The Mouth-Body Connection: How Oral Health Shapes Whole-Body Healing

0:00Coming up on this episode of the Dr. Hyman Show. And there's a lot of organisms that are in the mouth. In fact, the oral organisms, and we have hundreds of oral organisms, there's about a 45 % concordance between the bacteria that we find in the mouth and the bacteria that we find in the digestive tract. And you can think of the whole body as being like a tube. Magnesium is like the body's natural chill switch. It helps regulate stress, sleep, mood, and more. But most people are deficient, and most supplements don't give you the full spectrum. That's why I recommend Magnesium Breakthrough, the only formula with all seven forms of magnesium.

0:34Feel calmer, sleep better, and give your body what it's missing. Bioptimizers has increased their discount for my audience. Go to bioptimizers.com slash Hyman and use code Hyman to get 15 % off your order today. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one-on-one, there just isn't enough time in the day, so I built several tools to help you take control of your health. If you're looking for guidance, education, and community, check out my private membership, the Hyman Hive, for live Q &As, exclusive content, and direct connection.

1:05For real-time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated doctor-trusted supplements and health products at drhyman.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast ad-free with Hyman Plus. Just open Apple Podcasts and tap Try Free to start your seven-day free trial. The gut is sort of where everything starts and it can either lead you down the path of health or it can lead you down the path of disease. And the beginning of the gut is the mouth. So as you mentioned, you know, in medical school, we didn't learn anything about the mouth.

1:39That was like for the dentist, you know, we'll just ignore that. And the dentist just basically stay in the mouth and they don't really realize that there's a whole body connected to the mouth or some of the dentists don't. And this is where I think a lot of both, even functional medicine physicians and dentists really miss the connection. So unless you're working with a holistic smart dentist or a functional medicine doctor who's aware of the connection between the mouth and the gut and systemic immune system, you're going to be missing a lot of things. And as you mentioned before, you know, there are a host of conditions, including premature birth, obesity, diabetes, cardiovascular disease, rheumatoid arthritis, inflammatory bowel disease, and even dementia that are directly connected to poor oral health.

2:38it's incredible yeah i mean dementia and they're finding that the microbes in the mouth get absorbed and then go up into the brain and create inflammation in the brain pretty wow we know that your risk of having heart attacks is higher if you have gum disease we know that even uh you know weight metabolism are related to what's going on in your mouth so you know what's so what's wrong with traditional dentistry and its overall approach because you know a dentist does your teeth cleaning they might treat your gum disease they'll fill your cavities those thickened root canals. So tell us what is the problem with traditional approaches to dentistry?

3:13Traditional dentistry and dentistry has gone a long way. The original dentists were actually barbers. You remember that. The barbers used to pull the teeth out. And the dentists have come a long way since being barbers. But a lot of dentists are what we call drill and fill. And, you know, then you can do root canals and then you can do implants and those kinds of things. A lot of that's related to structure, function and cosmetics. People want to have white teeth and you don't realize, OK, just because you have white teeth doesn't mean you have a healthy oral microbiome. And you really have to look at the whole picture because, you know, the beginning of digestion starts with your mouth, starts with healthy saliva.

3:55and all of those things are interrelated to being able to digest and absorb your nutrients from the get-go. You need to have a proper salivary pH, you need to have sufficient amylase. So there's a lot of happening in the mouth that is the beginning of digestion. All right, so one of the challenges in traditional dentistry is they use certain techniques that we find problematic. For example, putting in silver fillings or mercury fillings. And recently you sent me a link to the FDA's new ruling that fillings were not acceptable for pregnant women and babies and kids. So why is it good for the rest of us?

4:32It's not good. It's not good for the rest of us. And, you know, the thing is, is that interesting thing about that is that, you know, I think, you know, as you said before, there's no safe level of mercury. You know, the mercury is a known neurotoxin. And some people are better able to detoxify it. My father is an example of that. My father, he practiced dentistry up until his 80s, and he used to literally handle amalgam in his hands. And he'd be throwing it on the floor and everything. I can remember going to his office and playing with the mercury in his office. And lo and behold, there are some people who are better at detoxifying mercury, and there are others that don't detoxify mercury as well.

