3. Why Your Gums Are Bleeding and What It's Really Telling You, with Dr. Caroline Labritz

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You've been told your whole life that bleeding gums mean you need to brush and floss more. Maybe you believed it for a while. Maybe you even started to accept it as just the way your mouth is. But what if bleeding gums are actually one of the earliest warning signs your whole body gives you, and most of us have been trained to look the other way?

In this conversation, Tosha sits down with Dr. Caroline Labritz, a biological and functional dentist with 22 years of experience, to talk about what is really happening beneath the gumline, why the dental industry has normalized something it never should have, and what a genuinely root-cause approach to oral health actually looks like in practice.

What You'll Learn in This Episode:

• Bleeding gums are not a flossing problem. They are a sign of infection, and that infection has the potential to affect your heart, your brain, your gut, and every system in your body.
• A biological dentist looks at the whole person, not just the mouth. Vitamin and mineral deficiencies, immune function, sleep, stress, and oral microbiome balance are all part of the diagnostic picture.
• The microscope changes everything. When you can see the actual bacteria living in a patient's mouth, the conversation shifts from "brush more" to "here is what we are treating and why."
• Dr. Labritz uses a three-prong approach to care: what happens in the office, what the patient does at home, and how the body responds. All three have to work together for real, lasting results.
• The dental industry is splitting into two models, and understanding which one you are sitting in matters more than most patients realize.

Key Insights:

There is a moment in this conversation where Dr. Labritz describes what it looks like to tell a patient that their bleeding gums are not normal, and it is worth sitting with. She references a professor who used to ask: if I touched your arm lightly and it started bleeding, would you be concerned? Of course you would. So why have we decided the mouth is different? That question alone is worth the listen.

Dr. Labritz also breaks down how oral pathogens do not stay in the mouth. The bad bacteria, the ones that thrive with no oxygen, living underneath the gum, are the same ones that course through the bloodstream and make their way into bone, brain tissue, and organs. She describes it like a party that slowly gets out of hand. You start with a couple of friends, then the moderate-risk guys show up, and before long the whole thing has become something nobody wanted. Getting healthy means picking off the bad bugs systematically and restoring balance, not just cleaning the teeth and sending the patient home.

Connect With Dr. Caroline Labritz:

sorrisodental.com

Connect With Tosha on IG: @toshardh  

Dental Professionals: tosh.care 

🦷 Ready to reset your oral health in 6 minutes? 

Start here: www.mouthymatters.com/start-here

Disclaimer: This podcast is for educational purposes only.  Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner.  Opinions from guests are their own.  This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Transcript

Why Gum Healing Takes Three Steps

SPEAKER_01 0:00

Hey everyone, it's Tasha. In today's episode with Dr. Carrie Labritz, we dive into the three-prong approach to healing bleeding gums and why it's not just about what your hygienist does during your dental visit. If you want an easy guide to healthier gums today, grab my six-minute guide to a healthier mouth. The link is in the show notes.

Meet Dr. Caroline Labritz

SPEAKER_01 0:21

Hello, everyone, and welcome to the Mouthy Matters podcast. Today we have the wonderful Dr. Caroline Labritz. Thank you for being here.

SPEAKER_00 0:31

Hi, so excited to be with you, Tasha.

SPEAKER_01 0:34

We are going to talk about so many incredible things. I am super thrilled to have you because you are beyond a wealth of knowledge. Being a dentist for 22 years, biological dentist, one of the first functional medicine-style dentists class. I can't wait to hear a little bit more about that as well.

What Biological Dentistry Really Means

SPEAKER_01 0:52

But what I really want to kick off talking about is what makes a biological dentist different than traditional dentistry. I know for me until not that many years ago, I really didn't even know what a biological dentist was or how to differentiate them because in the market, I guess you hear like holistic and natural and all these other words, but I wasn't really sure what they meant. So provide us with some clarity.

SPEAKER_00 1:17

It's a really hard thing to answer because there's such a big spectrum when we're talking about biological dentistry. And we can term that holistic or functional, however you want to talk about it. Most of us fall somewhere on that spectrum, but the gist of it is we don't just pay attention to the mouth. So when you come in, we're looking at the whole body, the whole person, understanding that the mouth is connected to the rest of the body and a lot of disease functions could be identified in the mouth. And so, in essence, it's like the highest standard of care that you can practice. And that is the key takeaway with it.

