dental matters (was Just Another Coincidence?)

[Guest guest]

My dentist still complains about my gums. But in general I rarely get sick

anymore so CR definitely fights infections. Since you brought up dental

matters, I am newly rinsing with antiseptic mouthwash as recommended in the

following article and we'll see on my next visit to the dentist what the

outcome is (however I'm sure it's going to be good since my gums no longer

bleed and I can tell my mouth feels " cleaner " )

_____________________________________________________________

Newly publicized clinical research carrying the imprimatur of the American

Dental Association (ADA) shows that rinsing twice daily with Listerine does

" at least as good " a job of reducing gingivitis (swollen, irritated gums)

and plaque (bacteria and the sticky stuff they feed on that cause

gingivitis) as once-daily flossing.

So is it time for slaves to dental hygiene to throw off their floss? Can

two 30-second rinses with the tingly elixir really replace the nightly

ritual of winding the twin digital tourniquets, spattering the mirror with

bits of dinner and drawing blood between those two unruly molars?

Of course not. If that were true, you'd have found out about it by now, via

the tickertape parades in major cities, the mass dental floss bonfires and

stadium-filling thanksgiving services.

Still, the research is tantalizing, especially to the estimated 85 to 90

percent of Americans who, according to dentist and ADA spokesman Matt

Messina, fail to floss regularly.

The story begins with a study that was funded by Pfizer Consumer

Healthcare, maker of Listerine, and published last year in the ADA's

journal.

The study showed that, among 600 people ages 18 to 65 who had mild to

moderate gingivitis, Listerine Antiseptic mouth rinse (civilians call it

mouthwash) used as directed (twice-daily, 30-second rinses) reduced plaque

between the teeth by 20 percent and gingivitis by 11.1 percent after six

months.

Flossing, by contrast, reduced between-teeth plaque by only 3.4 percent and

gingivitis by 4.3 percent in the same period.

The study confirmed the findings of earlier research, also funded by

Pfizer, published in 2002 in the American Journal of Dentistry. Both studies

apply to all versions of Listerine mouth rinse except the natural citrus

variety.

Both Pfizer and the ADA emphasize that the results relate only to people

with gingivitis, a mild form of gum disease that affects a majority of

Americans over 30. Those with periodontitis, a more serious condition in

which bacteria have affected the bony structure of the mouth, have no choice

but to floss if they wish to be well.

From these two studies, published in respected, peer-reviewed journals, a

reasonable person might infer that it's time to pitch the floss. But of

course that's not the message the ADA -- or, for that matter, Pfizer --

wants you glean. And with good reason.

The ADA has for decades recommended twice-daily brushing and daily

flossing, along with regular visits to the dentist.

That stance is reinforced by yet another Pfizer-sponsored study, this one

published in the April 2004 issue of the ADA journal, which demonstrates

that brushing plus flossing plus two Listerine rinses a day deliver the

biggest anti-gingivitis punch of all.

Those in the study who merely brushed saw little change in the amount of

plaque between their teeth or the degree of gingivitis they suffered at six

months. Those who brushed and flossed reduced plaque by 8.9 percent and

gingivitis by 7.7 percent during that time. Those who brushed, flossed and

rinsed with Listerine saw a 52.4 percent reduction in plaque vs. the

brushing-only group and a 22.3 percent reduction in gingivitis vs. the

brushing-only group; the triple-treatment group's plaque reduction was 47.7

percent better and its gingivitis reduction 15.8 percent better than those

of the brushing-and-flossing group.

Naresh Sharma of Bio-Sci Research Canada Ltd., a research laboratory that

conducted the first and most recent studies for Pfizer, speculates that

brushing and flossing not only scrape away most of the plaque (thus reducing

the ranks of bacteria to be reckoned with) but also help disrupt the surface

of any remaining plaque, creating opportunities for the Listerine to get at

more of the bacteria.

In the new study, patients in the brushing-only group and in the

brushing-and-flossing contingent both used mouth rinse that didn't contain

Listerine's essential oils, just to make sure that it was the ingredients in

Listerine, not the mechanical action of liquid swishing over teeth, that

improved outcomes.

In the mid-1980s, Listerine became one of the first mouth rinses to receive

the ADA's " seal of acceptance " for its role in reducing plaque and

gingivitis. Research supporting that distinction showed that Listerine's

four active ingredients -- the essential oils thymol, eucalyptol, methyl

salicylate and menthol -- were effective in reducing plaque and thus

limiting its assault on the gums. Now any private-label and store-brand

Listerine look-alike can make the same claims, provided it has Listerine's

exact mix of active ingredients.

