Monday, December 11, 2017

Natural or herbal supplements used in dentistry
One may ask: "is there a natural or herbal remedy for some dental problems?”  The answer is, “yes.”  Many natural substances can be used to assist in healing the gingival tissue after scaling and root planing, calm the pain of mouth sores, easing tooth pain after dental procedures and reducing inflammation from gingival infections. This article will address some of these familiar herbal supplements.
Reducing inflammation
“Inflammation is the body’s response to cellular injury.”[1] Our bodies respond to this cellular injury when we experience physical and even emotional distress.  Inflammation of the oral cavity such as gingivitis, periodontal disease and other dental conditions can produce unsightly as well as painful gum tissue.   The herbal supplements made from Aloe Vera, bloodroot, calendula, Echinacea, Goldenseal, and Grapefruit seed extract can assist in reducing inflammation and assist with pain control. 
Aloe Vera
            Aloe Vera is a clear sticky substance extracted from the internal membrane of the Aloe Vera plant.  Once the clear substance is extracted a dental gel can be made.  When used the Aloe Vera gel will assist in reducing inflammation from dental diseases like gingivitis and periodontal disease. A study done by the Department of Periodontics, ,Jaipur Dental College, in Jaipur ,India, found that Aloe Vera gel was effective at healing the gingival tissue after scaling and root planing.[2]  They took 15 patients with moderate periodontal disease.  Each patent was evaluated using a plaque index, a bleeding index, and periodontal probe readings.   Each individual was provided with scaling and root planing.  At the time of scaling and root planing one site per tooth in multiple areas in the mouth, probing 5mm with bleeding, were filled with the gel of the Aloe Vera plant.  All patients were evaluated before treatment at one month and at three month intervals. Results showed a significant decrease in pocket depths and bleeding in those sites that were injected with the Aloe Vera gel.[3] Brushing with Aloe Vera gel can reduce the inflammation associated with gingivitis and periodontal disease as well.
Aloe Vera

Aloe Vera toothpaste gel can be made from an Aloe Vera plant.
Step by step instructions can be found at:
Aloe Vera Toothpaste Gel
1. Find Aloe Vera
You can either buy or plant an Aloe Vera plant, or check around your neighborhood, at parks, and ask friends and family if they know where any Aloe Vera plants are located. Aloe is plentiful and very easy to find and most species are edible. It is a good idea to double-check your finds because some types of Aloe Vera have laxative effects.
2.  Gather the Ingredients
3 tsp. of Aloe Vera gel
5 tsp. of baking soda
5 tsp. of vegetable glycerin
freshly chopped mint

  3.  Mix the Ingredients

Extract the Aloe Vera Gel from the Aloe Vera plant.  Use a knife to chop the Aloe Vera gel into small juicy bits. Combine the Aloe Vera gel with the baking soda, vegetable glycerin.  Mix well.  Add the freshly chopped mint.  Place in an air tight container and use as you would your regular tooth paste.  Aloe Vera Gel is not thick like other tooth paste however it has a mild mint flavor and can help fight inflammation.

            Bloodroot is usually grown in wooded areas from Quebec to Florida on the eastern coast.  Bloodroot is not usually found west of Kansas.  Bloodroot responds best in shady, moist soil.  It is best to plant bloodroot from seed or use a root cutting from other plants; do not use plants that are out in the wild (Bloodroot is endangered).  Gather the root when the plant is flowering. Use gloves when handling bloodroot; the juice is red and can stain the skin.[5]  One of the substances found in bloodroot is Sanguinarine.  This substance can be effective for plaque control as well as dental inflammation such as gingivitis and periodontal disease.  Bloodroot should be used in very small doses.[6]   Toothpaste or mouth rinses containing bloodroot can assist in treating gum inflammation when used properly.  attaches this warning about the use of Bloodroot:
“CAUTION Use internally with caution, it contains toxic opium-like alkaloids and can cause mucous membrane irritation, an over dose can be fatal, do not use when pregnant or lactating. Bloodroot is not edible.[7]

            The dried petals of the Calendula plant can be used to treat inflammation and minor infections such as gingivitis and early periodontal disease.  These petals, fresh or dried,  can be made into ointments and creams.  Liquid extracts can be used to go into a periodontal pocket. 
Caution: Calendula is generally considered safe to use on your skin. DO NOT apply it to an open wound without a doctor's supervision. People, who are allergic to plants in the daisy or aster family, including chrysanthemums and ragweed, may also have an allergic reaction to calendula (usually a skin rash).
Pregnant and breastfeeding women should not use calendula. In theory, calendula could interfere with conception, and possibly cause miscarriage, so couples trying to get pregnant should not use calendula.7

Calendula officinalis; Garden marigold; Pot marigold
            Echinacea is usually grown in the Midwest areas of North America.  The plant itself is tall with pink or purple flowers with a central core.  Echinacea is used to treat inflammation including the gingival tissues in the mouth. 


