Children's Health Month

This is Dr. Michelle Hucke, and we are coming to you, talking about children's dental health month. February is children's dental health month and I'm here with Dr. Jason Lewis from Bart dental, I'm from Jax Beaches Family Dentistry. And we're talking about a topic that's near and dear to both of our hearts because we have our own kids and we're dentists. Obviously, we treat kids. So we're excited to bring this information to you. The topic today is dental decay. Is it hereditary or is it too many tootsie rolls? And so the behind the scenes taping of this would be showing you guys the banter that we had earlier about our own kids. We had a really good debate before we invited the rest of you in on it. So we both have kids. We're actually both twin parents and both of our kids have had decay. And what I was saying to Jason before you guys joined us, was that to me, that's a big failure.

Dr. Jason Lewis:
It is. It is. We try to, I'll use the word harp, harp on them every day, brush your teeth, make sure you floss and just when you think you're saying enough, then like my kids were in my office yesterday, or the day before, and one of them had a couple of cavities. So I'm just like, ugh, got to do something about that.

Dr. Michelle Hucke:
And what did we decide? What did we discover?

Dr. Jason Lewis:
We discovered that actually, both my kids will sometimes be home for a couple of hours before we get home from work and I'll get home and I'll see some rappers like chip rappers, some candy, in the trash can, on their nightstand, they think they're hiding it, but it's right out there for me to see. So definitely need to minimize the snacks for sure. And we'll talk about that in detail here.

Dr. Michelle Hucke:
Absolutely. So we're planning to discuss the hot topic of, is it hereditary or is it too many Tootsie rolls? And I'm excited to bring this information to you because even though I'm a dentist, this is the first time in a really long time that I've done any sort of literature review. So it was really interesting to me to find out this information and then to have two dentists that have kids, both of which we've had experiences with our own kids having decay. So it's really exciting and interesting for both of us. So the sort of state of the union is that 27.9% of kids in the United States under the age of five have decay and 51.17% of kids under the age of eleven have decay. I've been a dentist longer than Jason. When I first got out of school, we never took x-rays on kids that were under the age of five. Now obviously if 30% of our kids under the age of five have decay, we have to do that. We can't see in between the teeth unless we have x-rays. So I now assume that all kids have decay and when they are the age of three and they have back teeth, we go ahead and take x-rays to make sure that they don't have cavities. And also, when I was doing the literature search, found that there were a couple of really interesting twin studies. One of them was done in 2017 and that found that the identical twins that weren't in the same household started out with bacteria that were the same type. And then later on when the kids transitioned to having different bacteria, whether they were in the same house or not, it was precisely correlated to them being exposed to more free sugar. And we all know what free sugar is.

Dr. Jason Lewis:
Candy, sodas, you name it. And speaking of x-rays, earlier in my career, if I took an X-ray of a child and there may be a possibility a cavity was forming, I would just watch it. And then we wouldn't take another x-ray for a year. And then there were a couple of incidents where a year goes by and then that cavity is now to the point where the baby tooth either needs to be removed, or it needs a baby tooth root canal. So the x-rays, I know parents are very sensitive about their children have X-Rays, I think we all are, we don't want to be exposed to radiation if we don't have to be.

Dr. Michelle Hucke:
And it's uncomfortable.

Dr. Jason Lewis:
Yeah, absolutely. But it's so important because it can cause, if we don't catch those cavities early on, it can lead to lots of problems.

Dr. Michelle Hucke:
Well, that leads us to that other topic that we were talking about and it was posted on the promotion for this particular webinar is, why does it matter? Because a lot of parents ask us and I know that they ask you, because they asked me all the time, like, does it matter that my child's baby tooth has a cavity and can we watch it? So we talked about that earlier, you want to address that. It's a good topic and it's good for people to know about it.

