How To Prevent Cavities And Help Children Understand Why Oral Health Is Important

Episode Transcript

Dr. Nicole Beurkens
Hi everyone, welcome to the show. I’m Dr. Nicole, and on today’s episode, we are talking about all things oral health, cavities, and kids. All of us as parents deal with some level of frustration at some point around our kids’ oral health, whether it’s getting them to brush their teeth, or going to dental checkups and getting them to cooperate with that, or dealing with bigger picture issues like cavities, braces, and other kinds of things. Oral health is so important not only for our kids’ overall physical health, but also for their brain development, their brain function and their behavior, and often people don’t think about the connection between those things. Issues in the mouth can actually even be one of the first clues that something bigger might be going on physically or brain-wise that we need to deal with. So helping kids have healthy mouths is about a lot more than just the cavity issue. And to talk with us about this, about why oral health is so important, and how we can really help our kids to have the healthiest mouths, even if you’ve already struggled with things like cavities, I’ve invited Dr. Staci Whitman on the show today. Let me tell you a bit about her.

She is on a mission to create a world without cavities. I love that. She’s the founder of NoPo Kids Dentistry, where she 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 two years, and then went on to earn a certificate in pediatric dentistry from Oregon Health and Sciences University. In 2019, she founded NoPo Kids Dentistry, became a diplomate of the American Board of Pediatric Dentistry, and is a board-certified pediatric dentist and fellow of the American Academy of Pediatric Dentistry. She has taken numerous courses and training in children’s sleep and airway medicine, studying oral myofunctional therapy, cranial sacral therapy, and is a Breathe Institute ambassador. She’s also an internationally certified health and wellness coach, and dreams of a world without cavities and believes in motivating families to join her as a team, keeping their children healthy and thriving with small, manageable daily changes. Dr. Staci, I’m so excited to have you with us today.

Dr. Staci Whitman
Hi, Nicole, I’m excited too! Thank you for inviting me on, I’m a huge fan of your work, and I’m ready to tackle oral health in connection to this, systemic health, with you.

Dr. Nicole Beurkens
Awesome, because I really think that so much of the way that we think about this, in our culture, at least in the US, is “Oh, the mouth is totally different from everything else.” And I think part of that is probably the way we do things in terms of, “Oh, there’s medicine, there’s mental health, there’s dentistry,” and we lose this idea that it’s all connected. What’s going on in your kid’s mouth is important for everything. So I want to delve into all that, but first, I’m actually interested because I don’t know this story for you, about how you got into this aspect of dentistry, because most dentists do not practice in this way. So how did this come about for you?

Dr. Staci Whitman
Yes, great question. And most don’t practice this way yet, but we are working on that. But yeah, I graduated, I was trained very traditionally, I practiced very traditionally, but the way I was practicing never truly resonated with me, as I felt I was just dealing with end stage disease, more of like a band-aid approach. You’ve heard the term “Drill, fill, bill.”  So I was very dissatisfied with my career. I really didn’t like dentistry. And really so many adults too, they had so many phobias and traumas, and experiences that just felt unnecessary to me. And then I myself lived a pretty clean holistic life but yet I was doing these procedures, making these diagnoses and recommendations that never resonated with me and who I am. So I really wanted a more upstream or route cause approach, which is what functional medicine in dentistry is based on. And I realized the only way for me to truly get upstream was to start working with children, and before things were full blown issues. I wanted to catch things when they were still smoldering and not full-blown fires, and I felt I had more influence over the path of a child. So I went back and got my pediatric certification. I practiced again, fairly traditionally, knowing in my heart that I needed to stir things up a little bit, change my practice model. And I was very fearful to do so, and nervous because it is so new. There was no real formal training. It’s pretty piecemeal, how I had to get my certifications and my continuing education to make the practice model that I have today exist, but it is the best thing I’ve ever done. I really feel like we are changing lives, changing the trajectory of these children’s experiences at the dentist, but as you mentioned, also changing their long term overall health. And not only their oral health, their whole body health, their mental health, and we can dig into that deeper, but the mouth is a part of the body, it is not a separate entity. For whatever reason dentistry went one way, medicine went the other. I know the reason, it’s a long, boring story. But anyway, my goal is to get the mouth back into the body, and really educate all humans on how important oral health is. And I think there’s more and more research coming out about that, connecting our oral health with our gut health, and as you mentioned, our mental health, our brain development, our airway health, our sleep quality, and we will unpack all that later, but it’s really exciting stuff.

