missing teeth. The implant itself is usually made of titanium and is embedded in the jawbone in a surgical procedure. It will serve as the "root" or anchor for your new, replacement tooth. Ultimately, after the implant has been integrated with the bone - this can take up to six months - a tooth made to match your natural teeth is attached. The advantage of an implant over dentures is that it gives you a solid new tooth that doesn’t shift or move around as you eat or talk, as improperly fitting dentures can. The whole process can take as long as nine months and is not risk-free. You can develop an infection at the implant site, and there’s the possibility of nerve damage that can lead to pain and numbness. Other risks include injury to other teeth, to blood vessels, or to sinuses if the implant impinges on them.

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I discussed your question with my (holistic) dentist, Steven Swidler, who agrees with me that the bigger problem with dental implants is not infection or immunity but the issue of having something foreign implanted in the body. He said that bacteria and viruses tend to target implants, setting up colonies around them, and that the immune system can’t fight as efficiently in that setting as it can elsewhere in the body.

If I were replacing a missing tooth, I probably would choose a bridge rather than an implant, a recommendation shared by Dr. Swidler. We also agree that it is not better to leave a gap where the lost tooth was. First of all, when a tooth is missing, the jaw closes differently than it does when you have a full set of teeth. The remaining teeth begin to drift toward the gap, posing problems for them, your jaw joint and for your bite. This can affect the way you chew and beyond that, may limit the foods you are able to eat comfortably. Gaps also can trap food, which can lead to tooth decay and gum disease. Worse, when a tooth is missing, the supporting bone in the jaw begins to dissolve, a process called resorption.

There are cosmetic considerations, as well - when teeth are missing, you begin to look older, the shape of your face may change and you may not smile as broadly (because you don’t want to showcase the gap). This affects your confidence and self-esteem as well as your physical health. Whatever type of tooth replacement you choose, you’ll likely be in worse shape if you decide to do nothing.

Andrew Weil, M.D.

Rethinking Fluoride? - Dr. Weil

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No, I have not changed my views about fluoride. Its addition to most public water supplies is credited with a 40 to 60 percent reduction in tooth decay in children and adults. Fluoride not only helps prevent tooth decay and cavities, it promotes strong teeth and enamel.

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I have always maintained, however, that fluoride isn't risk-free. Excessive amounts can create chalky white, irregular patches on the surface of teeth, causing the enamel to appear mottled. In very large amounts, fluoride is toxic. It can cause gastrointestinal problems and, rarely, death. Signs of fluoride overdose include excessive salivation, tremors, weakness, convulsion and a soapy or salty taste in the mouth. While high amounts of fluoride over several years can cause brittle bones, this is extremely rare.

As far as bone cancer is concerned, every year about 400 children and adolescents (boys and girls) in the U.S. are diagnosed with osteosarcoma, a rare disease. In 2006, Harvard researchers reported an association between fluoride in drinking water and the incidence of osteosarcoma in boys (not girls). A preliminary analysis of a second set of cases doesn't appear to support the earlier observed connection between fluoride in drinking water and osteosarcoma in young boys, according to the U.S. Centers for Disease Control and Prevention.

Furthermore, the CDC concluded that analysis and reviews of earlier studies of water fluoridation and osteosarcoma don't support an association between the two. This case isn't closed - more research is in progress, but so far, we have no hard evidence demonstrating that fluoride causes or promotes bone cancer.

As far as dogs are concerned, a study by the Environmental Working Group (EWG), a Washington, D.C.-based consumer protection organization, found that eight major national brands of dog and puppy food contained fluoride in amounts between 1.6 and 2.5 times higher than the Environmental Protection Agency's maximum legal dose in drinking water and higher than amounts associated with bone cancer in young boys in the study mentioned above. All eight brands contained bone meal and animal byproducts, which is probably where the fluoride came from.

According to the EWG data, some 8,000 dogs in the United States are diagnosed with osteosarcoma each year compared to only 900 human cases (500 adult cases in addition to the 400 children). However, we simply don't know whether the fluoride in dog food or drinking water accounts for the osteosarcoma some animals develop. If you're concerned about any potential risk to your pets, avoid buying dog food containing animal byproducts. Regardless of the osteosarcoma risk, I strongly recommend this for the health of your pets in general. When choosing food for my own dogs I stay away from anything containing animal byproducts, rendered or recycled meats, poultry or fats. Avoid animal based "meals" (for example, "chicken meal") and look for quality meat or fish protein as first ingredients.

Andrew Weil, M.D.

Are Dental Sealants Safe? - Dr. Weil

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Most decay in the teeth of children and teens occurs in the grooves of the back-teeth chewing surfaces. Dental sealants are coatings of a thin plastic applied to these grooves to protect these teeth from decay. The sealants prevent food particles and bacteria from burrowing into grooves where they're hard to remove with brushing. Sealants are usually applied to first molars, which come in when kids are about six, and second molars, which appear at about age 12. The idea is to apply them as soon as possible after teeth erupt before decay can set in.

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Application of the sealants is quick and painless. After the target tooth is cleaned, a gel is applied to the chewing surface and then washed and dried a few seconds later. Then the dentist paints the sealant on the tooth. It hardens in about a minute.

Typically, sealants last five to 10 years, but they should be checked at every dental appointment to make sure they're still in place. Having sealants doesn't mean kids get a pass on brushing and flossing their teeth, but they may get fewer cavities and, therefore, need fewer fillings.

