Dear Dr. Ellie: 

I am wondering what the purpose of the crest is. It seems like you have said in children with cavities, just the Act is best to not further damage teeth…is that right? Is it better to brush or swish with the Act?

When do you have to get a cavity filled and if you do, what is the safest kind? I have my children on the program (xylitol and Act for the younger ones and the whole program for my eight yr. old) and wanted to recheck them in 6 months.

Someone earlier on your blog mentioned from your book about using the program for 2 years…is this a life long program or do you do the whole program and then a maintenance program?

Thank you so much.. we have been on the program for 2 months and are pleased!!


Hi L,

Sorry for the delay in responding to your question. I have had a lot of questions recently!

Toothpaste is not necessary for “cleaning” teeth. You can clean teeth just as well with or without a paste.

The purpose of paste when I suggest it – is for the application of sodium fluoride to remineralize teeth and offer them protection from acidity. Xylitol and probiotics do a far better cleaning job than any paste!

Listerine has been shown to be an extremely valuable rinse for eliminating gum disease bacteria. Recent studies show that a one-minute rinse with Listerine will eliminate almost all the harmful germs that cause gum disease. Twice a day rinsing with Listerine has been shown to be more effective than any flossing for cleaning between teeth.

The problem with Listerine is that it is very acidic – with a pH of 4.2. I suggest the use of Crest Cavity Protection paste immediately before the Listerine rinse to offer an immediate protection from the acidity. The sodium fluoride in this paste is easily released to the tooth surface, since the other main ingredient in this paste is silica ( not chalk). Chalk tends to bind the fluoride and not release it to the tooth surface. This is why I want people to coat their teeth with Crest BEFORE they rinse with the Listerine.

Children do not need to use the complete system until they have adult teeth. Once they start using the whole system – you really cannot pick it apart and use one piece without the other. Children younger than 6 can use xylitol and then brush ACT onto their teeth – until they are old enough to rinse with ACT.

I hope this answers your questions about toothpaste.

As for how long will you need to use this system…. – well……..this is your insurance against cavities and gum disease. If you are aware of all the health issues triggered by gum disease – you probably will want to live a healthy, happy , long and active life. I do – which is why a couple of minutes morning and night is not a very big price to pay!

Hope this helps,


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