SPEAKER_01 1:57

I love that. So what was the shift in your dental career and you know, maybe pivoting out of school? And did you know right away that you wanted to practice in a more functional, health-centered way, or was there a certain patient that you thought, there's gotta be something more going on here? Like what helped you to make that overall shift or the the desire?

From Band Aids To Root Causes

SPEAKER_00 2:18

I I really think it's it's a lifetime of things. I grew up with my my father who was a dentist, and so I grew up in a long line of dentists in my family, and I was in his practice, you know, an old school dentistry. And then as time went on, whenever I first got out of dental school, I actually practiced in a DSO for about five years. And that's a different type of practice model. But at the core of who I am, I've always been a very like health-conscious, health-focused type of person. So as I started to get into dentistry and get my footing a little bit more on what I was doing and what was going on, it made a lot more sense to continually marry who I was as a person to how I was treating my patients and getting more into, you know, root cause, like why is this happening? It's just as it's just as frustrating for a dentist to see a patient come back year after year after year with disease processes and to watch those disease processes continue to unfold. So it's so frustrating for the patient and it's frustrating for the dentist. And so there becomes a point in time where we have to kind of turn that mirror around and say, what can we do better? I always wanted to put my head on a pillow at nighttime and feel like I've done everything the best that I possibly could. So that was really the beginning of the process for me. And it's just unfolded over decades.

SPEAKER_01 3:47

I love that. I love that. It's it's such an evolution. It definitely has been for me too. I know early in my career, friends and family would come to see me as a dental hygienist. And I remember a couple of them had cavities all the time. And I remember saying to several of them, like, I don't know, some people just get a lot of cavities. I know you do a great job. And it was just every couple of times they would come in, like it would, they'd be good for a year and then a couple more cavities, good for a year and then a couple more cavities. And it was this constant process. And I knew these people, like they were my friends and family. So I knew they didn't have poor diets. I knew they were doing a really great job with their hygiene. I had no idea where else to look. And truly, until more, a lot more recently in my journey on this, I realized there is something else going on here.

Why Cavities Keep Coming Back

SPEAKER_01 4:34

And because I opened that word that rabbit hole just now, how would you approach a patient that came in? Maybe they're a new patient to your practice, and they come in and they go, Dr. Labritz, I just heard that you did things differently. I have been getting cavities for as long as I can remember. And I'm just so tired of the constant fillings, and I'm really worried about my teeth in the long run. Like, what would you do for them? How would you start?

SPEAKER_00 4:57

That's a loaded question because there's so many different ways to start. I mean, clearly we're always going to look at oral microbiome. We're going to look at the overgrowth of different bacteria in the mouth, but we have to start with the whole person and it becomes really the study of one. What is happening with that person? You know, I can control about a third of this process, and the other two-thirds of the process is the patient. So when I'm sitting down with a patient that's frustrated with the profession of, you know, the dental profession, and they're they're frustrated with us because every time they see us, there's a problem, there's a problem, there's a problem, and we're not helping them fix the problem. So I want to dive deeper into, you know, what are you doing? What are the products that you're using? What are you eating? How is your body reacting? What are the vitamins, mineral deficiencies? So I could go on and on, but it really comes down to your mouth and your body, and even your soul and the person and the human that you are, and how motivated are you to do some of the things that we might ask you to do? And then reality, like the reality of what is this going to look like long term. I remember back in my early days as a dentist when I was with this DSO, and we would always try to find out the core values of a patient. So they would have this long questionnaire and they would fill it out, and then you would be like, oh, this person wants to be this, or they like this. And I learned early on that I am more of like a longevity type of dentist, health span type of dentist. I want long-term stable mouths. So not necessarily like, I want it to be beautiful, but I wouldn't call myself a cosmetic dentist where I'm like, oh, let's, let's, let's do the Hollywood smile. No, for me, it's form and function and longevity. I had three grandparents live to very advanced ages, and I was able to help them understand that through a lifetime. But then kind of reversing that back, whenever my I had my kids, when you say really what got me into this, both of my kids had a hypoplastic enamel.

SPEAKER_01 7:11

So it was like one of my first What exactly is hypoplastic enamel in case somebody doesn't necessarily know that term.

