7. Fertility Problems, Arthritis Flare-Ups, and No Energy at 83: Three Patients Whose Answers Were in Their Gums, with Dr. Johnson

🦷 Ready to reset your oral health in 6 minutes? 

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What if the thing standing between your patient and her pregnancy was living under her gum line? 

What if the reason a woman in her mid-30s kept canceling plans, kept bracing for the next flare-up, kept shrinking her life down to what her body would allow, was a bacterial infection her dentist had never tested for?

Dr. Heather Johnson has been practicing dentistry in Grand Forks, North Dakota for nearly 18 years. She believes in prevention the way most of us believe in breathing. And when she started testing her patients for periodontal pathogens instead of just cleaning their teeth and hoping for the best, everything changed.

In this episode, Tosha and Dr. Johnson walk through three patient stories that are going to stay with you. A woman who had tried for over a decade to get pregnant. A woman in her mid-30s with rheumatoid arthritis who had stopped making plans because her flare-ups made everything unpredictable. And a woman in her early 80s who had been getting her teeth cleaned every single month and was still losing bone and running out of energy by midday.

Each of them had one thing in common. They were doing everything they had been told to do. Brushing, flossing, showing up. And none of it was enough, because none of it was addressing the infection that was quietly driving the inflammation.

This episode is for the patient who has a nagging sense that something is off and has never thought to ask about their gum health. It is for the practitioner who keeps watching patients do everything right on paper and still not heal. And it is for anyone who has ever been told their bloodwork looks fine while their body keeps telling them something different.

Dr. Johnson also walks through her three-tier clinical approach, what happens in the chair, what patients do at home, and how immune support fits into the picture. Tosha and Dr. Johnson close with practical guidance for patients whose practices are not yet offering microscopy or salivary testing, including the one question every patient should ask after their next cleaning.

If it is in the mouth, it is in the body. This episode shows you exactly what that means.

KEY TAKEAWAYS

1. Periodontal pathogens are a silent problem. Gums can look and feel healthy while harboring bacteria that are driving systemic inflammation. If you are not testing, you are guessing.
2. The fertility connection is real and it goes both ways. Research has linked three specific periodontal pathogens to poor pregnancy outcomes, and partners share the same bacteria through saliva. Both people in a couple need to be tested.
3. Treating gum infections can shift autoimmune symptoms. Dr. Johnson's patient with rheumatoid arthritis reduced her flare-ups so dramatically she ran a marathon and came off most of her medication after getting her gum infection under control.
4. A prophy and perio therapy are not the same thing. Getting your teeth cleaned every month is not the same as treating active gum disease. Understanding the difference is the first step toward recommending the right care.
5. The one question every patient should ask: did my gums bleed during today's appointment? If the answer is yes, brushing and flossing harder is not the solution.

Ready to go deeper on what you are actually seeing in your patients' mouths? Visit tosh.care to learn about Tosha's approach to Microscope Hygiene and the TOSH Method, or DM Tosha at @toshardh to start the conversation.

Connect with Dr. Heather Johnson: 

On IG: 📱 @1101dental 

Website: 🌐  1101dental.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

Healthy Smiles Homecare Instructions mentioned: 

www.tosh.care/download

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

Meet Dr. Heather Johnson

SPEAKER_01 0:00

Hello, everyone, and welcome. I am so excited for you all today because I am interviewing the amazing dentist, Dr. Heather Johnson from North Dakota, and she is a North Dakota native. And so Dr. Johnson has some incredible stories that she's going to share with us today about increased fertility, about getting off of some steroids, and also of an older woman that got so much energy after she got her gums healthy. So welcome, Dr. Johnson. Thank you for being here.

SPEAKER_00 0:30

Thank you so much, Sash. I'm so excited. This is gonna be great.

SPEAKER_01 0:34

Yes. So before we kind of get into it, can you just share with me a little bit about kind of your history as far as being a dentist and what got you so excited about the mouth-body connection? Because to be honest, I don't think most people are as nerdy as we are about it. But what really got you more interested in just really thinking about the mouth and the body and why there might be more to dentistry than just making sure that people's teeth don't hurt and look pretty?

