Don't Get Caught With Your Teeth Falling Out

By Deborah Sanborn

Follow the 2 Great Rules of Good Oral Health: start young and be consistent, even when you're on the road

The growing standard in dental care is teeth so straight they’d impress a drill sergeant, and so white they glow like neon. This is not a bad thing, since it means more people are subscribing to the modern mantra of good dental health, which is that teeth are for life. For travellers, following the two key rules of care—start young and be consistent—can be an inconvenience. In the throes of adventure, flossing is hardly top of mind. Of course, that’s exactly the reason to get a thorough dental checkup before you hit the road.

According to the Canadian Dental Association (CDA), there are several potential problems that only a dentist can spot. 

Unknown, but growing, tooth decay (a cavity or root infection in progress) is one of the most important. Tooth decay doesn’t happen overnight. It can take weeks of exposure to bacteria before you even sense a problem at work. “Specific bacteria in your mouth eat the sugar [you’ve consumed], and you get a 20-minute acid attack on your teeth,” says Carol Yakiwchuk, a dental hygienist and health promoter. During each attack, the enamel (surface) and structures of your teeth are demineralized, so the more sugar you consume—whether in natural foods like fruits and juices, or in artificial products like pop—the weaker tooth enamel becomes. Compounding the problem, especially for travellers, is not brushing as often as you should, since fluoridated toothpaste re- mineralizes and strengthens enamel. An X-ray will catch early signs of decay in places you can’t see, and long before it manifests as a toothache or problem needing a health professional.

Both Yakiwchuk and the CDA cite other concerns only a dentist can detect:

Deterioration in fillings or crowns; cavities between teeth; decay on roots exposed by receding gums; decay under the gum line; cavities growing under fillings; unknown tooth fractures; and early signs of infections or oral cancer. Not only should you see a dentist before a trip, but also be sure to do so well in advance, and heed any advice about treatment. You’ll need time to heal after most procedures, particularly a root canal. And if your dentist says you need three things done, says Yakiwchuk, get all three things done! 

If avoiding a problem is the best reason to get your teeth checked before you leave, the second has to be avoiding dental care in a foreign country. With worldwide standards still so precarious, you just can’t count on practitioners abroad adhering to infection control protocols. “Something we consider a simple or uneventful dental emergency [like a cavity] could become a significant problem” for a traveller, says Dr. Linda C. Basquill of the Organization for Safety and Asepsis Procedures (OSAP), a global group of industry professionals working to improve dental practices worldwide. “If you don’t feel confident in their safety practices,” adds Basquill, who is a dentist, “walk away.” And if you spot traces of blood on the needle as it comes toward you, don’t just walk—run.

Pre-Travel To Do-List 

  • At checkup, get: X-rays of your mouth; teeth cleaned (to remove plaque, make gums healthy); professional fluoride treatment (to strengthen enamel).
  • Get immunized for hepatitis B and C, since they can be transmitted by unclean instruments and unsafe practices.
  • Buy the best travel health insurance you can; ask if it covers dental care.
  • Buy or assemble a travel dental kit (try pharmacies or shop online). If self-made, include: soft-bristled toothbrush (medium/hard push on gums); toothpaste; dental pick and mirror; floss; fluoride antiseptic mouth rinse; common painkiller, oil of cloves, topical oral anaesthetic; rubber gloves, cotton pads; dental repair products like dental wax, cement and temporary fillings. 

Q&A with Carol Yakiwchuk, instructor, Faculty of Dentistry, and manager of Health Promotion Unit, University of Manitoba

Outpost: You’ve said one of the reasons for a pre-travel checkup is that a dental problem doesn’t always mean feeling pain?

CY: You won’t feel the pain of that kind of tooth decay until it gets closer to the inner, middle of the tooth where the nerve is...and that’s often late in the process. The dental hygienist will check the overall health of your mouth—your gums, oral tissue, head and neck lymph nodes. You might end up with another issue you didn’t know about by looking in your mouth.

OP: things you can’t spot yourself?

CY: Absolutely, [like] a filling that’s getting old, with the margins that touch the tooth starting to pull away, or a space between them, or it might be time to replace a filling. If there
is a filling breaking down, you can have micro-leakage [material getting under the filling], and that could blow up one day and give you a real toothache because bacteria has penetrated the pulp chamber and touched the nerve. There are over 700 species of bacteria in the mouth. We used to say there were 300-plus species.... There are more bacteria in your mouth after a day of not brushing or flossing than there are people on the Earth. So the key is control.

OP: Chewing sugar-free gum helps keep teeth clean, and is a great option for travellers, correct? What kind of gum should we look for?

CY: Yes—chew it after meals if you can’t brush your teeth. It not only gets the saliva flowing, which helps clear food particles [and neutralizes bacteria], but some of the products have a natural sweetener called xylitol made from tree bark or tree pulp, and it can prohibit bacteria from growing, making it less sticky. Avoid substituting that for brushing, but if you’re backpacking in Tibet and you’ve just eaten lunch, chew gum for 20 minutes to clear out the food debris.

OP: You’ve said it’s beneficial to not rinse your mouth out with water after brushing your teeth with fluoridated toothpaste. Why?

CY: You retain some of the fluoride.... If you’re travelling off-the- beaten path you might not have [access to] water—and we know from research that...[toothpaste] can do a better job of keeping teeth strong when it’s not rinsed out. All you need to do is floss once a day, [brush] twice a day, and time yourself to make sure you brush for two minutes, because we know you have to disturb the plaque for two minutes.... We say, ‘two for two!’ And follow with brushing the tongue, because the tongue can be the number-one source of bad breath molecules.

Note: this information is a guideline only. Always get individualized advice from a qualified health professional (doctor or dentist) before travelling. For more info, go to: the Canadian Dental Association, www.cda.org; and oSAP, www.osap.org, click on “Patients,” then “traveller’s Guide to Safe Dental Care.” For when and how to use temporary dental repair products like waxes and cements, google “temporary dental repair.” Some sites have detailed instructions.


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