Introduction: This is Your Brain Health was noted Neuroscientist, Dr. Kristen Willeumier. Your Brain Health explores strategies to maximize your cognitive functions through life. Here’s Dr. Kristen Willeumier.
Dr. Kristen Willeumier: Join me as we return to our conversation with Dr. Bina. I think I wanted to ask you, I have one crown and the one tooth that I chip where I have the crown, I notice right around the gum, it’s a little darker. It’s not as beautiful and pink and healthy as the other tissues around it. So, you know, I do my best to keep that area as clean and healthy as possible. But I noticed that’s the one tooth that has the most trauma.
Dr. Bina: Yes, we always try to do our best at the dentist, but we have to know when every time you have a filling or a crown on a tooth, there is a seam. So it’s not just I get a filling, I’m done, I’ve got a crown, I’m all set. That’s another misconception everybody has. Actually if you have any restoration, the more care because that seam is more prone for the bacteria to break through and cause decay again, imagine when the tooth was completely intact and didn’t have a seam, you got a cavity. So when you have a seam, much easier just like stitches in a clothing. If you have a shirt where you have the stitching is more prone to get opened up.
Host: Well, and as we age, I’m assuming most people are going to have some sort of dental work done so people get crowns and cavities, which makes it even more important to make sure we have great oral hygiene right now. Brushing, what did you say? 30 seconds for each quadrant. So now I’m going to have to brush for four minutes. So now you should changed my protocol, but that’s okay because I don’t want my mouth to be the portal where the bacteria are kind of end up in my brain or my heart.
Dr. Bina: You’re doing a fantastic job.
Host: Thank you.
Dr. Bina: In general, it’s a, I mean we don’t see too many people in the office that are really meticulous about keeping their oral hygiene like you do. But that’s very good, but in general I’m just like, want to address all the misconceptions that is in the dental field and people’s mind, one of them is that I need a cleaning every six months, which is totally, totally wrong and should be really thrown out of people’s idea. The reason you’re doing every six months is because how insurance is started to pay for a cleaning. So it’s not that how much you need. The need is based on individual habits. Everybody is different. It’s not that because that’s how much you need. And that every six months is the minimum we should do it.
Host: So for somebody who has good health, like myself, I could do twice a year, but for most people, are you saying that they should come in every three months?
Dr. Bina: I recommend every three to four months. It all depends again how well they’re doing it at home. We don’t want to push you. If you’re, for example, if you want to increase someone like you that doing a fantastic job. I don’t think actually in your case is needed, but if you were to increase the frequency would be every four months for you.
Host: I actually love it. I love, I love going to the dentist, but I’m the person who still wearing my retainer that I’ve had for, Oh my God, I’ve had it since I got my teeth done back when I was I think 14. So I’ve been wearing a retainer since I was 14. So this, you know, the thing that I don’t do, and I think every time I come into the office, I catch a little slack for it is I grind my teeth. And many people do. We grind our teeth when we sleep at night. And I do have, I have the mouth guard. I do not wear it, I do every once in a while. But I remember you told me if I don’t start wearing my mouth guard in 10 years or 15 years, I may need to start getting implants. So I don’t want that. So I need to now get over that hurdle and where that darn mouth guard a little bit more.
Dr. Bina: Yeah. So what I said for you probably every four months is good and but that’s, you’re doing the right thing and using all the [inaudible] water pick and all of that. But not everybody does that. The other factor that is also very important if people are diabetic, diabetes or any heart issues becomes more important because you don’t want to keep those bacteria sitting around on your gums for too long.
Host: That’s what I was wondering. Like if you have a health condition, like you said, diabetes are in my mind, cause I’m always thinking about the brain. If you have memory issues or you’ve been diagnosed with Alzheimer’s, do you feel it’s more important to get in there more frequently?
Dr. Bina: Absolutely. I can give you some examples actually of some of the patients that I’ve seen. One that stands in my mind is that this gentleman had some implants done by another dentist long time ago, came to the office for evaluation and I checked and the implants were infected. There was really puss was coming all around implants. I told him, look, you really have to get these implants out, go to see the other surgeon, and you have to do it quickly because now it is affecting your sinus. And there would be a point that there would be so much damage that it cannot be even corrected if all that bone around the sinus builds here, then you’re going to have a bigger problem. So I’m explaining to all of these in terms of the dental, but then when I got some health information from him and he did the, for the past several weeks prior to my visit, he says that he feels like sluggish, he’s tired, cannot focus, he has some many issues going on. And then everything just makes sense that you, you have a, like a source of infection in your body and it’s not just going to sit in the mouth, it circulates in your bloodstream. It can, and from the blood stream it goes everywhere. It can affect your brain and your health and everything else.
