Ditch Your Dentist's Drill: The 90-Day Cavity Cure Revolution

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most natural way. Hi everyone, thank you for joining me today on the Holistic Dentistry Show. I'm Dr. Sanda Moldovanovan, your host, and I'm very excited to have another fellow biological dentist with me today, Dr. Toni Engram. She holds a practice called Flourish Dental Boutique in Richardson, Texas, right outside Dallas. She had her own personal struggles with autoimmune disease, which led her into practicing more whole body health, not just tooth dentistry. So, Toni, welcome to the show.

Thank you so much for having me. I'm so excited to be here.

Yeah, you and I met through our Mindshare community group, and I'm very excited to, you know, have this mission, at least in the United States, to educate as many dentists as possible on whole body dentistry. But I really wanna talk about you and your journey and what led you to become a biological dentist.

Well, it definitely was not something that I sought out. I went to dental school, I graduated in 2008, which doesn't seem like that long ago, but I guess it was a little while ago. It was holistic dentistry was briefly talked about, but only in the context of don't be like those people. That was all I learned about holistic dentistry was don't—

It was like woo-woo stuff.

Yes, for sure. It was woo-woo stuff and they were taking out amalgam fillings for no reason, which is clearly not true now that I know better. But what got me into it was, like you said, I got sick. And so as I was trying to figure out my own health issues and kind of going down the rabbit hole of, for one, I didn't believe what my doctors were telling me that I was gonna have to be on medications for the rest of my life. I just, in my gut, did not think that that was right or true. Or maybe I'm just stubborn and I just didn't wanna think that that was right or true. But as I figured out ways to actually heal my gut, because what I had was Crohn's disease, I kept seeing all of these correlations between what I was experiencing as a patient and what my patients experience every day. And when you think about it, goodness gracious, Crohn's disease is an inflammatory condition caused by an imbalance in bacteria. What do we treat every day? We treat tooth decay and gum disease. It's all about inflammation and dysbiosis. So as I was getting better, and I did get better, I've been in complete remission, no medications for over a decade now. I just felt like a hypocrite if I didn't figure out how to do the same thing for my patients. If I can heal, they can heal, and it's my job to help teach them how to do it. So that was really what got me started into— first it was oral systemic health and learning all about the connections between the two that I didn't learn in school. And then it was my patients who kind of shifted me the rest of the way to the dark side, if you will, because they would—

the right side. That's right.

That's right. Because they would challenge me on things. They would say, oh, well, that's great, Dr. Ingram. I'm so glad that you're so knowledgeable in nutrition. I'm glad that you understand these things, but what are you still doing with fluoride? And oh, what are you doing to protect your assistants when you're taking out these amalgam fillings? And so it was my patients who gently nudged me into an area that I was frankly scared to go down. Because I felt the social pressure not wanting to be a rule breaker, not wanting, wanting to stay in good graces of the rest of dentistry. But once I learned that, oh, there actually is a lot of science behind these biological methods and understanding the terrain theory of disease, not just the germ theory of disease, and seeing the science, the brains, and the heart of all of the practitioners who have led the way before me. Yeah, I really didn't have a choice but to transition the way that I practice.

You also got a certification as an integrative health coach. Did that come after dental school or before?

Way after. Way after. I figured if I was going to talk about nutrition as much as I wanted to talk about nutrition, I didn't know of a way to— like, I didn't want to go back and get another degree, but I figured I needed a little bit of street cred in nutrition. And so I went through the Institute for Integrative Nutrition and did a health coaching certificate, which was a lot of fun. I loved it. I enjoyed it.

Oh, very nice. How do you integrate that, let's say, with somebody who comes in for cavity? They have a bunch of cavities. How do you use that?

My health coaching? I think that's really what we're all supposed to be doing as physicians of the mouth, is it's not just about teaching, but it's giving knowledge and walking alongside people, which is really the skills that the health coaching program helped fine-tune was how can we impart some knowledge but do it in a way that encourages and walks alongside and really gives patients the tools that they need to be able to do it on their own?

Yeah, you're absolutely right. I think the last thing we want to do if somebody comes in and especially kids or teenagers, a lot of cavities, make them feel ashamed and tell them, oh, you need to brush better and brush your teeth and floss. You're not flossing, making them feel guilty. That's such the wrong approach to help somebody. So how do you walk along somebody like, let's say, has cavities?

