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Posts for category: A Word from the Dentist

By Bill Kuttler, DDS
September 27, 2018
Tags: beverages   snacks   drinks  

Snacks.  Everybody seems to like them – I know I do.  Those little treats between meals that give us a burst of energy or help tide us over until the next meal time.  The challenge is: What makes up a “good” snack?  I suspect that each of us may define that word “good” differently...

Snack desires certainly vary by age as well as by the individual.  With younger children, parents are more often involved in determining what their kids will be snacking on whereas older kids are probably selecting the things they want to eat or drink.  So in the first instance, it’s probably more important to be certain that the parents or other caregivers understand what will be good for the children, but in the second, we need to help the teens make wise choices.  (Perhaps in both instances, some of the issue is heavily impacted by the choices that whoever does the grocery shopping makes when they are at the store!)

Snacks can be subdivided into beverages and items that are eaten.  Beverages are comparatively easy – water is good.  Everything else is somewhat questionable.  I know – that doesn’t really help, but it is true.  I suspect almost everyone knows that pop isn’t good for your teeth, whether it is diet or regular.  In fact, there is fairly good research that shows that diet pop is worse for your teeth than pop with sugar in it – purely based on the amount of acidity.  What is a surprise to many people is that sports drinks are also bad for teeth.  They often have lots of sugar and almost always have, again, high acidity.  Fruit juices also are usually high in acidity.  Even milk, in spite of what we’ve been told, can be damaging to teeth, because it contains sugar and is retained longer in the mouth than some other beverages. 

So, how can we make drinks available for children and not create dental problems?  The answer is actually rather easy.  After the beverage of choice is consumed, have your child rinse their mouth vigorously with water for at least a few seconds.  That’s actually far better than brushing since the rinsing either flushes the acidity out of the mouth or at least dilutes it significantly.  Brushing actually causes more breakdown by scrubbing the acid into the teeth. 

Once that is dealt with, your choice is much easier – which beverages are potentially helpful for your child’s growth and health?  Not pop.  Ever.  Once in a while as a treat, if your kids like it, is probably not a problem.  But if you can keep them from ever growing to like it, that’s ideal!  Sports drinks are rarely indicated unless your child is actively involved in sports programs that are very vigorous and the level of exercise is high stress and lasts for more than an hour at a time.  Even then, after consuming them, rinse!  So milk and fruit juices (real juice, NOT juice drinks – read the label!) are probably best.  And rinse after drinking them.

For edible snacks, fruits and high protein items are probably best.  For fruits, again, rinsing after eating is a good idea.  Fruits have the advantage of providing a quick energy boost, but they don’t provide sustained energy.  Popcorn is another fun snack that’s fairly dentally healthy – as long as you avoid the un-popped kernels!  Cheese and/or chunks of meat of some kind are great sources of protein, as are many nuts.  Nuts have an additional advantage of not being chewy or sticky, so they are more easily cleaned or even rinsed away.  Some protein bars are also good – again, read the labels!  Protein provides a longer lasting or more sustained level of energy and a somewhat smoother increase of it as well. 

Things to avoid?  Avoid highly processed foods and items high in carbohydrates.  Chips and similar types of foods are highly retentive (they stick around teeth and are hard to remove) and may provide quick energy, but no sustained benefit.  Cookies and other dessert-like foods are almost always very high in sugar and very low in food value, so it’s best to avoid them.  In general, very sticky foods are difficult to clean and usually lead to problems. 

I hope this helps provide a new perspective for you.  If you have other suggestions for healthy snacks or questions about dental health, please send them to me at drkuttler@mydubuquedentist.com,  Thanks!

By Bill Kuttler, DDS
July 30, 2018
Tags: cavities   summer   beverages   snacks   retentiveness  

The song, “Summertime” with lyrics by George Gershwin was written well before I was born, but I can still sing (at least as best as I can sing at all) almost all the words, and I love the melody and the “feel” of the song.  For me, it truly does capture what I dream of when I think of summer!

For many adults, summer represents lots of fun and relaxation and perhaps a vacation or two – playing in the water, frequently with their kids, and sometimes simply laying in a hammock. 

