Complete Oral Care

November 10th 2020

Host Kimberly King joins Dr. Brian Davey to discuss Complete Oral Care. Taking care of your teeth affects all parts of your body. Learn how you can give yourself the best dental care. Dr. Davey is a fellow with the American Academy of Systemic Health and operates a dental practice in North San Diego, offering a comprehensive approach to patient healthcare. Tune in!

00:00 Speaker 1: The advice and informational content does not necessarily represent the views of Mother's Market and Kitchen. Mother's recommends consulting your health professional for your personal medical condition.

00:10 Kimberly King: Hello, I'm Kimberly King, and welcome to the Mother's Market podcast, a show dedicated to the truth, beauty and goodness of the human condition. On today's episode, these days, it's especially important to keep our teeth and gums in good health and free from decay and germs. We'll dive into the latest in complete oral healthcare to make sure you've got a clean mouth and a pearly white smile. Plus, later, we'll tell you what's going on around town. But first up, Dr. Brian Davey is a fellow with the American Academy of Systemic Health, a Live Well San Diego partner and operates a dental practice in northern San Diego. And Dr. Davey is one of the first in the San Diego area to offer a comprehensive approach to patient healthcare, bridging the gap between medicine and dentistry. I love this. Dr. Davey, how are you? Welcome to the podcast.

00:58 Dr. Brian Davey: Great, thank you so much for having me on today.

01:00 KK: Yes. Why don't you fill our audience in a little bit on your mission and your work before we get to today's show topic?

01:05 DD: Sure, so our mission is to make San Diego the number one healthiest city in the US, and we're gonna accomplish this mission by working with the community or my fellow dentists and medical colleagues to educate the public about the health of your mouth and how it affects the health of your body. A healthy body starts with a disease-free mouth. You can't have an entirely healthy body if you have disease and inflammation in your mouth, and so that's our philosophy of care. And if we can support a healthy mouth, we're gonna spell to support a healthy body, a healthy immune system, healthy heart, healthy brain, so that people can live a long, well life.

01:43 KK: Wonderful, I'm on. I'm on board. We are really... I think it's fascinating, in that, you really are working with the medical community in this, but what fascinates me even more is how many diseases are tied into the health or non-health of our mouth. Let's talk about that.

02:01 DD: Sure. A lot of people don't realize that poor dental health is linked to a number of different health problems. We know that there's a link between cognitive decline and Alzheimer's disease with Periodontal disease. We also know there's a three times increased risk of stroke when you have gum disease. It increases your risks for head and neck cancer. We see people with sleep problems showing up in their mouth or signs of disordered sleep. We also know that having gum disease doubles your risk for heart disease. It affects your body's ability to maintain control over your blood sugars, and we also know that it increases your risk for a number of other cancers, colon cancer, pancreatic cancer. And it contributes to the rising healthcare dollars.

02:56 KK: Which you have some numbers, which I think are amazing as well. Let's talk a little bit about, first and foremost, when you do go back to the dentist and when you are seeing these gums, what does a healthy gum look like versus a non-healthy gum?

03:11 DD: Sure. So we stare at mouths all day, so it's a little more apparent. But a healthy mouth, obviously, are patients who are able to remove all the plaque off of their teeth, but healthy gums are this nice coral pink color and they don't bleed when you brush 'em or floss 'em. And they shouldn't be painful or tender.

03:32 KK: And oftentimes... I remember you saying that it's often when it's too late when that starts to happen, that the disease has already made its way in.

03:39 DD: Right, we were saying it's good and a bad thing, but I look at it... Unfortunately, gum disease is a painless disease until it gets to the most advanced stages, so a lot of people don't realize that they have gum disease. They might think that, "Oh, I just have a little bit of bleeding when I brush or floss." It's not particularly painful 'til it gets more advanced stage, but any type of bleeding when you brush or floss, that is an indication of gum disease.

04:08 KK: Wow, so what can we do? You obviously are advocating cleanings. How many times should we be going for teeth cleaning?

