We are Bitewing Games—two practicing dentists who are publishing three card games from world-famous designer, Reiner Knizia. AMA!

Do you also talk to your patients while they are undergoing a procedure?

Haha! I try not to ask them open ended questions when their mouth is loaded with dental tools, if that's what your asking ;)

Some patients do better with us distracting them with stories, one-way conversation, or the TV on the ceiling with pet/animal videos.

Last time I was at the dentist, I was getting plaque removed, and somehow it was so relaxing that I fell asleep for an instant. Woke up to him asking me something. Does this happen often?

Haha, yeah I've had several patients fall asleep while I was even drilling on their teeth and stuff. I take it as a compliment that they are so comfortable under my care, haha.

I was conversing with one guy and he was falling asleep while speaking mid-sentence, it was wild. Although I suspect he was high or something. I ended up just sending him home.

What additional challenges, if any, have there been due to anti-dentites?

Haha, I love Seinfeld! It blew my mind to go back and watch it recently only to realize that Bryan Cranston was the dentist.

As you know, us dentists have tall mountains to climb when it comes to anti-dentites. Hopefully us putting out some killer fun games will help to show others that we're not just sadists, haha.

What inspired you to work with Reiner Knizia?

I'm a HUGE fan of his work. I think he's one of the best in the industry at designing elegant games, or games with simple rules and emerging interactions and strategies. I find complex/fiddly games can sometimes detract from the core fun, and I prefer games where player interaction/influence can have a strong effect on the experience, so Knizia Games hit the sweet spot for me. Here are some of my favorites of his published games: https://bitewinggames.com/top-10-reiner-knizia-games/

Kind of an open-ended question but do you have any suggestions/advice for someone designing their own board game?

I've also learned a lot from the Board Game Design Lab! That's a huge rabbit hole of resources and information to help learn about publishing and design. https://boardgamedesignlab.com

I’m also a practicing dentist and have multiple close friends that do board game design. Is this a thing? Trying not to let patients notice I’m tired today because there’s no way I’m explaining it’s because I stayed up too late playing homebrew tabletop….

Haha, that's awesome! I always enjoy seeing a patient's reaction when I share with them that I also make games. They're just such starkly different professions.

Why did you decide to get into publishing board games? And why did you choose Reiner Knizia designs for your first project?

We started out designing our own games and have a few ideas that we are really excited about. But if you want to make the biggest splash as a debut publisher, then your best options are to work with a known designer with a fanbase or reimplement an out-of-print game that still has a solid fanbase. Otherwise, you have to deal with establishing credibility and spreading awareness on your own, which can be a long and difficult process.

I'm a huge fan of many Knizia Games, and I love his style of elegant, interactive games, so working with him has been loads of fun. While we still plan to publish at least a couple of our own designs, we've found that working with some of our favorite designers to produce exciting new games is super satisfying in its own regard. We already have plans to do more games with Reiner and other popular designers.

What's it like having a professional job and a creative one? How do you juggle your time and resources to afford it?

It's a nice mix for me where I can take mental breaks between worrying about patient health vs worrying about entertaining the masses. Dentists can easily burn out mentally or wear down their bodies if they stay too stressed about procedures or work under poor ergonomic conditions for too long. It's satisfying to help patients, but it's nice to not think about teeth and pour creative passion into games as well.

I'm currently working part-time in the afternoons at the dental office and focusing on publishing in the mornings and sometimes evenings. I'm really hoping we can get Bitewing Games to take off over the next couple years so I can keep this schedule. But I also have student loans and long-term financial planning to worry about, so we'll see what the future brings.

We definitely had to sink some COVID relief funds, tax returns, and savings into Bitewing Games to get it up and running. But Kickstarter is a great low-risk way to help fund the project from there.

Have you ever played a full game of battle star galactica the board game?

I have a friend in Ohio who tried getting our group to play it before I moved away, as it is his favorite game. I think the time commitment is what scared most of us off, haha. With the business of work, family, etc., I have to be super excited about a really long game to want to play it.