I'm not an expert in this field so I checked with my own (holistic) dentist, Steve Swidler, for his views on sealants. He's not a fan. He worries that undetected decay sealed into teeth can continue to move silently, so that eventually there will be deep decay or, worse, a dead tooth that will have to be extracted. Instead of sealants, Dr. Swidler recommends small, conservative fillings when decay is identified.

You should also be aware that BPA (bisphenol A), a chemical used in plastics and associated with some health and developmental problems in humans and animals, has been studied as a potential issue with dental sealants. According to research from the American Dental Association, BPA is rarely used in dental products. However, some composite resins used in dental materials might contain tiny amounts of BPA, and trace amounts of BPA used in the production of other ingredients used in dental composites and sealants could find their way into sealants. Considering the very small amounts of BPA involved, the ADA found no basis for a health concern.

Agreeing to the use of sealants on a child's teeth is a parental judgment call. You have to weigh the very real risk of cavities (by far the most common disease among young children and teens) against the potential risks of sealants. Discussing the pros and cons with your dentist could help you with your decision.

Andrew Weil, M.D.

Are Root Canals Risky? - Dr. Weil

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Root canal is a procedure in which dentists remove diseased or injured pulp that runs from a tooth's interior down its root. Pulp contains blood vessels and nerves and provides nutrients to the tooth. Infection in pulp can progress to an extremely painful abscess. In the past, a tooth with a diseased root had to be extracted, but dentists can now remove the pulp, seal off the cavity (root canal) to protect it and save the tooth.

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The idea that root canals pose a risk to general health comes from research suggesting that bacteria and viruses left behind at the tip of the root canal might persist and multiply in the space around the tooth. Other research cited by holistic dentists (including my own dentist, Steve Swidler) focuses on people with chronic health concerns. These dentists think that root canal procedures may raise disease risks.

As for the idea that root canal is associated with breast cancer and other serious conditions, Dr. Swidler subscribes to the theory that every tooth is in a different body meridian and is related to different organs, bones and joints. This doesn't mean that root canal on a tooth in the same meridian as a breast can cause cancer. But Dr. Swidler says that if he had a patient with breast cancer and an infected first or second molar on the same circuit as the affected breast, he would urge her to have the tooth removed.

To sum up, Dr. Swidler and other holistic dentists who subscribe to these theories believe that losing a tooth is sometimes better for your health than having a root canal. Mainstream dentists and the American Dental Association do not share those views and maintain that the procedure is safe. That's my personal belief, as well. Given a choice between losing a tooth or having root canal surgery, I would opt for a root canal.

Andrew Weil, M.D.

Fear of Dental Fillings? - Dr. Weil

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You're not alone. Dental anxiety and dental phobia are very common. Some estimates suggest that almost half of the U.S. population has some degree of dental anxiety (defined as fears that lead to avoiding regular dental visits) while dental phobia (anxiety so severe that sufferers never go to the dentist) affects 9 to 15 percent of the population.

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My first recommendation is to schedule a consultation with a hypnotherapist who specializes in phobias, so I discussed your question with Steven Gurgevich, Ph.D., clinical assistant professor of medicine at the Arizona Center for Integrative Medicine and an expert in clinical hypnosis. Dr. Gurgevich notes that all fears - including fear of the dentist - are learned behaviors, and that anything learned can be unlearned and replaced with something else. By learning to relax, you can desensitize yourself to your dental fears, Dr. Gurgevich said. He suggested trying these methods to get comfortable about going to the dentist:

Talk to the dentist about your anxiety before scheduling an appointment to have your teeth checked. The American Dental Association (ADA) recommends the same thing and explains that getting your fears out in the open allows your dentist to adapt treatment to your needs; the ADA also suggests scheduling your appointment for a day when you're less likely to be rushed and under pressure, perhaps a Saturday morning.

Read one of the many self-help books on anxiety and phobia for a start in the right direction. Dr. Gurgevich suggests Hope and Help for Your Nerves by Dr. Claire Weekes, and Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors, And Dentists by Martin M. Antony and Mark A. Watling.

List all the positive benefits of seeing the dentist to begin shifting your attention from avoidance to motivation.

See a counselor, psychologist or social worker who is skilled in techniques such as "systematic desensitization" and other methods for overcoming anxiety.

Learn and practice relaxation techniques: self-hypnosis, meditation, visualization, or progressive body/muscle relaxation are good options.

Dr. Gurgevich said that he recommends medical or clinical hypnosis for dental phobia because it easy to learn, rapid, and once learned can be used in other stressful situations. To find a qualified practitioner in your area visit the American Society of Clinical Hypnosis at www.asch.net . You could also try Dr. Gurgevich's audio program "Relieve Anxiety with Medical Hypnosis. "

Andrew Weil, M.D.

Guided Tissue Regeneration to Save Teeth? - Dr. Weil

http://www.drweil.com/drw/u/QAA400548/Guided-Tissue-Regeneration-to-Save-Teeth.html

Guided tissue regeneration, also known as guided bone regeneration, is a dental procedure used to prevent loss of teeth by strengthening the bone that supports them. Weakening of that bone is the outcome of a long process that begins with formation of dental plaque, the colorless, sticky substance that is a mixture of bacteria, mucus, and minerals from food and saliva. If you don’t brush and floss regularly, plaque hardens into tartar that can’t be removed by brushing your teeth and favors the growth of bacteria that cause gum disease or gingivitis.