Dr. Jason Lewis:
It is. And we're certainly sympathetic or empathetic with the parents and the child for that matter. Going to the dentist is not everybody's best activity to do. But at the same time, we don't want these cavities to get larger and turn into bigger problems, such as infection that can affect the development of the permanent tooth. And certainly, we were talking about, people ask us, well, can't we just pull the tooth? Let's say, there's a child that is six years old and one of their baby tooth molars, it has the K in it. The quiet and let's say it can be fixable with just the filling. A lot of times they ask me, Oh, why can't we just pull it? I'm like, well that particular tooth, the permanent tooth doesn't replace that baby tooth until age 12 on average. So that baby tooth needs to be in the mouth for six more years. And the reason that is, is because it maintains the space for the permanent tooth development for the permanent tooth to come in.

Dr. Michelle Hucke:
Yeah. So that is one of the misconceptions, you think, oh, it was just a baby tooth. We'll get rid of it. And the other thing I think that's important too is when you have primary tooth decay and you and I talked about it, unfortunately, we were talking about it in the context of our own kids, but I've always said to people too, when they have decay on the baby tooth, the important information about that is it's an alarm and we want to get the child's diet and hygiene and now potentially right, the bacteria, just like a whole new realm, we need to remind all of ourselves that it's a bacterial disease and this child must have more of the decay that causes, of the bacteria in your mouth that causes decay. So we need to control that before the permanent teeth start to come in. And you have the unfortunate news.

Dr. Jason Lewis:
Yes. So, my kids now, for those who are watching on zoom, you'll be able to see our little slide show, unfortunately, ones on Facebook live can't see the slide show, but we're going to post this later if anyone wants to see.

Dr. Michelle Hucke:
You see it on YouTube and share it with your friends. It's really important information to share with, if you have friends that have kids or you have kids, or you have grandkids or you know a pediatrician or another dentist, this is really, it was really enlightening information for me. And it's something that's going to impact our kids positively because we now know that it's preventable in terms of the traditional way. Right. Okay. You have to brush and floss more. Okay. If your kid is only brushing for 10 seconds once a day, we can holler at them. Right. And, and tell them that they should brush twice a day. But it's also interesting to know that the number of snacks is important. Which we also knew, but reminding us that it's a bacterial disease and the more number of times a day that you expose your mouth to the sugar, it changes the bacteria. So it's nice to know that we have control.

Dr. Jason Lewis:
Yes, absolutely. One thing that Michelle and I pride ourselves on as being dentist is we're not just tooth fixers. We care about the entire body. And when we talk about childhood dental decay, we're not just talking about fixing a cavity here or fixing a cavity there, we're talking about establishing habits for those children, once they become adults and they're taking care of themselves. So it's important to instill these good habits in our children while we have some kind of effect on them. Because once they get out into the real world and they're taking care of themselves, we want those habits that they learned early on to carry on into adulthood. And so eating, limiting the snack intake, brushing twice a day, using certain rinses and of course, flossing, those are all great habits that if we can instill those early on, they will be a lot better off as an adult.

Dr. Michelle Hucke:
Absolutely. The other thing that was shocking to me, because I did a lot of research. It was one of the things I always thought I was going to be a scientist and get my PhD, cause I love doing research and finding stuff out. So for those of you that are watching the zoom, or you can watch it later on, I found all these interesting, not so happy facts and figures about where we are, like the state of the unions, so like the state of the United States, but also the state of the world. And I know a couple of those jumped out at you. I know.

Dr. Jason Lewis:
Yeah. , it's just amazing. Every time, for instance, globally between 60 and 90% of the school children and nearly 100% of adults have some form of tooth decay often leading to pain and discomfort, discomfort is always the nice way of saying pain.

Dr. Michelle Hucke:
Yes.

Dr. Jason Lewis:
Let's just say pain. If anyone's ever had a toothache, it is not fun. So that's what we're trying to prevent. But it's amazing how we don't realize sometimes how getting a child's teeth healthier can affect our everyday lives. For instance, we're taking them out of school, so they're missing days in school. We're having to take off work, so people are missing work because they got to take their child to the dentist. So those are things that if we can, as Michelle mentioned earlier, all of this is preventable. So if there's one fact or thing you can do differently today that you can take from these webinars today, that's just knowing that it's preventable and we can do something about it.

