How to Improve Your Teeth & Oral Microbiome for Brain & Body Health | Dr. Staci Whitman

27:05But I don't want to villainize through, there's so many healthy benefits of polyphenols and everything in it. So not seeds, all of these pickles, I love fermented foods for gut health and then oral microbiome support too. So essentially a whole food diet, you know, things that come from the earth and let more from farms and less from factories, less things out of bags, arguably ultra -process foods should be avoided as much as possible or minimized and then trying to stick to minimally process or unprocessed foods. Is it fair to say that if one does that, either a child or an adult, that their oral microbiome will not only get healthier, but that their teeth will get whiter?

27:51And the reason I keep bringing this up is I think a lot of people want white teeth, or at least not yellow teeth. Sure. Having been involved in the public facing health education business for a little while, Now, I realize that nothing that is encouraged to be good for us that takes away from the way that people want to look and feel about how they look gets much traction. So what I like about what you're telling us is that all the things that are eating mostly unprocessed or minimally processed foods, those are going to be good for our entire body. Great that it's great for our microbiome. Probably it's good for our whole body because of its effects on the microbiome, at least and part, but what makes teeth white and will supporting the oral microbiome make our teeth wider?

28:36Yeah. And by the way, there are some folks out there who's teeth need to be less white, in my opinion. A great. Totally agree. And we're being somewhat physiatist, but not really. But I think most people would like to have teeth that are, would be characterized as mostly white. Yeah. We want to look good. I mean, I appreciate and respect that. I do think we've moved a little away from reality with some of that. So I agree with you. I think there's there are teeth out there that could could not be quite so bright, but you do you. I think everyone should do it makes them happy So what makes teeth white?

29:11So Interestingly, if you look at a baby tooth next to an adult tooth and I get this call all of the time from parents So the child loses their first baby tooth the adult tooth starts to come in and adult teeth are quite a bit darker than baby teeth which are very white and bright and they're worried. What's wrong with my child's teeth? They're so yellow. That's actually a very natural shade of enamel. And why is that? It all has to do with that crystalline structure in the mineralization. So baby teeth are less mineralized. And the crystalline structure is a little more haphazardly arranged. It's not quite as organized.

29:46So instead of like Lincoln logs lined up, it's more like pick up sticks to some degree. Why is that? that baby teeth are meant to resort, dissolve, and fall out. Okay, so this is why baby teeth are also much more susceptible to decay. So the whiteness is coming how the light reflects and refracts off the teeth, which is a lot of times while you hear, if you use hydroxyapotite, or even coconut oil, is changing the surface, the surface modification, so it's changing the way light reflects and refracts off that tooth to make it seem wider and brighter. Now, certainly with adult teeth, if you're using bleaching agents, you know, hydrogen peroxide or carbon -my peroxide, some of the stronger bleachings, that's actually penetrating into the tooth and changing the structure, pulling out stain.

30:35Do people do that? They gargle with hydrogen peroxide? Well, they do bleaching trays, essentially. I don't... Well, people will rinse with hydrogen peroxide, yes. And it will make your teeth brighter and wider, but I'm telling you, it's going to do a number on your oral microbiome. So I suggest it very in a very limited fashion. The only time I ever had a bad canker sore was because I I gargled with 50 % water, 50 % hydrogen peroxide because an acupuncturist recommended it. I looked at my tongue and they said, you should do that. You know, and then I did that and then, you know, four or five days later, I had this like, you know, nickel sized canker sore on the roof of my mouth.

31:16and I was like, ugh, and I will say, and I have no product affiliation whatsoever, but to any specific product site, but by switching to hydroxyapatite containing toothpaste, my teeth, they definitely have gotten a whiter. I drink a lot of yerbomatte and coffee and I brush, but it was sort of a progressive issue of my teeth dimming. So that's been great. I also used to get cavities fairly often when I was a kid. I'll talk about that a little bit later, but since switching to hydroxyapatite, toothpaste, I've had stellar dental reviews assuming my dentist is looking carefully. I believe he is, but we'll see.

31:57And to me, it just makes so much more sense, like give teeth the mineral that they normally use to re -mineralize. It just makes sense. It's biomimetic. It depends on how you look at life. I think I prefer biomimetic materials personally. It's, again, it's a personal choice, but I agree with you, my patients who have switched to hydroxyapatite. And I'd like to point out not all hydroxyapatite toothpaste are the same. It depends on sourcing and the other ingredients that are in there. But generally speaking, their teeth look healthier, stronger, wider and brighter. They just look more nourished, more hydrated, their microbiomes look more balanced, too.

32:38You're talking about kids and the fact that sometimes if they're teeth are a little bit yellow, that's normal. One thing that I've been really struck by as the discussion around longevity seems more and more prominent these days is occasionally I'll run into somebody who's in their 70s or 80s, even 90s. And it's very rare to encounter somebody in their 80s or 90s whose teeth are not like the color of this tea. And for those that are listening, it's like a very dark brown. I've never seen somebody unless they're doing something highly artificial with bleaching. I've never seen somebody 75 or older whose teeth aren't basically yellow to brown.

33:20And when you look at people when they're very close to death, their teeth often look very opaque. What is that? Is that a blood flow issue? Is it what's going on there? Yeah, it can be a zero -stomachymodrymol. So we definitely lose salivary capabilities as we age. Very likely more mouth -breathing. So mouth -breather's will tend to have darker teeth because the teeth desiccate. They dry out and over time You will experience mineral loss Decades and decades of coffee tea wine. We'll do it too. Well, I don't drink the wine But I'm actually a coffee tea since I was a little stain. That was a little kid of a drinking latte since I was like five Yeah, it's delicious.

34:00Yeah, gonna live life. Yeah, but um Yeah, and so they're and they they're losing minerals too, you know over time your teeth take a beating. I mean, we're living to be a hundred now. That's a long time to maintain this non -shedding surface in our body, you know. So, and then it depends on the generation too, but some some generations, especially as you mentioned, 70s, 80s. I'd wonder about tetracycline exposures when there's certain antibiotics that we don't use anymore that can were known to darken the teeth, which is why they pulled them from common prescription. That raises the question I've never thought about before.

34:36So if one takes a course of antibiotics, typically the advice is to ingest low sugar kombucha, to have some Bulgarian or Greek yogurt, like repopulate the gut with the substrates for healthy microbiota. We now know, because you've told us that the mouth is the gut, which makes perfect sense. We are but a series of tubes. So I always teach in my developmental neurobiology class, but it's true. In embryology, you learn that we're basically born of a bunch of tubes that are kind of do their thing in development, but the digestive tract obviously starts with the mouth. So is it the case? Therefore that we should be repopulating the oral microbiome if we take a course of antibiotics?

35:23Yes, yes. Very commonly patients, parents, will report, gosh, my child is finished this course of antibiotics and now their teeth are stained And, or their gums are inflamed, but they just seem off. And it usually is because they've wiped out a lot of the healthy bacteria too. You know, it's all connected. So I do suggest my patients, if I have to write antibiotics, I try to avoid, but sometimes we have to, that they do take a high quality probiotic and increase their probiotic rich fermented foods as well. So a high quality probiotic pill? Yeah. Generally, yeah, because they're hard to get in enough, especially in kids.

35:58I would argue, you know, kids aren't usually eating a lot of sauerkraut and kimchi and natto and but you know, you could do kefir yoga as you mentioned, low sugar, kombucha, etc. But usually a high quality diet probiotic will have some benefit to the oral microbiome but they also do have oral oral probiotics to focus on the bacteria of the mouth. What about mouth washes? Yeah. I've never liked them. They feel they burn. for one, and then I learned some years ago, and this is just kind of fun to queue to years ago. It must have been like eight, 10 years ago. I heard, I think I'm the Tim Ferriss podcast, somebody said, oh, you know, a mouthwash is when new certain chemicals that are essential for cardiovascular function.

36:47And so don't don't use them, don't use mouth strips, don't use any of of that stuff. And at that time, that was considered like clear quote unquote pseudo science. Nobody would like alternative science outrageous. Now we know this is actually true. And there's always, you know, there's always delights me and scares me at the same time that many of the things that right now people go, oh, that's pseudo science. I like, Cree team seems to be a big thing right now. 10 years ago, it was only the Jim, Jim rats that were talking about now everyone's like Cree team. So what's the story on on mouth washes and mouth strips and mints and things of that sort that again like people just want to have fresh breath or at least they don't want to be the person with the bad breath.

37:30Sure. Yeah. So, listerine and those stronger rinses in particular, they generally contain alcohol, astringence, really strong antimicrobials. you know, it says kills 99 .9 % of germs. Well, I think we've learned we're over disinfecting. You know, this is why asthma is up, eczema allergies are up in our children. We now are saying get into the dirt, get exposed to microbes and things. So we're carpet bombing the mouth. What we've learned through the data, and you're right, there are studies to show that chronic habitual use of these mouth washes, including prescription strength mouth wash, like chlorhexidine as a common one, it can damage the nitrate reducing bacteria.

38:17So we have bacteria in the dorsum of our tongue, specifically that is essentially your tongue, that reduces nitrate to nitrite, which is a precursor to nitric oxide. Nitric oxide is a molecule that is really important for cardiovascular health and vasodilation and immune health. And so if we're indiscriminately carpet bombing the mouth with these really strong stringents and rinses, we can be affecting our cardiovascular health and their studies to show it can increase blood pressure and potentially cause cardiovascular issues. So when I hear someone say, but my breath is so bad, you know, I have to use this multiple times a day, I immediately think, well gosh, why is your breath so bad?

39:01It's normal to have bad breath after you eat a garlic, you know, garlic hummus or have a cup of coffee. But if it's chronic halitosis or bad breath, I'm curious. You have periodontal disease, which is a chronic inflammatory issue in the mouth, which can have a slew of downstream effects, which we should discuss in a bit. Or do you have an infection? It could be a sinus infection, post nasal drip. Do you have tonsil stones or tonsil or infection? Like what else is going on in your mouth? where you feel you need this multiple times a day to even feel like you can present yourself in public. Really strong essential oils and men's again, I would be cautious with that every once in a while of throwing in a piece of gum or a man, of course.

39:49It's really the habitual use of these things that can be damn and jam. I'd like to take a quick break and thank our sponsor, AG1. AG1 is in all -in -one vitamin mineral probiotic drink with adaptogens. I've been taking AG1 daily since 2012, so I'm delighted that they're sponsoring this podcast. The reason I started taking AG1 and the reason I still take AG1 is because it is the highest quality and most complete foundational nutritional supplement. What that means is that AG1 ensures that you're getting all the necessary vitamins, minerals, and other micronutrients to form a strong foundation for your daily health.

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40:58They'll give you five free travel packs plus a year supply of vitamin D3K2 with your order of AG1. Again, go to drinkag1 .com slash Huberman to claim this special offer. Today's episode is also brought to us by Juve. Juve makes medical grade red light therapy devices. Now, if there's one thing that I have consistently emphasized on this podcast, it is the incredible impact that light can have on our biology. Now in addition to sunlight, red light and near -infrared light sources have been shown to have positive effects on improving numerous aspects of cellar and organ health, including faster muscle recovery, improved skin health and wound healing, improvements in acne, reduced pain and inflammation, even mitochondrial function, and improving vision itself.

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42:14Again, that's juice, spelled J -O -O -V -V dot com slash Huberman to get up to $400 off. Okay, so those are some don'ts. What are some things that we can do to improve the chemistry of our saliva and our mouth? And just to, in full disclosure here, won't be the disclosure most people are anticipating. What I'm trying to get at here is all the chemical aspects, the chemistry of the mouth. Because when I think about biology, just because of my training. I think, you know, you've got chemical forces and you have mechanical forces. Like there's stuff that literally moves or you could, you know, chip a tooth or things that you shouldn't do to protect your teeth and then there's how to create the right chemistry environment.

42:55So that's really what we're talking about here. And I'm trying to figure out, you know, how could I have the best possible saliva? Yeah. I want to be the person with the best possible saliva. Good spits. Good spits. Don't underestimate your spit. But it's true. It's the golden elixir. So if I were to put spit into like under the microscope, and then also take some of my spit and put it in mass spec and separate out all the goodies that are in there, just give us a sense of the kinds of goodies that are in spit. Because it just looks like a bunch of clear liquid to people, but blood looks like just a bunch of red liquid and there's a lot of stuff in there.

43:31There's so much in it. It's so important. So it has bacteria, viruses, fungi, like all kinds of protozoa, hopefully in the right ratios. So we want beneficial bacteria. We all have about 5 % pathological bacteria. However at that ratio, those may not be pathological. Like they are symbiotic at that point. We are still unpacking and learning more about the oral microbiome. But essentially you'll have bacteria. Yeah. There's hormones. There's free fortis all. There's hormones. There's all in our spit, folks. Yes, absolutely. There are enzymes, aid in digestion. There are immune cells and there are minerals floating around too.

44:15So think about how important saliva is to chew. If you have dry mouth or you're sick, you can't chew and swallow your food. This is why a lot of elderly people have a very hard time eating certain foods or if you've undergone cancer therapies and things. Once you get zero stomia, dry mouth, your teeth can degrade so quickly. So your saliva is so important. And so how do we keep it healthy? Hydration. You know, so many of us are dehydrated. I would argue we aren't getting enough minerals either. So, you know, I suggest to some kids, I can tell in a child's mouth if they're hydrated or not, by the way, their saliva looks.

44:55If it looks more thick and ropey and mucusy, they're dehydrated. If it looks like water, it's healthy. This is without any tests. So put a pinch of salt in your water or some electrolytes. I can really help with bioavailability and absorption. How your breathing is incredibly important too for your Salivary Health. So if you're mouth breathing, you will have less saliva. You know, your mouth's going to dry out. The pH will drop and you're going to be in trouble. You know, dry mouth leads to cavities, dry mouth leads to gum disease. So, and then the foods we eat, of course, too, we want to have a mineral -rich diet.

