A simple, hygienic, preventive approach to the problems of tooth decay, gum disease and bad breath
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Life is a process, not an event!

Trademarks are included with permission from the following companies: Stim-U-Dent is a registered trademark of Revive Personal Products; Oral B and Braun are registered trademarks of Oral B Laboratories.

"7 Steps to Great Dental Health" is the service mark of martin j. nigrelle, D.D.S. All artwork © 2000 martin j. nigrelle, as work for hire produced byJed Dunkerley.



A Little Philosophy, A lot of Education


Toothsome Topics will, over time, provide you with information you will need to be knowledgeable about oral health: how to achieve it and how to maintain it.

Basic information about the most prevalent yet preventable disease conditions will be described.

In the beginning, suffice it to say that good nutrition as well as a good host immune response is essential and imperative for good oral health.

Good nutrition creates the proper balance of nutrients, vitamins, and minerals required to support a healthy functioning body. It determines the contents of and amount of plaque forming on your teeth by attracting and supporting good bacteria.

Poor diets, consisting of refined foods, fast food, and other junk food, promote the formation of large amounts of plaque, bacterial toxic waste on the teeth and gums. Poor nutrition creates an imbalance in the microflora of the mouth, which then produces the acidic, destructive waste products causing breakdown not only of the teeth but also their supporting structures. Under these adverse nutritional conditions the other systems of the body are adversely affected so that optimal function of the full body system and its tissues is compromised at the very least, leading to the disease process which contributes to aging and death.

More on the topics of nutrition and the host immune response will be covered at a future time.

Basic Dental Care is a function and skill that is derived from the rites of our upbringing, our introduction to the world and the life we live.

It begins at home through example and education from our parents… the knowledge and practice of caring for oneself should occur on a daily basis. Life is a process, not an event. Processes are learned, practiced and assimilated by daily repetition at home by example from our parents, these are good nutrition and good hygiene habits, which include good oral hygiene habits.

  As childhood progresses, the process continues and expands at school in the classroom with our teachers instructing us about our bodies and how they function. Instructional books and videos may play a role in creating our daily dental habits.

In the dental office, when we receive our first dental examination, which ideally would be at 6 months of age when our first teeth begin to erupt, and subsequent dental care visits, we enhance our knowledge and experience of proper dental care.

Prior to going to the dentist, our physician or pediatrician should be observant and support a preventive approach to oral care by observing and noting the oral condition and condition of the teeth. Preventive measures can begin this early and the physician and dentist should share this responsibility in creating an optimal oral health environment. The learned behavior we are exposed to, first by parental example and our individual relationships with the dentist and dental staff, will help us create a healthy oral environment for a lifetime if the education and actions learned are practiced on a daily basis. For this reason it is incumbent upon parents to be the best example and teacher of their children. Daily repetition of good habits creates the opportunity for good habits to more easily take form in the offspring.

Dental disease can be prevented with proper thought and action!

We can look upon oral disease, specifically gum disease and tooth decay, as inevitable or we can do something about it and prevent it. Our lives are rich with opportunities where we can be the creative artist by meeting the challenges before us with knowledge and action. Doing so in one area of our life will free us to be successful in experiencing fulfillment in other areas.

This is the process! A like-attracts-like process! Thought (right thinking through knowledge) leads to action, which leads to material manifestation of health, and continues to manifest itself through repetition of an acquired skill, thus becoming a good habit.

There are two kinds of dental disease: gum disease and tooth decay


A) GINGIVITIS is an inflammation and infection of the gums surrounding the teeth caused by a buildup of plaque on the teeth. This is the most common cause and is the mildest form of periodontal disease. Inflammation is a normal tissue response to an unwelcome substance. Plaque is a soft, sticky biofilm that forms on the teeth everyday. The by-products or toxic waste (the unwelcome substance) produced by various specific strains of bacteria which form the biofilm are the major cause of gum disease and tooth decay.

Gingivitis is non-destructive inflammation of the gingival tissues. It is reversible and preventable, generally with good daily oral hygiene. Professional treatment may sometimes be required to eliminate the cause of the disease.