SPEAKER_00 7:18

This is um, well, you can go down a rabbit hole on the internet with that. Some people, some people will say it's fluorosis, some people will say vitamin mineral deficiencies. Basically, what it is is the enamel on that tooth did not form properly for one way or another. And we used to say, oh, if something happened to development, the mom had a high fever, or you had a high fever at the time those teeth were forming. And some of this never resonated with me. I was like, well, I can't understand. Why is it this tooth and not this tooth? And they both formed at the same time. I couldn't comprehend it from a really high level, and I could not find the answers. I had to search and search and search and search and search for the answers. And I can tell you almost two decades later, in my heart of heart, what I truly believe is that we're we're dealing with some major vitamin and mineral deficiencies in the mother and in the child and growth and development, which causes big issues. And that typically comes from, you know, standard American diet and potentially, yeah, too much fluoride exposure. So all of these things kind of come together. And so when that, and I'm sorry, I know I went off on a little bit of a tangent there, but that was great. Yeah, the whole, the whole point of the story is it's, you know, when you're dealing with a patient when they come in, there, there are just, you know, for me as a dentist, there were so many things that got me to this point. And so I want to start kind of digging into all of the things in that patient's history from the very, very beginning to try to get them all the way to the very, very end and still have all of their teeth in their mouth. So that sums it up.

SPEAKER_01 8:58

I love that. To me, it just resonates so much with like that functional medicine approach. I mean, I think it, you know, the largest growing section of the Cleveland Clinic is that functional medicine approach, like the why behind why all this is happening. There's not one single band-aid to fix any given problem. There's all these underlying health issues. There's, like you're saying, vitamin and mineral deficiencies, a diet that maybe on the surface looks healthy, but when you really look deeper into it, we're just feeding the unhealthy bacteria that are causing these cavities more and more. Cavities take so many years to form. So we have all these weak spots. You know, some people have all these weak spots on their teeth, and then they maybe didn't change anything, but they also didn't get remineralized either. So it's like maybe some poor habits in college kind of kept on, kept on. There's so much to it. There's so much to it. It's it's a rabbit hole, which is why filling, drilling, fill doesn't keep somebody from cavities, is what I'm hearing.

SPEAKER_00 9:55

Yeah, yeah. I mean, that's exactly what it is. I mean, it's the same thing as you have the mother that just had some babies and she comes in and she says, Oh, the baby stole the calcium from me and my teeth started falling apart. And I feel like when I was a young dentist and when I was in school, we were kind of taught to be like, you're lying. You're ha ha ha, you weren't brushing your teeth. And now I'm thinking about it more, and I'm like, yeah. Your diet probably was not on point. Your hormonal shift was all over the place. And anybody who's ever had a child will tell you, or a newborn baby will tell you, like, the last thing on your mind is taking care of yourself to this level. So you're like your sleep and your nutrition and everything, everything gets out of whack. So it does make sense that the oral microbiome would get out of whack too. And that could lead you susceptible to disease and disease processes.

SPEAKER_01 10:47

Yeah, totally. Yeah.

Bleeding Gums Should Raise Questions

SPEAKER_01 10:49

Let's switch gears to bleeding gums. So if a patient came into your practice and they said they saw one of your hygiene team and they knew that they've had bleeding gums for years and they've been getting their teeth cleaned religiously every six months. This is not somebody that misses. And they've just always been told that your gums bleed and that they should probably brush and floss more. And the patient's kind of frustrated because they're like, yeah, I do all the things. My mom had bleeding gums, my dad had bleeding gums. Like, my gums have always bled. What would you do potentially different? Or what would your hygiene team do different to investigate why has this person had bleeding gums forever? I mean, I personally have had patients, you know, in their early 20s that have told me that their gums have bled for as long as I can imagine, that they can remember. And I'm thinking, you're in your 20s. You haven't lived that long yet to have that much bleeding. So what do you guys do in your practice?

SPEAKER_00 11:40

Well, I mean, you have to set the tone first. You have to get them to understand that that's not normal. So I look back when I was in dental school, I had this really great professor. And he used to say, if I reached out and touched your arm very lightly and it started bleeding, would you be concerned? And the answer is, of course you would be. Could you imagine touching your head or your hand and it all of a sudden started bleeding? Wouldn't you be like, what is going on? But for some reason, we've completely normalized this bleeding in the mouth. Like it's like no big deal. So the first thing is, is I try to remove that thought process and let them know that this isn't normal and we need to dive deeper.

