At the very first well-baby visit, a divide begins.
Medical over here. Dental over there.
But the mouth isn’t separate from the body.
And that early separation is why so many kids fall through the cracks.
Let’s talk about four places this split is doing harm to children—and what we can do instead.
1) Stop recommending gummy vitamins
Most gummies contain up to 5 grams of added sugar.
That’s the same as an Oreo.
But worse than the sugar is the stickiness. These things cling to enamel. They linger.
They feed the wrong bacteria. And they’re showing up in the chair as molar after molar riddled with cavities.
You wouldn’t tell a parent to hand out a fruit roll-up every day. But that’s what a gummy vitamin is—just repackaged.
My grandkids take a monk fruit–sweetened vitamin (link to the one they take).
I like monk fruit because it tastes natural, unlike many other sugar substitutes. It does not raise blood sugar. It comes from a plant. It’s better than stevia. It could prevent microbial adhesion and growth. There’s evidence it inhibits Streptococcus mutans—the main bacteria involved in cavities.
It doesn’t spike insulin. It doesn’t feed sugar-loving bugs. It does the job without wrecking the oral microbiome.
Further reading on monkfruit:
If your child takes a daily multivitamin, make sure it meets the following criteria. (Link to the one my grandkids take and like)
- Zero sugar
- Isn’t sticky
- Free of synthetic dyes and flavors
- Sweetens using monkfruit or xylitol
- Third-party testing to ensure safety and quality
2) Screen for mouth breathing.
Mouth breathing dries out the oral cavity and could be the #1 factor in tooth decay. That alone increases cavity risk. But it also changes facial growth patterns, narrows the upper jaw, and disrupts sleep quality.
It’s one of the most common causes of poor sleep in kids—and often gets misdiagnosed as ADHD.
If you’re seeing behavioral concerns, frequent upper respiratory infections, or dark circles under the eyes… consider mouth breathing as the missing piece.
The earlier you catch it, the easier it is to fix.
Referrals matter here: ENT, airway-focused pediatric dentist, myofunctional therapist. Use my Functional Dentist Directory to find someone trained in oral-systemic health and airway-first care.
3) Ask about snoring. Every time.
Snoring in children is never normal. Pediatricians say “they’ll grow out of it.”
Keep pushing, keep advocating.
It’s not “just how they sleep.”
It’s a red flag for sleep-disordered breathing.
Ask the parent:
“Does your child snore, even occasionally?”
“Do they sweat a lot at night?”
“Do they toss and turn, or wake up cranky?”
A “yes” to any of these is worth a deeper look.
We now have research connecting pediatric sleep-disordered breathing to everything from bedwetting to delayed growth to learning difficulties.
A simple question at a check-up could change that child’s life.
4) Stop prescribing Tri-Vi-Fluor.
I still see this even in fluoridated areas!
The intention is good: combine fluoride with vitamins A, C, and D in one tablet.
But here’s the problem: it doesn’t make sense biochemically or medically. Fluoride and fat-soluble vitamins don’t even work the same way in the body.
Fluoride is absorbed best on an empty stomach—but vitamins A and D require food and fat to be properly absorbed. So when, exactly, is a parent supposed to give this?
It’s a corporate convenience sold to doctors as a time-saving “solution.”
Let me be clear: I’m not pro-fluoride. I don’t recommend it—not in toothpaste, not in tablets, and not in drinking water.
We have better, safer, more effective ways to prevent cavities that don’t involve neurotoxic tradeoffs.
Even if the child does manage to absorb it all, we’re still making a tradeoff:
We’re prioritizing fluoride over real dietary prevention—like fat-soluble vitamins, magnesium, vitamin K2, and a diverse oral microbiome.
We didn’t use fluoride with our three daughters and none of them got any cavities. It’s not magic—it’s minerals, nutrition, and habits.
And increasingly, there’s reason to be cautious. We don’t fully understand fluoride’s effects on the developing brain.
If you’re a pediatrician reading this:
You’re doing incredibly hard work. I know how many things you’re expected to cover in a short visit.
But these four changes could drastically shift the trajectory of a child’s health.
If you’ve read this far, thank you. Really.
If you’re someone who has read this far because it struck a chord—maybe your child mouth breathes, snores, has constant cavities, or just doesn’t seem rested—I want you to know that you’re not imagining it and you’re not overreacting. This is the stuff that gets missed in 7-minute well-child appointments—but matters for a lifetime.
👉 Some resources to find a provider who looks at the whole child, not just the teeth:
We’re all on the same team.
— Mark
P.S. One small thing I’d love to see: a shift in how we talk about sugar. Not just “it causes cavities.” But “it feeds the wrong bacteria, alters the oral microbiome, and shifts the pH.” That’s the real problem. And that’s the part we need to change.