Dr. Nicole Beurkens
It is. And it’s so just amazing to me how we have segmented all this. I mean, it’s one of my big frustrations in mental health, too. It’s like, since when does the brain not exist as connected to the body? But we go, “That’s a mental health issue.” The need to look at all of this stuff in holistic ways, meaning look at everything as being connected — and I think the mouth is such an important piece of that. So let’s delve into that. People are probably thinking “Oh, okay, wow, so the mouth is maybe connected to my kids sleep or behavior or other kinds of health issues? How is that possible?” Talk to us about what the connections are there?

Dr. Staci Whitman
Sure. So the mouth is the gateway into the body. Think of it that way. I mean, we have immune responses in the mouth. We put food in, bacteria enter in our mouth, it determines what’s going to happen. It’s part of the immune system. It’s also part of the digestive tract. Okay, so it’s connected to our gut health, and I think we all now know how important gut health is. You can’t look into someone’s gut, but you can look into their mouth. And very often if we are seeing things like gum disease, periodontal disease, cavities, mouth breathing, snoring — these are all signs that there’s deep rooted issues. Maybe it’s dysbiosis in the body, maybe it’s airway, health issues, behavioral issues. But for example, I can look in the mouth and tell if there’s nutritional deficiencies in a child, and there’s some very specific ones we look for. You can tell if there’s zinc deficiency, vitamin D deficiency, vitamin C deficiency, trace mineral deficiencies. Cavities were not in the human story about 10,000 years ago. They are very new to modern humans, based on modern diet since the agricultural and the industrialized revolutions. And so we really need to dig deep about why this is happening. I mean, it’s the number one chronic disease in children in the world, and I think so many of us just think cavities are just part of our story. They are part of our life, they are part of my family, we just get cavities, no big deal. But really, what is that indicating?

The other thing we can look at too, is how the jaws and the face are developing, and how that affects how a child is breathing. And breathing is critical for growth and development, including brain development, because it has to do with how we are getting oxygenated. If we breathe through our nose, we get more oxygen, if you breathe through your mouth, you can get up to 20% less oxygen. You’re also not getting the benefits of nitric oxide, which is really important for cardiovascular health. Your nose filters are part of the immune system, it humidifies. But so many of us now are mouth breathers, including children, and we are snoring and we are gasping in our sleep. We are tossing and turning, we are grinding. We are not getting deep restorative sleep. And it’s a silent epidemic. What this does is it can manifest into other behavioral issues in your child, very often masking things like ADHD, or ADD, just hyperactivity, inability to focus. So these kids are getting misdiagnosed, potentially, put on medications, when really it could be an underlying sleep issue, airway issue — And unfortunately, many dental dentists or my medical colleagues, pediatricians, were really not trained in this. You have to seek out additional training in airway-focused dentistry, functional orthodontics, and myofunctional therapy to really understand how this system is affecting growth and development in our children.

Dr. Nicole Beurkens
It’s fascinating, and I want to delve a little bit into why all these things are more of an issue, because we are seeing more and more kids — I can just say, anecdotally, obviously, I’m not in dentistry, but we see a lot of kids in our practice, we are seeing kids younger and younger with cavities. Younger and younger, even preschoolers coming in who already have multiple fillings or have had issues. And we certainly are seeing way more kids needing orthodontic work, especially at younger and younger ages. So what’s going on there? You mentioned nutrition. You mentioned this is sort of a newer phenomenon. What do you think are some of the factors that are really driving the massive increase in these oral issues in kids?

Dr. Staci Whitman
Yeah, great question. I think it’s multi-layered. So if you go back to the industrialized revolution, when we started processing and refining grains and mass-producing food, that’s a huge component of it. So we are now eating more processed foods, ultra-processed I should say, that are highly refined. They are soft, so we are not chewing like we used to. So ancestral humans, we used to chew a lot. The act of mastication, which is chewing, really does help facial development. Your tongue is a hugely strong and important muscle, as we chew, the forces are going out, it’s creating balance and strong muscles in the face, essentially, in our airway, but now our food is so soft, it’s so processed, we are eating it so quickly. we are not chewing. So there’s this lost art of chewing, and that’s affecting the jaw and facial growth and development. If you’ve read the book Breath by James Nestor, he said a lot about this, that we are dis-evolving.

