Optimal Home Mouth Hygiene

Medically Managing Your Mouth

First and foremost, don’t ignore any blood in the sink!  Blood means that inflammation is present, and that there is an avenue for bacteria to enter your bloodstream. Inflammation is commonly caused by high risk, disease causing oral bacteria.

Your Mouth is Like a Fishtank

Chris Kammer, DDS, past president of the American Academy of Oral Systemic Health (AAOSH) compares our mouth to a fish tank.

“Think of the saliva as water in a fish tank.  Think of your teeth as stones in the fish tank.  You could polish (and floss) the stones until they were perfectly clean, but if the water in the tank were dirty, the stones would immediately get dirty again. ”

His point is that cleanings by your hygienist are important, and flossing is good, but more important is to create an environment of clean saliva by promoting the growth of healthy, good bacteria, and eliminating the bad bacteria.

Healthy bacteria are less adherent to your teeth, making them easier to brush away.

Healthy saliva will allow gum inflammation to heal, and will help close off the connection between your mouth and the rest of your body.  It will also strengthen and protect the enamel on your teeth.  The return on your effort will be very tangible:

  • Reduced plaque and easier cleanings
  • Reduce your risk of tooth decay and other diseases of your teeth and gums
  • Fewer unplanned trips to the dentist to treat breakdown and disease!
  • Most importantly, you may significantly reduce your risk of several systemic diseases
Optimal Home Oral Hygiene

The number of over the counter oral health products is head spinning.  For the past year, we have been on a mission to find the best combination of products to promote a healthy oral environment.

Initially, we simply suggested using Listerine in addition to flossing and brushing with an electric toothbrush.   We’ve watched countless LpPla2 cardiovascular inflammatory markers plummet!  LpPlac2 is a blood test approved by the FDA to assess a person’s risk for heart attacks and strokes.  Some have not improved as briskly as others and saliva testing has shown an incomplete improvement in high risk bacteria.  We anticipate that this simple system, in addition to office hygiene care, will improve everyone.

We have been fortunate to have met and interviewed many of the leading Dentists and Hygienists in oral systemic care.  Taking their advice, and adding my medical insight, we now recommend the following system.

The System

There are 2 components to my optimal home oral hygiene regimen.  One is a specific combination of tongue scraping, brushing and mouth rinses.  The other component is the regular consumption of xylitol.

Flossing is good, but if you have crystal clear fish tank water, keeping the spaces between your teeth and gums clear of infection and debris with flossing will be less time consuming.  Your dentist or hygienist will tell you whether your efforts are adequate. Individual needs will vary.

Scraping, Oral Rinses and Brushing:

There is scientific basis for this regimen, so please follow the specific order, and not rinse your mouth with water between the steps.  It only takes about 5 minutes and should be done twice daily.  You could literally prevent significant systemic disease in a daily 10 min. investment!

  1. Scrape with a tongue scraper for 10-15 seconds.
  2. Rinse with Closys mouth rinse for 60 seconds.
  3. Brush with a preferred toothpaste for 2 min (see below).
  4. Rinse vigorously with Listerine for 30-60 seconds.
  5. Rinse with Act 0.05% Anti-cavity fluoride rinse for 60 seconds.


  • Tongue scraping is very important.  Teeth comprise only 22% of the surface area of our mouth.  Reach as far back as you can because over 80% of all bad breath originates from anaerobic bacteria on the back of the tongue that emit volatile sulfur compounds!
  • Gargle when you use the Closys and Listerine since they are killing bacteria. Again, many bacteria thrive on the back of your tongue.
  • Don’t eat or drink for 30 min. after this system is completed.  It is ideal at bedtime.
  • Soak your toothbrush in Listerine for 30 seconds after brushing to disinfect the bristles.
Why Use Closys?

This chlorine dioxide rinse offers 2 benefits.  It complements Listerine by more effectively killing the oxygen hating anaerobic bacteria.  Closys is also good because it neutralizes any acidity in your mouth prior to brushing.  Focus on bathing your back teeth and tongue. This is where anaerobic bacteria live, and deeper pockets usually form in your back teeth first.

Choosing a Brush and Toothpaste

Studies suggest that sonic brushes like Phillips Sonicare are best because they extend their reach beyond the tip of the bristles.  If you use a traditional brush, make sure the head isn’t too big, so that you can reach all surfaces.

Most important is to brush where your teeth meet the gums.  Rinse your brush in Listerine for 30 seconds when done, and store the brush in a cup, so the bristles can dry.

Choice of toothpaste is important.  You want one that has sodium fluoride as the active ingredient and is plain without any “whitening” or “tarter control” agents.  They are too abrasive.  If you have an ultrasonic toothbrush like Sonicare, a gel is best.  Examples are Sensodyne Pronamel Gel and Tom’s Toothpaste Gel.

Why Use Listerine with a Fluoride Rinse “Chaser”?

This antiseptic mouth rinse complements Closys in killing bacteria.  Any of the colors/flavors that say “antiseptic” are preferable.  Follow it immediately with the Act fluoride rinse because Listerine is acidic and dries your mouth.  Acidity and dry mouth are the main causes of tooth decay, especially in older adults.

Act Anti-Cavity 0.05% Fluoride Rinse

This non-prescription fluoride rinse will moisten your mouth, neutralizes the pH acidity, strengthen your enamel, and some dentists think it may strengthen your fillings.  It is especially helpful at bedtime when the solution coats your teeth while sleeping.  A fluoride rinse is particularly helpful for children, but only once they are old enough to spit it out.