Shirley Gutkowski, RDH, BSDH (a.k.a. “America’s Dental Hygienist”) is a renowned xylitol expert, an expert in Oral Disease Prevention, a clinician, speaker, and author. She is also a hard working patient advocate and a woman who genuinely cares about quality of life for people young and old. She is the co-founder of Adopt a Nursing Home, which provides dental hygienists the tools needed to educate caregivers about oral health, and The Stonkowski project, which increases oral health awareness in dependent adults. From her home in Sun Prairie, Wisconsin, the mother of five and grandmother of two spoke with CityGal magazine about her mission to help eradicate dental decay and bring awareness to the growing need for long term dental care.
Are you still a practicing dental hygienist?
I practice when I need to. Sometimes companies ask me to evaluate products or processes and then I call around to a few dental offices to see if I can sit in.
Do you work for yourself?
Yes. I do some consulting, I write and I speak. My speaking is usually funded by a number of dental companies. I don’t work for them, but in order for me to speak and make it work, the companies contribute to my honorarium.
Do you speak mostly about xylitol?
Xylitol does make it into almost all of my programs, yes, I have to say that that is true. If I’m talking about periodontal disease I have to talk about xylitol, if I’m talking about managing dental decay I have to talk about xylitol, if I’m talking about elders or children xylitol is a really big piece of that.
What is xylitol?
Xylitol is a sugar. It’s actually classified as a sugar alcohol. It comes from a plant just like regular sugar does, in a variety of forms. It is used as a sprinkling sugar in certain gums and mints, and can be found in some toothpastes and mouth rinses as well. It is so easy to use and can make a world of difference. People are so hounded with this brushing and flossing idea and it’s just a tiny fraction of the whole problem. There are other ways to reduce the bacteria in your mouth that can cause cavities. The whole dental disease model has been ignoring the bacteria. Until recently we have only ever given patients the opportunity to remove the bacteria from our mouths instead of preventing it.
And xylitol can help prevent bacterial growth?
Yes. Xylitol affects the metabolism of the bacteria and yeast that live in our mouths. The chain of decay starts with the streptococcus bacteria that is always present in our mouths. When the streptococcus bacteria eat regular sugar they pump out a sticky mucus called a biofilm. This biofilm invites other bacteria into it and it grows and sticks to our teeth and results in tooth decay and cavities. Xylitol interferes with the production of the biofilm so the bacteria have nowhere to grow. If the bacteria can’t grow, they can’t stick to our teeth and cause trouble.
It is simple! The current recommendation is five servings per day. One serving is 2 pieces of gum, 2 mints, or brushing teeth and rinsing with a mouth rinse that contains xylitol.
I can see why xylitol comes up in so many of your articles and talks. It seems to be the missing piece in regards to oral health and long term care.
My big focus for the last ten years has been on long term care, on the elderly who are dependent on others to take care of them. They are keeping their teeth longer and need somebody to take care of those teeth, and nobody is. I mean nobody. When we look at studies that assess nursing assistants and see what gets in the way of providing adequate oral care, it is that these nursing assistants are really afraid of being bitten. They are afraid of being spit on. The nursing assistants have not been trained on how to brush someone’s teeth. Dental hygienists, on the other hand, have over 350 hours of chair side training learning how to approach people. Nursing assistants do not — they are taught how to brush people’s teeth in the same class as hair washing. The elderly people in these care facilities are not getting their teeth brushed properly. Currently in Wisconsin, dental hygienists are not allowed to go into nursing homes because they have to be over seen by a dentist and the only place dentists are is in their own practice.
Is this what you are focusing on with the Adopt a Nursing Home and The Stonkowski Project?
Yes. What we started with was just trying to go into nursing homes and teach about xylitol because it was much easier than trying to teach these already over worked nursing assistants how to properly clean teeth on a daily basis. That is why we taught about the importance of xylitol and how xylitol can reduce the amount of biofilm on these people’s teeth.
Have the nursing homes been receptive?
They have been receptive, but they think it is expensive. What they don’t realize is that when there is less of this biofilm in the mouth they are reducing the risk of heart attack and stroke, lowering the risk of pneumonia, reducing the cost of diabetes care and reducing oral thrush, not to mention quality of life.
I was at the America Medical Directors Association and presented a poster on the cost benefits of having a dental hygienist on staff at nursing homes. There was one dentist who was talking about creating incentives for nursing assistants to do the oral care at these nursing homes, but there is a whole workforce of dental hygienists out there whose whole incentive is clean teeth! We need to have more people understand this ridiculous hurdle. When we talk about access to care, not only can people not see a dental hygienist without a dentist, dental hygienists can’t get to people. We’re just sitting here saying, “We can help you, we can help you!” but it’s almost like no one is listening.
Yes, it is just about spreading the word and I’ve been working very hard at spreading the word. Xylitol answers so many problems and it’s such a simple thing.
Tell me a little bit about Career Fusion.
It’s mostly related to dental hygienists. Because they are in such a tenuous situation they become injured pretty often. They have repetitive stress injuries. They can’t work anywhere but a dental office and if something happens to the dentist then they are out of work. It’s not very easy for a dental hygienist to find a job, and some hygienists just want to do something a little bit different so we help them transition and use their education to work for, say, a toothbrush company, a toothpaste company or any of the other thousands of companies that are dental related. We help them learn the skills they need to know and to network with the companies that are looking for skilled dental hygienists.
Xlear, a xylitol company, is one of our partners and they recently revamped their entire sales force. After attending career fusion and seeing what sort of dental hygienists we attracted they scraped their idea of regular people and now their entire sales force is made up of dental hygienists.
The fact that you are working day in and day out to improve the quality of life for others is really terrific.
Thank you! Sometimes I just shake my head and think, why can’t I just go to work and clock in and clock out and just be like everybody else. It would be so much easier. But I’m telling you Monday is my favorite day of the week and Friday is my least favorite day of the week. In the future I hope to talk more to consumer audiences. I think I have exhausted what I can do on the dental side. I would like more of the public to know what they can to besides just brushing and flossing. I am going to be speaking to a Le Leche group in October and an Autism group, and more consumer groups to spread the word.
I really, really love what I do — it’s something different all the time. I get to raise awareness, I get to advocate for these people and I have a mission to help eradicate dental decay. Xylitol is a huge part of that — not just brushing and flossing!
About the Author
Monica Maniaci lives in Milwaukee and is a stay at home mother of two young girls. She has an Art degree from UW-Madison and enjoys painting and drawing. She is currently working on her first novel which she hopes to publish one day.