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Posts for tag: dental health

By Bill Kuttler, DDS
March 19, 2017

“Why do I need to go to the dentist every _____?”  You can fill in the blank – I hear that blank space filled with words ranging from “6 months”, “year” to leaving it totally blank so the response is actually, “Why do I ever need to go to the dentist?”  I think that’s a legitimate question, and I also believe that the answer varies tremendously based on the individual’s health and needs.

First, let me be clear: No one “needs” to go to the dentist.  There I said it, and some of my colleagues may come after me for that statement.  BUT (and you notice that word is in bold, capital letters), almost all people benefit from going, especially if they want to keep their mouths and the rest of their bodies in good health.  While there are probably a few folks who could keep their teeth and stay dentally healthy without ever going to a dentist, the number of those people is very low.  

What we really should be discussing are each individual’s desires.  Good health, clean and shiny teeth, fresh breath, keeping natural teeth for a lifetime, or simply the ability to eat and enjoy a good meal?  There are others who simply don’t seem to really care about these things.  For them, there is a further issue – systemic health.  If good overall health is important to you, so are regular visits to the dentist.  Indeed, even if someone has false teeth, regular visits are important to allow for early detection of possible cancers and other systemic diseases.

Regular visits to the dentist are now considered important enough that some medical policies are paying for people with diabetes to see their dentist four times per year.  Those companies do this because there is solid evidence that consistent dental care reduces the incidence of major medical problems!  That’s truly a case of dental care potentially saving someone’s life.  

So if you are one who wants to keep your mouth and the rest of you healthy and have a bright shiny smile, how often should you visit us?  As a first premise, that’s a question to discuss with us -- ask us how often you would benefit from periodic visits.  Then ask us for the reasoning behind that answer.  Many of us were raised with the idea of seeing our dentist twice a year and brushing our teeth twice a day.  I don’t know that either of those ideas is well supported by clinical evidence.  There are simply too many other factors.

Consider these factors: 

  • Do you currently have a high decay rate?  (For example, do you need fillings more than once per year?)  
  • Do you have a mouth full of old fillings and / or crowns?  (This is a good clue to your historic susceptibility to dental disease.)  
  • Have you had or do you currently have some form of gum disease?  If so, how severe is it, is there bone damage, and how easily do your gums bleed?  
  • What is your systemic health status?  
  • Do you have diabetes or other inflammatory-related diseases such as heart disease?  
  • If you have any of these diseases, how well controlled are they?  
  • Has your medical doctor recommended you see a dentist?  (This might happen because you are going to have surgery soon or because your physician suspects you have active dental problems.)
  • Are you pregnant?  (If so, you being in good dental health is really important for the health of your baby.)

After all those factors are carefully weighed, what is the final answer?  Most people do come for a visit two times a year.  That may be as much because they have a dental benefit plan that pays for two visits a year as for any other reason.  We have some clients in our practice that we plan to see about once a year, and sometimes that gets stretched out to once every eighteen months.  I’m comfortable with that interval when they have a very low incidence of dental problems, are in good systemic health, and take consistently excellent care of their mouths.  On the other end of that spectrum are the people who don’t take very good care of their mouths, whether they are systemically healthy or not.  We want to see those people every three or four months, and sometimes as frequently as every two months.  That allows us to help them maintain a better dental condition than they have been able to do for themselves. 

We also have a few of our clients that are healthy, both dentally and systemically, and simply want to come in every two to three months because they want stains cleaned off their teeth.  Some people really love how their mouth feels after having their teeth cleaned.  

So talk with us and let us work it out together!  Together, we can determine what is right for you!

By Bill Kuttler, DDS
March 15, 2016

I was watching TV over the weekend and saw several separate ads promoting fresh breath, nice smiles, and a dating site. The key concept of the dating site was all about getting a second date. It stressed in a variety of ways that the first date was not a big deal, but having a connection good enough to warrant a second date was huge!

It made me wonder how many people go out for a first date, but don't make it to a second. And how many of those ‘failed’ dates are related to bad breath?

