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

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life I'm Andrew huberman and I'm a professor of neurobiology and Opthalmology at Stanford School of Medicine my guest today is Dr Stacy Whitman Dr Stacy whitmann 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 whitmann 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 upto-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 and our oral microbiome and if we go through uh 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 sure great question great way to start off so I first want to commend you and thank you for including the oral microbiome and oral health is one of the pillars of Health uh 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 uh unfortunately Dentistry has been separated in compartmental specialized out of the body like much of medicine you know we we we're so specialized and subspecialized um 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 toothpaste mouthwashes um certain gums and even what we're eating um and how we're breathing can 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 optimizing so do you think that most of the common over-the-counter toothpastes um while they smell Min minty or pepperminty and taste minty and pepperminty um are they effectively cleaning teeth and are they causing any damage to teeth by virtue of what they have in them it really depends on the ingredients so 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 they're 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 um what is what is toothbrushing what it 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 it's sort of extra credit but if you're perfectly IM balanc we shouldn't need all these stripping agents and strong mints and things so um for example sodium Laural 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 uh essential oils we think oh that those are natural they're they're healthy right well they're 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 uh is so bad or you have hosis that you feel the need for that then I would argue well let's dig deeper why is your breath so imbalance there's probably something else going on so I really encourage people to start learning about their products um 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 Healthcare 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 Laural sulfate and the problem is there's derivative so some cleaner versions might have coconut derived um SLS derivatives and many people will do okay with those but a common complaint I see in my office um are oral ulcerations and the first first thing I think of is what's in your toothpaste does it have SLS or a derivative because some we're all different and some people have more sensitivities and and we'll react more to those are oral ulcerations canker Source yeah or canor or yes so if one gets a canker sore what does that reflect typically um is it let's assume the toothpaste doesn't have anything to do with it is that a disruption in the microbiome is it from a a physical injury like a bite to the gum could be all okay so it could be um secondary to trauma certainly it can be viral related so the herpes virus often will result in uh oral ulcerations h v one yes um but also and this is off not on many people's Radars you know the 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 apus ulcers or ulcerations that can be a sign of Crohn's or Celiac um IBS like something going on deeper within that we need to be evaluating food sensitivities Etc I'd like to take a quick break and acknowledge our sponsor eight sleep eight sleep makes Smart mattress covers with cooling Heating and sleep tracking capacity now I've spoken before on this podcast about the critical need for us to get adequate amounts of quality sleep each and every night now one of the best ways to ensure a great night's sleep is to ensure that the temperature of your sleeping environment is correct and that's because in order to fall and stay deeply asleep your body temperature actually has to drop about 1 to 3° and in order to wake up feeling 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provide support in the form of emotional support or directed guidance and third expert therapy can provide useful insights with better help they make it easy to find an expert therapist who you resonate with and can help you provide these benefits that come through effective therapy also because better help therapy is done entirely online it's very time efficient and easy to fit into a busy schedule with no commuting to a therapist's office or sitting in a waiting room if you'd like to try better help go to betterhelp.com huberman for this month only March 2025 betterhelp is giving you the big discount offered on this show with 90% off your first week of therapy again that's betterhelp.com huberman to get 90% off your first week 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 um other factors so if if you would could you just just briefly walk us through you know this whole business of mineralizing a um and demineralization of teeth I find this so interesting and later I'll share a little bit um full disclosure uh I have a very complicated um oral health history um and had I known what you're about to tell us I think I would have spared myself a ton of pain potentially um I'm sorry to hear that but we'll we'll unpack that you weren't my dentist unfortunately no I have I have stories to share too we'll get we'll get to as well I think many people do and that's the problem um so I wasn't taught this in dental school interestingly enough so this is something I learned later um out in practice and um it's the concept that your teeth can naturally remineralize if you have a small cavity but let's let's start further back so your teeth are constantly going through demineralization and remineralization and this is very natural and anytime we put anything into our mouth besides arguably neutral water and this has to do with ph um so anytime we eat our mouth is the beginning of the digestive system so we release amase 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 leech out calcium phosphorus and minerals from our teeth um but the the concern is we don't want it to stay in that acidic state for for too long in that demineralized state for too long um 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 Stefon curve and um 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 mouths enough of a break enough of an opportunity to remineralize so many of us are staying in the state of constant acidity and demineralization um but what's interesting is so if you have a small cavity or or lesion that hasn't yet truly cavitated that 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 unquote 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 whole generally you do need some sort of treatment um but our body is meant to for stability you know it knows what to do but how you eat um 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 uh are not the same materials that are put into a lot of common tooth care products so uh without getting into a discussion right now about fluoride and water 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 toothpastes 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 you know so why would we give an artificial substance to our teeth maybe could explain demineralization remineralization in the cont TT of fluoride and these other minerals so we have hydroxy appetite which is essentially calcium and phosphorus in our teeth uh our enamel is about 90% hydroxyapatite the Dentin which is the layer below the enamel through the enaml is about 60 and our bone has hydroxy appetite too about 60% our our limb bones M all bone 60% hydroxy appetite yes which is calcium and phosphorus our saliva will also have calcium and phosphorus floating around too so what fluoride does is it it throws off the hydroxy group in the in hydroxy appetite and and so it changes it from hydroxy appetite to flor appetite so it restructures it a bit when it does this the bonds generally are considered stronger um and the dental crystallin structure is 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 Anor robes or pathogenic bacteria but it potentially could be damaging beneficial bacteria too um so that's why tooth 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 Denon it's closer to 6.5 so what fluoride does is it raises the the pH resistance I see so for people that aren't familiar with uh pH this a a measure of how alkaline or acidic a given environment or something is um and so what you're telling me is that fluoride makes teeth Ultra strong MH it's not a mineral that teeth normally see like if a child never used FL 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 hydroxy appetite to remineralize but we put fluoride in 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 crystallin structure can be more wav like and potentially the bonds could break more easily but generally you know topical flid does work 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 it's not a shoe 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 um in between me meals they're not eating if I just sort of naturally intermittent fast I generally eat my first bite of food somewhere around 11:00 a.m. sometimes a little earlier but um but that's just habit it sort of falls under this intermittent fasting kind of thing so I and many people have stretches of time of anywhere from 3 to 14 hours when we're not ingesting any food or caloric beverages is that when REM mineral remineralization occurs tricky word remineralization to do it remineralization right oh that's right you have put the accent remineralization thank you that helps um you said that before um thank you uh is that when our teeth repair themselves yeah that's this is great this is important so generally after you eat you know as I mentioned your your mouth will become more acidic um 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 2 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 your saliva if it's optimized and we should talk about that as well will be remineralizing but unfortunately I do feel so many of us are just not in Balance you know we're dehydrated we're mineral deficient we're calcium deficient we're phosphorus deficient um and we're mouth breathing so the pH is 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 fasting intermittent fasting or you know time restricted eating is a great way to combat dental decay it's also better on gut health um as well you know the migrating um complex the cleans 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 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 when I'm saying sugar I'm thinking about foods that taste sweet or that contain sugar that's masked by other flavors I just for 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 yes but um or we could just even say starchy carbohydrates fermentable carbohydrates is what I like to say that get kind 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 uh 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 flowers so the crackers the the bread good sourdough bread well the issue sour dough I like sourdough too the issue is more contact time so things that are really sticky and um 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 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 schmorgus board 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 hyper palatable 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 flour is kind of the Catalyst that feeds the bacteria to create that b imbalance is it fair to say I know you prefer the term fermented carbohydrates or um trying to for most people who don't think in terms of starches versus fiber simple although nowadays people are more versed in that sort of thing think of um 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 yes uh like a chip uh 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 material so it doesn't uh dissolve in the mouth and interestingly broccoli or Prebiotic fiber is what feeds the good bacteria so I work mostly with children now um and we can talk about why that transition happened I used to work with adults but um 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 um 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 hyperfocused 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 in 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 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 um and neither have my children just because I know there are other ways to prevent disease um 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 Etc 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 uh facets of A Clean Diet are through you know through your lens of you know what you consider Clean Diet sure so I'm not advocating for anyone diet and I do believe we're all different so it works for some people may not work for others but generally what I suggest is really high quality protein sources um a wide array of vegetables fruit I would arue you you should limit fruit potentially especially if you're a high Decay risk just because there is sugar fructose um but I don't want to villainize fruit there's so many healthy benefits the polyphenols and and everything in it so um uh not seeds olives pickles I love fermented foods for for gut health and then oral microbiome support too so essentially a whole food diet you know things that come from the earth and Le more from farms and less from factories things out of bags um 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 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 um having been involved in the public facing health education business for a little while now I realized that nothing that is um encourage 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 what I like about what you're telling us is that all the things of eating mostly unprocessed or minimally processed foods those are going to 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 on the microbiome at least in part uh but what makes teeth white and will supporting the oral microbiome make our teeth whiter yeah and by the way