Using Microscopy To Spot Infection

SPEAKER_00 12:28

So in walks the microscope and the salaberry diagnostic testing because we want to know what kind of underlying infection we're dealing with. So we'll take a sample of the plaque or we call it biofilm in their mouth, and we make a slide and we put it under a microscope and we check it out. And we want to see what kind of bacteria that they're looking at, which will give us an idea and a glimpse into their whole body health and, you know, indicate signs of infection that need to be treated.

SPEAKER_01 12:59

I love it. So when you look at the microscope, you're seeing different shapes, and those shapes let you know good guy, not so good guy. Correct. Yes. The one thing that I feel like is was such an eye-opener for me as a dental hygienist is when I started using the microscope. I guess I actually was normalized to bleeding a bit myself as a dental hygienist because so many of my patients bled. And I'm not talking like crazy bleeding. It wasn't like this profuse hemorrhage, but there was that quote unquote a little bit of bleeding. You know, Tasha had a little bit of bleeding, George had a little bit of bleeding, upper right, lower left, whatever the location is. But then once, you know, I would get into their entire mouth, I would see like generalized bleeding. And a lot of times I just thought, well, they haven't lost any jawbone yet. So from a coding standpoint and a medical standpoint of what I learned in school, I can't do a deep cleaning. I just have to do a really good, you know, you know, fla uh polish and scrape and floss and tell that patient you should have done a better job at home. But I know for me too, I thought very early in my career, within a couple of years, I thought, man, everybody bleeds. I guess they just do. That wasn't something I learned in school, but I guess anything that you experience that often just starts to feel normalized. And so I think from a healthcare professional too, I hate to admit it, but I thought it was kind of normal too, until I started learning more because I did know fundamentally like I knew down deep this can't be normal. Like, why would somebody's gums bleed so easily? And so getting that microscope showed me that a patient could have immaculate home care and still have an infection. Such an eye-opener.

SPEAKER_00 14:41

Such an eye-opener.

SPEAKER_01 14:43

So when you when you do see bleeding gums, and you mentioned earlier about this two-thirds and one-third. So if you're want to get somebody's gums healthy, let's say I'm in your chair and I have pretty good home care, as I should, but let's say I do have bleeding and you're like, hey, Tasha, I'm seeing some inflammation, and then you look at my microscope slide and you go, wow, you have some bacteria that should not be in a healthy mouth, and you want to get me healthy. So what is these one-thirds, two-thirds? What is that? Because I love I you love that.

SPEAKER_00 15:17

So, so this is really where is a um biological, holistic functional medicine, functional dental really kind of kicks in because we're not just looking at, oh my goodness, they have bleeding

The Three Prongs For Gum Health

SPEAKER_00 15:32

gum. So I I I use a three-prong approach, right? And the three-prong approach is what do we do in the office? What do you do at home? And how does your body react? So the first step is what do we do in the office? What is happening in there? You know, all of the things from gathering the information, understanding the patients, doing the diagnostics, looking at the microscope slide, all of the things that you would have, right? The x-rays, blah, blah, blah. We're looking at that and we're coming up with you have bleeding gums, we need to do some treatment. But this goes back to the very first question of the patient that comes into the office that is frustrated because they've had it forever and nothing has changed. We get into the second prong, which is what do you do at home? And this is where we get into the correct way to clean your mouth, the good quality products to clean your mouth, and then anything that we need to add. Like sometimes we add gum, sometimes we add certain rinses, sometimes we add pro and prebiotics and different supports, all depending on how the patient presents. I like to call this the study of one. This is the specific patient in the office, and we have to meet their needs where they are. So, for instance, one of my kids goes away to school. So when your kid goes away to school or they're living in an apartment situation or a dorm situation, you got to find ways around certain things that you are recommending. When you have a more elderly patient that doesn't have the dexterity, we have to find ways around it. So, in this approach, this is where we dial into the specific patient and try to help them where they're at, come up with solutions to how are we gonna keep this going for a long term? And then there's how does the body react? Remember, I talked about the vitamins and minerals earlier? We know that quality of saliva is extremely important. We know that vitamin D levels are extremely important, vitamin C, good immune support. Now, I mean, all of those things are just really basic for keeping a patient healthy and immune support. But what about the underlying disease processes? What's happening there? What about the medications that the patient's taking that maybe have a bad side effect to them, like dry mouth or make them so drowsy at nighttime they struggle to brush their teeth? So there's all of these pieces of the puzzle that you have to bring and put together in order to formulate how to treat that individual patient that's in your chair to get them to long-term health and stability.

