Dental Pamphlet
Samira is a dentist whose husband and daughter both have type 1. She left the hospital with brochures on eyes, kidneys, heart and feet — and nothing about teeth.
Jump to a moment
- Half her family has type 1. Her husband, also a dentist, was diagnosed sixteen years ago in his thirties — first told it was type 2 and handed metformin, until somebody finally ran antibodies. He has vitiligo. Their daughter was diagnosed four years ago at eleven, caught at close to 400 because a kid who sleeps through anything was getting up three and four times a night. Both dentists, and all either of them had ever been taught about type 1 was that beta cells are destroyed by an autoimmune response. Everything else in dental school was type 2 and gum disease.
- The mouthwash story is the one to remember. A mom, pleased with herself, had her son swish a blue alcohol-based mouthwash after overnight lows because he liked the taste and wouldn't drink water. Water sits at a pH of 7; that mouthwash is 5.5. Cavities need three things at once — sugar, an acidic environment, and specific bacteria most of us already carry. She was supplying the second one on top of the first. Doing nothing at all would have been better.
- Diet soda doesn't rescue your teeth either. Scott looked it up mid-conversation: Diet Coke runs about 3.1 to 3.3. The preservatives that keep anything shelf-stable — ascorbic acid, citric acid — are acids by definition. And xylitol, which dentists keep recommending to type 1 families, does nothing for a low, because it doesn't raise blood sugar.
- Her four asks of dentists, none of which make a dentist any money: sip water after treating a low and check what's actually in your mouthwash; come in every three to four months rather than every six, because salivary testing shows the bad bacteria are only starting to repopulate at three months and are fully back by six; the less sticky the sugar, the better; and look for dry-mouth products with glycerin, because blood sugar swings reduce salivary function and leave the mouth with less buffering capacity.
- Two things worth knowing if you take a GLP: she says they are starting to see reduced saliva production, which concentrates everything left in it — minerals, bacteria, and glucose. And whitening powder is an abrasive. It works immediately and it works by putting micro-scratches in your enamel, which then stain faster, which sells you more powder. A peroxide gel does the same job without scouring the surface.
- T1D Oral Health Foundation — Samira's nonprofit — the questionnaire she is using to build the first real data set, plus a family brochure
- ADA Takes Up Type 1 Education for Dentists — Her resolution was referred for study, with a report due back at the ADA House of Delegates this October
- Beyond Blood Sugar: Type 1 in Dental Practice — The course she teaches to dentists — CGMs, pumps, dental emergencies, and how type 1 and type 2 differ in the chair
- Dexcom G7 — Now in ten and fifteen day wear, with a twelve hour grace period and up to ten followers
- Omnipod 5 — Tubeless automated delivery, updated with a new 100 mg/dL target option — free starter kit at the link
- Small Sips Series — Listener-voted takeaways from the podcast in short episodes
Every word of the conversation
Welcome and Sponsors0:03
Hello, friends, and welcome back to the Juice Box podcast. On today's episode of the podcast, there will be nothing that you should take as advice, medical or otherwise. So please, please consult a physician before making any changes to your health care plan or becoming bold with insulin. I've got two OG sponsors for you today, Omnipod five and Dexcom. That's right.
The episode that you're about to enjoy was brought to you today by Dexcom and the Dexcom g seven, the same CGM that my daughter wears. You can learn more and get started today with my link, dexcom.com/juicebox. And this little slice of podcasting perfection is also brought to you today by the Omnipod five. The Omnipod five is a tube free automated insulin delivery system that has been shown to significantly improve a one c and time and range for people with type one diabetes when they've switched from daily injections. You can learn more and get started today at my link omnipod.com/juicebox.
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Meet Samira2:02
Hi, and thank you for having me. My name is Samira Chafay. I am a general dentist. I am a mom to a type one diabetic little girl, and I'm married to another dentist who has type one diabetes. We have a son and a daughter.
So fifty percent of our family is living with type one diabetes. So teeth and diabetes, sugar is our life, and so that is my story.
Interesting. Well, I'm sure that's just the beginning of your story. So when you
met I know. So
Yeah. When you met your husband, did he have type one?
No. He didn't. So we met at UCLA School of Dentistry twenty five years ago. I graduated in 2001, so literally twenty five years ago we graduated. But he was actually a year ahead of me.
He graduated twenty six years ago. And, no, he did not have diabetes. The only thing we got as far as our education and physiology is type one diabetes. Your beta cells are destroyed by an autoimmune response, and that's as much as we got. In dentistry, we got so much information on type two.
Type One Was Basically a Blurb3:09
Type two in dentistry with periodontal disease, gum disease, all those issues. Type one was basically a blurb. Mhmm. And years later, sixteen years ago, actually, we had a little rambunctious toddler. So my son was about three, four years old.
I was very, very pregnant with our daughter, and we were working out of a smaller practice, and we were building our kind of our forever practice. You know how people build their forever home? We were building our forever practice from scratch scratch startup, the construction, all of that. And while life is happening, he just was not feeling well. And he kept going to the doctor because that's what a person does.
And they run tests, and they tell him he's fine. And, you know, at at some point, somebody did a test, and they said, oh, your blood sugar is high. You have type two diabetes. And we're all like, okay. That's fair.
Life is stressful. He's in thirties. I... Like, we can accept that diagnosis. But, you know, exercise more, eat better, here's some metformin, and we'll check-in with you.
Mhmm.
Then They Found Antibodies4:18
And he just was not feeling better, and he was just really just... He was struggling. And at some point, somebody decided to do a little bit further testing, and they can... They found out he has antibodies, and it is actually lot out, you know, autoimmune and not type two. So when he got the diagnosis, I I was about to give birth.
You know? The toddler is still super, you know, rambunctious. The construction on... This is going on. Excuse me.
Take your time.
And and there was just so much going on. You know, we're selling our office and then moving into the other place. I'm not at the... And he's still showing up every day to see patients. I still have no idea how.
He's amazing. Right. And, you know, mad respect. And so, you know, he had to learn to do what his pancreas does on his own. He had to learn to manage that, and I was absent from that.
Mhmm. Well, I
Fast forward.
Dentists Make Perfect Podcast Guests5:18
Yeah. I wanna say, I just realized something. Dentists are the perfect podcast guest because you guys are completely custom to having a conversation where the other person doesn't have to be involved he don't want to. It just occurred to me. Was like,
I love that.
Yes. Thank you for feeling. Yeah. Yeah. Every once in a while, I, I have this feeling when I'm interviewing somebody that I could push the microphone away and leave and come back, and I'd be and I'd be like, oh.
And then they'd listen back and think, that was a great podcast. So... But it just occurred to me that dentists have, because you guys are absolutely insane the way you start conversations while you have your hands in people's mouths. Because you... There's a compulsion when you're sitting in the chair to respond.
Yeah. But you can't.
You can't. You're like, does she want an answer to this, or is this, like, rhetorical? What's happening exactly?
Oh, we learn how to, you know, understand understand nods and mumbling, you know, early on. That's funny. That's really funny. It's an occupational benefit.
You're... So let me make sure I understand. You're pregnant with your child who is... Will one day have type one diabetes while your husband's being kind of miss... Misdiagnosed and better diagnosed and then fumfering through the whole thing because you think his direction was terrible.
Can I ask you, do you think they gave him poor direction because he was a physician or because that was the how it usually works?
You know, I really don't know. He had he had a good care team. We live in Southern California, so I don't think access to care is an issue. He he saw multiple providers. And I think at just...
At some point, somebody said, Let's look at it with a different perspective.
Yeah.
And I think, you know, you kind of sometimes accept what they tell you. They tell you you have type two diabetes, and you're, you know, you're fitting into the mold. You... You're not gonna argue about that, especially if you don't know too much about type one. We don't know anybody who has type one in our family.
Right. Like, this came out of nowhere. And so, you know, when he got the correct diagnosis, it was a little bit of a shock. Like, are you sure? Is this...
