To Floss or Not to Floss? That is the Question!

dental flossRecently the Associated Press (AP) published an article entitled “Medical Benefits of Dental Floss Unproven”. This was a very interesting and well researched piece of journalism. It seems that the research in favor of flossing is not as solid as one would have hoped. This may in part be due to the fact that dental floss has been used in one way or another for over 100 years. It’s not surprising that research criteria were not as strict a century ago as they are today. It’s also disappointing though, that even the more recent studies involving flossing are not as rigorous as modern science requires.

That being said, it will remain my recommendation to continue daily flossing as it is my personal belief that proper use of floss not only prevents periodontal disease (the number one cause of tooth loss in adults), but also helps prevent tooth decay between the teeth. Let’s face it, no matter how well you brush, you can’t get a toothbrush in between your teeth to remove bacterial laden plaque. That I can prove!

I can remember my 10th grade history teacher proving that pigs can fly through the use of logic! Common sense however tells us that this is not the case. I suggest that we apply the same common sense to the question of flossing. For now…at least until additional research is done. After all, floss is cheap enough and only takes a minute or two to do.

Until I’m convinced otherwise, I’ll stand by my current recommendations:

  1. You don’t have to floss every day- just the days you eat!
  2. You don’t have to floss all your teeth- just the ones you want to keep!

I’d be more than happy to discuss any of your thoughts regarding flossing the next time you are in the office. In the meantime, if you have any questions regarding flossing, don’t hesitate to contact me or the staff at my office, Dr. Laurence H. Stone, DDS, any time at 215-230-7667.

CariVu – A new view at tooth decay

We are pleased to be introducing CariVu™ to our practice. CariVu is a new fiber optic trans-illumination technology from Dexis that will help us with better and earlier diagnosis of tooth decay (caries), between your teeth. Earlier detection of course, leads to more conservative and less expensive treatment options.

carivuThe CariVu technology is painless, and allows us to produce Images that are radiation free. The technology works by bathing the tooth in safe, near-infrared light which makes the tooth’s enamel appear transparent, while porous lesions trap and absorb the light. Images read like familiar X-ray images.

This new technology, in conjunction with your periodic exam, x-rays and hygiene visit will help to improve your overall dental health.

Please ask us about CariVu or any of oral health issue the next time you are in the office or in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA.

Halloween and the Surprising Truth about Cavities


Yes, it’s that time of year again – Halloween – now second only to the Christmas holiday in the amount of money and attention we pay to it as a culture. Halloween – that time of year when children across the country dream of dressing up as their favorite character and scouring the neighborhood for as much candy as they can carry. And for parents – it’s a time for enjoying the festivities but in the back of their minds – the worry of “sugared up” hyperactive kids bouncing off the walls and the inevitable tooth decay and dental bills from all of that sugar.

But if you think that it all begins with that first candy bar you couldn’t be more mistaken. The truth is that your child’s teeth are at risk long before their first exposure to sugar. Tooth decay is actually the result of a bacterial infection, specifically lactobacillus. Infants are born without these cavity-producing germs but typically are infected by their mothers before the age of two through sharing utensils and toothbrushes.

Once infected, children will be prone to decay for the rest of their lives! Sugars and other starchy carbohydrates contribute to the problem because they are the bacteria’s favorite food. Bacteria easily turn these foods into acids that eat away at the structure of the teeth by depleting calcium. Once the decay process destroys enough of the integrity of the tooth structure, it collapses, causing a cavity or hole in the tooth.

Bacteria do the most damage when they “colonize” on the surface of the tooth and form a transparent sticky film known as “plaque”. Plaque is actually a bio-film and concentrates the acids produced by the bacteria on the tooth surface. The CDC (Centers for Disease Control) estimates that bio-films cause 80% of all human illnesses! It may also surprise you to know that at least 4 million preschoolers (about 40% of all 2-5 year olds) suffer from tooth decay making it the most common disease in children, affecting even more kids than asthma and diabetes!

In recent years tooth decay has been on the rise in part for the following reasons:

  • Some communities have opted to discontinue fluoridating their community water supplies. (Fluoride makes teeth more resistant to the acids produced by decay causing bacteria.) This is particularly surprising in light of the fact that the CDC has stated that community water fluoridation is one of the top ten public health advances in the last 100 years!
  • There has been an increase in the use of bottled water, which typically does not contain fluoride.
  • The prevalence of high fructose corn (HFC) syrup used as a sweetener in most of our processed foods including juices and sodas. HFC syrup can actually be more damaging to our teeth than other sugars! Sodas are particularly harmful because they are acidic to begin with and lower the pH of the saliva, making it even more acidic.
  • Many of us get our drinking water from wells that may not be naturally fluoridated.
  • Access to care in underserved areas of the country, and in some underserved populations, continues to be an issue in this country as well as a throughout the world.