04:17 DD: So everybody's care is individualized, and so it's... Your dentist and hygienists work together as a team to come up with a regimen that's gonna keep you healthy and [04:25] ____ event-free. So some people are more predisposed to gum disease. There is a genetic factor, there's how well you take care of your teeth and what you eat, all affect your risk factor for developing disease. So patients who have more pre-existing conditions, we're gonna wanna see them every three to four months. From a microbiology standpoint, gum disease sets in every three to four months. The bad actors of the mouth start to show up. And so that's when we really wanna start to break up all the bacterial colonies and make sure that we're promoting normal, healthy bacteria. So some patients can actually go six months between cleanings and those are typically patients with low genetic risk, few underlying health conditions and they happen to be a world champion in brushing and flossing. And when they tell you they floss every day, they actually are.

05:23 KK: You believe them, but you can see it there though. Back up a sec...

05:25 DD: It's like dental confession, sometimes.

05:28 KK: Yeah, I bet you hear it all, don't you? And you see it all.

05:29 DD: Dear father, it's been two months since I flossed.

05:34 KK: I feel like I just said that to you not too long ago. But you... Back up a moment, because you also have... Talk about what is complete oral health, when you marry into the medical profession as well? What is complete oral health?

05:50 DD: So we have what we call a healthy mouth baseline. So there's a lot of people don't even realize what it means to have a healthy mouth. So a healthy mouth is healthy gums or free from bleeding gums, pocketing, gum recession, bad breath or loose or shifting teeth. A healthy mouth means teeth are free from decay, infection, broken or leaky fillings, worn teeth or unhealthy spaces between your teeth. A healthy bite means you're free from crooked teeth, pain or sensitivity in your jaw joint, excessive wear or even temperature sensitivity. And then also, oral health means freedom from unhappiness from your smile.

06:32 DD: It also means freedom from cancers or pre-cancerous lesions that we'll see in the mouth. It also means freedom from sleep apnea or snoring, and dry mouth or other breathing problems. So, those are the standards of what a healthy mouth is. And if you ask people on the street, "What does it mean to have a healthy mouth?" They're like, "Oh, that clean kinda slick feeling when you get your teeth cleaned or you just had a minty chewing gum," but it's definitely more involved than that and your dentist and your hygienist can work together to help you maintain a healthy mouth.

07:06 KK: I think that's great, that it really... The education behind learning about how the gum disease leads to the other diseases and maintaining that healthy mouth. Walk me through a little bit about how when you first have a patient that is new and you find out about their history, not just their oral history, but their medical history.

07:28 DD: Sure. So, our new patient visit starts off with a really thorough medical history. And so we wanna know what patients have had in their medical history. If they have something current, medical problem, something they've had, or even what they might have a family history of. There's definitely a genetic link between gum disease. There's also genetic links with heart disease, with Alzheimer's, and a number of other health problems, and we wanna make sure that the patients that have a family history, that we're aware of that, and so that we're even more cautious with those patients in keeping them on a good healthy regimen.

08:05 KK: And you also try to reach out to their medical, their primary...

08:09 DD: Yeah, absolutely. On our medical questionnaire, we wanna know who their primary care physician is. So, as we're gathering findings and people are coming in for their routine care, we can also give that information back to their primary care doctor, so they're aware that, let's say, a patient has gum disease and diabetes, their primary care doctor wants to know, but they might be struggling with a patient to help them maintain their blood sugar, and they're doing everything they can medically, and they're still not accomplishing it and then they're, "Oh, their gum disease is out of control," and we help get the gum disease in control. We are able to help support our medical colleagues in helping the patient maintain their sugar levels.

08:55 KK: I love that you are educating them. Talk a little bit about how gingivitis is linked to gut health, which you don't really think about that so much.

09:05 DD: Right. So, that's been a hot topic in health over the past six months or a year or so. Good gut health promotes a healthy body. The gut actually starts soon as you pass through the lips. That's the first place in our gut. And there's normal healthy bacteria and there's harmful bacteria, and we really wanna promote an environment, they call it the microbiome, which is the bacterial colonies that live in your mouth, and we want normal healthy bacteria. We don't wanna eliminate all bacteria. And so a healthy microbiome helps support a healthy mouth. A study recently came out that connected periodontal disease to irritable bowel syndrome. So, we know that when you have bacteria in your mouth, the bad actors, and you have gum disease, you're swallowing those bacteria that goes into your gut and that can complicate other problems.