Oh, okay. Let me go learn about that. You know what I mean? Mhmm. And, again, by then, I...
You got a brand new baby. You know, the other toddlers running around moving a whole practice. It's not like moving your house. I mean, you're moving patients, you're moving charts. It's it's quite an undertaking.
And then somebody had to take over our old location, you know, you have to sublease the other thing. It was it was a lot happening. And so, you know, I'm sure the stress of that probably triggered something that was brewing. But, I mean, you think back, and you're like, oh my god. We...
Did we really go through that? But... You know?
Did... Can I ask, is there other autoimmune in his family? Aunts, uncles, brothers, fathers, the... What are
they what they have? So he's always had a little bit of vitiligo, and the more I'm learning, there's a lot of... Just in our support group around here, we see a lot of kids with vitiligo that also have type one. So I don't... I I haven't really looked to see what the, you know, comorbidity with those two are, but that's as far as we've seen now.
You know, you know, somebody has a little bit of, you know, eczema. So we haven't seen, like, too much.
But but but...
I do think there's an underlying autoimmune gene somewhere.
Yeah. So eczema, how about Hashimoto's or celiac? Any of that?
We haven't seen celiac. We haven't seen Hashimoto. Arthritis, I know rheumatoid arthritis is autoimmune, but I feel like that's just so common. That wouldn't necessarily trigger a... Oh, you know, we better be on the look...
On the lookout for that.
You see anemic? Any anemic people?
Not that we know of.
And how about on your side of the family?
Not that we know of.
Okay. Okay. Yeah. And other type of
Again any I haven't... You know, sometimes people don't share.
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We're gonna get back to the show. Oh, no. Yeah.
The other part of it. You know? Maybe it's his second uncle and, you know, or my, you know, second... I... If they don't share.
You're never gonna know. They're
taking a
pill in the morning or something like that. Yeah.
Exactly. Exactly.
So so he teaches himself... This is, you're saying, sixteen years ago he was diagnosed?
This is sixteen years ago. So keep in mind, no iPhone.
Yeah. No.
Sixteen Years Ago, No CGM11:31
Right? He started out without a continuous glucose monitor. And keep in mind, as dentists, we're seeing patients. Like, you're, like, focusing on people and with, like, a, you know, a drill that's going, like, you know, thousands of RPMs an hour. So, you know, you gotta you gotta be really self aware.
I I
Your highs, your lows.
I have to be honest with you. My... I... It took it took me a while to find a dentist. I...
I've probably said this a couple times. The first dentist I had as an adult, I now look back and think he must have been on meth the way he ran around from, like, room to room, like, working on multiple people at the same time.
That's terrible.
Yeah. It... And and now I I have a great dentist. But my goodness, does he have a very specific personality that Uh-huh. That lends itself to this kind of fine detailed, like, like, aggressive but fine at the same time work.
You you know what I mean? He's Yeah. Yeah. Every time he's ever numbed me up, I, like, I get done, and he goes, you okay? And I'm like, I I...
I'm like, you're a you're goddamn magician. Like, I I... I don't even know that you just did anything.
That is so sweet.
Yeah. Yeah. He's just... He's he's so good at it. Right?
And... But I'm taking your point now as you're talking, like, if if you're funfering through figuring out type one diabetes, your blood sugar gets high or low or something, you're trying to do that work, that must be incredibly, like, I guess, just challenging is the word I'm looking for.
So one thing about my husband, he is... He's an incredible dentist. I mean, we both work together. We both went UCLA. I feel like I'm a great dentist, but he is above and beyond.
I mean, this man should... I mean, he he has an engineering mindset. I'm a big picture person. I'm the one that's going through their medical histories. I have...
I'm, like, warding any cavity. I'm the big picture person. But he's the one that... He's, like, making your tooth bionic. Like, he's thinking of, like, the best bonding agent, what's the best material.
Like, he's an engineer. Right? So he... With his OCD personality, we always joke. I'm like, you were made for type one diabetes.
Like, he's all about numbers and stats and how many... You know what I mean? So he... When he was diagnosed and he didn't have all the tech, his management was incredible because he was so self aware, and he was also so OCD about making sure it might work. It has my stamp on it.
I need to do a good job.
Yeah.
And so, again, kudos to him. You know? How many people can say that? But, yeah, it was
a different How did he manage in the beginning? Was it injections, pump?
Yeah. No. No. No. Injections.
You know? I mean, yeah. No. Everything manual. Okay.
But, again, it's... It it was a learning curve. Right? It was a learning curve. And I'll share with you.
Injections Until Four Months Ago14:13
He actually did not use a pump until probably four months ago.
Okay.
He was still on injections.
How
long? Just doesn't... Didn't like the feel of the pump on him. He's... Even right now, he had...
He's using one of the one of the tube pumps. He'd like... You know, it keeps getting stuck on things. He's just, you know, he's cursing it out all this time. But, but, I mean, he was okay with the injections, and, you know, he's like, I just don't like having something on me.
And it was working for him. And, again, his time in range is great. His a one c was great. So, you know, as long as...
I'm sorry. Why do you think he switched?
We... Well, that's gonna come on my next part of the story, but also out of convenience and, you know, just a lot of bruising. You know, insulin absorption starts getting a little impacted when you have a lot of callusing and bruising, and so it was more for that. And he did start the pump as a role model for our daughter.
Happens a lot. Also Yeah. I I mean, I've had a... I'm starting to realize I've had an odd number of conversations with people specifically about diabetes, but it's... It it leans a lot towards the father too.
Like, when I hear the stories over and over again, it's a lot like I was okay. I felt like I was alright, but I wanted to be a role model. Type one parents to a newly diagnosed type one child, I do hear the story more coming from men. It's... I don't understand why that is exactly.
Interesting. I'm just... I'm a 100% sure it's right. So Yeah. How long ago was your...
It's your daughter, right, that was diagnosed?
Her Daughter, at Eleven15:46
So my daughter, was diagnosed four years ago at the age of 11. So almost four years ago, not quite. But she finished school, like, you know, end of end of end of May. Like, I think it was, like, June 3. June 9, we were in the hospital.
And it was, like, a Tuesday. I'm looking at her. I'm like, gosh. She's drinking a lot of water, and this kid, like, will not... She will she will sleep through a bomb.
I mean, she does not wake up. She was waking up three, four times to go to the bathroom. I'm like, how is this possible? And, you know, your mommy instinct kicks in because you've seen this before. And then, you know, it was...
You know, we we already have the, you know, the finger stick, you know, do a little blood check one day and, you know, she was, I think, close to 400. And we literally got in the car and went to urgent care, and then I'm like, well, I kinda don't wanna go inside urgent care. There's all these sick people. So so I went... I was telling the receptionist.
I'm like, this is what's happening. I'm pretty sure this is what we need to do. So a wonderful sweet pediatrician that was on call that kind of saw us in a separate room with his nurse who looked like she was nine months pregnant and was supposed to go home, but she stayed behind for us until he called the endocrinologist. And then, like, you know, the... Or the closest pediatric endocrinologist who could see us was an hour away.
He called an ambulance, and they took us over there. And you know the rest of the story of how the diagnosis goes. And then she was diagnosed, and that was that was a big shock. And the difference for me as a mom is when he got diagnosed, you know, I was the spouse. I was taking care of the kids.
He did this on his own. But when the child got diagnosed, like, she can't do all the PKS stuff herself. I have to do it for her.
Mhmm.
So, yes, I kind of knew, but now you really, really have to know. And a big a big, like, kind of a, you know, look at... It was, like, something that, you know, like, light bulb that goes off was when it was at the hot... When we were at the hospital. So we had...
Yes. Of course, pediatric endocrinology came in, all these other subspecialists came in, nutrition came in, all the... You know, everybody comes through. Right? Do you know how to do this?
Do you know how to do that? Do you know how to curb count? And, you know, we even got, like, an avalanche of brochures. Like, right, I still... I think I have a picture somewhere with, like, how much information we got over a course of three days.