SPEAKER_00 1:00

Well, I got into dentistry. I have been practicing for, what is it even? I want to say almost 18 years now. And I've just, I'm just, I love the preventative approach. Anything that we can do now to prevent a problem later, that's always been just a huge motivator for me in all aspects of my life. And so I think, and I and I love the per like the teaching aspect too. At one point I thought I was gonna be a teacher, and then I turned into a I pursued dentistry. And so I think that's the prevention part is what really drew me into what we can be doing to be as healthy as possible. And I guess as far as the mouth-body connection goes, um, I feel like a lot of people had, you know, even before going into dentistry, a lot of people kind of seem like they would know or have heard how the mouth and like the heart are connected, or they might have heard about how the mouth impacts the rest of the body. But I feel like when you start talking to patients or, you know, people in the you know, it's like they don't really know how it how it connects, but they they've maybe heard of it. I usually ask a patient, have you heard of the connection between mouth body or you know, mouth heart? And some people say, Yeah, but you know, no one really knows. I think there's kind of like this idea out there where as long as you go to the dentist, like you're doing what you gotta do. But when I really got into all of this, that is absolutely not true. If you're going to the dentist, you can still leave with periodontal pathogens and you have no clue because you know it's considered a silent problem, gingivitis, inflame gums, or gum disease, um, or just having these periodontal pathogens, you have no may have no clue. And so the more that I started learning about and then realizing, oh my gosh,

Why Clean Teeth Still Bleed

SPEAKER_00 2:55

this information has been out for 40 years, and I just don't think it is emphasized enough. People, oh my gosh. And then once once we started learning about, you know, testing for micropathogen testing, and so many people have gingivitis, they may not realize it because if you're just kind of doing your normal routine at home, you know, brushing, which most people seem to that's that's a common thing, is we brush some people floss, and so they might not realize they have gingivitis, but when they're told, and it it it's just it's just crazy. The more I learned, the more I couldn't stop learning. And when we started really trying to help heal these patients after the first diagnosis, people's lives just changed. I just think to clarify, I've just been really into the mouth-body connection because if we can figure it out now, how can we get our mouth as healthy as possible now to prevent outcomes later? And this applies to everyone. You know, ever you never know. If you don't test, you have no idea if you have these periodontal pathogens or not.

SPEAKER_01 4:00

In most practices across the United States, we're just guessing. I mean, we're just looking at clinical presentation, and we think if somebody's mouth looks quote unquote clean, then they must be healthy. And so many hygienists, we get in there and start cleaning, we barely touch that gum tissue and it starts to bleed. The patient didn't experience any of that at home. And then as a dental hygienist for me, I was taught, well, that that patient needs to brush and floss better. But then in my career, I had tons of patients who did a fabulous job keeping their teeth and mouth clean, but they still had bleeding. And I was like, Well, I didn't learn what I should do in school for those patients because that to me felt like the majority of my patients in my picture.

SPEAKER_00 4:45

I felt the same way. You know, if you saw the gums bleeding, you would almost say, Oh, you need to do a 45-degree angle, you know, brushing, use an electric brush, more. Absolutely, but it wouldn't always get better. It was like I felt always felt like there was something more, something missing.

SPEAKER_01 5:01

Absolutely. Was there a specific patient that you had that you can remember that you thought there's gotta be something else going on here?

SPEAKER_00 5:09

Yes, I remember her so vividly. She had it was almost it was inflamed around like her kind of the front area, and it would always bleed. It would always bleed. And then when she came back, it was it was like more areas in the region. And so then after time, you know, I then I we tested her eventually, and then sure enough, she had these periodontal pathogens living under the gum line. And yeah, and now she's doing great, but it was just like what, you know, like she's doing everything, she's flossing and she's brushing, she's using electric toothbrush, she she's doing the angle. And so once we started implementing more of like the gum health prevention and just really emphasizing to these patients, this is not a dirty tooth problem. Like your teeth are so clean. This is a gum health problem. And we can try to we can figure this out and reverse it.

