It’s somewhat amazing that although this drug has been used to ease dental pain for more than a century, we’ve never had any definitive data on how well it works on toothaches in particular. That’s changed now, thanks to a study published in the Journal of the American Dental Association.

Its results were pretty straightforward.

“Both 10% and 20% benzocaine gels [common concentrations for over-the-counter products] were effective in the temporary relief of toothache pain and were well tolerated,” the researchers wrote. The stronger dose also acted more quickly.

About 80% of test participants who used the gel rated their “satisfaction” with pain relief as “good” or better compared with 61% of those who were given a placebo.

But there’s a downside that the study doesn’t address: benzocaine’s potential to damage gum tissue by triggering a process called hemolysis. Red blood cells are destroyed, transformed into a kind of hemoglobin (called methemoglobin) that can’t carry oxygen. The gums turn mushy and dark.

In some cases – such as with long-term use or overuse – benzocaine can trigger a condition called methemoglobinemia, in which oxygen levels in blood are greatly reduced. Seeing more cases of this disorder cropping up in very young children (as “blue baby syndrome”), the FDA has now twice recommended against teething gels that contain the ingredient. They recommend using non-benzocaine gels instead, or providing chilled teething rings or gentle gum massage.

Fortunately, there are also some good home remedies for temporarily relieving toothache pain, as well. A cold compress on your cheek may help, as may applications of vanilla extract (pure, not imitation), garlic or clove oil on the tooth and surrounding gums. An added virtue of garlic and clove oil is that they have antimicrobial properties, helpful when a tooth is hurting because of infection. (More home remedies)

That said, while pain is something we want to go away, it’s an important signal from your body that something is wrong. Killing pain may bring temporary relief, but it’s vital that you see a dentist as soon as possible to discover the source and get a real and lasting solution.

The longer you wait, the worse it’s bound to get – and the more expensive and time-consuming to solve.

Image by Edward, via Flickr

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The importance of eating well was underscored earlier this month by “the world’s largest organization of food and nutrition professionals,” the Academy of Nutrition and Dietetics (AND). The latest version of their position paper on diet and oral health makes plain that “nutrition is an integral component” of a healthy mouth.

According to the paper, dental caries “is the most prevalent, chronic, common, and transmissible infectious oral condition in humans.” In addition, a person’s overall health can be affected by tooth loss, since declining periodontal health can lead to diminished dietary quality because of lack of essential nutrients in a person’s diet.

Of course, these aren’t the only ways in which diet can affect dental health – just the more familiar ones. Nutritional deficiencies, notes the paper, can affect a broad array of oral conditions, from caries (cavities) to cancer (and plenty in between), as well as how a person responds to treatment. (You can download a copy of the whole paper here.)

Unfortunately, the AND paper is also pro-fluoride, despite the many well-documented risks and limited support for the efficacy of fluoridation in particular. Keeping a healthful diet, quite frankly, is apt to do much more good for you and your teeth.

And this means more than just avoiding the stuff that can harm your teeth – sugars, soda and the like. It’s about making sure you get the nutrients your teeth, gums and bone need. Here are some of the most important:

• Antioxidants
  Vitamins C and E are key. These anti-inflammatory agents help your gums stay healthy and reduce oral acidity, which makes it a little tougher for bacteria to colonize. Good sources of C include citrus and cruciferous vegetables (e.g., broccoli, cauliflower, kale). For E, try eating more whole grains and nuts.
• Calcium, Magnesium, Phosporus, Zinc, Iron and Trace Minerals
  Minerals support bone growth and maintenance. They’re also essential for remineralizing teeth. Meat, fish and dairy are all rich in minerals, but there are plenty of great plant sources, as well. (See, for instance, this guide to vegan sources of vitamins and minerals.)
• Vitamins D & K
  Like magnesium, vitamin D helps your body absorb and assimilate calcium more effectively. Helping it do so is vitamin K, which also helps with blood clotting, preventing calcification of the blood vessels and heart valves, and protecting against oxidative damage. While we can get some D through diet – such as fortified dairy – our bodies can actually produce this vitamin with the help of sunlight (10 to 20 minutes a few times each week). Dietary sources of K include dark, leafy greens, cruciferous vegetables, avocado and eggs.

Of course, although we know more specifically about how these nutrients work, the relationship between diet and dental health is not anything new. The important research of Dr. Weston Price paved the way…

Learn more about Dr. Price and his work.

Image by mini true, via Flickr

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Is it any surprise that half of us have periodontal (gum) disease, according to data from the CDC? This inflammatory condition has been linked with a number of systemic health problems, including diabetes, heart disease, stroke and rheumatoid arthritis.

It’s as simple as this: When you brush, you clean only about 60% of the surface area of your teeth – even if you use a fancy, sonic brush. It’s like bathing by washing from your feet up to the middle of your torso, leaving everything else increasingly filthy.

Flossing is what cleans the rest of your teeth – their necks, between them and at the gumline. As periodontal disease progresses, pockets form between your gums and teeth, becoming safe harbors for oral pathogens (bacteria, viruses and the like). The deeper the pockets, the harder to clean and the more gum disease advances.

And the more advanced your gum disease, the more likely you are to eventually wind up with a mouth like this:

Yes, gum disease also contributes to tooth loss. The disease ravages both the bone and soft tissues that support your teeth. As you lose this structure, your teeth begin to loosen. Eventually, they fall out (or your dentist recommends extracting them).

Knowing this, flossing suddenly doesn’t seem so bad, does it?

But there’s another option for cleaning the parts of your teeth that toothbrushes can’t manage: interproximal, or interdental, brushes. These fit between your teeth, where they can be manipulated along the necks and at the gumline. Many people find them easier and more comfortable to use than floss.

In fact, some research suggests they may be even better than floss! A research review in Evidence-Based Dentistry, for instance, found them more effective at removing biofilm. Pocket reduction also was much more “pronounced” among “proxy” brush users. A similar paper published early last year in the Canadian Journal of Dental Hygiene found these brushes to be “an effective alternative to dental floss for reducing interproximal bleeding and plaque.”

Here’s a quick demonstration of how they’re properly used:

You should be able to find proxy brushes at Walgreens or any other good sized drugstore. If all else fails, they’re readily available online from numerous retailers.

Whether you floss or use a proxy brush or even both (some do, especially if their gum disease is advanced), the main thing is this: Do it. Make it part of your routine for a healthy mouth (and a healthy rest-of-you, too).

Toothless mouth image via doctorspiller.com.

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