So here is a list of my top 10 things you can do to improve the dental health of your children:

  1. Make sure your child has a dental check-up by the age of one as recommended by the American Academy of Pediatric Dentistry (AAPD) and has regular visits thereafter.
  2. Use fluoride supplements if your local water is not fluoridated. Your dentist or pediatrician can supply you with appropriate prescriptions.
  3. Limit exposure to sugar and starchy carbohydrates, especially around the holidays. And remember, it’s not the total amount of sweets consumed, but the number of exposures to sweets throughout the day that matters most. I recall the mother of a childhood friend who took control of the Halloween stash and periodically doled it out to my friend over the next several months following the holiday!
  4. Set a good example. Take care of your own smile by practicing good oral hygiene, brushing and flossing regularly.
  5. Make sure your child brushes twice a day (after breakfast and before bed) for two minutes each time. Choose a child size toothbrush with soft bristles and replace it every 3-4 months.
  6. Consider using Xylitol products. Xylitol is an all-natural sugar substitute. It comes from beech trees and other natural plant sources and is “non-nutritive” to the bacteria that cause decay. It is also completely safe. (Studies have even shown that expectant mothers that chew Xylitol gum give birth to children who have healthier mouths!)
  7. Never allow infants to sleep or toddlers to walk around with milk or juice drinks. This produces what dentists call “baby bottle tooth decay”.
  8. Avoid toothpastes containing fluoride for children under the age of two; they tend to swallow it. Use water or a non-fluoridated toothpaste.
  9. For children ages 2-6 years old, use a pea-sized amount of a fluoride toothpaste, and make sure they spit it out after brushing. Any more than that is wasted.
  10. And remember – when in doubt, ask your dentist. With proper guidance, most children should be able to graduate high school today with no cavities!

There are many helpful references to this important topic, some of which have been used to develop this article. These include the ADA’s brochure: “Happiness is a Healthy Smile: A Message for Parents”, available through your local dentist, and Rebecca Feisenthal’s article in Parents Magazine: “The Surprising Truth About Cavities”, published in the October 2006 issue and available online at:

Other helpful websites where you can read more about this important topic include: (the ADA’s consumer site with a complete section on babies and kids) (for more information on healthy foods and drinks for your children)

Feel free to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA with any questionsor concerns on this important topic, or to schedule your next visit so we can talk more about this. In the meantime, have a safe and happy Halloween!

Fluoridated water – why all the fuss?

Fluoridated Water

When I read this morning that the city of Dallas, Texas was considering discontinuing fluoridating its public water supply I couldn’t believe my eyes! But it’s true! The city fathers want to save money ($1.8 million for a 3 year contract) by discontinuing the practice after nearly 50 years. Dallas would be the largest city in the country to do this. Approximately 210 million people in the U.S. receive the benefits of drinking fluoridated water-20 million people in Texas alone!

 So why all the fuss? Several reasons:

  • Firstly, the Centers for Disease Control (CDC) has stated that fluoridation of public water supplies is one of the top 10 public health advancements in the last century! No one can seriously argue that drinking fluoridated water helps prevent tooth decay by strengthening the enamel of children’s teeth while they are forming.
  • Secondly, the move by the industrial food chain in America to a corn-based and processed food diet has wrought havoc on the decay rate in children in particular. Decay rates that were initially lowered with the help of fluoridation are now climbing again thanks to foods and drinks sweetened with high fructose corn syrup. (As a reference consider reading The Omnivore’s Dilemma by Michael Pollan.)
  • And finally, in the end, the cost of treating dental disease would be much higher than the investment needed to prevent it. In this case an ounce of prevention really is worth a pound of cure!

Any questions? Don’t hesitate to contact me or the office, Dr. Laurence Stone in Doylestown, PA, today to schedule your next appointment and we can talk more about this. See you soon!


Olive Oil as a Gargling Agent?

Oil Pulling

The first time I heard of “oil pulling “ was a few years ago when a periodontist friend of mine suggested it for a patient of ours who was not responding to traditional therapy. I decided to write this blog about it in part because another patient asked me about it this morning. Apparently this centuries-old Ayurveda technique has seen a resurgence in popular culture. Why, I’m not sure!

The practice itself involves swishing oil (usually sesame, olive, sunflower or coconut oil) in the mouth for twenty minutes and then spitting it out. Theoretically, this “pulls” harmful bacteria and toxins from the body and traps them in the oil.

The ancient Indian practice of Ayurveda claims that oil pulling can be used to treat some 30 systemic diseases. What limited studies there are demonstrate that this practice can be used to reduce halitosis (bad breath) and to control the bacteria associated with tooth decay. Anecdotal claims have been made that suggest oil pulling can also reduce plaque and tarter in the mouth and even whiten teeth!

While there may in fact be some value to oil pulling, what bothers me the most about the practice is why someone would undertake this when we have so many tried and proven methods for achieving the same or better results today. In addition, I find that most people have a difficult enough time finding two minutes a day to brush and floss their teeth, let alone taking 20 minutes for oil pulling. That being said, if you are so inclined to try this technique, I would be more than happy to hear about your experiences with it next time you visit the office.

