Scott Benner 3/22/25 Scott Benner 3/22/25

#1469 Small Sips: Steal A1C Overnight

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Stable overnight blood sugars significantly improve A1C and make daytime management easier.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 00:00 Hello friends, welcome to the sips series. These foundational strategies were nominated by listeners. They told me, these are the ideas in the podcast that truly made a difference for them. So I distilled them down into short, actionable insights. There's not going to be any fluff or complex jargon, just practical, real world diabetes management that you can start applying today. And I know your time is valuable, so we're keeping these short. Another small sip will come out once a week for the foreseeable future. If you like what you hear, check out the Pro Tip series or the bold beginning series for more. Those series are available in the menu at Juicebox podcast.com and you can find complete lists of all of the series in the featured tab on the private Facebook group. Please remember that 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 or becoming bold with insulin. The questions you have, I guarantee you there's answers to them in the Juicebox Podcast, and it's all free. You Jenny, let's talk about apparently in, oh, look at this, apparently in Episode 37 again with you and I brought up in Episode 11, bold with insulin that, oh, I think I, the way I put it was, I steal a 1c overnight. So, like, take advantage of overnight hours. And the way I used to think of it back then with Arden, like, for full clarity, like, Arden's a 1c wasn't terrific when she was little. They were in the eights and and when I was first trying to imagine, like, how can I impact this, right? Like, how can I create, at least maybe stretches of time with less glucose in our system? The first thing that occurred to me was like, well, when she's asleep, there's no food in there. Like, maybe that'll help. You know, now, eventually she got big enough where there was growth hormone overnight, and that's a different headache. But if you're of the mind, like, I want to be stable overnight at 180 because I want to be safe or I want to sleep. You hear people say that all the time, like, oh, I leave my blood sugar 200 because I want to sleep. And I think, Gosh, what if you could keep it at 100 all night. Now, again, probably everything I say here in these smaller clips, people are going like, Yeah, great. Well, but if I know to do that, buddy, I would right. But the idea is that when you're you're overnight, you're at rest. I'm assuming the food should be I mean, unless you're eating late at night, there should be no food in your system by the time midnight comes around. It's just a great time to steal a 1c so if you're a six and a half during the day, but a six at night, you're going to be more like a six, two, maybe, or something like that. So, yeah,

Jennifer Smith, CDE 03:03 it actually gives you know, we break a 24 hour day into segments. You break it in easily. Most people should be sleeping, let's say, should be sleeping about eight hours, right? Kids might even be sleeping longer than that, because they go to bed earlier than most adults do. So stealing the overnight hours in terms of affecting that long term average, if you've got eight to 10 hours, even eight hours, that's a third of the weight of your overall a 1c right? Yeah. And if you've got 30 some percent of your overnight sitting at a blood sugar of 100 you are absolutely going to be able to wait a little heavier to a lower overall average, or a 1c so 100% take advantage of the overnight. And if you don't know how to do it, I think it's a good idea to start understanding the hours before the overnight impact the overnight. So if your blood sugar after your dinner or after your evening snack are consistently leaving you higher, but your basal is allowing you to then stay stable and flat at 161 4180, overnight, then it's not the basal fault, right? It's the problem before the hours of the overnight. And so I think it should teach you to look at time before, where you're having the problem.

Scott Benner 04:26 Everything that is happening to you right now with that number is from something that occurred before, correct? And it could be hours and hours before, like you used something. I think people all understand I had a slice of pizza at eight o'clock, and my blood sugar got high at 1030 you know, like that kind of thing. Like, there's food in your system. It's digesting once it's cleared out, the amount of insulin it takes to keep your blood sugar stable should be pretty consistent. And also, I think that what you learn from overnight not to shift gears too hard, but one. Once you learn how to keep overnight stable where you need it to be, where you want it to be, that information or way of thinking can go a long way into helping you in the waking hours as well. Absolutely. Yeah. So I tell people all the time when they're like, I don't know how to get my basal right. I'm like, well, it's easier to get it right because people don't want a basal test, you know? I'm like, Well, if you're not going to basal test, use overnight as a test, you know, clear system, basal test, and then use that as a jumping end point for the morning and the rest of the day. Okay, awesome. Look at us being all like, good one, if you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bowl beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginnings series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bowl beginnings in the menu if you're ready to level up your diabetes care. The Diabetes Pro Tip series from the Juicebox Podcast focuses on simple strategies for living well with type one. The pro tip episodes contain easy to understand concepts that will increase your knowledge of how insulin works and so much more. My daughter has had an A, 1c, between five, two and six, four, since 2014 with zero diet restrictions, and some of those years include her in college. This information works for children, adults and for the newly diagnosed and for those who have been struggling for years. Go to Juicebox podcast.com and click on diabetes pro tip in the menu, or head over to Episode 1000 of the Juicebox Podcast to get started today with the episode newly diagnosed, we're starting over and then continue right on to Episode 1025 that's the entire Pro Tip series episode 1000 to 1025 if you're not already subscribed or following in your favorite audio app, please take the Time now to do that, it really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. You.

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Scott Benner 3/21/25 Scott Benner 3/21/25

#1468 Teal Fingerprints

Theresa’s daughter had a freak accident and broke both of her legs on a trampoline.

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Scott Benner 0:00
Friends, we're all back together for the next episode of The Juicebox Podcast. Welcome.

Theresa 0:14
Hi. My name is Teresa, and I have a daughter who is almost 14 years old with type one diabetes, who was diagnosed back in December of 2020,

Scott Benner 0:25
please don't forget that 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 or becoming bold with insulin. AG, one is offering my listeners, a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure you check out drink AG, one.com/juice box. To get this offer, don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com I'd love it if you would go to T 1d exchange.org/juice box and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation, T 1d exchange.org/juice, box, it should not take you more than about 10 minutes. Today's episode of The Juicebox Podcast is sponsored by the ever since 365 the one year where CGM, that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the ever since now, app No Limits ever since. Today's episode is sponsored by the tandem Moby system with control iq plus technology. If you're looking for the only system with auto Bolus, multiple wear options and full control from your personal iPhone, you're looking for tandems, newest pump and algorithm. Use my link to support the podcast tandem diabetes.com/juicebox, check it out.

Theresa 2:19
Hi. My name is Teresa, and I have a daughter who is almost 14 years old with type one diabetes, who was diagnosed back in December of 2020,

Scott Benner 2:29
Oh, wow. That's four years ago, almost to the day her divers three was just this past Sunday. Wow. Did you set it up on purpose for the recording to be near that?

Theresa 2:39
I didn't. That was your first available on an email. Jeff, happens all

Scott Benner 2:43
the time. By the way, I'm always thrown by it. People like, Oh, my diversity was yesterday, or my birthday is today. And I'm like, You do this on purpose? And they go, No, I don't think so. I'm like, Okay, right? Four years ago, she was 10. At that point,

Theresa 2:55
she was about to be 10. She turned 10 in January, right after her diagnosis.

Scott Benner 2:59
Okay, well, how did you figure out she had diabetes? Well,

Theresa 3:03
so COVID was weird, of course, you know, everything was shut down. And you know, she was home, she started complaining of blurry eyes. So she said things would get blurry and then things at night in her room. Weird as it is, she said would get bigger and then smaller. I'm like, What is going on? So I, you know, took her to the eye doctor, and they did a routine eye exam because she had no history. She showed them more glasses. She, you know, has always had normal eye checks, and it was normal. So I thought, okay, and she's always really been, like my traumatic child. So there's something wrong with this kid every day, every day, there's something new that hurts or aches or something, so we don't put too much thought into it. However, you know, being her eyes, I was like, Okay, let's take care of this. But that wasn't it. She then was having some accidents. But, you know, looking back, of course, it makes all the sense, but at the time, it was always when she was playing outside and she had to go and didn't make it inside. But, you know, we were nine years old at this point, so that was getting kind of odd. And in October that year, she went on a camping trip with my husband, and she had an accident in the middle of the night, and he's like, you know, that's really weird. Like, what's going on? Things progressed really fast, from like, the end of October to the beginning of December, when she was diagnosed, to where the thirst was just insane. So my husband did some Googling, and he's like, maybe we should take her into the pediatrician. So I took her in, and I took her in by myself, and he did urine test, and he came back in the room and he's, you know, of course, gave the speech of, you know, don't freak out. But you know, she has type one diabetes, and you need to go home, and you need to pack a bag, and you need to go straight to the hospital. And of course, I'm freaking out, and it happened to be my daughter had a snow day, so that day, and I'm like, let's just go the doctor today, because we have off, because I'm a teacher. Also, you know, she's like, You ruined my snow day. So that's her story of her story of diagnosis is my mom. In my first snow day of the year. Why'd you do that? It's horrible, right? So terrible. But, you know, it was very it was very scary. The doctor was somewhat reassuring, because he's like, my wife has type ones, so you know it's gonna be okay. But you know, when someone goes tells you to go straight to the ER and pack a bag, like dying, like I thought she was dying right then and there. And I'm like, holy crap. It's

Scott Benner 5:20
my favorite part of those stories, by the way. Theresa, like, don't panic, but right home, grab everything you need to stay alive and immediately go to the emergency room,

Theresa 5:29
exactly, and you're going to be there for several days. I'm like, what? But don't

Unknown Speaker 5:33
panic. Please don't panic, right?

