Talking Pediatric Dentistry with Dr. Onwuka

Our very own Dr. E. Chioma Onwuka joins Dr. Michelle Stafford on the podcast this week! Dr. Onwuka is a board certified pediatric dentist and joined World Of Smiles in January 2019.

As a pediatric dentist, Dr. Chioma values preventive dentistry as the core of her practice philosophy. For this reason, she strives to build strong relationships with her patients and their families in order to provide adequate oral health education and in turn quality, comprehensive dental care.

Dr. Chioma was born and raised in Southern California, but she is excited to be back in the Pacific Northwest serving the dental needs of the children in the area.  In her free time, she enjoys hiking, watching movies, and spending time with her loved ones, including her boyfriend, Chidi.

Topics discussed in this episode:

• The importance of the age 1 dental visit

• Supporting your child’s brushing

• Silver Diamine Fluoride(SDF)

• The role of diet and nutrition

Downloadable resources to help parents

Listen, read, watch! You can listen right here, or with a podcast app of your choice. You can also read the complete transcript below, or scroll to the bottom of this post for the video.

You can browse all previous episodes on Anchor and Youtube!

Dr. Stafford: Hi, I'm Dr. Michelle Stafford here at World of Smiles with our podcast, Mixed Dentition, and today joining me is my associate Dr. Chioma Onwuka. Hello.

Dr. Onwuka: Well, thank you for having me.

Dr. Stafford: Thanks for coming on the show today. So I thought we could start off by just talking a little bit about you and your background. Maybe talk about what brought you here to Portland.

Dr. Onwuka: Yes, so I'm actually originally from Los Angeles area by way of Nigeria. My parents are originally from Nigeria, West Africa. But, I grew up in LA area and went to college at Stanford in the Bay Area and then, came back down to Southern California for dental school. Then, I fell in love with pediatric dentistry, so I made my way back up to the Northwest and I completed my pediatric residency at the University of Washington.

Dr. Stafford: Great school.

Dr. Onwuka: So I graduated, actually, in 2012 and then after graduation I was toiling with the idea of moving to Seattle, because my program was based in Yakima, which is about two and a half hours or so from Seattle. At the time, my sisters were just starting their families in the Seattle area. So I debated between staying in the Northwest or moving to So Cal, and I just decided to move back to be closer to my parents. So I worked in Southern California for about seven years and then in the meantime, I fell in love with Portlandier. Is that a word, or not really?

Dr. Stafford: Portlandier. I think it is now. Portlandian. Portlander.

Dr. Onwuka: Portlander, that's a good one. So all that being said, it just made sense for me to move back to the Northwest. I moved to Portland and the end of January of 2019, and joined your practice in the meantime and it's been great so far.

Dr. Stafford: Well I'm so glad you fell in love with him. It was a great guy. I've met him. And, selfishly, I'm glad that he brought you here. So it's been super fun having you in the office. I feel like because we're both board certified and we have very similar ideals for our patients, it's been very seamless to have you on the team. So I appreciate it.

Dr. Onwuka: Thank you. I'm happy to be here.

Dr. Stafford: So, I think, one of the things we can talk about is the first visit for kids. Kind of share with our audience that's listening out there, how important it is.

Dr. Onwuka: Oh, it's super, super important

Dr. Stafford: Super important.

Dr. Onwuka: The whole goal now, with pediatric dentistry is prevention. So we love to, in our office, to talk to the parents, provide them the information, as far as steps at home in terms of diet, hygiene, to help reduce their child's caries risk. Typically speaking, we do like to see our children within six months of their first tooth coming in or by their first birthday. Again, our whole goal is to give tips. Then, as far as helping to prevent cavities.

Dr. Stafford: Definitely. I think another important aspect of that, everything that you've said, and it's so hard to meet parents when they've had a trauma to their child's mouth. That's so hard for me when they're, say, a year and a half and I get this frantic call because the child's just fallen and broken a tooth or worse and there's bleeding and it's just so hard on parents. So it's nice when they have somebody that they can call directly and we have a relationship already. So they know that they can trust us bringing in their child.

Dr. Onwuka: And I agree, it's having that dental home, that place that their child, they know they can go to. I agree. It's super important.

Dr. Stafford: Yeah. I always warn parents that have multiple kids too, it's usually the second or the third kid that takes the big tumble. Having two kids myself, I can tell you the second one is the rough and tumble-

Dr. Onwuka: You're like, "I've been there, I'm going through it."

Dr. Stafford: He's the one that I'm always like, "Ah, don't break a tooth." But yes, age one is our preference or within six months of that first tooth coming in to get kids into our office. And, some other things we can talk about, why pediatric dentistry? I know we have the same reasons for going into it.

Dr. Onwuka: Yeah. So growing up I was always ... I'm actually going back. I'm one of five, so I have a big family and my parents ... I have lots of cousins, things like that. So for me it's always been natural, babysitting, things like that. So growing up, I used to babysit my cousins, and also, I was a camp counselor. For me, I've always enjoyed working with kids. In dental school I knew I did want to specialize, and for me, it was just a perfect fit, because again, I love working with children.

Dr. Stafford: Yeah. I feel like when you go into pediatric dentistry, it chooses you. There's just some of us that know that we're supposed to work with kids and it just, that's kind of our natural progression. So yeah, it's a lot of fun. What is the most enjoyable thing for you, being a pediatric dentist?

Dr. Onwuka: Over the years, I mean, of course, taking care of cavities, making sure kids are cavity free is always rewarding. But, for me, really building the relationships with the kids, the parents, the families that I've seen over the years has been great. I've been in practice, or finished with school for about seven years now. While I was in LA, I really did have a chance to see a lot of the kids grow over the years, so it's been great.

