Children Get Gum Disease Too

Barbara Tritz
· February 20, 2024 ·

5 minutes

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.


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

Hello, I'm Barbara Tritz

Unveiling the Stories Behind Dental Hygiene

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.

Share your thoughts below!


  1. Cindy Iglinski


    Thank you for your posts, I really love your insights and thorough research and always save your emails to read. I love to see them on my email list.

    I have a few questions: Which saliva DNA testing do you use and recommend? When you treat children and use guided biofilm removal do you use air polishers for biofilm removal? Any tips for helping kids cope with the air and water spray? Do you put them on oral probiotics? I am also a biological hygienist and know that in a biological practice parents may be more open to gingivitis treatment, but I am currently working in a traditional practice. Any tips on verbiage to educate parents who are so used to having all cleanings covered by insurance? In Idaho the D4346 is not covered very well by insurance or it is downgraded to a D1120, which the dentist doesn’t appreciate because you spent an hour on a kid and it was covered as a child prophy. Any insights to get insurance cooperation?

    Thanks again, I look forward to your thoughts.

    • Barbara Tritz

      Hello Cindy!
      Thank you for your kind words. It makes me happy to hear you enjoy my articles.

      #1. What salivary diagnostics do I use? It depends. There are so many great ones. Each is a little different. For decay patients- What I need to know is what is their decay bacterial load- do they have candida? (I cannot see decay bacteria on the slide so that’s why I do salivary diagnostics for decay patients>)I use a carimeter chair side for a quick analysis and when I need more then do salivary testing. For perio and gingivitis patients – slide first and then salivary diagnostics especially if there is still bleeding after therapy.
      If there is severe bone loss I look to Oral DNA- and esp their genetic testing. I want to rule out genetics- and if their severe bone loss is connected to that then we should also test the rest of the family’s genetics too. That is a game changer. Perio is kick-started with viruses so really it is a viral-based disease so testing for viruses is another important test. CMV, EBV, HSV, and HPV all could kickstart perio. And Viruses are part of Dementia – so if I see that on the report, I refer them right back to their primary care doctor.
      I like a new test – Simply Perio- it has a little of everything on the test and it is all on one page- makes life so much better than page after page and things get lost then. If your doctor’s not on board to test in the office, I refer the patient to Bristle Health. The patient can order the test independently of the office so they can do it from home, The patient can share the info with you if they want.
      #2. I use GBT and air polisher on all patients. I turn down the polish to its lowest and do it fast. It doesn’t always work but I try. depends on the age. I use optragate isolation and a tri-color disclosing solution. I have a shorty high vac suction tip and put it right next to the tooth. Let me reach out to Melissa at GBT and see if she has any tips on treating littles.
      #3. Yes to Oral probiotics. I Like BioGaia, and Dentalcidin Probiotics ( reseed te good guys, especially after any therapies.
      #4 – how do we make it profitable- if kids have tooth decay or gingivitis, then someone else is sharing their germs with them, It is time to treat the entire family. I had the same problem getting patients to see beyond their “free” cleanings and own their disease. It starts at the top- the doctor has to be on board, as well as the entire staff. That’s why we no longer accept insurance. What I would say is to bring your doctor to the next IAOMT meeting and start educating them to really and truly heal patients. Unless you address the root causes we are nothing more than pothole fillers and tooth scrapers. And you and I know the best predictor of future decay is current decay. It never stops until you find the root cause and fix that. It is time to have a heart-to-heart with your boss. What is their vision statement and office mission? What kind of care do they want to do- repair or heal? We have created the insurance mentality- now we must gently release our profession from it and do what it takes to educate, test and treat gum disease and decay the proper way. It takes time and education. We have the knowledge to stop decay and heal gums. It is not a simple fix but we can do it.

      I wish I had a magic verbage to get the insurance companies to see things though my eyes. They are in it to make money and the reimbursements are less and less. I wish we could just do away with dental insurance or connect it to medical insurance and really reattach the mouth back to the body. We could reduce heart attacks, strokes, and even dementia this way.
      I love hearing form you so please reach out again! and COME to IAOMT in MArch. It’s in Las Vegas…

  2. Rishi raj

    It’s great to see your proactive approach to using salivary diagnostics in your dental practice! By incorporating carimeter chair-side analysis for decay patients and slide analysis followed by salivary testing for perio and gingivitis patients, you’re ensuring a thorough assessment of your patients’ oral health. This personalized approach allows you to tailor your treatment plans based on individual needs, ultimately leading to better outcomes for your patients.


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