Is Sugar the Devil? Yes! A dentist helps you save your $50,000 smile
Disclaimer: The information presented in this article is for educational purposes only and is NOT intended or implied as a substitute for professional medical advice, diagnosis, or treatment from your dentist, physician, or any other healthcare professional. You should NOT use the information presented here for diagnosing or treating any health problem or disease. Never disregard advice from your personal medical care provider(s) or delay contacting your dentist/other healthcare providers because of anything you read or heard here. Reading this article and/or utilizing any of the information presented in any way does NOT create a doctor-patient relationship between you and the article creator or with any of the healthcare professionals in any way affiliated with this article. You use this information at your own risk. You should contact your dentist/healthcare professionals before beginning any new treatment or practice to address a health problem or improve your health. The author is not responsible for information on external websites linked to from this article or for the information on external websites that link to this article.
Part One: My Personal Manifesto
I was recently watching Wonder Woman (complete with intervening Brie Larson Sentra commercials about not compromising on your car or with your pay at work), which was perhaps unlikely since blockbusters aren’t usually my first entertainment choice. I can be a bit of a movie snob. I gravitate toward artsy/indie flicks.¹ Still, I have to say I enjoyed the film. For a big-budget Hollywood albatross, it actually tackled a profound theme regarding humankind’s capacity for both good and evil.² That impressed me.
If you can allow me to virtue signal for a moment, I will say that I am all for superhero movies about female empowerment. I really enjoyed Captain Marvel, too (Honestly, that one gets the nod from me for “overall fun factor,” but it wasn’t as deep, philosophically speaking.). As the sibling of a younger sister who was more athletic than all three of her older brothers growing up, I’m all about showing young girls they have every right to kick ass and take names.
All that being said, there is a scene in Wonder Woman between the ass-kicking when our hero, played by Gal Gadot, is offered an ice cream cone at a train station and remarks how “Wonderful!” it is, and all my dental brain could think was “Treason!” Here we were with Leo vaping at the Screen Actors Guild Awards again! Way to set a terrible example Hollywood! Curse you and your product placement! We’re going to fight global warming and greenhouse gas emissions, but we can’t even protect our own bodies from harmful substances? What are you doing, Leo?⁵
I lament all the underdeveloped adolescent brains being nudged toward a life of slavery to nicotine and sugar by celebrities out there vaping ice cream at their raucous Los Angeles jamborees! What is a conscientious bum of a Midwestern dentist supposed to do in response? Why, write articles and make videos and kick them out into the void of the internet for public consumption, of course. Leo, Gal, I beg of you: Think of the children! Think of their futures!
Ok, truth be told, ice cream is less dangerous for your teeth than some other forms of sugar, but it’s still not spectacular for your health in general. All I’m saying is this was a movie trying to combat pervasive subconscious stereotypes about what it means to be a woman in our culture, and my dental brain was freaking out about the subconscious sugar message being pushed. I’m sorry for being annoying, but this is just who you become after going through four years of dental school (10/10 do NOT recommend that experience) and then spending the rest of your life staring at peoples’ teeth for a living. I’m trying to do something positive with all my insider knowledge about how to save your teeth, and sometimes that involves very public meltdowns about Wonder Woman and ice cream! I’m sorry! How ‘bout this: How about we melt all the ice cream down and throw it in the ocean, that’s what I say!⁷
Alright, alright. You’re right. I’m not going to be very successful if I try to Boston Tea Party all the ice cream in the world. That’s kind of insane. Let me back up and try to explain to you why I’m so fired up about sugar.
I’m a dentist. My job is to protect the health of your teeth (and your overall health to the degree I am capable and qualified). I took an oath. I know that sounds weird, but it literally happened. I took an oath to protect your teeth. I haven’t taken that many oaths in my life, but that’s one of the ones I have taken. That’s a weirdly specific oath to take, but that’s where my weird-ass life has led me. I stand by my oaths.⁸ Partially because “oath” is a fun word that makes me feel just a little bit like Gandalf, but also because it’s important to keep your promises and stuff.
I had an experience in dental school that rankled me at the time and continues rankling me to this day. It was early in my clinical rotation, and I was trying to counsel a patient about what causes cavities so that they could prevent damage to their teeth in the future. One of my clinical professors cut me off, patted the patient on the shoulder, and said, “Everybody enjoys donuts. Don’t worry about it.”
I was momentarily embarrassed. Had I done something wrong? Was it not my job to help educate a patient so that they could make a fully informed decision about their healthcare? I wasn’t being judgmental. I wasn’t scolding. That’s not my vibe. I respect my patients’ autonomy. I don’t treat them like children. I treat them with respect like the responsible and capable adult human beings they are. Yet here was an authority figure silencing me when I thought I was doing my best to help someone such that they would be capable of helping themselves. Teach a man to fish and all that. So, yea, for a moment, I was a bit red behind the ears with embarrassment, but upon reflection, I wanted to scream.
Screams aren’t all that productive. They’re typically (there are always exceptions) a rather immature emotional reaction to a troubling situation. I didn’t scream. But I felt the emotion of wanting to scream. These blog posts online and these videos are what hopefully become a productive scream. A useful scream. I hope to make enough useful noise like a little Who down in Whoville such that I can help a whole bunch of people understand that protecting and improving their dental health isn’t all that tough if you just have the right information and some tips on how to implement that information practically in your daily life. You don’t even need a dentist for the vast majority of this stuff. You are perfectly capable of doing this all on your own once you know what to do. You really are.
