My Baby/Toddler/Child Hates Brushing…Help!

girl smile happy

My BabyToddler ChildTeen Hates BrushigThis is very likely the MOST common concern we hear from parents here at NoPo Kids…”My child hates it when I brush their teeth and I am afraid I am going to create emotional trauma if I force it!”

Oh, man…I know this feeling all too well. I am a mother first and foremost and it seems like only yesterday when I would ask my husband to close the bedroom windows in the summer for our brushing and flossing sessions so our neighbors wouldn’t think I was torturing my kiddos. But please know, this is common and this, too,  shall pass.  In fact, it is more common to have a child that hates oral hygiene than it is to have a child who is cool, calm, and collected for brushing and flossing over those first few years of life. That being said, I am here to offer support and this advice…just do it. I mean, you don’t need to aggressively pin them down, but gently restraining kids for dental care is a very necessary thing and I assure you, the more consistent you are with it, the easier it will get. I pinky-swear promise you.

I often share my story with parents here at the office, telling them how I used to do adult dentistry and wasn’t loving it. I was constantly bummed out by being told not only how many people HATE the dentist, but have legitimate fear (terror?) about having their teeth cleaned, checked, and worked on. And you know what?  Not one person ever sited a traumatic memory of their parents brushing or flossing their teeth as a child. Do you remember this? I sure don’t! Rather, almost every person I met recalls a horrible experience as a child getting their teeth fixed after being diagnosed with cavities (arguably from lack or homecare and poor diet). It got me thinking…it doesn’t have to be this way! How can I help to shape children into adults that not only care about their teeth and well-being, but love going to the dentist?! I mean, if your mouth is heathy, coming to the dentist is no big deal, right?! Luckily I was accepted in to the Pediatric Dental Residency program here at OHSU and the rest is history.

It all starts from birth…honestly. Before there are even teeth you can start desensitizing your child by doing gentle wipes of the gums and tongue daily with small facecloths or xylitol wipes. This will help your child get used to having their mouth touched as well as to help reduce bacteria in the mouth. Once teeth erupt, usually around 6 months old, I started my kids with a little silicone finger brush and that ever-present-at-every-baby-shower banana brush. Both are wonderful.  If your child feeds throughout the night, wiping the mouth and teeth after feedings is ideal, and certainly brushing every morning and night will help reduce bacterial load and acids in the mouth and will help to create a habit and routine in your child. I think my girls were around 2.5 years old before the brushing/flossing and screaming stopped completely. It was a gradual change, some nights being better than others, but eventually the switch went off and “poof,” it became a non-issue. Now at 5.5 and 3.5 years old, they are tooth-hygiene-ninjas and it is honestly only due to consistency (and constantly talking about germs in our mouth and cavities, etc). I also recommend to introduce a manual toothbrush or an electric toothbrush around 1 or so. I know most electric brushes say to wait until kids ae older, but I personally do not have any concerns with using a spin brush from an early age and believe it actually helps to expedite desensitizing your child to the “tooth routine,” plus it does a much better job of cleaning than a manual brush does!

Survival tips!

1) Remember: you are NOT hurting your child with brushing and flossing. They just don’t like it. My kids hated diaper changes, face wipings, and hair washings, but we did it no matter what. I want teeth to fall into the “no matter what” category. Avoiding cavities from ever starting is really what our goal should be from the very beginning.  Plus more and more research is linking disease and bacteria originating in the oral cavity to systemic diseases, so you truly are setting children up for better overall health by dialing in the oral hygiene routine from a young age.

2) If still in diapers, try brushing and flossing on the changing table. In the top drawer of my table, I used to have diapers, diaper cream and toiletries, and a toothbrush basket with tooth brushes (various types to play around with), toothpaste, tooth wipes and flossers. You are typically at that changing table every morning and every night, so why not stream-line life a little and do it there? Trust me…it works.

3) Sing songs (there was a lot of Katy Perry “Roaring” at our house in those early years), chase animals around their mouths, or play memory games! I used to pretend to see what my kids ate that day in their mouths.

“Sloan, what did we have for breakfast?”
“Oh, right, let me get all of the scrambled eggs and broccoli out of your teeth! How about lunch?”
“Soup and blueberries!”
“Oh, yea, let’s get ‘em outta there!”

You get the point.

I would shoot for around minute of brushing (or two rounds of ABC’s).  The “two minute” guide is really for full adult dentition and I prefer a quick but thorough one minute session to a drag-out-combative-teary two minute session.  Less can be more here.  Just try to be quick, but THOROUGH (ie:  get outsides by the checks and insides by the tongue).  And please, please, please floss daily anywhere teeth touch, especially back molars!!

