# survival dentistry article



## finn (Jan 5, 2009)

I found this, and though it's written for survivalists, it has much useful info:

Caries begins when bacteria in your mouth, digests sugar and creates acid, which dissolves tooth structure. As this process progresses towards the pulp of the tooth, you will experience pain. I know you all have heard this a million times but I’ll say it again because if you do this, you will have very few problems. Brush your teeth nd limit your sugar intake. . It really does work. If you can remove the bacteria, which predominantly resides in plaque, from your mouth, you will limit its ability to create acid. Also, the sugar intake frequency is more important than the amount of sugar. Every time you put sugar in your mouth, the bacteria will create acid for thirty minutes. If you drink one soda in 10 minutes, and then consume no more sugar the rest of the day, then you will only have acid in your mouth for about 40 minutes. If you take the same soda, and sip on it all day long, then you will have acid in your mouth all day long. Certainly limit the amount of sugar you ingest, but more importantly, limit the frequency with which you ingest it. Also, use a fluoride rinse every night. You should brush your teeth, then rinse your mouth, drink water if you want, and then rinse with the fluoride. Then don’t put anything else in your mouth and go to bed. The fluoride will sit on your teeth and make the enamel less soluble. It works.|

Toothpaste is not necessary in this regimen either. It is good but not necessary. Toothpaste is nothing more than a mild abrasive, flavoring and fluoride. If you want to make your own, you can use fluoride rinse and baking soda although baking soda is much more abrasive than commercially made tooth paste and can irritate your tissues. It is fine to use every now and then and just use fluoride rinse or water if that’s all you have the rest of the time.

If you do develop a carious lesion (a cavity), you can expect the following, which can take months or years to fully develop. These symptoms are never written in stone and vary greatly between individuals and even between teeth in the same person. But this should provide a general guideline so you can estimate what you are dealing with, what symptom may be expected with time and what treatment you may need. 

When the tooth structure has been sufficiently weakened, it will break and leave a hole (the cavity). At first you may have no pain and only experience a gingival irritation as food gets packed in it. You may have trouble getting all of the food out. Soon it will start to ache when you chew and possibly will be very cold sensitive. This decay is approaching the pulp of the tooth and is starting to irritate the nerves within the tooth. This is called reversible pulpitis, literally a reversible irritated pulp. This can be treated with a filling. When the tooth begins to hurt spontaneously, wakes you up at night and is sensitive to hot, then you most likely have an irreversible pulpitis. At this point, the tooth requires a root canal or an extraction. The toxins from the decay have reached the nerve and essentially have mortally wounded it. This may last for several weeks and if you gut it out, the pain will eventually go away. When the pain goes away, the nerve has died. Do not leave this tooth untreated! As the nerve decomposes, the body is unable to get inside the tooth to take care of it and you will eventually end up with an abscess. The pain will return with a vengeance. This tooth will no longer be sensitive to hot and cold but it will be extremely painfully to the touch. You may begin to run a fever and experience swelling. Some people say it feels like the tooth has “raised up”. It has. The infection is pushing it up. The infection will seek the path of least resistance in an effort to relieve pressure. If you are lucky it will establish drainage toward your cheeks or lips through the gums. Once the drainage is established, the pain may resolve somewhat. Again, don’t leave this untreated. If the infection, however, travels toward the tongue, neck or sinuses, to name a few places, it can become very dangerous, very quickly. Possible sequelae include septicemia, airway obstruction and pericardial infections. These complications are not common but are very dangerous and need to be treated by a medical professional. Some of the symptoms of these very serious infections will include increased temperature, swelling under your jaw, under your tongue and around your chin, swelling extending toward your neck, swelling in your throat that may begin to push your uvula aside, difficulty swallowing and/or breathing. Do not ignore these! Seek medical care immediately!

As far as field dentistry for non-dental personnel, you are pretty much limited to prevention, and possibly temporarily treating a reversible pulpitis. I have in the past taught 18Ds [The Army MOS for Special Operations Medical Sergeants] to extract teeth and even perform root canals but they are exceptional men in exceptional circumstances and we had a lot of time to work on it. In this venue I will suggest the names and techniques and perhaps you can fill in the gaps with a willing local dentist. 

Two long-standing temporary filling materials are Cavit and IRM. Both of these are a powder and liquid that when mixed will become very hard. The benefit of IRM is that it contains eugenol (clove oil), which is a sedative and can sooth a sensitive tooth. These will keep food and “cold” out of a cavity until you can reach definitive care. If you are somehow able to secure it, Fuji IX is a wonderful restorative material that will also release fluoride and can slow down/stop the decay process. I don’t know how you can get it without a dental license but if you are resourceful…please, I am not advocating non-dentists treating tooth pathology in any way, shape or form (i.e. don’t sue me if you try something and it doesn’t work). I am simply offering some observations from my own experiences that may be helpful when dental care is not available. In the end, you will need to find a dentist but hopefully these tips can help you prevent, treat or recognize the severity of dental pathology that you may encounter in remote areas.

link is at http://www.survivalblog.com/2008/12/survival_dentistry_by_the_army.html


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