45:33So many of us are mineral deficient, we're magnesium deficient, we're fat -soluble vitamin deficient, particularly vitamin D3, K2. So I think it is good. I like the idea of tests, don't guess. You know, if you have the capability to work with a doctor to see where you are with some of these things to know if you need to supplement or not or how you can change your diet. Sorry to interrupt, but would I test my saliva specifically? Is there a good saliva test out there? That would be a different test. So this would be more of a blood test. Like a standard blood test. A standard blood test. But there is salivary analysis, and we should discuss the importance of testing your oral microbiome.

46:12I think just like so many of us test our gut microbiomes now, you know, GI mapping stool tests to understand what's happening in the gut. They're a salivary analysis now, and this is what a lot of functional dentists are working toward. I do salivary analysis and biomarker analysis in my practice. We can tell a lot through a patient's saliva in what ratio and types of bacteria are there, as well as fungus and viruses and things as well. So if you have the capability, if you really want to optimize your health, I suggest testing your oral microbiome because there are certain keystone pathogens that you may have that you're unaware of that can lead to many downstream issues.

46:55And we can jump into this now, but the oral systemic connection is really blowing up now in how oral bacteria, specifically pathogens can contribute to Alzheimer's and dementia and fertility issues, pregnancy issues, cardiovascular issues, autoimmune disease, rheumatoid arthritis, diabetes, obesity, mood disorders, cancers, it goes on and on, all coming back to the bacteria and our mouth. Amazing. I really want to not just double click, but really dive into that, no pun intended. I do want to just ask because a subset of listeners will be interested in how they could get their saliva tested. Yes.

47:36I've never had my saliva tested. I will say that based on your teachings online, I've made an effort to drink more water in addition to massive amounts of your Vermont and small amounts of coffee. I've made an effort to, well, I switched to a hydroxyapatite containing toothpaste, which has been terrific for all sorts of reasons. I've really emphasized nasal breathing. That's something I was into before through the sports performance world because my friend Brian McKenzie use a human performance expert was really big on this a while ago. And the healthiest my breathing and cardiovascular function ever was for me was when something I don't suggest people do unless it's their profession.

48:20I was boxing for about a five year span and I had a fitted mouthpiece and I would do my running, my road work with my mouthpiece in breathing through my nose. And that taught me to like really how to breathe correctly through my nose. And it translated to switching to nasal breathing when I slept. I didn't sleep with the mouthguard. But I think that breathing through the nose is just so important for the reasons. You're describing James Nestor's described. And I will share this little factoid, and then I'll shut up and nasal breathe. A friend of mine who is a physician at UCSF, he told me that the methamphetamine addicts that come in have terrible teeth.

49:03Everyone knows this. Methodics have terrible teeth. But do you know why it is? He works with the School of Dentistry. It's because they're mouth breathing. I've worked with that population. You met doesn't actually deteriorate the teeth. It's the fact that they're mouth breathers. And so I find this fascinating. And then of course the book, JAWS, which was published by Paul Erlich and Sandra Conne, my amazing colleagues at Stanford years ago. And by the way, when they published that book, people said, oh, this is pseudoscience. This is crazy. you're saying nasal breathing epidemic of, you know, fear mongering.

49:33Well, it is. We now know this is a real thing. It's an epidemic. So, um, so how do you encourage kids and adults to switch from mouth breathing to nasal breathing? Yes. This is a big part of my practice. So, it, we need to understand the why, just like anything. Why are you a mouth breather? So humans are obligate nasal breathers where we are meant to be breathing through our nose. Unfortunately, so many of us are mouth breathers, they estimate up to 50 % of the population now breathes through their mouth. I personally think that's an underestimate with what I'm seeing at my practice. So why is this?

50:13So the theory is that, incestually, we used to chew and mass decay up to four hours a day. This active chewing, it pushes forces out, it was actually what grows the face, the lateralization of the tongue, the tongue elevating, it would grow the jaws wide, the sinuses wide, including breastfeeding. Okay. We now flash forward 10, 12 ,000 years. Okay. So we had the agricultural revolution, we went from hunter gatherer society to of a gerian, then the industrial revolution, we started milling and processing everything, everything soft and machine now. We used to chew four hours a day, we now chew four minutes a day.

50:58So there's very little, there's atrophy essentially. We slurp our food. We slurp our food. It's like that movie. What was that futuristic movie with the little robot? I hated that movie. Oh, I cried during that movie. I hated that movie. I was so worried that it was true. And here we are. Yeah, they were just slurping their food, lying on the recliners. really outsource pretty much everything. Yes. So this is general many generations of this happening. We're essentially shrinking. James, Nestor phrases that were disevolving. Okay, so faces are shrinking, jaws are shrinking. This is why we see so much crowding in teeth.

51:35If you go to the natural history museum in New York, Washington, D .C. look at the ancestral skulls. The teeth are pristine, there's no decay, and all 32 teeth, including the wisdom teeth fit perfectly into the dental arches. So that was not that long ago in human, you know, archery, jeckery. So what has happened into our food? And it's how we're chewing, it's how we're breathing. And so if this structure shrinks, the nasal volume shrinks, the sinusus the airway shrinks, our tongue has no room in our mouth anymore. So it either sticks out tongue thrust or it falls back, you know, and it's obstructing us.

52:15So there's so much sleep disorder breathing, dysregulated breathing, and sleep apnea. Now that's not getting diagnosed. So if we look at children early and they come into me and I can see it as they walk in, they generally will have forward head posture because they're trying to open their airway, okay? Forward head posture, they have dark circles, that's called venous pooling, that's a sign of inflammation, secondary to mouth breathing. You can see more of the whites of their eyes, so it has to do with their visual plane. So forward head posture, the droopy eyes from inflammation, you see more of the scleria, the white of the eye.

52:55They just look congested and sick. They just, in their mouth open. And those kids have major airway issues and we need to understand why. So it is generally either a hard tissue issue or a soft tissue issue. So what would the hard tissue issues be? That would be the size and shape of the jaws, the size and shape of the palate, the position of the jaws. You know, is your jaw set back? Is it forward like a bulldog? And do you have a deviated septum? You know, they asked to me 75 % of humans can have some sort of deviated septum and people think that's ridiculous. It's not just from getting in a fight and getting your nose broken.

53:38So think of it this way. If your palate is narrow and I smushed your face like this, the septum has to go somewhere and so it will can't. Okay, so that's what creates the deviated septum. And so if we expand a face and this is what early functional orthodontists and this is what I'm doing in my practice or doing in these younger kids. You put in a little retainer that can help expand the face and the septum straightens. Now we can breathe better. So that's hard tissue. Soft tissues could be in large adenoids and large tonsils, oral motor dysfunction, low tongue tone, low tongue positioning too.

54:18How much plasticity is there of the sinuses? So let's say somebody has a partially or severely deviated septum and they could get surgery and I want to talk about some of the different surgeries. There's a balloon expansion thing that online it looks really cool. I like a lot and try this. I really want this to happen to myself. Yeah, put the balloon up there. They inflate the balloon. And it's guided. Yeah. They do one that's guided. Yeah, they know I mean, then they take it out and the, you know, this kind of thing. Well, is actually the appropriate way to do it, both in and out through the nose.

54:50But if somebody makes the effort to nasal breathe, so maybe they mouth tape at night or I'm a big fan of shifting from any mouth breathing to nasal breathing by insisting that I nasal breathe while I do any cardio unless I'm pushing really hard and then I need to bring mouth breathing into it But I've noticed just because I can measure snoring through I'd sleep on an eight sleep I can measure snoring that way But even if you don't do that there are other ways you can measure snoring with an app or someone can tell you you're snoring So this isn't about a product per se, but if I force myself to nasal breathe during cardio workouts, especially kind of zone two, zone three stuff, translates to less mouth breathing and snoring and sleep.

55:33So the question is, do the sinuses actually dilate or if you have a DVA, it's up to them, do you need it surgically or somehow otherwise repaired? It depends on your age. So most facial development is done around the age of 10. So the issue I would say with traditional orthodontics, which is when you wait for all the baby teeth to fall out and then you put braces on, you can't control the modeling of the face, the mid -face, the jaws, which is why we now are starting with functional therapies as young as three or four years old with retainers. So in the middle of our palate is a suture filled with cartilage and so with kids it's really easy to manipulate and change facial development.

56:18If you make the jaws wider, not only is it improving airway, but the teeth will come in straight. Now they have room. The reason they come in crooked is there's not enough room for them to come in. It's important to know the floor of the mouth. The roof, sorry, the roof of the mouth is the floor of the nose. So if you expand the palate, the sinuses will get wider. The septum's going to upright. Everything's connected. Now as an adult, it's really hard to manipulate bone structure just through posturing in habit. There are my functional therapists, which are the best and they're really important in this conversation.

56:57Think of them like physical therapists for breathing, teaching you to keep your lips closed, your tongue up. All of this musculature is really important, toning it. If you don't use it, you lose it. So if you're a mouth breather, your tongue will lay low, your tongue's a muscle, it will get weak, it will get flaccid. So we want to strengthen these muscles to help with lip seal and nasal breathing. But as an adult, if you do have a skeletal discrepancy, usually you need some sort of intervention. You're not going to just be changing it through lip taping or how you're training or myofunctional therapy.

57:34and there are more conservative ways now besides true jaw surgery. There's an appliance called the homeoblock, which I know is what James Nester used. You can read about it in his book that will actually start to change facial structure. There's less invasive treatments. There's an MSC appliance. It's a maxillary skeletal expansion device. It does put these little mini screws in your palate, but it will pop the suture and adults in this is you really would have to want this because you're struggling so much. And people who aren't breathing well, they're struggling. I think it's the most important thing for health is how you're breathing and how you're sleeping.

58:16And with children, if they're not breathing appropriately and they're waking up a lot, which is why I would be interesting to get some sort of product on you. I'm just curious. Do you get into deep sleep? Do you get into REM sleep and for great? Yeah. I'm measuring deep sleep and REM sleep through the eight sleeper group or both. My deep sleep is great provided. I get to sleep by about 10, 10, 30 because that's when you capture the deep, when I capture the deep sleep window. If I go to sleep around 11 or midnight, I lose out on some deep sleep, even if I sleep longer. Yes. And my REM sleep is really solid these days.

58:52Yeah. I'm struck by how convincing the data are about nasal breathing and proving brain function. There were a couple studies that showed that if people either mouth breath or nasal breath in a laboratory study, the nasal breathers have better memory recall. But those were of odors. So everyone said, well, of course, it's of odors and your breathing through your nose. And so you can remember those odors. So they've now run these studies on with other types of memory and brain function. It's just very clear that you oxygenate your brain better and you think better. Your cognition's better, your memory's better for everything, not just odors.

59:27So you get 20 % more oxygen when you nasal breathe. And this is really important for children in these formative years of brain development. And this is why we're seeing studies showing that children who mouth breath have sleep disorder breathing, they have behavioral issues. And many are getting diagnosed with ADHD. and arguably potentially put on medications when really if we'd screened them for airway issues, potentially we could have avoided some of this. And it also has to do, we're not getting into deep sleep. The glumphatic systems aren't kicking in, hormone functions aren't kicking in, so a lot of these children, growth hormone is impaired, anti -dioretic hormone is impaired, if they're not getting into deep restorative sleep.

1:00:13So that's why we see bed wetting, some science to look for in your partner or your children is tossing and turning, clenching, grinding, snoring or noisy breathing, sleeping in really odd positions like craning the neck because they're trying to open their airway. Spinning around the bed, you know, the child's legs are in and the bodies like out of the bed, the bed sheets are everywhere and then certainly waking up unrested and then noticing behavioral issues too. Well, you have to do to convince the male half of the audience to focus more on nasal breathing as to tell them and to not use mouth washes is to tell them that being a mouth breather will give them a sexual dysfunction or will will predispose them to sexual dysfunction and they'll start working on their nasal breathing because of nitric oxide because of the paranasal sinuses is what will help produce nitric oxide too.

1:01:08So if you're breathing through your mouth, not your nose, you're not getting enough nitric oxide, which is very important in sexual health. But also we know men who have gum disease are 2 .85 times more likely to have erectile dysfunction as well. So no bleeding gums, we do not want inflamed bleeding gums on flossing, it's something we haven't touched upon yet, but it's incredibly important not only for cavity prevention but gum health, and pink in the sink. Any amount of bleeding is a sign of inflammation and it doesn't just stay in the body. It can impact the entire system. So please take your gum health seriously if you're nothing else and for your sexual health.

1:01:50Great message. So to shift over to nasal breathing, if somebody's really struggling with this, are you a fan of mouth taping? Yeah. You wanna make sure you can do so safely. So with kids, I always suggest they get screened by an airway focused dentist or potentially an otolaryngologist or an ENT. For adults, there is a task that you can do. It's the three minute task. Can you breathe your nose without panicking or feeling sympathetically challenged for three minutes? So you can either put water in your mouth, put a piece of paper, tape, tape relapse, and literally time yourself. And if you can, breathe through your nose successfully, then you, in theory, can safely lip tape.

1:02:35There are different tapes that you can do so you, that there are open in the middle so you can still off -gas or you'd feel less, it feels less invasive. And what I suggest if people are interested in it is just start five minutes while you're chopping vegetables for dinner and then move up to 30 minutes while you're watching a show and then watch a whole movie for two hours. And then if you've been able to tape that long, you can do so at night as well. I will tell you, it is one of the top things that I have done to improve my health. And I do see it with my wearables and my sleep data. Recently, I had the privilege of giving a talk at Stanford with Renee Fleming.

