#11 DM Debrief - All Your DMs Answered

In this episode Dr. Rusty and Dr. Mike round up all the DMs you all have sent in. They hit the topics of “waterpik vs string floss” to “can I rinse my mouth with urine” (yes someone really sent that question in). And that goes to say…if you ask it…they’ll answer it. So tune in, this episode is a wild ride.

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Transcript:

Welcome to DM A dentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike are here to make dental care approachable for everyone because everyone deserves a healthy smile without the fear. Well, well, welcome back everybody to another episode of DM A dentist. It feels really good to be back in the podcast studio. We took a little two-week hiatus for, you know, Fourth of July, been doing some camping and stuff, so it feels good to be back. It’s been good. It’s also been pretty hot, so we took a little bit of break. True. But this week had some big news. It did. It did. You know, officially, I think we can call it Mike, but politicians are officially more hated than Dentists. Jesus. It’s like, it’s insane that we had an assassination attempt. Yeah. I mean, it definitely is wild. I can’t believe it happened, honestly, you know, at least, I guess the Secret Service had a quick escape route, so, you know, Trump was able to just get in the van and go’ed. Right? Right? You get it? No! Sorry, sorry, y’all. What an eerie feeling. But anyway, I mean, in all seriousness, that’s terrifying that that’s happening. I mean, we should not live in a nation that we have to deal with this, regardless of the party you’re involved in, right? Like, insane. Well, I’m living a country that we are even making light of it. Of course, it’s a very serious thing, and we’re not taking it lightly. Regardless of what side of the street you live on, you know, violence is never the answer, and doing something like this isn’t going to help our situation as a country at all. Yeah. It’s completely unacceptable, which we all know that, and honestly, our thoughts in Paris, well, to everyone involved, because it’s terrifying and scary. Even if you’re the president, it’s scary to deal with that, so. Right, so. We definitely need to come together as a country so this stops happening. And, yeah. Yeah. Anyway, let’s, I know that’s a tough subject, but let’s dive in today’s episode in. I hope you’re all ears for this one. Oh, all ears, all ears. Today’s episode is DM deBrief number one. So, debrief, debrief, debrief. So our goal with the podcast, again, you may have heard this if you’ve listened or tuned in before, but our goal with the podcast is to be too done as here answering your questions. And the best way that you can do that is to ask us questions. I mean, that’s the only way we’re going to be able to help you is if you let us know what kind of content you want to see from us, send it our way, send us questions, send us videos, you don’t know what they are if they make sense if they’re real. Help us help you because that’s really what we’re here for. Yeah. So let’s dive into our first DMD brief and get to the questions. So our first question is from LaRie. So her question was, how often should the dental hygienist or dentist check the depth pockets between the bone and the gum? Yeah. So what she’s referring to is when you get a parietal chart done. So it’s when we go three, two, three, check all the spots around the teeth. And we talk about pockets. So ideally, it should be done at least once a year. But Rusty and I typically try to do it at least every six months because something that’s caught earlier is more predictable. So if you have something that’s happening below the gums we’d like to see it earlier than later. Yep. Definitely. And if you’re just establishing care with a dentist too, they should be doing this as a comprehensive exam. And then sometimes if you need some deeper cleanings or you have a lot of build up in there, a lot of times people are going to need to have a re-evaluation essentially where after around a deep cleaning, those gums are going to be measured again to kind of monitor and make sure you’re healing up and getting healthier so that those gums are on their rhythm proving. So thanks for sending that question, LaRie. Yeah. Thanks. And we’re going on the next one. I was supposed to get twin block, but my orthodontist gave me braces to straighten one of my teeth. I got them removed recently and my dentist told me that I’ll be getting twin block soon. But he didn’t give me retainers and now my teeth are wonked. So Rusty, you want to feel that one? I will. I will. Thank you, Eliana, for your question. I’ll preface this one with neither Mike or I are orthodontists. We’re both a general dentist. A twin block is a little bit of an advanced to orthodontic removable appliance that you’re going to be wearing to correct some jaw structure. And so, Eliana, it sounds like there’s some consistent, some big movement, rather, that you’re going to be having, right? Where you’re changing your jaw structure, changing your shape as you’re growing. It’s a lot of movement. And so a lot of times, these orthodontic treatments are