Dr. Saadia’s Wholistic Approach to Relieving Dental Anxiety in Children

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Kevin Kowalke:   Good day, everyone, and welcome to the latest edition of Spread Love, Banish Fear, the show brought to you by Dr. Saadia Mohammed. My name is Kevin Kowalke, and I have the privilege to be the host of this educational-filled, inspiring show where I get to tap into the brilliance and wisdom of Dr. Saadia Mohammed as we discuss what is the best way to create the foundation for your family to have happy and healthy children. Dr. Saadia has been in private practice since 1998, is a board certified pediatric dentist with her practice, Palm Beach Pediatric Dentistry, with a fellowship at Yale New Haven Hospital, while holding many certifications and memberships with countless associations and organizations. All in all, Dr. Saadia is a renowned expert when it comes to nurturing a happy and healthy child. Dr. Saadia, welcome to the show.

Dr. Saadia:   Thank you so much, Kevin. It's always such a pleasure when you introduce me and we do these talks. I am so excited.

Kevin Kowalke:   Good. I'm glad you're excited, and I'm excited too. When I saw the topic of today, I was like, this is something that I want to even know more about! What I'd like to start out discussing is the difference between a couple of technical words in the dental industry that I believe as a common consumer patient doesn't fully understand, and I know you're going to help to really get everybody more educated so they feel empowered and more knowledgeable when going in to take care of any kind of things when it comes to dentistry. Let's start off by discussing the difference between two things here, caries and cavities. If you want to take it away and give us a little bit of an oversight, that would be great.

Dr. Saadia:   Thank you for that, Kevin. Caries and cavities. A lot of times, dental professionals and dentists are guilty of interchanging those two terms. I was thinking about that. I'm like, we need to really clarify the conversation around caries and cavities. I'm going to put it in a very, very simple way: caries is the actual disease process which is caused by imbalance in the environment, and the end result is a cavity, which is a hole. There's a whole disease process that goes on, and the end result is a hole. I'm going to make an analogy like heart disease. Sometimes people have heart disease, but they don't have a heart attack. There's different levels of where you are in the disease process, and the whole idea is, if people really understand the difference between heart disease and heart attack, it's very similar to caries, which is a disease process and happens to be the number one most chronic childhood disease. It can occur at any age, but it is a chronic childhood disease, more common than asthma. A cavity, which is the end result, which is a hole in the tooth.

Kevin Kowalke:   It's interesting to hear you describe that from the standpoint of how big of a ... let's call it a problem, that this can be in a child's life. I would love, if you would, let's focus on caries for a minute here. Can you take a moment to define what that actual disease process is? I believe that everybody listening will be able to connect better and be more aware of what this actually is.

Dr. Saadia:   It would be awesome if I can paint a picture. Do you remember those Venn diagrams that we used to have when we were children, three of them? Kevin Kowalke: Oh, sure.

Dr. Saadia: Like the little circles that would overlap each other? Think of caries, which is the disease process, as having those three circles. In the middle, where all three things overlap, that is when the disease process starts. In today's world, I'm going to paint it as a picture of you're living in balance; anything that gets out of balance will start chronic disease. What's very fascinating these days is all the research that's coming out there in medicine and in dentistry, and they're going back to the very, very simple thing. They're realizing the body is an ecosystem which lives in a very small ratio of balance. The body is like ... I call it a supercomputer. The body has the ability to keep itself in balance in very narrow parameters. Our blood pH is very narrowly ... our body temperature, all of these things. Getting back to that diagram, the Venn diagram with three circles that comes to my mind is you've got a tooth, you've got a sugar, and you've got the bacteria. When all three of those things are present in the right conditions, or the wrong conditions I should say, you get the start of a disease process. The end result of that disease process is the hole in the tooth. Well, most of us these days have a tooth, most of us these days have the bacteria, most of these days are giving it the sugar. Why is it that some people get the cavity or have the caries and others don't? That's where the balance comes in. What are people doing to allow their body to naturally balance itself out? Our bodies are like an amazing human computer. It's amazing what we put it through just from even the tooth standpoint, the foods that we eat, the things that we do with our teeth, and most of us are not necessarily exposed to getting a cavity. Again, getting back to it, the caries process is the actual disease process, which if you break down the word dis-ease, you're causing some kind of a problem to interrupt that balance. As that balance does not get restored, it will end in a cavity. Kevin Kowalke: That makes so much more sense, and I believe most people probably have never heard that before. We focus so much on cavity, but yet we don't understand how do we ever get to the point of cavity. I appreciate you taking the time to explain that part of the process. Now I would like to, if you would, can you speak on some of the individual risk factors that when you're doing an assessment and those kind of things, that could play into whether this could be something that could be a problem for someone's child?

