Self-Care Guide for Health Professionals

This post may contain affiliate links. Please see my disclosure to learn more.

I know it’s year 2020 and all, but health care professionals have always had a tough job. Hence, the idea to write a post about caring for the self for health professionals. While I don’t represent all workers in the medical field, I also know many of them can relate to the routine exhaustion one feels in the physical, mental and emotional sense. Not only is dentistry back-breaking work (think hunch-back- of-Notre-Dame), it also requires mental concentration (we are making tenths-of-millimeters-micromovements inside a tiny cavity) and emotional stamina (the minute the patient’s chair leans back, their everyday lives come spewing out). Sometimes I wear the hat of clinician, while other times, I simply play the role of listener. I have to help anxious patients through to the other side of treatment, as well as psychologically support depressed patients through to the other side of life. It’s a fulfilling job, but also a taxing one.

Many times, I come home with no one to fully understand the tolls of my work. Mike wonderfully understands that having dinner ready and giving me space to decompress with yoga is very important. He understands that on some days, I simply don’t want to talk. But he doesn’t really know the why. Sometimes, I feel guilt over acting selfishly, but as clinicians, we need to start removing that word from our vocabulary. You aren’t selfish because you need me-time after giving everyone else their me-time.

This past weekend, I took four days off to vacation with family on the coast of Southern California. My sister-in-law joined us Friday afternoon after her four clients. She also works in health care as a psych therapist. She joined us after a hectic day, and still had a few clinical notes to write. I noted that she looked a bit tired and she mentioned that some of her clients are especially draining, not in the physical sense, but in the mental and emotional sense. She even has one client currently on suicide watch who constantly occupies her mind. We talked of the tiresome nature of healthcare and agreed on the importance of taking care of ourselves first. We also noted that while we are excellent care-takers of others, we usually fail to save room for us.

This is a reminder to all health-care professionals that self-care is key to success. And sometimes, the only person who would be able to give you that space is yourself. If you are a reader who knows of a health-care professional, make sure to check in on them during this time. You might be surprised at their sadness, tiredness, weakness, or loneliness. Below, I wrote a simple guide to taking care.

Self-Care Guide

+ Practice deep breathing in between seeing patients. Deep breathing is something I first picked up from yoga class ten years ago. Yoga itself is a practice focused on returning to the breath, which has been called our “life-force”. Returning to the breath is the last thing on a clinician’s mind. The immediacy of our work and the need that our patients have far exceed our willingness to turn inward and work on ourselves. However, I implore all clinicians to consider deep breathing. This practice was first recommended to me by a wellness coach, Michaela Puterbaugh of Starting from Within and it has been a real game-changer! I would highly advise getting a wellness coach like Michaela (you can book a consultation here), but if that is not your vibe, then deep-breathing is the one thing I learned to do that helped me most with my career. It’s simple. Before running to your next patient, stop by an office or a break-room or a quiet corner and breathe in for five seconds, hold at the top for five seconds, and breathe out for eight seconds. Repeat five times, then you’re good to go. I guarantee that your patients will notice and feel the difference in you. (PS: It helps to close your eyes.)

+ Stretch throughout the day. Many dentists end their careers earlier than they would like due to body aches and pains. Hospital workers also suffer from the same. Nurses and physical therapists have to carry and assist disabled bodies and the elderly. To be honest, physical tolls extend past the medical field and also applies to hospitality workers who stand on their feet all day and desk workers hunched in static postures in front of LED screens (blue light blockers for the win!). Stretching simply makes sense; for everybody. I picked up stretching advice from a continuing education course on ergonomics. There are certain stretches especially helpful to dentists, so I would seek professional advice regarding specific careers. For dentists, the upper back and shoulder muscles, as well as the core muscles, will help alleviate lower back pain and that hunched-back-look. Just like deep-breathing, this can be done in between patients or during any break. After work, I make it a point to roll out my Manduka mat and join a CorePower LIVE session to create movement in my body. I even took my mat on vacation with us this past weekend! That’s how important stretching is to me. Not getting on my mat is like a surfer not getting out on the water. Speaking of water…

+ Drink plenty of water. We are constantly moving from room to room and it’s very easy to forget about the water bottle we have sitting next to our desks. But wherever you choose to do stretches or deep breathing, keep a bottle of water close at hand. It also helps to have a habit built around staying hydrated. I drink two glasses right when I wake up and an entire glass before my shift. Between the start of my workday and lunch time, I make sure to finish at least another bottle. The same standard applies between lunch and the end of my shift. Then when I get off work, I drink two glasses straight away. My water bottle from Kinto_USA is quite portable and the tab at the top of the lid makes it easy to take with me wherever I go. If water is not your favorite drink, why don’t you try tossing pomegranate slices into your bottle or dress it up with ice? Check out my thoughts on staying hydrated!

+ Find someone to talk to. I know that Mike doesn’t fully understand everything that happens at the dental office, but it’s nice to have someone to talk to when I come home. It also helps that he is a great listener. My daily recaps help release any negative energy that I take home. But don’t get me wrong – dentistry isn’t ALL bad. Talking to someone is also a great time to celebrate the daily wins and highlights, a time to practice gratitude for a rewarding job. Of course, the person you choose does not have to be the same person every day. It can be different people, too. As long as you schedule a few moments to connect with someone outside of work, you’ll find less tension and stress when you unwind for the evening. (Sage tip: Don’t dwell on your workday alone. There are other things to address in life.)

+ Eat healthy. It’s hard to follow our own mantras of consuming healthy foods when we return home stressed and over-worked. I’d be the first to admit that fruits and veggies are not on my mind after a long day and if it weren’t for my husband making nutritious meals for us every day, I would probably be quick to order to-go foods a few nights a week. However, we must follow what we preach. I try to consume only one cup of black coffee a day (otherwise I’d live from coffee to the grave), and balance it with a cup of ceremonial-grade matcha green tea in the evening. I try to choose dark chocolate (88% cocoa or more) for dessert, and fresh fruits from the farmer’s market for snacks. I use a budget to monitor how often we dine out and we still try to follow our zero plastic diet religiously. Skip the temptation by choosing not to buy those bags of chips – or whatever else that has a gravitational pull during your weakest moments. Shop in such a way that sets you up for success.

