You Don’t Have to Play with the Deck That’s Stacked Against You
A few years ago during one of my surgery cases, I extracted seventeen teeth on a four year old.
Seventeen.
For my non-dental readers, that means that once the surgery concluded, this child was left with three teeth. Permanent teeth don’t start coming in until around six years old, so that meant he was going to have ONLY three teeth for at least two more years.
Three teeth. To chew with, speak, and smile. Most people immediately think of how the loss of teeth will affect eating, and that probably is the most direct consequence. But let’s not overlook the often crippling shame and embarrassment some of these kids feel about how they look once their peers start asking questions and often pointing and laughing. These kids smile with closed lips. They shift nervously and look down at their feet. They don’t make eye contact. They are self-conscious. And it’s not their fault. At all.
I wish I could say that this was a rare occurrence, but the truth is that I’ve seen this kind of tooth decay every week for my entire career. And after every patient case comes the most important part of the surgery: the post-op conversation with the parents. I’ve been having these conversations with parents for almost fifteen years now, and I can honestly say that those exchanges have probably had the most impact on the trajectory of my career. Why? Because it was those conversations that slowly revealed to me that if I continued simply fixing and extracting teeth, that I was on a hamster wheel of treating the symptoms of a much larger, much more serious underlying problem.
That did not sit well with me. It made me question the purpose of my profession. It made me examine whether I was actually affecting change or just perpetuating the norm. It forced me to ask what the norm even was. And why it was. Once I explored those questions deeply and honestly, I knew in the surest, clearest way that I could not continue to just fix teeth. As a dentist, that would be the equivalent of prescribing blood pressure medication for the rest of someone’s life without figuring out why the blood pressure was high in the first place. Or placing someone on Metformin indefinitely to control blood sugar levels without ever having a conversation about how nutrition and lifestyle could likely cure type 2 diabetes. Or waiting until a patient has a heart attack to do an invasive surgery when there were glaringly obvious signs for years that had they been addressed, may have prevented it in the first place.
Oh wait.
That’s exactly what we do. That is the norm.
More than half of Americans suffer from at least one chronic disease. One out of every two Americans has high blood pressure. One out of every two Americans has diabetes or pre-diabetes. And cardiovascular disease kills more Americans than all cancers combined. A recent 2022 study reported that only 7% of US adults are metabolically healthy. Seven. Freaking. Percent.
Those kind of statistics are thrown around so casually today that I think most people are desensitized to them. They’re common, and psychologically I think this makes being unhealthy become more tolerable because when something is common, it’s mistakenly accepted as normal. Well, this is a wake up call. When 50% of our population is headed toward premature death, and no, that’s not being dramatic, THIS IS NOT NORMAL. This is an emergency of epidemic proportion. It’s unsustainable from both health and fiscal vantage points, and if we don’t course correct, the future of America’s health and prosperity will sail right off a cliff.
And what are we doing about it?
Are we curing disease? Are we making effective, lasting change in the right direction? Is the medical system incentivized to make you healthier?
No.
No.
No.
This was the dilemma I started feeling in the post-op conversations with the parents of my surgery patients. It wasn’t uncommon to have the same child present twice for these surgeries. I often saw siblings of previous patients months or years later with the exact same pattern of severe tooth decay. Week after week I saw the same sad situations play out over and over, and I realized that fixing teeth and talking about brushing wasn’t enough to move the needle. No, in order to make any impact on these families and potentially the future of these children, I had to commit to identifying the root cause of their disease. And while that cause certainly can be and often is multifactorial, there was always one, glaringly obvious problem that if gone unaddressed, would not only lead to future tooth decay, but also high blood pressure, diabetes, and cardiovascular disease. The low hanging fruit snacks, if you will.
Diet.
When I started to talk less about teeth and more about what these kids ate and drank on a daily basis, it became abundantly clear what the source of the problem was. A 2021 study backed my theory up. The average American child eats a diet that consists of 67% ultra-processed food, and the CDC reports that the average child consumes three times the recommended amount of sugar each day.
There is no amount of tooth brushing that can fix this.
There is no blood pressure medication that can fix this.
Metformin can’t fix this.
Cardiac bypass and stents can’t fix this.
Well then, the things that do actually fix these problems must be mysterious! They must be expensive. Unattainable. They must be complicated and difficult! Otherwise why wouldn’t we be doing them? Why wouldn’t we want to FIX THE PROBLEMS? In actuality, the solutions to almost all of Americans’ chronic health conditions are indeed inexpensive and extremely attainable. They are uncomplicated. They don’t require a doctor’s prescription.
Yet here we are.