And it was, like, your eyes, your kidneys, your heart, your feet. These are all chronic issues. Right? And as a dentist, I'm thinking, okay. Well, she's waking up at 02:00 in the morning, having a sweet something because her blood sugar is low.
Where's the Dental Pamphlet18:28
Like, this is an acute problem. This is not a chronic problem. Like, where's the dental info?
Yeah.
Where's the dental pamphlet? Like, why why do we as dentists not do this? And so then, you know, you come home and you start seeing the twenty four hour exposure. I mean, literally, this is... Sugar is her medicine, and we dentists are like the sugar police.
How do we not have guidelines? How do we not have advice to give to families? And then, you know, I did what all the good moms do. You know, you join a bunch of Facebook groups and, you you know, you contact your local, you know, little support group or whatever. And, you know, you're reading all these things that people are writing, like, probably even in your juice box, you know, Facebook group.
Like, at least every day there's two, three people asking dental questions. Yeah. You know? And so I go back. And one of the things I will share as part of the California Dental Association, and I'm in Orange County, so Orange County Dental Society, kind of like the American Diabetes Association, there's the American Dental Association.
Yeah.
Oddly enough, they're both ADA. But... Side by ADAs. So I've always been involved with advocacy efforts. I've gone on, you know, when they cut, you know, benefits.
I I do a lot with them. So I already had captive audience, and I'm like, hey. This is happening. What are we doing? And it was like, Diabetes?
We already cover that. I'm like, no. No. No. No.
We're Covering Type Two With Gum Disease19:53
We're covering type two with gum disease. My kid is not at risk for gum disease when she's older, which she is, but I'm not worried about that right now. I just don't want her to lose her teeth. What are we doing? And it's like, I don't know.
Why are you giving your kid sugar at 02:00 in the morning? Why is she not waking up to brush her teeth in the middle of the night? And I'm like, my husband is type one, and he's not getting up to brush his teeth at 01:00 in the morning.
Like... How about no one's doing that? No one's doing that. Yeah. Yeah.
I just
go to... I gotta go to work. She has to go to school. Like, what kind of advice is that? And I think this is where, you know, it really hurt.
It felt personal because, like, you know, here's my own profession, and they don't understand. You know? I mean, in dentistry, like, when a patient comes to me and they say, you know, I smack... Smoked... I smoke, like, two packs a day.
I already know. I learned this. This is all the questions you asked. This is the guidelines. These are your, like...
You know, are you worried about oral cancer? Like, it's it's already set. Like, it's a formula. Right? And why is there not a formula for type one diabetes?
Yeah. Just a little There are many people with type one who don't even have a single cavity, but there are also people who smoke a lifetime and never get, like, lung cancer. You know? It... It's it's still a high risk.
It doesn't mean everybody gets it.
There's a
But there's
I'm sorry. I get a number of people who tell stories about going to the dentist, and the dentist is literally clueless. So they'll say something like, hey. You know, I'm worried about their, you know, their blood sugar falling while they're in here. And Yeah.
Then the dentist does not know how to accommodate that. I I will tell you... I mean, it's a long time ago now, but Arden had a lot of cavities on her baby teeth that... And some of the teeth needed to be, like, taken out and, like, work done and all this, like, stuff when she was little. And our dentist would only do it if it was in a hospital because because he was like, I don't know how to, like, have her out for thirty minutes and, like Yeah.
You know, and and manage her blood sugar. So... But the other thing you get is that once you start that conversation at the dentist, it's the exact same thing you just said over and over again. People will... They'll say, well, like, you know, well, my child has, like, juice in the middle of the night or we have to do this, that.
And the dentist's only advice is don't do that.
Yeah.
Yeah. You're like
That's stupid.
Awesome. Well, she'll be dead and not have cavities. I'm not sure what to do next.
But I think... You know, I I... And I and I do wanna preface that. I don't think they mean to come across as condescending. No.
Is condescending, but I don't think they mean it to. They think they're giving you good advice, but it's because they don't know. Like, I went to UCLA. I had an incredible education. I don't...
I mean, I... I'm good at what I do. Right? Mhmm. But I only got a little blurb.
And so I think it's just missing in the education part of dentistry
Oh, for sure.
Because nobody's talking about it. And when somebody is talking about it, it's because, well, you know, you should brush and floss every day and you should... And so, you know, okay. Well, how do we do that? So as part of my advocacy groups efforts with American Dental Association, California Dental Association, hopefully, we'll be expanding that.
I'm trying to say, hey. There is a little bit of a blind spot here. We need to do something.
Yeah.
And so they've been very receptive. Actually, just last night, I did a webinar for a group of dentists. Like, last month, I did another one. And so I... I'm actually...
Next weekend on the tenth, the American Dental Association scientific session is in Indianapolis, and I'm gonna be presenting in person. And so it's an honor to be able to present in person to the American Dental Association Yeah. And a scientific session. How do how are you? Incredible.
What do they give you? About twenty minutes? You get a half hour? How long do you get?
I get one hour and a half hour. Oh. Ninety minutes.
That's amazing. So what's your That is amazing. Oh, it really is. So Yeah. Let me tell you.
At a lot of the diabetes stuff, your presentations, you're lucky if you get twenty minutes even when they're asking you to present. So how are you gonna lay this out? Like, what's your
messaging? Messaging? And And So So you you know know what what mean? The reason... So the way I...
We started this. So after that kind of light bulb moment, after we came home with my daughter from the hospital, my husband and I looked at each other and we're like, this is stupid. We gotta do something. We can't possibly be the only dentist parents of a type one. You know what I mean?
Like, why is nobody talking about this? So we... We're like, we're gonna go to our local chapter of breakthrough and, you know, and, you know, our our children's hospital, and we're gonna talk to the people, and we're gonna be, like, super involved. And then we go there and, you know, and it... It's a little bit of kind of the similar thing.
Well, my dentist told me this. And I'm like, okay. Well, we can't just do this in our local area. We need to do this on a wider audience. So I established a, nonprofit with the state of California.
Starting the Foundation24:51
We called it t one d Oral Health Foundation. And with the help of, some amazing people we know in our community, we set up a little questionnaire. And the questionnaire is currently on our website if any of your listeners wanna go fill that out. And the questionnaire asks, did your endocrinologist talk to you about teeth? What does your dentist know?
And there's a... Just like there's five questions, and then has a little box that says, tell us your story. What do you want us to address? And when the responses came in, it wasn't that we as dentists need to talk to the public. We as dentists need to talk to the other dentists.
Because if the other dentist doesn't know, then, you know, that... That's kind of where the where the where the gap in in education is. Right? So when we got all the data from our questionnaire, I tabulated it. I wrote it up as a abstract.
I actually submitted it to American Diabetes Association. I haven't heard back. I submitted it to the International Diabetes Federation. Is that what it is? And so nobody has data.
You can even put it in PubMed, type one diabetes and, you know, dental health, like, minuscule amount of studies come up.
Yeah.
And so I'm really hoping that I can get people to fill out the questionnaire so I can publish this as a proper, hey. We need to do something about this. Somebody needs to study to figure out what do we need to do to close this gap. But but to that... So when people fill it out and they answer these questions, one of the first things that you see over and over again...
Xylitol Doesn't Raise Blood Sugar26:23
My dentist says instead of sugar, take a Xylitol. Xylitol is a sugar substrate that does not cause cavities. But Xylitol does not increase your blood sugar.
So not help.
I was just, like, blown away how many people said that.
Are you
blown away?
Are you really blown away? I'll... I'm gonna tell you.
I mean
I have a very, very close friend who's a pediatrician. His father is a dentist. We worked together one time, and I called his father doctor, and he goes, he's not a doctor. He's a dentist. And and and and they're laughing at each other, and he looks back at his son and goes, you're a pediatrician.
And they... And and so there's this, like, you know, already felt like there was, like... In between them, they're like, yeah. Like, we do the thing we do. Like, we're, like, kinda tacticians of a thing.