SPEAKER_01 18:15

I love that. I love that. So it's really about finding out why that patient is bleeding in the first place, what specifically are the causative components. And then based on those findings, it's an individualized treatment because I'm an individualized person. So based on what I'm doing now at home, those maybe need some tweaks and modifications. And then you're taking a deeper look into my medical history and asking me lots of great questions to understand why this infection started in the first place.

SPEAKER_00 18:44

Yeah.

Oral Bacteria And Whole Body Risk

SPEAKER_00 18:45

Yeah. And what we yeah, what we and what we know about the the oral microbiome is when we have a dysbiosis or an imbalance of the oral microbiome, your risk factors for disease processes go up, right? So let's just say I have a patient that comes in and they have um, you know, let's just say very minor, right? Family history of diabetes or family history of heart disease, but they haven't presented yet. And I see that their bugs in their mouth are showing that they've got some higher risks. And that's where like my concern starts coming in. And I start looking at them and I start saying, hey, we need to get in here and we need to treat this because what you do today affects you 10 years, 20 years, 30 years, 40 years down the road. Having a healthy mouth, whatever stage in your life that you're at, will actually help decrease all of these risk factors moving forward and help get these disease processes under control. So, in my opinion, is often the very, very, very first signs of sickness and illness in people and what is their future going to be like and how are they gonna present in the future? And then also we we can help get these disease processes better under control by getting the mouth better under control. So it goes both ways. It's really important. Um you know, this is where we're a little archaic in our our structure, where medicine is not quite on board and understanding, and all dentists aren't there either. So it's it's really maddening. You I believe it was back in the 1800s where you kind of have this like split where they said, okay, we're gonna do medicine degree and we're gonna do dental degree. And in dentistry, I feel like we we got a pretty decent education about like the full body, we really were understanding it, and then we, you know, go head and neck, but for some reason in medicine was I don't even think that they understand or grasp, but I feel like we're starting to wake up. And if you pay attention, you'll start to see, you know, the Institute of Functional Medicine is fantastic, integrated medicine is fantastic. They're really starting to understand how important it is. And my last little tangent that gets me every time are my heart patients that come in. This has been studied for decades upon decades that a healthy mouth is important for a healthy heart. I am blown away that part of, you know, a cardiac rehab or part of somebody that goes in and they show signs of just high blood pressure, that their doctors are not saying, go and see your dentist. Yeah. But I also think that the dentists are not doing their jobs either to the level that they need to be.

SPEAKER_01 21:45

It's a disconnect. It this that that really reminds me. I remember, gosh, this was probably over a decade ago. I there was a day that I had two 72 year old women in my chair. And it occurred to me much like one was in the morning and one was in the afternoon. And The first one, we'll call her Sue. She walks in spry as the day is long. I mean, she has a really great, clear medical history. I mean, she has a lot of porcelain in her mouth, a lot of restorative, but overall she's stable. Her gum health is stable, looks good, a bit of a grumpy woman, but man, her she looked great, like very cognitive aware, just walked like much younger than a 72-year-old and just in great shape. And I remember thinking, like, man, you know, because I'm every time I, you know, see just like these older, vibrant women, I'm like, yes, that's what I want to be. That's what I want. And then later on in the afternoon, we had another woman that would never come in on a regular basis. She came in a lot for emergency dentistry. So this is a woman, we'll call her Sandy. So Sandy like walks in with a walker, can barely move. Sandy's mouth has maybe half of her teeth, multiple teeth with large decay, large decay. Gum tissue that's so swollen and bleedy. Like you can smell her her breath from walking in the room. She's in and out of the hospital constantly. She's had multiple heart attacks. She's had a stroke. I mean, her health history is a wreck. She's on tons and tons of medications and she reports a lifelong history of terrible oral health. And I remember later on that, like when I was going over her medical history with her, which took quite some time, I remember just seeing her age and thinking to myself, whoa, the contrast for me that day was so real because I had seen both of these women, they both, you know, grew up in the same area. I mean, they were, they were, they had very similar, like upstarting, but the mouth was completely different. And I thought, yeah, your mouth is killing you.