there are some folks out there whose teeth need to be less white in my opinion agree totally agree we're being somewhat factious but not really um but I think most people would like to have teeth that are would be uh characterized as mostly white yeah we want to look good I mean I appreciate and respect that I do think we've moved a little away from reality with some of that so I agree with you I think there's there are um teeth out there that could 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 crystallin structure in the mineralization so baby teeth are less mineralized and the crystallin 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 why you'll hear if you use hydroxy appetite or even coconut oil is changing the surface surface modification so it's changing the way light reflects and refracts off that tooth to make it seem whiter and brighter now certainly with adult teeth if you're using bleaching agents you know hydrogen peroxide or um my peroxide some of the stronger bleachings 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 trays essentially um I don't 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 very in a very limited fashion the only time I ever had a bad canker sore was because I gargled with um 50% water 50% Hydro hydrogen peroxide because an acupuncturist recommended it he looked at my tongue and then he said you should do that you know and then I did that and then you know four or five days later I had this like you know nickel sized canker sore on the roof of my mouth and I was like uh and um I will say and I have no product affiliation whatsoever but um to any any specific products but but by switching to hydroxy appetite containing toothpaste my teeth they definitely have gotten whiter I drink a lot of yeah yeram mate and coffee and um and I brush but that that was it it was a it was sort of a progressive issue of my teeth dimming um so that's been 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 um but since switching to hydroxy appetite toothpaste I had like Stellar um 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 um it just makes sense like biometic it it depends on how you look at life I think I prefer biomimetic materials personally it's again it's a personal choice but I agree with you my patients who have switched to hydroxy appetite and I'd like to point out not all hydroxy appetite 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're 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 um that I've been really struck by as the discussion around longevity seems more and more prominent these days is um occasionally I'll run into somebody who's in their 70s or 80s um 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 um I've never seen somebody unless they're doing something highly artificial with bleaching um 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 uh very opaque uh what is that is that a blood flow flow issue is it um what's going on there yeah it it can be a zero stomia dry M 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 um decades and Decades of coffee tea wine will do it too well I don't drink the wine but I've def had coffee tea since I was since I was a little kid I've been drinking B since was like five it's good yeah it's delicious yeah got to live life yeah but um yeah and so they're and they they're losing minerals too you know over time your teeth take a beating I mean they're we're living to be a hundred now that's a long time to maintain this non-shedding surface in our body you know so um and then it depends on the generation too but some some generations especially as you mentioned 70s ' 80s I'd wonder about tetracycline exposures when there's certain antibiotics that we don't use anymore that can um were known to darken the teeth which is why they pulled them from common prescription that raises a question I'd never thought about before so if one takes a course of antibiotics um typically the the advice is to um ingest low sugar Kucha have some Bulgarian or Greek yogurt like repopulate the the gut with healthy uh with the substrates for healthy microbiota um 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 in embryology you learn that we're basically born of a bunch of tubes that are kind of do their thing in development um but the digestive tract obviously starts with the mouth so is it the case um uh therefore that we we should be repopulating the oral microbiome if we take a course of antibiotics yes yes very commonly um 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 they they do take a high quality probiotic and increase their probiotic Rich fermented foods as well so a high quality probiotic pill yeah generally yeah cuz it's hard to get in enough especially in kids I would argue you know kids aren't usually eating a lot of Sauer cro and kimchi and Nat and but you know you could do kefir yogurt as you mentioned low sugar kombucha Etc but usually a high quality gut probiotic will have some benefit to the oral microbiome but they also do have oral oral probiotics too focus on the bacteria of the mouth what about mouth washes yeah um I've never liked them um they feel they burn MH for one and then I learned some years ago and this is just kind of fun to qu to years ago it must have been like eight 10 years ago I heard I think on the Tim Ferris podcast somebody said oh you know mouthwashes will nuke certain chemicals that are essential for cardiovascular function and so don't don't use them don't use Min 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 there's always you know there always um Delights me and scares me at the same time that many of the things that right now people go oh that's pseudo science I like creatine seems to be a big thing right now 10 years ago was only the gym gym rats that we're talking about now everyone's like creatine creatine everybody needs so uh 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 uh they generally contain alcohol astringents 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 you know get exposed to microbes and things um so we're carpet bombing the mouth what we've learned through the the data and you're right there are studies to show that chronic habitual use of these uh mouthwashes including prescription strength mouthwash like chlorexidine is a common one it can damage the uh nitrate reducing bacteria so we have bacteria in the dorsum of our tongue specifically that is essentially your tongue that reduces nitrate to nitrite which is a precursor to nitric oxide nitric oxide is a molecule that is really important for cardiovascular health and vasodilation and immune Health um 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 studies to show it can increase blood pressure and 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 peronal disease which is a chronic inflammatory um issue in the mouth which can have a slew of Downstream effects which we should discuss um in a bit um or do you have an infection it could be a sinus infection post-nasal drip do you have tonsil stones or tonsler infect 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 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 I'd like to take a quick break and thank our sponsor ag1 ag1 is an all-in-one vitamin mineral probiotic drink with adaptogens I've been taking ag1 daily since 2012 so I'm delighted that they're sponsoring this podcast the reason I started taking ag1 and the reason I still take ag1 is because it is the highest quality and most complete foundational nutritional supplement what that means is that ag1 ensures that you're getting all the necessary vitamins minerals and other micronutrients to form a strong foundation for your daily Health ag1 also has probiotics and prebiotics that support a healthy gut microbiome your gut microbiome consists of trillions of microorganisms that line your digestive tract and impact things such as your immune system status your metabolic Health your hormone health and much more so I've consistently found that when I take ag1 daily my digestion is improved my immune system is more robust and my mood and mental focus are at their best in fact if I could take Just One supplement that supplement would be ag1 if you'd like to try ag1 you can go to drink a1.com huberman to claim a special offer they'll give you five free travel packs plus a year supply of vitamin D3 K2 with your order of ag1 again go to drink a1.com huberman to claim this special offer today's episode is also brought To Us by ju ju makes medical grade red light therapy devices now if there's one thing that I have consistently emphasized on this podcast it is the incredible impact that light can have on our biology now in addition to sunlight red light and near infrared light sources have been shown to have positive effects on improving numerous aspects of cell and organ Health including faster Muscle Recovery improved skin health and wound healing improvements in acne reduced pain and inflammation even mitochondrial function and improving Vision itself what sets juv lights apart and why they're my preferred red light therapy device is that they use clinically proven wavelengths meaning specific wavelengths of red light and near infrared light in combination to trigger the optimal seller adaptations personally I use the juv whole body panel about about three to four times a week and I use the juv handheld light both at home and when I travel if you'd like to try ju you can go to juv spelled jv.com huberman chuve is offering an exclusive discount to all huberman lab listeners with up to $400 off ju products again that's juv spell jv.com huberman to get up to $400 off okay so those are some don'ts what are some things that we can do to improve the chemistry of our saliva and our mouth and um just to in full disclosure here uh won't be the disclosure most people are are anticipating what I'm trying to get at here is all the chemical aspects of the chemistry of the mouth like um 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 out here and I'm trying to figure out you know how could I have um the best possible saliva yeah I want to be the person with the best possible saliva good spit don't underestimate your spit um it's true it's the golden Elixir so if I were to put spit into like a uh under the microscope or and then also take some of my spit and put it in MPC and separate out all the goodies that are in there just give us a a sense of the kinds of of goodies that are in spit cuz 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 um bacteria viruses Fung fungi like all kind protozoa hopefully in the right ratios um so we want beneficial bacteria you we all have about 5% pathological bacteria however at that ratio it may those may not be pathological like they they're symbiotic at that point we are still unpack talking and learning more about the oral microbiome but essentially you'll have bacteria um there's hormones there's free cortisol hormones cortisol is in our spit folks yes absolutely there are enzymes to aid in digestion there are immune cells and there are minerals floating around too so um 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 if you've undergone cancer therapies and things once you get zero stoia 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 um I would argue we aren't get enough minerals either so you know I 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 ropy and mucousy they're dehydrated if it looks like water it's healthy um this is without any tests so put a pinch of salt in in your water or some electrolytes that can really help with bioavailability and absorption how you're breathing is incredibly important too for your salivary health so if you're mouth breathing you will have less saliva you know your mouth's going to dry out the pH will drop um and you're going to be in trouble you know dry mouth leads to cavities dry mouth leads to gum disease um so and then the foods we eat of course too we want to have a mineral Rich diet so many of us are mineral deficient or magnesium deficient we're fat soluble vitamin deficient particularly vitamin D3 K2 so I think it is good I like the idea of test don't guess you know um if you have the capability to work with a a doctor to see where you are with some of these these things to know if you need to supplement or not or how you can change your diet sorry interrupt but would would I test my saliva specifically is there a good saliva test out there that would be a different test this would be more of a blood test a standard blood test standard blood test but there is salivary analysis and we should discuss the importance of testing your oral microbiome um 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 are working toward I do salivary analysis and biomarker Analysis in my practice we can tell a lot through a patient's saliva and what ratio and types of bacteria are there um 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 and how oral bacteria specifically pathogens can contribute to Alzheimer's and Dementia infertility 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 want to um not just double click but really dive into that no pun intended um I do want to just ask because a subset of listeners will be interested in how they could get their saliva tested yes um 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 um massive amounts of yamate and and small amounts of coffee um I've made an effort to well I switched to a hydroxy appetite containing toothpaste um which has been horrific for all sorts of reasons I've um 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 um and the healthiest my breathing and cardiovascular function ever was uh for me was when um something I don't suggest people do unless it's their profession I was uh boxing for about a 5year span and I had a fitted mouthpiece and I would do my running my road work with my mouthpiece in breathing through my nose um and that taught me to like really how to breathe correctly through my nose and it translated to switching to nasal breathing when I slept I didn't sleep with the mouth card in um but I think that breathing through the nose is just so important for the reasons you're describing James Nester has described and I