You know? And and when you hear people going to endocrinologists who don't get great direction about their type one diabetes, I mean, you can't be surprised that the endo bring up your teeth, and you definitely can't be surprised that the dentist doesn't understand your endocrinology issues. So Well, I
I contacted an endocrinologist. Actually, he was... He's not our endocrinologist. He's, like, the head of Children's Hospital here. And so he was really kind.
He actually, like, got on the phone, like, on his cell phone and started talking to me, and he's like, yeah. I've always wondered where the dentists are around here. He's like, I had one mom whose daughter was diagnosed with type one, and she wanted to sell toothbrushes at my office. I'm like, oh my god. That's really sad.
This is where this is where everybody's mind goes. Right? Let's capitalism.
2026. Like, I'm... I'll I'll start an Instagram. I'll get a... I...
Passive in... I'll get passive income. That's how everybody thinks it.
Are you serious? And I think that's why I kinda went to the American Dental Association because what I'm doing, I'm not making money off of this. Right? You know, creating awareness. Yeah.
Yeah. I'm trying to get a message. I wanna... I I... It's important.
My profession is important to me, but my child is also important important to me. My husband is also important to me. And I think everybody should have good functioning teeth. I mean, yes. I...
You know, it's it's like your kidneys, you need it to live. You don't need your teeth to live. But, you know, the psychosocial component of type one is so great. Like, if you can't smile, if you can't eat proper food, you know, what does that do to your psyche? So it is part of the equation.
Yeah. How about just, like, how about I'd like one less thing to be worried about or one less thing to have to pay for or to mess with or go to the dentist for? So so all you want is for dentists to know, like, here type one diabetes, and then kind of go through a checklist. Not any different than, by the way, when you go into, any health care at this point now. They ask you if you're feeling depressed.
Like, that that idea. Right?
Exactly. Exactly. And I'm using the data I've gotten off of the feedback people have filled out on our questionnaire to kind of navigate that. So I will tell you, I went to speak at, like, a little parents' group here. And you know how when you have a low...
You know, you take whatever, you know, whatever your preferred sugar source is and go back to sleep. Right? So I was telling the families, I'm like, you know what would be great? If you can just sip a little bit of water. Just dilute the sugar up.
He Loves Mouthwash29:27
And this mom is, like, super excited, and she tells me, you know, my son doesn't like to drink water. He gives me a hard time, but he loves mouthwash. So he... She has a little mouthwash and a little cup, and he'll swish with the mouthwash because he likes the taste of it and spit it out and go to bed. And initially, I'm like, oh, that's kinda sweet.
That's a great idea. But then, you know, you start digging into this. And she's using... Again, I'm not gonna use brand names, but Big Blue Bottle. You can find it at Costco and Target, you know, really tart taste mouthwash.
Right? And so those mouthwashes have alcohol in them. When you add alcohol to a liquid, it brings the pH down. So if water is at a pH of seven, that mouthwash is at a pH of 5.5. So cavities happen because when you have sugar, when you have an acidic environment, which means pH is below seven, and then the third one is a specific bacteria in your mouth.
We all have... You know how we have good bacteria and bad bacteria or natural biome? Their... Our mouth is the same way. That's why some people, like, never brush their teeth and never get cavities, and other people are, like, brushing all the time and they get cavities.
They just happen to have, you know, a disharmony of the good and bad bacteria. So there's a bacteria, streptococcus mutants, there's a couple of lactobacillus, those bacteria cause cavities. So if you have a little bit of those bacteria and then you add sugar and then you create an acidic environment You're getting a cavity. Either having... Then you're having a...
Then you're gonna get a cavity. Yeah. So this kid is taking... Is correcting his low blood sugar. So he has...
And he already has naturally the bacteria that cause cavities in his mouth, which majority of us do.
And then they're lowering the pH.
Then you're lowering the pH.
Makes it a perfect a perfect...
So doing nothing is better than that. Do you see what I mean?
Yeah. Yeah.
Wait. Yeah. Anybody with type one... Or actually, I kinda tell all my patients, please do not purchase any mouthwasher, any dental product that has a lower pH. And with...
You know, now with ChatGPT, you know, wherever you go, put it in your ChatGPT. What is the pH of blah blah blah whatever you're purchasing?
Right. But even as simple as what you just explained, like, I don't know that, and I would never think to ask about it. I mean, how would I... Like, can you imagine me sitting around going, oh, I wonder if the... I'd...
I'm not creating a perfect harmony of, like, you know, in my mouth to make a cavity big. That... There's no way that people would think the mouth... They definitely gonna think the mouthwash is the thing that fixes the whole thing.
Right.
Yeah. Yeah.
Right. Marketing.
Yeah. Marketing.
Exactly. It's capitalism. Marketing. But this is this is sometimes why, you know, I I kind of get a little cringey because people just read whatever that's on label or whatever is in the twenty second little reel they hear. Oh, this will fix.
No. You you need to understand the science behind it. So for cavities, sugar plus p eight... Low pH plus that specific bacteria. And some people have more of it, some people have less of it, and that's where your risk is high or low.
But
So
if you are
I have to ask one question. Would it have been better for that person to switch with Diet Coke than with mouthwash? Is it... Like, you know what I mean? Like, it really wouldn't be great.
This is what... Yes. So it's... Yeah. It's terrible.
I think... I don't know what the pH of Diet Coke is. I think it's probably around five, if not lower. Yeah. I mean, I I would hope, you know, mouthwash is higher than...
Now you've got me wondering what the pH of everything I drink is. I don't like the way I'm feeling while I'm thinking about it.
So this is the other conversation I have. Okay. You know, when you go to whatever your favorite store is, like Target, Walmart, Costco, whatever. Right? When something is sitting on a shelf...
And I'm not just talking about your regular shopping shelf. I'm talking about the truck that brings it over and it sits in the warehouse before it gets, you know, it gets sold.
Right.
It needs to not go back. Right? So when something does not... You know, what do they add? They add preservatives.
What are the common preservatives you think of?
Oh, got
it. Ascorbic acid, citric acid.
Oh, a... Right?... Things acidic.
Uh-huh.
Okay.
Do you see what I mean?
Uh-huh. Yeah.
Yeah. So a lot of times, know, what we find over the counter that we... Like, we're reading the... Oh my god. This sounds amazing.
Well, I have tell you.
I didn't chat too. I'm...
Diet Coke Is a Three33:38
So I'm wrong. Diet Coke is typically between three point one and three point three, making it strongly acidic. So it has a low pH.
Yeah. That's why drinking a diet drink is not gonna save your teeth.
It's not gonna save your teeth either. No.
Wow. Wow. So you what I mean? Like, people drink a diet drink thinking it's better for my teeth. But if you're having Diet Coke with a hamburger, well, the hamburger is your sugar substrate, right, because it's carbohydrate.
Oh, you're try to get people to understand that. Now... So, like
But I'm still still gonna go to In N Out. You know? You gotta go play.
Skip pivot. Well, not a... I I have two questions here. So my first question is is, like, I like the idea of, like, getting a dentist to, like, message you correctly in that situation. But as a person who just went to urgent care with their daughter, like, three weeks ago, the person at the intake didn't ask her if she felt depressed.
That person told her she didn't. Like this. Here's how the question was asked. You're not depressed. Right?
That's how it was asked.
Jeez.
Yeah. And I hear that happen all the time. Like... So now you're like... You know, now the...
I mean, listen. The person in urgent care is doing the intake is an intake person. They're not a doctor or a nurse or they're nothing, really. They're they're a person running them. They're them.
But, like, you know, they don't have a medical background. And people get bored of it because they... When you ask somebody to do something over and over again, I think it loses its desired intent at some point. And I've seen that in more places than just with that depression question. So my first question is is, like, how do you get the messaging the ninety third time that they've said it, like, to actually feel valuable?
That's my first question. And my second question is, at the dentist office, you've you've mentioned capitalism a couple of times. I know my dentist and like him. Just in case he hears that, I want him to know that. I think he's a fan...