09:58 DD: Obviously, a lot more research needs to go into it, but it makes sense that if we have gum disease and you have high levels of bad bacteria, it's gonna affect your gut 'cause we know it affects your heart, affects your brain, and...

10:11 KK: Talk about the... When you're talking about the brain, the blood brain barrier too, and how those white cells are...

10:18 DD: Yeah. So, we know that there's a number of different bacteria in gum disease that are now associated with Alzheimer's. These bacteria are able to evade the immune system, and some of them kind of hitch-hike along with the white blood cells. And so the white blood cells are able to pass through the blood-brain barrier with these bacteria inside them and they're finding in... It was actually in an animal study, whole bacteria from gum disease in the brains of Alzheimer's patients or Alzheimer's animals in this particular study, and not in the brains of the animals that did not have gum disease.

10:56 KK: Really? Wow.

10:58 DD: So, we know there's a strong association, we're just not exactly sure of all the mechanisms just yet, but I can tell you that in my family, we wanna make sure that nobody has these type of bad bacteria just because we wanna have them support a healthy brain as we get older.

11:14 KK: Right. And again, just that correlation between the two is fascinating, and if you can prevent the preventable is what you always say.

11:22 DD: Yep. We wanna prevent the preventable. We don't know the exact causes and exactly how these are all correlated, but we do know that a lot of chronic illnesses that we have are related to inflammation. And we know that periodontal disease is linked to systemic inflammation. And periodontal disease is directly linked to arterial inflammation. So, we've got 30,000 miles of arteries all over our body in all our organs, including our heart, and our brain, and if those are inflamed, there can be problems.

11:55 KK: And so talk about what we, as patients, can do at home or before we come to see you, when we feel like, "Uh-oh, my gums are bleeding and... " What can we do to help?

12:05 DD: Well, being honest is a good one. I feel like people go for the emergency flossing the day before their dental visit and we can tell, by the way.

12:16 KK: There's the true confession.

12:18 DD: Sure. But at home, obviously, we want to support our patients to brush twice a day for two minutes. That's about the time it takes to remove all the plaque off of our teeth, as well as at least flossing once a day, that way you get the bacteria in between the teeth and below the gums in between your teeth, breaking up those bacteria. There's some over-the-counter rinses that you can use that are helpful. You definitely wanna make sure that we're staying away from traditional mouth rinses that have alcohol in them.

12:52 DD: So there's alcohol-free mouth rinses that you can use that help reduce the amount of bacteria, and then you can also... There are some things that you can get from your dentist in addition to brushing and flossing, 'cause as we get older, things change, and we know that as we age, it's correlated with the amount of people that have gum disease. So 50% of 50-year-olds, we're gonna have some form of gum disease, and brushing and flossing might not be enough to prevent that. So working with your dentist and your hygienist, there's some extra tools, you can use interdental cleaners to help get in between the teeth where floss might not be able to get to. And if you really wanna prevent gum disease or if you wanna keep gum disease from coming back, there's something called Perio Protect Trays. It's a custom-made tray where we put medicine in. It's a hydrogen peroxide gel that kills the bacteria that are associated with gum disease and are also related to Alzheimer's, heart attack, stroke, colon cancer, pancreatic cancer.

13:54 KK: Wow. Wow. That's amazing. And so those trays, you just wear them once a day?

14:01 DD: Yeah. They're similar to a bleaching tray that people are pretty familiar with. They're custom-made. They match your periodontal pockets, and you put the periodontal gel in there, and you wear it for 15 minutes. It'll kill the bacteria, promotes normal, healthy bacteria love the oxygen and the bad bacteria don't, and your teeth might get a little whiter at the same time.

14:19 KK: That's not a bad thing.

14:21 DD: That's a bonus.

14:22 KK: Yeah, right. What other kind of diseases... We've talked a little bit about the gut health and diabetes, sugar, the intake. Like what can we... Should we not be drinking sodas to help this along as well?

14:36 DD: Sure. So overall health is proper nutrition and diet, and obviously, we get too much sugar in our system. Our food supply is a lot of hidden sugars, so we say if it comes in a box, a can, or a bag, there's a good chance that there are some hidden sugars in there. Obviously limiting the amount of sugary drinks is really important for preventing diabetes and metabolic syndrome, but also protecting your oral health 'cause when you eat or drink, your bacteria also. And so they're eating what you eat, and they create... Their metabolic byproduct is acid and also toxins, and so we wanna... We don't really wanna be feeding them high sugar diet 'cause bacteria love it.