+ Wind down the mind. In the evenings, I make it a point to wind down my mind. I try to do yoga after work to enter a calm state of energy. Afterwards, I shower and make myself a cup of tea and spend the evening writing or reading. This is the time I also connect with the people I live with. I check on my plants and move them around frequently, and I follow a skincare routine. I recently discovered The Nue Co.’s supplemental spray called Magnesium Ease, which I massage into my skin to help alleviate muscle tension and to improve my sleep. (Fun fact: 80% of Americans are deficient in magnesium!).

+ Get full night’s sleep. Lastly, but most importantly, is sleep. Sometimes, extra sleep sounds impossible but we can play pretend. I value sleep more than I value coffee – which is saying something! I make it a point to get at least eight hours of sleep (nine hours is my optimal sleep-time). On weekends, I can sleep as long as 12 hours although luckily, I value my mornings too much to oversleep often. In our home, we sleep around ten in the evening and wake up when Theo meowls for food at six in the morning. I know that many clinicians tend to be night owls due to the nature of our work (late shifts and night shifts are common), but may I suggest abiding by your circadian rhythm? I cherish sleep knowing that I am more helpful to others when I sleep well. For those who have trouble sleeping, you may find these sleep drops helpful!

If you are in the medical field and have somehow come across this self-care guide, I hope it finds you well. For those who need a helping hand with mental wellness, do reach out to a professional. My sister-in-law is practicing in Southern California and is offering video services. I would also like to recommend Michaela Puterbaugh for overall health and wellness coaching as she has helped me balance life earlier this year.

For those curious about the supplements that I recommended, they are from The Nue Co., a company making supplements that you can feel working! Receive 15% off your first order with code NUE15 (affiliate links above). I am really excited about what this company is producing and have ordered the sleep drops for my mom and the magnesium ease for myself. They provide many other supplements that aid with sleep, stress, gut health, and immunity. I would definitely check them out!

Dental Series: Bite’s Got It Right

This post is sponsored by Bite, a company dedicated to creating an oral-hygiene routine that is completely zero waste. This post may contain affiliate links. Please see my disclosure to learn more.

I heard of Bite about a year and a half ago, when I was first honing in on creating a zero-waste lifestyle. At the time I was starting to partner with companies such asPlaine Products and Bogobrush. I was intrigued to hear of a toothpaste company that was making a paste-less toothpaste. As the name implies, Bite sells toothpaste tabs that you simple chew. My first thought was, “Huh.”

What is Toothpaste?

Toothpaste (as we know it) was first invented by one of the nation’s most famous advertising executives in the early 1900’s who understood that for a product to sell, it had to be effective in creating a habit around said product. He was a very smart man who realized that it would be more successful to sell the feeling of fresh breath rather than the health benefits of brushing teeth. If he could get people to continually crave that minty fresh feeling, then he could get them to continually brush. If they create a habit of brushing their teeth, they will continually buy the product. The addition of a sudsy sensation convinced people that their mouths are actually clean when they use toothpaste.

What if I told you that the paste doesn’t do much to clean your mouth? Rather, it is the brushing techniques that one employs that really removes the plaque and debris from your teeth. It wasn’t until later that fluoride was added to toothpaste. However, fluoride also does not clean so much as strengthen the enamel. If it wasn’t for the fluoride, I would say that toothpaste has no benefit other than creating the mirage that you have a clean oral cavity.

Things to Know About Fluoride

There are a few facts that we need to get straight regarding fluoride.

It has been proven to strengthen enamel.
It has been proven to reduce caries (which causes cavities).
It has been proven to be especially effective in improving the oral health of low income communities when it’s added to their water systems.
When ingested in high quantities, it has been proven to be highly toxic. (Any parent of any child who has ever accidentally swallowed fluoride can attest to this. At the dental office, they vomit before they even get to the door).
Some people can get behind fluoride use, others cannot get past the toxic properties.

Knowing that final point, I think that it would be wrong of me as a dentist to promote only fluoride toothpaste. It is important to make the habit of oral hygiene inclusive to different populations with different belief systems. Therefore, we must have alternatives to fluoride. Enter nanohydroxyapatite.

Nanohydroxy-who?

Nanohydroxyapatite is a long name that describes a man-made calcium crystal. It is bio-mimetic, meaning it imitates a naturally occurring component of our bodies called hydroxyapatite. Hydroxyapatite makes up 60-70% of bone and 90% of enamel, the outer protective layer of teeth. Nano-hydroxyapatite are essentially very small crystals that replace missing sections of minerals that have dissolved out of enamel or bone, thereby fortifying both.

It is widely known that bone and enamel are made of calcium, but did you know that free calcium is not something your body can use? Nanohydroxyapatite, however, is readily bioavailable, without any additional processing required. There are multiple studies that repeatedly show the potential that nanohydroxyapatite has in improving both dental materials (when combined with glass ionomers it greatly increases the resistance strength against biting and chewing forces) and tooth minerals.

The most exciting thing is that it has been shown to be more effective than traditional fluoride treatments, remineralizing enamel surface in as little as 10 minutes. Gel that contains this crystal also reduces sensitivity after a session of teeth whitening. Even early lesions which signify the start of tooth decay can be treated with daily use of nanohydroxyapatite. Its ability to stimulate bone growth due to its direct effect on osteoblasts explains why nanoHA is widely used in oral surgery, periodontology and implantology. Lastly, it does not induce toxicity or inflammation within our bodies.

Why Bite’s Got It Right

Which brings me full circle to my original point. Bite’s got it right. Bite toothpaste recently launched a new summer flavor, Watermelon Hibiscus, that contains nanohydroxyapatite instead of fluoride. It also contains xylitol, which is a sugar substitute for sweeteners that I recommend to all my gum-lovers out there. The tabs come packaged in a glass bottle rather than a plastic tube, making it zero-waste. (They also have wooden toothbrushes that are vegan-free. cruelty-free, and extremely light – perfect for a biodegradable option when backpacking through the woods this summer.) Each bottle contains 62 tabs, which would last one month if you brush every morning after breakfast and every evening before bed.