What dental treatment are you excited to see coming down the pipeline?

Also, what are your preferred treatments for those with thinning enamel? Fluoride, Novamin, Dental Bonding, a full set of robotic teeth?

I think laser dentistry is pretty cool and has come a long way (although it is still rather expensive to get equipment for). There are lasers now that can numb tissue (so you don't need a numbing shot) and drill into teeth by simply energizing water molecules, so all the patient feels is a spray of water. Pretty wild stuff.

That's tremendous, congratulations! What has been the most rewarding part of the process?

Also what is a bite wing and are you both one of the 9/10 dentists who support Aquafresh?

I've really enjoyed the process of starting with a blank slate (a pure, clever game design from Reiner Knizia) and then crafting a production and presentation around it that makes the game pop off the table. It's fun to take a clever concept we are excited about and then dream up a final product that adds to the excitement. It's also really satisfying to help spread something into the world that brings laughter and enjoyment to others.

In dentistry, a bitewing is an x-ray that allows us to analyze and view a tooth in a different way than is seen with the naked eye. Thus, our goal is to create games and share experiences that, much like the x-ray, will provide you with a unique perspective and refreshing interaction.

Haha, Aquafresh, crest, you name it. Anything with fluoride and I'm there ;)

Hah, I came in here about to ask if that was the origin behind the name. Point against you, I hate bite wings. X-rays are an interesting way of looking at things though.

Haha, yeah hopefully we can turn people’s opinion around on Bitewings (at least our version of them ;)

But I don’t think anyone enjoys gagging on a plastic-covered sensor and then drooling everywhere when it gets pulled back out, haha!

Good work! 2 questions:

1. What was the motivation for these games? I'd imagine teaching kids about the impact of soft-drinks on their teeth would be a part of it?

2. Thoughts on the variety of different "energy" drinks that everyone seems to be drinking these days and their future impact on your profession?

Haha, the soda restriction is definitely a bit of an Easter egg / subtle nod to our profession. Reiner initially designed Soda Smugglers as a chocolate smuggling game (and he actually pitched it to us as an alcohol smuggling game), but we felt that soda smuggling would have the broadest appeal and provide for the best presentation. Our artist (Paul Halkyon) has had a blast coming up with interesting soda brands and we're excited to be using bottle caps in the game as well (the deluxe version has plastic, stackable bottle cap tokens)

I don't encourage my patients to drink sugary drinks, but they certainly help keep us busy, haha. I have no problem with people enjoying soda, juice, etc. (I drink it myself). The key is to reduce frequency. Too many people sip on a sugary drink throughout the day, and its the frequent exposure that increases cavities. Limiting snacks and drinks to meals or rarely between meals is the key to reducing cavities.

Hello there! :) I have two questions: Firstly, I've seen soda smugglers compared to Sheriff of Nottingham a lot, do you feel the same? Also, are there other games you that could be compared to the other Capers mechanically? ( Ok, ok that was a two-part question...but who's counting right?) And Secondly: In the podcast Dr.Rainer mentioned a particular monkey....curiously one of the Investigators looks a lot like said animal. Could you tell me a littlemur about that?

Soda Smugglers and Sheriff of Nottingham have a similar style in that they are about smuggling stuff through and bribing a guard to do so. But from there they diverge quite a bit.

Soda Smugglers plays in 20 minutes (SoN in 60). SS can play 3-8 players (SoN 3-6). SS is easy to break out, teach, and play with anybody (SoN is a bit more complex and sprawling). There a quite a few gameplay differences as well that fundamentally change the way players interact and such. We've had a lot of players tell us they prefer Soda Smugglers due to its speed, pacing, accessibility, etc. But it'll come down to your personal preferences.

I'm a big fan of For Sale, and the second phase of that game reminded me a bit of Hot Lead initially because both games use closed/sealed bidding to acquire a point-scoring card from the display. I'm a fan of auctioning games, and I think Reiner is one of the best at these kinds of designs. Hot Lead is different in that it brings in a spicy push-your-luck element of going for big bonus points but avoiding busting. I also love that low cards can be just as good as high cards because the highest bid simply takes the card closest to the deck, the lowest card takes the furthest.