15:24 KK: Yeah, and then they go to work with all the bad things. Heart disease. You've talked about gut health. We've talked a little bit about diabetes. What about heart disease? How can this help? And what... Do you have statistics?

15:37 DD: So if you have gum disease, you're twice as likely to die from heart disease, so it's a pretty serious connection. And an article came out in the British Medical Journal where they actually showed how the bacteria affect our arteries and they will... Oral bacteria are found... Whole bacteria in the walls of the arteries, that creates... Everybody's heard of plaque in your arteries, so the oral bacteria are associated with that can make plaques worse. They can actually make the plaques more unstable, and when a plaque breaks in your artery, if it happens in your heart, it can cause a clot and that's a heart attack or if it happens in your brain, it's a stroke. And so by reducing the amount of bad bacteria in your mouth, you can lower systemic inflammation, lower arterial inflammation, and therefore hopefully lower your risk for heart attack and stroke. So work with your medical doctor and your dentist to keep your arteries cool. If your arteries are cool, you will not have a heart attack or a stroke.

16:42 KK: I was gonna say that's a shocking headline there with that correlation. But again, the plaque also can correlate into our brains, which would turn into Alzheimer's, which you've been talking about as well, just that bad plaque and that bad...

16:55 DD: Sure. Yeah. We know that there's a handful of bacteria that are associated with Alzheimer's, either directly or indirectly relating to the inflammation that's caused by that. Bacteria can make it into the brain. Their by-products, the proteins that the bacteria make, can make it into the brain and that stimulates inflammation and that inflammation can damage the neurons, and that's where they think the... One of the links with gum disease and Alzheimer's.

17:26 KK: Wow. Just to again, caring for your mouth and where it starts from. You also talk to other dentists and others in the medical profession about just staying active with making sure the health of your mouth. It's really your passion.

17:42 DD: Yeah, there's been a disconnect with dentistry and medicine. We don't really talk to each other very much. We share the same patients. We're fighting the same fight against inflammation and disease, but we just don't happen to talk. And so we really... My mission is to bridge that gap between dentistry and medicine. If I can educate more dentists about the oral systemic connection, and then being involved in the American Academy of Oral Systemic Health has really been a big part of that. And then trying to bring the medical community into understanding the connection. They want to participate. It's just their job's tough too. They're seeing lots of patients. But the more dentists and physicians can talk about their patients, we can work together to keep them healthy.

18:29 KK: And I think that's wonderful. The other thing you've mentioned before is by clearing out and making sure that bacteria is cleared, then less hospital visits.

18:37 DD: Oh, absolutely. We do know that there's increased hospitalization when patients have untreated gum disease. Patients with diabetes, there's a 40% increase in yearly hospital admissions on patients with unchecked diabetes and unchecked gum disease.

18:56 KK: Right. Saving some money there too. This is such great information. Right now, we have to take a quick break, but more in a minute. Don't go away. We will be right back.

[music]

19:07 S1: Welcome back to the Mother's Market Podcast. And we wanna remind you that if you missed any portion of today's show, you can find us on iTunes by searching Mother's Market or download the show from our website, mothersmarket.com, click the link for podcast and listen to past shows. Plus download our healthy recipes and money savings coupons, all available at mothersmarket.com.

19:30 KK: And now, back to our interview with Dr. Brian Davey, and we're talking about complete oral healthcare and how when it starts in your mouth, it can be attributed to so many different diseases. Something we have not spoken about yet is sleep apnea, talk to me about how you can spot that, what happens when you're at the dentist?

