Season 3, Episode 2: Optimizing Oral Health Alignment with Dr. Staci Whitman

Evelyne Lambrecht: So Dr. Staci Whitman is on a mission to create a cavity-free world. I love that. She founded NoPo Kids Dentistry in North Portland Oregon, where she takes a whole-body, holistic, and functional approach with her patients. Her dentistry and practice philosophy are both grounded in science and powered by love. Dr. Staci attended Tufts University’s School of Dental Medicine and initially worked as a general dentist, eventually going back to school, earning reward certification in pediatric dentistry from Oregon Health and Sciences University. She’s an Institute for Functional Medicine Certified Provider and lecturer, and has her dual board certification in integrative biological dental medicine and naturopathic dental medicine. She’s also currently working on getting her functional diagnostic nutrition certification and her master’s in human nutrition and functional medicine.

She’s always been passionate about children’s nutrition and how to improve our food system, the oral microbiome and the oral systemic connection, and sleep and airway health, focusing on research in residency on how to improve airway assessments and diagnostic tools in the pediatric population. I have so many questions for you, Staci. First of all, was there something that made you change course after your first two years as a regular dentist? What happened?

Staci Whitman: Oh, yes. Well, again, thank you for inviting me on. I always love talking about these things. Yeah, I was a dentist actually almost for four years, and I just was not satisfied in my career. And part of that was I realized dentistry mostly deals with end-stage disease. It deals with putting out full-blown fires, not getting to the root causes, not spending a lot of time with our patients unpacking the why and advising and educating for prevention. And I just felt like what I was doing wasn’t moving the needle at all. So I wasn’t feeling very content. So I thought, “Well, gosh, how do I get more upstream and still salvage this career that I’ve spent so much time and money invested in?” And I thought, “Well, geez, it’s with kids. I need to get to the children, and I need to educate their parents before disease sets in.”

And so that’s why I went back to pediatrics. But unfortunately, it was still a very traditional program. And when I graduated, lo and behold, I still had the same issues, but now just with kids, and at a much more rapid rate of seeing patients, because in pediatrics, just like in medicine, you tend to have a very high volume of patients in your practice. And so I just thought, “This doesn’t need to be this way.” I attended a course by Dr. Low Dog, who… Yeah.

Evelyne Lambrecht: She’s one of my favorites.

Staci Whitman: I’ve never told her this, I don’t really know her, hopefully, someday, I can thank her in person, but she is the reason I completely change my trajectory. She spoke so much about nutrition and oral health at a conference I was at and things I had never heard of in my entire education and career, and really opened my eyes. And I went up to her after and I said, “How do I learn about what you’re speaking of, but also I have to work? I can’t go back to school.” And she said, “You should look into the Institute of Integrative Nutrition,” which is an online program. Which I did, and again, it’s piecemeal. And so I became a board certified health coach through IIN, and then through that, just met other biological dentists and integrative dentists. I learned more about ozone in dentistry. I was always focused on nutrition and food as medicine.

And that’s when I said, “Gosh, I’m going to go get my functional medicine certification and became IFMCP.” And this is all over the course of a decade. So my office that I founded, I would like to say is one of the only functional, holistic pediatric dental offices in the country. It’s one that I hope to replicate, and I’m certainly working on training other providers to practice the same way but it’s where we take a root cause approach. And part of that certainly is speaking at great depths about not only the root causes with food and nutrition, but the oral microbiome and how it impacts systemic health but also sleep and airway health, and just making all these connections in the body in the oral systemic connection.

And I’ve had such job satisfaction, I really see a change in my patients. I have patients come in that are very ill. They have chronic dental disease and we have to treat them sometimes traditionally, but because we really work with the families to unpack what happened in this child’s life, we do intakes from preconception even, and what happened in pregnancy and delivery and through the breastfeeding journey, et cetera, et cetera, we really get the kids healthy and well. And what’s so beautiful about it is this education spreads through the whole family and to that immediate family’s community too, because obviously, they’re sharing some of these little pearls with those around them. So it’s been really, really wonderful.

Evelyne Lambrecht: I love that. And before we continue, I just have to give some love to Dr. Tieraona Low Dog. We are going to have her on the podcast. So I did her Foundations in Herbal Medicine program, and like you, I’ve done IIN, I did IFMCP, I did my master’s when we were in Nutrition and Functional Medicine. And still, her program is still my favorite I have ever done. So maybe after you do your-

Staci Whitman: Oh, I’m going to add that to my list. Yeah, no, I should, I should.

Evelyne Lambrecht: After your MPH. She is absolutely wonderful. If you’re not following her, she’s just amazing.

Staci Whitman: Oh, I adore… No, she’s incredible. And yeah, my husband jokes, he says, “If you can make a career out of just education, just a perpetual student, that would be free for you-

Evelyne Lambrecht: I think it’s the case with a lot of practitioners who are listening to this podcast, we just can’t stop. But there’s always so much to learn and it’s so exciting. So yes. So what are some of the things that you look at that a regular dentist does not? And I guess I’m asking specifically in children, are you using the functional medicine timeline, the matrix? How do you incorporate all that? Okay.

