How to Improve Oral Health & Its Critical Role in Brain & Body Health

00:00:00.000 | Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life.

00:00:06.000 | I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

00:00:15.000 | Today, we are discussing oral health.

00:00:18.000 | Now, when most people hear oral health, they immediately think tooth health and appearance and presumably fresh breath or lack of bad breath as well.

00:00:27.000 | And while, of course, tooth and breath, freshness, whiteness, and health is a critical component of oral health,

00:00:35.000 | today you will learn that oral health, including the oral microbiome, the health of your palate, your tonsils,

00:00:42.000 | indeed the entire oral cavity, is an extremely important component of general bodily health.

00:00:49.000 | So much so that today we are going to add a seventh pillar to the so-called six pillars of mental health, physical health and performance.

00:00:58.000 | This is not a trivial step to add a seventh pillar to the six pillars.

00:01:03.000 | If some of you have been listeners of this podcast for a while, you may recall that the six pillars of mental health, physical health and performance,

00:01:10.000 | that is the six things that everyone needs to invest specific protocols into each day are in no particular order, by the way.

00:01:19.000 | Sleep, sunlight and light exposure generally, which by extension also includes dark exposure, nutrition,

00:01:28.000 | exercise, which we could also call movement, both cardiovascular exercise and resistance training,

00:01:34.000 | stress management and relationships and social engagement, including relationship to self.

00:01:40.000 | And today we are going to add oral health and microbiome health.

00:01:44.000 | And I suppose we could generally call this oral and gut health, because as you know,

00:01:51.000 | if you think about it, your mouth, your oral cavity and your gut are contiguous with one another.

00:01:58.000 | We are going to add oral and gut health as the seventh pillar of mental health, physical health and performance.

00:02:04.000 | Because as you will learn today,

00:02:06.000 | there are so many aspects of oral health and daily protocols for oral health that extend to cardiovascular health,

00:02:14.000 | to metabolic health and indeed to brain health and to staving off diseases in all of those bodily compartments.

00:02:21.000 | I cannot overemphasize enough how much oral health influences your general bodily health.

00:02:27.000 | So today you will learn about oral biology and health.

00:02:31.000 | We won't go too deep into the biology, but we will go deep enough into the biology that you will learn some incredible things,

00:02:37.000 | such as your teeth have the ability to literally fill back in cavities that have formed,

00:02:43.000 | provided those cavities haven't gone too deep into the teeth layers yet.

00:02:48.000 | You will learn that saliva, while most people think of it as just spit, is an incredible substance,

00:02:54.000 | fluid that contains all sorts of interesting and important things that allow you to rebuild the strength of your teeth

00:03:01.000 | and indeed to support the health of your oral cavity and gut microbiome and body generally.

00:03:06.000 | So saliva is super interesting and important.

00:03:09.000 | And today you are going to learn many, many protocols, including zero cost protocols,

00:03:14.000 | protocols that will actually save you money, as well as some low cost protocols to both restore,

00:03:21.000 | improve and maintain oral health and in doing so, maintain and improve your overall bodily health.

00:03:28.000 | Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

00:03:33.000 | It is, however, part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public.

00:03:41.000 | In keeping with that theme, I'd like to thank the sponsors of today's podcast.

00:03:45.000 | Our first sponsor is Matina.

00:03:47.000 | Matina makes loose leaf and ready to drink yerba mate.

00:03:50.000 | I often discuss yerba mate's benefits such as regulating blood sugar,

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00:04:03.000 | While there are a lot of different choices of yerba mate drinks out there,

00:04:07.000 | I love Matina because, again, they have the no sugar variety,

00:04:11.000 | as well as the fact that both their loose leaf and their canned varieties are of the absolute best quality.

00:04:17.000 | So much so that I decided to become a partial owner in the company.

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00:05:05.000 | Roca makes eyeglasses and sunglasses that are of the absolute highest quality.

00:05:10.000 | I've spent a lifetime working on the biology of the visual system,

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00:07:13.000 | Okay, let's talk about oral health.

00:07:15.000 | This absolutely critical aspect of not just having fresh, bright teeth and no cavities and fresh breath,

00:07:22.000 | or at least lack of bad breath, one would hope, but also total body health.

00:07:27.000 | As I mentioned a little bit earlier, oral health is inextricably linked to all aspects of brain and bodily health,

00:07:35.000 | both in the short term and in the long term.

00:07:37.000 | And it is perhaps the most overlooked aspect of mental health and physical health.

00:07:42.000 | So today I'd like to start off with a quiz.

00:07:45.000 | I'm going to ask you which of the following three categories you believe you best fall into.

00:07:51.000 | Okay, the first category is those of you out there who brush and floss every day, probably twice a day,

00:07:58.000 | and make some effort to try and keep your teeth clean, who like the feeling of your teeth being clean,

00:08:04.000 | and who pay a fair amount of attention to whether or not your teeth are getting whiter or not getting whiter,

00:08:12.000 | maybe whether or not your breath is fresh or not fresh, maybe, okay, these aren't requirements for being in this category,

00:08:17.000 | but maybe you're somebody who also uses a mouthwash or uses mints or gums in order to try and keep your mouth smelling

00:08:26.000 | and looking fresh and your mouth clean.

00:08:28.000 | Okay, so this first category does not require that you do all of those things,

00:08:32.000 | but let's just make a basic requirement of participation in this category that you routinely brush at least twice a day

00:08:40.000 | and that you floss at least once a day.

00:08:43.000 | Okay, if you fall into that category, you are in category one.

00:08:46.000 | And by the way, if you're in category one and you do those things and you do a bunch of other things like tooth whitening

00:08:50.000 | and maybe you go to the dentist, especially often more than the recommended twice per year,

00:08:55.000 | that still puts you in category one.

00:08:57.000 | Okay, second category are those of you out there who are, let's say, a bit more blasé about your oral and tooth care,

00:09:07.000 | those of you that perhaps just brush your teeth in the morning so that your breath is fresh

00:09:11.000 | and clean out that kind of sticky feeling in your mouth that's accumulated overnight,

00:09:15.000 | that sometimes brush and maybe floss at night, but, you know, a lot of times you fall asleep without doing that

00:09:21.000 | or you don't feel like doing it, or perhaps that don't really floss at all, okay,

00:09:27.000 | that perhaps go to the dentist once every six months, maybe a little less, maybe once a year, once every couple of years.

00:09:34.000 | So while there's a bunch of different things that could put you into category two,

00:09:37.000 | let's make a basic requirement for belonging to category two that you brush your teeth once a day

00:09:44.000 | but not twice a day on a regular basis, or that you brush twice a day but that you rarely floss, okay,

00:09:51.000 | that would put you into what I'm calling category two.

00:09:54.000 | And then, of course, there's the third category that maybe some of you out there fall into,

00:09:58.000 | and this is the category of people who are extremely diligent, not just about tooth care,

00:10:06.000 | but also about oral health generally, about maintaining the microbiome of your mouth,

00:10:11.000 | about making sure that your gums are very healthy, about making sure that your soft palate and hard palate is very healthy,

00:10:16.000 | about making sure that, yes, your teeth are clean,

00:10:19.000 | that they're devoid of as much bacterial buildup and other stuff in there that can cause cavities,

00:10:25.000 | but also that you're paying careful attention to your oral microbiome and the overall milieu of your health in the mouth

00:10:34.000 | and the fact that your mouth is linked to all these different aspects of brain and cardiac and metabolic health, okay?

00:10:40.000 | If you fall into that third category, great, but let's be honest.

00:10:44.000 | Most people, I would argue 95, maybe even 98% of people or more fall into either category one or category two.

00:10:55.000 | So as you're hearing this, you're probably thinking, okay, well, if I'm in category one, I'm good, right?

00:10:59.000 | I go to the dentist twice a year, I brush and floss, use some mouthwash, I even brighten my teeth,

00:11:03.000 | I make sure that if I had a sugary meal, I'll rinse out my mouth, I try not to drink acidic foods,

00:11:08.000 | things that we'll discuss today as to whether or not they actually have relevance for cavity formation or not.

00:11:14.000 | But guess what? If you were in category one, as I described it, or category two,

00:11:21.000 | chances are you are doing things to really deplete and disrupt your oral health.

00:11:28.000 | That's right. Even if you're paying a lot of attention to tooth health, chances are, if you're like most people out there,

00:11:34.000 | simply because you don't have the latest information on what oral health really is and how to best support it,

00:11:40.000 | chances are you are doing things that, yes, might be keeping your teeth white and clean and you're not getting cavities,

00:11:46.000 | or you're not being told you have cavities that need to be filled when you go to the dentist twice a year or more,

00:11:53.000 | but that you are disrupting your oral health in ways that are depleting other aspects of your brain and bodily health.

00:12:01.000 | And I'm not here to scare you. I'm just here to tell you that if you're in category one, okay,

00:12:05.000 | you're clearly doing some things that are beneficial for you, but that there's some additional things that you can do

00:12:09.000 | and a few things to avoid doing that very likely will improve your overall bodily health very quickly.

00:12:16.000 | And the good news is those things are also zero or low cost or in some cases can save you substantial cost.

00:12:23.000 | Now, if you're in category two, chances are you are depleting both your oral health and your overall bodily health.

00:12:30.000 | But here's what's interesting. Some of the folks in category two that are not doing as much for the,

00:12:35.000 | let's say, hygiene and freshening and whitening of their teeth actually have a healthier overall oral microbiome.

00:12:44.000 | That's not always the case, but often it can be the case.

00:12:48.000 | So what you're going to discover today is whether you're in category one or category two,

00:12:52.000 | there are some wonderful and easily accessible practices that are well backed by science.

00:12:58.000 | And by the way, in preparation for this episode,

00:13:00.000 | I also consulted with no fewer than five dentists, including a pediatric dentist.

00:13:05.000 | I talked to a periodontist. I talked to people who fall into the functional dentist category.

00:13:09.000 | I talked to people with a bunch of different orientations who are all heavily qualified to talk about

00:13:15.000 | and to make recommendations about oral health and tooth health, et cetera.

00:13:19.000 | And what I'm going to deliver today is essentially the overlap in the Venn diagram of what they all agreed on.

00:13:24.000 | I'll highlight a few differences that they each had and that several of them had.

00:13:29.000 | They do fall into different camps,

00:13:30.000 | but I was positively surprised how much overlap or consensus there was in terms of best protocols for tooth and oral health.

00:13:38.000 | And by the way, if you're in that third category of the person that's doing a lot for their tooth health and appearance and breath, et cetera,

00:13:43.000 | but also oral health and microbiome,

00:13:45.000 | I'm sure that today you'll also learn some new health practices

00:13:48.000 | and some things that will allow you to expand on your already terrific practices for oral health.

00:13:53.000 | So let's get into the material about oral health,

00:13:57.000 | focusing first on tooth anatomy and health and a little bit about mouth anatomy.

00:14:01.000 | I promise to not go into this in too much depth, but we really need to have a firm basis,

00:14:06.000 | a foundation of understanding of what the mouth cavity really consists of.

00:14:11.000 | And I'm not just going to throw a bunch of names out there for sake of nomenclature.

00:14:14.000 | I don't need to cloud your hippocampus with that sort of information unless it's functional information.

00:14:19.000 | But it is critical functional information for the rest of our discussion where we'll talk about ways that you can really build up the strength of your teeth,

00:14:26.000 | even if cavities have already started to form and how to really get your saliva to be the best,

00:14:32.000 | healthiest saliva for your overall mouth and for your gut and for your brain, your heart, et cetera.

00:14:38.000 | OK, so let's talk just briefly, I promise briefly about the anatomy and a little bit of the physiology of this stuff.

00:14:46.000 | OK, the teeth, we're all familiar with what teeth are in the tongue, the tonsils in the back of the mouth.

