The Importance Of Early Oral Health Habits For Children with Dr. Ashley Lerman, pediatric dentist and founder of Firstgrin

[00:00:04] [SPEAKER_01]: Welcome to Think Oral, where we connect the unconnected between oral and physical health.

[00:00:11] [SPEAKER_00]: I'm your host, Dr. Jonathan Levine.

[00:00:13] [SPEAKER_01]: And I'm your host, Maria Filipova.

[00:00:15] [SPEAKER_00]: Let's get at it.

[00:00:22] [SPEAKER_02]: Hello everyone, and welcome to another episode of the Think Oral Health podcast where myself,

[00:00:28] [SPEAKER_02]: Maria Filipova and Dr. Jonathan Levine build bridges across silos in different disciplines

[00:00:34] [SPEAKER_02]: in health.

[00:00:36] [SPEAKER_02]: Jonathan, hi.

[00:00:36] [SPEAKER_02]: I'm super excited about our guest today.

[00:00:39] [SPEAKER_02]: Do you want to tell us who is our conversation partner for this afternoon?

[00:00:43] [SPEAKER_00]: Well absolutely.

[00:00:45] [SPEAKER_00]: Ashley Lerman.

[00:00:46] [SPEAKER_00]: She is a board certified pediatric dentist and so much more.

[00:00:51] [SPEAKER_00]: We're so excited to have you here, Ashley.

[00:00:53] [SPEAKER_00]: I want to give a little bit of a background.

[00:00:56] [SPEAKER_00]: So Ashley went to Columbia University School of Dental Medicine.

[00:01:00] [SPEAKER_00]: They have an amazing program that connects the dots between dentistry and medicine.

[00:01:04] [SPEAKER_00]: We know how dear that is to our hearts.

[00:01:07] [SPEAKER_00]: They have a coordinated effort between the dental school and the medical school

[00:01:11] [SPEAKER_00]: of oral systemic health.

[00:01:13] [SPEAKER_00]: But Ashley has taken the pediatric dentist discipline and said, how do I help these

[00:01:18] [SPEAKER_00]: young mothers?

[00:01:19] [SPEAKER_00]: How do we help these young children, especially as it relates to the connection

[00:01:23] [SPEAKER_00]: of the mouth and the rest of the body?

[00:01:25] [SPEAKER_00]: And she created a company called First Grint.

[00:01:28] [SPEAKER_00]: It's a digital health care company and it's very exciting because it's very unique content.

[00:01:34] [SPEAKER_00]: There's a strong emphasis that Ashley pushes out, which is on early oral health habits

[00:01:40] [SPEAKER_00]: and behaviors.

[00:01:41] [SPEAKER_00]: She stresses the importance of maternal oral care during pregnancy, cavities being

[00:01:46] [SPEAKER_00]: number one chronic disease in children.

[00:01:48] [SPEAKER_00]: The health of baby teeth is really crucial, but Ashley talks about for the health

[00:01:53] [SPEAKER_00]: of adult teeth.

[00:01:53] [SPEAKER_00]: There's so much to talk about with Ashley that I can go on and on with the bio, but

[00:01:58] [SPEAKER_00]: let's jump in, Maria, because I'm just so excited for Ashley to open up this whole

[00:02:03] [SPEAKER_00]: conversation about pediatrics and the oral systemic health connection.

[00:02:08] [SPEAKER_02]: Love it. Well, Ashley, thank you for joining us in the podcast.

[00:02:11] [SPEAKER_02]: And First Grint, what a great name.

[00:02:13] [SPEAKER_00]: Great name.

[00:02:14] [SPEAKER_02]: Really get at it.

[00:02:16] [SPEAKER_02]: Right.

[00:02:17] [SPEAKER_02]: We're learning to start having that conversation.

[00:02:19] [SPEAKER_00]: Maria, Ashley is not only a pediatric dentist and entrepreneur, but she's also

[00:02:22] [SPEAKER_00]: quite an excellent marketer with that name of First Grint.

[00:02:27] [SPEAKER_02]: It gets it.

[00:02:27] [SPEAKER_02]: It gets straight to the point.

[00:02:29] [SPEAKER_02]: I love it.

[00:02:29] [SPEAKER_02]: And all of what we're describing is you need the right story and the right

[00:02:34] [SPEAKER_02]: language to bring science to life.

[00:02:37] [SPEAKER_00]: Yeah, that's right.

[00:02:37] [SPEAKER_02]: Because otherwise, that's why part of the reason why we do the podcast, because

[00:02:41] [SPEAKER_02]: we're trying to bring the stories that bring the science and the research papers

[00:02:46] [SPEAKER_02]: to life.

[00:02:47] [SPEAKER_00]: Yes.

[00:02:47] [SPEAKER_00]: And really create awareness around a lot of these great hot issues.

[00:02:51] [SPEAKER_00]: So if I can lead with the first question, Ashley, tell us exactly what

[00:02:56] [SPEAKER_00]: motivated you and when was that kind of aha moment to create First Grint,

[00:03:02] [SPEAKER_00]: to say here's an area that I think really speaks to a passion of mine

[00:03:06] [SPEAKER_00]: that I want to build awareness around.

[00:03:10] [SPEAKER_03]: Definitely.

[00:03:11] [SPEAKER_03]: So once I finished residency, my first job I was seeing between 60

[00:03:15] [SPEAKER_03]: and 80 patients a day.

[00:03:16] [SPEAKER_03]: That's not uncommon for a pediatric office.

[00:03:19] [SPEAKER_03]: We are having a lot of conversation on prevention, diet, nutrition.

[00:03:23] [SPEAKER_03]: And honestly, at the end of the day, I kept feeling like Sisyphus from Greek

[00:03:27] [SPEAKER_03]: mythology rolling this massive boulder off the top of the hill only for it to

[00:03:31] [SPEAKER_03]: come all the way down and do it again.

[00:03:34] [SPEAKER_03]: And I was like, we have the Internet, we have so much access to care and

[00:03:38] [SPEAKER_03]: creativity. There must be a better way to amplify this message.