Staci Whitman: Yeah, I do. I do. We really want to understand everything about that child and their journey, and even digging into the mom’s health and dad’s health too, and what the fertility journey was like. So we do use the functional medicine matrix. A lot of what we’re dealing with in kids, the early intervention, it does revolve a lot around airway. So a huge part of my practice is airway assessment and sleep assessment, but also nutritional deficiencies, which we see often in the mouth or in the skin, and gut dysbiosis that can impact oral microbiome dysbiosis and vice versa because it’s so bidirectional. So we do some salivary analysis in my office, we really focus on pH, and any microbial imbalances, if there’s yeast or candida overgrowth, because that can be very synergistic with oral pathogens that are known to cause cavities. With children, a lot of it is caries or cavities, not necessarily gum disease and periodontal disease. But that’s a huge component of it.

We could speak a lot about just clean materials, biomimetic materials, but how do we modulate the host or the terrain and the microbiome to be one of more balance and optimization? And sometimes, it’s tweaks to diet, sometimes, just tweaks to hydration, sometimes, it’s how the children are breathing, sometimes, it’s getting their gut health under control and working collaboratively with our functional medicine and naturopathic colleagues, allergists, working with a lot of other specialists. So it’s really a team approach with these children. But it’s so much beyond the teeth. The teeth to me are often secondary. I think the teeth tell us a story. So when I look at the teeth, I can tell a lot about the health of a child. I can tell a lot about the health of the child by just looking at their saliva, the appearance of the saliva.

And unfortunately too, we’re seeing a lot of children being born with mineral deficient teeth. And so that is the other passion project of mine, is helping to educate and unpack the why. Because a lot of families, they feel like they’re doing everything correctly, but their children still have all of these issues. And we are seeing an uptick in what we call hypomineralized or under mineralized teeth, and that can be due to fat soluble vitamin deficiencies, which we see a lot of vitamin D deficiency in pregnancy. Certainly, we know our soil is devoid of essential minerals and magnesium that infects tooth development. So we speak to parents a lot about that. We’re also know microplastics in the environment can now affect enamel formation.

So a lot of it is emotional support too. We really believe in the mind-body connection, and we focus a lot on supporting the families. Unfortunately, I think dentistry, there can be a lot of shame around it, and a lot of guilt for families. And so part of my goal is just to prioritize emotional health first with these parents, because as we know, we are all just doing the best we can and we just want the best for our children. So that’s really foundational for my practice.

Evelyne Lambrecht: Thank you for sharing so much information. I have multiple follow up questions. I was going to ask you about the under mineralized teeth, and what does the research show about microplastics, because that is something I’ve not heard about before in relation to dental health?

Staci Whitman: Yeah. So amelogenesis, which is enamel formation, is a very hormone driven process, and so endocrine disruptors, like plastics, are affecting it. So the research is showing that that is a concern. That can be a bit overwhelming to talk to parents about because we truly feel a bit helpless, but we try to give them support and tools to say, “Listen, your child’s baby teeth are affected. Who knows the underlying reason?” Often, many moms do report, they had really hard pregnancies, they know they were vitamin D deficient or mineral deficient, but it could be the microplastics as well. We just don’t know. And so we say, “But your children’s teeth are developing, their adult teeth, they’re developing right now.” So what can we do to minimize the burden? And certainly, that is what we’re choosing to cook in, and what we’re choosing to drink our drinks out of, and just doing the best we can.

Part of my goal too, I do think a lot of this can get overwhelming to many people, and I’m seeing an uptick in anxiety and fear, and as I mentioned that emotional health component too. And so that, again, that’s a really huge part of my practice, is to try to not overwhelm, and support, and give really easy tangible steps for patients. But yes, microplastics, I think, I theorize we’re going to realize, have a lot to do with the dental epidemic that we’re seeing. Cavities are the number one chronic disease globally in children and adults. It took a dip for a while, but now it’s on the rise again. And it’s hard to pinpoint why. I think it’s really hard to fight against big food, and these hyper palatable foods that are meant to be snacked upon, and how they’re impacting our gut microbiome and our oral microbiomes. But also, I think that the microplastics is a big component, and as well as nutritional deficiencies that we’re seeing.

Evelyne Lambrecht: Very interesting. So if a child comes to you and they have under mineralized teeth, what are some of the things that you do? And is that part also related to the cavities, the mineralization part?

Staci Whitman: Yes. So cavities really are from an acid imbalance in the mouth. So when there’s too much acid in the mouth for too long, that is where you will see a cavitation in the teeth. So teeth where the enamel didn’t form, often, they are more susceptible to acid attack. So those teeth do tend to get cavities or degrade more easily. So what we want to do ideally is to have the most optimal oral microbiome possible. We want to crowd out the pathogens, the strep mutans, and the candida, and the bugs that we know are really leading to some of these diseases. But also, we have to double down on diet. So we really need to stick to whole foods and less of the ultra processed foods.