Well, and we may talk more detail about this later, but one way that we do it is I found that I did not have enough time in a traditional dental consultation. Like a traditional exam visit. I didn't have enough time to help patients get the support that they need because they need help with nutrition. They need to review their diet choices. It's more than just telling people not to eat sugar. They need some actual coaching, like hand-to-hand, one-on-one coaching with how to brush correctly and floss correctly in a way that's not demeaning, that's supporting. A way to help moms know how to get their kids to do what needs to be done. And so the way that we did that was really utilizing my, my brilliant hygiene team because they're the ones that are the experts in this. They're spending way more time with patients anyway. And so we created a program around actually getting patients well. And so it incorporates in-person visits and virtual visits. And some saliva testing and really this back and forth strategy so that we can actually get patients well, which is what I've always wanted to do in practice, but early in my career just wasn't able to do with your normal, like, PPO-based dental office.

Of course, why? Because, you know, for people who are listening, I'm sure you've gone to the dentist. And by the way, we have people listening that are dentists and hygienists, and we also have Just our regular patients listening to the show. You know, you get— go to the dentist, diagnosed with cavities. Okay, let's drill. Pretty much that happens immediately. You know, let's drill, let's put a filling, let's put a crown, an onlay, whatever it is. Nobody exactly takes the time to explain, okay, the cavities are actually a disease process. And the worst time to drill into teeth is actually when they're very active because that's when the tooth is the softest. So I really want to talk to you about this, the Cavity Cure Accelerator program that you created in your office that really has this holistic, with a W, a holistic approach to getting someone well and having them stay well, not develop more cavities. How did you come up with the program in itself?

It really, it was just a culmination of everything, of me being frustrated with the model of care that is the most common. It was, you know, my teenage patients who I would do 10 fillings on these poor kids, like fillings on anterior teeth. And then a year or two later, I'm having to redo work and they've got decay around other dental work. Like it, it's the patient. And granted, now those are the extreme cases, but still it was the cases where I wasn't helping that broke my heart and ticked me off. And knowing that just like in medicine, that we don't spend enough time with our patients helping prevent time in my chair. And so that's the reason that I came up with it, was I wanted to have something that really could have more predictable results. And, and be able to quantify it and, and have objective results.

Okay, so how long is this program, or does it— is it different depending on the severity of the disease?

It's 90 days. So the Accelerator is, is a— it's a 90-day program, and at the end of that 90 days, if for some reason we haven't seen improvement, it's kind of like a— you can't guarantee anything in healthcare because patients are different, but what I tell patients is if we don't objective improvements within those 90 days that we look at when we're doing saliva testing, then I will personally work with them once a month until we do. And so far everyone has had improvements in those 90 days and we've gotten the results that we want to get.

So that's amazing.

Knock on wood, everybody's doing great so far.

Yes. What is the protocol that you follow? How do you start patients on Cavity Cure?

Well, I start with saliva testing. That's— I personally like Bristle because I get a wide variety of microbes that it's finding. So I can look for strep mutans and then all the periodontal pathogens and Candida species all in one test without having to do multiples. And then I'll do a pH test. We'll take photos and look at plaque levels. And so it really starts with that. With looking at those objective results. And then we base our protocols based on what we find. And the whole family gets the benefit of the classes and the virtual visits and the coaching. But clinically, we're just focusing on the one person, the one patient in the family. So it's usually who—

and they're not probably understanding why you're even testing for bacteria and what is that, what kind of role that has in cavity formation. So we're going to go a little back to the basics, especially for those people listening that have no idea what cavities are, right?

That's right. We want to see— and, you know, we used to think that it was just one bacteria, Strept mutans, that was the cause, the ultimate, the original cause of cavities, or the root cause of cavities. We now know that there's many more bacterial strains that can lead to cavities. Any of those strains that are out of balance, if they are strains of bacteria that are creating acid in a high carbohydrate environment or creating acid within the plaque, then it's going to dissolve the enamel of the tooth and lead to cavities.

Awesome. So you mentioned also you're testing for the pH. My guess is, how do you test for the pH? Do you use a salivary strip? Or you do?

Okay.