will share this little factoid and then I and then I'll um then I'll shut up and and nasal breathe um a friend of mine who is 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 I've worked with that population doesn't actually deteriorate the teeth it's the fact that they're they're they're mouth breathers and so I find this fascinating and then of course the book Jaws which was published by Paul erck and Sandra Khan 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 breed epidemic of you know fear-mongering well it is we now know this is a real thing it's an epidemic so um so how do you encourage kids and adults to switch from mouth breathing to nasal breathing yes this is a big part of my practice so it you 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 breathe through their mouth I personally think that's an underestimate with what I'm seeing in my practice um so why is this so the theory is um that ancestrally we used to chew and masticate up to four hours a day this active chewing uh it pushes forces out it was actually what grows the face the lateralization of the tongue the tongue elevating it would grow the Jaws wide the sinuses wide including breastfeeding okay we now Flash Forward 10 12,000 years okay so we had the Agricultural Revolution we went from hunter gatherer Society to agrarian then the Industrial Revolution we started milling and processing everything everything's 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 um I was so worried that it was true and here we are they slurping their food lying on recliners theyve outsourced pretty much everything yes yes so this is gener many generations of this happening we're essentially shrinking James now um phrases it 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 DC 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 hased happen 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 you know and it's obstructing us so there's so much sleep disordered breathing um disregulated breathing and sleep apnea now that's not getting diagnosed so if we look at children early and they come into me and I can I can see it as they walk in they generally will have forward head posture because they're trying to open their Airway okay forward head posture they have dark circles that's called Venus pooling that's a sign of inflammation secondary to mouth breathing um 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 Scara the white of the eye they just look con gasted and and sick they they just and their mouths 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 pallet um this the position of the Jaws you know is your jaw set back is it forward like a bulldog um and do you have a deated septum you know they they estimate um 75% of humans can have some sort of deviated septum and people think that's ridiculous it's not just from getting in a fight and getting your nose broken so think of it this way if your pallet is narrow and I smooshed your face like this the septum has to go somewhere and so it will can't okay so that's what creates the deviated septum and so if we expand a face and this is what early functional orthodontist 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 enlarg adids enlarged tonsils um oral motor dysfunction low tongue tone low low tongue positioning too how much plasticity is there of the sinuses so let's say um somebody has a partially or severely deviated septum and they they could get surgery and I want to talk about some of the different surgeries there's a um a balloon uh expansion thing that online it looks really cool I like want to try this I really want this to happen to myself yeah they put the balloon up there they inflate the balloon it's guided they do one that's guided they numb it and then they take it out and you know this kind of thing well is actually the appropriate way to do it both in and out through the nose but um if somebody makes the effort to nasal breathe so maybe they mouth tape at night or um 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 a n 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 um so this isn't about a product per se but if I force myself to nasal breathe uh during cardio workouts especially kind of zone two zone three stuff translates to less mouth breathing and snoring and sleep so the question is is do the sinuses actually dilate or if you have a DV8 septum do you need it surgically or somehow other otherwise repaired it depends on your age so most facial development is done around the age of 10 so the 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 can't control the the modeling of the face the midface the Jaws which is why we now are starting with um functional therapies as young as three or four years old with retainers so in the middle of our palet 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 it improving Airway but the teeth will come in straight now they have room the reason they come in crooked is there's not enough room for them to come in it's important to note the floor of the mouth the roof sorry the roof of the mouth is the floor of the nose so if you expand the pallet the sinuses will get wider the septum is going to Upright everything's connected now as an adult um you it's really hard to manipulate bone structure just through posturing and habit there are myofunctional therapists which I 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 um if you don't use it you lose it so if your 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 you usually you need some sort of intervention you're not going to just be changing it through lip taping or how you're training or myof functional therapy and there are more conservative ways now besides true jaw surgery there's um an appliance called the homeoblock which I know is what James Nester used you can read about it in his book that will actually start to to change facial structure there's less invasive treatments there's an msse appliance it's a Max maxillary skeletal expansion device it it does put these little mini screws in your palette 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 I 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 in for great yeah I'm measuring deep sleep and REM sleep through the eight sleep or Loop or both um my deep sleep is great provided I get to sleep by about 10 10:30 because that's when you capture the Deep when I capture the Deep Sleep window if I go to sleep around 11: or midnight I lose out on some deep sleep even if I sleep longer yes um 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 studies that showed that if people either mouth breathe or nasal breathe in a laboratory study um the nasal breathers have better memory recall um but those were of odors so everyone said well okay 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 uh you think better your cognition is better your memory is better for everything just odors so you get 20% more oxygen when you nasal breathe and this is really important for children in these formative years of brain development and this is why we're seeing studies um showing that children who mouth breathe have sleep disordered breathing they they have behavioral issues and many are getting diagnosed with ADHD and um arguably potentially put on medications when really if we'd screened them for Airway issues potentially we could have avoided some of this and and it also has to do we're not getting into deep sleep the glymphatic system is not kicking in hormone functions not kicking in so a lot of these children um growth hormone is impaired anti-diuretic hormone is impaired if they're not getting into deeper Sor of sleep so this is why we see bed weding um some signs to look for in your partner or your children is tossing and turning clenching grinding snoring or noisy breathing um sleeping in really odd position like craning the neck cuz they're trying to open their Airway um spinning around the bed you know the child's legs are in and the B's like out of the bed the bed sheets are everywhere and then certainly waking up unrested and then noticing behavioral issues too all you have to do to convince the uh male half of the audience to um focus more on nasal breathing is to tell them and to not use mouthwashes is to tell them that um being a mouth breather will uh uh give them sexual dysfunction um or will will uh predispose them to sexual dysfunction and they'll start U working on their nasal breathing because of nitric oxide because 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 wow so so no bleeding gums we do not want infl blamed bleeding gums um flossing is something we haven't touched upon yet but it's incredibly important not only for cavity prevention but gum health um 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 um please take your gum health seriously if for nothing else and for your sexual health great message so to shift over to nasal breathing if somebody's really struggling with this do you are you a fan of mouth taping yeah you want to make sure you can do so safely so with kids I always suggest they get screened by an airway focused dentist um or potentially an oenologist or an ENT um for adults there is a test that you can do um it's the three minute test can you breathe through your nose without panicking or feeling sympathetically challenged for 3 minutes so you can either put water in your mouth put a piece of paper tape tape your lips and literally time yourself um 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 that are open in the middle so you can still off gas or you feel less it feels less invasive um 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 2 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 I do see it with my um my wearables and my sleep data recently I had the privilege of giving a talk at Stanford with uh Renee Fleming it's like one of the world's greatest opera singers alive today and I said what are some things that you do for your breathing because I end up talking a lot for the podcast and she gave me some um lung and diaphragm strength in exercises but then the one that she uh suggested for emphasizing nasal breathing because there's a lot of nasal breathing that's done quickly and subtly um in order to maintain air air pressure in the lungs and for her craft which I know very little about but is instead of like doing weight training for the neck it's kind of a fun one it doesn't make the neck big so people um will who don't want a larger neck will appreciate that but the 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 cuz 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 oh for 15 seconds per side interesting and she said it builds the the muscle the the mus 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 yoga move too yeah so and you're just like really like lip smack as if you going to kiss this guy from side to side 15 seconds per side a couple times per day or just whenever you remember it and I mean her voice is amazing like her speaking voice and her uh posture and everything so um 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 orthodonist the ENT that's a lot just the just the scheduling of that alone makes me want to take a nap but it is it's a it's it's a lot to unpack Airway issues if parents are out there there's two books three I'd recommend if you're very interested in this since it impacts so many people certainly Breath by James Nester Jaws as you mentioned by SRE KH and um sleep wrecked kid by Sharon Moore if you're a parent what's the title again sleep wrecked kids sleep wrecked W E Sharon Moore um so it will just help you screen and understand why we're worried about these things more um but yeah I we can't overemphasize Airway Health um especially in our children you know and catching it early and intervening early is really important great um in trying to maintain Airway health and healthy saliva and now I'm obsessed with saliva I 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 um skin microbiome we know that um you know women go to an OBGYN they they get path smears they get a you know I mean they we know if you ever raised a kid or change diapers you you can tell a lot about somebody's Health by the fluids yeah they Emit and that they have within them I'd like to play salival on the list of critical things to pay attention to but gum is this good for our breathing and for our saliva or not um I I not a big gum chewer but um is it good bad neutral yeah I think it's time and place can be very beneficial so where I like it um is if because I will say hey parents you really need to avoid crackers and chips and granola bars and they sayh do I feed my kid you know um so if we' missed the window of of how to introduce food to children or they just favor those type of foods what's a good strategy if you're out on the go to minimize Decay risk and increase salivary Health choose some gum particularly Xylitol gum because xylol will inhibit bacterial proliferation um it will reduce strep mutans which is the bacteria that causes cavities um big fan of xylol 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 you know Mastic Gum I always get asked about that you can overdo it you know I worry about Temple mular dysfunction I have bad experience with mastic gum I was buying it I love the kind of the the um primordial aspect of it's like a it's like a tree sap that you chew on it comes in this beautiful paper package and you know no plastics or anything you get it going in there and you feel like you're really like working it the same way my Bulldog costell would like work he to like teeth on like bricks and like he was just and you feel great and then all of a sudden you'd go and your jaw would kind of stick and then and then later you like w like my jaw really hurts or you feel something pop up in your joint pop and yeah it'll give you that you know these days the the in the young influencers are so obsessed by this it'll give you a little bit of a golf ball um hypertrophy of your jaw that's not why I was doing but um 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 picture I mean how many of them go on the disabled list because they're overusing their shoulder it's 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 