Vitamin D basics

Maddy Draper, APRN, a health care provider at OSF OnCall, says vitamin D is a nutrient our body needs to produce calcium. Calcium helps create strong teeth and bones. So logically, not having enough vitamin D leads to brittle bones (a risk for greater injury after a fall), plus muscle aches and pains. Others with a vitamin D deficiency may not show symptoms. Either way, a provider may order a blood test to confirm the issue and then may advise you to take a supplement. This is usually in pill form and can be prescribed or bought over the counter by itself or as part of a multivitamin.

“Or the provider may just talk about vitamin D-rich foods first before starting a supplement,” Draper says. “High fat fishes, egg yolks, some cheeses and mushrooms.”

Draper adds that pregnant women, babies (especially babies who are breastfed), the elderly and people with darker skin often lack vitamin D.

On the flip side, Draper says it’s rare, but a person can get too much vitamin D. Symptoms include nausea, vomiting and heart palpitations (feeling like your heartbeat is fast, pounding or otherwise irregular). You may also suffer kidney damage.

Summer sun

Here’s advice to commit to memory: Draper says research shows 10 to 15 minutes of sun exposure three times a day can get you a healthy amount of vitamin D.

“You want to protect your skin while doing that,” Draper adds. “Sunscreen and protective clothing like a hat and sunglasses. There’s not any research showing that sunscreen or clothes will prevent you from getting the vitamin D you need.”

Experts say your sunscreen should have a sun protection factor (SPF) of 30 or higher, and you should reapply every two hours. Clothing should be lightweight and light colored (Dark colors absorb more sunlight, leading to quicker heat illness.) Stay hydrated, and watch for redness and blisters from sunburns and suspicious moles that may be skin cancer. See a provider right away if you have issues from getting too much sun.

Another thing to note: Experts say a specialized lamp can help with seasonal affective disorder, a mental health condition often seen in the winter due to decreased daylight. The same logic does not apply for vitamin D. You need natural, not artificial light to get the vitamin D you need.

The bottom line

Draper says most people don’t have to worry about getting too much or too little vitamin D.

“The average person will get it through the sun,” Draper says. “If you live in a cold and dark environment, you’re at higher risk for vitamin D deficiency. People farther away from the equator are higher risk.”

If you have symptoms of too much or too little vitamin D or just have a concern, talk to your primary care provider.

Interview clips

Related stories

Fun in the sun: Remembering more than just sunscreen
Year-round sun safety
Heat exhaustion vs. heat stroke: Know the difference

• Teeth issues, such as cavities and discoloration. Loose teeth (not baby teeth that are intended to come out) are also a red flag.
   
• Gum issues, such as redness, bleeding or swollen or sore gums.
   
• Chewing and swallowing issues, whether from pain or a diagnosed disorder.
   
• Chemotherapy can also negatively impact oral health, Dr. Splaingard says. So if you’re going through cancer treatment, keep a close eye for changes in your mouth.
   
• And while we can’t control our age or gender, Dr. Splaingard says to be aware: poor oral health and the poor bone health that could come with it are more common as you age. He adds that women who have reached menopause are especially at risk.

Prevention

Having good oral health is no secret. Think back to what your parents told you as kids.

• Brush and floss regularly. The American Dental Association recommends brushing twice per day and flossing once per day. If you have questions about frequency, talk to your dentist.
   
• See a dentist regularly. Twice per year is a good starting point, but some people who need extra attention could go four times per year.
   
• In between those appointments, watch your teeth and gums and let your dentist know if something doesn’t seem right.
   
• Avoid smoking.
   
• Eat a healthy diet that’s low in cavity-causing sugar and high in beneficial things like calcium.
  
  “Calcium and vitamin D deficiencies can affect calcium balance in the bones,” Dr. Splaingard adds
   
• And if you are diagnosed with osteoporosis, follow the medication plan outlined by your health care provider.

Learn more

Read more about how to maintain good oral health on the OSF HealthCare website.

Interview clips

Related stories

How to get kids to brush their teeth
Dirty nails and mouths don't mix
Brush, floss and see your dentist

November, December and January bring bountiful holiday meals.

While it’s tempting to chow down, experts are cautioning about how overindulgence can make you feel mentally and physically crummy in the moment, plus open the door to long-term unhealthy eating habits.

Have the right mindset

Andrew Zasada, MD, provides emergency department care at OSF HealthCare. He says avoiding stuffing yourself starts before you sit down for the meal.

“If you come to the meal hungry, you tend to try to make up for not having breakfast. You load your plate up, which is going to cause you to overeat,” Dr. Zasada says. “Instead, have a light snack an hour or two before you sit down to the meal.

“Put the food in one room and sit down in another room to eat. That necessitates you going there rather than having food available for another fill.”

