Live chat transcript: Dentist Larry Kuhl on having a healthy Halloween

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photoDr. Larry Kuhl, senior dental consultant at Delta Dental/Washington Dental Service.

For oral health month on Live Well Dr. Larry Kuhl of Delta Dental/Washington Dental Service joined us for a live chat about oral health and dental services on Tuesday, Oct. 11 at noon. Below is the transcript of the conversation with some great tips on caring for your teeth during Halloween candy season.

Libby Tucker:

Welcome to our live chat with Dr. Larry Kuhl of Delta Dental/ Washington Dental Service. We'll get started in about 10 minutes.

Dr. Kuhl:

Hi - Dr. kuhl here - thanks for having me

Poll: What do you most hope to talk with Dr. Kuhl about today?

Halloween candy tips ( 33% )

Oral health and nutrition ( 33% )

Personal dental questions ( 33% )

Other (please tell us! ( 0% )

Libby Tucker :

Why should we care about our oral health at Halloween? Isn't it the one time of year that we're allowed to go sugar crazy?

Dr. Kuhl:

It certainly is a time for concentration on candy - but the concern about oral health is year-long. It just intensifies at this time of yr.

Libby Tucker:

How much damage can a candy splurge have on our overall oral health?

Dr. Kuhl:

It depends! How much for how long - and what types of candy (hard, sticky or melts quickly?)

Comment From Polly Hicks:

I have periodontal desease I had rpc last may...i have been told that I need rpc again ...of course insurance only pays for that every three yrs. so I will have to pay for this out of my own pocket...will this really help me or is there anything other procedure that can b done to save my teeth?

Dr. Kuhl:

RPC is a non-surgical treatment to help control the depth of periodontal pockets. It is primarily done to provide an enviornment that the patient can keep clean. If the pockets are too deep, then bacteria collect and the disease progresses. I would suggest that you talk to your dentist about various strategies to help

Comment From Polly Hicks:

wont u tell me what other procedures are available to treat PD ? rpc is the only treatment I have been offered

Comment From Polly Hicks

Since I just had rpc in May of this year I'm wondering how well it's going to work the second time and if i really need to throw $1800.00 dollars away

Dr. Kuhl:

There can be lots of individual factors involved. RPC is the primary treatment - but your age, severity of disease, ability to contol plaque, your resistance to specific kinds of bacteria, directly affect how much and how fast the disease may progress. This is complex and I would suggest you get a second opinion if you have additional concerns.

Comment From Polly Hicks

thank you

Comment From prairiewinters

Why do older people often have mothball breathe? Is it plaque or medications or a combination?

Dr. Kuhl:

It is a combination of many factors - to include: medications; diet; lack of sufficient saliva; lack of effective oral hygiene.

Libby Tucker:

How would somebody combat that mothball breath?

Comment From prairiewinters

I worked around Alzheimer patients and I noticed how many had that distintive mothball breathe.

Dr. Kuhl:

First - ensure that good oral hygiene habits are developed and maintained. Additionally, check with a dentist knowledgeable in this area and make sure that he/she knows what diet is being used and all medications taken - because some medications do directly contribute to the problem.

Comment From prairiewinters

my mother seems to have healthy teeth, flosses daily but still has that mothball breathe. Anything in her diet she could change?

Dr. Kuhl:

Do you know what her diet is? What and on what schedule?

Dr. Kuhl:

Does she wear dental appliances - or have lots of fillings?

Poll: What are you giving out to trick or treaters this year?

Candy, candy and more candy ( 40% )

Candy and a healthy alternative ( 20% )

No candy at my house ( 20% )

I'm not sure ( 20% )

Other (tell us in a comment) ( 0% )

Comment From curhanium

If I am okay with my child eating a piece of candy, at Halloween or other time, what's the best time of day to offer it?

Dr. Kuhl:

Time of day is not as important as how quickly the effect of the candy is stopped - such as brushing or at least swishing well with water. Ideally, the teeth cleaning would happen within 30 min of eating the candy (whenever that is)

Libby Tucker:

One of our Live Well advisory board members told me she hands out bottled water with her Halloween candy. I guess that's useful for keeping teeth clean while trick or treating!

