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

Welcome to the Huberman Lab podcast, where we discuss science and science -based tools for everyday life.

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

My guest today is Dr. Stacy Whitman.

Dr. Stacy Whitman is a functional dentist with expertise treating both adult and pediatric patients.

She focuses on oral health as a key feature of overall gut health and a powerful modulator of brain longevity, heart health, hormones, and fertility in both men and in women.

Today we discuss many of the common myths about tooth and gum care, and how to use specific nutrition, breathing, and cleaning methods to repair cavities, whiten teeth, and freshen breath while at the same time improving the oral microbiome.

This is very important, because as Dr. Whitman explains, most of the things that people do in pursuit of better tooth health and appearance and fresh breath actually damage their oral microbiome and indeed can lead to serious cardiovascular issues.

So today we discuss how to brush, how to floss.

I know we've all heard that we need to brush and floss, but Dr. Whitman explains exactly how to do those so that they are of the maximum benefit for our tooth health, gum health, and oral health generally.

We also discuss the signs and benefits of things like tongue scraping and oil pulling.

And we discuss fluoride, which of course is a very controversial and timely topic nowadays.

It's a very interesting conversation that I believe everyone, young, old, parents and kids need to be aware of.

We also discussed treating things like tongue ties, deviated septums, canker sores and more.

By the end of today's episode, you'll have the most up to date knowledge about how to take care of your oral health, both for aesthetic reasons and of course, to reduce cavities and gum disease.

And in doing so, how to support your brain and heart longevity.

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero -cost -to -consumer information about science and science -related tools to the general public.

In keeping with that theme, this episode does include sponsors.

And now for my discussion with Dr. Stacy Whitman.

Dr. Stacy Whitman, welcome.

Thank you, Andrew. I'm super excited to talk about oral health from all perspectives.

your public -facing content, especially on Instagram, has completely transformed the way I think about this thing that I call my mouth, that people think of as their teeth and their mouth and their breath and their tongue and all this stuff as a key site for evaluating and maintaining health of my brain, my body, and today you'll make it clear as to why that's the case.

I'd like to just start by looking at this oral health thing through the lens of what I think most people think of when they hear the words oral health, which is people want it seems whitish or very white teeth depending on their preference.

They want fresh breath or at least to not have bad smelling breath.

And they want their mouth to sort of feel good, right.

The question I have is, what are some of the things that many, many people do in trying to have white teeth, fresh breath, that actually are very destructive for our teeth in our oral microbiome?

And if we go through that entry point into this conversation, then we can get into some of the specifics of why that is.

So what's something that you see many people doing in terms of trying to have bright white teeth that actually is harming their teeth?

Great question. Great way to start off.

So I first want to commend you and thank you for including the oral microbiome in oral health as one of the pillars of health.

That means a great deal and it has a lot to do with this answer.

So unfortunately, we have been taught that we need to carpet bomb the mouth.

We need to add astringents and alcohols and foaming agents and really strong essential oils to clean, disinfect and to freshen the breath, but we're really what we're doing with these products is damaging our delicate microbiome, which can make things far worse.

So much of oral health is a less -is -more approach, and it's not so product heavy.

It should be more focused on diet and lifestyle like anything with health.

Unfortunately, dentistry has been separated and compartmentalized out of the body, like much of medicine.

You know we were so specialize and sub -specialized in dentistry is included in that and we need to remember it's all interconnected and what we're doing to the mouth whether it be strong toothpastes, mouthwashes, certain gums, and even what we're eating and how we're breathing can really do a number on our oral health and so it's taking a different perspective and it's a bit of a mindset shift to really get us back to optimization.

So do you think that most of the common over -the -counter toothpaste while they smell minty or pepper minty and taste minty and pepper minty, are they effectively cleaning teeth?

Are they causing any damage to teeth by virtue of what they have in them?

It really depends on the ingredients.

I'd like people to start looking at their oral healthcare products like they're starting to look at food labels.

We should be reading the ingredients and understanding why they're there and what are doing?

Where are they sourced from?

But certainly that I think so many of us feel it has to burn in foam to be effective.

What is tooth brushing?

What is it really doing?

You're disrupting the biofilm, which is really the plaque or the bacteria that are adhered to your teeth.

And so all these extra bells and whistles, it's sort of extra credit.

But if you're perfectly imbalanced, we shouldn't need all these stripping agents and strong and things.

So for example sodium lauryl sulfate is a foaming agent but it also can be really disruptive to the oral mucosa and can lead to oral ulceration.

So that's a common ingredient that causes foaming that I would argue we do not need.

Your toothpaste shouldn't foam nor should it burn.

Essential oils we think, oh those are natural, they're they're healthy, right?

Well many are very antimicrobial and so they could be damaging the healthy bacteria in your mouth.

So that's where that that strong burn after many toothpaste, you really don't need that.

And if your breath is so bad, or you have halitosis that you feel the need for that then I would argue well let's dig deeper.

Why is your breath so imbalanced there's probably something else going on.

So I really encourage people to start learning about their products.

I think we just give dentistry and teeth just we push it to the side.

It's kind of an afterthought many times and just like we're prioritizing skin care, shampoo, things what we're putting on our bodies.

We need to be focused on the ingredients in our oral health care products too.

Especially since we're literally putting it into our body, not just on the surface of our body.

What was the foaming agent again?

Sodium lauryl sulfate and the problem is there's derivatives.

So some cleaner versions might have coconut derived on SLS derivatives.

Many people will do okay with those, but a common complaint I see in my office are oral ulcerations.

And the first thing I think of is what's in your toothpaste?

Does it have SLS, or a derivative?

Because we're all different, and some people have more sensitivities and we'll react more to those.

Are oral ulcerations canker sores?

Yeah. Or are canker sores?

Avic ulcers, or yes.

So if one gets a canker sore, what does that reflect typically?

Well, let's assume the toothpaste doesn't have anything to do with it.

Is that a disruption in the microbiome?

Is it from a physical injury, like a bite to the gum?

It could be all. So it could be secondary to trauma, certainly it can be viral -related.

So the herpes virus often will result in oral ulcerations.

It just be one. Yes, but also, and this is not on many people's radars, the mouth is the gateway into the body and the mouth is the gut.

I want people to start thinking of it that way.

So what happens in the mouth can be a reflection of what's happening in the gut.

And so a lot of times when I have patients that come in with recurrent Aptis ulcers or ulcerations, that can be a sign of Crohn's or Celiac, IBS, like something going on deeper within that we need to be evaluating food sensitivities, et cetera.

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This would probably be a good time to talk about the whole concept that teeth can essentially build themselves and destroy themselves, independent of sugar intake and other factors.

So if you would, could you just briefly walk us through, you know, this whole business of mineralization and demineralization of teeth?

because I find this so interesting and later I'll share a little bit, full disclosure.

I have a very complicated oral health history and had I known what you're about to tell us, I think I would have spared myself a ton of pain.

Potentially, I'm sorry to hear that, but we'll unpack that.

You weren't my dentist unfortunately.

I have stories to share too, we'll get to as well.

I think many people do and that's the problem.

So, I wasn't taught this in dental school, interestingly enough.

So this is something I learned later out in practice and it's the concept that your teeth can naturally remineralize if you have a small cavity.

But let's start further back.

So, your teeth are constantly going through demineralization and remineralization.

And this is very natural.

And any time we put anything into our mouth besides arguably neutral water and this has to do with pH So anytime we eat our mouth is the beginning of the digestive system So we release amylase which is an enzyme that helps break down our food and in doing that the pH drops This is how we start digestion When that happens we lose minerals in our teeth the acid will leach out calcium phosphorus and minerals from our teeth But the concern is we don't want it to stay in that acidic state for too long, in that demineralized state for too long.

Because if we allow our body to do its thing, our saliva will naturally remineralize our teeth.

This is all part of a healthy balance system.

So our saliva is this golden elixir of our body, and it contains immune cells and enzymes, but also the minerals that we should need, if balanced, to create that remineralization.

So there's something called the Stefan curve, and essentially it's showing us how our mouth will become acidic and neutral and acidic and neutral throughout the day as we eat.

The problem is in modern society, we tend to be snacking and grazing and sipping all of the time so we're not giving our mild enough of a break.

Enough of an opportunity to remineralize.

So many of us are staying in the state of constant acidity and demineralization.

But what's interesting is, so if you have a small cavity or a lesion that hasn't yet truly cavitated, that in a cavity means a hole.

So if you look on an x -ray and I see a shadow on your tooth, it's called an incipient lesion.

Those, if they're still in the enamel, those can quote -on -quote heal or remineralize, and this is where you would need to work with let's say a functional or biological dentist to understand how deep your cavity is once it becomes a hole generally you do need some sort of treatment, but our body is meant for stability you know it knows what to do but how you eat how frequently you're eating and then we can get into this with how you're breathing and certainly the products you're using and your hygiene practices all factor in as well.