4) For children that are reaaaallllly tough, sometimes you may need to use more clever tactics and positioning. You can place them on changing tables, bean bag chairs, the couch or beds and gently lie on them/rest your body on them (having someone assist with hands, legs and head can help), swaddle them in a big beach towel, or if with another adult try the lap to lap position. For those of you that have been to our office, you know this position well as it is how we approach the first few dental visits until the child will sit in the “big chair.” I am a HUGE advocate for lying kids back to brush and floss. There is a reason the dentist lays you back…you can see so much better and the angles and ergonomics are much easier. Plus, it gets them used to this position for future dental visits. I still often brush and floss my girls on their beds right before nighttime stories. I use either a non-fluoridated toothpaste (look up Theodent toothpaste…it is amazing) or only a tiny smear of fluoridated toothpaste (I like Kiss My Face, Berry Smart) if they are still not spitting or if you are brushing in the bedroom where spitting may not be happening. If your child has mastered the art of spitting, a pea-sized amount is generally sufficient for bathroom brushing.

5) Older kids seem to really get into their oral hygiene routine with the addition of charts. We have brushing and flossing charts on our website under KIDS CHARTS to print out at home and we also give them out at dental appointments. I use charts for almost everything at home: good sleeping, good manners, helping with keeping our home neat and tidy, etc. They are magic and seem to empower most children to embrace their homecare, overall health, and to be good humans! Rewards at the end of a chart’s completion helps, too. And if your kids fill them out and bring them in to us we have extra prizes for them! It’s a win-win for everyone!

6) I am not always a big advocate for more screen time, but parents of older kids often use tooth brushing and flossing as a way for kids to earn screen time. Give it a try?! I also really want parents supervising or helping to assist with brushing, and especially flossing, until kids are around 10 years old. This is an age based on my clinical experience and, of course, each child is different, but I find the understanding and dexterity simply isn’t there until kids are older. You will hear us say this to all kiddo’s here at the office…hit double digits and you can likely be free to brush and floss on your own.

7) Games and Podcasts! I have had many parent report that Sonicare Kids and their app for kids has changed their lives. It links via Bluetooth to your phone and allows the kids to chase ‘sugar bugs’ around their mouths, actually recording where kids are missing most and helping to get kids to focus on problem spots. Also, Chompers is a wonderful Podcast released twice a day (morning and night) to help motivate and excite kids about oral hygiene…check it out. Most kids seem to love it based on the smiles on their parent’s faces, relieved that the brushing battles have subsided a bit at home.

8) Flossing ideas: for trying to get older kids into good flossing (and brushing) habits, try buying a suction mirror for the shower and leave floss and a toothbrush/toothpaste in the shower. This is how I got my hubby to floss daily and it works! Leave flossers on the nightstand, in the car, near the TV viewing area, in backpacks, at reading stations…get creative. I don’t care where it happens, I just want it to be happening, ideally daily. Also, if you have older children, try looking for books or Google searching about dental hygiene and dental disease…the stuff you will find can certainly be very motivating for all of us. Dental disease is now being very strongly tied to increases in various systemic diseases, and most older kids will grasp this concept easily. Education is key! We have some great books and images here at the office that we are happy to share with your child if you think this may help them. Let us know!

I know this is a lot to process and when you come to see us we will happily share more tips and tricks  and positioning tactics with you. I am all about parental survival and will work with you to come up with ideas that will meet your individual family needs. Also, check out our YouTube channel (Doctor Staci) for my video showing positioning ideas for smaller kiddo’s. Stay strong parents! You got this! Try to keep it positive and educational and everyone will come out ahead! #nomorecavities #eatarainbow #flossisboss


Love and Health,

Doctor Staci and the NoPo Kids Team xo

The information provided on this site is not intended as medical or dental advice and should not be interpreted as such. The intent is to provide as much scientific information as possible on different dental materials and aspects of dentistry where controversy exists and scientific clarification would be of benefit to patients, staff, dentists, physicians and scientists in making informed judgments. If you seek medical or dental advice, please consult with a health care professional. You must always exercise your own best judgement when using the services of any health care practitioner.

Thumb and Finger (Digit) Sucking: Problems and Solutions

teething thumb suck

When an adult needs to de-stress they often turn to a variety of coping mechanisms—whether that be exercise, a hobby, reading a book, a nice glass of Pinot Noir, etc. But when an infant or toddler needs to de-stress, very often children turn to thumb or finger-sucking for comfort.