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 in place too so especially from a a cavity standpoint or um hydration you know increasing salivary flow but just I would just chew it for a couple minutes throw it out you don't need to be chewing it for an extended period of time but chewing food is good yes yes thank you so the issue as we mentioned is you know we are slurping and smooshing our food I don't I to me almond butter is like never existed in in nature like the idea that you would take like I mean almonds are so delicious right but that you would like like grind them up and put them into a paste like to me that the texture is so aversive you do that in your mouth you're supposed to do that through chewing just the fact that like you peanut butter like to me these things make no sense whatsoever Yurts and app sauces and fruit snacks and baby food baby food for animals and people without teeth exactly so I'm not advocating in one camp or the other can be a mix but you know there's there's blended food that's offered or you can do more of a baby Le weaning which is eating more real foods obviously please be smart about this don't give 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 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 chicken nuggets and french fries and yeah we need to chew when really asked what's gone on with the airway why does everyone why your face is shrinking it's chewing we've lost chewing and then arguably breastfeeding too we've moved away from exclusively breastfeeding too what 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 down I think it's making a Resurgence and a lot of people though are doing a blend you know we do what we what we need to do I mean a lot of women are working and so it it's important to know if you're not able to breastfeed or it doesn't resonate with you or you are working and having a pump that there are fixes 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 they're nasal breathing and we're breastfeeding we it's hard to combat generations and generations of dis Evolution essentially so a lot of human are needing intervention now I'd like to take a quick break and acknowledge one of our sponsors function last year I became a function member after searching for the most comprehensive approach to lab testing function provides over 100 Advanced lab tests that give you a key snapshot of your entire bodily Health this snapshot offers you with insights on your heart health Hormone Health immune functioning nutrient levels and much more they've also recently added tests for toxins such as BPA exposure from harmful Plastics and test for P fases or forever chemicals function not only provides testing of over a 100 biomarkers key to your physical and mental health but it also analyzes 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their scientific Advisory Board and I'm thrilled that they're sponsoring the podcast if you'd like to try function you can go to function health.com huberman function currently has a weight list of over 250,000 people but they're offering Early Access to hubman podcast listeners again that's function health.com huberman to get early access to function 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 in science and medicine there are Direct effects like this mediates that and then there are indirect effects you know like if fire alarm goes off in the middle of the night your sleep isn't good but fire alarms don't regulate sleep they just can mediate they can modulate your sleep but my understanding and I'm not 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 you know oh you broke your ankle so you move less you move less your heart gets less healthy your heart gets less healthy your brain gets less healthy this is the kind of point I'm trying to make but that there's 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 dpois or oral pathogens um 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 not about 80% of the global population suffers from some sort of gum disease that's huge you know and um about 10% of the the population will have severe periodontal disease which is chronic bone loss tissue loss and this is where we get tooth loss too so gum it's a 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 this these are the five bacteria that most influence gum disease and disbiosis um that can affect the heart and other organ systems the big contenders pin jaalis f nucleatum um T dentac Cola um there's AA um and then strep mutans too um is can affect the heart as well but why do these bugs how do they get where where these other organ systems are and what are they doing so I like to term this leaky gums so we've all heard leaky guts MH so let's say we're just in disbiosis 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 now have created a 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 so um an inflammation okay and then also these bacteria release endotoxins okay they can create cyto kind 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 um 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 um fertility is 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 um 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 um then they their fertility conception improves by 70% that's significant you know yeah and it's not only gum disease but just any oral infection and P and jaalis is being linked to Alzheimer's and Dementia you know these bacteria end up in the brain they cross the bloodb brain barrier and they create amalo plaques and inflammation in the brain and so there's 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 pin jaalis 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 pin jaalis so there's a lot of Association and links right now um 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 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 coloral 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 uh I sorry to interrupt I must say I've had a couple 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 cuz it was precancerous procedure yeah if they catch it early enough it goes anterior to posterior and if if you catch it early enough they can um Lop off the anterior portion the Whipple procedure as it's called but even a colleague of mine um a brilliant um uh bioengineer um few years ago who had the Whipple done and he was progressing well and and then he passed away about a year and a half ago yeah pancreatic cancer is don't want it no joke and um so if you could just test your spit yeah you know it's a simple test it's a and I we I can give some of the tests that I like in the show notes but you just spit into this little vial and mail it off and then they send back your results with you I mean that's pretty amazing 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 virulent they're spet so they're cork screw 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 an amoxicillin um type of blind that they'll use okay radical idea that's going to get me in trouble with my more um Natural Health audience but I speak to those are there more pharmaceutical more nothing don't take anything um what is the argument against once every three years as a healthy adult doing a round of of uh antibiotics to kill off um unhealthy bacteria replenishing the the microbiome and various tissues preventatively yeah just preventive like like kill off what might be living in the mouth might kill off what might be living in the prostate I learned recently that you know the prostate doesn't have its the same sort of immune system protection and so a lot of men you know while they don't have UTI they they have a prosti and they basically just need to do a 21 day or 31 day round of antibiotics and everyone will be like oh you're you're spreading meras with that or something no but um you can uh protect against a number of different cancers related to the prostate and things like that why don't um 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 the gut in the oral microbiome than one might think um I like less is more approach I think there's better ways to kill off bad things like ozone Therapies being used a lot I use ozone in my office tell me more about ozone so ozone um it's 03 okay so it's a very unstable molecule I use it in gas form or water you can use it as an oil it's carried usually in uh 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 um and peronal pathogen but then also under fillings or under sealant 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 um 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 um very localized I got to try this but um what's the deal with with people swishing olive oil and and um oil pulling I know this is big in some of the um I don't even know what to call anymore what's what used to be alternative and it's now mainstream it sounds like music in the 90s right um Indie Indie medicine is now mainstream they sold out right like the the um I'm just joking folks but not really um it's there's so many mimics between the the Health Arena and kind of music and art like what used to be Niche becomes trendy and then becomes mainstream everyone's cool with it now yoga breath work uh resistance training used to be Niche um swishing olive oil spitting it out acupuncturists love this um alternative medicine types like this um is there any truth to it does it relate to Ozone it can so you can find ozonated oils on the market um for oil pulling so this is an ancient aric practice going back to Ozone though just killing off mot toxins and bacteria this can get kind of controversial but a lot of natural paths will use um gas ozone either rectly or they'll use that IV too you have to go to someone who knows what they're doing re ozone yes to get all the way up to the oral microbiome no it would affect more like the gut area um the pancreas the liver Etc it's it's used a lot with mold um elimination Moto toxin elimination you know I get a lot of questions nowadays about U 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 uh toxicity because of a lot of new Building architecture they say a lot new building cold the heat cold variation and the moisture I don't know I don't know if this is true or not but you know the last thing you ever want to do is tell somebody who thinks they have something that they don't and I'm I'm not saying they don't I I just I hear this a lot I've known a number of people that have left the City of Austin because they couldn't deal with the mold interesting mold that can be scary I mean it we see it affect the teeth the teeth will just start degrading too and some of kids who have tested really high microt toxins so rectal ozone yeah Wild Well Hey listen it's the digestive tract I mean you know we're a health science 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 Arabic practice it used to be with sesame oil more people do it with coconut oil now um I oil pull a couple times a week occasionally so what is that pract look like so I put a spoonful of organic raw coconut oil in my mouth let it melt and just swish it around as I'm you know dottling around nasal breathing yeah don't spit it into your sink it will clog your sink spit into the trash can um so what is it doing well it's dislodging the bofilm as you're switching okay lauric acid which is in coconut oil is antimicrobial um it can help with um lymphatic stimulation and and um has some anti-inflammatory properties too and a lot of people report makes their teeth look brighter and whiter I mean you do have great teeth well I'll tell you the story why Ian 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 really nice teeth they're not real I had facial trauma should we get into that yeah let's get into that so when I was 10 it's why I became a dentist when I was 10 um I was my I was trying to gain the attention of my older brother's friends who were very into dirt biking and being MX 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 my bike and landed on the asphalt in a vault and knocked out my teeth and I broke my premaxilla and you can see this car 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 theater kid I loved working with my hands um But as time went on I thought well gosh I don't want to be sleeping on couches in New York City I need to make sure I make a living what am I going to do and I really love science and I thought well how do I work with my hands and it was dentistry and Dentistry can be a little creative and artistic too so these are not real but thank you oh well you're welcome and thanks for the full disclosure they look very natural unlike some people's falsies you know or whatever what do you call them I I call them them FAL cuzz like cuz I've got half you know I've got a tooth that was kind of chipped in half from from getting hit honestly dumb you know if you're going to box make sure you're getting paid a lot of money and you wear mouth guard yeah and wear a mouth guard there they're better martial arts where you can go full uh 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 um support boxing but I remember the movie rad I remember the back flip at the end I remember thing I was I think I was trying to do that I don't know what I was doing anyway didn't land it yeah well you landed it but on the wrong but uh so this is a bridge you can get implants um people have flippers we were talking about hockey players earlier they you'll see them flipping their flippers around with their fake teeth so a flippers a retainer with fake teeth on it there's a 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 so that's cool I wanted them to look not quite as contrived I suppose well they look very natural and uh thanks and today we're learning all the ways in which teeth are just part of this whole ecosystem that's so critical I have to ask and we will come back to some um things related to um avoiding really horrible diseases by way of taking better care of one's um oral health nicotine these days everyone knows or should know that smoking vaping dipping and snuffing and yes I did say vaping are all terrible for your health the vapors will say it's not progenic um cancer-causing and I'll say remains to be made really clear but the whole popcorn lung thing is