So my understanding is that the minerals that make up teeth are not the same materials that are put into a lot of common tooth care products.

So without getting into a discussion right now about fluoride in water, we will get to that conversation a little bit later, but in order to frame that properly when we arrive there, could you explain why it is that fluoride is in most toothpaste, when basically we don't have fluoride in our teeth at birth.

But there are other minerals in our teeth that certain toothpastes have. And so why would we give an artificial substance to our teeth?

Maybe you could explain demineralization, remineralization in the context of fluoride and these other minerals.

So we have hydroxyapatite, which is essentially calcium and phosphorus, in our teeth.

Our enamel is about 90 percent hydroxyapatite.

The dentin, which is the layer below the enamel through the enamel is about 60 and our bone has hydroxyapatite too about 60 percent." Are our limb bones?

Mm -hmm. All bone. 60 percent hydroxyapatite?

Yes, which is calcium and phosphorus.

Our saliva will also have calcium and phosphorus floating around too.

So what fluoride does is it throws off the hydroxyl group in the hydroxyapatite and so it changes it from hydroxyapatite to fluorapatite.

So it restructures it a bit when it does this the bonds generally are considered stronger and the dental crystalline structure is a more densely packed so it's known to be more acid resistant and so we can get into the history of how they discovered this, but essentially fluoride was put into toothpaste in about the 1960s, it became very popularized.

So that is why many dentists love fluoride, is that you're using it and it makes your teeth more acid -resistant, and also it has some antimicrobial effects, too.

The issue I have, and we can unpack this more later, is that it's not super selective.

So it's not only selecting anaerobes or pathogenic bacteria, but it potentially could be damaging beneficial bacteria too, so that's why toothpaste has fluoride in it.

It also will lower the critical pH, so the critical pH is the pH of which your enamel will start to demineralize or degrade, and for enamel it's 5 .5 and then for dentin it's closer to 6 .5.

So what fluoride does is it raises the pH resistance.

I see. So, for people that aren't familiar with pH, it's a measure of how alkaline or acidic a given environment or something is.

And so, what you're telling me is that fluoride makes teeth ultra strong.

It's not a mineral that teeth normally see, like if a child never used fluoridated toothpaste or drank fluoridated water, they basically, unless they happen to drink from a stream with fluoride in it.

Um, their teeth would rely on hydroxyapatite to re -mineralize, but we put fluoride into toothpaste and into water and that allows teeth to become even stronger and even more acid resistant.

Yes, some out there argue the enamel structure actually is weaker.

This is very nuanced, but generally the dental community believes it's a stronger version of enamel.

Some will argue when you look under scanning electron microscopy, um, the crystalline structure it can be more wave -like and potentially the bonds could break more easily.

But generally, you know, topical fluoride does work.

However, it is no match for a poor diet, you know?

So all of this really comes back to what you're eating.

So it will make you less at risk for cavities, but it's not a shoo -in, like it's not for sure going to prevent decay.

What are the times in each 24 -hour cycle when our teeth are repairing themselves?

So like in the middle of the night, provided somebody's asleep, they're not eating, they're not drinking unless they get up for a moment and have a sip of water or something.

In between meals they're not eating.

I just sort of naturally intermittent fast. I generally eat my first bite of food somewhere around 11 a .m. sometimes a little earlier but that's just habit that sort of falls under this intermittent fasting kind of thing.

So I and many people have stretches of time of anywhere from 3 to to 14 hours when we're not ingesting any food or caloric beverages.

Is that when remineralization occurs?

It's a tricky word. It's a tough one.

Remineralization. We'll have to do it.

Remineralization. Right.

Oh, that's right. You have to put the accent.

Remineralization. Thank you.

That helps. You've said that before.

Yes. Thank you. Is that when our teeth repair themselves?

Yeah. This is great.

This is important. So generally after you eat, you know, as I mentioned, your mouth will become more acidic.

After about 20 to 30 minutes your saliva will naturally start to buffer.

So it will start to rise and raise the pH up.

I like to see us eating more on a schedule.

So generally every two hours or so is when we'll get full optimal remineralization.

The issue is we are a society on the go and we're grabbing crackers and chips and granola bars and we're eating and nibbling and sipping on frappuccinos.

so we never allow that remineralization to take its full effect.

So yes, when you're not putting food or drink, in theory, in your mouth, your saliva, if it's optimized, and we should talk about that as well, we'll be remineralizing, but unfortunately, I do feel so many of us are just not in balance.

We're dehydrated, we're mineral deficient, we're calcium deficient, we're phosphorus deficient, and we're mouth breathing, So the PH is changing just for mouth breathing can make the mouth more acidic.

And so there's a lot of factors at play, but in theory, if I can make one suggestion to someone out there who might be struggling with cavities, I want to know not only what are you eating, but how frequently are you eating it?

And this is a great reason why from a dental standpoint, intermittent fasting or time -restricted eating is a great way to combat dental decay.

It's also better on gut health as well, you know, the migrating Complex the cleanse ability just giving things a break and a rest is really important.

I Grew up hearing that sugar causes cavities Does sugar cause cavities and when we say sugar, of course all the biologists and people with a nutrition background Roll their eyes because the sugar is a very broad statement.

Right there are simple sugars.

There's fructose. There's sucrose There's glucose, there's all sorts of variation within the simple and complex carbohydrates.

But when I'm saying sugar, I'm thinking about foods that taste sweet or that contains sugar that's masked by other flavors.

For sake of simplicity.

Like added sugar. Like added sugar.

I mean, now if you buy a cracker, typically if you look at the package, there's some sugar in there, which is ridiculous, but that's a whole other discussion.

Or we could just even say starchy carbohydrates.

Fermentable carbohydrates is what I like to say, but that gets kind of nerdy.

So not directly. It's really acid that causes cavities.

So what sugar does, and I like everyone to think of flour like sugar.

This is also very important because the bacteria in our mouth, they thrive the pathogenic bacteria.

They thrive on sugar, but flour will act like sugar in the mouth.

So they'll also thrive on on flours.

So the crackers, Bread.

The bread, yup. Even a good sourdough bread?

Well, the issue is, Do I have to do up sourdough bread?

I like sourdough too.

The issue is more contact time.

So, things that are really sticky and dried, I would argue, so crackers or toast. Chips.

Chips. I mean, think about if you take a handful of goldfish crackers.

I haven't done that in a long time, but imagine that it's all throughout your teeth, in between the teeth, down in the grooves.

It's sticky. It's just a smorgasbord for the bacteria.

And so what do the bacteria do when they metabolize the sugar or the flour?

They release acid. And so, if that food substrate is stuck against the tooth for a long period of time, and these foods are also hyperpalatable, so we're meant to be just snacking and grazing, hitting the bliss point, you know.

Grab a handful, go do something, come back, grab another handful, you're just constantly feeding that bacteria so your mouth is staying constantly acidic.

So it's truly the acid that causes cavities.

But I would argue that sugar or flour is kind of the catalyst that feeds the bacteria to create that imbalance.

Is it fair to say, I know you prefer the term fermented carbohydrates or trying to, for most people who don't think in terms of starches versus fiber or simple, although nowadays people are more versed in that sort of thing.

Think of carbohydrates or foods, for that matter, that if you put them in your mouth and you just kind of kept them there for a little bit, that they would dissolve like a cracker.

Like a chip, like rice, like a piece of pasta, as opposed to like a piece of broccoli, which would get soggy, but it's got a lot of fibrous materials, so it doesn't dissolve in the mouth.

And interestingly, broccoli or prebiotic fiber is what feeds the good bacteria.

So I work mostly with children now, and we can talk about why that transition happened.

I used to work with adults, but I teach them eat the rainbow, feed the good guys.

Okay. So we want to feed our healthy bacteria more than we want to feed the bad bacteria.

And that's not to say you can't ever have fun and enjoy some fun foods, but it's all about balance.

And so I think people don't realize the true root cause issue with dental disease is primarily diet.

You know, we're so hyper -focused on fluoride and what's in your toothpaste and the mouthwash and all these products, but all of those things are really just masking the underlying issue, which is how are these bacteria behaving, what types of bacteria and in what ratios do we have them in the mouth, and how often are we feeding them?

So I'm hearing this as a repeating theme that diet and lifestyle are going to be more important than and drugs or products for keeping the mouth looking good and healthy.

Yes, I mean, for example, I personally haven't used fluoride for many, many years, and neither have my children just because I know there are other ways to prevent disease.

And I have many of my patients that choose not to use fluoride or these products also.

I think so many people have been taught you have to have this product, fluoride, et cetera to stay cavity and disease -free.

But if you eat a clean diet, focus on just some of the pillars of health, that will translate into the mouth as well.

Perhaps it's worth mentioning just what some of the facets of a clean diet are through your lens of what you consider a clean diet.

Sure. I'm not advocating for any one diet and I do believe we're all different.