Most pediatric dentists, they know this, that our big issue, it’s not candy bars and soda as maybe it used to be, it is Goldfish Crackers, it’s Cheerios and cereals, it’s granola bars, it’s chips, it’s pretzels, it’s fruit snacks, it’s fruit leathers, it’s those things that many parents might think, “Well, it says organic or it says non-GMO,” but flour acts like sugar in the mouth. And again, it’s all about acidity, it’s about contact time too. So sticky snack foods, you think if you eat a bunch of crackers, they’re all throughout your teeth, they’re going to sit there all day, and then you have a young child where hygiene might be challenging because they’re not super receptive to it, and then you have under mineralized enamel, it just can create this perfect storm. And if you add mouth breathing to that on top of it, which is another epidemic that we’re seeing globally… When we breathe through our mouths, our saliva is diminished. So our saliva has many protective features to it, essential proteins, and immunocells, and enzymes, and calcium, and phosphorus, all these ions and minerals that actually help the mineralization process.

So if we have dry mouth or xerostomia, we lose that benefit, but also, when we breathe through our mouths, the pH drops. So we have an acidic environment, which is the perfect environment for pathogens to thrive. So sometimes, I’m packing many layers for these families, but the whole goal that I have is to really teach parents, “Listen, these baby teeth, they’re practice teeth as far as I’m concerned. Mother nature was kind that way. They’re very important, but we do get a do-over, we get a second chance, but we need to figure out what’s going on in your child now so that once their adult teeth start coming in, we really have things optimized.

Evelyne Lambrecht: Yeah. Tell me a little bit more about the airway assessment that you do and the importance of this, how can it be prevented, and what do we do about it if a child or an adult, is not breathing properly through their nose?

Staci Whitman: Yeah, we do see it in adults. Once you start learning about the airway epidemic, if you will, you can’t unsee it. You can’t go to an airport or a large crowd of people and not look around and see, “Gosh, we have a problem.” So it’s hard to say how do we prevent it because we’re fighting with generations of dis-evolution, is what some people have coined it. James Nestor has a wonderful book called Breath. If people are interested in this, it’s a great way to start your education and understanding of what’s happened in humans. But essentially, our jaws are getting smaller, our airways are getting smaller, our sinuses are getting smaller, our mid-faces are getting smaller. If you go to the Natural History Museum, or if you look at ancestral skulls, you’ll see they have these big wide jaws, they have all their teeth in this perfect alignment. They’re perfectly straight. They didn’t have access to orthodontists, their wisdom teeth are in there.

What’s gone wrong? And many anthropologists theorize, it’s that we’re not chewing as much as we used to. So form follows function. So the act of chewing, the tongue going up to the palate and lateralizing, and the muscles of mastication, they do help grow and form the face from a very young age, and that includes starting with breastfeeding. So ideally, that was the only option we had back ancestrally, was to breastfeed. And so that act of the tongue rising up and lateralizing outgrew the face. But now, we have ultra processed foods, again, is the problem. So since the agricultural revolution and then the industrialized revolution, even more so, we’ve really seen an issue with our airways and crowded teeth, more allergies, more asthma, more mouth breathing. And so what can we do to prevent this?

We are fighting with generations and epigenetics. So at some point, genetics are powerful, but getting issues identified and diagnosed early would be my best advice. So certainly, if you can breastfeed, that is ideal, but not everyone can. And there are things you can do to mimic that lateralization of the tongue and those muscles of mastication. Once food is introduced, ideally chewing as much as possible, so apples, and carrots, and meats, and things that require a lot of mastication really is important. I love to make sure young babies, if a mom is struggling with breastfeeding, if there’s a lot of pain, mastitis, just failure to thrive, a lot of reflux, this could be an entire podcast about some of these things, but seeing an airway trained dentist who might be able to help identify oral ties, whether there’s tongue-tie, if there’s oral motor dysfunction too, sometimes working with occupational therapists, or cranial sacral therapists, chiropractors, they can all help as well.

So also, as your children age, and we’re starting to see small jaws, high palates, crowded teeth, mouth breathing, working with an airway trained dentist who can help you determine the underlying cause. Because it can be many things. It can be enlarged adenoids or tonsils, a deviated septum, it can be enlarged nasal turbinates, chronic allergies, whether environment or food. It can be just a bad habit. Sometimes kids get a cold, they start breathing through their mouth, and then they just never start breathing through their nose again. So if you stop using your nose… Sometimes you forget how to use it, believe it or not. And then there are early interventions like seeing an early functional orthodontist, where we use essentially retainer therapy to help grow the jaws, the midface, the palate, like spread everything back out wide again to not only create room for teeth and help with crowding, but really it’s helping with airway health too.

There’s myofunctional therapists who can help us retrain how to breathe through our mouths… sorry, our noses, and help with any muscle imbalances. Because sometimes, it deals with low-tone, sometimes you need to see an ENT. So there really is a whole airway team that’s involved that can seem incredibly overwhelming to parents. If people are interested, Breath is a great resource, but also there’s a book called Sleep Wrecked Kids, by Sharon Moore, where you can learn a lot more about this. It’s a great read for providers too, to help the pediatric population. But the best bet is to really try to find a more airway trained dentist in your area. And I can certainly share resources for the show notes for you. And just giving yourself grace and just knowing this can be a process, you’re dealing with generations and generations of things going sideways.

