Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1183 Jill Meyer-Lippert RDH of Side Effect Support, LLC : Dentistry Uncensored with Howard Farran

1183 Jill Meyer-Lippert RDH of Side Effect Support, LLC : Dentistry Uncensored with Howard Farran

5/1/2019 6:36:06 PM   |   Comments: 1   |   Views: 162

Jill began her dental career in 1992 as a Dental Assistant and Receptionist. At the same time, her mother was diagnosed with breast cancer. Helplessly watching her mother suffer horribly with oral side effects from chemotherapy, she developed a strong interest in the oral concerns of cancer survivors.

VIDEO - DUwHF #1183 - Jill Lippert

AUDIO - DUwHF #1183 - Jill Lippert

Jill earned her degree and became licensed as a Registered Dental Hygienist in 1994 and continued to pursue knowledge to help this very underserved area of cancer care. After losing her father to Hodgkin’s Disease in 2005, she developed an enhanced level of motivation to act and do more. Jill created a volunteer program providing oral care kits with product samples and patient education at a local oncology department from 2006 to 2012.

She earned a certificate in Oncology Management from the University of Southern Indiana. Jill and her husband are the owners of Side Effect Support LLC (, which is dedicated to helping cancer survivors manage short-term oral side effects and prevent long-term damage to oral health associated with chemotherapy, radiation to the head and neck, and some targeted therapies.

Jill is a 2014 recipient of the Sunstar Americas/RDH Award of Distinction, a member of the Registered Dental Hygienist Advisory Board for the Oral Cancer Foundation, and has been published in several dental and oncology publications. She is a member of the American Academy of Dental Hygiene, the American Dental Hygiene Association and the American Academy of Dental Oncology.

Howard: It's just a huge honor for me today to be podcast interviewing Jill Meyer-Lippert RDH from Manitowoc, Wisconsin. She began her general career in 1992 as a dental assistant receptionist at the same time her mother was diagnosed with breast cancer, helplessly watching her mother suffer horribly with oral side effects from chemotherapy she developed a strong interest and the oral concerns of cancer survivors. Jill earned her degree and became licensed as a registered dental hygienist in 94 and continued to pursue knowledge to help this very underserved area of cancer care. After losing her father to Hodgkin's disease in 2005 she developed an enhanced level of motivation to act and do more. Jill created a volunteer program providing oral care kits with product samples and patient education at a local oncology department from 2006 to 2012. She earned a certificate an oncology management from the University of Southern Indiana. Jill and her husband are the owners of which is dedicated to helping cancer survivors manage short-term oral side-effects and prevent long-term damage to oral health associated with chemotherapy radiation to the head and neck and some targeted therapies. Jill is a 2014 recipient of the america's RDH award a distinction a member of the registered dental hygienists Advisory Board for the oral cancer foundation and has been published in several dental and oncology publications. She is a member of the American Academy of dental hygiene the American dental hygiene Association and the American Academy of dental oncology. Jill thanks so much for coming on the show today.

Jill: Thank you for inviting me.

Howard: So tell us what are you doing at site affect support comm if if people go to that website right now what are they gonna find?

Jill: They're going to find information we have articles blog posts that are directed more towards survivors and their family caregivers but then we also have more technical information for medical and dental professionals to help get us more on same page and then there's also a product sections that they can find very affordable products that are geared towards helping to minimize some of the symptoms and side effects and also protect long term oral health in the process.

Howard: So I see you got a lot of amazing resources links to the National Cancer Institute on oral complications of chemotherapy and head neck radiation. It's just a what what do you think the average dentists and hygienists are not staying on top of it they need to know more of?

Jill: There's quite a bit as it's a very complex subject matter and with everything else that we're doing and dealing with during our daily process of seeing patients this is something that tends to get lost in the shuffle in our education and it's hard to stay at font on top of all these things because it is such a complex subject so one of my goals was to really make kind of a one-stop shopping a resource for people because that is something when I developed a passion for the subject I really struggled to find information and resources so I wanted to create something to make it a little easier for people to find what they need.

Howard: Well you know the the chemo therapies all came from the fact that when they were learning how to make mustard gases for Wars they realized that the cells are dividing quickly and had a high turnover those were the ones susceptible to it but a cell that wasn't multiplying was not and so that's kind of tough for the mouth because the cells in the mouth have some of the highest turnover especially if you compare it to a bone or nerve.

Jill: Exactly

Howard: So how do they help alleviate some of those symptoms?

Jill: One of the biggest things we can do and unfortunately it's one of our greatest battles is getting patients in very early very soon after diagnosis before treatments begin allows us to be very proactive that we can remove irritations in the mouth and get them started on some preventive strategies that will help to reduce the incidence and the severity of side effects. It may not totally prevent them but at least it may help to keep more quality of life for them and reduce their risk of infection before or during the process and they also help to reduce those long term damage issues into survivorship.

Howard: and are these mouthwashes I'm treating just dryness I mean a lot of the chemo people get a fungus infections you know candida, what are what are you seeing is the most common side effect that you can that you can help them with?