Caution: Use with caution if you are allergic to ragweed. If you have an autoimmune disease such as rheumatoid arthritis or lupus, or a chronic infection such as HIV/AIDS or tuberculosis, you should not use Echinacea.[8]

"Goldenseal is a plant that grows wild in parts of the United States but has become endangered by overharvesting. With natural supplies dwindling, goldenseal is now grown commercially across the United States, especially in the Blue Ridge Mountains."[9] The dry root of goldenseal is used to make pastes and gels to be used to treat cold sores and sore gingival tissue.[10]   Goldenseal has been used to treat bacterial infections such as periodontal disease to reduce inflammation.[11]


Grapefruit seed extract

"Grapefruit Seed Extract (GSE) is a substance derived from the seeds, membranes, and the pulp of grapefruit. Used as a broad-spectrum, non-toxic, antimicrobial product, it is known to be highly effective for fighting infection and promoting health."[13]
According to Dr. Sachs’ book “The Authoritative Guide to Grapefruit Seed Extract”,  these oral conditions were listed:
"Cold sores, cuts, wounds – Use 1 – 5 drops in 50 drops of water. Frequent application of solution to wound will promote faster healing.
  • Gums (Gingivitis) – Dilute 5 to 10 drops of GSE in 6 to 8 ounces of water, and rinse mouth with solution thorough
  • Sinusitis - Using a spray atomizer, add a pinch of salt, and no more than two drops of GSE. Shake and spray into nose. Repeat every four hours. If the solution is too mild, add one or two more drops of GSE and shake. Do not use this treatment with young children.
  • Sore throats – Dilute a few drops in water and use as a gargle. This will fight even Strep germs. Use approximately 2 to 3 drops in 5 ounces of water for the gargle.
Many natural substances can be used to assist in healing the gingival tissue after scaling and root planing, calm the pain of mouth sores, easing tooth pain after dental procedures and reducing inflammation from gingival infections.  "The use of herbs is a time-honored approach to strengthening the body and treating disease. However, herbs contain active substances that may trigger side effects and interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care provider knowledgeable in the field of botanical medicine."[14].
Tess Hulet RDH MHSM



[1] JoAnn R. Gurenlian, RDH, PhD. INFLAMMATION: The Relationship Between Oral Health and Systemic Disease. Https://

2.  Alperovich lisa Ana.  How to: Make Aloe Vera Toothpaste.

[3]. Geetha Bhat, Praveen Kudva, and Dodwad: Aloe vera: Nature’s soothing healer to periodontal disease.


[5]6  Alternative Nature Online Herbal.

[7] Alternative Nature Online Herbal.


Friday, June 10, 2016

Dental x-rays

Dental x-rays are a vital tool in the diagnosis of dental diseases such as cancer, bone infections, abscesses, cysts and decay.  Rays that were able to penetrate an object revealing the contents within were discovered by Wilheim Roentgen in 1895.[1]

Radiation is known to be accumulative in the cells of our bodies.  How much radiation do we as dental consumers get from a regular set of x-rays during a routine dental visit?  This and many more questions should be asked and understood by each dental care consumer. This article will address these and other issues that dental consumers should be made aware of.

History of dental x-rays
Dental x-rays began to be used by Dr..Otto Walkoff  in Germany, 1896[2].  The first dental x-ray was used by Dr. Edmund Kells and in 1856.  He used glass plates to capture the desired image. The first dental x-ray film was used by Dr. Frank Vanwoert.  Dental x-ray equipment and procedures have progressed over time.  Glass plates, used by Kells in 1856 were changed to film, used by Vanwoert.  Today X-ray film has been replaced by a digital form reducing almost eliminating exposure to unsafe doses of dental radiation.