00:14:51.000 | We have our soft palate, hard palate, gums. Let's talk a little bit about how all that fits together.

00:14:56.000 | Centering around the thing that most people think about when they think about oral health, and that's the teeth.

00:15:00.000 | It's just a good jumping off point for us. Your teeth are layered structures, like pretty much every structure in your body is a layered structure.

00:15:09.000 | It's just the way those structures form. Cells are born at one location.

00:15:12.000 | They migrate out and form stacks or layers. Those different layers have different cell types and your teeth are no exception.

00:15:18.000 | So while there are different kinds of teeth in your mouth, teeth have an outer layer, which is the enamel.

00:15:25.000 | The enamel, believe it or not, is not white. It is translucent. Light can make it through, but it's not transparent.

00:15:30.000 | It's not like a clear window is translucent. Light can make it through, but it's a bit opaque.

00:15:35.000 | Beneath the enamel is a structure called dentin. Dentin is important for today's discussion because as it turns out, cavities form, not surprisingly, from the outside of teeth inward.

00:15:47.000 | And cavities, as the name suggests, are holes that bacteria burrow down through the enamel.

00:15:53.000 | And if you're unlucky, make it down to the dentin. Our goal, meaning your goal, is to engage in daily protocols.

00:16:01.000 | That's right. Daily protocols that are simple and fast and zero or very low cost that allow you to avoid the formation of those cavities.

00:16:11.000 | Yes, but also that can allow you to fill in those cavities.

00:16:15.000 | This is one of the most important things to understand about oral health that, frankly, I didn't know until I started researching this episode and talking to all these experts in the field, which is that you can repair cavities that have started to form.

00:16:26.000 | That's right. Your mouth environment, based on its chemistry and some things that are mechanical, but mostly based on its chemistry, in particular, how acidic it is or how basic it is, is always in a state of what's called either demineralization or remineralization.

00:16:46.000 | Now, those words are hard to say, and they're especially hard to say fast.

00:16:49.000 | So demineralization, remineralization, it's a little bit of a tongue twister. Today, I'm going to use a shorthand that's a convention in the dentistry field, which is demin or remin to refer to demineralization or remineralization.

00:17:05.000 | Remineralization is good. It is the process by which within the enamel and to some extent in the deeper dentin layer of the tooth, but especially within the enamel,

00:17:16.000 | there can be the addition of new minerals that form very robust, essentially chains of crystals, okay?

00:17:26.000 | If you've ever looked at a crystal of any kind under a microscope or you've seen a picture of it, they are incredibly well organized.

00:17:32.000 | They form a lattice of very strong, often, although there are weaker crystals, too, very strong bonds and structure.

00:17:40.000 | It's like the structure of a really well-formed building, okay? Remineralization is the process of putting minerals back into that crystal structure,

00:17:49.000 | and it's actually possible to fill back in those cavities that bacteria have started to form, especially when those cavities have burrowed down into the enamel but have not yet made it into the dentin layer of the tooth or teeth, okay?

00:18:05.000 | This is very important to understand. It's especially important to understand the context of the fact that typically, not always, but typically, if you have a cavity formed at one tooth,

00:18:15.000 | and let's say it's just halfway or three-quarters of the way through the enamel layer, that if you have cavities elsewhere in your mouth, chances are that they are at the same depth or level.

00:18:25.000 | Not always, but chances are, and that's great news if those cavities have not yet made it into the dentin layer. Why is it great news?

00:18:32.000 | Well, I don't know about you, but I don't like having my teeth drilled. I don't like having cavities drilled and filled.

00:18:39.000 | I had a very traumatic childhood with respect to dentistry and oral health. I'll talk about it a little bit later in the episode.

00:18:48.000 | It's not that I had tons and tons of cavities. I actually had this other issue where my adult teeth came in behind my baby teeth.

00:18:54.000 | I had all my baby teeth pulled. I had to get a bunch of injections of Novacaine in my mouth.

00:18:59.000 | I didn't like getting injections into my mouth, so I opted to have any cavities I had drilled without Novacaine.

00:19:04.000 | It's not because I was a tough little kid, although that definitely toughened me up.

00:19:08.000 | It was because I hated having syringes in my mouth. I might've even bitten a dentist or two or three.

00:19:13.000 | I don't bite the dentist anymore. I thank the dentist.

00:19:16.000 | By the way, I think dentists are wonderful. Regular cleanings are wonderful. We'll talk about frequency of cleanings.

00:19:21.000 | But here's the point. If you are somebody who enjoys getting your teeth drilled, well, then I don't know what to say.

00:19:28.000 | But if you're like most people out there with proper wiring of your neurology,

00:19:33.000 | well, then you don't like getting your teeth drilled and you can avoid it in many cases by remineralizing that enamel layer of your teeth.

00:19:43.000 | Now, if there's demineralization down to the deeper dentin layers of the tooth, then most often you're going to need it to be drilled,

00:19:52.000 | drilled and filled, as they say, or as some people say, which is a bit more cynical, drill, fill and bill,

00:19:58.000 | because you get charged for that or your insurance gets charged for that.

00:20:01.000 | OK, back to some tooth anatomy and mouth anatomy. We talked about the enamel layer of the tooth on the outside.

00:20:07.000 | I told you that it either can demineralize, demin or remineralize, remin.

00:20:11.000 | This is a key point. Your teeth are always in a state of either demin or remin.

00:20:18.000 | That's right. Either demin or remin. It's not both at the same time.

00:20:22.000 | It's one or the other. And it is largely dependent on the pH that is the acidity of your mouth,

00:20:30.000 | which is largely dependent on how much saliva you're producing and the mineral content of that saliva.

00:20:36.000 | Keep that in mind. I think it's a very important point. Now, another key point is that next to your teeth, right,

00:20:41.000 | you have your gums, the gingiva, as it's called. Now, the gingiva provides a really important role in keeping the teeth stable.

00:20:50.000 | We don't often think of it like that. But even though that stuff seems gummy and soft, it is soft tissue.

00:20:55.000 | It is very important for fixing the teeth to the bone. It's not just about the roots that extend down into the jawbone below.

00:21:01.000 | The gums are very important for keeping the teeth where they are.

00:21:05.000 | There's actually a little ligament, too, between gums and the teeth that resides a little bit deeper.

00:21:10.000 | But the gums form a critical barrier between the oral cavity and the deeper layers of what eventually is bone and into the general blood flow or bloodstream of the body.

00:21:23.000 | Now, this is so important to understand that the gums are a seal around the tooth.

00:21:28.000 | This is why when you go to the dentist, they're paying attention with that little pick. They're paying attention to how high or hopefully low the tinting is.

00:21:37.000 | The little recesses or pockets of gums along the hair going, "Yes, I have my tooth hanging in my mouth. Yes."

00:21:45.000 | I'll try not to do that during today's episode. Point to my teeth so much so that I'm then, you know, you can't understand what I'm saying.

00:21:50.000 | That the gums are providing a seal between the oral cavity and essentially the bone and the general bloodstream.

00:21:59.000 | Now, this is so critical because let's just take a step back and think about the oral cavity and what a remarkable place it is. Think about it.

00:22:06.000 | This is a gaping hole in our body. Okay, we have some other gaping holes in our body, but those tend to be sphincter based holes.

00:22:14.000 | Yes, I realize there are probably some chuckles as soon as you say sphincter. Like, yes, the anal sphincter. Okay, we're anatomists, we're biologists, we can talk about that.

00:22:20.000 | Stay shut. Stuff is generally not going up there and if it is, not very often. Okay?

00:22:26.000 | Your nasal passages. Yeah, those are holes, but you know, there's a lot of stuff there. There's mucus to catch stuff.

00:22:33.000 | There's a cribriform plate. There's a bone. There's a bunch of things that act as barriers between the nasal cavities and the brain, which sits right behind it, the olfactory bulb.

00:22:43.000 | And yes, we have eyes and then, you know, we have the outside of the eyes and there's a, you know, a susceptibility there, but we have our blink reflex.

00:22:49.000 | There's also an ocular microbiome. There's a bunch of things there.

00:22:52.000 | But think about the just this gaping hole in the front of our face that we use to eat and speak and breathe.

00:22:58.000 | Okay? It's a huge hole and as a consequence, it's filled with bacteria from our outside environment all day long.

00:23:06.000 | All day long, sometimes at night, although we're going to talk later about the critical, critical need to be a nasal breather at night and not a mouth breather.

00:23:15.000 | Not just for sake of staving off sleep apnea, but also because it turns out the dryness of the mouth is one of the ways that you really can throw off your oral health in major ways.

00:23:24.000 | In fact, it's one of the leading causes of tooth decay in people like methamphetamine addicts.

00:23:28.000 | Or if you see people that are mouth breathers, their oral health and their teeth generally, but certainly their oral health is severely depleted.

00:23:36.000 | So you've got this big hole in front of your face and you're talking and eating and moving about during the day,

00:23:40.000 | even if you're a nasal breather, when you're not talking or eating and all this bacteria is getting in and it's a really moist environment and it's really warm.

00:23:48.000 | So the combination of bacteria moist and warm means that this thing is like a Petri dish for growing stuff that could potentially be really bad for us.

00:23:57.000 | But it has this incredible feature, which is that if the pH is right, then the bad stuff is killed off.

00:24:06.000 | Doesn't make it into our system, doesn't disrupt our oral health or our bodily health.

00:24:10.000 | It also has a critical feature, which is that the bacteria that are good for us proliferate and supports the sealing process of the gums against the teeth and tooth health and tongue health and palate health, et cetera.

00:24:22.000 | Okay, so the oral cavity is amazing by virtue of how vulnerable it is, but also how robust it is.

00:24:28.000 | And the way it stays robust is by keeping the saliva healthy.

00:24:32.000 | Now there are other ways too, but that's one of the main ones and it's a huge portal into the rest of the body.

00:24:37.000 | And if the oral cavity isn't amazing to you already, based on what you've heard thus far, think about this.

00:24:42.000 | If you get a cut on your arm or your hand or your shin, unless you're one of these remarkable people that always heals up without a scar, as long as you're about 25 years or older, typically you'll form a little scar.

00:24:56.000 | There'll be something noticeable there.

00:24:58.000 | The oral cavity also can take cuts and burns and things like that.

00:25:02.000 | Unfortunately, those things occur, but with rare exception, heals up with nearly zero scarring.

00:25:08.000 | Sometimes there's a scar, but nearly zero scarring, which is remarkable.

00:25:12.000 | Why? Well, it's basically an open wound with a bunch of bacteria in it and it's warm and it's moist.

00:25:18.000 | So clearly there's something special going on in this thing that we call the oral cavity.

00:25:22.000 | Indeed there is.

00:25:23.000 | And it's anchored in the fact that if we treat it right, you can encourage remineralization.

00:25:29.000 | How do you do that?

00:25:30.000 | By keeping the saliva healthy.

00:25:31.000 | How do you do that?

00:25:32.000 | By supporting the proper bacteria within the mouth and making sure that you're eliminating the bacteria that you don't want, or at least limiting those bacteria.

00:25:40.000 | And today we're going to talk about how to do that.

00:25:42.000 | And by virtue of doing all the things that support tooth health, you're also going to support gum health.

00:25:48.000 | Okay, those gums are critical because they form that barrier that if it gets too big, if those pockets, those recesses get too big and you're not taking care of the bacteria in your mouth, meaning you're not getting rid of the bad bacteria.

00:25:59.000 | Those bacteria worm their way down into the deeper recesses near the roots of the tooth, sometimes into the tooth.

00:26:06.000 | We'll talk about that and can get down into the bone and then can cause serious, serious issues.

00:26:12.000 | This is so-called periodontal disease.

00:26:14.000 | And periodontal disease is associated with all sorts of really bad stuff, including Alzheimer's.