clearly problematic um but nicotine doesn't cause cancer it's the delivery mechanism yes but these days a lot of people realizing the cognitive uh enhancement if you will I don't even like the phrase uh the stimulant effect of nicotine are using nicotine pouches and particular gums um let's set patches aside for the moment um 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 uh 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 um nicotine is a Vaso constrictor what does nicotine do to the oral microbiome are you going to make me quit nicotine I'm I don't feel addicted but every addict says that so yeah the first step is admitting the issue um so I don't want to villainize anything no you can villainize it 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 um 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 um and then I have colleagues who are reporting this all throughout the globe but they one brand in particular it will have man and maltodextrin in it which are sugar alcohols and different carbohydrate and they Market them as sugar-free well products are allowed to have Trace Amounts of sugar still in the product very small amount and still be called sugarfree 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 the cellular um structure up in that area so you can see luopa which is like white patching which can be precancerous so this is why I just like everyone to get checked out and we are seeing bone loss and gum recession um again anytime you put put anything into the mouth it's going to change and shift the microbiome and that could be a filling that could be a piece of gum that could be a toothpick anything you know arguably besides neutral pH water um 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 checkups 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 going to choose to use these I just say know the risks and make sure you're going to checked regularly at your dentist don't just ghost your dentist um because if if they're starting to see cellular changes recession or early Decay then you may say gosh I should really cut back on this or maybe they if somebody is really adamant about taking nicotine they should just take a milligram or two milligram pill of nicotine yeah or a patch right you scared me with lucco plakia yeah cuz growing up we were all told you know don't no one really dips in in Northern California but um you know like don't dip or uh because and then I saw these pictures of luia jaw recession and it's pretty vile and and so you the design to scare you it scared me sufficiently I never wanted to chew tobacco uh anyway but good to know uh coffee are you in do I need to stop drinking coffee okay thank you you're from Portland after all or near Port say that okay yeah you wouldn't be able to return home coffee is great I mean it will dry out the mouth a bit just counteract it with hydration and it will stain in your teeth so go in regularly for cleanings and you may want to I mean if if that bothers you um there ways to bleach your teeth or lighten your teeth hydroxy appetite is a wonderful way to improve the brightness and whiteness of your teeth and oil pulling as well um or you can use heavy hitter bleaches to just just don't overdo it everybody's overdoing everything now and bleaching too much can damage your teeth it can cause um chemical harm to the 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 like bleaching all the time the people who you need sunglasses to look at their teeth and it's just not really a natural aesthetic but some people are into that but just know what the risks are is what I would say the two things I've done in the last couple of years that have completely transformed my um oral health say says my dentist and um and how I feel are first of all I start 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 going to do it so I eat meat fish eggs you know fruits vegetables and I eat some rice oatmeal and um sour a good sour dough bread butter olive oil I just 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 I hear you and what was interesting is I used to get a lot of tarar buildup a lot um despite brushing and flossing on the um what are the lower front teeth called in sizers yeah and it was and they scrape it away it's a non-issue now like it's completely gone yeah so we have minor salivary glands on the floor of our mouth and that is a common place people will see calculus or tarar those lower teeth that's where you'll feel your hygienist 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 um I switched and I have just full disclosure because there's nothing to disclose I have no Financial relationship to the toothpaste that you make or the toothpaste that they um that Gator dentists makes I don't know who I actually know his real name but he hides as Gator dentist um Gator dentist uh but I switched from fluoride containing toothpaste not because of fear of fluoride but excitement about hydroxy appetite so I switched to using your toothpaste and I occasionally well I routinely switch back and forth with knobs or I think it stands for nobs which is Gator densis uh to tablet product yes so I use them and no neither of them pay me I pay full price um I don't they don't send it to me I purchase it like anyone else and that's made a tremendous difference says my dentist like no cavities whatsoever I was constantly battling this when I was a kid had 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 um my teeth and oral microbiome never felt better um it's it's just remarkable yeah it's just remarkable and I have a family member who has some um gut issues like just digestion issues and it's unclear what's going on there and um I'm inspired to try and help them address that through the oral microbiome by switching to hydroxy appetite and and um and test oral microbiome that'd be very interesting to know what's going on in there cuz think you're swall sorry is there a Best test um like if because a lot of listeners are going to say okay I want if if they have the disposable income they're going to want to test their oril microbiome yeah is there one that your office uses or that I use either the silha test which is more just biomarkers so it's how do you spell that s i l l ha a this is done in an office it's just testing basic biomarkers so I use it a lot as an educational tool it will show um the pH the acidity if there's glucoside 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 swap um spit spit so kid or adult will spit in yeah kids usually won't spit till about four just physically it's hard it's hard okay anyway um but I really like tests that use shotgun metagenomics because you're looking for the whole array of bacterial DNA um 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 and in their home so bristle um is a company that people can it's 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 cuz some of the audience will I am actually yes that's fine oral probiotic um we have a collaboration with their oral probiotic but regardless if it's bristle or not you look for a test that's using shotgun metagenomics shotgun metagenomics yes um 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 parodontal 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 um it's called again it's oral DNA and I have no affiliation with oral DNA great thank you for that um I think people some people want to test their oral microbiome um and and other things in their in their and there's more and more popping up like if the oral microbiome is really blowing up so for those who are looking for investment opportunities I'd say look toward the oral microbiome it's kind of what the got 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 you know consider a hydroxy appetite containing toothpaste instead of fluoride which brings us to fluoride let's talk about fluoride I've already been accused of being a sunscreen denier no I actually believe that sunscreen exists I do occasionally use zinc oxide sunscreen a little bit I prefer physical barrier because I'll wear a hat or something if I you I don't tend to burn very easily but if I feel like I might burn I use a physical barrier um I'm being somewhat factious here because people will say all sorts of things but um I did an episode about water a little bit about oral health Al certainly not the depth uh or expertise that that you're providing today so thank you and I said yeah fluide 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 me they put these like a 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 I it was probably six or seven so I drank it I just sucked it up drank it down turned around barfed all over the wicker chair oh my gosh fluoride's a poison but everything is a poison at high concentrations so most everything is a is a fluoride is a poison excuse me high concentrations so I don't have anything against fluoride but it is a 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 this is what I have issu like people say oh going through the X-ray machine no big deal but what if you fly 150 times a year yes is it cumulative and so like the logic of the the sort of push back from the traditional if I will uh Community sucks like they're just not logical these are my colleagues sometimes too right just you go to the dentist you get an x-ray they're like running behind the the next wall put you in a Le shield and then they're like oh no it's no big deal well how many you know know maybe how many times a year can you do this before it becomes a deal so my question is what is the rationale for putting fluoride in water in drinking water given that the contact time in the mouth is so short and then what 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 hydroxy appetite 60% I think you said 60% your bone minerals are made from hydroxy appetite fluoride infiltrates the minerals of the teeth and replaces it so is fluoride going into our bones skeletal fosis okay so I'm not trying to paint a scary picture here but but frankly and people can probably tell my blood pressure goes up a little bit when people say oh you know you're anti fluoride I'm not anti fluoride but I just don't get the logic 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 poor populations don't have uh 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 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 well I appreciate that and and I'll take the heat I 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 so and I haven't had a cavity for multiple decades and haven't used fluide and Portland isn't floridated Portland is not floridated not so let's talk about so fun story uh back in 2011 2012 I was working on the proat floration campaign volunteering in Portland picketing and handing out educational Flyers um because I thought we needed it in our water and this is because that's how I was trained um and I just never questioned it I never picked up a journal to look at the other side I thought anyone speaking out against water floration that's the tin hat Brigade that's the woooo caucus all the things I was that person the woo woo that's pretty funny I like that so I went to a debate um in Portland Pro versus against I don't like those terms but it's just the easiest way to describe it and I was sitting kind of on the pro side and just waiting to see these pseudo scientists come out to to speak and I was so profoundly impressed with what they said and also had no idea that there were any concerns with with fluoride I had never been taught that in dental school the endocrine disruption the neurotoxicity um this the skeletal fosis I knew about dental fosis 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 H holding and it there's so much literature and this again this was quite a while ago um and more and more data in literature is coming out to question the practice so it's important to go back to the history of water fluoridation I'll try to be brief but in the early 1900s there was a dentist in Colorado Springs Frederick McKay who noticed his patients had modeled um brown spotted teeth but they were really strong they weren't getting Decay and so this kind of spread and they started kind of trying to understand the why and they realized there was a really high concentration of fluoride in the natural water supply that this community was drinking and this just kind of spread like wildfire with very little evidence-based medicine to back it because this was in the early 1900s now it was like the 1930s um so no long-term safety studies or efficacy studies and it was put in as an experiment in gr rapis Michigan in the mid-40s after about a decade or so they noticed that carries 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 floridated so the pro Advocates if you will will say it's the greatest Public Health movement of the the century because Decay was such an issue it's important to know 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 you know 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 you know the fluoride ion um Can interfere with iodine um uptake and again skeletal fosis neurotoxicity Etc so about seven years ago um there there was the PE there's a federal trial in Northern California but it was Federal the people versus the EPA it was a Taska trial and this has been ongoing for the past seven years and basically they were saying where is your safety data EPA on the longterm term effects of water fluoridation so the idea was that if we put it in the water it's not a very efficient way to get fluide to people but eventually it may 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 anamal 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 um and we do know fluid 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 okay but this is the easiest way to get fluoride to the masses because carries 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 really see dental decay in humans until the Agricultural Revolution the Industrial Revolution and now the alter 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 and live people skeletons and dead people uh from dead people that um died prior to 1900 how are their teeth 1900 they still have they would have Decay but if you looked at about 10 thousand years