War of the Worlds

March 2005

By: Scott R. Harden

After sixteen years of practicing dentistry, it is clearly evident that dental home care remains a challenging focus for dental professionals and their patients. Despite education from multi-media reaching us at numerous levels, and despite new dental products including better quality tooth pastes, oral rinses, excellent tooth brushes, electric tooth brushes, better floss, floss holders, disclosing solutions to identify plaque, and water irrigating devices, a high majority of new patients present with gum disease. Most patients are not adequately removing bacteria and plaque from their teeth, despite the fact they have the tools and knowledge to do so successfully.

This observation is supported in the literature by official statistics that estimate 30% of the U.S. population does not clean their teeth. Other statistics state nearly 75% of all patients demonstrate some level of gingival inflammation or damaging periodontal disease. Further, thirty percent of people over the age of 65 years old have no teeth and wear complete dentures as a result of poor oral hygiene.

It is not uncommon to see a new patient present with teeth as shown below. This patient is reflective of a person who chronically neglects proper oral hygiene and professional visits to the dentist. The result is devastating and equates to severe toothaches, chronic infection in their mouth that subsequently spreads throughout their body, and poor eating habits that leads to problems with digestion and other systemic effects.

Reflecting on my passion for old movies, there exists no greater story on the tremendous effects of bacteria than in the escalated triumph of microbes over intergalactic invaders from Mars born in the novel of H.G. Wells, War of the Worlds. With his literary brilliance demonstrated by his foresight and prophecy in time travel, space flight and interplanetary travel, Wells remains one of my all-time favorite authors. In War of the Worlds, as Martians invade Earth, they unveil a Martian war machine complete with Heat ray guns, poison gas and other devastating weapons, invoking a full-scale war against our armies. Despite what appears to be limitless power and an impenetrable defense, the Martians withstanding all our military power, succumb to the simplest of all things, “tiny microbes”.

H.G. Wells wrote War of the Worlds in the late 1800’s. A radio broadcast about this book in the 1930’s reached over 30 million people and once again microbes provide the paramount conclusion to the story. Therefore, microbes are clearly not a new topic of conversation among people.
The more than 100 species of bacteria, and hundreds of species of fungi, protozoa, and viruses that have taken up residence in our mouths is as difficult for people to fathom today as it was for people to understand microbes in the 1800’s.

Microbiologists estimate that, in addition to these known species, there are up to 500 other living, breathing organisms inhabiting our mouths, although only 50 have been identified and named. The sheer number of these creatures is astronomical, considering the fact that our mouths contain more bacteria than the entire world’s population, and the fact that our bodies house approximately one trillion bacteria.

In the overall dental picture, dental plaque is a sticky, invisible film that sticks to all surfaces of the teeth, including the spaces between the teeth and under the gums. These bacteria react with sugars and starches in foods to produce acids and other substances that can seriously damage the teeth, gums, and surrounding bone. Acids can dissolve tooth enamel by removing minerals from the enamel (a process called demineralization).
Plaque constantly forms on the teeth and needs to be removed every day. It tends to accumulate in areas that are undisturbed, such as in the grooves and on the biting surfaces of the back teeth, between the teeth, and next to the gum line.

Testing for dental plaque with disclosing solution or tablets is done so you can see how thoroughly and efficiently you are brushing and flossing your teeth. This can help you take better care of your teeth, and allows your dentist to customize techniques that will help you optimize your daily routine.

There is still a War of the Worlds happening every day in dentistry. A war is being waged 24 hours a day between oral microbes and patient dental health. As dental professionals, we are trying to educate our patients on the benefits of oral hygiene, so dental health emerges the victor. Regular visits to the dentist, at least two times per year, will reinforce your motivation and great dental hygiene habits, allowing you to be in the top 25 percent of the population that possesses dental health. Keep smiling.