#1467 Pediatric Dentistry and Type 1
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Dr. Niekia Franklin is a pediatric dentist with T1D, she dives deep into how foods and oral microbes affect teeth and cavity prevention in diabetes.
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Scott Benner 0:00
Hello friends and welcome back to another episode of The Juicebox Podcast.
Dr. Niekia Franklin 0:15
My name is Nike a Franklin. I'm a pediatric dentist I practice in the Bay Area and California, and I'm excited to talk a little bit about pediatric dental health, general dental health, and how it relates to patients that have diabetes type one or type two.
Scott Benner 0:38
Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan. I know this is going to sound crazy, but blue circle health is a non profit that's offering a totally free virtual type one diabetes clinical care, education and support program for adults 18 and up. You heard me right, free. No strings attached. Just free. Currently, if you live in Florida, Maine Vermont, New Hampshire, Ohio, Delaware, Missouri, Alabama or Mississippi, you're eligible for blue circle health right now, but they are adding states quickly in 2025 so make sure to follow them at Blue circle health on social media and make yourself familiar with blue circle health.org. Blue circle health is free. It is without cost. There are no strings attached. I am not hiding anything from you. Blue circle health.org, you know why they had to buy an ad. No one believes it's free. Today's podcast is sponsored by the insulin pump that my daughter has been wearing since she was four years old. Omnipod. Omnipod.com/juicebox, you too can have the same insulin pump that my daughter has been wearing every day for 16 years. US med is sponsoring this episode of The Juicebox Podcast, and we've been getting our diabetes supplies from us med for years. You can as well us med.com/juice box or call 888-721-1514, use the link or the number, get your free benefits check and get started today with us. Med,
Dr. Niekia Franklin 2:25
good morning. My name is Nike or Franklin. I'm a pediatric dentist. I practice in the Bay Area and California, and I'm excited to talk a little bit about pediatric dental health, general dental health, and how it relates to patients that have diabetes type one or type two.
Scott Benner 2:48
Well, it's Nike. Yeah. Is that? How is that? Yes, perfect, perfect. I was listening Nike. I appreciate you doing this. I want to get a little bit about your background. So first, do you have a connection to diabetes?
Dr. Niekia Franklin 2:58
I do. I have been a type one diabetic since I was in dental school about 15 years ago. Oh, no kidding, I lived that life.
Scott Benner 3:08
Yeah. How old were you when you were diagnosed? You
Dr. Niekia Franklin 3:11
know, I was 22 when I was diagnosed, but looking back, I probably had it towards the tail end of 21 when I was learning about diabetes and joking about, oh, I might have diabetes because I'm drinking all of this water all the time. And then it turns out that I did so jokes
Scott Benner 3:29
on you, as they say, yeah. So any other type one in your family, extended or or close family, relatives or other autoimmune issues, you
Dr. Niekia Franklin 3:39
know, there really aren't any other type one diabetes that I know of. I do think there's a history of hypothyroidism, hyperthyroidism, so I don't really have, like, the full family tree in my family. So sometimes I wonder if there would have been people who had it, you know, if we were talking or if they were still alive. But for the most part, I think it just popped up for me
Scott Benner 4:11
again. Lucky you. Well, lucky us, because now you're here to talk about it. You know that people joke all the time like, Oh, if this, we really want some headway on this. We need somebody famous to get it. You're the Juicebox Podcast version of that. So thank you very much.
Dr. Niekia Franklin 4:23
Maybe for dentistry at least.
Scott Benner 4:28
Yeah, what kind of a student are you in high school, and what are your interests that lead you to think I'm going to become a dentist? Because, if I'm not mistaken, it's an incredibly difficult thing to accomplish. You know,
Dr. Niekia Franklin 4:39
in high school, I was really into debate, and I also loved healthcare, and I was always wanting to volunteer at the nursing home or hospice, and then I was really interested in all of these medical conditions that people had. Then I was also babysitting. And tutoring kids. And so I guess it was like a question of, oh, do I want to go to law school, or do I want to go into the healthcare field? And then in college, I got to volunteer at basically a free clinic, and I loved and then I was always on the medical side, but then whenever I got called in to volunteer on the dental side, I got to talk a lot with the patient, and I fell in love with talking to the same patients over and over, and they would come in, and I would get to know their whole family, and then we would also like take care of that tooth that was hurting them, or that infection in their gums, and they would walk out just like amazed and so grateful. And I thought, wow, this is really, really cool to one. Get to talk so much, and they can't say anything back, no, really, just to, you know, get to build that rapport and have like, a full hour with somebody, and then also get to provide immediate relief. And that kind of started me into dentistry, which I love school and I love science and learning. So give me four years, plus another two and a half of just straight dentistry and pediatric residency in the trenches, and it was, it was magical. I loved it. So anybody that thinking about it, if your kids are thinking about it, I highly suggest considering a career in dentistry. It's so rewarding and super fun. Do
Scott Benner 6:36
you think there's a mindset like a type? You know how people say, Oh, I seem like an engineer. I can tell what an engineer is like. Do you think there's a dentist?
Dr. Niekia Franklin 6:43
That's a great question. So I think there is. But also there are so many different types of dentists that it really varies. Dentistry is like a lot of medicine, but it's a lot of art, and so I think if you take somebody that loves science and helping people but also has this, like artistic, kind of adventurous side, I think that sounds like a dentist to me. I
Scott Benner 7:11
have to tell you, I've had a couple of dentists in my adult life, and one of them, I would joke that I thought he was on meth, because he would set four rooms up with patience and literally jump from room to room and work on all of them. And it was like, he'd be in the middle of something that you'd be like, Okay, I'll be back and be back. We're not done. And you'd hear him next to be like, Hi, and then he start again. And I was like, then you hear him do it again and again. And I was like, I mean, I know times are tough, right? But like, I moved and I met another gentleman, and he's been my dentist forever, and he's lovely. There's one person in his office at a time, and he sits with you until you're done, and he's very specific and lovely, and his work is always excellent. I've never had somebody inject a needle into my gum and thought, like, Oh, that wasn't bad, really, kind of amazing. Now, which one are you? Are you the sit still with one person, or are you the like, jump around like or like? Have you never even heard of that before? You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you, but I'm set up to be called if I don't respond to the email, because I don't trust myself 100% so one time I didn't respond to the email, and the phone rings the house. It's like, ring. You know how it works? And I picked it up. I was like, hello, and it was just the recording was like, us, med doesn't actually sound like that, but you know what I'm saying. It said, Hey, you're I don't remember exactly what it says, but it's basically like, Hey, your order's ready. You want us to send it, push this button if you want us to send it, or if you'd like to wait. I think it lets you put it off, like, a couple of weeks, or push this button for that. That's pretty much it. I push the button to send it, and a few days later, box right at my door. That's it. Us, med.com/juice box, or call 888-721-1514, get your free benefits checked now and get started with us. Med, Dexcom, Omnipod, tandem, freestyle, they've got all your favorites, even that new eyelet pump. Check them out now at us, med.com/juice, box, or by calling 888-721-1514, there are links in the show notes of your podcast player and links at Juicebox, Podcast com, to us, med and all the sponsors. My daughter is 20 years old. I can't even believe it. She was diagnosed with type one diabetes when she was two, and she put her first insulin pump on when she was four. That insulin pump was an Omnipod, and it's been an Omnipod every day since then. That's 16 straight years of wearing Omnipod. It's been a friend to us, and I believe it could be a friend to you, Omnipod. Com slash Juicebox. Whether you get the Omnipod dash or the automation that's available with the Omnipod five, you are going to enjoy tubeless insulin pumping. You're going to be able to jump into a shower or a pool or a bath tub without taking off your pump. That's right, you will not have to disconnect to bathe with an Omnipod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an Omnipod for 16 years. She knows other people that wear different pumps, and she has never once asked the question, should I be trying a different pump? Never once omnipod.com/juicebox get a pump that you'll be happy with forever.