[00:03:41] [SPEAKER_03]: I was getting really frustrated with it.

[00:03:42] [SPEAKER_03]: So I decided to quit clinical care at the time and figure out a better

[00:03:47] [SPEAKER_03]: way to do it. So I started First Grint about four years ago, just the idea.

[00:03:53] [SPEAKER_03]: Started brewing with the idea and with the concept of prevention, it's not

[00:03:57] [SPEAKER_03]: necessarily something interesting.

[00:03:58] [SPEAKER_03]: We know with dentistry people often seek care once there's a problem

[00:04:01] [SPEAKER_03]: established, especially with pediatrics.

[00:04:03] [SPEAKER_03]: I hear all day every day, baby teeth don't matter yet.

[00:04:07] [SPEAKER_03]: Cavities are kids number one chronic disease.

[00:04:09] [SPEAKER_03]: So there's a big disconnect there.

[00:04:10] [SPEAKER_03]: So my challenge is trying to make prevention interesting, tangible and

[00:04:15] [SPEAKER_03]: getting this through the door of people.

[00:04:17] [SPEAKER_03]: We know how much access to care is a big issue.

[00:04:20] [SPEAKER_03]: A lot of payers are looking for a solution for that.

[00:04:23] [SPEAKER_03]: So what I think First Grint has done really successfully and we've shown major

[00:04:27] [SPEAKER_03]: growth and traction, we've helped 220,000 families and still growing, is

[00:04:32] [SPEAKER_03]: making this emotional touch point as almost like a baby registry gift to new

[00:04:37] [SPEAKER_03]: and expecting parents by getting that preventive information and tools through

[00:04:40] [SPEAKER_03]: the door to them.

[00:04:42] [SPEAKER_00]: Amazing.

[00:04:44] [SPEAKER_02]: We don't, I heard a myth.

[00:04:46] [SPEAKER_02]: So let's just take a pause.

[00:04:47] [SPEAKER_02]: We've made it a mission on this podcast to disperse myths.

[00:04:51] [SPEAKER_02]: So you mentioned the myth that baby teeth don't matter.

[00:04:55] [SPEAKER_02]: That's a convenient mindset to have, right?

[00:04:59] [SPEAKER_02]: I don't need to worry about it.

[00:05:00] [SPEAKER_02]: I don't need to go to the dentist.

[00:05:01] [SPEAKER_02]: I need to spend time and effort on it.

[00:05:03] [SPEAKER_02]: So help us unpack this.

[00:05:05] [SPEAKER_02]: Why is that a myth?

[00:05:07] [SPEAKER_03]: Like I said, I hear that all day every day.

[00:05:10] [SPEAKER_03]: Cavities are kids' number one chronic disease.

[00:05:12] [SPEAKER_03]: Cavities are a disease.

[00:05:13] [SPEAKER_03]: It's not binary.

[00:05:14] [SPEAKER_03]: So once we get our first permanent teeth, the six-year molars, those are

[00:05:19] [SPEAKER_03]: the most commonly decayed permanent teeth.

[00:05:20] [SPEAKER_03]: That's not a coincidence.

[00:05:21] [SPEAKER_03]: They're in the mouth at the same time with the baby teeth.

[00:05:23] [SPEAKER_03]: So that bad bacteria from the baby teeth that are diseased can spread to

[00:05:27] [SPEAKER_03]: those teeth.

[00:05:28] [SPEAKER_03]: So we need to intervene early if we're going to take oral health

[00:05:31] [SPEAKER_03]: seriously as well in the adult teeth.

[00:05:33] [SPEAKER_03]: And I discuss that to parents all the time.

[00:05:35] [SPEAKER_03]: They're often unaware that those first permanent molars come in at age six.

[00:05:39] [SPEAKER_03]: They don't know they're popping in the back.

[00:05:41] [SPEAKER_03]: So that's a touch point I like to discuss with parents.

[00:05:43] [SPEAKER_03]: Another is between the ages of 13, we have a mix of both baby and adult teeth.

[00:05:48] [SPEAKER_03]: So again, if we have those sick baby teeth in the mouth, we can transmit

[00:05:52] [SPEAKER_03]: that sickness, quote unquote, to those adult teeth and really set the stage

[00:05:55] [SPEAKER_03]: for poor oral health from the start.

[00:05:59] [SPEAKER_00]: And Ashley, comment a little bit about poor oral health habits.

[00:06:03] [SPEAKER_00]: Flip that, get to the kids early developing good oral health habits and

[00:06:08] [SPEAKER_00]: how that impacts the early dentition, the mixed dentition, and then of

[00:06:14] [SPEAKER_00]: course into adulthood.

[00:06:16] [SPEAKER_03]: This is super interesting.

[00:06:17] [SPEAKER_03]: So there have been studies that have showed strep mutans, that number one

[00:06:21] [SPEAKER_03]: bad bacteria that causes cavities has been found in the predentate

[00:06:25] [SPEAKER_03]: neonate in the furrows of the tongue.

[00:06:27] [SPEAKER_03]: So before there are any teeth, we have that bad bacteria.

[00:06:30] [SPEAKER_03]: So we have to come guns blazing with the prevention around six months

[00:06:34] [SPEAKER_03]: is usually when the first teeth come in.

[00:06:36] [SPEAKER_03]: So to start off the bat with preventive behavior, wiping the gums early,

[00:06:41] [SPEAKER_03]: getting the parent used to these routines is really going to set the stage.

[00:06:46] [SPEAKER_03]: One of the biggest issues in blind spots I see as parents are never

[00:06:49] [SPEAKER_03]: told this information.

[00:06:50] [SPEAKER_03]: We have kids coming into the first time to the dentist between ages

[00:06:53] [SPEAKER_03]: three and four with full sets of teeth.

[00:06:55] [SPEAKER_03]: They usually have a full set of teeth by age two, let's say.

[00:06:58] [SPEAKER_03]: And those habits behaviors have compounded over time.

[00:07:01] [SPEAKER_03]: We're talking nutrition, we're talking diet that hasn't been discussed.