For kids, it often represents two to three months of NO school!  That may involve later bed times, sleeping in, goofing off, less studying and more time for snacking and enjoying cold beverages....  OOOPS!

Sorry, but this is where reality and being a dentist sneaks in!!  I’m all in favor of good snacks and beverages – whether they are for big or little kids (and I believe we ALL need to let ourselves be a kid now and then!)  However, I want to encourage each of you to take care of your selves while you are being a “kid” as well as taking care of your actual kids. 

We dentists see a big jump in cavities whenever there is a jump in between-meal snacks and beverages.  So what’s the best way to keep that from happening?  Brush more often (especially with a fluoridated toothpaste), clean between your teeth more often, and even vigorous rinsing several times during the day helps prevent problems from happening.

Perhaps even more important than cleaning your mouth is being careful what you put in your mouth in the first place.  Let’s look at snacks first, and then beverages.  I look at three different factors about snacks:

  • How retentive are they?
  • How much sugar and / acid is in them? 
  • How “natural” are they? 

Retentiveness has to do with how long the food remains in your mouth after you eat it.  Snacks such as strawberries, carrot sticks, and celery aren’t very retentive.  On the other hand snack bars, such as “Cliff Bars”, stick to your teeth and hang around in your mouth a long time.  Thus LESS retentive is good. 

You don’t need to be a dentist to figure out that more sugar and more acidity are problems for teeth, so avoid them.  Fresh fruit may be somewhat high in acid and sugar, but that is balanced by the other properties of the fruit.  Crackers aren’t acidic at all, may be high in sugar (or not, depending on the brand), but they are extremely retentive.  Darn it, this isn’t as easy as you thought it might be, huh?

Then we add “natural”.  While lots of people get caught up in “natural” being better than “refined” or “processed”, with what is allowed in advertising today, I don’t trust those words.  I am a HUGE fan of label reading.  What is or isn’t added to what you are buying?  Fresh, raw fruits and vegetables are a great place to start – I believe they are almost always better snacks than refined stuff.  But some of the refined materials still make OK snacks – read the labels -- frequently!  It’s amazing how the product that you’ve bought for years suddenly changes – and often not for the better.  Suddenly sugar (and sugar substitutes) and other ingredients (often chemicals) are added when they weren’t there before.  By the way, sugar is often included in labels under a variety of names, often ending in “ose” such as dextrose, etc.  That allows the manufacturer to put lots more sugar in their product without it being apparent.

Now that I (hopefully) have created a bit of healthy paranoia, let’s switch to beverages.  Simply, water, right out of the faucet, is your best bet.  There is no sugar added, and it is a great neutralizer to minimize the effects of sugar and acidity that may have arrived from anything else you have eaten or drank.  It even helps rinse those more retentive snacks out of your mouth. 

Are you and your kids always going to want water? Probably not, but it would be great if we all did!  Almost ALL adult beverages are acidic.  Yes, that’s true of wine and beer as well. Most mixed drinks are acidic AND sugary.  Consuming them quickly versus sipping over a period of hours is far better dentally.  (This is emphatically NOT an excuse to binge drink!!)  Again, rinsing your mouth with water and alternating a glass of water with an adult beverage benefits you in MANY ways!) Pop or soda (whether sugar or sugar-free) and sports drinks are almost never good for you or your kids – again, read the labels.  If you do consume one, don’t brush right away – RINSE with water.  It helps eliminate the acid in your mouth and lets your saliva buffer that acidity so you don’t scrub away weakened tooth structure.

So, have a GREAT summer...and enjoy a treat every now and then.  Moderation is almost always a good rule to live by.  Use it to guide activities, rest, snacks, beverages, being with good friends, and some simple relaxation napping in a hammock!  ENJOY!

By Dr. Bill Kuttler, DDS
April 09, 2018
Tags: HPV   oral cancer   vaccination  

I remember when I was scheduled for my first colonoscopy, I was reluctant to proceed with it.  My doctor looked me in the eye and said “Colon cancer is the only cancer we can truly prevent, and we can do it by detecting polyps in your colon and removing them before they can develop into cancer.”  His comments had a huge impact on me, and my colonoscopy was performed the next day – and several polyps were removed.  Many years later I have colonoscopies scheduled when my doctors tell me to.  Yep, it’s a small hassle.  But based on the number of polyps I’ve had removed, it seems like a really small price to pay.