It works for some people, may not work for others.

but generally what I suggest is really high quality protein sources, a wide array of vegetables, fruit.

I would argue you should limit fruit potentially, especially if you're high decayerus just because there is sugar fructose, but I don't want to villainize fruit.

There's so many healthy benefits of polyphenols and everything in it.

So nuts, seeds, olives, pickles.

I love fermented foods for gut health and then oral microbiome support too.

So essentially a whole food diet, things that come from the earth and more from farms and less from factories, less things out of bags.

Arguably, ultra processed foods should be avoided as much as possible or minimized and then trying to stick to minimally processed 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?

And 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 Well, 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 of eating mostly unprocessed or minimally processed foods, those are gonna be good for our entire body.

Great that it's great for our oral microbiome.

Probably is good for our whole body because of its effects on the microbiome at least in part, but what makes teeth white?

And will supporting the oral microbiome make our teeth whiter?

And by the way, there are some folks out there whose teeth need to be less white in my opinion.

And we're being somewhat facetious, but not really.

But I think most people would like to have teeth that 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 are teeth out there that could not be quite so bright, but you do you.

I think everyone should do what makes them happy.

So what makes teeth white?

So 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 chrysaline structure in the mineralization.

So baby teeth are less mineralized and the chrysaline structure is a little more haphazardly arranged.

It's not quite as organized.

So instead of like Lincoln logs lined up, it's more like pickup sticks to some degree.

Why is that? Baby teeth are meant to resorb, 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 why you hear if you use hydroxyapatite or even coconut oil is changing 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, hydrogen peroxide or carbon dioxide, some of the stronger bleaching, that's actually penetrating into the tooth and changing the structure, pulling out stain.

Do people do that? They gargle with hydrogen peroxide?

Well, they do bleaching trace, essentially.

Well, people will rinse with hydrogen peroxide, yes.

And it will make your teeth brighter and whiter, but I'm telling you it's going to do a number on your oral microbiome.

So I suggest it in a very limited fashion.

The only time I ever had a bad canker sore was because I gargled with 50 % water, 50 % hydrogen peroxide because an acupuncturist recommended it.

He looked at my tongue and then he said, you should do that.

And then I did that and then four or five days later I had this nickel sized canker and the roof of my mouth.

And I was like, ugh.

And I will say, and I have no product affiliation whatsoever to any specific product, but by switching to hydroxyapatite containing toothpaste, my teeth, they definitely have gotten whiter.

I drink a lot of Yerba Maté 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.

We, I'll talk about that a little bit later, but since switching to hydroxyapatite toothpaste, I've had like stellar dental reviews assuming my dentist is looking carefully.

I believe he is, but we'll see.

And 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.

Like it's biolumetric.

It depends on how you look at life.

I think I prefer biolumetric 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, whiter and brighter.

They just look more nourished, more hydrated, their microbiomes look more balanced too.

You're talking about kids and the fact that sometimes if their 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.

And 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 xerostomea dry mouth.

So, we definitely lose salivary capabilities as we age.

very likely more mouth breathing, so mouth breathers 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 will do it, too.

I don't drink the wine, but I've definitely had coffee tea since I was a, since I was a little kid, I've been drinking latte since I was like five.

It's good. Yeah. It's delicious.

Yeah. Gotta live life.

Yeah. But yeah, and they're losing minerals, too, over time.

your teeth take a beating.

I mean, we're living to be 100 now.

That's a long time to maintain this non -shedding surface in our body.

You know, and then it depends on the generation too but 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 we're known to darken the teeth, which is why they pulled them from common prescription.

That raises a question I've never thought about before.

So 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.

That's why I was teaching my developmental neurobiology class.

But it's true. And embryology, you learned that we're basically born of a bunch of tubes that 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?

Yes, yes, very commonly, patients, parents will report, gosh my child just finished this course of antibiotics and now their teeth are stained or their gums are inflamed or 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 which I try to avoid but sometimes we have to that the they do take a high quality probiotic and increase their probiotic rich fermented foods as well.

So a high quality probiotic pill.

Generally yeah because they're hard to get in enough especially in kids, I would argue.

Kids aren't usually eating a lot of sauerkraut, and kimchi, and natto.

But you could do kefir, yogurt, as you mentioned, low sugar, kombucha, et cetera, but usually a high -quality gut probiotic will have some benefit to the oral microbiome, but they also do have oral probiotics too, focus on the bacteria of the mouth.

What about mouthwashes?

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 cue two years ago.

It must've been like eight, 10 years ago, I heard, I think on the Tim Ferriss podcast somebody said, oh you know, mouthwashes will nuke certain chemicals that are essential for cardiovascular function.

And so don't use them.

Don't use mouth strips.

Don't use any of that stuff.

and at that time that was considered like clear quote unquote pseudo science nobody like alternative science outrageous now we know this is actually true and this always you know this always delights me and scares me at the same time that many of the things that right now people oh that's pseudoscience I like creatine seems to be a big thing right now ten years ago is only the gym gym rats that we're talking about now everyone's like creatine creatine so what's the story on on mouthwashes 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.

Sure. Yeah. So listerine and those stronger rinses in particular, they generally contain alcohol astringent, 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 mouthwashes, including prescription strength mouthwash, like chlorhexidine is a common one.

It can damage the nitrate -reducing bacteria.

So, we have bacteria on 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, in vasodilation and immune health.

So if we're indiscriminately carpet -bombing the mouth with these really strong astringents and rinses, we can be affecting our cardiovascular health and there are studies that 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?

It'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 do 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 tonsillar 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.

Um, really strong essential oils and mints.

Again, I you'd be cautious with that every once in a while of throwing in a piece of gum or a mint of course.

Um, it's really the habitual use of these things that can be damaging.

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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 of the chemistry of the mouth.

Like, 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 like 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.

So that's really what we're talking about here and I'm trying to figure out how could I have the best possible saliva.

Yeah, I want to be the person with the best possible saliva.

Don't underestimate your spit.

It's true. It's the Golden Elixir.

So if I were to put spit into like under the microscope or 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 That's a sense of the kinds of goodies that are in spit.

What's in there? 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.

There'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.

They're symbiotic at that point, we are still unpacking and learning more about the oral microbiome.

But essentially you'll have bacteria.

There's hormones, there's free cortisol.

Cortisol's in our spit, folks.

Yes, absolutely. There are enzymes for aid and digestion, there are immune cells, and there are minerals floating around too.

So 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.

And 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 serostomia, 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 if it looks more thick and ropey and mucusy.

They're dehydrated.

If it looks like water it's healthy and this is without any test. 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 your mouth breathing, you will have less saliva, you know, your mouth is going to dry out, the pH will drop.

And you're gonna 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 to we want to have a mineral rich diet, so many of us are mineral deficient, or magnesium deficient, or 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 a blood test. Like a standard blood test for...

A standard blood test, but there is salivary analysis, and we should discuss the importance of testing your oral microbiome.

I think just like so many of us test our gut microbiomes now, you know, GI mapping, stool test, to understand what's happening in the gut.

There's 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 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 and 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 in our mouth.

Amazing, I really wanna 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.

I'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 yerba mate 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, who's 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.

I was boxing for about a five year span, and I had a fitted mouth piece, and I would do my running, my road work, with my mouth piece and 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 a mouth guard in, but I think that breathing through the nose is just so important for the reasons you're describing, James Nestor has 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.

Everyone knows this, meth addicts 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 before.

That 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 Ehrlich and Sandra Kahn, 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.

Well, we now know this is a real thing.

It's an epidemic. 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 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? So the theory is that ancestrally we used to chew and masticate up to four hours a day.

This act of 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 where we went from hunter gatherer society to agrarian.

Then the industrial revolution, we started milling and processing everything, everything soft and mushy now.

We used to chew four hours a day.

We now chew four minutes a day.

So 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.

They were slurping their food, lying on recliners.

They've outsourced pretty much everything.

Yes. So this is many generations of this happening.

We're essentially shrinking.

James Nester phrases that were dis -evolving.

Okay. So faces are shrinking, jaws are shrinking.

This is why we see so much crowding in teeth.

If 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, our trajectory.

So what has happened?

It's our food. It's how we're chewing, it's how we're breathing, and so if this structure shrinks, the nasal volume shrinks, the sinuses shrink, the airway shrinks, our tongue has no room in our mouth anymore.

So it either sticks out, tongue thrust or it falls back.

and it's obstructing us.

So there's so much sleep disordered breathing, dysregulated breathing, and sleep apnea, now it's not getting diagnosed.

So if we look at children early and they come in to 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, OK?

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 sclera the white of the eye.

They 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 percent 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.

So think of it this way, if your palate is narrow and I smoosh your face like this, the septum has to go somewhere and so it will can't.

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 and now we can breathe better.

So that's hard tissue.