He's a fantastic dentist. He's a wonderful person. He's a good friend. Yeah. But every time I look up, it's have you tried these trays with the gel?
Have you done this? Have you done that? We were thinking of doing a test on your saliva to see... It feels like I'm being upsold at the dentist a lot of times. And the the reason why it here's an example.
Okay? Mhmm. I'm not a good dental patient. I just wanna be honest. I'm honest with him when I talk to him.
When somebody says, you know, do you do you floss? Do you do this? I tell them the exact same truth. Right? But the last time I was there, they're measuring pockets and doing things with your cleaning and everything.
And, oh, your pockets are deeper. You're gonna use those trays and definitely use your rubber sticks. And I'm like, okay. Okay. Okay.
And I get back Yeah. And all my pockets improve. So he comes and he goes, it's really encouraging to see that you're doing the things I asked you to do. Can I be honest with you?
You're not doing
the do one goddamn thing he asked me to do. Okay? And so I brush my teeth the way Jesus intended when I learned in the seventies. Okay? And I don't really do a whole...
And look. I gotta tell you differently. If something gets stuck in my teeth, I take it out. Okay? But I don't eat and then turn for my for my pics.
Or... And I'm not saying I shouldn't. Don't get me wrong. But the minute they tell you how important it is and then you have an improvement without doing that, you start to question the whole thing.
Absolutely.
Okay. So that you gotta... Trust me. I'm trying to help you with this dentist associate. You guys gotta fix that because
Oh, you're absolutely correct.
I know.
No. No. I mean, keep in mind, you know, dentistry is not any different than medicine, endocrinology. I mean, you know, the the dilution of, you know, private equity and corporate involvement and, you know, everything is not numbers is is gonna have an impact on all our health care. Right?
You know, beef... With the days of, you know, you would hang your shingles and you would have, you know, one girl help you and you would set up your own little office and just, you know...
That's
Those days are over. And it's not because I don't want that. It's because it just costs so much to run a business. My little dinky practice has to abide by the same rules in California that the giant hospital has to abide by.
Yeah. No. I understand.
You know what I mean? And these things, they... It cost money. Money. But, you know, you know, some people, yes, I have wonderful...
Many, many colleagues who have larger practices. They sell their toothbrush and the tooth... And the water pick and the gel trays. I personally don't sell anything at my office. I just don't have time for that.
I'm so involved with so many other things. It's it's fine. I just love doing the dentistry. But but I get it. You know?
It costs money to run a business. At the end of it, it is still a business, but it doesn't mean it can't be beneficial, like, directionally. It goes both ways.
Just tell me, are the gel trays any value at all?
Well, it can be. It depends on what you're trying to do.
I feel like I just heard you say no. But... Okay. So what...
No. It is. I mean... So here's the thing. Like, if if...
I'm assuming the gel trays, you're talking about the whitening trays. Right?
No. No. They're for, like, to get, like, this peroxide gel down between your gum and the line. I don't know exactly.
For... Okay. Well, there's different gel trays, so it just depends on what kind of gel it has. I mean, the tray is just the mode of delivery.
Yeah.
Yeah. Yeah. So there's there's ones that are peroxide based that are... You know, they're basically anti... Antimicrobial.
Remember we said we have good back... Good bacteria.
By the way, that's that's the word. Antimicrobial. Go ahead. Sorry.
Yeah. So there's there's, like, good bacteria and bad bacteria. So that what you're referring to is probably trying to address the bacteria that are specific for gum disease. So if you have deeper pockets, that mean... You know how your gums hug your teeth?
Right? Yeah. Yeah. Gum disease is when your gums don't hug your teeth so well. And if you let it go, they keep falling down, falling down, and that's how...
You know, back in the day when nobody paid attention to gum disease, this is how they... Everybody lost their teeth. It wasn't because they had too much candy and chocolate. It's because their gums, at some point, just weren't hugging their teeth because so much bacteria would cause the detachment to happen. Yeah.
We don't see that as much. Right? Because we're flossing, we're going in for cleanings, we're a little bit more mindful of that. But, you know, whether that gel is the one specific for you... I'm not sure.
I haven't examined you, and I don't know what's in the gel.
Let's start. I'm 55 years old. I don't appear to be having gum disease. Like That's awesome. Yeah.
No. That's awesome. Of course, it's awesome. But I'm saying I don't need those damn trays. I clearly don't need those trays.
And it's like...
And we're good. Well... Yeah.
Well, they're good. I own the damn thing now. Now it's like, oh, I'll take a mold. It's a thousand dollars. Buy this stuff.
Like, by the way, even that, like, I don't... By the way, don't remember what it cost. But it feels like... I'm an adult. Everything feels like it cost a dollars at this point.
You know,
like Oh my god.
You know what I mean? Every time you look up, I I I looked the other day, my lawnmower was like... I'm like, I might need a new lawnmower in the next couple years. I went and looked at how much lawnmowers cost. I was like, I'm gonna buy a goat.
I didn't realize lawnmowers were so expensive. So... But but fella. Yeah. Yeah.
Thank you. So my point is is that, like, I love your idea, and and I like where it's coming from. Like, you know, you guys have a real expertise. You saw a real need. It's something I know is is is truly a need because I hear people talk about it constantly.
But just like everything else, I don't know how you're gonna get it into practice. It's... Know what I mean?
So, Michael, just with our foundation, with our efforts with, and this is gonna be kind of the basis of the talk I'm gonna give at the American Dental Association, the dentist. Here's four things you can tell your patients to do. I'm so sorry. It's not gonna come... It's not gonna make you money.
Four Things to Tell Your Patients41:09
But these are, you know, what a good health care professional should do. And the first thing I tell them is number one, like we talked about, sip some water. Make sure you don't have the blue alcohol based mouthwash.
Mhmm.
Have them literally whatever they're using, whatever that's on the, you know, bathroom countertop, take a picture of it, put it in chat GPD, what is the pH? If the pH is low, that's not a good product for you.
Mhmm.
Okay? So that's the first thing I tell them. The second thing I tell them is, you know, how your insurance... You know, you have Delta Dental, you have Aetna MetLife, a lot of these common insurances and, you know, let's it. A lot of people are, you know, kind of use what insurance guidelines are as this is what I need to do.
Your insurance doesn't have your best interest in mind. The average person without gum disease, without cavity risk, that's a low cavity risk person goes in once every six months. Mhmm. Considering type one diabetes has increased risks associated with it every three months. Come in every three months for a cleaning.
It doesn't cost that much. I promise you. Just going in for a cleaning cost less than it cost me to color and, you know, cut my hair. Okay? Literally going every three months for a cleaning.
Not only it'll... Every time you go for a cleaning, you know how to scale your teeth and all of that, it removes the biofilm. It disrupts that little matrix that's forming on the teeth that the bacteria can attach to. They use that at the little, you know, little nook to propagate in numbers and cause problems. Even that one little extra cleaning, even if it saves you from one cavity, it paid for itself.
So I usually tell them, instead of going twice a year, try to aim for three to four times a year. So every three months or every four months instead of every six months.
I'm glad you said that because I also thought I was being shaken down on that. So it's... Because they're like, we'll see you in ninety days. I'm like, ninety days. You know me better than my wife does at this point.
Like, so... Alright. So that is a good
I I think it's... It it controls your risk factors. Right? Mhmm. They're removing...
I mean, I'm not saying, like, buy, you know, buy good gels or get all the episodes. Literally, just go in for a cleaning every every three to four months. And, also, if a cavity or something is starting and it's super small, they can catch it.
Well, that is incredibly valuable. Like, to not let a cavity get out of control is
Right.
Is great.
How about It's... If if if your mouth is a little bit more acidic as type one, and this is, like, a whole other segue here, but when they... One of the things that... With the up and down up and down blood sugar, the salivary glands are impacted. They don't function as well as they used to, so you have less food lubrication.