Part of the oath I took was about respecting my colleagues. I do respect all the hard work that dentists do all over this country and all over the world to help improve patients’ dental health. This is a tough job. It is crazy stressful intellectually, emotionally, physically…it is just plain hard. I respect that the dentist who made that donut comment to me has worked within the profession far longer than I have. He has way more experience. He has helped more people than I have. He is, without question, a better overall dentist than I am given his experience and lengthy dedication to the profession.
And yet…the more I have reflected on this incident over the years, the more it has filled me with a rage that I cannot appropriately communicate through written words. Imagine, if you’re willing to indulge my silly fantasies, just humor me and imagine me repeatedly punching and kicking a wall while screaming incoherent nonsense in a public place. People are staring at me, wondering, “What the heck is wrong with that guy?” I don’t care. I keep screaming and punching and kicking the wall. The police come. They tase me. I am undeterred, continuing to flail and gyrate on the floor in frustration, all the while foaming at the mouth generously. That’s an approximation of how mad I get when I think about the attitude embodied by that dental professor back when I was in school. I shudder thinking about that attitude being ingrained in the minds of future dentists and healthcare providers in general.
“Don’t worry about educating and empowering patients. Behavior change is too hard. They don’t want to learn. They don’t want to improve. They just want to stay sick and have to come pay you to slap a band-aid on their growing, deepening ulcer.” I don’t believe that. I can’t believe that. I am not naive. I know that some patients have adopted a paternalistic attitude toward healthcare. These patients often don’t like me very much when I tell them there is no simple, low-cost fix to their huge and complicated problem, which has accumulated over many years of damaging habits. They mistakenly believe that pills and surgery can “fix” them.⁹ But who’s fault is it that the public has been convinced of such nonsense? Knowing what I know, I’ll say it is absolutely my fault at this point. I share the responsibility of telling patients the truth.
If your smile breaks down to the point where you have to have all of your teeth removed (and this happens to A LOT of patients), in order to replace all of your teeth and get close to the full function and attractiveness of your original smile, it will cost around $50,000. Even then, all that expensive, complicated hardware that took years of training and amazing amounts of coordination between a small group of highly trained professionals to deliver to your mouth — even then, that full mouth tooth replacement solution is NOT as versatile, durable, or attractive as your original teeth in the high majority of cases. There are other less expensive options, but trust me: dentures are NOTHING like real teeth. They are better than no teeth at all, but they are far from great.
Here’s the truth I believe in. I believe that most people do want to know how to be healthier. I think we, as healthcare providers, have failed you miserably. We have allowed ourselves to be misled. We have failed to be strong leaders. I’m sick of this system that prioritizes maximizing profitability over actually improving anyone’s life. It’s disgusting and revolting to me. If I have to keep being a healthcare provider like that, I’d rather not be a healthcare provider at all. It’s a misnomer. I refuse to knowingly continue contributing to people's ill health through misinformation and scientifically and economically unsubstantiated “care” models steered by administrators more concerned (due to faulty incentive structures) with financial bottom lines than patient health.
Our healthcare system is failing. It is failing patients and providers. I love capitalism, but vultures who are not healthcare providers have hijacked the system and set their sights on the incomplete ideology of the almighty dollar instead of aiming to improve patients' health. That’s the wrong goal. Making money is a consequence of doing something valuable for people. When the goal is to make money by any means necessary, you will destroy others and yourself in the process. Money cannot be the goal in and of itself. Money has no value. It is empty. It is only a placeholder for whatever you truly value. Do we truly value the health of our patients? Is that being born out by the actions we take each day when they come to us, trusting us to take care of them? Are we being honest with them when it comes to the difficult truths of being healthy? Let’s actually pursue health. Health is wealth.¹⁰
If your smile breaks down to the point where you have to have all of your teeth removed (and this happens to A LOT of patients), in order to replace all of your teeth and get close to the full function and attractiveness of your original smile, it will cost around $50,000. Even then, all that expensive, complicated hardware that took years of training and amazing amounts of coordination between a small group of highly trained professionals to deliver to your mouth — even then, that full mouth tooth replacement solution is NOT as versatile, durable, or attractive as your original teeth in the high majority of cases. There are other less expensive options, but trust me: dentures are NOTHING like real teeth. They are better than no teeth at all, but they are far from great.
Are you starting to pick up on what I mean by health is wealth? Why am I so adamant that preventative medicine is the only logical way forward for our country? People don’t have to end up in these situations where they don’t have any teeth. You don’t have to end up in a position where the teeth you do have are breaking down and unattractive. I don’t expect you to pull yourself up by your bootstraps all alone, but I am here to tell you that I can’t pull you up by your bootstraps by myself either. We’re going to have to each grab hold of each other’s bootstraps and pull to help each other up. We’re social animals, and we have to work together to get anything done the right way.
Part Two: Identifying the Sugar Devil
Another Devil
I hope that the videos I make and the articles I write make dentistry less confusing and scary for you. I see so many patients who are incredibly anxious about dentistry.