Now, it doesn’t work like the toothpaste that you grew up with. When I first tried Bite, I did in fact think to myself, “Huh.” You take a tab and bite into it. My first thought was to swallow it like candy (perhaps it was the watermelon flavor that threw me off. I’m sure the mint flavor would be a bit different). For obvious reasons, you aren’t supposed to swallow it. Instead, you take a wet toothbrush and start brushing. The chewed up tabs dissolve, although you can’t expect the same sudsy sensation as traditional toothpaste. After brushing, you spit out the contents like you would with toothpaste. You may be surprised to find solid pieces of the tab still left, which is nothing to worry about. I have found that no matter how long I brush, not all of it dissolves. A trick is to chew it very well because the smaller pieces have an easier time breaking down once brushing.

I know this all sounds weird. A dentist not forcing fluoride treatment. A toothpaste company that’s zero-waste. Tooth brushing without suds and minty freshness. Unfortunately, the man who first invented toothpaste, his name was Claude C Hopkins by the way, has got one thing straight. Pepsodent, his invention, created the fresh feeling and suds which revolutionized America’s relationship with tooth brushing. Prior to the early 1900’s Americans did not brush their teeth. Afterwards, they don’t feel clean without mint’s tingly sensation. And all I’ve got to compete with that are boring facts.

But you know what? Bite may be on the verge of something here.

If we can dissociate Americans from that nostalgic, socially-learned feeling long enough for them to understand a few things (such as brushing technique reigns supreme), maybe we can turn away from decades of sodium laurel-sulfate use towards zero-waste planet-loving, non-toxic body-protecting products that are good for both the environment and our health. Isn’t that what we are moving towards these days?

All I’ve got to say is, try it. With an open mind. Understand why it is that you are so tied to traditional toothpaste. Who knows? You may like it.

This post was sponsored by Bite. The information regarding Claude C Hopkins was from “The Power of Habit” by Charles Duhigg. To learn more about nanohydroxyapatite, you may find Ann Stomatol’s literature review published in 2014 a good read. All thoughts and opinions are my own.

Dental Series: Choosing Chocolate

The Dental Series was created in collaboration with Bogobrush in an attempt to make dental health care not only important, but COOL, too! In it, we answer common questions and address current topics in the dental field. When Bogobrush is not helping spread the word about oral healthcare, they act as a source for ethically made, sustainable toothbrushes, with a one-for-one give-back program catering low-income communities that may not have access to something as simple as a toothbrush.

Chocolate is my dessert of choice. Actually, it’s my snack of choice, and when it comes to foods good for our teeth, sometimes I think that choosing chocolate could be good advice. It is true that I will take every opportune moment to make chocolate-eating okay, but there is logical reasoning to back up my stance. And we’ve got our salivary glands to thank for that.

Saliva is Our Superhero

There are multiple protective factors for our teeth, one of which is the saliva that we produce. The hallmark of dental cavities is the demineralization of our teeth initiated by acidogenic plaque flora. In human tongue, this means that bacteria living on our teeth convert left-over foods (in the form of plaque) into acidic by-products, which then causes our teeth to rot. Combating this process is our saliva.

Saliva helps prevent cavity formation in three epic ways. First, it cleanses the mouth via its salivary flow, breaking down plaque and washing it away from our teeth. Second, it provides a buffering system by depositing calcium which is good for our teeth, especially when it recognizes an increase in acidity by a lowering of pH levels. Lastly, it has been shown to oppose demineralization by supplying minerals, specifically calcium. In other words, saliva is our superhero.

So why does this make choosing chocolate good advice?

Why Chocolate Is Better Than Other Snacks

Do you remember that M&M selling point, “melt in your mouth, not in your hand”? That’s EXACTLY the selling point I’m going to pitch here. Chocolate has an ability to be broken down by your saliva that most foods on the grocery shelves do not. If you stick a piece of chocolate on your tongue, it dissolves. If a stray piece of chocolate gets stuck on your tooth, it will also dissolve. However, if you eat a piece of candy, the stickiness makes it very difficult for saliva to wash it away from your tooth. Unfortunately, when saliva and a piece of Jolly Rancher battle it out, no matter how many waves of saliva tries to pry that stubborn candy off your tooth, the Jolly Rancher will win every time. I suppose this is part of the reason why my sister’s candy-loving self had cavities, when my chocolate-loving self had none.

However, it isn’t JUST candies that chocolate beats. Some of the worst kid snacks come in the form of non-sweets as well. As much as I love Cheetos, the cheesy goodness leaves a grimey mark, and it is actually the number one snack that dentists warn against. All you have to do is look at a child’s fingers, or have them smile at you afterwards, and you’ll see why. In fact, all chips covered in some sort of flavor (such as barbecue, sour cream and onion, and yes, Hawaiian!) can leave a residue.

Likewise, juices, which so many parents love, also contain heavy amounts of sugar, especially when store-bought. Unfortunately, juices stick to teeth despite being a liquid, and can be difficult to remove. And don’t get me started on soda! Worse than being sticky, those beverages are acidic, which we already know is a factor in the beginnings of cavity formation. Well-meaning parents have turned to dried fruits, but those too have their down-sides. Have you ever gotten a dried mango or a dried date stuck in between your teeth? If you’ve experienced this, then you know that the fibrous being likes to be retentive, and no matter how hard you try to maneuver your tongue and cheek to dislodge said piece, efforts end up being either futile or extremely excessive. Lastly, any snack that stains kids’ teeth and tongues, even momentarily, I would warn against. If it’s sticky enough to stain, then it’s sticky enough to stay.