Amount of radiation from dental x-rays
As a clinician I am asked a variety of questions regarding the amount of radiation received from our dental x-rays.  X-rays come from a variety of sources and are accumulative throughout our lifetime.  A unit called a “rem” is used to measure radiation. A rem is a large unit, much like a mile is a large unit of length, so we usually use a millirem (mrem) instead, much as you would measure in inches instead of miles for most purposes. (It takes 1000 mrem to equal one rem.)[3]  A typical dental x-ray image exposes you to only about 2 or 3 mrem. The National Council on Radiation Protection (NCRP) says that the average resident of the U.S. receives about 360 mrem every year from background sources. This comes from outer space, radioactive materials in the earth, and small amounts of radioactive material in most foods we consume.3

Just for your information, “Some typical sources that may expose you to radiation also include smoke detectors (less than 1 mrem per year), living in a brick house instead of a wood one (about 10 mrem per year due to radioactive materials in the masonry), cooking with natural gas (about 10 mrem per year from radon gas in the natural gas supply), reading a book for 3 hours per day (about 1 mrem per year due to small amounts of radioactive materials in the wood used to make the paper), and even from flying in an airplane (about 5 mrem for one cross-country flight because of the increased altitude.) In fact, you receive about 2 mrem per year from sleeping next to someone! This is because all of us have very small amounts of naturally occurring radioactive materials in our bodies. [4]

Why do I need a Dental X-ray?
At times dental consumers wonder, “x-rays again”.  It is important to be aware of the advantages of having regular dental x-rays taken. 

Advantages of Dental x-rays
  • Digital radiographs reveal small hidden areas of decay between teeth or below existing restorations (fillings), bone infections, gum (periodontal) disease, abscesses or cysts, developmental abnormalities and tumors that cannot be detected with only a visual dental examination.
  • Digital radiographs can be viewed instantly on any computer screen, manipulated to enhance contrast and detail, and transmitted electronically to specialists without quality loss.
  • Early detection and treatment of dental problems can save time, money and discomfort.[5]
  • Digital micro-storage technology allows greater data storage capacity on small, space-saving drives.
  • Dental digital radiographs eliminate chemical processing and disposal of hazardous wastes and lead foil, thereby presenting a "greener" and eco-friendly alternative.
  • Digital radiographs can be transferred easily to other dentists with compatible computer technology, or photo printed for dentists without compatible technology.
  • Digital sensors and PSP (photostimulable phosphor) plates are more sensitive to X-radiation and require 50 to 80 percent less radiation than film. This technology adheres to the ALARA (As Low As Reasonably Achievable) principle, which promotes radiation safety.
  • Digital radiograph features, including contrasting, colorizing, 3-D, sharpness, flip, zoom, etc., assist in detection and interpretation, which in turn assist in diagnosis and patient education. Digital images of problem areas can be transferred and enhanced on a computer screen next to the patient's chair.
Disadvantages of dental x-ray
Are there disadvantages to having routine dental x-rays?  There is always a risk involved in taking any type of x-ray especially to the physically compromised however the risk involved with digital dental x-rays outweigh the disadvantages.
Digital dental x-rays are a necessary and vital tool to the diagnosis and care of dental disease.  Exposure to digital x-rays are now so minimal that even those individuals that are at risk can safely take care of their dental needs.
Tess Hulet RDH, MHSM

[1] Assmus, Alexi.  Early History of x Rays.  Summer 1995 P24.
[2] Singer, Steven R. DDS. The History of OralRadiology Part II.


[5] Rondon Nayda, Nosti John, DMD. Digital Dental Radiography: Zooming in on the Future of          Dental Imaging.

Wednesday, August 5, 2015

Care of children’s teeth

How do I care for my child’s teeth? Are my child’s baby/deciduous teeth important?  At what age should I expect to see my child’s teeth come in?  At what age should I take my child in for their first check up?  What products are safe for my child?  These are some of the questions that mothers/fathers may have regarding the dental health of children’s teeth

Importance of baby/deciduous teeth
It is important to maintain and care for children’s teeth.  Baby/deciduous teeth are vitally important to the overall health and well being of the child.  Baby teeth hold the place for the permanent teeth that will continue with them into adulthood.  They form the frame work of the child’s face and guide the facial bones as they grow into maturity.  Children’s teeth are used to chew contributing to adequate nutrition and the health of the child.  Self worth is also framed at a young age; a healthy and vibrant smile contributes to a strong sense of individuality and character.

Caring for children’s teeth
One of the preventable diseases in children is tooth decay, carious lesions or cavities. Government data statistics states, “Dental caries (tooth decay) remains the most prevalent chronic disease in both children and adults, even though it is largely preventable.”  What can be done to insure that your child’s teeth are free from disease and that they are staying healthy?

Here are seven tips that can help you in the fight against childhood cavities/tooth decay.

1.     Limit Snacking: Whenever a person consumes any type of food or beverage, the pH level lowers and the mouth becomes more acidic to aid in digestion. This first step in our digestion process ends about 30 minutes after we eat, and the pH returns to normal to help protect our teeth. When we snack, though, our teeth remain bathing in this acidic environment, wearing down tooth enamel, and providing a breeding ground for S. mutans. The same, of course, is true with infants who feed continually, or without a long enough break. You can counter this effect by planning mealtimes with a reasonable start and finish time. Ask your dentist or GP for the best advice for your child.