Yes, that’s right, your child—even at the age of one or two—may need a de-stressor. Stress can start that early in life. We all know that growing up is tough and navigating the world around us can be really difficult for these little ones. Since your child is not old enough for most of our “adult” coping mechanisms, they may resort to thumb or finger sucking.

Digit sucking is normal for young children. Early on, they develop a positive association between sucking, comfort, and satisfaction—think about breastfeeding, pacifiers, bottles and sippy cups. So, naturally, when children need comfort or a de-stressor, they turn to sucking something. While this is totally normal for infants and smaller children, if they fail to grow out of it in time, it can negatively impact their oral health, growth, airway and speech development.

Thumb Sucking Complications:

Open Bite
Open bite occurs when the top and bottom front teeth begin getting pushed outward. This misalignment causes the front two teeth to not touch, not even when closed. This can make many sounds difficult to articulate and also can make it so biting or incising into things is nearly impossible!

Speech and Airway Issues
One common and concerning issue associated with thumb or finger sucking at too old of an age is narrowing of the jaw or palate. This is where the roof of the mouth develops too narrowly due to the pressure from sucking a thumb, finger or pacifier. Intensity and duration affect this, too, with children who suck on digits all day and with lots of suction-power having worse outcomes. Palate narrowing often result in improper speech patterns such as lisps, including an inability to pronounce hard consonant sounds like “D” and “T.” It also affect tongue positioning and can create a narrow nasal floor which can lead to difficulty with nasal breathing and may lead to sleep apnea issues down the road. If the habit doesn’t stop by the time the adult dentition begins to erupt, patients often need orthodontic interventions including expansion, headgear and possibly even traditional braces. Myofunctional and/or speech therapies are often needed, too.

How Old is Too Old?
If you think your child is too old to be sucking their thumb or fingers or have concerns with their growth and development secondary to a digit habit, feel free to contact us at NoPo Kids at (971) 978-0009 to get an appointment and some personalized recommendations. Most children will drop a digit habit on their own, usually around kindergarten (likely due to social pressures…ie: their peers make comments about it). A nice way to begin the conversation is to start and discuss germs on our hands and how we do not want to put our dirty hands into our mouths as it can make us sick. Kids will understand germs, but not necessarily that they are changing the way they are growing or their airway development. We also sometimes recommend a bitter ointment, Mavala Stop, which really can help to break the habit, but often we do not advise this until kids are a little older…say 3 to 4 years old.

If your child resists giving up their habit and continues to suck their thumb or fingers past the age where they should be stopping to avoid long-term issues, here are a few tips to encourage them to grow out of the habit.

Use Positive Reinforcement
Be proud of them and reward them when they use other healthy coping mechanisms for comfort. Comment when you notice they aren’t sucking their digits (instead of only focusing on when they are). We have charts here and on our website for “No Thumb-Sucking” that kids can fill out and return for extra prizes. Charts seem to really motivate children and are a great way to keep track of their progress!

Limit Times
You can try and establish rules like trying for no thumb or finger sucking in public or they can try to only suck digits in the morning or right before bed. Cutting back of time (duration) can really help them to break out of the habit.

Give Them a Few Reasons to Suck Their Thumb/Fingers
Remember that digit sucking is a comfort and de-stressor for them. While you cannot remove every stressor, if you see your child about to suck their thumb or fingers, you can distract them with a game or something that occupies both of their hands and help them find better ways to cope.

Raising a young child is rewarding, but also often challenging. Trying your best to wean them off thumb or finger sucking at the right time can help avoid extra challenges and issues later down the road. We do know it can take 21 days to break or start a habit, so trying to keep your child digit free for a full month will ensure the most success with reprogramming their brains and helping to alleviate the habit.

If you come and see us at NoPo Kids, the team will spend more time discussing all of these thumb and finger sucking solutions with you. Remember…at NoPo Kids we believe the mouth is not a separate body part from the rest of the system and strive to educate with a Whole-Body Approach. We teach kids to ”Eat A Rainbow” for optimal oral and systemic health and will work with you to find suggestions, tips, and tricks that fit into your specific family needs. We’d love to chat more! Book an appointment with us today to help prevent future developmental issues!

Love and Health,

Doctor Staci and the NoPo Kids Team xo

The information provided on this site is not intended as medical or dental advice and should not be interpreted as such. The intent is to provide as much scientific information as possible on different dental materials and aspects of dentistry where controversy exists and scientific clarification would be of benefit to patients, staff, dentists, physicians and scientists in making informed judgments. If you seek medical or dental advice, please consult with a health care professional. You must always exercise your own best judgement when using the services of any health care practitioner.