[00:07:04] [SPEAKER_03]: So how do we undo behavior

[00:07:07] [SPEAKER_03]: that may not necessarily be optimal for oral health rather than start off

[00:07:10] [SPEAKER_03]: on the right foot? It's much easier to start off on the right foot.

[00:07:13] [SPEAKER_03]: We just have to make that effort.

[00:07:15] [SPEAKER_00]: Amazing. Maria, how do we undo behavior?

[00:07:19] [SPEAKER_00]: Is that a great question for everyone?

[00:07:22] [SPEAKER_02]: I mean, it's actually you know what?

[00:07:24] [SPEAKER_02]: I think it's much easier to learn something positive

[00:07:28] [SPEAKER_02]: to unlearn than unlearn something negative.

[00:07:30] [SPEAKER_00]: That's right. That's right.

[00:07:32] [SPEAKER_02]: We have figured we as humans, we're creatures of habit.

[00:07:37] [SPEAKER_02]: Could be good habits or bad habits.

[00:07:38] [SPEAKER_02]: Jonathan, remember when we were

[00:07:39] [SPEAKER_02]: I was fortunate to be part of your last mission in the island of Eleuthera.

[00:07:46] [SPEAKER_02]: Culturally, babies are given soda

[00:07:48] [SPEAKER_02]: pop like a Fanta in the baby bottle before they go to bed.

[00:07:54] [SPEAKER_02]: And so that's part of the culture, right?

[00:07:57] [SPEAKER_02]: I the mom grew up that way, the dad grew up that way.

[00:07:59] [SPEAKER_02]: That's how they raise their children.

[00:08:01] [SPEAKER_02]: So being able to even get into those cultural habits

[00:08:04] [SPEAKER_02]: and change behaviors at that early, early stage.

[00:08:07] [SPEAKER_02]: It's more than just health care and medicine.

[00:08:10] [SPEAKER_00]: That's right.

[00:08:11] [SPEAKER_00]: And that leads to the question of actually, what is the role of the parents?

[00:08:16] [SPEAKER_00]: Right. Developing these good habits as early as possible versus what

[00:08:20] [SPEAKER_00]: Maria is describing and how we as a foundation,

[00:08:23] [SPEAKER_00]: we work with the parents and the teachers and go into the schools

[00:08:26] [SPEAKER_00]: and develop those good habits.

[00:08:27] [SPEAKER_00]: But what is that? What is the role of the parents?

[00:08:29] [SPEAKER_03]: I think the education information is everything.

[00:08:32] [SPEAKER_03]: And there does need to be a large degree of cultural awareness.

[00:08:36] [SPEAKER_03]: Different cultures are going to have different practices.

[00:08:38] [SPEAKER_03]: The last thing we want to do is to be shaming and lecturing parents

[00:08:42] [SPEAKER_03]: on how to do things, when to do it, because parents are focused on sleep

[00:08:45] [SPEAKER_03]: nutrition. I fully believe parents want the best for their kids.

[00:08:48] [SPEAKER_03]: The problem is oral and dental health isn't part of the conversation.

[00:08:51] [SPEAKER_03]: But if we include tangible practical tips for parents, that's my goal

[00:08:56] [SPEAKER_03]: because they're coming in very confused once problem is established,

[00:09:00] [SPEAKER_03]: when they didn't know how to divert the problem to begin with.

[00:09:04] [SPEAKER_02]: Right. So another myth here.

[00:09:06] [SPEAKER_02]: OK, first time moms, pregnant mothers.

[00:09:09] [SPEAKER_02]: Is some moms believe that

[00:09:12] [SPEAKER_02]: it's not safe to go take care of your cavities if you're pregnant.

[00:09:16] [SPEAKER_02]: Right. So let's talk a little bit about that.

[00:09:18] [SPEAKER_02]: We know Jonathan keeps reminding me daily,

[00:09:21] [SPEAKER_02]: and I know from my time at an insurance company as a health executive

[00:09:26] [SPEAKER_02]: and one of the second largest insurance companies, we saw.

[00:09:30] [SPEAKER_02]: One preterm birth of both mom and baby

[00:09:34] [SPEAKER_02]: costs upwards of half a million dollars in costs in the system.

[00:09:40] [SPEAKER_02]: And then both mom and baby tend to be less healthy

[00:09:44] [SPEAKER_02]: and more costly as members to take care throughout their life.

[00:09:49] [SPEAKER_02]: So preventing even a single preterm birth is good business,

[00:09:53] [SPEAKER_02]: not only good clinical practice.

[00:09:56] [SPEAKER_02]: So let's talk a little bit about that myth of pregnant moms

[00:10:00] [SPEAKER_02]: and the importance of before you become a parent,

[00:10:03] [SPEAKER_02]: the importance of taking care of your oral health.

[00:10:07] [SPEAKER_03]: Absolutely. I think this is such an important topic.

[00:10:09] [SPEAKER_03]: I think there's a lot of unknown and mystery around it,

[00:10:12] [SPEAKER_03]: even among clinicians who don't know how to handle pregnant patients

[00:10:15] [SPEAKER_03]: in the dental world. This needs to change.

[00:10:18] [SPEAKER_03]: Last year in ACOG's output to New England Journal of Medicine

[00:10:24] [SPEAKER_03]: through their catalyst, they proposed a cocoon pregnancy care model.

[00:10:27] [SPEAKER_03]: What that means is working interprofessionally with different professionals,

[00:10:31] [SPEAKER_03]: such as behavior health clinician, social worker,

[00:10:34] [SPEAKER_03]: case manager, physician, nurse midwife.

[00:10:39] [SPEAKER_03]: But dentists wasn't included.

[00:10:40] [SPEAKER_03]: I think dentists need to be included in that at least one time

[00:10:44] [SPEAKER_03]: during your pregnancy, you will be overlapping with your biannual

[00:10:47] [SPEAKER_03]: checkup and cleaning. It's not only recommended,

[00:10:50] [SPEAKER_03]: but tons of research has shown correlation with poor oral health

[00:10:54] [SPEAKER_03]: and preeclampsia, preterm labor.

