Optimize Your Oral Health for a Longer Life with Dr. Mark Burhenne

00:00:00.000 | We have all heard to brush and floss our teeth, but what if that's just the tip of the iceberg?

00:00:04.740 | In this episode, we'll dive deep into oral health and the critical and often overlooked

00:00:09.620 | connection between your mouth and your entire body. From systemic inflammation and heart disease

00:00:14.340 | to Alzheimer's and longevity, your oral health might actually be playing a far bigger role than

00:00:19.660 | your last dental cleaning suggested. As Dr. Mark puts it, if you're worried about feeling better,

00:00:24.320 | looking better, living longer, quality of life, make sure the mouth is tight and clean

00:00:29.120 | and problem-free. We'll unpack exactly how to do that, including what products to be using and

00:00:34.100 | stop using. We'll discuss a test that could change your oral health plan. We'll talk about the right

00:00:38.300 | daily habits you need, as well as some that might be silently undermining all your hard work and a lot

00:00:43.760 | more. I'm Chris Hutchins. If you enjoy this episode, please share it with a friend or leave a comment or

00:00:48.480 | review. And if you want to keep upgrading your life, money, and travel, click follow or subscribe.

00:00:53.160 | Mark, how much does our oral health impact our overall health?

00:00:58.240 | It's pretty much in every case, a life and death decision. It is a very prevalent disease,

00:01:05.540 | oral health issues, cavities, gum disease, bad breath, however you want to call it. And 80% of

00:01:13.460 | us have some version of that. So if there's a connection to systemic health, because it'll take

00:01:18.340 | you down, it'll take other organ systems down, it will, it spreads throughout the body. And so it's a

00:01:23.480 | big deal. It's a big connection. It should be a pillar of health.

00:01:26.220 | And what's the mechanism by which it connects? Is it bacteria that builds up from all these things in

00:01:30.680 | your mouth or inflammation?

00:01:31.700 | It's complicated, as you would imagine. It hasn't been proven in all cases, 100%. But pretty much

00:01:40.720 | everyone's behind it. There is a way for bacteria in the mouth to travel throughout the body. There are

00:01:46.660 | many different conduits. It's you can get past the gums, especially if you have gum issues, which again,

00:01:51.900 | about after age 45, 70% of us have some form of gingivitis or gum disease. And when you have that,

00:01:59.460 | that barrier, kind of like inflammation of the gut, kind of the same concept. These bacteria,

00:02:04.660 | and these are different bacteria than you see throughout the body. There's some uniqueness to

00:02:08.740 | the biome or the oral microbiome as opposed to other biomes. But these bugs wreak havoc. I mean,

00:02:14.460 | P. gingivalis, one of the big bugs that causes gum disease in the mouth,

00:02:18.400 | very prevalent in the mouth. That has now made connections to research and studies as a causative

00:02:26.300 | agent, not the causative agent, but one of the causative agents of the stimulus for laying down

00:02:34.200 | amyloid plaque, which is kind of in the old days, we thought that was Alzheimer's. But now we know that's

00:02:38.600 | a sign that you're headed towards Alzheimer's. So that's how the body responds to a bug in the mouth.

00:02:43.680 | It becomes inflamed and it lays down the amyloid plaque, which leads to a degeneration of all the

00:02:50.560 | neuronal pathways that leads to dementia. So plenty of other examples with the heart, cancer,

00:02:57.880 | metabolic syndrome, insulin resistance, all of that. Pretty much everything is connected to the mouth

00:03:06.600 | and it can also be bi-directional too. But the mechanism, it's typically through an infection

00:03:12.680 | from a bug in the mouth somewhere else in the body. You can just have injury. In other words,

00:03:18.600 | it's kind of like you can damage the tissue. It's not necessarily an infection, but for example,

00:03:23.720 | you can damage heart tissue to the point where it can't function anymore. It could be a small part of

00:03:27.540 | the heart. And then the last one is inflammation. And if you seed inflammation throughout the body,

00:03:33.780 | if it's coming from the mouth and you don't deal with that root cause, then that just continually

00:03:39.720 | goes on. You'll have elevated C-reactive protein index. In other words, your markers will show that

00:03:45.720 | you're inflamed. A lot of physicians are sometimes just confused because they're working with a patient,

00:03:52.180 | it could be a cardiologist working with a patient on heart disease. It could be an endocrinologist.

00:03:56.860 | It could be a nephrologist for kidneys. And they're looking at that as one of the markers. And then

00:04:02.040 | they don't understand or they haven't been taught in medical school. And we have our dark blind spots

00:04:08.720 | too in dentistry. And this is the issue. There's no connective tissue between the two, even though it's

00:04:13.880 | the same body, you know, there are two different distinct ways of looking at the body and treating the

00:04:19.180 | body. But that nephrologist is going to wreck its brains. If he doesn't know about the gum disease,

00:04:23.620 | then he doesn't know where the inflammation is coming from. And he can't successfully treat that

00:04:27.820 | patient. So it's really kind of a shit show out there, unfortunately. And then again, our insurance

00:04:35.380 | system is different as well. But the actual way the bugs get into the bloodstream, they can be absorbed

00:04:40.220 | through the oral mucosa, which is the inside lining of our cheek, the floor of the mouth. But they're all

00:04:44.860 | one cell thick, just like the gut lining. Those bugs can get through to the brain. If it crosses

00:04:50.400 | the blood-brain barrier, it gets into the bloodstream. It can get into tissues, into areas where the immune

00:04:55.380 | system isn't very active. And these bugs are there all the time. And in a healthy person, that's fine.

00:05:02.060 | For example, when you go in for a cleaning and your teeth are scraped and the gums bleed a little bit,

00:05:08.300 | that patient is experiencing a very short-term transient bacteremia, meaning bugs in the mouth

00:05:13.840 | are into the bloodstream. But a healthy person can handle that every once in a while. So these

00:05:19.900 | bugs will cross through the oral mucosa between the gum and tooth area. That is a very anaerobic

00:05:26.840 | environment. It's different than the rest of the mouth. The rest of the mouth is more aerobic. It's

00:05:30.580 | oxygen. There's plenty of oxygen and pH balancing saliva. But once you get into those deep pockets and the

00:05:36.420 | deeper they get, the more oxygen-hating those bugs become, anaerobes, they also become more

00:05:42.780 | virulent. And so they're sitting down there. And then there's a breakdown due to a lot of inflammation,

00:05:47.120 | increased blood flow. And the body's trying to manage that connection between the mouth and the

00:05:53.420 | inside of the body. And remember, this is the most unique part of the body. You have a hard tissue

00:05:59.360 | erupting through the body. And the fingernails don't count. They're completely external.

00:06:04.480 | But a tooth has an internal component to the inside of the body systemically. And it has this

00:06:09.740 | external component. It's sitting outside. And you can see them. And you chew on them. And they're

00:06:14.440 | inert. So that area, to seal off that area, is complex. And when it goes bad, the bacteria in the

00:06:21.560 | mouth get into the body. And then, of course, you know, from there, it can be pretty detrimental to

00:06:29.040 | overall health. So that connection is important. Oral health, systemic health.

00:06:32.880 | And is the inverse true? If you have, you know, above average, really optimized and dialed in oral

00:06:38.520 | health, can that impact the rest of your body? Can that add years to your life?

00:06:43.360 | Yes. 100%. If I were to answer that in one sentence, and obviously we can talk more about

00:06:48.320 | it, but it would be nourishing and treating your oral microbiome with respect. Not taking it down,

00:06:53.460 | not disinfecting your mouth, managing that oral microbiome. It's like the gut microbiome. The gut

00:06:58.100 | is fine. So is the rest of the body when the gut is well. So that means feeding it properly,

00:07:02.800 | taking care of it, making sure the pH is stable, making sure you're not using products,

00:07:07.420 | oral care products that actually disinfect the oral microbiome, make it difficult

00:07:10.740 | to do what it's supposed to do. I wouldn't have answered that way 15, 20 years ago. It would

00:07:15.620 | have been more, see your dentist twice a month. I mean, twice a year, make sure you're brushing and

00:07:20.260 | flossing, eat well, don't eat sugar, don't eat candy. That was kind of the standard answer. It's

00:07:25.780 | become a lot more nuanced. It's also become more factual, more evidence-based. We now have the

00:07:32.300 | right information. It's all about the oral microbiome.

00:07:35.020 | And is the biggest influence on that food? When you said sugar, I was thinking, you know,

00:07:39.180 | as a kid, it was like sugar equals cavities and that is dentistry, right? Like that, that was,

00:07:43.580 | that was my understanding as a child. If the oral microbiome is the most important thing,

00:07:49.040 | maybe what are the components of it and how do we influence it?

00:07:51.420 | Right. It's all about for good oral health, for optimal oral health, you need to address all aspects,

00:07:58.020 | good or bad. If you're doing something bad for the oral microbiome, that has to be addressed. And then

00:08:02.200 | what are the good things you can do for oral microbiome? And it is diet. I mean, it's

00:08:05.960 | fermentable, you know, it's sauerkraut. It's, it's not carbohydrates or anything out of a package,

00:08:11.460 | obviously, because the bacteria go to town with that stuff. I mean, they overfeed and then they

00:08:16.840 | become dominant. They become bullies in that kind of colony of bacteria. That's not what you want.

00:08:22.140 | You're feeding a certain type of bacteria called the S-mutan bug. And by making that a very prevalent bug

00:08:28.120 | and a very virulent bug in the, in the biome, you're creating cavities. There are other components

00:08:32.920 | though, too. There's pH of the mouth, there's mouth breathing. There is a, you know, if you run a

00:08:37.380 | marathon, you, there's a chance that your, your pH will drop in the mouth. You could be dehydrated.

00:08:42.780 | There's certain medications. Uh, there are certain conditions. I mean, the mouth is kind of the pole

00:08:48.420 | position in the body. It's, it opens, I mean, and it's the entrance to the digestive tract.

00:08:54.300 | And what's going on with that microbiome every day is that, you know, I've been doing some research

00:08:59.200 | in preparation. Is that the D and re mineralization of our teeth or, or what's kind of the day in the

00:09:05.380 | life of our oral microbiome? Yeah, that's a great question. That's one component of it. Every time

00:09:09.400 | you have a meal, the teeth demineralize and then the biome that sits on the bio, the biome that sits

00:09:15.120 | in the biofilm brings in calcium phosphate, other minerals from the saliva. Again, that's a bank too.

00:09:22.000 | And it pulls it past that thin film, the biofilm. And again, if it's dysbiotic and too thick and you

00:09:28.620 | haven't been brushing or you've been feeding it with carbohydrates, that biofilm becomes dysfunctional.