ago um very little you know unless they lived in an area with a lot of fruit abundance or honey like where are you getting your sugar from you know and you go pick some berries on a bush you're competing with the animals and the birds you didn't have much opportunity to overc consume sugar um 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 's talking about you know we're just saying let's slap fluide 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 um do uh judge Edward Chen was waiting for this National toxicology programs report which was under the Department of Health and Human Services and this is it reads like a soap opera to be honest with you um and it kept getting delayed and 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 um and so with that he he took this information and he made his ruling now this was after years of expert testimonies as well okay um 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 I mean it's this is very new and EPA you now need to fix this you need to regulate this better what people will argue is a lot of the studies they were looking at that are showing lowered IQ in children or neurocognitive issues it was at 1.2 or 1.5 milligrams per liter of you know um that was the concentration the United States we now do 0 .7 milligram per liter but what this that's per liter okay so how many liters of water do you drink a day this is the controversy so for example the American Academy of Pediatrics generally recommends pregnant women drink 2 to three liters a day um you might be cooking with fluoridated water making your pasta making your soup um 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 um ssris and pyc a lot of these have fluoride in them really yes Ultra processed foods will have fluoride so the factory that's making your Rockstar Energy Drink or your high SE or you know whatever you're consuming they're not do 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 um they follow there's many studies now but a famous one was the Rifka green study out of Canada and they followed about 520 mother child pairs um they tested urinary fluoride and the mother per trimester averaged it and then followed these children to the age of three or four and did IQ tests and found that mothers who had higher concentrations of urinary fluoride the children tested lower on their IQ test up to five to seven points and that's on par with lead 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 Jamma Pediatrics okay and this is very controversial for these editors to be putting out by the way so I commend them um and also a Cochran report came out Cochran 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 quar 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 um 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 and now it's everywhere we get fluide 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 fluide varnishes um 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 derivatives and it's what makes them so sticky yeah I I still loathe going to the dentist I I think it's because of that that um 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 um we you know the American Dental Association the American Academy of pediatric is doubling down and saying we have to put fluide in the water and for nothing else I think it's important to know 97% of the world does not fluoridate their water this is a very United States controversy um 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 and what's really causing Decay and also made fluide toothpaste accessible and I have Dan relatives they have very nice teeth if you told me that there's no fluoride in the drinking water in England I might um I might uh be like well you know sorry my English friends but that's the stereotype right that their teeth are bad I don't think that that's true any longer I think that that uh was true at one point that I think they're crowded and crooked too and a lot of that has to do I think with facial development as well I think we're we're we see a lot of um Western European they do have that kind of dis moric face if you will probably from nasal breathing who knows why Industrial Revolution allergies belth breathing Etc why did it why does it seem more prevalent there um so that's this that's the 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 fluide you can go out to the store I mean you can get fluide toothpaste at the dollar store now they give it out for free at many clinics um to me I just think it's a it's a medical ethical issue where'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 floridated areas versus those that don't can 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 it cavities wouldn't be the top disease in our country and our children and many worry well if we take it from the water Decay may go up and it may I mean there's been they they did this in Calgary Canada where Decay rates went up but 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 um 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 I think that should be an individual Choice are you for 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 the data that um show deficits on par with what one sees with lead exposure that's the most striking yeah 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 a brain we have one shot to grow a faith you know it's really important 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 um you pointed out a number of um logical flaws in in just the the way the whole system is is um arranged right now which is this um Mass uh treatment of everybody with a with a potent chemical especially given the amount of water that people drink and cook with Etc um without their consent and um and without a risk assessment so you're a low Decay rate I might be a really high Decay rate you you don't need anything extra your diet your balance your microbiome's great I'm not eating well my hygiene's terrible you know we we can't just blanketly be treating everyone the same we're supposed to be doing risk assessments I'd like to to take a quick break and acknowledge one of our sponsors element element is an electrolyte drink that has everything you need but nothing you don't that means the electrolytes sodium magnesium and potassium all in the correct ratios but no sugar proper hydration is critical for optimal brain and body function even a slight degree of dehydration can diminish cognitive and physical performance it's also important that you get adequate electrolytes the electrolytes sodium magnesium 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sample pack okay so I think that pretty much puts fluoride in a not 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 two 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 um blue versus red left versus right thing we're never going to get to the heart of the matter um yeah and that would be really sad and the ones that would really suffer would be kids their children yeah so a uh a nonpartisan uh look at this which is how I heard everything that you said um just seems really critical uh where are they getting the fluoride so water fluoridation um the flid that they get is a byproduct of the phosphate fertilizer industry and it's it's um called hydrofluosilicic acid so as a byproduct of the phosphate fertilizer industry it's considered a hazardous waste and it's very expensive to dispose of of uh but they have found that if diluted in theory and put it's an acid first of all so if it's put into our water system it is so diluted that it becomes safe but I will say it you know everyone can go 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 um they're supposed to titrate it and I think what's interesting you know we're supposed to Target 0.7 milligrams per liter um I've been involved in some educational campaigns and 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 um if you're concerned you can call your local walk um Bureau municipality I will say I don't think the federal government's going to have much control over this it would be nice if the EPA stepped in um they have appealed by the way uh 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 um have run it through and initially done a we're going to ban this um as a mandatory thing in our state and I think it's uh North Dakota Kentucky there's other states picking this up too and other communities that are removing it or or not adding it to their water so it's an interesting time to observe all of this super interesting um I will resist the temptation to ask questions about why it sounds like mostly red states are the ones doing this as opposed to Blue States although Portland is in a blue State Portland's traditionally City for sure blue City yeah yeah right blue City in a um red state in it went Oregon went red this last election uh the cities make up it's kind of like many states so Eugene Portland Bend tend to be pretty blue and I think the surrounding is is more conservative but no it it's shifted a bit but not enough to shift out of voting okay liberal all right well we'll do another episode in um uh 2090 about politics um meanwhile back to the oral micro 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 um what if any knowledge is there about how the oral microbiome or oral health would be impacting egg Health fertility um ovulation uh ovarian reserve is is that the sort of the level that the regulation of of fertility is thought to occur like what's what's what's known about the link yeah so again it ties back to that translocation and creating an immune response and inflammation as well as the endotoxins that are released um with men particularly they're seen increased um sperm challenges with sperm motility and sperm Mobility as gum disease and parodontal pathogens increase and again it probably it has to do with the inflammation um and with women you know it we can show that women take about two months longer to become pregnant um it does affect ovulation egg quality um but also we know it can lead to miscarriages and low term birth um a low weight birth pre-term birth um and just pregnancy complications as well and so we are finding oral bacteria in the placenta you know we're finding there's different microbiomes everywhere now the breast has a microbiome the placenta has a microbiome and so oral bacteria can end up in many of these places and and just create that Cascade of inflammatory events and so um 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 and P gingivalis or F nucleatum and they eradicated or less in that bacteria I mean I'd be interesting to see how pregnancy and fertility outcomes would would change and possibly improve great what are some of the mechanical as opposed to chemical things that we can do to improve our oral health so we were all taught Russian floss twice a day uh I even have a colleague Who Um can be caught in the bathroom brushing his teeth after lunch um so he's brushing three times a day um I don't know what motivated that do you okay um great so what's the deal with brushing when let's say kind of like exercise let's say if someone were going to only brush once yeah a day better to brush in the morning or at night obviously they people should brush twice a day but or 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 bofilm so that you're not sitting sleeping all night 8 10 12 hours if you're a child with that sticky potentially dis biotic bofilm on your teeth um 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 um 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 to revamp there but most cavities that I see in children and this translates to the adult population as well are in between the teeth or in proximally in the molers um and it's really common so 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 molers and so it happens between the teeth where you're eating those Goldfish crackers those pretel those chips they 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 we 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 um 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 um 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 bofilm 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 um this works really well in patients that can't put their hands in the mouth maybe they have like an aversion to that sensory um 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 um but I can't overemphasize how important flossing is I or proximal cleaning it stimulates the gum tissue and and you're less likely to have gum disease as a result what about those little uh tooth picks with a little sling of floss across um you know the the hard piics that um yeah floss picks floss picks they're great especially in kids um it's the only way to floss a child's teeth first of all so I want parents as soon as teeth touch they should be flossing that could be the anterior teeth 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 age of two and a half the mullers 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 you know some people have big hands it's hard to get floss in I I have to use them I can't get in I can't get my hands into into my mouth they're fine yeah okay you just want to try not to just go straight up and down just kind of angle angle if you can okay and then maybe a water pick too and I was told by my dentist soft toothbrush because I tend to get in there and like I'm hearing all this stuff about how the you know oral health is so important for the brain and for and you 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 brushstroke 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 you could be your bristles could be damaging your enamel and creating um just wearing it away and creating little marks and and it 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 with a little baking soda a lot of this is perfect world okay and I I get it but just I like 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 uh had the idea to include fluoride um 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 fosis um spots and markings on the teeth can be many different things uh one is fosis one could be hypoplastic enamel I I think we should touch on that but so fluorosis can be mild moderate or severe