Yeah. So again, for those people that don't understand why we're testing pH, in the mouth. Tell us a little bit about why you're testing for this and what are your objectives?

I want to see, is the saliva able to buffer acid? So by the time you come into the dental office and your dental appointment, chances are it's been at least 15 or 20 minutes since you've eaten or, or drank anything, most likely. And so in that amount of time, any acid that you've been exposed to should have naturally neutralized. And so you should have a salivary pH that's close-ish to neutral. And so if we do a quick test and see that in my chair it's, you know, pH of 6 or below, if you've got an acidic pH of your saliva, then we know that there's an issue there. And it's again, just one other piece of the puzzle. Yes, bacteria cause cavities, but it's the bacteria that produce acid. The acid is the ultimate cause of the decay. And so it's getting all of those pieces of the puzzle telling us the story on what we need to do to actually reverse that disease process.

Right. Okay, so somebody comes in, we get the pH test and the bacterial test. What's next?

And it depends on what we see. Then we will— I'll have my hygienist. We're talking about the more difficult cases, the hygienist and I are, but they've seen enough now that we've got some, some pretty good protocols based on what we see. And we'll, a lot of times we'll do kind of a more intense protocol for the first couple of weeks where we're really trying to knock bacterial levels down. And so we may start with different antimicrobials either in rinses usually, or ozone. If the patient is wanting to oil pull, we'll use different things, sometimes essential oils to knock down bacteria levels. And then it's really a, a matter of being strategic in the probiotics that we use because some work better for different strains than others and making sure that we're reseeding and adding the beneficial bacteria back in, restoring bacteria that help produce nitric oxide. And helping everything achieve that really nice, beautiful homeostasis.

Okay, so after we're balancing the microbiome, which is basically what you want to do, decrease the pathogenic or cavity-causing bacteria, at what point do you start to put fillings or crowns on?

It depends on the patient. And what's been really interesting is that we've had some who, which I think was a, a good strategy, they prioritized the, the nutrition and the supplements and the oral hygiene. They, they prioritized that and then held off a long time on their dental work. And so what we saw was when we retested the saliva, they had these amazing, beautiful results in every key area except they still had crazy high strep mutants.

Interesting.

So it gave us, it really gave us the information we needed and that that patient needed to say, okay, now it's really time to prioritize the restorative work because the only source left of the bacteria that's out of balance is the lesions that are already on the teeth.

Okay. And usually, do you see some resolution? Like, do you take x-rays to check for the mineralizing of teeth at some point in time, or how do you determine whether or not a tooth has been mineralized?

Really stay pretty conservative with my X-ray usage. And so I, I will usually stay on a normal schedule, you know, instead of doing X-rays at a year, I'll do them at 6 months, maybe 3 months. But I don't rely on that for my decision making. It's really just a bonus because I'm hoping that I see good results in everything else first before it's time to take more X-rays.

Yeah, makes sense. Great. And what about home care? What kind of advice do you give people, you know, for home care?

And I like to meet patients where they are, and it depends on where they have a tendency to build up more plaque and what their lifestyle is currently like, the size of their hands and their manual dexterity, and just what the patient needs. Yeah, I would love, and I know my hygienists would love, if everybody used a sonic toothbrush and a water flosser and traditional floss, and they did all of those things twice a day, I'm sure that would be amazing. But I am very pragmatic in my advice, and so I will take wherever a patient is, and we will start with wherever we can get the most benefit the fastest is where we'll start. If they've never flossed at all, then I'll see if I can get them to use some floss picks, even knowing that it might not be the most effective and it breaks my hygienist heart just a little bit.

Yeah, that's so true. I guess sometimes baby steps are okay.

Baby steps can be okay. Yeah.

Sometimes I feel, I hear hygienists saying, you got to floss more. You got to floss more. And I feel patients are going to tune us out after a while. It's like they don't even hear that part anymore, repeating it.

For sure. Yeah. I really, really dislike when I hear from a hygiene room, brush better, floss more.

Yeah, that's right. It's more like a command. It's not like, well, how can we help you floss better? Or how can we, you know, what is it in the way for you of not being able to do this?

Right.

You know, so we get to the bottom of why.

And what's crazy is that on occasion I find patients who do okay without being perfect flossers. So I, I think it's good for, for all of us as healthcare providers to, to maybe ease up just a little bit and have some humility. And maybe we don't know what's best for every single scenario. So I, like I said, I'm very pragmatic with my advice.

