Insider Secrets From a Top Dentist

There are medications you can take to try to stimulate more saliva flow, such as pilocarpine (Salagen) and cevimeline (Evoxac), both FDA-approved. Or for over-the-counter remedies, consider xylitol candies (make sure you keep them away from your pets!), which encourage your salivary glands to produce more saliva, or Dr. Jen Dry Mouth Gel — which can relieve discomfort and gives you more lasting protection. And there are all kinds of toothpastes for dry mouth, too. One I like is Dr. Jen nano-hydroxyapatite toothpaste, available online. There are minerals in your saliva that help repair tooth enamel, and it basically supplements those minerals.

When you shouldn’t brush your teeth

There are two times when you should not brush your teeth. One is right after vomiting, even though it’s when you’d want to! The reason is because your mouth is very acidic after you’ve vomited. If you brush your teeth, you’re now moving all that acid around in your mouth, which can erode the enamel on your teeth. If you must brush after vomiting, rinse your mouth out first so you don’t spread all that acid around. The second time to avoid brushing is right after eating. And that’s for the same reason: As soon as you put food in your mouth, your mouth becomes acidic. Its pH drops. So if you go and brush, you’re brushing that acid all around. It takes about 20 minutes for your mouth to buffer all that acid, so you want to wait at least 20 minutes after eating to brush.

Control your snacking

The fact that it takes 20 minutes for the pH level in your mouth to return to normal reminds me that what you eat doesn’t matter as much as how often. It’s snacking frequently throughout the day that leads to more cavities. Because every time you put something in your mouth, it takes 20 minutes to buffer. If you take another bite, that’s another 20 minutes. If you’re constantly snacking, that means all day long, you’re bathing your mouth in acid.

Switch up your swishing with coconut oil

I don’t think it’s as important as flossing and brushing, but antibacterial mouthwash can be helpful because it gets under the gums. One of the most effective things to rinse and swish with, however, is not mouthwash. It’s coconut oil. Coconut oil is great because it’s cheaper than mouthwash, and because the fats in coconut oil can actually help break down some of the bacteria that’s in the mouth. In fact, there have been studies (most recently a March 2025 small triple-blind study with 30 participants) comparing chlorhexidine — a prescription-strength antibacterial mouthwash — with coconut oil, and the coconut oil was just as effective. 

It’s less about the order

There’s some disagreement about the proper order for brushing and flossing and using mouthwash. I’ve been a dentist for 17 years and I still don’t know the answer. Personally, I use my water flosser first, then I floss, then I brush. My feeling is that if you floss after you brush your teeth, now you’ve got a piece of steak floating around in your mouth after you’ve already brushed.

But on the flip side, when you brush your teeth first, you’re creating fluoridated saliva, basically. So when you floss second, you’re getting that fluoridated saliva in between your teeth, which could be a good thing. Either way, you want to avoid rinsing with water or mouthwash after you brush. Because if you’re using a fluoridated toothpaste, you want that fluoride to stay on your teeth. The one exception would be if you’re using a fluoridated mouthwash. If you’re using a fluoride rinse, I would do that after brushing.

Ask about prescription toothpaste

One thing that makes prescription toothpaste different from regular toothpaste is the fluoride content. It’s higher than what they can sell over the counter. Prescription toothpaste is worth getting if you’re at high risk for tooth decay. If I see somebody who has a lot of tooth decay, I’ll recommend it. It’s a lot more expensive than regular toothpaste — like, $25 per tube if you pay out of pocket — but it’s cheaper than a crown. Sometimes prescription insurance will pay for it.

Prevent cavities with probiotics

Bacteria in the mouth are normal — everybody has them — but our bodies are constantly trying to balance the good bacteria with the bad bacteria. And when the bad bacteria are in higher amounts, they’re producing more harmful acid that breaks down the teeth and causes cavities. There are now probiotics aimed at reducing those bad bacteria specific to the mouth. One that comes up more than any other is called BioGaia (you can buy it online at biogaia.com). It comes in little droplets you put on your tongue daily, or there are little lozenges. The drops, but not the lozenges, are also available at CVS. No prescription required. It’s basically good bacteria that reduces the bad bacteria, and there are more than 200 studies that have shown it’s more effective in many cases than just fluoride alone. I just started using it a couple of months ago. It’s not cheap, but it’s one of the more promising things happening right now in preventive care.  

Be wise about whitening

A lot of whitening products are gimmicks. Charcoal, for instance, I’m not sold on. Whitening toothpastes are very abrasive, which is fine for removing, like, a tea or coffee stain from the outside of the tooth. It might help a little bit. But most stains require bleach to sit on the tooth for 20 to 30 minutes. So whitening strips usually work better. But the older you get, the more compacted the pores of your teeth are, which means bleach isn’t as effective. Someone who’s 15 is going to get very, very white teeth when they bleach, but somebody who’s 70 might only get their teeth a little bit whiter. Their teeth are still going to be somewhat yellow, because it’s just hard to get older adult teeth very white.

Try Curodont for filling-free cavities

While we’re talking about preventive care, Curodont Repair Flouride Plus is a new anti-cavity treatment product that’s FDA-approved to reverse tooth decay. It’s been in Europe for a while, but it’s relatively new in the United States. It’s basically a peptide chain that comes in the form of a gel that you paint on the tooth. It takes the calcium, phosphorous and hydroxyapatite from your saliva, and it soaks it back into the tooth and actually reverses cavities. It’s the first product that’s been proven to reverse cavities. It has a 90 percent success rate. No drilling and no filling. It doesn’t work if there’s a physical hole from the cavity, but it’s a wonderful preventive treatment for an early lesion. I’ve seen it work in my office where someone has had a cavity, and six months later we take an X-ray and the cavity is gone.

Be mindful of menopause

During menopause, women can experience changes in oral health due to hormonal fluctuations — primarily a decline in estrogen, which can lead to dry mouth, increased risk of gum disease and bone loss in the jaw. When there’s a hormonal imbalance, some women also get burning-mouth syndrome, which feels like your mouth is on fire. Very often it’s a deficiency in vitamin B12 or estrogen. So if you have a burning mouth at random times — not just when eating — you should have your primary-care doctor do some blood work to find out why.

Identify sleep-disordered breathing

A lot of older adults will find that their teeth are wearing down. They’re breaking teeth, for example, or they’re cracking fillings, or their teeth are falling out. One potential cause is clenching or grinding, and the No. 1 reason somebody is clenching or grinding their teeth at night is that they cannot breathe. Sometimes it’s a nasal obstruction. More often than not it’s their tongue choking them. When you’re awake and alert, you have muscle tone. Your tongue is up and forward. But as you go to bed and fall asleep, that muscle tone starts to go away, especially when you’re older. The tongue just kind of flops back into the airway. So now you have to work a little harder to get the same airflow you’re used to, which causes you to toss and turn and clench and grind.

So what can you do about it? The first thing is to ask your dentist or primary care physician about sleep-disordered breathing. That usually requires a sleep study to get to the root cause. If you do a sleep study and determine that you’re not breathing well at night, there are oral appliances you can wear at night. Some are better than others. Some of them pull your lower jaw forward to open your airway. Some of them are like a suction cup that pull your tongue forward. There also are implants that are linked to your nerves, almost like a pacemaker, but for breathing. And for some patients, myofunctional therapy can help strengthen tongue muscles to reduce sleep apnea. A lot of times, a CPAP is the only solution.