The Tooth (and Health) Benefits of Chocolate

But back to chocolate. I am not saying that all chocolate is good, or that chocolate all the time should be one’s daily practice (I wish!). But I am saying that compared to the many things we reach for on the shelf, chocolate falls under that category of “not so bad”. It is a basic snack (in terms of pH) that does not contribute to the acidic environment detrimental to our teeth. It is easily broken down by saliva, and just as easily washed away. And chocolates are contributors of calcium, which is essential in opposing the demineralization process. Recent research posits that chocolate actually is a superfood for our teeth because it contains a chemical called CBH, which is similar to caffeine. CBH has been shown to be more effective than fluoride in strengthening enamel in animal tests, and there is hope to add this chocolate superpower into mouthwashes and toothpastes for humans in the future. So for those who are against fluoride treatments, perhaps the answer to the solution lies in chocolate! Chocolate also contains antioxidants that have been argued to protect your teeth, the list of which includes tannins and polyphenols which supposedly prevent the sticking of substances to your teeth and neutralize the bacteria that reduces bad breath. As if this wasn’t enough, have I mentioned that chocolate has been shown to improve not only mood elevation, but also blood flow? Not that you needed the extra ammo.

Important Caveats and Tips on Chocolate Eating

If you do reach for chocolate bars on the shelf, here are some very important caveats and tips to consider.

Not all chocolates are created equal. When I say that chocolate is healthy, I am talking about chocolate that’s as close to the cacao bean as possible. The best thing to do would be to chew on cacao nibs, but I think that most people would not find that palatable. The second best would be raw chocolate which is less processed. When in doubt, reach for simple dark chocolate bars with 70% cacao or more and less than 6-8 grams of sugar per serving. Obviously, the order of chocolate healthiness goes from dark chocolate to milk chocolate to white chocolate, so as we go down the tier, the sugar content increases and the benefits of chocolate decreases. And please do not choose anything other than simple chocolate bars or chips or nibs. As we’ve previously discussed, any additives to chocolate bars in the forms of nougat, dried fruit, and – the absolute worst – caramel (!) – may make it taste better, but reverses everything I’ve said in this piece, thus turning chocolate from your best friend into your worst enemy.
Eating a whole bar of chocolate in one sitting is better than eating a piece every hour. A whole bar in one sitting?! I know what you’re thinking. “She’s crazy!”. But it’s the truth. Our saliva works diligently to wash away excess foods. But it doesn’t help if you are constantly re-dirtying the teeth every hour after the saliva has already done its cleaning up after you. Eating a piece every hour is like putting the teeth at a perpetual state of exposure to chocolate. I’d rather you expose it once and get it over with. Plus, the amount of exposure to chocolate when you eat a bar in one sitting is actually LESS than when you eat it over the course of a few hours. Why? Because our teeth has a limited amount of tooth surfaces. When you’ve covered the teeth with chocolate, eating more chocolate will not cause more of it to stick. The tooth is already covered! The excess chocolate just goes down the pipe. But if you wait one hour, your saliva has freed up more tooth structure for chocolate binding. And as the saying goes… “you want to work smarter, not harder”.
Brushing your teeth afterwards is still recommended. If you don’t have access to a toothbrush, swishing with water or drinking some water would be very helpful in the dissolving process. This is especially true the farther you go down the chocolate spectrum.
Chew sugar-free xylitol gum afterwards. Xylitol gum has its benefits, but chewing gum (or chewing anything rather) is beneficial because it stimulates salivary flow. The minute we start chewing, we send our body signals to increase salivary flow. So chewing sugar-free gum afterwards helps with dissolving any left-over chocolate, if you were at all worried.

So the catch-all phrase of “sweets are bad” isn’t entirely true after all. If anything, I would posit that sticky foods are bad, and sticky sweets are worse. But chocolates … chocolates make my world go ‘round.

Dental Series: Oil Pulling

I may be a little late on reporting the “latest craze” with this one, but here we are. Oil pulling. When I first heard the term, I couldn’t believe it has nothing to do with gas companies or oil rigs. Essentially, oil pulling involves taking a tablespoon of oil (I later learned that coconut oil was the more glamorous option), and swishing it around the mouth for twenty minutes to reap supposed oral health benefits. Most people opt to take up oil pulling in hopes to replace flossing. My thought? I didn’t even know people could hate flossing THAT much.

Where did oil pulling come from?

Oil pulling has actually been around for centuries. Previously known as “kavala” or “gundusha”, this ancient dental technique has its roots from India. It is believed that the oil is capable of binding to toxins and pulling them out from the body. It was primarily used to improve oral health but has been applied to other aspects of health as well. However, the oil needs to be in contact for long periods of time in order for it to have an effect, hence the twenty minutes of swishing.

Supposed benefits

The internet is teeming with a number of supposed health benefits to oil pulling. It seems that there are many advocates for this holistic trend spanning social media websites. Below is a list of benefits that I found people were claiming this new trend has to offer.

whiter teeth
cavity/gingivitis prevention
better breath
stronger teeth and gums
less jaw pain, sleep problems, and sinus issues
alleviation of headaches, hangovers and skin issues

My Personal Perspective

No offense, but my first non-filtered reaction was “uhm, ew?!” Just the thought of swishing a tablespoon (why so much?!) of coconut oil around made me shudder. Coconut oil at room temperature is SOLID, and it takes a while for the oil to melt in your mouth due to body heat. Taste and texture definitely makes or breaks the practice, and while they say you can use other plant-based, cold-pressed, organic oils such as sunflower oil, sesame oil and olive oil, I do agree that coconut seems to be the most … manageable? Don’t get me wrong, I love those oils in my salads and I’ve been known to make a famous chocolate chip cookie recipe using coconut oil, but letting them sit in my mouth is just not the same thing. Of course, curiosity kills the cat, and I did try it out for myself. Verdict? As predicted, I was not able to cope. I could hardly keep the oil in my mouth for longer than a few seconds! Forget about twenty minutes. I couldn’t help but wonder, is flossing SO bad that one needs to spend twenty minutes of their day oil pulling instead of flossing for two?! I know, I know, I’m biased. But STILL. I say, more power to the people who are able to do oil pulling successfully once, let alone three to four times a week. Plus, if it were all true and the oils do bind to microbes, hypothetically after twenty minutes of swishing, pushing and pulling that oil into all the gingival crevices of your mouth, you’ve essentially got a wad of bacteria. And still swishing…which to me, seems a bit gross. And that’s coming from a DENTIST!