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Gum disease begins as inflammation and swelling of the gums. You can reverse this with good dental hygiene and professional care, but untreated gingivitis can progress to periodontitis, inflammation of tissues around the teeth, with recession of gums leaving pockets that harbor bacteria. The immune system tries to fight the infection, but this inflammatory process can damage both soft tissue and bone that support the teeth.

Guided tissue regeneration is a surgical technique to replace damaged or destroyed tissue and bone. A small piece of mesh made of fabric is inserted between the damaged bone and gum to prevent the gum from growing into the area where bone should be. This encourages regrowth of bone and healthy connective tissue. (It is an alternative to an older procedure in which dentists lift back gums to remove tartar deposits from deep pockets and then suture them back in place.)

I checked with my own (holistic) dentist Steven A. Swidler, DDS about these procedures. He is very familiar with them, although he doesn’t perform either one himself. He recommended getting a second opinion from a periodontist, a dental specialist who diagnoses and treats gum diseases before consenting to such an invasive treatment.

If you’re considering guided bone or tissue regeneration, be sure to ask the dentist about his or her experience with the procedure and rates of success among patients.

Andrew Weil, M.D.

Medicate With Mastic Gum? - Dr. Weil

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Mastic is a sticky substance exuded from the branches and trunk of the mastic tree (Pistaccia lentiscus var. chia ), which grows in the eastern Mediterranean and North Africa. The sweetest-smelling variety comes primarily from trees on the Greek island of Chios. Mastic gum has been chewed for at thousands of years to soothe upset stomachs, ease gastritis, and freshen the breath.

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I discussed your question with Tieraona Low Dog, M.D., an internationally recognized expert in the fields of integrative medicine, dietary supplements and women's health and an authority on botanical medicine . She told me that researchers have found that mastic gum kills many of the oral bacteria that cause bad breath and promote cavities, which is why it's included in a variety of toothpastes and mouthwashes. Some evidence also suggests that it can help reduce inflammation in the gastrointestinal tract. For this reason, you'll often find mastic gum in supplements for heartburn, usually in combination with deglycyrrhizinated licorice (DGL), a natural remedy I often recommend for stomach irritation.

Dr. Low Dog also told me that doctors use a liquid adhesive called Mastisol that contains mastic gum to help keep bandages in place. In addition, you can find this natural product in a number of topical ointments and salves for minor wounds and scrapes. Some evidence suggests that the essential oil in the gum is responsible for its antibacterial activity.

The most recent scientific findings on mastic gum come from a study performed in Greece showing reduced total cholesterol and LDL ("bad" cholesterol) and an improvement of total cholesterol/HDL ratio among volunteers over the age of 50 who took five grams of mastic powder per day. The same study showed improvement in levels of some proteins involved in cholesterol transport. While checking its safety, the researchers noted mastic induced a reduction in certain liver enzymes and concluded that the Chios mastic powder used in their study could have protective effects on the heart and liver. The study was published in the April 20, 2007 issue of the Journal of Ethnopharmacology.

Andrew Weil, M.D.

Mouthful of Mercury? - Dr. Weil

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Mercury amalgam fillings have been around for more than 150 years and have been generating controversy from the start. The material is inexpensive, versatile, durable, and easy to work with. But over the years, repeated concerns have been raised that toxic mercury vapor escaping from fillings poses all kinds of health problems.

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In June 2008, the FDA settled a lawsuit with some consumer groups by agreeing to warn the public about the potential health risks posed by mercury from amalgam fillings, even though no new evidence has emerged linking the amalgam fillings to health problems. While there is no question that mercury vapor is toxic, its release from amalgam fillings is very slow, and I'm not aware of any studies here or abroad showing that it presents a health risk. Most release occurs when fillings are put in, making it more hazardous for the dentists who work with amalgam regularly than for the patients whose teeth are being filled. The only documented problems that have been traced to the fillings are rare, local side effects or allergic reactions.

In a notice posted on its Web site, the FDA said that the mercury in dental amalgams "may have neurotoxic effects on the nervous systems of developing children and fetuses" and that pregnant women and anyone else who may have a health condition that "makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden" should discuss the choice of filling materials with their dentists.

The groups that filed the suit argued that the mercury in the fillings can lead to such health problems as multiple sclerosis and Alzheimer's disease. I have seen no evidence to support those claims. One of the FDA panel members was quoted as saying that while there is a "theoretical reason" to suspect harm from the fillings, there is no evidence of actual harm. The use of amalgam fillings has been on the wane in recent years in favor of tooth-colored resin composites (which don't last as long as amalgam fillings but are getting better).

The FDA did not recommend that consumers replace amalgam fillings to cut down on the potential risk they may pose. Given the lack of evidence that the amalgams cause health problems, I wouldn't worry about fillings you already have. When they break down, you can replace them with non-mercury-containing material. But make sure the dentist who removes them takes precautions to protect you from inhaling mercury vapor during the process.

Andrew Weil, M.D.

Help For Halitosis? - D. Weil

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The usual cause of bad breath is bacteria growing on food that accumulates between the teeth, on the tongue and around the gums. The obvious solution is brushing your teeth twice a day, flossing between your teeth daily and brushing your tongue as well as your teeth. You can do this with a toothbrush or gum scraper, a special metal or plastic instrument you use once or twice a day. I wouldn't put much faith in mouthwashes like Scope or Listerine to eliminate bad breath. While they may help, they often don't penetrate into the crevices of the tongue. That's why I prefer brushing or scraping the tongue directly. It may seem uncomfortable at first, but you will quickly get used to it.