19:49 DD: Sure. So obviously, as a dentist, we're living in your airway, if you're in for your cleaning, we're an hour and we get a good chance to really take a good look at everybody's airway and also signs of sleep apnea can show up in your teeth. Certain wear patterns start making our thought processes our brain get moving into asking questions with the patient. Patients that have sleep apnea, untreated sleep apnea or even patients that snore, you will grind your teeth at some point during that whole sleep cycle, so definitely tooth wear is a big caution flag that we wanna start asking about it. Also we're looking at people's tongues, the shape of a person's tongue, the position of the tongue in their mouth affects your airway, and then actually physically looking at the back of your throat, we take a look at the airway and sometimes we don't see the airway, the tongue is really high, the people might have tonsils and you don't see an airway and then that gets the questions going with patients like, "How's your quality of sleep? How's your quantity of sleep? If you sleep six to eight hours, do you feel rested?"

21:07 DD: Patients that have sleep disordered breathing, either snoring or sleep apnea, they might get six, eight hours of sleep, but they are not rested, they're tired all day. They might doze off at their computer or maybe even at a stop light, a long stop light. I've had sleep apnea patients say, "Yeah, I would... Coming home from work after a long day, I'm tired, I'd stop at the stop light and somebody'd honk at me and I'd realized that I had dozed off." So one of the risks for untreated sleep apnea is motor vehicle accidents, so your untreated sleep apnea four times increased risk for a motor vehicle accident.

21:42 KK: Wow.

21:43 DD: So when we see these signs and symptoms and we ask questions and then we also get to cheat too, we can ask spouses and significant others about our patients, if they're both patients of ours, about their quality of sleep, and then usually they rat out their spouse. They say "Well, my quality of sleep is terrible because... "

22:01 KK: This one's snoring over here.

[chuckle]

22:02 DD: "My significant other is snoring." And our body needs good sleep to heal our body, heal our brain, it reduces inflammation, so that's part of our overall mission when you come to our office, it's one of the things that we're screening for.

22:19 KK: Well, that's great. And again, it's something I really would never have thought about that when you go to the dentist and now all of a sudden you're talking about sleep apnea, so it's great. It is overall, your health of your mouth. Let's talk a little about grinding, we didn't really talk about when you see the grinding, I know I clench my teeth and I'm thinking about everything that needs to go on and so, is there any way other than you put a device in or something?

22:45 DD: Unfortunately, we don't have a cure for teeth grinding.

22:49 KK: Turn your brain off.

[chuckle]

22:51 DD: You'll see me in the Caymans when I figure it out.

[laughter]

22:54 KK: Right.

22:55 DD: So unfortunately, we live in a very stressful world these days, obviously, we're in the middle of a pandemic. I am seeing so many people clenching and grinding their teeth right now. They're just, people are under a lot of stress and, unfortunately, we don't have a magic cure for it. So what we do is we wanna minimize the impact or the risks from the clenching and grinding, so there's a lot of different types of night guards that you can make for people and usually, we can find one that will work for them, not every night guard is a cookie cutter works for every patient, so you have to find something that works. But also we wanna rule out snoring and sleep apnea, 'cause that's definitely one of the causes of clenching and grinding. And so if you have unchecked clenching or grinding at night, you can put enough force on your teeth to crack and break teeth and when we were closed down to just seeing emergency patients, we saw a lot of broken teeth.

23:52 KK: Really?

23:53 DD: Oh yeah. It was actually kind of shocking just to see and people are, "Yeah, I'm stressed. This is under a lot of pressure." So we're really feeling for them, and obviously, we wanna fix their teeth and then a good doctor doesn't just fix the problem, we wanna prevent future problems, prevent the preventable.

24:11 KK: And so even on that note because it is interesting about the broken teeth, but you did stay open during the pandemic for emergency cases and one thing that I remember you saying was, "We're open because we wanna keep 'em out of the hospitals."

24:24 DD: Yeah, absolutely. So it's been a phase. Initially, we were closed down to only seeing emergencies and the goal of keeping dental offices open for just emergencies is really to keep patients out of the emergency room at the hospital, even now, the last place that you really wanna go, unless you have to is the emergency room. That's where sick people are headed and patients with COVID, so we wanna avoid that. And my brother is an emergency room doctor, and he says, if you show up with a dental problem, pretty much you're gonna get pain medicine and antibiotics, they can't do a whole lot for you. So we were grateful that we're allowed to stay open to treat emergency patients, and we saw a lot of people that had asymptomatic dental issues that they knew about before the pandemic and then while we were shut down, all of a sudden it's not so asymptomatic anymore and so we were able to treat a lot of people.