[00:10:57] [SPEAKER_03]: It's part of the overall body.

[00:10:59] [SPEAKER_03]: It needs to be treated systemically as well and shown that it's safe.

[00:11:02] [SPEAKER_03]: Part of that is showing dentists as well how to manage these types

[00:11:05] [SPEAKER_03]: of patients. Otherwise they get stuck in a limbo

[00:11:07] [SPEAKER_03]: and we're not treating our most vulnerable populations.

[00:11:12] [SPEAKER_00]: So Ashley, go right there.

[00:11:15] [SPEAKER_00]: You are raising the flag.

[00:11:17] [SPEAKER_00]: You started first Grin.

[00:11:19] [SPEAKER_00]: There's this huge disconnect between medicine and dentistry.

[00:11:22] [SPEAKER_00]: And this, in fact, is very near and dear to our hearts, Maria. Right.

[00:11:27] [SPEAKER_00]: Wave this flag and build awareness.

[00:11:29] [SPEAKER_00]: Tell us about what first Grin is doing and tell us what you're doing

[00:11:33] [SPEAKER_00]: personally to create the awareness that the mouth is connected

[00:11:37] [SPEAKER_00]: to the rest of the body, that there are so many things

[00:11:39] [SPEAKER_00]: we could do preventatively if the parents are educated,

[00:11:43] [SPEAKER_00]: which then translates to a healthier child.

[00:11:46] [SPEAKER_00]: Tell us more about that.

[00:11:48] [SPEAKER_03]: Definitely. So for me, as a pediatric dentist, it seems obvious to start

[00:11:52] [SPEAKER_03]: either when the first teeth are coming in or even before.

[00:11:55] [SPEAKER_03]: People look at me like I'm crazy when you're like,

[00:11:57] [SPEAKER_03]: brush your baby's gums.

[00:11:58] [SPEAKER_03]: It'll make a better oral health foundation down the line.

[00:12:01] [SPEAKER_03]: And then I was thinking about this further.

[00:12:02] [SPEAKER_03]: Let's take it a step back.

[00:12:03] [SPEAKER_03]: Let's target the maternal oral health because we could kill two birds

[00:12:06] [SPEAKER_03]: with one stone.

[00:12:08] [SPEAKER_03]: So when I was making this plan, I basically cold called a bunch of payers

[00:12:12] [SPEAKER_03]: and I was like, do you have plans for maternal oral health initiatives

[00:12:15] [SPEAKER_03]: alongside childhood oral health initiatives?

[00:12:17] [SPEAKER_03]: What first Grin does is we send out intro oral care kits

[00:12:20] [SPEAKER_03]: alongside a digital app that's all evidence based,

[00:12:23] [SPEAKER_03]: parsed down to a health literate.

[00:12:25] [SPEAKER_03]: There's a digital trauma guide for toddlers, traumas,

[00:12:28] [SPEAKER_03]: sports age traumas and adult traumas, as well as how to find a dentist,

[00:12:32] [SPEAKER_03]: information on fluoride, things that are really hot topics,

[00:12:34] [SPEAKER_03]: especially in the pediatric community, maternal health community

[00:12:37] [SPEAKER_03]: and just dentistry overall.

[00:12:39] [SPEAKER_03]: We call it the oral care companion because we don't expect people

[00:12:42] [SPEAKER_03]: to be scrolling on it all day every day.

[00:12:44] [SPEAKER_03]: It's if you think of something you don't want to sift through Google's ads,

[00:12:47] [SPEAKER_03]: you could go to this and know that it's going to be evidence

[00:12:49] [SPEAKER_03]: based, easy to understand and for you to have peace of mind.

[00:12:52] [SPEAKER_03]: And for me to take it past that preventive education,

[00:12:55] [SPEAKER_03]: which I think can be a hard sell to people, people aren't going online

[00:12:59] [SPEAKER_03]: and searching preventive dentistry.

[00:13:01] [SPEAKER_03]: We send that intro oral care kit to people as well with the tools

[00:13:04] [SPEAKER_03]: of how to take care of your baby's teeth.

[00:13:06] [SPEAKER_03]: It's a nice registry gift that people have absolutely loved

[00:13:09] [SPEAKER_03]: because it's so niche and unique and it teaches them and it's practical.

[00:13:13] [SPEAKER_03]: And the reception has been amazing.

[00:13:16] [SPEAKER_02]: So is the kit available today?

[00:13:18] [SPEAKER_02]: And we could probably put a link in our notes of the podcast

[00:13:20] [SPEAKER_02]: so people could could order and take a look because that's the

[00:13:24] [SPEAKER_02]: that's definitely a much more helpful and useful lasting gift

[00:13:29] [SPEAKER_02]: than a kitchen appliance.

[00:13:31] [SPEAKER_02]: Yeah, absolutely. So our website.

[00:13:34] [SPEAKER_02]: This is going to be a baby registry gift.

[00:13:37] [SPEAKER_02]: I guess just getting to it.

[00:13:41] [SPEAKER_00]: Ashley, it's such a great idea about a baby registry gift

[00:13:44] [SPEAKER_00]: and build the awareness of the wedding teams to think about that.

[00:13:49] [SPEAKER_00]: It's right. Yeah, it's a good hint.

[00:13:51] [SPEAKER_00]: And the parents are hitting it because they want grandparents like myself.

[00:13:54] [SPEAKER_00]: But it's a great hint for everyone.

[00:13:57] [SPEAKER_03]: We've had so many grandparents reach out to the company being like,

[00:13:59] [SPEAKER_03]: I'm sending this to my kids and your positive feedback.

[00:14:04] [SPEAKER_00]: I love it. Exactly.

[00:14:06] [SPEAKER_02]: What has been the response?

[00:14:08] [SPEAKER_02]: Speaking of positive feedback,

[00:14:09] [SPEAKER_02]: I'm hoping that's still going to carry over.

[00:14:12] [SPEAKER_02]: Ashley, what's been the response from employers and payers?

[00:14:15] [SPEAKER_02]: Have you you mentioned you've reached out to them?