1:03:15It's like one of the world's greatest opera singers alive today. And I said, what are some things that you do for your breathing? Because I end up talking a lot for the podcast. And she gave me some lung and diaphragm strengthening exercises. But then the one that she suggested for emphasizing nasal breathing, because there's a lot of nasal breathing that's suddenly quickly and subtly in order to maintain air pressure in the lungs and for her craft, which I know very little about. But is instead of like doing weight training for the neck, it's kind of a fun one. It doesn't make the neck big, so people who don't want a larger neck will appreciate that.

1:03:51But to exercise the internal muscles of the neck and the way you do this is something called kiss the sky The boxers will actually know this the old school boxers. It looks ridiculous But I'll do it because I look ridiculous on this podcast all the time intentionally So you look up at the sky and you pucker like you were a pufferfish For 15 seconds per side And she said it builds the the muscle the muscle the strength and the neural control over the internal muscles of the neck So again, no widening or thickening of the neck, but on the inside and it makes it much easier to take deep breaths through your nose It probably increases the amount of resistance so that you can fill your lungs more easily So I'm doing a little bit of like kiss the sky and it looks completely ridiculous Let me go that move too.

1:04:31Yeah, and you just like really look lips back as if you were gonna kiss the sky from side to side 15 seconds per side a couple times per day or just whenever you remember it and I mean her voice is amazing like her speaking voice and her posture and everything so So I borrowed that one from her. You can do a lot to improve your airway health through breathing rehabilitation. So I think that is a big part that's missing in these conversations with airway health. We talk about, well, you need to see the airway train dentist. You need to see the myofunctional therapist, the orthodontist, the ENT.

1:05:04That's a lot. Just the scheduling of that alone makes me want to take a nap. But it is. It's a lot to unpack airway issues. If parents are out there, there's two books, three. I'd recommend if you're very interested in this since it impacts so many people. Certainly, breath by James Nester Jaws, as you mentioned by Sonder Khan. And sleep wrecked kids by Sharon Moore. If you're a parent. What's the title again? Sleep wrecked kids. Sleep wrecked. WR. Yes. By Sharon Moore. So it will just help you screen and understand why we're worried about these things more. But yeah, we can't overemphasize airway health Especially in our children, you know, and catching it early and intervening early is really important great In trying to maintain airway health and healthy saliva and now I'm obsessed with saliva It was like cool.

1:05:59It's got all this stuff in it. I was thinking it's just like if we know blood as all these goodies in it We test blood. We know Skin microbiome we know that that women go to an OBGYN, they get past smears, they get, I mean, we know if you ever raise a kid or change diapers, you can tell a lot about somebody's health by the fluids. Yeah. They admit and that they have within them. I'd like to place saliva on the list of critical things to pay attention to. But chewing gum, is this good for our breathing and for our saliva or not? I, not a big gum sure, but is it, good, bad, neutral? Yeah, I think it's time and place can be very beneficial.

1:06:43So where I like it is if, because I will say, hey, parents, you really need to avoid crackers and chips and granola bars. And they say, what do I feed my kid? You know, so if we've missed the window of how to introduce food to children, are they just favor those type of foods? What's your good strategy if you're out on the go to minimize decay, risk, and increase salivary health. Choose some gum, particularly xylitol gum, because xylitol will inhibit bacterial proliferation. It will reduce strep mutants, which is the bacteria that causes cavities. Big fan of xylitol. So offering a piece of xylitol gum after an exposure to some of these snack foods, these fermentable carbohydrates is great.

1:07:29It will loosen the food. It will increase salivary health. Some people like it to strengthen, you know, mastigum, I always get asked about that. You can over do it. You know, I worry about temple mandibular dysfunction. I have bad experience with mastigum. I was buying it. I love the kind of the primordial aspect of it. It's like a tree sap that you chew on. It comes in this beautiful paper package and you know, no plastics right? You get it going in there and you feel like you're really like working it the same way my bulldog costo, like work east and like teed on like bricks and like he was just and you feel great and then all of a sudden you'd go and your jaw would kind of stick in then and then later you're like whoa like my jaw really hurts and you feel something pop up in your joint.

1:08:15Yeah it'll give you that you know these days the young influencers are so obsessed by this. It'll give you a little bit of a golf ball hypertrophy of your jaw that's not why I was doing it but boy does it make your jaw feel sore. Yeah, I'm not a big fan. I like to just explain it. Think of a baseball pitcher. I mean, how many of them go on the disabled list because they're overusing their shoulder? It's a similar joint, you know, rotation. If you're two, we're only meant to chew really for the sustenance. That's how we were evolved. So if you're chewing gum all day, it's very likely wearing down the cartilage in your joints.

1:08:54So I'm not a huge fan of it. I just personally don't love gum chewing, but I think time in place too. So especially from a cavity standpoint or hydration, you know, increasing solivary flow, but just I would just chew it for a couple minutes, throw it out. You don't need to be chewing it for an extended period of time. But chewing food is good. Yes. Yes, thank you. So the issue, as we mentioned, is, you know, we are slurping and smushing our food. I don't, but to me almond butter is like never existed in nature. Like I did that you would take like I mean almonds are so delicious right but that you would like like grind them up and put them into a paste like to me that the texture is so over.

1:09:38So you do that in your mouth. You're supposed to do that through chewing. Just the fact that like the peanut butter like to me these things make no sense whatsoever. It's gogerts and apple sauces and fruit snacks. It's any food. Baby food exactly. It's for animals and people without teeth. Exactly. So I'm not advocating that one camper the other there can be a mix but you know there's there's blended food that's offered or you can do more of a baby -led weaning which is eating more real foods. Obviously please be smart about this don't get choking hazards for your children. There's a lot of information out there that you can look on how to safely prepare food for your child but chewing is incredibly important for facial development.

1:10:18Well I was thinking for adults. I was kind of making fun of the fact that adults are eating like kids like they're like slurping their food and Chicken nuggets and french fries and yeah, we need to chew when really ask what's gone on with the airway? Why does everyone why our face is shrink -ed? It's chewing we've lost chewing and then arguably breastfeeding too We've moved away from exclusively breastfeeding too What are the numbers on that? I don't know the numbers on that how many people? I don't know you there. I don't know but it's certainly yeah I think it's making a resurgence and a lot of people, though, are doing a blend.

1:10:50We do what we need to do. I mean, a lot of women are working. It's important to know if you're not able to breastfeed or it doesn't resonate with you or you are working and having a pump that there are fixes. This isn't dire, but just working with someone to catch these issues early and also, unfortunately, Even if we're doing all the things correctly, introducing hard foods, our child's chewing, and their nasal breathing and our breastfeeding, it's hard to combat generations and generations of disavolution essentially, so a lot of humans are needing intervention now. I'd like to take a quick break and acknowledge one of our sponsors, Function.

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1:13:15Earlier you mentioned the many different systems and diseases of the body that the oral microbiome has been directly linked to. I would say in science and medicine, there are direct effects. This mediates that and then there are indirect effects. Like if fire alarm goes off in the middle of the night, your sleep isn't good, but fire alarms don't regulate sleep. They just can modulate your sleep. But my understanding, and I'm not deep in this literature, but my understanding is that we now have fairly conclusive evidence that certain bacteria from the mouth make its way to the brain or heart or other tissues and directly increase either the occurrence or the susceptibility of dementia cardiovascular disease.

1:14:06This isn't just, you broke your ankle, so you move less, you move less, your heart gets less healthy, your heart gets less healthy, your brain gets less healthy. This is kind of the kind of point I'm trying to make. But that bacteria in our mouth, bad bacteria, can cause real problems for the brain and heart. Yes, and many other systems too. So much research. So they're finding 57 diseases are linked back to oral dysbiosis or oral pathogens, which is quite a lot. And different species can affect different parts of the body. So what is this all come down to? It comes down to gum disease. So it's important to note about 80 % of the global population suffers from some sort of gum disease.

1:14:50That's huge, you know, and about 10 % of the population will have severe periodontal disease, which is chronic bone loss tissue loss, and this is where we get tooth loss too. So gum, it's a sort of a continuum, but these all have one thing in common is the type of bacterial species that live in our mouths and when they get out of balanced. So there's something called the red complex. These are the five bacteria that most influence gum disease and dysbiosis that can affect the heart and other organ systems. The big contenders, P. Gen. Javales, F. Nucleate, T. Dentechola, there's AA and then Strap Mutants too, can affect the heart as well.

1:15:38But why do these bugs, how do they get where these other organ systems are and what are they doing? So I like to term this leaky gums, so we've all heard leaky guts. So let's say we're just in dysbiosis and probably because maybe our oral hygiene isn't the best as well as some other things. So we're not flossing, let's say. And our gums bleed. Okay, that's a sign of inflammation, but you've now have created a vector in opening in the skin, in the mucosa, where bacteria can get into the circulatory system, catch a free ride and end up in places they shouldn't be. And that creates an immune response.

1:16:18So, in inflammation, okay, and then also these bacteria release endotoxins, okay, they can create cytokine storms, all kinds of things. So the body doesn't like these bacteria to end up where they shouldn't. So heart disease, for example, if you have gum disease, your twice is likely, two times is likely to have cardiovascular issues. If you have gum disease, your three times more likely to have stroke. A lot of this is correlative, not quite causal yet, but some of these are looking to have more influence than others, and there's more research that's needed. Fertilities, a big one that I like to speak about.

1:16:57So women who have gum disease can take two months longer to get pregnant and to conceive. And there are studies that show in couples that can't conceive, that 90 % of the men show some sign of gum disease. And once they go in and get it treated, then their fertility conception improves by 70%. That's significant, you know. And it's not only gum disease, but just any oral infection. Pigeon jivalis is being linked to Alzheimer's and dementia. You know, these bacteria end up in the brain. They cross the blood brain barrier and they create amyloid plaques and inflammation in the brain. And so there have been studies.

1:17:38Many studies now, one big one was at a Harvard where they sampled the cerebral spinal fluid in the brains and saw that in these plaques, they had pigeon jivalis of almost 100 % of the patients. And when they tested them against other patients who had passed away without dementia or Alzheimer's, they didn't see any pigeongeballa. So there's a lot of association and links right now that we need more research on the other to be where I was cancer. And this is why I love people to consider oral microbiome testing. I personally have a friend who we tested her oral microbiome and she was through the roof with F -nucleadum, pretty asymptomatic otherwise, but F -nucleadum is linked to increased risk of pancreatic cancer, breast cancer, and colorectal cancer.

1:18:27I mean, we swallow 2 ,000 times a day, and we know some of these bugs, these bacteria, they can live through the stomach acid and make their way down into the gut. Pancreatic cancer is, sorry to interrupt, I must say I've had a couple of friends die of pancreatic cancer, and while I wouldn't want any cancer, that's the one that I really wouldn't want, because so many of them are deadly. I have someone really close to me dealing with her right now. He actually just had his pancreas removed prophylaxically because it was pre -cancerous. He's a Whipple procedure. Yeah, yeah. He's a feature. Yeah, if they catch it early enough, it goes anterior to posterior.

1:18:59And if you catch it early enough, they can lop off the anterior portion. The Whipple procedure is it's called, but even a colleague of mine, a brilliant bioengineer, a few years ago who had the Whipple Dawn and he was progressing well and then he passed away about a year and a half ago. Yeah, pancreatic cancer is no joke. And so if you could just test your spit, you know, it's a simple test. It's a set and I can give some of the tests that I like in the show notes, but you just spit into this little vial and mail it off and then they send back your results with you. I mean, that's pretty amazing.

1:19:38You do need to find a dentist who can then guide you. What do you do with this information? A lot of these pathogens, they do need antibiotics. They're very virulent. They're spyrachetes. So they're corkscrew shaped and they can just impregnate and wedge into tissue. And so sometimes we really do need to be pretty heavy hitting with how we treat them. So antibiotics. Well, kind of antibiotics are used to treat these things. It's usually a moxasillin type of blind that they'll use. Okay, radical idea that's going to get me in trouble with my more natural health audience. But I speak to those who are there more from suitable, more nothing don't take anything.

1:20:18What is the argument against once every three years as a healthy adult doing a round of antibiotics to kill off unhealthy bacteria, replenishing the microbiome in various tissues. Preventatively? Yeah, just preventative. Like, kill off what might be living in the mouth, but kill off what might be living in the prostate. I learned recently that, you know, the prostate doesn't have the same sort of immune system and protection. And so a lot of men, you know, while they don't have UTIs, they have a prosthitis and they basically just need to do a 21 day or 31 day round of antibiotics and everyone will be like, oh, you're spreading merses with that or something.

1:20:54But you can protect it against a number of different cancers related to the prostate and things like that. But why don't we do this as a regular practice? Like every three years or so, you just kind of hit the system hard for about a week, kill off a bunch of bad stuff, and a bunch of good stuff, and then replenish the good stuff. Yeah, it's a good question. I mean, I think it's harder to repopulate the gut and the oral microbiome than one might think. I'd like to lessen more approach. I think there's better ways to kill off bad things like ozone therapy is being used to lie. I use ozone in my office.

1:21:27Tell me more about ozone. So ozone, it's O3, okay? So it's a very unstable molecule. I use it in gas form or water. You can use it as an oil. It's carried usually in olive oil or hemp oil or flax oil. And so it's antimicrobial, it's antiviral, it's antifungal. And so what I'd use it for is to treat gum disease in parodonal pathogens, but then also under fillings or under sealants, or if I'm doing a pulp automy or kind of a root canal procedure. Because otherwise we're just blasting water everywhere. So is this oil pulling? This is the basis of... I use it as a gas. It comes out of the machine and I use it in a wand as a gas.