Dr. Michelle Hucke:
And yeah, it's not just yelling at people about brushing and flossing, and it's also not saying, oh, sugar is an evil thing. It's really limiting the number of exposures, my dad who hopefully is watching too or will watch it at some point, taught me early on, cause my dad's a dentist, that the reason that sipping is bad and snacking is bad is it's the number of exposures to sugar. And that's what came up over and over again, you can take, and I use this example a lot. You can take the same big jug of Gatorade and it can be one exposure to your teeth of sugar. Or you can sip at it the whole time you're playing golf. Jason plays golf too. Or you can sip at it for the whole four hours because it's in your perch and it can become 40 exposures to sugar and that's a big difference for your teeth. And now what we're seeing in this research that I uncovered is that all that exposure to sugar is what can change the dynamics and the makeup of the bacteria. And so that is probably what's going on with our kids. So when we go home, we're going to deliver the really good news to our children that it's all come to an end.

Dr. Jason Lewis:
If they want to have a Gatorade, I think we're all guilty. And that's another conversation I'll have with parents or even teenagers as well. Teenagers who are very active in sports, they drink Gatorade or PowerAde a lot of times, so they'll come in and they have cavities all over the place. And they're just shocked because they're saying, well, I eat well and I'm brushing and flossing every day. I'm brushing twice, flossing at least once and they don't understand where the cavities are coming from. And then I start asking questions about their diet and then, I usually know that they're pretty active and I say, do you ever drink Gatorade while you're doing your activity and they will say, Oh, well, yeah,

Dr. Jason Lewis:
So I'm like, well, that's most likely what's happening, as Michelle mentioned, they're not just gulping the whole thing in one sip, they're taking a little at a time over maybe a two-hour practice or game.

Dr. Michelle Hucke:
Yeah. And that's just, a matter of not being aware of that. Cause I do, I just, I have patients all the time, kids and adults that say to me, Oh, well I only have a little bit of coffee or I only have one of this. And my first question is always, well, how long does it take you to drink it? I had an amazing experience. This is not kid related. And I know that's the purpose of this particular webinar, but I had a patient who in my practice up North, so 25 years ago, come in and she had not ever had an adult cavity and I had seen her for years, she'd take her annual x-rays, everything was fine. I took a set of x rays and she had nine cavities and this was just after a 12 month period of time. So I was asking a bunch of questions and I said, well, what do you drink? And she said coffee. And I said, what's in it. She said sugar, but it's the same two cups of coffee she's always consumed. Well, the difference was she was a stay at home mom and she used to be working. And so she was drinking it over, a two hour period instead of 15 minute periods. So it's all about the exposure.

Dr. Jason Lewis:
Yeah. Michelle, as she mentioned, she did a lot of this research and as I was reviewing it, I was just like, wow, I had either forgotten that or didn't know that or something had changed. So even we were, what she was saying earlier, she's learned a lot just by preparing for this presentation and, and me as well. So we're definitely going to make some changes in our household and certainly be able to share the information with our patients too.

Dr. Michelle Hucke:
Absolutely. And one of the reasons that Jason and I spend time together is because we have a passion for complete health. And so what you were mentioning earlier is true when you're looking at the facts and figures. If you see this slideshow, it's talks about oral disease affecting and impacting every part of your life. So as a child, or, as an adult, if you have significant oral disease, it impacts you from a pain standpoint. But another thing my dad taught me early on was that if people don't like the way that their mouth looks, even starting at a very early ages, then they're uncomfortable and they also have a tendency to not care for their teeth as well. If you're happy with your smile and it's white and your teeth are straight, then you have more of a tendency to take care of your teeth. So I think that's another important aspect of giving our kids a good start, but in order to give our kids a good start, we have to be educated about what the source is and get a little bit more away from the traditional. Okay, well, we're just going to yell at you about how many times a day you're brushing and how often you're brushing and whether you're flossing or not. And in our office, and I've been sharing it with Jason, Sam is we use the CTX products. You can find them right on Amazon. You can get them on auto-ship. It's a gel. And then there's a rent system and it helps with the acidity. It also helps with antibacterial properties and you can get it with, or without fluoride. Now I am a fan of fluoride, but not everybody is. And I appreciate the fact that that CTX has that if you have a bacterial issue and you're older, so an adult. We also have a product called perio protect trays to help again, control that bacterial environment, which is important. We're finding more and more important in addition to traditional methods of brushing and flossing. But I was taught to just yell at people about brushing and flossing. What else are you going to do? That's our job.