Jill: Dry mouth is a big one and the nice thing is, is we have so many patients with dry mouth that even aren't necessarily in oncology situations that these are also helpful for them but if you deal with the dry mouth effectively and not just mask the issues you're going to be actually helping to prevent a lot of other problems like the oral mucositis because it helps to lubricate the tissues and you know there's even to avoid the fungal infections and things like that the drier people's mouths are the more susceptible they are to the problems. So the only prescription product that there is available on our site is the saliva Max and saliva cane but everything else is just affordable over-the-counter products that are have a healthy ph and void of irritating detergents that may cause complications irritations in the mouth, extra soft toothbrushes sometimes there are really just simple changes that can make a big difference for people.

Howard: and tell us about saliva maxsize you need a prescription for that are you a big fan of that?

Jill: Yeah I think the supersaturated calcium phosphate rinses are a great option for people and that also if you can start that you know about two weeks before treatments begin they've proven to reduce the incidence and the severity of developing the dry mouth and the oral mucositis. So is a great preventive option and also it you know it's really replenishing those natural elements of healthy saliva that's missing in a dry mouth with having the calcium on the phosphate that are our teeth are dependent on for remineralization and our tissues dependent on for healing properly.

Howard: and how long has that been on the market it's for forward science makes that correct?

Jill: Yes, I would say four years or so.

Howard: Four years and is that your is that your go to treatment for dry mouth?

Jill: If we're able to get people started on that early I think that's a great option for them we do have some people that whether it be financial issues or lack of insurance coverage that they choose not to go that route at least we do have some over-the-counter options that they can try as well it's kind of depending on that individual person's situation.

Howard: Is it pretty expensive?

Jill: No and then they actually have a copay assistance program so if there is insurance coverage through the prescription insurance plan forward science can help to reduce or possibly eliminate the co-payment.

Howard: Forward science it says on there that they're proud producer of Oral ID, CYTID , pass ID, HPVID, PHID and Saliva Max. You just mentioned Saliva Max do you do you ever have an indication for all the other ones?

Jill: Yes the other aspects are actually for screening for oral abnormalities so all of those other devices and products are part of their ID for life program and that is part of your early detection for oral cancers, oral abnormalities with the fluorescence and then the more advanced testing kits like the Site ID is actually a liquid cytology so if you would see a suspicious lesion and you can take some of those surface cells send them into a laboratory and have a report sent back to know if it's something that needs to be looked at further.

Howard: Forward Science that's in Stafford, Texas.

Jill: Yes

Howard: Forward Science , so do you work with CEO Robert Whitman on that?

Jill: Yes we've known Rob for many years.

Howard: Yeah and and Bryan Pakula Piccola?

Jill: Yep, yeah there it's a great company great group of people working there.

Howard: That is a they've got a lot of a lot of things going on. So what you also have a moistened mist you have lozenges you have all kinds of products on dry mouth. What would what makes you use one product versus the other?

Jill: Sometimes it is just a very individual situation and like I said them there's really no one-size-fits-all I wish there was a magic bullet that worked perfectly for everybody but I have many patients that I have issues and just swear by a certain product and the next person tries it and maybe doesn't have as good as a result with it so sometimes treating these issues is a little bit of trial and error so you can try one thing and it doesn't work you go on to the next and eventually you find the right fit for that person.

Howard: and you said on the board of the oral cancer foundation org what is that like?

Jill: It's a newly formed dental hygiene advisory board and it's really focusing on helping to get the word out there and promote early detection and promote what the oral cancer foundation is doing because they are a really nice organization that does a lot of great things in the terms of research and raise awareness and promoting early detection for oral cancers.

Howard: and how you know it's tough in dentistry because you have to wear so many hats I mean you gotta learn how to do root canals fillings and crowns, you got to be a leader at HR advertising market everything and I've always noticed that if you don't see a case every week if you don't do a filling every week or a crown or an implant you know it's that if you if you do it 52 times a year you can get really fast high-quality profitable. The problem with the oral cancers they don't see it that yeah cancer patients it's just not that common or do you think it is more common like in a dental office right now today you know there's a hundred and fifty thousand general dental practices, how often do you think they see a cancer patient that is having the side effects?

Jill: It would be a hard number to guess but not only thinking of people that are actively going through treatment now the every week we're seeing people who are cancer survivors. So being aware of what type of treatments they had what type of side effects go along with those treatments and being able to deal with those into survivorship is also part of this. So in the ideal world we would see people collectively before they start treatments be able to be very proactive to help reduce those problems be there for them during the process of problems arise but then also be their support structure you know into survivorship and understand what some of the damage is that can happen what we can do for them.

Howard: and then where are your you say that you have online articles for the dentists or the patients so what were those that on your, under resources for survivors and caregivers?

Jill: Actually there's a blogs tab on top click on that you can separate those from the survivor caregivers that are more in layman's terms and then the professionals medical dental professionals that are more tactical.

Howard: I love the anti cancer Club it's about life that is really amazing. So are you getting a lot of positive feedback from survivors that are using this website and articles and products?