Are you referring to Inspector Cotta Lemur? We actually had Paul Halkyon (our artist) include Cotta in Hot Lead as a result of that interview with Reiner! You can see Cotta's name on his necklace in the illustration. Reiner and his team were super pumped when they saw Cotta's inclusion in the game, haha.

Aw yisss, that's awesome to hear! I always loved the core loop of sheriff but felt it ran too long and felt bloated at times. I also love the fact you are sometimes forced to smuggle in Soda Smugglers if I understand that correctly! :) And I love the Lemur easter egg! :)

The highest card not always winning and some push your luck mechanics all sound amazing too, overall I am really excited for the collection. Getting all three!

Thanks for the support! Yeah we've loved how refreshing and succinct these games are. You get a lot of bang for your buck gameplay in such a short span of time.

Littlemur. Hahaha. Firstly, yes I think soda smugglers is similar to sheriff of Nottingham. I thought that the first time I played it. I prefer the shorter playtime, but mostly I enjoy the restraint that the border guard (sheriff) for the round can’t arrest everyone. He/she has restrictions which makes the choices for the smugglers much more exciting. I can’t think of any other direct comparisons for the other games. Maybe Nick has something, but to me that are semi unique (as unique as games get). A nice twist on trick taking and set collection.

That's cool indeed! That and the fact you're sometimes forced to smuggle already make me like the base rules more than Sheriff :)

I also just now got the connection between the name of your brand, your real-life profession and the soda theme! :O mind blown

Somehow I always had a bat in mind when thinking about bitewing....don't ask me why^{^}

haha! A bat makes total sense without the dental context.

And yeah, the hand of cards you get each round and the optional event cards really keeps travelers on their toes.

What games got you into the hobby and are there any games that have come out recently that have really impressed you?

Oh man, there are so many good options. Games like 7 Wonders, King of Tokyo, Camel Up, Catan, Ticket to Ride, Love Letter, etc. are ones that we played a ton of initially (and still do, from time to time) because they are great for people who never play board games as well.

Lately I've been impressed with heavy, complex games like Oath (from Leder Games) and Sidereal Confluence Remastered Edition (from WizKids Games) as well as light, accessible, clever games like Kabuto Sumo (a dexterity game from BoardGameTables.com) and Equinox (a cutthroat betting game also from Reiner Knizia and Plan B Games).

Thank you for the response. I really resonate with the pull between heavy complex games and light but clever games. When I first got "past" beginner friendly games I thought I had to step up to more complex stuff. While I do love some heavy games I have come to realize that a well designed family weight game can be just as impressive and just as much fun as a heavy euro.

One more question. I, somehow, do not have a single Knizia game in my collection. My wife and I love all sorts of games but our favorites are Brass: Birmingham, Quacks of Quedlinburg, Clank!, and Concordia. What Knizia game do you recommend for us?

I agree, I love the whole spectrum of games and have the most fun playing games the best fit the tastes/personalities of the people around the table.

Check out some of my favorites of Reiner's published games. https://bitewinggames.com/top-10-reiner-knizia-games/

If you play primarily 2-player, then I'd specifically recommend Lost Cities, Babylonia, Royal Visit, Schotten Totten 2, and The Quest for El Dorado.

Man I want to get Oath so badly but it wouldn't ever see play because no one else I know right now is as crazy as I am.

I just moved across the country after playing Oath 4 times with my gaming group and definitely feel that pain, haha. Finding people here in Prescott AZ to game with has been a struggle to say the least.

