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How to Medically Manage Your Mouth: Optimal Home Oral Care Guide

person brushing teeth

First and Foremost:

Don’t Ignore 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 Fish Tank

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.”

Dr. Kammer’s 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 tooth plaque and promote easier professional 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 periodontal disease and several systemic diseases influenced by uncontrolled periodontal disease!

Optimal Home Oral Hygiene

There are 2 components to the 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, which is a natural sugar substitute that helps reduce acid-causing bacteria in the mouth.

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

Please note that the following system is NOT a substitute for regular (at least twice a year) prophylaxis and oral exams with your dental professional.

Oral Rinses and Brushing

There is scientific basis for this regimen, so please follow the specific order, and do 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 periodontal disease and significant systemic disease with a daily 10 min. investment!

  1. Scrape with a tongue scraper for 10-15 seconds.
  2. Rinse with CloSYS or ProFresh (chlorine dioxide mouth rinse) for 60 seconds.
  3. Brush with a preferred (non- abrasive or non-whitening toothpaste) or ClinPro5000 as recommended, for 2 minutes.
  4. Rinse vigorously with Listerine for 30-60 seconds.
  5. Rinse with Act 0.05% anti-cavity neutral sodium 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! If you have difficulty with gagging, I suggest you try this gagging desensitization protocol:

  1. Gargle when you use CloSYS or ProFresh, and Listerine since they are killing bacteria. Again, many bacteria thrive on the back of your tongue.
  2. Don’t eat or drink for 30 min. after this system is completed. It is ideal at bedtime.
  3. Soak your tongue scraper and toothbrush in Listerine for 30 seconds after brushing to disinfect them and store the brush upright in a cup, so the bristles can dry.


Why Use CloSYS or ProFresh? The chlorine dioxide ingredient in both products offers 2 benefits. It complements Listerine by more effectively killing the oxygen hating anaerobic bacteria. Chlorine dioxide rinses are also good because they neutralize 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 around your back teeth first.

Choosing a Brush and Toothpaste:

Studies suggest that sonic brushes like Sonicare are best because they extend their reach beyond the tip of the bristles and loosen the plaque biofilm more completely.

If you use a traditional manual brush, make sure the bristles are soft and the head of the brush isn’t too big, so that you can reach all surfaces. Most important is to brush where your teeth meet the gums.

Choice of toothpaste is important. You want one that contains neutral sodium fluoride as the active ingredient and does NOT contain “whitening” or “tarter control” agents. They are too abrasive.

If you have a sonic toothbrush, 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 the chlorine dioxide rinse in killing bacteria. Any of the colors/flavors that say “antiseptic” are suitable. Follow it immediately with the neutral sodium fluoride rinse (example ACT) 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 (neutral sodium fluoride) rinse will moisten your mouth, neutralize the pH acidity and strengthen your enamel. It is especially helpful at bedtime when the solution coats your teeth while sleeping. Do not swallow the fluoride. A fluoride rinse is particularly helpful for children, but only once they are old enough to spit it out.


Multiple dentists I’ve spoken to feel the regular use of xylitol is a very effective way to prevent gum disease and tooth decay.

Xylitol is a 5-carbon sugar alcohol used as a sweetener. It is very different from other sugar alcohols like sorbitol and mannitol. It’s very low glycemic index of 7 makes it the ideal sweetener for diabetics. Humans don’t actually use insulin to metabolize it!

Originally extracted from birch bark, xylitol now mainly comes from corn cobs. American Indians chewed on sticks made from birch bark, which is likely why their dentition was so good. Military dentists provide xylitol to troops in the field who often aren’t able to brush regularly.

Xylitol works by killing the bad bacteria. The disease-causing bacteria are able to ingest xylitol, but they are not able to use it for food. Therefore, they starve themselves to death! Xylitol promotes the growth of good bacteria, which are not as adherent to teeth, and are more easily brushed and flossed off.

Other Xylitol Facts:

  • The bacteria mix produced by consuming xylitol is less adherent to teeth, so it brushes off more easily.
  • Xylitol plus the fluoride rinse whiten teeth. A film of bacteria can accentuate staining substances like coffee and red wine. Stains brush away when the less adherent good bacteria are released. Enamel strengthened with fluoride will better resist staining. Also, strong enamel reflects light and will appear whiter than soft teeth that are more translucent and show the underlying yellow dentin.
  • Studies show that 6-10 g must be consumed daily to receive the beneficial effects. More is not likely dangerous, just not shown to be more effective.
  • Xylitol must be consumed frequently over the course of a day, preferably 5-6 times per day. Gum, breath mints, and a granular form for drinks make this easy.
  • Xylitol effectively neutralizes an acidic meal or drink, so consuming it after meals and snacks is perfect.
  • Purchasing 100% xylitol without significant other ingredients is important. Other ingredients can reduce its effect.
  • Keep xylitol away from your dog. It can be deadly!

Reducing Sinus and Ear Infections:

Bacteria found in our nasal passage are similar to those found in the mouth. Studies have found that young children who consume xylitol experience 42% fewer ear infections. Xylitol nasal spray is available and may reduce sinus infections. I’m sure this is particularly exciting to many of you!

There is very little downside to xylitol consumption. Some people get some mild gastrointestinal symptoms like gas. Most find this gas resolves with continued use.

Simplifying the Process

Most mouth rinses and toothpaste/gels can be purchased on Amazon, and most grocery stores and pharmacies, although the availability of CloSYS and ProFresh is variable.

Call us today at 813-448-6555 with any questions or to schedule your appointment.

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