SPEAKER_01 5:58

I love that. I love that. And just so some of our audience knows, what Dr. Johnson does in her practice in North Dakota is she uses a microscope similar to what's behind me. And so all she has to do, or one of her team members, is take a very small piece of plaque from her patient's mouth and she can put it under the microscope, and we can actually see based on shape if those are healthy bacteria that are helping our body stay healthy, or if they're unhealthy bacteria that are not keeping our body healthy and actually making us really sick and making our gums bleed. And those bacteria, because they actually live inside of our gum tissue, not just on top of it, patients can do a great job and they're not able to brush them away. And from there, we can do lab testing to find out even more. So there's so much technology that's changed in dental in dental health care that it really has changed the way that a lot of us can um help and treat our patients. The the other piece of this is that it's new science, and so a lot of practices are not yet utilizing this, but it certainly is becoming more and more mainstream. Next

Fertility And The Oral Microbiome

SPEAKER_01 7:01

question. I want to talk about fertility because there's so much science now that is showing that the bacteria that causes gum infections and bleeding gums, silent infections, can actually contribute to people not being able to get pregnant. Fertility issues, not just being able to get pregnant, but can actually lead to stillborns and other pregnancy complications. I know you have some stories that you were going to share with us about that. So I will I will let you take it away and share with me what you've seen in your practice.

SPEAKER_00 7:31

Yeah, well, that's so interesting because that this whole topic on fertility or poor pregnancy outcomes is what really got me passionate about all of this that we're talking about today, because it truly applied to me. I'm someone who practice tries to practice what I preach, brushing, flossing, electric toothbrush. I never miss a day, flossing, right technique, everything. My gums never bled, thought everything was doing it by the book. Then fast forward, and I'm starting to have start a family. And then down the road, I experienced we had a devastation. We had a stillborn. And I always kind of heard about, and at this point, I hadn't started periodontal pathogen testing. I didn't hadn't really gotten into that. But I just had always in the back of my mind, we had tried to think of every single scenario of like, how could have this happened? We we looked at all the outcomes, and in the end, after time had passed, I thought, I wonder, you know, and it was just all this, I don't even remember how it all got sequenced. But then before I know it, I started, you know, learning about it. And I was like, you know, I want to get a test. I want to see, because it's been known for several decades now that there's three of the 11 pathogens. Well, there's 11 pathogens you don't want harboring in your gums, but three of those research has shown are connected to pregnancy, poor pregnancy outcomes. And when I got my test result back, because I was like, oh, I'm not gonna have any of these pathogens, I don't have bleeding gums, I do everything. I had some of these periodontal pathogens and some some of the the pregnancy one, and it was at above threshold. And I was like, oh my gosh, like this is crazy. You know, how can this happen to me? I mean, this really can happen to anyone. I do not have periodontal disease. Thankfully, I was able to catch this before these pathogens had had, you know, caused all this destruction. And so from there, I felt so passionate. I just thought, oh my gosh, I wish someone would have offered this testing to me. I think so. I'm so passionate when I have really anyone in the chair. I have a young female. I always share, I just said, I am so glad that I'm crossing paths with you, especially if their gums are not healthy. I and I I explain, I don't know if pregnancy is something down the road that you're considering, but getting your gums as healthy as possible, pathogen-free, is gonna be so important for when if and when you do consider a family. And so that was my personal story that just lit the fire. And of course, it's not just fertility, um, concern how these periodal pathogens can affect a native negative outcome. Of course, there's more, and we're gonna get more into that later. And so, yes, so now as I see women, we we talk about that, and I've had many patients, but one woman in particular, her gums were she didn't even realize she had gingeritis, but you know, you start measuring the gums and start, you know, and the gums were really bleedy. We took a slide, a plaque sample. We saw all those shapes of bacteria that we know just aren't healthy for for a healthy outcome of like a healthy body. Um, and we did a microbe test, it came back, you know, all the pregnancy ones above threshold. And she left that appointment and she just said, You are giving me hope. She was in tears. She was she was just like, I have no I never knew this information. So I gave her different resources. And now that now that she knows about it, she's getting it reconfirmed, you know, because there's it's the information is out there. I just don't think it gets talked about enough. Yeah. And so now fast forward that we got our husband in because we know that bacteria, usually partners, share the same bacteria because it passes through saliva, so through a kiss, sharing a spoon, sharing a straw. And so we got partner in there, tested. Well, fast forward time and they were able to get pregnant. So, of course, you never know, but I think we really increased her odds. And she had tried for over a decade. And so anytime we see each other, she's just, I mean, we have a special connection.