00:09:32.760 | It doesn't re mineralize as well, but that's what that little layer does on that inanimate object.

00:09:37.640 | It keeps the calcium from getting pulled out. And if it is, it puts it back in. That's that

00:09:44.300 | demineralization, remineralization cycle. Again, 15, 20 years ago, it was like you had a hole in the

00:09:49.000 | tooth. That was it. You're done. Get a, get a filling. But now we understand it's dynamic.

00:09:53.480 | Which means that, that an early cavity might not need to be filled in 2025, like it did in 2005.

00:10:00.840 | Exactly. Okay. And, and is it important to do something? Or if you have that early sign of a

00:10:07.280 | cavity, um, do you just wait and let the body do its thing? And it's, it's like a bruise where,

00:10:12.800 | you know, I have a bruise on my arm. I don't do anything about it. I just kind of wait it out.

00:10:16.440 | It would help to remineralize that area and, and potentiate the environment for that. So,

00:10:22.340 | and I only say that because we're, we're not in a very good state right now. I mean,

00:10:26.900 | we're eating junk, we're eating crap. Most of us are sleeping with our mouth open at night.

00:10:30.680 | There are a variety of external epigenetic factors that have caused that in our modern environment.

00:10:36.260 | And because of that, uh, and because we're using oral care products that actually are taking down

00:10:42.100 | the oral microbiome so that it can't do its job, it's, we're getting cavities. It's the number one

00:10:47.480 | disease in the world. It's the most prevalent disease in the world. And there's a reason for it. So

00:10:51.780 | obviously we're doing something wrong. I mean, and dentistry is part of the problem. We've been

00:10:57.400 | recommending these products. We haven't been addressing the root causes of what decay is. Uh,

00:11:02.440 | I have a list of what causes decay and it was very controversial, um, about 10 years ago,

00:11:08.660 | and then it became less controversial. And then James Nestor, uh, spoke about it in his book,

00:11:13.700 | breath that was during COVID. And now pretty much everyone's on the same page. The number one cause

00:11:18.060 | of cavities, if you're a mouth breather is mouth breathing. It's not the food you eat. It's not

00:11:22.200 | brushing and flossing the lack of it's not oral hygiene. Uh, so it's really, it's typically mouth

00:11:28.380 | breathing, then diet, then brushing and flossing. Again, if you have those first two under control,

00:11:34.780 | you don't need to brush and floss. You can see your dentist way less often. And then of course,

00:11:40.080 | the last one, which we have some control over there's genetics, and then there's some epigenetics and,

00:11:44.520 | and, and, and that all ties in. So, you know, why are you mouth breathing? It has to do with

00:11:48.580 | facial development. For context, James has been on the show. We've talked about a lot of the,

00:11:52.600 | the health issues. I don't think we went particularly deep on the issues that are in the mouth when it

00:11:59.640 | comes to oral hygiene and, you know, our oral microbiome. So that's super helpful. You know,

00:12:05.380 | for someone who knows that mouth breathing could be bad, understands the impact of cavities. How do you

00:12:11.140 | connect those dots? What's actually happening when our mouths open all night, or we're reading through it,

00:12:16.020 | that's creating such a, an imbalance in our mouths?

00:12:18.920 | Two things. The most obvious, maybe to most is that your mouth dries out and without saliva or

00:12:26.100 | without the right, correct amount of saliva, your pH drops. Saliva is essentially continually buffering

00:12:33.140 | the pH in your mouth. The gut, the gut can buffer itself a lot easier because it's inside,

00:12:38.380 | but when you're right in front of the outside world and your mouth is open for six, seven,

00:12:44.120 | eight hours at night. And saliva flow rate drops off anyway at night, even if your mouth is closed,

00:12:49.960 | the saliva glands shut down. If you're in deep sleep, that's part of the, the, the restorative

00:12:54.560 | process. And again, saliva isn't really needed. Your tongue is not moving. If you're in REM sleep,

00:12:59.140 | there's not much washing and cleaning going on. I mean, think of a, of a spin washer, you know,

00:13:05.620 | a clothes washer with the, the impeller, and it's not going to clean the dirt and, and do what it's

00:13:11.520 | supposed to do if it's not spinning and moving. And if there's not, if there isn't enough water in

00:13:15.400 | there. So it's, it essentially what it does is it allows the bad bugs to proliferate and do more

00:13:24.380 | damage. It also drops the pH in the mouth so that you're demineralizing quicker than you are

00:13:29.240 | remineralizing. Again, you need a optimal pH for that, that fixing that equilibrium to work.

00:13:35.760 | And so at night, I guarantee you, if your mouth is open for more than 15, 20 minutes,

00:13:40.000 | your pH is dropping in the mouth. There's one more reason. It's a little bit, a little bit more

00:13:45.020 | subtle. It's not, it's more subtle, but it's as important, maybe even more important. When you

00:13:51.320 | breathe through your mouth, you don't, you're losing that feature that when you breathe through your nose,

00:13:56.980 | you cannot over-breathe CO2. And so the mix of CO2 and O2 in your bloodstream, again, when we inhale,

00:14:04.600 | you know, the, the atmosphere, it's actually very little oxygen. Um, we want to get oxygen to all

00:14:11.120 | the tissues. And so we, we breathe it in, it passes through the alveoli into the bloodstream, and then

00:14:16.160 | to release the oxygen to the brain, for example, which is pretty important, right? Or muscle or,

00:14:20.980 | or, or an organ, um, you need CO2 on board. Well, if you're breathing through your mouth at night,

00:14:26.520 | that oxygen uptake is, has, has been compromised because you're over-breathing the CO2. Um, so,

00:14:33.820 | but if you breathe through your nose, that's all done automatically. And the ratio between the two

00:14:38.500 | is optimal. It's actually a three gas system. There's another gas, NO, nitric oxide, but that's,

00:14:44.280 | that's something that doesn't get talked about much. And that's why you want to keep your mouth

00:14:48.320 | closed even during the day, if you can, even while you take a brisk walk, obviously, if you're running

00:14:52.980 | for your life from a grizzly bear, that's emergency breathing, your mouth is going to be open and

00:14:57.220 | that's short term, but long-term you want to keep that ratio of the two together. How does that affect

00:15:01.880 | oral health? It can affect sleep, uh, which indirectly can affect oral health. It affects overall health,

00:15:07.920 | obviously, but without, and without the optimal, uh, uh, pH in your blood, you're going to have some

00:15:16.180 | issues with, uh, gum disease. And that's a chronic disease that is very hard to get rid of.

00:15:21.040 | Okay. Yeah. I'll, I'll put a link to the show in the show notes to the episode of James Nestor.

00:15:25.160 | There are countless examples of ways to help practice and learn mouth breathing. We actually

00:15:31.400 | did the episode on the couch behind me in person, and we went through some of those exercises. So,

00:15:35.780 | uh, for people who want to want to check that, I highly recommend it. The one thing I'll ask you is

00:15:41.280 | as a dentist, how do you feel about mouth taping? Is that, is that a solution that's pro dental,

00:15:45.960 | uh, approved? I'm a big fan. Uh, I've been talking about it for, uh, probably 15 years and I got a lot

00:15:53.860 | of flack for it. Uh, now it's mainstream, but I love mouth taping. Uh, it started out in my practice,

00:15:58.820 | uh, as a differential diagnostic tool. I can tell when someone's mouth breathing, I can tell certain parts

00:16:06.420 | of the mouth that turn kind of a bright red. Uh, obviously the biofilm is thicker. The, uh,

00:16:11.660 | the viscosity of saliva changes. The patient has a lot of oral health issues. I mean, I can go on,

00:16:17.240 | but, um, but if you ask someone, you first have to get someone to acknowledge that this could be a

00:16:23.240 | problem before they're open to treatment. Not everyone benefits from mouth taping, but there are a lot of

00:16:27.400 | people that, that do and can and will when they mouth tape, but you have to find out.

00:16:32.560 | I'm going to say, go back and listen to the episode, do a little deeper dive, but I I've heard

00:16:36.900 | from multiple people in person that that one change of mouth tape changed so many aspects of their health

00:16:44.420 | and their life. So, um, to everyone that shared those stories, thank you. Okay. So you talked about

00:16:49.360 | mouth tape, maybe number one, number two is what we eat aside from our childhood learning that, you know,

00:16:54.100 | sugar is the bad thing and everything else is okay. What, what is the, you know, decades of research

00:16:59.900 | that have come out recently led you to think are things that we should be eating, we shouldn't be

00:17:04.720 | eating. And then, you know, not just the makeup of it, but the consistency of blending things or, um,

00:17:12.380 | certain types of food. So many different ways I can answer that. First thing that came to mind

00:17:16.740 | was you can eat sugar. You know, if you, if you just go out and have a little, uh, sticky little,

00:17:23.880 | uh, uh, gummy or something and it's down the hatch quickly and you drink water, that's not long enough

00:17:30.560 | for the bacteria to demineralize your teeth. The remineralization system will come on board and it'll

00:17:34.480 | be fine. Uh, it's more in dentistry and we've known this for a while. It's more about the frequency that

00:17:40.180 | you have sweets, not the quantity. Now in medicine, it could be the quantity. You could, you could have

00:17:45.720 | a thousand calories of sweets in a matter of minutes. And obviously that's not good for you because

00:17:50.320 | there's a blood glucose spike and, and there are issues there, but in the mouth, a high glycemic

00:17:56.060 | food, which medicine talks about in relationship to diabetes, metabolic disease, it has the same

00:18:02.000 | effect in the mouth. You're still feeding those bacteria and you're making them more prevalent.

00:18:06.200 | And then the next time you eat that little bit of refined carbohydrates, they're already there in

00:18:11.880 | bigger numbers and they're going to excrete more acid. Okay. So I like to pick on goldfish and it could

00:18:15.740 | be a saltine cracker. It could be, uh, it could be a pretzel. It could be a healthy rice snack with no

00:18:22.120 | seed oils in it. It doesn't matter. That is a refined product. And the bacteria love that. It's

00:18:27.400 | the same thing as eating candy. Um, and so you're eating that. And if you snack on that every day at

00:18:32.940 | lunch and you don't brush afterwards, and then you have a long conference call afterwards,

00:18:37.420 | essentially mouth breathing, you know, that's going to lead to decay. Um, so obviously whole foods,

00:18:44.040 | uh, paleo diet, uh, uh, you know, leafy green vegetables. I mean, uh, fermented food products.