Theresa 5:37
So, you know, I took her to the Children's Hospital. We're in Ohio. We have a really good children's hospital in the area, and took her there, and they were great, you know, but it all happens so fast and there's so much information that it's kind of a blur. Looking back, I think they gave me good information, but, you know, you got home and you're just panic stricken. I mean, my life just everything just stopped. So it was pretty traumatizing for everyone, I think, but we figured it out somehow

Scott Benner 6:04
in two days. You're the second person to say that he used those words, like my kid was diagnosed, and everything else stopped.

Theresa 6:10
Oh, everything just stopped on the dime. And I'm I've always been a working mom. I'm a teacher. I used to teach preschool that I taught in this I actually taught in my daughter's school system when it happened. So that was somewhat comforting. Of like, I contacted the school, you know, that kind of took care of me and her for excuses of being absent or whatever. But it was just time just stopped for, like, I would say, a good week looking back on it, and nothing else mattered. I felt so bad for my older daughter because it was just like, sorry. Can't do you right now. Your sister needs me so felt super guilty about that, but yeah, time just it just stopped that day.

Scott Benner 6:45
Isn't it funny to how we, in the course of a regular day, will say, I don't have time to do that. I can't make time to do that, but when something really shows you there's no option, you make time and everything's fine afterwards,

Theresa 6:59
right? The World kept going. Nobody needed me for that week. Everybody survived. Turns

Scott Benner 7:03
out you're not the only reason the company is working exactly. I'm not talking directly to my wife right now, just in case you're wondering, there's an opportunity there to look back and to have a moment where you say, Oh, maybe I can give myself a little more leeway throughout my days. Yeah, when someone says, Hey, your kids got to go to the emergency room, all of a sudden, everything else you thought was super important doesn't matter. It gets a perspective shift Absolutely.

Theresa 7:29
Yeah, I was lucky enough to be working from home at that time too. I was the lucky teacher that got to be virtual that year. I teach, or I taught reading intervention K to four, and I was just doing it virtually. So looking back, everything happened for a reason. Right before her diagnosis, I had left a job that I had been at for 17 years, and I'm a creature of habit, like I never want to change jobs ever. And I just so happened that, you know, an opportunity presented itself and I changed, and my first thought at diagnosis is, this is what you get for changing jobs. Like I That's my reason, my rationale for it, because, you know, I didn't know my bosses real well yet. I didn't have a rapport with them. I'd only been there two months, I see, and now all of a sudden, I'm like, I need a week off. My life has fallen apart.

Scott Benner 8:15
They're like, Oh, great. We hired one of those exactly

Theresa 8:19
that person at that moment. And at my previous job, I was, I was an administrator of a pretty large preschool, and, you know, I managed all these staff and had all these people that called off all the time. And I'm like, oh my god, I'm that person. Now.

Scott Benner 8:31
I really appreciate this job. I'm super excited to get started. Can I just get a month off? Right? Yeah, right,

Theresa 8:35
yeah. So it was pretty crazy, right? But, you know, we left the hospital and we left without a Dexcom. They didn't really push it, you know, we googled real quick, and so we brought it up, like, you know, what's this Dexcom thing? And they're like, oh, yeah, you know, we could get you started on that, but it's really expensive, so you're going to need to figure out, like, your insurance situation first. So I called the insurance, and of course, it takes forever. And you know, generally, before this, we were pretty healthy household, so we had not met our deductible when it was December, like we hadn't even done it our deductible. And so it was, do I order this and have to pay completely out of pocket for it, or do I wait and deal and get everything squared away in the new year? So we opted to wait, not knowing, like, what information we were missing out on. Yeah, so we actually did finger sticks from december 2020 till the end of April 2021, so about five, six months, and boy, if I could rewind time, that would be what I changed for sure. Yeah,

Scott Benner 9:37
they always tell you, you're going to learn something by doing it the old fashioned way. Did you learn anything? Let's talk about the tandem Moby insulin pump from today's sponsor, tandem diabetes care, their newest algorithm control iq plus technology and the new tandem Moby pump offer you unique opportunities to have better control. It's the only system with auto Bolus. It helps with missed meals and preventing hyperglycemia. The only system with a dedicated sleep setting and the only system with off or on body wear options, tandem Moby gives you more discretion, freedom and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out at tandem diabetes.com/juice, box. When you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you learn about tandems. Tiny pump that's big on control tandem diabetes.com/juice box. The tandem Moby system is available for people ages two and up who want an automated delivery system to help them sleep better wake up in range and address high blood sugars with auto Bolus. This episode of The Juicebox Podcast is sponsored by ever since 365 and just as the name says, it lasts for a full year, imagine for a second a CGM with just one sensor placement and one warm up period every year. Imagine a sensor that has exceptional accuracy over that year and is actually the most accurate CGM in the low range that you can get. What if I told you that this sensor had no risk of falling off or being knocked off? That may seem too good to be true, but I'm not even done telling you about it yet. The Eversense 365 has essentially no compression lows. It features incredibly gentle adhesive for its transmitter. You can take the transmitter off when you don't want to wear your CGM and put it right back on without having to waste the sensor or go through another warm up period. The app works with iOS and Android, even Apple Watch you can manage your diabetes instead of your CGM with the ever since 365 learn more and get started today at Eversense cgm.com/juicebox, one year, one CGM

Theresa 11:59
learned I had no idea of what I was doing, you know, not being able to see after you eat, what happens. Because, you know, she's new to this too. So, like, I didn't want to stick her finger every five minutes, right? Like, you know, with the Dexcom. So, you know, we were always reacting, because you could never be proactive without a CGM. It was just, I'm reacting to what that number said and what she's about to intake, and we'll hope it all works out in a couple hours, and we'll see where we're at. So that was very frustrating, because I'm definitely, like, control freak in a lot of areas, so always having to be on on the reaction mode, versus the, you know, being proactive. So that was hard for me, but once we got that in place, it was like, holy cow. You know, this whole new world of information, and then it became obsessive, now that I have this information, and I had actually joined your Facebook group before getting to CGM, and I just kind of lurked in the background, and I actually left the group, because I felt like everybody's doing this better than I am, like everybody, and so I couldn't take like, the guilt is I would scroll through the page of, like, look at all these perfect numbers, and people are eating Olive Garden, and people are eating pizza, and here I am, my kids eating, like, you know, everything that is carbs or low carb and just easy to control. And then, actually, after I got the CGM, I rejoined the group, and that's when I was like, Oh, I can do this now. I can figure this out. Can

Scott Benner 13:22
we dig a little more into that? Because I had an interesting moment this morning when I was setting up for you, and I thought, is this like a guest that's been on before? Because I really recognize your name, but from the past, it felt like but then I looked and you were more recently in a post about, like, newly diagnosed people, and I was like, I got really confused. I was like, I don't understand what's happening. But that didn't occur to me. And what happened to you is not uncommon. We get a lot of people who are like, you know, I don't know what to do. Someone suggested this, or, you know, I was inundated online. 75 different people told me Juicebox Podcast. So I went and looked. Then I got there. I was overwhelmed. I left, but then I came back. It's the but then I came back. I hear a lot. So, yeah, go more into that.

Theresa 14:10
Well, I was actually a part of some of the other groups online. I won't mention their names that are as active as yours, obviously, and not doesn't reach the people you reach. I saw them banning post with your podcast in it. And I thought, What am I missing? You know what I mean, like, it intrigued me more to go back, and that's actually what made me go back, is like, why does this group hate this being mentioned so much? I

Scott Benner 14:31
hope they don't hear this, because they don't realize they're my secret weapon. I bet.