00:26:19.000 | Okay, this is not just some wellness culture, woo science leap to Alzheimer's.

00:26:24.000 | There's literally evidence that the specific bacterias that cause recession of the gums can cross the blood brain barrier if they make it into the general circulation and potentially cause plaques and tangles.

00:26:37.000 | Some of the hallmark features of neural degeneration in Alzheimer's.

00:26:41.000 | Okay, probably not the only cause of Alzheimer's, but potentially one of the major causes.

00:26:46.000 | This is a new theory, but it's one that a lot of people are trying to pay attention to and it's also very clear that bacteria make it down into these deeper recesses near the roots and into the bone that you can end up with issues related to cardiac health and certainly metabolic health.

00:26:59.000 | Okay, so again, the goal today is not to scare you.

00:27:01.000 | It's not to spend too much time on all the terrible things that can happen, but rather to emphasize the positive, which is that if you do the right things at the right times, especially if you do them on a regular basis,

00:27:11.000 | that you can really improve the health of your total oral cavity and your teeth and your breath and all the other stuff that people care about for aesthetics and interpersonal interactions will flourish as well.

00:27:23.000 | I'd like to take a brief moment and thank one of our sponsors and that's AG1.

00:27:27.000 | AG1 is a vitamin mineral probiotic drink that also contains adaptogens.

00:27:32.000 | I started taking AG1 way back in 2012. The reason I started taking it and the reason I still take it every day is that it ensures that I meet all of my quotas for vitamins and minerals and it ensures that I get enough prebiotic and probiotic to support gut health.

00:27:47.000 | Now, gut health is something that over the last 10 years we realized is not just important for the health of our gut, but also for our immune system and for the production of neurotransmitters and neuromodulators, things like dopamine and serotonin.

00:28:00.000 | In other words, gut health is critical for proper brain functioning.

00:28:04.000 | Now, of course, I strive to consume healthy whole foods for the majority of my nutritional intake every single day.

00:28:10.000 | But there are a number of things in AG1, including specific micronutrients that are hard to get from whole foods or at least in sufficient quantities.

00:28:17.000 | So AG1 allows me to get the vitamins and minerals that I need, probiotics, prebiotics, the adaptogens and critical micronutrients.

00:28:24.000 | So anytime somebody asks me if they were to take just one supplement, what that supplement should be, I tell them AG1 because AG1 supports so many different systems within the body that are involved in mental health, physical health and performance.

00:28:37.000 | To try AG1, go to www.drinkag1.com/huberman and you'll get a year's supply of vitamin D3K2 and five free travel packs of AG1.

00:28:46.000 | Again, that's www.drinkag1.com/huberman.

00:28:50.000 | Okay, let's talk about how cavities form because I think this is the major question that people ask when asking about or thinking about oral health.

00:28:59.000 | As I mentioned before, cavities are literally holes, they're fenestrations as the nerds call them, nerds like me call them.

00:29:07.000 | Well, fenestrations, little holes down into the enamel that if they make it down to the dentin layer of the tooth, most likely do need to be drilled and filled and presumably build.

00:29:18.000 | Okay, but your goal, I think all of our goal is to try and keep our teeth in a state of remineralization by keeping the pH that is the relative acid-alkaline balance of the mouth such that the saliva supports remineralization.

00:29:35.000 | Now, let's think about how a cavity actually forms.

00:29:39.000 | Turns out that no specific food, not even sugar causes cavities.

00:29:45.000 | Cavities are not caused by sugar. Cavities are caused by bacteria that feed on sugar.

00:29:52.000 | And now that's not just a little bit of a twist in the mechanism, that's a critical point.

00:29:57.000 | There's no specific food, not even pure sugar, not even like a hard candy, like a delicious Jolly Rancher, I used to like those when I was a kid, that gets stuck in your tooth that causes cavities.

00:30:07.000 | No, it's the bacteria that feed on sugar that then produce acid that burrows down through, that degrades, that demineralizes the tooth in this very focal area that we call a cavity.

00:30:22.000 | Okay, now, if that isn't surprising enough, get this, the bacteria that causes cavities by eating sugar and releasing this acid,

00:30:33.000 | while there are several of them, the major one is called Streptococcus mutans, or what I'll call strep mutans for short.

00:30:39.000 | Strep mutans is not something you're born with. It's actually a communicable bacteria.

00:30:46.000 | That's right, you give it to one another through how? Sharing of glasses, sharing of bottles, kissing on the mouth, et cetera.

00:30:55.000 | Now, I am not here to tell you not to do any of those things. I'm certainly not here to tell you that.

00:31:00.000 | However, and by the way, in researching this episode, I did learn that there is a specific category of person out there.

00:31:07.000 | Typically, they are a dentist or married to a dentist that have opted, believe it or not, to never kiss their children near or on the mouth,

00:31:15.000 | so as to help their children not get Streptococcus mutans because almost all adults carry it, not all, but it's communicable like a STI or like a flu or like a cold.

00:31:27.000 | It's communicated between individuals. We are not born with it.

00:31:30.000 | Now, that's a whole area of let's just call it biosocial ethics decision-making that I think most people are not going to be too concerned with

00:31:40.000 | or at least act on because let's face it, most people are not going to change their overall behavior of kissing or usage of bottles or glasses in order to avoid getting strep mutans.

00:31:53.000 | Most people in the world have strep mutans or will get strep mutans and it lives in the mouth, okay?

00:32:00.000 | It just resides there. Strep mutans is there and it's hungry. What's it hungry for? Sugar.

00:32:07.000 | When there's sugar present, it eats it, it produces acid, the acid produces cavities, taking teeth from a state of remineralization to demineralization or,

00:32:18.000 | and by the way, this is really important, if your mouth is already in a state that's more demineralization mode, so to speak,

00:32:27.000 | well, then it will capitalize on that and it will cause cavities much faster, okay?

00:32:34.000 | So keep in mind that acidity is bad for the mouth. Does that mean that you should never consume a lemon or, and by the way, yes,

00:32:42.000 | I'm guilty of every once in a while, chew a lemon slice or drinking water with lemon in it or carbonated drinks or sodas or tea or anything that has acidic flavor?

00:32:52.000 | No. Likewise, should you completely avoid ingesting any kind of sugar because strep mutans love sugar?

00:32:59.000 | No. Turns out, strep mutans like sugars in the form of complex carbohydrate sugars, too.

00:33:04.000 | So if you eat pasta or rice or oatmeal and some bread every once in a while, as I do, I'm an omnivore.

00:33:10.000 | I eat meat and fish and eggs and also starches and vegetables and fruits. I'm an omnivore, as most people are.

00:33:17.000 | Well, then strep mutans has an opportunity to eat the sugars that come from those other carbohydrates.

00:33:22.000 | Does that mean that if you were to have a zero carbohydrate diet, no sugars, no starches, et cetera,

00:33:27.000 | you would reduce the opportunity for strep mutans to consume sugar and release acid?

00:33:33.000 | Maybe. Maybe. However, most people won't do that. And strep mutans is a very clever, maybe even diabolical bacteria.

00:33:41.000 | And if you are on a zero carbohydrate, zero sugar diet,

00:33:44.000 | there's some evidence that strep mutans will figure out ways to feed on other components of food in order to create this acid to then create cavities in your teeth.

00:33:54.000 | So the key thing to understand here is that cavities form not from foods, not from sugars per se,

00:34:00.000 | but from strep mutans and other bacteria that eat those sugars and create acid.

00:34:04.000 | Hence the critical need to keep your mouth as alkaline as possible,

00:34:09.000 | which does not mean that you can never drink some lemon water or coffee or tea.

00:34:13.000 | Here's the key point that everyone needs to remember,

00:34:15.000 | because this dovetails beautifully into how often you should brush and floss and when you should brush and floss specifically.

00:34:22.000 | The key point is the degree to which your mouth is in a demin state or a remin state and the degree to which cavities have the opportunity to form

00:34:32.000 | is dependent on the amount of time, the amount of time in which your mouth is net acidic or net alkaline,

00:34:40.000 | the amount of time that you are in a demineralization mode or remineralization mode.

00:34:47.000 | Okay, so it's the amount of time. No one, no one can avoid having their mouth be acidic every once in a while

00:34:54.000 | or ingesting a sugar or a food that strep mutans can feed on and produce acid.

00:34:59.000 | The key is to try and reduce the amount of strep mutans and reduce the amount of acid in the mouth.

00:35:05.000 | That's the best way to reduce cavities and even reverse cavities that have started to form.

00:35:10.000 | Now in a moment, I'm going to tell you about fluoride because I know there are a lot of questions about fluoride,

00:35:14.000 | but in order for you to understand what I say about fluoride and to make the best decision about fluoride,

00:35:19.000 | both in drinking water and toothpaste, et cetera, for you,

00:35:22.000 | you have to understand the remineralization process just a little bit, just a little bit.

00:35:27.000 | So a little bit of chemistry here, a little bit structural biology, and this will be fun.

00:35:30.000 | I promise, even if you know no biology, no structural biology, no chemistry, you're going to like this part.

00:35:35.000 | And it's very simple. Those minerals that form the crystals within the enamel and some of the deeper layers of your tooth or teeth rather,

00:35:45.000 | those crystals form through a specific type of bond and those bonds are very strong.

00:35:49.000 | Think of them like Lego chains, but these are not, you know, just conventional Lego chains.

00:35:52.000 | These are Lego chains that when they stick, when two pieces come together, things are tough to pull apart.

00:36:00.000 | They're not indestructible, but they're tough to pull apart.

00:36:02.000 | And they're also special because unlike a string of Legos, like a single string of Legos,

00:36:07.000 | these bonds that form during remineralization of the teeth are interdigitated with one another,

00:36:14.000 | or rather are at angles with one another that make those bonds especially strong.

00:36:18.000 | Any architect or somebody that understands structural biology will understand that bonds can be weak or strong,

00:36:23.000 | depending on whether or not they're linear, whether or not they're crossed, whether or not they're in lattices.

00:36:27.000 | There's a whole bunch of interesting, you know, angled forces stuff that the architects will understand

00:36:32.000 | and the construction workers will understand at a very intuitive and concrete level, no pun intended, and on and on.

00:36:38.000 | But just think about it. A bond is only as strong as the number of different points at which it can resist shearing and pressure.

00:36:47.000 | So the way that these remineralization bonds form is through the addition of specific minerals at specific angles

00:36:55.000 | and the naturally occurring mineral that's responsible for the majority of these bonds in the enamel and teeth is called hydroxyapatite.

00:37:03.000 | What a great name if you're talking about oral health, right? Because we use the mouth for a lot of things.

00:37:07.000 | You can think of the small list or long list of those things.

00:37:09.000 | There are many of them, depending on who you are and what you like to do with your mouth.

00:37:13.000 | But the point being that we do indeed eat with our mouth. Appetite is part of eating.

00:37:18.000 | So you just remember hydroxyapatite bonds and they are very strong, but they're not indestructible.

00:37:23.000 | Acid can actually break those bonds, okay? That's the demineralization process.

00:37:28.000 | Now, fluoride is a substance that is not a vitamin. It's not a mineral.

00:37:34.000 | It is not an essential nutrient, but that in the last century it was discovered can actually replace some of the hydroxyapatite bonds in teeth

00:37:44.000 | and actually make those bonds hyper strong, super physiologically strong.

00:37:49.000 | Now we'll talk about the safety considerations with fluoride in a little bit because there are some safety considerations.

00:37:54.000 | But it was decided en masse in the United States and Europe that the addition of fluoride to the drinking water

00:38:01.000 | and to many toothpastes or tooth powders would be useful because it creates these super physiologically strong bonds

00:38:10.000 | within the minerals of the teeth. And indeed it does. It does.

00:38:15.000 | Fluoride gets between those Lego pieces and makes them extra, extra strong.