[00:14:19] [SPEAKER_02]: What's the feedback so far?

[00:14:20] [SPEAKER_03]: It's been so exciting. It's been great.

[00:14:23] [SPEAKER_03]: Some payers are looking at as an add on benefit for family planning.

[00:14:27] [SPEAKER_03]: If people wanted to add it on as an extra benefit,

[00:14:30] [SPEAKER_03]: they can add it on and get access to the app.

[00:14:32] [SPEAKER_03]: But a lot of pairs are really interested in the utilization of data

[00:14:35] [SPEAKER_03]: that we get from the app as well.

[00:14:36] [SPEAKER_03]: What people are looking at, what habits they're logging,

[00:14:39] [SPEAKER_03]: we added a gamification.

[00:14:41] [SPEAKER_03]: So if you're logging, brushing and flossing perfectly,

[00:14:43] [SPEAKER_03]: you'll get a gift card to a certain store, those kinds of things

[00:14:46] [SPEAKER_03]: to really make it a sticky user experience,

[00:14:49] [SPEAKER_03]: because it's really easy to have that app fatigue.

[00:14:51] [SPEAKER_03]: We hear that all the time.

[00:14:53] [SPEAKER_03]: But I think to see payers

[00:14:58] [SPEAKER_03]: not be so risk averse is exciting

[00:15:00] [SPEAKER_03]: because that could be a challenging thing to do.

[00:15:02] [SPEAKER_02]: And are they currently covering it as part of the benefit?

[00:15:05] [SPEAKER_02]: Or is that something that they only may or considering currently?

[00:15:10] [SPEAKER_02]: Or the employee needs to pay out of pocket to have access to it?

[00:15:14] [SPEAKER_03]: So there are a bunch of different models,

[00:15:15] [SPEAKER_03]: depending on if it's strictly dental insurance, medical and dental insurance.

[00:15:19] [SPEAKER_03]: So there are EMPM models where it just rolled into like negligible price

[00:15:23] [SPEAKER_03]: because of scale versus an add on benefit.

[00:15:26] [SPEAKER_03]: Or you get a percentage off if you're a member of that company.

[00:15:29] [SPEAKER_03]: So it really ranges depending on the payer.

[00:15:32] [SPEAKER_03]: And what's really exciting and again for me is I want this

[00:15:34] [SPEAKER_03]: to be accessible to everyone.

[00:15:36] [SPEAKER_03]: So reaching out to public health as well, talking about Medicaid payers.

[00:15:40] [SPEAKER_03]: So come 2025 and the child and adult oral health quality measurement sets,

[00:15:45] [SPEAKER_03]: there's going to be an oral evaluation during pregnancy.

[00:15:49] [SPEAKER_03]: So basically, yes, which is huge.

[00:15:51] [SPEAKER_03]: It's going to be recording who received a comprehensive

[00:15:53] [SPEAKER_03]: or periodic oral evaluation from a dental provider during pregnancy.

[00:15:57] [SPEAKER_03]: So I think it'll push us in the direction to show that it's safe

[00:16:00] [SPEAKER_03]: and recommended and I don't want to say required,

[00:16:03] [SPEAKER_03]: but recommended during a pregnancy to get that oral health evaluation.

[00:16:07] [SPEAKER_02]: Actually, in this patient journey, right, a pregnant mom on Medicaid,

[00:16:12] [SPEAKER_02]: whose responsibility is to tell her that she needs to go see a dentist?

[00:16:17] [SPEAKER_02]: Is this the OBGYN?

[00:16:20] [SPEAKER_02]: Is this the primary care provider she has?

[00:16:23] [SPEAKER_02]: Who? Because I maybe it's a wild guess.

[00:16:26] [SPEAKER_02]: But my sense is that none of those moms to be

[00:16:29] [SPEAKER_02]: are even aware to think about going to the dentist.

[00:16:32] [SPEAKER_02]: It's not something that's top of their mind.

[00:16:35] [SPEAKER_02]: They probably want to meet see a OBGYN and maybe a primary care doctor.

[00:16:40] [SPEAKER_03]: Definitely. And I don't think it's even specific to just the Medicaid population.

[00:16:43] [SPEAKER_03]: I think we could expand it across all demographics where

[00:16:46] [SPEAKER_03]: the recommendation to go to a dentist is lost,

[00:16:50] [SPEAKER_03]: and whether it's translation or just not thought about

[00:16:53] [SPEAKER_03]: because there are so many other things to consider.

[00:16:55] [SPEAKER_03]: And I'm very aware of that.

[00:16:57] [SPEAKER_03]: Obviously, OB's primaries have a million other metrics to follow,

[00:17:01] [SPEAKER_03]: especially if a patient has a lot of other systemic health issues going on.

[00:17:04] [SPEAKER_03]: They may just assume that the patient is going to the dentist on their own.

[00:17:08] [SPEAKER_03]: And then there adds the complexity of finding a dentist, that access to care component.

[00:17:12] [SPEAKER_03]: So what we want to do is really divert the issue of getting a patient

[00:17:15] [SPEAKER_03]: into the chair for the dentist by getting the information

[00:17:18] [SPEAKER_03]: and education through the door to them.

[00:17:20] [SPEAKER_02]: I know I struggle with that because we talk about access

[00:17:24] [SPEAKER_02]: and I really love the opportunity to raise awareness.

[00:17:28] [SPEAKER_02]: But at some point you have to intervene.

[00:17:31] [SPEAKER_02]: And so and Jonathan jump in here, because I know you have

[00:17:35] [SPEAKER_02]: you're building the practice of the future, if you will.

[00:17:38] [SPEAKER_02]: But we have to if the if if the patient is engaged enough

[00:17:42] [SPEAKER_02]: to go to see their dentist regularly and hopefully that's a oral health

[00:17:47] [SPEAKER_02]: physician like Jonathan, they would probably have some awareness.