The Problem of Dental Decay
Decay. Cavities. Caries. These are three different names for the same scourge. You may be questioning why I’m so fired up about sugar causing tooth decay. Is it really that big of a deal? Yea. It kinda is. Especially when it is so easily preventable. Few diseases that affect such a massive number of people can be prevented successfully and predictably in the way that tooth decay can be. The scientific evidence is very straight-forward. If you don’t believe me, maybe you’ll listen to the World Health Organization (WHO):
“Dental caries can be prevented by avoiding dietary free sugars. Moreover, dental caries is largely preventable through simple and cost-effective population-wide and individual interventions, whereas treatment is costly, and is often unavailable in low- and middle-income countries.
In low-income countries, the majority of dental caries goes untreated. Teeth affected by caries are often extracted (pulled out) when they cause pain or discomfort. Severe dental caries can impair quality of life. For example, dental caries may cause difficulties in eating and sleeping, and in its advanced stages (abscesses), it may result in pain and chronic systemic infection. Dental caries is also associated with adverse growth patterns. Further, tooth decay is a frequent cause of absence from school or work.
Almost half of the world’s population is affected by dental caries, making it the most prevalent of all health conditions. High levels of dental caries occur in middle-income countries, where sugars consumption is high. In such countries, health systems are challenged to provide preventive population-wide strategies and primary oral health care often is not available…
…The disease is also associated with socioeconomic status, with high prevalence rates among the poor and disadvantaged population groups…
…Dental caries develops over time; loss of tooth substance (enamel and dentine) is caused by acid production resulting from bacterial metabolism of sugars. Early stages are often without symptoms, but advanced stages of dental caries may lead to pain, infections and abscesses, or even sepsis.
Population-wide strategies to reduce free sugars consumption are the key public health approach that should be a high and urgent priority. Because dental caries is the result of lifelong exposure to a dietary risk factor (i.e. free sugars), even a small reduction in the risk of dental caries in childhood is of significance in later life; therefore, to minimize lifelong risk of dental caries, free sugars intake should be as low as possible. It is important that population-wide prevention interventions are universally available and accessible. Such interventions include the use of fluoride, and comprehensive patient-centred essential oral health care.
Globally, dental caries poses many challenges. The disease burden is unequally distributed — it disproportionally affects poor and disadvantaged populations, which have lower access to prevention and care. Often, dental caries does not receive adequate priority in health planning due to an underestimation of the true burden and impact of the disease. The focus of interventions is generally characterized by an isolated disease approach and a focus on costly clinical treatment, rather than on integrated cost-effective public health strategies that address entire populations…
…Economic growth is often associated with nutrition transition to a diet that is characterized by a high proportion of energy from free sugars and fats. In particular, such transition is associated with increased access to sugars-sweetened beverages and other dietary sources of free sugars. Increased availability of sugars in the absence of adequate oral health preventive measures is associated with marked increase in the burden of oral disease…
…The direct financial costs alone are considerable. It has been estimated that, globally in 2010, US$ 298 billion was spent on direct costs associated with dental caries. In addition, indirect costs came to US$ 144 billion, with the total financial cost reaching US$ 442 billion in 2010…”
- The World Health Organization note on sugars and dental caries¹¹
All that juicy (hopefully sugar-free) info was courtesy of The World Health Organization. That’s the health organization of like, ya know, THE WHOLE WORLD. All of planet Earth. So yea, maybe I’m not just a foaming at the mouth lunatic raving about some quack review of Wonder Woman ice cream. Maybe one of the most expensive chronic diseases to treat in the world is worth a little bit more of our time and attention to prevent.
Let’s not forget how scared most of you seem to be of people like me (dentists). Wouldn’t it be nice for trips to see us not to be fraught with anxiety because you’re confident we’re going to tell you how healthy and wonderful your beautiful teeth are? Wouldn’t you rather get a high five from your dentist instead of having an awkward conversation tip-toeing around the sugar elephant in the room?
So, as a dentist, what is my population-wide strategy to help decrease the financial strain, pain, social stigma, and anxiety associated with dental disease? I’m writing articles and making videos online to empower patients to live their best tooth life y’all. What’s less expensive than information disseminated over the internet (and then hopefully by word of mouth to everyone you know)?
Why Sugar is the Devil
If I’ve successfully convinced you that tooth decay is a big problem, let me now explain how it happens in the first place. If you’re tired of reading my words, you can also watch this TED-ED video for a spicy, fun, animated journey!
The crazy thing is, when I was in dental school, we didn’t talk that much about nutrition or nutritional counseling for our patients to prevent cavities. There was a lot of talk about fluoride, brushing, flossing, sealants, and cleanings, but not much discussion of the ultimate source of the problem. That was only mentioned in passing and never emphasized much.
Here’s the critical concept to understand: three things are necessary for a cavity to form. They are:
Bacteria
Food sources the bacteria convert to acid (aka sugar and other carbohydrates/carbs)
Time
That knowledge hit me like a lightning bolt when I heard it. It makes perfect sense. There’s nothing profound in that formula. Bacteria convert food into acid poop, and then that acid poop destroys our teeth. The longer the acid poop is on the teeth, the more the teeth get destroyed. Very basic cause and effect. No mystery. The only mystery is helping people keep the acid poop off their teeth. That involves understanding human psychology and behavior change. That’s where we need to focus if we want to improve patient health significantly. That seemed very obvious to me when I learned this information.