Having your children vaccinated against the human papillomavirus (HPV) is also a way to prevent cancers.  Research has shown that 2.5% of adolescents have HPV, and that 1 in 9 American men have oral HPV.  While HPV vaccinations are probably not quite as effective as colonoscopies, they are far easier.  The statistics I’ve read indicate the vaccinations are probably preventing 90% of related cancers.

HPV causes 70% of oralpharyngeal cancers.  While happily the numbers of oralpharyngeal cancer aren’t enormous, HPV causes about 31,500 cases of cancer in the US in both genders.  (While not all of those cancers are oralpharyngeal, I’m all about preventing ALL cancers.  So, if vaccinations can prevent 70% of those linked to HPV, that strikes me as huge!)

I suspect that there are people reading this who are against all vaccinations.  While I don’t agree with that perspective because I believe the safety of vaccinations is incredibly high, I’m not going to spend any ink arguing against that position.  I simply ask that they study the research and the options.

What I know is that when I first became a dentist, people who developed oral cancers were generally older adults, mostly males, who had smoked and consumed an above average amount of alcohol.  Today, the average age of people developing oral cancers is plummeting.  A significant percentage of those people don’t use tobacco and most of them don’t drink excessive amounts of alcohol either.  Further, most of them test positive for HPV.

For a large number of years the majority of HPV related cancers were cervical cancer in women.  Today, with HPV related cancers, oralpharyngeal cancer has overtaken cervical cancer.  Also for many years it seemed that most HPV related cancers were in women.  Today men are four times more likely than women to be diagnosed with oralpharyngeal cancer.  In less than 40 years, many of the statistics have been turned upside down – I find that both amazing and terrifying!

To make this even worse, many of the oralpharyngeal cancers related to HPV are found in and around the tonsils and are often far more difficult to detect than the more “traditional” types of oral cancer.  That translates to the reality that by the time those are detected, they are larger and are more likely to have spread – making treatment far more difficult and less likely to succeed.

In the beginning HPV vaccinations were encouraged more for girls than boys.  Today, I would want all of my children to be vaccinated.  The recommended age is 11-12, but the vaccinations can be given as early as age 9, and it is most effective if given before the age of 13.  Having said that, if your children have not been vaccinated or if you are a young adult, vaccinations can be given up to the age of 26, and they will still provide significant benefits.

I encourage you to have a discussion about HPV vaccinations with your medical doctor.  April is Oral Cancer Awareness Month – this seems like a GREAT time to take action!  Don’t just be aware of it, PREVENT IT!  (And tell your medical doctor that I sent you.)

By Dr. Bill Kuttler, DDS
February 26, 2018
Tags: smile   February  

It’s February – the month for lovers.  It’s also Dental Health Month which is essentially focused on the awesome goal of helping children have healthier and more comfortable mouths.  It’s also American Heart Month, Black History Month, and the National Organ Donation Event is on Valentine’s Day.  For a great many people I know, the most important part of February is that it is the SHORTEST month of the year – the one they celebrate when it’s over since that signals that spring is coming....

So no matter how you view it, there’s actually a lot going on in this month beyond simply waiting for it to be over!  While I don’t ski or do other active outdoor winter activities, I happen to LOVE winter.  When I looked out this morning to see 4" of fresh snow, I truly loved it.  I think it is awesomely beautiful.  And I still felt that way after spending two or more hours this morning plowing the road for the subdivision I live in and shoveling my driveway (and I still have half of that to go...!)

Which leads me back to that word “love”.  The Webster’s dictionary I have sitting here offers many definitions of the word, and the one that I like the most is also most fitting for what I’m writing about: “Warm attachment, enthusiasm, or devotion”.  That’s how I like to see people feeling about their smile – enthusiastic about it, devoted to caring for it and keeping it healthy and attractive, and being attached to it in a very positive way.

Sadly, my experience is that many people either aren’t happy with their smile or want it changed in some way or other...but don’t make the commitment to do so.  How many people do you know that you never see smile?  Or whenever they do, they have their hands in front of their mouths so you can’t see their actual smile.