B) PERIODONTAL DISEASE , periodontitis, is an infection and inflammation of the tissues surrounding the teeth. It occurs when inflammation and infection destroy the tissues that support the teeth, including the gums, the periodontal ligaments, and the surrounding bone (the tooth socket). It is a clinical sign of a worsening condition of periodontal health, as associated with changes in the kinds of bacteria (infectious agents) present, the extent of inflammation, and the presence of bone loss around the tooth.

It can be caused by a local irritant or a systemic condition, and can affect the total system, not just our mouths. In other words, other parts of our body are not immune from the effects being created in our mouths and vice versa. The destructive periodontal disease process is the result of an infection-induced host immune response.


A) DENTAL CARIES is a destructive disease process, a bacterial infection, causing decalcification of the tooth enamel and dentin, and cavitation to the tooth. It is initially a demineralization (a dissolving) of the tooth surface caused by specific bacteria and their by-products.

It is a reversible, multifactorial process of tooth demineralization and remineralization that is communicable and transmissible since is caused by specific bacteria. The initial lesion can appear as a white spot or colored spot on the enamel or dentin. The hard tissue (enamel or dentin) is beginning to dissolve. At this stage a cavity does not exist and the process can be reversed; remineralization can occur. If remineralization does not happen, then continued destruction of the tooth occurs and a cavity results.

Our teeth are composed of calcium and phosphate, a substance called hydroxyapatite. These components, calcium and phosphate are also present in everyone’s saliva. When fluoride is added to hydroxyapatite, fluoroapatite is the result and this can coat the enamel making the enamel less susceptible to the effects of acid in plaque. A protective shield is created on the tooth; this helps prevent tooth decay.

If the cavity penetrates the dentin, that tissue under the enamel, the bacteria are then able to invade the pulp chamber where the blood supply and nerve tissue are. The tooth will be fully infected forming an abscess. Then root canal therapy or extraction will be required.

Food per se does not cause dental caries; however, one’s diet may exert an effect on carious lesions locally in the mouth by reacting with the enamel or root surface and by serving as a place where cariogenic (decay causing) microorganisms may live. If food is acidic enough, (a low pH), it may cause, “erosion of the tooth surface”, which is


an overall direct effect on the enamel. As an example, sucking on lemons all day will dissolve, (erode), the enamel off the crown of a tooth. The phosphoric acid contained in cola drinks, both diet and regular, will dissolve (demineralize) the enamel on the tooth. This is different from dental caries, which is caused by and requires bacteria and their localized acidic waste products to create the carious lesion. The sugar contained in the sugar sweetened cola drink will compound this effect by feeding the decay causing bacteria present allowing them to excrete acid waste on the enamel to cause a localized area of decay, a cavity.

B) NONCARIOUS LESIONS are lesions of the crown and root of the tooth not caused by bacteria and the effect of their waste products which demineralize the tooth.

These lesions are classified as abrasion, abfraction, erosion, attrition and fracture. As the population begins to age and live longer, these noncarious lesions become more prevalent. Generally, they occur very slowly and, in most cases, are asymptomatic; however, thermal sensitivity is sometimes an issue. In many cases a combination of these conditions can exist at the same time and compound the problem.

Abrasion occurs when a tooth surface is physically worn away by excessive force of contact with an object, such as in using a hard bristle brush and/or using abrasive toothpaste. Our teeth can be abraded by the texture of the food we eat.

Abfraction is the commonly seen condition of notching of the teeth near or even under the gum line… noncarious cervical tooth loss. It is suggested that due to continual stressing and flexing of the tooth over time the enamel rods separate from the inner dentin layer, forming the familiar notching associated with this condition. The minerals that form the dental root and crown dissolve due to the abnormal forces placed on the teeth exhibiting the lesions. The way our teeth occlude (come together) determines the forces exerted on the teeth. Abnormal occlusion, excessive occlusal forces, creating high occlusal loads on a tooth, create a flexure in the tooth which causes the dissolution of tooth structure and notched out lesion to form. At this point, abrasion and erosion can add to (compound) the destructive process, causing more loss of tooth structure.