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Switching toothpastes might also help to resolve a bad breath problem. Try one containing chlorine dioxide or look in your local health-food or herb store for products containing tea-tree oil, a powerful disinfectant that smells a bit like eucalyptus.

To deal with temporary bad breath stemming from eating garlic, onions or other pungent foods, try chewing a bit of parsley or some fennel seeds . Brushing, flossing and mouthwashes don't eliminate this kind of odor but can mask it until your body eliminates the food that is responsible. Avoid regular use of breath freshening mints containing the artificial sweetener aspartame, which tastes peculiar and has been linked with headaches in some people.

Persistent bad breath (or a bad taste in the mouth) can be a warning sign of gum disease. Here, the bacteria that make up plaque create toxins that irritate the gums, so that they become inflamed and may bleed. If you have regular dental checkups, your dentist should spot early signs of this problem and recommend treatment (often from a periodontist).

Another potential cause of bad breath is dry mouth due to insufficient secretion of saliva as a result of salivary gland problems, breathing through the mouth or taking one or more of a number of medications that make the mouth dry. These include decongestants, diuretics and other blood pressure medications, antidepressants, antihistamines, muscle relaxants, drugs for urinary incontinence, and drugs used to treat Parkinson's disease . If you take any such drugs regularly, ask your doctor or pharmacist to suggest an alternative.

Bad breath can also be a sign of thrush, postnasal drip, chronic bronchitis, a respiratory tract infection, diabetes, a gastrointestinal problem or liver or kidney disease. Before investigating these possible causes, see your dentist to determine whether or not your breath problem originates in your mouth. If not, see your physician to investigate further.

Andrew Weil, M.D.

Dealing With Dry Mouth?

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Dry mouth or "xerostomia" is due to insufficient secretion of saliva. This happens to everyone occasionally; you're most likely to notice dry mouth if you're nervous or under stress. But dry mouth that is more long lasting is most likely to be a drug side effect. Hundreds of drugs, illicit, prescription and over-the-counter, can cause dry mouth. The commercial ones usually responsible are decongestants, diuretics and other blood pressure medications, antidepressants, antihistamines, muscle relaxants, drugs for urinary incontinence, and those used to treat Parkinson's disease . If you take one of these or any other drug regularly, ask your doctor or pharmacist to suggest an alternative that doesn't cause dry mouth.

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Dry mouth can also be a symptom of an autoimmune disease such as rheumatoid arthritis or Sjogren's syndrome or related to conditions like diabetes and Parkinson's disease, and it is a common and unpleasant side effect of radiation therapy to the head and neck. If you are having trouble chewing, that, too, can lead to dry mouth. Dry mouth is more than just an uncomfortable annoyance; it can lead to serious dental problems. Saliva helps prevent tooth decay by washing food and plaque off of your teeth. It also limits the growth of bacteria that can damage tooth enamel and cause gum disease. Your dentist or physician may recommend medication to stimulate the flow of saliva if your problem doesn't resolve. Here are some other suggestions that may help:

Sip water frequently during the day, and keep a glass of water at your bedside at night. Adding a little lemon juice can help stimulate saliva flow.

Avoid both salty and sugary foods.

Avoid alcohol (and mouthwashes containing alcohol), caffeine and tobacco. All can dry the mouth.

Suck on sugar-free hard candy or chew sugarless gum to improve your saliva flow. (the sweetener Xylitol helps reduce cavities, but avoid lemon-flavored hard candy - it turns saliva acidic, which increases the risk of tooth decay.)

Use a humidifier at home.

Try commercial saliva substitutes - available at drugstores - to help keep your mouth moist.

While you're dealing with dry mouth, make an extra effort to keep your teeth and gums in good shape: Be sure to brush twice a day and floss daily to prevent plaque build-up, and have your teeth and gums checked regularly.

Andrew Weil, M.D.

Tea-Stained Teeth?

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Like coffee and colas, tea can stain teeth, although it's not as big an offender as tobacco (smoked or chewed). Any food or drink capable of staining clothes or carpets can also stain teeth - that includes fruit juices, red wine, blueberries, soy sauce, and curry. Good quality green tea that is really green in color is less likely to stain teeth than inferior grades of "green" tea that looks brown when brewed. The best way to get rid of stains from any food or drink is with professional teeth cleaning, but afterward, it's up to you to keep your teeth free of stains from foods and beverages.

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I suggest rinsing your mouth with water after you drink tea (or coffee or colas). Be sure to brush your teeth twice a day with a whitening toothpaste and to floss daily (stains around the edges of your teeth occur when plaque accumulates at the gum line and absorbs color from food and drink).

You also may want to talk to your dentist about teeth whitening options. Do-it-yourself kits are available for home use and can do a pretty good job. You're most likely to get the best results if your teeth are yellowish. Whitening won't "take" on teeth that have had bonding or tooth colored fillings. The home-bleaching kits are generally considered safe, although you may notice some tooth sensitivity. My (holistic) dentist Steve Swidler tells me that over time bleaching might break down the integrity of the teeth, leaving them more susceptible to future stains.

As an alternative to home whitening, your dentist can bleach your teeth in the office with professional products, sometimes augmented with laser light. This is more costly than the do-it-yourself route, but it usually can be completed in a two to six sessions. These treatments can also create tooth sensitivity, but it usually decreases over time.

Andrew Weil, M.D.

Keeping Your Toothbrush Clean?