00:38:20.000 | And this is why fluoride is added to the drinking water.

00:38:23.000 | But and this is very important to emphasize, but nowadays there is a really polarized debate about fluoride

00:38:32.000 | because some people out there believe that fluoride can disrupt thyroid health, might even be disruptive for brain health.

00:38:39.000 | Certainly if fluoride levels are too high in drinking water or any substance, it can be very dangerous, it can be a poison.

00:38:46.000 | But of course the dose makes the poison, right? Fluoride itself may not be poisonous at very low levels.

00:38:51.000 | But there are really two camps now that have formed. And I'll just illustrate those two camps by virtue of what's happening right now.

00:38:57.000 | Right now in the state of California there is a major lawsuit against the government because people want fluoride removed from the drinking water

00:39:05.000 | because of the long list of bad things that excessive, I want to highlight, excessive fluoride can do for bodily and brain health,

00:39:12.000 | especially in kids, but also in adults. At the very same time, meaning right now, there is also a major lawsuit,

00:39:18.000 | this one in Buffalo, New York, from mostly parents who are suing the city of Buffalo saying that there was not enough,

00:39:24.000 | maybe even zero fluoride in the drinking water for some period of time.

00:39:27.000 | And as a consequence, their children's teeth or oral health or both is depleted and they are suing for damages.

00:39:35.000 | Okay, so this is a really polarized camp. Now, I did a full episode of the Huberman Lab podcast all about water.

00:39:41.000 | And I talked about fluoride levels, which levels are thought by the CDC to be safe, which levels are not thought to be safe.

00:39:48.000 | I talked about some of the theories as to how fluoride might disrupt function of the thyroid and some considerations there.

00:39:55.000 | Please check out the timestamp in that episode. I linked to that timestamp in the caption for this episode.

00:40:00.000 | But the important point here is that if you are at all concerned about fluoride in the drinking water,

00:40:04.000 | the simple answer is to just filter the water that comes out of the tap.

00:40:08.000 | If you're concerned about fluoride, then I suppose you'd probably want to avoid toothpastes that have fluoride.

00:40:12.000 | Indeed, there are some. I will provide links to some of those in the shownote captions for this episode.

00:40:17.000 | There are a variety of these zero fluoride toothpastes that have started to accumulate.

00:40:21.000 | But keep in mind that when fluoride is introduced into the bonds of the minerals of the teeth, they do make the teeth really, really strong.

00:40:29.000 | But and all the dentists I spoke to emphasize this point, the bonds that form are not the natural bonds.

00:40:35.000 | Now, the fact that they're not the natural bonds doesn't necessarily mean that they aren't good for us or that they're bad for us.

00:40:40.000 | But the bonds that form when viewed under what's called electron microscopy look different.

00:40:44.000 | They look wavy. They're not smooth bonds. And they do increase the resistance to different forces,

00:40:52.000 | including cavities or acid that would create cavities. To be specific, they make the teeth stronger structurally.

00:40:58.000 | So resistance to chipping, et cetera. But there is a growing concern about excessive fluoride, which, by the way,

00:41:06.000 | if you drink a lot of tap water, you're going to be exposed to more fluoride than if you drink less tap water.

00:41:11.000 | That just kind of stands to reason. But people don't really talk about this, right?

00:41:14.000 | When you talk about X amount of fluoride by concentration in a given liter of water, a gallon of water,

00:41:19.000 | you also have to ask, well, how much tap water are you drinking every day? Okay, you have to ask that question, right?

00:41:23.000 | It's not simply the concentration. It's how much you're ingesting overall.

00:41:27.000 | And that's something that's much harder to control for. Again, in the water episode,

00:41:31.000 | I talk about ways to eliminate or reduce fluoride in the drinking water if that's a concern of yours.

00:41:35.000 | But if you want to know why there's fluoride in drinking water, it's because governments figured out, hey, well,

00:41:40.000 | if we want to reduce tooth decay, what's the simplest low-cost method to do that?

00:41:45.000 | Well, it's to put fluoride in the drinking water. And you now also now know why there's fluoride in a lot of toothpaste.

00:41:52.000 | But given the concerns about thyroid health, potential concerns about brain health,

00:41:57.000 | you also know why many people, including some dentists that I spoke to, are not big fans of fluoride,

00:42:04.000 | both for children and for adults. So you just have to make a decision for you. I'm not here to tell you what to do.

00:42:09.000 | You just have to decide, are you pro-neutral or against fluoride in your drinking water?

00:42:13.000 | And if so, are you going to filter? Are you going to completely avoid drinking any water,

00:42:17.000 | maybe even cooking with any water from the tap and on and on?

00:42:20.000 | But now you know why fluoride is in drinking water and fluoride is in toothpaste.

00:42:24.000 | If you're somebody who's concerned about fluoride in either or both of those sources, well,

00:42:29.000 | then what you really want to think about and what most of us probably should be thinking about anyway,

00:42:33.000 | is trying to increase the remineralization state of our teeth and mouth in ways that don't create the opportunity for any other health hazard.

00:42:43.000 | And I will say this as well, which is that there's some data, not a lot,

00:42:48.000 | but some data that fluoride might not be so great for our oral microbiome.

00:42:52.000 | And as we'll soon learn, the oral microbiome is critical for our oral and overall health.

00:42:57.000 | I'd like to take a quick break and thank our sponsor, InsideTracker.

00:43:00.000 | InsideTracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you reach your health goals.

00:43:09.000 | I've long been a believer in getting regular blood work done for the simple reason that many of the factors that impact your immediate and long term health can only be analyzed from a quality blood test.

00:43:19.000 | A major problem with a lot of blood tests out there, however, is that you get information back about metabolic factors, lipids and hormones and so forth,

00:43:26.000 | but you don't know what to do with that information. With InsideTracker, they make it very easy because they have a personalized platform that allows you to see the levels of all those things,

00:43:35.000 | metabolic factors, lipids, hormones, et cetera, but it gives you specific directives that you can follow that relate to nutrition, behavioral modification, supplements, et cetera,

00:43:44.000 | that can help you bring those numbers into the ranges that are optimal for you.

00:43:47.000 | If you'd like to try InsideTracker, you can go to insidetracker.com/huberman to get 20% off any of InsideTracker's plans.

00:43:55.000 | Again, that's insidetracker.com/huberman.

00:43:58.000 | So in a moment, we are going to get into what to do, the to-dos, the behavioral to-dos and some of the other to-dos for trying to keep your mouth in the best possible remineralization state,

00:44:10.000 | the best pH for tooth health, for gum health, for avoiding periodontal disease, maybe even for reversing some aspects of tooth and periodontal sickness,

00:44:19.000 | because indeed you can do that if you shift your mouth to the correct pH, if you're putting it into that remineralization mode, okay?

00:44:27.000 | However, before we get into the to-dos, I think it's very important to discuss the do-nots that every dentist and periodontist I spoke to agreed on.

00:44:36.000 | The quick list, as I'll call it, of bad for your teeth, bad for your mouth, and therefore bad for your brain and body are, not surprisingly perhaps, alcohol,

00:44:50.000 | which by the way, I did an entire episode about alcohol. It's one of our more popular episodes.

00:44:54.000 | I'm not here to tell you to never drink if you're an adult who's non-alcoholic, but the cutoff seems to be two alcohol-based drinks per week beyond which you run into trouble.

00:45:05.000 | And yes, zero is better than any, but here when we say alcohol is not good for oral health and for tooth health,

00:45:11.000 | what we're talking about is the disruption that alcohol creates to the microbiome and the way that it alters the pH of your saliva and places the mouth and the teeth into a demineralization state.

00:45:25.000 | That's very clear. It also kills certain cells of the mouth.

00:45:28.000 | Some people, I remember this in college, would say, oh, you know, if you've got a, you know, you've got a like scratch in the back of your throat, you're getting sick, you know, you should drink.

00:45:35.000 | And that's what they said. You should drink. It's going to kill that thing off.

00:45:38.000 | Well, guess what? It does the exact opposite. It kills off a bunch of things that you want,

00:45:43.000 | like the cells in and around the mucosal layer of the mouth that are actually going to provide immune support and eliminate those bacteria or viruses that are making you sick, et cetera.

00:45:52.000 | So alcohol is bad. I'm not saying you shouldn't drink at all. If you're a non-alcoholic adult, you have to decide for you.

00:45:58.000 | But just understand that if you're drinking alcohol, that you want to pay extra attention to your oral health and your tooth care practices,

00:46:06.000 | especially on the days around that alcohol consumption. And if you're somebody who doesn't want to drink alcohol,

00:46:10.000 | now you have yet another reason to not drink alcohol. The second thing on the no fly list or the not good for us list for sake of oral health are stimulants.

00:46:21.000 | Now, of course, things like methamphetamine, which are severely deleterious, addictive drugs for all sorts of reasons.

00:46:29.000 | They kill dopaminergic and other brain neurons. They are highly addictive and on and on.

00:46:35.000 | But also stimulants like Adderall, Vyvanse, et cetera. Those stimulants,

00:46:40.000 | basically any drug that increases epinephrine and norepinephrine called adrenaline and noradrenaline and are the other names for those are going to have a negative effect on oral health.

00:46:50.000 | Does that mean you should stop those medications if you've been prescribed them?

00:46:53.000 | No, it means that you should do some other things to try and offset the negative consequence of stimulants.

00:46:58.000 | Why would stimulants cause such disruption in oral health? Well, there are really two reasons.

00:47:02.000 | There's a chemical reason and there's a mechanical reason. The chemical reason is that stimulants change the pH of your saliva,

00:47:12.000 | making the mouth more acidic, which makes strep mutans and other bacteria more capable of creating cavities down into the teeth.

00:47:20.000 | They take your mouth and your teeth from that remineralization state, or as I've been referring to it, mode to that demineralization, demon mode.

00:47:30.000 | Demon mode. That's a way to remember it's bad. Demon mode. Demon mode, not good.

00:47:34.000 | Maybe in a video game, demon mode is good. Demon mode, not good for the mouth.

00:47:38.000 | Demon mode. Demoneralization mode. So there's a chemical reason why stimulants disrupt the oral health milieu and cause disruption in tooth health and degradation,

00:47:49.000 | demon of the enamel of the teeth and deeper layers of the teeth. And this is profoundly evident in meth addicts.

00:47:56.000 | But the other reason, and this was a reason that was shared with me by a physician, an MD from University of California,

00:48:01.000 | San Francisco, who interacts by virtue of his profession with a lot of methamphetamine addicts who have terrible teeth is that stimulants encourage mouth breathing.

00:48:12.000 | Watch a meth addict or watch somebody who's on a high dose of stimulants and they tend to mouth breathe because of the shifts in autonomic nervous system function.

00:48:21.000 | They tend to be mouth breathers. So it's the drying of the mouth that also shifts the mouth from that remineralization mode to demoneralization mode.

00:48:31.000 | So if you do take stimulants by prescription, I would hope not methamphetamine or illicit drugs,

00:48:35.000 | but if you take prescription stimulants and by the way, things like, well, butrin, modafinil, they do qualify as stimulants,

00:48:41.000 | even though modafinil is a little bit of a special case. Any drug that increases norepinephrine, epinephrine, any stimulant.

00:48:48.000 | And yes, indeed coffee, we'll talk about coffee as well and tea will make the saliva more acidic and make your oral health potentially less good.

00:48:57.000 | Mouth breathing, bad for oral health, bad for teeth, bad, bad, bad. There's just no question about it.

00:49:03.000 | So today's discussion, I'm calling oral health, but that includes oral airway health.

00:49:08.000 | And I've talked before on this podcast about the fact that if you can be a nasal breather, be a nasal breather, please.

00:49:13.000 | As long as you're not speaking, as long as you're not eating, try and breathe through your nose.