00:18:51.880 | Again, I love sauerkraut. You can eat a pate, which is great. That's high in vitamin K2.

00:18:56.820 | There are three dental vitamins, a D3 and K2. Those are the three dental vitamins. Um, you want to have

00:19:03.520 | those on board, especially with your kids, cod liver oil there, there, you, you have to make sure

00:19:08.940 | that that system that provides calcium, that makes it available in saliva is working.

00:19:15.220 | Is there like some sort of test someone could be doing where it's like, how is my oral microbiome

00:19:19.800 | doing? Um, and is that actually necessary if you have a healthy diet and healthy teeth?

00:19:24.880 | So there is a test. There's a recent test. It's out of San Diego. It's the first

00:19:29.740 | kind of metagenomic, uh, shotgun approach where it measures for every, it looks for every

00:19:34.540 | and quantifies every single bug in the biome, in the oral microbiome. A few years ago, it was 750

00:19:39.700 | bugs. We're probably over 800 now. And so you can test it. They will send you, it's called bristle.

00:19:45.360 | Uh, I work with them and I'm an advisor for them. Highly recommend it. I've, I have said,

00:19:50.820 | been on record for saying that this will change, or if not should change dentistry, because again,

00:19:56.500 | we've been kind of looking at indirect markers. Oh, you have a cavity that means something's well,

00:20:01.640 | I'd rather treat before you get the cavity and know that that it's coming. Right. So this test

00:20:07.280 | is available even to the public. You don't have to go see your dentist. Uh, although I would recommend

00:20:12.620 | that you go see a dentist and it, it has a bad breath score, which is very popular. That's where

00:20:17.520 | most people go, not the cavity score, not the NO score. Uh, but, and then, but there's a lot of raw

00:20:23.540 | data there for your dentist. And so if your dentist is educated, if they're an expert in the oral

00:20:28.140 | microbiome, then they, when they treat you, it's a much more targeted way of, of treating that patient.

00:20:33.340 | But there's a lot of indirect, uh, I mean, if you have bad breath, for example, uh, if your gums bleed,

00:20:37.900 | when you floss, these are all signs that you have a dysbiosis of the oral microbiome. You have to make

00:20:42.180 | changes. And are all those changes medical or could it be diet changes and product changes?

00:20:48.100 | I always tell patients, you know, if you're not willing to get tested, then, then turn all the

00:20:52.400 | channels on and turn off the channels that, you know, are, are, we know that are going to give you

00:20:56.700 | a problem, for example. And, and, you know, when you go see a dentist, ask for a, a customized approach,

00:21:03.340 | tell them you don't want to just come in every two, twice a year. And, you know, the, the routine

00:21:07.900 | stuff and be told to floss and brush, find out exactly, get tested, find out what's going on

00:21:12.640 | and find out what those channels are, what those triggers are. Is it your diet? Have a conversation

00:21:17.280 | with your, uh, I mean, you're sitting there for an hour with your hygienist, he or she will do all

00:21:20.940 | the talking, but that's fine. You're going to sit there and listen, ask one question, then just say,

00:21:24.620 | okay, I'm going to shut up now. Tell me about how, what is the ideal dental diet? And, and then,

00:21:30.860 | and then you could go on from there. I mean, uh, you, you really, as a patient these days,

00:21:36.740 | you have to be your own advocate. You really have to ask, what can I do about it? And most

00:21:40.720 | professionals will be go like, we'll be like, Oh my God, this is a interesting patient that wants

00:21:46.300 | to know. And the floodgates will open. You'll get all the data you need, but there is no rubber stamp

00:21:51.560 | to every patient that comes in. Um, unfortunately it just doesn't work that way. There's individuality

00:21:56.700 | in each biome, whether it's a gut microbiome or an oral microbiome. So you really need a customized

00:22:01.620 | approach. Okay. Ask for it. Now, before we go past food, are there anything I saw a post you wrote

00:22:06.640 | where it was like, you know, 10 things you should stop doing. One of them I noticed was like,

00:22:10.320 | stop using a blender, but are there any kind of quick hits of, you know, aside from switching

00:22:16.380 | to whole foods and these big broad scopes, are there some just really bad actors that we can

00:22:20.980 | all try to avoid? Yeah. One is kids are not eating what they used to eat, uh, before we had blenders

00:22:28.180 | and processed foods and part of their developmental process of getting that jaw to its full width,

00:22:34.220 | downward forward growth, which when that develops correctly, uh, then the airway develops correctly,

00:22:40.340 | then the nose develops correctly. Then they become an obligate nasal breather. That development,

00:22:44.980 | one of the aspects of getting that to happen by age nine, by the way, 90% of it's done by then,

00:22:50.040 | uh, is chewing on meat sticks and really hard, crunchy things, carrots. And I would give them

00:22:56.080 | xylitol gum. I'm, I'm one of those parents that say xylitol gum is great. It suppresses the,

00:23:00.960 | the bug that causes cavities. It promotes saliva flow. Instead of having them brush after a meal,

00:23:06.780 | especially at school, give them some xylitol gum. They'll chew it. It's sweet. It's wonderful.

00:23:10.820 | Um, so that chewing motion actually is key. If, if they're sucking down baby food and,

00:23:17.240 | and they're not chewing on a hard crusted bread, or that's going to have an effect on the rest of their

00:23:23.040 | quality of life curve. I mean, obviously if it's in a bag and you're, you know, looking for a pair of

00:23:27.040 | scissors or tearing it open, be careful if it's a processed food. Uh, the bacteria love that. That's

00:23:32.700 | what turns the oral microbiome into a real hot mess. Um, and if that's a hot mess, then the rest of your

00:23:38.220 | body is, is dealing with inflammation, infections. It's fighting all those bad bugs that in the,

00:23:44.020 | from the mouth that are getting into the rest of your body. Um, what else? Uh, mouth breathing

00:23:48.860 | obviously is a big one. Address that right away as soon as you can. Uh, that is very,

00:23:53.240 | very important. Uh, there are certain medications, actually most medications cause dry mouth and that's

00:23:58.620 | a tough one. Obviously the medication, most people need to be on those medications, but go back to your

00:24:04.020 | physician, tell them you have a dry mouth, tell them that your dentist is concerned, uh, and that it

00:24:08.620 | could lead to worsening the disease that they're being treated for by that medication. Cause again,

00:24:13.220 | there's that oral systemic link and look for a different brand or, or try and microdose it, you

00:24:19.340 | know, cut it in half and, and titrate that to see. And that works well as often, very, very often. And if

00:24:26.400 | you can just keep that saliva flow going, that is so important. Choose all a tall gum, easiest hack out

00:24:31.660 | there. Gum's getting a bad rap these days because of microplastics. Uh, I do recommend a gum. It's on our

00:24:37.180 | website. It's out of Italy. Uh, brilliant young woman in Montreal is the one that imports it. Um,

00:24:44.800 | and it's microplastic free and it has Zolitol in it. Uh, Zolitol can really, it's almost better than

00:24:51.980 | brushing. In some cases it is better than brushing. On that same list was, was fruit juice. Is that,

00:24:56.780 | is that a similar, just stop chewing or is it more the concentration of sugars? I mean, fruit juice is bad

00:25:02.620 | for you systemically. You know, if you're a blood glucose, uh, a system, uh, insulin spikes, get the

00:25:09.620 | fiber, get the fiber, bite into an apple. Uh, that's what your teeth were designed for originally. It wasn't

00:25:15.240 | designed to drink apple juice. You mentioned if you, if you solve the mouth breathing, if you solve the food, maybe

00:25:19.600 | you don't need to brush that often aside from food and breathing. What is a proper oral care routine? It varies

00:25:25.580 | from person to person. Uh, there are some people probably very few that don't need to do much. Uh, I would still

00:25:31.760 | encourage them to floss. Uh, if they think they have a thick biofilm or they've had a cold for two weeks,

00:25:37.200 | they would do a little brushing. You don't necessarily need to use toothpaste, but again,

00:25:41.160 | that's probably 1% of the population. And I mean, they're probably carnivores or they're eating a pure

00:25:46.480 | paleo diet and nothing else. And their mouth is shut. They're not, they're sleeping well, they're nasal

00:25:51.780 | breathing, but most of us have to brush. They have to floss. They have to address the pH of the, of the

00:25:57.700 | mouth. Uh, we have to be careful when we snack, we can't brush too early. We can't brush too late. So

00:26:02.760 | I can kind of go through what my protocol is with a few variations, probably the, the most, uh,

00:26:09.320 | precarious time for the oral microbiome is early in the morning. So let's say you've slept with your

00:26:14.380 | mouth open all night. There's been very little tongue movement and the viscosity of the saliva has

00:26:20.520 | changed. There's, there's no way around that. Uh, so I will, it depends. I will, obviously I'll get out

00:26:28.120 | of bed, stretch a little bit. I'll drink a full glass of water. Remember you haven't had something

00:26:31.880 | to drink for six, seven hours. It's definitely something you want to do that does help the, uh,

00:26:37.440 | the biome because obviously the pH changes right away. Then I would scrape your tongue. Uh, the biofilm

00:26:43.000 | on the back of the tongue is key for NO production. It can wake you up. NO can wake you up. It can,

00:26:48.460 | uh, make your day better. Um, and that's a great place to start. That's typically where

00:26:53.420 | the biofilm is at its thickest. You could also floss in the morning. I know this sounds like a lot,

00:26:57.740 | but you can usually do this while walking through the house or, you know, it literally will take

00:27:02.920 | less than three or four or five minutes at most. Um, that would be my morning regimen. I did not

00:27:08.680 | mention brushing. I don't think that's necessary unless you were awake all night, asleep all night with

00:27:15.560 | your mouth open and you just have this thick layer on your tongue, you know, dry cakey stuff on,

00:27:21.900 | on the edges of your, your commissaries here. Then you're, you're going to have to stir things up a

00:27:26.140 | little bit. And remember, brushing is not removing the biofilm. It's just resetting it. And then with

00:27:30.400 | the water, then you've got a good start. Then every meal you consume after that, your breath,

00:27:35.420 | your NO production, everything will have a good start from that point on. You can brush your teeth

00:27:40.100 | after breakfast, but I would wait 30 minutes. Most of us have something acidic. It could be coffee.