[00:17:51] [SPEAKER_02]: If I am among struggling to make ends meet

[00:17:56] [SPEAKER_02]: and trying to go to my hourly to my job to get a paycheck

[00:18:01] [SPEAKER_02]: and trying to also get to the dentist, that's probably still going to fall

[00:18:04] [SPEAKER_02]: through the tracks for me as a patient.

[00:18:10] [SPEAKER_02]: So is there things that and I don't know what's in that pamphlet,

[00:18:13] [SPEAKER_02]: actually, but are there things that the patient could change behavior

[00:18:16] [SPEAKER_02]: at home that could reduce the risk or increase the chances

[00:18:22] [SPEAKER_02]: of them having a healthy pregnancy?

[00:18:24] [SPEAKER_02]: Or is the call to action truly find a dentist, go get checked out?

[00:18:29] [SPEAKER_02]: What's the you know what I mean?

[00:18:31] [SPEAKER_02]: It seems to me the hardest thing is to get them in the dental office.

[00:18:34] [SPEAKER_02]: And if we could do things before that, because some of them

[00:18:37] [SPEAKER_02]: don't want even make it.

[00:18:40] [SPEAKER_03]: I 100 percent agree with you.

[00:18:41] [SPEAKER_03]: I think it's a really complex question and so many factors

[00:18:44] [SPEAKER_03]: that play into the answer and obviously depends on an individual basis.

[00:18:48] [SPEAKER_03]: But even speaking about rural communities, it's so hard

[00:18:51] [SPEAKER_03]: getting people into the dentist, let alone being pregnant,

[00:18:53] [SPEAKER_03]: let alone having multiple children and having a job, those kinds of things.

[00:18:56] [SPEAKER_03]: So what we want to do is send those oral care instruments,

[00:19:00] [SPEAKER_03]: a packet of flossers to promote.

[00:19:02] [SPEAKER_03]: Yeah, we send flossers, a toothbrush, all of these alongside

[00:19:06] [SPEAKER_03]: a little booklet of what to use, how to use it and when and stress again,

[00:19:10] [SPEAKER_03]: why this is important during pregnancy and for the newborn child

[00:19:13] [SPEAKER_03]: infancy into childhood and setting the stage for adulthood.

[00:19:16] [SPEAKER_03]: But again, that doesn't mean that we don't promote going to the dentist

[00:19:20] [SPEAKER_03]: with the app. We are able to connect you to a dentist

[00:19:22] [SPEAKER_03]: and those kinds of things based on location as well.

[00:19:26] [SPEAKER_00]: Yeah, that doesn't look at the end of the day.

[00:19:28] [SPEAKER_00]: It comes down to education

[00:19:31] [SPEAKER_00]: and building this awareness in the community.

[00:19:35] [SPEAKER_00]: Unfortunately, in the poor areas where you don't have access to care,

[00:19:39] [SPEAKER_00]: you don't have access to the education.

[00:19:41] [SPEAKER_00]: It falls short that then we need the payer community

[00:19:46] [SPEAKER_00]: to think about the ramifications of what happens when we go upstream,

[00:19:52] [SPEAKER_00]: when we go early in the preventative mode that Ashley's talking about.

[00:19:57] [SPEAKER_00]: And what impact does it have?

[00:19:59] [SPEAKER_00]: For example, pregnancy mumps,

[00:20:01] [SPEAKER_00]: ginger, full inflammation, pregnancy, ginger,

[00:20:03] [SPEAKER_00]: vitas, pre diabetic patients with pregnancy, ginger, vitas,

[00:20:08] [SPEAKER_00]: preterm babies that you questioned, Maria, that cost the health care system.

[00:20:13] [SPEAKER_00]: So it's what billions of billions of dollars.

[00:20:17] [SPEAKER_02]: It's preventable.

[00:20:18] [SPEAKER_00]: So it's the payer system appreciating and getting into the science and saying,

[00:20:24] [SPEAKER_00]: where do we need to go for intervention?

[00:20:26] [SPEAKER_00]: And how do we level the playing field between people with access to care

[00:20:30] [SPEAKER_00]: and people who are being challenged because of the communities that they live in?

[00:20:35] [SPEAKER_00]: And Ashley, how are you creating leverage?

[00:20:39] [SPEAKER_00]: Tell us about digital health, your view of it and our technology

[00:20:44] [SPEAKER_00]: today is really shining a light on being hopeful about building this awareness,

[00:20:49] [SPEAKER_00]: whether it's social media or your website and things that you're doing through first

[00:20:53] [SPEAKER_00]: screen, tell us what you're doing today and what are some of the things

[00:20:56] [SPEAKER_00]: you hope to do into the future?

[00:20:58] [SPEAKER_03]: Definitely. So I think creating the app has been huge again,

[00:21:01] [SPEAKER_03]: overcoming that friction of getting into the dentist chair for that first

[00:21:04] [SPEAKER_03]: dental visit at pediatric dentist.

[00:21:06] [SPEAKER_03]: We're reviewing education, nutrition, diet, what you should be doing at home.

[00:21:10] [SPEAKER_03]: If we're able to get that to you before you get into the dentist,

[00:21:13] [SPEAKER_03]: that's a huge win for us in a way that's understandable and practical

[00:21:17] [SPEAKER_03]: for parents as well.

[00:21:19] [SPEAKER_03]: On top of that, we rolled out like a beta pilot of AI based text messages.

[00:21:23] [SPEAKER_03]: So we're able to reach out to pregnant parents as well as new parents.

[00:21:28] [SPEAKER_03]: So once they have the child and the message will change

[00:21:30] [SPEAKER_03]: based on at what stage of life we're at.

[00:21:32] [SPEAKER_03]: If we send easy, quick tips to busy parents, that's what we want to do.

[00:21:36] [SPEAKER_03]: We want to break through their busy routine, just like, hey,

[00:21:39] [SPEAKER_03]: your life doesn't have to revolve around oral and dental health,

[00:21:42] [SPEAKER_03]: but at least consider it because right now it's not being considered,

[00:21:45] [SPEAKER_03]: especially at that stage.

[00:21:47] [SPEAKER_00]: Yeah, and that is great and exciting.

[00:21:50] [SPEAKER_00]: And it's a lot about building that awareness, right?