Theresa 14:35
I bet. I mean, it was kind of crazy. It was like, that name could not be mentioned. And, then, you know, I saw that a few times. I'm like, well, maybe I am missing out something, and now your group is really the only group I'm in or pay attention to. Anyways,

Scott Benner 14:47
I'll have to tell you something. I don't know. How do I tell you this story without giving away more than I'm supposed to? I was involved with somebody who was speaking publicly somewhere, and in the audience stood up a person and. Who railed against me, and this person who was speaking, I have a relationship with them. So this person in the crowd is railing against me in this public forum, and most people would think, Oh my god, like, that's going to ruin my relationship with this person, or people are going to think ill of me, or something like that. I got a phone call later in the day from the person who was on stage, and they said, I have never been more sure of my affiliation with you until I saw how much that woman hated you, right? And I thought, He must really be doing something different for someone to dislike him that much. And I thought, Wow, that's awesome. Like I thank you for seeing that. First of all, the truth is this right is that, you know, there's a way things get done. It makes everybody comfortable. They don't seem to care if it actually works. It's just what the system or what society or whatever agrees is okay. And I think we all know that, generally speaking, what we all agree is like safe is generally not helpful. When those other Facebook groups say, like, you can't post about Juicebox, I always assume it's one of two things, either they're scared of just that tagline that came out of one of those episodes, like bold with insulin, which is, by the way, something I said in passing. It's not like it was a rule or something like that, but I said it in passing, and people responded to it, and then they found value in it. And it's a thing that people have heard because it's something that works for people, not because I made it up and I marketed it to the end of its life. It's out there because it was valuable. They either are scared of that idea and haven't actually listened to the podcast. If they would listen, they would see all I'm talking about is, like using the right amount of insulin at the right time. I'm not making any grand pronouncements about anything. Or they just are trying to fence off the people that they've somehow gotten to come into their group and keep them there. Because I feel like the other thing is, what they know for sure, is, if they leave their group and come to mind, they're not coming back. So, like, I think it's like one of those, like, you know, opposite of, if you love something, set it free. I think what they're saying is, I've got numbers. If I let them go find out what they're saying at Juicebox, I'm not getting them back again. So, and that happened to you, right? Yes, yeah, yeah.

Theresa 17:20
Yeah. And I didn't even listen to the podcast until after we had the CGM, because I, you know, I left the group because it was just overwhelming. And then once we had the CGM, and I kind of started to figure out what was happening in between meal times and overnight and things like that, that's when I started listening. And I didn't start at number one. I started by like, group recommendations for new listeners. And they were, kind of, the numbers were kind of all over the place, yeah. But the one episode that really hooked me in was the one where you talk about, I think it was the M, M S, and like, figuring out, like, if I eat 1m M, what does this do to my blood sugar? If I two, what does it do? And just process of elimination and just just figuring out, you know, how long did this impact it? Why did it impact it? And that's kind of where I became obsessed with, like, figuring out what the food does and and how to avoid those spikes. Yeah,

Scott Benner 18:08
that's awesome. Yeah. It's far too often that we think more about how is the insulin impacting us, when we should be thinking too about, How is the food impacting us, and how is the food impacting the insulin, and how is the insulin impacting the food? Like, there's it's not just as simple as, like, I counted my carbs and I did the math and then whatever happens, happens, and my throat up to God, that's not what's going on. There's more going on than that. It's not that complicated. It turns out, if you listen to it discussed on a podcast, that kind of just kind of melts into your head. And I have to

Theresa 18:38
remind myself of that all the time, because just the other day, you know, she's turning 14, and she's eating random things without telling me, and she's pretty she's almost completely independent, but she doesn't always come get the insulin pen and she'll eat a Jolly Rancher that's sitting in her room or whatever, you know, but it's interesting to think of like, how can we reduce these spikes and still live normally where I'm not Like patrolling her all the time, because that's what that's a real point of contentment in my household. It's like I'm overbearing and I need the control all the time, and she's trying to figure it out. So I actually asked her to listen to some episodes too, and she begrudgingly, I think, listened to one or two. But I do think it helped her, because I can see her making different doses depending on what she's eating, and thinking more about the food and the impact. And, you know, sometimes we have those terrible highs, you know, I find myself going, what's going on, and then I just remember, like, just give her more insulin. Like, what are you doing, staring at this number, even though you gave her a couple units half hour ago or whatever. You know, we're now 60 points higher. I can give more like, and I think that's where I was stuck for a long time, is that whole like, two hour holding pattern of like, I gave insulin and I can't do anything about it for two more hours. And I was really stuck there for a long time. And then I was, like, I treated it when it was 190 well now we're 260 and I'm still staring at it because. Hasn't been, you know, quote, two hours. And that's what really kind of changed how I managed it was, like, I don't have to wait that long. Does that make sense? Also,

Scott Benner 20:08
the randomness of someone told you two hours. Sometimes people get told three hours, right? Yeah, right. I've heard people been told six hours, wait six hours and then treat again, six Yeah, no. It's the insulin action time. Like, generally speaking, probably lasts about six hours in your system. But, you know, Oh, you don't want to stack. And then, you know, of course, you don't want to stack, but it's not stacking if you need it. That's Bolus thing. And, you know, like, right? It's awesome, by the way. It's great that she begrudgingly listened, but that it actually was valuable for

Theresa 20:36
I think. So she'll never admit it, but she heard it, you know. I mean, try to

Scott Benner 20:40
put yourself in her shoes. Oh, yeah, yeah. Your mom comes to you when you're 14 and says, I want you to go listen to this Lawrence Welk fella. Oh, wait, that's too old for you. Johnny Carson. Go listen to Johnny Carson, because I think it's hilarious. And he's gonna watch it, and you're gonna be like, I don't I don't know what these old people are talking about. I tried to show my son something from All in the Family last night, and I was trying to make the point about how, you know, like, he's always running around talking about how freedom of speech is very important. And I'm, I'm happy he thinks that way. And I'm like, Look at what you could watch on television in the 70s. And I played him a clip he didn't even hear the content. He was just like, this sucks, right? The look of it just sucks. They're just sitting there talking. And, you know, I said this is probably a cultural pivot point this television show, and he's, like, it sucks, so, you know? And by the way, he agrees with what was being said inside of the clip, and he agrees that it's important for people to be able to speak and like, this whole thing, but like, it just didn't look the way it was supposed to look to him, right? You know, because the way the world shined up for him, and it moves faster, and, you know, there's sound effects behind it and stuff like that. Your daughter is probably the same way. She's like, my mom gave me a podcast. I don't even know what a podcast is. Oh yeah. And there was this old guy, and he was talking about insulin, and, oh, my god, he doesn't even have diabetes. And yeah, but listen, tell her I agree with her.

Theresa 22:05
Yeah. A couple weeks ago, something came up, and I said, I'm a pretty fun mom. And she's like, your idea of fun is listening to a podcast about diabetes.

Scott Benner 22:14
You're not fun lady, by the way, they're not fun either. They're not. No, they're totally not. This is the first generation of kids that suck a little bit. They do. They absolutely do. You're right. They don't really do anything. They just talk to each other through text chains and laugh at memes and, you know, say snarky about like, their friends, but privately, like, I don't know, like, what, you know what I mean. So she has

Theresa 22:41
a sister also that's 19. So I have another generation up of a daughter. She's a much better communicator and open mindedness. And my younger one is just so much more closed off. And I see that more and more when I work with middle schoolers. They know everything, and they're not even willing to, like entertain ideas. They just know everything. And it's it's frustrating. Yeah,

Scott Benner 22:59
listen. I mean, every kid thinks they know everything. That's fine. I think I know a lot. I think the bigger problem for them is that they're being siloed, you know, by what 14 year olds agree with, by their social media feeds. They get that reinforcement constantly of the thing I think is right, because my my shiny thing told me, right, yeah, you know. So there's no reason to go wonder about anything else, because the thing that I have in my hand, the magic box, it like it agrees to me all the time, and it feeds me exactly what I want to see all the time. Listen, the other day, my son said I was thinking of getting a leather bag for work. My wife and I have been inundated with leather bag social media post. No, kind of crazy. Never seen them before in my life. So if your kids out there, you know, having thoughts and listening to certain stuff, they're gonna just gonna get it fed back to them. But that's not why you came on the podcast to figure out how corporate chills are controlling our children, right? What did you want to come on and talk

Theresa 23:58
about? Nothing really in particular. I think the biggest thing was that a lot of the Facebook group and somewhat the podcast is really geared toward pump users, at least. That's what I think a lot of people think. And I think it's important for listeners and people in the Facebook group to understand that you can take everything that you say and you do and the success that you have and apply it to MDI long term, my daughter has no interest of using a pump. The deal is, is the Dexcom is a non negotiable, you know, we have to have that. But whether she gets on a pump or not is her decision, and she is holding out. And I think mostly it's because I want her to get a pump. Because right now I'm at the pump pretty much, and it's just a, you know, a battle wills, right now, she doesn't want it. She doesn't want anything attached to her body. She'll even try it, but yeah, like long term MDI, it's hard, but you can have great success on it. And I think people get overwhelmed and think of pumps the answer. And I know people who have pumps and that pump wasn't the answer.