Do bitewing x-rays (and other intraoral x-rays) hurt most patients? I had x-rays taken yesterday and mentioned to my partner later that the roof and floor of my mouth were a little sliced up from biting down on the vertical film/holder/sensor. He looked at me like I was absolutely crazy and said "that never happens, what are you talking about?" I thought it was normal because it always happens to me, even with my favorite hygienist who is super gentle with cleanings??? But apparently the film actually fits into the mouths of adult humans like my partner?!?!? Sorry for the interrobangs, but this has absolutely blown my mind. I had always found it kinda weird that dental practitioners were blase about asking me to suppress the urge to avoid pain and bite down despite the sharp edges, but I figured it was unavoidable discomfort, everyone winds up with cuts from x-rays, and I should just suck it up while the practitioner moseys over to the button. Does this not happen to everyone? Does my partner have a giant mouth? Do I just have a small mouth? Is there anything I can do to mitigate it, like asking for a different angle or a child-sized holder or something?

The sensor that goes into your mouth for an x-ray is typically rectangular with sharp corners, and often times it feels like you're trying to fit a massive sensor into a tiny mouth, so yeah you're definitely going to bully the soft tissues a bit to fit it in there and get the image you need. All patients are different. Some have thick oral tissues, strong gag reflexes, small mouths, etc.

Some offices do have pediatric sensors that are smaller, so you could try asking about that. But usually it's just one of those things that sucks but is worth it because the a certain sensor size or angle is only way to get a diagnosable x-ray.

Why did you decide to be dentists? And if you had to specialize which would you choose? Plans for a dental related board game? The party game with the cheek retractor ain't bad

Sincerely, a former dental assistant

I've grown up with family members in the medical field, so it always appealed to me to be able to help people who are injured or sick. Dentistry appealed most for a variety of reasons. You get to form long-term relationships with patients and their families by seeing them on a regular basis. You generally have more freedom and flexibility to run your own practice, which means you can do crazy things like start a publishing company on the side!

I enjoy oral surgery, but that can be pretty high-risk and high stress. Possibly Orthodontics or Endodontics for me. But I like the variety that comes with general dentistry.

If we come across or come up with an excellent dental game, then we'd for sure be all over that!

I've played that cheek retractor game. I think it may have forever died with COVID though, haha.

Should I wait to use mouthwash after I brush my teeth? Also, which mouthwash, if any, do you recommend?

I don't have too strong of opinions on mouthwash, but I'd say anything that has fluoride and that you feel freshens your breath is probably the best option!

If you use fluoride mouthwash after brushing, then you're giving your teeth a nice anti-cavity boost as the fluoride residue sits on your teeth for much longer than if you rinse the toothpaste out with water after brushing. Another alternative would be to spit out all the toothpaste but simply don't rinse with water (leave the residue on your teeth); studies have shown that this reduces cavities.

What is your creative process? By that I mean, how are you able to think of new ideas for your game that haven't been done before?

There's an interesting YouTube video called "Everything is a Remix" that talks about how nothing is ever really 100% new but creativity is more a process of remixing, recombining, reimagining, etc. https://youtu.be/nJPERZDfyWc

But when you combine two individual things that have never been combined before, or in a unique way, then you do end up with something "new".

As far as how that actually works in real life, that may be Reiner Knizia asking the question "What if the second highest card was the winner of the round?" and that question leading to Pumafiosi. Or for my own future design "What is interesting about constellations, and how can we convert that into a game" and coming up with Con Artist where players draw constellations related to a topic and try to deduce who was faking it (who had no clue what the topic actually was but constellations are so fiddly and abstract that just maybe they aren't lying).

I'm a board game fanatic, married to a dentist, and I work in the clinic as office manager. Doing something to get away from dental stresses seems very smart!

Since this is an AMA, I should ask a question...

Can you think of anything positive about a dental clinic having to manage 1000 different insurance plans for their patients, and dealing with the expectation that we are experts in every one of them?

Oh man, you office managers are saints! Dealing with insurance has to be one of the absolute worst parts of dentistry. Sometimes it feels like they are looking for any and every excuse to not cover a patient's needed treatment, and other times they are barely paying the dental office enough to just cover staff/resources costs.