00:27:45.380 | If you don't eat breakfast, there's no need to, uh, to brush. And then I would, um, I would chew on gum,

00:27:52.660 | xylitol gum during the day. Um, after meals, let's say you have a snack, uh, or the snack could be the

00:27:58.840 | xylitol gum, but let's say you have a little, let's say you're at work and they are handing out a little,

00:28:03.960 | uh, you know, sports bars or something. And it has, it's based on oatmeal. Oatmeal is not the best

00:28:09.980 | food for your teeth. It's not paleo, right? It has a glycemic index. And so you have that. There's

00:28:15.980 | obviously some sugar in there. It could be rolled oats with maple syrup, that kind of thing. Uh,

00:28:20.000 | don't brush your teeth right away. That's what most people do. And that alleviates their guilt of having

00:28:24.480 | had that, that bar. No, you're scraping off enamel because there's an acid attack and a low acid

00:28:30.000 | event going on in your mouth and that's it's, and calcium is lifting off the teeth. If you're

00:28:35.500 | going to get in there with nylon bristles, you are helping remove more calcium than you would if you

00:28:40.640 | didn't brush. So xylitol gum just brings on, uh, more saliva that changes, that helps balance the pH a

00:28:48.360 | lot quicker. And then the remunerization moment is more likely to happen. And then brush your teeth,

00:28:52.960 | maybe 30 minutes later. And then dinner, maybe brush after dinner, especially if you've had wine or,

00:28:57.840 | or tea or something, uh, wait for 30 minutes and then just brush right away. Don't wait

00:29:02.340 | till bedtime. You haven't had anything to eat, anything to drink for a few hours. Um, you don't

00:29:08.200 | want to be using a very strong minty toothpaste. Uh, so brush after dinner. And sometimes by brushing,

00:29:15.180 | people are less likely to snack because they don't want to go through the, uh, motion of, uh, you know,

00:29:19.900 | the activity of, I do this so many times, but for that reason, not, not because a dentist told me,

00:29:24.600 | but it's like, as soon as I'm done with dinner, if I brush my teeth, there's not going to be the

00:29:28.380 | late night. Oh, let's go. Uh, let's go have a cookie. Let's go have some ice cream. And does

00:29:32.600 | it work? It works great. I don't think I've brushed my teeth twice more than once in a year because it

00:29:38.260 | just, it works really well. This episode is brought to you by stable, which is a company that has really

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00:30:33.520 | new digital mailbox at chrishutchins.com slash stable, or the link in the description. This episode is

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00:31:35.580 | slash Daffy, where you can get a free $25 to give to the charity of your choice. Again, that's chrishutchins.com

00:31:42.360 | slash Daffy or the link in the description for a smarter way to give when it comes to brushing. How do you feel

00:31:48.180 | about regular versus electric toothbrushes or favorite brands? Again, it depends on the patient, but electric

00:31:53.820 | toothbrushes do have and they've been around a long time and the studies do support the efficacy of a sonic

00:32:02.300 | toothbrush or an oscillatory rotary type, a back and forth type movement. It has to be a high quality

00:32:09.540 | head. You have to replace it often. Nylon becomes very abrasive. Always use the extra soft brush, which is

00:32:15.260 | usually not the default or stock toothbrush head that comes with it. And if it is an abrasive or a cheap

00:32:21.660 | toothbrush head, the fact that it's mounted on a motor means it's going to be, it's going to cause a lot more

00:32:27.020 | damage and cause sensitive teeth, gum recession. So it depends. I mean, most of us are not brushing

00:32:33.600 | correctly. Walk people through what that means. You see people in films. I think on our website, we have

00:32:38.660 | a video of Natalie Portman brushing her teeth and she's just in there scrubbing. And that's every time

00:32:44.020 | I see someone brushing their teeth in a scene, they've got this hammer grip. I mean, hold it like

00:32:49.560 | it's a pencil. And what you're doing is you're aiming for the gums and you're just jiggling the bristles.

00:32:53.920 | You're not sweeping them or sawing them back and forth. You're jiggling them right at the gum line.

00:32:58.520 | Make sure it's a nice sized head, not too big, but more round or oval. The long rectangular ones

00:33:05.080 | sometimes don't, if you're aiming for the gum, they don't get the bottoms of the teeth. You know,

00:33:09.280 | if they were upper teeth, they don't get too far down on the gum. Make sure it's ultra soft. Make sure

00:33:13.700 | you replace it after three or four weeks. I mean, the nylon becomes abrasive and then you go in there and

00:33:19.120 | brush back and forth. You are gouging your tooth surface. I mean, the teeth are hard. The roots are

00:33:24.320 | less calcified, but that can lead to problems. So I think depending on whether you have gum disease,

00:33:30.440 | whether you have open embrasures, crowded teeth, maybe you're not a flosser, Sonicare is best. I

00:33:35.640 | always recommend people over age 40, 45, start using a Sonicare toothbrush. But again, hold it lightly

00:33:40.920 | and just, just guide it over the teeth because the electric toothbrush is doing all the work for you.

00:33:44.900 | And then people tend to underbrush with a manual toothbrush, although you can be very adept

00:33:49.260 | and you can, you can have full, the full therapeutic effect with a manual toothbrush. It may take a little

00:33:55.860 | bit longer, but for young people, I would say a manual toothbrush is fine. Just make sure it's a high

00:34:00.400 | quality one. And we have recommendations on our website.

00:34:02.520 | And so it's funny because I was looking at toothbrush heads just for a quick second. I was like,

00:34:07.060 | you know, if you're replacing your toothbrush head every, you said three or four weeks. So maybe

00:34:10.880 | once a month, you know, that's, it's probably, you know, an expensive undertaking. I know there are

00:34:15.860 | tons of much less expensive than, you know, from Phillips or whatever brand of toothbrush Oral-B

00:34:23.360 | that on Amazon, would you say avoid those kind of discount cheaper toothbrush heads and go for the

00:34:29.820 | brand name? Yeah. There's no guarantee that they're, they're, they're well-made. I would use the ones

00:34:35.080 | that are recommended for use for the toothbrush. Again, I have no affiliation with them, but remember

00:34:40.080 | dental care is expensive. It depends on, you know, how you want to look at it, uh, short-term gains

00:34:44.560 | or, or long-term gains and, and less costs, less time in the chair.

00:34:48.280 | Yep. That makes sense. Especially, and we're going to talk a minute about dental insurance and costs,

00:34:52.700 | but if you could avoid all of those extra costs, other than your preventative work, you can save a

00:34:57.000 | lot of money. It's so funny how the length of time you have a toothbrush head wasn't really

00:35:01.320 | compounding or making sense because I didn't really think why now that I understand that

00:35:05.780 | the bristles could be, could be not as soft and that could be causing problems. It makes a lot more

00:35:10.900 | sense. Yeah. There are a lot of people out there that are trying to use the, the bore, wild bore

00:35:15.280 | bristles, but they don't hold up and they don't really work well. I mean, the nylon bristle

00:35:19.740 | is effective, but make sure it's has the end rounding procedure.

00:35:24.600 | Okay. And on floss, um, how often are you flossing and what kind of floss and how do you

00:35:32.360 | think about floss picks versus threaded floss? Yeah. I love flossing. Make sure you're not using,

00:35:37.620 | um, and before microplastics were big, I kept telling people don't use nylon floss. We don't know

00:35:42.540 | where those little nylon particles are going. So, uh, silk floss, uh, you can buy silk floss. Again,

00:35:47.200 | we have examples on our website. Um, and, and that works well, uh, learn how to become a good

00:35:52.900 | flosser. Most of us will never become good flossers. And there's now a new, uh, device out there called

00:35:59.060 | the slate flosser, uh, electric flosser. And I absolutely adore that thing. Um, I do, uh, do ads

00:36:05.060 | for them. Uh, I absolutely think that's a game changer before an electric toothbrush. I would invest

00:36:09.700 | in a slate electric flosser. Okay. It's, and I know you've put out a bunch of videos on how to

00:36:14.960 | properly floss and how people are doing it wrong. So, um, if I can find at least one of those, I'll

00:36:19.920 | put that in the show notes. What about those water pick flossers? How do those fit in the game?

00:36:23.780 | They're great. A well-made water pick used properly is the equivalent of flossing. And in certain

00:36:29.340 | patients, it could be better. If you have a lot of bridge work, a lot of nooks and crannies, gum

00:36:33.460 | recession, open embrasures, IE, you've had some gum disease and the gums have receded. Uh, they can

00:36:40.140 | be very, very effective. Is it redundant to do both? Oh boy. Uh, I mean, you're asking the wrong

00:36:45.460 | person. I would say there's no redundancy when it comes to keeping your mouth clean, but I would say

00:36:50.640 | yes. Um, again, there could be some cases where both would work, but you're fine with either one.

00:36:56.960 | Okay. In most cases. Yeah. Now I know the, the ultimate bias that you could have in this space is,

00:37:02.360 | is toothpaste. Cause you, you've co-founded a toothpaste company, but let's talk about

00:37:05.700 | toothpaste. Absolutely. Um, uh, a necessary evil, uh, you know, the food that we're eating and the

00:37:11.760 | environment we live in, uh, devoid of minerals, uh, you know, uh, high decay rates. Uh, we do need

00:37:20.140 | toothpaste. Uh, toothpaste was invented, uh, before world war one, I think it was Pepsodent. And that's

00:37:25.880 | when the GIs had terrible, uh, teeth and they were, you know, on the front line in Europe and also in,

00:37:33.000 | in, in, in the Pacific theater. And they literally couldn't do their job because they were in so much

00:37:38.980 | pain, uh, never underestimate, uh, odontogenic pain, dental pain. Uh, it has changed world history. It

00:37:45.200 | really has. And so the armed services, uh, to their credit, uh, they, they were the ones that came up

00:37:51.940 | with all these ideas. They did a little research and they got the private industry, uh, uh, investing

00:37:58.440 | in this. And, and that's where toothpaste came from. Now, before that we had balms and we had

00:38:04.000 | essential oils and, and that was actually the wrong thing to do. And in fact, a lot of that carried over

00:38:09.660 | into toothpaste. Then we added fluoride and emulsifiers and surfactants, which are ingredients

00:38:14.600 | that are added supposedly for foaming the toothpaste, but that's a, uh, a, a result of

00:38:22.260 | the emulsifier and surfactant. And the only reason they put that in there so they can make large batches

00:38:26.820 | that mix well so that when you mix, when you fill a tube, it's all homogeneous. I mean, it's all,

00:38:31.760 | every mix is, is similar. So, so really, um, the toothpaste industry is changing. Fluoride is on its

00:38:38.100 | way out. There's been a successful lawsuit tried against the EPA. They lost their case. They couldn't

00:38:44.160 | defend it. Couldn't defend the efficacy and safety, um, of fluoride. And that was a seven-year case that