Human skulls are getting smaller, our jaws are getting smaller, our airways are getting smaller. And you can see this with ancestral humans, looking back at their skulls. And we used to have room for wisdom teeth, there weren’t oral surgeons walking around 10,000 years ago, but now everyone gets their wisdom teeth out. But even more so, and I agree with you, I am seeing more and more crowding in children and more cavities, we will get to cavities in a minute. But again, we are shrinking, we are getting smaller. So it has to do with how we are chewing and what we are eating.

Our food is definitely depleted of important nutrients that we need for growth and development and dental development and job development, like fat-soluble vitamins, trace minerals, magnesium, phosphorus, we know that a lot of these essential nutrients are being depleted from our soil due to various reasons: How we are farming, chemicals that we are using, and so we are just not even getting the nutrition that we need for proper growth and development. And also, there are more pollutants in the air, there are more allergies, there’s more asthma, so we have more chronic sinusitis and issues of that nature, and so we are breathing through our mouth. And when you breathe through your mouth, that changes the way you grow, it changes your face to grow in a long downward, very thin, narrow face. Your jaw is usually set back. It’s literally affecting your airway. And it also affects our oral microbiome, and this is where we need more research, but we do know the oral microbiome is impacting our entire human microbiome, especially our gut microbiome. We swallow 2000 times a day.

All these oral bacteria is seeding our gut. And we do know too, if you look at ancestral humans and look at what their oral microbiome is like, it’s completely shifted. We have microbes now we didn’t use to have, some microbes are missing, and because of this, decay rates have skyrocketed. We are seeing more and more under mineralized teeth. So I agree with you. I see under one-year-olds now with rampant decay, and so many mamas are told it’s because they are breastfeeding, that’s a whole other topic, it’s not breast milk. There are other issues. The teeth are underdeveloped. they are under mineralized. Food is being introduced that’s really highly processed. It’s refined carbohydrates, fermentable carbohydrates, which is what our pathogenic bacteria thrive on. Kids are mouth breathing; it just creates this perfect storm for these issues. We are learning more and more the downstream effects are significant, not only for children and how they are growing and how their microbiomes are developing but as adults, we know oral health, particularly gum disease, is being linked to many systemic issues. These include cardiovascular disease, Type 2 diabetes, preterm labor or just pregnancy complications, Alzheimer’s, dementia, COVID outcomes. I mean, these are big ones. Especially for me, like brain health, I don’t want to get Alzheimer’s or dementia! So oral health is so important, and so I’m just trying to spread this message that we really need to be taking our oral health more seriously.

Dr. Nicole Beurkens
So interesting, all those factors, and many of which are the same ones that I talk about when people say, “Why are we having such rampant levels of developmental and mental health issues in kids?” It goes back to the same kinds of things, and so we just see systemically how things like toxins and poor nutrient quality in the soil, and nutrient-poor foods, and all of these things are impacting everything. The chewing part, that’s so fascinating to me, because as I think back on when I do intakes with new families at the clinic, and you look at what the diet is, you’re so right. The vast majority of kids are eating this soft, almost-puree diet. They have got everything in these pouches, and they are doing soft processed chicken nuggets and mac and cheese, and all of these things that don’t require any chewing.

Dr. Staci Whitman
Correct. Yeah. It’s a scholarly debate, and there are different camps about the baby-led weaning camp and the puree camp, and I think balance is key. I don’t believe in fear-mongering, I do believe in education and doing the best you can with the information or resources that you have. But I will say: Introducing your children strictly to processed foods, purees, soft cereals, crackers, you’re not really doing them any benefit with jaw development and airway development. And so there are really cool appliances now. There’s one called the Myo Munchee. That is a medical-grade silicone appliance that actually helps stimulate chewing again. And it’s really amazing what it can do to a child’s facial development, airway health, and a lot of parents notice behavioral regulation once you get a child breathing through their nose again, and sleeping better. Sleep is very complicated. It’s not only about the airway, it can be about overstimulation before bedtime and nutrient deficiencies and things of this nature, but how we breathe is hugely important for our sleep quality.

Dr. Nicole Beurkens
Absolutely. I want to get into the issue of cavities, because I think this is the bane of a lot of parents’ existence with their kids, either trying to prevent cavities or going in for a cleaning and discovering a kid has a cavity. And I know that some of our listeners are dealing with kids that they feel like no matter what they do, their kid just keeps getting cavities. And so there’s a lot of, I think, misconceptions around cavities. And I know you have some really interesting insights to share with parents around how we can not only prevent them but how we might be able to heal them. I’d like to hear your thoughts. Is there only one way to deal with them? Are there things that we can do if the hygienist maybe does cleaning and finds some issues? So let’s delve into all of that with cavities.

