Guide to Natural Dental Care
The straight truth about natural dental care
I’ve been seeing a lot of pins and posts about natural dental care lately and am a little bit concerned about what some people are doing and trying. As both a dental hygienist and an aromatherapist I’d like to help you decipher the world of natural dental care. What is the best way to take care of your mouth naturally? Can I believe the claims about dental remedies I see on the internet?
This article will
• Explain the true goal of oral care and why keeping it simple is a very natural way to care for your teeth
• Help you understand the most common dental diseases and what you can and can’t do about them
• Give you tips on how to evaluate dental recipes and claims on the internet so you can make choices that are safe for your teeth and oral tissues.
This post contains affiliate links.
The most natural way to care for your teeth
Here’s the kicker, a lot of us don’t need any fancy oral products, just a brush and some floss. We don’t really even need toothpaste. You see, most of the benefit comes from mechanically breaking up bacterial colonies with your toothbrush, and then with floss in the places where your brush can’t reach.
Sure, toothpaste has some benefits. There’s a little bit of abrasiveness to help remove external stains like this morning’s coffee or last night’s wine. Many toothpastes have fluoride, which helps to build a stronger enamel layer that’s more resistant to cavities. A few have antibacterial ingredients, desensitizing agents, or an ingredient to help reduce tartar formation. But those are all fringe benefits and the real deal comes from the mechanical action of your brush and floss.
Many seem to think we are trying to kill and remove plaque (i.e. bacteria). But it turns out that plaque is a biofilm, and it’s not so easy to get rid of.
Perhaps you have heard of biofilms—they make the news when they get into water lines. A biofilm is an organized colony of bacteria. Worse than that, it secrets a polysaccharide matrix that helps to protect it. This means it is less susceptible to antibacterial agents as well as to our body’s host defenses.
Biofilms-United they stand, divided they fall
So, the goal with oral care is not so much about killing or getting rid of the bacteria than disrupting its colonies. Biofilms that are disrupted are less damaging. It’s like an army, scatter them and you’ll be safe for awhile until they re-group. Our goal is to break up bacterial colonies, and then before they have a chance to fully re-form, break them up again!
Toothpaste doesn’t break up their colonies, swishing a mouthrinse or some coconut oil might detach a few bugs from the outer layer at best but doesn’t disrupt the colonies. What does disrupt biofilm is the most natural thing you can do. Grab some floss and physically disrupt those colonies between your teeth, and then grab a toothbrush and brush your teeth. It doesn’t need to get anymore complicated than that.
Anything else you do on top of brushing and flossing is gravy. But, when you have a dental problem you might just need a little gravy, so read on.
Understanding Dental Problems
If you have a diagnosed dental condition, you may need a little extra help keeping your mouth healthy. The most common dental problems people have are:
Decay happens when bacteria metabolize the sugars and starches we eat and excrete an acid, causing a ph drop in your mouth. This causes minerals to be lost from your tooth, primarily calcium and phosphate ions. The good news is once the ph of your mouth rises back over 5.5, those minerals are replaced in your tooth by your saliva.
Every time we eat, there is a ph drop and minerals are lost from your teeth in that more acidic environment. About 30 minutes later the ph rises and remineralization occurs. When this cycle falls out of balance, where we are having more demineralization than remineralization, we can develop a cavity in those demineralized areas.
As you can probably guess, a very natural thing you can do to combat cavities is to watch your diet. You may be surprised that I am not going to tell you to eat less sugar (although we should avoid excess dietary sugars for many reasons). What I am going to suggest is that you eat at defined times and don’t sip or graze in between.
If we have a ph drop for 30 minutes every time we eat, then it makes sense that if we eat less frequently we will have fewer ph drops. This goes for your kids too—have defined meal and snack times and don’t allow them to carry that sippy cup of juice all afternoon. Even organic juice.
Gum disease can be complex, but basically bacteria living just under the gums are responsible. The body responds to them with inflammation, which manifests as redness and swelling of our gums. Your body will also try to move away from the bacteria as a protective response. So, the part of the gums that attach to the tooth moves down the root, creating deeper gum pockets (these are the numbers your hygienist is measuring when you go in for your cleaning). The bone right under the gum attachment moves along with it, resulting in bone loss. That is an overly simplified explanation but it’s enough for our purposes.