2.     Avoid The Sugar Dip: Some parents are prone to dipping pacifiers in substances like honey or sugar to acclimate a child to using the device. This is generally a bad idea. For the same reasons you wouldn't want to suck on a honey stick, you shouldn't give one to your child as well, it is bad for the teeth.

3.     Don't Share The Spoon: Here's a surprise! Did you know that tooth decay can be transmitted from one person to another? By sharing your child's feeding spoon, you can actually transmit S. mutans living in your mouth to your child. If you want to use a spoon to show your child it's okay to eat in this fashion, you're best off using your own spoon, and then doing a little slight-of-hand-swicheroo.

4.     Keep A Washcloth Nearby: For children who currently do not have teeth, use a washcloth to clean their gums after eating. Think of this as tooth brushing 101.

5.     Brush Away: And, for those lucky enough to have teeth already, use a child-safe toothbrush to clean away any food debris after a meal. It's good training for your child, and good for their teeth as well!

6.     Fill The Bottle Wisely: Avoid putting anything in your child's bottle except formula, breast milk or milk. Anything sweet or sugary will just further promote decay.

7.     Obey Naptime Rules: Restrict bottle usage prior to bedtime, or at least brush or wash their mouth prior to bed. Allowing a child to sleep with a bottle is considered to be the number one reason for baby bottle tooth decay as the bottle tends to continually drip into the child's mouth. For more on why this is important, see tip, #1.

Pit and fissure sealants can be placed by your dental professional to protect the deep grooves of the teeth from bacteria invasion.

 Eruption of children’s teeth
Many questions arise as to when baby teeth come in and when they are supposed to fall out.  It is vital that the baby teeth are healthy for they hold the space for the permanent teeth.  The jaw bone is guided by these teeth creating the framework for the face.  What can you expect when your child begins teething and what can you do to alleviate the discomfort that may occur during teething?  Baby center provides these suggestions:

Symptoms of teething:
  • red flushed cheek or face
  • ear rubbing on the same side as the erupting tooth
  • heavy drooling
  • your baby might be sleepless at night and wakeful during the day
  • she may not be feeding as well
  • gum rubbing, biting or sucking
  • general crankiness and being unsettled
Things you can try to alleviate discomfort from teething:
  • Rubbing a finger or a cold spoon over your baby's sore gums to numb the pain temporarily.
  • Giving your baby a teething ring. Solid silicone-based teething rings are recommended over liquid-filled products, which could leak and cannot be sterilized. You could put the teething ring in the fridge for a while before giving it to your baby.
  • Giving your baby a pacifier or dummy. Chewing on the teat may help them to soothe themselves.
If your baby is over 6 months old, try:
  • Letting your baby chew on hard non-sweetened rusks, breadsticks or oven-hardened bread.
  • Using fresh and frozen fruit and vegetables, such as cucumber or frozen bananas, as a chewable soother.
There will be times when your baby will reject all of these offerings and, at these moments, a cuddle is the best therapy you can give.

For more information about teething tips go to:

Eruption/Shedding of Baby Teeth

Products for children’s teeth

     Product selection for children can be confusing due to the variety of dental care products available.  Care of infant’s gums can be accomplished with a soft cloth; however there are many products available to assist parents in cleaning children’s teeth.
    It is important to floss children’s teeth especially those who are touching.  There are flossing devises available that will help to encourage children to floss and assist parents in flossing their children’s teeth. 
     Gentle mouth rinses have been formulated to help fight cavities and gum disease.  These rinses should be used by children who are old enough to rinse and spit without swallowing the solution.  More information about dental products can be found at:

Dental Check up
It is essential that your child have regular dental check up and professional cleanings.  A child should have their initial dental check up at the age of 2.  At this time the child will be introduced to the dental staff, take a ride in the dental chair, and experience the sounds, smells and things to see in a dental office.  Continuing regular dental check up’s and professional cleanings for a life time will help to prevent unwarranted pain, and finance hardships.

It is important to maintain and care for children’s teeth.  Baby/deciduous teeth are vitally important to the overall health and well being of the child.  Preventable diseases such as tooth decay can be prevented by simple dental health habits.  Brushing and flossing, controlling sugar intake and providing children with a healthy diet, regular professional check up’s and dental cleanings including placement of dental sealants can help to prevent unwarranted, pain, and finance hardships.  Remember that your child’s feelings of self worth are framed at a young age; a healthy and vibrant smile contributes to a strong sense of individuality and character.

Tess Hulet RDH MHSM