Holistic Pediatric Dentist Questions: Dr. Staci Whitman

Natural parents often face a challenge when it comes to taking our kids to the dentist. Of course, we want to set our kids up for optimal oral health. But some conventional dental practices don’t align with our low toxic living philosophy. We asked holistic pediatric dentist, Dr. Staci Whitman, to answer some of our readers’ most pressing questions.

Dr. Staci Whitman is a Functional Kids’ Dentist in North Portland, Oregon. Her practice NoPo Kids Dentistry takes a whole-body, holistic, and functional approach with her patients.

She attended Tufts University School of Dental Medicine and worked as a general dentist for 2 years before earning a certificate in pediatric dentistry from Oregon Health & Science University. She has always been passionate about children’s sleep and airway health, focusing her research in residency on how to improve airway assessments and diagnostic tools in the pediatric population.

She’s also a mother of two. You can follow Dr. Staci on Instagram for actionable information on raising healthy kids.

Holistic Pediatric Dentist Q+A

Our readers sent these questions via social media and our newsletter. If you have a question, feel free to comment below and we’ll include it in the next round with Dr. Staci.

What’s the right age to take your child to the dentist? Our pediatrician said age three if there are no issues. But how do I know if there’s an issue?

The American Academy of Pediatric Dentistry recommends that children see a dentist by the age of one, or when their first teeth erupt (which can happen much earlier). Personally, I like to see children even sooner – preferably around six, seven, or eight months of age. That’s because I’m looking for growth and developmental issues as well as for oral ties, which are a big cause of cavities in infancy. 

Parents also introduce solid foods around this time, and that’s when kids start to get cavities. So it’s an ideal time to teach parents about good hygiene, brushing and flossing techniques, and good dental product choices. We also talk about how to introduce foods, and how to make sure a child’s diet will promote good dental health. 

I think age three is much too late. My philosophy is that if we can start early and prevent disease, then going to the dentist’s office will be easy and even fun for a child. Research shows that children who come to the dentist earlier are more comfortable at the dentist’s office and are less likely to have dental issues.

How do I find a holistic pediatric dentist near me?

To locate pediatric dentists in your area, check out the website of the American Academy of Pediatrics or the American Academy of Physiological Medicine and Dentistry.

Dr. Mark Burhenne put together a directory of functional dentists. The Holistic Dental Association also offers a directory. You can find one in your area, view their website or call and ask if they follow holistic pediatric dentistry practices.

(Green Child also has a guide to finding a holistic pediatric dentist here.)

It’s also smart to ask around. Like-minded parents or natural parenting groups in your area are a wealth of information and personal experience when it comes to local healthcare professionals.

What are the best toothpaste ingredients for small children?

Less is more.

I know it’s a little controversial, but I’m not a fan of fluoride toothpaste for small children. They often still swallow toothpaste at that point. We just don’t know enough about the long-term and overall health effects of daily exposure to fluoride.

Also, I recommend avoiding toothpastes that contain sodium lauryl sulfate (SLS), which can strip the oral tissues and lead to ulcers in the mouth. And steer clear of products with surfactants, emulsifiers, dyes, artificial flavors, Triclosan, or excessive amounts of essential oils. 

Some parents start with a xylitol “training” toothpaste like Spry, which I think is fine. However, my favorite toothpaste for kids (and for adults, too) is a hydroxyapatite toothpaste.

Hydroxyapatite is a natural mineral that makes up much of our bones and tooth enamel. In fact, up to 97% of our tooth enamel is made of it, so it’s perfectly safe for kids to swallow.

Editor’s note: Since the time of this interview, Dr. Burhenne and holistic pediatric dentist Dr. Staci Whitman have created their own toothpaste. FYGG, it stands for Feed Your Good Guys, is a hydroxyapatite-based toothpaste that is free from fluoride, emulsifiers, surfactants, essential oils and every other harsh, unnecessary ingredient.

They created this toothpaste with the goal of using natural, supportive ingredients that nourish the oral microbiome. You can find it at FYGG or Amazon.

My daughter is four and wants to floss like me. Is it okay to give her the toothpick style floss?

Yes, absolutely! Flossing is essential for oral health. I believe it’s even more important than brushing. That’s not to say you should skip the brushing, but I really want parents to prioritize flossing and even do it first.

However, at four, I wouldn’t want your daughter flossing entirely by herself. I think it’s great that she’s playing with the floss. But the rule at my house is that until kids are ten, a parent needs to brush and floss with them.

That’s particularly true for flossing, because the right technique is important, and little kids may not have the necessary focus or dexterity. Even if you’re watching and it looks like they’re flossing, they’re probably not flossing all the way down, or they’re skipping some teeth. 

Most pathogenic bacteria are anaerobic, meaning that they don’t like oxygen. They love to hide out between the teeth where there’s less oxygen.

You might need to start flossing as teeth erupt, if your child’s front teeth are touching. If not, you’ll definitely want to start when the second “two-year-old” molars come in, between two and three years of age. These molars will touch the first molars, and that is where dentists see cavities the most.