But you can get your kids back on track, it can just take some time. My own daughter, she’s 10 and a half now, but she’s the reason I pursued more airway dentistry. They do not teach us in traditional dental programs, although that is slowly changing, but they certainly didn’t when I was in school. And so it was having her have a missed tongue-tie, struggles breastfeeding with her, she had a lot of reflux, I was starting to see behavioral issues, because some of these sleep and airway things can mimic ADHD, and anxiety. And so it just took me realizing, “Gosh, she was mouth breathing, she was snoring, sleeping poorly.” And so I just had to re-educate myself. And she’s 10 and a half, we started her journey at probably four and a half, or five, and she is fantastic now. So it is taken that many years, but in the grand scheme of her life, it’s a blip in time that we worked with some various specialists to get her back on track.

Evelyne Lambrecht: That’s amazing. And you’re right, it is overwhelming, even for provider listening, I’m thinking, “Oh, my goodness, all of these other things that I now need to consider when assessing patients.” I’m curious what your thoughts are on fixing tongue-ties in adults. And I’ve also… I don’t know what the term is, but where you expand your palate as an adult? What do you think about that?

Staci Whitman: I’m a fan. I had my tongue released three years ago at the age of 42. So you can do this any time. And I’m trying to get talked into doing an expansion with… My best friend’s a functional orthodontist, and she wants me to become a Guinea pig of hers. They used to teach us you can’t expand an adult without true jaw surgery. That’s not true. There’s really cool techniques now. There’s something called the Homeoblock, which is an appliance that works beautifully. There’s an MSE appliance, which we know we can break the suture… At the palette, there is a suture that fuses, we used to think it fuse solidly. We know that’s not true. We actually can still manipulate it. And it sounds worse than it is, but they’re just doing really neat things now without doing double jaw surgery, I guess, is what I’m saying.

So there are options, and of course, this isn’t for everyone. Some people are like, “Heck no, no way Jose, I’m fine.” But some people who really want to be optimized or maybe their health are very much impacted, you can always… it’s never too late. And so I noticed a huge difference after I had my tongue addressed. You have to remember, I existed four decades with improper tongue function. So there is therapy, physical therapy, which is called myofunctional therapy that’s required before and after, because your tongue’s a muscle and you need to retrain it. But I noticed I was able to chew and swallow better, and I was having less neck, shoulder, almost chest tension because it’s a fascial restriction too. So again, that’s why you want to just work with a very knowledgeable airway provider.

And again, I can give resources for adults too, but I do want to say it’s never too late. And James Nestor will speak about that in his book. His experience, he had airway issues that he had addressed in adulthood. And the goal is maybe not perfection, I wouldn’t say my issues are completely resolved, but they’re certainly better than they were prior to treatment. And so just know there’s a lot of resources out there.

Evelyne Lambrecht: Very cool. Thank you for sharing. Yeah, I’ve heard of the neck pain releasing, so I just find it absolutely fascinating, especially if somebody’s been living with that their entire life. And you wouldn’t think that releasing a tongue-tie could undo all of that. That’s incredible.

Staci Whitman: So it’s really, really interesting, people can look this up, there is a band of fascial tissue that they just dissected, I don’t know, it might’ve been five, seven years ago or so, it was in Italy by an Italian surgeon, it’s called the deep frontal plane. If you want to look it up, you can see an image of it. Fascia is now being considered an organ. We used to just cut through it and dissections, we’re realizing, “Wait, wait, wait, there’s a lot to this.” And so the deep frontal plane, it’s a band of fascia that comes from the tongue, and it comes all the way down the sternum, it wraps around the iliac, cross around the hips, it goes down your legs, back on the posterior of your legs, and down onto the base of your feet.

And so a lot of patients that have plantar fasciitis, they have found… and these are just case reports, but I’ve seen these procedures actually done live in person in various classes, and a lot of the patients, the tongue will get released on the camera and you’ll see the patients reach down to their foot. They go, “Whoa.” They feel a release in their feet. So it’s much more than just the tongue. Everything’s interconnected.

Evelyne Lambrecht: Yeah, that’s amazing. Very cool. Staci, let’s talk about the oral microbiome a little bit. Can you tell us some cool facts about the oral microbiome, and just the local and systemic role of the oral microbiome?

Staci Whitman: Yeah, it’s really blowing up. You’re going to hear more and more about it. So just like the gut microbiome just became this big phenom about 15 years ago or so, now, it’s time for the oral microbiome. It’s the second most diverse microbiome in our bodies, but after the gut. It does have a bidirectional relationship with our gut, so people will call them kissing cousins. And this is really important for functional medicine providers. I think if you’re working on gut health, if you are not working on oral health too, you are doing a disservice to your patients, because the theory is, and the ideas are, you cannot have a healthy gut without a healthy mouth, and vice versa. We do swallow 2000 times a day. So if we have pathogenic bacteria or dysbiosis in our mouth, we are swallowing those microbes and just inoculating our guts.