going to take a long time. It’s going to be several years to be able to get the movement that you need. It sounds like your orthodontist likely has a plan for you with a twin block. And I would continue to follow your doctor’s recommendation so that your teeth, as you said, are less wonked. Good. Yeah, less wonked is good, right? Very good. Very good. I mean, no one likes wonky teeth. For our next question, so the next few questions kind of dive into a little bit of some oral hygiene. So this first one is from Joe and Joe just really simply asked floss versus waterpeck. What do you say, Dr. Mike? Well, Joe Biden, I would like to first start by saying thank you. And second, start by saying something is better than nothing, Joe. So when you and Kamala are flossing, it’s important that you use string floss. And the reason I say that is string floss is tried and true, kind of like you. And the mechanical action of string floss is what’s really going to divide those teeth clean up the bacteria and kind of scrub. Waterpeck is great. It’s kind of like a high powered, it’s a pressure washer for your mouth. I think they’re great. So if you’re going to pick one floss, but if you’re going to do nothing, and if not a water pick, we’d rather use a water pick. I mean, they’re great. Yeah, water pick is better than nothing for sure, but again, string floss is probably better than a water pick. Both is ideal. Yeah. And waterpeck is going to be useful for other things too. Like some of my patients have tonsill stones, for example. And sometimes that’s pretty far back in the throat can be hard to get to. So like a water pick to kind of jet some water back there can be really helpful for things like that. Or just a quick rinse in between meals and stuff. Yeah, exactly. It can be pretty helpful. And again, if you want to learn more about these oral hygiene topics, we went into a really in-depth dive in episode four of our podcast, oral health tips and tricks from two DENIS. So dive in to episode four if you want to learn more. The next question is very important and it’s something that’s very dear to my heart. So Timothy asks, does rinsing with urine provide any benefit? Very near to your heart, is it Mike? Okay, well, there is some history with urine being used in dentistry. So maybe that’s why it’s near and dear to your heart. I’m hoping because you learned about it in dental school and you’re not going to kink shape this part. Of that. Yeah, no kink shaming, you’re right. Whatever you’re into, do your thing. I’m not into that. But let’s be very clear. Let’s talk about if there’s any scientific basis for the benefit of urine as a mouth rinse. Mike, what is urine made of? Urine is 95% water. So it’s mostly water. Yeah. And honestly, it leans towards the side of being neutral, but I say generally, probably acidic. Probably. Yeah, because it has what uric acid, urea is a big, big amount of it. Ideally. Just rinsed with water. But if you want to rinse with urine. And this can kind of come from some place that we actually looked into this and did some research. And there’s actually some historical basis for this question where urine was used for an extensive amount of time. What did we find when we dove into that, Mike? Yeah, we found that the Romans used to use it as a rinse for their teeth and they thought the ammonia in it would cleanse the bacteria, but also whiten their teeth, which is wild. And what, like it became so popular that what, Resty? Not only were they drinking their own urine, rinsing their own urine, they were buying bottles of Portuguese urine and importing them. And they got so advanced or so common, I guess, that they imposed attacks on the import of urine into the, into the, into the, Rome. That’s just no. We don’t want to tax urine tax. That’s the last thing we need. Yeah, so. But if y’all want to buy your, uh, if y’all want to buy Resty’s urine, we’re going to start selling it on the website. Another surprise to me, but, you know, uh, DMS, we’ll see. Again, we don’t want to get too political in this episode at all, but a urine tax sounds pretty insane. Yeah, not doing that. No, no, no more. No more. Mm-hmm. Uh, onto the next question, kind of back into some more oral hygiene stuff. Um, this question comes. We were just talking about oral hygiene. Uh, okay, more, I guess, uh, modern, really, right, relatable, more modern oral hygiene, we’ll say. This one comes from one of our listeners, Jamie, uh, and Jamie asked, what do you think of this type of toothbrush? With this DM, she sent us a photo of one of the type, uh, you may have seen them. We’ll post a video along with this, uh, that we’ll show what we’re talking about. But it’s one of the kind of full arch type toothbrushes. It’s basically like a big, you shaped thing that you put into your full mouth, bite into it, and then it has kind of the brushes around them. Uh, what do you think of those, Dr. Mike? I, honestly, I like them. I like them for two reasons. One, for people that don’t have a lot of dexterity or lower dexterity than average, and also for nursing homes. So like if your mom, dad, sibling is in like a nursing home or assisted living, something