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Your mouth harbors millions of germs, and when you brush your teeth, the toothbrush can become contaminated with bacteria, saliva, oral debris and blood (if your gums bleed). You should rinse your toothbrush thoroughly with water after brushing, but that might not remove everything. Still, using mouthwash or disinfectant solutions really isn't necessary. It could end up exposing you to more, not less, toothbrush contamination, particularly if you reuse the solution. And you can damage your toothbrush if you try to disinfect it with heat in the microwave or dishwasher.

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Frankly, I wouldn't worry about toothbrush contamination. I've seen no research suggesting that brushing with a potentially contaminated toothbrush leads to infections of the mouth or any other adverse effects on health. Just rinse the brush carefully after use and let it dry in an upright position. If you keep your brush in the same holder as others in your family, make sure the brushes don't touch each other. And don't share toothbrushes. Keep your toothbrush in a location away from the toilet and never store your toothbrush in a closed container - bacteria are more likely to multiply in a warm, humid, closed environment.

According to the American Dental Association, it's best to replace your toothbrush every three to four months, even sooner if you notice that it looks worn. If the bristles are splayed or bent out of shape, the brush won't work as well as it should.

Incidentally, the plain, old-fashioned toothbrush works as well for cleaning your teeth (if you brush regularly) as the power toothbrushes that are now so popular. Ultrasound toothbrushes with timers can help with plaque build up, but their main advantage is that you keep brushing as long as the head vibrates, which is probably longer than you would use a standard toothbrush. Brush twice a day, be sure to floss once a day and see your dentist for regular check-ups and professional cleaning.

Andrew Weil, M.D.

Is It Wise to Remove Wisdom Teeth?

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Removing wisdom teeth (the third molars) has long been considered appropriate dental treatment, whether or not the teeth are causing trouble. However, a recent review of the subject in The Cochrane Database of Systematic Reviews, Issue 2, 2005, a publication of an international organization that reviews and evaluates medical research, concluded that no reliable scientific studies support the common practice of routinely removing impacted wisdom teeth, those that don't fully emerge from the gums because there's not enough room in the jaw or because the tooth isn't angled properly. The only studies the researchers unearthed were two involving just over 200 adolescents, which looked at the question of whether removing wisdom teeth prevents crowding in the lower jaw within five years. Neither showed a significant benefit. The lack of studies on this subject was attributed to the fact that it's difficult and expensive to monitor dental patients over the 10 to 20 years it would take to assess the benefits and risks of leaving impacted wisdom teeth in place. Another obstacle: the practice of routinely removing wisdom teeth means that few adults who have retained the teeth are available for a study.

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There's no doubt that impacted wisdom teeth should be removed if they do cause trouble -  pain, inflammation or infection of the gums, gum and bone disease, damage to adjacent teeth and the development of cysts and tumors. This is typically done between the ages of 17 to 21 because at that age the wisdom tooth roots may not be fully formed, are softer and easier to remove, and because young people heal more quickly.

The report concluded that in the absence of strong evidence suggesting that it is better to remove impacted wisdom teeth, even though no symptoms are present, the routine practice of taking them out can't be justified. Instead, the Dutch researcher who headed the study concluded that patients who are untroubled by impacted wisdom teeth should opt out of surgery.

Andrew Weil, M.D.

A Funny-Looking Tongue?

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Geographic tongue (also known as benign migratory glossitis) is a condition in which the tongue has a map-like appearance due to irregular smooth patches that have lost the tiny, finger-like projections that characterize the surface of a normal tongue. The patches may be red, can change location from day to day and, in some cases, can be sore. Although it can be uncomfortable, geographic tongue is not a serious disorder. Some people worry that it is a sign of oral cancer. It definitely is not.

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Unfortunately, we don't know the cause of this problem. In some cases, it may be due to an allergy, and it seems to occur more often in people with psoriasis -  in one study, 10 percent of psoriasis patients were affected compared to about 2.5 percent of people without psoriasis. Some cases seem to be triggered by irritation from hot or spicy foods, alcohol, or tobacco, and some may occur in response to stress. There is no specific treatment for geographic tongue. It tends to go away on its own, usually within a month, but may come back periodically. Different areas of the tongue may be affected at different times.

I wouldn't worry about your daughter's geographic tongue. Chances are it will disappear as her nutritional status improves or, if it is stress related, as she becomes more settled and comfortable in her new surroundings. Conventional treatment, if necessary, is topical prednisone, but I would first try DGL powder, a much less toxic licorice derivative.

Andrew Weil, M.D.

Metallic Taste in Your Mouth? - Ask Dr. Weil

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A metallic taste in the mouth is a common complaint and can be due to a variety of causes - from medication you may be taking to dental problems. In the absence of other symptoms, it is unlikely that a metallic taste in your mouth indicates serious disease. But if you haven't had a thorough general checkup recently, I would suggest seeing your doctor to rule out any undiagnosed health problems.

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You might also want to visit your dentist, because the taste might be a symptom of gum disease. Even if you don't have gum problems, poor oral hygiene can affect taste. Be sure to brush your teeth carefully at least twice a day and use a tongue scraper to remove the bacteria and debris that can collect on your tongue. Dental work done in the past can break down and alter taste, so your dentist will probably look at that as well.

In addition, not drinking enough water can contribute to problems with taste. Increase your intake and see if it helps. While you don't have to drink the standard recommendation of eight 8-ounce glasses of water a day, my rule of thumb is to drink as much of that amount as you comfortably can and more than you think you need.