Host: Arthritis, I wish shocked to see that rheumatoid arthritis is linked to this bacteria. So if you know that you are someone who has an active infection in the mouth and you’ve got other health complications, a really smart thing to do would be form a great partnership with your dentist and create a protocol, brushing protocol and how often you need to come into the office just to keep the teeth clean, keep the biofilm off the teeth, and just really bring down the bacteria load in the mouth so that the body’s immune system can help to support you know, your overall health.
Dr. Bina: Yes. One of the things that you’ve just mentioned about arthritis and all the other inflammatory issues related to the, again the same bacteria. Because bacteria is not only causing the infection, that’s one big blow to our health, but it is an inflammatory response. Also when is all around the gums? This is why the gums become like red and start to recede. And all these programs, that’s an inflammation also. So the inflammatory toxins that gets released in our system aside from the infection. So it’s actually two fold. Those inflammatory byproduct for someone who already have inflammation in the system, arthritis, can be potentiated because now you’re adding fuel to the fire. So if someone has inflammation in other parts of the body and then you know, have added another source, that feeding more inflammatory response circulating in your system and other ways to indirectly also reduces your immune system ability to fight other infection, other parts of the body because your body cannot be fighting too many Wars all over. So if you are just like giving more area to be busy with, it would be less the energy for the other parts.
Host: I like that. Right. So again, another glowing recommendation for having a really good oral health protocol. And it really just says, Hey, if you can get into your dentist every two months or once a month, I mean, if you’re really struggling with issues, I see no reason why you shouldn’t just go in and get a cleaning and keep you know that bacteria load down.
Dr. Bina: Yeah, exactly. Usually what I want to like people that I see that I have a lot of plaque or some health issues or some gum issues, I want to put them on the every three months to begin with, and then we can adjust it to make it every four months if you some improvement or other things. And everybody is different. It’s not a one size fits all formula. I have one patient that she’s coming every month. You may have even seen her in the office because sometimes when you were at the office, she was there too. She had some issues. She, every single month she’s coming for a cleaning. That’s because she doesn’t want to lose more teeth and she has other health issues. So for some people would be once a month, sometimes twice a month, once every two months. But majority of people I think would benefit by having a clinic every three months or four months.
And one of the things is that people get scared because they hear about deep cleaning. I just want to their mind at ease, deep cleaning for someone who hasn’t been to a dentist for about a year or two years or they don’t have a good habit, you probably the starting point, you start doing a deep cleaning, but it doesn’t mean that every time you have to have a deep cleaning. Once you clean everything from under the gum and everything’s nice and clean, then the maintenance would be much easier, which is every three months. That’s another example I tell all my patients is that imagine you cook something. If you wash the pan right away, you only have to use the sponge, a little bit foam. Everything comes off. Now you leave the same pan for the next day. Now you have to scrub it and use the part that’s not sponge because that’s not going to do it. You have to scratch it. So if you do every three months, once the plaque is soft, your visit would be quick, less scraping, less scaling around the root because the plaque is much softer.
It comes up much easier and it hasn’t got the chance to cause damage because even if you do every six months, by that time, some of the plaque is hardened, you have to scale a bit more. But the bacteria has caused some damage to the gum and the bone and it’s accumulative because if you lose, let’s say one 10th of a millimeter of the bone every six months or after two, three, four years, that adds up. So that would be like a slow, but procreative bone loss and gum disease around your teeth, which you can simply avoid all of that by having a maintenance interval about three or four months. And believe me, believe me, it is far, far less costly than all the money that I see people have to spend on correcting the problems caused by those infection. Right? All the gum surgeries or the tooth loss and implant replacement that can be done.
Host: Oh my God, I’ve, I’ve heard that, I’ve heard the costs of putting implants in and it’s, you know, that can be 40,000, $60,000, I mean, it’s extraordinary the dental cost.
Dr. Bina: That can give you for like a three, four, five years of cleaning.
Host: Well, I’m thinking of people that I know that have actually had to have, you know, a whole bunch of implants put in and you know, I’ve heard the story, so he, I’ve got a couple of quick questions that I wanted to ask. They’re curious questions I have, but I think people would appreciate them. So I wanted to get your thoughts on fluoride in toothpaste. So, you know, we know fluoride protects teeth from decay by demineralization and.