Dr. Niekia Franklin 10:45
No, I have absolutely heard of all of these, like archetypes, right? And that's one of the fun things about dentistry, is that we still very much operate in this mode where you get to own your practice if you want to, and kind of run it how you want to and so there are the practices where they see 10 patients a day, and there are practices where they see a lot more than that. Being a pediatric dentist, my my job is certainly a little bit more energetic, because we're working with kids so much of what I do is actually just talking and education. So yeah, when we have a one year old who's coming into the office and we say, Oh, we're gonna schedule this for an hour, families are thinking, What in the world are you going to do for an hour? And realistically, a lot of that is my really well trained team showing that child. These are our tools. Let's play with these stuffed animals. Isn't this a fun place to be? And then moving into education and talking about snacks, reviewing habits, reviewing airway questions, and then that last little minute is me doing the exam and then following up with any questions. And so we do have probably about three patients in at one time, but every single minute is like high intention and really hopefully impactful for the family, even if a lot of it is with my amazing team members, not necessarily with me. So
Scott Benner 12:28
then if your time with the kids is 20 minutes a piece, then you just stagger it so that there's three kids in the office, but they're all in a different portion, so that you can be there during your time. That's really something you
Dr. Niekia Franklin 12:39
are brilliant. Up on that very fast. That's called block scheduling. Is
Scott Benner 12:44
that what it's called? Yeah, I didn't go to college, so I don't know what anything's called. But my last question, I want to ask one about you and one about me, and then we're going to get into dental care for for kids and type ones. Okay, so I, I'm going to say something that's going to sound ridiculous to people. So first of all, I grew up very poorly. I didn't have any money. Dental Care was not a thing that my family did. I don't think I went to a dentist until I was, like, 19, and it makes me sound like I live in a cave on a hill when I was growing up, but we were just poor. I went on my own because I had like, you know, Wisdom teeth, and I was in trouble and, like, that whole thing. But now today, I've had a number of root canals throughout my life, and I'm gonna say that it's probably from 20 solid years of, you know, brushing my teeth and nothing else I love. This is the question I love. Oh, my God. I feel stupid saying this. I love getting a root canal. I find the dentist so relaxing. I go, and I sit back, and I'm just, I put my headphones in, and I close my eyes, and, you know when you're doing a root canal, and there's that, what I imagine, in my mind is this little, like burr thing that maybe is bumpy, and it goes and it goes in there, and it cleans out the canal, and that kind of, like it shakes, just ever so it's like, Do you know what I'm talking about?
Dr. Niekia Franklin 13:59
Yeah, it's like a massage for your tooth. I love it.
Scott Benner 14:05
I think it's wonderful, awesome. What's wrong with me? That's my question. Oh,
Dr. Niekia Franklin 14:09
you know, great question. I would say there's absolutely nothing wrong with you, Scott, you're being nice. No, we have kids who are getting fillings and they fall asleep, and parents are like, amazed, and they're thinking, we've given them something, and I'm like, No, the laughing gas actually doesn't do that. They're just super relaxed, like they're watching Disney and hanging out. And in our office, you do not feel the N, E, E, D, L, E, you don't feel that. So there's nothing for them to be afraid of. They're just hanging out getting screen time on a Friday morning. It's a great time.
Scott Benner 14:46
Like, yeah, I am maybe not more relaxed anywhere in my life than when I'm sitting in a dentist chair. I actually,
Dr. Niekia Franklin 14:51
I love it too, and I will tell you, there is no judgment. So I went to the dentist once before I volunteered in college. Much at that clinic? Yeah, it was at a community clinic, and they did sealants. And those sealants saved me, because I was the statistic of the poor kid that doesn't go to the dentist, which is unfortunate and still very accurate 30 years later, that was part of the reason why, when I went to the dentist, as you know, a college kid, I also loved it because I was amazed to find out that dentistry is really important for things like your heart and your brain and all of those things, and that just was not something that I grew up with. So we're in the same boat. Ironically, I ended up with myself. I have like, 10 to 12 cavities. I've been able to keep them small, happy to talk about that later and tips for that. But I love your story, and I'm so glad, yeah, I'm so glad that you're not afraid of the dentist, not
Scott Benner 15:54
afraid. I look forward to it. I don't tell anybody. I'm like, oh, it's gonna be wonderful. It's two hours. I just sit there. It'll be great. Anyway. Okay, so just go over your education for me real quick, and then let's jump in. So you got to go to an undergrad, obviously. And then what happens after that? What's the progression?
Dr. Niekia Franklin 16:09
Yeah, then you do four years at a dental school. Some people will, you know, do something called a post baccalaureate, and they'll study and get a Master's beforehand. But I would say a lot of us go from three to four years in undergrad to four years in dental school, and then some of us decide that we want to continue the fun, and we choose a residency which are between one and six years long, so that we can specialize and do things like treat children in medically complex cases, and do things like oral surgery or braces.
Scott Benner 16:49
So, so you did that. What? What did you end up getting your advanced degree in? I have
Dr. Niekia Franklin 16:55
a master's in the science of dentistry and a certificate in pediatric dentistry. So I'm a board certified pediatric dentist who completed a residency that was both in a hospital and in a dental school so that I can, yeah, so that I can treat children. And specifically, got a lot of information on kids that have medical complexities and behavioral challenges, and did a lot of work with kids and also adults who have special health care needs.
Scott Benner 17:29
Well, you sound awesome, so let's find out what you learned at that school. If I just said to you, hey, Nikki, I'm gonna leave now and you've got 45 minutes tell people what you want them to know about about their dental care. Like, I'm gonna jump in once in a while, but that is really what I want from you. Like, what do you think people should hear? What do you think they should be paying attention to? What are some tips and tricks that they can use along the way? Wow, yes,
Dr. Niekia Franklin 17:52
okay, I will try to do an outline. Yeah, of some of the things I think are most important, and please hop in, because this is my life. So I get very passionate, because I think there's so many things that we are learning right now. And I'll start by saying that, which is the science and dentistry is evolving so quickly that things that I'm going to talk about, I was not trained on in school, things that I'm talking about. I mean, you can research them yourselves. You can go on PubMed. You can which is like this great website with free research articles. Or you can even reach out to me if you have questions as well, because it is so important. I guess, to start out, I just want to say that going to the dentist is about so much more than preventing cavities. And it turns out that our mouth is kind of like the window into our whole body, and so if we are getting cavities, if we have gum disease, if we are not breathing well. It will impact our whole body when you are going to the dentist, or when my patients are coming to see me, we are trying to do so much more than just say, Oh, this is a cavity. Let's fix it. And so when we are choosing our dental home and we're going in. I just love when families are open to talking about so much more than just, Oh, do you brush and sauce? I love sitting down with a family and really reviewing their diet, their kind of, their birth history, their oral habits, different risk factors in their life, for trauma, and just kind of getting an overview of the entire patient, because oral health involves so many facets of our life, and so that's kind of where where I practice from.
Scott Benner 19:56
So what I think most people are accustomed to hearing at this point is. Think you know your dental health could impact your heart health. That's the thing most people have heard by now. There's more to it than that. You think
Dr. Niekia Franklin 20:08
there is, especially for patients that have diabetes. My
Scott Benner 20:14
let's start here. Like, how does my dental health impact my heart health? Or how can it impact it?
Dr. Niekia Franklin 20:18
So when we're talking about your dental health impacting your heart health. Mostly we're talking about the inflammation, which is like kind of a term that a lot of us know, like when our tissues are upset and they're irritated, we're talking about the inflammation that happens if you have periodontal disease. And I think it's really important, because I know I didn't realize this when I was not in dental school, but when we're talking about losing your teeth, that can happen primarily from two diseases. One is cavity, and like cavities, you you have a big cavity, and eventually, you know you've gone through the crown, you've gone through the root canal, you've gotten the implant, and now you've lost your tooth. And the other way that a lot of people lose their teeth is actually through something called periodontal disease. And periodontal disease is super relevant, because it's actually something that we know patients with diabetes mellitus type one or type two are much more prone to, and there's a variety of reasons for that, but if you have this inflammation and this bacterial infection in your gums and the bone that holds your teeth, it causes a lot of inflammation that goes throughout your entire body. And there's interesting findings, like they've found plaque in people's hearts that is actually formed with the same bacteria that we find in the mouth of that person, that's only found in the mouth when you have periodontal disease, and the only other place that they find it in the body is in these plaques in the heart sometimes. And so when we're talking about the inflammation factor from periodontal disease, increasing the risk of heart disease, we're talking about the fact that it is irritating the vessels in your heart and making you more prone to different things like fat build up, which is, ultimately, you know what causes different levels of heart disease, right? And so. And it's
Scott Benner 22:33
gonna sound crazy, but just brushing and flossing and what else water picking like. What about those trays like here, here's one for you, my doctor. But my dentist says to me, I see where people get like, can be like, I don't know. I think he's trying to make money. But like, you know, when my dentist says to me, like, oh, we see a pocket here. It's a three buy this tray and put this stuff in it and put it in your mouth for 10 minutes. It only cost $1,000 to have the tray made. Like, what, you know, you're laughing, but, but as the end user, when you're hearing that, you're like, what? Like, my dad died when he was like, you know, 76 he didn't have a dent. Now, of course, it was a heart issue, but he also smoked. But I'm saying like, people have lived long into their lives without dental trays. Like, why am I standing here now suddenly being told, for just $1,000 I too, can have less inflammation in my gums, and that's very important. Like, I'm not arguing, I'm I really want an explanation,
Dr. Niekia Franklin 23:26
right? Good question, and I actually think that it is great for any patient of any provider to question what is being recommended. An interesting fact of dentistry and in general healthcare, which I'm sure many of us have experienced, if we're listening to this podcast, is that different providers do things so differently, and there's certainly a level of trust there. So when you go to the provider, you want to basically vet them as much as you can ask them questions, get a sense for who they are, and then, at some level, you just have to trust what they're suggesting. You can ask them questions. You can ask for research that doesn't hurt our feelings, at least it doesn't hurt my feelings, but at the same time, you aren't going to be able to follow all of the research, in addition to all the things you have going on in your life, you just don't have enough time, right? So there is so much research coming out about different ways to help once you have periodontal disease, there are different treatments. There's laser treatments, antibacterial treatments, there's things that I like to do as a pediatric dentist, which are more preventive, you know, talking about the oral microbiome, talking about oral probiotics. Yes, if you have a pocket or an area that's catching food, talk, you know, I'll suggest a water pick for that area, in addition to great flossing and brushing. But. There are so many different ways to address different issues you have that you might be suggested something that you have never heard of, that honestly wasn't available two years ago to help out. Now, a pocket of three does not sound that sounds within normal.