MTHFR Gene Polymorphism: A Closer Look

kid mom hold hands

As many of you may have been hearing about from your naturopathic physicians or reading about on social media or various blog posts, MTHFR gene polymorphism is a pretty hot topic, especially when it comes to using nitrous oxide or receiving sedation at the dental office.  Dr. Ryan Allred, a board-certified dental anesthesiologist that I trust so much (he is a seriously brilliant and incredibly kind human) is as close to an expert on this topic that I have yet to discover and was gracious enough to share his very informational and educational presentation on MTHFR with me recently.  Here I breakdown and summarize his main take-home points in an attempt to clear the air about MTHFR and hopefully ease some parents minds about this condition.

  • MTHFR (Methylenetetrahydrofolate reductase) is the rate limiting enzyme in the methyl cycle. MTHFR catalyzes the production of the active form of Methylfolate which is used for DNA production and homocysteine regulation.
  • Genetic alterations in the MTHFR gene are relatively common. These are called SNPs (single nucleotide polymorphisms).  Individuals with MTHFR SNPs have a decreased ability to regulate homocysteine levels.
  • Patients with MTHFR SNPs are likely at a higher risk for various problems: Increased risk of vascular inflammation (increased cardiac risk), Neural tube defects , Neurological deficits (mylenation defects), and Autism.
  • KEY POINTS! 1) Severe MTHFR SNPs are rare 2) Risk Factors are children under 1yo, severe vitamin B deficiency, and severe MTHFR SNP  3) AAPD (American Academy of Pediatric Dentistry) states that Nitrous Oxide is contraindicated for those with a severe MTHFR SNP         4) Signs and symptoms for severe MTHFR SNPs are hypotonicity, motor dysfunction, mental delay
  • Patients can be heterozygous or homozygous. Homozygous mutations are usually considered more severe.  Be leery of self-diagnosing from tests like 23 and Me or from markers only.  These can certainly highlight potential issues, but if you have true concerns, please see your doctor where proper testing can be completed to differentiate between severe or mild mutations (or any at all!).
  • Mild variations of MTHFR are fairly common in America.
  • Severe MTHFR mutations are rare and lead to a serious medical condition called hyperhomocysteinemia. There are currently only around 50 patients worldwide diagnosed with severe MTHFR mutations.  Signs and symptoms of severe MTHFR include:  developmental delay, motor and gait dysfunctions, seizures, and neurological impairments.
  • Recommendations if your child would truly benefit from Nitrous Oxide or General Anesthesia Sedation at the dentist and has diagnosed mild MTHFR…
    • B12 supplementation before and after procedure
    • Increase green leafy vegetables (methylfolate) before and after procedure (Green Smoothies!)
    • Avoid Nitrous Oxide use in any patient with a known Vitamin B12 deficiency or who is known to have a severe MTHFR SNPs-particularly a homozygous SNP
  • Conclusion: MTHFR polymorphisms are common, but it is controversial as to how important mild SNPs are to a patients overall health.  Nutritional intake of folate and vitamin B12 is important to help improve MTHFR activity in the event your child need Nitrous Oxide or other forms of anesthesia sedations.
  • Remember…major problems from MTHFR SNPs are really rare and Nitrous Oxide use remains a safe modality for patients with no mutations or only mild mutations.

If concerned with your child metabolizing (methylation) of medications and to speed up any residual neurological effects of anesthesia, it is recommended to supplement with B12, leafy green vegetables, and Methylfolate a few days prior to your appointment and a few days after.  Epson salt baths (magnesium sulfate) can help expedite the processes as well.

If you still have concerns, we are always here to listen and to help to offer more information and potential alternatives.  Getting your child properly tested is the best place to start, however.  Going off markers alone is not generally conclusive in differentiating the degree of mutation your child may (or may not) have.

Call us today at NoPo Kids Dentistry to schedule a consultation and to discuss your options or talk more to your doctor about your concerns.  We always want parents to feel informed in their decisions and encourage you to reach out to all sources possible to gain as much information about this topic as possible.  Visit to book an appointment of to see more of our office’s offerings.

Love and Health,

Doctor Staci and the NoPo Kids Team xo

The information provided on this site is not intended as medical or dental advice and should not be interpreted as such. The intent is to provide as much scientific information as possible on different dental materials and aspects of dentistry where controversy exists and scientific clarification would be of benefit to patients, staff, dentists, physicians and scientists in making informed judgments. If you seek medical or dental advice, please consult with a health care professional. You must always exercise your own best judgement when using the services of any health care practitioner.