Dr. Jason Lewis:
Let's talk about fluoride a little bit more. Because I think there is certainly some misconception about fluoride intake and how much fluoride we should be consuming. If you want to, I know you did a lot of research on this, but let's talk about a little bit as far as in the tap water.

Dr. Michelle Hucke:
So one of the things, and I think it's pretty common knowledge, that we do know that, well, first of all, the decay rate has gone up significantly in the last 20 years. And I've been a dentist, I'm going to say it out loud, 30 years. Yeah. Don't anyone do any math. So it's gone up significantly since the first 10 years of my practice. And that is about the same time where bottled water was invented. Right. And so we're all consuming water that is filtered. A lot of it doesn't have any fluoride, even if you have fluoride in your water, which is a good thing to find out and discover just so that you know whether it's fluoridated. Most of us aren't consuming it anyway. So it's really important to have fluoride in the environment and it's important whether you're a child or an adult because as you have acid attacks to your teeth and that area is demineralized, if it's remineralized with fluoride in it, it's stronger. So that's why there are several misconceptions, right? Well, it's only important when the tooth is developing, but the reality is that teeth are assaulted all day long by different things. And if you have fluoride in your oral environment, then your teeth are going to be stronger and healthier when they remineralized cause that's what a cavity is.

Dr. Jason Lewis:
Yeah, it's almost like as maybe, an everyday example, like when you polish your car, when you polish your car, you're, you're putting like a nice protective varnish or just wax on your car so it protects it better from the environmental things that are going on. Raining, we don't have to worry about snow around here, but just anything that may be getting in your car. So fluoride, we call it a fluoride varnish because literally it's a protective layer that is going over your enamel and your enamel, as Michelle mentioned, everything we drink these days seems to be more on the acidic side, and if your mouth is just below or just in that acidic under seven on the pH scale, then that's putting your mouth in an acidic environment where your teeth are, are going to start to get damaged.

Dr. Michelle Hucke:
Agreed. Yes. So I think what we'll do is head back toward, the recommendations and things that people can actually, take away from this webinar because we certainly promise to do that. The primary recommendation, especially as we went into a free fall again, the first 10 years of me practicing, and the decay began to escalate, and I think it's a great recommendation. It's just a recommendation that most people aren't aware of. But the recommendation is that we see children essentially at the time when their first tooth comes into the mouth, that's the best way for people to think about it. And then definitely prior to their first birthday, which shocks many people. The reason for that is because dental decay is our number one childhood disease. And the only hope that we have is to share the information similar to what we're doing today with our patients and honestly hopes meets a lot of times too my hope is that the patient may then share it with their pediatrician. So if any of you are watching and you have contact with me or with Dr. Lewis, we would love connections with any pediatricians that you know. I definitely would like to spend time with them and educate them, some of them about why they should be encouraging their patients to see us before the child is one.

Dr. Jason Lewis:
Yeah. And again, obviously, we're going to check in the mouth to make sure the teeth are coming in okay but more importantly, as Michelle mentioned, just to find out what is the baby drinking a Sippy cup at night when they go to bed or what is their diet? So that, and not only at that time but for the future when the child starts to age.

Dr. Michelle Hucke:
Absolutely. And then the sooner we can be cleaning their teeth and getting them on a regular schedule and having because sometimes they have early challenges in terms of what they've been exposed to. So, we need you again, not just to be yelling at people and scolding people about what they are doing, but having an ongoing dialogue about what they can do for the child to stay healthy. Yeah. And then it's good to find out about your water source and, try to be realistic about where most of the water is coming from. As soon as the child is able to, it's good to have them flossing. Another thing that's, I think shocking to a lot of people is that until your child is about eight, it's good to let them brush and then re-brush

Dr. Jason Lewis:
Someone, I believe it was a hygienist told me years ago that, and I never heard this example before, when your child is able to write legibly, that is a good, you know, that they can brush your teeth. You still probably want to supervise. But I have parents who are letting their kids brush their teeth at age four by themselves. And that's probably not.