Soft tissues could be enlarged adenoids, enlarged tonsils, oral motor dysfunction, low tongue tone, low tongue positioning too.

How 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 long try. I really want this to happen to myself.

They put the balloon up there.

They inflate the balloon.

And if you guide it, they do one that's guided.

Yeah, they numb it and then they take it out in the...

This kind of thing, well, is actually the appropriate way to do it, both in and out, through the nose, but 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 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.

So the question is do the sinuses actually dilate, or if you have a deviated septum 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 midface, 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 if you make the jaws wider not only is an 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 It's important to note the floor of the mouth is the floor of the nose, so if you expand the palate the sinuses will get wider, the septum is going to upright, everything's connected.

Now as an adult, it's really hard to manipulate bone structure just through posturing and habit.

There are myofunctional therapists, which they're the best, and they're really important in this conversation.

Think 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 gonna just be changing it through lip taping, or how you're training, or myofunctional therapy.

And there are more conservative ways now besides true jaw surgery.

There's an appliance called the Homioblock, which I know it's 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, maxillary skeletal expansion device.

It, it does put these little mini screws in your pallet, but it will pop the suture and adults.

And 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, it's the most important thing for health is how you're breathing and how you're sleeping and with children, if they're not breathing appropriately And they're waking up a lot, which is why it 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 in REM sleep through the eight sleeper loop are 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.

And my REM sleep's really solid these days.

Yeah, I'm struck by how convincing the data are about nasal breathing, improving brain function.

There were a couple of studies that showed that if people either mouth breathe or nasal breathe 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 you're 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 you think better.

Your cognition is better, your memory is better for everything, not just odors.

So you get 20 percent 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 on showing that children who mouth breathe have sleep disordered 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 glymphatic system's not kicking in, hormone function's not kicking in, so a lot of these children, growth hormone is impaired, anti -diuretic hormone is impaired if they're not getting into deep restorative sleep.

sleep, so that's just why we see bedwetting.

Some signs 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 body is like out of the bed.

The bedsheets are everywhere and then certainly waking up unrested and then noticing behavioral issues too.

Well, all you have to do to convince the male half of the audience to focus more on nasal breathing is to tell them, and to not use mouthwashes, is to tell them that being a mouth breather will give them sexual dysfunction, or will predispose them to sexual dysfunction, and they'll start working on their nasal breathing.

Because of nitric oxide.

So the paranasal sinuses is what will help produce nitric oxide, too.

So 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 so no bleeding gums We do not want inflamed bleeding gums on Flossing it's something that 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 we're nothing else and for your sexual health.

Great 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 test that you can do.

It's the three -minute test. Can you breathe through 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 your lips and literally time yourself.

And if you can, breathe through your nose successfully, then you in theory can safely lip tape.

There are different tapes that you can do so you 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.

It's like one of the world's greatest opera singers I'll have today.

And I said, what are some things that you do for your breathing?

Because I ended 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 done 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 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.

But 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 puffer fish for 15 seconds per side.

And she said it builds 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've been doing a little bit of like, kiss the sky and it looks completely ridiculous.

It's kind of a yoga move, too.

Yeah. And you're just like, really like, lips smacked as if you were going to kiss the sky from side to side, fifteen 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 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.

You know, we talk about, well, you need to see the Airway trained dentist. You need to see the myofunctional therapist, the orthodontist, the ENT.

That's a lot. Just the scheduling of that alone makes me wanna 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 Breathed by James Nastar, JAWS.

as you mentioned by Sonder Khan.

And Sleep Rect Kids by Sharon Moore, if you're a parent.

What's the title again?

Sleep Rect Kids. Sleep Rect, W -R -E -C -K?

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.

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's like cool. It's got all this stuff in it.

I was thinking it's just like if we know blood has all these goodies in it, we test blood.

We know skin microbiome.

We know that, you know, women go to an OB -GYN, they get Pap smears.

They get you know, I mean, we know if you ever raise a kid or change diapers, you can tell a lot about somebody's help by the fluids.

that they emit and that they have within them.

I'd like to play 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 chewer.

But is it good, bad, neutral?

Yeah, I think it's time and place can be very beneficial.

So 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 or 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 gone, particularly xylitol gone because xylitol will inhibit bacterial proliferation.

It will reduce strep mutans, 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.

It will loosen the food, it will increase salivary health.

Some people like it to strengthen.

Master gum, I always get asked about that.

You can overdo it. You know, I worry about temple mandibular dysfunction.

I had bad experience with mastic gum.

I was buying it, I love the kind of the primordial aspect of it's like a tree sap that you chew on.

It comes in this beautiful paper package and you know no plastics.

You get it going in there and you feel like you're really like working at the same way my bulldog Costell would he used to like teeth on like bricks and you feel great and then all of a sudden you'd go, and your jaw would kinda stick And then later you're like, whoa, like my jaw really hurts.

Or you feel something pop up in your joint.

Feel something pop.

And yeah, it'll give you that these days and the young influencers are so obsessed by this.

It'll give you a little bit of a golf ball, the hypertrophy of your jaw, that's not why I was doing it, but boy does it make your jaw feel sore.

Yeah. 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 chew... We're only meant to chew, really, for 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 joint.

So I'm not a huge fan of it.

I just, personally, don't love gum chewing, but I think time and place, too.

So, especially from a cavity standpoint, or hydration, you know, increasing salivary flow.

but I would just chew it for a couple of 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 smooshing our food.

Oh, gross, to me, almond butter has like never existed in nature, like I knew that you would take, like I mean, almonds are so delicious, right, but that you would like grind them up and put them into a paste.

For me, the texture is so aversive.

When you do that in your mouth, you're supposed to do that through chewing.

Just the fact that like your peanut butter, to me, these things make no sense whatsoever.

It's Go -gerts and applesauces and fruit snacks.

Baby food. Baby food, exactly.

It's for animals and people without teeth.

Exactly. So I'm not advocating in one camp or the other.

There can be a mix, but 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 to 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, and...

Well, 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 they're like - Chicken nuggets and french fries.

And yeah, we need to chew.

When really asked what's going on with the airway.

Why does everyone, why are faces shrinking?

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 either, 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.

You know, we do what we need to do.

I mean a lot of women are working.

And so, 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 to pump that there are fixes okay so 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 breastfeeding, it's hard to combat generations and generations of disevolution essentially, so a lot of humans are needing intervention now.

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Earlier 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, and there are direct effects like this mediates that.

And then there are indirect effects.

Like if a 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 mediate, they 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.

That this isn't just a, oh, you broke your ankle, so you move less, you move less, you heart gets less healthy, your heart gets less healthy, your brain gets less healthy.

This is kind of what I'm trying to make, but that the 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 does 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.

That's huge. 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 sort of a continuum, but these all have one thing in common, it's 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 Pigenne Jivalis, F Nucleatum, T.

denticola, there's A .A., and then strep mutans too, can affect the heart as well.

But 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 gut.

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, an 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 in inflammation.

And then also, these bacteria release endotoxins.

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, you're twice as likely, two times as likely to have cardiovascular issues.

if you have gum disease, you're 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.

Fertility's a big one that I like to speak about.

So 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.

And it's not only gum disease, but just any oral infection.

P. gingivalis is being linked to Alzheimer's and dementia.

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, many studies now.

One big one was out of Harvard, where they sampled the cerebral spinal fluid in the brains and saw that in these plaques, they had PGEN -Givalis 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 PGEN -Givalis.

So there's a lot of association and links right now that we need more research on. The other to be aware of is 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 nucleatum, pretty asymptomatic otherwise.

But F nucleatum is linked to increased risk of pancreatic cancer, breast cancer and colorectal cancer.

I 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 it right now.

He actually just had his pancreas removed prophylactically because it was pre -cancerous.

He had the Whipple procedure.

Yeah, they catch it early enough.

It goes anterior to posterior and if you catch it early enough they can lop off the anterior portion.

The whipple procedure, as it's called.

But even a colleague of mine, a brilliant bioengineer, a few years ago who had the whipple done 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, it's a simple test. It's a site and I can give some of the tests that I like and 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 You 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 very lint.

They're spirochetes 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... What kind of antibiotics are used to treat these things?

It's usually a moxacillin type of gland 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 that are more pharmaceutical.

More nothing, don't take anything.

I think, what 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 and various tissues?

Preventatively? Yeah, just preventative, like kill off what might be living in the mouth, like kill off what might be living in the prostate?

I learned recently that 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 they have a prostitis and they basically just need to do a 21 day or 31 day round Of antibiotics and everyone be like, oh you're spreading MRSA's with that or something you know, but It can protect against a number of different cancers related to the prostate and things like that What why don't we do this as a regular practice like every three years or so?

You just kind of you 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, one might think.

I'd like a less -is -more approach. I think there's better ways to kill off bad things.

Like, ozone therapy is being used a lot.

I use ozone in my office.

Tell me more about ozone.