Jill: Yes it was a it was tough too the word out there at first and tough for me to have people understand what it was about because I think that assumption was mostly that it was only oral cancers that they may not be presented with these cases often enough so as people are understanding more that's all types of cancers all types of treatments and it is very a very universal problem and when you talk to so many survivors that tell you their stories about the lack of information that they received you know that they had problems during the process that they weren't told ahead of time what they may experience they weren't told what they could do to prevent it and being so grateful when they actually have something that helps them.

Howard: You also have articles from the American Academy of Dental Oncology?

Jill: Yes that is a organization that really isn't connected so much anymore but I was I was very very fortunate to go down with Dennis Abbott in Texas he was one of the instructors there a main instructor and the organizer of the Academy and I was one of the only hygienists in the country that was part of that a non girl meeting and it was very exciting very instructive a lot of great people that all had similar interests so it was a really great experience being a part of that.

Howard: That was with dr. Abbott?

Jill: Yes

Howard: Dennis Abbott, so what's he doing down there?

Jill: He actually um specializes with dental oncology, so he's spoken all over the country teaching other dentists about things that they can do in regards to cancer treating our patients going through cancer what's some of the same types of interests that I have so it was really fine like finding a kindred spirit when I found him online.

Howard: Oh that's awesome Internet is very very cool.

Jill: It is.

Howard: So what else are they gonna find on

Jill: You know just those resources the information the products and having that support structure or the support system that I have a lot of patients that email me personally a lot you know that they have questions about now I know I might be dealing with this or now I might be dealing with that do you have any suggestions and and they go back to their support groups and they bring information for their other friends and there's other people that are dealing with the same types of problems so it's just it's really awesome to see kind of how it's spreading from word of mouth from the patients and trying to help each other through it all.

Howard: Is it more professional or more consumer on your site?

Jill: Both we're just starting a bulk section that is going to be designed for providing products for clinics, hospitals, long-term care facilities so we have one product on there at this time and I would like to grow that obviously to have more options.

Howard: So I've also noticed I follow you on twitter your twitter is oh my gosh what are you on Twitter what's your Twitter?

Jill: @supportjill

Howard: @support_Jill isn't it?

Jill: Yes

Howard: Yeah and that newspapers have picked up on your articles yeah so it's @support_Jill I noticed the Green Bay you're only a half an hour away from Green Bay so the you've gotten some community press with that congratulations on that.

Jill: Thank you yeah it's um I went to some of the soar meetings which is basically like a small business advisory group and they helped kind of get things started for me and yeah they've gotten something good progress or good exposure what some of those things.

Howard: What has been the most help growing this website and this business

Jill: Well I think winning what or be one of the recipients for the RDH Award of distinction was much larger than I had imagined it to be at the time I really didn't understand what that award was when I was a recipient but the connections and the community that it has brought it has been wonderful so I met so many great people and it just continues to blossom from there a lot of just networking and finding people with similar interests and the entrepreneurial spirit that really everybody wants to help each other so it's a great group of people out there.

Howard: So that's the Americas Award Sun star America's RDH Award a distinction.

Jill: Yes

Howard: and that was largely you said larger than life for you how so is that tell us more about that award and how that got you so much attention.

Jill: They give the award at RDH Under One Roof and the year that I was a recipient we had eight of us that were chosen they have sense narrowed it down to four people each year that they choose as award recipients but they just form a really awesome community where it is meant to support each other and in your endeavors and to recognize a hygienists that are doing something unusual they're going above and beyond typical clinical work.

Howard: Well congratulations of that, that's just awesome yeah that RDH under one roof that is the main event and dental hygiene every year would you agree?

Jill: It is a great event.

Howard: Yeah

Jill: I definitely recommend anybody going.

Howard: It's what?

Jill: I definitely would recommend a hygienist attending.

Howard: Do you go every year?

Jill: Oh I wish I could I would love to go every year but it's a little limited right now when I'm able to get away to do that but I hope so too in the future.

Howard: Do you make any of these products are you just a one-stop shop resource for all these products?

Jill: Basically its distributor one-stop shop there is one product that is fairly exclusive to us that's the lip balm it is made from actually my cousin is a beekeeper here in Wisconsin and she makes products from her for bees and that is as one of the products that we have so it's petroleum free and free of other harsh chemicals that may cause irritation.

Howard: That's the nourishing lip balm?

Jill: Yeah

Howard: Wow that is amazing so now do you do you is it all virtual online or do you actually have to warehouse product and and put it in a box and ship it?

Jill: Yes I am um I'm like Bill Gates so I'm building a computer in his garage I have it I have a bedroom that is converted into an office in a storeroom I am physically packaging and mailing out orders and doing sometimes my kitchen table is just filled with packaging supplies and boxes and products just getting everything together.

Howard: So you've been doing this since 2012 to 2019 so you've been doing it seven years is this I is this a growing business?

Jill: It is, it is and this it seems like this last year has really been a year that it's starting to take off more.

Howard: and what do you tribute that too?

Jill: I think it's just more of awareness maybe and people understanding better what a need there is that seemed to be hard to get through to people at first you don't really understand why this was a need.

Howard: Yeah I also see that you're a Burst ambassador talk about that why are you Burst ambassador?