SPEAKER_01 11:46

Absolutely. How could you not? I just love that. And I wish so many more people would know that it if if you're doing a great job keeping your teeth clean and you're not able to get pregnant, there might be a mouth connection. There might be bacteria that at some point you came in contact with. I mean, we all come in contact with all kinds of crazy stuff here and there. We don't necessarily know, but I don't, I mean, for me, it even as a high dental hygienist, after I got out of college, I truly thought that patients that had an infected mouth that had gingivitis or that had periodontal disease would look really bad, really fleedy, would look really inflamed, and would look like a quote unquote dirty mouth. And in practice, they don't. So many people's mouths and gums, they rate. And yet they can still harbor these bacteria. So if we're not testing, and you know, it's it's so important to get the husband and the wife and both partners, because even for getting pregnant, we know that with men now, it's 50-50 to try to get pregnant, right? And so if a man has those periodal pathogens, they can affect his ability to get his wife pregnant. And so it's it's so important. And even when you're pregnant, like, wouldn't it be so great to just know that your oral health is excellent before you get pregnant? Because as a woman, we know that pregnancy, we don't always feel very good. It's gonna be hard to keep our mouth really clean. And then when baby arrives, it's pretty busy. So it's not like we're gonna have more time in the bathroom to be getting ourselves shined up.

SPEAKER_00 13:12

Well, and just one thing to say on that, you know, having that spouse come in is so important. I remember a situation where when we had the spouse come in, his gums looked awesome. I did not see bleeding, and it was, and I kind of thought, well, like he's probably fine. But in the back of my mind, I'm like, test, don't guess. I was trained on that. Um, and then his report came back and I was like, oh my gosh, like he has them too. So it's like your immune some people have these rock star immune systems, and then other, you know, and it's just like wow, his immune system must just be really strong because his gums look at this moment healthy, but I'm so glad that we tested him because he would have just given it right back to her. So it's crazy. It's awesome.

SPEAKER_01 13:56

Love that so much, Dr. Johnson. Thank you so much for sharing that both of those stories. I mean, they're incredible, they're incredible. And this is our everyday patients. Okay, I want to um get to a couple more stories because the other ones are just just as incredible. I'm gonna jump to the patients that you shared with me about, I think it was over maybe over a year ago now. I don't know,

Rheumatoid Arthritis Improvement After Gum Care

SPEAKER_01 14:16

we've been friends for so long. And so you had a young woman that had been on steroids, she had a lot of rheumatoid arthritis flare-ups. Um, and when she came in, she had no idea. I think that she didn't think she would realize that she had gingivitis and she had all these medical items. But I'm gonna let you share her story and the success of really getting your gums healthy.

SPEAKER_00 14:37

Yeah, this, oh my gosh, I have so many stories that just this one holds a special place in my heart because she she was just in a couple weeks ago again, too. Um yeah, so she has rheumatoid arthritis and just she just lives in pain and she never knows when she's gonna have a really bad flare-up. So she's kind of she's not even that old. I want to say she's like mid-30s. And when I first met her, her gums weren't the healthiest. And again, she didn't really realize because I think no one really knows what normal is, and you know, even like the coloring of gums or if gums are puffy, it they kind of just think that's their normal. And so it's like we first we raise awareness, and um once I let her know that, you know, and then I show, you know, if we were seeing some bleeding or like the coloring, and long story short, we went through it all. And yes, she had gingivitis, her slide didn't look healthy. We tested, it showed the periodone pathogens. So we taught her, you know, the preventative strategies, how to reverse that gingivitis so that her reverse that bleeding, and she was so motivated. And I think she thought, oh my gosh, this is something that, you know, because I was talking telling her, you know, it's like a three-tier approach. Like what we do here is really important, but what you do at home is just as important. Then, of course, your immune system, like how fast you're gonna heal. We're gonna, we're gonna do what we can today to reboot everything, a good flesh out. And then we gave her the tools of what she could do. So, anyways, fast forward time. She started just her next appointments, her gums, just the next time her gums looked so much better, and then the next time so much better. One point along the line, we had our spouse come in, get tested. So now they're like they're both healing together. Okay, so and in the beginning, she used to be kind of a little fearful in the chair. You know, a lot of patients come in with dental anxiety. Okay, she has no, she appears to have no anxiety. She comes in, she's like so happy to see me, smiles. My gums aren't bleeding when I, you know, floss or soft pick, I'm water picking every day. And she's like, I feel so much better. She said, I never used to plan hardly anything because my flare-ups would come all the time. I never knew when I would and when I get a flare-up, I it it just like would knock her out. And she so she was almost living, she kind of she started living her life, not planning much because she just felt like she'd have to cancel everything or so, anyways. She's like, you will never guess this. She came back after a summer. She's like, I signed up for a marathon because I knew that I was gonna, and she ran that thing. She's like, and I had no flare-ups. She's living her best life. Her medication changed dramatically. It it was just it was awesome. Yes, they changed her, they decreased everything. I can't remember all that, but yes, they changed them. So she's hardly on anything, and she has no like she says she really has no flare-ups. This was the last time I talked to her. She has gone like it's like over a year now. No flare-ups, you're on a marathon, and she's just the happiest. It's like she has hope again. That's what patients are telling me. They're like, I feel like I have hope. It's great.