Mhmm. So your mouth just has less buffering capacity. So I don't know if you've noticed this, but a lot of type ones, they say, not so much that they have dry mouth, but just things stick to their teeth more over the years.
I... My teeth are, like... They're they're horrifying. I mean, I've got those big incisors that are... I could easily be a vampire if I needed to be.
And and then I have the ridges in the back that, like, you know, it looks like they were built to hold Doritos in. You know what I mean? Like, that whole thing. So I'm not allowed I'm not allowed to chip now, you know, because it'll get stuck and
Stuck. Yeah. And... But but, like, think about yourself. Like, years ago, did you feel like food gets stuck in your teeth as much as it does right now?
Two Hundred Dollars, In the Chair44:30
I mean, can I tell you something horrifying? I don't... I I wanna make... I'm gonna do my best to get the number right. I don't think I went to a dentist till I was, like, 20 years old.
Mhmm. Like, I grew up, like, pretty broke. And I only ended up at a dentist because I was having pain from... Well, I probably tell this to every dentist I talk to, but here, you'll enjoy this. I I think I only went to a dentist originally because I had wisdom teeth pain.
So I got to the dentist. I did not have insurance. I also didn't have any... I was actually just telling Arden the other day. She was asking me, how much money did you make when you were my age?
And I was like, $4.50 an hour. Aw. Yeah. Yeah. And so so I go in.
Dennis says, I need to refer you to the oral surgeon. They're gonna have to take out your wisdom teeth. And I said, how much will that cost? They told me, and I said, well, that's not gonna be happening. So I said, what are other ways I can manage it?
And there were not a lot of other ways. And I just looked him in the face, and I said, what do you get for an extraction? And he said, $50. And I said, pull him out here. I'll give you $200.
Yeah.
So in the office with a dental assistant over top of me, both hands on my forehead, holding my head on the chair, I I had my wisdom teeth taken out in the office like that. And and then I never went back again because I just couldn't afford That's
a horrible experience.
Well, I'm I'm 55 now. This was Yeah.
I mean Yeah.
The the end of the eighties. There were other horrible experiences going on. I don't know if
you heard about it. Exactly.
And stuff like that. But, but Yeah. But but...
So Different times.
Yeah. Yeah. I take... So I don't think that people... I think there are some people who still just don't go to the dentist.
I don't I I don't imagine
Yeah. Yeah. And keep in mind, you know, and I and I hear this. Like, diabetes is expensive. Right?
Your glucose monitor is expensive. You gotta pay for insulin. You gotta pay for the pump. You... The...
Diabetes is expensive. And I I do get if, cost is a factor, if you are struggling, if you're... You know, if it's between buying diabetes supply and going to the dentist, I'm pretty sure most people will choose to stay alive than going for a cleaning. So this is assuming everything is level. Do you know what I mean?
Yeah. Yeah. And so, yeah, dental is gonna is gonna suffer. But having... That's why it's important to have good advice.
And on our t one d oral health foundation website, we have a brochure. Actually, I need to upload the updated version. But it has it has little... It has these little tidbits. You know, look at the pH.
Go in a little bit more frequently. And I know these days fluoride is a little bit controversial. I get it. And so... But I do still believe in it.
I still... I think within limitations, there are alternatives. There are mineralizing paste. Like, one that you see... You hear a lot about is called hydroxyapatite.
Have you heard about this?
No.
So the matrix of your tooth is made out of different things, calcium phosphate, you know, and this other thing called hydroxyapatite. So now, like, if you go to Whole Foods and you'll see it online, they sell hydroxyapatite toothpaste because hydroxyapatite is remineralizing your teeth, and that is true. However, it has a little asterisk. Hydroxyapatite is not very stable. It has to be in a specific shape, like, you know, molecules, like, it...
It's it can be a rod shaped. It can be circular. It can be cone shaped. It comes in different shapes. It has to be in the right shape for your tooth to absorb it.
And that shape is hard to manufacture, and it's not very shelf stable. You see what I mean? So if somebody's telling... Selling you a $5 hydroxyapatite toothpaste and that hydroxyapatite is expensive to make and it's very hard to keep stable, well, is it really the correct hydroxyapatite?
Oh, jeez.
Do you see what I mean?
What see is that everybody's got their hand in my pocket, and I don't know what to do. So can I ask a phone? Can I ask a question for myself?
Sure.
Whitening Powder Is a Brillo Pad48:26
You know the powder that you brush with to whiten your teeth? Is that dangerous? Like, is... You you never seen, like, a powder you put on your toothbrush and you just brush your teeth and it whitens your teeth almost, like, in two brushings?
Oh god. Please don't use that.
Really? Works so well. What what is it doing to... I know it can't
be done. Your enamel needs to be nice and glossy. Think of it like, I don't know, like the surface of a countertop.
Mhmm.
When you use something that's abrasive that has silica or anything abrasive on there, Essentially, it's like you're taking Comet or you're taking something, you know
Oh, yeah. That's exactly how it works.
Really pack... So even though it whitens it, it's creating micro scratches. It looks great. Right? But if you were to put in a microscope and zoom in, now you have all these micro scratches.
Well, guess what? It's gonna stain... Restain faster.
Can I use it like?
Are you gonna do? You're gonna go buy more of the stuff.
I don't know. So... Well, yeah, I know. But, like, four times a year, I speak in public. Is it not okay just four times a year?
Like, how often do I need, like
Go back to your go back to your countertop example. If you have a beer countertop as a stain on it, do you take do you take a Brillo pad, or do you put some bleach on there?
It depends how long do I... How long am I gonna live in the house. You know what I mean? So I But
but when you use a chemical, like a safe chemical to... Like a gel to whiten it, it doesn't create micro scratches. It's just blending it out.
Oh god. Does the peroxide gel whiten my teeth?
It does a little bit. Yeah.
What... So I should be using a gel, not... Listen. I wanna be clear.
Not a powder.
I have not used it with any frequency. But there was this one time I was like, something's odd is happening. I couldn't do anything about it. I tried this powder. I mean, I gotta be honest with you.
My teeth were immediately. And and that... But I had the same thought. Was like, oh, I am, like, barkeepers friending my teeth right now. Exactly.
Yeah. Yeah. Okay.
Short term, looks good. Long term, you're probably causing... You know? Yeah.
How come we can't reenamel our teeth? Why don't you guys come up with that? That'd be awesome.
I... I'm still waiting for somebody to regrow teeth in the lab. Feels like they've been saying we're working on it for a very long time. Stumps up. Haven't regrown teeth.
You can grow it in a cyst. You can't grow it in a lab. That... That's... Have you ever seen those cysts
that have
teeth in them?
I know. But you haven't been... How are you gonna put it back in somebody's mouth?
Listen. I'm not I'm not a genius. I don't know.
So I... And I think there's so many other body parts that are worth regrowing before we get into teeth. So Teeth.
Teeth is super interesting. It it... It's also... It's interesting not just what they are, how how you need them, how you have to stay on top of them. Even the history of dentistry is amazing.
Like, it it was almost ignored even back then. Right? Like, because it's, Yeah. More like... It was, bartenders were...
Because they had booze so they could No.
Yeah. Barbers.
Barbers. I'm sorry. Yeah. Yeah. Yeah.
Yeah. Yeah. That's that's amazing. Like, it... They were...
It's funny.
Yeah. Physicians wanted to take care of teeth, and then the barbers are like, well, they're there for their hair. We're gonna take care of it. And then I don't know. Somebody must have duked it out so the health care side got the teeth.
Mhmm. But, yeah, it's it's interesting. Have you seen the little model they have of George Washington's teeth?
I might have, actually. Yeah.
They're like Yeah. You should you should Google it. Yeah. It's it's kinda fun.
It's like braces behind it and all this stuff and and he had a mix of wooden teeth and and human teeth. Like,
oh my god. Jesus. Where he lost his teeth, yeah, they... It looks like the little pegs in there.
That's crazy.
They were creative.
Yeah. They were creative. Alright. So if so if you have type one diabetes in the... I mean, listen.