Jill: I loved that toothbrush was a Sonicare fan for many many years the Burst for me is something that you know people are going through treatments a mechanical brush may not be the best option for everybody but when they are ready for a mechanical brush it has extremely soft bristles they're very feathery it's got three modes of a setting so it has like a sensitivity setting so it doesn't have you know the real intense vibrations it has like an antibacterial quality to the bristles and if you put too much pressure on the head like if you get up into a tight spot in your mouth and you put too much pressure on it it'll actually shut down the motor of that so you're not you're going to really minimize your risk for having tissue trauma by using it.

Howard: There's really been a lot of innovations and a toothbrush layer I mean they have been connected electronic brushes to the smartphone there's Burst and Quip there's all kinds of it made of bamboo shoots for disposable. It's just a huge market because they're seven and a half billion sapiens living on the surface of Earth and they all should be brushing their teeth twice a day and throwing it away every three months. I mean if you do the math on that if anybody does about 1% of the toothbrush market and it would be a major company. I remember when Bob Ibsen and the founder of Denmat he didn't like you need the tooth pastes he thought they were all just generic and he wanted to have a high-end toothpaste Rembrandt for composites and I remember him telling me he says this markets so huge if I just got 1% of it it'd be the biggest thing I did and he did and it went on but as you were saying earlier that everybody's different everybody likes different stuff. Are you having success with Burst toothbrushes

Jill: Yes yes I I found that my excitement for it, it was the Christmas gift of the year my family every every single family member I have I think it has gotten the first toothbrush from us but it's really a quality toothbrush I think it does a great job with keeping down the bacterial burden inside of the mouth and it's a good seller it's it's a really great product.

Howard: and you have a lot of interesting I'm people should go there just look at all these products you have a lot of  interesting products like Ora Chill what is Ora Chill? Why is that on your site?

Jill: That is actually like a cryotherapy type of a device for the mouth so some people if they have tissue irritation, soreness inside of their mouth rather than having a drug to try to fix that problem they can use cold items to try to reduce some of that swelling or tenderness inside of their mouth and actually when people have chemotherapy treatments done one of the ways of helping to prevent getting mouth-source is by sucking on like ice chips or something cold and the concept is is that it shrinks the blood vessels in your mouth or constricts them and then it prevents the same amount of chemotherapy from reaching those tissues to contribute to oral ulcerations. So the cryo the Ora Chill can help to do that same type of a cold cryotherapy for the tissue.

Howard: and that's Joey Santoro out of Sacramento?

Jill: Yes

Howard: and the how's that product doing?

Jill: Good we're more of a kind of a resource that we don't carry it directly on our site but Joey's had a lot of a lot of cancer his family he's lost a lot of people close to him through cancer so it is a subject that's really near and dear to his heart and he's extremely generous that if people are going through treatments he often offices product for free for them because for him it's more important that they get the help that they need.

Howard: and then that seems like your motivation to this hit really close to home and losing your father to Hodgkin's and your mother had breast cancer, do you see that a lot in the in the oncology space?

Jill: Yes I see that a lot that most people that are involved in it in some aspect is usually because they've been touched by it personally they've seen it firsthand and they want to make a difference for others.

Howard: You also you just have a lot of that I mean there's so many amazing studies all kinds of products another one is an Oral ID shine light save lives.

Jill: Yes and that's with forward science as well that's part of their ID for Life program the oral ID is a fluorescent device that helps with early detection for oral abnormalities oral cancers when we're doing our screenings in the office and the other products that go along with it are like the Site ID the Path ID, HPV ID and those are all agentive tests that can be used to help to help with diagnosis.

Howard: I always found it bizarre how you know you go to the other end of the body on a female and these lights and types for pap smear screenings and they had the UV lights and the toluidine blue stains and all like I said and it was all paid for by medical insurance and it was just the go-to and then you were over here in dentistry and it's like insurance just don't want to bill for that stuff and it's like 50,000 Americans drop dead from oral cancer every year, correct is that the number 50,000?

Jill: Yes

Howard: and could you imagine the outrage if the metal community told women oh we're not gonna cover the pap smears and toluidine blue and the purple light and I mean the women would go crazy but then the other end of the mouth the mouth men and women it's just so it's one of the huge side effects of dentistry breaking off from medicine and what do you think of the typical dental insurance billing for oral cancer screenings, oral cancer exams. Like you're talking about this Forward Science with with the oral ID I mean almost none of that has an insurance code is that correct?

Jill: For some of them there be some some codes used there is a code for using that adjunctive fluorescent device whether it's going to be covered or not probably not but not alot of dental offices charge for that either.

Howard: but do you think it's bizarre that 50,000 people dying from oral cancer?

Jill: Yes, absolutely

Howard: It's just this lame attempt to go after and subsidize any technologies because money matters. I mean money is the answer what's question you can't do all these things with with unicorns and tooth fairies it takes cash and a lot of the I watched it for 30 years a lot of these oral cancer companies coming out with all kinds of technologies they were assuming the dentist would take it as serious as like OBGYN and there but there's no financial support for it.