Dr. Staci Whitman
Yeah, sure. So many of us just think cavities are in our destiny, but it goes back to epigenetics. So just because you may have a family history of it, it doesn’t mean it’s your destiny. You have control. And so many patients are told they have soft teeth. I think that’s a bit of an oversimplification about what’s happening that many dentists perhaps are utilizing to explain the situation, but you have control and so much of it, especially for children, it’s getting into a very good hygiene routine from a young age, starting brushing and flossing early, especially flossing. I can’t emphasize this enough because again, we are talking gum disease and periodontal disease into adulthood, leading to systemic disease.

So just doing the best you can, introducing that early, as young as six or seven months old to desensitize, and really making it non-negotiable, especially if you are offering some of these ultra-processed foods here and there. if you eat — and I’m not trying to advocate for a certain diet, but if you eat a more paleo diet, you’re really not going to get cavities. The things that cause cavities are fermentable carbohydrates, highly processed foods, pasta, crackers, granola bars, fruit snacks, and things of that nature that are really geared to busy parents and kids. So hygiene is critical. But also what products we are using is critical. And again, this is a very long conversation, but many of our dental products right now, are actually doing more harm than good, based on the microbiome. So many of them have surfactants and emulsifiers and artificial sweeteners and maybe natural flavoring and food dyes, and foaming agents and all of these things, and even fluoride, that are antimicrobial, and again, more research is needed, but we do know that that changes the terrain and the health of the oral microbiome.

Potentially a lot of these things — essential oils is a big one, it’s killing off healthy bacteria too, and allowing more pathogenic bacteria to thrive because a lot of toothpaste and rinses and things, not only are they drying because they are alcohols, but also they are acidic. Many of the very popular conventional toothpaste, if you do a pH test, they run acidic, so you have to be very careful in what type of products you’re using. I also think we are just nutrient deficient. We know we are trace mineral deficient, so we really emphasize with young children and parents trying to introduce whole foods, eat a rainbow is our mantra, encouraging adventurous eating, and when we can’t, supplementing with especially D3K2 is a really important nutrient for dental health, and trace minerals, and trying to introduce fermented foods, which is helping our gut health, but also our oral microbiome. Probiotics are needed. And I know that you speak a lot about that too.

And getting our breathing under control because if a child is mouth breathing, as many are, you are drying the mouth out, you are changing the microbiome, and you are more prone to cavities. So all these parents coming in, they are doing everything right. Very often, the first thing I will say or look at is how is your child breathing? And if they are mouth breathing, that could be the cause. Okay, so in all cavities, you’re right, they don’t have to be filled. I do think many of our treatments of children are aggressive.

So many children are being put under anesthesia, and are getting baby root canals and crowns and extractions. And don’t get me wrong. I mean, I practice traditionally that way when I need to, but I do often get asked for a lot of second and third opinions, and I do feel we are being a little too aggressive with our children. I think we need to allow the families, the parents the opportunity to make changes at home to potentially either arrest some of these cavities, or reverse, or heal them. And you really do need to be working with a dentist that’s on board with this, like a functional dentist or holistic dentist. All cavities cannot be arrested, all cavities cannot be healed. But when they can, and if a parent or family is committed, we do see great success with that.

What we do is we have a whole protocol at my office, and it involves pretty strict dietary changes. And we use ozone gas which is antimicrobial, we really emphasize hygiene, we get the breathing under control. We use supplements, we recommend hydroxyapatite toothpaste, which is almost like a calcium dried toothpaste. hydroxyapatite is what our enamel is made of, it’s very research-backed, there’s a lot of data behind it. And so we have a whole protocol, and very often we have a lot of success with this. At the very least, it stabilizes the teeth until the children are maybe a little bit older and not needing to undergo anesthesia and all these more invasive procedures.

Dr. Nicole Beurkens
It’s awesome. Such good information. I want to circle back to what you said about brushing and flossing, because I know we have people listening who are like, “I really struggle to get my kid to brush their teeth” or “I don’t know what toothpaste to use. How in the world do you go about flossing with a kid?” So what are some of your tips for people around that?