when it gets more severe that is where it can be dark spotted orangey Brown mild fosis usually is more brighter white you often see it on the incisal tips or on the cusp tips of the MERS a very attractive feature it's not and um it is a sign that you've had excessive fluoride you know and I will say 40% of teenagers now have dental fosis that very likely means they also have some degree of skeletal fosis as well so for all the um challenges that the debate around fluidization of water has um I willing to bet a significant amount of my savings that this issue will end up being the Lynch pin 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 be 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 kids feels fine or there's nothing I can do about it now they're 15 maybe they're you know 10 10 IQ points down from where they would be but if you tell people this is 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 that are those white spots or dark spots that are really unattractive that's because of fluoride now you've got everybody Aesthetics Aesthetics and and it's it's either a shame or whatever that this is the way that people 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 to motivate human behavior but those white spots nobody wants those dark spots on the teeth nobody wants those and I I'd be willing to bet that that becomes one of the the key issues and if people go oh listen it's actually making my teeth uglier yeah maybe stronger but uglier um I I bet you this becomes a wedge in 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 for the patient and I think that's not our right as providers to make that decision for someone but it's really common um fosis is very common I I've even seen late more recent data saying as high as 60% but that 40 is kind of the standard number that we go with of teenagers with fosis there is something called hypoplastic enamel this is something I'm very passionate about um this is under minized enamel and I believe it's a silent epidemic in children I see more and more children who their teeth erupt and they're model and chalky and some are so severe they're crumbling and I've seen a big optic in this in the 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 you're not brushing and flossing their teeth you're neglecting them um 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 um I believe and colleagues globally agree that it's very likely due to all the mineral deficiencies that we're seeing globally and the vitamin D deficiency that we're seeing globally you know we're inside all the time we're not outside all the junk light that we're getting the blue light it can also be from environmental toxins high fevers viruses um but it's a real concern and so many children are under having to 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 that's you know there's risk to general anesthesia and this is where I do love to consider a more conservative approach like can we remineralize 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 I don't think we have the data for all the long-term potential cumulative effects and we've 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 um relationship between the oral microbiome oral health and hormones um and focusing specifically on female hormones um the menstrual SL ovulatory cycle that occurs each month as well as per menopause menopause um about half of our listeners are are women I'm curious are there certain phases of the menstrual cycle or certain uh phases of uh per menopause menopause or prior to it uh in which women should pay particular attention to their oral health is like is there a known association with like a 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 um gum inflammation and you know and certainly if they're on oral contraception that can change things too and and they'll go into the D and be accused of maybe not brushing a fline appropriately but it's really a hormonal issue so it's important to know that um 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 um but it's important to know that you can also have relaxing can you know it helps us prepare for child birth but it can shift teeth we have a ligament around our teeth much like we have ligaments in our in our pelvis and that perodontal ligament is impacted by relaxing so you can see teeth shift and move and women May sometimes say my bite is different now um my gum health is different so it's very important preconception and certainly during pregnancy to to be really on top of your oral hygiene as best as possible and see a dentist regularly and then per menopause and menopause there's a whole slew of issues that happen to women and from an oral health perspective with hormonal shifts you know decreases in estrogen and progesterone can impact collagen synthesis so more TMD more headaches um certainly gum inflammation dry mouth burning mouth syndrome um more bad breath taste changes too and so what if it's just so powerful to be able to have these conversations with women rather than just say well just use this product 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 2 or 3 months instead of every 6 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 um more and more I'm getting asked questions on social media and elsewhere but you know like what how is this different for women versus men um and in particular different phases of the cycle and um per menopause menopause and and essentially the entire lifespan so appreciate that yeah I I get burning mouth question a lot too from my community mouth sounds awful so your mouth feels metallic and it truly feels burning almost like itchy I think I I haven't experienced it but 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 in that um in those with per menopause 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 um it's the same with wh varations on the line on your fingernails that can be a zinc deficiency B vitamins can be burning mouth or um geographic tongue is something people experience um what is geographic tongue caused by I don't have it I have a family member who has it it's a it's it's permanent because they're they're quite um you know far along in their life now and still have it from childhood um we're told in dental school it maybe has changed but it's benign you know and just tell patients to avoid Citrus and acidic Foods um it is cross link to um latex allergy and psoriasis so it's it's a autoimmune issue um it can be a sign of nutritional deficiencies usually zinc bee or iron mhm um and also it can be a sign of celiac Crohn's or gut issue again it's all connected so a lot of times when kids see me I will send them to a functional medicine doctor or naturopath to just make to rule that out you know and there's genetic predispositions too as we progress further along this conversation these ideas pop to my mind that I'd never thought of before like um because I don't tend to use them like um lip balms lipstick um 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 on my uh and um now I'm wondering like was that just a terrible idea I mean it's good burn right people are going to use but I I suppose specifically like lipsticks are they safe for the oral microbiome well I don't think it's getting into your I mean hopefully you're not eating it that much but I mean we need to be mindful of our products you know there's a petroleum based products a lot of lipsticks lip balms they just have nasty ingredients in them we're learning more and more and you know they're not necessarily as regulated here from a cosmetic standpoint as they might be in the EU so read your ingredients but a lot of petroleum based products will actually cause more dryness you know and it has a reverse effect which is why people get addicted to chapstick I think they just their lips dry out more but when I see chronic dry lips I'm thinking dehydration and are you mouth breathing because when you mouth breathe all the tissues dry out so if a kid comes in with chronically dried lips I I do wonder if they're a mouth breather another way to to assess if if you have a mouth breather on hand is do you 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 closed breathe through your nose but if you can't because of an obstruction deviated septum inflamed nasal turbonet you'll have that kid that Mells always open and they tend not to chew enough they kind of mash food and swallow it um because they 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 nuggets mac and cheese because you can just mash it and swallow it that can be a sign of oral motor dysfunction in adults and kids so if 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 um but the I would want to know why why are you chewing that way is your occlusion or your bite off are you avoiding a tooth because you're in pain um it can be a bad habit there's ways to retrain but we everything should be symmetrical so you should kind of chew chew your tongue should to move the Bolis of food to the other side Sho Cho so if you can't do that it can be a sign of oral motor dysfunction too maybe your tongue doesn't have good range of motion or Mobility maybe you have a tongue tie or low tone um 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 TI a few years ago this was a controversial area tongue tie being the the um 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 um and this idea that in babies it should be caught other people say it shouldn't be cut uh and then everyone starts looking day K me I think mine just seems to have naturally torn back some distance but you know uh what's what's the deal with tongue tie and should it should it be cut we're going into all the controversial conversations here I I'll take the heat so um it that's called your freenom okay so we all have a freenom it's the band of tissue that attaches our tongue to the floor of the mouth we also have a labial freenom and sometimes you have little um buckle foms up up here in the vestibule the cheek if you put your finger up in your mouth you'll feel yeah you may have them you may not and they dried my teeth out for something once they pull it back see yeah it's like webbed yeah so the whole thing with this conversation is all about function okay so does your tongue and do the oral structures function appr appropriately in which case you're good you know um what's hard is something 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 so is is it impairing or impacting breastfeeding can the tongue not lift appropriately it's all about um lifting elevating and lateral izing so many think tongue tie impacts you sticking your tongue out we don't care as much about that what grows the face in the pallet in in utero and then beyond is that tongue lifting elevating and spreading that pallet almost like an expander like an orthodontic expander and so if it can't lift that's the first sign and that means it can't um pull in the breast tissue and breastfeed appropriately um babies might have a lot of reflux women will have pain okay so that's one of the first things we look at um but then as children get older we look well is 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 pallet and it should have enough tone to stay there ideally while we sleep too but if your tongue is Tethered it can't lift up your tongue's going to lay low and you're going to have more of the Napoleon Dynamite look okay so that open mouth forward head posture that's just because the tongue can't lift many times when people have tongue tie their pallets are narrow too because in uteral the tongue wasn't up to grow the face optimally um 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 that 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 and had the risk benefit discussion with the parents I do think a frenectomy is indicated you know um and I myself have had one and it benefited me a lot my issue were u neck strain and and a lot of shoulder tension that really 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 you know so this is where you do want to work with someone with additional training to see um if you have a tongue tie you know how are they assessing that and then is it impairing function and then do you actually need a procedure done sometimes just working with a myof functional 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 just a few years ago um and because I had chronic tonsilitis um and so I knew I had a posterior tongue tie and I just told the surgeon just 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 um usually it is local it's really not bad especially they're using lasers now for the procedure it's pretty straightforward yeah yeah that can cauterize mhm as you make the cut exactly 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 release peptides and red light therapy now we're we're in the um sort of specialized uh next um sort of cutting edge of uh health and self-directed health um or self-directed slash working with a working with a professional like yourself um oral health care so um can red light therapy like shining red light and near infrared light so long wavelength light into the mouth provide any benefits for a person that doesn't have any other issues like they just want to maximize their oral health is that something that can be helpful what else is it potentially helpful for yeah it certainly couldn't hurt I haven't seen any solid data on that but um it would reduce inflammation improve um blood flow you know so I'm not opposed to it it's wonderful posts surgery you know so if you have wisdom teeth out or a periodontal surgery a lot of um dentists and Specialists are using red light therapy extraorally or intraorally to help expedite healing collagen synthesis Etc um peptides are newer and exosomes as well that are being used particularly in root canal therapies and maybe cavitation surgeries and things um again just to help with inflammation healing collagen synthesis um 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 um the idea is to regenerate tissu specifically with peptides it can when put down in the pulple chamber potentially can help um build up the Dentin within the tooth and maybe help increase vascularization and get some more Vitality back to the tooth