My Professional Opinion

There is little formal trial data that supports any of the health benefits claimed by oil pulling. While it may be true that oil pulling pulls toxins out of the body, we must remember that causes of cavities and gingival disease involve acid produced by bacteria, not toxins. Therefore, the pulling of toxins does not necessarily have anything to do with cavity prevention. Some may argue that vitamin E resides in coconut oil which have antibacterial properties, but that isn’t necessarily a good thing. Vitamin E does not select for the bad bacteria and may actually be doing as much damage if it is also removing the good bacteria. Our oral biome consists of both the good and bad, and if we take away good bacteria, we will give the bad bacteria an opportunity to thrive. Because Vitamin E isn’t proven to be selective for removing only the bad bacteria, I don’t think this argument suffices for supporting that oil pulling reduces cavities and gingival disease. Lastly, some people claim that oil pulling is as effective as chlorhexidine in treating bad breath, but may I suggest that swishing WATER around for twenty minutes would result in better breath too…

I am not here to completely shut down the idea of oil pulling. But I am here to say that there is not enough scientific evidence to support this ancient dental technique. There are studies, but most have been found to have flaws in their methods. I would still consider oil pulling as a possible supplement to brushing and flossing, but not a complete replacement. As of now, the American Dental Association has deemed insufficient clinical research to support oil pulling as a stand alone preventative treatment that works. Sorry, but yes this means that you still need to floss. Yes, you can roll your eyes at me.

Giving Oil Pulling a Try? Things You Should Know:

If you are going to try oil pulling, may I recommend the following?

Still floss! Just as water flossers cannot fully replace flossing, any oil you swish in your mouth cannot get in between tooth contacts!
Swish gently. Twenty minutes is a very long time and vigorous swishing can result in jaw pain and tension. Headaches have been reported as a side effect of oil pulling, which can be due to the stresses placed on the temporal muscles. Headaches are also common in clenchers and grinders who undergo similar long periods of muscle tension. Take it easy, take it slow.
Do not swallow the oil. If the point is to bind to toxins, we do not want to ingest all those toxins you’ve collected by swishing the oil around.
Once you are finished, spit the oil into the trash, not the sink. Oils can clog up the sink’s drain pipes, and explaining to the plumber why you’ve got clogged pipes will surely be interesting.
Brush as you normally would after a session of oil pulling. I would feel much better knowing that you’ve removed all the oil after the swishing, just in case. Plus, I am sure brushing will help to remove that slimy, oily feel and taste that I just couldn’t take. I guarantee your cup of coffee would taste much better if it wasn’t chasing coconut oil from a morning’s session of oil pulling, wouldn’t you agree?

Dental Myths Demystified

Myth 01: “Brushing Hard Helps”

Good for Teeth, Not for Gums

Growing up, I was always told to brush my teeth every night. But how to do so? As an avid rule follower and extremely prudent child, I sought out any tips in preventing the dreaded sugar bugs. Unfortunately, the only advice that most adults had to give was to brush twice a day, and hard,in order to remove all of the plaque on my teeth. If I had any left-over gunk at the end of brushing, it must have been because I didn’t brush hard enough.Today, we know that brushing hard does more damage than good, but do you know why?

I do admit that harder pressures are better at mechanically removing plaque and debris than softer pressures. And a tooth is a very sturdy thing, able to withstand stiff bristles and manually applied forces. However, we must remember that the teeth are surrounded by pink soft stuffs, known as gums, which aren’t as resistant to pressures. Brushing really hard, especially in left-to-right motions as we were previously taught, can lead to gum loss, in a process called gingival recession.

What is Recession?

Gingival recession occurs when gums move away from your tooth. Your gums experience wear, and soft tissue is prone to the damaging effects of heavy brushing. Consider gum recession as your body’s way of protecting itself by retreating. Over time, gum tissue disappears, and less and less gums surround your teeth. Unfortunately, once gum recedes, it does not grow back without the help of surgical dental procedures.

How Does this Affect Teeth?

What does gum health have to do with teeth health? Well, they are all inter-related. The gums are part of the structure that holds your teeth in place and keep the teeth stable. As you experience gum loss, multiple things can happen. First, you are losing the protective barrier around your teeth. Severe gum loss leads to exposure of your tooth’s roots. Unlike the rest of your tooth, the roots are not covered by an enamel layer. Therefore, the outside of your roots are closer to the nerves, and experience more sensitivity to things such as sweets, hot and cold temperatures, and movement. You may find eating ice cream a suddenly unpleasurable experience!

What’s more, as gums recede, there is an increased chance of food getting stuck in between your teeth. The space that gums once occupied is now empty, allowing for more food to be trapped every time you eat. Difficulty in keeping the areas around your teeth clean can lead to constant inflammation, your body’s way of fighting off anything it deems foreign. This can lead to gum disease, otherwise known as periodontitis, thereby causing further bone loss and gum loss! And the cycle continues.

The Right Way to Brush

Knowing all of this, we need to switch up our brushing techniques. Here are a few tips on how to brush successfully, without doing any harm.

Use a soft or very soft bristled toothbrush. I would avoid medium and hard bristled toothbrushes entirely.
Hold the brush like a flute. You’ll soon realize that there is very little force that can be applied when you hold it in this manner.
Point the toothbrush at the gums at a 45-degree angle.
Brush in circles or in small, vibrational motions. You never want to brush left-to-right.
Spend 3-5 seconds per tooth, vibrating the toothbrush around the gum line. Do the same with each tooth, and don’t forget to swing around to the back of each tooth. A person who has all their teeth should take about 2 minutes to brush.
If you own an electric toothbrush that already does the vibrations for you, don’t push down. You can still hold it like a flute and you should still angle it at a 45-degree angle. You simply need to hover it in this way over each tooth for 5 seconds, and your brush will do all the work for you. The worst thing you can do with an electric toothbrush is to use it the same way you would a manual toothbrush. There is such a thing as too much.