SPEAKER_01 18:02

Well, it's it's one of those things that if you don't know that there's constant inflammation in your mouth because it doesn't hurt. You know, there's so many people have no pain, they have minor inflammation and they don't realize that that chronic inflammation is also chronic infection. And their physicians don't know necessarily to ask, is your oral health optimal? And even if they did, how do we define an optimal oral health? If you haven't had a microscope slide or a lab test, you don't necessarily know. There are other signs of health, of course, you know, no bleeding, nice tight gum tissue, very pale pink. But sometimes those little critters are are hiding below the surface. And how amazing for her to just feel like she has a new lease on leg. I mean, this could completely change who she is. Like for years.

SPEAKER_00 18:51

Yeah, and even just her whole like her energy about her. It's like I'm talking to a different person. It's it's amazing. She's just like pulling that curtain back and she's living life to the fullest.

SPEAKER_01 19:02

I just think about like how much happier her friendships are, her marriage, or just everything. I mean, it just it all it's all connected. We're all connected.

SPEAKER_00 19:12

Absolutely. And you know, I say it every single day, you know, healthy mouth, healthy body. We gotta get this just right so that you know it's just gonna decrease inflammation and it's just setting you up for long-term success.

SPEAKER_01 19:26

Absolutely. I love that. And what now on to the next story?

More Energy In Your 80s

SPEAKER_01 19:30

This one just tickled me. I think when you texted it to me, like I'm pretty sure I had tears in my eyes because I had not heard a story like this before. And so it just blew me away. So you had a patient that was, I think, in her mid 80s, and she came in and she was just feeling kind of sluggish and just assuming that it was because she was getting on in her years, but you found something completely different going on.

SPEAKER_00 19:52

Yes, this was a really interesting story. So she is from my town, but she had lived in a big city. I think she was living in Minneapolis for several years. And so when she was living there, she was getting her teeth cleaned once a month. I just that's just not a common recall. But she was trying to do everything she could because she she always just kind of I don't know, it was almost like she had like this gut instinct about her mouth, but she wasn't they were saying she was losing bone, but she they thought this was the answer.

SPEAKER_01 20:25

So anyways, losing losing jawbone that supports her teeth.