1:22:13I got to try this, but what's the deal with people swishing olive oil and oil pulling? I know this is big in some of the, I don't even know what to call anymore. What used to be alternative in its now mainstream, it sounds like music in the 90s, right? Indie medicine is now mainstream. They sold out, right? Like the, I'm just joking folks, but not really. There's so many mimics between the health arena and kind of music and art. Like what used to be niche becomes trendy, and then becomes mainstream. Everyone's cool with it now. Yoga breathwork, resistance training used to be niche. Swishing olive oil, spitting it out.

1:22:55Acupuncturists love this. Alternative medicine types like this. Is there any truth to it? Is it related to ozone? It can. So you can find ozone -eated oils on the market for oil polling. So this is an ancient aeravated practice. going back to ozone, though, just killing off micotoxins and bacteria. This can get kind of controversial, but a lot of natural paths will use gas ozone, either rectally or they'll use the IV2. You have to go to someone who knows what they're doing. Rectol ozone. Yes. To get all the way up to the oral microbiome. No, it would affect more like the gut area, the pancreas, the liver, etc.

1:23:33It's not that you use a lot with mold elimination, micotoxin elimination. You know, I get a lot of questions nowadays about mold toxicity, especially people in Austin. I don't know if you know this, but like it's either theory or real that lots of people who live in Austin or used to live in Austin think they have mold toxicity. Because of a lot of new building architectures. They say a lot of new buildings. They keep cold variation and the moisture. I don't know. I don't know if this is true or not, but you know, the last thing you ever want to do is tell somebody who thinks they have something that they don't.

1:24:08And I'm not saying they don't. I just, I hear this a lot. I've known a number of people that have left the city of Austin because they couldn't deal with them all. Interesting. Mollen, that can be scary. I mean, we see it affect the teeth. The teeth will just start degrading to some of the kids who have tested really high microtoxins. So rectal ozone. Yeah. Wild. Well, hey, listen, it's the digestive tract. I mean, you know, we're a health science podcast. Everyone's looking up on their own, but there are providers out there doing that. So ozone can be great as an antimicrobial instead of an antibiotic.

1:24:39Now going back to oil polling, oil polling is an ancient aeravated practice. It used to be with sesame oil, more people do it with coconut oil now. I oil poll a couple of times a week occasionally. So what does that practice look like? So I put a spoonful of organic raw coconut oil in my mouth, let it melt and just swish it around as I'm you know, dottling around in the morning. nasal free. Yeah, don't spit it into your sink. It will clog your sink, spit it into the trash can. So what is it doing? Well, it's dislodging the biofellon as you're swishing. Okay, loric acid, which is encoken oil is antimicrobial.

1:25:18It can help with lymphatic simulation and it can have some anti -inflammatory properties too. And a lot of people report, it makes their your teeth look brighter and wider. I mean, you do have great teeth. Well, I'll tell you the story why. Meant's in your profession to have great teeth, but I walked in and I met you for the first time in person. I was like, wow, you have really, really nice teeth. I had facial trauma. Should we get into that? Yeah, let's get into that. So when I was 10, it's why I became a dentist. When I was 10, I was trying to gain the attention of my older brothers, friends, who were very into dirt biking and BMX biking.

1:25:55And we had just watched the movie Rad. and I thought I would impress them and they were all doing tricks out in the neighborhood and long story short, I fell off my bike and landed on the asphalt and a vault to knock out my teeth and I broke my pre -maxilla and you can see the scar still. But this is part of my story and it's why I became a dentist because I was in and out of dental offices in oral surgeons and orthodontists and at the time I was an art theater kid, I loved working with my hands But as time went on, I thought, well, gosh, I don't want to be sleeping on couches in New York City.

1:26:31I need to make sure I'm equal living. What am I going to do? And I really love science. And I thought, well, how do I work with my hands? And it was dentistry. And dentistry can be a little creative and artistic, too. So these are not real. But thank you. Well, you're welcome. And thanks for the full disclosure. They look very natural. Yeah. Unlike some people's falsies, you know, or whatever. What do you call them? I call them false because I've got you know, I've got a tooth. It was kind of shipped in half from getting hit honestly. Dumb, you know, if you're going to box, make sure you're getting paid a lot of money anywhere.

1:27:07Yeah, and wear a mouth guard. They're better martial arts where you can go full, full blast like a Brazilian Jiu Jitsu where you stand less of a chance of brain injury. Let's just say so as a neuroscientist, I can't support boxing. But I remember the movie Rad. I remember the back flip at the end. I remember the whole thing that I think I was trying to do that. I don't know what I was doing. Anyway, didn't land it. Yeah, well you landed it, but on the right, but on the right. So this is a brave, you can get implants. People have flippers. We were talking about hockey players earlier early. You'll see them flipping their flippers around with their fake teeth.

1:27:44So flippers are retainer with fake teeth on it. There's about a lot of different things you can do. But what's interesting, I was part of making my teeth. I sat in the lab and held. So I wanted them to look Not quite as contrived as I suppose but they look very natural. Yeah, thanks and Today we're learning all the ways in which teeth are just part of this whole ecosystem that's so critical I have to ask and we will come back to some things related to Avoiding really horrible diseases by way of taking better care of ones or health Nicotine. These days, everyone knows or should know that smoking vaping, dipping, and snuffing, and yes, I did say vaping are all terrible for your health.

1:28:31The vapors will say it's not persinogenic cancer causing, and I'll say remains to be made really clear, but the whole popcorn lung thing is clearly problematic. But nicotine doesn't cause cancer. It's the delivery mechanism. Yes. But these days, a lot of people realizing the cognitive enhancement, if you will, I don't even like the phrase, the stimulant effect of nicotine are using nicotine pouches in particular gums. Let's set patches aside for the moment and mince in things that sort for the stimulant effect. It's an unusual stimulant because it also relaxes one self a little bit at the same time.

1:29:18So it's kind of that sweet spot. And I confess I will occasionally take one or two milligrams, very low dose. Most pouches are anywhere from three to eight pouches, milligrams rather. I'll take, you know, like one to two milligrams of nicotine in form of a gum. I'll just chew it, you know, and then take it out. Nicotine is a vasoconstrictor. What does nicotine do to the oral microbiome? Are you going to make me quit nicotine? I don't feel addicted, but every addict says that. So, yeah. The first step is admitting the issue. So, I don't want to villainize anything. No, you can villainize it. So, I agree with you.

1:29:58I don't think it's the nicotine itself, but like the pouches, for example, are becoming very popular. So what else is in those? And there's a really interesting case study that maybe we can link it for people to look at and I'll share it with you later. And then I have colleagues who are reporting this all throughout the globe. But they're one brain in particular. They will have manotal and maltodextrin in it, which are sugar alcohols and different carbohydrate. And they market them as sugar free. Well, products are allowed to have trace amounts of sugar still in the product, very small amount and still be called sugar free.

1:30:41And the issue with these products is the duration of action, the contact time, and you're supposed to leave them in for 20 to 30 minutes. Am I correct? That's right. So it's quite a long time to have that up in the mucosa along the bone and along your teeth that potentially has some sugar in it. Okay, so it's like if you're sucking on a hard candy. But also we're seeing changes to the cellular structure up in that area. So you can see local plakia, which is like white patching, which can be pre -cancerous. So this is why I just like everyone to get checked out. and we are seeing bone loss and gum recession.

1:31:22Again, anytime you put anything into the mouth, it's going to change and shift the microbiome. And that could be a filling, that could be a piece of gum, that could be a toothpick, anything. You know, arguably besides neutral pH water. And so this case study, this gentleman was going in. I believe he was in his mid -50s. He started using these pouches. and had always had very wonderful dental checkups with X -rays and one in regularly, and maybe he missed one appointment, and after 15 months of use, the X -rays are outrageous. He has rampant decay along the side where he had the pouch, very likely from potentially that trace amount of sugar, the microbiome changes.

1:32:11I mean, it looked like mothball chunks taken out of his teeth and he lost some teeth. Wow. So this isn't to scare people, but if you're going to choose to use these, I just say, know the risks and make sure you're going to check regularly at your dentist. Don't just ghost your dentist because if they're starting to see cellular changes, recession or early decay, then you may say, gosh, I should really cut back on this. Or maybe they should, if somebody is really adamant about taking nicotine, they should to just take a milligram or two milligram pill of nicotine, or a patch. You scared me with leukoplaicia.

1:32:47Yeah, because growing up, we were all told, you know, no one really dips in northern California, but you know, like don't dip or, because then I saw these pictures of leukoplaicia, jaw recession and it's pretty vial. And so you, the designer scared me sufficiently. I never wanted to chew tobacco anyway, But good to know, coffee, do I need to stop drinking coffee? Okay, thank you. You're from Portland after all. Yeah, or can I possibly say that? Okay, yeah. You wouldn't be able to return home. Coffee's great. I mean, it will dry out the mouth a bit. Just counteract it with hydration. And it will stain your teeth.

1:33:26So go in regularly for cleanings. And you may want to, I mean, if that bothers you, there are ways to bleach your teeth or lighten your teeth. the hydroxyapetites a wonderful way to improve the brightness and whiteness of your teeth and oil pulling as well. Or you can use heavy -hitter bleaches to just just don't overdo it. Everybody's overdoing everything now. And bleaching too much can damage your teeth. It can cause chemical harm to the to the pulpit, the nerve over time. And some people will get spontaneous abscessing or need root canals. I mean, these are people who are really like bleaching all the time, the people who you need sunglasses to look at their teeth and it's just not really a natural aesthetic.

1:34:10But some people are into that, but just know what the risks are. That's what I would say. The two things I've done in the last couple of years that have completely transformed my oral health says my dentist and how I feel are, first of all, I switched a few years ago, So I would say really about 14 months ago, I just said, that's it, I'm not eating processed foods again. I'm just knocking do it. So I eat meat, fish, eggs, you know, fruits, vegetables, and I ate some rice oatmeal and a good sourdough bread, butter, olive oil. Which is not to say that I won't have a slice of pizza someday, but I was like, that's it.

1:34:47Like I'm kind of over it. 49 years old, I've eaten enough of that stuff. I'm kind of like bored with it anyway. I hear you. And what was interesting is I used to get a lot of tartar buildup a lot. despite brushing and flossing on the lower front teeth calc. Insiders. Yeah, and it's scraped it away. It's a non -issue. Interesting. It's completely gone. Yeah, so we have minor salivary glands on the floor of our mouth, and that is a common place. People will see calculus or tartar. So it's lower teeth. That's where you'll feel your hygienic scraping a lot, but I wonder if it's because you increased your K2 in your diet, which helps with calcium metabolism.

1:35:24And nice supplement K2, but I was doing that before. And then I switched and I have just full disclosure because there's nothing to disclose. I have no financial relationship to the toothpaste that you make or the toothpaste that they that Gator Dentist makes. I don't know who I actually know his real name, but he hides as Gator Dentist. Gator Dentist. But I switched from fluoride containing toothpaste not because of fear of fluoride, but excitement about hydroxyapatite. So I I switched to using your toothpaste, and I occasionally, well, I routinely switch back and forth with knobs, where I think it stands for no BS, which is Gator Densis to tablet product.

1:36:04So I use them, and neither of them pay me, I pay full price, I don't, they don't send it to me, I purchase it like anyone else, and that's made a tremendous difference, says my dentist, like no cavities whatsoever. I was constantly battling this when I was a kid, and a bunch of oral health issues. And now I don't want to waste our time talking about those right now. Maybe we'll return to them a little bit later, but My teeth and oral microbiome never felt better It's it's just remarkable. Yeah, it's just remarkable and I have a family member who has some gut issues like just digestion issues and it's unclear what's going on there and I'm inspired to Try and help them address that through the oral microbiome by switching to hydroxyapatite and and And test their oral microbiome.

1:36:48I'd be very interesting to know what's going on in there. Because thank you for having me. Is there a best test? Like if, because a lot of listeners are going to say, okay, I want to, if they have the disposable income, they're going to want to test their oral microbiome. Yeah. Is there one that your office uses or that I use either the silha test, which is more just biomarkers? So it's a, you spell that? S -I -L -L -H -A. Okay. This is done in an office. Okay. It's just testing basic biomarkers. So I used it a lot as an educational tool. It will show on the pH, the acidity, if there's leukocytes, if there's red blood cells, inflammatory markers.

1:37:26So a lot of parents, this is so new to them when I'm talking about this. But it prints out in a graph form for that spit. So kid or adult will spit in the end. Yeah, kids usually won't spit till about four, just physically. It's hard. It's okay. Okay. Anyway, but I really like tests that you shock on metagenomics because you're looking for the whole array of bacterial DNA and so my favorite is bristle like a toothbrush bristle and it's direct to consumer. So because the issue is I can talk about all of these things but sometimes it's hard to find providers that are offering them. So I really love people to be able to get the tools to an inner home.

1:38:08So bristles is a company that people can... oral microbiome test. Yes, and it's really user friendly. Their interface is wonderful. And they will give guidance and protocols. Are you affiliated with them? I should probably ask because some of the audience will ask. I am actually. Yes. I am. That's fine. I use it. There's oral probiotic. We have a collaboration with their oral probiotic. Okay. But regardless if it's bristle or not, you look for a test that's using shotgun metagenomics. Shotgun metagenomics. Yeah, there's PCR testing too and a lot of biological dentists will offer something like oral DNA is the most popular.

1:38:45The issue with that is it's really only looking at the top 12 pathogens, parodonal pathogens, which is important, but there can be a lot of other information that you're missing. So it's a great place to start and your dentists may offer that. And it's called again, it's oral DNA and I have no affiliation with oral DNA. Great. Thank you for that. Um, I think people, So some people want to test their oral microbiome and other things in their... And there's more and more popping up if the oral microbiome is really blowing up. So for those who are looking for investment opportunities, I'd say look toward the oral microbiome.