So ozone, it's O3, 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 periodontal pathogens, but then also under fillings or under sealants, or if I'm doing a pulpotomy or kind of a root canal procedure, because otherwise we're just blasting water everywhere.

Wait, so is this oil pulling?

This is the basis of - I use it as a gas.

It comes out of a machine and I use it in a wand as a gas.

Very localized. I gotta try this.

But what's the deal with people swishing all of oil and oil pulling?

I know this is big in some of the, I don't even know what to call it anymore.

What used to be alternative and it's now mainstream.

It sounds like music in the nineties, right?

Indie medicine is now mainstream.

They sold out. Like, I'm just joking folks, but not really.

It's, there's so many mimics between the health arena and have 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.

Acupunctureists love this, alternative medicine types like this, is there any truth to it, does it relate to ozone?

It can, so you can find ozonated oils on the market for oil pulling.

So this is an ancient, aerobatic practice.

Going back to ozone though, just killing off mycotoxins 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 IV too, you have to go to someone who knows what they're doing.

Rectal ozone to get all the way up to the oral microbiome?

No, it would affect more like the gut area, the pancreas, the liver, et cetera.

Nothing shocks me anymore.

It's used a lot with mold elimination, mycotoxin 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 architecture, they say a lot of new buildings or two.

The heat -cold variation and the moisture.

I don't know, I don't know if this is true or not, but the last thing you ever want to do is tell somebody who thinks they have something that they don't.

And so I'm not saying they don't.

I just, I hear this a lot.

I had known a number of people that have left the city of Austin because they couldn't deal with the mole.

Interesting. Molar can be scary.

I mean, we see it affect the teeth.

The teeth will just start degrading to, and some of the kids who have tested really high in mycotoxins.

So, rectal ozone. Yeah.

Wild. Well, hey, listen, it's the digestive tract.

I mean, you know, we're a health science podcast. Everyone can look it up on their own, but there are providers out there doing it, so ozone can be great as an antimicrobial instead of an antibiotic.

Now going back to oil pulling.

Oil pulling is an ancient, aeroveatic practice.

It used to be with sesame oil.

More people do it with coconut oil now.

I oil pull a couple 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, dawdling around in the morning.

Nasal breathing. Yeah.

Don't spit It will clog your sink and spit it into the trash can.

So what is it doing?

Well, it's dislodging the biofilm as you're swishing, okay?

Loric acid, which is in coconut oil is antimicrobial.

It can help with lymphatic stimulation and has some anti -inflammatory properties too, and a lot of people report it makes their teeth look brighter and whiter, which is nice.

I mean, you do have a great teeth.

Well, I'll tell you the story why.

it'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 I had facial trauma should we get into that yeah let's get into that so when I was ten it's why I became a dentist when I was 10 I was trying to gain the attention of my older brothers friends who are very into dirt biking and BMX biking and 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 and knocked out my teeth and I broke my pre maxilla and you can see the scars 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 and oral surgeons and orthodontists.

And at the time I was an art theatre kid.

I loved working with my hands.

But as time went on, And I thought, well, gosh, I don't wanna be sleeping on couches in New York City.

I need to make sure I make a living.

What am I gonna 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 falsies.

Cause I, cause I got a tooth though.

It's kind of chipped in half from, from getting hit honestly, dumb, you know.

If you're gonna box, make sure you're getting paid a lot of money.

You know, yeah, and wear a mouth guard. They're better martial arts where you can go full, full blast, like 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 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 your face.

So this is a bridge, you can get implants.

People have flippers.

We were talking about hockey players earlier, you'll see them flipping their flippers around with their fake teeth.

So flippers are retainer with fake teeth on it.

There's 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 helped.

And so I wanted them to look not quite as contrived, I suppose.

But they look very natural.

Yeah, thanks. And today we're learning all the ways in which Keith 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 one's oral health.

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.

The vapors will say it's not carcinogenic 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.

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 mints and things of that sort for the stimulant effect.

it's an unusual stimulant because it also relaxes one self a little bit at the same time.

So it's kind of that, like, you know, that sweet spot.

And I confess I will occasionally take, you know, 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 the 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 mean, I don't feel addicted, but every addict says that.

The first step is admitting the issue.

So I don't want to villainize anything.

So I agree with you.

I 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 their one brain in particular it will have mannitol and maltodextrin in it, which are sugar alcohols and a 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.

And 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 um but also we're seeing changes to the cellular structure up in that area so you can see leukoplakia which is like white patching which can be procancerous so this is why I just like everyone to get checked out and we are seeing bone loss and gum recession um again any time 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 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, and had always had very wonderful dental check ups with X -rays and went in regularly and maybe he missed one appointment and after 15 months of use.

The x -rays are outrageous.

He just has rampant decay along the side where he had the pouch very likely from potentially that trace amount of sugar, the microbiome changes.

I 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 gonna choose to use these, I just say know the risks and make sure you're getting checked 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 if somebody is really adamant about taking nicotine, they should just take a milligram or two milligram pill of nicotine or a patch. You scared me with leukoplakia.

Yeah, cause growing up, we were all told, no one really dips in Northern California, but like don't dip or because...

And then I saw these pictures of leucatlachia.

Jaw recession. And it's pretty vile.

And so you... The design to scare you, it scared me sufficiently.

I never wanted to chew tobacco anyway.

But, good to know. Coffee?

Are you in a... Do I need to stop drinking coffee?

Okay. Thank you. You're from Portland after all.

How can I possibly say that?

When you're in Portland, 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.

So going 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.

Hydroxyaptate is a wonderful way to improve the brightness and whiteness of your teeth and oil pulling as well.

Or you can use heavy hitter bleaches too.

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 pulp or the nerve over time, and some people will get spontaneous abscessing or need root canals.

I mean, these are people who are really bleaching all the time.

The people who you need sunglasses to look at their teeth, and it's just not really a natural aesthetic.

But 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 our...

First of all, I switched a few years ago, I would say really about 14 months ago, I just said, that's it, I'm not eating processed foods again, I'm just not gonna do it.

So I eat meat, fish, eggs, 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 just, I was like, that's it.

Like 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.

And what was interesting is I used to get a lot of tartar buildup a lot despite brushing and flossing on the, what are the lower front teeth called?

Insizers. Yeah and they'd scrape it away.

It's a non -issue. It's completely gone.

So we have minor salivary glands on the floor of our mouth.

And that is a commonplace people will see calculus or tartar so those lower teeth.

that's where you'll feel your hygienists scraping a lot, but I wonder if it's because you increased your K2 in your diet, which helps with calcium metabolism.

And I 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 Gator Dentist makes.

I actually know his real name, but he hides as Gator Dentist. I love Gator.

Gator Dentist. But I switched from fluoride containing toothpaste, not because of fear of fluoride, but excitement about hydroxyapatite, so I switched to using your toothpaste.

And I occasionally, well, I routinely switch back and forth with NOBs, where I think it stands for no BS, which is Gator Denses to tablet products.

So I use them and neither of them pay me, I pay full price.

I don't, they don't send it to me.

I purchased 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 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 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 test their oral microbiome.

That'd be very interesting to know what's going on in there, because you think you're swallowing.

I'm sorry, is there a best test, because a lot of listeners are going to say, okay, if they have the disposable income, they're going to want to test their oral microbiome.

Is there one that your office uses or that?

I use either the Silha test which is more just biomarkers so it's...

How do 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 use it a lot, it's an educational tool.

It will show the pH, the acidity, if there's leukocytes, if there's red blood cells, inflammatory markers, so, a lot of parents, this is so new to them when I'm talking about this, so, but it prints out in a graph form for them...

It's a sheet swap. on spit.

So kid or adult will spit in that form.

Yeah, kids usually won't spit till about four, just physically.

It's hard. It can spit and taste, yeah.

Yeah, it's hard. Okay.

Anyway, but I really like tests that use shotgun 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 in their home.

So, Bristles is a company that people can...

An 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 us.

Some of the audience will.

I am, actually. Yes, I am.

That's fine. As long as people know.

or probiotic, we have a collaboration with their oral probiotic, but regardless if it's bristle or not, you look for a test that using shotgun metagenomics.

Shotgun metagenomics.

Yes. Okay. There's PCR testing too and a lot of biological dentists will offer something like oral DNA is the most popular.

The issue with that is there, it's really only looking at the top 12 pathogens, periodontal 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 dentist may offer that.

Again, it's oral DNA.

I have no affiliation with oral DNA.

Great. Thank you for that.

I think people, some people will want to test their oral microbiome and other things in there.

And there's more and more popping up.

The oral microbiome is really blowing up.

So for those who are looking for investment opportunities, I'd say, look toward the oral microbiome.

It'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 mouthwashes, consider a hydroxyapatite 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.

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.

I don't tend to burn very easily, but if I feel like I might burn, I use a physical barrier.

I'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, 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 remains, why are we drinking fluoride.