Dr. Saadia:   Yes. I would really want to get into those risk factors, because I think that is really where the empowerment can come in. If, as dentists, we can start talking to people and really informing them about the disease factors, the risk factors of the disease, because sometimes they are as simple as you got braces on. When you have braces on, more food kind of hangs around those teeth. That's an increased risk factor for getting cavities. Now the body naturally cannot just wash the food away. You've got wires and you've got braces, and food sitting around there. Boom, your risk factor goes up. You live a very active, stressed life. Boom, your risk factor went up. You could think, like, "What is she talking about?" Well, if you live a very stressed, active life, what happens to your mouth? The mouth tends to get very dry when you are very stressed. Anytime we're stressed, our mouth gets dry. If we are not hydrating ourselves properly, boom, the bacteria, the food that's sitting around, our risk factors go up. There's a number of very, very simple risk factors, and I'm going to go as far as to say, not a whole lot of them are very different when you start looking at heart disease, to cavities. I need to clarify this, because there sometimes people will misunderstand or mistake what I'm saying. "What? Caries and heart disease?" If you think about it, what are the risk factors for heart disease? Usually it's poor diet, poor hygiene - and when I say hygiene, I mean mental hygiene, and/or not letting things go. All of those will affect the mouth. All of those will increase the risk factor for cavities, and there's a whole host of-

Kevin Kowalke:   It's really interesting to hear you-

Dr. Saadia:   I'm sorry. I said there's a whole host of them.

Kevin Kowalke:   I'm sorry to interrupt, Doctor. Go ahead with ... you were talking about the whole host of them.

Dr. Saadia:   A whole host of risk factors. No, no, I didn't mean to interrupt.

Kevin Kowalke:   You know how excited I get to put in my two cents, too.

Dr. Saadia:   Yes, this is one that we're both so excited, we won't let each other talk now. It's a good one.

 Kevin Kowalke:   I know! You know what's so interesting, is I heard you describe that ... Again, Dr. Saadia, you know, and this is why you and I get along so well, that I believe that the mouth is connected to the rest of the body and does have an impact on some of the other problems that we can experience physically. To hear you again talk about the importance of all of these things, including hydration and all that kind of stuff, I get very passionate and excited about it because I believe that if we paid more attention to this, especially with our children very early on, and we can educate them more so than we've ever been educated as adults, we can really start to shift the problems that we have faced. I truly believe in that, I know you do too, and that's why I get super excited about this. I appreciate you letting me jump in and share that with everyone listening. If you wouldn't mind, I would love to now, if we could focus a little bit on cavities. We've talked about caries, we've defined what that disease process looks like, some of the things that could be risk-assessing, so we can be aware of it. If you wouldn't mind, let's spend a little time on the actual cavities themselves, and explain more of that to our listening audience.