(Alcohol, which accounts for up to 26.9 percent of Listerine's volume, is

listed as an inactive ingredient. Last decade's scary stories linking

Listerine's alcohol to oral cancer risk have been largely discounted.)

The results of the 2002 and 2003 studies have been in dental professionals'

hands for some time. You're just hearing about them now because of the

vagaries of ADA protocol: Products such as Listerine that wish to publicize

research-based claims must first have those claims reviewed by the ADA's

Council on Scientific Affairs. Cliff Whall, a leading member of that

council, explains that it was only in March that Pfizer won permission from

the ADA to publicize Listerine's effectiveness relative to dental floss.

The 2004 study hasn't yet been reviewed by the council, Whall says, so

while your dentist may have read it and may be figuring out how to deliver

the news to patients, you're not really supposed to know about it yet.

" The ADA's position still is clear, " Whall said. " Brush two times a day

with a fluoride dentifrice, floss every day to remove plaque. But we also

recognize that this company [Pfizer] has done two studies [not counting the

2004 one] that satisfy our criteria " for establishing that

essential-oil-containing mouth rinse is as good as flossing at combating

plaque and gingivitis.

Which puts you in a funny position. On the one hand, the compelling data

from the 2003 study might support your tendency to go floss-free. But now

that we've told you about the newer study, which shows that Listerine is

even more effective when added to a flossing regimen, you can't pretend not

to know better.

Dentist Messina, who practices near Cleveland, is in the same boat. " I'm

afraid people will make too big a jump " and give up flossing altogether, he

said. " I'm not willing to let go of something I know works really well

[brushing and flossing] for something we believe may be a good adjunct

[adding mouth rinse to the mix]. "

Messina concedes that while brushing, flossing and rinsing remains the best

approach against gingivitis, " if we have only time to just brush and rinse,

that's better than not doing anything. "

Is that permission to ditch the floss? At least once in a while?

You didn't hear it from us. •

Flossing 101: Know Thy Enemy

Just getting participants to floss properly presented one of the biggest

challenges of mounting the studies discussed in this article, said

, associate director for clinical research in Pfizer's oral care

area. Participants in the flossing groups were taught the proper technique

by dental hygienists and then made to demonstrate that they could do it

themselves before they were sent home (carrying written instructions) to go

it alone.

Just jamming the floss between your teeth until it meets the gum isn't

effective at removing plaque, said, and can actually cause problems

by pushing bacteria into the gum. Instead, she suggested, think of shining a

shoe: Wrap the floss around the edge of the tooth the way a shoeshine cloth

gets wrapped around the edge of a shoe.

D'Sousa, Pfizer's vice president for consumer health care research

and development, said flossing's main purpose is to scrape

bacteria-harboring plaque off your teeth every day, before it can cause

gingivitis or more serious disease. If you're just trying to get that stray

popcorn kernel or bit of steak out from between your teeth, he says, a

toothpick will do just fine.

Here's the American Dental Association's guide to flossing:

• Break off about 18 inches of floss and wind most of it around the middle

finger of one hand. Wind the remaining floss around the same finger of the

opposite hand. This finger will take up the floss as it becomes soiled. Hold

the floss tightly between your thumbs and forefingers.

• Guide the floss between your teeth using a gentle rubbing motion. Never

snap the floss into the gums.

• When the floss reaches the gum line, curve it into a C shape against one

tooth. Gently slide it into the space between the gum and the tooth.

• Hold the floss tightly against the tooth. Gently rub the side of the

tooth, moving the floss away from the gum with up and down motions.

• Repeat this method on the rest of your teeth.

Don't forget the back side of your last tooth.

-- Huget

Huget, a regular contributor to Health, wrote about a new approach

to understanding religion in last week's issue.

on 7/6/2004 8:11 PM, Rodney at perspect1111@... wrote:

>> have had for the past four years under that root-canalled tooth?

> It's gone! " .

>

> The only thing I can think of, that has changed since my last dental

> appointment, that conceivably could explain it, is CR. (Just a

> single anecdotal example, worth no more than what Dr Walford thinks

> anecdotal 'evidence' is worth. But kind of interesting, nonetheless.)

>

> DON'T TELL ME THIS STUFF REALLY WORKS? ;; ^ )))

>

> Rodney.

>