Scott Benner 25:18
I was just saying things that I noticed that that's all, but the pockets go up to five. Is that?
Dr. Niekia Franklin 25:24
Right? Oh, my goodness. I mean, when we had to wiggle out some of my dad's teeth because he had periodontal disease, not cavity, some of his pockets were 10 millimeters. That's almost to the to the root of the tooth, which is just, you know, a fact, right that some people are going to get more periodontal disease because of their bio factors, because of their immune system, because they didn't floss. And so depending on how deep your pockets are, you might get surgery to reduce the depth of your pockets, and they might be stuffing in pretty expensive little pieces of material that have antibiotics. And I would say that a huge part of why it's $1,000 and not more affordable as it should be, is just because dental insurance in America is terrible. That's terrible. Yeah, it's terrible for everybody. It's not like medical insurance, where you're like, Oh darn, I had to use it. Dental insurance literally is now it's like a business, and so I think that's frustrating for people, and especially for parents. If a provider is telling you this is really good for your teeth, and then also saying, Oh, but your insurance isn't going to cover it right,
Scott Benner 26:39
because you're left standing there thinking, like, Okay, you hippie. Like, are you right about this? And, like, because, like, look, I don't want my teeth to fall out. And if you take me ahead 30 years and say, Hey, Scott, if you would just spend $1,000.30 years ago, guess what? You'd have all your teeth. I'd have been like, right on, like, when they're standing in front of you and saying something that you're just like, I don't know. Like, that doesn't make sense. Like, wasn't this happening to people 10 years ago? How come? But I guess the truth is, is, I don't know a lot of 80 year old people whose teeth just fall out when they bite into mashed potatoes. So like, but it doesn't mean it's not happening well.
Dr. Niekia Franklin 27:11
And you hit on a good point, right? Which is, this is your one set of teeth at your age? Sorry to say it. Yeah. You know a lot of 80 year olds, unfortunately, they don't even have their teeth anymore, and they are relegated to just eating things like mashed potatoes. We have so much evidence now that says if we start with oral health at a young age, if we're taking care of these teeth, if we prevent the what our textbooks call the spiral of death for tooth starting at a young age. Fun. Title, yeah, we are going to actually help you to live a healthier life, and especially in that last 10 years. Can you imagine, if you are eating crunchy celery carrots, how good that is for your oral musculature and for your whole body, if you're still eating nutritious food versus if you can only eat, you know, bologna sandwiches and mac and cheese because you have dentures.
Scott Benner 28:07
So like, Hey, if you're telling me that I just have to spend $1,000 so I don't have to eat wet celery when I'm older, then I think that's a good enough reason. I don't, I don't want to do that.
Dr. Niekia Franklin 28:17
And I know it sounds like a lot, and sometimes these things, even, you know all, I'll read the prices, because I have dental insurance, and it's terrible, right? Like it doesn't cover my implant crown, it didn't cover basically anything. And luckily, I know that these things are great, and I'm going to providers who I absolutely trust, and I can look up the research to see, you know, oh, wow, this prolonged the life of the tooth by three years on average, just by doing this one thing, right? I get to go and know all this information, and I still look at that bill like, really, and none of it is covered. Why am I paying for dental insurance? So I totally get where you're coming from, but I'm also going to tell you that your dentist sounds great if they are recommending it, most likely it's because it is something that is really going to help your choose. I
Scott Benner 29:14
know it just sounds like a hippie when he's saying it. He's like, hey, like, you know what I heard at a conference I went to? I'm like, Oh, it sounds like it's gonna be expensive for me. Go ahead. What'd you hear? And you know, it's cutting line. I want to say, in case you listen to this, like he's an awesome dentist, and I do listen to everything. He tells me, actually, it's just, I'm just kind of playing devil's advocate. It's difficult, like when, when people start talking about things, like your immune system has trouble with it, and it's about chronic inflammation. It's a lot of things you can't see that aren't it's, you know, you know what it is. It's a lot like diabetes, really, because it's a lot of things that you can't see physically today that are definitely going to cause you a problem down the road. It's hard to plan ahead, like that for people you don't even like. That's why I'm happy to have you on especially because, listen, we get over some. Find this and say, Look, your kids have diabetes. They're probably drinking more juice than other kids. They're probably eating more candy, like, for low blood sugars and stuff like that. You know you're you're feeding them overnight, sometimes giving them juice overnight. That's not good for you to have that, that sugar sitting in your mouth all night, like that. Like, I mean, that is just obvious stuff, right? But like, when you say that and people hear it, they go, Well, I don't know what you want me to do. Like, should the kid not drink a juice at not drink a juice at 2am if he's low, like, I need this juice. Is it possible that, if just you attack the entire thing, bigger picture, that you can offset some of this stuff that's happening with diabetes? Absolutely,
Dr. Niekia Franklin 30:34
and that should be the goal. When I have any child come into my practice, I know that there are 41 factors that can influence like influence their risk for cavities, and I'll be really honest, controlling their type one diabetes is not my job, right? So that I'm going to lead to your other more qualified doctors and to your parents to figure out what works best for your life, but what I can do is give you tips on foods that you can use to correct a low that are going to be less likely to cause cavities. What I can do as a provider is to look at everything else like do you also have dry mouth because your mouth breathing? Do we need to address that? Are you flossing? Do you understand that 40% of the areas on your teeth are actually where your toothbrush cannot reach, and that as a type one, you are 30 to 50 times more likely, or 30 to 50% more likely, I should say, to have periodontal disease, especially at an age where children who do not have type one diabetes do not get periodontal disease yet. Okay, basically, there's so many factors that go into somebody's oral health, and I think having diabetes mellitus, type one, type two, or being pre diabetic, that's just one factor, and it's an important one, because it does impact saliva content, oral microbiome you have, like, more kind of icky bacteria in your mouth, for some reason, but at the Same time, interestingly enough, kids that have type one diabetes may not be more at risk for cavities, and so I think we're kind of setting the bar a little bit low, because basically half of kids in America by the time they're six have had cavities. But when I'm talking to a child who drinks juice for type one diabetes, I kind of view that more as medicine and that's just part of their life. But I have tons of kids who don't have type one diabetes that drink multiple juice boxes a day as well. So yeah, yeah, Arden
Scott Benner 32:53
had a lot of trouble, but luckily, that all happened with her baby teeth. So as an adult, you know, she wasn't in the same position. She was is also, you know, when Arden was first diagnosed. Like, there weren't CGM and stuff like that. So, you know, for those of you who are like, Oh my God, it's, you know, something happens, and I have to do it. Like, my whole, like, my entire day, was that constantly, like, just like that, up down, up, down, up, down. Like, here's some juice, here's some insulin, like that. Thing just never stopped. For a while. The CGM helped so much with that, but so our poor Arden, like, had so many little like, like, cavities, and, you know, when she was little, but thank God we technology moved along. We figured out what we were doing better, so we weren't always stopping lows. And, you know, like, she hasn't had that trouble as an adult. But yeah, I mean juice boxes. I'm talking like they're something magical that only type ones use. But sadly, I think a lot of people get a lot of sugar through the things they drink, whether they realize it or not.