Jill: Correct you know it's one of those things that we battle all the time that thinking of the molt is somehow not connected to the rest of the body and I think that's part of so much what side effects support that that people aren't getting that information the support they need because whatever is happening in their mouth you know the physicians are making that connection what effect that has on the rest of their body and their medical conditions but yes it's very sad that there's so many people out there that are being affected by oral cancers and the numbers are rising they're not they're not going away if they're not getting smaller through the years cases oral cancers are growing and is something that the dental industry test does very much take seriously to make sure that we're screening properly and if there is something starting to catch it at the earliest stages.

Howard: and we're seeing some interesting statistics that at my age of 56 I never thought I would see like life expectancy pretty much always went up every year and for the United States and then it's gone down the last 2 or 3 years and some of these cancers you just I just always assumed that I was in college that there would just be less that they would just go down every year with more and more knowledge and technology but smoking is one that shocked me like smoking floored bottom doubt a couple of years ago and now smoking is coming back up and they attribute a lot of that because of vaping and all kinds of things. So oral cancer is gonna it's gonna be here a long time.

Jill: It is and the highest growing demographic is not typical of what we were used to through the years it's now the younger non-smoking males because of the human papilloma virus. So you know we may see a trend changing with bad as more young boy start getting vaccinated along with all the young girls because there was such a push for the young females to be vaccinated but now they're also trying to get more young males vaccinated so hopefully as time goes on the more vaccinations that occur but fewer cases we'll start seeing with some of these oral cancers as well.

Howard: and you know this anti vaxx it doesn't surprise me at all because I was the dentist with a Jack Dillon burger that got Phoenix for date and 89 and I mean I use it was like one fourth of all Arizona people that they just had the most insane theories about communist plots and big government one world government and so the people are the same I can't believe it's 2019 and now we're having measles outbreaks and anti-vaxxers you're talking about HPV vaccine. I mean there's just a good solid I I think it's about right at about one in five Americans are completely batshit crazy I am I can't believe we'd be seeing the measles outbreaks. I mean diseases I should have just been going and this HPV I mean I'm embarrassed of my homies were when this HPV association with oral and ferengi cancer came out hardly any dentists dental offices are talking about this to parents. I mean it's more important to the hygienist of the dentist to get in there and do the Profi and cleaning and do all of that and it's like my gosh this kids 12 I mean wouldn't it have been better to give them a flu shot but they can't legally give them a flu shot but walk across the street to Walgreens and have a non pharmacist at give a flu shot and and the flu can kill 30 to 80 thousand Americans each year the HPV vaccine. I mean why do you think dentistry isn't giving staying on top of flu shots, HPV vaccines, I mean you're you have a four-year degree that's a registered nurse in any Hospital in America where they're giving shots all day long for that stuff. Why do you why do you think that culture is so vastly different?

Jill: That is a hard one to explain and I think there is such a disconnect and our patients minds and and unfortunately that goes over into the professionals minds as well that you know that is not even on the on the radar I think for a lot of dental professionals to be even thinking about that but that is the one nice thing that I really like with Forward Science as well as that they offer great information that we can provide for patients that talks about HPV. So you know I still practice and it's something I try to do pretty consistently when I get kids in they've been 10 11 12 years old I have a pamphlet I can hand them and talk about you know to mom and dad this is information for you that if your pediatrician has not already talked to you about the HPV vaccine ask them about it you know give them some background on it and be proactive on our end so even if we can't be the one is administering the vaccination we can at least inform them about it and encourage a conversation with their pediatrician.

Howard: Well I mean last year 2018 20 the the flu winter of twenty seven twenty eighteen eighty thousand Americans died of the flu including a hundred and eighty babies children and teenagers more than any year since they started tracking pediatric and it's like and still a pharmacy tech with nine months of school across the street from my office at Walgreens can give me these shots and the dental office I mean we we legally can't even do it I mean it's just really bizarre and with 50,000 oral cancer deaths and and and having a technology the HPV vaccine you would think access to health that a flu shot and HPV vaccine would be far more important than determining if they had five cavities and gingivitis.

Jill: Yeah and I guess you never know where how that tide may turn through times because I think a lot of that anti vaccination mindset comes from not believing it's real you know they've we've never had to deal with measles you know growing up so it wasn't real to us so until unfortunately people start to see these personal experiences of people being affected by it I think all of a sudden we're probably going to start seeing a trend going the other way again that if they'll understand the importance of it.

Howard: I mean to put that in perspective the bubonic plague it killed a third of Europe and it took care of two hundred years to regain its pre plague population and what's the what's the answer to that, I'm against vaccines. I mean it's just it's just people are there so imposable. You're very close to Canada what percent of your business of your shipping from is America only versus Canada or other countries?

Jill: We've been staying a miracle only at this point as we grow more there might be some other opportunities especially with if we look at the bulk end of options for facilities for hospitals things like that but right now with shipping even though that we are so close it still is it makes it hard to to do.

Howard: So when you woody ship mostly UPS FEDEX?

Jill: Usually the postal service.

Howard: and it's significantly more expensive to ship across the border into Canada.

Jill: The few times that I've done it yes.

Howard: Wow that seems like such a I'm ninety percent of the Canadian population lives within a hundred miles of the border you would think that would not be an issue. I noticed that one of your products you sells Closes which is in my backyard with Perry Radcliffe and

Jill: Yep

Howard: started that I remember going to dinner with Perry God three decades ago, getting a bottle of that it used to be called Retardant before is closest do you remember that?