Among the drugs that can cause a metallic taste in your mouth are antibiotics like Biaxin (clarithromycin) and Flagyl (metronidazole), used to treat a wide variety of infections; drugs used to treat an overactive thyroid; captopril, used to treat high blood pressure; griseofulvin, used to treat skin infections; lithium, used in bipolar disorder; penicillamine, used for rheumatoid arthritis, kidney stones , and too much copper in the body; plus some drugs used in cancer treatment.

If you rule out all of these possible causes and still have the taste, it might be worthwhile to consult with a practitioner of Chinese medicine. That system might have an answer for you.

Andrew Weil, M.D.

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Bleeding Gums?

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Bleeding from the mouth could be caused by anything from gum disease to a coagulation problem. My first suggestion would be that your husband see a periodontist (a dentist who specializes in the treatment of gum diseases) to check on the condition of his gums.

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Bleeding from the gums is usually due to inflammation related to the accumulation of plaque at the gum line, a condition known as gingivitis. Plaque hardens into tartar and can lead to periodontitis, an advanced form of gum disease, which causes even worse bleeding. Periodontal disease constitutes a major stress on the immune system, using up resources that would be better suited for fighting more serious infections, scavenging waste products or defending the body against cancer. In addition, open sores in the gums provide an access point for blood-borne infections to gain entry into the circulatory system.

With gingivitis, the gums tend to be soft, swollen and red-purple, signs of inflammation. Treatment is a thorough teeth-cleaning and removal of the tartar deposits by a dentist or dental hygienist. Afterward, you have to follow up with regular brushing and flossing and visit your dentist at least twice a year. Periodontitis is treated the same way, but may also require dental surgery to remove pockets of plaque that develop between the gums and teeth. These are inflamed and can become infected. Long-term inflammation can destroy surrounding tissues and bone.

In addition to gum disease or a coagulation problem, bleeding from the mouth may be due to a blood thinning medications, such as Coumadin, or a deficiency of vitamin C or K. If your husband gets a clean bill of dental health, his next step should be a general physical checkup that includes a complete blood count. In addition to anticoagulants, medications that can cause bleeding from the gums include certain antidepressants, antihistamines and some drugs used to treat high blood pressure.

Andrew Weil, M.D.

Does Poor Dental Health Determine Overall Health?

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I do ask patients about any problems that they may have with their teeth or gums, and dental health is one of the keys to good health, but I don't believe that it is the key. There is evidence that some dental problems may impact general health, most importantly the risk of heart disease and stroke. One of the first studies linking the two was published online in the journal Stroke on July 31, 2003. It showed that the more teeth a person has lost, the more likely he or she is to have both advanced periodontal infections and potentially clogging plaques in the carotid arteries that supply the brain.

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Conceivably, oral health may contribute to heart disease through the inflammatory process, and perhaps because of inadequate nutritional intake. If you don't have teeth, you can't chew food well and may not get adequate amounts of heart-healthy nutrients and fiber. Research suggests that people with poor oral health should have cardiac exams even if they have no symptoms of heart disease.

There is also preliminary evidence that gum disease poses an increased risk of having a preterm, low birth-weight baby and makes it more difficult for diabetics to control their blood sugar levels. All of these connections remain to be confirmed.

In general, low-grade, persistent infections in the oral cavity and elsewhere drain immune strength and weaken health. Teeth and gums are not separate from the rest of the body, and dentistry should not be so separate from general medicine. Taking care of your teeth and gums is vital. Be sure to brush and floss daily and see your dentist regularly so that any problems can be detected and corrected.

Andrew Weil, M.D.

Is It Safe to Whiten Your Smile?

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Tooth whitening is becoming more and more popular, particularly with the availability of the bleaching kits for do-it-yourself, at-home treatment. But before investing in one of them, I suggest checking with your dentist to find out whether whitening is appropriate for you. According to the American Dental Association, you're likely to get the best results if your teeth are yellowish. Bleaching doesn't work as well on teeth that have a naturally brown or grey hue. Tooth whitening (whether you do it yourself or have it done by your dentist) can brighten teeth stained as a result of drinking coffee, tea, soda or red wine as well as teeth darkened as a result of aging and those stained as a result of smoking cigarettes and chewing tobacco. However, if you have had bonding or have tooth-colored fillings in your front teeth, the whitening won't  "take" on those materials, which will contrast with your other, newly whitened teeth.

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At-home bleaching solutions use carbamide peroxide as the bleaching agent. While this is generally considered safe, you may notice some tooth sensitivity while using it. My (holistic) dentist, Steve Swidler, tells me that over time bleaching might break down the integrity of the teeth, leaving them porous and more susceptible to future stains.

Another concern: there's a chance that the bleach could travel through a deep cavity to a tooth's root and set off a toothache or trigger an infection. Bleaching could also result in some soft-tissue shrinkage among people with periodontal disease. Beyond that, we don't yet have long-term safety data on these products.

As far as the chlorine in water is concerned, it isn't relevant. The low levels of chlorine in drinking water are there to kill germs and have nothing to do with the color of our teeth.

Andrew Weil, M.D.

Losing Your wisdom Teeth? - Ask Dr. Weil

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Wisdom teeth are the last of your teeth to emerge, usually between the ages of 17 and 21. These teeth often become impacted either because there's not enough room for them to erupt or because they are improperly positioned in the jaw. Impacted wisdom teeth can be painful and can become a breeding place for germs. There is also the possibility that a cyst or tumor can form near an impacted tooth and destroy surrounding bone and tooth roots. If you have an impacted wisdom tooth that is painful, the sooner you have it pulled, the better. However, if you have no pain, consider getting a second opinion about whether an impacted wisdom tooth should be extracted.