Anyhow, you gotta— what's your opinion on Listerine?

I used to be the biggest Listerine addict. I kid you not. When I was— I love that stuff. If it burned, I knew it was working right now. I know better now, but man, that stuff was so good. I started as a dental assistant. I took a year off after my undergrad and I worked as a dental assistant in a dental office before I got into dental school. and that is what started the habit because they had those big pump bottles in the sinks. It was a pediatric office.

Oh yes.

So like this big row of sinks and pump bottles of Listerine. And I wanted to make sure it was my first time in any kind of dental setting. I wanted to make sure my breath didn't smell bad. So I would have a little swig of Listerine, um, swish and spit in between like every other patient. But my, my opinion now is that Listerine is equivalent to Roundup for your mouth. It's really no different. It kill— it's like an antibiotic for your mouth, similar in that it's killing things indiscriminately, and it has alcohol in it, which is really drying. It's incredibly acidic, so it's not doing your teeth any favors at all. So it's excellent at killing bacteria, but even then, I've got antimicrobial rinses that I think work as good or better than Listerine does.

So I don't know.

Do you ever approve of your patients using Listerine anymore?

No, I don't. Exactly. But I like your analogy about Roundup for the mouth because, yeah, number one, I actually tested the pH of Listerine. A few years back, it had a pH of like 2.5. It's insane.

It's like soda as far as the pH goes.

Exactly. And that strong thing, I mean, for the microbiome is definitely just way too much to be using it all the time.

Great.

What natural mouthwash do you use or do you prefer instead?

There are a lot of different ones that I love, a lot of different ones. So it can be as simple as Like, let's see, what would be the most simple homemade you could really do? I mean, salt water for one. Yeah. Salt water a lot of times can work great. Obviously that's not gonna kill very many bacteria, but if you're needing to knock down some bugs, then it could be some tea tree oil. You know, there are a lot of essential oils that work really well. And then if you wanna take it a step up and use something that's bottled and packaged, then there are a lot of different one, the ones with with silver in them, I think do a really nice job. I like the one from RiseWell that I think it has some tea tree oil in it too, and I like the taste of that one. I've used StellaLife for a long time and I find that it works really well and is soothing for patients. Usually patients like it pretty well. So lots of different ones. Ozone oil works great. And so there are lots of There are rinses now that incorporate ozone oil, which is fantastic.

Yeah, I really like ozone oil a lot for just wiping off the pathogenic microbes, whether it's cavities or gum disease. I think that's great. For sure. But I like that you mentioned, like, a do-at-home formula for mouthwashes. Right? That's great. I mean, so not to be fancy. Yeah, so true. Like, you just have them use a little salt water and then put some drops of, like, tea tree oil, for example, or You really could. Yeah. Yeah, that makes sense. Yeah. I like tea tree oil. I think especially with a little bit of dilution would be good. So it's not the actual tea tree oil.

You don't want it to be too strong.

Yeah. That's one thing that I think it's important for people to know, that just because it's natural doesn't mean it's not going to be too strong because it can be. But I'm a big fan of natural mouthwashes, and I agree with you. There's just so many different ones out there. Today that are effective.

Oh, and peroxide. That's— I forgot. That's such an inexpensive, great tool that we have too, because it'll work similarly to work the same way that ozone works. And there are some bottled peroxide mouthwashes that taste nice, that aren't disgusting.

So true. Now I want to talk a little bit about diet because cavities usually form also because of a diet problem. And I want to touch upon this because there's a lot of people that think they eat healthy, and in fact, that those health foods can cause cavities. So what kind of diet advice or food advice do you give people? What is some of the examples that you see out there of, like, health foods that are cavity-causing?