Not all of my colleagues shared my enthusiasm for this insight. One classmate got very upset with me making the statement that it was perfectly possible to prevent cavities based on diet alone. I had come to what I thought was the pretty obvious conclusion: no carbs/sugars means no fuel for bacteria, means no acid, means no decay. Boom, boom, boom. Easy peasy.
Now, I understand that having zero carbs in your diet is not practical or desirable for most people's overall health. That’s why it’s still important to brush, floss, and rinse with water after you eat. Still, low-carb is very attainable for most people. And, theoretically, zero carbs/sugars=zero cavities is pretty rock solid based on our current scientific understanding of tooth decay.
One particular classmate told me I had no idea what I was talking about. In their view, I was a naive fool for believing such a thing, and they made sure to tell me so, quite forcefully. I didn’t push the issue, but the fact that the logic of what we just learned in class wasn’t sinking in with everyone was surprising. It was as if a scientific profession, which dentistry claims to be, was resorting to some sort of spontaneous generation theory when it comes to cavities. Have we forgotten the lessons of Louis Pasteur? Something from nothing? No causality? That seems like a tenuous position to take as a modern dentist, at least so far as tooth decay is concerned.
A few years later, after I had been out in the “real” world working as a dentist, I picked up pediatric dentist Dr. Roger Lucas’s book More Chocolate, No Cavities and found a kindred cavity spirit. Finally, someone else in the dental community who agreed with me enough to publish a book about it! He notes in the book how “controversial” a stance this is within dentistry. Knowing what we know at this point, I think that’s ludicrous.
As you’ll see below, sugar isn’t the only carbohydrate you need to be careful with when it comes to your teeth, but it is the primary culprit in our diet responsible for our dental woes. The amount of sugar in the American diet is devastating to our overall health, not just our teeth. Sugar is also addictive. It throws your body all out of whack, and you end up trying to balance out with more sugar. It’s not a healthy cycle.
The crazy thing is, when I was in dental school, we didn’t talk that much about nutrition or nutritional counseling for our patients to prevent cavities. There was a lot of talk about fluoride, brushing, flossing, sealants, and cleanings, but not much discussion of the ultimate source of the problem. That was only mentioned in passing and never emphasized much.
Obviously, I’m not the only voice you should listen to when it comes to living the life that is healthiest for you. If anything I’m saying conflicts with your physician or nutritionist's advice, definitely run everything by both of them before you would make changes to your diet. If you’re looking for some basic initial dietary guidance, I would highly recommend Dr. Mark Hyman, MD’s excellent book, Food: What the Heck Should I Eat? My goal is to help you as much as I can without causing you harm. My ideas aren’t for everyone, and that’s totally rad, my dude. There are billions of people on this planet. My understanding of things isn’t going to work for everyone. That’s way too high of a bar. I just hope it helps some of you.
Part Three: Slaying the Sugar Devil
Slayer of Sugar Devil Dragons
What You Can Do
Now you know the enemy. It’s an addictive substance that food corporations have been dumping into our food supply like crazed banshees for decades now. It’s in most of the available food out there. You can’t even properly identify it based on our government’s current food labeling standards. It’s advertised to you everywhere you look. It’s culturally ingrained so that if you don’t accept the sugar dogma as gospel, you come across as some kind of lunatic fringe ideologue who is threatening the very fabric of American society. That all may very well be true and intimidating, but if you dare to step forward and live differently, I will be standing right there alongside you when the sugar acolytes start throwing rocks at us. That’s probably cold comfort, but at least you won’t die alone in the defense of teeth, right?
You now know that for the enemy to succeed, three things must be true:
Bacteria in your mouth have to accumulate on your teeth in the form of plaque so that they can break down food into acid, which dissolves your teeth and causes cavities.
You have to give those bacteria a food source (carbohydrates/sugar).
The bacteria and the food source have to mingle on your teeth for an extended period of TIME.
Once you know what causes cavities, prevention becomes easy:
Brush and floss your teeth to remove plaque each night. Plaque takes 24 hours to build up on teeth. If you gently wipe it off each night, you greatly decrease the amount of bacteria available to turn food into acid.
Eat foods and drink drinks that don’t give the bacteria a ready fuel source to make acid. This is an awesome guide to tooth-healthy vs. unhealthy foods.
Limit the amount of TIME tooth unhealthy foods are in your mouth and on your teeth.
The most important aspect of prevention is limiting the amount of time simple carbs and sugars are in contact with your teeth. More time on the teeth, along with bacteria, equals more acid and thus more tooth damage. You can prevent this through organized meals and “smart snacking.” What am I talking about?
I mentioned Dr. Lucas and his excellent book, More Chocolate, No Cavities above. If you want an even more in-depth discussion than my article provides, you can buy his book, but the main point is that we have to keep the carbs/sugars off your teeth. What are the best strategies for doing that? It’s all about building the right habits. Cavities don’t show up quickly. They don’t hurt until they are already big. Preventing them is about healthy habits each day before you ever notice a problem.
I also don’t want to be overly negative with this article. There are SO MANY delicious foods you CAN eat and ENJOY that are healthy for you and your teeth.
