Our Blog

Posts for tag: dental hygiene

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
August 31, 2015

As I write this article, a new school year is just getting underway. I’ve lost count of the number of people who have been telling me (ever since the 4th of July actually) that the summer is over. I always chuckle at that since for me summer usually lasts well into September, if not October, in terms of beautiful weather, etc. But then I must admit, I don’t have to factor in the back-to-school rush of shopping for school supplies and getting kids ready for those first days back in the classrooms.

To add one more thing to that “to do” list, I want to add getting your children to the dentist. In my experience that is often not the first thing that occurs to parents as they go down their check list. And it isn’t that I think “back to school check-ups” are a big deal–I don’t. What I think is a REALLY big deal is having your children seen regularly by the same dentist. And by regularly, I mean at least once per year and for most children twice a year (and there are some children who would benefit greatly from being seen even more often than that!)

There are two points I’d like to emphasize and explain from that previous paragraph. First, why do I stress the “same” dentist? And second, why do I feel strongly about the frequency of visits?

I believe in prevention. My greatest joy is seeing kids that I’ve watched grow up graduate from high school, and then perhaps college, and never have a cavity. And it doesn’t usually happen by accident. But it can, and often does, happen. In my experience it happens because the children’s parents are committed to good dental health and the dental personnel (dentist, hygienist, dental assistants) get to know the children, learn how to best work with them and motivate them, and serve as their “cheering squad”. In other words they form relationships with those children. And like most of us, children respond positively to that. Beyond what I believe is a HUGE aspect (i.e., building relationships), having the same dentist monitor growth and development and evaluate changes in tooth structure also provides a huge benefit for everyone.

I am often amazed when people transfer their care to a new dentist when that new dentist doesn’t want previous x-ray films. That history contained in those films is something I evaluate every time I see a patient. It helps me determine how often I need to take new films (potentially saving someone money and certainly x-ray exposure) and, even more importantly I believe, whether or not any dental disease present is active, progressing, or simply “old news”. We have patients in our practice that have had “beginning” decay on teeth for ten or more years. If it isn’t progressing, it almost always is “arrested”. That’s a term that dentists use to mean it has stopped and usually once that happens, it doesn’t ever progress. So people with arrested decay don’t need fillings, but without that history, those areas often look suspicious, and we dentists are trained to treat suspicious areas. So that’s another really important aspect of having a dental “home” where, if I can use the line from the TV show “Cheers”, “everyone knows your name” (and your mouth!)

Frequency of dental visits has been a subject of debate both within and outside of dentistry for many years. And the importance of “frequent” visits varies from child to child. Without getting into issues that pertain more to adults, for children the issues relate to susceptibility to decay (that is, do they get lots of cavities), growth and development, and helping them develop healthy dental homecare habits.

With children that have lots of decay, we want to be working with their parents as well as them, and we utilize a variety of strategies to help reduce and ultimately eliminate the number of problems (cavities). While we don’t always succeed, we improve things more often than not. The concerns about growth and development are somewhat more subtle but often have a large impact over the years. By watching how things change in your child’s mouth, we can suggest strategies to minimize problems and time referrals for braces, etc. when it is necessary. Sometimes timing is truly everything!

So what I’m suggesting here is that you use this time to schedule dental appointments for your children with us. We want to develop a long-term relationship with both you and your children, and we want you to feel good about asking us questions about your children’s mouths. We like kids and want to help them… and we hope they like us as well! And if that visit doesn’t happen until mid-September, that will still be OK. Then we can find out how your children like their new teachers!

By Bill Kuttler, DDS
October 26, 2013

The “magic” night is almost here, and if you are not an actual ghost or goblin, you know that Halloween is THE night for children to be on the prowl for treats — mostly high sugar ones! And that means that parents and grandparents need to be ready to deal with the onslaught of candy and hyper kids.

Are there dental consequences? Absolutely! Are they gigantic? Probably not IF there are some steps taken to minimize the issues. First (and this isn’t a news flash) sugar isn’t good for us — not for our dental health and not for our total health. Keeping sugar usage minimal and raising kids to like fresh fruits and vegetables is key.

But Halloween will arrive, and the kids will come home with bags of goodies. I know some parents who take it and parcel it out over the next several days or weeks. I know others that let their children eat all they want for a day or two and then get rid of the rest. (I even know some parents who’ve been known to “save” their kids from all that candy by eating it themselves!)