of that variety, uh, the worker is there typically don’t have enough time to do like two minutes brush all your teeth. So this is better than nothing because it’s, it’s essentially a bite guard that has bristles on every aspect of it. So you can really get in there and touch every, every part of the tooth. Is it a replacement for brushing with a toothbrush for two minutes for your average person? No. But I think it’s a great addition to our special needs dentistry. Yeah. It’s something that can definitely be used there. Or kids or just anything like that. Yeah. But for a regular average patient, it’s probably not going to be doing the type of plaque removal that you really need. It’s going to be better than nothing. Yeah, like like Michael Sam for those special needs, those difficult, um, you know, limited dexterity, I think Parkinson’s disease or people with severe, you know, handicaps and things of those mattress. Yeah. They’re like a tremor like it’s a lot. Right. Yeah. Yeah. And I’ve even seen people attach them to a wall if they don’t have the capacity to do it. Oh. And then like use it that way, which is awesome. Okay. Plug and play. Yeah. Yeah. Yeah. So the next question is, um, also near and dear to my heart. It comes from a gal named Heather. So Heather, thank you so much. And the question is, do I have to brush my teeth? Emphasis on the half. Half is all types of people. It was in capital. It was in capital. Half to brush my teeth. So yeah, Rusty, if you don’t mind fielding this one. I mean, I’d love to. You don’t have to do anything, you know. You have absolute free will. You certainly do not have to brush your teeth. I always tell my patients, brush the teeth you want to keep. So if you don’t want to keep them, you’re not interested. You don’t mind bad breath. You don’t mind all the negative things that come with it. You know, you don’t have to brush. Some people let their oral hygiene or oral health get in such bad shape that brushing can be really painful. So if you’re someone that’s in that scenario that’s avoiding brushing for a particular reason, go see a dentist and get some help because you know, it’s important, but you don’t have to do anything. Again, episode four, give that a listen if you want to learn why it’s important. Yeah, I’ll send it to you. We have a next few questions. So one of our listeners sent in several questions. So thank you, Trudy, for sending those questions. These next three are all going to be from Trudy. So this first one, Mike, why does my back muller trap in bacteria? I floss and I brush regularly. So there’s a couple things without seeing your mouth or an x-rayer photo, but sometimes the back teeth have a different contour to them. So maybe it’s not as concave or convex as it should be. So you have kind of an area where plaque or bacteria, food gets stuck in it. So that’s one reason. And sometimes the floss is not able to kind of contact the tooth the way that the food is caught. So that’s where water pick comes in handy because it kind of sprays everywhere. So if you floss and use a water pick, then you’re kind of getting every aspect of the tooth. But also sometimes if you’ve had a filling done back there, maybe the contact between the teeth is not as good. So contact between teeth are important, right? So it’s what really keeps the food and bacteria from kind of getting below the gum, things like that. So when you floss, we like to hear that nice snap with the floss. So sometimes even if you didn’t have a filling done, sometimes when your teeth grow in, you have spaces. So spaces kind of lead to food impactions. So I’m thinking along the lines of that. Do you want to talk about maybe an opurculum, like something like that, maybe? Sure. So an opurculum is what Mike just said and what that is is basically a piece of like extra gum. Typically it’s going to be on your lower teeth behind your very back molar. And it’s just a piece of like extra gum that grows up and over the tooth. And that’s an area that’s definitely going to be trapping a lot of food, a lot of bacteria. That’s a scenario where a water pick can be really effective and really helpful to get down there and get underneath that inflamed gum tissue and clean that out. And a lot of times that’s going to be successful. Some people that have really bad gum overgrowth sometimes have to have it removed to really effectively clean it. But typically it’s not going to be that. And like Mike was saying, spacing and alignment is so important. If you have too much or too little space, it can cause food trapping. So if there’s a big gap between your teeth, if there’s any crowding, crookedness, rotations, there’s a bunch of stuff that can cause food trapping, the more food that you get stuck, the more bacteria you’re going to have, the more likely you’re going to be to develop things like cavities, gum disease, bad breath, all the above. So if you’re having this issue and it’s been a chronic problem for you, go see a dentist, get a trucked out and have someone look at it to see what might be going on. Yeah, agreed. And just like anything, too much of anything is bad. So too much space, too much contact, things