Nothing positive here, haha, sorry! Unless we can think up a fun game of this concept... perhaps a puzzly insurance management Euro game? I'm sure that'll excite gamers, haha.

Do you hand out candy on Halloween?

Absolutely, gotta keep the dental business flowing! /s

Actually, I feel like I'm now facing a moral dilemma for the next Halloween (and every one thereafter) now that you've asked me that question, haha. Whatever I decide to hand out, it won't be something lame like cheap toothbrushes, haha.

Do you wet your toothbrush before brushing?

Do you have plans to work with other German designers, maybe the great Stefan Feld?

I'm team wet for life! Brushing dry just feels too wrong, haha

We're open to working with any designer whose games we are excited about and fit our target audience! I do enjoy myself a good game of Castles of Burgundy, but I'm not sure we could do a better job at producing Feld games then what other publishers have done, especially at the price point his games are sold at.

One thing that really drives us in game selection is where we feel that we can produce a game better than anyone else. Particularly with a theme, art style, and components that we can really pour our passion into. For example, with Soda Smugglers, our goal has been to make the coolest soda game ever, and we've enlisted our artist to concoct unique soda brands and interesting bottle caps and such.

I've always wanted to ask if there new flossing technology coming out. I just feel like it's a hassle to floss but there hasn't been any improvements on the technique in what seems like forever! Any flossing insights/tips for the future?

Excited to check out your games!

Thanks for checking them out!

A lot of people like using disposable floss picks for their convenience. Another really good option would be a Waterpik, which shoots water between your gums and teeth. You can get a cordless rechargeable version and use it in the shower, which is also pretty convenient. Really whichever method gets you regularly cleaning between the teeth and gums is the best one!

What are your thoughts on treatement of a lower 2nd molar with a crack over the distal marginal ridge? Crown every time?

I think it depends on the specific situation. If there is no opposing tooth for it to bite against, then the risk of further fracture is pretty low. Otherwise, 2nd molars are typically taking more force and pressure than any other teeth in the mouth.

Also if the crack is pretty superficial like a craze line, then it's probably not a big deal. If it looks like it extends deeper (you can sometimes tell via transillumination of the tooth), then a crown can be a wise precaution.

What is your favorite family game?

Ooo, I can't pick just one, but Chinatown, Camel Up, and Wavelength would be pretty high up there! We did a podcast episode on our Top 10 Family Games earlier this year! https://bitewinggamespodcast.buzzsprout.com/1573393/7826239-top-10-family-games

Is it better or worse if I look at you in the eyes while you clean my teeth?

Haha! This is my favorite question of the morning. Odds are I can't even see your eyes because I'm zoomed in on your teeth with my loupes.

The real question is, which one is better for you?

Do you play board games with your patients?

I had one patient tell me he was into Warhammer, and while that's a little too extreme for my tastes, I told him he's welcome to hit me up anytime for some quality board gaming. He hasn't taken me up on it though, haha

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Extractions are still a commonly used and widely accepted orthodontic technique. Some people have smaller jaws that can't fit all their teeth, so it's either extract some teeth to let the others have breathing room or deal with crowding, impactions, etc.

Tooth extractions don't have any effect on developing bone (such as jaw/facial growth). They can obviously have irreversible effects on the arrangement of the teeth and how those teeth support the lips and such, so it's definitely something that should be carefully considered and applied in the right situations.

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You will typically see jaw growth until 19-21 years old, which is why that's the earliest age you would want to do something like dental implants. 3rd molars (wisdom teeth) typically finish fully developing/growing a few years after that.

I've not heard of teeth affecting sinus or bone growth in general facial structures. But during teenage years, Orthodontists can usually see the writing on the wall and know whether a tooth is better off coming out (because there won't be enough room) or staying in.

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I'll ask around and see if anyone else has heard anything about that. Can definitely let you know if I hear anything different.

Do you think the cost of dental procedures is justified?

And would you support legislation that would include it in publicly available healthcare coverage, if that exists in your country.