Scott Benner 24:55
I have to tell you a couple of things here. So first of all, preach, because I. I am constantly hit by people who are like, hey, the podcast doesn't have any information about MDI in it. I'm like, the information is about insulin. It doesn't matter how you get it into your body, the ideas will work overwhelming. So I'm glad that you had that experience. I also think that you're probably two, maybe three years away from her bringing home the scruffies looking boy she can find to see if you will say, Don't go out with him. So you're gonna have to tell her how much you love him when she comes home with that kid, right? Yeah, reverse psychology. Oh my god, you're gonna be like, Oh no, he's awesome. Yeah, I can't wait for can you bring him over again? I'd like to chat with him. I like him more than I like you. I swear to God, I'm thinking of leaving dad for this boy. Don't tell anybody. I know it's creepy. Now you want to lean hard the other direction. When this happens, definitely going to happen, by the way, because I could see her wanting to argue with you already. Just Oh, for sure. Did you do this with your mom?

Theresa 25:47
No, actually, I was a very I mean, looking back, I wasn't an arguer. I was disrespectful. But back then, it was different your person. They weren't over your shoulder all the time. I don't remember having a lot of points of contention with my mom. I just

Scott Benner 26:00
like, my mom didn't even talk to me. How could I argue?

Theresa 26:03
My mom worked afternoons. She was a nurse, so she worked afternoons forever. So like, I would go to school from eight to three, and she went to work from three to 11. I would only see her, like, on weekends. That's great.

Scott Benner 26:13
Take high five at the front door, and then, right that was the Oh, so you're kind of like a latch key kid? Yeah, totally. But you're up your kids. You're with your kid all the time. I

Theresa 26:23
wouldn't be, but diabetes, you know, makes that a little more difficult than it would be if she didn't have diabetes too much

Scott Benner 26:29
or or, do you think no?

Theresa 26:32
Well being MDI, I think I'm definitely a much more hover. I try not to bother her. I only text her when it's getting to the point of like, okay, I don't know if she did anything or not with this blood sugar number. I need at least text and say, Hey, you see this. And usually she lie to me and be like, Yeah, I fixed it. And then he comes home, and she always throws her pen needles into her purse. And I'm like, why is there only one pen needle in here? This means this was lunch. Where's the correction you told me you did. So that's kind of how I catch her in that. But usually she handles it, but and I try to stay out of her way, but she doesn't wake up at night. So I haven't slept in a long I mean, I shouldn't say I haven't slept, but, you know, several nights a week I'm up dealing with it, which is hard.

Scott Benner 27:16
What do you think when you when you step back from this and you and you say, okay, in the short term, I feel like this is what we need to be doing. But when you step back and wonder about the long term, what are the things you worry about?

Theresa 27:29
I worry about her losing her eyesight. I worry about her losing limbs, like I worry about all those long term complications. I worry about the highs more than I worry about the lows, honestly, because up until this point, she's good about treating her lows, you know, like when it happens, she's she's not waiting, she's dealing with it, the highs, I worry, just for long term effects. What about, like,

Scott Benner 27:49
interpersonal or do you have that? Do you have a concern? Or, am I, am I introducing this concern to you? Do you have the concern that she'll be healthy, but we won't talk? Um,

Theresa 28:00
you know, that's a great question we read. She recently started going to therapy because I've been noticing, like, like, we just argue a lot, and it's not always about diabetes. It's just, if I say, Look up, she's, like, I look down, like she's has to be opposite. And I kind of worry that, like, with medical trauma, like, maybe this is part of it. And she went to her first therapy appointment. She came out, and I said, How did it go? Because we do have a good relationship. I shouldn't make it sound like we don't we do. And she's, like, talked about you the whole hour. Great. Glad I'm paying for this.

Scott Benner 28:34
That lady really helped me see What a bitch you are, exactly,

Unknown Speaker 28:38
exactly I

Scott Benner 28:41
tried to tell her, you were just trying to be a good mom, but she said, No, it sounds like your mom's horrible well, so

Theresa 28:47
now I go back for the second appointment with her, because I'm like, All right, go ahead. Talk to my face now, you know. And of course, she doesn't, but you know, she's the lady starts to ask her about her diabetes, and she's like, my sister's a type two, so I totally understand it. And then starts to give like, advice, and I'm like, Oh no. So we walk out, my daughter's like, we're not going back there. It's like, I can't listen to her diabetes crap. I can't, Mom, isn't

Scott Benner 29:13
that something like, I'm not here for your personal stories. Just, I mean, if you listen to Eric on the podcast, talk right? Like, there's, oh, she's amazing. There's things you're supposed to be listening for, ideas you apply questions, you ask to move people in directions of thought. That's it. Like you're not there to tell people about your type two sister, your cat that lost a Paul, or, I didn't mean a curse or sorry, but like, you know you're not there to tell your stories. Like you're there to facilitate the conversation.

Theresa 29:39
Yeah, and I had to actually interrupt her at one point. And I'm like, you know, we're really not here for diabetic advice. We have that handle. You know, she's a good a, 1c her doctor is in no shape worry. She's like, well, if she would just get on a pump, you know, it'd be so much easier. You'd have so such better control. And I'm like, lady, you have no idea. Yeah, control we

Scott Benner 29:57
have about the control we already, we've already. To accomplish? Yeah, honey, it's not your podcast. It's a it's a therapy session, right? You want people to pontificate. Listen to me. I'll talk forever about shit that I think. That's not what you're looking for. You're looking for, you know, a good therapist hard to find. Yeah, I know. So

Theresa 30:13
we're switching. So we're in limbo right now waiting for a new one. This was just like two weeks ago that this happened, so we're gonna try to go with our endocrinologist suggested somebody in her office, so we're going to try there and see. I just need someone to understand diabetes, not to talk about it with her, but to know like that's a stressor, and understand what kind of stressor that is. I

Scott Benner 30:32
have to tell you something. I am not a qualified mental health professional, but I think people should start sending me their case to talk to. I think your kid, yeah, I just let her come on here, and she could bitch about you for a little bit, and I'd tell her she's right, and then I'd tell her she's wrong, and I'd tell her, no, it would be end of it. We'd be all good. Maybe we don't need therapy. Maybe we just need an honest friend who knows what the hell they're right? Yeah, talking about a little bit. All right, that's my next job. I'm going to be a what do they call it? What is that pretend job? People have life

Unknown Speaker 31:01
coach, yeah,

Theresa 31:04
I knew exactly what you're doing for there.

