From Dr. K

🚰 The Florida Fluoride Update: What Our Patients Need to Know

patient brushing his teeth because he knows, cause Dr. Kunwar showed him.

You may have seen the headlines recently about a major shift in Florida’s public health policy. As of late 2025, Florida became the second state in the country to effectively phase out community water fluoridation.

This decision has sparked a high-profile “face-off” between state officials and national public health agencies like the Centers for Disease Control and Prevention (CDC).

As your trusted dental care team, we want to look past the political noise, explain exactly what is happening, and—most importantly—help you protect your family’s smiles.

🔍 What Happened to Florida’s Water?

Through the passage of the Florida Farm Bill, the state prohibited local water utilities from introducing additives that aren’t strictly required to meet basic drinking water safety standards.

Because fluoride is added to prevent cavities rather than to purify the water itself, utilities across the state—including right here in our local communities—have had to shut down their fluoridation systems.

⚔️ The Face-Off: Florida vs. The CDC

The debate centers on two completely different views of public health:

  • The State of Florida’s Position: Backed by State Surgeon General Dr. Joseph Ladapo, state officials advocated for the change by labeling mass fluoridation as “forced medication.” They pointed to select studies suggesting potential health risks from high levels of fluoride exposure, arguing that individuals should choose their own vitamins and minerals.
  • The CDC & Dental Community’s Position: The CDC, the American Dental Association (ADA), and our team view community fluoridation as one of the top public health achievements of the 20th century. Decades of data show that keeping a low, safe level of fluoride in tap water reduces tooth decay by roughly 25%. Experts note that the risks cited by the state involved fluoride concentrations far higher than what Americans ever receive from a standard tap.

🦷 What This Means for Your Teeth

Fluoride acts like a shield for your teeth. Every day, minerals are lost from a tooth’s enamel layer when acids from food and bacteria attack it. Fluoride promotes “remineralization,” putting those vital minerals back and making the tooth surface more resistant to future acid attacks.

Without fluoride in our local tap water, the natural shield is weakened. This means both children and adults in Florida are now at a higher risk for developing cavities.

🛡️ 4 Ways to Protect Your Smile Today

You do not need to panic, but you do need to be proactive. Because you can no longer rely on your tap water for automatic protection, we recommend taking these steps:

  1. Switch to Fluoride Toothpaste: Ensure every member of your family is brushing twice a day with a toothpaste containing fluoride.
  2. Incorporate an Anti-Cavity Mouthwash: An over-the-counter fluoride rinse adds an extra layer of defense after brushing, especially for children prone to cavities.
  3. Ask Us About In-Office Varnish: During your routine cleanings, we can apply a professional-strength fluoride varnish directly to your teeth. It takes seconds and provides months of targeted protection.
  4. Consider Supplements if Necessary: For young children whose permanent teeth are still forming under the gums, dietary fluoride drops or tablets can be prescribed if they are not getting it from other sources.

👋 We Are Here to Help!

Public health policies may change, but our commitment to your family’s health never will. If you are concerned about how these water changes will affect your dental health, let’s talk about it at your next visit. We can evaluate your specific cavity risk and build a personalized protection plan just for you.


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Dr. Kunwar image
Dr. Kunwar

About the Author

Dr. Kunwar is an independent primary care physician practicing in Lakewood Ranch area since 2017. He trains medical students and residents and has a background in regulating Fraud, Waste and Abuse.

The Vitamin D Bubble Has Burst: Why TV Doctor Hype and Routine Overtesting Can Actually Hurt You


The obsession with Vitamin D has officially crashed into reality. For years, daytime television medical gurus and wellness influencers bombarded us with claims that the “sunshine vitamin” was a miracle cure-all. We were told that boosting our blood levels could magically fix fatigue, cure low moods, and prevent chronic diseases.

At East County Urgent Care and Immunizations (eastcountyim.com), we advocate for evidence-based medicine, not media-driven trends. The truth is out: the multi-million-dollar wellness hype machine has misled millions of healthy people into ordering unnecessary lab tests and consuming massive, unmonitored doses of supplements.

The financial and clinical consequences of this overtesting trend have forced federal action, and it is time for patients to stop the unmonitored pill-popping and focus on basic, healthy nutrition.

The “TV Doctor” Hype Machine

The obsession with Vitamin D did not happen by accident. It was heavily popularized by celebrity doctors who took minor, observational studies and blew them completely out of proportion. These media personalities framed the average person’s normal, seasonal fluctuations as an urgent health crisis.

By convincing healthy adults that a slightly low lab reading was a toxic threat, they manufactured a massive market for expensive proprietary supplements and endless diagnostic tracking. It is a classic wellness marketing playbook: manufacture an epidemic of deficiency, and then sell the cure.

Why Medicare Stopped Footing the Bill

The financial burden of this media-driven overtesting became so severe that federal programs had to step in. Vitamin D screening exploded to become one of the most frequently ordered laboratory tests under Medicare Part B, costing taxpayers millions of dollars for routine screenings that yielded zero clinical benefits.

Because the vast majority of these tests are completely unnecessary, the Centers for Medicare & Medicaid Services (CMS) cracked down. Today, Medicare enforces strict Local Coverage Determinations (LCDs) that restrict reimbursement for routine screening. Medicare will now generally only cover the test if a patient has an explicit, documented medical necessity—such as chronic kidney disease, severe hypercalcemia, or advanced osteoporosis. If a clinic orders a routine screening test without a valid diagnostic reason, the test is deemed medically unnecessary.