With these helpful tips, hopefully you can enjoy eating ice cream and drinking hot tea for a very long time.

Habit Shift: Teeth Grinding

We all have habits and tendencies. I’d be the first to admit that some of them are not good – such as always needing to eat a sliver of dessert after dinner, or never drying our good knives after washing them. I have a history of even worse habits during my teen years, such as chewing my nails, or chewing on the caps of pens, neither of which are good for my teeth. But like most habits, these I have direct control over, and I can change them whenever I so please, like when chewing on your nails turned from cool to gross. Unfortunately, there are some habits that are subconscious, and therefore much more difficult to break. An example of such a habit is teeth grinding, otherwise known as bruxism.

I am a heavy bruxor, meaning that I have the tendency to grind my teeth at night. Like so many others, it was undiagnosed until I landed myself in a dental chair due to a painful ache on my lower left tooth. I was prepared for a root canal and a crown, convinced that something this painful must be caused by a severe infection involving hateful bacterial species. So I was surprised when my co-worker showed me the x-ray and there was an absence of any signs of decay. Wait, then was going on?

Bruxism!

Bruxism is the subconscious habit of grinding your teeth. It is also considered a sleep-movement disorder. It is not uncommon for people who have other sleep disorders (such as snoring or sleep apnea) to grind their teeth as well. While some people grind their teeth from side to side, others chomp and chew, and yet others, like myself, clench really, really hard. It has even been reported by loved ones that their partner’s grinding habits are so loud it keeps them up at night! However, most people who grind their teeth are undiagnosed until they start to experience pain. The pain can be anything from mild to severe, and can be persistent or transient. Sometimes, bruxism is so severe that it causes to the teeth to fracture! This can then cause you to lose your tooth, depending on how it breaks. In order to prevent this from happening to you, it’s important to be aware of the most common signs and symptoms, as well as to try and protect your teeth from the effects of heavy grinding.

Signs and Symptoms

There are many signs and symptoms for bruxism, and they are different for every person. The severity depends on the frequency, duration, and weight of your bruxing habits.

Common sign and symptoms include:

Abfraction Lesions – These look like little chipping of your teeth around the gum line. Teeth are anchored in the jaw, and when we clench and grind, we are causing these teeth to flex in all sorts of directions. As they flex, the part of the tooth closest to the gumline (where it is most tightly anchored) experiences the most stress, causing these areas to be prone to chipping.
Flat Occlusion – As we grind our teeth, we are slowly grinding away at the top portion of the enamel. Eventually, heavy bruxism may lead to completely flat teeth.
Fractured Teeth – Under the stresses of grinding and clenching, part of the tooth itself can give way and fracture. Teeth with large existing fillings are more prone to fracturing than a complete tooth or a tooth with a crown. When we start to see the first signs of cracking or microfracture, we want to take precaution and monitor the tooth closely. Sometimes, it may be beneficial to remove the cracked portion and place a crown, to help prevent any unpredictable and unfavorable fractures in the future.
White Lines Inside the Cheeks – Look inside your cheek to see if there is a white striation. These are formed from the repetitive sucking motion related to teeth clenching and grinding.
Tight or Tired Jaw Muscles – It may be that you are spending the entire night working your jaw left and right. Your jaw joints may then get tired, or feel very tight. If you ever wake up in the morning with a soreness in your jaws, you may have just experienced a night of heavy grinding!
Tooth Pain or Sensitivity – Teeth can experience sensitivity to hot, cold, or pressure if they are continually experiencing trauma from bruxism. There are nerves running to each tooth, and repetitive trauma to the tooth can cause these nerves to become hypersensitive. If treated right away, the hypersensitivity can be reversible.
Migraines and earaches – The nerves that innervate your teeth run up along the sides of your head. If they are hypersensitive, they can also cause migraines and earaches.
Sleep Disruption – Some people wake up in the middle of the night due to the sounds of bruxism. Others awaken due to aches and pains. Untreated bruxism can definitely take away a good night’s rest!

Causes of Teeth Grinding

The exact cause of bruxism is difficult to pinpoint. It could be a myriad of factors, so it’s important to evaluate whether any of the following apply to you.

Stress or Anxiety – The most common cause of teeth grinding is stress. I will always ask my patients if they are experiencing any stressful events in their lives lately when they report bruxism. Most people identify a difficult time at home, or a job change, or a recent move. Identifying the cause of stress and trying to manage or decrease it is really helpful in treating bruxism!
Abnormal Bite – Children often time experience grinding when their teeth first erupt and again when their adult teeth start to erupt. Sometimes they outgrow it, and sometimes they don’t. I have also noticed that bruxism is more common when people are missing teeth. A theory would be that an abnormal bite or a bad occlusion can lead to grinding.
Side Effects of Medications – Some medications are known to cause grinding. If you have recently started taking a new medication, ask your doctor whether grinding could be a possible side effect. Antidepressants, for example, have been shown to cause grinding.
Weight Gain and Sleep Disorders – Recent weight gain can make breathing more difficult when one is sleeping. Soft tissues around the neck and throat tends to push downward when we are lying down, thus obstructing the airway. This can lead to a number of sleep disorders, including snoring, sleep apnea, and grinding!

How to Protect Your Teeth from Grinding

There are many ways to protect our teeth! Unfortunately, since grinding is subconscious, eliminating the habit can be very near impossible to do. Therefore, we must find other ways to help prevent further wear and tear on our pearly whites!