Strategies to Keep Carbs/Sugar off Your Teeth
1. Shop Smart/Only Keep Healthy Foods at Home
Avoid sticky foods. Sticky foods stick to your teeth. What’s sticky? Crackers. Pretzels. Cereal. Even though they have sugar, some sugary foods aren’t as bad for your teeth because they don’t stick to the teeth for longer periods of time. This doesn’t mean these foods are good for your overall health, but if you need a little sugar/carb fix here and there, pick one that isn’t sticky.
As a parent, it can be difficult to keep sugar away from your kids, as Donald Glover knows. But Donald Glover had great parents, and look how awesome he turned out.¹² Your best bet is to avoid areas in the grocery that have sugary foods. Don’t even walk your kids down the cereal aisle. That’s asking for trouble. I’m not sure if there is a way to filter out commercials for sugary cereals with parental controls, but there ought to be. Don’t let them ever come in contact with those drug-peddling rabbits and leprechauns unless they plan on doing this to them.
If you never bring home foods that damage teeth, you and your family can’t eat them regularly. It’s ok to have those foods occasionally, but they shouldn’t be staples of your diet that are always ready on hand. Stay away from the soda aisle at the grocery store as well.
Things to Avoid Buying/Never Bring into the House:
Soda
“Energy” Drinks
“Sports” Drinks
Fruit Juices
Low-Fat Milk/Chocolate Milk
“Fruit” Snacks/Strips
Candy
Cookies
Crackers
Pretzels
Dried/Enriched Flour Cereals
Never may be too harsh, but reducing your purchases of the above items and replacing them with whole foods will drastically reduce your risk of cavities. Whole, unprocessed foods are great for your teeth and overall health.
I also don’t want to be overly negative with this article. There are SO MANY delicious foods you CAN eat and ENJOY that are healthy for you and your teeth. Meats and fats won’t cause any trouble for your teeth. Neither will whole vegetables. Check out Dr. Lucas’s excellent snack guide. Foods in the blue and yellow category are generally very safe for your teeth, especially if you brush and floss at night and if you rinse with water after eating.
2. Rinse with Water After You Eat or Drink Anything
This is easy and practical. I’ve carried a water bottle with me everywhere I go since I started swimming in high school. Once you make that a habit, you’re golden. It’s great to stay hydrated for all sorts of reasons. Eating is a perfect reminder to drink too. Swish thoroughly with water after you eat, and you’re not giving bacteria much time to turn food into acid. You’re also rinsing the acid that’s already present off your teeth.
If you’re a parent reading this article, consider yourself lucky. If you’re a child reading this article, consider yourself a genius. You’re going places, kid.
3. Straws, Not Sippy Cups
If you do have a sugary beverage (like juice, low-fat milk, “sports,” or “energy” drinks), consider using a straw (I guess a paper one because as a massive former TMNT fan, I don’t want to be responsible for murdering turtles? Turtle Power.). If you don’t let the liquid get on your teeth, it can’t cause damage. Smoothies are also a little better than straight juice because they still have some fiber in them, making it harder for bacteria on your teeth to access the sugar.
Unlike straws for adults, sippy cups are bad news bears for kids. That gives the child direct access to the drink whenever they want. Sipping whenever a kid wants is a very disorganized way to drink. If you give your child a sippy cup with juice, low-fat milk, a sports drink, or soda (yes, some parents don’t realize that this is an unhealthy choice), they will be exposing their teeth to damaging sugar all day long.
If you give your child a sippy cup (or if you like to use one yourself, because hey, you’re unique and don’t care what other people think), you should only ever put water in it. Good ole’ H₂O.
Future Wonder Woman with Kick-butt Teefers
4. Build Healthy Habits Early for Kids
You want a lifetime of dental health? Hope you are lucky enough to be born into a family that has been lucky enough to be properly educated about dental health. If you’re a parent reading this article, consider yourself lucky. If you’re a child reading this article, consider yourself a genius. You’re going places, kid.
How do we help more kids get lucky (not like that, keep your mind out of the gutter) and be born into lucky families? Well, we spread the word. Politely, non-judgmentally, and casually, let people you care about and who you are on good terms with know how easy it is to have amazing dental health. Share this info with anyone who you think would be grateful to have it. Changing the dental health of an entire country or the whole world seems like an impossible and futile task for one person or a small group of people, until you realize that if each person who gets the message kindly passes it along to a few other people throughout the year, and then you let that knowledge compound over time…this is how things get just a little bit better for everyone.
Shared knowledge is a helluva drug. I think it’s an even more powerful drug than cocaine sugar. Gradually, we can all eat in a way that makes us feel better. Then all of a sudden, we’re going through our day with a little more pep in our step. We’re sleeping a little better. We’re smiling a little broader.
The easiest time to get all these wonderful habits that lead to an improved world in place is during childhood. You can always change habits as an adult, but it’s tougher. Help set your kiddo on the right track and lead by example.
I’m not judging anyone. You were born into an unhealthy culture. That’s not your fault. It’s not fair. You have been misled, and your health has been abused. The good news is that so much of that can be changed at a very low cost if you have the right information and know-how to incorporate it into your life.
A culture is a society’s acceptable patterns of actions in life. Our health culture has taught people the wrong action patterns. If you want to be healthy, you have to reject the action patterns of our culture. Mainstream American culture is unhealthy. That is an undeniable fact at this point. We are stressed out, not sleeping well, wracked with a butt load of preventable chronic diseases that make it difficult for us to fulfill our potential in life.