Scott Benner 31:05
Yeah, I would be no offense though. I mean, I guess there's no way for me to say no offense to life coaches, but, like, no offense, right? Yeah, your common sense buddy, like a little doll that just tells you when you're being a shed, right? I could do that all right. And she's

Theresa 31:20
also had some other medical trauma. So when she was diagnosed with type one, we also found out she had Hashimotos, of course. So she now takes Harrison for that. That goes well, but, you know, I did a huge deep dive into type one, and I feel like I know so much about it, but I kind of never really did a deep dive in Hashimotos. So that's, like, my next thing. I've listened to all your podcast episodes on it, but I'm in a group online, and they just talk about different foods they should eat and different eat on I'm like, Wow, maybe I really need to, like, get some more information on this, but at that point, my brain just couldn't, like, handle any more information, and I forget about it. You know, you take a pill and you're done. I know

Scott Benner 31:57
I could have Addie back on and she could really dig through it, but I have to tell you, I think it would get so far into the minutia of Hashimotos, I don't know that people would follow it or listen. I

Theresa 32:07
sometimes think that that's why I haven't went further. Because when I start to I'm like, Oh, they're like, the air matters, the wind. Like, how do you dial this down and figure out, like, what's affecting you as a person? So I just kind of wash my hands of it. She takes her pill. We get her blood work done every six months, and we haven't thought too much about it. But she does also have that. So I wonder, like, how's that playing into the teenage mood swings and the, you know, all that kind of stuff, her numbers are generally fine with that. We've had to do some adjustments with her tears and but not do too much. Yeah,

Scott Benner 32:38
your story mimics mine, like, I have a daughter who has type one and and, you know, takes tears in as well. And, you know, every time something gets said that's crossed, you're like, is this hormones? Is this bad mood? Is this tired? Am I being a jerk? Like, is your thyroid Did you skip your thyroid medication for three days? Is your blood sugar moving right now? Like, you can't possibly know all those things you know. So you do your best to keep things steady, and then you know, and just assume that I'm being a jerk, or she's being a jerk if somebody's having a problem. I mean, it's tough for raising kids. I also I find myself recently, more and more coming to the conclusion that one day, I mean, not that I didn't know this before, but it feels like it's getting closer now. Like, there'll be a day where I just will not have any influence anymore, and then whoever she is right there, like, That's it, you know what I mean? Like I did, but I was, I did what I could do, like Kelly did what she could do, and now she's going to go live her own life, and probably not going to ask us for our opinion ever again, or only if you know, things are upside down, yeah,

Theresa 33:41
it's scary to think about, yeah, you know, I'm also, you know, some people, you think about, like, Oh, you were diagnosed when you were so young. And, you know, I know your daughter was way younger than mine, but like, I think my daughter was diagnosed at a perfect time. She hadn't really become herself yet to where I could still, like, I taught her everything I knew about insulin, and I, you know, tried to get everything down pat if she would have been diagnosed at 13 versus nine, it would have been a way different store. I really feel for people who maybe were diagnosed in those really tough teenage years, because she would have been completely non compliant if it happened right now, so I had a little bit of time to, like, shape her and mold her before, you know, being

Scott Benner 34:19
bad first day, you would have been in trouble. Oh yeah, it would have been bad. There's an after dark episode about the girl that had to go into a home, right? And then just pregnant. Her story is, to me, is like it feels so much around what you're talking about, like timing, you know, and the things you can't impact, like you're listening, sounds like you're a really involved mom, and you're you're trying really hard. It's awesome. Like that girl I just mentioned, she didn't have that kind of parents, and, you know, and just like that, like you don't get reasonable direction catches you at the wrong time for whatever reason. You know, a couple of those things pile on top of each other, and the next thing you know, you're having your own worst nightmares happening to you, right? And then it's hard for you, or. People like me or anybody else listening to think like, well, I don't want that to happen to my kid. And then you keep putting in these efforts everywhere, and you do one like, I do wonder listening to you like, will your daughter grow up being a person who understands her insulin, takes good care of it, keeps herself safe, has her health in line that way? But, you know, has resentment towards how it got done, and is that maybe the cost of doing business like I don't know. You know what I mean, you know.

Theresa 35:26
And I've thought about that, and I thought, you know, do I be her friend now and just relax on it, let her ride higher. I'm her mom, not her friend. My goal is for her body to be as close to non diabetic as possible, so without being too overly crazy about it, you know, I don't really need to be her friend right now. I just, I need to be your mom. And hopefully, in the end, she'll realize that she's got a really dark sense of humor and like, she's really She's very smart and very funny, like people on the outside looking in to be like, Man, you guys really go at it sometimes, but sometimes it's our love language, you know? Like we just quit back at each other, and at some point she'll go too far, and I have to cut it off. Like whoa. Like, stay in your lane. I'm still your mom. Yeah, that's just our relationship right now, listen,

Scott Benner 36:11
I think you're not you everybody. You're walking in a line, you know what I mean, and sometimes you stumble one side of the other, etc, but it sounds like you're doing a good job to me. Oh, thank you. Yeah, please. I mean, I don't add

Theresa 36:24
on the medical trauma. So let me fast forward then to last December. So December 2023, this just about a year ago. You know, everything had been pretty smooth for a while. Diabetes was going fine. She goes to a birthday party at Sky Zone, and of course, I don't stay. She's, you know, 12 years old at this point, and I get a call maybe 20 minutes after I dropped her off of a screaming Mother, you have to come now quick. Lucy's hurt. Lucy's my daughter. Lucy's hurt. And I'm like, what? And she's like, come. Now come and this this person's nurse. This person is a nurse, and I'm like, is she okay? Yes, but get here quick. I mean, I drove Luckily, I had didn't get too far, drove there as fast as I can. My husband was with me. Get there. My daughter is laid out on the trampolines. She's at Sky Zone, and she has broke both of her legs, whoa, oh yeah. And she's laying on a trampoline. Give

Scott Benner 37:21
me a second. I know she broke her legs, but now I'm I'm having trauma. Give me half a second.

Theresa 37:24
Oh, mind you, this is a, like, School Night Out type thing. There was a birthday party, and then, of course, it's a Friday night, so there's tons of friends from school, so everybody has been cleared the trampolines. They're all staring at her. I beat the squad there, so they call it EMS. They have her covered in a blanket. So I walk in, I step on the trampolines to go to her, and then they're all screaming at me, Stop, don't move her. And because I'm stepping on the trampoline, it's like moving her body, you know? And so I get off real quick, so and they won't let me near her. I can only see her. She's about 10 feet away from me. And the other kid's mom, whose birthday party was is on the trampoline with her, like, like, cradling her, and they have a blanket over her legs. And I look at the worker, and I was like, Is it out of her skin? And they're like, We think so. Oh, my God. And I'm like, What do you mean? You think so? Well, she has pants on. It's hard to tell. I'm like, Okay, I mean, I don't even know what's happening in my body at this point. I'm just, you know, in a daze, and so they remove the EMS. Gets there, they get her on a board and take her off. And I can see like her leg is just not the right way the bottom of her leg. So she ended up breaking both her tibia and her tibula completely cracked in half. Didn't come out of the skin though it, but you could see it where it was about to come out of the skin.

Scott Benner 38:39
Sorry, not almost. I don't understand what happened. So

Theresa 38:44
going back and they won't let me see the tapes, that's apparently you can't ask for that as a customer to see their footage. It was sold out. That you know, if you've ever been to a Sky Zone, they get pretty packed. It was sold out. They had closed down an area for younger kids, so it forced the older kids to be more of them in an area. Well, one of her friends was on the same square as her, and, like, double jumped her. So when my daughter was up in the air, the other girl bounced down. So when my daughter came down, the force of the trampoline was coming up. Apparently it's pretty common, like, sadly, it's common. But so she broke her right Tibi on fibula, and actually, she didn't break her left leg. She broke her left ankle, so the bone wasn't so EMS gets there, they load her up. What really warmed my heart is the minute I walked in the trampoline. Guy goes, I know she's a type one diabetic, she told me, and I've went over that a million times with her. Like, if you're ever not with me and somebody has to treat you medically, you need to say this. This is really important. So I was very proud of her at that moment. Yeah, and she's white as a ghost. She's not crying, but she is, like, you can tell her body's in shock. So they get her on there. We hop in the they want to take us to the nearest er, and we have a lot of hospitals around us. And like, No, I want to go the extra 10 miles and go to Children's Hospital. She's diabetic. That's where we need to go. So they kind of fought with me a little bit, because they're like, well, that's not. Protocol or whatever. And I'm like, I don't care, that's where we're going. We get there and they do some X rays, you know, they tell me she she's going to need surgery, like she needs a rod and screws put in this one leg. And I tell them that She's diabetic. And the next thing is, well, we're going to control that from here on out. And I was like, what? And they're like, Well, you're not, you're not, you're not allowed to give any more insulin. You can't give her anything from home. Like, if you have insulin pens with you, we can't use them. And I was like, well, she's independent, if you could just call and because we're at the same hospital that she was diagnosed with type one at, and we have a great relationship with our Endo, I was like, call the endo office, like, they'll tell you, like, we're cool, you know, like, you don't need to, like, harp on us about this. Apparently, hospital policy is is, once they're admitted, I am stripped of every right I have. They're wanting to take her decks come off, they're not letting me give insulin. That was very scary for me, and that's the ER, so I thought, okay, it'll get better once they get on the phone and get the right people, whatever. So we get admitted, we're up in the room. It's the evening, you know, the night before surgery, and, you know, she's, like, 300 I'm like, Hey, she needs some insulin, man. Like, I understand, like, her body's going through shock and her sugar is going to jump, but, like, we've been there now for a minute, like, she needs some insulin. And they're like, Okay, well, we'll call, you know, we're going to put her on a sliding scale. We don't really correct unless it's, you know, meal time. And I'm like, well, that's not how we operate. Like she's not used to feeling 300 like this is off for her. You know, they talked about it, and they came back and said, we've decided we're not going to give her any insulin, because she has surgery in the morning. At that point, oh, my God, it's happening. Like this is happening to me. I've been stripped of my rights, and they don't know what they're talking about. So the first night, we suffered it out. In the morning, I asked to speak to the endocrinologist, and one came in who we don't, it's like a group of, like 10, so we never, we don't see this woman. But she came in and, you know, she was very pleasant and very well spoken, and explained that it's okay to be 300 and she's in a lot of pain. And I said, Yes, but she's also going to have to heal from surgery later today. Like, she doesn't need to be 300 Well, we'd rather have her 300 going into surgery. And that just blew my mind. What about 200 Right? Like, I wouldn't even be happy with 200 can we?