00:49:17.000 | If you're exercising and exercising really hard, like you're running really hard, fine, mouth breathe.

00:49:21.000 | I don't think there's any evidence that staying in nasal breathing mode all the time while exercising is best for performance.

00:49:26.000 | In fact, to the contrary, there are times when you need to mouth breathe.

00:49:29.000 | And there are sports where you need to exhale through the mouth specifically, certain martial arts, for instance.

00:49:33.000 | So not saying don't ever breathe through your mouth, but as much as possible, try and keep the oral cavity moist and closed.

00:49:41.000 | This is critical. So stimulants dry out the mouth, they increase the acidity of the saliva, that's bad. Smoking, cigarettes, and yes, also cannabis.

00:49:49.000 | And yes, vaping does this too. It's so funny. Anytime I talk about smoking being bad, people are like, well, what about cannabis?

00:49:54.000 | Well, I did an episode about cannabis. Cannabis does have certain medical uses that are very interesting and there's good evidence for those.

00:50:02.000 | But for many people, cannabis is not a good idea. You can check out that episode to decide for you.

00:50:08.000 | Then people ask, well, what about vaping? Vaping is not as bad as smoking, right?

00:50:11.000 | That's what they say where they're sort of asking, saying, hoping, wishing, fantasizing.

00:50:16.000 | And the truth is that vaping is terrible for your oral health as well. Is it as bad as smoking?

00:50:21.000 | Probably not. But it's bad for a bunch of other reasons that offset any gain or gains you would get from vaping instead of smoking.

00:50:27.000 | So just know that if you're a smoker or a vapor or if you vape, rather, that you're going to want to pay extra attention to some of the other protocols discussed

00:50:36.000 | and that we will discuss going forward in order to try and support your oral and therefore your whole body health.

00:50:43.000 | OK, so we've got alcohol, stimulants, smoking vaping and by extension, dipping tobacco, frankly, not good for oral health or tooth health.

00:50:52.000 | In fact, they can be pro cancerous to the gum tissue. That's well established.

00:50:57.000 | And they can also cause degradation of the gum tissue and even some of the underlying bone.

00:51:03.000 | If you tend to do it on the same side all the time or often at all. So that's not good.

00:51:08.000 | We already discussed that sugar is not good for oral health. Does that mean you can never ingest sugar?

00:51:13.000 | No, of course not. Enjoy the sweets you enjoy every once in a while. Enjoy a nice pastry.

00:51:18.000 | You know, do as you will. If you're somebody who never eats those things, great.

00:51:21.000 | But then understand that any carbohydrate, any starch provides a sugar that strep mutans can eat and create acid and demineralize your teeth, create cavities.

00:51:30.000 | That is so avoid sugar in excess. And if you eat sugar, try and rinse your mouth after.

00:51:36.000 | And ideally you would brush, maybe even floss after.

00:51:39.000 | I do know those people that after every meal that run in even the middle of the day, they run to the bathroom and brush their teeth and floss.

00:51:45.000 | And that's great. But most people don't do that. So swishing water, rinsing your mouth out again,

00:51:51.000 | plain water, maybe with a little bit of salt in it is going to be beneficial.

00:51:54.000 | We'll talk about mouthwashes later just to give you a little window into where we're headed with that. Most mouthwashes, terrible, terrible for your oral health,

00:52:03.000 | especially alcohol based or antiseptic based mouthwashes, except under certain conditions prescribed or otherwise.

00:52:08.000 | OK, so if you eat any sugar and frankly, after you eat anything, it's a good idea to try and clear as much of that food product from your mouth.

00:52:17.000 | You may not think you still have food in your mouth and teeth, but trying to swish some water, maybe spit it out, maybe swallow it.

00:52:22.000 | That's up to you. Are you a spit or swallow? Not my business. Don't want to know. Don't tell me. Don't put in the comments.

00:52:27.000 | Just decide for you. But sugar and other food products residing in the mouth for long periods of time, not good.

00:52:35.000 | And similarly, acidity, foods that are acidic. So certain things like citrus fruits, which I love, I love oranges.

00:52:42.000 | I have an orange tree in my backyard now and I absolutely love it. I love oranges, grapefruit.

00:52:46.000 | I just I love the peel. I even eat the peel sometimes. It's so delicious. And no one's telling you not to eat acidic foods or to avoid acidic drinks like lemon water or carbonated lemon water.

00:52:59.000 | Some people are really extreme and they decide to just use a straw when they drink those things.

00:53:03.000 | In fact, the dentist I spoke to said, yes, could you ask people, please, if they're going to drink acidic drinks to try and use a straw?

00:53:09.000 | But then I said, well, you know, a lot of straws, they disrupt the environment.

00:53:12.000 | Most people aren't carrying around metal straws or, you know, and what about the turtles, this kind of thing?

00:53:16.000 | And they said, well, OK, here's the real truth. The real truth is it's the amount of time that the mouth is exposed to that acid.

00:53:23.000 | So if they're going to drink it, drink it over the course of five, 10, 15, maybe 20, 30 minutes and then be done with it.

00:53:28.000 | Rinse out the mouth with a little bit of water and try and clear out that acidity. It's not about completely avoiding acid foods or sugary foods or acidic drinks.

00:53:37.000 | It's about, again, limiting the amount of time that the overall milieu of the mouth is acidic because of this whole demon remin thing,

00:53:45.000 | strep mutans and the acid created by strep mutans that can erode the teeth.

00:53:50.000 | And the fact that if your mouth is kept acidic for long periods of time, you're going to provide the opportunity for faster and deeper development of those cavities.

00:53:59.000 | And keep this in mind again, anytime we talk about demineralization, the formation of cavities, remember, it's like a seesaw.

00:54:05.000 | It's either demon or remin, but not both. So anytime you're demineralizing your teeth, you're also not remineralizing your teeth.

00:54:12.000 | OK, so really avoid alcohol stimulants, smoking, vaping, sugar, mouth breathing, acidic foods, acidic drinks.

00:54:22.000 | But many of us, most of us can't avoid any sugars, any acidic foods.

00:54:27.000 | The other things can be avoided. But some of us are prescribed these drugs and need these drugs.

00:54:31.000 | Some people like a drink with alcohol in every once in a while, and it's perfectly fine for them or they've deemed it perfectly fine for them.

00:54:38.000 | In that case, try and rinse the mouth, try and keep the milieu of the mouth as moist and as basic or alkaline, rather less acidic as possible.

00:54:48.000 | So to translate this a bit more to the real world, if you're somebody like me who loves tea, I drink cold brew zero sugar yerba mate.

00:54:55.000 | That's my favorite source of caffeine. I also like a nice black double espresso or coffee every once in a while.

00:55:02.000 | It's fine to drink that, but you don't want to sip on those sorts of things all day and you don't want to sip on them for hours and hours.

00:55:08.000 | And if you're going to combine those things with some acidic foods or with any kind of food, you know, try and get your meals done.

00:55:13.000 | Wrap them up and rinse your mouth and move to the next part of your day.

00:55:16.000 | And that actually segues into a really important point that came about when researching this episode, that if I had to highlight, boldface, underline and light up one particular protocol that I think most everybody is not thinking about,

00:55:30.000 | is that there are certain times in the 24 hour circadian period in which your mouth makes the maximum amount of saliva.

00:55:39.000 | Okay. And that the saliva has an opportunity to be the optimal pH that is chemistry for encouraging remineralization of your teeth.

00:55:51.000 | And that's during the daytime and especially through the middle of the day.

00:55:55.000 | Now, there are a couple of things that can disrupt that. For instance, eating anything.

00:56:00.000 | I don't care if you're carnivore or vegan, whatever. Omnivore. When you eat, you change the pH of your saliva and you're introducing those sugars that the bacteria can feed on.

00:56:11.000 | So one thing that became very clear to me when researching this episode, talking to experts, reading manuscripts and also reading some really interesting books about remineralization opportunities for the teeth,

00:56:23.000 | is that having a stretch of time of maybe two, four, six hours or more where you're not eating anything or ingesting anything that's acidic in terms of liquids can be very beneficial.

00:56:36.000 | Now, this is a vote in support of so-called intermittent fasting.

00:56:40.000 | This is something that I practice typically by eating my first meal somewhere around 11 a.m. every morning, sometimes earlier.

00:56:46.000 | I'll sometimes have a little breakfast at nine if I'm particularly hungry, but typically I eat my first meal around 11 a.m. or noon and then I eat my last bite of food by about 8 p.m.

00:56:54.000 | Not everyone likes to do intermittent fasting. And I realize for sake of weight loss, it's probably interchangeable with caloric restriction generally.

00:57:02.000 | And there's a lot of debate as to whether or not intermittent fasting is going to extend lifespan, whether or not it's better for metabolic health and simple caloric restriction.

00:57:09.000 | I don't want to get into that debate. Frankly, it's a barbed wire debate that's been carried out on this podcast and elsewhere before.

00:57:14.000 | I think it's ongoing. I think it's the best way to couch that debate.

00:57:19.000 | But in researching this episode, it became very clear that we have an amazing opportunity during the day, especially in the morning and throughout the day, to create a lot of saliva.

00:57:28.000 | That's the right pH to support remineralization of the teeth, provided that there isn't a lot of food or acidic liquids in the mouth at that time.

00:57:36.000 | So at least to my mind, this is an interesting opportunity to place intermittent fasting, which again, or even just gaps between meals, not constantly snacking or sipping on acidic beverages throughout the day,

00:57:47.000 | as an opportunity to create that healthy milieu during which the teeth can remineralize and the overall oral health can improve.

00:57:55.000 | Now, does that mean you should never eat or drink anything during the middle of the day? No, I'm not saying that.

00:57:59.000 | I'm saying that if you're going to do those things, try and clear them from your mouth as I described before.

00:58:05.000 | Now, many of you will probably say, hey, during the middle of the night, I'm not eating or drinking anything.

00:58:11.000 | For some of you, that might be the only time that you're not eating or drinking anything because you're asleep.

00:58:15.000 | One would hope you're asleep. But here's the interesting thing.

00:58:19.000 | Every cell, tissue and organ in our body is on a 24 hour circadian clock.

00:58:24.000 | I think many of you have heard me say that in the context of viewing Morning Sunlight and other protocols that I suggest on the Huberman Lab podcast.

00:58:31.000 | But here's the interesting and important point. In the middle of the night, indeed, you're not ingesting any food or fluids, presumably,

00:58:39.000 | but your saliva production is dramatically reduced. Again, dramatically reduced.

00:58:45.000 | And as a consequence, if there's food or rather food opportunity for strep mutans and other bacteria to feed on and create acid to erode your teeth,

00:58:56.000 | the saliva necessary to offset that, to combat that is simply not present or at least not present at the same levels that it is during the day.

00:59:05.000 | So this is a sort of two pronged protocol. On the one hand, I'm saying you might consider trying to introduce maybe an hour or two hour or longer stretches during the day

00:59:16.000 | in which you're not ingesting any food. And if you're drinking anything, it's not acidic.

00:59:21.000 | Or if you are to try and rinse away that acid as much as possible. So plain water would be great.

00:59:26.000 | Avoiding carbonated lemon water would be great. But if you like those things, and indeed, I love those things.

00:59:30.000 | I love carbonated lemon water. I love things like yerba mate. Indeed, the yerba mate I like is cold brew, zero sugar, but has some lemon and ginger in it.

00:59:39.000 | That's fairly acidic. But then drinking it down either pretty quickly or if you're going to sip on it,

00:59:44.000 | then rinsing it away with some water and not doing that throughout the entire day.

00:59:47.000 | And indeed, I tend to drink my caffeine early in the day and not so much throughout the day, maybe a little bit of mate in the afternoon sometimes.

00:59:54.000 | OK, so that's one aspect of maintaining or encouraging the correct pH of saliva to remineralize your teeth.