In addition to starting early, be consistent. That means flossing your child’s teeth every single night, even when you’re tired. In my house, flossing is non-negotiable, just like wearing a seatbelt or a bicycle helmet.

It truly is that important.

I recommend the pick flossers, because they’re the easiest to use. You can floss your child’s teeth in the bathroom during tub time. I used to floss my girls’ teeth on the changing table when they were very little, initially just playing with the floss sticks to get the girls used to them.

Now they’re six and eight years old, and we still floss in the bedroom. I’m not worried about them spitting their toothpaste out because we use hydroxyapatite toothpaste and you actually don’t want to rinse that toothpaste off.  

My simple flossing routine

• I leave a bowl of floss picks on the bedroom nightstand, so they’re right at hand.
• When it’s time to floss, I lean the girls back on a beanbag or on their beds. (There’s a reason dentists lay patients back. You can see much better if you’re looking down into the mouth, and you can be gentler and more successful.)
• I start with the back molars, teasing the flosser down until it pops through that contact point and scraping one side of the tooth and then the other side. 

If your child gives you a hard time when you first start a flossing schedule – and yes, mine did! – at least get the back molars done, because that’s where most of the bad bacteria in the mouth are lurking.

What’s the best way to show my 6-year-old how to brush his teeth and maybe empower him to do a good job himself?

The first thing I will say is that at six years old, I wouldn’t expect him to be a fantastic brusher. I have found in 15 years of clinical experience that until children are about middle-school age, or around ten – as I tell kids, “until you turn double digits” – parents should help.

Young kids just don’t have the understanding, the focus, or the dexterity to do a good job. However, it’s great for your child to practice, and modeling good brushing for him will help him to be a better brusher when he’s older.

There are lots of YouTube videos that can help children learn to brush. Also, next time you’re at the dentist’s office, have the dentist or hygienist use a mirror or a model to show your child how to brush. Many parents have success with apps. For instance, there’s a Pokémon app, and I think Colgate has one. Sonicare makes a kid’s toothbrush that comes with an app. 

Disclosing tablets can be a good teaching tool as well. These are those little tabs you chew up, swish around, and spit out, and they stain the biofilm pink so it shows kids where their plaque is.

How do I handle a dentist giving me grief about refusing fluoride treatments for my child?

As a holistic pediatric dentist, I get this question all the time, and it really bums me out. There seems to be so much attitude, shaming, and guilt-tripping on the part of dentists when parents say they don’t want fluoride. 

Dentists are supposed to do risk assessments and recommend fluoride for high-risk patients. But these days everyone gets fluoride no matter what their risk status is. That includes kids who have never had a cavity, and whose dental hygiene, gums, and diet are great.

My advice is simple: Don’t let a dentist bully you into getting fluoride treatments for your child if you don’t want them.

Just say, “We don’t use fluoride in our home,” or, “No, thank you.” If the dentist gives you a hard time, I really suggest finding a different dentist. You want a dentist who acts like a teammate and a teacher, not a dictator who’s rude and condescending or tries to shame you.

A few nights a week, we let our kids have milk and cookies after dinner. Should they brush their teeth right after having sweets, or is it fine to wait until bedtime?

Actually, you never want your kids to brush right after eating. That’s because every time we eat, the mouth becomes more acidic — which is a normal part of the digestive process — and this acid attack slightly weakens the tooth enamel.

By the way, this is why I don’t like chronic snacking. When kids eat all day, or sip on juice or soda all day, their mouths are constantly bathed in acid. This can lead to tooth decay. If you wait anywhere from 20 minutes to 30 minutes after your kids eat, this will allow the enzymes and calcium and phosphorus in the saliva to slowly start re-mineralizing the teeth and lowering the acid level of the mouth. 

So, instead of having your kids brush right away, offer a glass of water after their snack. Or give them something crunchy like apple slices or carrot sticks. Chewing crunchy foods will help to cleanse some of the cookie crumbs off their teeth. And it will stimulate saliva to help wash away the sugar and flour.

You can also offer a cheese stick, because dairy products not only have calcium but also help to neutralize acid in the mouth. Then save the brushing for bedtime—and definitely floss their teeth too, to get out those cookie crumbs.

My 9-year-old breathes through her mouth. Is there a way to make sure kids breathe properly? And what age is it safe to try mouth taping?

Again, this is why I like to see babies by 6-8 months of age, because we can tell right away if they’re starting to head down the path to mouth breathing. Working together, a dentist and ear-nose-throat doctor (ENT) can find the source of the problem and correct it.

Mouth breathing can stem from many causes. It may be a result of enlarged adenoids or tonsils, inflamed nasal turbinates (the structures within the nasal passageways), a deviated septum, food allergies, or environmental allergies. Sometimes, it’s a combination of things.

If the problem is environmental, you may be able to solve it by cleaning up the bedroom, getting an air filter, using a humidifier, and making sure pets don’t sleep with your kids.

If mouth breathing stems from a chronic sinus infection, eliminating dairy or gluten may help. And if the root cause is structural or myofunctional, a Myo Munchee or “mini myo” therapy can help.