Scott Benner 42:14
Can we meet in the middle? Yeah, exactly right. Yeah.

Theresa 42:17
So that was when it, you know, it kind of hit me like, Oh, this is going to be a fight. This is going to be a big fight. So she had surgery. She was actually came down a little bit before surgery, and she stayed steady while she was in there, but she was still much higher than I would have liked. And then afterwards, I thought, okay, we're going to we're going to take back control. And I asked to speak to the endocrinologist again, and she's like, No, I'm sorry. While she's admitted, you don't have any right to give her insulin. And that just really stopped me in my tracks. I was like, it scared me, you know, like in the future, if I'm not here to fight for her, and I'm losing this fight, but at least I'm fighting, you know, is she going to know how to navigate this kind of situation on her own? And I thought, well, this is a time where I need to show her like they're not always right. And I know that sounds terrible, because I really do trust the medical profession. I do like my my mom's nurse, my sister's nurse practitioner, like I do have faith in the medical community, but at this moment, I thought, I need to teach her that they're not always right, and that you know your body and you know we have to manage this disease. So I talked to them again, and they're still they. They started to agree to correct every three hours. So I thought that's a start. Well, that whole day, she rode high. And then when meals would come, they do this thing where two people have to look at the insulin pen or syringe, whatever they were using. Her food would come. I'd ring the buzzer. The nurse would take 10 minutes to come in, and then she'd be like, Okay, and this will be, you know, 10 units or whatever. And then she'd be like, I have to get a second pair of eyes on the needle before I can inject. So her food's ice cold. We're 20 minutes in, she's starving, and we're waiting for a second. And I said, Can I be the second person that looks at the pet? No, you can't be it. I'm like, Oh my gosh. So it just went downhill. We were in hospital first three days with that, and I ended up just giving injections when they weren't in the room. Oh, I had to. I mean, it was, that's

Scott Benner 44:03
what most people end up doing. But yeah, yeah, yeah. So,

Theresa 44:07
so then we have our next endo appointment, and we never got to see, like, our endo while she was there, because she wasn't one on call. And she told me when we went to our next appointment was like, next time that happens, just my chart me, message me personally, and I'll make sure to take care of it. And that made me feel a little better. But then we wanted to change some stuff when she went to camp this past year, and this is after the broken legs, and the endo fought me on it, like she didn't want to change, like her correction factor and things like that. Like we were looking at camp and she kind of said, you have to do what the school nurse says. And I was like, boy to my face, you tell me, oh yeah, just call me. But then when we need you, like, you revert back to, well, this is policy. This is how we do it. And that, to me, is very frustrating,

Scott Benner 44:53
yeah, well, it's pretty common as well. Yeah, also, you fought to go to that hospital.

Theresa 44:59
Yeah. I know I paid extra to go there, you're probably like, damn it, like

Scott Benner 45:03
the wrong one. It is not an uncommon story to get into a hospital. They don't know what they're doing, and your diabetes is not actually their concern. That's what you learn, is that the legs were their concern. They apparently can't be concerned with two things at one time.

Theresa 45:18
Well, and I asked my end, I'm like, can't we put something in her chart that, like, if we're not admitted for something diabetic related, Let's just not talk about it. But like, because we're not there for that, if I was there and she's in DKA, of course, by all means, help me out. But if we're there for something random, why? Why is her diabetes even a question? Yeah, I know

Scott Benner 45:38
I've had friends in the hospital with type one, and they just get somebody to bring them their stuff, and they hide it in the room and take care of themselves.

Theresa 45:44
How sad is that? You know, like, I'm typically a rule follower, so I don't like to go around the rules or bend the rules or but in this instance, it was, it was absolutely absurd. And you just felt like you were talking to a wall. You know, it was like you weren't getting anywhere. They were just like, sorry, this is how we're going to do it.

Scott Benner 46:02
Please don't look at me with your dead eyes. Tell me there's nothing you can do.

Theresa 46:07
You know they were all pleasant. They were nice about it, but it just, I know they're and then I have to, like, check myself, because I'm like, Are they looking at me like I'm crazy? Because then they would say you are too worried about her numbers, like you don't need to be that worried. And I'm like, Oh, my God, they think I'm crazy. Are they gonna, like, put a complaint in that, like, I'm, you know, treating my kid inappropriately with diabetes, like it's then that fear said, and of like, okay, don't look crazy. Just go with it.

Scott Benner 46:33
Don't. No one's ever not looked crazy, trying not to look crazy, by the way.

Theresa 46:39
Probably, it was a lot happening. It was just a rough It was a rough few days, and then she was stuck in a wheelchair for for almost four months as her surgery healed. So that was really tough, you know, figuring out, you know, she was so much less active. I

Scott Benner 46:54
mean, did they look later at her legs? Was this like a genetic thing? Was it structural, or is it just the the force from the trampoline.

Theresa 47:02
I asked that because I was worried about, like, calcium, or, you know, something like that. And they did a whatever, a bone whatever during the surgery, and the ortho said that, no, it was just, it was a force of impact. He's like, wrong time, wrong place, that sucks. And, you know, he's like, was this? He said, was this a playground accident or trampoline? I'm like, trampoline. He's like, those are the only two broken lakes we get in here with kids. I'm like, Oh, interesting. He's like, I would never take my kids to Sky zones. Sorry, Sky Zone. Is she athletic? Not really, but we do, like, she doesn't play, like, sports, but he's pretty active outside. Like, we have a pool, we have trampoline. She's running around all the time, but not, like, workout athletic.

Scott Benner 47:45
I just wondered. Like, trust me, I'm not blaming her, but like, if I put, like, a super athletic person in that same situation, like, do you think they would have rolled with it better, or fought it? Like, not fought it? You know what I mean? Like, sometimes there are people just more in control of their bodies. I don't know if that makes sense or not, but

Theresa 48:01
yeah, it does. Like, could she have landed better? Could she have seen that impact coming, or absorbed it better with her legs? I don't know. I mean, we have a trampoline at home, so she's no stranger to like, how how the balance feels, if that makes sense, right? But those trampolines are so much more powerful. Yeah, you know, thick within our backyard, $150 you know, trampoline, which we don't have anymore, by the way. Oh, my God, she was really mad at me when I gave that away.