like that. So for sure. Yeah, it’s important. Next one’s pretty quick as well from Trudy. She asked, is a manual toothbrush or an electric toothbrush better? Well Trudy, electric. Yeah. That’s the way to go. Electric toothbrushes are more user friendly. A lot of them have timers. They tell you if you’re pressing too hard, things like that. So yeah, electric toothbrushes are great. Plus the oscillating factor disrupts bacteria better. So I’m a big advocate of electric toothbrushes. Yes, electric is great. And I got the question a lot from patients, which brand is there a brand specific you like? Personally, I’m a fan of the Sonic care brand. Brand joy use. The brand joy use. Again, all the electric ones are going to be good. There’s a lot of them on the market. So just get something be consistent with it. Yeah, agreed. All right. So when getting a regular checkup, do I have to get the electric. Electronic pick. I find it’s really aggressive and hurts. I would prefer the manual pick. You want to feel that one? Yes, I’d love to. So thanks Trudy for this last question you sent us. So I think you’re talking about kind of the cleaning instruments that are used during your dental cleaning. And so the manual pick is kind of the hand instruments that the dentist or hygienist typically will use. And a lot of times those are less scary to the patient because they don’t make any noise. There’s no water. There’s less vibration. It’s all just kind of there. The electronic one is something like a piezo or a cavern. It has a bunch of vibration and it puts some water out that allows the hygienist to really get in there and disrupt a lot of stuff that’s below the gumbline. And it cleans a lot of that stuff that’s below. But for some people, it’s really uncomfortable. And it sounds like that might be the case. So Trudy, there are options. Your hygienist can do typically like some topical numbing jelly, some spray, some material or even numb, you know, if things are uncomfortable. And they can also use the hand instruments more than the electronic ones. Some hygienists will only use the manual ones as well. But I will say most hygienists I think are typically going to prefer the electric ones. It’s easier to get things cleaned. It’s going to be faster, quicker. And they’re going to be able to do a better job for you. But talk to your hygienists. See if there’s a way that they can make it less painful or seem less aggressive or if they can maybe do a little bit more of the manual. Well, Trudy, I agree with you. I don’t like it either. I’m really sensitive teeth. It hurts. It hurts. No matter what setting it’s on. But honestly, the cappodron of piezo is like the best way to clean your teeth. Yeah. And I’m the type of psychopath that like went in there and they’re like, oh, it kind of feels good. No, it kind of like hurts just a little bit. It feels good. Just zing. But I know they’re getting in there and they’re getting in there at the ball. It’s like the best way to clean. All that stuff they’re getting in there at it. It feels good. Yeah. I’m weird, so don’t trust me. Next question is from Bonnie. So Bonnie asked, would you suggest getting extensive treatment like crowns of an ears done outside the US? You know, it’s hard because there are people that don’t live in the US, right? But there’s good dentists everywhere. The US is not the best dentist that ever existed. We all have different countries of different standards. So just make sure you find a dentist that has the standard of care that you would expect from what you’re getting, so what you’re paying for. I mean, obviously money talks, I get it. But also the issue. So if you are from the US and you go outside and get dental care somewhere else, if you’re getting extensive dental care done, you’re not going to have the follow up you would have if you got it done like in the US. That’s the issue. So like it’s cheaper on the front end, but if you go get it done somewhere else and then you’re not going to have someone that’s going to warranty it, take care of it, do things like that in the home that you live. So you’re going to be traveling back and forth and by that, it just seems more expensive to me, but I get it. I understand wanting something for cheaper. So just make sure you do your research and if you’re thinking about going somewhere, we’re happy to check them out for you. There’s good people everywhere, right? For sure. There’s good people. Yeah, absolutely. There’s good and bad people everywhere you go. But definitely do your research. Again, like Mike just said, we’d be happy to check into some places, give you our opinion on what we think of the clinic or whatever. I’ve seen a lot of videos where recently people having worked on abroad and then having to go back and having it redone abroad. And then some of the redoes, I’m still like, oh, I don’t know about that. So just do your research because it’s your teeth. You only get one set of adult permanent teeth and that’s all you have for life. I mean, there’s replacement options nowadays, but those are expensive and just be careful before you go and get your teeth shaved down to these little pegs. I’m sure you’ve seen