You don’t have to accept that way of life. You can be different. You can stand on your own two feet and do what is healthy and best for you. Other people in the culture will criticize you. They will mock you for being different. That’s cool. This isn’t about them. This isn’t about being better than or different from anyone else. This is about being you. The best you that you can be.
If other people have a problem with you striving to be the best version of yourself in life, I suggest you focus on surrounding yourself with more supportive friends. How do you surround yourself with more supportive friends? By being a supportive friend. By wanting the best for others. You improve the culture by taking actions to positively improve your own life. People will see that and get curious. They might start asking you questions. Be as generous as you can afford to be in sharing what you think may help them, and then they can pay it forward. Gradually, our collective effort over time can safely and effectively cause the culture to shift to a healthier place.
I’m not judging anyone. You were born into an unhealthy culture. That’s not your fault. It’s not fair. You have been misled, and your health has been abused. The good news is that so much of that can be changed at a very low cost if you have the right information and know-how to incorporate it into your life.
Why I’m Writing and Creating Videos Online
Very early on in my work as a dentist, I realized two things:
It’s straightforward to protect your teeth and keep a healthy, beautiful smile in your head and on your face for a lifetime if you know what to do.
It’s really hard to communicate effectively with patients in a clinical dental office setting and help empower them to take charge of their dental health for a lifetime confidently.
That frustrating reality bummed me out for a long time, but then I remembered we have the internet. The worldwide web. The information superhighway. Our world is more connected than ever before. If I could simplify the message and make it fun for people to follow along, maybe I could help turn the tide on dental disease and breakdown. Maybe people could go through life with a little more confidence to smile at their next job interview or when they lock eyes with some cutie pie across the way. Maybe fewer people would wake up in the middle of the night with a searing pain¹³ in one of their teeth that disrupts their life. Maybe if we nix all these avoidable dental problems, you could save up your money you were spending on treading water repairing your teeth, and you could afford to do braces the right way. Maybe I’m just a vain sack of potatoes, but I personally would prefer to spend money on improving my smile as opposed to fixing it as it deteriorates.
Then again, maybe your smile doesn’t need any improvement. Maybe you have a healthy balance of self-esteem. Maybe you like that little chip on your front tooth. It gives you character. There’s a story behind it. You like how your right maxillary canine is rotated 20° to the left and that there is a gap between #7 and #8. Beauty is in the eye of the beholder. Our “flaws” are what make us unique.
Who am I to judge? I’ve got more than my fair share of flaws and personal shortcomings. I’m just here to help people understand options so they can make ideal choices for them. None of the work I’m producing is meant to make anyone feel guilty. Guilt is a poor motivator. I don’t know your life. If it’s more useful for you to print this article out and wipe your butt with it instead of listening to any of my ideas, I would encourage you to do that. At least my writing will have reached the status of “World’s Most Pretentious Toilet Paper.” I’m ok with that.
I hope that the videos I make and the articles I write make dentistry less confusing and scary for you. I see so many patients who are incredibly anxious about dentistry. I sort of get it. It’s weird having someone reach in your mouth. That’s your personal talky box. That’s not a place for a stranger’s hands. “What are you doing in their hands? Get out of their hands!” I’ve been reaching into people’s mouths for years now, and I still think it’s bizarre. I’m an awkward person to begin with. Pro tip: If you’re going to be a dentist, be better than me at small talk. I am the worst at small talk, but it’s kind of super important to establish some rapport with a patient before you reach your hands inside the top of their body, ya know?
Even if I don’t succeed in humanizing dentists and thereby improving your relationship with your dentist and other dental healthcare providers, I hope this article has at least convinced you that sugar is the devil. That doesn’t mean you can never have any sugar. You can dance with the devil a little bit. As Aleksandr Solzhenitsyn so brilliantly observed, we all are stuck with that urge deep inside our psyche. You just don’t want to ever let the devil take the lead in the dance, ya dig?
Have a lovely day.
Thanks for reading.
YouTube Videos You May Find Helpful:
Protecting Your Teeth From Acid
Stopping Dry Mouth from Wrecking Your Teeth
Do We Need to Remove Wisdom Teeth?
How Does Pregnancy Affect Your Teeth and Gums?
Do Services like Invisalign and Smile Direct Club Work?
Teeth come in cute. You have the power to keep ‘em that way. I believe in you!
Footnotes:
¹ I’m not a big fan of big-budget action flicks just for the sake of the explosions. The Fast and Furious series makes me feel stupid when I watch it, and I realize that’s offensive to a lot of people. I’m sorry that this is one of my more regrettable character flaws when interacting with people in society, but it just is. Sure, it’s fun to watch somebody get creatively hit in the balls during a Jackass sketch/prank, but we’re going to make that into a movie? Several movies? That makes my brain hurt.
I know this article is supposed to be about sugar, and I’m just meandering around talking about how I can be annoyingly pretentious when it comes to movies, but the point is that sugar is like Jackass for your teeth (and the rest of your body). Sure, it’s fun to get hit in the nuts and make some friends in the process because you can all laugh about how it sucks to get hit in the nuts. But if your whole relationship revolves around getting hit in the nuts? That’s reckless my guy. You’re going to pulverize your nuts. Nuts are valuable. That’s how you propagate the species. Don’t let sugar wreck your nuts.