[00:21:54] [SPEAKER_00]: And you as an entrepreneur,

[00:21:57] [SPEAKER_00]: it's creating the collaborations, right?

[00:21:59] [SPEAKER_00]: And working with people that we know that building businesses,

[00:22:03] [SPEAKER_00]: Maria is a team sport.

[00:22:05] [SPEAKER_00]: And we got to come together with like minded people

[00:22:08] [SPEAKER_00]: who are looking to really make a difference in people's lives.

[00:22:12] [SPEAKER_00]: And this is one of such a main area.

[00:22:14] [SPEAKER_00]: And it's so exciting that you're you are shining a light on this

[00:22:19] [SPEAKER_00]: and doing something about it, not just talking about it.

[00:22:23] [SPEAKER_02]: It's almost kind of be fuzzling.

[00:22:25] [SPEAKER_02]: And that's a technical term because we be fuzzily great.

[00:22:29] [SPEAKER_00]: That is a great new word.

[00:22:32] [SPEAKER_02]: It's a great new word.

[00:22:33] [SPEAKER_02]: Just this conversation is

[00:22:34] [SPEAKER_02]: that we mean it. I wanted to say I wanted to say it's frustrating,

[00:22:38] [SPEAKER_02]: but let's call it be fuzzling because we spend so much money on motherhood.

[00:22:43] [SPEAKER_02]: Motherhood is such a industry, right?

[00:22:47] [SPEAKER_02]: From a pharmaceutical perspective, from like toys preparing

[00:22:51] [SPEAKER_02]: and first time moms are notorious about being overly compliant

[00:22:57] [SPEAKER_02]: and enthusiastic to buy things. Right.

[00:23:00] [SPEAKER_02]: So I think about how much time has been spent in targeting that

[00:23:05] [SPEAKER_02]: customer base.

[00:23:07] [SPEAKER_02]: Let's call them what they are, their patient, that customer base

[00:23:09] [SPEAKER_02]: from where it was like whoop or Fitbit.

[00:23:14] [SPEAKER_02]: Now we're targeting ways to predict what when your term

[00:23:17] [SPEAKER_02]: date is going to be right.

[00:23:20] [SPEAKER_02]: Or if you've come across, but different states

[00:23:23] [SPEAKER_02]: of instituted free texting messages, services, text for baby

[00:23:28] [SPEAKER_02]: where a mom could text baby in this on the phone,

[00:23:30] [SPEAKER_02]: but the phone number and then get weekly texts

[00:23:33] [SPEAKER_02]: and updates about their pregnancy.

[00:23:36] [SPEAKER_02]: And somehow we've managed to create this complex,

[00:23:40] [SPEAKER_02]: profitable ecosystem that targets motherhood

[00:23:44] [SPEAKER_02]: and pregnant women without including dental.

[00:23:48] [SPEAKER_02]: And it's just be fuzzling to me how we would be able to do that.

[00:23:54] [SPEAKER_02]: And go out of our way, nothing could be done.

[00:23:58] [SPEAKER_00]: I got it.

[00:24:00] [SPEAKER_00]: The fuzzling is going to be the I think we should change the name

[00:24:03] [SPEAKER_00]: of the podcast, the fuzzling between medicine and dentistry.

[00:24:07] [SPEAKER_00]: It is be fuzzling.

[00:24:09] [SPEAKER_00]: Oh, God. But you know what?

[00:24:11] [SPEAKER_00]: It's it's really when because I'm a I'm pros and honest.

[00:24:14] [SPEAKER_00]: We treat adults.

[00:24:16] [SPEAKER_00]: I've met Ashley.

[00:24:17] [SPEAKER_00]: I was so impressed with everything she does

[00:24:19] [SPEAKER_00]: and how she's really getting after this.

[00:24:22] [SPEAKER_00]: And it's part and parcel of our goal, really, to shine a light,

[00:24:26] [SPEAKER_00]: build awareness and do something about it.

[00:24:29] [SPEAKER_00]: Do something about it, which then leads me to the next question

[00:24:33] [SPEAKER_00]: to Ashley because she's a young mom personally.

[00:24:35] [SPEAKER_00]: And you have quite a personal story.

[00:24:37] [SPEAKER_00]: You got two young children.

[00:24:38] [SPEAKER_00]: She's practicing pediatric dentists.

[00:24:40] [SPEAKER_00]: She's launching and has this first year.

[00:24:43] [SPEAKER_00]: I'm telling you, Ashley, tell us how do you do it?

[00:24:46] [SPEAKER_00]: What's the secret that you're able to do these all these things?

[00:24:50] [SPEAKER_00]: Because for everybody listening to this, for a lot of people,

[00:24:53] [SPEAKER_00]: it is quite the balancing act.

[00:24:56] [SPEAKER_00]: Tell us about how you do it.

[00:24:57] [SPEAKER_03]: So kind, so thoughtful.

[00:24:59] [SPEAKER_03]: I definitely don't do it with grace.

[00:25:00] [SPEAKER_03]: And it really does take a village.

[00:25:02] [SPEAKER_03]: I have such an amazing support system for me to be able to

[00:25:06] [SPEAKER_03]: chase this while having a young baby.

[00:25:09] [SPEAKER_03]: I can't stress that enough.

[00:25:11] [SPEAKER_03]: And I like behind the scenes.

[00:25:12] [SPEAKER_03]: Trust me, my head is always spinning because this is I chew on this problem

[00:25:17] [SPEAKER_03]: all day every day.

[00:25:18] [SPEAKER_03]: I wake up thinking about it, go to sleep thinking about it,

[00:25:20] [SPEAKER_03]: because I know we can do better.

[00:25:22] [SPEAKER_03]: It's so timely.

[00:25:23] [SPEAKER_03]: I was saying before how time just came out with a new article

[00:25:26] [SPEAKER_03]: called The Rise of a New Kind of Parenting Guru,

[00:25:29] [SPEAKER_03]: and it talks all about mom experts on social media

[00:25:32] [SPEAKER_03]: and how we can share evidence based information

[00:25:35] [SPEAKER_03]: to disseminate this information with a loudspeaker

[00:25:38] [SPEAKER_03]: in the way that people are looking to digest it.