Dr. Niekia Franklin 33:48
Yeah. I mean, I prefer juice to some of the other things that we can correct. I appreciate the fact that when they're a little bit older, a child can open a juice box by themselves and correct it, you know, correct a low as they need to or as they feel when coming on. And then my suggestion is to rinse with a little bit of water afterwards, if they can. We're all a little dehydrated, being type one, you know, we're actually more prone to dehydration. Our saliva is maybe a little bit thicker, and because of that, our mouths are more acidic, and we're more prone to cavities. So if I can get that child to correct with the juice box, and then, just out of habit, drink a sip of water, rinse off some of that acidity, some of that sugar, I'm really not that concerned about that juice okay? Versus, I get a little bit concerned when we are correcting with Skittles and starburs, things that are very sticky and fermentable, that will stay on the grooves of the teeth literally all night long, and when we're talking about cavity formation. And so much of that is just based on this acid. So basically, we've got different bacteria, especially one called Strep mutans. It eats a carbohydrate, be it crackers, which are a huge cavity causer, or candy or pasta, even you know, it's eating any sort of carbohydrate, and that bug poops out something that's very acidic.
Scott Benner 35:27
Oh, my God, no one's ever put it that way to me before. Hold on, you took me for surprise there. Let's make sure nobody missed that. So there's like, it's a bacteria,
Dr. Niekia Franklin 35:38
yeah, I mean, primarily, it's Streptococcus mutans. There are other bacteria that can also contribute, but the big cavity causer is called S mutans. You can find this on YouTube and show it to kids, and I do love to educate children that it is literally bug poop that is sitting on their teeth and the acid in that is eating little holes in their teeth over time. Maybe
Scott Benner 36:03
we should all just give up. What do you think about that? Isn't it strange to think of yourself as this organism, but then there are many, many, obviously countless, tinier ones that you can't see, and they're going through a life process, too, of consuming and and excreting and ex Oh, wow, yeah. And on your team,
Dr. Niekia Franklin 36:24
yeah, fun fact, there are 700 species of bacteria in your world, microbiome alone. And, yeah, there's about 2 billion with a B bacteria in your mouth.
Scott Benner 36:38
Isn't that cool? Listen, you're a dork. I just want to say that, which is fine. I mean, it in a very nice way, but so you think it's cool. Everyone else is like, Hey, can you just go back to flossing? And what do I do? I brush in a swirl.
Dr. Niekia Franklin 36:53
Okay, so back to the science. I digress. It was wonderful. Yeah, think about all of this food that's sitting on your teeth overnight, right? And you're correcting overnight, the bacteria in your mouth does not need to sleep. So if you leave that food on your teeth, the bacteria will eat it all night long, and will produce acid all night long. And you have an acidic area on your tooth, it will eventually demineralize the tooth and break it down enough to cause a cavity. So if that helps to explain, that's why, whenever I'm talking about a raisin versus a grape, to talk about which one I would rather you have, right? You need a snack, you're going a little bit low. Which one is stickier? Which one's going to stay on your teeth longer and feed the bacteria more? And most be more likely to cause a cat? Okay? That's like a really reason, right? Yeah? You
Scott Benner 37:53
want the grape in that situation? Yeah? Juicier, uh, softer, fleshier, that kind of thing. Okay, I listen. I I'm aware of this because my hippie doctor told me that it's so funny, if you saw him, he's not a hippie, like, he looks the least like that. But, you know, he once said to me, he's like, you know what's bad? He's like, Doritos. And I'm like, really, because, yeah, because, like, when you compress them the, I don't know how to put it exactly, but the the Dorito itself gets stuck in grooves in your teeth, like it's dry, and it packs in. And I was like, yeah. I was like, Oh, No, kidding. So that's the first time I started thinking about what you're talking about, which is just that food hitchhikes on your tooth then, and then it sits there. And I didn't think about the part where bacteria is what's breaking it down. But Okay, fair enough, we get a cavity because, like, I think you just said it, but I want to make sure I understand. So let's really break it down, like make it very simple. So the bug digs a hole in the tooth because it's acidic, and then other stuff gets inside of that tooth where it's not meant to resist those sort of things that your enamel is supposed to keep that from the interior of your tooth. But once it gets in there, it can't resist it the same way as the exterior of your teeth, which also, once you lose enamel, you can get a cavity on the outside of your tooth as well, but, but, and then it's just rot. Then, right? Then the tooth is rotting. Well,
Dr. Niekia Franklin 39:11
yes and no. Okay, so with dentistry, there's a whole bunch of stuff to consider, right? So all day, every day, our teeth have these acid attacks. Right? Anytime that you eat any food with carbohydrates, the bacteria is going to eat that food, that carbohydrate, it's going to produce acid. So if you look at a pH example of somebody's mouth, every time you eat, if there's any carbs, you have an acid attack, and then the mouth will recover. There are things that we can do to help with that. One is to avoid really sticky stuff, like crackers or Doritos, and the other is to maybe rinse with water afterwards, or to choose some nice Xylitol gum after we eat, to help to get the pH of our mouth back up. Up and get that saliva flowing. Saliva also raises the pH back
Scott Benner 40:04
up. They make gum that helps with this. Yes, absolutely. Why my hippie not told me about that? Go ahead. So
Dr. Niekia Franklin 40:11
all gum that is sugar free is probably going to help with cleaning your teeth afterwards like that is actual proven science. Me, personally, I do like to avoid certain sweeteners, like aspartame. So the gum that I choose, and then I give out to a lot of my teenagers, is called Pure it's P, u r, it's got the xylitol, which helps to reduce the risk of cavities. That's another trick that I like to tell people, If you love candy, you choose one with xylitol in it. It actually helps to distract the bacteria and reduce your risk of cavities, right? So you're going to eat this food, you're going to rinse with water, or maybe you're chewing gum afterwards, or maybe you are, even if it's, you know, something really, really sticky. Maybe you try to brush your teeth afterwards, or you eat an apple afterwards, and then you rinse with water. You're basically just trying to get your teeth cleaner faster, or avoid those foods in the first place.
Scott Benner 41:12
So do I eat this like, but I try a piece of gum, like, after a meal, for example? Yeah, that would be great. All right. Well, listen, I'm not lying to you right now, I'm buying some right now online. Yes,
Dr. Niekia Franklin 41:23
I mean, it's delicious. It's great. And, yeah, it will actually help to clean off your teeth and bring up the pH in your mouth faster. But you hit on a good point, which is that a lot of times when we are reviewing the Snap Guide, which is this amazing tool from the dentist, dad, anybody can go online and find it. Parents think, oh yeah, I know what causes cavities. And then we get to the part where it says crackers are a huge cavity closet because they're 10 times stickier than bread, and they basically break down into sugar, just like candy. We get to the part where we're talking about gummy vitamins. Are essentially gummy bears with vitamins sprayed on top, and they are a huge cavity causer. We talk about oranges and bananas causing cavities. And think about an orange like how much acid plus sugar plus little pieces to get stuck in between your teeth is can be packed into one thing, and you've got an orange. I call them cutie cavities. Oh,
Scott Benner 42:20
because they're cutie oranges, I get you You're funny. Okay, go ahead.
Dr. Niekia Franklin 42:24
Yes, exactly. I know I should copyright that. Basically, we talk about the fact that maybe not all foods that are good for your body are great for your teeth to be subjected to all the time. And then we talk about ways to mitigate that. So if your kid loves crackers because they're super predictable and also they're easy to pack. I mean, my daughter loves crackers too. Share it with some cheese. Cheese is great for your teeth. Cheese will never cross cavities, and it actually helps to neutralize the acid that is produced when the bugs eat the crackers. Really? Yeah, awesome. So pair your crackers with cheese or peanut butter, if they're allowed to have that, pair it with salami. Salami is like a great snack. High fat helps to neutralize the acid, gets those proteins in your mouth. There's just, there's creative ways to kind of structure meals and snacks so that they're better for your teeth and less likely to cause cavities. Wow,
Scott Benner 43:30
I didn't Okay, that's awesome. Can I jump around a little bit and go to inflammation like so, yeah, if you have an autoimmune issue, I mean, I think it's pretty well understood that you probably have an excessive amount of inflammation in your body, right? And so is that part of why diabetes is one of the risk factors for poor dental health?