25:18 KK: I wanna ask you about the precautions that you're taking with your patients when they return, but really quickly you mentioned that your brother is an ER doctor...

25:26 DD: Sure.

25:26 KK: So the conversation between the two of you, that's really interesting because your whole passion is about bridging the gap between medical and dental community, how is that going overall, getting the medical community on board?

25:39 DD: I would say it's going slow, but myself and my colleagues who practice in this way, we're committed and healthcare's got its challenges, and I really feel for my medical colleagues that are under a lot of pressure. They have to see lots and lots of patients in a very short amount of time. And also, when you go to medical school, the dental training for them is very minimal. And so if we can support them in providing them the information so that they have that, they can tie that into their medical care for them. But it's going slow, but it's going.

26:15 KK: You're starting conversations.

26:16 DD: In the general public, people are starting to be more aware about the oral-systemic connection. 10 years ago, when I first started this conversation, people were like, "What? I don't really know too much about it." And now physicians are mentioning it at their exams, "Hey, make sure you see your dentist." And so we're making good forward progress.

26:37 KK: That's good.

26:38 DD: You were talking about... Obviously, we're in a pandemic and we wanna let the community know that dentistry... We've taken a lot of steps to make it safe.

26:46 KK: Okay.

26:48 DD: So, safety of our patients and of our dental team is our number one priority. So we put in a lot of steps. Obviously, we pre-screen our patients before they come in. We're utilizing tele-dentistry, so you can text with your doctor, you can send photos back and forth, and we can really triage and screen patients before they even have to come in and encounter other people. We've reduced the capacity of the waiting rooms. We call it a no-wait waiting room. We used to have eight or 10 chairs, now we have two chairs. But ultimately, the goal is that we don't have people in the waiting room. They come in, we've staggered the schedules to not have patients showing up at the same time and leaving at the same time.

27:31 DD: So that helps, and obviously social distancing within the office, and you'll see the screens up, the plastic shields everywhere in the first part of the office before you get to the back office. We have a whole screening form that patients fill out to make sure that we're only treating asymptomatic healthy patients. Every staff member and every patient gets their temperature taken before they cross the barrier to the back of the office. All these steps are designed to reduce risk. Obviously, there's hand sanitizer at every nook and cranny and corner of our office.

28:05 KK: You even hand those out too.

28:07 DD: Yes, we were handing... Don't tell everybody, 'cause they'll come to our office. We have a little two-ounce hand sanitizer that we give out to our patients. We also obviously upgraded our PPE. You know, that's a big... Everybody hearing about PPE and PPP in the world these days. But we've upgraded from pre-pandemic to what we wear now. Every one of our team members wears an N95 mask, has a face shield, head cover, disposable gowns and gloves that all get changed before we are on to the next patient, so avoiding any kind of cross-contamination. We've installed medical air purifiers in every room, that filter size is smaller than the virus so that the virus gets... If it happened to be floating in the air every five minutes, the room air is being purified. And then also we've introduced some additional instruments, machines, so to speak, in the office that help with suctioning up any aerosols that get created, so we're really... All these layers are mitigating the risk of COVID, so much so that MIT designated in a study that we're the second safest place in the reopening of America to go to.

29:29 KK: Is a dentist's office. So, that's really interesting. I guess, as you were mentioning everything, all the precautions you guys are doing. What are some questions patients should ask their dentist before they go back and general questions?

29:48 DD: You just wanna make sure that they're... The ADA, the CDA, CDC... They spelled out some pretty specific guidelines. There was... The ADA put a Return to Work Tool Kit, and so those... I would say most dentists are utilizing those Return to Work Tool Kits for their criteria. So, you just wanna make sure that your dentist is aware of all of the regulations. During the pandemic, when we were closed for emergencies, they were changing weekly. And sometimes I'd get an email at 11 o'clock at night for a regulation change for the morning. So, just to make sure they're on top of their game. The San Diego Dental Society has really worked hard to educate our patients... Excuse me, our teams... On how to wear protective equipment, so there's... Luckily for dentistry, we've been practicing universal precautions and blood-borne precautions for a long time, and now, we're adding the aerosol precautions. It was a jump, but it wasn't a huge jump for us. We're already used to wearing a lot of protective equipment when we're working because we're working in patients' mouths.