But this relates to, okay, I'll tell the story briefly.

It's not as cool as your story.

I was taken to a dentist when I was a kid and 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, and I hated it.

It tasted awful and it kind of like had this sour thing.

So it was probably six or seven.

So I drank it. I just sucked it up, drank it down, turned it around, barfed all over the wicker chair.

Oh my gosh. Fluoride is a poison, but everything is a poison at high concentrations.

So most everything is a fluoride, 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, like people say, oh, going through the x -ray machine, no big deal, but what if you fly 150 times a year?

Is it cumulative? And so like the logic of the sort of pushback from the traditional, if I will, community sucks, like they're just not logical.

These are my colleagues sometimes too, right?

You go to the dentist, you get an x -ray, they're like running behind the next wall.

Put you in a ledge shield and then they're like, oh no, it's no big deal.

Well, how many? 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, and 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 fluorescence.

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 you're anti -floride.

I'm not anti -floride, but I just don't get the lodge.

It doesn't make sense.

You're thinking critically about the, about it.

Like, 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 poorer populations don't have decaying teeth.

Sounds like a good argument, not even counterarguing it, but I can't piece together the logic.

And like most public health arguments, I feel like neither side 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 things.

Okay, I'll do my best. Yeah, and please don't worry that you're going to offend anyone because I'll offend everybody.

And they've already said anything.

They, everything they possibly could, and they'll, and they'll say more.

So I'm not afraid to open up these topics anymore.

Okay, I appreciate that.

And I'll take the heat.

Well, I will get it too.

don't worry. I've already, I have thick skin at this point.

But you have great teeth and they don't.

Yeah, and I haven't had a cavity for multiple decades and haven't used fluorine and Portland isn't fluoridated.

Portland is not fluoridated.

So let's talk about that.

So fun story back in 2011, 2012, I was working on the pro water fluoridation campaign volunteering in Portland, picketing, and handing out educational flyers because I thought we needed it in our water.

And 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 again, it's Water Floridation, that's the Ten Hat Brigade, that's the Wuh Wuh Caucus, all the things.

I was that person. The Wuh Wuh Caucus, that's pretty funny.

Yeah. 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 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.

I'd 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 holing and there's so much literature and this again this was quite a while ago and more and more data and 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 Dennis in Colorado Springs, Frederick McKay, who noticed his patients had modeled brown spotted teeth, but they were really strong.

They weren't getting decay.

And so this kind of spread, and they started 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 Grand Rapids, Michigan in the mid -40s.

After about a decade or so, they noticed that caries rates, cavity rates were going down.

And so based on this observation, it just went like wildfire throughout the United States.

And I believe about 80 % of the United States is fluoridated.

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 note dental decay 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.

Our domesticated animals do, because of what we're feeding them, the kibble, processed animal food.

So here we are. So it's been controversial from the beginning.

You know, epidemiologists, endocrinologists, neuroscientists have always challenged it saying, this is a bad idea.

It's a highly reactive element.

The fluoride ion can interfere with iodine uptake and again, skeletal fluorescence, neurotoxicity, et cetera.

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 is a TSCA trial, and this has been ongoing for the past seven years.

Basically, they were saying, where is your safety data EPA on the long -term effects of water fluoridation?

The idea was that if we put it in the water, it's not a very efficient way to get fluorite to people.

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 enamel 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 Fluoride 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, 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 -processed 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 the past many decades, okay?

Is that right? So if we look at skeletons from dead people, obviously, well, you can look at skeletons in live people, skeletons in dead people from dead people that died prior to 1900, how are their teeth?

1900, they still, they would have decay, but if you looked at about 10 ,000 years ago, very little.

You know, Leslie lived in an area with a lot of fruit abundance or honey, like where are you getting your sugar from, and you go pick some berries on a bush, you're competing with the animals and the birds.

You didn't have much opportunity to over consume 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 fluorine on it.

How about we educate and teach people what is really causing cavities?

But anyway, okay. So the task of trial was going on and the judge, Judge Edward Chen was waiting for this National Toxicology Program's report, which was under the Department of Health and Human Services.

And this is, it reads like a soap opera, to be honest with you, 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.

And so with that, he took this information and he made his ruling now this was after years of expert testimonies as well, okay.

And saying there's an unreasonable risk to current water fluoridation practices in the United States.

This was his ruling that just happened late last year, this is very new.

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 in children or neurocognitive issues, it was at 1 .2 or 1 .5 milligrams per liter, that was the concentration.

In the United States we now do 0 .7 milligrams per liter.

But that's per liter.

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 do 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 Prilosec, a lot of these have fluoride in them.

Really? Yes. Ultraprocess foods will have fluoride.

So the factory that's making your Rockstar Energy Drink or you're high C 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, they follow, there's many studies now, a famous one was the Rivka Greenside out of Canada and they followed about 520 mother -child pairs, they tested urinary fluoride, and the mother per trimester averaged it and 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 tests up to five to seven points and that's on par with lead.

Okay. 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 JAMA Pediatrics.

Okay. 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.

Cocker and 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 toothbrushing, flossing.

But also, we now have fluoride everywhere in our toothpaste.

So, fluoride was 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, it does have a poison control label on it.

You're not supposed to swallow it, but these varnishes also have polyurethane and hexane drivatives and it's what makes them so sticky.

I still loathe going to the dentist. I know that flavor.

I think it's because of that early association.

Yeah. So it's very controversial, and unfortunately, we've lost sight of the science is getting buried 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.

The American Dental Association, the American Academy of Pediatrics is doubling down and 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 Florida eat the water.

This is a very United States controversy.

Many 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 fluoride 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 be like, well, 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.

I think they're crowded and crooked too.

And a lot of that has to do, I think, with facial development as well.

I think 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, et cetera, why does it seem more prevalent there?

So that's the take, the quick take on it.

And so I just think it should be a personal choice.

You know, if you want to use Fluoride, you can go out to the store, I mean, you can get Fluoride 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? You know people that live in fluorinated areas versus those that don't we follow them Maybe it's a prospective cohort study to just see how their microbiomes are different because 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, 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 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.

So but again, it's a risk benefit analysis.

I mean, I think dentists 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 as a parent, do I want to choose one quarter 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.

I can fix a one -quarter cavity in a tooth, I can't fix the developing brain.

We have one shot to develop our brain.

We have one shot to grow a face, you know, it's really important.

Well, I really appreciate you taking us through the full arc of the history of it.

I think it's extremely important that people take that in so they can start to form their own opinions.

And 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.

And without a risk assessment.

So your low decay rate, I might be a really high decay rate.

You don't need anything extra.

Your diet, your balance, your microbiome is great.

I'm not eating well.

My hygiene's terrible.

I think, well, we can't just blanketly be treating everyone the same.

We're supposed to be doing risk assessments.

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Okay, so I think that pretty much puts fluoride in a box, let'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 going to get to the heart of the matter.

Yeah. And that would be really sad and the ones that would really suffer would be kids.

Kids, the children, yeah.

So a nonpartisan look at this, which is how I heard everything that you said, just seems really critical.

Where are they getting the fluoride?

So water fluoridation on the floor that they get is a byproduct of the phosphate fertilizer industry and it's it's called hydroflurosolicic 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 and theory and put it's an acid, first of all.

So if it's put into our water system, it's so diluted that it becomes safe.

But I will say, everyone can go research this 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 and they're supposed to titrate it.

And I think what's interesting, we're supposed to target 0 .7 milligrams per liter.

I've been involved in some educational campaigns and have tested communities surrounding 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 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 gonna have much control over this It 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 gonna ban this as a mandatory thing in our state and I think it's North Dakota, Kentucky.

There's other states picking this up too 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. 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, Portland's traditionally.

Blue City for sure.

Blue city that, yeah, right.

Blue city in a... Red state.

Oregon went red this last lecture.

This city's makeup, it's kind of like many states.

So Eugene, Portland, Bend tend to be pretty blue, and I think the 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 2019 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.

And obviously hormones could be about men or women, but let's talk about oral health and fertility.

What, if any, knowledge is there about how oral microbiome or oral health would be impacting egg health, fertility, ovulation, ovarian reserve?

Is that sort of the level that the regulation of fertility is thought to occur?

What's known about the link?

Yeah. 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 paranormal pathogens increase.

And again, it probably, it has to do with the inflammation.

And with women, we can show that women take about two months longer to become pregnant.

It does affect ovulation, egg quality, but also we know it can lead in miscarriages, and low -term birth, low -weight birth, pre -term birth, and just pregnancy complications as well.

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, there'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 in pigengevaleis or f nucleatum.

And they eradicated or lessened that bacteria.

I mean, it'd be interesting to see how pregnancy and fertility outcomes would change and possibly improve.

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 to brush and 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 him three times a day.

I don't know what motivated that, do you?

Okay, great. So what's the deal with brushing?