Since bacteria in this case are a little below the gumline, it is important to tease your bristles under the gums when you brush, and wrap your floss around the tooth in a C shape as you move it up and down.
Once you start to get pockets that are deeper than 4 mm, your toothbrush and floss can’t reach under the gums that far. This is why your dentist or hygienist may recommend coming in for more frequent cleanings. Their instruments can reach into those deeper spaces and disrupt the colonies. This too doesn’t require any sort of chemicals, it’s all mechanical.
Now, antibacterials can certainly be helpful when you have gum disease. Since these bacteria live in hard to reach places, anything we can do to lend a helping hand will be beneficial.
When looking for natural antibacterials, unfortunately what many people are suggesting are pretty irritating and powerful essential oils for oral use. Clove and Cinnamon are frequently mentioned but are two strong oils that should be used in very low dilutions on skin let alone on the thinner and more permeable oral tissues.
In my opinion, hydrosols and herbal infusions (i.e. tea) are best for intraoral use as they are gentler yet still effective (see more about this in the mouthrinse section below).
One of the biggest confusions I see is people think that gum recession and gum disease are synonymous. In fact they are quite different. Gum disease is caused by bacteria and inflammation. Gum recession is a shrinking of the gums around a tooth or teeth, exposing the root.
People with gum recession may also have gum disease, but you can have recession without gum disease. Recession can be caused by improper brushing (hard bristles, scrubbing too hard), improper bite, orthodontics, and flexing of the teeth during chewing or grinding.
At this time, we know of no way to grow back gums once they have receded. The focus is on preventing further recession, and possibly stopping or correcting it with a gum graft. Those posts on Pinterest about “curing” gum recession are bollocks. Most likely they are confusing recession with gum disease and I have yet to see one with a convincing before and after photo.
Tooth sensitivity can be ongoing or temporary. Common causes include bleaching your teeth, exposed roots due to recession, or cavities.
Without getting into a dental histology lesson, the leading theory right now is that when something hot or cold hits your tooth, it causes fluid movement in the tiny tubules running through your tooth that connect to the nerve. The nerve in your tooth doesn’t really distinguish sensations like hot or cold or pressure (as in from fluid movement) so it just sends the message to the brain that says “pain.”
Alleviating tooth sensitivity involves trying to plug up those little tubules on the surface of the tooth so they can’t conduct the stimulus to the nerve. Potassium nitrate is commonly added to sensitivity toothpastes for this purpose.
Amorphous calcium phosphate paste is something your dental office can help you get, and for some it helps to reduce sensitivity (as well as help repair demineralized areas). It is calcium and phosphates, just like the minerals already in your teeth and saliva.
Making your own dental products—the do’s and don’t’s
Armed with some information about oral diseases, lets now take a look at some of the DIY oral products out there and what to look for in a quality recipe.
Some people turn to natural toothpastes because some regular toothpastes have SLS in them. SLS has been demonized but quite frankly it’s mostly a problem if you’re sensitive or allergic to it, or it gives you canker sores. SLS is actually derived from coconut or palm oil and even gets a “low hazard” rating from the controversial EWG Skin Deep database.
If you’re not sensitive to it and you want to avoid it anyways, that’s fine. The following brands have SLS free toothpastes:
Toms of Maine
The Natural Dentist
Xyli-White (Now Foods)
Toothpaste makes brushing more pleasant because it tastes good. The other benefits include removing external stains, providing a little fluoride, desensitizing, and reducing tartar formation. The latter three benefits are a little out of the scope of the home formulator so we will stick to stain removal, taste, and antibacterial action.
Making your own toothpaste or alternatively tooth powder is fine as long as you’re mindful of the abrasiveness of the ingredients you put into it.
Abrasiveness is determined by the size, shape and hardness of the particles as well as the pressure and speed at which they are applied to a surface. To visualize this, think of the different grits and types that sandpaper is available in, as well as the difference between sanding by hand vs. with a power sander.
Scientists have developed a way of evaluating toothpaste abrasives by using an index called the RDA or relative dentin abrasivity.