Studies show that half of adults have had bad breath at some time in their lives, and I bet the number is actually far larger than that. There are lots of reasons why people get bad breath. Many are harmless, although annoying, and others are an important warning of much bigger problems. 

  • Garlic, onions, and coffee are perhaps the things we most commonly associate with bad breath. Of course there are many other problem foods and beverages, but these probably deserve their bad reputation. Yes, what we eat does affect our breath. So if you’re trying to make a second date a reality, you might want to pay attention to what you eat on your first date! 
  • Tobacco use is another frequent cause of problems. I suspect we all know smoking isn’t good for us, but some people don’t realize it’s also a cause of stained teeth and bad breath. Further, it reduces people’s sense of taste and smell, so they aren’t even aware of the impact it has on how their breath smells!
  • Most bad breath happens thanks to hundreds of types of bacteria that naturally live in our mouths. When we eat, they do too, and often leave bad smelling waste behind. And of course, what we eat sometimes helps determine how those waste products smell….
  • A related issue is if your mouth often feels dry, you might not be creating enough saliva. Saliva is essential to help “rinse out” your mouth. Without enough “spit”, your mouth isn’t lubricated, setting the stage for waste products to collect and smell. Dry mouth can be caused by medications, by breathing through your mouth, and sometimes also with age, as the quality and quantity of saliva changes. What can make it worse is that people who struggle with a dry mouth or bad breath often resort to mouth washes that contain lots of alcohol. While that may temporarily mask the dry feeling or the odor, the alcohol dries out your mouth and makes the problem worse!

Bad breath that always seems to be present and is often accompanied by a bad taste may be a sign of gum disease. So if you notice either of these problems a lot, it’s extremely important to seek dental care right away – call us! Other mouth infections can also cause bad breath, and we can help you determine if the problem is being caused by a problem in your mouth. 

Your bad breath could also be the result of a systemic problem, such as a sinus condition, gastric reflux, diabetes, liver or kidney disease. So if you have a persistent problem and have ruled out dental issues, it is very important for your over-all health for you to see your medical doctor to investigate the issue further.

If you’ve dealt with all of the previously mentioned issues and bad breath is still an occasional problem, what else can you do to prevent it? First, of course, is to make sure you are doing an effective and thorough job of cleaning your mouth. Note I didn’t say “brush and floss”. Thorough brushing, ideally more than once a day, cleaning between your teeth, and scrubbing your tongue are all important facets to effectively cleaning your mouth. Ask us to coach you based on your individual circumstances on this very important issue.

If you wear removable dentures, be sure to thoroughly clean them as well, and clean the tissue underneath where they rest in your mouth. Leaving them out overnight also often helps.

If you have a dry mouth and we haven’t already discussed it with you, talk with us about steps you can take to get more saliva flowing. Eating healthy foods that require lots of chewing often helps and chewing sugar-free gum may also help. There are also over-the-counter products that are designed to help this problem. We can recommend the appropriate choices for your situation. If you are taking medications, talk with your doctor about your dry mouth. It may be possible to change your medications and find one equally effective that doesn’t reduce your saliva flow.

Eliminating smoking is a given. I know for most people that isn’t easy, but it really will change the health of your mouth as well as the rest of your body!

And if you’ve done everything else I’ve mentioned, and you really want to get a second date, using an alcohol-free mouthwash on an occasional basis may help. It may dislodge some of the bacteria and debris in your mouth and improve the situation for a short term “fix”. 

And who knows, maybe the second date will result in a lifetime of happiness! And perhaps effective care will result in a lifetime of good oral health! There’s a win – win!

By Bill Kuttler, DDS
January 13, 2016

I am writing this in Door County while intermittently gazing at the beautiful water of Green Bay. It has been a very serene Christmas for my wife Sharon and me – restful and a bit contemplative. And as I’ve been sitting here (not being terribly active), I’ve thought a lot about resolutions or “goals” as I often think about them. I have some friends who are very goal oriented – they make lists, check them twice (just like Santa!), and then go charging out and accomplish them. And I have some other friends that I doubt ever make a list. I like them all, AND I think that they all are living the lives they are meant to live and are being “successful” both in their own eyes and those of the people around them.