The reason I’m asking this question in February – the month of lovers – is that I personally believe that people need to feel good about themselves and love themselves before they can truly love others.  Which leads me to believe that before they can form honest connections with another, they need to have that connection with themselves.

Of course we can fake out other people and work around the things that we don’t like about ourselves, but we are most authentically ourselves when we’re happy with who we really are.  We can more effectively share our joy with others when our smile shines through.  I also believe that lots of the beauty of a smile comes from within each of us – we don’t need to have perfect teeth to have a beautiful smile.  But for some people they really want to have a beautiful smile so it truly represents who they feel they are.  And that’s awesome.

My experience in helping people get that smile is that what each person expects or wants is very different while almost everyone is reluctant to ask us about it because they are afraid of what it will cost.  While some situations do require very extensive treatment that involves a substantial investment of time, money, and energy, some desires are easily fulfilled.  I treated someone last week who was convinced that his problem was going to require several thousand dollars to resolve.  We did it for him for a few hundred dollars, and he was both stunned and thrilled.

That’s the time that we have fun – bringing smiles to people’s faces!  And what it really takes is good communication.  If you don’t like something about your smile, talk to us about it.  Get ideas from us and then let us work with you for solutions that fulfill your desires in ways that allow you to be able to have it done.  Then you can really be the “lover” you want to be whether it’s with your kids, your significant other, or some new acquaintance.  Most importantly, so you can fall in love all over again with your smile!

By Dr. Bill Kuttler, DDS
December 15, 2017
Tags: dentist   smiles   hugs   kindness   toys for tots   holidays  

As teeth chatter in the arriving cold weather, we see more smiles as people prepare for the Holiday season. It doesn't seem to matter what your religion ( or lack thereof ) is, almost everyone seems to get into the joy of celebrating at this time of the year. Although we live in turbulent times, that doesn't seem to stop most of us from expressing gratitude and joy.

Want a brighter smile? Call us. Want to prevent teeth from shattering due to the chattering? Call us. Want to make a New Years resolution revolving around better health? Make an appointment with us and we can help you include your oral health with the bigger plan. I and our team can help you in many important ways. So with that, I've done my job of promoting dental health and services -- on to more fun stuff!

One of the things I'm most grateful for is that over 40 years ago I decided that I wanted to be a dentist. As a result of that decision, off I went to college and dental school because just like Hermey the Elf, I knew that's what I wanted to do. While lots of things turned out differently than I expected, I'm still joy-filled and delighted that I made that choice way back then. I, and the wonderful team I work with get to help people every day. What an honor and a privilege that you have placed your trust us, and then you even thank us when we've done for you what we really love doing!

So what fills your heart with joy? I hope you'll pause in the midst of this busy and crazy time of the year to consider that question. Then, when you've come up with some answers, do MORE of it! Maybe even LOTS more of it! Partly because you deserve it, but perhaps even more than that, I notice that when people I'm around are filled with joy, everyone around them is more joyful as well. What a great way to give gifts that don't even cost a dime.

Smiles are free! Hugs are free! Kindness is almost always free! Maybe many of us want to receive something material for Christmas, especially kids, but usually a lot less is expected than what is received. I remember as a kid often having more fun playing with the boxes that the gifts came in than the gifts themselves. Spending time with people who maybe don't have family near them might be the best gift you give OR receive all year long. I know that when I've done that, I almost always walk away feeling better than when I arrived.

The ‘Santa Spirit really IS alive! Probably the greatest gift was given by Santa, or any of us, is to really listen to each other. (Something I'm still working at learning....)

As many of you know, we have a box in our office collecting for Toys for Tots. Yes, buying something to put in that box costs some money, but I also believe it helps some kids feel a little love and joy that maybe they wouldnt have felt otherwise. That can bring joy as well to those of us who contribute. Thanks to Bryce Parks and all of the volunteers who help him make that happen every year in Dubuque and they are gifts to so many!

So PLEASE have a joy-filled holiday, no matter what your spiritual beliefs are. I only hope part of your belief system includes Peace on Earth and Good Will to all Men, Women, and Children! I hope everyone reading this has many reasons to smile this season, and a blessed 2018!