00:38:50.640 | went, started before COVID and ended, uh, this last August, August 24th. Um, I, I literally teared up

00:38:58.940 | when I heard the news. It was, uh, something I've always been against. There's so much data now. It

00:39:04.220 | doesn't really work when it's in the water and it causes brain damage with kids. That's all you,

00:39:07.820 | it's all you need to know. And if you need to know more, reach out to me, go to the fluoride

00:39:12.920 | action network site, go to the NTB, a government agency. I mean, it's all there now. And this is

00:39:17.680 | fluoride in water, or this is fluoride. I remember putting those trays in my mouth that I feel like

00:39:23.280 | I thought those have fluoride as well. They do a lot of fluoride in the tens of thousands of parts

00:39:29.120 | per million where toothpaste is 0.7 to 1.2. Um, and it doesn't really work in toothpaste, but

00:39:35.320 | topically fluoride does have a chance of working, uh, topically meaning it's, you put it in your mouth

00:39:41.560 | and, and it actually binds with calcium and it creates this kind of Frankenstein, uh, mineral

00:39:47.680 | called fluorapatite. And it is useful. It was useful in that regard. Um, but now that we have other

00:39:54.140 | alternatives, actually, they've been around for a long time in Japan, uh, for 50 years. Now we have

00:39:59.220 | natural remineralizing agents that can replace fluoride and they're much safer, uh, and they

00:40:04.880 | work better and they make for a smoother surface so that you have more reflectivity on your teeth. Uh,

00:40:11.000 | and that's the hydroxyapatite that everyone's talking about. And if that's so much better,

00:40:15.040 | I have to assume all these tubes of crest and, you know, whatever Colgate, are they still all using

00:40:22.100 | fluoride or, or is this a shift across all of these major brands as well?

00:40:25.800 | So the shift hasn't quite occurred in that realm and they're, they're making so much money. They're

00:40:30.260 | not going to change their formula until they, until they see a real shift in the patterns of buyers,

00:40:37.000 | but it's, it's happening. It's beginning to happen. A lot of the boutique brands have been bought up by

00:40:41.120 | the big boys. Um, but for right now they haven't really budged. Uh, I speak to some of them.

00:40:46.580 | They call me sometimes we do a little focus groups and, uh, it's all about, it's all about the bottom line.

00:40:52.540 | And that is, I mean, it costs, uh, Colgate and crest. It cost them about 35 cents to put a tube of

00:40:59.260 | toothpaste on the shelf. And that includes everything buying the shelf space, the packaging, the marketing,

00:41:04.840 | and then they sell it for four to $6. And this is one of the easiest ways to, to, to make money in the

00:41:10.940 | world. And everyone's using it like clockwork, uh, twice a day. Uh, so that change will come. Uh, and I

00:41:18.440 | think they will shift away from fluoride, but for right now they like their ADA seal of approval, all the,

00:41:25.020 | the American dental association, all, all that the ADA looks at is that it has fluoride in it. They have

00:41:29.820 | dug their heels in so far. It is so deeply. It is, it is shocking actually. And how, you know,

00:41:35.400 | you say it's better to use these other things. If someone out there is like, well, I'm using my,

00:41:39.000 | my crest Colgate. Is it like drop everything, go change it, or it's okay, but there are better

00:41:43.900 | options. You know what? I would say drop everything. And it's not just the fluoride. Um, I mean,

00:41:49.980 | you're using a toothpaste that it was designed like the early versions of toothpaste and the versions

00:41:56.360 | before that it's essential oils, bactericidals, uh, emulsifiers and surfactants. Those are the

00:42:02.680 | ingredients that help make large batches, but an emulsifier will break down a lipid layer. Guess

00:42:06.920 | what your cell wall is made up of a lipid layer. So you don't, you're taking down bacteria. How do

00:42:11.880 | you know you're taking down the right ones? We don't. And that's never a good approach because

00:42:15.660 | sometimes a bug can have a good purpose or a bad purpose. It depends on how it's fed and the

00:42:20.760 | environment that it's in. I would say, drop it, drop it. It's the best thing you can do. It's one of

00:42:24.800 | the best things you can do. If you have oral disease, first thing you should look at is what

00:42:29.660 | are you using to prevent it? Yep. Okay. And what ingredients should they be looking for when

00:42:36.160 | they're shopping for toothpaste to find something that's better? There are very few. I, and I'm

00:42:41.120 | shocked that there are so few, but I think the basis for the success of our formula, and I'm not talking

00:42:46.220 | about people liking it. I'm talking about clinical studies that we've done at the university of Texas

00:42:50.760 | that we'll be presenting soon. The first study was just presented in New York at a big craniofacial

00:42:56.880 | kind of dental nerd researcher meeting. So a toothpaste will work very well and will feed your

00:43:04.760 | good guys. It will nourish your oral microbiome. And again, remember we talked about that earlier.

00:43:09.700 | The oral microbiome is online. There's no chance of oral disease. Everything's going to work well,

00:43:14.960 | even systemic diseases down the road. So how do you do that? Well, first of all,

00:43:18.800 | don't get in the way of the oral microbiome by taking it down. So look for a toothpaste that

00:43:22.720 | has no essential oils, no botanicals. Again, there's no data that supports that. Those are

00:43:27.760 | important. Most of the time, a, whether it's a cosmetic, uh, manufacturer company or toothpaste,

00:43:35.420 | they add those because it's a natural way, or it's a way of hiding the fact that they're trying to

00:43:40.500 | preserve their formula instead of adding other preservatives. So an essential oil, could it be

00:43:45.660 | acting as a, like the emulsifier? It's there for the manufacturing process and to give it a long

00:43:50.840 | shelf life. So, but eucalyptus oil, like in Listerine can, is one of the most bactericidal

00:43:57.980 | essential oils. It will kill a bug. It's cytotoxic. It's bactericidal. So no essential oils,

00:44:04.840 | no botanicals, no emulsifiers, no surfactants. Those four are the first things you want to look for.

00:44:10.000 | And that's what's unique to our formula. I think it's the first time that's ever been done

00:44:13.140 | with a remineralizing agent in place. There are some very natural toothpaste that maybe are just

00:44:18.920 | like coconut oil and, and, and maybe like a calcium, a calcium carbonate or, or like a xylitol or

00:44:26.500 | glycerin. And then obviously no fluoride. And if you're, you need a remineralizing agent, you need

00:44:32.080 | some calcium in, I mean, if you need the same ingredient that's in your teeth, in your saliva,

00:44:36.520 | which we all do, don't use fluoride. Fluoride will bind with calcium and do the job, but it also

00:44:42.860 | gets into your bloodstream, to your brain, especially if you're pregnant, especially if you have young

00:44:47.120 | children, do not use fluoride. There's no need for it. So then if you need a remineralizing agent,

00:44:51.780 | then think about nanohydroxyapatite. And other than flavor, you really, you don't need much.

00:44:58.820 | Don't overthink toothpaste. It's not a magic bullet. But most of the toothpaste out there are actually

00:45:05.320 | doing the exact opposite. They're actually harming your oral microbiome and therefore your oral health

00:45:09.900 | long-term short-term.

00:45:11.660 | I imagine a lot of people listening are going to think, okay, if it were really true that most of

00:45:15.920 | the toothpaste out there are hurting your teeth, why would my dentist not be telling me why would

00:45:21.220 | they even be allowed to be sold? So is this cutting edge science or what's behind the probably large

00:45:27.560 | number of skeptics listening, thinking is Mark kind of way off the deep end telling us that this thing,

00:45:32.660 | they're all doing that my dentist approves and even probably gives me in a little bag every time

00:45:36.400 | I go, it's hurting me.

00:45:38.380 | Great question. First of all, toothpaste is regulated under the category of cosmetic products.

00:45:45.020 | There is no FDA approval unless it has fluoride in it. That's carefully regulated.

00:45:50.380 | So the reason dentists do this is because they are so frigging busy running their own business,

00:45:56.420 | high overhead business, sole proprietorship, keeping up with the new techniques, continuing education.

00:46:02.160 | They just kind of go with the flow. I mean, what they're taught in dental school and that fluoride

00:46:05.880 | is this miracle product. It's been around for 75 years. No one's ever questioned it. There's no hard

00:46:11.440 | data that supports it. They just kind of go along with it. It's easier to do that. And then if you're

00:46:16.540 | against fluoride, you're part of this conspiracy group or whatever you want to call it. And that

00:46:21.080 | was the right thing about this lawsuit. Seven years of back and forth, expert testimonial. It proved

00:46:27.400 | that fluoride is bad. So that's one thing. Dentists really kind of go with the flow and whatever the ADA

00:46:33.820 | says, that's what they're going to do. There are many dentists that are against this and understand

00:46:38.620 | this. These are what I call functionally minded or integrative dentists, biological, holistic. I prefer

00:46:44.760 | the term functional that covers all of that. And they're looking at Ruca's reasons for why oral

00:46:51.600 | disease is the number one disease in the world. We're recommending all these wonderful products,

00:46:55.400 | toothpaste, floss, mouthwash. Mouthwash actually causes high blood pressure. Two thirds of Americans

00:47:02.300 | have high blood pressure. Two thirds of Americans use a conventional type of mouthwash. I mean,

00:47:06.860 | we're just, we're just not understanding the science in our profession. We are not an evidence-based

00:47:12.360 | profession overall, overall. So, so it's kind of, it's laziness and it's kind of ubiquitous,

00:47:19.860 | but there is an arm of dentistry that is seeing it for what it is. And again, it's all about the oral

00:47:24.220 | microbiome. When that came online, now we understand all the, a lot of the recommendations we've been

00:47:29.700 | making have been incorrect based on the knowledge of this new biome.

00:47:36.320 | Yep. Do you think in five, 10 years, most dentists will stop, you know, handing out a little tube of

00:47:41.700 | crest toothpaste with fluoride?

00:47:43.500 | Probably not. I'd be happy with a 50, 50 mix, but remember private equity is buying dental practices.

00:47:49.820 | And again, it's just, it's whatever's cheapest. And unfortunately, a lot of this is cost-driven.

00:47:55.700 | Uh, my toothpaste costs $14 a tube. That's what it costs to make. I have the same margins. Actually,

00:48:01.140 | I have less of a margin than Colgate does, but you know, Colgate is much cheaper. Uh, and especially if

00:48:07.220 | you go to Costco, right, you're, you're not going to see my toothpaste at Costco, uh, not anytime soon.

00:48:12.220 | So, so a lot of it is, is economics. Um, I would say, and here's, here's a bold statement for you.