To add to the complexity of thinking about resolutions, I’m very aware that I’m married to a wonderful woman who loves to set goals for ME. And I’m pretty aware (after 36 wonderful years of marriage) that neither of us expects that to work very well.... But I do observe that happening a lot in various kinds of relationships – people setting goals for other people. And I suspect it has roughly the same success rate, at least on average.

So what does this have to do with dentistry (since I think that’s what this is about)? I think there’s a point or two to be made here, if you’ll hang with me. We see both kinds of people in our office every week. Some come in as new patients with a list of things they want to accomplish. They are usually easy to work with because they know what they want, and we can help them achieve it – then we’re all happy. Others arrive because they know dental health is important (or their spouse or parent does), but they really haven’t given it much thought. These folks are more challenging to work with, but when we can help them clarify what they want and then help them accomplish it, we all feel really great! That’s fun for us (and usually for them as well)!

Are we helping them make resolutions? Maybe. Do they think about it that way? Almost certainly not. But when we listen deeply to them, give them feedback about what we’ve heard, listen some more, and repeat as needed, we do help them clarify what they’d like for their mouths and their smiles. And then we help them achieve it. I’m pretty sure they aren’t setting goals, at least as it is conventionally thought about, but I know that we’re helping them achieve things that they value. And to me it is what they value that’s important.

So what does this have to do with a “revolution” that is in the title? In my experience as I visit my doctors and watch my dental colleagues help people, our approach is a revolution. By our training we doctors (no matter what type of degree we have) are educated to fix what we see is “wrong”. And that is often a blessing. But sometimes we need to pause and listen, often for an uncomfortably long time for us before we move forward into the “fix it” stage. Because sometimes we are trying to fix something that the person we’re trying to help doesn’t want fixed or isn’t particularly concerned with. Again, that person who I love and live with points that out to me all of the time. I’m often into fixing things for her that she can handle just fine on her own, thank you very much!

So my resolution for the coming year is to listen longer, more actively, and better. Is that a goal? Based on what I know about goals being measurable, I don’t know. But I know it will help my relationships with everyone I come in contact with – especially, perhaps, and I hope, my wife!

I wish you all a wonderful and blessed New Year filled with many opportunities to be helpful to your family, friends, and strangers as well! I pray for listening, tolerance, patience, understanding, and peace in each of our lives and in the world. THAT would be a revolution!

By Bill Kuttler, DDS
January 16, 2014

At this magical time of the year, we all seem somewhat more open to “starting over.” I know a lot of people who start out on a new diet, a new exercise program, or various other “new” ideas to improve themselves and their lives. New intentions for better, healthier lives are good no matter when they occur, so I think all this attention to new beginnings is great.

My experience leads me to believe that most of us need coaches or a supportive group around us to help us stay on track. Two years ago when I was getting ready to ride RAGBRAI, I had a personal fitness coach tailor a program for me, and IT WORKED! What made it work was more than just the program she designed for me – I was accountable to Nicole Hutchison every week or so. Every time she saw me, she monitored my progress and tweaked my program to help me keep improving and on track. When July came, I was confident and ready, and I thoroughly enjoyed my RAGBRAI experience. I don’t think I would have had the same result without her!

So who is on your health coaching team? And what are your goals for the new year? If you’d like to prevent problems before they occur or become major, starting sooner rather than later is always a good idea. I’d suggest that one of your best coaches may be someone you wouldn’t suspect. Your dentist and dental hygienist may be valuable resources, and I’m not just talking about your dental health!

These dental health professionals can be valuable resources for your general health as well. They can help you prevent problems that can affect your total health and give you some early warnings about other health issues.

Here is a list of health concerns that are related to your dental health:

  • Research has shown that people with gum disease are almost twice as likely to have coronary artery disease as those without periodontal disease. There is also research that points to a possible relationship between oral infections and strokes. While no one would claim that a healthy mouth will grant you immunity to either heart attacks or strokes, it seems likely that you can lessen your risks simply by having a healthy mouth.
     