Jill: No I don't remember that.

Howard: Yeah it was first called Detardent and then they changed the name to Closes so are you what what do you think of Closes?

Jill: I like it I think those product line is very gentle it's you know void of so many irritating detergents and other chemicals that really helped to initiate some of that tenderness of the tissue or may help to result in some of the oral alterations and things like that.

Howard: So I you do like it then?

Jill: Yes

Howard: So Perry was a periodontist and he was good buddies with Omari Reed here in Phoenix and now his son James Radcliffe runs Ropar pharmaceuticals make her closest he was on the show he was show 484 but yeah and Perry also was I don't know why we don't do anymore but in his office he would always take a swab of saliva and put it underneath the scope and you know and it was just so that the teaching was so impactful because you know back then in the in the 80s I mean you had to explain what gum disease was to people I mean they just and and there were just so many people that just could not believe they were that was in their mouth. I still think it's one of the biggest blasts from the past that we have to bring back, I think putting your saliva under a scope and letting them see the zoo of the San Diego Zoo of what's going on in your mouth. Now what we've been talking a lot about this oral cancer but dry mouth is probably a lot more common outside of oral cancer especially with polyphagia when people are taking five or more prescription medications it seems like everything gets out of whack and so are usually are you doing a lot of this for pharmaceutical induced Xerostomia?

Jill: Yes I've really found quite a few patients that really aren't even oncology situations but they've been struggling because of different medications different medical conditions that they have with their dry mouth and of course the drier your mouth is it becomes more acidic and throws off that whole bacterial balance inside of your mouth and unfortunately there are a lot of products that are out in the market that are marketed to people with dry mouth and they are damaging to oral health they're acidic some of them have other irritating detergents in them so they're really not good choices for especially people in oncology situations so that was one of the goals with choosing products were things that we're not only going to mask the symptoms but you know benefit oral health and be very soothing to the tissue altogether.

Howard: You also got a link on your website to oral cancer Consulting LLC

Jill: Yes that is one of my hygienist friends Susan Cotton she is on the advisory board with me for the oral cancer foundation and she is a great advocate for oral cancers for early detection and for training Dell professionals how to do a proper thorough screening because that is something that really tends to get lost in the shuffle and a lot of our appointments.

Howard: and she goes out screening the cotton method?

 Jill: Yes

Howard: and tell us about the cod method.

Jill: She goes through this very systematic approach of what we should be looking for the proper ways of doing it to get the best visualization the proper ways of documenting and creating office protocols to make sure that your whole staff is on the same page for doing it consistently.

Howard: and what is her first name it's cotton Issei is her last name?

JIll: Yes Susan Cotton

Howard: and so how can you educate more dentists and hygienists how to do all this I mean have you made like an online CE course or have you tried to summarize this faster, easier?

Jill: I will be working on an online CE course in the near future and I do in-person presentations. So I go to a lot of dental offices and I'll do full staff trainings I will speak at different conferences or meetings for maybe like the oral oncology Nursing Society or a genital Study Club or dentist or hygienists and it just helps you get the word out to educate and and put some of that those key informative pieces in the back of their mind so when the time comes up their situations they know where to go and how to approach it.

Howard: Well if you ever want to make an online CE course on dentaltown that would be an option we've put up 401 our courses and they've been viewed almost 1 million times because I think it is just so much more convenient to watch something an hour at a time instead of you know committing the whole day flying somewhere I think the human mind is about an hour's about enough. I mean a long I do my show because that's it they're our commute but I think humans learning an hour at a time is just a lot better when and and a lot of the studies that I see in education are frightening. I mean that I've seen studies that show that when kids go to grammar school they can remember nothing long-term before 10:00 a.m. and then when they're listening to the teacher talk they can only listen and comprehend for seven and a half to 15 minutes and then they need a break and a half they need to go eat. I mean that's all you got with the Sapien mind I mean that's just the nature of it. So online courses or something that you're thinking about doing in the future?

Jill: Yes  the opportunity has has been approached to me and I would like too, it's one of those new aspects that I will be going into but definitely I would love to do that with dentaltown and the nice thing is this is such a complex issue that there would be a potential accommodating several courses just focusing on dental oncology.

Howard: So there's done what would you just focus on dental oncology or do you focus on Xerostomia too?

Jill: Well and all that is part of it you know part of the talking about what types of side effects why they have the side effects it's so involved that just going into dry mouth in itself is it's a very complex subject and talking about why it happens in oncology or what we can do about it and that's only one aspect of what possible side effects can occur.

Howard: You also cover toothpaste what toothpastes do you think are better for dry mouth and versus others?

Jill: The ones that we chose on our website we do the Closes and then I have two types from the Squiggle toothpaste the things that really attracted me to these toothpastes where were the lack of irritative detergents they're very very mild a lot of problems that will complain about is that lot of toothpaste the the taste is too sharp it'll burn their tissue if sometimes aggravate nausea things like that so these toothpastes are very very mild but they're pleasant they're not watery like some of the dry mouth toothpastes are out in the market and they just have a lot of benefits to oral health.