5:11But mercury is definitely, for some people, a real problematic issue. as you experience that yourself. And there's testing that we do for mercury. You can check for mercury body burden and you can check for both organic and inorganic mercury. One of the labs, Quicksilver, that we use does that test and it can tell you how you're excreting both organic and inorganic mercury. And the one from fillings is the inorganic mercury, which is the more toxic to the brain. Right. And so we've got the filling problem, which really nobody should ever have silver fillings. And if you have them, it's tricky.

5:50Do you get them out? Do you not get them out? How do you determine when? I think you need to know that there are biological dentists who do it safely. And there's a website called iaomt.org. You can put that show notes, iaomt.org, which is a resource of learning more about biological dentistry and finding a biological dentist in your area who knows how to practice safe removal and all. and other dental techniques that actually help to rejuvenate your mouth. One of the other challenges is root canals. I think people are getting a lot of root canals. I certainly had one, and I had to take it out.

6:25But tell me, what is the problem with root canals? Why should we be concerned? And should everybody with root canals have their teeth pulled, or what do we do? All right. So I'm not an endodontist who does root canals. And I've spoken with my family members about this. And if somebody is really, really skilled at doing a root canal, you can do a root canal. The real, I think the key thing about root canal, uh, uh, doing a root canal is to make sure that you're dealing with a sterile environment, which is very, very difficult in the mouth. Um, because, uh, you know, when you're doing a root canal, my sister, uh, Gail, she made a comment that like a root canal is basically a dead tooth.

7:01And if you had a dead spleen, would you leave a dead spleen in your body? No, you just, you know, you want to remove a dead, uh, organ. and a tooth that's devitalized doesn't have nerves. So if you get an infection, you oftentimes won't get pain unless it starts surrounding to the other area. You don't have a lymphatic system to drain infections. You don't have a blood supply, arterial and venous supply. So you can really get these, you know, these stealth infections. And by that, you know, we typically think of an infection as someone who's, you know, got a fever, there's swelling, et cetera, but you can have these smoldering infections.

7:40And I've seen, you know, just this past week, I've had two patients who had a history of root canal issues that were manifesting as systemic issues. And they really didn't have a whole lot of oral issues. They're having peripheral issues. Yeah. That's interesting. Exactly. Yeah. And then when they open, open those root canals up, if it's a bad root canal, root canal gone bad, they often find these anaerobic infections and they are foul smelling. The anaerobic bacteria produce things like putrescine and cadaverine. And you don't want a lot of cadaverine in your body unless you're a cadaver. And putrescine is very, very, very...

8:17Doesn't sound good either. And there's a lot of... Yeah, right. And there's a lot of organisms that are in the mouth. In fact, the oral organisms, and we have hundreds of oral organisms, There's about a 45 % concordance between the bacteria that we find in the mouth and the bacteria that we find in the digestive tract. And you can think of the whole body as being like a tube. And the opening of the tube starts at the mouth. And then it goes all the way down into the stomach, the small intestine, large intestine, and then out the anus. And those bacteria that are in the mouth get swallowed by the body.

8:56I mean, you will swallow about 10 billion bacteria per day. And some of those bacteria, when you swallow them, can actually cause systemic inflammation. And those systemic inflammation can manifest in the joints, in the heart, or in the brain. It can also promote systemic inflammatory diabetes, as you well know. So it's a real important issue. And it's not just, you know, just having, okay, my teeth look white, everything's fine. You can't see the types of bacteria that you have in your mouth. And not only that, but your individual immune response to the bacteria is really critical. We know that in terms of, you know, with like, say for example, COVID, you know, COVID is a virus.

9:42And as a virus, you know, for the vast majority of people, it's not going to kill you. You get it and you may be totally asymptomatic. You may have a mild cold or you may die from it. The same thing with certain types of bacteria. Everybody's immune system is unique. And when certain people are exposed to certain organisms at critical levels, it provokes a low-grade inflammatory response, or in some cases, actually even more acute, and that can lead to a whole host of systemic issues. Yeah, I think that's true. And I think both of us have seen patients who, when addressing their dental issues, often resolve other systemic issues.