SPEAKER_00 23:42

If I could pick a decade of life where I start to see it pull apart, it would be the flies for me. It would be the flies. So in where where you really start to see the divergence in that. Because I've always said what you do in your 20s will catch up with you in your 40s, and your 40s will catch up with you in your 60s. So what you're describing is likely somebody that didn't get intervention at an earlier age and just continue down this one path. And what we're trying to do is to get them to go to this path. Yes, a good story.

SPEAKER_01 24:17

So do you feel like this? I mean, this conversation really makes me feel like do you feel like when you graduated as a dentist 22 years ago, do you feel like you were equipped to really understand even what periodontal disease was and how to treat it properly, like just right out of school?

SPEAKER_00 24:32

So we're gonna open a bit of a can of worms because actually, yes, I think I was fantastically prepared. The school that I went to was great. I went to West Virginia University. The period department was great. Kudos to the teachers that taught me that. I don't know if it was that I had a member of my family that had severe periodontal disease at the time that I was in dental school that really allowed me to kind of dive into that. Or if I just thought that it was a really interesting field. I'm not, I'm not sure how, but regardless, the education came to me when I was in school. So when I got out of school, you better believe that I knew exactly how to treat, how to code, what to do, all of the things. What I noticed over the years, because this is where this conversation is gonna go, and this is what happens to my patients. Sometimes I'll have a patient that walks into my office and sits in my chair, and let's just say it's a 40-year-old woman, and I say, okay, we're gonna take a sample of your oral microbiome. I'm gonna look at it under a microscope, we're gonna look at the bugs in your mouth, and this is gonna give me an idea if there's signs of infection. The second thing I'm gonna do is take some x-rays, we're gonna look at the bone level around your mouth, and that's also gonna indicate if it's been a long-standing infection, if there's something going on. And then we're gonna do something called a periodontal evaluation and charting, where we're gonna check the pockets

Periodontal Exams And The Insurance Squeeze

SPEAKER_00 25:59

around your teeth, and we're gonna take six measurements around your teeth. Anything that's a one, two, or three is within normal limits, and anything that's above a three could indicate signs of disease or infection. If you've noticed that you have bleeding gums, and sometimes I'll look in the mouth and say, I do see some inflammation, this could be a little uncomfortable in those specific areas. And I ask patients, do you recall having this done in the past? And I am blown away with the people that have been to a dentist for years and years and years and years and years and have not had a periodontal evaluation. What has happened to our industry? I had to pass my board exams, clinical board exams. I had to know how to do this 22 years ago. I had to know how to diagnose and treat periodontal disease, which included which not the microscope, right? But it did include the the x-rays and the periodontal evaluation with the um probings. Shocked at patients that tell me that they don't have that done. And standard of care is that you started at the age of 18. So did I have the education? Yes, 100%. Did I know, have I always known how to treat periodontal disease, gum disease? 100%. I have always I've known how to do that since the minute I walked out of school because I paid attention and I remembered what I was taught in school and I took that into private practice. The problem, because I know you're gonna say, well, what happens, right? What's the problem? Where is the disconnect? Because where's the disconnect? Yeah. And that is a really loaded question. So and I think that we have to talk about the elephant in the room, which would be insurance companies, reimbursements um, and that feel as if they're overworked and are are demanding and wanting higher pay. I think the hygienists deserve to be paid. I think that what they do is amazing, but we need them to do that level. And sometimes when you're a practice and your only reimbursement is an insurance company, which doesn't pay for the cost of the hygienist, the only way around that is to stack patients on top of each other. The turn and burn method, turn and burn. So essentially, when you're in that cycle and you're a patient, you're going to a practice like that, and you're seeing a hygienist and it's in and out, in and out, in and out, and there is no time for correct diagnosis. There is no time to look at that. And so you start developing a culture in your practice of there's bleeding, there's bleeding, there's bleeding, but you don't have the 10 or 15 minutes to sit with a patient. And that takes to have a practice, you have to have a doctor and a hygiene team that come together, that they co-diagnose, that they work together as a team to take care of the patients. So let me tell you this: about a decade ago, I remember thinking, and this was before COVID, right? Right before COVID, I remember starting to see the breakdown of medicine, starting to see what was happening. Big hospitals were overtaking medicine and thinking, you know, this is gonna take over, this is gonna happen in dentistry, and starting to see the reimbursements or how insurance companies were paying doctors and seeing how we're burned out and how people, you know, you're having to do more and more dentistry faster and faster and faster just to pay the bills. And I and I was like, okay, we're gonna split. What's gonna happen in dentistry is a split. And I believe that this is what we're seeing. And I think for the consumer or the patient that's out there that's listening to this, it's really important that they understand this because it's a choice and they make the choice. I think we're gonna turn more into a public health aspect where we're gonna turn more into the type of dental practice that's gonna exist, that's gonna be, you know, get me in, get me in, get me in, whatever my insurance pays. That's all I want over and over and over again. Not really focused on the disease process or what's going on. And then you're gonna have your other dental practice over here that's gonna be more focused on taking time with patients, spending more time with patients, really diagnosing root causes of things that are going on. And for the specific type of patient that's looking for that, these practices are out there and they're developing more and more. And we're starting to see the split more and more like this. Yeah.