Dentin is the layer of tooth that lives under the enamel, and is usually what is visible when we have exposed roots. (Roots are usually covered with a thin layer called cementum, but it can be worn away fairly easily). Dentin is softer than enamel (which is one of the hardest substances in the body) so whether an abrasive is damaging to dentin is a better measure than whether it will damage enamel.
The American Dental Association has determined that any toothpaste with an RDA of <250 should be fine for long term use. If stains are an issue, pastes with an RDA above 100 will work best.
A common ingredient in homemade toothpastes or powders is baking soda. Baking soda (at 100%) has an RDA of 7, which is really low. As a particle, its hardness is 2.5 (Moh’s hardness scale) which is equal to the hardness of dentin.
In an article reviewing baking soda in toothpastes, the authors summarized their findings as follows: “Besides its low-abrasive nature, baking soda has biological compatibility, acts as an acid-buffering agent, and possesses antibacterial activity in high concentrations. Other advantageous features are that baking soda is compatible with fluoride and is inexpensive. Two limitations are that baking soda adds a salty taste to toothpaste and negatively affects foaming.”
So, homemade toothpastes with baking soda should be safe for your teeth.
Besides the abrasiveness of your homemade toothpaste, consider the shelf life of your toothpaste. If you’re making something without preservatives that has any sort of water-based ingredient you can keep it in the fridge for one to two weeks, or you can keep it on the counter for a day or two. Unless you have a very easy to make recipe and are okay with whipping up a new batch frequently, I would avoid recipes with water based ingredients. Also, avoid glycerin in un-preserved recipes as it is humectant, which means it will draw water to it. Recipes with glycerin should be used within a day or two, or kept in the fridge for 1-2 weeks.
Another consideration is how you package your toothpaste. Dipping your toothbrush into the container of tooth powder or paste puts a bacteria contaminated toothbrush in contact with your clean tooth powder. There’s a reason toothpaste comes in tubes–because we want it to be squeezed out and not have stuff that touched your toothbrush retract back into the tube. While tooth powder looks cute packaged in jars, either use a clean scoop to apply to your toothbrush, or a squeeze bottle like this one (Amazon).
Some toothpastes recipes have essential oils in them and it’s important to make sure the essential oils are diluted in something oil-based so they stay dispersed. If you use essential oils in a toothpaste or tooth powder keep the dilutions exceptionally low. This is for a couple of reasons. First, many of the oils commonly recommended for oral use are mucous membrane irritants. This includes cinnamon & clove. Peppermint is also widely used, but has a low risk of irritating your oral tissues when used prudently. Secondly, you are using this two or three times a day, every day. In general, I recommend lower dilutions whenever an essential oil is used daily.
So, to recap, when evaluating a natural toothpaste recipe look for:
- Abrasives that have an RDA of <250; if you need stain removal, look for an RDA between 100-250
- If there are any water based ingredients, it should be used with a couple days, or 1-2 weeks if stored in the fridge
- Use packaging that minimizes contact of your toothbrush with the paste or powder
- Avoid irritating essential oils like cinnamon and clove, and use in very low dilutions (<.5%)
Many DIY mouth rinse recipes are nothing more than essential oils and water. You should not place essential oils in water and swish. Since oils and water don’t mix, even if you stir or shake it up the essential oils will quickly congregate back into droplets. This could cause undiluted essential oils to contact your sensitive mucosal tissue. Mucosal tissue is thinner than skin and is what lines the inside of your mouth, throat, and other parts of your insides.
Any rinses that you make should have some ingredient that disperses an essential oil in water so it will not separate. Alcohol is commonly used in room sprays and perfumes, but excessive alcohol can be drying to oral tissues, cause a burning sensation, and irritate any ulcers or canker sores. Polysorbate 60 is one ingredient that is often used in oral rinses as a dispersant and would work in place of alcohol.
Rather than use essential oils though, my suggestion is to either use a hydrosol, or make an herbal tea to swish with. Choose a high quality hydrosol that is labelled safe for consumption. Hydrosols: The Next Aromatherapy (Amazon) is an excellent reference book if you are interested in learning more about using hydrosols.