Dr. Michelle Hucke:
We're going to call it that brushing.

Dr. Jason Lewis:
Not really sure how good of a job that they're doing. So, yeah, when they, when they're able to write legibly, that's usually a good indication that they can brush their teeth. Now, my sons are 13, so I probably still should be brushing their teeth? Because their handwriting is terrible, but that's okay.

Dr. Michelle Hucke:
Well, and I have another vulnerable share that I'm going to admit, which I'm not very good at, but we're going to do it anyway. My daughter, again, I'm a dentist and my children have already suffered from decay, all excited that we found the CTX products. It's been a miracle. Because for the last three years, we haven't had any decay in the hockey household. My daughter announced to me while I was driving an automobile, which was not a good time to announce it to me. I know no parents out there have that whole automobile announcement where you're almost ready to drive off of the road, but she announced to me that she made a great decision to start brushing once a day.

Dr. Jason Lewis:
Oh, interesting.

Dr. Michelle Hucke:
Yes, because she just decided that it made sense. And for the last six months, she's been reverse brushing once a day. Now Dr. Lewis will explain to you why that's not a good idea and why we might need to, my children are 11, not only monitor her exactly how they're brushing or how long, but verifying that it's actually getting done twice a day, super important.

Dr. Jason Lewis:
And even going back to the dexterity issues when they can brush I've had my kids use an electric toothbrush now since they were probably eight or nine years old. So at least I know the toothbrush is doing most of the work as long as they keep it in their mouth for about two minutes. But yeah, brushing once a day, your mouth has bacteria in it all the time and so, depending on when they're brushing, if they're brushing in the morning but not brushing at night, which I would say, did she say when she was brushing?

Dr. Michelle Hucke:
I can't remember. I think she was not brushing at night. She had all kinds of really good rationale to, but yeah, and what I've found in my practice, and I'm sure, any other dentists out there is, if you only brush once a day, there there's legitimate reasons for brushing twice a day, lots of testing and all of that and then anecdotally or whatever word you want to use for it. When I have patients that only brush once a day, their decay is just as bad as somebody that drinks mountain Dew all day. It's extremely different when you look in someone's mouth that brushes only once a day. So I really calmly explained to her that that was a bad idea and did not get in a car accident, which was good.

Dr. Jason Lewis:
Cause the plaque part, it takes 12 hours for the plaque to harden. So if you go, let's say that child brushes at night, so then they're going 24 hours without brushing again. So that plaque, at the 12-hour mark is hardening on the tooth and then you can't get it off with the toothbrush anymore. So then that plaque which becomes harder starts to cause damage.

Dr. Michelle Hucke:
Yeah. And then what I tell my adults too, cause I know, it's obviously adults that are listening, so it's good for you guys to get some tidbits too. But what I tell, most adults don't brush at night, they get home, they eat dinner, we're all exhausted from running around all day. And we get in front of the TV or whatever and fall asleep. The real problem with not brushing your teeth at night is your saliva completely shuts off. And saliva is your defense to the acids and to the bacteria. So nighttime brushing super important. So what I tell my adults is, as you push away from the table, stand up and walk to the bathroom, please brush your teeth versus going over to the recliner. Don't go to the recliner, just go straight to the bathroom.

Dr. Jason Lewis:
That's nice

Dr. Michelle Hucke:
And then Dr. Lewis was talking about the Sippy cups. I think everybody knows, right? We're not supposed to have bottles in bed. Everybody knows that we're not supposed to breastfeed as kids are falling asleep or are sleeping. The new recommendation that came along about the same time as seeing kids at 12 months was discouraging Sippy cup use. Not at all, obviously, because otherwise you have stuff spilled everywhere, but you should, all your kids should only have four to six ounces of juice a day. It should really never be in a Sippy cup. But if it is, it should just be at the table with meals that shouldn't wander around. So no at-will Sippy cup use, wandering around the room is what I say. It should not be mobile. It should stay put. So if the Sippy cup is moving around the room and should only have water in it. And so that's a really good thing to keep in mind. A little bit like the at-will snacking that we were talking, free-range snacking.