I am not judgmental. But I find that my vegan patients tend to have a hard time if they're not really intentional with exactly what they're eating and making sure that they're getting all the nutrients, because there are a lot of foods that become staples in a vegan diet that contain these antinutrients, oats and spinach, kale, all the things that contain oxalic acid. And so I think that— well, I don't think there are— I don't think it's necessarily a subtraction issue. I think it's an addition issue. So where I'm not going to say, oh, you should never eat things with oxalic acid or things with phytic acid or some of the antinutrients, I do think it's important to make sure that we're adding in enough good, healthy proteins and fats in our diet, especially fats, because those fat-soluble vitamins are really what our teeth depend on to remain resilient and prevent cavities. So I always say, especially when I'm talking to parents and they're wanting to have good advice for their kids, wherever we can add healthy fats to combat what, especially what our kids tend to gravitate towards, the Goldfish, the Cheerio kind of snacks. Then I think that's where we get the most bang for our buck. So olives, avocados, coconut oil, tallow if you're okay with animal products. Good, healthy, nutrient-dense sources of fat.

Yeah, that's very important. I agree. I mean, even Weston Price, back in the beginning of the 1900s, he was talking about how important healthy fats are, the formation of teeth. But it's nice that you educate your patients on this because the reality is in dental school, I don't even remember having one nutrition class. Did you have a nutrition class?

I had one and it was a joke.

Yeah.

It was all just food pyramid, standard American diet kind of stuff.

I had a nutrition class in my periodontal program, but it was really very basic on macronutrients, on severe deficiencies to vitamin C, like vitamin B. It's really non-educational. So we both had to go out and study after the fact to see how— what is nutrition? How does it play a role in healing of cavities, of gum disease, of surgery, things like that?

For sure.

For sure.

And do you— I'm curious, do you have your patients— so I haven't enforced it and made it a rule yet, but I have some colleagues, some friends who do. Do you require your your patients to supplement with either vitamin D or vitamin C or get their levels up to a certain level before you do surgery?

Yeah, I would like to have vitamin D levels up to a certain level. So that's something that we do test in my office for. It's a blood spot test. I would like them to be closer to 60 nanograms per mL in vitamin D levels in the blood. In our previous episode, we actually had this geneticist which we're talking to, he's fascinating, Dr. Tyler, how vitamin D absorption and the conversion from the form of vitamin D that we take actually affects us. So he was even suggesting for some people to be on the higher level of like 80+ if they don't— if their cellular receptors— and apparently you can have 10 different mutations in the cellular receptor of vitamin D. It's like amazing, all these things, even though you and I know more about vitamin D than your average dentist, these are things that even physicians are not really educated on. Yeah.

Oh, yeah.

So, yeah, it's really interesting where medicine and dentistry can be so personalized in the future so that we give our patients adequate levels because my level of 60 vitamin D in the blood is going to react differently in my body than it will for you at the same level based on our cellular ability to absorb. So it's really fascinating.

That is so fascinating.

But I'm not like, you know, a lot of my patients, probably a lot like yours, already have an integrative physician and they're on a certain level of track. And if their vitamin D is getting monitored, like, I know my physicians in the area, if they're already being monitored by them, then I don't do that monitoring for them.

Makes sense.

Yeah, but I could see why you're asking about vitamin D because we know there's a correlation. The lower the vitamin D, the higher the caries risk.

Oh, yeah, it's huge. It's huge.

Yeah. Do you advise them to do any testing for vitamin D when it comes to cavities?

I do. Yeah. And now we send it out and I have ways to send it out just because I wasn't happy with the testing that I had in the office. But absolutely, that's a huge one when we're talking about gut health and how they're absorbing the nutrients, that internal resilience that we want our teeth to have to tooth decay, then vitamin D is such a huge component of that.

Absolutely. And also, you're mentioning gut health. Cavities are a problem of absorption. So that's also an issue. And obviously, it's the opening of the GI tract. But it's so important to— if somebody has rampant cavities, yes, diet and everything that we're doing as dentists, but also pairing up with a functional medicine doctor or naturopath to help them with gut healing is super important.

Absolutely. I think we're both fortunate to be in areas where we've got really good integrative and functional medicine providers around us because obviously I'm We can't legally treat gut health issues except in the context of helping their mouth. But yes, you better believe if the microbiome looks good in their mouth, but we've got a kiddo who only poops once a week, then there's a problem. And that's going to be a huge hindrance to them getting well and not having cavities down the road because things are clearly out of balance. And so we've got to be able to get things back in balance to make sure the mouth can be in balance.

Absolutely. Is your program, the Cavity Cure Accelerator program, for kids only or also for adults?