I’ve watched this dilemma unfold over and over in my patients’ lives and the lives of people I love. That dilemma has lead me to ask the following series of questions, to which I now feel quite confident about the answers. And because I feel quite confident about the answers, my approach to dentistry and where I feel the most impact can be made has completely evolved. My dissection of thought goes something like this:
What is this patient’s reason for seeing me? Severe tooth decay and/or pain.
What is the primary root cause of this patient’s tooth decay and/or pain? A diet high in sugar and ultra-processed food.
Once patients/parents are made aware that diet is causing them disease and pain, why don’t they change their dietary habits? Because they are addicted.
Let me say that again.
Because they are addicted.
It’s easy to say, “Eat healthier!” “Why do you eat that crap?” “Make better choices!” Well, perhaps we should back that assumption and judgment train up just a bit first. And let me say also that you’ll find no stronger advocate for discipline, autonomy, and enduring adversity than I, so I’m not letting everyone off the hook for poor personal choices, myself included. But I do think context is important. To have an intelligent conversation about solutions, we have to be honest about what and who we’re up against. And make no mistake about it, the destruction of our health is deliberate, and a small group of people are getting exorbitantly rich from our poor food choices and subsequent chronic disease. So yeah, let’s take a slightly deeper dive.
Did you know that sugar causes huge surges of dopamine in the brain, the same way cocaine and heroin do?
Did you know that food companies spend millions of dollars formulating the exact amount of salt, sugar, fat, crunch, crisp, melt-in-your-mouth effect, and flavor intensities that will be the most addicting and keep you coming back for more?
Did you know that food companies spend $2 billion each year marketing their products to children?
Did you know that in the 1980s and 2000s (when increasing regulation and health concerns started to hurt their bottom line), tobacco industry giants Philip Morris and RJ Reynolds purchased the five largest food companies: Kraft, General Foods, Nabisco, Del Monte, and RJR Nabisco? (Their product may have changed, but their marketing strategies and tactics did not).
Did you know that a FOIA request revealed that the Academy of Nutrition and Dietetics had financial interest in Nestle, PepsiCo, pharmaceutical companies, and has accepted substantial corporate financial contributions?
Did you know the United States is only one of two countries in the world that allow pharmaceutical companies to market directly to consumers?
Did you know pharma and healthcare product companies spent $372 million in lobbying money, outspending every other industry?
Did you know that it’s common for the regulators within the FDA and CDC to go work for the very food and pharma companies they were once supposed to oversee?
There’s a reason why drug dealers hand out free samples of heroin and crack to prospective customers on the street. They know they’ll be back and once addicted, they’ll have a customer for life. What we’re witnessing in the crisis of American health is not that different.
We market extremely addictive, cheap, sugary and ultra-processed “food” to people, knowing that once addicted, they’ll suffer catastrophic effects on their health. And then once all of the known, expected complications arise: high blood pressure, diabetes, cardiovascular disease, obesity, autoimmune disorders, cancer, Alzheimer’s, depression, and yes, tooth decay…..we sell them pills and surgeries to manage their disease.
Manage.
Not cure. Not fix.
We take the most vulnerable among us, our children, and we hook them early so they’ll continue to get their fix as adolescents and adults from the food industry (that turned them into addicts in the first place), and then we turn them over to the pharma industry who sells them not a solution, but a band-aid that will keep them just sick enough to be paying customers for life.
And then we look at the sick adults around us and wonder, “why don’t we just make better choices?”
If your child got hooked on heroin by the age of three, what do you think the odds are that he grows up and spontaneously kicks the habit as an adult? Is it possible? Of course. Is it likely? Not so much.
It’s time for a rebellion. A grassroots effort among parents, families, coaches, teachers, healthcare providers, and any concerned human who no longer wants to be the means to an end for the billionaires of the food and pharma industries. STOP PLAYING THEIR GAME. Very few adults are aware of the deck that’s stacked against them, but once they are, they’re free to make the choices they want that lead to the health outcomes that accompany them. It’s our job to tell the truth and at the very least, provide people with the knowledge to make informed choices.
Kids are a completely different story. Kids are vulnerable. They are largely at the mercy of the choices that the adults around them make. We must do better. Quite literally, our future depends on it. We do not have to accept the narrative that chronic disease is normal. We do not have to participate in the Frankenfood industry that is poisoning our kids. And we don’t have to be perfect. But we do have to be better. For our sakes, but mostly for our kids’ sakes. And we have to start right now.
What does that mean? The healthcare industry would love for you to believe that it’s complicated and that you need their help to figure it out. You don’t. You can make simple, meaningful change today. If I had to boil that down in to the simplest terms that were the most broadly understood, it would be the following:
Eat real food at home. Don’t get sucked into thinking that one type of eating is the “right” way. Whatever it is you prefer, just try to eat real food. Vegetables, fruits, meats, dairy, eggs, herbs, spices, etc. Think the perimeter of the grocery store (there’s a reason why they put things that can last on shelves for months in the middle…it’s more efficient to keep the things that have to be restocked often closest to where it’s unloaded). Restaurants often prepare your food in huge amounts of ultra-processed oil adding hundreds of calories to your meal, and it’s more expensive. When you cook it, you control it.