Dr. Kuhl:

Absolutely - great idea

Comment From prairiewinters

Sorry, my phone rang. Yes she does have some dental appliance. Maybe that is part of the link with the Alzheimer's people also. I also heard that Simvastatin can cause some issues with breathe also.

Dr. Kuhl:

Dental applicances can help harbor bacteria and therefore contribute to an odor

Comment From curhanium

A family member has had quite a few teeth crack below the gumline. They wear a night guard and have no history of cavities. Why would this be happening?

Dr. Kuhl:

I do not know if Simvastatin, specifically, contributes to malodor or not?

Dr. Kuhl:

Cracked teeth can happen under many circumstances - our dental science is not very helpful in this area. Wearing a bite guard appliance is usually very helpful - but may need to be worn more than just at night (if a patient is grinding and putting a lot of pressure on teeth when stressed, the appliance would really help during those times). The cracks are usually a result of chronic abuse - not just one traumatic episode. So figuring out the specific life-style and at risk times would be useful to help prevent further problems

Libby Tucker:

What are some of the behaviors of chronic abuse? This can happen during the day, too?

Dr. Kuhl:

Sitting in bad traffic - having uncomfortable conversations - or just about anything that raises the stress level to the point a person grinds their teeth. A way to help manage this is to be aware of it and unclinch the jaw to keep the teeth apart

Poll: How do you find dental information when you need it?

Online ( 40% )

From my dentist ( 40% )

From friends or relatives ( 0% )

In the news ( 0% )

Nowhere, really ( 0% )

Other (tell us in the comments) ( 20% )

Comment From al_light23

I have a phobia of the dentist and am petrified of going. But I have some pain in my tooth when I eat sweet stuff sometimes and think it may be infected. Is there any chance this could need a root canal? I don't think I could take it!!

Dr. Kuhl:

Unfortunately, it does sound like the nerve of the tooth may be infected. When that happens, there are only two choices = have endodontic treatment (root canal) or extract the tooth. Many of us have had a bad experience with a dentist in the past that may prevent us from having good professional relationships in the future. But like have a bad experience in any area of life - it does not mean that the next one will be that way. The great majority of dentists are knowledgeable and caring people - I would encourage you to check around and find the right one. Leaving an infection (if that is what it is?) is not advisable.

Comment From curhanium

When should a child start brushing their teeth by themself? And how do you recommend teaching kids to brush?

Comment From al_light23

Thank you for your advice!

Dr. Kuhl:

I think it greatly depends on the child (and relationship with the parent/caregiver). Some children walk, talk, know their numbers, etc at a different time than other children - no different with the skills necessary to properly clean the teeth. All that to say that I think it is probably not possible for a child to regularily and effectively clean their teeth before the age of 10. I think that an involved parent/caregiver who works with the child - daily - encouraging them and checking things and helping them improve to the point they can "fly solo" is vitally important. It takes time and commentment - like all of learning how to do things

Comment From Jennifer Smith

So, my 8 year old son was recently diagnosed with TMJ! It was a sudden onset on Friday! Now they say eat only soft foods, and see if it is still painful in three days! What good will exactly come from that? Why could they not treat him right away?

Dr. Kuhl:

TMJ is a very complex set of circumstances - it is not just one diagnosis. It is higly unusual for a child that age to have a true diagnosis of TMJ. The soft foods is almost always recommended to reduce the pressure on the joint and the muscles that are involved. The treatment depends on the diagnosis - and it sounds to me like they are just starting with the most conservative treatment and then re-evaluating

Comment From Jennifer Smith

Thank you so very much!

Libby Tucker:

Alright, we're nearing the end of today's chat. If there are no more questions I'd like to thank Dr. Kuhl for sharing his time and expertise with us today!

Dr. Kuhl:

And thank you for inviting me to participate - I thouroughly enjoyed the exchange

Dr. Kuhl has more than 40 years of experience in the dental profession, including 25 years in the Navy Dental Corps—where he served as the commanding officer for two Naval dental centers—and four years on the White House Presidential Support Team, providing direct dental care to two U.S. presidents and their staffs. He has been a part-time affiliate instructor at the University of Washington Dental School for the last 10 years and is a Fellow in both the American College of Dentists and the International College of Dentists.