The meal itself

Enjoy holiday meals, Dr. Zasada says. It’s not a race.

Grab a smaller plate, and take smaller portions of each item. Pretend you’re filling the plate up for a child. You wouldn’t take five rolls and two big slabs of meat for a youngster, so don’t do it for your adult self.

Other tips: Chew slowly. Between bites, put your utensil down, take a drink of water and talk to someone. This allows your stomach to fill up and tell your brain that you’re full.

When you finish eating, leave the table, and go to another room. Staying next to the food increases the temptation to keep nibbling.

If you can’t help it

Dr. Zasada says despite our best efforts, sometimes you overeat during holiday meals. Maybe you don’t want to offend your aunt by not having a slice of her famous pie.

If that happens, Dr. Zasada says there are two pitfalls to avoid: Drinking alcohol and lying down right after the meal.

“That opens up the sphincters of your stomach, slows down digestion and increases the chance for heartburn,” Dr. Zasada says.

Try tea or coffee after a meal instead of alcohol. But if you must indulge in a spirit, Dr. Zasada says to wait at least 90 minutes so your stomach can partially empty.

Instead of lying down for that post-meal nap, sit upright, talk to people or play a game. If the weather is nice, go for a walk.

A word on more serious eating issues

Holiday meals may be difficult for people who suffer from eating disorders, such as binge eating (eating a lot in one sitting and feeling you can’t stop), anorexia nervosa (an unwarranted fear of being overweight which leads to things like starvation) or bulimia nervosa (taking unhealthy steps to avoid weight gain like purging your food).

Dr. Zasada says, in the moment, you should have someone you trust who can help you through the holiday meal and check in with you later. Long term, he says these are serious issues that should be talked about with a health care provider.

“Repeated bulimia will damage your teeth. It’s corrosive. You lose electrolytes when you vomit,” Dr. Zasada says. “You become sick. If you do this repeatedly, you will lose weight in an unhealthy way. You will possibly dehydrate. You will start losing muscle mass.

“It’s just not a good thing.”

Bottom line: Don’t get discouraged

Dr. Zasada says one day of extra eating may make you feel bad, but it isn’t going to derail your overall health.

“One day won’t make you fat,” he says.

Get back into your healthy eating habits the next day while enjoying those leftovers in moderation. If you feel you are struggling to maintain a healthy weight or body image, talk to your primary care provider. They may refer you to a specialist like a dietitian or mental health provider. From there, plans could include a diet and exercise regimen, medication or, in rare cases, weight loss surgery.

Interview clips

Whether it's that look on your significant other's face when they smell it, or that unpleasant odor coming from a stranger chatting you up at a party, bad breath can cause a little anxiety for everyone involved.

Bad breath is common. One in four adults have had it at some point in their lives. It can also be chronic. 

According to Breanne Gendron, a nurse practitioner with OSF HealthCare, some people don't even know they have bad breath due to a condition called olfactory fatigue, which is when people lose their sensitivity to odors.

“Bad breath can be a totally benign thing, and you just need to brush more, or it could be a sign that something more serious is going on. If you are someone who has bad breath despite regular like twice daily brushing and flossing, then it would be important for you to see your dentist to make sure everything's healthy on the inside of your mouth,” Gendron says.

Gendron adds in addition to brushing your teeth twice a day, flossing is also extremely important. She says brushing at bedtime is the most important time of the day.

Video Version With Chyrons

Video Version Without Chyrons

When it comes to oral health in kids, Emily Isom has seen it all.

Cavities, gum disease and infections, improper tooth alignment and tooth loss come to mind quickly. Not to mention all the missed school time dealing with these issues.

But she’s also seen plenty of young people who are the picture of good oral health. And she’s on a mission to make more of the latter.

“The mouth is the gateway to the body,” says Isom, a certified medical assistant in pediatrics at OSF HealthCare and a former dental assistant.

“A lot of people don’t think about what our oral health can do to us if it’s not being taken care of,” she adds. “It can cause heart disease, diabetes and respiratory infections.”

Everyday prevention

Isom says kids and their parents should commit to daily habits that will improve their oral health.

For infants without teeth, Isom says parents should use a soft, cool washcloth to wipe the child’s gums twice a day. This helps clear bits of food and milk that can lead to bad breath, irritation and cavities.

“Touching their gums will help when they are older. They’ll be okay with brushing their teeth. They won’t fight the parents about it,” Isom says. “So, it’s good to start [oral health care] early."

Older kids should brush their teeth for two minutes, twice a day. Floss once a day. When a child has two teeth that touch, it’s time to start flossing. That could happen from ages two to six.

Before you rinse out your mouth with water, don’t forget about the tongue, Isom says.

“If we do not brush our tongue, bacteria can sit on it. It can get what I call ‘tongue sick,’” Isom says. “Bad breath can also happen.”