Real Side Effects and Adverse Drug Reactions (ADRs)

Many people mistakenly assume that over-the-counter vitamins are completely harmless. This is a dangerous misconception. Because Vitamin D is fat-soluble, it accumulates directly in your body’s tissues instead of being safely flushed out in your urine like Vitamin C.

When people follow unmonitored advice from television or social media and take massive megadoses, they run a serious risk of Adverse Drug Reactions (ADRs):

  • Hypercalcemia: Excess Vitamin D forces the body to absorb too much calcium, leading to nausea, vomiting, muscle weakness, and profound confusion.
  • Severe Kidney Injury: A spike in blood calcium forces the kidneys to work under extreme stress, frequently causing painful kidney stones and potential long-term kidney damage.
  • Tissue Calcification: In severe cases of toxicity, calcium deposits can settle into your soft tissues, stiffening blood vessels and inducing life-threatening heart arrhythmias.

The Prescription: Stop the Pills, Just Eat Right

The scientific consensus has finally caught up to the hype. Current clinical guidelines from the Endocrine Society firmly advise against routine Vitamin D screening or high-dose supplementation for healthy adults under the age of 75.

The message from the medical community is loud and clear: stop overcomplicating your health with synthetic supplements and focus on eating a balanced diet.

  • Focus on whole foods: You can naturally get your required baseline of nutrients by consuming fortified milk, wild-caught fatty fish, eggs, and a variety of whole foods.
  • Get moderate sun exposure: A few minutes of daily sunshine provides your skin with all the natural synthesis it needs.
  • Listen to your primary doctor: Do not let a celebrity on a screen dictate your medical care. If you genuinely have an underlying condition that impacts your bone density, your local provider will evaluate you safely.

Before you request another automated lab panel or buy an unverified supplement online, talk to a real medical professional who looks at your complete clinical history.


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Dr. Kunwar image
Dr. Kunwar

About the Author

Dr. Kunwar is an independent primary care physician practicing in Lakewood Ranch area since 2017. He trains medical students and residents and has a background in regulating Fraud, Waste and Abuse.

Breaking the Cycle: Why Untreated Anxiety is a Threat to Your Physical Health



Between managing a career, navigating the rising costs of family life, and keeping up with the daily pressures of modern parenting, stress has evolved from an occasional nuisance into a permanent fixture of daily life.

In our practice at East County Internal Medicine, we are seeing an unprecedented surge in patients battling severe stress and anxiety. It is spreading rapidly across Manatee County, placing an especially heavy burden on younger parents who are constantly juggling competing pressures.

Too often, people try to “tough it out.” But as internists, we see the hidden reality: anxiety is not just a mental battle—it is a physical disease that degrades your body over time.

The Dangerous Ripple Effect of Chronic Anxiety

When anxiety goes untreated, it rarely stays confined to your thoughts. It triggers a systemic domino effect that directly compromises your physical health:

  • Chronic Insomnia: Anxiety keeps your nervous system in a constant “fight-or-flight” mode. This floods your body with cortisol and adrenaline, making deep, restorative sleep nearly impossible.
  • Diminished Quality of Life: Constant worry drains your daily energy, eroding your patience, your relationships, and your ability to present at home.
  • Poor Work and School Performance: Anxiety impairs the prefrontal cortex of the brain, directly damaging your focus, memory, and decision-making capabilities.
  • A Gateway to Chronic Disease: Prolonged, unmanaged stress creates chronic inflammation, spikes your blood pressure, and strains your cardiovascular system. Over time, this significantly increases your long-term risk for heart disease, type 2 diabetes, and gastrointestinal disorders.

As strange as it sounds, we as humans are actually addicted to our anxiety. It’s all fun and games until it crosses the line. Once it interferes with your sleep, or work, schooling or relationships, it’s become pathological – Shaan Kunwar DO


Don’t Suffer in Silence: Rethinking Medication

The most heartbreaking trend we see is patients suffering in silence for months—or even years—out of fear or stigma surrounding mental health treatment.

Many patients express hesitancy about prescription medications. It is completely natural to want to understand what you are putting into your body. However, medical intervention must always be viewed through the lens of a clinical risk-to-benefit analysis.

While medications are not always the automatic first choice for mild stress, they become a vital, evidence-based necessity when the symptoms of anxiety begin to outweigh the potential risks of treatment. When anxiety is actively destroying your sleep, your health, and your ability to function, the medical risk of leaving that disease untreated is far greater than the risk of a carefully managed prescription.

Partner with an Established Expert

You do not have to navigate this overwhelming cycle alone, and you do not have to rely on trial-and-error to get your life back.

As an established expert in internal medicine, Dr. Kunwar specializes in diagnosing and treating the complex intersections of mental stress and physical illness. Our practice focuses on comprehensive care—evaluating your lifestyle, your sleep patterns, and your physical health to create a safe, balanced treatment plan tailored exactly to you.

Anxiety thrives in isolation, but it is highly treatable. Let’s protect your health, your family, and your quality of life before stress transforms into a chronic medical condition.

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Dr. Kunwar image
Dr. Kunwar

About the Author

Dr. Kunwar is an independent primary care physician practicing in Lakewood Ranch area since 2017. He trains medical students and residents and has a background in regulating Fraud, Waste and Abuse.


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