[00:25:40] [SPEAKER_03]: If a mom is nursing or feeding in the middle of the night

[00:25:42] [SPEAKER_03]: and scrolling on her phone, she can't read a book.

[00:25:45] [SPEAKER_03]: Or maybe she doesn't want to turn on the light to read a book.

[00:25:48] [SPEAKER_03]: But it's just a creative way and staying up with the times

[00:25:50] [SPEAKER_03]: with how to get this information out there to make hopefully

[00:25:53] [SPEAKER_03]: better outcomes and decisions down the line.

[00:25:56] [SPEAKER_00]: So great. Mom expert on social media.

[00:25:59] [SPEAKER_00]: Bam! That is so necessary.

[00:26:02] [SPEAKER_00]: And using this technology to really build this awareness

[00:26:04] [SPEAKER_00]: is a great place to put the focus, because there's many places

[00:26:09] [SPEAKER_00]: you can build. And that's one that's tremendous.

[00:26:12] [SPEAKER_00]: Well, personally, Maria, as we're working on the practice of the future

[00:26:17] [SPEAKER_00]: and I was so fortunate to have met Ashley, she came on our foundation mission.

[00:26:22] [SPEAKER_00]: She would have been on the last one, but she had her hands full.

[00:26:25] [SPEAKER_02]: You missed each other, Ashley. I'm sorry.

[00:26:26] [SPEAKER_02]: We missed each other.

[00:26:27] [SPEAKER_00]: She had her body was a little bit busy without creating a beautiful baby.

[00:26:32] [SPEAKER_00]: But hopefully she'll join us on future missions

[00:26:35] [SPEAKER_00]: and will be joining us in the whole thesis around the practice

[00:26:39] [SPEAKER_00]: of the future and using technology and using all this educational approach.

[00:26:45] [SPEAKER_00]: It's been so great.

[00:26:46] [SPEAKER_00]: Ashley, how do people find out more about this?

[00:26:49] [SPEAKER_00]: We want to put it into our notes and we want people to have access to you.

[00:26:53] [SPEAKER_00]: How would people find out more?

[00:26:55] [SPEAKER_03]: So First Grins website is your first grin dot com on social media.

[00:26:59] [SPEAKER_03]: The handle is at first grand.

[00:27:01] [SPEAKER_03]: And my personal hand is pediatric dentist mom.

[00:27:04] [SPEAKER_03]: Pretty straightforward on that one.

[00:27:06] [SPEAKER_00]: I love that. Pediatric dentist mom.

[00:27:07] [SPEAKER_00]: That is great. That is great.

[00:27:11] [SPEAKER_02]: Powerful. I'm going to do I'm going to do another plug for you, Ashley,

[00:27:15] [SPEAKER_02]: because as an investor,

[00:27:19] [SPEAKER_02]: both Johnson and I look at many entrepreneurs and startups

[00:27:22] [SPEAKER_02]: and companies and the one thing that differentiates smart people

[00:27:25] [SPEAKER_02]: who want to start a company from entrepreneurs

[00:27:28] [SPEAKER_02]: who make it and build a category defining business

[00:27:32] [SPEAKER_02]: are the people who are really good at studying their problem.

[00:27:37] [SPEAKER_02]: People who are the word that comes to mind is obsessed.

[00:27:41] [SPEAKER_02]: Right. They go to bed thinking about this.

[00:27:43] [SPEAKER_02]: Wake up thinking about this.

[00:27:44] [SPEAKER_02]: They're just such they become such deep experts into the in the problem

[00:27:49] [SPEAKER_02]: they're solving that they not work on it.

[00:27:53] [SPEAKER_02]: And just listening to you, it's very clear that you're one of those

[00:27:57] [SPEAKER_02]: rare entrepreneurs.

[00:27:58] [SPEAKER_02]: And so for all those investors out there, here's a shameless plug from Maria.

[00:28:03] [SPEAKER_02]: Look up first grin and call up Jonathan and I because we are the experts.

[00:28:07] [SPEAKER_02]: We could tell you what we think about this company and where it's going.

[00:28:10] [SPEAKER_02]: So super excited, super excited about what you're doing.

[00:28:12] [SPEAKER_02]: And any upcoming events, products, exciting things that you want

[00:28:17] [SPEAKER_02]: our listeners to be looking out for.

[00:28:20] [SPEAKER_03]: Stay tuned. We'll do a bunch of announcements on social media.

[00:28:23] [SPEAKER_03]: I can't announce any just yet.

[00:28:25] [SPEAKER_03]: They're in school.

[00:28:26] [SPEAKER_03]: But it's a really good one.

[00:28:26] [SPEAKER_01]: We're just amongst friends. You could share.

[00:28:29] [SPEAKER_00]: There's some.

[00:28:29] [SPEAKER_03]: Big Macarons in front of everyone, maybe followers.

[00:28:32] [SPEAKER_03]: But seriously, go check it out.

[00:28:33] [SPEAKER_03]: They're really exciting partnerships that I think people will be excited to hear.

[00:28:37] [SPEAKER_00]: Fantastic. Awesome. Amazing.

[00:28:39] [SPEAKER_00]: Well, thank you. Yeah, that's right.

[00:28:40] [SPEAKER_02]: We're grateful to have you.

[00:28:42] [SPEAKER_02]: Thank you.

[00:28:43] [SPEAKER_02]: And now we can't wait to have you back.

[00:28:46] [SPEAKER_02]: Appreciate it.

[00:28:53] [SPEAKER_00]: Thanks for listening to the Think Oral podcast.

[00:28:56] [SPEAKER_01]: For the show notes and resources from today's podcast,

[00:28:59] [SPEAKER_00]: visit us at www.outcomesrocket.health.

[00:29:05] [SPEAKER_01]: slash think oral or start a conversation with us on social media.

[00:29:09] [SPEAKER_01]: Until then, keep smiling and connecting care.