SPEAKER_00 20:29

Yeah, yeah, like the x-rays were showing that her she was losing the jawbone, um like her on her bite wings, it was over her ears, and so they thought, you know, just come in regularly and she was brushing flossing. Okay, so we met and we I took a claque sample and microbe tests, and she had periodal and pathogens through the roof, and this is someone that was getting their teeth cleaned every single day. But I don't think the public knows that there's different types of cleanings, and we just need to make sure that the patient is getting recommended the right type of cleaning because we're just cleaning doing a regular cleaning, like we call it a profane like a polish, yeah. Yeah, it's just I tell patients that's like cleaning the gunk off the teeth. Well, this woman, and that's what this woman was getting. But this woman needed help underneath her gums, and so we shifted how we cared for her. Um, and then we treated her pathogens and we got her on a home care regimen that involves gum health too. So water pick, soft pick. Um oh my gosh. She healed so great. So then we have her in for six to eight week follow up. At that point, she was feeling so good. Because sometimes it can take a little time. I mean, it doesn't ever take like a crazy amount of time, usually, but if a person's lived with these types of bacteria and that's been their normal, I tell patients we can't just assume it's gonna, you're gonna just fight. It in a day or in a week. Everyone's immune system, but typically don't use detox that people do once they do the home care and we make the diagnosis and we get them on the right path. Like their gums are some of the fastest healing tissue in the body. Gum bodies want to heal. It does seem like usually people are getting pretty quick results. Yeah. But anyways, this woman, yeah, at her six, eight-week check, she was like, I feel great. She she had so much energy. She said, I was so tired before. She said, I just would feel like I had to take a midday nap for an hour and a half because I just could not move my body. She was sore, but her big thing was her energy. And she's like, I mean, it was almost like it's not like she was almost like hyper because she's like so excited. She's like, I now can read all the time. She is, I have so many books I've wanted to read, but I get so tired and I'm reading and I'm doing my arts and crafts. Like, she is living her best life in her retirement. And she's come numerous times for her recalls, and she's just so happy. And she always talks about all of her energy. And her daughter has also mentioned it, just how great her mom is. It's almost like her mom is this, like just another energy about her. It's just, it's like their whole demeanor changes. She's finally her body is healing.

SPEAKER_01 23:26

Well, to be running around with an infection for probably decades that she didn't. I mean, to lose, to lose jawbone that supports our teeth, that is just that chronic inflammation over time. And it happens very slowly over time. So she probably had her infection for decades, but her previous doctor, they just didn't know what to look for. They were doing the best they could, clearly recommending a one-month recall. They were, they were really trying, but just not quite hitting the nail on the head, so to speak, of of what truly we needed to do.

Gingivitis Therapy And Ozone Irrigation

SPEAKER_01 23:55

Earlier, you you mentioned that three-tier approach of what we need to do. So I just wanted to give to the audience a little bit more clarity there. So when we talk about truly getting somebody healthy and the different types of cleaning, when we're doing like a traditional profi, you go in every six months and get your profi. What we're trying to do there is just clean your teeth, remove any debris, and it's preventative in nature. I always talk to my teams about it's like, why do you wash your hands after you use a public restroom? Because you might have some germs on there that you don't want to get sick. So that's your prevention. You're not sick, you're just prevention, checking everything over, ensuring that you're healthy. So when somebody comes in every six months, like that's our job to make sure that they're healthy and to let them know if there's anything that could prevent them from health, whether it be teeth, gums, airway, all the different things that we do. Then when somebody comes in for therapy, there's a big difference there. So share, share with us what your therapy in office protocol looks like kind of in a nutshell.

SPEAKER_00 24:50

Yeah, in a nutshell, when we recommend therapy, it's because someone has, you know, inflamed gums or ginger vitis, and a lot of times they didn't realize it. But then when we show them and show picture, like we have a mirror and we're showing them, you know, even to a light touch of your gums, they should not bleed. If you put a little soft pick, like those little, they look like little Christmas tree um tips, if you put those in between, your gums really shouldn't bleed. Um, and if they're they're bleeding, um, that's a good sign that we're probably not very healthy with our gum health. And so we explained that therapy is would be recommended here because it's no longer, like you said, Tosh, a healthy mouth. If it was a healthy mouth, you know, we're staying mainly above the gums where you kind of get all that gunk off the teeth, polish them up really good, and you know, tell them to keep doing what they're doing. But we gotta shift something because we can't expect tissues to improve if we don't change anything. So we recommend the gingivitis therapy in that situation, which yes, we're also we're still cleaning the teeth and getting, you know, the gunk off the teeth. But the gums, that's that's the concern here to address the gingivitis. The I always tell patients you know, the bacteria in your mouth, they get really smart. They go in places in those nooks and crannies underneath the gum line, in those nooks and crannies where the toothbrush flasks just can't reach. And so when we do this type of therapy, we need to uh flush those areas just under the gum line in those nooks and crannies. And so in our office, we use ozone water for cleanings, meaning water that has extra oxygen in it. Because what we know is the bacteria that hides in those nooks and crannies just under the gum line, they're what we call anaerobic bacteria, meaning bacteria that don't do well in oxygen. And so when we use our water, our ozone water, the water that has extra oxygen in it, and we're flushing in those nooks and crannies under the gum line, they don't do well. And so we're just kind of helping get get them out of there. It really helps reset the immune system. And then just to make sure that the patients are comfortable, we do use some like numbing creams. Usually that does a really, really good job. So we usually don't need to use a needle for numbing, which is a bonus. We call it ginger cane, but some numbing jelly. Um, so we just do a really good flush out, and then of course, their home care that we talked about, that three-tier approach we did with that therapy was really good with that irrigation, just with that ozone water, reset things, and then we give them, we give our patients, we tell talk about the home care. I always want to send them home with a sheet of everything we talked about. So we talk about it, I write out like sizes of a soft pick, how to use a water pick, I demonstrate it on a model, I have the patient demonstrate it, but then on my handout, I also have a QR code. It's actually a view test. Yes. And so, yeah, so then they have their guide, they know what they need to do. And then we generally, because I think patients usually feel or they've heard or they think that they get their teeth cleaned every six months. And so, but that I really try to emphasize that doesn't really apply when you have gums that aren't healthy. And so when we're in therapy, I say that's our goal at some point, but you're not quite there yet. We want to see you back in six to eight weeks. Let's check keenly, let's make sure that your slide's looking better. We don't have that your bleeding is reducing. And then we I like to touch base because now they've really been doing home care and they have better questions because they're uh, you know, like touching the little things, and then we kind of go from there and decide, you know, what their recall is. But yeah, so I think the big difference with therapy is that we gotta address for those bacteria heightening.