Outside of the bathroom, Isom reminds us that sugary and starchy food and drinks are prime suspects in oral health issues like cavities. So, parents should offer those foods in moderation. Isom calls out sticky candy as an example. She says the sugar tends to sit on your teeth for a while. Isom also says starchy food like bread, potatoes, rice, pasta and cereal can sit between your teeth unless you floss right away.

Another must-know for parents with babies: don’t put your baby to bed with a bottle. Aside from a choking hazard, Isom says the constant stream of milk or formula can lead to cavities and corrosion. She also says this can cause infants to be fussy and demand a bottle more often.

It takes some convincing

A mother of a six-year-old, Isom knows that some kids won’t brush and floss willingly. They see it as a chore.

Her response: make oral health fun.

“Make a dental chart. Add stickers to it, morning and night,” Isom suggests. “Give them rewards like a little toy. After each cleaning, they can get a reward. Turn on music or a timer for two minutes [of brushing.] Get toothbrushes with their favorite characters on them.”

Dentist visits

Isom says children usually have regular visits with a dentist twice a year. Others with known mouth issues may go every three to four months. But see a dentist right away if you notice red flags: pain in the mouth, persistent bad breath, discolored gums or teeth, bleeding gums or trouble swallowing.

A regular dental visit usually includes a thorough cleaning of the teeth and gums followed by fluoride treatment.

“[Fluoride] protects the enamel of the teeth,” Isom explains. “It protects your teeth from cavities. It just makes your enamel really strong so you can eat the things you want.”

A dental professional may also perform X-rays on your teeth regularly.

Something else for parents to make sure the dentist has in mind: oral cancer screening.

“Those are huge,” for oral health, Isom says.

A dentist may use their hands to examine your mouth and neck. They could use a light or have you rinse your mouth with a blue dye. Each method looks for abnormal, possibly cancerous tissue.

At the end of a dental visit, you may be sent home with a prescription or just instructions to keep your mouth happy. For example, you may get a prescription mouthwash to help with gum disease.

Learn more

Read more about how to keep kids’ mouths in good health on the OSF HealthCare and U.S. Centers for Disease Control and Prevention websites. If you don’t have a family dentist, talk to your primary care provider about finding one. OSF HealthCare Children’s Hospital of Illinois in Peoria offers dental care for children with special needs.

Interview clips

Related stories

Dirty nails and mouths don't mix
Brush, floss and see your dentist
No lip service when it comes to oral cancer

Kent Splaingard, DMD, recalls decades ago when he learned his mother had stage three gum disease. Her dental providers told her that dentures were likely in a few years.

But after thirty years of treating his mother, Dr. Splaingard says she lost just one tooth.

“I always point it out here,” Dr. Splaingard says, gesturing to where the tooth was. “I remember taking that tooth out thinking, ‘What a failure.’ But I really look back at it and say, ‘What a success.’ Mom had her teeth all her life.”

It’s a prime example of how therapeutic dental treatment can reverse the effects of gum disease. And it’s something he sees weekly with patients at OSF HealthCare in Alton, Illinois. Dr. Splaingard is a retired private practice dentist and an instructor at Lewis and Clark Community College in nearby Godfrey. He and his students regularly see OSF patients who need extra dental attention.

It’s important work, Dr. Splaingard says, because our body functions as a whole. Advanced gum disease will likely make other medical conditions worse.

“The mouth is like a picture window into the body’s health,” he says.

Gum disease basics

Dr. Splaingard says gum disease is a bacterial infection caused by poor oral hygiene. The bacteria embed into the gum tissue, and that typically results in a low-grade chronic infection (in other words, a problem over a longer period). Left untreated, your gums will constantly be red (not the normal pink), swollen and sore. Bleeding is possible, too.

“You see a lot of debris on the teeth. You may see a film of bacteria. You also see a white-ish coating on the soft tissue,” Dr. Splaingard adds.

“You also see the social and economic problems with the people who can’t chew properly. The poor nutrition they may be getting,” he adds.

Treatment for gum disease is a combination of thorough cleaning by a dental professional, treatments that stop bacteria from reproducing and antibiotic medication. In severe cases, a dental specialist may perform surgery. That could involve pulling some or all of a person’s teeth.

Prevention

Dr. Splaingard says gum disease can be passed down genetically, but general prevention goes back to what dentists have told you since you were a kid.

• Brush and floss regularly. The American Dental Association recommends brushing twice per day and flossing once per day. If you have questions about frequency, talk to your dentist.
• See a dentist regularly. Twice per year is a good starting point, but some people who need extra attention could go four times per year.
• In between those appointments, watch your teeth and gums and let your dentist know if something doesn’t seem right.

“It’s education, motivation and self-treatment,” Dr. Splaingard says.

Learn more

Read more about oral health on the OSF HealthCare website.

Interview clips