00:48:19.580 | I would say instead of using Colgate, you're better off not using toothpaste at all, just floss and brush

00:48:25.980 | the mechanics of just that alone is fine. Okay. So you talked about, you know, perfect world,

00:48:31.660 | 50, 50 functional dentistry. How should someone listening, you know, find a dentist? What questions

00:48:37.100 | should they be asking their existing dentist? And if they need to find a new dentist, what questions

00:48:41.480 | should they be asking to find them? It's not easy. So I, we, we created a directory on our website.

00:48:47.280 | It's not a big directory. Uh, there are other directories. Um, I think really what you need to

00:48:52.340 | do, and I mentioned it earlier, you need to advocate for yourself. You need to educate yourself.

00:48:57.100 | It's the same thing with your financial part of your life, uh, health. Certainly you need to become

00:49:03.200 | informed. You need to go out there and find out what is the right thing. And it's not necessarily

00:49:08.740 | the norm dentistry and medicine. They're 20 years behind what the new research is talking about.

00:49:13.880 | So I would say find a, find a influencer that you like and trust that's been around for a long time.

00:49:18.440 | Um, that's a great source because it's free. All you have to do is listen while you're running,

00:49:23.000 | going on a run or driving in your car, commuting. Also go to the internet. The internet has democratized

00:49:30.080 | healthcare. Not all of it's correct, but most people can pick through what's right and what's wrong.

00:49:35.600 | You can even read studies. Now you can take a study and drop it into chat GPT or LM notebook.

00:49:41.240 | It will pull out all the main points. You can ask chat GPT. Is this a good study or bad study as a

00:49:46.800 | lay person? I mean, this is not out of the realm of the lay person anymore, but it does take some work.

00:49:52.240 | The other thing you can do is ask around, you know, find out, find out from your coworkers,

00:49:57.660 | friends, family, uh, other than just seeing the hygienist. When I had my cavity done,

00:50:03.640 | the dentist told me how not to get the next cavity. They explained it. They didn't give me fluoride.

00:50:09.540 | These are all questions you can ask behind the scenes. And then your friend or coworker will say,

00:50:14.500 | yeah, this is how it went. Just know what questions to ask. We have a list of questions on our website,

00:50:19.920 | ask the dentist. We have the directory on, on our website. It's, and we also have a blog post on how

00:50:26.580 | to get a good referral from a loved one or a family member. Again, it's work. It's work. You can't just,

00:50:32.020 | don't just take, take the list that you're given by your employer and, and go down the list and pick

00:50:38.660 | the one that's closest to you. Yeah. You're, you're playing with fire. Yeah. I mean, a couple of things

00:50:42.580 | I learned. So one, the reason we even got connected was I was at the dentist's office and I was asking my

00:50:47.460 | dentist a question that I learned to ask my doctor, which was, you know, if I was going to spend a little

00:50:53.300 | bit of money out of pocket, not covered by insurance, what should I do? And my dentist's

00:50:57.880 | answer was get a third cleaning. You know, your insurance will cover to get a third one. It's about

00:51:02.700 | $120. And I was like, well, that doesn't seem that expensive for if the best thing I could be doing for

00:51:07.880 | my dental health is $120 a year. That seems wild. Um, and, and then I asked him, you know, who should I,

00:51:15.200 | who do you look up to in the space as someone you respect in the dental world? Because I'd love to

00:51:20.100 | do an episode on it. He suggested you and here we are. So I've got a handful of questions, but first

00:51:25.700 | off, we talked about all the things in your oral health routine. We didn't talk about dental

00:51:30.220 | cleanings. How important is that process? So that twice a year was completely arbitrary, uh, way back

00:51:37.240 | when 20, 40, 50 years ago, again, dentistry as a profession was thinking, well, how, what's the

00:51:43.220 | biggest bang for the patient's buck? In other words, how can we treat everyone the same and guarantee

00:51:48.860 | that we can stop, you know, gum disease in its tracks? And they came up with twice every six months.

00:51:54.740 | It was easy. Insurance had something to do with it, uh, as well. Uh, it's just an easy formula. Uh,

00:52:00.940 | again, as I said earlier, look for a customized program. Uh, most people don't do well with,

00:52:07.000 | every six months. It could be every three to six weeks. That actually is something that we do

00:52:13.120 | recommend for some patients. Um, and again, at $120 a cleaning, deep cleanings are, it costs more

00:52:19.460 | just to let you know, they're quite a bit more, but insurance, uh, will cover 80% of that. If you

00:52:24.400 | have dental insurance and up to a maximum, of course, when you first mentioned that that's a great

00:52:28.880 | suggestion. And what's going on in that cleaning that is beyond what, you know, is happening at home

00:52:34.960 | that would make it something worth doing. You're scraping off a toxin. It can be tartar.

00:52:39.240 | It can be a biofilm. Uh, it can be some bugs that are in those pockets. They are, they're continually

00:52:44.920 | and more often removing the source of this inflammation. We haven't really used the word

00:52:50.500 | plaque that often, but is that when you say, is that plaque? Yep. It's plaque, plaque and tartar,

00:52:56.200 | calcified plaque. Those are irritants. I mean, the body responds to that. It's a foreign

00:53:00.880 | body and it starts bleeding and sending blood to that area. And those aren't things we can easily

00:53:05.840 | remove at home. Not really. No. Once it forms, it's very difficult. I have some patients that buy

00:53:11.380 | instruments on eBay and they're in front of the mirror and cutting themselves. And you can't,

00:53:16.320 | I can't even do it. You just can't work on yourself. Uh, you really need someone else to

00:53:21.160 | come in with a mirror and good lighting to be able to get to all the different, uh, there's so many

00:53:25.220 | little nooks and crannies in the mouth in between the teeth. And so a good cleaning can accomplish

00:53:29.380 | that. Now that doesn't necessarily address the root cause of why you need three or four cleanings a

00:53:33.460 | year. That also has to be addressed, but that was a good answer on his part. It was, that is a quick

00:53:39.760 | and easy way. No brainer. Don't even think about it. Just come in a third time every year.

00:53:45.180 | So I have a lot more questions for him the next time I go in, which will be sooner than six months now.

00:53:51.600 | Another thing I learned, I went really deep on dental insurance because we were on a Cobra policy

00:53:56.620 | that included a dental and then we had to shift and now we were responsible for deciding whether

00:54:01.200 | we wanted our own dental insurance. It was a little mind blowing how dental insurance works because

00:54:06.280 | unlike medical insurance, there's always some sort of cap. And the cap in my mind was relatively low

00:54:13.380 | one to $2,000 for most of the plans. So, you know, no matter what best dental plan you had,

00:54:20.120 | I didn't really find a plan that would cover you for more than $2,000 of dental cost a year.

00:54:24.920 | And if your employer is paying for it, of course, why not? But if you are, you know,

00:54:30.000 | those plans costed anywhere from, you know, probably on the low end $30 to $50 a month.

00:54:37.380 | You could make a case if you have good clean health that self-insuring might actually be a more

00:54:42.400 | appropriate path here because your maximum out-of-pocket loss was $2,000. But with a lot of

00:54:49.300 | these dental plans for anything that is beyond cleaning, you know, there's like a tier one,

00:54:54.960 | 80% covered, tier two, 50% covered. So you're going to be paying a lot even if your dental insurance is

00:55:01.540 | kicking in. So I'm not going to tell people not to get dental insurance, but definitely take a look

00:55:06.620 | at it. It's significantly cheaper to get dental plans that are preventative only. And I guess

00:55:13.040 | people don't get their annual cleanings because it is cheaper to get a preventative only dental plan

00:55:18.560 | that covers two cleanings and x-rays than it is to pay for two cleanings and x-rays. Presumably

00:55:24.920 | because people aren't using it. Right. It's a very well engineered product. It is not an insurance

00:55:30.240 | product. It's more of a service. If your employer pays for it, try and get a high quality product.

00:55:35.400 | There are deductibles. Even the first moment you walk in, there's a, even for preventative work,

00:55:41.400 | not always, it depends. Low maximums. It's designed for very, they control the utilization of

00:55:47.680 | the plan very well. It's actually a more lucrative product, not in overall dollars, but per plan.

00:55:52.900 | There's very little, there's no loss really. Um, so, uh, we have a blog post. It's quite old now,

00:55:59.560 | but we call it the margarita plan where we would always encourage our patients to do this, uh,

00:56:04.540 | depending on what the payout and what plan they had, especially if they're paying for their own plan,

00:56:09.420 | put the money aside, put a hundred dollars aside and you, you have the same maximum almost,

00:56:14.340 | maybe a little bit less, but you can spend a hundred percent of it. It's not limited by those

00:56:18.800 | different tiers that you were mentioning. So there's not a 20% copayment. So

00:56:22.640 | it's a tricky product. Again, if your employer pays for it, uh, hopefully it's a good plan. If

00:56:28.660 | it forces you to go to a kind of a capitation or a DSO type of office, maybe you'd want to get paid a

00:56:37.540 | little bit more instead of getting that dental plan. Uh, and then talk to your employer about

00:56:41.420 | that before you get hired. Medical insurance, of course, is very, very important that protects you

00:56:45.620 | against catastrophic financial loss. If you were to get into a car accident, Chris, and,

00:56:49.580 | and this, I see this happen a lot, the damage to the teeth and the face, but mostly the teeth

00:56:54.900 | easily exceeds 20 to $60,000. Your insurance will not pay for that. Even if you over a period of 10

00:57:01.580 | years, it won't because it's limited by the year, the maximum. So it's really not an insurance product.

00:57:07.560 | There are a lot of issues that we've really never addressed in, uh, this schism between, uh, dentistry

00:57:14.660 | and medicine. And, and anyway, um, it's, it's, it's a very interesting area.

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00:59:49.000 | Two more little things I learned in the process. One, many, not all, but many dental plans offer

00:59:55.540 | out-of-network coverage. And I was surprised to see that a lot of the out-of... In a lot of medical

01:00:01.580 | plans, you'll see, well, we cover... You have a 20% copay in-network, maybe you have a 40% copay out-of-network.

01:00:07.100 | A lot. I probably looked at 9 or 10 different dental provider options. And it was more common than not

01:00:14.640 | that the out-of-network coverage equaled the in-network coverage. So if that's the case,

01:00:20.020 | by no means restrict yourself to the dentists that are on the list. Does that mean you might have to

01:00:25.800 | file your claim yourself? Not always. Some dentists will even take care of the out-of-network claim

01:00:30.920 | management also. Correct.