When, let's say, kinda 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, I guide parents on this a lot because brushing a child's teeth can be challenging Nighttime 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 ten twelve hours If you're a child with that sticky Potentially dysbiotic biofilm on your teeth and 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 nighttime, 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 are in approximately in the molars and 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 X -rays for the first time and 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 pretchills, 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 flossing.

So 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.

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 cut mirror, they'll do it in the shower, some people do it in their commute, in the car, I'm not going to 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, you know we want to put it between the teeth and they suggest you do a C and a backward C, 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 a 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, so water picks can be fun.

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 have gum disease as a result.

What about those little toothpicks with a little sling of floss across?

You know, the hard picks that...

Yeah, floss picks. Floss picks?

They're great, especially in kids.

It's the only way to floss the 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.

Our 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 teeth touch, we should be flossing, but usually around the 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 that floss, become adults who floss.

But also, floss picks are fine for adults, too.

Some people have big hands, it's hard to get flossed in.

Yeah, I can't, I have to use them.

I can't get in to my, I can't get my hands into my mouth.

They're fine. Yeah, okay.

You just want to try not to just go straight up and down, and just kind of angle, angle if you can.

And then maybe a water pick too.

And I was told by my dentist, soft toothbrush, cause I tend to get in there and like I'm hearing all this stuff about how the, you know, oral health is so important for the brain and that could lead some people, including me to get in there and just start like scrubbing and scrubbing and trying to get everything out of there.

And that's not the right approach. Hate brush stroke.

Very gentle. So you want to do gentle, circular movements.

You don't want to 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 demineralize a little bit, right?

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 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.

So, 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 cause 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.

So 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, orangy brown.

Mild fluorosis usually is more bright or 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.

And I will say 40 % of teenagers now have dental fluorosis that very likely means they also have some degree of skeletal fluorosis as well.

So 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 or my kid feels fine or there's nothing I can do about it now, they'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, 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 that those spots on your teeth, those white spots or dark spots that are really unattractive, that's because of fluoride?

Now you've got everybody.

Aesthetics. Aesthetics.

And it's either a shame or whatever that this is the way that people are.

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.

But those white spots, nobody wants those.

Dark spots on the teeth.

Nobody wants those.

And I'd 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, maybe stronger, but uglier.

I bet you this becomes a wedge in the conversation.

That will come from the public.

But I will tell you, I have dentists, when I speak, as I do, about water fluoridation and in 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.

But it's really common. Flurosis is very common. I've even seen more recent data saying as high as 60 percent, but the 40 is kind of the standard number that we go with teenagers with fluorescence.

There is something called hypoplastic enamel.

This is something I'm very passionate about.

Um, this is undermineralized enamel and I believe it's a silent epidemic in children.

I see more and more children whose, their teeth erupt and they're modeled and chalky and some are so severe, they're crumbling.

And I've seen a big uptick in this in my 20 year career, and the data is starting to show this as well.

Um, and so unfortunately so many parents, their kids will get decay, it's really common and they get shamed and blamed.

Like what are you feeding them?

and 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, We're inside all the time, we're not outside, all the junk light that we're getting, the blue light.

It can also be from environmental toxins, high fevers, viruses, but it's a real concern and so many children are under 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.

there's risk to gentle anesthesia.

And this is where I do love to consider a more conservative approach. Like, can we re -mineralize these teeth?

Are there strategies that we can do to even just kick the can 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.

And 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 are women.

I'm curious, are there certain phases of the menstrual cycle or certain phases of perimenopause, menopause or prior to it in which women should pay particular attention to their oral health?

Is it like, is there a known association with like, you know, 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 or flustering appropriately, but it's really a hormonal issue.

So it's important to know that as well as women who are pregnant, pregnancy gingivitis affects 50 to 70 % of women.

50 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 relaxin can, 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 by relaxin.

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 very important preconception and certainly during pregnancy to be really on top of your oral hygiene as best as possible and see a dentist regularly.

And then perimenopause and menopause there's a whole slew of issues that happen to women, 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 you, it's just so powerful to be able to have these conversations with women And rather than just say, well, just use this product, brush and floss more, maybe we could talk, speaking of it from a hormonal lens, like, is hormone replacement therapy appropriate for you?

Or 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 about you know like what how is this different for women versus men and in particular different phases of the cycle and peremonial pause men and pause and and especially the entire lifespan so appreciate that yeah I get burning mouth question a lot too from my community sounds awful so your mouth feels metallic and it truly feels burning almost like itchy I think I haven't experienced it So that's how it's described to me, or kind of like a dry mouth.

It can be a sign of zinc deficiency or vitamin B deficiencies.

And we can see changes in those with perimenopause 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.

It's the same with white striations on 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 long in their life now and still have it from childhood.

We're told in dental school it maybe has changed, but it's benign you know and just to tell patients to avoid citrus and acidic foods, 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.

And also it can be a sign of celiac, Crohn's or gut 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 meet, to rule that out.

You know, and there's genetic predispositions too.

As we progress further along in this conversation these ideas pop to my mind that I'd never thought of before like, because I don't tend to use them like lip bombs, lipstick, I don't use lipstick.

I don't use lip balm.

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?

But more often people are gonna use, but I suppose specifically like lipsticks, are they safe for the oral microbiome?

Well, I don't think it's getting into your, hopefully you're not eating it that much, but I mean, we need to be mindful of our products.

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 they're not necessarily as regulated here from a cosmetic standpoint as they might be in the EU.

So read your ingredients.

But a lot of petroleum base products will actually cause more dryness, 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, So 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 through your nose.

But if you can't because of an obstruction, deviate a septum, inflamed nasal turbinates, you'll have that kid that his 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 going to 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, now they get 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.

Should 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 want to 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, that your tongue should move the bolus of food to the other side.

So, if you can't do that, it can be a sign of oral motor disfunction 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, so I'll have to ask.

Tongue tie. A few years ago, this was a controversial area.

the tongue tie being the stretch of skin between the bottom of the tongue and the bottom of the...

was it bottom of the...

Floor of the mouth.

Floor of the mouth, thank you.

And this idea that in babies it should be caught to other people saying it shouldn't be cut and then everyone starts looking at it like, Kaimi I think mine just seems to have naturally torn back some distance, but, you know, what's what's the deal with tongue tie and 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 freenums up here in the vestibule.

Yeah, the cheek. If you put your finger in your mouth, you'll feel.

Oh yeah, yeah. We may have them, we may not.

And they dried my teeth out for something once they pull it back.

You see it's like webbed.

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 somebody to be mindful of, you can't diagnose anyone from a photo on social media.

So I see a lot of parent blogs 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.

And so is it impairing or impacting breastfeeding?

Can the tongue not lift appropriately?

It's all about lifting, elevating, and lateralizing.

So many think tongue -tight impacts you sticking your tongue out.

We don't care as much about that.

What grows the face and the palate in utero and then beyond is that tongue lifting, elevating, and spreading that palate almost like an expander, like an orthodontic expander.

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?

So, 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 gonna lay low and you're gonna 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 palates 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.

So then the next thing we look at is speech, you know, and, and is it impacting speech or is it impacting chewing and swallowing?

Um, 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 phrenectomy is indicated, and I myself have had one, and it benefited me a lot.

My issues were neck strain and a lot of shoulder tension.

There's a lot of fascial 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.

You know how were they assessing that and then is it impairing function and then do you actually need a procedure done?

Sometimes just working with a myofunctional therapist or different body workers, a chiropractor, a cranial sacral therapist, an osteopath can be enough to create balance again.

So 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 only just a few years ago because I had chronic tonsillitis.

And so I knew I had a posterior tongue tie and I just told the surgeons, go ahead and do it.

I'm already getting my tonsils out.

Sure, you're already 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 their procedure.

It's pretty straightforward. Yeah.

that can cauterize as you make the cut.

You do want to generally suture, and you want to make sure you're working with a myofunctional therapist before and after for optimal outcomes.

It's like, think about if I went in for a knee 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 reliefs.

Peptides and red light therapy, now we're in the 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.

So can red light therapy, shining red light in near infrared light, so long waveline 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 potentially helpful for?

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, extraorally or intraorally, to help expedite healing, collagen synthesis, etc. Peptides are newer, and 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 very cutting edge and it's very new and there's 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 idea is to regenerate tissues specifically with peptides.

It can, when put down in the pulpal 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.

so it's pretty cool.

Alright, so we'll stand by on that.

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.

So mercury fillings, this can get controversial.

I think the first thing to do, I don't love mercury amalgam 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 biomimetic material.

But if you have existing mercury fillings, amalgam fillings, and you're concerned, 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.

And certainly if a filling is breaking, damage, it needs to be replaced 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 are BPA -free but that is a bit of a marketing idea, you know, there's still other plasticizers in there, Diggma, any, et cetera, so I do really like ceramic -based materials if you can find them.

