Prairie Doc perspective Week of December 28th, 2025
“Keeping Us in Balance: The Work of the Kidneys”
By Andrew Ellsworth, MD


Picture a man crawling through the desert in tattered clothing, whispering “water” as he nears an oasis. He isn’t thinking about his kidneys, yet they may be the main organ still keeping him alive.


The human body does an amazing job at maintaining the balance of our internal environment, known as homeostasis. The kidneys, those two bean-shaped organs at our sides, are vital for maintaining that balance. Through filtration, reabsorption, and the secretion of hormones, the kidneys are one (or two) of our most important organs. 


Each day, the kidneys filter roughly 50 gallons of blood, enough to fill a bathtub. In doing so, they remove waste products and toxins that would otherwise build up and cause harm. They also regulate electrolytes such as sodium, potassium, calcium, and phosphate, which are essential for proper muscle, nerve, and heart function.


The kidneys regulate our fluid balance. If we are dehydrated, they will reabsorb more fluid back into the bloodstream.  Meanwhile, if there is excess, they will increase urine production.  On a normal day, a healthy person usually only needs to drink when feeling thirsty.  Anti-diuretic hormone is secreted by the brain when you start to get dehydrated, telling the kidneys to retain more fluid, and giving yourself the sensation of thirst.


The kidneys help regulate blood pressure through their control of salt and water retention or excretion. They maintain acid-base balance, keeping the body’s pH within a narrow, safe range. In addition, the kidneys secrete hormones involved in bone health and stimulate the bone marrow to produce red blood cells.


With all these responsibilities, preserving kidney health is essential. You can support your kidneys by preventing imbalance where possible. Eat a healthy diet low in salt and added sugar. See your healthcare provider regularly to screen for diabetes and monitor blood pressure, the two leading causes of chronic kidney disease. Avoid taking excessive amounts of medications such as ibuprofen or naproxen. Other prescription and over-the-counter drugs, supplements, and herbal preparations can strain the kidneys as well—so use them carefully and follow directions.


With the kidneys, balance is key. Avoid excess, protect your health, and your kidneys will likely manage the rest. Whether you are sleeping soundly at home or desperately seeking water under a desert sun, your kidneys continue their quiet work—filtering, regulating, protecting, and keeping your body in balance.


Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of December 14th, 2025
Happy Holidays! Use Occupations to Balance Seasonal Stress
By: Karen Hebert, Ph.D. & Mackenzie Feldhacker, OTD
The holiday season is fast approaching with all its festive occupations like decorating the house, buying and wrapping presents and preparing and serving holiday meals. Between the additional time requirements, costs, travel and interactions with family members, this can be a particularly stressful time of year. Difficulties with getting around the house or community, remembering and managing multiple to-do lists, and feeling comfortable socializing for long periods of time can compound holiday stress.  While some people experience a sense of deep engagement and enjoyment with holiday preparations and celebrations, others find the additional demands tiring and overwhelming. Many of us experience a variety of emotions, from deep joy to stress, during this busy time. No matter how you view the season, faculty in the Department of Occupational Therapy at the University of South Dakota have some advice to help reduce stress and enjoy your festive occupations this year.  
    Take a moment to think about your favorite holiday activities and identify what makes these moments enjoyable for you. This might include visiting friends and family, the smell of peppermint hot chocolate or memories associated with listening to songs from your childhood. Early in the season, map out the preparations that need to occur ahead of various celebrations or events. Using a calendar or planner to proactively schedule activities and tasks reduces the demand on your memory, especially during times of high emotion. This may involve scheduling a time to wrap presents ahead of a gift exchange or planning when to make appetizers ahead of an after-work party. Break larger occupations like decorating the house into smaller tasks that can be spread over time. Try to balance completing stressful tasks and fun activities across a week. If a large holiday gathering is planned for a Friday, consider scheduling quiet activities that you can complete independently the day or two before. Physically demanding occupations like hanging holiday lights or going shopping can be balanced with smaller activities like writing greeting cards. 
    You can also reduce stress during holiday preparations by avoiding multi-tasking.  Evidence from the occupational therapy and cognitive psychology literature suggests that trying to engage in multiple activities at the same time results in worse performance and higher feelings of stress and anxiety.  Use this as an opportunity to fully engage your senses and emotions in the event. Put on holiday music or a favorite movie while decorating the house or wrapping presents. For those who enjoy socializing, seek out small groups for wrapping or cookie decorating parties. Don’t forget to engage your other senses by enjoying the special tastes and smells of the holidays. Finally, be sure to schedule quiet moments for yourself to relax and recharge.  Research has found that scheduling periodic breaks ahead of time provides greater stress reduction than waiting until you feel overwhelmed to take a break. Go for a walk, enjoy a holiday coffee, take a long bath or just take a moment to rest and remind yourself of the joy of the season.  
Karen Hebert, Ph.D., OTR/L, is an assistant professor in the Department of Occupational Therapy at the University of South Dakota. She studies how working memory and cognitive processing influence the experience of positive and negative emotions during the completion of daily occupations, particularly among those with neurological and mental health conditions. Her favorite occupations include reading, swimming and traveling with her husband and two girls. Mackenzie Feldhacker, OTD, OTR/L, CLT-LANA, is an associate professor in the Department of Occupational Therapy at the University of South Dakota. Her interests are the scholarship of teaching and learning and the needs of individuals with neurological conditions, particularly Parkinson’s disease. Her favorite occupations include baking, spending time outdoors and playing games with her family. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of December 7th, 2025
Silent but Serious: How to Spot and Manage Gum Disease
By Katie Pudwill, RDH, PhD
Gum disease is one of the most common chronic health conditions in adults. For those 40 and older, it’s also the leading cause of premature tooth loss. Unlike cavities, which often cause sensitivity or pain, gum disease is silent. Because the infection starts under the gums, you may not notice symptoms right away.
There are two types of gum disease: gingivitis and periodontitis. Gingivitis is an early, reversible infection of the gums caused by bacteria and hardened plaque (calculus). Once the bacteria and calculus are removed, the gums can return to their healthy state. Think of it like a sliver in your skin: once it’s out, the redness and swelling go away.
Periodontitis is irreversible and develops when the infection reaches deeper structures: the gum tissue, the ligament holding the tooth, and the bone beneath. Over time, this leads to gum recession, loose teeth, and tooth loss if untreated. Signs include gum recession, teeth appearing longer, shifting teeth, or changes in your bite. These symptoms reflect permanent damage to the tooth’s support system.
Because gum infections are deeper in the gingival pocket, they can go unnoticed. Signs of both gingivitis and periodontitis include red, swollen gums and bleeding when brushing or flossing. This is often called “pink in the sink.” Other symptoms may include bad breath, a bad taste in the mouth, or irritated or “itchy” gums. If you notice these, it may be time to get your gums professionally evaluated. Most dental hygienists recommend a cleaning every six months, as that’s when gingivitis commonly returns.
When periodontitis is diagnosed in a dental office, the first step is usually nonsurgical periodontal therapy. This involves scaling and root planing; a thorough cleaning to remove bacteria, plaque, and calculus. Dental hygienists will use special instruments, including ultrasonic scalers, to clean the roots of the teeth and allow the gums to heal. For advanced cases, they may even recommend laser treatment, localized antibiotics, and other adjuncts individualized for your needs. Patients with advanced disease may be referred to a specialist called a periodontist for surgical options to repair the damage that the infection has caused. This might include flap surgeries or bone grafting. 
Home care is an essential part of managing both forms of gum diseases. Brushing twice a day with a soft-bristled toothbrush and cleaning between teeth is not just about preventing cavities, it’s about the gums too. The infection starts in the gum pocket, so cleaning under the gumline is key. Interdental brushes and water flossers often outperform traditional floss at removing bacteria from the gingival pocket around the tooth.
Gum disease may be silent, but its effects are not. Periodontitis has lasting consequences not only for your smile but for your overall health. Fortunately, with early recognition and consistent care it can be managed effectively. If your gums bleed, your breath smells bad, or it’s been more than a year since your last dental visit, now is the time to act. A healthy mouth is a vital part of a healthy body.
Sources: National Institutes of Health. Oral Health in America: Advances and Challenges. U.S. Dept of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research; 2021. 
Katie Pudwill, RDH, PhD, is a registered dental hygienist and educator in South Dakota. She teaches periodontics, ethics and jurisprudence, and dental anatomy at the University of South Dakota Department of Dental Hygiene. Katie is passionate about improving oral health through education, prevention, and advocacy. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of November 30th, 2025
“Oral Caries Prevention in South Dakota: Challenges and Opportunities”
By Carissa Regnerus, RDH, MA, FADHA
Dental caries (decay) remains the most common chronic disease in the U.S. and globally, despite decades of research and proven preventive strategies. In South Dakota, 60–65% of adults and over half of children have experienced tooth decay, with higher rates among low-income, rural and tribal populations. These disparities reflect longstanding challenges in accessing preventive care, especially in underserved areas.
Two of the most effective, evidence-based strategies to prevent dental caries are fluoride use and dental sealants. Community water fluoridation (CWF) and topical fluoride treatments help strengthen enamel and repair early damage, while sealants protect the deep grooves of molars, where 90% of cavities occur. Sealants can prevent up to 80% of decay within two years and remain partially effective for several more years. Yet only 49% of South Dakota third graders have sealants on at least one permanent molar, falling far short of the CDC’s Healthy People 2030 goal of 60%. Studies show that children from low-income or rural areas are at higher risk for decay- yet they are less likely to receive sealants.
Although South Dakota Medicaid covers sealants for eligible children, many dental practices do not accept Medicaid primarily due to low reimbursement rates, further limiting access. Meanwhile, over 94% of South Dakotans benefit from systemic fluoride through CWF, thanks to state regulations requiring optimal fluoride levels in public water systems. However, this cornerstone of public health is under threat.
In April 2025, the U.S. Secretary of Health and Human Services proposed ending CDC recommendations for CWF, citing alleged health risks. Despite continued support from the ADA, CDC and WHO, this shift has fueled a wave of anti-fluoride legislation across the country. Utah and Florida have already enacted statewide bans on water fluoridation, and several other states have introduced bills to restrict or eliminate it. In South Dakota, Senate Bill 133 sought to remove the mandate for maintaining optimal fluoride levels in public water systems. Although the bill was ultimately defeated, it reflects growing skepticism among some lawmakers and constituents. Similar legislation is likely to resurface in 2026, especially as national debates around fluoridation intensify.
The consequences of reduced access to fluoride and sealants are significant. Untreated caries can lead to emergency visits, costly restorative procedures and general anesthesia for children. Dental pain and infection also contribute to missed school and work, financial hardship and diminished quality of life--impacting nutrition, sleep, emotional well-being and social participation.
Sealants and fluoride are complementary, affordable and preventive, costing far less than treating decay. Their combined use is endorsed by the ADA and exemplifies the adage: An ounce of prevention is worth a pound of cure. Sustained protection depends on consistent access to both, especially for those most vulnerable.


Carissa Regnerus, RDH, MA, FADHA, has been a licensed dental hygienist for over 25 years and a faculty member in the University of South Dakota’s Department of Dental Hygiene since 2001. She has taught courses in dental public health and sealants, and has served on several medical mission trips, reflecting her commitment to prevention and global service. For more information, contact her at [email protected]. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
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