Dr. Niekia Franklin 43:53
Absolutely Okay. Sometimes it's like the chicken and the egg when you're talking about diabetes, because periodontal disease, which is that systemic inflammation causing oral disease, it complicates blood sugar control, because the inflammation kind of makes your cells less likely to be able to uptake sugar, or at least, that's the theory behind it. And why, with periodontal disease, you actually see an increase in insulin resistance. And so sometimes you're kind of wondering, like, what is the base cause of these things, and how do you tackle it? So with my job, it's like, easier, right? Because I have younger kids, there are periodontal diseases less severe if I can get them to sign on to doing the water pick, making sure that they floss. That is the biggest thing that they can do, flossing every night. You know, using the water pick, just to reduce their their periodontal disease once you get older. I think that some of those more. Complicated treatments and seeing a periodontist, who's a dentist who specializes in periodontal disease, and who's also going to be really familiar with treating more medically complex cases, I think that's probably a good idea.
Scott Benner 45:16
Are there places that people who don't have the ability to afford this, like, you know, I've heard people say, like, Oh, I got mine done at like, dental school because they need to practice. Like, are there ways for people to mitigate the costs
Dr. Niekia Franklin 45:29
absolutely so when I do think that some insurances, especially once you get older, like, you have the option of adding on dental care. And so that usually will be more helpful, especially if you have type one diabetes, right, like or type two diabetes, they'll cover more things, possibly even dental related things, under your medical insurance. And so sometimes that might be an option, but certainly going to the dental school is a great idea. There are also, usually free and low cost clinics or events like Mission of Mercy. I know contacting your local Dental Society is a great way to find out about these events. I volunteer at these events. Sometimes I'll even host one for children. There are certainly ways that you can find pre or low cost care. It's just you might have to stand in a line, or there might be a really long wait list, in which case, my suggestion is still sign up, because a year will pass by in no time. It's unfortunate that we have two tiers of care in America. So certainly doing as much as you can at home will be helpful. Okay,
Scott Benner 46:46
I have a question for myself, maybe again, to help us get back on track. I definitely think so. It's a very boring story, but when I was five years old, I was walking down the stairs. I was wearing new shoes. I lifted up my foot to show my uncle my new shoes that I was very happy about, and I fell down the stairs, and so since then, my nose is like, not great, and I don't breathe well through my nose. I've been saying to my wife for two years, I have to do something about this, because I end up when I'm sleeping breathing through my mouth too much. I need to go to an ENT, right? And this is the thing that like when you say people are mouth breathers, what should they do? Yes,
Dr. Niekia Franklin 47:23
oh, I'm so glad you asked about it. Airway health is so important. And I'm really, you know, I'm sad to hear that you fell down the steps.
Scott Benner 47:32
Really, really, I still remember it like it was. I could replay it for you in my mind right now. It's very devastating. I just like, because they were shiny, like, like, fancy shoes, and so they were slippery on the bottom, and I lifted up one foot, and my other foot, like, slid out from under
Dr. Niekia Franklin 47:46
me. You know, a lot of a lot of kids and people, they have airway issues, and they don't even know about it. So I'm glad that you're aware of yours. Ideally, all of us would actually breathe through our nose. Nasal Breathing is ideal. It helps with producing nitric oxide, which lowers our blood pressure. It filters our air so we get sick less. It also helps with saliva production, so your mouth can actually be less acidic and less dry. So being able to breathe through your nose, especially when you're sleeping, is amazing for your health. I do think that seeing an Ear Nose Dirt Doctor, especially with the history of trauma, sounds so reasonable. I think that would be a great place to start. They can certainly help with scoping and whatnot. In my practice, we actually help a lot of kids to get diagnosed with either sleep disordered breathing or childhood obstructive sleep apnea. And can I tell you that it changes their whole life?
Scott Benner 48:54
I have to tell you, I believe it. It's going through. Yeah,
Dr. Niekia Franklin 48:57
it turns out that if a child is not able to breathe through their nose, and if they feel like their body has to like constantly be grinding and shifting their jaw forward so that they can get air into the proper places, they will not give deep sleep. And it affects their school life. Kids are a lot more likely to show signs of ADHD. It affects how often they're getting sick. It affects how their jaw develops. Actually narrows your jaw and changes your facial shape if you are breathing through your mouth. So I think you've done really well. I can only get excited for how you will do once you address this nasal problem that you have that are able to pre
Scott Benner 49:46
am I going to get to pick a new nose? Like, what's going to happen? Exactly, honestly,
Dr. Niekia Franklin 49:50
I've had some patients that had such deviated symptoms they had to get surgery, and they can totally do it in a way where you are not getting a rhinoplasty. Like. Like your nose is going to stay your gorgeous nose, and nobody's going to judge you or think that you did it to hide a nose job that you will be able to breathe as you should be. I would love that.
Scott Benner 50:12
I'm not kidding. I'm I'm impacted by it, especially a simple test, okay, like so our test, all right, you have a test? Yeah,
Dr. Niekia Franklin 50:21
can you? Can you close your lips okay and breathe through your nose for three minutes?
Scott Benner 50:28
Die if you No, we should do it now, because three minutes from now, here's what you would hear, big Oh, Scott passed out.
Dr. Niekia Franklin 50:39
I mean, for kids, we do this test, we put a little piece of paper in between their mouth. And you would just like, parents feel so bad, because when they're really little, it's super cute, right? Like they've got this little snore. And I hate to be the one to say it, but like, kids shouldn't be snoring. They should not be breathing through their mouth. And then, you know, I feel like sometimes people are very excited to say, like, oh, let's go mouth tape. And I'm like, if they can't breathe through their nose, the mouth tape will never work. Like, we need to find out what's going on in the big picture first. So I can't
Scott Benner 51:15
sing in the car because I'll get short of breath. Oh no, because if I'm actually making the podcast is difficult for me, because when I go on my little tirades, like I'm not breathing during them, wow, yeah, oh
Dr. Niekia Franklin 51:27
goodness. Well, I'm really excited for you. Like, feel free email me afterwards. Okay, if you need some more evidence to convince you that it is worth seeing the anti and then, I don't even know if they're going to do a sleep study for you. They might just do an x ray and a scope and, like, call it a day, because
Scott Benner 51:46
I don't need a sleep study. Yeah, I yeah, you just have to look at my I'm assuming that a trained professional can just look up there and go, Oh God, we'll open that up for you. Oh, great. What are they going to do to open it up? I
Dr. Niekia Franklin 51:59
mean, the, I don't want to say, like, you know, rotor Rooter, but there's going to be structures, and they can definitely go in there and reshape those. Some people, they have things that are called turbinates, and they're pretty big in their nose, and those can cause issues anatomy wise, like if you have a very narrow palate, which is the top of your mouth, like your upper jaw, you'll have a narrow base of the nose. There are different ways to address that. Say that they do find that you like broke part of your nose, or there's like scar tissue, and they clean that out and you're still having issues. That is when maybe a dentist can come into play. There's different things with your soft palate at the back of your throat that can affect your airway. If the base of your nose is, like, still too narrow, or something like that, a dentist can help with that. I think that dentists have a lot of tools to work from inside the mouth. I think your nose, throat, doctors have a lot of tools to work for basically the rest of the body in that area. How
Scott Benner 53:02
do I find a good one? Oh,
Dr. Niekia Franklin 53:04
isn't that the million dollar question? Yeah. And
Scott Benner 53:07
can I just do that thing with that weird guy on on YouTube puts balloons on people's nose and chiropractic their nose? Is that not real?
Dr. Niekia Franklin 53:16
Oh, goodness. Okay, so I have seen some of those videos, and there are actually techniques where there's, like, an inflatable bullying that definitely not a dentist. I mean, I haven't seen a dentist do it, but I've seen other people do it. I think that there are really things that you can do that are non surgical interventions that I would be down for trying, right? Like, if they think that that might be helpful, but when they're sticking those things up there and, like, cracking bone, and I don't know what
Scott Benner 53:47
they're doing when they do it on YouTube, I just assume they're making noises for the microphone. But so I'm gonna tell you, then we're gonna move on from this. I have in front of me that stuff you're not supposed to use. Are you spraying your nose when it opens up your nose when you're sick, like, Mucinex kind of thing that's not good for
Dr. Niekia Franklin 54:01
you, right? Yeah, over time, that can, like, thin the skin in your nose and increase bleeding and actually make you, like, dependent on it.
Scott Benner 54:11
Yeah, yeah, I know, like, like, so I rarely if ever use it, but it's here in case I get stuck, because I have to make the podcast, but for the interest of science, I'm gonna do it right now. Hold on a second.
Dr. Niekia Franklin 54:20
Oh, no. Have you tried nasal rinses? Yeah, would
Scott Benner 54:24
you squirt the water up there and it comes flying out the other nostril?