Diagnosis And Education Beat Quick Cleanings

SPEAKER_01 30:44

Yeah. I think that's such an important uh, you know, note because as I was listening to how you diagnose and the time you take with that three-prong approach, it takes a lot of time. And I know I've spoken to so many hygienists that their expectation of when the patient comes in to get their teeth cleaned is they feel like that's the most important job is to clean that patient's teeth. And I say, well, no, the most important thing for you to do is to evaluate them to see if there's any potential concerns that could cause them harm now or in the future, like that diagnostic piece of really evaluating them. And yes, a cleaning's important. We all want to have nice, smooth feeling teeth. But I mean, if you're going in to get your teeth cleaned two or four times a year, there's 365 days in a year. So if we're not educating that patient what they need to do most of the year, we're not really getting them healthy. We're not preventing heart attacks and strokes, we're not preventing diabetes, we're not saving their life. And I think that that, like for me, is just such a huge disconnect because the general public does not know that how linked their oral health is to the rest of their body, in a large part because it almost never hurts. I mean, until even a cavity is a giant and probably needs a root canal or potentially a loss of a tooth. I mean, until that tooth's about needs to be gone, like it doesn't hurt. And so for me, I think, well, that just seems like natural, you know, evolution. If you don't eat, you're you're dead. So it's one of those things that's like, well, of course your mouth doesn't hurt. It shouldn't hurt. But a lot of things that don't hurt us, like high blood pressure, like sleep apnea, they kill us. And it's it's the human body. I mean, we're so darn resilient until we're just not.

SPEAKER_00 32:29

Yeah, I always my response to it doesn't hurt is that's good. Because when it does hurt, we're in trouble. So we're we're at a good point. If we're not hurting, typically we can treat. If we're hurting, then we start getting into some irreversible damage and we have to come up with different game plans.

SPEAKER_01 32:51

Yeah.

Bad Bugs Spread And How To Prevent

SPEAKER_00 32:52

Yeah.

SPEAKER_01 32:52

What what do you wish all of your patients knew the most when it comes to oral health? So, like your patients that step into your doors, what information do you wish they were armed with from the moment they walk in in terms of importance of oral health?

SPEAKER_00 33:06

I I think that that is a great question. What do I think that I wish that they knew? I wish that they understood that the mouth is made up of bacteria and pathogens, and it could be viruses and fungi and all of those things. And hundreds and hundreds and hundreds of these. I wish that they understood that what's in the mouth is also in the gut, in the blood system, and touching every single part of the body. So when this is imbalanced, in essence, you're touching everything, your brain, your heart, your GI tract, I mean, on and on, every single part of your body is affected by the bad bacteria that can reside in your mouth. And I think like let's define bad bacteria because this is where they're like, what does that mean? And this is just a really easy way of describing it. Like when we just describe, you know, a high-risk type of bacteria or pathogen in the mouth. I say it thrives on no oxygen. So that is not at all what we want. That means it's living underneath the gum, thriving on no oxygen, coursing through your blood system, putting itself into, you know, into the bone, into the brain, into all different areas of the body. And I say they say, you know, how does that happen? What happens? And so I like to explain it like a campout, right? Or or like a party, you know, you've got two friends that are hanging out in the party, and they're hanging out, and that might be kind of the good bacteria, and they're really in, they're really just jiving with each other. But then they say, hey, well, like, let's invite some of our friends. And you get some of the other friends that come in, and these are some of the like not good guys, but they're not terrible, they're not good guys. We call that kind of moderate risk bacteria. And then they want to turn it into a rager. So then the bad guys start coming in, and these are the people that you don't want. These are the ones that the police are gonna get called on, and the bad guys come in, and now we've got a big, big problem. And in order to break it up, you got to start picking them off. You got to pick off the bad bugs, you gotta pick off the moderate, and then we got to get back to balance. So that's kind of how I I describe it a little bit to patients. I have lots of different ways of describing things that I love it.