While I understand the logic of both approaches, the latter one is actually better from a dental perspective. Exposure time to sugar (even one bite!) is the main issue to the potential of cavities developing. Every time someone consumes sugar or other carbohydrates, the sugars provide enough nutrition to the bacteria to keep them generating acid for at least a half hour. If the substance is retentive (sticky), it stays in the mouth longer, and the acid exposure time is also lengthened.

If people eat all the candy they want for a day or two, the exposure time totals a couple of days. They are also hopefully sick of it by then. If the candy is parceled out over days or weeks, the exposure time is very likely to be greater. It’s also more likely to create a habit where the person wants and expects candy each day. (Please note that I’m not addressing the impact that amount of sugar has on the child’s systemic health which is also NOT positive!)

The accompanying graphic says much of this better than I can. Candy, baked goods, and pop produce problems. But if anyone is going to consume it, there are things that can be done to mitigate the damages. Eating candy with meals at least restricts the exposure times. Have it for dessert! Brushing and flossing after consuming sugar also reduces the exposure times since it eliminates things sticking around. Using fluoride toothpastes will help remineralize the tooth structure that has been demineralized by the acids produced by the bacteria.

So, what’s the bottom line? I believe “moderation in all things” and “timing is everything” are good mottos to live by. As a dentist I’m just glad that Halloween only comes once a year! We’ll be giving out toothbrushes at our house….

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

Every two years as a licensed dental hygienist in the state of Iowa, I must report my continuing education credits for re-licensure to the Iowa Board of Dental Examiners.  This year as I am reviewing my records and compiling the last two years of my learning opportunities, I am in awe.

I have been in practice since 1973 when I graduated from the University of Hawaii.  Needless to say some things have changed over the years!  Who would ever have guessed the scope and variety of the things I am continuing to learn! In looking through the listing of classes I have attended, I am amazed by the scope, breadth, and variety of  topics contained in what I have most recently learned!

I have:

  • Been certified in the use of lasers for dental hygiene therapy
  • Learned about the role of the dental team in sleep medicine
  • Reviewed new preventive therapies and products including fluoride varnish and xylitol for reducing and eliminating cavities
  • Learned about saliva testing for periodontal disease and dental decay
  • Discovered more about testing for the DNA markers for the genetic links for the predisposition to dental disease
  • Taken nutrition classes to learn about nutrition for women’s health,  nutrition for oral health, and dietary supplements for oral health
  • Been certified in CPR  and OSHA, and attended reviews on infection control
  • Taken over 24 hours of continuing education on the most recent data regarding periodontal disease  alone
  • Taken  more than 13 hours of continuing education just on learning about new products, both prescribed and over the counter
  • Given classes in dental yoga for jaw relaxation and stress reduction
  • Heard more about myofunctional therapy to change swallowing patterns and orthodontic development for children and people with sleep disorders

So I just added up the total hours of my continuing education to report to the Iowa Board of Dental Examiners and discovered that I have taken 73.5 hours of continuing education in the two year biennium from September 2009 until the end of this month -- 39 of those just since the beginning of this year!  (This is not counting the non-clinical courses on behavioral and spiritual development, and business management and marketing classes that the Board of Dental Examiners does not recognize for re-licensure.)  The required number of continuing education by the state is 30 hours – so I was very surprised to learn that I have more than twice what is required!

Along with preparing my re-licensure application I am also in the midst of preparing to host my dental hygiene classmates from the University of Hawaii.  It’s the first time we have gathered in Iowa, but we have gotten together almost every 5 years since 1973.  This year, I want to pull out this list and compare notes with my buddies. I wonder if they are as excited as I am to be a dental hygienist.!  I wonder if they believe, as I do, that there has never been a better time to be learning, un-learning, re-learning, and exploring the myriad of opportunities research and scientific data has given us for continuing and integrating evidence-based clinical and behavioral dental hygiene practice.  I can’t wait to talk with my friends who have shared the history, the passion, and the commitment to dental hygiene with me.  I can’t wait to be with the same friends who helped me get through chemistry, microbiology, pharmacology,  and so much more. I know we will have a wonderful time!

(… And there will be a luau too!)

-- Sharon Kuttler, RDH