  • There are also studies that have shown a relationship between Chronic Obstructive Pulmonary Disease (COPD) and gum disease.
     
  • There are also proven connections between gum disease and premature delivery of babies and low birth weight in those babies. If you are thinking about becoming pregnant, here is another reason to have a healthy mouth. And it is far easier to get your mouth healthy before you become pregnant and then keep it that way, than it is to try to accomplish it after you are pregnant! (The hormonal changes that occur during pregnancy make it more likely that gums will swell and bleed when they aren’t in very good health).
     
  • Diabetes is a chronic disease that is often missed in its early stages. Yet the earlier it is detected, the sooner it can be treated and its effects on your body minimized. When we see someone with chronically bleeding gum tissue who says they are doing everything we suggest, we recommend that they be seen by their medical doctor and tested to see if there is a diabetic condition. More than once the results have come back positive, and once that disease was controlled, the person’s mouth became healthy and free of bleeding. What a great a win-win! I don’t believe that the gum disease they had was caused by the diabetes nor do I believe that their diabetes was caused by their gum disease, but I’ve certainly seen a link. Some research has clearly shown that diabetes is difficult if not impossible to control in the presence of gum disease, but once the gum tissue is healthy, the diabetes is easily controlled.

If you want to get or stay as healthy as possible, select a good team of coaches to help you succeed. And I encourage you to include your dentist and dental hygienist as part of that team! When your coaches can blend their knowledge with years of experience and wisdom combined with a deep understanding of you and your goals, they can help you achieve those goals and more. They can help you accomplish more than you ever thought possible and improve your dental health as well!

This article originally appeared in Dubuque 365ink magazine. It is republished with permission from the publication.

I love it when it is a new year! I love when the sands of time wash away the old year and we embrace the hope and promise of a new year!

For many it’s a time of new beginnings and resolutions. In the past week I have noticed how many times I have said to our friends sitting in my treatment room, “That would be a great New Year’s resolution!” (Bill would be the first to tell you I am great at making resolutions for others!)

One young woman, who we see each year when she returns for her holiday visit to her family, shared that since her visit last year at this time she had not missed one day of flossing!

"After years of sporadic flossing, (at best!) Sharon finally found the key to motivating me. I was concerned about some new staining between my teeth and after she worked so hard to remove it, I asked her the best way to prevent it from coming back. Regular flossing was the answer! I decided to try an experiment: floss every day for a year until my next visit and see if they noticed. I was pleased with how quickly it became a part of my routine. Now I can't think of going to bed until I have both brushed and flossed my teeth. A year later I was rewarded with no staining and my healthiest gums ever. Just ask my dentist!" ~ Jenny E.

Wow! It worked! The habit Jenny began last year had not only the cosmetic effect that was her motivation, but I immediately asked her what she had been doing differently because her gum tissue was in excellent health. Happy dance!!

This week I was reading an installment from one of our dental practice coaches, Kirk Behrendt of Act Dental Coaching, and he gave these statistics:

  • 45% of people make some type of resolution
  • Just 8% of people always succeed at their resolutions
  • 24% of people have never achieved any type of resolution…EVER

In this month’s article Kirk suggests that instead of making resolutions to instead try making commitments. He says, “Resolutions are more about the use of ‘willpower’ and changing the things you don’t like about yourself. Commitments, on the other hand, are appointments with yourself (or others) to hold you truly accountable to a result.”

I really like what Kirk has said, both for myself for this new year, and also as a way to be a ‘coach’ to the people that come to us for better dental health. We believe that becoming healthy is a ‘process’ or ‘journey’ - and one of our foundational practice commitments is to help people attain the level of dental health they desire. When we can share that intention together GREAT things happen! Look at Jenny – what an inspiration! In this coming year we look forward to your appointment with us so we can hear about the ‘appointment you made with yourself’ for your commitment to health and your intentions that have become actions! Perhaps daily flossing?

-- Sharon Kuttler, RDH