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Your dentist probably will use a local anesthetic for the procedure, which can take up to a half an hour, depending on how the tooth is positioned. It is much less traumatic to have upper wisdom teeth extracted than lower ones.

You'll probably be told not to eat anything for six hours before the surgery. In addition, I suggest increasing your dosage of vitamin C on the morning of the surgery, which will help in the healing and repair of damaged tissues. I usually recommend 500 mg twice daily for three or four days following the surgery. When you go to the dentist, take a dose of homeopathic arnica 30X dilution (place four to five tablets under your tongue) and repeat this dosage again every hour after the extraction for first four hours and then every two hours to reduce bruising. The next day, take the arnica every four hours. You can discontinue this after the second day.

After the extraction, I also recommend taking bromelain, an enzyme extracted from the fruit of the pineapple plant, to help reduce any swelling. Take 200-400 mg three times a day on an empty stomach (at least 90 minutes before or three hours after eating). To reduce stress that can contribute to pain and slow your recovery, consider mind/body approaches such as progressive muscle relaxation, guided imagery, and self-hypnosis.

Andrew Weil, M.D.

White Tea for Healthy Teeth?

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White tea, imported mostly from the Fujian Province of China, is the least processed form of tea -  to make it, leaves are simply picked and air-dried. Perhaps for that reason, white tea does have even greater antioxidant activity than green tea, which is produced by picking, heating (steaming or pan firing), and drying the leaves. To make black tea, another step, oxidation, is required. White tea comes from the same plant as black and green tea, Camellia sinensis , and has a delicate taste and pale color. It releases the least amount of caffeine of all three teas, typically from five to 15 milligrams per cup.

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I haven't seen any evidence that white tea protects oral health any better than other types of tea, but studies at the University of Illinois College of Dentistry have shown that compounds in black tea can destroy or suppress growth and acid production of cavity-causing bacteria in dental plaque. Black tea also affects an enzyme responsible for converting sugars into the sticky material that plaque uses to adhere to teeth. Furthermore, upon exposure to black tea, the Illinois researchers learned that certain plaque bacteria lose their ability to adhere to others, thereby reducing the total amount of dental plaque that forms on teeth. They also found that rinsing with black tea for 30 seconds, five times in a row (in three-minute intervals), stops plaque bacteria from growing and producing the acid that breaks down teeth and causes cavities, although it might stain your teeth if you do this frequently (white tea is much less likely to cause this problem.) In addition, tea contains fluoride, which may further explain why it helps protect teeth.

Even if white tea works better than black tea to promote oral health, it would be a pretty costly mouthwash. Although widely available in the United States now, it can be more expensive than other types of tea. You can order white tea online from many sources, including one of my favorites, In Pursuit of Tea (www.inpursuitoftea.com).

Andrew Weil, M.D.

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Brushing Off Gingivitis?

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Gingivitis is an early stage of gum disease, an infection of the tissues that surround and support the teeth. The cause is plaque, a sticky film of bacteria that forms on teeth and creates toxins that can damage gums. The bacteria also form acids from starchy foods, which can lead to tooth decay.

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With gingivitis, gums become red and swollen and bleed easily. Fortunately, with proper care, you can reverse the disease process and prevent further damage both to the gums and, more importantly, to the bones that support your teeth. Here's how:

If you smoke, quit. A study published in the May, 2000, issue of the Journal of Periodontology found that smokers are four times more likely than people who never smoked to have advanced gum disease. Smoking interferes with healing by restricting blood flow, making smokers less likely to respond to treatment and more likely to lose teeth.

Take 100 mg. of coenzyme Q10 (60 mg. of the soft-gel variety) as well as my antioxidant formula daily. I also suggest taking a calcium supplement daily (500-700 mg divided into two or three doses).

Be sure to brush your teeth twice a day and floss once a day. I recommend using a natural toothpaste containing myrrh (a natural antibacterial) or chlorine dioxide. I also suggest making a paste of baking soda and hydrogen peroxide and massaging it into your gums once a day. Leave it on for a few minutes, and then rinse your mouth with water.

Be sure to get a dental check up every six months, and ask your dentist if you should consult a periodontist.

Andrew Weil, M.D.

Mercury in Your Mouth?

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Mercury amalgam fillings have been around for more than 150 years and have been generating controversy from the start. The amalgam is inexpensive, versatile, durable, and easy for dentists to work with. But over the years, repeated concerns have been raised that toxic mercury vapor escaping from fillings poses all kinds of health problems.

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There is no question that mercury vapor is toxic, but its release from amalgam fillings is slow, and studies here and abroad have found no evidence to show that it amounts to a public health risk. Most release occurs when fillings are put in, making it more hazardous for the dentists who work with amalgam regularly. The only documented problems that have been traced to the fillings are rare, local side effects or allergic reactions.

In 1993, the U.S. Public Health Service (USPHS) published a report on the safety and use of dental amalgam and other materials commonly used to fill cavities that found no evidence of harm - but also failed to show that the material is entirely safe. Since then, USPHS scientists have analyzed some 175 peer-reviewed studies submitted in support of citizens' petitions received by the FDA. The scientists concluded that none of the studies supported claims that people with dental amalgam restorations will experience problems that include nerve, kidney, or developmental effects (other than rare allergic or hypersensitivity reactions).