Dr. Jason Lewis:
And I did have control of my, which obviously I still do, but when they were coming home and mom and dad were there the whole time, we would dilute their juice. So that way, it was half water, half juice. So at least, we're trying to control the amount of juice that they have, the amount of sugar. So diluting a little bit can, can certainly help.

Dr. Michelle Hucke:
And don't let it leave the table. So yeah, we've talked a lot about things that are bad news, right? And then we've also talked about the good news and the good news to me is that it's preventable. It's not something that you're stuck with. The main remedies are, diet control and things that we've talked about. And making sure that if necessary, especially while we're in the process, right, like you're going to be, with your kids, Right. You're in the process of figuring out, Oh my gosh, my kids have decay, what the heck? So making sure that they switched to a prescription toothpaste, especially one that has calcium hydroxide, xylitol, and fluoride in it. So it's awesome, that there's a solution, that there are things that we can do and limiting the sugar in order not to get decay again, but also to begin to work on the bacteria that are the population in your mouth.

Dr. Jason Lewis:
Yeah. And certainly, we all know that sugar is a drug, so when we addicted to it that as I was talking earlier, once we get into adulthood, if we take those habits of eating a lot of sugar from our childhood to adulthood, then we start having not only mouth problems, which is again the kind of the gateway to the rest of our body. So if we're having lots of cavities or gum problems in our mouth what is the rest of our body looking like? If we have bleeding gums when we brush our teeth, what are our organs looking like? What's our heart look like over time? So these are all things that if we can control the diet and can control the sugar intake, it can certainly give us a healthier life down the road.

Dr. Michelle Hucke:
Yeah. Because they were saying, if you're looking at the screen, consumption of free sugars more than four times a day dramatically increases the decay. And what we learned from that twin study is, cause it changes the bacterial makeup, but also obviously dramatically increases things like diabetes and other diseases like Dr. Lewis was alluding to, so super, super important. And we love being dentists and we love doing dentistry and I am so happy that I picked it for a career. But what we really love is helping people be healthy, overall, again, not just by criticizing people or lecturing to people. But by uncovering things that people can do.

Dr. Jason Lewis:
Absolutely.

Dr. Michelle Hucke:
So those are some of the main awesome conclusions and we would love to have you guys share this webinar with other people that have kids and other professionals too, that might be interested in it. We're doing at our office at Jax Beaches Family Dentistry, maybe the Lewis' will do it. We're going to do a $79 new patient special for children. That includes cleaning. If you tell people that you saw this webinar and I'm going to put a screen up too with our different phone numbers for anybody that's watching here, so you can reach us, you can also always email me or, look me up on Facebook or I'm pretty accessible to everybody.

Dr. Jason Lewis:
And I do like to copy Michelle and a lot of things just because she's awesome. So yes, we will do that for our practice as well.

Dr. Michelle Hucke:
And then Dr. Lewis and I have an incredible mission, which we are really fired up about and that's to get 5 million people healthier in Florida through the practice of complete health dentistry, and the reason that we're going to be doing that or how we're going to be doing that is sharing this information with other dentists throughout Florida. So if you're a dentist or you know a dentist, please have them contact one of us because we want to be communicating with other professionals and sharing this information so that we can right the ship because the ship isn't headed in a good direction right now. Yeah. And it's funny. We talk about it as colleagues, but then we also talk about it as, people that live in the United States, like everybody's on all these medications and there's all this decay and we talk about it and talk about it. So, the intention of this is just to share information and the intention is to impact people just through knowledge, the power of knowing what you can and can't do. And next month is national nutrition month. So I'm going to have a webinar on March 27th with my dear friend, Katie Giardo at one o'clock. So jot that on your calendars. We'll post, I'll be posting a Facebook invite about that also.


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