We’re still learning more about what microbes can survive the stomach acid environment and down into the GI tract, and what can’t, but we do know some can, and that they can wreak havoc. So we know leaky gut, there are leaky gums. So gingivitis is now what I would call leaky gums. What does that mean? It means the microbes and their exotoxins, they can get into the circulatory system. So oral microbes, they don’t just stay in the mouth. What happens in the mouth doesn’t stay in the mouth, they tend to travel around the body. And so we are finding that a lot of these pathogenic microbes can catch a free ride through our circulatory system or our lymphatic system, and they can end up in places they shouldn’t, like our brains, and our hearts, and our livers, and our stomachs. And so we’re seeing a correlation and a link to increased events with Alzheimer’s and dementia, mood disorders, fertility issues, pregnancy outcomes, diabetes, autoimmune disease, cardiovascular disease.

So a lot of it is about inflammation. We know inflammation is a cause of so many issues, and a lot of this inflammation can be coming from the oral microbes and their byproducts and components of their cell wall. And so it’s really important, especially if you have a patient with bleeding gums, gingivitis, or even if they’ve been diagnosed with periodontal disease, even more importantly that that’s not just getting ignored. Unfortunately, dentistry is just really treating periodontal disease pretty archaically. In my mind, if you’re diagnosed with periodontal disease, generally, you just go in for deep cleanings. So they’re just removing tartar and biofilm, but they’re not treating it medically. And we don’t know how to treat it unless we know what microbes we’re dealing with.

So just like we do gut mapping and stool testing to see what is happening in the gut, we really, in my opinion, should be testing the oral microbiome with salivary analysis, and understanding what pathogens are there, because some can be treated herbally, some need antibiotics, some just need tweaks to diet, it really depends on what the pathogens are. There might be yeast. We’re learning a lot about how yeast has a synergistic effect. They’ve identified seven different types of candida now in the mouth, and so working with your medical providers to talk about maybe a candida protocol that might be needed as well. So unless we know thy enemy, it’s really hard to get patients healthy again. And so there’s a big movement to try to encourage microbial testing of the saliva as well.

Evelyne Lambrecht: What’s the testing that you use?

Staci Whitman: Yeah. So it’s hard in peds because peds… I’ve been doing some pilot studies with a company called Bristle, which is one of my favorites. Yeah, they’re wonderful. Their test is really good. They use shotgun metagenomics, which means it basically can assess for all 700 plus microbes in the mouth. There are other tests like oral DNA… there’s so many now, but a lot of them just target the top 12 to 20 pathogens, and you can be missing a lot by not testing for all 700. So I really like Bristle. With kids, with pediatrics, it’s a little tricky because the microbiome is very transient, because kids put so many things in their mouths. So you might test their mouth one day, and they might be really high in, let’s say, strep mutans, which is the cavity-causing bacteria. But they’re showing no signs of cavities, so you’re a little surprised. And then three days later, you could test them again and there’s really no strep mutans.

We all do harbor some pathogenic bacteria, it usually should be just around 5% or below, but it’s when it starts creeping up to 30, 40, 50% that we do see dysbiosis and health issues. But I am a fan of Bristle. They’re new and I think they’re still figuring out some aspects of their product line, but I believe their science and their team is pretty cutting edge. So that’s the one that I really support.

Evelyne Lambrecht: Very cool. So what are some of the things that we can do to optimize our oral microbiomes?

Staci Whitman: Yeah, great question. Think of the gut, what would you do for the gut? So prebiotic fiber, right? Prebiotics I think are more important than probiotics. So eat the rainbow foods, whole foods, fermented foods. Hydration is very important as well, ensuring that we are breathing through our noses so that we are keeping the pH optimized in our mouth. Cutting out or eliminating ultra processed foods, and it’s honestly eating frequency too. So it’s just like how that affects the gut. We know our gut needs time to rest, we’re not supposed to be dumping food into it constantly. It’s the same with our mouth. So every time we eat, our mouth becomes more acidic. If we don’t give it 20, 30, 40 minutes to rest, and ideally, even eating on a two-hour schedule is better, then we’re just in this constant state of acidity. So we really need to allow our saliva a chance to buffer and neutralize.

So I do suggest eating on a schedule. And that’s the problem. So many kids just snack and graze all day long. And so I really encourage parents to get their kids on an eating schedule. And starting the day off with high protein. So we do know blood glucose regulation. Periodontal disease is considered a metabolic disease. Again, it’s inflammatory. So blood glucose stability is really important as well. The unfortunate thing though is we are dealing with big food. So then how do we combat that with products? So I do love oral probiotics. There’s a lot on the market right now. Obviously, hygiene is important, so we want to make sure the biofilm is reduced and that it’s not adhering to the teeth for too long. So that’s all you’re doing with brushing and flossing, is you’re disrupting the biofilm. Unfortunately, it comes back again, and how it comes back has a lot to do with what we’re eating, how we’re breathing, our nutrition, and our hydration.

I’m a big fan of flossing, I love tongue scraping, I’m a fan of oil pulling, but sometimes we need products that can re-mineralize too. And so I am a big fan of hydroxyapatite products as opposed to fluoride, especially nano-hydroxyapatite. I have seen it work clinically in my office now for almost eight years, and it is magical what it is doing to patients. I’m avoiding so many fillings and anesthesia visits with these kids who switch their toothpaste. The problem with fluoride, besides a lot of things, but the thing a lot of people don’t realize is that fluoride is antimicrobial. It’s not selective. So we used to think that was a benefit, but it’s actually targeting… I shouldn’t say targeting, but it’s affecting commensal and beneficial bacteria too. And so that can cause a lot of dysbiosis, so it can be counterproductive. When a lot of patients drop the fluoride, I see a huge uptick in their oral health. So even though fluoride makes teeth more acid resistant, it can be impacting the oral microbiome too.