Read food labels. Avoid packaged, ultra-processed food. Even if it says “100% whole grain” or “gluten free” or “heart healthy.” These are often marketing ploys designed to fool you. Read labels. If a food has an extraordinary long list of ingredients that includes words that you can’t easily pronounce or you don’t recognize as food, avoid it.
When getting started, worry less about fat, carbs, proteins, and calories and more about the quality of your food. Yes, if you need to lose weight, then calories matter. But ultra-processed food is engineered to be addicting and by design does not make you feel full, even if it’s “low-calorie.” I promise you that if you stick to #1 and #2 above, you are almost guaranteed to take in less calories AND increase your nutrient intake, both of which lead to a healthier you. And by the way, fat does not make you fat! Eating too many calories makes you fat, and eating the wrong kinds of fats (and foods in general) makes you inflamed, which makes you unhealthy. It’s a shame that fat the noun and fat the adjective are the same word, because fats are fabulous and absolutely necessary for good health. You just need to focus on the good ones: olive oil, avocado oil, avocados, nuts, seeds, coconut oil, butter (REAL butter, not the wannabes), and ghee are good places to start. And bonus, they WILL make you feel more full.
Avoid added sugar and ultra-processed refined grains as much as possible. These have no nutritive value and ultimately contribute to poor lifelong health. And. Life is not about trying to achieve perfection. 99% of us will still have ice cream, cookies, and dinner rolls once in awhile. The key is to minimize it as much as possible. And the best way of doing that, for yourself and your kids, is to NOT KEEP IT IN THE HOUSE. Don’t buy soda. Don’t buy Fruit Loops. Don’t buy juice. Don’t buy Goldfish. Don’t buy Twinkies. Don’t by Doritos. If you don’t have it available, you can’t eat it. And your kids, who might be addicted to it already, will have a shorter meltdown when they realize you literally don’t have any to give them, than if they think they can wear you down long enough until you give in. You always have a say with your dollar. Companies pay extremely close attention to what moves and what doesn’t. If you don’t agree with how Big Food and Big Pharma contribute to today’s health crisis, don’t support their efforts with your hard-earned money.
Don’t assume eating this way is more expensive. I personally do the majority of my shopping at Aldi and cut hundreds off of my grocery bill compared to when I shopped at one of the larger chains in town. Of course every store, including Aldi (and Whole Foods and Trader Joe’s for example), still has plenty of less-than-ideal foods on their shelves. You still have to read your labels. You still need to avoid sugar and ultra-processed food. But I promise you it doesn’t have to break the bank. Between buying beef from a local farmer in bulk, getting my weekly staples at Aldi, and ordering only the pantry items that I absolutely need from Thrive Market, I’m spending about 30-40% less than when I was going to a larger grocery store for everything.
There is a way out of this mess. The overwhelming majority of us have the opportunity to profoundly change the trajectories of our health by simply making different choices. Eat more nutritious food. Walk more. Get seven hours of sleep. Spend time outside. Laugh. We’ve been sold a lie that our genetics determine our destiny and that we must rely on our doctors and meds to fix us. Well I call bullshit. Stop buying what they’re selling. Literally. And if anything I said here struck a chord with you, then I highly recommend reading or listening to the book Good Energy by Dr. Casey Means. As a physician who used to be in the system, she knows how it works and why it’s set up the way it is, and she lays out very clearly why the health care industry does not have your best interest in mind and how you can take back control of your health.
I don’t have grandiose expectations that the conversations I have with parents after their children’s surgeries will create a 180 degree course correction in how they choose to live their lives. I usually get five to ten minutes with them, and that means I have to choose my words very carefully. I have two simple goals at the end of each of those conversations: #1-that they are more aware of how their choices around food and habits affect their health and #2-that they understand that they are not doomed genetically and that they have significant control over their futures. That’s it. If one parent decides not to buy juice the next week, that’s a win. If one parent feels hopeful and empowered to make sure their child stays cavity-free, that’s a win.
I hope you’ll join the revolution to rewrite the norm. Not by preaching. Not by judging. Not by bloviating. But by your own daily choices, particularly if you influence the life of a child. People notice. Companies notice. Kids definitely notice. But most importantly, YOU will notice. You will notice your energy levels improve. You will notice that you sleep better. You will notice that your skin looks healthier. You will notice that your mood seems elevated. You will notice your clothes fit better. You will notice your mind seems sharper. Most importantly, you will notice that you are in charge of you.
“Be the change you wish to see in the world.”
That is enough.