10:18So maybe you can share a little bit about some of the patients you might have seen that have links to their systemic health from their oral health. Oh, absolutely. I have three cases. Real briefly, the first case is a patient who actually was a friend of mine. And I remember we were talking over a beer and he was telling me, you know, some of his health issues. And, you know, he was bemoaning the fact that he was having all these symptoms and nobody could figure it out. And, um, and I said, well, why don't you come see me? I'll, you know, I'll do a consult on you. We'll take a look at it. That's what sort of what I do.

10:55And, uh, he told me, you know, in going over his history that he had a Cadillac in his mouth. And I said, well, you have a Cadillac in your mouth. Yeah. I got about$40 ,000 worth of dental work in my mouth. And he goes, you know, the dentist said I have weak enamel. And I said, well, what do you mean? Weak enamel. And I said, you know, weak enamel is not normal. I said, did he tell you why you have weak enamel? And the first thing that popped into my head is that he probably had undiagnosed celiac disease, which we thought he can amel. And lo and behold, I tested him. And sure enough, he had a response to gluten.

11:32And when he got off of it, I mean, a lot of the symptoms, they didn't affect his teeth because the horse was already out of the barn. But he also was having sort of unexplained fatigue and malaise and all that kind of stuff. And actually just getting off of gluten cleared up those other conditions. And you and I well know that there are multiple autoimmune conditions that are associated with gluten sensitivity. But weak enamel is one of those things. And I try to get my patients and the dentists who I see, either as patients or dentists who I meet in social circles, to really be aware of that.

12:06Because I just think it's below everybody's radar. Yeah, it's incredible. Yeah, it was a really, and it was a very life-changing for him. Another case is a patient who I saw who was diagnosed as having rheumatoid arthritis. And this is a woman over from Europe, and she wasn't getting anywhere in the European system. Not that the European system is better or worse. It's just different than our system. But she was not getting any significant help over there. and they wanted to use the disease-modifying anti-rheumatologic drugs for the DMARDS. And when I did a workup on her, I did a deep dive in her, and she had a seropositive rheumatoid arthritis.

12:50And by seropositive, meaning that when you check for rheumatoid arthritis, you can have a positive rheumatoid factor, or you can have a positive CCP antibody, or both of them. One or the other, or both of them. You can also have seronegative rheumatoid arthritis. And as we talked about earlier, rheumatoid arthritis is just a label that we put on things, and lots of different things can cause rheumatoid arthritis. The most virulent, aggressive type of rheumatoid arthritis is the one that has both RA positive and CCP antibody positive. Now, if you go into the medical literature, CCP antibodies are associated with periodontal disease.

13:28So anytime I see a rheumatoid patient who's got a positive CCP, there are other things that can do that. Epstein-Barr virus can do it also, but it's strongly associated with the periodontal disease. And then they have to start doing a deep dive. So what I did with her, they did a deep dive and lo and behold, she had a lot of dental issues. She had old root canals, she had silent infections. And I did as much as I could. And then I also referred her to a very good colleague of mine, Doug Thompson, who runs the Wellness Dentistry Network out of Michigan, and he helps to teach other physicians about integrative dentistry.

14:09So I referred my patient to see him, and he did all the different things that he did. In addition to having rheumatoid arthritis, she also had undiagnosed Lyme disease. So she had two things going against that can affect the joints. So I basically treated her Lyme disease, did that successfully over a period of time, had her see an integrative dentist. We did testing on her oral microbiome. He did his thing and she had a dramatic improvement. She also really changed her diet. And all of those factors really, really made a huge difference in her life. She was basically not able to function. And when we treated the underlying causes, the root causes, she had a dramatic improvement in her health.

