Children Get Gum Disease Too

Parents always ask me, “Does my child have any cavities?”
What I also want parents to wonder and ask; “Does my child have gum disease?”
People – parents – don’t know what they don’t know! Too often, we dismiss a “little bleeding” or tartar buildup in children (never mind adults) as poor oral hygiene and admonish them to brush and floss. Yet, this build up of plaque and bleeding are actually signs of infection and inflammation which cannot resolve on its own with more brushing or different toothpaste. They won’t outgrow it. It is a disease.
February is Children’s Dental Health month so today’s blog is all about the importance of oral health care for our favorite littles. Dental hygiene care must look deeper into bleeding gums in children and spend more time with our little people to help them heal. Then we must educate the entire family as our dental pathogens are communicable, and finally we must find better tools to help all patients stay healthy.
Gingivitis
Gum disease does not cause the same pain as an untreated cavity, but the long-range ramifications of having infections in the gums reaches and hurts every corner of the body. The bacteria don’t know they are only allowed to live in the mouth, Instead, they “translocate” with every toothbrush stroke, chew, and swallow. Every breath you take also allows oral pathogens to infect the lungs. Aspiration pneumonia has its roots in the oral cavity. Dentures, bite guards and retainers all harbor the same bugs which can get inhaled into the lungs causing translocation and the same inflammation as that of the mouth.
Test, Teach, Treat, Repeat
As a biological dental hygienist, my mantra is test, teach, treat, repeat. To test my patients, I use salivary diagnostics as well as phase contrast microscopy to look more deeply at each patient’s oral microbiome. More often than not, I see spirochetes on the microscope screen. Spirochetes have the ability to move forward, backward and drill into nerves and cells. They are not a healthy good bacteria.

Oral spirochetes in adults cause many problems – they translocate to other parts of the body and cause other chronic health issues such as heart attacks, strokes, and arthritis. We know spirochetes from Lyme disease have a profound effect on childrens’ health. Why do we, the dental profession not give oral spirochetes the same emphasis? Oral pathogens have also been found in the brains of dementia patients, and sadly dementia is set to triple by the year 2050.
With the brain a short four inches from the oral cavity, inflammation so close to the brain should not be ignored. Just recently in the news, we saw a former NFL football player die at age 36 due to bacterial sepsis from poor oral health. We cannot treat what we cannot see, so we must improve our treatment protocols. Children should never have spirochetes but I see it all the time on my microscope. These pathogens go into spore form and hide in the body for years. We know that Lyme spirochetes change shape and become “persisters”. Our dental spirochetes do the same. And, we have more research coming out linking dental diseases to dementia. The importance of testing has never been so critical.
Prevention and Screening
It is up to the dental professions, both dentists and dental hygienists, to be on the lookout and screen every patient, young and old, for these pathogens before they cause permanent destruction to both the oral cavity as well as the entire body.

We are the medical experts of everything above the neck. And, just as the medical doctor does lab work on every patient, young and old, we too need to become comfortable recommending testing for all our patients. Enter the visit with a factual set-point. We have gotten too complacent – saying “brush better and see you in six months” – because insurance covers that apointment. We are not doing our patients a service by “saving them money” in the short term. By not testing everyone, we are missing disease. This sets them up for chronic diseases or even early death in the long run, which we all know is more costly. Dental Hygienists are prevention experts. This should be our number one tool.
Not every office has a phase contrast microscope, but every office can perform salivary diagnostics. Test every patient. The bacteria, viruses, fungi, and parasites are there long before you see signs of tissue inflammation and destruction.
Gum Disease
Children get gum disease too. They do not have the dexterity, skill, and knowledge to brush and floss correctly, and they deserve the same attention to oral hygiene instructions as parents and caregivers. Note the floss cuts in the photo below. This youngster is indeed flossing and doing his best but you can still see swollen, inflamed gums. We should be recommending tools children can use safely. Electric brushes for children, better tasting (less spicy/minty) nanohydroxyapatite toothpastes that are safe to swallow, and electric flossing aids and waterflossers as well as recommending gum therapy and biofilm testing on them.

Gingivitis pathogens are just as damaging to the body as periodontal pathogens and as we know, every six-millimeter pocket starts out as a one- or two-millimeter pocket. Gingivitis is the gatekeeper to periodontitis. By having this infection in the gums, it activates the genes connected to periodontitis. Gingivitis is not benign – it sets the stage for further tissue breakdown and elevates the patient’s risk for vascular disease.
Children with bleeding, swollen, puffy, and infected gums deserve the same attention and therapy as adults with the same signs and symptoms. Assigning children to a dental assistant to polish teeth and allotting only 30 minutes for this “prophy” is a disservice to our youngest clientele. Children need a full 60-minute appointment to do a proper biofilm and tartar removal, disclose and teach them how to brush, and clean in-between teeth to remove the plaque properly, and then, educate the entire family on the importance of nasal breathing, nutrition, and oral hygiene on a daily basis. These pathogens repopulate within 24 hours. By not addressing the dysbiotic biofilm we are perpetuating this infection.

Test, teach, treat, and repeat until the child’s mouth is healthy and free of disease. Test for dysbiotic biofilm. Teach oral hygiene, nasal breathing, and proper tongue rest posture. Treat by utilizing guided biofilm therapy, ozone therapy, oral probiotics, and nutrition therapy. More on this in future blog posts. 😉
Then, retest to ensure our therapies are successful.
Healthy Smiles for Life

Let’s conquer dental diseases from the very beginning and our littlest patients will have oral and systemic health for a lifetime. We can give them the tools and knowledge to have a healthy happy and confident smile. Every adult patient I have that values their teeth learned it from their parents.
Every month should be Children’s Dental Health Month.
Keep Smiling!
Barbara Tritz
Biological Dental Health Educator and Happy Smile Maker

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Loving science, especially biology, from an early age, Barbara is a registered dental hygienist, certified biological hygienist, and orofacial myofunctional therapist. In 2019, she received the Hu-Friedy/ADHA Master Clinician Award from the American Dental Hygienist Association.

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