01:00:02.000 | Create these windows of opportunity where there's a lot of saliva for long stretches of time during the day as long as possible,

01:00:08.000 | while still making it compatible with your nutrition needs and your hydration needs, of course.

01:00:12.000 | The other prong or the other aspect of this protocol is that at night when you go to sleep, you need to know you're not producing very much saliva.

01:00:21.000 | And that's the critical time to make sure that there is as little opportunity as possible for strep mutans and other bacteria to feed on sugars or other food products

01:00:31.000 | and thereby to create acid that creates cavities.

01:00:34.000 | And so this is a very important protocol that every single dental and oral health care professional I spoke to supported and indeed champions,

01:00:43.000 | which is if there is a most critical time of day or night to brush your teeth and floss and clean your teeth, it's at nighttime.

01:00:52.000 | It's at nighttime. Why am I saying this with such whispered importance?

01:00:56.000 | Well, I think there are many people out there, in particular people that fall into that second category that I mentioned at the beginning of today's episode,

01:01:04.000 | that wake up in the morning and brush their teeth, maybe even use mouthwash, maybe floss and do a bunch of things to try and get their mouth clean and fresh,

01:01:13.000 | especially if they're going to interact with other people during the day and to get rid of all the kind of stickiness and morning breath, that kind of thing.

01:01:21.000 | But that at night they're finishing dinner, maybe having some dessert, doing some work and passing out without brushing their teeth or flossing or simply getting too lazy to brush or floss.

01:01:31.000 | And by the way, I'm going to raise my hand and just say for many years, I was in that category.

01:01:37.000 | I know, ew, gross. But I was in that category. I had high motivation to brush and floss or at least a brush in the morning.

01:01:43.000 | Very little motivation to do it in the evening.

01:01:45.000 | Every professional said if you're going to brush and floss just once per 24 hours, and that is not what they recommend, by the way,

01:01:52.000 | but if you were going to do it just once, the critical time, the most essential time to brush and floss and clean the mouth

01:01:59.000 | and get the milieu of the mouth correct for tooth care and mouth overall oral health is at night before you go to sleep,

01:02:07.000 | because you already know the mechanistic backbone for this argument, because at night you're producing far less saliva.

01:02:13.000 | And if there's any food product there that the bacteria can feed on,

01:02:17.000 | the saliva isn't there to combat that because it's a constant battle between acidity and alkalinity.

01:02:22.000 | Your saliva is coming in trying to save everything in the strep mutans is trying to destroy your teeth.

01:02:27.000 | And the acid is the weaponry they use and what fuels that weaponry,

01:02:31.000 | what provides them more ammo to destroy your teeth are sugars and acidity.

01:02:36.000 | So if you were going to brush or floss and ideally you do both only once per 24 hours, it would be at night before going to sleep.

01:02:44.000 | Indeed, so much so that I would say that nighttime brushing and flossing is perhaps one of the most important things that we can do for overall oral health care.

01:02:53.000 | We'll talk about what to do, what to use for brushing and flossing in a few minutes, but that's absolutely essential.

01:02:59.000 | I do not want that to be translated into you only need to brush or brush and floss once per 24 hours.

01:03:08.000 | Every professional I spoke to and all of the data point to the fact that doing it twice per 24 hours is best or perhaps even three times per 24 hours.

01:03:17.000 | But let's be honest, most people are not going to brush and floss three times every 24 hours. Some will, but most won't.

01:03:23.000 | And now of course I've been saying brushing and flossing, but I haven't talked about the incredibly extensive landscape of how to brush and floss.

01:03:32.000 | So now let's take ourselves back to being little kids, right?

01:03:36.000 | When we were taught to brush our teeth in a particular way, you know, you're supposed to spend a certain number of minutes at a timer, supposed to floss in a certain way.

01:03:43.000 | Every time we go to the dentist, they tell us to floss in a certain way, do this, not this.

01:03:47.000 | What did the data really say? What are the modern health professionals in dental and oral health really suggesting we do when it comes to brushing and flossing?

01:03:56.000 | And fortunately here, there's a near uniform consensus.

01:04:00.000 | There's always that outlier, that person that says to do things a little bit differently or no.

01:04:04.000 | There's in fact one person very prominent in the dental health space that is not a fan of flossing, but they are really the outlier.

01:04:11.000 | The vast majority of dentists out there all say the same thing.

01:04:16.000 | You need to brush, you need to floss, you need to do it twice a day or more, and you need to do it correctly.

01:04:22.000 | So now let's talk about what correct brushing and flossing really is.

01:04:26.000 | Okay, so I'm not going to demonstrate how to brush your teeth, but one very actionable protocol that was told to me by all the dental professionals I spoke to was use a soft toothbrush.

01:04:38.000 | Now this one hurts, or I suppose hurts less.

01:04:41.000 | Anyway, it hurts my heart a little bit because I enjoy very much using a medium or hard toothbrush and really like scrubbing back there, especially in the teeth in the back.

01:04:52.000 | It just feels good. I feel like I'm doing something good. I get into the backs of the teeth, the fronts of the teeth.

01:04:56.000 | I actually enjoy brushing my teeth, especially lately. Don't ask me why, but I do.

01:05:02.000 | But every single one of them said that that very vigorous brushing with medium or hard, as they're called, bristles, really disrupts the interface between the teeth and the gums in ways that's not healthy for the gums.

01:05:16.000 | It actually makes tenting of the gums in those pockets, those recesses, as they're called, far more likely to form.

01:05:21.000 | And every single one of them said, if you are regular with your brushing, and especially if you're brushing and flossing regularly, that a soft toothbrush, that is one that's moved in a circular motion on the fronts and backs of your teeth for all your teeth.

01:05:36.000 | And that is gentle. You're not providing a lot of pressure is going to be the best way to break up that biofilm layer each and every time and promote the best tooth and overall oral health.

01:05:48.000 | So I suppose manufacturers are making medium and hard toothbrushes, maybe give us some rationale for that, you know, because the dental professionals that I spoke to, and again, I spoke to a fair number of them, all said the same thing.

01:06:01.000 | Soft toothbrush, not just better, soft toothbrush best.

01:06:05.000 | Likewise, if you use an electric toothbrush, which I now do, sometimes I switch back and forth, but use an electric toothbrush, it was recommended that you not provide too much pressure that you really try and keep the tips of the bristles on the teeth and gums.

01:06:20.000 | And yes, it was also suggested that people brush their gums. This is interesting for people out there who have tooth sensitivity. One of the major suggestions from people in the dental and periodontal field, at least the ones I spoke to, was to actually brush your gums lightly to increase circulation of blood and other nutrients to the deeper portions of the tooth that actually extend into the bone.

01:06:43.000 | There is a tremendous amount of blood flow to the gums. Anyone who's, you know, sort of nicked their gum with a while flossing or with a toothpick can tell you it bleeds very readily.

01:06:55.000 | And that's not a good thing, right? You don't want to create bleeding of the gums. We'll talk about bleeding of the gums during flossing in a moment, by the way, so don't jump the gun just yet.

01:07:02.000 | I said jump the gun, not jump the gum, by the way.

01:07:06.000 | If you are brushing your gums, make sure you're using a soft toothbrush. If you're using electric toothbrush, make sure you're going very lightly on the gums.

01:07:15.000 | And because there's so much blood flow to the gums, it does encourage a lot of circulation to some of the deeper cavities of the tooth, as it turns out.

01:07:23.000 | I don't want to revert to tooth anatomy in any kind of detailed way now, but of course, within the tooth, you have, again, enamel, you have the dentin, you've got what's called the pulp or the center. There's a lot of nerves innervating the center of the tooth.

01:07:38.000 | There's a bunch of other tissues and the bone around it and layers, et cetera.

01:07:42.000 | And when you massage or lightly brush the gums around there, you're encouraging a lot of blood flow to those deeper components of the tooth, which are really the live and active components of the tooth that require blood flow and nutrients.

01:07:53.000 | So this is a good thing. In fact, it's probably such a good thing that most people, perhaps all of us should do it, but most people probably won't take the time to also brush their gums.

01:08:01.000 | But if you have a little bit of time, it can be beneficial, especially if you have sensitive teeth. The idea that's emerging now in the dental field is that it can help promote resilience or less sensitivity of the teeth to things like hot and cold and maybe even to pressure.

01:08:16.000 | So before we talk about flossing, I just want to reemphasize that the reason to brush your teeth and the reason to brush your teeth lightly or without too much pressure, that is, is that if you're regular with your tooth brushing and flossing, the main goal of brushing is to break up the biofilm layer that provides a substrate for strep mutans and other bacteria to layer on thicker layers of bacteria, so-called plaque, that will eventually turn to tartar.

01:08:41.000 | If we really want to gross ourselves out and really motivate brushing and flossing, maybe we should describe that what happens with strep mutans is it forms these strand-like bacteria.

01:08:51.000 | So these are like little celia, so they're attached to the tooth as the biofilm layer, so like little strands of strings.

01:08:57.000 | But if enough of it accumulates, then it gets thicker and kind of mossy, and it's kind of like, you know, thicker and looks kind of spongiform, and that's the plaque.

01:09:05.000 | And then if enough of it forms and there's enough acidity in the mouth, then it forms tartar, which is the hard caked-on stuff that requires scraping off by the dentist.

01:09:14.000 | You know, and some people get a lot of tartar, some people have less tartar buildup, depending on how diligent they are at removing the biofilm with brushing.

01:09:22.000 | Now, you can remove biofilm and plaque with brushing, but once it starts to form tartar, that is, once it's layered on, sometimes it has a yellowish tint to it,

01:09:31.000 | then you really start to run into trouble because brushing and flossing will not remove that tartar, and that's why the dentist needs to get in there and scrape it away.

01:09:39.000 | So it's ideal to be diligent about removing the bacteria while it's still in that strand or plaque form, ideally when it's still in that strand form, removing that biofilm.

01:09:49.000 | If you've ever been to the dentist, you may recall they'll do this tooth polishing, you know, they'll do that thing with the kind of gritty stuff on your teeth,

01:09:56.000 | and you wonder, you know, "Is this to make my teeth whiter?" And indeed, it can create a bit more shine or sheen to your teeth,

01:10:03.000 | but the main reason for doing that, it turns out, is to make the surfaces of your teeth smooth.

01:10:08.000 | After all, they do it on the backs of your teeth too, right? If they're good dentists, they do it on the backs of your teeth as well.

01:10:13.000 | Why would they do it there? It can't be for cosmetic purposes.

01:10:16.000 | Well, they do that because the smooth surface makes it harder for those strands, that biofilm, to stick and form,

01:10:22.000 | and certainly for the more dense plaque and tartar layers to build up on top of it.

01:10:27.000 | So they're making your teeth smooth so that the bacteria can't adhere to it as readily.

01:10:31.000 | But it's the daily protocols of tooth and oral health that are really critical.

01:10:37.000 | We'll talk about dental visits and frequency of dental visits and what a dental visit is really about.

01:10:41.000 | Is it always about cleaning or filling, et cetera?

01:10:43.000 | But in the meantime, brushing and brushing often enough such that you don't get any buildup of biofilm for very long periods of time,

01:10:53.000 | eliminating or reducing the amount of plaque and tartar that builds up is going to be your best strategy for improving tooth health.

01:11:02.000 | Now, what about flossing? There's a little bit of debate about flossing in the dentistry field.

01:11:08.000 | Some people say if your gums bleed when you floss, you need to floss more.

01:11:14.000 | In fact, most dentists I spoke to said that. But they also emphasize that you need to floss correctly.

01:11:20.000 | You can't just pull the floss down onto the gum in between the tooth.

01:11:24.000 | You need to glide down the side of the tooth, get a little bit underneath the gum and use a circular motion and then lift up from between the two teeth,

01:11:34.000 | which frankly is a lot easier if your teeth aren't very, very close together, right?