Erosion is the progressive loss of hard dental tissue by chemical processes not involving bacterial action. Dissolution of mineralized tooth structure occurs upon contact with acids that are introduced into the oral cavity from intrinsic (i.e., gastroesophageal reflux (GERD), vomiting) or extrinsic sources (i.e., acidic beverages such as most cola soft drinks containing phosphoric acid, citrus fruits and other highly acidic foods).

Attrition is the loss by wear of the surface of tooth or restoration caused by tooth to tooth contact during mastication (chewing) or parafunction. We all wear out as we age. Just part of being alive! Time has its effect!

Fracture occurs due to trauma, an external blow to the tooth or teeth resulting in a break in the tooth and possibly loss of tooth structure. Fractures can also occur in teeth that have been restored due to previous treatment for decay. This generally occurs because the remaining tooth is unsupported and derives no nutrients from the vital part of the tooth, namely, the pulp which has both nerve and blood supply to serve the tooth. Teeth which have been restored with dental amalgam are most commonly susceptible to this type of fracture due to the fact that the tooth must hold the filling material in place, as no bond exists between the filling and the tooth. Generally, whole cusps of the tooth are frequently lost due this condition.

© 2006 martin j. nigrelle, dds

from dr. nigrelle

Why I Should Share These Thoughts?

A Kindly word was in my mind.
I never set it free.
It died from lack of exercise
And made its tomb in me.
Therefore, I wish to share these thoughts and not bury them!


Our perceived needs may not determine our survival, but they affect our quality of life, the way we see ourselves – as successful or unsuccessful.

A life of quality does not begin with what is seemingly lacking until we determine that something else, or better, exists. It begins as we turn our attention to what is present, to what we experience.

What do we experience in the present moment and how do we react to it?

If we are able to appreciate the present moment for its value in our life, the quality of our life is enhanced. Then, we are able to express gratitude for these circumstances, no matter what they are.

At times it may seem difficult, almost impossible, to calm ourselves in a situation and express gratitude for our present experience, viewing it as an opportunity to grow. Yet, as we are able to express gratitude for our circumstances, no matter what they are, our view opens to a vision and realization of opportunities not before seen, as our true nature is revealed, listened to, allowed to act, and experienced.

Expect the good to happen!

More to come. Next topic: Host Immune Response and How It Affects Our Total Health from a dental perspective.

©2006 martin j. nigrelle dds


What is the current status of your oral health?

Do you know enough to make that determination? Do your daily actions (habits) on a regular basis achieve and maintain a state of oral health? Life is a process not an event! Health is a habitual way of living, yet open to the adventure of change! We continually adopt good habits from knowledge, experience and example and adapt to the constant change in our lives.

Our life styles begin in the realm of our senses and our thoughts, and then move to experience. Knowledge initially has to be present for our thought process to take us to a point of action. We can’t do what we don’t know. Action, with attention and focus, will produce an experience we can evaluate and judge, then either incorporate into our daily exercise of living or discard as not being essential or not worth our effort. We become what we think about and do.

Man learns and creates through the use of his mind. Knowledge is the fuel for the mind which is taken in through the senses. Initially pure sensual experience fills the mind for processing. As the environmental surroundings increase, definitions and relationships become a part of self awareness which develops along with the awareness of others as part of our activity boundaries, which can be limitless and at the same time limiting.

In the beginning of our life, example is the primary source of our knowledge and experience as it is taken in by our senses. This is the right or condition we are born into and the rite that we will pass through in our early development. This formative process is the beginning of our future. As we develop, our experience expands and we begin to use the faculty of judgment, which constitutes our ability to make decisions and create our lifestyle.

When we are able to see our good, evaluate the situation so that we can identify and define the condition, identify that which keeps us from moving forward, the “needs” then move us to the “dream”, our good which we ought to have. Our vision, focus and desire can then inspire us, leading us to the action of creation which will result in our named good… successful, healthy living as we define, strive for, and achieve our goals.


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