31:02 DD: And we practice to the standard that even though we're trying to screen patients that are asymptomatic and healthy, we still pretend that everybody has COVID. So our standard is, if you think that everybody has COVID then we're gonna be super careful 'cause nobody wants to get it. So, if we practice like everybody has it, we don't wanna contaminate our rooms, we don't wanna contaminate each other, and that way we're able to keep a super high standard, and that's why it's safe to go back to the dentist.

31:34 KK: That's kind of your headline right there is that you practice thinking that people have COVID, and so you'll take all those precautions.

31:40 DD: Yeah. We wanna take all the precautions possible, and when you're playing the game at that high level, then we're pretty confident in our protocols that it's time to come back to the dentist. Your oral health is not elective. Your oral health, if left untreated, you're gonna develop disease and these diseases have downrange effects to your overall health, so it's... It's definitely not optional type care or whether you just don't go and... But some people are... People are coming back and people are ready to get their mouth healthy, and of course, there are some people that still have some fear and that's okay. Everybody's got their own level where they're at to be comfortable.

32:24 KK: Well, I appreciate you spending a little bit of time in telling us about those precautions. Again, going back to self-care, what we can do at home, what are some... I don't know if you can recommend, but what are several toothpastes that you prefer?

32:39 DD: Sure, so people walk down the aisles of the grocery store and there's a million different choices out there. I don't have a personal individual recommendation, but just a toothpaste that has fluoride in it, that's your number one thing. So you really wanna avoid using a whitening toothpaste 'cause they're abrasive. So if you look at under a microscope, it looks like sand paper.

33:07 KK: Oh wow.

33:08 DD: So, a whitening toothpaste is really is this kind of extra grit that's polishing off surfacing, so it doesn't truly whiten your teeth. Also, I'm not a big fan of tartar-control toothpaste because that has materials in it that pulls the calcium out, and we want... Calcium is something good, it helps protect our teeth. So basically just any toothpaste that has fluoride in it. Avoid all the extra fancy stuff. So yeah, those are...

33:39 KK: Those are marketing tools.

33:40 DD: That'll be my recommendation.

33:41 KK: I wanted to hear it from you. What about rinses?

33:44 DD: Sure, there's... Once again, there's lot of different rinses out on the market. You really wanna make sure that you're using an alcohol-free mouth rinse, good old Listerine is the gold standard for mouthwash, they make an alcohol-free mouth rinse that actually... They make one that has fluoride in it, too, so that's really good at reducing the bacteria. If that's too harsh, there's one called Biotene that's for a little bit more sensitivity. There's a lot of different products out there. You kinda have to do your research. There's some tried and true, but really just ask your... Every hygienist and every doctor is gonna have their couple of favorites.

34:25 KK: And thank you. We also talked a little bit about flossing and those pics that you [34:30] ____.

34:31 DD: So obviously, we want people brushing twice a day for two minutes. I'm a big fan of electric toothbrushes. I like a Sonicare toothbrush, just because I see patients that have that toothbrush come back to their visits and tend to be pretty healthy. So that's why I like it. As we get older, brushing and flossing's not enough. I'm sorry to say. There's no free lunch. So there's something called interdental picks, they look like little miniature Christmas trees or little miniature pipe cleaner, and they're really effective at cleaning in between your teeth and around the gums, especially as we get older, we're more susceptible to gum disease and...

35:14 KK: Getting things stuck in our teeth.

35:15 DD: And getting things stuck in out teeth as we age. It's just part of the deal. And then there are some other things like the periodontal gel is a way to fight the bad bacteria. You can brush it on, or you can have a custom tray and you can wear that tray for 15 minutes and that kills bacteria that cause gum disease.

35:36 KK: Great. Well, this has been fascinating information, and I know you're gonna make a difference with your following in your passion. Thank you for your time, some great advice and really appreciate the knowledge from today. So to get more information with Dr. Davey, check out his website. It is drdavey.com, it's D-A-V-E-Y. We look forward to your next visit.

35:57 DD: Thank you so much, I really appreciate it.

36:03 S1: The advice and informational content does not necessarily represent the views of Mother's Market and Kitchen. Mother's recommends consulting your health professional for your personal medical condition.

[music]