Although health authorities continue to study this issue, the FDA reports that the use of dental amalgams in the United States is declining. Pediatric dentists are now using mercury-free, resin (plastic), tooth-colored materials that are bonded to teeth. Sadly, these do not last as long as amalgam. And amalgam remains the best material available for large cavities in rear teeth and cavities below the gum line.

Given the lack of evidence supporting claims that dental amalgams cause health problems, I wouldn't worry about any fillings you may have. When they break down, you can replace them with non-mercury-containing material. But make sure the dentist who removes them takes precautions to protect you from inhaling mercury vapor during the process.

Andrew Weil, M.D.

Is Fluoride Safe for Kids?

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The only children who need fluoride supplements of any type are those who live in communities without fluoridated water supplies or in homes with water purifiers that remove minerals. The easiest, most efficient and most cost-effective means of making sure that children have adequate fluoride to protect against tooth decay is to support fluoridation of your area's water supply.

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If your community's water is not fluoridated, your child will need dietary fluoride supplements which are available only by prescription from your dentist or physician. To protect against tooth decay, children need fluoride on a daily basis from the age of six months to 16 years. (Actually, I recommend that pregnant women take fluoride supplements beginning in the sixth month of gestation to ensure strong tooth development in the fetus - check with your obstetrician about this.) The correct dosage for your child must be calculated on the basis of the natural fluoride concentration of your local drinking water as well as your child's age, and the extent of his or her exposure, (if any), to other sources of water that may be fluoridated.

Some fluoride is present in all water sources but, according to the American Dental Association, most bottled waters don't contain enough to prevent tooth decay. Fluoridation of community water supplies involves adjusting the fluoride content to the optimal level for dental health, 0.7 to 1. 2 parts fluoride per million parts water.

Too much fluoride can be as bad for children's teeth as too little. An excess can lead to mottled, chalky white spots on the teeth. Other health risks include weight loss, brittle bones, anemia and weakness. Data suggesting that excess fluoride can increase the risk of cancer or contribute to hip fractures in seniors are contradictory. These conflicting reports continue to fuel the often heated controversy over fluoridation. My feeling is that, at proper levels, fluoride is of immeasurable benefit to your teeth during childhood and throughout life.

Andrew Weil, M.D.

Is the Fluoride in Green Tea Harmful?

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Both green and black tea contain fluoride, although green tea contains twice the amount found in black. However, I wouldn't worry about the fluoride you get from either type of tea because even with green tea, the amount that people drink is unlikely to supply enough fluoride to reach toxic levels. About 50 percent of fluoride (from any source) is deposited in the bone and teeth; the other half is excreted.

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In general, I think concerns about fluoride are overblown. I've heard arguments against fluoride ranging from that it may cause bone cancer to the notion that putting fluoride in the water supply is a government plot to destroy our brains. High amounts of fluoride over several years can cause brittle bones, but this is extremely rare. Fluoride is toxic in very large quantities and can cause gastrointestinal symptoms and sometimes even death. But you'd have to ingest about 20,000 times more fluoride than what's in an 8-ounce glass of fluoridated water to see such an effect.

On the other hand, I believe the evidence is overwhelming that fluoride builds and maintains strong, cavity-free teeth. The addition of this mineral to most public water supplies is credited with preventing tooth decay between 40 and 60 percent in both children and adults who live in fluoridated communities. Even seniors who live in these communities have less tooth decay and tooth loss.

A trend that is working against the dental health gains made by adding fluoride to public water supplies is the increased use of bottled water. A rise in cavities among children reported in 1998 - after years of decline - may be due to consumption of bottled water, which typically contains minimal levels of fluoride. If your children drink bottled or filtered water, be sure they get supplemental fluoride (ask your dentist to prescribe the proper dosage). If you drink bottled or filtered water, be sure to use a toothpaste containing fluoride. Or, sip more tea; green or black , just hold the sugar.

Andrew Weil, M.D.

Table of Contents

Brushing Off Gingivitis? - Ask Dr. Weil

Can Bad Teeth Kill You? - Ask Dr. Weil

A Threat From the Zinc in Denture Adhesive? - Ask Dr. Weil

Gingival Overgrowth: Gums Growing Over Teeth? - Ask Dr. Weil

Best Cure for Bad Breath? - Ask Dr. Weil

Are Dental Implants Safe? - Ask Dr. Weil

Rethinking Fluoride? - Dr. Weil

Are Dental Sealants Safe? - Dr. Weil

Are Root Canals Risky? - Dr. Weil

Fear of Dental Fillings? - Dr. Weil

Guided Tissue Regeneration to Save Teeth? - Dr. Weil

Medicate With Mastic Gum? - Dr. Weil

Mouthful of Mercury? - Dr. Weil

Help For Halitosis? - D. Weil

Dealing With Dry Mouth?

Tea-Stained Teeth?

Keeping Your Toothbrush Clean?

Is It Wise to Remove Wisdom Teeth?

A Funny-Looking Tongue?

Metallic Taste in Your Mouth? - Ask Dr. Weil

Bleeding Gums?

Does Poor Dental Health Determine Overall Health?

Is It Safe to Whiten Your Smile?

Losing Your wisdom Teeth? - Ask Dr. Weil

White Tea for Healthy Teeth?

Brushing Off Gingivitis?

Mercury in Your Mouth?

Is Fluoride Safe for Kids?

Is the Fluoride in Green Tea Harmful?