RENEE MONTAGNE, HOST:
David, you take care of your teeth, right?
DAVID GREENE, HOST:
(Laughter) Yeah, I guess I try to take care of my teeth, yeah.
MONTAGNE: OK, some question - something to think about in the morning for sure. Well, we're going to get advice in a few moments about using the right toothpaste.
MONTAGNE: Though, as we all know, if you don't brush enough, get ready for this.
(SOUNDBITE OF DRILL)
GREENE: That is terrible. That is not what I want to hear early in the morning.
MONTAGNE: Well, there is good news, and we're going to hear it now about a new painless way for adults to avoid the drill. Here's NPR's Vanessa Rancano.
MARION MANSKI: OK, Alice, we're going to put the fluoride varnish on your teeth now, OK?
ALICE CLASH: Yeah.
VANESSA RANCANO, BYLINE: At the University of Maryland Dental School, instructor Marion Manski peels the foil cover off a pack of fluoride varnish to reveal a skinny brush and a little pot of yellowish liquid.
MANSKI: I'm going to dry your teeth off with a little piece of gauze. I'm going to paint it on about 30 seconds or so, OK?
RANCANO: Fluoride treatments like this one are standard practice for kids. But today, Manski's patient is 91-year-old Alice Clash.
MANSKI: We're going to take this little brush and we dip it into the varnish.
RANCANO: While Manski carefully paints on the varnish, she explains why Clash is at risk for cavities.
MANSKI: You have some areas of decay, also because you have just a little bit of dry mouth, you know, from your medications. You have bacteria staying in the mouth - more of a problem with causing cavities. So the fluoride varnish will help that too, OK?
RANCANO: The varnish will help by seeping into her enamel and drawing in the calcium and phosphate that's naturally present in her saliva. The minerals will boost her teeth's natural healing process and make them more resistant to future decay.
MANSKI: And that's all there is to it.
RANCANO: Clash's age makes are especially susceptible to cavities. Like many adults, she's taking medications that cause dry mouth and she has a history of cavities.
NORMAN TINANOFF: So these preventative approaches work on adults just as well as they do on children.
RANCANO: Norman Tinanoff teaches dentistry here. He says part of what's made fluoride treatments popular for adults is a move to make dental care personal with individual treatment plans. To do that, you have to weigh a patient's risk of getting cavities. In the U.S., one of the biggest proponents of this approach is a man named John Featherstone. He's the dean of the University of California at San Francisco's Dental School. Featherstone came up with a way of measuring risk. It includes testing the level of bacteria in the mouth, looking at dietary habits, medical conditions, medications, saliva flow and history of tooth decay. Then he put his patients on personal treatment plans. The strategy worked.
JOHN FEATHERSTONE: It really proved that drilling and filling did not fix the disease. Putting in a filling fixes that hole in the tooth, but it doesn't deal with the bacteria in the rest of the mouth.
RANCANO: Traditionally, dentists were taught the only way to deal with decay was to drill it out. That's still important in some cases, but Featherstone figured that without fixing the underlying problem, bad bacteria, patients would just keep coming back for more fillings. He saw another way.
FEATHERSTONE: It's a little bit like your car starting to rust. If you can stop the rust before the rust goes right through the body of the car, then you're in good shape.
RANCANO: Like rust, tooth decay is a slow process. A full-on cavity is a hole that needs to be fixed. But if you catch decay early, Featherstone says, it can be reversed using treatments like varnish and concentrated fluoride toothpaste. A recent study found these techniques reduced the need for fillings in adults by 30 to 50 percent. Now it's a matter of getting insurance companies to pay. It's something they've been willing to do for kids, not always for adults. Vanessa Rancano, NPR News.
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