1:39:22It's kind of what the dot microbiome was doing a decade plus ago. Yeah, I feel like oral microbiome is so much more tractable. I mean, switch to nasal breathing, get away from alcohol containing mouth washes, consider or a hydroxyapotite containing toothpaste instead of fluoride, which brings us to fluoride. Let's talk about fluoride. I've already been accused of being a sunscreen denier. No, I actually believe that sunscreen exists. I do occasionally use zinc oxide sunscreen a little bit. I prefer a physical barrier because I'll wear a hat or something if I, you know, I don't tend to burn very easily, but if I feel like I might burn, I use a physical barrier.

1:40:01I'm being somewhat facetious here because people will say all sorts of things, but I did an episode about water, a little bit about oral health, so certainly not the depth or expertise that you're providing today. So thank you. And I said, yeah, fluoride does a bunch of things. My question was, and it remains, why are we drinking fluoride? But this relates to, I'll Okay, I'll tell this story briefly. It's not as cool as your story. I was taken to a dentist when I was a kid and they put me, they put these like a mouthpiece with fluoride gel in it on the top and bottom and they sat me in a little wicker chair in front of a TV with cartoons.

1:40:47And I hated it. It tasted awful and it kinda had this sour thing. So it was probably six or seven. So I drank it. I just sucked it up, drank it down, turned around, barfed all over the wicker chair. Oh my gosh. Fluorides are poison, but everything is a poison at high concentrations. So most everything is a poison, excuse me, at high concentrations. So I don't have anything against fluoride, but it is a poison. Then the question becomes, if something is not dangerous in a small dose or concentration, what are its cumulative effects? This is what I have issues. People say, oh, going through the X -ray machine, no big deal.

1:41:29But what if you fly 150 times a year? Yes. Is it cumulative? And so the logic of the pushback from the traditional, if I will, community sucks. Like, they're just not logical. These are my colleagues sometimes, too. Right? Just you have the dentist to get an X -ray. They're like wanting behind the next wall. With a leg wall. With a leg wall. And then they're like, oh, no, it's no big deal. Well, how many? You know, maybe how many times a year can you do this before it becomes a deal? So my question is, what is the rationale for putting fluoride in drinking water given that the contact time in the mouth is so short?

1:42:08And then what's the cumulative effect of bringing fluoride into the gut over and over? And then earlier you said something and I've never thought about this. The bones contain hydroxyapatite, 60 % I think you said. 60 % of your bone minerals are made from hydroxyapatite. Fluoride infiltrates the minerals of the teeth and replaces it. So is fluoride going into our bones? Skeletal fluorosis. Okay, so I'm not trying to paint a scary picture here. But frankly, and people can probably tell, my blood pressure goes up a little bit when people say, oh, you know that your anti fluoride, I'm not anti fluoride, but I just don't get the lodge.

1:42:45It doesn't make sense. You're thinking critically about it. Why would I continually bombard my system with fluoride at the level of the gut at the level of my bones? If it's good for me, tell me it's good for me, but they're saying, oh, it's so that poor populations don't have decaying teeth. Sounds like a good argument. Not even counter -arguing it, but I can't piece together the logic. And like most public health arguments, I feel like neither side is is explicitly clear about what exactly they're arguing about. And that's part of why I have this podcast to try and get clarity on the things.

1:43:22I'll do my best. Yeah, and please don't worry that you're gonna offend anyone because I'll offend everybody. And they've already said anything. Everything they possibly could, and they'll say more. So I'm not afraid to open up these topics anymore. Okay, well, I appreciate that. And I'll take the heat. I, well, I will get it too. Don't worry, I've already, I've thick skin at this point. But you have great teeth and they got so yeah, I haven't had a cavity for multiple decades and haven't used foreign and Portland isn't florida Portland is not Not so let's talk about that so fun story back in 2011 2012 I was working on the pro water of Florida, Asian campaign, volunteering in Portland, picketing and handing out educational flyers, because I thought we needed it in our water.

1:44:13And this is because that's how it was trained, and I just never questioned it. I never picked up a journal to look at the other side. I thought anyone speaking out against water, Florida, Shane, that's the Tin Hat Brigade, that's the Wulu Caucus, all the things. I was that person. The woo -woo cock. That's pretty funny. Yeah. So I went to a debate in Portland, pro versus against. I don't like those terms, but it's just the easiest way to describe it. And I was sitting kind of on the pro side and just waiting to see these pseudoscientists come out to speak. And I was so profoundly impressed with what they said and also had no idea that there were any concerns with fluoride.

1:45:00I had never been taught that in dental school, the endocrine disruption, the neurotoxicity, the skeletal fluorosis. I knew about dental fluorosis, but I at that point was of the mindset, well, it's just aesthetic, you know, but your teeth are stronger. And the microbiome issues too. So it didn't take long. I just started rabbit holeing, and there's so much literature. And this, again, this was quite a while ago, and more and more data in literature is coming out to question the practice. So it's important to go back to the history of water fluoridation, I'll try to be brief, but in the early 1900s there was a dentist in Colorado Springs, Frederick McKay, who noticed his patients had modeled on brown spotted teeth, but they were really strong.

1:45:46They weren't getting decay. And so this kind of spread and they started kind of trying to understand the why. And they realized there was a really high concentration of fluoride in the natural water supply that this community was drinking. And this just kind of spread like wildfire with very little evidence -based medicine to back it because this was in the early 1900s. Now it was like the 1930s. So no long -term safety studies or efficacy studies. And it was put in as an experiment in grammar app is Michigan in the mid -40s. After about a decade or so, they noticed that carry rates, cavity rates were going down.

1:46:26And so based on this observation, it just went like wildfire throughout the United States. And I believe about 80 % of the United States is Florida. So the pro advocates, if you will, will say it's the greatest public health movement of the century because decay was such an issue. It's important to know, dental decays, is the top chronic disease globally in children and adults. It's almost entirely preventable. I think we've just normalized it. You just get cavities, but I'd like to point out we're one of the only species to get dental decay. Wild animals don't get decay or domesticated animals do because of what we're feeding them, the kibble, processed animal food.

1:47:10So here we are. So it's been controversial from the beginning, epidemiologists and or chronologists neuroscientists have always challenged saying this is a bad idea. It's a highly reactive element. You know the fluoride ion can interfere with iodine, uptake and again skeletal fluorosis, neurotoxicity, etc. So about seven years ago there was the people there's a federal trial in Northern California but it was federal. The people versus the EPA, it was a task attrial. And this has been ongoing for the past seven years, and basically they were saying, where is your safety data EPA on the long -term effects of water fluoridation?

1:47:54So the idea was that if we put it in the water, it's not a very efficient way to get fluoride to people, but eventually it will make itself into the saliva and have a topical effect coming out through the saliva. They used to think systemically it was actually incorporating into the developing teeth and children making the animals stronger that way, but that's been debunked. So now it's most likely still a topical benefit, maybe a little bit of a systemic benefit touching the teeth. And we do know the Florida really needs to work topically. We don't need to be ingesting it, and that is all through the data, and they're teaching that in dental schools now too.

1:48:35Okay? Okay. But this is the easiest way to get fluoride to the masses because caries or cavities are such an issue. Now my first comment on this is we're not addressing the root cause of dental decay, which is our food. It's all the ultra -process foods. Again, we didn't really see dental decay in humans until the agricultural revolution, the industrial revolution, and now the ultra -processed food craze that's been happening in the past many decades, okay? Is that right? So if we look at skeletons from dead people, obviously, well you can look at skeletons a lot of people. Skeletons and dead people, dead people that died prior to 1900, how are their teeth?

1:49:181900, they still have, they would have decay, but if you looked at about 10 ,000 years ago, very little. You know, and Leslie lived in an area with a lot of fruit abundance or honey, like where are you getting your sugar from? You know, and you go pick some berries on a bush, you're competing with the animals and the birds. You didn't have much opportunity over -consumed sugar. But, you know, there was the sugar trade, and then we just sugar was a sign of wealth and royalty and people's teeth just rotted out, and it was because of our diet. So that's the root cause issue that no one's talking about, you know, we're just saying, let's slap fluoride on it.

1:49:56How about we educate and teach people what is really causing cavities? But anyway, okay, so the task of trial was going on in the judge, um, uh, judge Edward Chen was waiting for this National Toxicology Programs report, which was under the Department of Health and Human Services. And this is, it reads like a soap opera to be honest with they owe and it kept getting delayed and postponed and they wouldn't release it. And finally, under the Freedom of Information Act, he said this needs to be released. And it said, there is a strong correlation between increased fluoride consumption and IQ issues in children.

1:50:39And so with that, he took this information and he made his ruling. Now, this was after years of expert testimonies as well, okay? Saying there's an unreasonable risk to current water flow radiation practices in the United States. This was his ruling that just happened late last year. I mean, it's this is very new. And EPA, you now need to fix this. You need to regulate this better. What people will argue is a lot of the studies they were looking at that are showing lowered IQ and children are neurocognitive issues. It was at 1 .2 or 1 .5 milligrams per liter. That was the concentration. The United States, we now do 0 .7 milligrams per liter.

1:51:25But that's per liter. Okay, so how many liters of water do you drink a day? This is the controversy. So, for example, the American Academy of Pediatrics generally recommends pregnant women drink two to three liters a day. You might be cooking with fluoridated water, making your pasta, making your soup. How do we really know how much someone's getting exposed to? What's their body composition? How much should they weigh? What are the other outside sources of fluoride? Are they swallowing their toothpaste? Fluoride is in many pharmaceuticals because it helps increase bioavailability, especially SSRIs and Prylasac.

1:52:06A lot of these have fluoride in them. Really? Yes, ultra -process foods will have fluoride. So the factory that's making your rock star energy drink or your high sea or whatever you're consuming, they're not using reverse osmosis to filter the water. So you're getting fluoride that way. It's naturally found in green tea and black tea. And this is not to make people worried about green and black tea. I still consume them. It's more to say how are we really understanding how much is exposed to? And so they were finding that pregnant women, and they followed, there's many studies now, but the famous one was the Riftka Green Study out of Canada, and they followed about 520 mother child pairs.

1:52:50They tested urinary fluoride and the mother per trimester average yet, and then followed these children to the age of three or four and did IQ tests and found that mothers who had higher concentrations of urinary fluoride, the children tested lower on their IQ test up to five to seven points, and that's on par with lead. On par with lead. On par with lead, yes. And so that was in 2019. There's been so many more studies now. So the judge ruled EPA, you need to regulate this better. In that amount of time, there was a meta -analysis that came out that further supported the NTP report by JMA Pediatrics.

1:53:31Okay, and this is very controversial for these editors to be putting out, by the way. So I commend them. And also a Cochrane report came out Cochrane Collaborative, which has said, this again, was very recent. Looking at all the data from water fluoridation, water fluoridation isn't reducing decay, like we thought it was. It's only reducing decay by about one quarter a cavity per person. one quarter of a cavity per person. So that's not statistically significant. So people will say, well, what gives? Why were cavity rates going down when we added fluoride to the water? Well, it's hard to say, maybe they were already just going to going down due to education, more access to dental hygiene and tooth brushing and flossing.

1:54:22But also, we now have fluoride everywhere in our toothpaste. So Florida's put in the water in the 1940s. It wasn't added to our toothpaste until the 1960s. Now it's everywhere. We get fluoride everywhere. Rinses, the varnishes that made you vomit at the office. And by the way, that's very common. That's very common. And it's because a lot of those fluoride varnishes, number one, fluoride, you know, does have a poison control label on it. You're not supposed to swallow it. But these varnishes also have polyurethane and hexane derivatives. of some of that, it's what makes them so sticky. I still love going to the dentist.

1:54:58I think it's because of that early association. Yeah. So it's very controversial and unfortunately we've lost sight of the science. It's getting varied in politics right now and it really upsets me because it's not a political issue. We just need to look at the data and I feel like we're losing sight of the scientific method. And you know, the American Dental Association, the American Academy of Pediatrics is doubling down on saying we have to put Florida in the water. And for nothing else, I think it's important to know 97 % of the world does not Floridaate their water. This is a very United States controversy.

1:55:36Many countries removed it and found, I think it was Denmark, Germany, Japan. They have very low decay rates and why is this? Well, they educated their population on what's really causing decay and also made Florida toothpaste accessible. And I have Danish relatives. They have very nice teeth. If you told me that there's no fluoride in the drinking water in England, I might I might Like well, you know, sorry my English friends, but that's the stereotype right that their teeth are bad I don't think that that's true any longer. I think that that was true at one point that I think they're crowded and crooked Too and a lot of that has to do I think with facial development as well.

1:56:14I think we're we see a lot of Western European, they do have that kind of dysmorphic face, if you will, probably from nasal breathing. Who knows why? Industrial revolution, allergies, health breathing, etc. Why does it see more prevalent there?

1:56:33So, that's the quick take on it. And so, I just think it should be a personal choice. If you want to use Florida, you can go out to the store. I mean, you can get Florida toothpaste at the dollar store now. they give it out for free at many clinics. To me, I just think it's a medical ethical issue. We're mass -medicating a population without their consent. And then the even bigger issue for me is no one's talking about this, nor can I find any literature on it. What is it doing to the gut microbiome? Because it is an antimicrobial. So that would be a wonderful study, NIH, if you're listening, can we test people that live in Florida in areas versus those that don't, we follow them, maybe it's a prospective cohort study to just see how their microbiomes are different.

1:57:22Because it just doesn't make sense to me, and why would we ingest something systemically with all these potential risks when we could just use it topically or actually talk about what's really causing decay? If fluoridation worked, It, it, cavities wouldn't be the top disease in our country, in our children. And many worry, well, if we take it from the water, decay may go up. And it may, I mean, there's been, they, they did this in Calgary, Canada where decay rates went up. But then if you actually look at the data, the decay rates were already going up when they removed it, but they only show you the data that they kind of want to show you for that.