I don’t advise mouth taping in children under the age of nine, unless with the help of an airway-focused dentist or knowledgable ENT. Also, if you’re considering mouth taping, make sure your child understands the reasons for it. 

There’s a tape called Myotape that many parents and kids tend to prefer because it has an opening in the middle. It’s designed especially for kids, and it acts almost like a girdle, squeezing the lips close and pulling them in.

By the way, if your child is a mouth breather or has other airway problems, there is a wonderful book called Sleepwrecked Kids by Sharon Moore. It’s written specifically for parents, and I believe that parents who read the book will know as much as many dental care providers do (if not more) about dental, sleep, and airway problems and how to address them.

Do kids who suck their thumbs have a higher chance of needing braces? Any ideas on how to get kids to stop?

(This topic was so detailed, we created a separate article on thumb sucking here. Be sure to read it if this is one of your concerns.)

Thumb sucking in infants and toddlers isn’t typically a concern. Most of the time they grow out of it. So this advice is geared toward older children – ages four and up.

When kids are heavy thumb suckers, it doesn’t just change the position of their baby teeth. In addition, it actually changes their facial and jaw development. This can lead to an overbite and a narrow, high palate—which in turn will alter the position of the tongue, affecting how your child breathes and eats and frequently causing mouth breathing. Find out how to handle thumb sucking from a holistic pediatric dentist perspective.

Are there any vitamins for kids that can help with dental health?

Yes! We know that fat-soluble vitamins (that’s A, D, E, and K) are critical for dental and jaw development. In particular, I recommend that kids take a D3/K2 supplement, because vitamin D deficiency is so widespread. It’s important to choose a vitamin D supplement that also contains K2, because vitamin D3 needs vitamin K2 to be bioavailable.

Because these are fat-soluble vitamins, your child needs to take them with fat for them to be absorbed. Some brands actually suspend the vitamins in olive oil or sesame oil. A good brand for kids is Mary Ruth D3/K2, which is what I give my girls.

I also recommend supplementing with trace minerals. Magnesium is crucial for vitamin D and calcium utilization. Many people around the world are deficient in magnesium, because our topsoil is depleted of this mineral. As a result, even when we’re eating the healthiest foods, we’re just not getting enough. 

Of course, kids also need to get plenty of calcium to build strong teeth. In addition to cheese and other dairy foods, lots of leafy greens have high levels of calcium.

Finally, probiotic supplements can help keep your child’s microbiome healthy. You can buy brands specifically designed to seed the oral microbiome; two of my favorites are Hyperbiotics and BioGaia. 

What are the best foods for dental health? Bonus points if they can please a picky eater.

The best foods for dental health are “eat the rainbow” foods. Load your child’s plate with vegetables and add a little fruit. Skip the fruit juices and go easy on sticky fruits like raisins.

Also, feed your child foods rich in fat-soluble vitamins—for instance, eggs, pastured meat and poultry, and organ meats. Of course, liver is not a kid favorite! However, these days, you can get organ meats in desiccated capsules.

Fatty fish like sardines, anchovies, and salmon are also excellent because they’re good sources of omega-3 fatty acids. Dairy is a great choice too, if your child can tolerate it.

The most important lifestyle change is to choose whole foods. I like to put it this way: Choose foods that came from a plant, not things that were manufactured in a plant. And select foods that come from the earth, not from bags.

I don’t like to advocate for a specific diet, but people who eat more of a Paleo-style diet do have much better oral health.

As for getting a picky eater to accept healthy foods, I know it’s tricky. Here are three tips that can help:

• Always have a “safe food” on the plate. I like to offer one “love it” food, one “like it” food, and one “learning to like it” food. I keep the serving of the learning to like it food very small—about as big as a fingernail. If one of my kids pushes this food aside, that’s fine, because it’s all about exposure. Research shows that kids often need 12 to 15 exposures to a new food before they’ll accept it.
  
• Make new foods yummy. Add enough butter, salt, or sauces to make food fun.
  
• Expose your child to foods in different ways. For instance, use broccoli as a “sponge” to make clouds when finger painting, or use asparagus as a paintbrush. This helps to desensitize your child to new foods.

My son loves to chew on ice. Should I be worried or dissuade him?

Please, please ask him not to do that! I was an adult dentist for years, and many adults who were habitual ice chewers had a lot of dental issues – not only worn-down teeth or little cracks in their teeth, but even tooth fractures. Prevention is important to maintain strong, healthy teeth.

Our teeth are very strong. In fact, enamel is the strongest substance in the body. But they’re not meant to be used for chewing repetitively on ice, hard corn kernels, or things of that nature. If it’s difficult for him to break the habit, switch him to shaved or crushed ice.

If you have holistic pediatric dentist questions or concerns about your child’s oral health, feel free to ask in the comments below.

More About the Oral Microbiome and Dental Health

How to Find a Holistic Pediatric Dentist
Mouth Breathing vs. Nose Breathing
How to Boost Your Child’s Microbiome
Fluoride in Drinking Water and Your Child’s IQ
Sippy Cups and Kids’ Facial, Dental, and Jaw Growth
How to Curb Thumb Sucking
Dr. Mark Burhenne on the Oral Microbiome