² If you’re thinking, “Huh? What’s this kookaroo dentist man talking about?”, you should read up on Aleksander Solzhenitsyn:
“Gradually it was disclosed to me that the line separating good and evil passes not through states, nor between classes, nor between political parties either — but right through every human heart — and through all human hearts. This line shifts. Inside us it oscillates with the years. And even within the hearts overwhelmed with evil, one small bridgehead of good is retained. And even in the best of all hearts, there remains…an un-uprooted small corner of evil. Since then I have come to understand the truth of all the religions on the world. They struggle with the evil inside a human being (inside every human being). It is impossible to expel evil from the world in its entirety, but it is possible to constrict it within each person. And since that time I have come to understand the falsehood of all the revolutions of history: They destroy only those carriers of evil contemporary with them (and also fail, out of haste, to discriminate the carriers of good as well). And they take to themselves as their heritage the actual evil itself, magnified still more.” — The Gulag Archipelago
If you take the time to thoroughly understand what that man is saying about humankind in that quote and apply that understanding honestly in your life, you’re going to knock it out of the park as a human being. You won’t need no stinking sugar. I don’t know whether or not it was intentional, but there’s lots of Solzhenitsyn-ian thought coursing through Wonder Woman thematically as a work of art. People today question why war and genocide happen, what kind of people could do such things? Wonder Woman gives the honest answer: People kind of people. Me. You. Everybody. Because we ALL have the capacity to be evil. We’re all in glass houses throwing stones on Twitter. We should humble ourselves. Just listen to Gal Gadot nail the closing monologue of the film:
“I used to want to save the world. To end war and bring peace to mankind; but then I glimpsed the darkness that lives within their light. I learnt that inside every one of them there will always be both. The choice each must make for themselves — something no hero will ever defeat. And now I know… that only Love can truly save the world. So now I stay, I fight, and I give — for the world I know can be. This is my mission now. Forever.”
Forever. The struggle is real and it is eternal (or at least until the sun esplodes³ and makes all conscious existence go bye-bye cya later). We all have to deal with our own internal demons and emerge victorious to contribute to maintaining the stability of a harmonious society in the face of ever-present and shifting threats to our existence in this harsh-ass universe. What a bummer, but also what a thrill, eh?⁴
So, here I am, trying to protect you and your teeth from the chaos of sugar. It’s dreadful for you. You probably know that. I am working on putting together lots of online videos, articles, and graphics to help you in practical ways to remove excess sugar (and other damaging health challenges) from your life so you can be the best you that you can be. I want you to be able to let your hero potential loose on the world. I’m excited to see what you might create when unnecessary medical problems don’t burden you. That’s what this kookaroo dentist man is up to.
³ Yes, I meant to spell “explodes” as “esplodes.” It’s more fun that way. Just pronounce it both ways, and you tell me which one is more fun. That’s what I thought. You’re welcome.
⁴ What, does this joker think he’s Canadian or something now?
⁵ To find out what Leo is doing and why, read chapter 2 of this book. After reading chapter 2, pay close attention to what is said on page 13–14, page 171, and page 292. After that, you could also watch the 2017 film First Reformed⁶ for more context.
⁶ I mentioned that I gravitate toward indie flicks. A24 studios distributed First Reformed. You should really check out the films being produced/distributed by A24. They are doing the work, and it is lovely. Lots of their work is even available to the public if you have a library card via using Kanopy.
⁷ This is my public bid to be voted “Most Unpopular Kid to Ever Run for High School Class President.” I imagine the scenario playing out as follows: “That jackass wants to make ice cream free? Yeah right! How about this? We melt all the ice cream that has ever existed and dump it in the ocean. Sounds pretty good, huh? Am I popular and well-liked yet? What do you mean I’m expelled? The teachers have voted to expel me? Is that even legal? Who cares if teachers like ice cream too; they’re setting a bad example. Hey, wait a minute, hold up. You can’t just burn me at the stake in front of the school! I have rights! I’m a person! Mrs. Gilbert? Why are you carrying matches, Mrs. Gilbert? Your history class was my favorite. I worked for hours all weekend on that diorama depicting the Siege of Vicksburg. You said you loved that diorama. I was the diorama boy, Mrs. Gilbert. Don’t you remember? Ow, it burns Mrs. Gilbert! It burns! I just wanted to save you all from ice cream addiction. Was that so wrong? This hurts so much. I can’t even describe to you all how much it hurts to have your legs be on fire. This is the most awful pain I’ve ever felt. Ouch. Ouchy ouchy. It hurts so bad. I could say ‘ouchy’ 1,000 times and that wouldn’t capture how much it hurts. How did that monk in Vietnam do this voluntarily? That’s wild to me. Ya know, what, screw it. If I’m gonna die, I may as well enjoy myself. Does anyone have any ice cream? Please? Black raspberry chip is my favorite. Just put a little bit on my tongue so that I may have an ounce of pleasure as my conscious being disintegrates into nothingness. I’m begging you all. Have mercy! Just a tiny dip of black raspberry chip! It doesn’t matter anymore. I’ll be dead soon. I only need my teeth for a couple more minutes. It takes much longer than that to develop cavities. I’m very low risk for tooth cavities right now. I just want some bloody ice cream before my life force is so brutally extinguished. Gee, I just realized how funny it is to say the word ‘extinguished’ when half your body is literally on fire. That’s really silly. If I wasn’t neurologically screaming with agony right now, I think I might even be able to laugh a little. I feel like laughing. I want you all to know that. That’s probably not the worst way to die, feeling the slight urge to chuckle, eh? ‘Extinguished.’ I crack myself up sometimes.”