1:58:01So, um, but again, it's a risk benefit analysis. I mean, I think Dennis tend to be too focused on teeth. And so you mentioned like if they say it's good for me, I'll do it. Well, good for what? Good for your teeth or good for your whole body or good for your brain. And I think that should be an individual choice. Are you, as a parent, do I want to choose one quarter or less cavity in my child? Or do I want to preserve their optimal brain development? I mean, the data that show deficits on par with what one sees with lead exposure, that's the most striking thing to me. Yeah, and I'm a dentist. I was trained to fix teeth.

1:58:45I can fix a one -quarter cavity in a tooth. I can't fix the developing brain. We have one shot to develop a brain. We have one shot to grow a face. You know, it's really important. I really appreciate you taking us through the full arc of the history of it. but I think it's extremely important that people take that in so they can start to form their own opinions. You pointed out a number of logical flaws in just the way the whole system is arranged right now, which is this mass treatment of everybody with a potent chemical, especially given the amount of water that people drink and cook with, et cetera, without their consent.

1:59:30and... And without a risk assessment. So you're low decay rate. I might be a really high decay rate. You don't need anything extra. You're diet, you're balanced, you're microbiomes great. I'm not eating well, my hygiene's terrible. You know, we can't just blanketly be treating everyone the same. We're supposed to be doing risk assessments. I'd like to take a quick break and acknowledge one of our sponsors, Element. Element is an electrolyte drink that has everything you need, but nothing you don't. That means the electrolytes, sodium, magnesium, and potassium, all in the correct ratios, but no sugar.

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2:00:39I also drink element dissolved in water, drink any kind of physical exercise that I'm doing, especially on hot days when I'm sweating a lot and therefore losing a lot of water and electrolytes. They have a bunch of different great tasting flavors of element, they have watermelon citrus, etc. frankly I love them all. If you'd like to try element, you can go to drinkelement .com slash Huberman to claim a free element sample pack with a purchase of any element drink mix. Again, that's drinkelement .com slash Huberman to claim a free sample pack. Okay, so I think that pretty much puts fluoride in a box.

2:01:13Let's say on the shelf for all of us to look at, I think this is going to be a very important aspect of public health in the year to three years to come with this new administration and Bobby Kennedy paying a lot of attention to fluoride. And I really like what you said about trying to remove the political aspects of this. If this becomes a blue versus red, left versus right thing, we're never gonna get to the heart of the matter. And that would be really sad and the ones that would really suffer would be kids. The children, yeah. So a nonpartisan look at this, which is how I heard everything that you said, just seems really critical.

2:01:57Where are they getting the fluoride? So water fluoridation, the fluoride that they get is a byproduct of the phosphate fertilizer industry, and it's called hydrofluorosolistic acid. So as a byproduct of the phosphate fertilizer industry, It's considered a hazardous waste and it's very expensive to dispose of. But they have found that if diluted in theory and put it's an acid, first of all. So if it's put into our water system, it is so diluted that it becomes safe. But I will say it, you know, everyone can go researches and look at themselves, but it does come in like cement bags with skull and crossbones on the front and they do have to wear hazmat suits to put it into our water.

2:02:50They're supposed to titrate it and I think what's interesting, you know, we're supposed to target 0 .7 milligrams per liter. I've been involved in some educational campaigns and have tested communities around in Portland. It's very hard to keep it in range, you know, and so there are some communities testing as high we've seen as 2 .2 milligrams per liter, which definitely falls into, based on the science and literature, more concerning zone for neurocognitive issues and other health issues. So if you're concerned, you can call your local water bureau municipality. I will say I don't think the federal government is going to have much control over this.

2:03:28It would be nice if the EPA stepped in. They have appealed, by the way. but it will come down to more like on the state level and local level and we're already seeing states like Florida and Utah have run it through and initially done a we're going to ban this as a mandatory thing in our state and I think it's North Dakota Kentucky there's other states picking this up to and other communities that are removing it or not adding it to their water so it's an interesting time to observe all of this. Super interesting. Um, I will resist the temptation to ask questions about why it sounds like mostly red states are the ones doing this as opposed to blue states, although Portland is in a blue state.

2:04:14Portland's traditionally city for sure. Blue city. Yeah. Yeah. Right. Blue city in a, um, state, you know, what Oregon went red this last election? Uh, But the city's make a, it's kind of like many states. So Eugene, Portland, Ben, tend to be pretty blue. And I think this surrounding is more conservative. But no, it shifted a bit, but not enough to shift out of voting liberal. All right, well, we'll do another episode in 2090 about politics. Meanwhile, back to the oral microbiome. And otherwise, I'm very interested in, the relationship between oral health and what you described as fertility, pregnancy, and hormones.

2:05:01And obviously hormones can be about men or women. But let's talk about oral health and fertility. What, if any, knowledge is there about how the oral microbiome or oral health would be impacting egg health, fertility, ovulation, ovarian reserve? Is that the level that the regulation of fertility is thought to occur? What's known about the link? Yeah. So again, it ties back to that translocation and creating an immune response and inflammation, as well as the endotoxins that are released. With men particularly, they're seeing increased sperm challenges with sperm motility and sperm mobility. As gum disease and parodonal pathogens increase, and again, it probably has to do with the inflammation and with women, you know, we can show that women take about two months longer to become pregnant.

2:05:58It does affect ovulation, egg quality, but also we know it can lead in miscarriages and low -term birth, low -weight birth, preterm birth, and just pregnancy complications as well. And so we are finding oral bacteria in the placenta. You know, we're finding there's different microbiomes everywhere. Now the breast has a microbiome, the placenta has a microbiome. And so oral bacteria can end up in many of these places and just create that cascade of inflammatory events. And so certainly it's an exciting time to be alive because of all the research happening. And right now it's, again, not causal.

2:06:40There's a lot of correlation, but I would love to see fertility clinics focusing more on oral health. Like how amazing would it be if they started testing the microbiome of patients? And if they realize they're really high and Pigeon Jivalis are F nucleateum and they eradicated or less in that bacteria, I mean, I'd be interesting to see how pregnancy and fertility outcomes would change and possibly improve. Great. What are some of the mechanical, as opposed to chemical things that we can do to improve our oral health? So we were all taught Russian floss twice a day. I even have a colleague who Can be caught in the bathroom brushing his teeth after lunch So he's brushing it three times a day.

2:07:24I don't know what motivated you do you? Okay Great. So what's the deal with brushing when let's say Kind of like exercise. Let's say if someone were gonna only brush once a day better to brush in the morning or at night Obviously, people should brush twice a day, but one more. But if one could only brush once or a day, would it be morning or night? Yeah, a guy parents on this a lot because brushing a child's teeth can be challenging. Night time is always the most important. One, you're removing the food particulate matter from the day away. You're disrupting that biofilm so that you're not sitting, sleeping all night, eight, 10, 12 hours if you're a child with that sticky, potentially despiotic biofilm on your teeth.

2:08:11And then you add in maybe your mouth breathing. That's going to shift the microbiome and drop the pH more. So it's really nice to go to bed with clean teeth. So I suggest focusing on the night time. And what does drive me a little bonkers is the fact that we tend to focus so much on brushing, but we leave out flossing a lot of the conversation. So thank you for mentioning that. If you read children's books, you'll see they all say go brush your teeth but never floss. So we need a revamp there. But most cavities that I see in children, and this translates to the adult population as well, are in between the teeth, they're interproximally in the molars.

2:08:49And it's really common. So a lot of parents will bring their kids in. They think they've been doing everything correctly. They haven't been flossing quite yet. And we take extras for the first time in the children have eight cavities, which sounds like so many, but it's really common because we have eight molars. And so it happens between the teeth, where you're eating those goldfish crackers, those pretzels, those chips, they get stuck in between the teeth, the bacteria come to feed, the acid gets released, and it just sits there hour after hour day, after day, arguably week after week, if you're never floss in.

2:09:23So I really like flossing, to be part of the routine too. Again, if you can only do it once a day, that's great. That's fine, do it at night. I like to floss first, then brush. And you're dislodging the food in between and kind of brushing it away. There's actually studies to support this too, that order, however, beggars can be choosers. Just do it. You know, some people get a suction cup mirror, they'll do it in the shower, some people do it, and they're commute in the car. I'm not gonna be picky about it. And I will also say as we age, flossing doesn't always cut it by itself. So think about a little string of floss.

2:10:00You know, we want to put it between the teeth and they suggest you do a sea and a backward sea. You're scraping the sides of the teeth to disrupt that biofilm. But as we age, we all lose a little bone. So you get this little pocket where that string isn't cleaning the bacteria out of and that's where water pick can come in. And so if you really want to be an overachiever, I do love a little water picking too. I personally will alternate. So one night, I might floss the next night I might water pick. This works really well in patients that can't put their hands in the mouth. Maybe they have like an aversion to that sensory children often will struggle with flossing.

2:10:38So water picks can be fine. You can do it in the bathtub so it doesn't get totally messy or in the shower they make cordless versions. But I can't overemphasize how important flossing is. That inner proximal cleaning, it stimulates the gum tissue and you're less likely to gum disease as a result. What about those little toothpicks with a little sling of flaws across? Oh. You know, the hard picks that... Yeah, floss picks. Floss picks. They're great, especially in kids. It's the only way to floss a child's teeth, first of all. So I want parents as soon as teeth touch, they should be flossing. That could be the anterior teeth.

2:11:18Our jaws are shrinking, our teeth are crowded. It's rare for me to see a child with space in their front teeth. That is how we should be developing because adult teeth are wider than baby teeth. They need more room to come in, but very often we're crowded. So anywhere to touch, we should be flossing, but usually around the age of two and a half, the molars are in touching. And parents look at me like, I'm crazy, but we really should be flossing. And so if you start some of these behaviors early, it becomes easier and easier. We know kids at floss become adults who floss. But also floss picks are fine for adults too, you know some people have big hands.

2:11:55It's hard to get floss in Yeah, I have to use them. I can't get into my I can't get my hands into into my mouth. They're fine. Yeah, okay You just want to try not to just go straight up and down just kind of angle angle if you can okay And then maybe a water pick too and I was told by my dentist soft toothbrush Because I tend to get in there and like I'm hearing all the stuff about how the you know or all health is so important for the brain and for any of that could lead some people including me to get in there and just start scrubbing and scrubbing and trying to get everything out of there and that's not the right approach.

2:12:27And brushstroke, very gentle. So you wanna do gentle circular movements. You don't wanna wear away your enamel. This is also important. Many people will eat and then run to the bathroom and brush their teeth. Every time we eat, our teeth de -meneralize a little bit, remember I mentioned it takes about 20 or 30 minutes for that remineralization to begin. So if you're immediately going to brush, your bristles could be damaging your enamel and creating, just wearing it away and creating little marks and lead to sensitivity recession. So if you can try to wait 20 or 30 minutes after you eat or drink to brush, this includes with vomiting, the same thing.

2:13:10So we all want to brush our teeth after we maybe get sick, try to just maybe rinse your mouth, maybe a little baking soda. A lot of this is perfect world, okay? And I get it, but just I like people to have the information. You said marking and I meant to ask something earlier, not to return us to the fluoride conversation, but you said that the person who initially had the idea to include fluoride in treatment of tooth decay, noticed that kids teeth had dark spots on them. Does fluoride caused darkening of the teeth? It can. So I believe it was his pediatric and adult patients. It was just this whole community had these spotted teeth.

2:13:51So that is something called dental fluorosis. Spots and markings on the teeth can be many different things. One is fluorosis, one could be hypoplastic enamel. I think we should touch on that. But so fluorosis can be mild, moderate, or severe. When it gets more severe, that is where it can be dark, spotted, orangey brown. Mile flurosis usually is more brighter white. You often see it on the incisal tips or on the cusp tips of the molars. It's not a very attractive feature. It's not and it is a sign that you've had excessive fluoride, you know, and I will say 40 % of teenagers now have dental flurosis that very likely means they also have some degree of skeletal flurosis as well.

2:14:37So for all the challenges that the debate around fluoridization of water has, I am willing to bet a significant amount of my savings that this issue will end up being the linchpin issue. It might seem crazy, right? Like here's the substance that may or may not be safe, that we're ingesting for various reasons, and there's a history there which you beautifully described. But having been in this public facing health education game for a little while now, for the typical person who's like, yeah, whatever, I've been drinking water, and I feel fine, and my kids feel fine or there's nothing I can do about it now.

2:15:19They're 15, maybe they're 10 IQ points down from where they would be. But if you tell people, what I find so interesting about human psychology, if you tell people, So did you know that fluoride not only might have some neurodevelopmental impact, it's probably getting into your bones, just like it's getting into your teeth, but you know the spots on your teeth that are those white spots or dark spots that are really unattractive, that's because of fluoride. Now you've got everybody. Yeah, aesthetics. aesthetics. And it's, you see, they're a shame or whatever that this is the way that people are, but But the moment that people realize that something that either is good for them or was intended to be good for them might be bad for their long -term health, you sort of got them hooked, but these long -term correlations are very hard to motivate human behavior.

2:16:08But those white spots, nobody wants those, dark spots on the teeth, nobody wants those. And I be willing to bet that that becomes one of the key issues. And if people go, oh, listen, it's actually making my teeth uglier. Yeah, maybe stronger but uglier. Um, I bet you this becomes a wedge in the conversation. That will come from the public, but I will tell you, I have Dennis, when I speak as I do about water fluorination and fluorosis specifically say, well, it's just aesthetics, at least their teeth are strong. Like they're making the decision for the patient. And I think that's not our right as providers to make that decision for someone.