Dr. Staci Whitman
So much of this is so visual, that I do have some videos on my Instagram account that you can check out, it’s under Tooth Tips, and I have more coming. But ideally, we start introducing things earliest is best. But if we have missed that window, the biggest thing is to just try to keep it as positive as possible, but also in your heart trying to think of it as a non-negotiable, just like you put your child in a car seat, just like they get clipped into a seatbelt, just like they put a bike helmet on. I mean, my girls hated their teeth being brushed, they hated their faces being wiped also, they also hated their hair being washed, but these are things that we still did. And so we try to encourage you to make it fun. I love suggesting laying your kids back. So put them on their changing table or back in your arms or on their bed or on a beanbag.

There’s a reason dentists lay patients back. You can look down into the mouth and see what you’re doing and be more efficient, and if you can see what you’re doing. You can be not only faster but less likely to cause trauma, which is where some of the battles come from. And you can sing songs, do countdowns, chase animals around their mouths, like have memory games about what they ate for the day, you can do reward charts. I mean, there’s a lot of positive reinforcement that you can do. And knowing that some nights will be better than others — A lot of times parents will do it out of the bath, take the bath towel and kind of swaddle the child and lay them down so they are like a little burrito. And then flossing. Yeah — again, early introduction. I started with my girls at seven or eight months old.

They didn’t need to be flossing at this point. But I just played around with those little plastic flossers. And you can rinse and reuse them, it’s more environmental. I’m working on a compostable flosser, stay tuned for that. But anyway, just play around, it’s desensitization. And what I hear so often from parents is, “But they have so many spaces in the front, I don’t need to be flossing.” Well, if your child’s around two and a half, and their second molars have come in, you need to be flossing. Before that, it’s all practice. But it’s in between the back molars where we see most issues. And again, it’s a lot to do with our diet. We are eating crackers and Cheerios and things that are getting pushed down between the teeth, and that’s just a feeding ground for this pathogenic bacteria; they love carbohydrates, they love flours, they love sugars. they are anaerobic, so there’s less oxygen in there. So they just thrive. And it can sneak up on you very quickly. So I always say I would pick flossing over brushing, I really mean that. Our tongue does a lot of cleansing for us, assuming we are not tongue-tied, but nothing’s getting in between our teeth.

So I really love parents to get into that habit, but deep breaths, you got this. Consistency is key. Both of my girls, around the age of three, which I know seems like forever if you have a one-year-old, but around three, they became more cooperative. They are six and eight years old now. It is not a big deal. I will say I really do like parents supervising and even helping children brush and floss till they are about 10 years old, which I know can be shocking, but I have found clinically and observationally until about middle school, most children just don’t have the focus, the patience or the dexterity to be doing a really thorough job. I do love Sonicare toothbrushes, I think it really does take a lot of the work of the parent or even the child if they are doing it on their own. The toothpaste I like, I do love hydroxyapatite toothpaste.

It’s kind of blowing up. More and more companies are putting it in their toothpaste. You do have to be careful about the concentration of Hydroxyapatite. Most research is showing it’s effective 15 to 18% concentration. Hydroxyapatite is expensive, so it’s not regulated. So you can say your hydroxyapatite toothpaste and only have 1% Hydroxyapatite, so it’s really just kind of greenwashing or branding if you will. The toothpaste I really like are Boka and RiseWell, and RiseWell does have a kid’s flavor. Those are the ones I generally recommend to patients right now. I think there’s room for improvement. There’s going to be more coming down the pike, but an early introduction to the dentist really helps. I like to see children under the age of one because I’m looking for airway issues. And that includes tongue tie, jaw development issues, allergies, whether that’s food or environmental. The general recommendation is around the age of one of their first teeth, but I think if your goal could be trying to get your child in to see a dentist, ideally probably a pediatric dentist around the age of one, who will set them up for success.

Dr. Nicole Beurkens
That’s great. So hydroxyapatite toothpaste or at least if we are going to use regular toothpaste, being mindful of the ingredients in there, avoiding the artificial dyes, and chemicals, and sugars and that kind of stuff. And then you said Sonicare, which is an electric toothbrush — and I find that some kids, even with sensory issues and things, you may have to try a few, but you find one that they can tolerate and let them play around. That desensitization piece is huge, just letting them get used to — on their own terms, even, playing around with the brushes, the floss pegs, just letting their sensory system get used to that when they can kind of maneuver it in their mouth, I think goes a long way.