⁸ Here is that oath in full:
“As a member of the dental profession, I shall keep this pledge and these stipulations.
I understand and accept that my primary responsibility is to my patients, and I shall dedicate myself to render, to the best of my ability, the highest standard of oral health care and to maintain a relationship of respect and confidence.
Therefore, let all come to me safe in the knowledge that their total health and well-being are my first considerations.
I shall accept the responsibility that, as a professional, my competence rests on continuing the attainment of knowledge and skill in the arts and sciences of dentistry.
I acknowledge my obligation to support and sustain the honor and integrity of the profession and to conduct myself in all endeavors such that I shall merit the respect of my patients, colleagues, and my community.
I further commit myself to the betterment of my community for the benefit of all of society. I shall faithfully observe the principles of ethics and code of professional conduct set forth by the profession.
All this I pledge with pride in my commitment to the profession and the public it serves.”
I’m sorry I said the word “ass” earlier. That was perhaps unbecoming of a learned professional. But also, c’mon man, I’m only human over here.
⁹ Obviously, pills and surgery can be useful for some patients in some circumstances. But knowing what I know about what is going on in dentistry, these “solutions” are not working. They are the wrong prescription for what ails us. They are not sustainable. I am not a physician, but I also am not ignorant of the wider structural problems in health care and the incentive structures that emphasize procedures and medicines that can be sold over techniques such as behavior modification through patient education that our healthcare culture has historically treated with great disdain. It is a field that is underexplored in part because it is hard to convince a patient to pay you for a treatment that doesn’t involve you doing anything to or for them other than educating and coaching. Fair enough. It’s hard to change a culture so thoroughly ingrained. That culture isn’t all bad either. It does help people, but it’s not working well enough. We are falling far short much of the time. We need to adapt and change to meet modern challenges in the provision of healthcare. We cannot stubbornly cling to only the old methods when they are demonstrable failures for so many patients.
¹⁰ For those of you who think I am being too critical of healthcare providers, please understand that I say all of this coming from a place of understanding that working in healthcare is insanely challenging and taxing. It has beat up my physical and mental health significantly, and I am a wickle little baby in this industry. I am not trying to overwhelm anyone with negativity, but I feel compelled to state my opinions strongly and forcefully. I do not have all the solutions. No one ever does. But I have ideas, and I think some of them are pretty good and worth trying out. I have total respect for people willing to continue slugging it out in the healthcare trenches. Still, I just cannot convince myself that our current strategies are appropriate or effective knowing what I know. There is genuine courage and value in your endurance. You are likely more impressive than I am in your ability to care for patients hands-on. We all have our roles to play.
¹¹܁Continuation of That World Health Organization Document, Public Health Strategies:
“Public health solutions for the prevention of dental caries and other oral diseases are most effective when integrated with the prevention and control of other [non-communicable diseases], based on the principles of addressing common risks and the wider shared determinants of health. Implementing policy measures to promote the reduction of free sugars intake is an effective way of addressing the burden and impact of dental caries globally.
Policy measures include:
- Taxation of sugar-sweetened beverages as well as foods with a high free sugars content — this is important in discouraging the consumption of these foods and beverages, which are contributing to increased free sugars intake, in particular in children and adolescents.
- Implementing clear nutrition labeling, including the information on sugars contained in a product;
- Regulating all forms of marketing and advertising of food and beverages high in free sugars to children through the use of a nutrient profile model that helps to identify products high in free sugars;
- Improving the food environment in public institutions, particularly schools, through regulating promotion and sales of foods and beverages high in free sugars; n removing all sugar-sweetened beverages for sale and service from hospitals, schools (including kindergartens and preschools), universities, public buildings and public workplaces; and n making it a priority to increase awareness and access to clean water as a drink that is ‘safe for teeth’.
Implementation of public health strategies to promote appropriate exposure to and use of fluoride should also be encouraged. Although exposure to fluoride reduces the development of dental caries and delays the onset of the cavitation process, it does not completely prevent dental caries if implemented as a sole (i.e. an isolated) action. Addressing the cause (i.e. free sugars) is therefore essential in preventing and reducing dental caries.”
¹² In case you’re unaware, Donald Glover made this song. And this one. Oh yea, and this album. He also created this show. Oh yea, and was part of the cast of this show. He’s one of the most prolific creative people working today. If somehow you’re not yet on the Donal Glover train, hop aboard. Choo, choo!
¹³ And if you think I’m exaggerating or being melodramatic, I get calls on a pretty regular basis from patients in extreme pain at random hours. I’m just one dentist in a big old world here. Lots of those patients have to wait long periods of time to get out of pain. Many of them end up at hospitals, which is a costly and inefficient way to take care of a dental infection. Even more expensive and inefficient than seeing a dentist instead of preventing the problem in the first place. This is no small issue. This affects countless people every day.