2:16:48But it's really common. Florosis is very common. I've even seen more recent data, saying it's highest 60%, but the 40 is kind of the standard number that we go with up teenagers with Florosis. There is something called hypoplastic enamel. This is something I'm very passionate about. This is under minorized enamel and I believe it's a silent epidemic in children. I see more and more children whose their teeth are wrapped and they're modeled and chalky and some are so severe, they're crumbling. And I've seen a big optic in this in my 20 year career and the data is starting to show this as well. And so unfortunately so many parents, their kids will get decay, it's really common and they get shamed and blamed.

2:17:33Like what are you feeding them? You're not brushing and flossing their teeth, you're neglecting them or they're told to stop breastfeeding because that's what's causing the issue. But it's really that the teeth, the enamel didn't form properly and it's not as acid resistant. It's more fragile, it's more pickup sticks than the Lincoln logs, okay? And I believe in colleagues globally agree that it's very likely due to all the mineral deficiencies that we're seeing globally and the vitamin D deficiency that we're seeing globally. You know, we're inside all the time, we're not outside, all the junk light that we're getting, the blue light.

2:18:08It can also be from environmental toxins, high fever, virus, But it's a real concern in so many children are having undergo general anesthesia now to get their teeth fixed. The study I read said about 100 to 150 ,000 a year for a preventable issue. You know, there's risks to general anesthesia. And this is where I do love to consider a more conservative approach that can we re -meneralize these teeth? Are there strategies that we can do to even just kick the can? and so the child's older, so they could sit for treatment so that we're not putting so many children under anesthesia because I don't think we have the data for all the long -term potential cumulative effects.

2:18:54And we talked about this earlier, it's not just one exposure, right? It's not just one exposure from an X -ray or one exposure from fluoride or one anesthesia exposure necessarily, but it's that cumulative effect that we don't have enough data on. Going back to this relationship between the oral microbiome, oral health and hormones, and focusing specifically on female hormones, the menstrual slash ovulatory cycle that occurs each month, as well as perimenopause, menopause, about half of our listeners or women, I'm curious, Are there certain phases of the menstrual cycle or certain phases of paramanopause, menopause, or prior to it, in which women should pay particular attention to their oral health?

2:19:51Is there a known association with when estrogen is rising or falling, that the oral microbiome tends to be more vulnerable and they perhaps should spend a bit more attention on their oral health? Yes, so we see it both ways rising and falling. So around puberty, we'll see changes to gum health. So a lot of young girls will have more gingivitis or gum inflammation. And, you know, and certainly if they're on oral contraception, that can change things too. And they'll go into the dentist and be accused of maybe not brushing a floss uniformly, but it's really a hormonal issue. So it's important to know that as well as women who are pregnant, pregnancy, gingivitis, effects, 50 to 70 % of women.

2:20:3350 to 70. It's a lot. Wow. Yeah, and it usually goes away once you have the baby and you've gotten through some breastfeeding and hormones regulate. But it's important to know that you can also have relaxing. It helps us prepare for childbirth, but it can shift teeth. We have a ligament around our teeth, much like we have ligaments in our pelvis, and that periodontal ligament is impacted to buy relaxant so you can see teeth shift and move. And women may sometimes say my bite is different now. My gum health is different. So it's a very important preconception is certainly during pregnancy to be really on top of your oral hygiene as best as possible and see a dentist regularly.

2:21:14And then paramanopause and menopause, there's a whole slew of issues that happen to women and from an oral health perspective with hormonal shifts, decreases in estrogen and progesterone, can impact collagen synthesis, so more TMD, more headaches, certainly gum inflammation, dry mouth, burning mouth syndrome, more bad breath, taste changes too. And so what if it's just so powerful to be able to have these conversations with women rather than just say, well, just use this product, Russian flasmoir, maybe we could talk, be speaking of it from a hormonal lens, like is hormone replacement therapy appropriate for you?

2:21:53Or how can we help support you in other ways? Maybe you should see the dentist every two or three months instead of every six months. And also just the mental health component to say, hey, this isn't something you're neglecting. This is a change your body's going through. And so how can we support you from a dental community? Yeah, thanks for that. More and more, I'm getting asked questions on social media and elsewhere, where about, you know, like, how is this different for women versus men? And in particular, different phases of the cycle and impairment, oposment, oposment, and, and essentially the entire lifespan.

2:22:25So appreciate that. Yeah, I get burning mouth question a lot too from my community. Which burning mouth sounds awful. So your mouth feels metallic and it truly feels burning, almost like itchy. I think I haven't experienced it, but that's how it's described to me or kind of like a dry mouth. health, it can be a sign of zinc deficiency or vitamin B deficiencies and we can see changes and that in those with paramanopause and menopause. I think it's important to know the mouth is the gateway into the body and we can see nutritional deficiencies in the mouth as well. So cracks in the corner of the lips can be a zinc deficiency.

2:23:04It's the same with white striations on the line or in your fingernails that can be a zinc deficiency, B vitamins can be burning mouth or geographic tongue is something people experience. What is geographic tongue caused by? I don't have it. I have a family member who has it. It's permanent because they're quite far along in their life now and still have it from childhood. We're told in dental school it may be hit changed but it's benign and just tell patients to of wood citrus and acidic foods. And it is cross linked to latex allergy and psoriasis. So it's an autoimmune issue. It can be a sign of nutritional deficiencies, usually zinc, B or iron.

2:23:51And also it can be a sign of celiac, crones, or that issue. Again, it's all connected. And so a lot of times when kids see me, I will send them to a functional medicine doctor or natural path to just make to rule that out. You know, and there's genetic dispositions too. As we progress further along in this conversation, these ideas popped to my mind that I'd never thought of before. Like, because I don't tend to use them like lip bombs, lip stick. I don't use lip stick. I don't use lip bomb. I suppose I've put like one of those sunscreens when I went skiing or snowboarding years ago on my, and now I'm wondering, was that just a terrible idea?

2:24:34I mean, it's been not some burn. People are going to use it, but I suppose specifically, like lipsticks, are they safe for the oral microbiome? Well, I don't think it's getting into your, I mean, hopefully you're not eating it that much, but I mean, we need to be mindful of our products. You know, there's a petroleum -based products. A lot of lipsticks, lip balms, they have nasty ingredients in them. We're learning more and more, and you know, they're not necessarily as regulated here from a cosmetic standpoint as they might be in the EU. So, reading ingredients, but a lot of petroleum -based products will actually cause more dryness.

2:25:08You know, and it has a reverse effect, which is why people get addicted to chapstick, I think they just, their lips dry out more. But when I see chronic dry lips, I'm thinking dehydration, and are you mouth -breathing? Because when you mouth -breathe, all the tissues dry out. So, if a kid comes in with chronically dried lips, I do wonder if they're a mouth -breather. Another way to assess if you have a mouth breather on hand is, are you always asking someone in your life to chew with their mouth closed, especially kids? So when we're chewing, we have to breathe. So you should chew, lips close, breathe your nose.

2:25:43But if you can't because of an obstruction, deviated septum, inflamed nasal terminates, you'll have that kid that's mouth's always open and they tend not to chew enough. They kind of mash food and swallow it. because they're worried about oxygenation. They feel like they're gonna choke. These kids tend to get picky eaters because they stay away from meat, carrots, apples, things you have to chew a lot and they eat more chicken nuggets, mac and cheese because you can just mash it and swallow it. That can be a sign of oral motor dysfunction in adults and kids. So if you have a hard time chewing with your mouth closed, that's something you can explore and get help with.

2:26:20Should we be able to chew equally on both sides of our mouth? you should chew equally on both sides of your mouth. So if you're chewing just on one side, not only will you get hypertrophy of the muscle on that side, but it can cause a shift, especially in kids of the way you're growing. But I would wanna know why. Why are you chewing that way? Is your occlusion or your bite off? Are you avoiding a tooth? Cause you're in pain. It can be a bad habit. There's ways to retrain, but everything should be symmetrical. So you should kind of chew chew. Your tongue should move the bolus of food to the other side, chew chew.

2:26:52So if you can't do that, it can be a sign of oral motor dysfunction too. Maybe your tongue doesn't have good range of motion or mobility. Maybe you have a tongue tie or low tone. So there's a lot that can go into that. And this is where seeing a myofunctional therapist could really help. You said it's all have to ask tongue tie a few years ago. This was a controversial area. Tongtie being the stretch of skin between the bottom of the tongue and the bottom of the, was at bottom of the floor of the mouth. of Florida mouth. Thank you. And this idea that in babies it should be caught to other people say, it shouldn't be cut.

2:27:28And then everyone starts looking at it or they call it me. I think mine just seems to naturally torn back or with some distance. But you know, what's the deal with tongue tie? Should it be cut? We're going into all the controversial conversations here. I'll take the heat. So that's called your freedom. Okay, so we all have a freedom. It's the band of tissue that attaches our tongue to the floor of the mouth. We also have a labial freedom. And sometimes you have little buckle freedoms up here in the vestibule. You can cheat. If you put your finger up in your mouth, you'll feel. We may have them, we may not.

2:28:06When they dried my teeth out for something, once they pull it back, you can see it's yeah. Like webbed. Yeah. So the whole thing with this conversation is all about function, okay? So does your tongue and do the oral structures function appropriately? In which case, you're good, you know? What's hard is to be mindful of, you can't diagnose anyone from a photo on social media. So I see a lot of parent logs who are saying, My child has a tongue tie. My child has a lip tie. You can't tell. We have to look at function. So is it impairing or impacting breastfeeding? Can the tongue not lift appropriately?

2:28:46It's all about lifting, elevating, and lateralizing. So many think tongue tie impacts you sticking your tongue out. We don't care as much about that. What grows the face in the palate in utero and then beyond is that tongue lifting, elevate name, and spreading that palate, almost like an expander, like an orthodontic expander. And so if it can't lift, that's the first sign. And that means it can pull in the breast tissue and breastfeed appropriately. Babies might have a lot of reflux, women will have pain. Okay, so that's one of the first things we look at. But then as children get older, we look, well, is there a tongue tie that is potentially leading to mouth breathing.

2:29:31So when your lips are closed and you're breathing through your nose, your tongue should be up at the palate and it should have enough tone to stay there, ideally while we sleep too. But if your tongue is tethered, it can't lift up. Your tongue's going to lay low and you're going to have more of the Napoleon dynamite look, okay? So that open mouth forward head posture. That's just because the tongue can't lift. many times when people have tongue tied, their palettes are narrow too, because in utero the tongue wasn't up to grow the face optimally. And this runs genetically in families as well, the predisposition.

2:30:09So then the next thing we look at is speech, you know, and is it impacting speech or is it impacting chewing and swallowing? So if all of those things are fine, if it looks like there's a tongue tie, but you're thriving, you're doing great, assuming you're not compensating and using other muscles and now having other downstream effects like shoulder pain, headaches, postural issues, you're great. But if a child is having issues and you've gone through the right screening and had the risk benefit discussion with the parents, I do think a connect to me is indicated. And I myself have had one and it benefited me a lot.

2:30:49my issues were neck strain and a lot of shoulder tension that really there's a lot of facial tissue that's impacted with a tongue tie or can be and so it helped me a tremendous amount. But nothing's one size fits all and we're all different. So this is where you do want to work with someone with additional training to see if you have a tongue tie, how are they assessing that and then is it impairing function and then do you actually need a procedure you're done. Sometimes just working with a mild functional therapist or different body workers, a chiropractor, a cranial sacral therapist, an osteopath can be enough to create balance again.

2:31:27So it's not always a surgical intervention. In your case, was it a general anesthesia or a local anesthesia? I had my tonsils out also very recently, just a few years ago. And because I had chronic tonsilitis. And so I knew I had a posterior tongue tie and I just told the surgeon to go ahead and do it. I'm already getting my tonsils out. Sure. You're right in there. Yeah, already in there. But for most people it would be a general anesthesia. Usually no. Usually it is local. It's really not bad especially they're using lasers now for the procedure. It's pretty straightforward. Yeah. That can cauterize as you make the cut.

2:32:06Exactly. You do want to generally suture and you want to make sure you're working with a mile functional therapist before and after for optimal outcomes. It's like think about if I went in for a new replacement. I wouldn't just walk into the operating room. Here's my knee. Usually there's physical therapy before and after to make sure you're optimized and so it's the same with a tongue release. Peptides and red light therapy. Now we're in the sort of specialized, next sort of cutting edge of health and self -directed health or self -directed slash working with a professional like yourself, oral health care.

2:32:48So can red light therapy, like shining red light and near infrared light, so long wavelength light into the mouth, provide any benefits for a person that doesn't have any other issues, like they just want to maximize their oral health. Is that something that can be helpful? What else is it potentially helpful for? Yeah. It certainly couldn't hurt. I haven't seen any solid data on that, but it would reduce inflammation, improve blood flow. So I'm not opposed to it. It's wonderful post surgery. So if you have wisdom teeth out or a periodontal surgery, a lot of dentists and specialists are using red light therapy extra -orally or intra -orally to help expedite healing, collagen synthesis, et cetera.

2:33:34Peptides are newer in exosomes as well that are being used, particularly in root canal therapies and maybe cavitation, surgeries and things. Again, just to help with inflammation, healing, collagen synthesis, it's pretty cool. It's a very cutting edge and it's very new and there's a very few out there doing it right now. There's a couple in LA that I know are, so I can share names, but the ideas to regenerate tissues specifically with peptides. It can, when put down in the pulp -hole chamber, potentially can help build up the dentin within the tooth and maybe help increase vascularization, get some more vitality back to the tooth too.

2:34:16So it's pretty cool. All right, so we'll stand by on that. Yeah, see you. Should we be concerned about metal fillings, whatever, I don't know what material they use for the other fillings. And sometimes they'll use quote unquote sealants, like they'll see a pit. They'll put some sealant in there. And retainers are made from plastic. Now everyone's worried about plastic. So what gives? So the best dentistry is no dentistry. I will always say that. So that's why we always want to take a preventative lens as best we can, but that's not the reality since 90 % of us have suffered from some sort of dental disease in our life.