This is what we... Know, it's what I tell people on the podcast is a swish of water you treated a low blood sugar overnight at any time, honestly. Great idea. My question always is, though, if I keep a bottle of water next to the bed, like... So what if I don't drink it?
What if it becomes my swishy bottle? Like, how long till there's bacteria growing in that, and I shouldn't be using that anymore?
I mean, biofilm grows pretty quickly. Mhmm. So, you know, grab a new glass every night if you can, if not every two nights. Okay. But, you know, the other thing that I...
And I haven't seen too much research on this. They sell these little dry mouth sprays, and it's great for the elderly. It has Xylitol. It has glycerin. Almost like...
Imagine if you have dry lips and you put a stick, it feels kind of nice and hydrated.
Yeah.
So they sell these little, like, dry mouth sprays. And so the pH of that is runs around an eight. So the other thing that I was kind of, like, brainstorming in my head... Again, nobody has done studies, so I don't know if this is true. But they come in, like, different flavors.
They even have, like, pediatric versions of it. So I'm like, okay. Let's say a kid doesn't wanna rinse with water or drink water. I know sometimes I get pushed back on, you know, on that from my own child. It's like, sleepy.
Leave me alone. I don't wanna drink water. Mike, you know, it's like a little spritz, you know, like the old old school, you know, fresh breath spritz. And so you spray a couple of that. It seems like it would bring the pH down.
Okay.
Yeah. Others are... The pH up, not down. Mhmm. And then the other thing I was kind of brainstorming was, you know, alkaline water.
I know our Costco brings alkaline water now, and that's, I think, a pH of eight eight point two, I believe.
Oh, okay. I
thought drink water, then why don't we try alkaline water?
I thought that was just a thing that, hippie white ladies did. But the... There's, like, a real value to that?
Well, I mean, when they're talking about your... You know, drinking it as your tuba water, it seems like once you... It passes your stomach acids, it kind of, you know, neutralizes it. But in your mouth, I can see value in that.
Alright. I see you thinking about this. Do you think there's... I... What's your hope, like, leaving...
When you you leave after you give your talk, like, what would you call a success? Do you know I mean? Like, how are you gonna measure how well the talk went and how well your advocacy is going?
What the Dentists Said in the Chat54:21
Well, you know, last night, I gave a webinar on this. And I don't remember how many people were in there, but it was quite a few number of people. And, you know, when you do a Zoom webinar, there's, a little chat box. And I was, like, reading the comments on there, and it was like, oh my god. I never knew what a lived experience of a type one was.
Mhmm. And so that kind of made me think. I kinda want people to understand what the lived experience is, what the twenty four seven hour, you know, twenty four hours a day, seven days a week looks like. Not just, oh, your pancreas doesn't work. Yeah.
And so if they can understand that this is, like, around the clock problem that you can't just fix by, like, floss more, then I feel like, you know, at least having that compassion, being able to... You know, understanding that, you know, that sugar is gonna be part of your life. You can't tell them don't have candy. You know? You can't just...
The old the old little, you know, do this, do that is not gonna work. I mean, if they understand that, I feel like I did my job.
Right. That's awesome. And it also makes me think that maybe every, I don't know, every different kind of discipline could use an explanation from a group of people about what their... Maybe that would help more than... Because like you say...
We always say, like, you can't teach them everything in medical school. Right? And... Yeah. And
so There's so much.
Yeah.
And and that's the other thing. Like, some people... Like, I've had a couple of people say, I can't believe my dentist doesn't know about type one diabetes. I'm like, do you know how much information you need to learn in a short period of time? And, you know, type one diabetes is not the only disease.
Yeah. There's so much to learn.
I am always stunned by that too. I tell people, I'm like, I don't understand anything that doesn't impact me. Like, what... And do you and do you? You you know, that's that's sort of the...
That's the pearl clutching a little bit. Like, they should know. Like, who's they, and why should they know? And Yeah. And who's gonna tell them and, you know, etcetera.
So
Exactly. I mean, there's there's a lot of there's a lot of, like, chronic illnesses that impact you twenty four seven. And I think, like, for for us in dentistry, you know, if you pair it down to five, six major diseases that are super common, that are super impactful on your oral health, and you really get a clear understanding of not just the physiology, but the lived experience of what that person is going through, you're just gonna be a more compassionate caretaker for that person.
You'll have more context, and it... It'll be easier for you that when you reach for what you think is just throw away common sense, you won't say something like, well, just don't drink juice overnight.
Exactly. Right. Exactly. I mean, flossing is important, but, like, you know, you you can't... You can only say it so many times.
You know what I mean?
Mhmm. Also, I find it valuable to say in this situation that sugar is sugar. It doesn't matter if you give your kid a a banana or, you know, I don't know, a piece of candy. Like, there's still sugar in your mouth at that point. So Exactly.
Yeah. Now Exactly. Now now I would say... Here's the thing I think that I hope... I'll I'll check with you if I'm right or not.
I do think organic stuff washes out of your mouth easier sometimes, but it also can still get stuck. Right? So, like
Well, I've had I've had people say, oh, I don't give my kid, like, Starburst, but I give them a lot of, like, cranberries and raisins. I'm like, well, that's not any better. It's still getting stuck in the grooves of your teeth. I mean, know? So, like, you probably, you know, going with juice might be a little bit less sticky.
But, again, nobody has studied this. Like, for a type one diabetic kid at night, is it better to give them sugar? I mean, to give them apple juice versus, you know, like, I don't know, like a Starburst? Like, this is not something that's been studied. So everything I'm saying is me...
I'm kind of logic in my way through this. Do know what I
mean? If I did the same thing after talking to you, I would say go try to find something that's liquid and not acidic. And that
would So that is one of my... On the website, that is one of the things we write. I'm like, less sticky, the better. Right. And keep in mind, like, you know, yes, sugar is sugar, but, you know, glucose or dextrose.
But then you have the fructose, you you know, there's, like, different kinds. And certain ones tend to be more cariogenic. Remember I said we have good bacteria and bad bacteria? So the bad bacteria, some of them that cause cavities, certain ones use certain kinds of sugar for substrate. So depending of what your bacterial population is, you might be more susceptible one way or another.
Okay. And you
So that's where your dentist doing a salivary testing comes in, but salivary testing is in its very, very early stages.
So not a thing....
Why not everybody's doing it. The the... I mean, it's getting better, but it's also very expensive. And once you have the data, okay, what are you gonna do with the data? The best thing that I saw on salivary testing is that...
What... You remember I said going every three months for a cleaning? Mhmm. It's like, Monday, we're doing the salivary testing every three months, it showed all the bad bacteria was down. Whereas if you wait, like, six months, like, you're repopulated again.
Oh, really?
Yeah.
Okay.
So let's say, like, this is the bacteria that causes gum disease. This is bacteria that's... So you do the salivary testing after the cleaning. Oh, look at all these numbers. We've got really good numbers.
All the good bacteria are thriving. All the bad bacteria are gone. Right? So you do the testing in three months, and they're just starting to repopulate. You wait six months, they're all back.
Oh, well, you are gonna make me go. I do go every three months, by
the Do
you see
what I mean? Like, you don't need the salivary testing to tell you that, but this is what salivary testing has shown us. So, yes, go in every three, four months.
I... I'm still... It's okay if I still complain it, though. Right? It's almost like
You're absolutely allowed to go. I'm a dentist, and I complain when I get my dental work done.
I walk in. They're like, hi. I'm like, we have seen each other too frequently. And hello. I know more about the girls that work in my dentist office than other people in my lives.
I'm not even joking.
You know, if you have a fun office, isn't that the best?
They're lovely, actually. Yeah. Yeah.
This is why women like going... Getting their hair done. You know? Once you find a girl you're comfortable with, it's the same with your hygienist.
I make them tell me that I'm their favorite patient. I don't imagine it's true. But then I'm like... Like, I walk in. I'm like, it's me.