Dr. Staci Whitman
Yeah, we recommend dress rehearsals with cleaning dentists. I will see for kids with a lot of oral sensory issues. Sonicare sometimes can be a little much. There is a toothbrush called Quip. Yeah, it’s more silicone bristles. I’m going to be like this in full disclosure: I don’t think it does a great job, but beggars can’t be choosers. So it’s an introduction, and also at Myo Munchee, not only is it helping us with chewing and eating development in myofunctional issues and muscle tone, but it helps clean teeth too. And so Myo Munchee actually can help a lot of our sensory kids with their oral hygiene as well.

Dr. Nicole Beurkens
That’s an awesome tip. And I will say too with the Quip, because I’ve recommended that sometimes too: It’s quieter. And so if you have sometimes for some kids, if they have a lot of auditory sensitivity, having that electric toothbrush right there, which is right by the auditory nerve can be a lot. So you may need to play around with something, but I love your point about we need to stay confident and steadfast as parents, that we are going to work on this, we are going to keep going with this because the alternative is just not an option to say, “Well, we are just not taking care of your teeth.” And so to keep trying to keep introducing — play around with different options, but to keep setting the standard of this is going to be part of our daily routine.

Dr. Staci Whitman
Yeah, and finding a dentist that really resonates with your family can help you. It’s so sweet, and it’s why I do what I do, but so many parents come in and say “We play Dr. Staci,” or “We say Dr. Staci says we have to do this, this is Dr. Staci’s rule at our house.” So there’s a lot of power with the providers in your child’s life too, they want to make these people happy and proud. But yeah, I say this to a lot of families. I’ve met thousands and thousands of humans in my life, and I’ve never met an adult who remembers their parents brushing their teeth — because a lot of parents are worried about creating trauma. But I do know a lot of adults, a lot of adults, who have dental phobia from dentists fixing their teeth, and that is a lifelong fear. And very often, if you have had a traumatic experience as a child, you’re less likely to go to the dentist and seek care unless there’s an emergency. So try to hold that in your heart too, and when you’re feeling bad.

Dr. Nicole Beurkens
Yeah, I think that’s a great tip. And what I’ll say, just from the anxiety piece, because certainly, we see kids who develop specific phobias around things like going to the dentist, and just know: If that’s you with your kid, there is the treatment for that. You need to be working with somebody. And sometimes pediatric dentists can work with it, sometimes the pediatric dentists in our area will refer to us to work on the anxiety and the phobia. We work together on that. But just know that’s an important thing to address. The sooner the better. Because otherwise, to your point, Staci, they grow up to be adults who now are completely phobic about it. And so if we can address the anxieties and use good psychological treatments in combination with these other things, we can really do a great job of getting kids over those anxieties and those phobias so that they don’t then avoid dental care throughout their adult life because they are afraid of the dentist. So I think that’s a really important piece that you mentioned there.

Dr. Staci Whitman
Yeah, you can read books together, many dentists offer acclimation programs or almost dress rehearsal programs where you come in every week for five weeks, and you just kind of build. The first time might just be a tour of the office, the next time they sit in the chair and go for a ride, watching videos, watch my videos, go on YouTube, I’m sure there are a bazillion video of that. But again, keeping it positive, and remembering: Dental phobias is something that we have created. It’s from past experience. Many adults have it. Try to remember: Emotional energy is transferable, and if you have dental phobia, and you have had a traumatic experience, that is not your child’s experience. And so do the best you can to not express that to them, their experience is their experience, try to keep them pure from that. So we talk to parents a lot about that too.

Dr. Nicole Beurkens
Excellent point. Once again, friends, we come back to us managing ourselves in order to be able to support our kids, it even applies to dental stuff. So there we have it. Staci, I want to spend the bit of time that we have left having you say a little bit more about airway issues, because I think this really is an underrecognized, under-addressed issue that’s affecting more and more kids. And so you spoke earlier about how noticing what’s going on with the airway is important, how issues with the airway and breathing can negatively affect not only oral health, but physical health and even brain and behavior. But I think probably, a lot of people are wondering like “How do I know? How do I know? How do I know if my kid’s airway is okay?”, what are some of the things? So what do we need to be thinking about with this?

