As dentists, our main priority is to implement the best practices in oral health care to our patients. This comes with knowing exactly what contributes to the many different dental problems we treat day in and day out. As you may already know, one of the biggest factors that lead to deteriorating oral health is imbalanced pH levels in the mouth.
In today’s processed-food, sugar-driven world, our patients’ oral pH levels are constantly at risk of becoming too acidic for their teeth and gums to handle. Though much of this is dependent upon a patient’s personal lifestyle choices, we have to ask ourselves: How can we use knowledge of pH in our practice to better assist our patients?
How Oral pH Works
Before applying your knowledge of pH in your practice, it’s best to make sure you’re fresh on your facts. pH stands for “potential of hydrogen” and measures the acidity of a substance. The pH scale begins at 0 and ends at 14, with 0 being the most acidic and 14 being the most alkaline. The very center of the scale indicates neutrality. We want our patients’ mouths to be as close to 7 as possible. However, when our patients ingest sugar, citric acid, or foods high in certain kinds of carbohydrates, it combines with the bacteria in their mouth and creates lactic acid.
An acidic mouth allows harmful bacteria to thrive. And we all know what happens once harmful bacteria begin to thrive: enamel erosion, tooth decay, gum disease, and even bad breath. Add measuring and recording your patient’s pH level with Litmus Paper as part of your risk analysis.
Treat and Prevent Oral Acidity
Even if a patient does not exhibit signs of oral acidity—such as cavities or cervical erosion—you should create a log by using saliva pH strips. Oral pH strips are a simple way to measure a patient’s pH levels. If you notice his or her pH level are regularly lower than 6.25, talk to your patient about his or her lifestyle habits and suggest the necessary changes that need to be made.
Furthermore, consider keeping products meant to balance pH levels in your office for patients to use. Some of these products include chewing gum sweetened with xylitol and good old-fashioned baking soda, both of which alkalize pH levels. Offer alkaline mouthwash during the hygiene visit instead of alcohol-based rinses which dry out the mouth.
Regardless of what products you have on hand, make sure you inquire into your patient’s lifestyle. Although dietary habits are the most common cause of oral acidity, it could be an indication of other medical conditions. Geriatric populations and post-radiation treatment survivors are most prone to root decay from acid erosion due to the reduction of saliva flow and volume.
Add pH to your Dental Practice
Testing saliva and prescribing a take-at-home medicament are covered insurance codes that can be a profit center for your dental hygiene department. As part of CAMBRA risk analysis, dietary acids and the quality and quantity of saliva are key determinants for caries management:
#D0425 Caries susceptibility tests. Get trained in CAMBRA risk analysis.
#D0418 Analysis of saliva sample-chemical or biological analysis of saliva sample for diagnostic purposes. Test and keep a record of pH before/after an acid challenge.
#D1310 Nutritional counseling for control of dental disease. Consider hiring an in-office licensed nutritionist as part of integrated practice.
#D9630 Medications dispensed in the office for home use.
Source: CDT 2011-2012 The ADA Practical Guide to Dental Procedures Code Book