01:00:32.120 | So I would say, don't be restricted to the list you see on your dental network plan. And then my dentist,

01:00:39.020 | they have their own dental plan, which costs, I think, $375 a year. It includes your x-rays,

01:00:45.620 | two cleanings, and then they give a 25% discount on any dental work you have to do beyond that.

01:00:52.360 | And so we've decided, let's self-insure our dental with a plan from them.

01:00:58.400 | And I did the math. And the number of scenarios where we would end up better with dental insurance

01:01:03.460 | was like only the scenario where we exactly had $2,000 worth of dental work. But if we had $1,000

01:01:10.600 | of dental work, nope, we were better paying ourselves. And I'm surprised for the sake of

01:01:16.000 | dentists around the country, getting my teeth, a cavity filled with a dentist and a hygienist,

01:01:24.240 | both there in the chair for almost an hour is a few hundred dollars.

01:01:29.380 | I know.

01:01:29.960 | Whereas last night, unfortunately, we took my daughter to urgent care to get an x-ray for her

01:01:36.540 | leg, which may or may not have resulted in a fracture from a gymnastics trampoline. Turns out

01:01:42.800 | we might not know for three days. We have to go back to get another x-ray if she's still hurting.

01:01:47.240 | I am almost certain that the cost behind that, where we engaged with the doctor for minutes,

01:01:53.900 | is going to be over $1,000.

01:01:56.640 | Oh, I would say it's probably more.

01:01:58.420 | That will be billed to, well, in our high deductible health plan case, us to some extent.

01:02:03.340 | But it's just mind-blowing that healthcare has gotten so expensive and dental care relative to the

01:02:11.400 | number of minutes you're sitting down with someone who's gone through rigorous education

01:02:16.080 | seems relatively affordable. And I know that there are lots of people that can't afford that in their

01:02:21.900 | budget, but relative to medical, it seems like I was surprised at how affordable it was once I

01:02:26.860 | started looking at covering it ourselves.

01:02:29.040 | This is a perfect illustration of a question you asked earlier, what to look for in a dentist.

01:02:34.740 | That's another thing to look for. If your dentist is basically looking at you when they look in your

01:02:41.640 | mouth as just an insurance plan, and you could be a really good insurance plan, you could be a very

01:02:46.240 | poor insurance plan, they are literally indirectly being influenced by that insurance plan. If you have

01:02:51.880 | a great plan, they're going to think, oh, that patient's more likely to go for the crown. And that's

01:02:56.180 | not the kind of dentist you want. You want to see the guy, the dental clinic that you're seeing.

01:03:01.960 | That's a brilliant move. And that should be an indication to the patient that they are immune

01:03:07.760 | from the influences, the external influences of a dental plan. Most dentists practice based on what

01:03:13.780 | kind of insurance you have. And if you're a cash patient, they're just used to not getting paid or

01:03:18.340 | to being turned down on the correct treatment plan, which may seem expensive to begin with, but it's the

01:03:25.340 | right one, whatever that may be. Do you want to be seeing an extension of an insurance plan that's

01:03:29.900 | reducing utilization, or trying to increase profits if it's a private equity owned corporate kind of

01:03:35.520 | dental insurance? Or do you want to be seeing a mom and pop that really has some flesh in this game,

01:03:41.860 | and they want their kids to be dentists and work in this practice, and they've set up a system,

01:03:46.140 | like what you mentioned, their own dental plan, or, which is what I did for over 36 years is I would

01:03:53.520 | ask for the cash up front. I was tired of chasing down the insurance companies that cost me money.

01:03:58.640 | So I charged my patients less, I would ask for everything up front, and we would bill their

01:04:02.960 | insurance for free. And guess what? Insurance companies are regulated in the state of California,

01:04:07.200 | I'm sure it's in every state, and a payment has to be made or denied within 30 days, right? Well,

01:04:13.560 | if you play the regular game that most dentists do, where you just bill the insurance, you wait,

01:04:18.840 | and then you bill them a second time, and you get on the phone, you pay someone to get on the phone,

01:04:21.980 | and get that payment, usually it's 90 days out, right? And no one ever prosecutes them or slaps

01:04:27.480 | their hand, and that kind of thing. Why not let the dentist regulate their cash flow in a very

01:04:34.540 | expensive, high overhead business, and give them the cash at the time of service. And then you wait for

01:04:42.920 | the insurance payment. Here's the kicker. When we did that, when we switched to that, we had to drop Delta Dental to do

01:04:47.980 | that. The punchline is this, the insurance payment came to the patient like 1315 days, every single

01:04:53.240 | time, which by the way, is probably before the credit card bill they paid on was due. And you know, for

01:04:58.660 | anyone listening that likes points and miles, let's say you have $1,000 of dental work a year, if you pay

01:05:04.380 | for it, you get points on $1,000, the dental insurance reimburses you. If you go direct to the insurance

01:05:10.240 | company, now you don't get that spend. So it's an extra 1000 or two or 4000 points that you might have

01:05:16.500 | running that model. We were happy as a profession to help support that point system. Yes. That next

01:05:23.720 | flight to Europe or whatever it may be. Yes, that's dental insurance. I'm sure we could unpack that a

01:05:28.000 | lot deeper. Oh, yeah. It's a fascinating subject that does not get talked about often enough.

01:05:32.360 | One other thing. I remember a time where my sister went to the dentist, and the dentist was like, I think

01:05:37.080 | you have four cavities. And she was just blown away. It was a new dentist. So she went to another dentist

01:05:42.240 | dentist and got a second opinion. And they were like, you're fine. Right? How important do you think

01:05:46.560 | someone who gets a diagnosis from a dentist of something like three, four cavities, or even one?

01:05:52.900 | Is it worth getting another opinion on either whether these are real cavities, whether they could be

01:05:58.960 | something treated in other ways, like just letting your body remineralize the area? How should someone

01:06:06.260 | react when a dentist tells them they need work? This happens a lot. Unfortunately, a lot of the new

01:06:12.360 | patients I would get would be second opinions with outrageous treatment plans. I don't know if you

01:06:16.700 | remember, but a lot, maybe 1015 years ago, there was a Reader's Digest article on and the, the journalist

01:06:23.280 | went to eight or nine different practices in in her area. And she literally got, you know, every treatment

01:06:29.260 | plan was way different than the other one, not just in cost, but in terms of which tooth was being treated.

01:06:34.220 | And that was a real problem for the profession. And there were a lot of explanations given,

01:06:38.040 | and then it popped up again later. Someone else, you know, had a slow day in journalism. They tried

01:06:43.020 | the same thing and it happened again. So this is a problem. So we have a blog post on this on our

01:06:48.520 | website. It's pretty simple. Gut feeling, you know, if you've been going along every, every twice a year

01:06:56.120 | and you get a cavity once or twice a year or less, or you've never had a cavity and all of a sudden

01:07:02.120 | something has changed, uh, definitely get a second opinion, uh, because this does happen. And

01:07:07.800 | everyone quote unquote has a different philosophy. A lot of dentists say, well, if there's any chance

01:07:13.360 | of a cavity, I want to go in, well, I can keep it small. Well, but if there isn't a cavity, is that

01:07:18.180 | ethical? I mean, and what if the cavity never occurs? Sometimes, um, uh, sometimes root canals are,

01:07:24.520 | are jumped to. In other words, there's no need for the root canal. The tooth is hurting,

01:07:28.400 | but it's reversible pulpitis. That's a diagnostic code. And if it's reversible, that means that it

01:07:33.940 | could recover. But then the dentist says, yeah, but the patient's in pain. They're going to Barcelona

01:07:38.880 | next week and we don't want it to blow up in Barcelona. I mean, this is the kind of reasoning

01:07:43.180 | that goes on either upfront with the patient or without a lot of knowledge for the patient. The

01:07:48.340 | patient's just taking the word of a dentist. So if it seems a little out of whack, like in the case of

01:07:53.920 | your sister, all of a sudden four cavities, absolutely. Those could be cavities that didn't

01:07:58.280 | exist to begin with. Um, or it could be a cavity that could be reversed. Uh, so definitely get a

01:08:04.560 | second opinion. And you know what, if they resist or get a little funny or, or just throw you a set

01:08:09.460 | of records, or you don't get copies of the x-rays as quickly as you would like, and it's a difficult

01:08:14.220 | process, or you pay an exorbitant amount for those copies, then you're probably better off moving on.

01:08:20.020 | There's something wrong there, or they just don't like to be second guessed. A lot of dentists

01:08:23.160 | don't like to be second guessed. Yep. And I'll just remind everyone that as much as it might seem

01:08:28.860 | in the medical world, like a second opinion is a pretty expensive process. If you're able to get

01:08:33.660 | your x-rays from your dentist and you're taken to another dentist for a second opinion, even if it

01:08:38.820 | weren't covered by insurance, my guess is that second opinion is going to be in the low hundreds of

01:08:44.280 | dollars, if not as much as you might think. Um, right. So as a policy, I'd never charge for a second

01:08:50.040 | opinion unless we had to take another x-ray, but if it's just a quick look, it's 15 minutes. I did

01:08:55.140 | that for the betterment of the profession. I did. I wanted patients to do well through the process and

01:09:00.600 | it wasn't because I wanted them to stay with me. A lot of the time I would send them back and say,

01:09:04.320 | you know what, they're right. Or it would be a lot of these second opinions are about bad dental work.

01:09:09.800 | And then I would send, I would give them an option. There's a very inexpensive option.

01:09:14.920 | Instead of hiring a lawyer, there's a peer review system. And I would hook them up with that.

01:09:19.340 | Every dental society has a peer review system. They go in, they have three dentists look at it. If it

01:09:24.680 | is bad dental work, then the, it gets written up and those that their, their membership is at risk.

01:09:30.880 | So they return the money and then they move on. It's way better than handling it with attorneys and,

01:09:35.660 | and the result is better for the patient. So yeah. Uh, if that happens, gut, I mean,

01:09:40.720 | follow your gut instincts. If it doesn't feel right and, and, and ask for the x-rays right away,

01:09:46.260 | say, I just want to run this by someone else. And for the cases where maybe it is the case that you

01:09:51.020 | need a lot of dental work, whether it's a root canal crowns, bridges, you know, the accident you

01:09:55.640 | mentioned, but maybe, maybe not in an emergency sense. I did an episode recently on medical travel

01:10:00.440 | and I, I, we talked about turkeys well-known for hair transplants and there's all kinds of

01:10:05.220 | procedures that people can travel for where the healthcare system isn't like the healthcare

01:10:10.440 | system in the U S where things can be quite expensive. I know traveling for dental care,

01:10:15.920 | maybe not your, your preventative care, but for, for really expensive things is, is a possibility.