01:11:39.000 | Some of us have teeth that are very close together and we try and bring it up through the teeth.

01:11:43.000 | It's more of an effort, OK? But they really all emphasize trying to not drop this rather sharp floss.

01:11:51.000 | And here we could also be talking about the toothpick based floss where there's a little arc with a little bit of floss across from it,

01:11:57.000 | the ones that you can buy. Some people actually use toothpicks, an old fashioned method.

01:12:03.000 | Frankly, most dentists I spoke to don't want people jabbing their mouth and gums with toothpicks.

01:12:09.000 | You can decide for yourself. But almost all of them,

01:12:12.000 | except for one, felt that flossing is a great idea for tooth health and that if your gums bleed when you floss correctly,

01:12:19.000 | as I just described what correct flossing is, that your best strategy is to floss at least twice a day between all of your teeth.

01:12:27.000 | And if you're not going to floss twice a day for whatever reason in protest or for lack of time, at least once a day.

01:12:33.000 | And when would that once a day be? It would be at night before going to sleep for the reasons we talked about earlier.

01:12:37.000 | And several dentists I spoke to said that using a water pick is going to be better than using more typical floss

01:12:45.000 | or using those toothpick based floss approaches because it's gentler on the teeth.

01:12:50.000 | I personally have not used a water pick,

01:12:52.000 | but I'm sort of intrigued by the concept because it sounds like it's much harder to damage the gums and teeth by doing it.

01:12:57.000 | And that it is at least as efficient as standard flossing.

01:13:01.000 | So for those of you that have the disposable income and the interest in using a water pick,

01:13:06.000 | sounds like it could be a really good idea for the vast majority of us like me,

01:13:10.000 | just getting some traditional floss and using dental floss at least once a day at night.

01:13:16.000 | And ideally also in the morning after brushing, that seems like the most direct and low cost strategy.

01:13:23.000 | I should just mention that the pediatric dentist that I spoke to mentioned that flossing is really about removing food product from between the teeth.

01:13:32.000 | And therefore children younger than six who typically have big spaces between their baby teeth and their adult teeth have not yet come in.

01:13:40.000 | In fact, that's what those spaces are about, by the way, unless you're me.

01:13:43.000 | And when you were a kid, your teeth were too close together and all your adult teeth came in behind those teeth.

01:13:48.000 | It was really miserable experience for me.

01:13:50.000 | Most kids, their baby teeth are spaced out a bit in order to allow the adult teeth to come in, to erupt as it's called, such a dramatic word.

01:13:58.000 | I love reading this literature, you know, when the molars erupt, it's like, whoa, no, it's just come up through the gums.

01:14:05.000 | Those spaces are really there for the adult teeth to come up through the gums.

01:14:09.000 | And so it was suggested that children who have those spaces between their teeth and the spaces are big don't need to floss between those teeth because it could cause some damage to the gums.

01:14:20.000 | Rather, they should just focus on their brushing.

01:14:23.000 | Now let's talk about some protocols that involve changing the chemistry of your mouth, not just immediately after meals or during brushing or flossing, but really around the clock.

01:14:34.000 | And one of the key protocols that I'd like to discuss is the use of an artificial sugar called xylitol.

01:14:40.000 | Xylitol is a very low calorie sweetener.

01:14:44.000 | I can place it among the other low calorie sweeteners like aspartame, sucralose, stevia, et cetera.

01:14:50.000 | But what's unique about xylitol is that very much like standard sugar or any kind of carbohydrate sugar.

01:14:58.000 | The bacteria Streptococcus mutans loves to eat xylitol, but when Streptococcus mutans eats xylitol,

01:15:07.000 | it doesn't, meaning it cannot produce the acid that normally would demineralize the teeth and create cavities.

01:15:15.000 | In addition to that, when Streptococcus mutans eats xylitol, it kills Streptococcus mutans.

01:15:21.000 | So what this means is that if xylitol is present in the oral cavity after a meal, say in the minutes and hours after a meal,

01:15:28.000 | then any strep mutans that happens to be there is going to preferentially feed on the xylitol, not other sugars, and it won't be able to release acid.

01:15:37.000 | And because xylitol can actually inhibit the growth, and that is the proliferation of more strep mutans,

01:15:43.000 | we've got a twofer, we've got a situation where strep mutans can't release acid to demineralize the teeth and potentially cause cavities,

01:15:51.000 | and the total amount of strep mutans that can grow, that can proliferate in what are called colonies,

01:15:56.000 | literally the bacteria colonizes on the teeth and forming that biofilm, well then that can't happen.

01:16:02.000 | So xylitol is a very potent tool for improving oral health in this way.

01:16:06.000 | In addition, xylitol reduces inflammation of the gum tissue and other soft tissues of the mouth.

01:16:12.000 | And so xylitol is providing an array of positive benefits, especially when it's present in the mouth immediately after meals.

01:16:19.000 | And for that reason, there are a number of different dentists that have created xylitol products in the form of gums,

01:16:25.000 | or in the form of mints, specifically to be used after meals.

01:16:29.000 | So by chewing a few of these xylitol mints, or by chewing a xylitol-based gum immediately after a meal,

01:16:34.000 | you're taking substantial steps towards improving the chemical milieu of your mouth and inhibiting the proliferation of cavity-forming streptococcus mutans.

01:16:44.000 | Now you can also find some literature on other proposed benefits of xylitol, such as improving overall microbiome,

01:16:52.000 | such as reducing inflammation in other tissues besides the gums and within the mouth.

01:16:57.000 | There is some evidence that it can support the gut microbiome, because of course the oral microbiome and the gut microbiome are contiguous,

01:17:03.000 | they have different compartments. I mean, you might even be surprised to learn that within your mouth, there are different niches, as they're called.

01:17:10.000 | For instance, there's different microbiota that live on the gums versus the hard palate versus the soft palate back in the throat,

01:17:17.000 | and then as you descend into the gut, et cetera.

01:17:19.000 | And it does appear that xylitol has certain positive benefits for all of those different gut microbiome niches.

01:17:25.000 | But the literature on that is less well substantiated than, for instance, the literature showing that if xylitol is put in as a surrogate sugar substrate for strep mutans,

01:17:36.000 | that it disables strep mutans and can prevent the formation of cavities.

01:17:40.000 | Now, as far as I know, when consumed in mint form or gum form, I'm not aware of any specific side effects or bad effects of xylitol,

01:17:48.000 | provided that it's not consumed in excess. But as with everything, dosage matters.

01:17:53.000 | So if you're somebody who wants to explore the use of xylitol gum or xylitol mints after a meal,

01:17:58.000 | I wouldn't suggest going from consuming zero xylitol mints to consuming 50 a day or something like that, or even 10 a day.

01:18:04.000 | You might start off slowly and just consume one or two after a meal, maybe just your morning meal, maybe just your evening meal,

01:18:10.000 | something of that sort, rather than chewing xylitol gum all day long, et cetera, et cetera.

01:18:15.000 | I'll just mention one other positive benefit of xylitol gum, which is if you use xylitol gum after, say, your noon meal or your early day meal,

01:18:24.000 | it further increases the production of saliva, which, as we talked about before, is a great thing,

01:18:30.000 | because one of the best ways to support oral health and tooth health is to have a long stretch of time in the middle of the day

01:18:36.000 | where you're producing a lot of healthy saliva in large amounts,

01:18:39.000 | because again, saliva is this incredible stuff that's supporting remineralization of the teeth.

01:18:43.000 | So lots and lots of reasons to think about, maybe consider using xylitol gum or xylitol mints.

01:18:49.000 | There are a number of different ones available out there.

01:18:51.000 | I have zero, again, zero financial relationship to any of those mint or gum companies.

01:18:56.000 | I'll provide a link in the show note captions to one source.

01:19:00.000 | The company and the products were developed by a dentist, Dr. Ellie Phillips,

01:19:03.000 | who is quite prominent in the public health education space around dental health.

01:19:07.000 | Some of her views are a little bit controversial, like her views on flossing.

01:19:11.000 | Other of her views, I find, frankly, quite ahead of their time

01:19:14.000 | in that she's been talking about a number of these things like promoting the health of the oral microbiome

01:19:19.000 | and the potential value of xylitol gums and mints, et cetera, for some period of time.

01:19:25.000 | I think most of the information that she puts out there is supported by other dentists,

01:19:29.000 | and she still suggests regular dental visits, so nothing renegade out there or heretical.

01:19:35.000 | Again, there are other sources of xylitol gums and mints that you could consider.

01:19:39.000 | I'm simply putting a link to the one that I use because I happen to use them and like them.

01:19:43.000 | So I'd like to use the discussion about xylitol as a segue into a discussion about toothpaste

01:19:48.000 | because there is a lot of controversy out there about which toothpaste are better for us,

01:19:54.000 | maybe even bad for us, and best for us.

01:19:57.000 | I think it's fair to say, based on what we all now know about xylitol,

01:20:01.000 | that if you can find a toothpaste that contains xylitol as a sweetener, that can only be a good thing.

01:20:07.000 | And indeed, there are a number of them out there.

01:20:09.000 | We'll talk about specific sources in a little bit,

01:20:11.000 | but let's just put xylitol on the short to not so short list of things that would be great to have in a toothpaste

01:20:18.000 | for all the reasons that you now understand.

01:20:20.000 | The real big question with toothpaste is always,

01:20:23.000 | should I use a toothpaste that has fluoride or avoid toothpastes that have fluoride?

01:20:28.000 | And in order to answer that, we have to go back to our earlier discussion about fluoride.

01:20:31.000 | It really depends on whether or not you're somebody that thinks that fluoride is great

01:20:35.000 | because it creates these super physiologically strong bonds within our teeth.

01:20:39.000 | The crystal structures are that much stronger than when formed by hydroxyapatite,

01:20:43.000 | or whether or not you're somebody who is wary of fluoride,

01:20:47.000 | that you're concerned about potential brain health issues or thyroid issues.

01:20:51.000 | And here, I think people really do fall into either camp or the camp, frankly, of, I don't know, should I be worried?

01:20:57.000 | I don't know if I should be worried.

01:20:58.000 | I personally grew up using fluoride toothpaste.

01:21:02.000 | We had the kind of standard name brand fluoride toothpaste in our bathroom.

01:21:06.000 | I brushed my teeth with those for years.

01:21:08.000 | Whether or not that negatively impacted my health or not, I don't know.

01:21:12.000 | Get my blood work done, my thyroid hormones are normal.

01:21:15.000 | My brain works at least reasonably well.

01:21:18.000 | But I do realize that some people are very concerned about fluoride

01:21:21.000 | and they just don't want it anywhere near their kids.

01:21:23.000 | They don't want it anywhere near themselves.

01:21:25.000 | So if you're somebody who's going to err on the side of caution with fluoride

01:21:28.000 | and you are seeking a non-fluoride containing toothpaste,

01:21:32.000 | there are such toothpastes out there.

01:21:34.000 | And most of those, if not all of them, contain, you guessed it, hydroxyapatite.

01:21:40.000 | They contain the minerals that naturally form the bonds that create that additional enamel

01:21:45.000 | that can potentially fill in cavities by remineralization of the enamel

01:21:50.000 | and some of the deeper layers of the tooth.

01:21:52.000 | So if one is seeking toothpaste and you want to avoid fluoride,

01:21:55.000 | you'd want to find something that ideally had hydroxyapatite

01:21:58.000 | and something that had xylitol.

01:22:01.000 | And they often also contain some sort of mild abrasive.

01:22:04.000 | Not a really scratchy abrasive substance,

01:22:08.000 | but a mild abrasive that can really allow for breaking up with the biofilm that we talked about earlier.