For adults. But really, and I know you know this probably better than anybody, but tooth decay and gum disease, those bacteria are all transmissible. And so I really view these chronic oral health issues as family infections. It is a family condition. And so the things that we do clinically will typically focus on one patient, but all of the coaching, the education is for the whole family. And so the family gets to take advantage of that. You know, I'm a, I'm a general dentist, I'm not a pediatric dentist. And so that's really my sweet spot. And what I love is to be able to help a whole family so we can change that narrative that just really tugs at my heart when people say, oh, I've always had bad teeth, and so little Johnny is just gonna have bad teeth too because it's genetic. Like, no, it doesn't have to be that way. And so if we can help change that family and give them a good start moving forward, then I feel like I've done a little piece of my job.

Yeah, absolutely. There's definitely, I would say, 3 components, right? Maybe even 4. Number 1 is, okay, maybe genetically your teeth are formed a certain way, right? They have thinner enamel. But there's also a factor of lifestyle, like what do you put in your mouth? How are you cleaning your teeth? Right. Oral hygiene. And probably the 4th one would be absorption. How is your stomach health? If your intestinal lining is not absorbing nutrients like calcium, magnesium, vitamin D, it's like How are these teeth going to get nourished? They can't. They can't. Yeah, exactly. Now let's talk a little bit since we're on this cavity topic. Like, what's your favorite way to restore the teeth? Like, let's say you've gotten into a point where now you got to put some fillings and crowns. Like, what are some of the healthier materials out there that, or what are some of the questions that people should ask if they go to a dentist so that if they're not in your area to ask about, to make sure that the fillings that they're getting are not toxic?

I love that question. So I think probably a question before what material are you going to use to restore the teeth, I think a question would be, is there something that we could do to try not to restore the teeth, or has it gone too far? Because sometimes cavities that are very small, if they're still in the enamel, then sometimes we can use things like silver nitrate or ozone, and sometimes we can get those to heal hydroxyapatite products, get them to heal and remineralize and maybe not need restorative work at all. That would be the first thing that I would ask. You know, in my office we try to avoid metals and, and things that are gross wherever we can. I don't use any fluoride in the office, so I'm not using any glass ionomers or, or anything like that. Uh, the filling material that I use, I try to be picky about. You know, we make sure that we use a BPA-free filling material. But what I tell patients, especially parents that are concerned about it, I'm like, you know, it's— there's no such thing as a natural filling material. And so we do the best we can to find the safest products that we can and cover the rest in prayer.

Yeah, absolutely. Glad you brought up fluoride, because I think a lot of people don't know that, Dr. Sanda Moldovan, that you mentioned there's filling material with fluoride releasing, and those can get released over a period of probably months, if not years. I'm not, I'm not sure how much they get released. So if somebody, you know, like wants to stay totally away from fluoride, you have to make sure that the fillings themselves are free of fluoride.

And I'm not— I say I'm not dogmatic, but I kind of am dogmatic about fluoride. So I think the risk of fluoride applied topically, and this is for patients out there listening, but for dental professionals too, I understand the evidence and the literature that says ingesting fluoride is less has less risk than the topical application of— no, I said that backwards. Oh, my gosh.

Yes. I think fluoride is more of a risk. Yes.

You all know what I mean? Yes. Ingesting fluoride is more of a risk than the topical application of fluoride. And in reverse, the topical application of fluoride is more effective than ingesting fluoride. So while I think it has no place in our water. I think the fact that we're exposed to it everywhere and we can't control the dose and it's not necessary for remineralizing cavities is why I really put my stake in the sand and said we're just not going to have it in the office at all. So do I think it's horrible, terrible if you have a filling that is made of glass ionomer and releases fluoride. I think the risk of that is pretty minimal, but it's just a matter of we're getting it everywhere and we have no idea how much, which patients are more sensitive to it than others. And so for me, I don't have it anywhere in the office.

Yeah, makes sense. You're right. I mean, you go out to eat and it's probably the water contains fluoride. So now you're getting water from that or you're drinking like something bottled, the prebiotic soda or something. Those are popular. Day, so you never know.

Even like, think if you're growing your own food at home, but you're not filtering the water that you use to water the vegetables in your garden, then you're getting fluoride.

So true.

It is everywhere.