SPEAKER_01 28:44

Yeah.

SPEAKER_00 28:45

In those nooks and crannies just under the gum line. Patients do well though. It they they aren't, you know, cringy and like we're keeping them comfortable.

SPEAKER_01 28:53

Yeah.

SPEAKER_00 28:53

That that ginger cane really does help.

SPEAKER_01 28:55

And so many of these infections, I mean, I think you find this too, just like I did. It's it's it's not like a really dirty mouth. I mean, some people, you know, they have taken a dental sabbatical, you know, for for various reasons. And some people do get some hardened debris that, you know, maybe takes a little bit more elbow grease um from the dental hygienist. And we have lots of methods to help make sure they are really comfortable. But when we're talking about strictly an infection and we're going after just, you know, the bacteria, not so much the debris, yeah, it's it's that those numbing creams are really, really affected just to make sure. I I kind of compare it to floss in a year. It might be a little tender, and that's kind of how it would feel for us. Like as we're getting in those nooks and cranny crannies, it's kind of like flossing after you haven't flossed in a year. It's it's not horrible, but it's not that either. So you might as well use the numbing cream just to make sure flushing out and cleaning everything out. We're good to go. That second tier, of course, is all on our patient. It's using that water floss, or really breaking up that bacteria, using an antimicrobial, you know, and then whatever else your dental professional recommends. I mean, all of us are a little bit unique and it's gonna look exactly the same. I certainly am like everyone gets a water fit kind of a gal, um, just because it blasts the bacteria so well underneath the dungs. A really awesome toothbrush technique. And then for that immune support piece, and of our patients are really healthy and they just, you know, got an infection and we can get them healthy and we don't really have to lean too hard on that immune response. But other patients need a little bit more help. You know, people do well with probiotics and prebiotics. You know, sometimes we even use limited antibiotics with a challenging infection. So understanding what this infection is actually being caused from, like, you know, why does somebody have this in the first place? And what, what do they have helps guide us so much more as professionals to have a targeted approach. And I I love that so much. And I know, I know your patients, like, you just have so many that have such incredible success stories of they understand that I'm not just going to see a dentist or a dental hygienist. Like, this is truly part of my overall healthcare routine.

SPEAKER_00 30:52

Absolutely. Absolutely. I feel feel that when we take this approach, patients see things. It's like at first they might not, you know, it's kind of new in a way, thinking about all these things that we're saying, because they haven't always been heard this information. It's I feel like our culture is really all about or our society. It's like what what we do to keep our mouth clean is we brush and floss. We brush and floss. And most people brush, they don't always floss, but they let you know, brush and floss. And so I've really tried to rewrite that narrative and explain, you know, brushing and flossing is still really, really important, but that's really for your teeth health. At some point, it's not enough for your gum health, and your gums will suffer because we've talked in the past about the crazy percentages in our country of how many people have these pathogens and yeah, where that we get them from. And but anyways, I could keep talking about it.