Dr. Staci Whitman
Sure. So I think the first thing to do is: Go watch your child’s sleep. So I don’t know if you were like me, but once we got into a good sleep routine, I would close that door and I would go down the hallway, never to return. I didn’t want to wake my kids up. Your kids are sound asleep. Put them to bed, and about an hour later, two hours later, go and watch them. So these are the things to look for: Is their mouth open? Are they noisy breathing, like Darth Vader breathing? Are they snoring? Do you hear grinding? Do they toss and turn? Are they kids that spin around in the bed and the bed sheets are all wound up? Or do they fall out of their bed? Do they sleep in weird positions, like their neck craned in all these yoga poses? Do they wake up frequently? Do they have bedwetting at a kind of inappropriate age? Are there night terrors? Sleepwalking? Sleep talking? Frequent waking? Do they wake up exhausted after a full night’s sleep? Are they starting to get dark circles? And are you starting to notice behavioral issues in your child? These are all red flags, that there might be sleep-disordered breathing or an airway issue. So the best advice I have is, go watch them sleep, and if you’re noticing any of these, I would take a video of them.

Take a three or four-minute video. A picture is worth 1000 words. So very often, I hear parents go to their pediatrician, their dentist or even some ENTs, and they say “I’m concerned with this”. And unfortunately, very often they are told “This is normal, they will outgrow it. No big deal.” I politely disagree with that. I think it might be common, but it’s not normal. It is a silent epidemic in children. And again, many, many are not trained in this, and there’s a lot of scholarly debate about this. But I really believe: Trust your parents’ intuition. And if you feel there’s a sleep or airway issue with your child or you’re noticing a behavioral issue, seek out help. That might be looking for a functional or airway-focused dentist to kind of be your quarterback. Things that I will look for — So we go through this questionnaire, but then what I’m looking for is I’m always looking for restricted freedoms or tissues. So that might be tongue tie or lip tie.

I’m also looking for jaw development. Is the lower jaw receded or tucked back? And is the upper jaw coming out really far? Is the upper palate narrow? So the roof of the mouth is the floor of the nose. If we have a narrow palate, we have narrower sinus passages, so we are less likely to be able to breathe through our nose, so we want to survive as a species, we breathe through our mouths. Deviated septums, nasal turbulence, allergies can all contribute to this. So I’m going through all this list of things. If they do have cavities, and they are doing everything right, it’s always a red flag for me that maybe they are mouth breathing too. And so the important thing is finding providers that can support you, and a lot of times you might need to see a functional pediatric dentist, or a myofunctional therapist, which is a physical therapist for the mouth. ENTs are very often involved, PTs and OTs,  speech-language pathologists, orthodontists, I mean, it can be a lot to unpack, which is why I like to catch it when they are infants, when they are babies because we can course correct that way sometimes.

There’s also this wonderful book, it’s called Sleep Wrecked Kids by Sharon Moore. It’s written for parents. And I highly suggest if you feel your child has an issue, but you’ve been dismissed from providers, I highly suggest you read this, you will very likely know more than many providers in your area do, and you can be a true advocate for your child. There are so many charts and questionnaires and things to fill out to help you get to the root cause for your child and that way you can take this information and try to be an advocate along with that video that you’re going to take when your children sleep.

Dr. Nicole Beurkens 

Such great resources and I just know, even in my clinical experience, when these things are going on, and it’s negatively impacting a kid’s sleep, it negatively impacts their behavior, their development, all of that. So often one of the fundamental things we have to trace back and look at when a kid’s having symptoms is what’s going on with their sleep. And even more fundamentally then, what’s going on with their airway, what’s going on with all this? It just can be so amazing when you work on and address these issues. Just the 180 that kids do, not only in terms of their oral health and their physical health but in terms of their brain function and behavior. So I think we just can’t overstate the importance of you all as parents and professionals who are listening just being aware of this, having it on your radar.

Dr. Staci Whitman
Yes. We know this sleep is foundational, and so is breathing. We have to breathe, if we are not breathing, we are not living. And so it doesn’t matter how clean you’re eating or how much you’re exercising, or any of this. If you are not getting deep restorative quality, oxygenated sleep — and that affects so much, there’s so much to talk about. That hormone release and all of this right? So, um, if you’re not getting solid sleep, I mean, it’s going to have downstream effects in all aspects of your life. So you have to get that under control first.

