Saturday, August 07, 2010

Spiffies pH Question


Dear Dr. Ellie,

A month or so ago I posted a comment on your blog, and can't find my comment or a response from you, so I am writing to you via Zellies. I have read your book, which I found very interesting. I inquired at spiffies what the pH of their wipes was and it was acidic (I had posted it to you, and no longer remember). SO, my question is, if it is acidic, does it harm teeth, ot does the xylitol somehow negate the fact that it is acidic and has citric acid it it? On a similar note, I have noticed that some xylitol mints (not yours) have citic acid in them. Would you advise to stay away from them? Thanks so much!


 - A

Dear A:

I apologize for any confusion with the blog.  You have a great question and I agree there is confusion between xylitol effects and mouth acidity.

Dental disease can always be traced back to mouth acidity. This may be from diet particularly drinks but also from acidic saliva,acid reflux, and most often acid producing bacteria (plaque). Obviously we must worry about any mouth acidity, but for each patient we must decide the best or most important way to control dental disease. The "best method" will vary from individual to individual and will vary at different stages of a
child's development.


*    For example, an infant will be more exposed to carbohydrate and have less direct exposure to acidity so plaque is the main enemy.
*    A two-year old with a sippy cup may be more exposed to acidity (juice drinks etc) so teeth should be protected after each drink if possible ( alkaline snacks, plus some fluoride in his oral care routine to make teeth acid resistant).
*    An elderly woman may have constant exposure to acidic saliva or acid reflux all day, everyday ( she needs constant help from Zellies breathmints throughout the day and/or to sip water with xylitol PLUS good
fluoride in her oral care routine to make her teeth more acid resistant).

The "best methods" to control dental disease are chosen from the following list:

1. Control plaque ( since this is the most common form of direct acidic assault on teeth) with xylitol.
2. Build resistant tooth enamel (by the use of dilute sodium fluoride rinses  or toothpaste)(Remember, if tooth enamel is more acid resistant it will be
more protected and less vulnerable to acidic attack. Fluoride gives teeth
a tough outer "skin").
3. Protect teeth from any acidity that could damage teeth. (Without fluoride, you need to be ultra careful about acidity because you teeth are "thin skinned"!)

For an Infant PLAQUE is the #1 enemy:
Xylitol ( in a product like Spiffies) will eradicate plaque and any acidity in this product will not be enough to harm teeth. Evidence based research shows that xylitol will eradicate "acid producing
plaque". For baby, it is essential to eliminate plaque and I believe that any acidity in Spiffies is of no consequence.

Sugars and carbohydrates in breast or formula milk feed plaque bacteria and without plaque, milk will not harm teeth. Without plaque teeth will be safe even if you are breast feeding. I cannot think of strong acidic attacks that would be a hazard to baby teeth. The #1 hazard for an infant is plaque fed by carbohydrates in the diet. Since Spiffies eradicate plaque they are terrific for an infant.

If you are concerned that a child has signs of tooth decay, immediately wipe or brush teeth two or three times a day with a drop of ACT mouth rinse to give teeth more acid resistance.

For a Toddler ACIDITY AND PLAQUE are the enemy: If your toddler has frequent exposure to apple juice (extremely acidic) then it is essential to find a way to neutralize this mouth acidity as quickly as
possible. There are many foods as I described in my book, that will help alkalize the mouth possibly have your child eat a piece of fresh apple, celery or a piece of cheese! . Alternatively, you could give him a xylitol
mints or candy or xylitol dissolved in water as a "tooth wash" ( in this situation it may be best to avoid xylitol products that contain citric acid).

For an older lady with dry mouth and low immune system ACIDITY is the enemy:
Zellies breathmints throughout the day and/or sip granular xylitol in water PLUS ACT fluoride in her oral care routine ( see my complete mouth care system)

Hope this helps to unravel the confusion!


Best Wishes,

Ellie

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