Wear a Night Guard

Getting a night-guard is the best way to protect your teeth from the effects of bruxism. Since bruxism is a subconscious habit, it can be difficult to catch yourself doing it, let alone to stop yourself from grinding or clenching. A night guard is a protective plastic piece that sits on either your upper teeth or on your lower teeth. The plastic piece acts as a barrier between upper and lower teeth while you are grinding, so that you are not placing as much forces on your teeth and you aren’t wearing them down. The upper night guard works really well, but can feel very bulky for some. The lower night guard is a much more comfortable fit for first time users. You have the option of either buying universal night guards over-the-counter or making a custom-fit night guard with your dentist. Off course, the custom-fit night guard will protect your teeth better, but I can understand if you don’t want to spend that much money until you’ve tried an over-the-counter one to see if you can tolerate sleeping with a night guard. It will take awhile for you to get used to! It took me about two weeks. One thing is for sure: Once I started wearing my night guard, the pain went away. And if I ever forget, the pain will come back, which shows me that the night guard is doing its job!

Reduce Stress

There are many ways to reduce stress. I was first diagnosed with bruxism during dental school, which no doubt was a very stressful time. I find that I clench my teeth while I work or concentrate on something. When I involve myself in stress-reducing practices, I find that I clench less. Below are some ways to alleviate stress or anxiety.

- Avoid stressful activities an hour before bed.
- Drink caffeine-free tea in the evening after dinner.
- Avoid screens in the last hour before bed. Try reading a book instead, or listening to calming music.
- Choose exercises such as yoga in the late evenings, rather than hitting the gym and working out.
- Write positive events or affirmations down. Gratitude has been shown to decrease stress and anxiety levels greatly. Try a 5-minute journal.
- Spend time with your family, friends, or pet.
- Practice deep breathing, and letting thoughts go.

Lose Weight

If you’ve recently gained weight and have noticed that you started grinding your teeth, try to get back to your previous weight. As mentioned above, weight gain is a common cause of grinding. Many patients have found success in decreasing bruxism by simply losing weight.

Regular Dental Visits

Regular dental visits are important when you grind your teeth. Make sure your dentist knows of your bruxism. They will be able to detect early signs of tooth fracture. When you start to see a hairline fracture, it shows that your tooth is giving way underneath all those chewing forces. You want to treat a small fracture with caution. It may be that a crown will be needed in the near future to cover the tooth and help protect it. A small crack can grow into a big one, and there is never any telling when and how a tooth will break. Sometimes, a tooth breaks and we can save it with a filling, a crown, and/or a root canal. However, other times, it breaks in a completely unfavorable way, and you may end up losing your teeth. Speak with your dentist about the best preventative practices you can engage in to save your teeth!

A Parent’s Guide: The First Dental Visit

Child raising is no easy task, especially if you’re a first-time parent. Despite all the advice that friends, family, and well-wishers throw at you, it seems that none of them actually work in terms of making the job easier. I’m sure you’re frantically trying to find space in your hectic schedule to get a bathroom break in peace, let alone a wink of sleep! So of course, I understand the look you’re going to give me when I tell you that somewhere in between the baby bottle juggling and the diaper toss, you’ve got to schedule your child’s first dental visit, too. A look that’s mixed between, “Can you not see I’m busy drowning in to do lists?” and “Why don’t you try your hand at this?” As if you don’t already have enough advice being thrown at you left and right, a few words on a child’s first dental visit:

When:

A child’s first baby tooth appears around 6 months old. Typically, it will be one of the lower two front teeth. Look out for it, although I am sure your little one will let you know it’s coming as they’re gnawing away at all those teething toys, or in some cases, whatever they can get their mouths on. Some might wail as a precautionary measure to warn you that it’s teething time! If the tooth comes earlier or later than 6 months, don’t be alarmed! It is considered normal to be within 3 months of the scheduled timeline. It is important to remember that some babies have a head start, and others are late bloomers. The eruption of the first baby tooth is the first sign that your child should see their dentist. It is recommended that a child establishes their “dental home” no later than a year after their birth. The sooner, the better – here’s why!

Why:

When it comes to teeth, we can get behind creating good dental habits early on. It is best if a child establishes a dental home at a young age for multiple reasons.

To check and maintain a healthy oral cavity: It’s obvious that there is tooth decay when a tooth has turned black. Anyone can diagnose that. Unfortunately, by that point, it may be too late! Most tooth decay detected by our eyes have already been present for a long time! We recommend seeing your child every six months as soon as the first tooth erupts, so that we can spot problems early on! Maybe our exams will be limited until your child is old enough to take radiographs, but an exam is still better than nothing at all! Let’s be proactive with our dental care!
To develop good oral hygiene habits: When your little one is six months old, the people dentists really want to talk to are the parents. As parents, you will have to guide your child toward good, daily oral hygiene habits. Sometimes, that means holding their hand and doing the brushing for them until they are five years old! We know that they will want to grow up fast but we want them to grow up WITH TEETH! So don’t let them go on their own too early. If your child insists, maybe give them time to brush on their own, and then immediately afterwards, follow up by re-brushing their teeth. Your dentist should be willing to go over some tips if you’re having difficulty with your child’s brushing tendencies. I am sure you have a lot of questions, so do not hesitate to ask your dentist on these visits. Plus, the more times your child gets their cleanings, the more opportunities the dentist has to inform them on ways they can improve, too!
To become familiar with the family dentist and dental procedures: Dental procedures can be seen as scary to kids, no thanks to the bright lights, loud sounds, and perception in the media. But they shouldn’t be! We want kids to be familiar with going to the dentist. We want appointments to be fun! And we want to make check-ups easy for them. You know the saying: practice makes perfect. The more times they see the dentist, the more comfortable they will be.
To avoid fear of the dentist: Humans, especially little ones, fear the unknown. By developing a dental home early on, a child can become more comfortable with the dentist and will start to see check-ups as part of a routine. When you start to brush your child’s teeth, at first they will resist. But after many practice runs, much resistance, and possibly battle scars, they will soon accept it as a part of life. That’s the same with the dental visit (minus the battle scars!).

Things to Expect:

The first dental visit is not going to be perfect. But it establishes the start of what will be a great relationship between your child and their dentist. Here are some things that you might need to prepare yourself for.