Dr. Nicole Beurkens
Yeah. Staci, I know one of the things that you’re passionate about is you’re always trying new products, keeping your finger on the pulse of what’s out there. So my last question for you today — and there’s many more than I could ask, this is such an important topic, and you do such a great job of educating all of us. But I’m just curious, is there something that you’re looking at, innovation wise down the pipe that you’re seeing in dentistry or oral health or something where you’re like, “This is really something I’m paying attention to/something I’m excited about that’s coming”?

Dr. Staci Whitman
I love this question. Yes, I think the oral microbiome, 100%. We are focusing on all the wrong things. Disease, ultimately, is due to dysbiotic issues, dysbiosis of our microbiome, and I don’t think we have been supporting that enough. We are doing things to wipe out our bacteria, we are overly disinfecting, and we are not being selective. So that’s where I think a lot of research will go. There are companies coming out now, which I’m so excited about that are doing at-home tests, where you can actually test your microbiome, almost like 23andme, and it will tell you your likelihood or trajectory of getting gum disease, dental disease, all of these other things. But I also think there’s a huge opportunity in the dental product market, where instead of talking about 99.9% germ-free, blah, blah, blah, we are focusing on nourishing and supporting the microbiome. So not so much killing stuff off, but allowing things to thrive and grow and be supportive is really the way we need to be looking at things. And so stay tuned for more on that, but I see it as a huge opportunity, this research and focus on the oral microbiome.

Dr. Nicole Beurkens 

And I can just confirm that that’s so accurate because in the work that I do with microbiome-focused companies, particularly in the supplement and personal care product space, this is a huge area that they are looking at and racing towards addressing with clinical research, with products. So I think you’re absolutely right, in the next couple of years, we are going to see a lot more available that is targeted to the oral microbiome, everything from toothpaste and mouthwashes to supplements too. And that’s exciting! Even thinking about different flosses, all kinds of things that we can do to support that, I think you’re right, and just like with everything in health, it really does come back to that microbiome. And it’s especially interesting now in this — I don’t even know, we can’t really say post COVID world, we are still in it. But the whole issue with all of the sanitizing that’s been done, all of the stuff that is sort of the fallout for our microbiome, from all of this, I think it’s going to be even more necessary for us to be addressing those microbiome issues.

Dr. Staci Whitman
Yeah, I couldn’t agree more. It’s exciting stuff. I know I have a lot of colleagues working on this too. And so I agree with you, I think it’s coming in hot in the next couple of years. The gut has had its moment, as it should, because it is so critical, but I think the oral microbiome is going to get front and center here pretty soon.

Dr. Nicole Beurkens
I think you’re right. Stay tuned folks, we will report back as things become available and Staci and I get to try stuff out, we will let you know what we think. That actually would be cool. We should, Staci, at some point, do a podcast episode or an Instagram Live or something, just showing different products that you love and that you find work, I think that would be awesome. We will put that on the schedule for next year.

Dr. Staci Whitman
Let me just say I have some exciting announcements in 2022, too. So I would be happy to be back.

Dr. Nicole Beurkens 

Awesome, and I want you to share now with people where they can find out more about you and your work, because yes you have your practice, but you also are very active on social media, online. So tell all of our friends where they can get more Dr. Staci?

Dr. Staci Whitman 

Yeah, for sure. So if you are looking for direct patient care, my office is NoPo Kids’ Dentistry in Portland, Oregon. It’s for North Portland. We do have families that traveled very far, including from other countries, across the country to see us, if that’s available to you. If not, I do offer a lot of education and resources on Instagram and that’s @doctor_staci. I am going to be on Tik Tok very soon. I will not be dancing, but I will be educating, so look for that. And I have a website too, doctorstaci.com, where you can get more information too, and I have a lot of my favorite products and guides, and I do have some courses coming out soon geared to parents that can’t come see me. That will offer strategies about prevention, maintenance, and some of the protocols that I use to help heal and arrest cavities too.

Dr. Nicole Beurkens 

Fantastic so needed. We will make sure all of those links are in the show notes, and I just want to say Dr. Staci’s Instagram is great, as she mentioned, videos, so many resources there, you do Instagram Lives on a regular basis with other people. So definitely go follow her, check all that stuff out. Staci, I really appreciate you spending time with us today. So appreciate the fact that we have connected, and are now colleagues, and just thank you for being here and sharing your wisdom with everybody.

Dr. Staci Whitman 

Oh, you’re so sweet. I’m honored. Nicole. Thank you so much.

Dr. Nicole Beurkens 

And thanks, as always, to all of you for being here and for listening. We will catch you back here next time.