Howard: and it has a lot of xylitol in it.

Jill: Yes yeah I'm a fan of xylitol I think that's a great product to help stimulate saliva gives the doesn't taste and it helps to keep that healthy bacterial balance inside of the mouth.

and who's the makers of squiggles

Jill: Squiggle is a company that's out east and

Howard: Just

Jill: His name is dr. Cutler yes

Howard: and is he a dentist?

Jill: I believe he is a pharmacist maybe, can't remember exactly what his background was but he's been very passionate really it was a great fit for us because was when I told him what our mission was with side-effects of oral heath he was very excited because that was really something that he had been trying to Squiggle into an apology settings it for quite a long time because he really has seen the benefits that people have had late with using it with oral irritations.

Howard: Dr. Edward Cutler in Narberth, Pennsylvania. It's amazing I am and it's it's amazing how the long tail is the Millennials made the long tail when when the baby boomers a little you had three TV station ABC, NBC, CBS, you had just a couple radio stations in the radio station be half commercials have song so you'd have six three-minute songs and then thirty minutes of commercials so you had all these stars that would get sell 10 million albums whether it be the Beatles or Elvis Presley or all that kind of stuff and then the digital world came out and that instead of having three television channels ABC, CBS, NBC, yet cable which has a thousand channels and you have digital and you have the Internet so whereas like Americans the baby boomers would have liked by one big album by the you know the Rolling Stones or the Beatles or whatever and everybody's buy like American cheese the Velveeta cheese all those products have plummeted but the long tail of individual products is going out. I mean Amazon reports that no matter what book they put on their shelf they'll sell one unit of it every quarter same thing with iTunes on the songs I mean you could put a song on iTunes from a Tibetan monk who filmed it cave on her iPhone and it would sell one song a quarter and I'm looking at some of these tooth pastes like the squiggle says a is vegan, free of gluten dairy and soy. I mean that that just wasn't a market for a baby boomers 20 years I mean 30 years ago you had crushed or Colgate or get out of it and get out of town and this is that long tail war we're probably gonna have a hundred different toothpaste and a hundred different mouthwashes probably selling to a huge probably a third or a half the market so I would only expect Crest and Colgate and Procter and Gamble they're never gonna see the glory days that they did when they could control all the commercials on ABC, CBS and NBC. I mean these these big-box brands are gonna get replaced by the long tail and I just think that's amazing who I mean I just couldn't imagine thinking that being a vegan was associated with a toothpaste but it obviously is.

Jill: Right, yes and I think for you know this demographic that they are so susceptible to that tissue irritation that anything that we can do to help you know keeps that quality of life for them and keep them comfortable during the process and just be void of some of those triggers you know like I never thought about gluten being an issue either in toothpaste like but for people that do have those sensitivities if they have a certain chemical in a toothpaste that might just even the trigger that starts with the ulcerations and have tenderness that starts a snowball effect where then they have a hard time brushing and then we do get the plaque buildup and makes them more susceptible to infections and complications but there are treatments in general.

Howard: Yeah and you know and we also live under this false bias that we know so much I don't think humans want to realize that they probably don't even know 1% of all the knowledge in the universe and so so much this stuff you just don't know and you just gotta listen to people I mean when someone's telling you when I use this too pace I get canker sores well who are you to sit on your you know pulpit and say that's crazier there's no researcher I mean I don't even know if they if they know what causes canker sores and who's to say that everybody's canker sores are caused by the same thing. So trying these different trial and error I mean that's the art of dentistry it's an art and a science and and then also there's trying to find something that the patient will like some patients...

Jill: Yes

Howard: I noticed a lot of the old baby boomers huh they loved Listerine mostly because it burns their eyes and burns your mouth it's got to be doing something it almost killed me I mean my mouth's on fire how could a how could a germ or a bug let's do that so this long tail in toothbrushes and toothpaste and mouthwashes I find very very interesting. What would happen when you started this what products really surprise you in popularity? What did you start carrying and shipping a lot of that that caught you by surprise?

Jill: I think I was surprised how popular the Spry gum and the Spry gems and mints are I thought that was going to be something that would just be a nice thing to carry because obviously when you're chewing you're sucking on these products it is helping to stimulate saliva and it's got the xylitol to help also stimulate saliva and give you that healthy bacterial balance but I was surprised how many people swear by those with helping with their dry mouth symptoms much more than I thought they would and when you talk about you know the newer developments in certain products and their ingredients I think that's what I'm really excited about the newest additions that we had with the Moisyn and the Synedent are made by Prisyna and they've got a really unique combination of kitazan and arginine so the arginine is an amino acid that will feed the good bacteria in your mouth so it's kind of getting away from that concept of the past of Listerine you want to just get in there and kill everything because as everything starts to recolonize you know what is preventing all of the bad bacteria from overtaking the good one it's recolonizing but if you can concentrate more on feeding that good bacteria and overpowering the bad with that the arginine comes into play the kitazan it helps to maintain a stable pH in the mouth and it's anti-inflammatory and it's got a really great potential I think with that combination of those two.