Evelyne Lambrecht: Interesting.

Staci Whitman: Yeah. Yeah. So but you notice I put hygiene lower down on the list. If you eat a really clean diet and you’re optimized, hygiene is less important, hydration is extremely important, things all of that nature, you just kind of chip away at it. I think a lot of us are deficient in vitamin D, so if we can’t get optimal in our vitamin D ranges and obviously work with your physicians, you can’t get out in the sun like we should. If you’re just still low, I do love a vitamin D supplement. This is what I tell patients, is considering a vitamin D3, K2 supplement. Magnesium is really important too. We know our soil is so depleted. Magnesium is extremely important for bone and tooth and facial development. And trace minerals as well. Just in general, I find they’re just so important for our teeth, for our saliva, and for microbiome stability too.

Evelyne Lambrecht: Tell me a little bit more about maybe success stories that you’ve seen in your practice from people who switched to fluoride to hydroxyapatite. Do you find that you actually physically notice that the teeth re-mineralize with hydroxyapatite?

Staci Whitman: Yes, 100%. So there’s different types of hydroxyapatite, there’s micro or there’s nano, and depending on the percentage in the toothpaste, they both can be super effective. So yes, I see remineralization, caries arrest, caries reversal all of the time. It’s part of the protocol I have. I have actually caries reversal protocol at my office or arrest protocol. I have an oral microbiome reset protocol too, it’s honestly why a lot of people travel far to see me. It’s been extremely successful, and part of that is hydroxyapatite. So hydroxyapatite is calcium, it’s phosphorus, it’s biomimetic. Our enamel is made of hydroxyapatite. 97% of our enamel is hydroxyapatite. 60% of our bones are made from hydroxyapatite crystals. So it’s been around for about 50 years. There’s a ton of research on it.

What’s interesting is the American Dental Association went through and approved a new CDT code, which is an insurance code, just the January 1st of this year, 2024, it’s brand new, and it was for a hydroxyapatite varnish. It’s the first time they’ve approved any code for hydroxyapatite, and so what does that mean? It means the big dogs know that this stuff works. It means they know people are moving away from fluoride, and that patients are asking for alternatives. So I’m a huge fan of hydroxyapatite. My whole family uses it.

Evelyne Lambrecht: Very interesting that you shared that, because I wanted to ask you, out of curiosity, if you still go to any of your old American Dental Association meetings. I’m curious. Do they still talk about fluoride?

Staci Whitman: Oh, yes. I actually not really a member anymore either, that’s for all kinds of different reasons. But yeah, they still promote fluoride for sure, they promote water fluoridation. They haven’t come out and spoken out against mercury fillings, even though we know they’re terrible. The EU is banning mercury fillings, actually. They did ban them. I think they’re giving the dentist a couple of years to get them out of the offices. So it’s just frustrating that stuff gets just brushed under the rug. But yeah, I tend to avoid meetings like that. I want to learn from people that are going to help me become a better provider, and I want to share my experiences with people that want to listen. You know what I mean? So yeah.

Evelyne Lambrecht: Yeah. And I think the thing with fluoride, if I understand correctly, it’s not necessarily bad in toothpaste because it does what it’s supposed to do, it’s just swallowing it, right? Just like in our water, we try to avoid it for that same reason.

Staci Whitman: Yeah, it’s a little up for debate, but we can talk about it separately. So there’s systemic fluoride and there’s topical fluoride. So systemic fluoride, that’s water fluoridation, that’s prescription pills, and things of that nature. Fluoride’s also in a lot of pharmaceuticals, especially like mood stabilizers. So we’re getting fluoride from all kinds of sources. There is a federal lawsuit. The testimonials in the trial happen a month ago or more now. It’s been going on for many, many years, and the judge should be ruling very soon. And I will tell you, it doesn’t look great for water fluoridation. So we are one of the only developed countries that still fluoridates our water. Many people don’t realize that, but 97% of the planet does not fluoridate their water.

Many… I shouldn’t say many, most European countries have removed it. And why is that? It’s for a few reasons. There are neurotoxicity concerns, there are now many very high quality studies that show it can reduce IQ in children whose moms, when they were pregnant, were exposed to too much fluoride, and also in those early infancy and young childhood years, because we just can’t calculate how much we’re getting exposed to, it’s too hard. You might drink a glass of water, I drink eight glasses of water, you’re swallowing fluoride supplements, and I’m eating processed foods with fluoride, and it’s just really hard to calculate. And obviously, it’s weight dependent. And someone who’s 250 pounds should be getting a different amount than someone who’s 50 pounds. It can compete with iodine. So there’s thyroid issues, and fluorosis is a big concern. So that’s the systemic concern, and I think that’s pretty much a no-brainer. I think most people could say, “Yeah, that doesn’t even make sense.”