Dr. Saadia: Absolutely. I hope I have made one thing very simple and clear, the caries being the disease process can be interfered with at different times or stages of the disease. You can change the outcome from a caries disease process to not allow it to turn into a cavity, which is a hole, or before it becomes an actual hole that you can see, it's what we call irreversible, meaning it is beyond the stage where the body can actually heal itself. That's when dentists will say, "Okay, this is a cavity that needs to be fixed." Even though a lot of times it is not an actual hole in the tooth, but because of our training, our education and our assessment of the patient, we have come to the conclusion that this disease is at a process where it cannot be reversed. To preventively help the body heal itself, we need to go in and technically clean that disease process and fill the hole. If we don't do that, it will just continue spreading. Again, very similar to we've got heart disease. If you're going and getting prevention checkups, they can say, "You know what? This artery is partially blocked. Let's go in and open this up." Not because you've already had a heart attack, but because the body needs a little extra help. No different in the caries process. Very simply put, caries starts out in very different stages. I'm going to paint a picture of, well, enamel is the hardest substance in the body. That's the outer layer of the tooth. The first stage of caries is when the minerals start to leech out of the enamel. This is the first stage of caries or cavities. Again, interchangeable in average, everyday life words, but there is a difference. When there is an imbalance and there's demineralization happening, it can be reversed. When the caries process spreads past enamel into dentin, a lot of times it will not be reversed, but it can be arrested, meaning the disease process can be stopped. There are different things that a dentist can do and prescribe, and it can be stopped without having to actually drill or laser and fill. If it gets beyond a certain point, then there is no choice but to actually clean out the decay and fill it. That's where a lot of times the difference comes in, because some people's training, and maybe it could be the patient's risk factors, the dentist will assess, "Well, I'm not going to take a chance. This is a very high risk patient. I'm going to try and take care of this cavity at the earliest stage possible," meaning it could be at a reversible stage, but the patient's risk factors do not support the fact of taking the conservative route. In other ways, it could be, "Okay, this is a patient's risk factors, which I can really, really modify even though the caries is at a more advanced stage." The dentist will decide and will come to this conclusion, saying, "You know what? This is a caries that can be arrested and may never have to be fixed as a hole." I hope I made that a little clearer. I get a little passionate about this. Kevin Kowalke: [crosstalk 00:16:30] I have to tell you, Dr. Saadia, as you know, I think you're brilliant, and the information that you share with people is so valuable. This may be some of the most valuable information you've ever shared, because I'm certain that there's many people who are listing, and similar to me, before I knew you and I really understood all of this, you've painted a picture so clear now as to why someone may go to one dentist and they say one thing about a cavity, and you go to another and they say another thing about a cavity. It can be very confusing for people, and I think that you've made it very clear with regards to what this all means. I get it now, and by no means am I a clinician. For me to understand it, I believe that it's going to be very helpful for others, and you did it in such a way that I believe will empower people to be able to understand conversations that they will have with their dentist moving forward. The final question I have for you, and then if there's anything else you'd like to share, is when somebody does go to a particular dentist, especially if it's a new dentist they've never been to before, are there any kind of tips that you can give for people when a dentist would begin having a conversation about whether it's caries, whether it's about cavities, so that people can be tuned in to that conversation and feel educated, and feel smart, and not feel overwhelmed by what that discussion is like? Is there anything that you can suggest, maybe a question or two that they could ask to make sure they have clarity when trying to make really good decisions for their children, and for themselves, really? Dr. Saadia: The first tip I would say is have an open, honest conversation with the dentist. The dentist is on your side. The dentist is not just out to drill and fill. Have the conversation, like, "Hey, I'm the type of person that I want to own my issues, I want to be empowered. Tell me how I can make my health better." You have to initiate that conversation, because everyone comes from a different place. Everyone's in a different place in their journey. Some people will go and only go for an emergency visit when they're feeling chest pains. Other people go for regular visits and want to prevent problems. Until they have that open conversation with their dentist, saying, "You know what? I want to own my health. I want to own my oral health, which I understand is the gateway to the rest of my health. I understand, you as the dentist are the professional whose eyes are trained, whose ears have heard a lot of things, who has the knowledge to process all that you are seeing, but after you process it for me, give me the tools and tricks, because I want to be empowered. Explain to me what's going on. Show me what's going on. Tell me how I can heal myself." When people start having these kind of conversations with their dentist, things will shift.

Kevin Kowalke:   I love that, because it's so simple and it's such a smart way to approach your own personal care, your family's care, all of the above. Thank you for sharing that. That alone is such a great tip, to give people the opportunity to go into a dentist's office and feel smart, to feel empowered, educated, all those kind of things, so that they can make the proper decisions when it comes to the health of their children and themselves. Thank you so much for sharing that. It really couldn't be any more simpler. I'd love to just give you a final opportunity here, as we wrap up the call, to share any other thoughts or tips or anything that maybe we haven't covered yet today. Dr. Saadia: I think we covered everything. The key thing was really understanding that caries is the disease process, cavity is the end result, and approaching it like a disease process of any other part of the body, and recognizing that the role of the dentist is really to empower a person in their own health journey, and what point can they heal themselves and what point can the dentist actually help them heal by taking care of something which will potentially, down the road, cause them pain and discomfort? In a nutshell, it's about spreading love through knowledge, banishing fear. Shine the light of love.

Kevin Kowalke:   I love it, and it's a really great way to wrap up our call today. As always, you do such a wonderful job of explaining it in a way and in terms that I believe our listening audience can really understand and appreciate. Of course, we know that that happens because of all the wonderful comments that we get about the information you're sharing. Dr. Saadia, excellent information today. It's always great to come together, because you have so much wisdom and so much insight for others to benefit from, and I can't think you enough.

Dr. Saadia:   Thank you so much, Kevin.

Kevin Kowalke:  Yes, you're welcome. Thanks to all of you who have been listening in to the latest edition of Spread Love, Banish Fear, the show with Dr. Saadia Mohammed. Dr. Saadia would love to hear from you guys. I tell you this on every one of these that we do. If you have thoughts, you have questions, and you want to come see her, which obviously I would encourage you to do, let's reach out. Dr. Saadia is here to help. Her team is here to help. The best way to reach Dr. Saadia and her team is to give them a call at (561) 477-3535. Until our next time together, I hope all of you make it a great day.