Howard: and that's a Blaine Yates out of American Fork Utah. Do you work with him very much?

Jill: I don't know him personally I just know the people that I the reps that I deal with but they also are a great company to work with. I've been very pleased with some of the updates that they made and some of their products through time and Prisyna is actually out of California that's the the Synedent and the Moisyn I can't say enough about their company has I've been very very blessed to make a lot of great contacts and...Synedent and moisten that is comes in a rinse and a spray and with Moisyn they've actually found on through studies that it can raise resting salivary rates

Howard: and that's made by the company Prisyna? 

Jill: Yep Prisyna 

Howard: and how long have you been aware of Prisyna that's a that's a new one to me?

Jill: I would say maybe six months or so we haven't had it on our site that long but I really can't say enough about the product so far and the company they're they're fabulous to work with.

Howard: Any of any other surprises?

Jill: Trying to think of one, I really enjoyed the Zollipops as an adult I probably shouldn't enjoy lollipops as much as I do but they are such a neat product and that is one that I'm hoping to actually add to a bulk section at some point because a lot of oncology department is use they may provide things for their patients just stuck on during chemotherapy infusions to help stimulate saliva and sometimes they can get that bad taste in their mouth so it's just a a nice thing that they try and do for them but many times they're giving them you know Jolly Ranchers or lemon drops or things that really could cause a lot of damage to oral health you know down the line stones I would love to offer some other options that they can provide for their patients that can their that taste good they can stimulate the saliva and offer them some oral health protection in the process.

Howard: That is amazing is there any other thing that you wanted to talk about today that I didn't cover? I've been all over the board with all these different products and companies, is there any anything else?

Jill: I just hope that you know I'm grateful to have this opportunity to make more people aware of the services that we offer through side effect support and then also just to encourage dental offices to use it as a reference for their patients. So when you have your patients with dry mouth that you have someplace that you can direct them to to get these products because unfortunately when you make recommendations for products in the office unless you give them a source to where to get them they're put out into these big box stores wandering aimlessly through these long aisles they could confuse they're not sure what to get and they just get what they're what they would otherwise or just pick the next thing out rather than really following what you've recommended. So it's so convenient for your patients to just direct them to once setting that they can just have it delivered right to their door and also to use it for the education and use it for the resources to reach out you know I am always available that if an office has a situation or a patient has a situation and they have a question to contact me because if I don't know the answer I will try very hard to find out.

Howard: and how do they contact you, what's the best way to contact you?

Jill: There is a link on the site the contact us link but my web my email address is

Howard: and I love your blog's I mean you got some really amazing blogs in there I mean

Jill: Thank you

Howard: Very good I mean your last one on understanding risk of MRONJ in cancer patients. I mean this is just some stuff that you just it's very fascinating.

Jill: It is fascinating like I really think we're going to be seeing more cases of the medication related osteonecrosis of the jaw as dental professionals because of some of these newer targeted therapies that are are coming out, so it's very important that we're aware of the risks.

Howard: I also love your chart on the pH of common substances a battery acid, stomach acid, all the way up to a bleach it's dental erosion is another thing. I remember when I was in school they thought they still thought the dental erosion was from sawing the toothbrush back and forth and then they thought it was from occlusion and then they thought it was from acid in pH and it's probably from multifactorial from all the above isn't it?

Jill: Yes and it's something to be aware of also that sometimes the medications that people are being given in an oncology setting are very acidic or they may contain sugar so it's good to be aware of what some of those medications are or what the risks may be and what we can do to help curb the effects from them.

Howard: Well III think you should just do an online CE course I mean just to cover for the team because it's one of those things where if a dentist is listening this podcast he needs the hygienist to be on bored the you know everybody everybody has to be on board and what's scary what's frightening is when you study a dental office you know who gets asked the most questions in the entire dental office?

Jill: Front desk.

Howard: Front desk and when you give them a prescription or they got a questions I got a problem they call they're asking Valerie who's answering the phone and then when you go to these dental course like I just lectured Saturday in Phoenix there wasn't any staff it was a couple hundred doctors I think three hygienists and that was it. It's like why do these people not realize that it's a team approach and whenever I see a dental office where the dentist it's just standard where you know the whole office goes to CE together and because he gets it because they're gonna be asking the front desk or asking your assistant when you leave the room hell they're in there with the hygienist for an entire hour I mean that's the most a dialogue that if you if you can't get your staff on board to form informative educating relationships with your patients on all these issues it's just not gonna get done.

Jill: Absolutely and I think that it's one reason I love doing like the in-office education to going in and having a complete staff at one time that can all ask questions and and there may be aspects of the educational part or the technical things that you know they may feels a little bit like they don't understand what that has to do with them but it really is so important because they are the first line of making contact with patients and I always use the example that if they're confirming Mr. Smith's appointment to him and he says well I think I'm gonna cancel because I just found out I have cancer I'm gonna be starting treatments in two weeks you know unless they're aware of some of the issues that can arise it would be human nature to say oh by all means you know call us back when you're feeling better but they're missing out on the golden opportunity then to instill in that patient the importance of keeping their appointment and making sure that any work that needs to be done is taken care of before they enter into cancer treatment. 

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