the videos on TikToks and those full mouth, veneers, crown situations that are a lot of preparation of two structures that may not be totally necessary. Yeah. So just make sure you’re doing it. Once it’s prepped away, it’s gone. Yeah. Yeah. And then you get it replaced, more is gone. So just be mindful of it. Yeah. Yeah. We did have this me or you. I don’t forget. We had a video sent in from Jerry. So thank you. And it was a video of a microscope looking at a sample of a lidocaine, so the liquid we used to numb you in the needle. And the person doing the video was saying that they see nanotechnology particles within this like image on a slide and they’re looking at it. So what do you say about that, Rusty? Because I saw it. It’s square and it looks weird. It looks like a weird little floating thing within this solution, right? Again, please don’t believe everything you see on the internet, right? Lidocaine, any of these anesthetics are, it’s like lidocaine, excuse me, lidocaine hydrochloride, right? And so that’s a crystal. And so what you’re looking at under this microscope is the crystal structure floating within the liquid of the anesthetic. And so you’re literally just seeing the lidocaine crystal structure once you take it out and it starts to be exposed to air and things. These things crystallize and that’s why the sterilization, the packaging is so important for them. Once you start to expose them to air and they start being in a way they shouldn’t be stored, they’re going to start to crystallize and do weird stuff. So don’t believe everything you see. This video actually cracked me out because it was saying Novacaine, Novacaine, Novacaine, right? I’ve never even seen Novacaine as a dentist. Novacaine is an outdated, it is a local anesthetic and a lot of people think, oh he’s giving me the Novacaine shot. I’ve never even held Novacaine in my hands and I’ve been a dentist for years, right? Novacaine is not used anymore in the US because there was a lot of allergic reactions to it. We use Lidocaine, Zylycane, Prylycane, Bipyvacane, lots of canes, no Novacane, no cocaine anymore. Yeah, no cocaine either, but that used to be an anesthetic too, actually, yeah. Rub a little of that on the gums and that’s what they used to use. How do you know that? From studying dental history. I see. So the last question is, hey funny dentist, tell us why white spots form my gums. Thank you, Barbara. Yeah, yeah, Barbara, great question. This could be due to a lot. It’s hard to say, yeah, there’s a lot, so it’s like, let’s piggyback it. Yeah, piggyback in it, you know, one thing without seeing you, it could be plaque or food debris. You could do that. You have dry mouth. We see a lot where things start to stick to the gums, things turn white in the mouth when they’ve been there for a hot minute. Yep, could be a difference in pigmentation. Systemic conditions. Yeah, like what? It could be something like vitamin deficiencies in terms of, it could be like a fungal infection. Yeah, autoimmune conditions, canes, sores, you know, signs of, yeah, lots of stuff. So if you’re seeing any new growth or bump, lump in your mouth, go get it checked out. It could be normal. It could just be your normal healthy gum tissue that has different texture, different uniqueness to it. It could be something growing. That’s an infection. It could be a sign of a systemic condition. It could be nothing at all in a piece of food, right? Yeah, so I always say, if you can rub it away, good. If it comes back, go see a dentist. If it’s something that’s there, goes away. Good. If it’s two weeks, it doesn’t go away, go see a dentist. Yeah, gentle rubbing, too. Don’t like it. Yeah, I’m not saying it’s your gum. Damn, it’s sandpaper. Yeah, yeah, yeah, be cautious. Yeah, if it goes away, then that’s good, but it’s always good to get things checked out. Sometimes anything new, growing anywhere in your body, especially your mouth, go get it checked out. But not by me. We do hear up. I’ve had people in the dental chair that are like, can you look at this rash? Here to hear. And they lift their fur about. I’m at least five times. And sometimes the rash can be connected, right? I mean, we talked about– And it was. –cifalus. You’re talking about your syphilus case, I think, where we talked about oral STDs in a previous episode that can have systemic conditions. Yeah, so. So people just like to talk about weird things sometimes. So, yeah. Anywho, I hope you enjoyed this dissection of our DMs. Yeah, thanks for tuning in. And please send us more DMs like we said in the beginning. We want to be here. We want to be a voice for you to answer the questions that you want to hear. So if you don’t send us questions, we don’t know what to talk about. So send us some questions. Yeah, we’d love to hear from you. Yeah. Bye. Bye. See you later. [MUSIC PLAYING] Thank you for listening to today’s episode of DM Adentus. Brought to you by Dose of Dental. And thank you for your interest in improving your oral health. If you’d like your questions answered by Dr. Rusty and Dr. Mike, visit us at doseofdental.com or DM us on Instagram @yourdalidoseofdental. [MUSIC PLAYING] [MUSIC PLAYING]