Dr. Niekia Franklin 54:27
Nasal saline? You can even do it with xylitol. That's like a nice natural thing for you. It sounds like there's like a physical barrier, but for for my children, I oftentimes will recommend kind of more like as a holistic approach, like even local honey to reduce allergies, running a really great air filter in the home, keeping pets and animals outside of the bedroom, things like that, because, you know, they just have like inflammation, like tons of inflammation. So
Scott Benner 54:57
you just said something I want to go back to for a second, though. If somebody heard it, they're gonna be like, This lady's a hippie, too. But I think there's a real reason here, like, Why does local honey help you with your allergies? Oh,
Dr. Niekia Franklin 55:07
great question. Yeah, so local honey, it does sound a little woo, woo. But basically, you can take the allergens from your environment, and by ingesting them, you can help your immune system to be more tolerant. That's kind of the base idea there. I will say that it does seem that it's best if your honey is from your neighborhood. Interesting.
Scott Benner 55:33
That's, that's what I thought you meant. I was just like, she just, you just coasted by that. Like, we were all like, oh yeah, local honey. But No kidding, I actually know where to get local honey. See, that's
Dr. Niekia Franklin 55:44
why I tell families this, because sometimes they'll say, You know what, there is somebody in my neighborhood, and I'm like, Well, go ask them. They probably get 50 jars a year, and they would love to give some to your adorable child.
Scott Benner 55:55
So interesting. Okay, all right, thank you. I like talking to you. Okay, hold on a second. People don't know that you sent in an extensive list. So it's so long that I've given up on trying to go through it, because I think we'll end up talking for seven hours if we do that. What else have you not said so far? Like, we're getting up on an hour. I'm not rushing you out. But what have you not said that like you definitely want to say, can
Dr. Niekia Franklin 56:16
I just do a very quick rundown of, like, basic, low hanging fruit for Yeah, cavity prevention like
Scott Benner 56:26
little rapid fire. Go ahead. I won't, I won't talk. You talk. Go ahead. Okay.
Dr. Niekia Franklin 56:30
I'm going to start with a big one that everybody kind of knows, which is brushing and flossing. But I'm going to add in there, if you can brush with an electric toothbrush for your child or for yourself, you will reduce the amount of plaque by an extra 30 to 40% in the same amount of time. That's been proven. Tell me why? Because the electric toothbrush, especially if you get one with like that, rotating, oscillating movement, is moving so fast and doing a lot of the work for you, what
Scott Benner 57:00
do you prefer? Oral B or A? Phillips
Dr. Niekia Franklin 57:05
world B did their first redesign of their toothbrush in like, 20 years. A couple years ago. It's called the IO. I had always been a Sonicare girlie, until the IO came out, and then I loved my husband so much that I paid for one. And as a dentist, I like, never pay for an electric toothbrush. So that tells you how much I love my Oral B, I O,
Scott Benner 57:26
there's the tell them, or there's series 2357,
Dr. Niekia Franklin 57:30
like, oh, just get, just get one of them. They're all good. And if you get it from Costco, it's great, because I don't know why, but my toothbrushes break, like, every year, and I'll call Oral B to get a new toothbrush. Or sometimes I just take it to Costco, and I'm like, hey, this broke,
Scott Benner 57:45
I don't think Remember earlier, before we got on and I said, there's something she shouldn't say on the I think the fraud in Costco is one of the things you don't want to say on the are you like, Hey, I just bought this. Like, I don't know how long it was, a couple days. Can I get another
Dr. Niekia Franklin 58:00
one? Okay, well, to be fair, I mean, it's a $200 toothbrush, and it should last more than a year, but there's
Scott Benner 58:06
some here on just looking on Amazon, you can get them from between 60 and $220 so, but they're that worth it. They
Dr. Niekia Franklin 58:14
are so worth it. It's great for your gum health. It's great for reducing cavities. Think about the copay for one cavity filling, it's totally gonna save you money. And there's a two minute timer on there, because studies say if you don't have a timer, you're not going to brush for more than 40 seconds, and you're going to think it was two minutes. So yeah, get in there, get an electric toothbrush. So I would say, brushing and flossing. Hey,
Scott Benner 58:43
like, here's my last toothbrush question. Are they water pressure? Can I use in the shower?
Dr. Niekia Franklin 58:49
That's a great question. I would not. I
Scott Benner 58:52
love brushing my teeth in the shower, though it's so time effective, but go ahead.
Dr. Niekia Franklin 58:55
Okay, I will say this. My husband does that. Here's why I would not. I see mold develop on these tooth brushes. I will tell you a secret that I think as den to snow, which is, I like to wash my toothbrush like I will get in there with soap, and I will wash my toothbrush at least every couple of days. I feel like, if you have your toothbrush, think about it. It's in your mouth. You sit it out. It's kind of moist. Maybe you flush the toilet nearby. I mean, there's just so many germs that go up in the air, and then you'll start to see mold develop on your electric toothbrush. And I feel like if it's in the shower, at least from personal experience, I don't have a study for this. I think my husband's toothbrush heads get mold on them like way faster.
Scott Benner 59:42
Now I sound like a hippie. I'm so with you on this. So I have a stand like I have a little thing that I stand my toothbrush, and I would never, here's an insight into me, in case you're all listening, I would never, ever, ever, ever, ever lay my toothbrush down anywhere. Okay? I don't understand when my wife puts her razor on the same tray as the soap. And I'm, I'm like, Do you not see that the soap thing gets dirty, and then you put the razor on it, and then whatever's there is getting on the razor. Then you're cutting yourself open with little micro abrasions with, I'm sorry, there's a look at mine. Totally with you. Okay, good. But
Dr. Niekia Franklin 1:00:16
I'm a little extra so that when you know, I don't pass along to everybody, but you, you kind of ask for it, though.
Scott Benner 1:00:23
No, I appreciate it. Okay, so I All right, listen, I'm with you. So okay, I'm gonna get an electric toothbrush also, by the way, my nose just opened up from that horrible stuff I just sprayed in it. I
Dr. Niekia Franklin 1:00:34
think this is telling me that you might also have some inflammation nasal passages. Yeah, it's not just a physical obstruction, if that is working for you, but these are things that your provider is going to spend so much time asking you questions about to really get to some of the potential base causes, instead of just like passing you medications. Yeah, I
Scott Benner 1:00:56
have to tell you that I had such hope when I started the GLP that my nose would open up, because I thought, if it temps down my inflammation, maybe that'll help with that. But I haven't seen that there. I'm sorry but brushing, flossing, electric tooth brush, God, go on your Rapid Fire list that I talked over. Sorry. Oh, no,
Dr. Niekia Franklin 1:01:13
anytime. So kids need help brushing. I cannot tell you how many times a parent tells me that a five year old can brush their teeth, or that a seven year old can floss, and I have them demonstrate in the mirror. And I mean, it's like one out of every 200 so one
Scott Benner 1:01:29
out of every 200 teeth, they hit one out of 800 kids.
Dr. Niekia Franklin 1:01:35
So children need help brushing until at least like seven, when they are tying their own shoes. And really it's more ideal until about 10, at least with supervision. And they need help flossing until 10, because they will not get the back teeth. And after six, the back is so hard, and that's where the grown up teeth are. Yes, they get permanent teeth at six years old, and they get cavities often. Please help the kids with their brushing and flossing. Okay, tongue scraping, tongue scraping. And you can do this if you don't have, you know, the money to get a fancy tongue scraper. You can use a spoon like scrape your tongue. It will reduce the bacteria. You'll have fresher breath, and it supports a great oral microbiome by not having all that dead skin cell on your tongue, just collecting bacteria.
Scott Benner 1:02:22
Hold on a second. When do I scrape my tongue? Yeah, oh,
Dr. Niekia Franklin 1:02:26
I love this question. Okay, scrape your tongue at night. I would do it in this order. Scrape your tongue was if you're going to water, pick water. Pick as well, because you want to loosen all of that debris that's in between your teeth. And then you will come in and you will brush, and that will sweep away the debris. And also, you're going to brush with a great re mineralizing agent, not just training toothpaste. You're either going to use a hydroxy appetite, which I personally use, or a fluoride if you so choose to, so do it in that order. You're good. All right,
Scott Benner 1:03:03
wait, I'm looking at tongue scrapers. Does there? Does it matter which one I get? No, but I
Dr. Niekia Franklin 1:03:08
will also say, because people do this, it's kind of addicting. So only do it like literally scrape max twice. You're
Scott Benner 1:03:17
saying I could get a monkey on my back, scrape up my tongue.