Dr. Stafford: That's awesome. Yeah, I enjoyed that too. I also find it really rewarding when you see somebody that's fearful, maybe like a toddler. Then, you kind of coax them out of it, and when they leave happy, I'm always like-

Dr. Onwuka: I agree with that.

Dr. Stafford: ... a great moment in the day, so we celebrate as a team. So thinking about different ways that we help families, what are some of the unique things we do, as far as maybe more conservative treatments?

Dr. Onwuka: So in our office, it's great that we have one of the tools we have available is silver diamine fluoride. With that, it's pretty much an ointment. It's been around for decades, actually, in Japan. But, it's made its way to the US a few years ago. But, pretty much the great thing about the silver diamine fluoride, it's an ointment or a cream you can apply to the tooth, that helps to, in essence, freeze or stop the cavity from growing. So the great thing about it is we don't have to use the traditional route of a drilling filling. If we're able to catch the cavity early, we can apply the silver diamine fluoride to the tooth, in conjunction with good hygiene at home, with a healthy diet. So many studies have formed that silver diamine fluoride does a very great job, as far as arresting or stopping the cavity from growing. So it's a great tool that we've used here in the office. I know you've told me from the patients you've seen over the years, it has done a great job. The ones you followed up with, as far as preventing those cavities from getting bigger.

Dr. Stafford: Yeah, I know. It's nice when you can follow up with those patients every three months or every six months and see how it's stopping the cavities. Sometimes we still have to do a filling, but it's usually they're a little bit older, and they're a little more accustomed to coming in, and it's just an easier treatment for our kids. So that has been a game changer, I think, for us. Tell me some tips and tricks that you tell parents, and how we educate our families, as far as how old kids should be when they're brushing and maybe some tips for our families listening that still are struggling with that routine.

Dr. Onwuka: Yeah, so a lot of parents have told me, "Oh, I have a two year old , a three year old, that really wants to brush their teeth all by themselves." That's great that their kids are encouraged, that they want to be on top of their hygiene. We want to definitely encourage that. But, after their child is done brushing, it's highly recommended that parents follow up just as best as they can just to brush their teeth. Most kid just don't have the manual dexterity, the coordination to be able to properly clean their teeth. Not until age eight, or nine, or so. So again, we really do emphasize that parents should really be involved in terms of their child's oral home care.

Dr. Stafford: Definitely. And, helping with flossing as well.

Dr. Onwuka: Yeah. So yeah, one of the most common areas that cavities do occur in the baby teeth, are between the back molars. So it's really beneficial to start flossing your child's teeth anytime the teeth are in contact or start coming together. Unfortunately, the bristles of our toothbrush won't be able to fully clean any spots where the teeth are in tight contact, so we do recommend flossers, especially for younger kids. It's a great way to get between the teeth.

Dr. Stafford: Yep. I think something that parents are often surprised about, is the last baby tooth doesn't fall out until the kids are 10 to 12 years of age.

Dr. Onwuka: Yeah, so there can be a significant ... There is that broad range ... I describe it to parents like a bell curve. There's some kids that are on the earlier side of the teething average and then later. But, we oftentimes see teething up until age 12 or so.

Dr. Stafford: Right, which is surprising. I mean, kids are in middle school at that age. And the problem is, as I explain to parents, and I know you do as well, if they get a cavity in the baby tooth, sometimes that baby tooth is touching the permanent tooth and that bacteria is spread and then that permanent tooth, unfortunately, can end up with a cavity, which is why we're always trying to get good habits. Brushing twice a day and flossing. That's what makes us happy. So any other tidbits to give our listeners out there, Dr. Onwuka?

Dr. Onwuka: Yeah. So other thing too is, diet plays a huge role, I know.

Dr. Stafford: Agreed.

Dr. Onwuka: It's very clear, okay. We need to avoid candies, things like that. For most households, they understand that, but it's not just candies, it's also chips, crackers, cookies, any sort of fermentable carbohydrate has the potential of creating a source of fuel for the bacteria in our mouth that cause the cavities. So we really emphasize in our office a healthy diet. So fresh fruit, cheese, nuts, lots of water, plain water. So again, we also emphasize nutritional counseling with our parents, our families and our children here.

Dr. Stafford: Yeah, that's one thing that you and I do that I just love about you, is really talking about nutrition and diet with our families, and because we see families a couple of times a year, we can kind of check in and see where they're at and talk about the dangerous of snacking and how that can impact their teeth, as well as their overall body health, and trying to keep our whole families as healthy as we can and doing our part.

Dr. Stafford: I'd also like to mention that on our, if you check out our website,, you'll find some resources that are very helpful. Brushing charts, breaking the binky, or the finger, or the thumb habit chart. We also have a new chart that you can actually record the dates of when your child starts to lose teeth and you give it up to the tooth fairy, and whn to expect those teeth coming in. I have to tell you, I made that chart because I now have a seven year old, and a few months ago he started losing teeth, and I was like, "I need a chart to record this." I was so excited because I put together this whole chart and now we can hand it out to our families.

Dr. Onwuka: Giving that handout out families really appreciate it.

Dr. Stafford: That's great.

Dr. Onwuka: Being able to track the teething, and also, to see ahead when the baby teeth, for instance, the back teeth should typically fall out. That's all written down on that chart.

Dr. Stafford: Yeah, and that's on our downloadable too. You don't have to be a patient or come in, just download it and start recording those teeth coming out for all you scrapbookers out there. Well, thank you, Dr. Chioma Onwuka for being in my practice. I think you are such an amazing doctor and I appreciate you as a doctor and a friend.

Dr. Onwuka: Oh, thank you. I appreciate it. All right, well, thank you for having me on your podcast.

Dr. Stafford: Thank you. And to all our listeners, thanks for being out there and remember, fill the world with smiles.

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