Scott Benner 48:27
Gave it away, settle on fire. Oh, that's crazy. And then how about her blood sugars through that the healing process. So,

Theresa 48:34
through the healing process, she was, she was pretty much fine. She developed some really bad like blood blisters from the medical tape, which were probably the hardest part of healing because they were so sore. And I really worried about, like, is she not healing better because she's diabetic? But, you know, we have a good a 1c like, I think our last a 1c was 62 maybe. So I knew it probably wasn't anything diabetic related. The hardest part was getting the basal right with the lack of activity, okay? And increasing that to a point to cover all that food with very little activity. But then she would have to, like, go to therapy, because she was in therapy, like twice, physical therapy like twice a week, and then she would be low all night long, because she had physical therapy that

Scott Benner 49:18
day, and you had their and her basal was jacked up all day long, too,

Theresa 49:21
exactly, right, to cover the inactivity, right? That was the hardest thing was, was just figuring out, like, to being proactive, to what the day was about to bring when she was laid up,

Scott Benner 49:31
yeah, and how is she doing now? Like, did she heal? Well, she did. She's

Theresa 49:35
completely fine. She's released from any kind of medical thing. She can do anything she wants, and they said her leg will never break again. That leg will never break again, and it's stronger. What's really crazy? If you go back through my Facebook post, you'll see it because I posted it in the group. So you know how you have the two bones in your legs? Well, the the bigger one is the one that they put the rod and then the screws in for from the knee down from the knee to the ankle, but the other bone. Bone. That's the smaller bone on the back of your leg. They just left it broken. They said she don't need it no more. It's literally in there, broken. Is that weird? Making me

Scott Benner 50:09
upset? They

Theresa 50:10
said eventually it will fuse back together, like crooked, but she doesn't need it because she has the other that she has the rod in there. Now

Scott Benner 50:17
it won't cause a problem later. It won't, like, grow to something or heal to something, or they said, no, they said it. They also didn't know anything about it. Diabetes, I just want to point that out. They didn't, yeah, didn't. So when she gets a tail in that leg, I think we know what's going to happen,

Theresa 50:31
right? And you know, she can feel the screws, which is really weird to me, like she feels them in her ankle, and if she pulls her skin right, you can actually see the head of the screw, which is super creepy to me. Oh yeah. How does she

Scott Benner 50:43
describe the experience and the pain? Does she remember the pain? She said

Theresa 50:48
it was only painful when she had to move. So when somebody didn't move her, he was fine. But when we got home, I think that's when, of course, we live in like a split level home too, so there's stairs everywhere. So that was really trying. Of like, you know, all of our bedrooms are upstairs with the bathroom. Well, of course, she want to sit in her bed, so she wanted to come to the main floor to be in the living room or wherever. But then the bathroom required stairs. So pain level, I think just going up and trying to get up and down the steps was the worst. And getting in and out of the house okay, and I made her go to school, looking back, if she had a few weeks off, but they offered to do homeschool instruction. And I thought, no, she really needs, like, the socialization. And looking back, I'm not sure if I made the right decision there, because I think, I think she was bullied a little bit. I don't even want to say bully, just, you know, picked on for being in a wheelchair, because the other option was a walker. And she's like, Mom, they will kick a walker out from under me. There is no way I'm taking a walker to school. Where the hell did you lose? You took

Scott Benner 51:49
the wheelchair, right? Where do you live? I just wanna make sure I don't move there. Find this paper in Ohio,

Theresa 51:54
but it's middle school, you know? Okay, they're kids. She's like, I can't walk in a hallway with that Walker. It won't work. They'll kick

Scott Benner 52:01
it out from under. Yeah. He's like, they totally will. Oh, my God. Well, listen, she did it, right? Is she okay? She's fine now, yeah, she's not talking about, like, I shouldn't have done that. Or, although she did go into that, she did go into that therapy session and talk about you

Theresa 52:16
for a while, she did talk about me the whole time. I don't think it had much to do with broken legs. Great. If

Scott Benner 52:20
the whole thing was, like, she made me go to school in a wheelchair, they said they'd send my work home. But no, my mom said I should go, tough it out,

Theresa 52:28
walk it off, yeah, quote, unquote, that's totally the mom I am, though, like, I, you know, I'm a teacher, so, you know, suck it up. Just do it. You're fine. You live through it. Like, that's just kind of how we live. So, and she, she adapts well, you know, and she likes school. So when her whole world was falling apart with these broken legs, I thought, I'm gonna, I don't want to homeschool her and keep her away from the one thing that she actually misses. No. I mean, I take looking back, it was rough.

Scott Benner 52:55
Listen, I wouldn't I mean, you know what? I mean, most of the parenting is a coin flip. You they didn't set her on fire. I think she's fine. Exactly. She made it, yeah. Does she have a core of friends?

Theresa 53:04
She does. She has a few friends that are real close, and they were real good to her, and that, you know, they got to leave class early to help her carry her books. And so I think she enjoyed the attention for the most part. Amazingly enough, you know, this happened in December. She was walking by, like April, maybe fifth or sixth. It was real early April, and once she was walking like it was, almost like it just magically disappeared. Once she was upright and could bear the weight, she healed really

Scott Benner 53:31
fast. When quickly after that, very quickly. Did you need any temporary accommodations to send her back to school?

Theresa 53:37
I did. So I needed, you know her leave class a little early for certain things. The nurse there, I worked for the school system for a couple years. Actually worked there while she was diagnosed, so I made real good friends with who I needed to so I know the district nurse very well, so she was really cool about it. So they did everything they needed to do. Okay,

Scott Benner 53:55
it wasn't tough towards the end here, unless you have something else you want to talk about, I'd like to pivot back to something you you mentioned earlier. So I want to make sure I've got you've had a chance to talk about the things that were on your mind first. Oh,

Theresa 54:06
yeah, you feel good. I think the only other thing I wanted to talk about was now I work. I work at a community college. I'm the instructor, and we do this summer program called kids college, and it's really cool. Ages K to six come for us for a month in the summer, and we just do really cool things with them. I've spent all this time with diabetes, and you know, I understand it so much. And anytime I meet someone with diabetes, I try to, like, educate them a little bit. But what really sticks with me is this kid's college, I had a parent reach out, and he said, Hey, my daughter has type one. She was only eight years old when she first started coming. He said, Every year we've reached out trying to see if it was okay for her to come. And each year, we've been told, No. I just wanted to reach out again to see if, this year, if there's any change. And I was like, Well, of course she can come. And they're like, what? I'm like, Well, my daughter's type one. I'll just meet up with her at lunch every day, and I will help her dose. And she's on an Omnipod and a, you know, g6 I said, I don't know that. Interface for a while, because my daughter's MDI, but I'd be happy to, like, follow her, or whatever you want me to do. And these parents, like, were over the moon appreciate. They sent me flowers the first year, like they said that their daughter has been turned away from every summer camp because she's type one. And I thought, oh my gosh, that's so sad.

Speaker 1 55:17
Yeah, well, it's nice for you to help. It was, and

Theresa 55:21
it's really cool to care for every summer. So this will be your third summer coming back. And I'm like, this is really cool. Just, you know, sometimes our kids might not get to experience things, but you know, my knowledge of it is helped another family. And that was,

Scott Benner 55:33
that was really cool. Very nice. That's awesome. So I would like, if you wouldn't mind, to spend the last couple of minutes telling me how you adapted what you heard on the podcast to MDI. So

Theresa 55:44
I started with, you know, I didn't really go in order, but then once you kind of organized the pro tips, because you were still making pro tips when I really started diving in. So the pro tips were huge. They really, in a nutshell, taught me pretty much everything that I needed to know in MDI, I just had to get out of that mindset of like, I don't know why she's high, or I don't know why she's low, and I think everything started to fall apart or come together once I got the basal right. So I didn't really understand. They just told me when we left the hospital, take nine units. That's all they told me, nine units of at that time, it was Atlantis, and then we moved to basal gar basal. Now we're on traceva, which is so much better just figuring out how much of an impact basal has throughout your day, because I think we had it so wrong. Because from where I started, once I started listening with you, I think she was at maybe 10 units at that point. By the time my basal tested her and figured out her basal, he needed 17 units of basal. Oh, okay, so nothing was going right. And he used to say, like, if your basal ain't right, nothing's right. And that that really stuck with me. Okay, this is where I have to start. This is my starting point. And it's not always easy to figure out your basal, because the thing I hate most about MDI is I can't change it once it's in. So every morning when my daughter goes to school, she she always yells at me, because she'll be like, I don't know, 95 and she'll be leaving for school. And I'm like, here, you need a unit in half. She's like, Mom, I'm 95 I'm like, I know what's about to happen in an hour. You're going to be 140 if you don't take this unit in half. When I tell people that, they're like, Oh my gosh. Like, don't you get nervous about giving her that? And I'm like, no, because I know what's about to happen when she walks into school doors. And that's something else she always used to say, is trust. I forget how you said it. Trust what will happen is what you think will happen or something. The

Scott Benner 57:30
problem is the way I said it was very clunky, but what I ended up saying was trust that what you know is going to happen is going to happen. It does

Theresa 57:37
almost every day. I think it's it failed me once she went low when she got to school. But, you know, Juicebox fixed it so adrenaline,

Scott Benner 57:45
like, you know, nerves, that kind of stuff, when you get to school. I did a talk with a bunch of kids in person a few months ago now, and I've said this in the podcast before, so I'll go over it really quickly. But one of them started talking about, I don't understand why my blood sugar just goes up at school. We talked about anxiety, pressure, stress, that kind of stuff. And then the entire group of kids was like, Wait, that happens to me too. And then they all just kind of out loud, you know, reinforced to each other that, you know, oh, gosh, there. I guess there's variables here that I don't know about.