For a mouthrinse made from an herbal tea, try chamomile, calendula, peppermint, neem, or sage. Another option is to put a few drops of tincture of myrrh in a glass of water and swish. Learn more about how to make an herbal mouthwash with tinctures.
Oil pulling has been super popular for a few years now. Sesame or coconut oil is vigorously swished for several minutes (up to 20 min. if you can tolerate it) and then spit out. Some people add essential oils, and others use the fatty oil straight up.
There has been some limited research conducted on oil pulling. In general, results were positive, but not overwhelmingly so.
Interestingly, many claim this is an ancient Ayurvedic technique, however I have come across Ayurvedic practitioners who have never heard of oil pulling, at least not in the way it is currently being promoted.
I have tried oil pulling with plain coconut oil and after a few days felt like my gums looked a bit pinker. Remember, I am a hygienist so my oral care is good to begin with. But, I also have a trained eye looking for these minor changes and I did see some!
I feel like oil pulling is something that can’t hurt, and might help so why not give it a try? I do not think it is necessary to add essential oils, but if you do, keep the dilutions very low (.25-.50%), especially if you are swishing for several minutes. If you sense any irritation, stop adding essential oils and just use plain coconut or sesame oil.
Two main methods for DIY tooth whitening that have been circulating in recent years are turmeric and strawberries. Neither is a substitute for bleaching.
To understand why, we need to look at external stains vs. internal stains. External stains are on the surface of our teeth and come from things like black licorice, red wine, tea, coffee, well water, etc. They can be removed by abrasives.
Internal stains are beyond the tooth surface and is the natural color of our teeth. Some internal stains can also come from things like taking antibiotics during periods of tooth development, but most people are just dealing with teeth that look a little yellow.
Is it just me or is it counter-intuitive that turmeric stains everything under the sun, but supposedly it can whiten your teeth? I have not found any real evidence that this works other than the abrasiveness of turmeric powder removing external plaque and/or stains.
This informal experiment suggested the results are no better than just using plain baking soda on a toothbrush once in awhile (and it’s much less messy than turmeric!). So, turmeric may remove external stains but it has no bleaching action to change the color of your teeth.
Strawberries and Baking Soda
Strawberries have been touted as a natural way to whiten teeth but should you try it? Probably not.
First, someone has actually done an experiment and found no effect from strawberries and baking soda.
The study used extracted human molars and compared the DIY strawberry and baking soda method to conventional dental bleaching. The conventionally bleached group of teeth all showed whitening, while the strawberry group of teeth showed no color change. Any benefit from this technique is simply removal of plaque and stain from the external surface of the tooth. Any toothpaste with a little bit of grit will do the same for you.
What the researchers also discovered was that the acid in strawberries actually weakened teeth by up to 10%. Yikes! While there is some conflicting information on the internet about the acidity of strawberries, a list from Clemson University places it as having a ph of 3.0-3.9 (anything below 7 is acidic). Repeated exposure to acids causes erosion of enamel. I recommend you stay away from this method of whitening.
Most commercial dental bleaching systems use hydrogen peroxide or carbamide peroxide (which breaks down to hydrogen peroxide) and actually do cause a change in the intrinsic color of teeth. I believe that it is safer for you to use a proper bleaching product than try to DIY it. Overdoing bleaching—professionally or DIY can lead to tooth sensitivity and/or gum tissue irritation.
If you are concerned about swallowing hydrogen peroxide (which you should avoid) ask your dentist about in-office bleaching. This is usually done with a protective dental dam and an additional gel that seals around every tooth so the peroxide is strictly confined to your teeth. The downside is people tend to experience more tooth sensitivity with this method since it uses a stronger peroxide.
Lemons, strawberries, and vinegars all are acidic and should not be applied routinely directly to teeth (although they are awesome as part of your diet!).
Natural dental care is possible, and there are many natural dental products on the market that are a fine substitute for conventional toothpastes and mouthrinses. If you want to DIY it, just be careful about the ingredients you choose (abrasiveness, acidity, irritating), and how you store and package it to prevent bacterial contamination. Herbal remedies will generally be safer and gentler than essential oil recipes, yet still effective. If you have a question that I haven’t answered, please feel free to ask in the comments.