15:00And then one other case, and this is a really anecdotal case, and I really like this case. And Mark, you probably have seen some patients or, you know, I'm sure in your career that you've seen a lot is a patient who has a frontal temporal dementia. Yeah. Right. That's a bad, it's a bad thing. And it's like Lewy body, you know, we don't really understand, you know, these kinds of conditions. And I saw the lady and she was actually quite advanced with her frontotemporal dementia when I saw her. And I did a big workup, did the ion test, nutritional metabolic testing, testing for leaky gut, testing for heavy metals.

15:36And I did, and actually at the time I did a relatively new test, which is the myperiopath test, which is looking at the DNA of the oral microbiome. And she had one of the worst oral bacterial microbiologist analysis that I've ever seen. And my hypothesis was, is that I think her frontotemporal dementias was really being driven by undiagnosed severe periodontal disease that was spreading up to her brain.

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16:42you just said a mouthful there because i just i just wanted to highlight a couple of things one there is an oral microbiome yes and just like there's an intestinal microbiome and that has implications for your health and there's ways that now we can test this and this is not something you're going to get at your traditional doctor it's what we do here at the the layers to see what's really going on. There's also genomic variations in our own DNA that affect our risk of periodontal disease. And there's also tests we can look at to look at the heavy metals in the mouth and see if the mercury in your fillings is getting off-gassed and if you're absorbing it and detoxifying it or not.

17:23So there's a lot of tests that we do in functional medicine that can be very helpful to identify whether the issues you're having are oral. So the other thing is, you know, what do we do to change our diet, to keep our gums healthy and keep our teeth healthy? And what do we know about food and nutrition and oral health? And then, of course, basic lifestyle hygiene stuff that we should all be paying attention to. Yeah. So I actually, Mark, when I prepared for this, I made a couple of slides, which should be available as an add-on for the podcast for those who want to look at it. But the big thing is the introduction in the diet, in the modern day diet, the standard American modern day diet is the introduction of acellular starchy fiber or foods.

18:11And when you think of this, it's very sort of simple to think of it. These are the things like, you know, rice crackers and pretzels. They basically have very little nutritional value. And then sugars. And the modern American diet is very high in these types of foods. And these types of foods are basically instant sugar and they feed the oral bacteria. And those bacteria also will multiply in the body. We obviously know that, you know, you can have bacteria that can cause dental caries and tooth decay, but it can also feed some of these other pathogenic bacteria. And you mentioned the role of the various types of bacteria.

18:53There's a couple of bacteria, which I like to see on the Myperiopath test, which is Pusobacterium nucleotum. And then another one, which is a real bad actor, which is the Porphyromonus gingivalis. And these organisms are in the mouth and you're swallowing them. So the diet that you eat will feed both the bacteria in the mouth and then also the bacteria in the gut. So some simple things that you can do is avoid snacking, drink water after you've had a meal, watch for processed carbs, sort of fake food, if you will, in your diet. Chewing xylitol gum is actually something that is a simple thing to do that can actually have an anti-dental caries type of an effect.

19:42and then using electric toothbrush. That's another thing that is a simple thing to do. I pretty much recommend that for all my patients. And you can, you know, use that right after you eat. And then also having lots of fiber in your diet. When you're eating fiber, it basically is cleaning the teeth. And we all know, we've all woken up in the morning with that film over our mouth. Well, you know, that film is actually a biofilm. And unless you're actually keeping your oral hygiene clean, you're going to get, you know, some some slime on your teeth. And that's really where the bacteria really sort of take hold in the mouth.

20:18And good integrative dentists will actually work on oral biofilms also. That's great. And, you know, it's often there's a lot of things we can do to improve our oral health through supplementation. Things like CoQ10 is very important. Proethosadins from colorful plant foods, vitamin C for gum disease, even things like vitamin D to help the bone structure and prevent osteoporosis in the jaw which can cause weak teeth and so forth. So there's a lot of things you can do to actually help improve your overall oral health. One of the things that I loved was developed by a friend of mine who was a dentist in Lenox years ago.