Dr. Niekia Franklin 1:03:21
Okay, so because you'll, you'll like, say, oh my gosh, look at all this stuff coming off my tongue. If you haven't been tongue scraping, this is going to, like, revolutionize your thoughts about tongue. Scrape in your tongue, and it will make your food taste a little bit better, too. So added bonus, when you tongue scrape, people are like, amazed, and then they're grossed out, and they will scrape their tongue raw, and then they'll be so uncomfortable. And so just do it like twice, you know, okay? And over a week, you're gonna start to see that wonderful pink. Seriously,
Scott Benner 1:03:51
my tongue is gonna change colors.
Dr. Niekia Franklin 1:03:54
Most likely. What does your tongue look like when you look at it in the mirror? Is it pink? I
Scott Benner 1:03:58
can't see it right now because,
Dr. Niekia Franklin 1:04:00
yeah, wait, there should not be a coating on your teeth. Will you
Scott Benner 1:04:04
hold on a sec? I'm trying to see if I can see the tip. Wait, I can see it, but not well enough to tell you what color it is. So you're saying people have like a like a haze over top of their tongue. A lot
Dr. Niekia Franklin 1:04:14
of people do. And so also, sorry, I forgot to mention,
Scott Benner 1:04:19
I'm sorry I'm sorry, I'm looking at my tongue now, but my phone, it looks pretty good, but I have a huge tongue, by the way. Oh, you know, that
Dr. Niekia Franklin 1:04:27
makes it harder for you to breathe, too. Oh, gosh, the tongue is like a whole topic that we didn't get into. But tongues are so interesting. I one. I will say, I think make sure that you have a tongue tied before you get a ton released. I'll just throw that out there for the people who know, you know, make sure that you need it before you get a surgery, or that your kid needs it before they get a surgery. But I will say a tongue should rest at the top of the mouth, especially if you have a big tongue. Think about where that tongue goes when you lay back. Oh, okay. If it's not resting at the top of your mouth, it's flopping into your airway. And that's just another thing that your amazing provider is going to help to check. And then if you need to, you can do some exercises to really tone up your tongue. And sorry, but when you have a big tongue, like it's just it needs to go somewhere, so you might have more work to do. I
Scott Benner 1:05:16
seriously think this is why I have a big mouth, because I have a big ton. Also my head is huge. This could be like a structural issue for me. My wife says that my head is very heavy. I mean,
Dr. Niekia Franklin 1:05:25
my daughter's in the 95th percentile for her head, and she's only in the 50th percentile in general. So I also have a big head, and so does she. It's just a thing. But
Scott Benner 1:05:36
okay, sorry. Scrape my tongue just twice. Don't get addicted to it in a week, I might see a pinker tongue. Are you about to tell me about oral rinses now? Is that the next thing you're
Dr. Niekia Franklin 1:05:46
gonna say, Oh, goodness. Okay, so most mouthwash is not good for you. It's not necessary. Think about it this way, if you look at it and there's antibacterial agents, those agents do not know if it is the good bacteria or the bad bacteria. Remember, there's 700 bacteria in your mouth, in your oral microbiome.
Scott Benner 1:06:08
They're all pooping on my teeth right now. I know. Go ahead, if
Dr. Niekia Franklin 1:06:11
you take that old school Listerine that has the alcohol, you actually are dehydrating your tissues. You're more likely to have dry mouth. And if you take the new ones that have all of this benzo chlorine sort of activity going on, and it's just indiscriminately killing the bacteria in your mouth, that's not good for your oral microbiome. So you even have to be careful with the ones that have just a bunch of essential oils, because essential oils are actually very strong anti bacterial agents sometimes. So I don't like anything with oregano oil too much cinnamon oil in general. You just probably don't eat a mouthwash. But for people who do like one, there's one from carry free, and it's PH balancing, and it has xylitol in it, and it has a little fluoride. And that one I like because it does more and it doesn't have anything that's going to kill your microbiome. My wife
Scott Benner 1:07:09
has to avoid some toothpaste. So what do they do? It's almost like, not like a burn, but it peels the skin inside of her mouth. Yeah,
Dr. Niekia Franklin 1:07:16
yeah. So avoiding, um, I don't want to say it, because you'd probably have to beep it out, but there is a brand that is notorious for causing sloughing. It's one of the ingredients. Also stainless fluoride sometimes causes slept in and then a lot of people have to avoid something called sodium oral sulfate, which is a trash additive, like it does nothing besides make your toothbrush bubble, like, it doesn't help at all. Same with, like, the minty feeling that's not actually helping your teeth get clean. It just causes irritation for some people. Um, so she's avoiding those things, hopefully picking a nice, clean toothpaste I like rise well, it's free of all the icky additives and whatnot, or for families
Scott Benner 1:08:02
rise well, is the toothpaste you like for this? Yeah, it's
Dr. Niekia Franklin 1:08:05
got Hydroxyapatite. It's naturally whitening. It helps to remineralize the teeth. That one is fluoride free. For families that are wanting fluoride, I think that, hello, is a nice, accessible, really affordable brand of toothpaste that doesn't have artificial colors, dyes or sodium, all sulfate.
Scott Benner 1:08:25
Okay, hey, listen. What's the one that you said? Also sloughing? Spell that?
Dr. Niekia Franklin 1:08:30
Yeah, l, o, u, G, H, I N, G,
Scott Benner 1:08:33
I think. And what does it mean?
Dr. Niekia Franklin 1:08:36
It's like where the outer layer of your mucosa peels off.
Scott Benner 1:08:40
Oh, Jesus, that sounded upsetting. Okay, yeah, it
Dr. Niekia Franklin 1:08:44
doesn't hurt. It's just like, you get these weird, slimy pieces of skin and, like, unsettling for some people,
Scott Benner 1:08:50
okay, yeah, well, it sounds settling when you describe it. All my wife's been able to do so far is to just use, like, a child's toothpaste, and that's helped her. But I'm gonna try the Hello, like, for her. Yeah, yeah, I actually have used this. Oh, how did I end up using Hello toothpaste before? Oh, because I saw that it. There was, like, activated charcoal, black toothpaste. And I was like, What is this? So I bought it just to try it. But it's disturbing when you spit in the shower. So I stopped using it to each their own. Is there any reason that I would want to use activated charcoal. Hello.
Dr. Niekia Franklin 1:09:23
Well, okay, be careful with activated charcoal. Be careful with anything you see on Tik Tok. And also, can I just say just because it has ADA seal of approval doesn't mean that it's like, recommended, okay, some of these things that they put into toothpaste are basically like Comet for your teeth. So yes, it will whiten your teeth because it's charcoal and that's really scratchy, but it can also damage the outer layer of your enamel and make it so that in 10 years, your teeth are going to look really dull, aka baking soda. That's not regulated to see how. Big the little particles are that are scratching on your teeth. So
Scott Benner 1:10:03
they're gonna scratch up my teeth to make them whiter now, but forget to tell me that later. They're all gonna fall out because of it. Well, some
Dr. Niekia Franklin 1:10:10
of them, so hello, is a good brand. So they're going to make sure that the charcoal that's in their cheek paste is not too big, not too scratchy, right? There's a certain level of abrasivity that teeth have, or, sorry, that toothpaste have. So kids, toothpaste has, like, none of that. And that's why kids sometimes will have a little bit of more yellow teeth, and then when they get to be teenagers, I'm like, Okay, time to use an adult toothbrush or toothpaste, because you need more cleaning. You need, like, the fancier toothbrush, you need the more abrasive toothpaste, right when you're looking at some of those charcoal toothpaste like that are online, especially they're not regulated, so they can be super abrasive, which does clean your teeth and make them look whiter because it's scraping off all the stains. But that's not something that you should use daily. I bring up baking soda because my dad was one of those. And we'll see it with people who like to use baking soda because it makes your teeth feel really clean and look white. Yes, it does, but over time, it will brush off your enamel, especially if you eat and then you brush your teeth within 30 to 60 minutes. So that'll be another thing that'll add to my list. Don't actually brush your teeth immediately after eating when possible,
Scott Benner 1:11:26
because the food's abrasive,
Dr. Niekia Franklin 1:11:28
well, because your teeth are sitting in the acid from the bugs that are eating the carbohydrate, and so that's when your enamel is the softest, is right after you eat. And so, yeah, the American Dental Association, I believe they say 60 minutes. I think it kind of depends on what you're eating. Like, if you had something with acid, like you had orange juice, wait a little bit longer, closer to that 60 minutes, so that your teeth can re mineralize a bit and not be an acid. If you just had like, a salami snack, like, that's fine,
Scott Benner 1:12:03
okay, I never would have thought of that. Okay, what? Uh, keep going. So good you're doing good, smart
Dr. Niekia Franklin 1:12:08
snacking. So this is one that I talk about a lot with kids. If you are eating constantly, that will keep your teeth in acid constantly. So we should really not snack over extended periods of time. Remember how I told you I had, like, a lot of cavities that I got in dental school? It's because I was drinking tea and coffee with milk no sweetener. I didn't realize that milk had a lot of milk sugars in it, and I was sitting there drinking it for hours while I was studying. And so if your kids are snacking, if they're grazing, if they hold food in their cheeks, that contributes to cavities, because their mouth is just always acidic. So trying to do mini meals or organized snacks, not really eating more than six times a day, unless they need to for nutrition, right? Or if they're type one, right, you need what you need. So you take care of your health first, and your whole body health and your blood sugar, but outside of that, trying to watch for things that you can control. Oh, wow. All right, and please drink a ton of water. Water is great for you. It helps with the dry mouth. It helps with your having more saliva. It rinses off stuff. It's great. My favorite snacks are my favorite, like blood sugar, kind of agents whenever I go low. So I do like juice. Sometimes, if I don't trust myself to stop at half a half a carton, I'll use the honest juice so that it's already watered down for me. And then I like the glucose SOS packets, because one, they don't have all of the icky red dye 40 that, like, you know, Starburst and Skittles have two, they don't taste too delicious. So I'm not like, Oh yes, oh whoa. I get to eat something yummy. And three, like, I've literally washed them in my pockets, and they don't get everywhere, and it's good. So those are my two favorites, the SOS powder and the juice. Let's see other things.