SPEAKER_01 35:33

Yeah, it's well, and I think it's it's one of those things too that I don't I don't think a lot of people know that if that bacteria, those really unhealthy dudes, are in your mouth, they're not just in your mouth. They're everywhere, they're all over the body. Feel them or not, they're still there. And we want an overabundance of good guys, not an overabundance of bad guys.

SPEAKER_00 35:54

And we should share this too. They're not just in your mouth, you can share them, right? So contagious. So, so contagious within a whole family. Uh, you know, it's always it, it's the partners. I always say anybody you're you're swapping, sharing saliva with, and then whether that be a dog kissing your face. Yep, yep. The dog, dogs. Well, you know, and then also dogs or cats, like you're playing with um their toys. And sometimes we don't even think about this. Like you don't think about I'm picking up that ball and I'm throwing that ball, and then the dog is grabbing the ball and bringing it back to me, and then I'm picking up the ball again, or I'm tugging on a toy, and it's all, yeah. So it's it's everything. There's different ways to be contaminated in lots of different ways. But the key is is when we're looking at that three-prong approach, because I don't want to scare people, right? So we're looking at that three-prong approach and we're like, okay, how did how do we prevent that from happening? Well, we have to have a good immune system, and we have to have really good home hygiene. So those two thirds of the process are so, so important because with a good immune system and good home hygiene, you could actually prevent that from happening. So I don't wanna, I don't want to make anybody freak out that has an animal and they're playing with their animal or kissing their spouse. But at the same time, you know, there are things that we want to be cognizant of and you know, make sure that we're we we're aware and we know what's happening.

SPEAKER_01 37:25

I mean, knowledge is power. And like you said, I mean, the the three the three-prong approach, two-thirds of that is in our hands. I mean, we don't even need the dental practice for that. Like we need to be doing that every single day. We need to be paying attention to are you getting enough sleep? How stressed out are you? Doing all the things that we all know we should the all the shoulds that we should all do, but it really pays off so exponentially as we get older.

unknown 37:50

Yeah.

SPEAKER_01 37:50

I absolutely love it. Dr. Liberts, I could talk to you all day long and geek out because I just love these conversations, but I definitely want you to come back because as we were talking, there were so many avenues. I was like, we didn't talk about fertility. There were so many pieces that we're gonna have to talk about another time. Yeah, yeah, absolutely. Do you have any final uh closing thoughts that you would like to share with our listeners?

Final Encouragement And Local Resources

SPEAKER_00 38:15

I think it's just important that they're aware, that they're aware of what's going on. I think the all you have to do is start. When sometimes I have patients that come in and they have a lot going on in their mouth and they come with, you know, fear and anxiety and embarrassment. And I just look at them and I'm like, no, no, no, no, no. This is what we do. You walk through the door, and all you have to do is walk through the door every single time, and we will guide you and we will coach you. And there's coaching every single step of the way. And I truly believe that the profession, that is what we're doing. We want to help people, and we want to help people over and over and over again. And if people were just aware, aware of the problems that could exist, that bleeding gums are not normal, and that is an indication that something is wrong, and they start asking those questions, we can help save their lives. I love it.

SPEAKER_01 39:13

Well, if you all would like to see Dr. Carrie Labritz as your dentist and you're near Morgantown, West Virginia, you need to check out Riso Dental because they are absolutely fabulous. If I was in your town, you would my dental practice for sure. Uh, thank you so much for your time. I greatly appreciate it, and we'll see you next time.