Right? And they're like, well, there's a couple that are better than you. I'm like, that's insane. Who?
Oh, no.
And then one day, I was there leaving, and this woman was like... She was checking out in front of me. And every... Everyone's, like, kind of, like, half laughing, half smiling behind the desk. They walked out.
I was like, what was just going on then? And they and they got all quiet, and the one goes, that's the woman we like better than you.
Oh, no.
And I was like Oh, no. You get
the stuff of your day now.
I made them tell me why. I was like, what's it about her that you... They... It's so... But but I thought they were lying to me because...
Obviously, I was joking at first, but then I realized I was onto something. They do have... Like, they do like patients on different, like, levels. You you know what I mean? From their experience with them.
It's not... I don't think it changes how they're how they're managed or helped or anything. But... And and then one day, just joked. I'm like, well, I must be the best one.
And they're like, well, not really. And I was like, oh. And I... So they they gathered together. Like, we think you're in, like, the top seven.
I was like, that's not bad.
I don't think top seven.
But then that one day, they're like, that lady, we like... That's the that's the lady we like the best. And I was like, I knew there was a favorite.
We take him some treats next time we go in.
Yeah. They say my wife... My... And then my... They like my wife.
And then my... Every time I come home from my dentist, my wife goes, did they mention me? Oh. And even if they do, little bit of doctor. Even if they do, I go, no.
Nobody brought you up. Oh.
Well, it sounds like your dentist is taking wonderful care of you. It's a blessing to have a health care provider in any any field that you feel comfortable with, that you can trust, that you know they have their best interest in mind.
No joke. Really a wonderful experience, honestly. Save me because my teeth were in... But, obviously, I got a late start to dentistry. They weren't in great shape.
GLP-1s and Dry Mouth1:02:18
You know, I had to have a number of root canals, like, in the beginning to get things, like, back in line again. And I I I do have a personal question for you. I would tell you that I think my dental health has been better since I've been on a GLP. And do you think that's just metabolic health, or do you think there's something to the the
So there's definitely... You know, with inflammation, just systemic inflammation, oxidative stress, all of that stuff, it does play a role with it. We are slowly, slowly starting to see some oral health impacts with GLPs, just more like a decreased salivary function. Remember our saliva is the buffer... Has the buffering capacity.
It's the lubricator in our mouth. And so with GLPs, we're seeing that there's less saliva being produced. So I would encourage you to look at products that are specifically geared for dry mouth even though you might not feel like you have cotton mouth or dry mouth. You know, people say I have dry mouth when they're, like, their cheek is dry and sticking to their teeth, but that's, like, severe dry mouth. Mhmm.
But what if you're only producing, like, 10% less saliva? Would you even notice it?
Oh, I would, and I am, and I do. So... Yeah. Yeah. I, a 100%, since I've been on a GLP, have a harder time keeping my mouth feeling wet.
And and so so much so that I... There's... I use... When I'm recording, I've done it, like, three times. I I touch my finger into, like, a tiny bit of just petroleum oil, and I put it on my lips when I'm recording.
Because if I don't, like, I'll start... I'll smack my lips. And I'm always some level of thirsty to quench a thirsty mouth, and that is definitely since the the GLPs. But my oral health has gotten much bigger.
So, you know, keep in mind, again, think of the preservatives, things that have acidity. Because if your mouth is dry, that means there's less water. So our our saliva is not like filtered water. It's like tap water. Right?
It has other stuff in it. It has minerals. Mhmm. So if you just have less water, then that means everything is more concentrated. That also includes glucose.
Right? So if your blood sugar is high, and then there's more sugar in your saliva if everything is more concentrated. But it also means you have more minerals, the bacteria, everything is just more concentrated just like anything else. There's less H2O, less water. So when you are choosing dental products, make sure you use things that have glycerin that are indicated for dry mouth, things that help with production of saliva.
I have tried those... The... There's, like, a gel in a tube that works really well, like, just, like, a tiny dollop of it, like, before I begin. That'll help. But I don't always have that.
I'll tell you. I'm gonna... I'll I'll come clean on something. The only time I drink diet soda is when I'm recording the podcast because it quenches my mouth and keeps it moist longer than water does. And I've never understood why that is, but I'm gonna ask you if you know.
I mean, I would guess it might be just a bubbly nail. So have we tried just using bubbly water?
I can give that a whirl. I I... Because it's It
might it might just be the carbonation.
Yeah. I use it when I'm recording because it keeps my mouth from getting dry while I'm recording.
I mean, you gotta live your life. I mean, you know, it's it's
I made it this far. I'm
not kidding. Yeah. It... It's it's a... It's one piece of a larger, you know, picture, so you gotta do what you need to do.
Yeah. But but I I do encourage you to look at the products that you're using. Sometimes what is right in front of us is not the best thing, and I definitely have recommendations thing I... Things I use in my... For my family.
But there... There's there's a lot of bad, and then there's a lot of good, and there's a lot of snake oil. And it's just so hard to figure out, you know, what is the one that I need to use.
Yeah. No. I appreciate you talking with me about it. Hey. Tell people...
I mean, if they're in dentistry, where can they go to find your your foundation?
Where to Find the Foundation1:06:02
Our website is t one d oral health foundation dot org. We also have an Instagram account that, honestly, I don't post a ton on, but it's t one d oral health foundation. We're on Facebook, t one d oral health foundation. Whenever I see somebody on your on your Facebook group, I try to respond, so I might show up here and there. But, you know, I have my cell phone number listed.
I have an email number listed. Just... You know, have them email me or reach out to me. I'm happy to share. Again, my next presentation is gonna be at the American Dental Association in Indianapolis.
I have a couple more webinars coming up for dentists to listen to if they would like to, or they can just honestly reach out to me if there's a study group or a study club or even a local dental society. I'm happy to get on a Zoom with them and share my experience because this is what it's about. You gotta share your experience so everybody learns, and then they go and share it along the way.
Right. I'm happy you're doing it. I I appreciate doing it too. I I find that every person who has, you know, some little bit of, I don't know, professionalism or, you know, a way to get their voice out about stuff like this, everyone helps a little bit to increase, you know, the the overall knowledge around type one out in the zeitgeist people's lives. And you never know when it's gonna, you know, intersect you and and be valuable.
So I I
100%.
More people should do it.
Yes. 100%.
I really do appreciate your time. Thank you very, very much.
Thank you, Scott. It was a pleasure chatting with you today.
Oh, awesome. I'm glad you had a good time. Hold on one second for me. Okay?
Sure.
Heck of an episode today, wouldn't you say? Let's thank Dexcom and the Omnipod five for sponsoring. That's right, my friends. We were sponsored today by the Dexcom g seven. Dexcom.com/juicebox.
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Let me see. Go to juiceboxpodcast.com. And from there, there's these two little lines on the right side top. That's the menu. Then click that.
Then click series. Then there's pro... There's small sips right there, pro tips at the top, all beginnings, bolus four, asks that. There's a lot of them there. There's actually a little search there too.
Could you just type small sips into the search? Oh, wow. That search works great. Look at that. And then you could go right to, like, all results for small sips.
Oh, and that takes you to the FAQ. You should check out the FAQ page too. I think that's juiceboxpodcast.com/jbfaq. Seriously, that thing's amazing. Amazing.
Actually, whole website is... I mean, have you, like, seen it? You should you should go check out the website. The website rocks. It is a potpourri, a never ending of support for you and your diabetes journey.
That's right. It really is. What else we got over here? Oh, I don't like the way that works. I'm gonna fix that.
Note to self. Change the change the masthead on the frequently asked questions page. Yeah. I don't like that. Fix that.
Oh, Claude. Oh, hell. I forgot to say thank you. Thank you so much for listening. I'll be back again very, very soon.
What is that noise? Stop it. Stop. Can you hear that? It's my chameleon squeaking.
Are you squeaking? What are you rubbing the branch against the... Don't tell people I have reptiles. They'll think I'm weird. Thanks so much for listening.
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