2:34:52So mercury fillings, this can get controversial. I think the first thing to do, I don't love mercury and algum fillings and they were recently banned in Europe. I think if you're getting a new filling, I would try not to have mercury placed. That would be my recommendation. Try to use a composite, ideally a ceramic based bio -magnetic material. But if you have existing mercury fillings, a malgam fillings, and your concern, the first thing to do is get a test, get a blood test to see what are your mercury levels. If they're within normal, I wouldn't worry too much. If you have mercury toxicity or mercury through the roof, then you probably should have that conversation with your dental team and your medical team to see could this be coming from my fillings.

2:35:42And certainly if a filling is breaking on damage in your career place, maybe considering not doing an amalgam metal filling. So that's kind of my stance on that. Composite fillings, you know, they are plastics essentially most or BPA free, but that is a bit of a marketing idea. You know, there's still other plasticizers in there, BGMA, et cetera. So I do really like ceramic based materials. If you can find them. Nothing is perfect. You know, this is the best available that we have. Regarding retainers, I get this question a lot too. Acrylic retainers, those are the pink retainers. It was interesting about those methyl, methacrylate can have gluten in it.

2:36:28So if you are celiac, there have been case reports of teams, especially who they keep having GI distress or rashes because it's silly, I often come out in the skin and they can't figure out why. And it ties back to their retainer. So just be aware of that. And then people will ask well about invisalign. And again, nothing's perfect. Usually most of these retainers and things you're only wearing for a short period as you're trying to correct your airway issue. So, lesser of two evils. I mean, I'm a big airway advocate. I want people breathing optimally. That is the most important thing here, health in my opinion is optimize oxygenation and breathing and rest in recovery.

2:37:17So, you know, I am an advocate for expansion and some of these materials and products for short durations if necessary. So we can't take all the risk out of everything, right? And this is why the host making sure your immune response is optimized. Your detox pathways are open. Your phase two liberty talks is optimized. You know, that's ideal. So yeah. Chrissifers vegetables, sulfur, fainting, supplementation, maybe. Dan D 'Lion. The same things that were recommended in the microplastics episode that I did that other people have touched on. So things like I saw an usulfuraphane. Yes, binders. Chrissiferous vegetable intake should help bind to some of the microplastics that surely we are ingesting.

2:38:03Everyone has. So you just try to minimize your exposure. And then sealants, I am an advocate of sealants. They really do reduce cavity risk. They're usually put on the molars in the grooves and the fizzures of the back teeth. But again, I use... So I use spectomatry to make sure I'm not sealing in bacteria, so it's an image that shows me if there's like carries or cavity there. I'm using ozone to make sure I'm killing the bacteria. Sometimes I lose my laser, which helps disinfect to open the groove up, and then I'm using ceramic based materials too. So I think it depends on your risk as well. If you're low risk, you're not eating a lot of these ultra processed foods.

2:38:48You're probably okay. But a lot of kids, you know, we have control over our children's diets only to a certain point and then they go off to middle school and Start eating the tockies and the Doritos and you know, they make maybe some bad choices And so if you want their teeth as protected as possible, it suggests the alliance a somewhat unpleasant topic, but Something that I've heard repeatedly and I don't know if it's true is that dentists more than people in any other profession commit suicide at very high rates. And then there's this very dark joke that people make. Well, you know, their hands are always in other people's mouths so they don't have anyone to talk to.

2:39:30You know, like, you know, like, and then I always think, well, the logic's wrong there. They actually could talk as much as they want. It's the patients that can't talk. So, you know, setting aside that kind of like, you know, gallows humor, which I don't, it's not my style of humor. Do dentists kill themselves more than people in other professions? Yeah, thank you for bringing this up. I think it's important to talk about. Dennis do have a really high rate of depression, anxiety, and yes suicide too. And I always heard this too even before I became a dentist. And it's a really hard profession.

2:40:03And so we tend to be the brunt of the joke. You know, we're in the song. There's songs like I'm afraid of dentists in the dark, you know, by Vance Joy and like Steve Martin playing the eccentric Dennis and multiple different movies, I think. Little shopper horse. Little shopper horse, horrible bosses. There's like a crazy Dennis. There's always like horror movies have Dennis. I mean, we are the Brent of the joke a little bit. And so that's hard. And unfortunately, there are just so many negative childhood experiences at the dentist. And this is partly why I went into pediatrics is that I was an adult dentist for many years.

2:40:43I felt very dissatisfied with my career because I just felt like I wasn't making a difference. Dental disease is so prevalent. And unless we're talking about it from this root cause lens, we're not going to move the needle. But it's very hard when you get in the system to get out of it, you know, the way our appointment times are set up and the overhead is crazy and the student debt now and the pressure is in the things with dentists is we are the clinicians, but we're also kind of the CEOs of our businesses, like many of us have private practices. So you're wearing two hats. So when you're done with treatment all day and seeing patients all day, then you're sitting in front of the computer and you have people to help you, but you're trying to manage the business and we didn't go into school for that, you know, looking at spreadsheets, HR issues, etc.

2:41:33And many of us are in solo practices, so it can be very lonely. But also, we tend to be more type A personalities, perfectionists and dentistry is hard. There's a lot of unknowns, there's a lot of variables. You know, I can put a filling in your mouth, but I can't guarantee that you're going to brush floss, follow my rules, not eat ultra -process foods. You're breathing through your nose, which you're microbiome -like. So then you're doing all of these things that I've instructed you not to do, and then you come back because the filling fails. And we're the ones to blame for that. And don't get me wrong, there's all variations of providers out there, and there's people doing excellent work, and people doing not so excellent work.

2:42:16But I do think it's important for everyone to know that many Dennis are having a hard time with work, especially post -COVID, I would say. There's a lot of pressures. Our dental insurance is very challenging. It's not truly insurance, like medical insurance. It's really a benefit package. So you tend to only get a thousand or twelve hundred dollars a year, and then everything else is out of pocket. And so people kind of look at us like that's kind of a scam, you know, like it's so expensive, but what they don't realize is many of these dental supply companies, they have essentially monopolies on us, like our equipment is outrageously expensive and prices keep going up and up and up, but what isn't changing our insurance reimbursements.

2:43:04Okay, so where does that delta come in? And usually it's coming out of the dentist pocket too. So it's why corporate dentistry is taking over. In a lot of ways kind of what happened in medicine, But I would just say be kind to your Dennis. There just recently, it's very timely, but I don't know where this came from. Maybe it was like a tick -tock thing, but there were letters being mailed. Specifically, I saw in the Pacific Northwest to Oregon and Portland that Dennis were receiving these hate letters saying, Dennis, or scumbags, and they should all kill themselves. So I think it's important for people to know what we kind of deal with behind the scenes, you know, and to just be kind to your dentist.

2:43:47And I would say if someone doesn't resonate with you, if their personality doesn't resonate with you, just go find a different dentist. And I will, I do want to understand there is a lot of post -traumatic stress disorder from patients who truly fear the dentist. It's usually from experiences in childhood. And that's what I wanted to change too. I just said, it doesn't have to be this way. We can make dentists through a very positive place, a safe place. So that children go into adults without dental disease, but also that find the dentist to be a safe comfortable place to go. So I mean some people if you're really that fearful, you know, maybe considering therapy or, you know, some sort of anxiety, like do you need something to help you feel calmer at the dentist?

2:44:31But I encourage everyone to go to the dentist, sort of avoid the dentist, but also trying to understand it. It is a challenging profession. It really is. And there's a lot of unknowns. And there are some mental health challenges out there too. Thank you for being an incredible ambassador for dentistry and no small part that comes from your obvious kindness and goodness. And also the rigor with which you approach it. So the two are certainly not incompatible. You're proof of that. So I wonder if now would be a good time for us to just summarize the top 10 or top 12 things. There are a bunch of don'ts.

2:45:12Maybe we can leave those out like avoid sugary, starchy, flowery foods that get stuck between teeth, that kind of thing. But maybe I'll fire off a few and you can tell me what I'm missing. Being nose breathed or not a mouth breathed or unless you're eating or speaking, you promote shit basically, right? Yeah, absolutely. Or you're exercising really hard and you need to suck for some air. or your scuba diving and you would drown otherwise. Eat non -processed minimally processed foods. We're hearing that over and over again these days. Brush twice a day, floss twice a day, water pick if you can.

2:45:51Yeah, that's loading a lot on to people. I would say floss at least once a day. Crossing twice a day is extra credit. Great. Yeah, because a lot of people don't floss. So we want to start out reasonable. So just sleep. Yes, ideally. So it's brush, then floss. Floss them brush. Floss them brush. But however you can do it. No, no, I didn't get it wrong on purpose. I also like to hunt straight pain. We forgot to talk about that. Yeah, so I want to add in these things. So maybe oil, poll, three times a week, put some olive, a coconut oil in there, swish around practice your nasal breathing while you're doing it.

2:46:32It's spitting out, but not in the sink. Not in the sink. And why just a few times a week? I don't know if I was clear on that. It's because coconut oil is antimicrobial. So I'm airing on the side of caution because it will target more anaerobic, pathological bacteria, but less is more. We don't want to disrupt the oral microbiome too much. So just a couple times a week, you don't need to do it daily. Great. Soft toothbrush, be gentle. avoid alcohol containing mouth washes for all sorts of reasons. Pay attention to the floor I debate. Yes. Consider hydroxyapatite if you're concerned. Great. I love these hydroxyapatite toothpaste.

2:47:13Yours and Gator dentist. Love them. I don't get paid a dime for it. I pay my own money for them. I really love them. I keep there so much healthier now. I just like them too. I like that I can, they taste good. I don't actually rinse afterwards. We didn't talk about that, but ideally, you don't rinse after you brush. Correct. So think about if you were a big advocate for sunscreen or a lotion, you put it on, you immediately jump in the shower. You're washing it all off. So it's the same with your toothpaste. There is a duration of action that it takes for maximum efficacy. So if you're brushing for two minutes and spit and rinse, all that goodness is getting rents down the drain.

2:47:54So it really should, you can still spit. People get confused by this. You can still spit, but try not to vigorously rents everything off. You do want to try to, trying to sit on the teeth and in your saliva a little bit. Avoid nicotine. Alcohol. And alcohol. Hydrate well. Yes. Keep your cell. Electrolytes. Keep your saliva abundant. Yes. Especially for older people. Yes. Yeah. Yeah. The nasal breathing during sleep, but we can double -click on that. Yeah, absolutely. That's what I get your sleep right. Because I just check so many boxes. I'd say optimize minerals and fat soluble vitamins. This is kind of Western Christ stuff.

2:48:36I'm trying to think here if there's anything I missed. Well, we could say tongue scraping. Tongue scraping. Excuse me. I do like tongue scraping. So again, aeravetic, Chinese medicine will look at the tongue from a health standpoint. If you have a white coating on your tongue, that's a sign of dysbiosis. You could have candida. This is important to touch upon. Strap mutants get blamed for cavities so much with kids especially, but with children, we really need to be focusing on fungus too. So candida is really prevalent in early decay in children. No one's screening for this or treating that. Candida love sugar.

2:49:13And this is also with diabetics. We're seeing a bidirectional relationship with gum disease, peridonal disease, and insulin resistance, and blood sugar and balances too. So tongue scraping, and it will do a better job than your toothbrush. People always ask because it is removing the biofilm as the toothbrush is kind of moving it around. So it's taking off that film of bacteria, you know, it's kind of gross, but they tend to be anaerobic. And that can help with nitric oxide production too, because the good bacteria on the tongue tend to live down more in the crypts. So you don't want to scrape too hard, but just get that film off.

2:49:56You'll also notice improvement in your taste perception too, because you're getting food remnants and things off as well. What about that? Yeah, oh, I love it. Once you start tongue scraping, you usually, most everyone's a big advocate for it. Thank you so much for this. You know, really extensive and exceptionally clear voyage through oral health. I am sure that people are going to take away many, many things that are actionable. And I really appreciate that you've been such a strong advocate for pointing out that oral health is not just about teeth. It's not just about breath. It's about that, but it's also about your whole digestive tract and about brain health and about heart health.

2:50:38And we have a lot of control over this particular aspect of our body as opposed to like heart health, which we have to get to indirectly unless we're heart surgeon or gut health, which we have to get to indirectly unless we're gastroenterologist. Right. What other biofilms you have access to, I mean, it really is a window into the body. So if you have gum disease or cavities, that is a sign of a metabolic imbalance in your body. So not to make you panic, but I just want people to take it seriously. That it is a window into other things that could be happening deeper within the system. Well, I absolutely love the work that you're doing.

2:51:15I couldn't think of a better person to bring on here to educate us all. And like I said, you've given us so many valuable tools. And we will provide links to all the incredible resources that you're continuing to put out into the world. So thank you for doing that. Thank you for coming here. Thanks for it's clear that this is a labor of love for you. It's not just about like clean and teeth or something. So yeah, the year people probably can't see well certainly if they're listening they can't see the the incredible extensive notes that Dr. Whitman brought with her and her incredible handwriting goodness gracious.

2:51:48What beautiful handwriting. Thank you So I could read it later. Not all doctors have bad handwriting. No, they're notoriously have bad handwriting But yours is you certainly offset whatever failures of handwriting the other physicians have so This was really fun. Thank you so much. Thanks. Well, we'll do it again and and I'm really grateful for you Coming on here today. Thank you. Thank you Thank you for joining me today for my discussion with Dr. Stacey Whitman I hope you found it to be as interesting and useful as I did to find links to Dr. Whitman's work and the various resources We discussed please see the show note captions if you're learning from and or enjoying this podcast Please subscribe to our YouTube channel That's a terrific zero cost way to support us.

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