The first dental visit will be a visual exam. At six months old, we are not going to take radiographs, a fact you probably already knew. “So what’s the point?”, you may ask. The first visit is usually a visual exam. Meaning, we have your child open their mouth and take a peek at their brand new chompers. If we can get a dental instrument in there to feel the surfaces for any ‘holes’ or ‘soft spots’ that might indicate a cavity, then great! If not, then there is always the next visit. What we really want to accomplish is the familiarity of going to the dentist. Good habits are easier developed early on.
Your child may cry. Let’s face it. Everything at the dental office is completely alien to your little one. There’s a lot of stimulation going on and your child may not like it. So, they cry. Well, crying is actually good, because I can stick my head in their tiny mouths and peer at their teeth, mid-cry. Sometimes, that’s better than fighting with a child to open their mouth. If your child cries, do not immediately assume it’s related to trauma or pain. And please do not stop coming to the dentist. As mentioned before, the more they get used to coming in, the more cooperative they’ll be in future visits.
Nothing may get done. If the baby or child is not cooperative AND does not cry, then it’d be pretty difficult to take a look at their teeth. No worries! Let’s just call this an introductory visit! “Here’s the dentist, your new friend!” “Nice to meet you, little one! Next time, you are going to do so great, we just know it!”
We have to be patient: We don’t want your child to have a traumatic experience, because that can affect their perception of dental procedures and can keep them away from their six month check ups when they grow older. We want the experience to be positive, therefore, forcing a child to cooperate is not the best way to go. We can always try again next time. If there IS treatment that needs to be done, but your child stops cooperating, there are also other things we can do, such as refer to a pediatric dentist (also known as a pedodontist) who specializes in working with children!

So there you have it! Now you are equipped with the to-dos and the whys and the hows. If you can find time to establish a dental home for your child early on, you and your child will have an easier time as your child gets older. Hopefully this advice helps you sleep soundly at night too, knowing that their teeth are in good hands!

Getting to Know: Cat and Chrystle Cu of Cocofloss!

This post may contain affiliate links. Please see my disclosure to learn more.

Cocofloss is a product created by the sister duo, Cat Cu and Chrystle Cu. Cocofloss is a fun (and highly effective!) floss that is bridging the gap between a socially perceived arduous task, and a walk on the beach. Their vision imagines a future where everyone can keep their teeth for the entirety of their lives! Their reach is on the global scale, helping those at home develop good preventative oral hygiene habits, as well as those outside our borders, who may not have access to the tools and education needed to maintain a healthy smile. The truth of the matter is, flossing is not exactly exciting stuff… until NOW!

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Who are the imaginary minds behind Cocofloss?

I’m Cat, and I started Cocofloss with my sister, Dr. Chrystle Cu! My sister is a tooth geek, philanthropist, and preventative dentist who graduated from Wellesley College and the Arthur A. Dugoni School of Dentistry. I’m an entrepreneur, yoga-addict, and art-lover. I studied engineering at Stanford and worked in finance, art, and tech before joining forces with Chrystle to start Cocofloss.

What was the inspiration behind creating Cocofloss?

Chrystle is very prevention oriented – she’s that dentist who spends an hour educating each patient about their teeth and gums – and Cocofloss embodies her dream to make taking care of your smile more effective and fun. Chrystle’s dream is for everyone to be able to keep their teeth for life.

I love how Cocofloss is geared towards making flossing a fun experience! What are some of your favorite aspects of the product?

I love the Caribbean-blue floss color. It evokes freshness and blue oceans full of possibility. And of course, it’s functional! Folks can see their progress flossing as plaque contrasts against the blue threads.

Which one is your favorite flavor? Are there any limited editions to try?

Watermelon! Just launched this summer as a limited run.

What are ways that Cocofloss can incentivize people to develop good flossing habits?

Cocofloss delivers a flossing experience that’s both rewarding and fun!

When I ask a lot of young patients if they have been flossing, their main excuse is, “We ran out of floss in the house”. Tell us more about your 6 month floss plan!

Would you floss tonight if you knew more floss would be arriving tomorrow? Customer behavior suggests so!

If you guys have ONE piece of pro tip for people who can’t get into flossing, what would it be?

Flossing is an acquired taste. Floss daily for 21 days (the number of days it takes to create a habit) with Cocofloss and soon enough you’ll begin to crave it.

Would you care to share some of your favorite flossophies?

Our flossophy:

Bliss is a life lived in balance – take an adventure and enjoy the familiarity of home, take something and give back something, set big dreams for the future and enjoy improvisation also, eat your cake and don’t forget to floss too!

I notice that you guys love to travel, just like me! I think it’s especially important that you’ve linked travel with having floss with you, all the time, when you’re on the go. Any tips on how to remember to floss during times when we are busiest and most on the go?

Keep floss in your bag so that you can floss whenever you feel like it and don’t be embarrassed to floss on-the-go! I’m often that awkward human flossing in public or on-the-go.

How is Cocofloss making an impact on a global scale?

We’d like to inspire folks to keep their teeth for life around all corners of the globe. To name a few, we’ve donated Cocofloss to communities in the Caribbean, the Philippines, and Mexico. The worldwide floss party is just getting started.

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I was born in the Philippines, so I share a connection with your mission. I, myself, personally returned home to Manila to give free dental care for a week. Can you share any insight as to how your experience was?

Chrystle:

The global tooth decay epidemic is so painfully real. What people need most is prevention and nutrition education. Unfortunately, sugar is used as a universal rewards across all cultures. We need to shift the way people think about rewards, and instead educate and reward with preventive tools like Cocofloss.

More on Philippines mission trip here (happy to discuss more also): https://cocofloss.com/blogs/cocofloss-life/a-note-to-the-kids-in-bohol-philippines

How do you envision making preventative dental care attainable to all groups of people?

We’re using the internet and social media as vehicles for prevention education. Our Cocofloss website has free education for all, and we’re on a mission to make flossing something everyone looks forward to daily.

Where will Cocofloss go next?

We have big plans to help folks find their smile wherever they go. Stay tuned!

A sincere thank you to Cat and Chrystle, who took the time to talk about what Cocofloss has to offer. If you’d like to read more about my personal experience with Cocofloss, check out my review here!