Please contact Dr. Laurence Stone in Doylestown, PA today to schedule your next appointment.


Candy and tooth decay – It’s raining candy; what’s a parent to do?


With Halloween upon us I would be remiss without making a few hopefully helpful suggestions on how best to weather the “ candy storm”! With almost $ 7 billion in sales, Halloween has somehow become the second most popular holiday in America, only outdone by the Christmas season. The Huffington Post reports about $2 billion of that in the sale of candy alone!

No, this doesn’t translate to an immediate need for my services starting the day after, but it does give pause for thought on the consequences of our behavior. The consumption of treats sweetened with high fructose corn syrup not only adds to the problems of obesity and diabetes, but promotes tooth decay as well. Every parent is tasked with the responsibility of how to handle this challenge, so here are a few suggestions to minimize the destruction. I hope this helps.

  1. Take control of the candy supply and dole out sweets periodically throughout the holidays.
  2. Make sure your kids swish with water after indulging to dilute the acids created by  decay causing bacteria. (Don’t brush immediately after eating candy as this could contribute to erosion of enamel!.)
  3. Avoid hard or sticky candies that stay in the mouth a long time and feed those nasty bacteria.
  4. Substitute healthier snacks when possible.
  5. Don’t allow late night snacking before the kids (you too!) go to bed.
  6. Make sure you brush and floss before bedtime.
  7. Insist on fluoride treatments for the kids when at the dental office. (The CDC has called fluoridation of public water supplies one of the top 10 public health advances of the last century!)

I hope you enjoy the holiday and don’t wind up paying the unanticipated costs of overindulgence.


Best wishes,
Larry Stone, DDS

Tooth decay prevention – Without question, the best way to treat it is to prevent it!


Is tooth decay prevention really possible? We believe it is by sticking to a diet that does not promote decay and by performing our home care procedures adequately. (Anyone reading this post who has been a patient in our office, knows that we give homework!)

Occasionally, however, we still come across situations where tooth decay rears its ugly head. Here are a few novel ways we sometimes recommend for dealing with this problem today.

  1. Increase the amount of arginine in your diet. This means eat more spinach, soy, seafood and nuts.
  2. Brush with baking soda or mix your preferred tooth paste with baking soda. This neutralizes the pH in the mouth making it less desirable for the bacteria that cause cavities.
  3. Use Nuvora products ( These lozenges contain Xylitol and baking soda and prevent the pH in the mouth from dropping to critical levels.
  4. Use a chlorhexidine mouth rinse for a few weeks to kill some of the bacteria. Then return to fluoride containing products.
  5. Try using Glylic lollipops ( Glylic is a compound from licorice root that has specific antibacterial properties against the germs causing tooth decay and periodontal disease.
  6. Chew Xylitol gum. Ice Breakers “Ice Cubes” gum has the highest concentration of xylitol. Chew 2 pieces of gum three times a day.
  7. Try using MI paste. This is the only product that changes plaque biology. We have it in the office and can show you how to properly use it.
  8. Get your saliva tested! There are several diagnostic tests now available at the office that can analyze your saliva for decay risk.

Call us if you think you may be at risk or have a history of tooth decay! And remember – do your Homework!

What is Dry Mouth (Xerostomia) and Why Should You Be Concerned?

Drinking water to alleviate dry mouth

(Hint: Think Desert)

One of the most serious problems facing the dental profession today Is dry mouth (xerostomia).

First of all, let’s look at what produces dry mouth. There are actually many reasons you could experience dry mouth including:

  1. Dehydration
  2. Medications – there are over 400 medications that create dry mouth as a side effect
  3. Smoking
  4. Aging – aging salivary glands naturally produce less saliva

Why is dry mouth such a problem?

Your saliva not only contains enzymes (naturally produced chemical compounds) that aid in the digestive process, but it also contains antibacterial elements that fight tooth decay and gum disease.

So, you can imagine that without an adequate quantity and quality of saliva, our mouths can suffer from the ravages of tooth decay and gum disease.

What are the signs of dry mouth?

  1. A cottony feeling in the mouth
  2. Difficulty in chewing food properly
  3. Difficulty swallowing
  4. Alterations in taste

 What can you do?

There are many things we can do to help alleviate xerostomia.

  1. First on my list is keeping adequately hydrated, by drinking enough water.
  2. Use products like Biotene that are specifically designed to help alleviate the problem.
  3. Avoid foods high in acid content like sodas, which can demineralize the teeth.
  4. Chew Xylitol gum. Xylitol is an all natural sugar substitute that kills the bacteria that cause tooth decay and the very act of chewing stimulates salivary flow!

Also, call our office and request a salivary test! There are new diagnostic tests that are easy and painless that will guide us in customizing a treatment for you if you are suffering from dry mouth!