Theresa 58:20
And, yeah, and learning from your podcast what all those variables were, because nobody was going to tell me that. No doctor was going to tell me. So sometimes at school, or if she gets called on in the middle of the class, her blood sugar could go up, or just figuring out all those variables and then trying to plan for them. And with MDI, you kind of, I still feel reactive in a lot of ways, but I could also be proactive by giving her insulin before school, changing her basal rates. If we know we're like, going on vacation and we're going to be more active, but really, that holding pattern of waiting for that basal to kind of kick in. Don't really understand. Why does it take three days for my change in place, but it like, catch up. Like, do you understand that? Yes.

Scott Benner 59:04
So, I mean, understand vaguely, like, be able to explain it technically, probably not. But that medication lasts, they say longer than 24 hours in the system, right, I guess. But then, why do I give it every day? Because there's a half life. So it becomes less and less efficacious as the hours go on. So you basically have multiple injections of it, multiple boluses of it under the skin that are working at different rates, on different at different times. And if that makes sense or not, like, so sort

Theresa 59:34
of, but then I think about it more, and I'm like, but if it's only good for, you know, 36 hours, or whatever, like, it takes longer than 36 hours when I up at a couple units to show in effect?

Scott Benner 59:45
Yeah, no, because that's just weird. Well, it is, but it isn't like so when you inject your basal insulin at noon, let's just say it's at noon. It's not working at full power immediately, right, right? So the first day you ever you put it in, you put it in. Noon. I'm just using noon as a number, and it takes a number of hours before it's working at its full capacity. And then from there, it's diminishing returns as the minutes and hours go on. You're not at full power at the beginning, you're maybe at full power for some time in the middle, and it wanes as it goes away. It's waning, waning, waning. It's not completely gone by 24 hours, but you put it back in 24 hours from now, you don't have full power from the second injection, but you do have some leftover from the first injection. And after you do a couple of revolutions like that, it starts to cover itself more completely. Does that make sense? It does. Yeah, it just sucks, because it's not very trackable.

Theresa 1:00:39
No, no. And then, and then you start to second guess yourself. Okay, was that the basal error, or was that the mist on the food I tried to figure out, or whatever? Yeah, so I feel like I just have to worry about it more than someone with a pump. And that's probably the hardest part of MDI. Besides getting that basal rate, it's just I'm always aware nothing's gonna work for me. I gotta do all the work so, and it definitely means a lot more injections. You know? Yeah, I would say that I correct her a couple times a day outside of food, at least some days, a lot, some days not that much, just because she'll eat more or less than I anticipated or whatever. Yeah, but she wants that correct. She doesn't want to pump right? Well, she, oh, so she doesn't necessarily want the injections, but she accepts the injections to avoid a pump. Yes. Does she ever tell you why she doesn't want to pump, that she doesn't want to wear anything on her body? Okay? And, you know, we've got, like, the demo pod and stuff, so I could show her, like, it's really not that, you know, it is. She just doesn't want it to be visible. She never wants it to be visible. So that's, and I think that's her way of having control of this, of somewhat of the situation. Yeah, nothing wrong with that. Yeah. And, you know, I'll do it as long as she wants me to. And like I said, she mostly manages, but I typically have to fix what she messes up. It's a pain when she decides that she wants a snack at 1030 at night and she misses the correct, you know, doesn't hold a sport, right? And then, you know, 2am that's where I'm getting out of bed here in the high alarm,

Scott Benner 1:02:07
you're like, Oh, good, beep, beep, I'm coming well. And

Theresa 1:02:11
then it's like, I have to, like, drill her. Because I'm like, Okay, what'd you eat when you take it? Because it's hard to manage with her, because I don't have all the information, right? When it's just me, I know what I gave, what she ate and when, but with her, I'm like, prying and out of her and she's half asleep. I'm like, What time did you eat the whatever you ate?

Scott Benner 1:02:28
How many gummy bears?

Theresa 1:02:32
Best guess? How many squeeze

Scott Benner 1:02:34
my wrist if you ate these potato chips I'm looking at on the floor. You know what's

Theresa 1:02:38
the worst is those stupid talkies. Talkies. They're like, this chip that's really popular with, like, the middle schoolers. They're this ungodly color of teal. Like, you should definitely not put that in your body. But they're really big with that age group, some kind of Mexican, like,

Scott Benner 1:02:53
I don't know, but any teal chip sounds awesome,

Theresa 1:02:57
right, right? Yeah, it can't be good for you. It can. She likes the snack on those, and we never seem to get those completely under control.

Scott Benner 1:03:04
Are there any foods occurring naturally that are teal? I don't believe no, it is

Theresa 1:03:09
totally not natural color and just the dust from them. Like, I'll find it in my house, like she'll eat one and then touch a wall and I see, like, teal fingerprints. I'm like, that's weird.

Scott Benner 1:03:21
Chat, G, P, T, says that any natural teal foods would be blue, green algae, certain heirloom varieties of corn, turquoise, dragon fruit, fiddlehead ferns, lightly cooked seaweed varieties. There are some process prepared prepared foods, like macarons, candies. Now, if those are processed smoothies, no, no, yeah, so fiddlehead ferns, if they're lightly cooked, dragon fruit, heirloom corn, these are teal. They don't mention your your your talkies.

Theresa 1:03:49
No, no, you'll have to check them out sometime there. I don't eat them.

Scott Benner 1:03:53
I don't believe I'm going to, but thank you.

Theresa 1:03:57
I clean them off my walls.

Scott Benner 1:04:00
That's awesome. Oh, my God. Okay, well, I appreciate you doing this very much with me. This is a fantastic conversation. You were terrific at telling your story and your daughter's story. I look forward to the many, many situations where you have to call in probably a hostage negotiator to help you have conversations with your daughter, and then one day, when she's 37 when the day she comes to you and just under her breath, as you're dying, says, Thanks, Mom.

Theresa 1:04:27
I told her I was recording. She's like, you're going to talk about me the whole hour, right? And I'm like, how's that feel after your therapy appointment last a couple weeks ago? Yeah, listen,

Scott Benner 1:04:36
if you really want this to dig in, send me a $40 copay.

Theresa 1:04:41
40. That's a steal, really?

Scott Benner 1:04:42
Am I not? Am I not pretending to charge enough? How much should I be Well,

Theresa 1:04:47
right now, we've met our deductible, so it's okay, but I told her, I said, you need to, either we need to find a therapist or not, because when our deductible rolls over in January, I'm not paying. It's like $125 an hour, really?

Scott Benner 1:04:57
Yeah, you get the information about. Her type two cat or whatever she told her about, right?

Theresa 1:05:02
That's what we walked away with, was, oh, they also gave her, like, a book of feelings, like she was five years old, a book of feelings, yeah, like, like, a way to, like, describe how you're feeling without having to say it, like, you know, like, like, like, the emotion emojis or whatever. And I'm like, oh, we need a new therapist. Oh,

Scott Benner 1:05:20
the book of feelings. $125 for that. I'll stop by the way. I don't know what the book of feelings are, but I'll put Benny other my own. I feel free to sell it to you for $45 so yeah, I just want to be very, very fair about that. What is this? A literal book. Core emotions, happiness, sadness, anger, fear, disgust and surprise. Nuanced emotions like melancholy, joy, frustration, euphoria and longing. Well, culture, perspectives on feelings, expressions of feelings, tools for emotional health, tips, wow, just stop rubbing your dusty fingers on the wall. Let's start there exactly. Suck it up and do what you need to do. Just rub your hands on your pants like a reasonable person, right? Lick your fingers like a normal human. It's awesome. All right, Theresa, hold on for me one second.

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Scott Benner 3/20/25 Scott Benner 3/20/25

#1467 Pediatric Dentistry and Type 1

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.

+ Click for EPISODE TRANSCRIPT

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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