01:10:22.080 | How do you feel about that? Do you have any thoughts?

01:10:23.820 | Yeah, that's called dental tourism. Again, we have a blog post on that. Um, that was a difficult one to

01:10:29.560 | write and we did a lot of research and we spoke to a lot of patients, some great success, uh, success

01:10:34.780 | stories, huge, uh, Hungary. We listed some of the countries that we would recommend. We would not

01:10:39.220 | recommend Mexico, uh, Canada. Uh, there are differences, local regional pricing, uh, take

01:10:45.160 | advantage of an exchange rate. For example, the problem is, and again, we mentioned this in the,

01:10:49.620 | in the post, a lot of dental work needs a follow-up. Are you willing to travel back? And then what about

01:10:55.700 | the follow-up and the care? And then if you go to a new dentist, then, you know, they're, they're,

01:10:59.900 | they're taking over that dental work. It's going to be more expensive. So there are some issues with that,

01:11:04.340 | but people have had success stories. I know people that have had their hip transplants done

01:11:08.860 | in Belgium. I had a lot of patients that did that. And that typically is a good example of why you'd

01:11:13.100 | want to do it. It's cheaper. You get better physical, uh, you get better PT, physical therapy

01:11:17.960 | afterwards. And then after that, you're done. Okay. All right. So I was thinking at the end of

01:11:22.200 | this, cause we're about to wrap is maybe I could just rapid fire a few topics and you could say,

01:11:26.180 | because I imagine any of these, we could talk for a long time. Um, so I'm going to run through a few.

01:11:31.840 | So when it comes to gum recession, is that reversible? Is it how important is it? What

01:11:36.940 | should we be doing? Typically not reversible. Try and prevent it. Okay. If you're aware that it's

01:11:41.820 | happening to get on that bandwagon right away, prevention, find out what the root cause is.

01:11:46.140 | Is it your brushing? Is it grinding? Is it trauma? Is it orthodontic trauma? 10 years ago,

01:11:51.540 | there are many, many reasons for it. Okay. Next one's orthodontia. Um, you know,

01:11:56.760 | we, we have kids under, under five right now, so it's not something we're thinking about,

01:12:01.220 | but there was that age when I was a child where it's like, well, everybody goes and gets their

01:12:04.780 | braces, anything, you know, people should be thinking about in today's world with orthodontia.

01:12:10.700 | The problem with the current model is that we wait too long right now. The, the new model and the,

01:12:15.820 | um, the functional model is get an assessment by age two or three years old. And by age nine,

01:12:22.860 | the development is done. So you want to be intervening at age five or earlier or slightly

01:12:27.540 | later. So orthodontia is very important, but the generalized form. And again, I get a lot of

01:12:34.600 | flack for this, but it's pretty much a racket when you wait for all the adult teeth to come in,

01:12:38.080 | or even with phase one, phase two therapy, that's not the way to go. It doesn't give you a good result

01:12:43.100 | and it doesn't fix the, the bigger issues. And that is the size of your airway, the shape of your face

01:12:48.060 | and all of that. So start early. And for adults with unstraight teeth, you know, any,

01:12:53.940 | is there anything they should be thinking about other than, you know, there's a lot of companies

01:12:57.340 | now offering trays as an alternative to braces. Right. Right. Expansion maxillary expansion. Uh,

01:13:03.760 | my daughter's going through it right now. She's 27 years old as an adult. You can, it's harder to do.

01:13:09.220 | It's easier to do on a child because they're soft and malleable and it goes a lot quicker,

01:13:13.140 | but you can do that on adults. Expand the maxilla to make room for those teeth.

01:13:17.540 | Even expanding the maxilla will help increase the size of posterior nasal apertures. You can breathe

01:13:24.040 | better through your nose. It helps in so many different ways beyond oral health. Uh, yes,

01:13:28.660 | it can be done as an adult. And then on the note of children, any other thoughts on, you know,

01:13:34.120 | oral hygiene, dental care for kids? Chew gum, keep throwing gum at them, get, find a healthy gum.

01:13:40.740 | That is the best thing you can do. There are plenty of studies out there. In fact,

01:13:44.140 | if mom, a pregnant mom chews gum and when the baby is born, her child will have, I think it's 64%

01:13:54.140 | less chance of having a cavity by age six. If the kid is chewing gum, I think it's like a 93%. There we

01:14:02.140 | have, I have a podcast episode on that, on, on those studies. And so brushing your kid's teeth is

01:14:06.600 | difficult. Flossing. It is difficult. Reminding them to do it is difficult. They're not going to do

01:14:10.680 | it correctly. Um, you know, mouth breathing is, is tough on teeth and it promotes decay. Diet is

01:14:17.740 | tough to regulate. Xolotol gum is a no brainer. It's so easy. Have it stashed everywhere after every

01:14:23.200 | meal, or if your kid is wakes up with a dry mouth, Xolotol gum.

01:14:27.080 | Okay. And then the last one I have is a teeth whitening. I know it's kind of a, you know,

01:14:31.180 | they, you talked about, you're not going to have your toothpaste at Costco. I always see the white

01:14:34.840 | strips at Costco. I know people are, are very concerned about their appearance and their breath

01:14:39.640 | and how does teeth whitening fit into functional dentistry?

01:14:42.980 | It was kind of like the diet industry. Everybody wants to be thin before they're healthy and,

01:14:46.600 | in overall medical health or overall health. Um, it's the same thing with whitening. In fact,

01:14:52.860 | a lot of dentists jump right to it and they see some yellow teeth. They know that the patient's

01:14:56.380 | probably concerned about it. Even before they mentioned cavities and other things, whitening

01:15:00.140 | is a big moneymaker. You know, it's, it's not readily known, but there's no regulation of dental

01:15:06.240 | whitening in the U S in Europe. It's heavily regulated. In fact, you can only use a 10% gel.

01:15:12.480 | We're handing out, you can get it on Amazon here. We're handing out 35, 40%, uh, concentration of

01:15:18.620 | gels. Uh, also it's, it's age gated. You cannot whiten a kid's teeth. You have to wait till they're

01:15:25.220 | 18. And there's a reason for that. Pulpal sensitivity, et cetera. It's the wild, wild west

01:15:30.300 | out here in, in the U S with dentistry. So whitening is fine. It works. Make sure you do it correctly.

01:15:36.020 | Make sure it's a tray that's cut away from the gums. An Invisalign tray is the ideal, uh,

01:15:40.800 | tray for whitening because it only holds the gel on the teeth. If the gel gets out,

01:15:45.240 | it's going to affect the oral microbiome because it's, it's bactericidal. It's hydrogen peroxide.

01:15:50.160 | It creates free radicals in your mouth. The last thing you want, but, and if you whiten too often

01:15:54.740 | and too aggressively, you're going to have issues, even permanent ones. Um, so I would just make sure

01:16:01.000 | you're doing it the European way. Again, we have a blog post on this. I think I have a podcast episode

01:16:06.300 | on this. Do it slowly. I mean, if you waited to the last minute, you're getting married in four days,

01:16:10.780 | yeah, we can whiten your teeth. We can do it, but it's going to come at a cost,

01:16:15.340 | not just financial cost, a lot of sensitivity, uh, damage to the enamel. Be careful.

01:16:20.220 | Yeah. Yeah. You're probably better to use Photoshop in that case.

01:16:23.040 | Uh, okay. I think I hit so many of the things in here. I have a lot of takeaways for me. Uh,

01:16:31.300 | one that I, we didn't explicitly talk about, but it sounds like there's a lot going on in your oral

01:16:36.080 | microbiome snacking throughout the day, you know, give your teeth some time to go through

01:16:40.800 | these processes throughout the day. Is there, is there a window of time that you might need to say,

01:16:45.440 | Hey, make sure every day you've got two or three hours, two or three times to kind of do their own

01:16:49.880 | thing. Right. Again, it's that frequency issue. Uh, and that's why intermittent fasting has its,

01:16:55.320 | uh, advantages to oral health as well. I mean, if you keep snacking all the time,

01:16:59.840 | then think about it. Your, your teeth are always trying to remineralize and, and that demon is,

01:17:04.980 | we call it the Stefan's curve. It's a, it's a graph and it, it, you know, it based on pH and how

01:17:10.740 | often you eat, there has to be a recovery time. Otherwise the body cannot keep up with the fixing

01:17:15.740 | of the teeth and the remineralizing of teeth. So if you could eat two or three meals a day,

01:17:21.020 | six hours, four to five hours apart, if you're eating two meals a day, uh, I think the best way to

01:17:27.160 | intermittent fast is to eat a good breakfast, maybe an hour or two after you wake up, not

01:17:31.860 | immediately, uh, have a big lunch like the Europeans do, and maybe just some protein powder for dinner.

01:17:37.840 | That is a great way to go when it comes to teeth. I know that doesn't sound ideal for a lot of people,

01:17:42.500 | but it's kind of what my grandkids are doing. That's what my wife and I do. And it works and

01:17:47.440 | you can enjoy that if you're snacking all day long and you're really not aware of it and you're

01:17:52.300 | drinking, sipping a Red Bull and, and diet sodas, regular sodas, coffee, all of these beverages,

01:17:59.840 | uh, your, your teeth don't have a chance really to recover. You will pay the dentist.

01:18:05.840 | Great. Um, this has been fantastic. Uh, we referenced a lot of blog posts. I'm going to try to put as

01:18:11.220 | many of them as I can or podcast episodes in the show notes, but for people who want to go deeper on

01:18:16.920 | everything you're doing, where do they find you? Instagram, ask the dentist, uh, our website,

01:18:21.780 | ask the dentist.com. You could go to our toothpaste site. We've got a lot of information there.

01:18:25.980 | It has its own separate, uh, Instagram site. Fig F Y G G stands for feed your good guys. Um,

01:18:33.500 | we're on Tik TOK. Uh, we've just kind of started. Um, uh, I have a book on sleep. Uh, again, that's

01:18:39.720 | something we didn't talk about, but probably better to see your dentist first, rather than a physician.

01:18:44.740 | When it comes to sleep, we can see it decades before a physician can. It's not because they're

01:18:48.760 | dumb or stupid and, and, or we're super smart. We just have a different training. We see it differently.

01:18:54.120 | Um, so yeah, I would say start at the Instagram channel and, and probably the website.

01:18:59.280 | All right. This has been fantastic. Thank you so much for joining me.

01:19:02.520 | Thank you, Chris. I enjoyed it.

Optimize Your Oral Health for a Longer Life with Dr. Mark Burhenne

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