Unfortunately yes, but a lot of the costs issues stem from dental insurance companies, supply companies, and education costs. I'd say those costs are frequently not justified, yet they trickle down to inflate the patient procedure cost.

A dental degree can cost 300-600K or more, and that's not including the required undergrad. There are dental supplies out there that are the equivalent of a paper clip, but you call it a dental material and the company charges $15 for something that realistically only costs a few cents.

I think the right legislation could do a lot of good to help with rising medical and dental costs, but many existing solutions aren't great either. Medicare/medicaid dental plans often won't cover braces for patients who desperately need it just because their teeth aren't messed up enough. Or they won't cover a crown on a tooth so the only solution is to extract it, which can lead to even more problems.

Thank you for the reply,

I'm currently looking at a $300 extraction or a $1700 root canal/crown.

That sounds pretty close to standard prices. If you are near a dental school or residency program (GPR or AEGD) then often those are even cheaper.

I recently noticed a small gap at the top of my front two top teeth. I had limited ortho to fix a larger gap about 9 years ago. What do you think caused the new gap and what is the best route for treatment?

Are you still wearing your retainer? Often people will stop wearing a retainer and teeth can drift back to old positions or out of place.

There are a few options you could take to close the gap including another round of ortho or veneers (veneers would add more tooth structure to fill in that gap where ortho would just adjust their positioning).

Awesome to see you guys here! I've enjoyed several of your articles. I have a few questions.

If you had to keep only 3 games in your collection what would they be?

How did you get your foot in the door of publishing games and how did that lead to getting a big name designer?

What do you find most gratifying about publishing?

1. Assuming I had people to play them with, I would likely choose Tigris & Euphrates, Oath, and Crokinole.

2. In some ways, we just tumbled down the rabbit hole from casually enjoying games to becoming woefully addicted to designing games and pitching them to publishers to finally coming up with designs that we feel are truly excellent that we have an exciting vision for. Once we had a complete vision for a couple of our games, we realized that we were the only ones who could fulfill that vision to its fullest. Every publisher likes to have their own creative control, and while it's more work it's also a bigger creative payoff to do it yourself.

We started https://bitewinggames.com at the beginning of 2020 as a way to embrace our passion for gaming (with a blog, videos, podcast) and engage fellow gamers, but the end-game has always been to start a publishing company.

Many big name designers don't make enough games to have the luxury or desire to take risks on indie publishers, but Reiner Knizia is like the Willy Wonka of board games, and he has a system that works well with indie publishers and corporations alike. It helps that he respects his dentist as well ;)

1. I shared this in another answer, but I've really enjoyed the process of starting with a blank slate (a pure, clever game design from Reiner Knizia) and then crafting a production and presentation around it that makes the game pop off the table. It's fun to take a clever concept we are excited about and then dream up a final product that adds to the excitement. It's also really satisfying to help spread something into the world that brings laughter and enjoyment to others.

Some of my favorite classes in undergrad were the marketing ones, so it's been fun to put those marketing fundamentals to use as well.

Thanks for the response! You're marketing classes are clearly paying off because you got me interested in the Kickstarter campaign you guys are running.

Haha, glad to hear it, and thanks for the support! There is perhaps no worse feeling in education than that of "Well, I'm never going to use this in my career or life" while paying through the nose for tuition.

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My understanding is that the main issues come from smoking (the heat and vapors can cause inflammation and gum disease). But other side effects can indirectly lead to more cavities and such. This is a pretty good article that covers everything pretty well: https://www.brightnow.com/blog/marijuana-and-oral-health-what-you-need-to-know

Is it true that most dentists are suicidal? Why do you think that is?

No. It was once true (and may still be) that dentistry sees a higher suicide rate than your average profession. I imagine the reason is that dentists have traditionally worked in private practices as sole practitioners, meaning all the pressure and stress of helping patients and managing the practice is on them alone and they have no colleagues in the workplace who can relate or support them.

Group practices have become more prevalent in recent years, I imagine that rate has dropped.