Dr. Bina: Yeah, fluoride toothpaste is very good because that’s how things started from the many, many years ago when they started putting added fluoride to toothpaste, it started to show that there was a decrease in number of cavities that people have. And it really does help, right now we are in controversial issues for many people. Some people don’t believe in fluoride but some that live in Florida, love them because we see the benefits and it started from nature, it started observing in cities or population when the fluoride is and is already naturally in the water. And then they noticed that those people don’t have cavities. So that’s how they got the idea to add fluoride in our water, you know, water or in toothpaste and everything. So we see the benefit of it.
Host: Well, I’ll tell you, you know, we’re exposed to fluoride, you know, in the water supply and we know that excess consumption can lead to cancer. You know, I would say, you know, I don’t always use fluoride in my toothpaste. So are you comfortable with people who have good oral health to use fluoride free toothpaste?
Dr. Bina: I am comfortable. Then the example, I use it, well, if some people don’t want fluoride in the water, I can understand the angle they’re coming from. And I said, okay, that’s fine. If you don’t want to have a systemic fluoride, that is a separate issue. But the angle that I come from, so just imagine putting a sun tan lotion on your skin. You don’t eat this sunscreen, you don’t swallow it. If you swallow it, you get sick. But you’re applying on your skin and you get some protection. So you can apply topical fluoride. Fluoride that is the right cover, the surface of the tooth and ammo and gives you some protection. It doesn’t effect your whole body. It’s not a systemic fluoride. So our teeth can benefit from those, people who are more prone to cavities. Then they should get the benefit from fluoride rinse or for in office fluoride varnish or the gels. And a lot of people who are medications eight out of 10 medications that people are taking, one of the side effects is dry mouth.
And dry mouth increases chance of getting cavities. And so that is very shocking to many people and it’s really upsetting to dentists, and such as myself, that the patient comes and they have some issues going on. They’re on medication and on top of it you have to tell them that, Oh, you have like six, 10 cavities, and all of that. They didn’t have anything in the life before and they don’t know why all of a sudden they have all these issues. You have to tell them look, you have to be on a fluoride to procure your other teeth from getting cavities. And this is something that I always recommend people that as soon as I find out are on anti depressant or medication, other medications, because most of them cause dry mouth. So this is something that they need to be aware of. The topical fluoride is [inaudible 16:08], is another problem but these controversy, I know a lot of people they just don’t use it or don’t get it. And that is a, it’s just okay if you want to have cavities and root canals and other things, then don’t do it. It’s a catch 22.
Host: Well, I agree. I appreciate your, I appreciate your perspective. And I knew in asking a dentist, I was probably going to get the answer. Please use fluoride in your toothpaste and you see so many patients that have such poor oral health that, you know, a dentist is going to say, we want you to be armed, right, with everything you can do at home to help reduce the bacterial population. I unfortunately, I’m going to have to wrap up. I love talking to you. I actually have more questions, but would you be willing to come back on another show and we can continue this.
Dr. Bina: I would love to talk to you any time. So many things we can cover. And that part of the bacterial infection and inflammation just around the gum, I can just even go in more detail.
Host: Yeah, we can talk next time. We can talk about periodontal disease and there’s all kinds of really fascinating thing. Well, Dr. Vena, thank you so much for your time today. You are a wealth of knowledge again, every time I come and talk to you I learn something new and I really just thought it was important to share some of these gems of knowledge with my audience and I’m already going to change my brushing protocol now. Now you need to set a timer two to four minutes. So thank you so much. I’m wishing you a wonderful day.
Dr. Bina: Thank you so much for having me on your show. And I again want to thank you for what a wonderful job you’re doing for your listeners and all the staff that helps us provide this service today. I want to thank them as well.
Host: Oh, thank you so much and I will be seeing you in the office soon. All right, have a great day.
Dr. Bina: Thank you, you too.
Host: Bye. Bye. I want to thank Dr. Shahin Bina and if you happen to be in the Southern California area, you couldn’t ask for a better dentist. You can learn more about Dr. Bina by visiting his website at encinodentalassociates.com. I’m Dr. Kristen Willeumier and thank you for listening to Your Brain Health.
Conclusion: You’ve been listening to Your Brain Health with Dr. Kristen Willeumier. For more information or to contact Dr. Willeumier, visit DrWilleumier.com. That’s D, R, W, I, L, L, E, U, M, I, E, R.com.