Scott Benner 1:14:09
Let me say this while you're thinking, if you're not too busy being a dentist and having children and a husband and everything else, and you would like to write this up as a blog post. I would put this up at the same time as your episode comes out.
Dr. Niekia Franklin 1:14:23
I would love to do that. I feel like I have been so disorganized.
Scott Benner 1:14:27
No, no, no, that's my fault, because I try to keep it conversational so people are interested in it. Because, again, if you come on in and you start like, rambling through things, people are gonna be like, Oh my It's so boring. And they're gonna shut like, it's hard to get people to take care of themselves. I often say that part of my job is tricking you into listening to this podcast long enough that you actually help yourself. But for people who are still, you know, who are really into it, it would be nice for them to go somewhere and have something like a reference to go back to. Oh, yeah,
Dr. Niekia Franklin 1:14:52
I can totally do that, and I can put on some links. Can you give me a little bit of time? I don't know if I told you
Scott Benner 1:14:58
as much time as you need. Don't worry about that. Oh,
Dr. Niekia Franklin 1:15:00
good. Yeah, yeah, my husband's going through chemo and just had surgery and,
Scott Benner 1:15:04
oh, my God, what are you telling me that for 90 minutes into this thing, I would have talked to you for a half an hour about that. I'm so sorry. Oh,
Dr. Niekia Franklin 1:15:11
no worries. I mean, life is crazy, but you know, I'm glad that I have all the healthcare experience that I do, because it's really helped me to, like, be able to help him, but, yeah, it's kind of crazy tired Jesus
Scott Benner 1:15:22
Christ. You know you're gonna make me cry at the end of this dental episode here i And let me tell you why. And by the way, don't go see this movie, because I just saw that movie with Andrew Garfield and the Florence pew lady. It's about her getting cancer and then being married and everything, and then she says, what kind of cancer she has, the kind of cancer my mom had, and I'm sitting in a theater. I went with my girls. I went with my wife and my daughter. And I'm in, I want to be clear, I'm in a theater with 500 women and five guys that were like, I'm a good guy. I'll come to this. It was that and, and I'm like, sitting there, they go, did you cry? Because I cry in movies. I'm just gonna put that out there. Now, me too. I said no, but my eyes did fill up. So then we had an existential conversation for 45 minutes in the car about whether or not I was crying, if my eyes watered but did not drip. I maintain that crying involves like like that, right? And they say, No, if my eyes are leaking at any level or moisture than they should be, I was crying. I'm going to get into this in another episode with somebody, because it's too late to talk to you about it, right? You about it right now. But I'm just gonna say to you, please don't go see that movie. So
Dr. Niekia Franklin 1:16:26
I will skip that until we kick those cancers, but yes, which we will totally do. But my gosh, my heart goes to you. I am in the middle of this, and it is the scariest, hardest thing we've ever had to do so, certainly. And I always thought, oh my gosh, I have type one. And, you know, it feels insurmountable, just like everything feels insurmountable until you get through it, right? Yeah, but yeah, i My heart feels for you, and you can, you can cry. That's okay. I think that's really sweet, by
Scott Benner 1:16:57
the way. I would have cried if I wanted to cry, but I didn't cry. I just got filled.
Dr. Niekia Franklin 1:17:02
Knows, you couldn't.
Scott Benner 1:17:05
I just got filled up. And I did have to listen, I'm not gonna lie, like when the lady said What kind she had, and it's what my mom had, I was like, Oh, come on. It took me a long beat to, like, hold myself together, but I didn't. I've cried. I know what crying is. I tell people I cry all the time, like I that is anyway, I think those girls are just screwing with me if you want to know the truth. I think it's their past time. That's their job. Yeah, so we're a little long now, but anything else that we like that we missed here on your on your Rapid Fire list, or should we tell people to go check out the link at Juicebox podcast.com, for the rest,
Dr. Niekia Franklin 1:17:38
I mean, I think they should check out the link. I'm sure I missed so many things. This is why our appointments are an hour long. The first time that I meet somebody, conversation,
Scott Benner 1:17:47
though, you brought up a lot of stuff. I don't think people had any idea about,
Dr. Niekia Franklin 1:17:51
Oh, that's good. That was my goal. I was like, I really want to go on there and provide some information. You've literally, like, revolutionized my care, especially when I was pregnant, oh my gosh, I was just going through all of your resources like, now I'm gonna cry like my child's life literally depended on it. So I hope that somebody finds this helpful. And again, I'm so excited to put together a blog, I'll try really hard to make it useful. And then, yeah, best of luck. I think that cavities happen. Don't feel bad, even if you haven't been to the dentist. There's no judgment. We are excited to see you. We're excited to see your kids. Life happens. You're doing a great job, and our job is just to make it a little bit easier for you and to make sure that you know we can give you some tools that work in your day to day life to really promote as much excellent oral health and whole body health as you can have. I
Scott Benner 1:18:47
appreciate that very much. Thank you. I appreciate the kind words. I'm glad the podcast has been valuable for you, and I think you have just added to it and made it more valuable for other people. So I appreciate that too. Wonderful.
Dr. Niekia Franklin 1:18:57
Yeah, awesome. Thank you so much, guys. It's a pleasure. You Omnipod
Scott Benner 1:19:06
five sponsored this episode of The Juicebox Podcast. Learn more and get started today at omnipod.com/juice box. Links in the show notes links at Juicebox podcast.com, the conversation you just enjoyed was brought to you by us Med, US med.com/juice, box, or call 888-721-1514, get started today and get your supplies from us. Med, earlier you heard me talking about blue circle health, the free, virtual type one diabetes care, education and support program for adults. And I know it sounds too good to be true, but I swear, it's free, thanks to funding from a big T 1d philanthropy group, blue circle health doesn't bill your insurance or charge you a cent. In other words, it's free. They can help you with things like carb counting, insurance navigation, diabetes technology, insulin adjustments, peer support, prescription. Assistance and much more so, if you're tired of waiting nine months to get in with your endo or your educator, you can get an appointment with their team within one to two weeks. This program is showing what T 1d care can and should look like currently, if you live in Florida, Maine Vermont, New Hampshire, Ohio, Delaware, Missouri, Alabama or Mississippi. If you live in one of those states, go to blue circle health.org to sign up today. The link is in the show notes, and please help me to spread the word blue circle health had to buy an ad because people don't believe that it's free, but it is. They're trying to give you free care if you live in Florida, Maine, Vermont, Ohio, Delaware, Alabama and Missouri. It's ready to go right now. And like I said, they're adding states so quickly in 2025 that you want to follow them on social media, blue circle health. And you can also keep checking blue circle health.org to see when your free care is available to you. I can't thank you enough for listening. Please make sure you're subscribed you're following in your audio app. I'll be back tomorrow with another episode of The Juicebox Podcast. If you're looking for community around type one diabetes, check out the Juicebox Podcast. Private Facebook group Juicebox Podcast. Type one diabetes, but everybody is welcome. Type one type two. Gestational loved ones. It doesn't matter to me, if you're impacted by diabetes and you're looking for support, comfort or community, check out Juicebox Podcast, type one diabetes on Facebook. The episode you just heard was professionally edited by wrong way recording, wrongway recording.com. You.
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