Nothing is perfect, you know, at least it's the best available that we have. Regarding retainers, I get this question a lot too.

Acrylic retainers, those are the pink retainers, what's interesting about those, methyl methacrylate can have gluten in it.

So if you're celiac, there have been case reports of teens, especially who they keep having GI distress or rashes because celiac often can 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 for your health in my opinion is optimized oxygenation and breathing and rest and recovery.

So, 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 liver detox is optimized, you know, that's ideal.

So, yeah. Cruciferous vegetables, sulfurophane supplementation maybe.

Bitters, dandelion.

The same things that were recommended in the Microplastics episode that I did that other people have touched on.

So things like sauna, sulfurophane.

Yes, binders. crucifix, vegetable intake should help bind to some of the microplastics that surely we are ingesting.

Everyone has them, 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 fissures of the back teeth.

but again I use so I I use spectrometry to make sure I'm not sealing in bacteria so it's an image that shows me if there's like caries or cavity there I'm using ozone to make sure I'm killing the bacteria sometimes I'll use my laser which helps disinfect you to open the groove up and then I'm using ceramic based materials too and so I think there's it depends on your risk as well if you're low risk you're not eating a lot of these ultra -process foods you're probably okay, but a lot of kids, 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 talkies and the Doritos and they make maybe some bad choices.

And so if you want their teeth as protected as possible, I would suggest sealants.

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, their hands are always in other people's mouths so they don't have anyone to talk to, 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, sending aside that kind of 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 I always heard this too even before I became a dentist and It's a really hard profession.

And so we tend to be the brunt of the joke, you know, we're in this 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 dentist in multiple different movies I think.

Little Shop of Horrors.

Little Shop of Horrors, Horrible Bosses.

There's a crazy dentist. There's always horror movies have dentists.

We are the brunt 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.

I felt very dissatisfied with my career cause I just felt like I wasn't making a difference.

You know, 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 pressures and the things with dentists is we are the clinicians, but 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, looking at spreadsheets, HR issues, et cetera.

And 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. Now 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 gonna brush, floss, follow my rules, not eat ultra -processed foods, you're breathing through your nose, what's your microbiome like?

So then you're doing all of these things that I've instructed you not to do, and then you come back cause 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.

But I do think it's important for everyone to know that many dentists are having a hard time with work especially post COVID, I would say.

There's a lot of pressures.

Dental insurance is very challenging.

You know, it's not truly insurance, like medical insurance, it's really a benefit package.

And so you tend to only get 1 ,000 or $1 ,200 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 are insurance reimbursements.

So where does that delta come in?

And usually it's coming out of the dentist's 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 dentist there.

Just recently, this is very timely, but I don't know where this came from, maybe it was like a TikTok thing, but there were letters being mailed.

Specifically I saw on the Pacific Northwest, Oregon, in Portland that dentists were receiving these, these hate letters saying dentists are 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. And 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 and childhood.

And that's what I wanted to change to.

I just said it doesn't have to be this way.

We can make dentistry 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, maybe considering therapy or some sort of anxiolytic, like do you need something to help you feel calmer at the dentist?

But I encourage everyone to go to the dentist, don't 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.

Well, thank you for being an incredible ambassador for dentistry.

And in 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.

I wonder if now would be a good time for us to just sort of summarize the top 10 or top 12 things.

There are a bunch of don'ts, maybe we can leave those out like a void, sugary, starchy, flowery foods that get stuck between to eat that kind of thing.

But But maybe I'll fire off a few, and you can tell me what I'm missing.

Be a nose breather not a mouth breather.

Unless you're eating or speaking, give your mouth shut basically.

Or you're exercising really hard and you need to suck for some air, or you're scuba diving and you would drown otherwise.

Eat non -process, 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.

Yeah, that's loading a lot onto 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.

Before sleep. So just, yes, ideally, mm -hmm.

So it's brush, then floss.

Floss then brush. Floss then brush.

But however you can do it.

No, no, no, I didn't get it wrong on purpose, you were correct.

Tons scraping. We forgot to talk about tons.

Yeah, so I want to add in these things.

So maybe oil pull three times a week, put some all coconut oil in there, swooshing around, practice your nasal breathing while you're doing it, spit it 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 anti -microbial.

So I'm erring 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 of times a week, you don't need to do it daily.

Great, soft toothbrush, be gentle.

Avoid alcohol containing mouthwashes for all sorts of reasons.

Pay attention to the fluoride debate.

Consider hydroxyapatite, if you're concerned.

Great, I love these hydroxyapatite toothpaste, yours and Gator dentist one.

Love them. I don't get paid a dime for it.

I pay my own money for them.

I really love them.

I think they're 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.

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 a maximum efficacy.

So if you're brushing for two minutes and spit and rinse, all that goodness is getting rinsed down the drain.

So it really should.

You can still spit.

People get confused by this.

You can still spit, but try not to vigorously rinse everything off.

You do wanna try to sit on the teeth and in your saliva a little bit.

Avoid nicotine. Alcohol?

And alcohol. Hydrate well.

Yes. Electrolytes. Keep your electrolytes, keep your saliva abundant.

Yes. Especially for older people.

Yes. The nasal breathing during sleep, but we can double -click on that one because that's going to get your sleep right.

Cause that just checks so many boxes.

I'd say optimized minerals and fat soluble vitamins.

This is kind of Western price stuff.

I'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, Ayurvedic, you know, Chinese medicine, we'll look at the tongue from a health standpoint.

If you have a white coating on your tongue that's a sign of dispiosis, you could have candida.

This is important to touch upon.

Shrep mutans gets 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.

And no one's screening for this or treating it, Candida loves sugar, you know, and this is also with diabetics, we're seeing a bi -directional relationship with gum disease, paradontal disease, and insulin resistance and blood sugar imbalances too.

But, 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.

I 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 it to scrape too hard. But just get that film off.

You'll also notice improvement in your taste perception too because you're getting food remnants and things off as well.

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.

Thank you Andrew. 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 and 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 a heart surgeon or gut health, which we have to get to indirectly unless we're gastroenterologists.

What other bio films do 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.

I 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 continue to put out into the world.

So thank you for doing that.

that, thank you for coming here, it's clear that this is a labor of love for you, it's not just about, like, cleaning teeth or something.

People probably can't see, well certainly if they're listening, they can't see the incredible extensive notes that Dr. Whitman brought with her and her incredible handwriting.

Goodness gracious, what beautiful handwriting.

Thank you. So I could read it later, not all doctors have bad handwriting.

They're notoriously have bad handwriting, but yours is certainly offset, or 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 we're really grateful for you coming on here today.

Thank you. Thank you.

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And on both Spotify and Apple, you can leave us up to a five star review and you can now leave us comments at both Spotify and Apple.

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That's the best way to support this podcast. If you have questions for me or comments about the podcast or guests or topics that you'd like me to consider for The Huberman Lab podcast, please put those in the comments section on YouTube.

I do read all the comments.

For those of you that haven't heard, I have a new book coming out.

It's my very first book.

It's entitled Protocols, An Operating Manual for the Human Body.

This is a book that I've been working on for more than five years and that's based on more than 30 years of research and experience and it covers protocols for everything from sleep to exercise, to stress control, protocols related to focus and motivation.

and of course I provide the scientific substantiation for the protocols that are included.

The book is now available by presale at protocolsbook .com, there you can find links to various vendors.

You can pick the one that you like best. Again, the book is called protocols, an operating manual for the human body.

And if you're not already following me on social media, I am Huberman Lab on all social media platforms. So that's Instagram, X, Threads, Facebook, and LinkedIn.

And on all those platforms I discuss science and science related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the information on the Huberman Lab podcast. Again, it's Huberman Lab on all social media platforms. And if you haven't already subscribed to our Neural Network newsletter, the Neural Network newsletter is a zero cost monthly newsletter that includes podcast summaries as well as what we call protocols in the form of one to three page PDFs that cover everything from how to optimize your sleep, how to optimize dopamine, deliberate cold

exposure. We have a foundational fitness protocol that covers cardiovascular training and resistance training.

All of that is available completely zero cost. You simply go to HubermanLab .com, go to the menu tab in the top right corner, scroll down to newsletter and enter your email.

And I should emphasize that we do not share your email with anybody.

Thank you once again for joining me for today's discussion with Dr. Stacy Whitman.

And last but certainly not least, thank you for your interest in science.

[Optimizing Oral Health: The Microbiome, Breathing, and Systemic Longevity]-[How to Improve Your Teeth & Oral Microbiome for Brain & Body Health | Dr. Staci Whitman]

📋 Summary

The Oral Microbiome: A Pillar of Systemic Health

The Dynamics of Mineralization and Decay

The Role of Fluoride and Hydroxyapatite

Nasal Breathing and Structural Development

The Oral-Systemic Connection

Practical Protocols for Oral Longevity

🎯Key Sentences

📝Key Phrases

📖 Transcript