It's not like it evaporates via cooking. It doesn't. It stays in the water. Yeah. And dentists in general will use fluoride topicals to prevent cavities. I actually don't know of any studies that actually have proven that topical application of fluoride in the office will actually decrease cavities. I like what you said about the hydroxyapatite. I think if there was a way to work like calcium hydroxyapatite is a mineral that's found in a lot of the toothpaste and tooth powders formulations out there that you can find at a local store or online that will actually fill in the pores and the enamel that are created from this acid. That bathes the teeth that creates cavities. So I'm glad that you mentioned that.

A much better safety record than fluoride.

Exactly.

Immensely better.

Yeah, absolutely. And another thing I like about the calcium hydroxyapatite is that it whitens teeth a little bit. So it's always a good— there's some studies to show that using calcium hydroxy, you get a little teeth whitening. So another good reason to use it. That's right. Yes. Yeah.

So if we don't— so if fluoride has potential risk and we're overexposed to it potentially from all other sources in our environment and we have tools that we can use that work really well, then why do we need fluoride? In my opinion, we don't. We can use the hydroxyapatites, we can use therapeutic levels of xylitol. We can do all of these things and use ozone in the office if we've got access to some ozone. Who the heck needs fluoride?

Exactly. You're absolutely right. And xylitol. You mentioned xylitol. And do you recommend that for your patients with cavities?

I do, yeah. And I want to make sure that they are using it frequently enough that we get the most bang for our buck. The studies that I've read really are still saying that we want to make sure we have at least 3, if not 5 exposures a day to xylitol for it to have the effectiveness that we want it to have.

Makes sense. So you have them take that as a sweetener, as a candy, or what's your favorite way to recommend it?

However they will take it. So it's already gonna be in there cuz all of the toothpastes and powders that we have them on, all of those products are most likely going to have calcium hydroxyapatite and they're going to have xylitol. So if they're using that twice a day, then there's two exposures, easy done. And then I just tell them after meals to find a product that they like, that they enjoy, whether that's gum or mints or candies or whatever the case may be. For, for toddlers, I even, there's a dry mouth spray that I like. And so I will tell families with toddlers to keep some of that Xylitol spray in their purse or in their pocket so they can just give kiddos a, a couple of squirts after a meal. And then it's— they're getting— then they're easily getting their 5 exposures a day if they're doing something after every meal. And it has all the added benefits of not only is it the amount of exposure over the course of the day, but if you do it after meals, then you're directly combating that acid exposure. You're helping to rebalance the bacteria and rebalance the pH. So I think it's a really, really useful tool.

Yeah, you mentioned also something just now about dry mouth, even though you were talking about a spray. Yeah, people that are listening and have dry mouth, the incidence of cavities usually tends to go up if you have dry mouth. And like, who tends to have dry mouth is, yeah, definitely older patients. When we get older, our glands atrophy, they don't produce as much saliva. So people with autoimmune issues, or it could be, you know, people that are taking like ADD, ADHD medication or other medications that cause dry mouth. There's just so many of them. And 2 out of 3 Americans today are taking some form of medication. So, yeah, yeah. So really pay attention for those of you that you are starting to experience dry mouth and you haven't been to the dentist in a while. Definitely get a checkup because you might have been cavity-free for 30 years and all of a sudden your mouth gets dry and your cavity starts to set in. But, you know, in the program you have, Dr. Toni, I feel like it probably works best when the cavities are in their, like, initial phases, correct? Is it easier to reverse them?

Sure, sure. Absolutely.

Yeah. Okay, well, I'm so glad we got a chance to discuss and go in depth in this cavity prevention program that you have and just what are cavities in general and what can people do at home besides brushing and flossing? Any last tip of the day that you want to give to anybody listening? Yes.

My tip is that you can heal your mouth, your body. You were designed to heal. You were not— I mean, most likely, there are some rare cases, but most likely you were not born with bad teeth. You have the ability to heal and you can do it. Don't lose hope.

I love that. Very true. Everyone, thank you for joining us today. Please leave us a comment on Instagram or on our YouTube channel where we'll have this episode posted. You can find out about Dr. Toni Engerth's practice in the show notes below, Flourish Dental in Richardson, Texas. Thank you so much, Dr. Toni. Good night, everyone.

Thank you so much. Thanks, everybody.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @DrSandaMoldovan. This is Dr. Sanda Moldovan, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.