SPEAKER_01 31:45

So I love

What To Ask Your Dentist

SPEAKER_01 31:47

it. Well, my last my last question to you is for anyone listening that maybe their dental practice doesn't have a microscope or they can't come up to Grand Torks uh North Dakota and see you, um, what should they ask their dental professional about their gum health? So, you know, if if you know, maybe they can think, I don't know if my dental practice does salivary testing to look for the microbes or if they have a microscope. Is there something that they could particularly ask their dentist or their dental hygienist to help to verify if they're healthy or not and what else they can do for themselves?

SPEAKER_00 32:19

Yeah, I think the number one thing, even if your office isn't, like you said, Tasha, like offering the microscope and celebrate testing, I think it's really, really important to ask whoever cleaned your teeth if there was any bleeding. And not just when they measured, but when they're actually cleaning.

SPEAKER_01 32:38

Yes.

SPEAKER_00 32:38

You could just say, I just have a question. When you were at any point, did you see any of my gums bleed? Even like when you were cleaning, when you were, you know, touching them or cleaning them, were any spots bleeding? And if they say yes, there's a really good chance that something's not quite right. And so really, really think about what you can do for your gum health. And it's gonna take more than brushing and flossing. Tasha and I, we love the water pick, water flosser, but you got to ingle it under the gum line to really break up that bacteria. But I think don't you think that would be a good number one thing to ask?

SPEAKER_01 33:14

I think that's perfect. I think that's perfect. And the the sad truth of the matter is that, you know, for myself, when I graduated, if I had a patient that had a little bit of bleeding, it really didn't get me too hyper because unfortunately, even Listerine last year, Listerine of all voices, did a study and showed that 90% of the world's population had some form of chronic gingivitis. And I don't recommend Listerine for anybody because there's better stuff out there that's that's a lot more gentle. But if even Listerine is saying 90% of the population has some form of gingivitis, what causes gingivitis? The person doing a bad, poor job on their home care. It's that you came in contact with some unhealthy bugs, and those bugs thought that they found some great real estate in your mouth, and they wanted to stick around. And so the water flosser is great because it breaks through that biofilm. And truly, this three-tier approach that you were talking about, Dr. Johnson, I mean, it's what we're gonna do for you in the office you can do for yourself at home, and then what else in the patient anyway? So we all have the ability to take more control of our health um if we know the right things to do. Um, on my website, I have a little guide with this QR code that Dr. Johnson was talking about, and we'll link those in the show notes. So if you want to take a look at your technique, um you can watch those quick little YouTube videos of the right angles for the water pick, the correct angles um for the for brushing technique. And truly, if using those things, you know, even make them five percent better, that's a huge difference. Sometimes it's just the smallest leaks that can make radical differences. There's supplements, there's all kinds of great things that we can do, but start simple and start with the techniques, I think, too.

SPEAKER_00 34:54

Absolutely. That QR code is huge because I think so often people, when they try the water pick, they don't always know they think they're doing it right, but technique is huge with those. I find that a lot of my patients, if they come back and they still have bleeding gums, I have them show me how they were doing it. And they're like, the water is just like the the water pick is just set right at their teeth. So then I say, that's really what your toothbrush is doing. You really have to angle it in that to flush under that gum line. So just that video on your website is gonna be really huge because a tiny little change can make a huge difference with your gum health.

SPEAKER_01 35:35

Yep, I love it.

Simple Technique Fixes And Closing

SPEAKER_01 35:36

Well, this has been so much fun, Dr. Johnson. I hope you will come back and chat with us again because your stories are so inspiring. They seriously melt my heart. I mean, there's been so many messages over the years of your wins that literally make me tear out because I'm just I'm just so happy and so proud of you guys for doing just the most incredible job for your patience. They're so fortunate to have you. And you're just an incredible leader. So thank you so, so much for your time today.

SPEAKER_00 36:03

You're welcome. Thank you for having me. This has just been such a great opportunity. I always love chatting with you. You inspire me. And I just I am so passionate about this. I could talk about it all day long. So anytime you want me back, you tell me what we want to talk about, and I just love chatting about it because it really truly makes a huge difference. And I just wish the whole world knew about this.

SPEAKER_01 36:25

That's the goal here.