There’s also just medical consent issues, we are mass medicating people without their consent. So that’s a concern. And that’s why many European countries took it out actually. So then with toothpaste, yeah, I think any child under six who might be swallowing it, I would be very cautious with it. We don’t fully understand what the cumulative effects of ingesting toothpaste are. Of course, it is a lesser dose, but there will be some mucosal absorption. And so that still needs to be studied. So I do say to families, if you want to use fluoride, just use it topically. Use a very small amount, and make sure your child’s spitting. But even better, because I do have concerns, I can’t look a parent in the eye and completely reassure them that it’s totally safe. That’s when I suggest a hydroxyapatite.

Evelyne Lambrecht: Great. Thank you for that. I have some other questions about other things that we can do for our gums, for our oral health, for our teeth. So what are your thoughts on oil pulling and tongue scraping?

Staci Whitman: I love them both. I love them both. Please do them. Yeah. So oil pulling is an ancient Ayurvedic practice. It used to be done mostly with sesame oil. I think now, more modern times, people are doing coconut oil, so like a raw, organic coconut oil. Coconut oil has an antimicrobial effect. So I do think we should be a little cautious, we shouldn’t be overdoing it. Because again, it’s not just targeting pathogenic bacteria, but it can have an effect on some of the beneficial bacteria. So I oil pull the… I say, maybe don’t do it every day, just do it a few times a week. And so I do love it, but I love, love, love tongue scraping. So I think everyone should do that daily. We know there are different niches in the mouth that harbor different bacteria. So the bacteria that stick to our teeth are different forms of bacteria that live under the gum, that live on the surface of the tongue, that live in the tonsillar bed, that live on the cheek. So there’s all these different ecosystems. It’s like a rainforest in there.

And so on the tongue… there can be a lot of pathogens that live on the tongue, including candida. And learning more about nitric oxide, which is the molecule that influences cardiovascular health so much, and immune health, and those pathogens that can live on our tongue can really inhibit nitric oxide production. So again, you don’t want to overdo it, but I tongue scrape once a day. I happen to do it in the morning usually, but you can do it twice a day. I don’t want people to become overly obsessive with it because you don’t want to strip the healthy bacteria too too much. But I think it’s one of those things… until you start doing it, you don’t understand how wonderful it makes your mouth feel. You’ll actually be able to taste your food better because you’re removing small molecular particles that can influence taste, and cravings even. And that’s where we can get a lot of candida too.

So yeah, I’m a big fan. People always ask, “Well, when can we start?” You can start in kids, is once they can stick their tongue out and they understand what’s happening, you can tongue scrape them. And then people also say, “Well, can I just use my brush?” And the answer is no. The studies actually shown, no, your toothbrush doesn’t get the microbes off quite like a stainless steel or a copper tongue scraper does. And plus, then you can create cross contamination a little bit too. Because again, those microbes are very different than the ones that might be living on your teeth. So it’s just something to think about.

Evelyne Lambrecht: I’m glad you brought up the nitric oxide, which did come up in at least one, maybe all of our shows on cardiovascular health a few months ago. And we know that mouthwash can also inhibit… regular mouthwash, can inhibit nitric oxide production. So that could be even leading to high blood pressure in someone-

Staci Whitman: 100%.

Evelyne Lambrecht: … just one other thing to think about as a provider.

Staci Whitman: Yeah. Yes. Traditional mouthwashes are usually very highly concentrated with alcohol, and antiseptics, and astringents, and that whole concept of, “It kills 99.9% of germs.” I think we know better than that. We’re over disinfecting, we’re using too much hand sanitizer, we’re bleaching our kitchens too much. Let your kids play in the dirt. There is so much benefit to that to help with preventing allergies, and obesity, and asthma. But the same as with the mouth, we’re over disinfecting. We don’t want to carpet bomb the mouth. And so that’s what these mouthwashes are doing. We really need to move away from that concept of the burn, and the tingle, and the foam. That’s not good. That whole minty, burn, really b essential oils, they’re antibacterial. And so I think you’ll find that’s why a lot of healthier toothpaste, it takes some getting used to. And I tell patients, “Just be patient.”

It’s just like if you moved away from your traditional aluminum deodorant, maybe there was a little transition period, that as you got off from it, where you just felt maybe you were odorous a little bit, or just things… You were reestablishing your microbiome. And a lot of hair products too. We’re not shampooing as much. We don’t want that sodium lauryl sulfate, that foaming. That can strip the oils and the healthy microbes on our scalp too. There’s a skin microbiome, and so sometimes, as we’re changing our hair products, we notice our hair’s a little more oily, it feels dirtier. But you just need to allow the body to reset. And so mouthwash, yes, it can strip away a lot of healthy bacteria that can produce nitric oxide. And then there are some studies that are showing an increased in blood pressure and cardiovascular issues. And then also, erectile dysfunction is another one that is heavily influenced by nitric oxide production.

Evelyne Lambrecht: Right. It’s so interesting to me, Staci, just kind of aside, but I was interviewing ophthalmologist most recently, and she’s looking at the eyes to see what’s going on in the rest of the body, we’re looking at the teeth and the mouth. And it’s so interesting to me because we all have health insurance, or hopefully, we have health insurance, and yet our teeth and our eyes are treated separately, like they’re not connected to our body.