20:57It was called the Dental Tooth and Herb Gum Tonic. And essentially it's a series of herbs. And it was amazing. He basically showed me, he would scrape my mouth and we'd put it on a slide and showed all the little bugs swimming around. Then I'd do the dental swish with this dental tooth and gum tonic, this herbal tooth and gum tonic, and it was just totally different. And all the bad spirochetes and things that are causes of gum disease would improve. So there's a lot of simple things you can do from, you know, obviously electric toothbrush to water picks and flossing to, you know, using these different kinds of herbal tonics that can really help to keep your teeth and gums healthy.

21:37And it is really important because your overall health is so connected to your overall health. That's interesting that you mentioned that, Mark, because I... You probably knew him, remember? He was in Lettix years ago. I don't remember, but you know what? There's a company, I believe it's up in New Hampshire. I don't know if it's the same company or there's another company that uses, it's like a tooth tonic, if you will, which is an antimicrobial. So yeah, that's actually quite interesting. The other thing is, which I'll mention because it sounds sort of hokey, but it's actually in the medical literature.

22:10In fact, by preparing for the talk, I actually looked on PubMed and there's an article from 2020 about oil pulling and the benefits of oil pulling on the oral microbiome and oral hygiene. So you can do that with a variety of different oils. You can do it with coconut oil. I don't know if you've ever done it, Mark, but it also leaves the mouth with a very clean taste, a very clean feeling in the body. And then that also comes out to the other aspect of the oral hygiene is halitosis. So somebody has really bad breath. Yeah, bad breath. Exactly. So bad breath is not just an embarrassment. It's telling you that you've got some bugs in there that are producing chemicals that are not very good for your body.

22:56And these are usually some of the bacteria that can actually reside in the tongue and the tongue fissures. and they're what we call sulfite or sulfur reducing bacteria. And there's a dentist who came up with a product, which is a very effective one. It's called TheraBreath, which I oftentimes will have patients use. And that's a very effective way of dealing with halitosis, but then also then looking at how can we actually improve the oral microbiome in addition. And there are some products that are out there, you know, with some lactobacillus salivarius and such that are oral probiotics to also help balance out the microbiome.

23:42Canker sores. What are canker sores? We've all probably had them one time or another. Why are they a problem? And what do they signify? And how do we think about them differently in functional medicine than traditional medicine? Absolutely. So canker sores are those ulcers, those sores that you get in your mouth. They're usually at the side of your mouth, you know, by your cheek, inside of your cheek, that is, underneath your tongue. Those are some typical places for them. and uh and they are um about three to five millimeters in size and they are a sore that comes if you look at them they'll look like a round circle um they're they're they're reddish sometimes they'll have like a yellow uh coating coating on it yeah and they hurt like heck they hurt like heck yes and and like you said most of us have had them at least once or twice and having one once or twice is not a big deal, right?

24:40Or even more than that. But what we get concerned about or what we want to talk a little bit about are those people that are getting lots and lots of canker sores. And could that mean that there's something we need to be looking into and thinking about? Yeah, I mean, I think that's right. I think, you know, in traditional medicine, we go, oh, well, canker sore is not a big deal. You know, swish your mouth with like tetracycline and Benadryl was the cocktail we used to use. And that'll help reduce the pain and inflammation. But there really wasn't ever a conversation about, well, what was the cause of these?

25:13And how do we diagnose the root cause and make it so people don't get them anymore? Absolutely. And what does a functional medicine doctor think when they see a canker sore? You know, again, if it's been like, if it's an isolated incident, it might not be a big deal at all. But if people are getting them all the time or even a couple times a month or even, you know, five or six times a year, you make sure you want to ask that question, why? What could be going on? And there could be many things from celiac disease to an impact in the immune system not working properly to eating a food that causes inflammation for your body.

25:53So celiac disease, it would be gluten, but there's other foods that for people can be inflammatory for them. It's like a food sensitivity or food reaction. Definitely, we see it with some food additives. So some food coloring and some food additives, people will get canker sores. There are some more rare situations where people get lots and lots of canker sores, Bichette's, they'll get sores in their mouth and other areas of their body. So, you know, that's an autoimmune process. Another autoimmune process, lupus can cause some recurrent sores in the mouth as well. And of course, nutritional deficiencies.