too so it's pretty cool yeah all right so we'll stand by on that yeah should we be concerned about Metal fillings um whatever I don't know what material they use for the other uh fillings and sometimes they'll use quote unquote sealants like they'll see a pit they'll put some sealant in there um and retainers are made from plastic now everyone's worried about plastic so uh 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 disease in our life um so Mercury fillings this can get controversial um I think the first thing to do I don't love Mercury amalgam fillings and I I they were recently banned in Europe um 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 biom mtic material but if you have existing Mercury fillings amalgam fillings and you're concerned the first thing to do is 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 um and certainly if a filling is breaking um damage it needs to be replaced maybe considering not doing a an amalgam metal filling so that's kind of my stance on that um composite fillings you know they are Plastics essentially um most are BPA free but that is a bit of a marketing idea you know there's still other plasticizers in there Biz GMA Etc so um I do really like ceramic based materials if you can find them nothing is perfect you know Le is the best available that we have regarding retainers I get this question a lot two um acrylic retainers those are the pink retainers what's interesting about those methyl methacrylate can have gluten in it so if you are Celiac um there have been case reports of of teens especially who they keep having GI distress or rashes because Celiac of often come out can come out in the skin um and they can't figure out why and it it ties back to their retainer so just be aware of that and then people will ask all Invisalign and again nothing's perfect um 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 um that is the most important thing for your health in my opinion is optimize oxygenation and breathing and rest and recovery so you know I I I am an advocate for expansion and some of these materials and products um 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 2 liver detox is optimized you know that's ideal so yeah cruciferous vegetables sulphoraphane supplementation maybe dandelion the same things that were recommended in the Plastics episode that I did that um other people have touched on so things like sauna sorane yes bers cruciferous 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 um and then sealants I am an advocate of sealants they they really do reduce cavity risk um they're usually put on the molers in the grooves and the fissures of the back teeth um but again I use so I I use um spectometry to make sure I'm not sealing in bacteria so it's an image that shows me if there's like carries or cavity there I'm using ozone to make sure I'm killing the bacteria sometimes I'll use my laser which helps disinfect too to open the groove up and then I'm using ceramic based materials too um so I think there's it depends on your risk as well if you're lowrisk you're not eating a lot of these Ultra processed foods you're probably okay um but a lot of kids you know we have control over our children's diets only to a certain point and then they go off to middle school and start eating the Takis and the Doritos and you know they make maybe some bad choices and so if you want their teeth as protected as possible I'd suggest cence 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 um and then there's this very dark joke that people make well you know their hands are always in other people's mouths so they don't have anyone to talk to you know like you know like or and then I always think well the logic's wrong there they actually could talk as much as they want it's the patients that can't talk so you know set setting aside that kind of like um you know Gallows humor which I I don't it's not my style of humor um 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 um dentists 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 um it's a really hard profession and so we tend to be the brunt of the joke you know we're in the the song um 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 horse Little Shop of hores um Horrible Bosses there's like a crazy dentist there's always like horror movies have dentist I mean we are the brunt of the joke a little bit and um so that's hard and 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 cuz I just felt like I wasn't making a difference you know dental disease is so prevalent and 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 and the pressures and the things with dentists is we are the clinicians but we're also kind of the CEOs of our businesses like many of us have private practices so you're wearing two hats so when you're done with treatment all day and seeing patients all day then you're sitting in front of the computer and you have people to help you but you're trying to manage the business and we didn't go into school for that you know looking at spreadsheets HR issues ETC um and many of us are in Solo practices so it can be very lonely but also um we tend to be more type A personalities perfectionists and Dentistry is hard not it's there's a lot of unknowns there's a lot of variables you know I can put a filling in your mouth but I can't guarantee that you're going to brush floss follow my rules not you know 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 because the filling fails and we're the ones to blame for that and don't get me wrong there's all VAR 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 postco I would say there's a lot of pressures um are dental insurance is very challenging you know it's not truly Insurance like medical insurance it's really a benefit package and so you 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 um and prices keep going up and up and up but what isn't changing are Insurance reimbursements okay so where does that Delta come in and usually it's coming out of the dentist pocket too so it's it's why corporate Dentistry is taking over um in a lot of ways kind of what happened in medicine but I would just say be kind to your dentist they're um just recently this is very timely but I don't know where this came from maybe it was like a Tik Tock thing but there were letters being mailed um specifically I saw in the Pacific Northwest Oregon and Portland that dentists were receiving these these hate letters saying dentists are scumbags and um 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 and to just be kind to your Dennis and I would say if if if someone doesn't resonate with you if their personality doesn't resonate with you just go find a different dentist and and I will I do want to understand there is a lot of post-traumatic stress disorder from from patients who truly fear the dentist it's usually from experiences in childhood and that's what I wanted to change too I 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 you know maybe considering therapy or you know some sort of um 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 a uh an incredible Ambassador for dentist and um no small part that comes from your like obvious kindness and goodness and also the rigor with which you approach it uh so thank um the two are certainly not incompatible you're proof of that so thank you I wonder if now would be a good time for us to just sort of summarize the top 10 or top 12 things uh there are a bunch of don'ts maybe we can leave those out like avoid sugary uh starchy flowy foods that get stuck between teeth that kind of thing um but maybe I'll fire off a few and you can tell me what I'm missing um be a nose breather not a mouth breather unless you're eating or speaking keep your mouth shut basically right absolutely or you're exercising really hard and you need to suck for some air or you're scuba diving and you would drown otherwise um eat non-processed minimally processed foods we're hearing that over and over again these days brush twice a day floss twice a day water pick if you can yeah that's loading a lot on to people I would say floss at least once a day flossing twice a day is extra credit great yeah because it's a lot of people don't floss so we want to start out reasonable before sleep yes ideally mhm so it's um brush then floss floss then brush floss than brush but however you can do it no no no I I didn't get it wrong on purpose so you T scraping we forgot to talk about t yeah so I want to add in these these things so um uh maybe oil pole three times a week put some olive coconut oil in there swish it around practice your nasal breathing while you're doing it spit it out but not in the sink not in the sink and why why just a few times a week I don't know if I was clear on that it's because coconut oil is antimicrobial so I'm Aid on the side of caution because it will Target more anerobic pathological bacteria but less is more we don't want to disrupt the oral microbiome too much so just just a couple 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 um pay attention to the fluoride debate yes consider hydroxy appetite if you're concerned great I love these hydroxy appetite toothpaste yours and Gator dentists love them I don't get paid a dime for it I pay my money for them I really love them my teeth are so much healthier now um I just like them too I like that I can um they they taste good I don't actually rinse afterwards we didn't talk about that but ideally you don't rinse after you brush correct so think about if you were a big advocate for sunscreen or a lotion you put it on you immediately jump in the shower you're washing it all off so it's the same with your toothpaste there is a duration of action that it takes for maximum efficacy so if you're brushing ma for 2 minutes and spit and rins 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 want it trying to trying to sit on the teeth and in your s a little bit avoid nicotine I like alcohol and alcohol hydrate well yes keep your electrolytes keep your electrolytes keep your saliva abundant yes um espec for older people yes yeah um the the nasal breathing during sleep we can double click on that one because AB get your sleep right cuz that just checks so many boxes I'd say optimize 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 SCP excuse me I do like tongue scraping so um again aric you know Chinese medicine we'll look at the tongue um for from a health standpoint if you have a white coating on your tongue that's a sign of disbiosis you could have candida this is important to touch upon strep mutans gets blamed for cavi so much with with kids especially but with children we really need to be focusing on fungus too so candid is really prevalent in early decay in children no one's screening for this or treating it candy to love sugar you know and this is also with diabetics we're seeing a bir directional relationship with gum disease paranomal disease and um insulin resistance and and blood sugar imbalances too but so tongue scraping and it will do a better job than your toothbrush people always ask because it's it is removing the bofilm 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 Anor robic um and that can help with nitric oxide production too because the good bacteria on the tongue tend to live down more in the CPS so you don't want 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 want that yeah oh I love it it once you start tongue scraping you you usually most everyone's a big advocate for it thank you so much for this you know really extensive and exceptionally clear Voyage Through oral health I am sure that people are going to take away many many things that are actionable and I really appreciate that you've been such a strong advocate for pointing out that oral health is not just about teeth it's not just about breath it's about that but it's also about your whole digestive tract and about brain health and about heart health and um 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 yes or gut health which which we have to get to indirectly unless we're gastroenterologist rightly what other biofilm 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 Tok you 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 thank you for coming here thanks for uh it's clear that this is a a labor of love for you it's not just about like cleaning teeth or something so yeah that you're people probably can't see well certainly if they're listening they can't see the the incredible um extensive notes that uh Dr whitmann 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 no they're notoriously have bad handwriting but yours is you certainly offset uh whatever failures of handwriting the other Physicians have so this was really fun thank you so much thanks well we'll do it again and and um really grateful for you coming on here today thank you yes thank you thank you for joining me today for my discussion with Dr Stacy whitmann I hope you found it to be as interesting and useful as I did to find links to Dr Whitman work and the various resources we discussed please see the show note captions if you're learning from Andor enjoying this podcast please subscribe to our YouTube channel that's a terrific zero costway to support us in addition please follow the podcast by clicking the follow button on both Spotify and apple 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 please also check out the sponsors mentioned at the beginning and throughout today's episode that's the best way to support this podcast if you have questions for or comments about the podcasts or guests or topics that you'd like me to consider for the huberman Lab podcast please put those in the comment 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 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it's hubman lab on all social media platforms and if you haven't already subscribed to our neural network newsletter the neural network newsletter is a zeroc 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 coverage cardiovascular training and resistance training all of that is available completely zero cost you simply go to hubman lab.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 [Music]