Staci Whitman: This is my personal project. It’s partly why I want to get my master’s in public health. Because as I move out of clinical dentistry, I want to go… I want to take on big food, but I also want dental care to be part of healthcare. It’s ridiculous that they’re separated, and dental benefits are just garbage for patients. It is part of our body. And with this oral systemic connection, it’s really a disservice for the health of our fellow humans. So I’m hoping at some point, there’s a way that we get them all, get the mouth back into the body, get the eyes back into the body. It’s really unfortunate. But I think people are waking up to it, and I think it’s going to be like a grassroots effort, where these changes are going to come from patients and from the general population, because they’re going to be demanding for different providers and just a different approach.

Evelyne Lambrecht: Yeah. Absolutely. Staci, where can practitioners learn more about you?

Staci Whitman: Yeah. I try to show up on Instagram as much as possible when my schedule allows. You’ll see I have moments of ebb and flow because I am still very active in my practice. But I’m on Instagram quite a bit. Doctor_Staci, it’s D-O-C-T-O-R, spelled out, underscore Staci. I am on TikTok a little bit with the same handle. I have an oral healthcare line that I created, it’s called Fygg.com, which is Feed Your Good Guys. You can check out some of the stuff I’m doing there. And then if you want to come see me in person, I have my office in Portland. And we have people that travel from all over the country. And it’s NoPo Kids, N-O-P-O Kids.com. And yeah, I’m working on a training program. There’s some discussion of the institute of functional dentistry. And I’m trying to create some training programs to train other dentists at my office too, who want to practice specifically pediatrics a little differently too. So everyone can reach out to me. You can find me on Instagram, DM me, and I usually answer those messages.

Evelyne Lambrecht: Wonderful. And I also wanted to add that you’ve some excellent information just on your website for providers and parents.

Staci Whitman: Yes, my website. Silly me. I have so much information on my website, I have blogs and videos. Thank you. Yeah. And that’s doctorstaci.com

Evelyne Lambrecht: Wonderful.

Staci Whitman: I knew I was missing something.

Evelyne Lambrecht: Staci, I just have three more questions for you that we ask everybody, these can be rapid fires. So what are your three favorite supplements just for yourself?

Staci Whitman: Well, if I could consider water and oxygen, I would prioritize those. But let’s assume those don’t count. I do take a D3+K2 every single day, I take my magnesium blend every night before I go to bed, I would say, trace minerals. Those are my go-tos. They make me feel better. I also, I do like to take B vitamins as well. I have methylation challenges, as so many of us do. And so methylfolate and the B vitamins are important for me as well.

Evelyne Lambrecht: Great. And what about your favorite health practices that keep you healthy, and resilient, and balanced, running practice, being a mom, studying?

Staci Whitman: Totally. I’ve become neurotically obsessed with my sleep. I do not sacrifice my sleep. Sleep hygiene’s important to me. I make sure I’m getting a full night’s rest. I lip tape at night because I’m a bit of a mouth breather for various reasons, and I want to be breathing optimally through my nose. And so that helps me feel rested and restored. So sleep. And I think just hydration, I think it’s just so important. I feel so much better. I do electrolytes too in my water, but sleep and hydration would be my two… Just easy things that are accessible to everyone really, to some degree. So movement, of course. I try to move my body every day. I try to get sunlight. I also just really value community and laughter. I think this was these little things that… I actually, admittedly, am very into the whole biohacking scene, but you can rabbit hole on some of that stuff. And if you just focus on the basics, you’ve really hit help in a lot of ways. So yeah.

Evelyne Lambrecht: Yeah. And then the final question, what is something you’ve changed your mind about through your years of practice? And I guess I’d almost focus more on not when you were in traditional dentistry, but maybe as you shifted just in the last couple of years. Is there anything?

Staci Whitman: Oh, well, I was going to say fluoride was the big one. I think for me, it’s been that shift to emotional health first. The blinders go up and you’re just tooth, teeth, mouth, tongue, like oral health, and then you realize, “Wait, there’s this whole child attached to this mouth, and there’s a family attached to this child, and there’s a community attached to this family.” And so when I start thinking that way, it just really helps give perspective of how I approach educating this family, and supporting this family, and not overwhelming the family, and supporting the child. So I just think prioritizing emotional health, it’s just become foundational in my office. I think we don’t give enough credit for the importance of the mind, and the outlook, and the power of positive affirmations, and things like that too. So yeah.

Evelyne Lambrecht: Wonderful. Thank you for sharing. And Staci, thank you so much for coming on today. I feel like we could have talked for another hour because there are so much more we didn’t even get to.

Staci Whitman: Oral health tends to do that. Yeah. Yeah. Usually, it could be a really long, long podcast. So I am always happy to come back if you’d like to focus on anything else.

Evelyne Lambrecht: Thank you so very much.

Staci Whitman: Thank you, Evelyne.

Evelyne Lambrecht: Thank you for tuning into Conversations for Health. Check out the show notes for resources from today’s show. Please share this podcast with your colleagues, follow, rate, or leave review wherever you listen and watch. And thank you for designing a well world with us.

Voiceover: This is Conversations for Health with Evelyne Lambrecht dedicated to engaging discussions with industry experts exploring evidence-based, cutting edge research and practical tips.