01:22:14.000 | Now I've provided links to a couple of sources for such toothpastes

01:22:17.000 | and also for these little toothpaste tablets that I've been using lately as well.

01:22:22.000 | I sometimes switch back and forth between the two.

01:22:24.000 | These are tablets that you chew up

01:22:26.000 | and then you brush your teeth immediately after with your wet toothbrush.

01:22:29.000 | Both of them work quite well.

01:22:31.000 | Again, I want to be clear that the companies that I've provided links to in the show no captions

01:22:35.000 | are companies for which I have absolutely zero financial relationship.

01:22:38.000 | I do know some of the people that started these companies.

01:22:42.000 | I actually discovered these companies because these people are dentists or periodontists

01:22:46.000 | or other people in the oral health field.

01:22:49.000 | But I also want to be very clear that there was no exchange of promotion of their products

01:22:53.000 | for information or otherwise.

01:22:55.000 | I simply tried and liked the products

01:22:57.000 | and I just so happened to have learned some things about oral health care from these people

01:23:02.000 | separate and away from anything about toothpaste or xylitol, et cetera.

01:23:06.000 | Okay, so I want to be very clear that I do believe these are quality sources.

01:23:10.000 | These are the toothpaste and tooth tablets that I happen to use, gums and mints that I happen to use.

01:23:15.000 | Large part as a consequence of researching this episode, but I pay full price for them.

01:23:20.000 | I'm certainly not suggesting that anyone else has to use them.

01:23:24.000 | They just represent one option if you're looking for non fluoride containing toothpaste

01:23:29.000 | and some other things to promote oral health.

01:23:31.000 | And I'm sure there are other sources out there.

01:23:33.000 | And if you'd like to refer the various viewers

01:23:36.000 | and listeners of this podcast to those sources,

01:23:38.000 | because you feel very strongly about those other sources,

01:23:40.000 | just put those in the comment section on YouTube.

01:23:43.000 | Okay, let's talk about mouthwash or mouthwash is plural.

01:23:47.000 | At the beginning of today's episode, I said, let's determine what category of oral health you are in.

01:23:53.000 | Are you somebody who pays a lot of attention to oral health?

01:23:56.000 | You brush and floss at least twice a day.

01:23:58.000 | You're using mouthwashes, tooth whiteners perhaps as well.

01:24:01.000 | Or are you in category two or three?

01:24:04.000 | Well, here's the deal.

01:24:06.000 | Most all, most all, not all, but most all mouthwashes,

01:24:11.000 | those containing alcohol are terrible for oral health.

01:24:18.000 | Simply put, they deplete certain components

01:24:22.000 | of the mucosal lining of the mouth,

01:24:24.000 | and they disrupt the healthy components of the oral microbiome.

01:24:28.000 | So for those of you that rely on such mouthwashes,

01:24:31.000 | I would really encourage you to learn more about them.

01:24:34.000 | You're about to do that now.

01:24:35.000 | You're already doing that now.

01:24:36.000 | And to really consider whether or not they are helping or harming your oral health.

01:24:40.000 | Now, I'm not suggesting that you create a scenario

01:24:42.000 | where your breath is causing other people to dissolve into a puddle of tears

01:24:47.000 | or back away from you quickly.

01:24:49.000 | That's not what you want.

01:24:50.000 | That's not what I want.

01:24:51.000 | That's not what anyone wants.

01:24:52.000 | But I think it's important to realize that these alcohol-based mouthwashes are not good for us.

01:24:59.000 | In addition, there are antiseptic mouthwashes,

01:25:01.000 | some of which contain alcohol, some of which don't,

01:25:04.000 | which sometimes are prescribed for very serious bacterial overgrowth

01:25:08.000 | and infections of the oral cavity.

01:25:10.000 | If your dentist or physician or periodontist prescribes those,

01:25:14.000 | I certainly am not going to try and get in the way of that prescription.

01:25:17.000 | That's between you and your healthcare professional.

01:25:19.000 | But you would be wise to ask them whether or not these chlorhexidine-type mouthwashes, et cetera,

01:25:25.000 | are potentially bad for other components of oral health

01:25:29.000 | or microbiota in the gut generally,

01:25:32.000 | because in some cases they have been shown to be not good for us.

01:25:35.000 | At the same time, we don't want over-proliferation of really bad bacteria in the mouth,

01:25:40.000 | so we don't want infections to run wild either.

01:25:42.000 | Most people, however, are using mouthwashes to freshen their breath

01:25:46.000 | and to kill off additional bacteria in the mouth

01:25:49.000 | that they might believe they couldn't get with brushing or flossing.

01:25:52.000 | If you are somebody who really wants to use a mouthwash for that reason,

01:25:56.000 | I encourage you to try and find a mouthwash that is not alcohol-based

01:26:01.000 | and that is not a strong antiseptic

01:26:04.000 | or that if it is an antiseptic, that it's not alcohol-based, okay?

01:26:08.000 | And such mouthwashes exist out there.

01:26:10.000 | They're a little bit hard to find.

01:26:12.000 | I'll provide a link to at least a couple of them in the show note captions.

01:26:15.000 | Here I have to say I have not tried those mouthwashes yet.

01:26:18.000 | They do come from sources in which they were developed

01:26:21.000 | by licensed dental healthcare professionals,

01:26:23.000 | but this is always the case when somebody's selling something.

01:26:26.000 | It's worthwhile to do diligence.

01:26:29.000 | Now, as we talk about toothpaste and mints and gums and mouthwashes,

01:26:33.000 | I think it's worth taking a step back and also asking the question,

01:26:37.000 | are there any zero or very, very low cost

01:26:39.000 | or even cost-saving alternatives to any of this?

01:26:42.000 | And the great answer is yes.

01:26:44.000 | There are actually a number of things that you can do with basic over-the-counter stuff

01:26:48.000 | from the grocery store that all the dentists I spoke to said,

01:26:52.000 | "Yeah, that's a pretty good option."

01:26:54.000 | It's not the best option available perhaps, but it's a pretty good option.

01:26:57.000 | And in many cases, it's better than the typical commercially available toothpaste or mouthwash.

01:27:02.000 | For instance, I would imagine,

01:27:05.000 | based on everything I now know about the structure of teeth,

01:27:09.000 | that using something like baking soda to brush the teeth would indeed scrape off the biofilm,

01:27:14.000 | perhaps even whiten the teeth a little bit.

01:27:16.000 | Although as we talked about earlier, you're not really whitening the teeth.

01:27:18.000 | You're actually just changing the reflectiveness

01:27:21.000 | and some of the composition of that enamel, which is translucent

01:27:25.000 | so that you can see the underlying components better.

01:27:28.000 | Well, I talked to several dentists and they told me that baking soda actually is fairly low

01:27:34.000 | on the abrasiveness rating scale.

01:27:36.000 | They have a specific rating scale for this that we don't have to go into,

01:27:39.000 | but it's actually considered quite safe for the enamel of the teeth,

01:27:42.000 | especially if you're brushing with a soft toothbrush

01:27:44.000 | and you're not like really grinding the stuff against your teeth at maximum intensity

01:27:48.000 | or even near maximum intensity.

01:27:50.000 | So it turns out that baking soda and water is actually a pretty good toothpaste

01:27:54.000 | if you're not going to go buy a toothpaste.

01:27:56.000 | So that's good news.

01:27:57.000 | Now you may have heard that you can make a sort of mouthwash or mouth rinse

01:28:01.000 | with baking soda, water, and a little bit of hydrogen peroxide.

01:28:06.000 | I want to emphasize a little bit, but I'm also going to emphasize

01:28:09.000 | I don't think this is a good idea at all.

01:28:11.000 | Why is it not a good idea at all?

01:28:13.000 | Well, first of all, when we were kids, we used to take baking soda and hydrogen peroxide

01:28:16.000 | and put them together to simulate volcanoes.

01:28:18.000 | So that tells you right there the kind of chemical reaction that you're going to get.

01:28:23.000 | But in addition to that, it's pretty clear that hydrogen peroxide,

01:28:28.000 | unless there's a specific medical recommendation to do so,

01:28:31.000 | is not something you want to introduce to the oral cavity.

01:28:33.000 | Now, this is something that I'm very familiar with because when I was a postdoc,

01:28:37.000 | so this is in the 2005 to 2010 stretch,

01:28:41.000 | I started to get some pretty bad canker sores.

01:28:45.000 | I don't know about you, but canker sores feel awful to me.

01:28:49.000 | I hate them.

01:28:50.000 | When you eat, they hurt.

01:28:51.000 | When you swallow, they hurt.

01:28:52.000 | When you do anything, they pretty much hurt.

01:28:53.000 | And someone gave me the recommendation to use a little bit of baking soda,

01:28:57.000 | dissolved in some water, and a little bit of hydrogen peroxide,

01:29:00.000 | and to use that as a oral rinse, and of course then to spit it out.

01:29:04.000 | And I did that.

01:29:05.000 | And actually what happened to me is I got almost quarter-sized ulcers

01:29:09.000 | on the roof of my mouth and on the sides of my mouth.

01:29:12.000 | It took those little canker sores, which were annoying and kind of painful,

01:29:16.000 | and turned them into full-blown ulcers.

01:29:18.000 | I know this because when I stopped using it, those healed up almost immediately.

01:29:21.000 | And then when I spoke to some dentists and periodontists, they said,

01:29:24.000 | "Oh yeah, yeah, hydrogen peroxide is just far too abrasive

01:29:27.000 | for the mouth cavity."

01:29:28.000 | And the reason I raised this is because I don't think I'm alone

01:29:31.000 | in that if you kind of venture into some of the,

01:29:34.000 | let's call it alternative recommendation space for oral health,

01:29:39.000 | you may hear that things like hydrogen peroxide can be useful

01:29:43.000 | for gargling with or swishing with if you are starting to get

01:29:46.000 | a little bit of a throat tickle, maybe an infection.

01:29:48.000 | It turns out it's a really bad idea.

01:29:51.000 | Now, if there are physicians or oral health experts out there

01:29:54.000 | that strongly believe in the use of hydrogen peroxide rinses

01:29:57.000 | or gargling with it to promote oral health for any reason,

01:30:00.000 | let me know in the show, no captions.

01:30:02.000 | I don't want to go against any of those recommendations,

01:30:04.000 | but this now considered kind of old school recommendation

01:30:07.000 | of creating one's own mouthwash with a little bit of baking soda,

01:30:11.000 | some hydrogen peroxide and water does not seem like a good idea,

01:30:15.000 | not just based on my experience,

01:30:16.000 | but every one of the dental professionals that I spoke to.

01:30:19.000 | That said, it does seem that creating a high salt solution, okay?

01:30:24.000 | So taking some salt, putting it in water, dissolving it,

01:30:27.000 | and then finding the point at which it won't quite dissolve

01:30:30.000 | because the concentration of sodium is just high enough

01:30:33.000 | and using that as, of course, not something to swallow,

01:30:36.000 | but rather as a dental rinse.

01:30:37.000 | So putting your mouth and swishing it around

01:30:39.000 | and then spitting it out and it's going to taste very salty.

01:30:42.000 | And then taking a swig of water, you know,

01:30:44.000 | just plain water and then swishing it around

01:30:46.000 | and then spitting it out.

01:30:48.000 | That actually provides a really nice milieu

01:30:51.000 | for the production of healthy mouth bacteria.

01:30:55.000 | It's near zero cost.

01:30:57.000 | I suppose you need a little bit of salt,

01:30:58.000 | a little water and a glass to put it in,

01:31:00.000 | but it's basically zero cost.

01:31:03.000 | And if you think about it,

01:31:04.000 | that high saline or high salinity solution

01:31:07.000 | is a lot like the sort of brines and the liquid

01:31:12.000 | that comes from these low sugar probiotic foods

01:31:15.000 | that earlier I was suggesting,

01:31:17.000 | and in other episodes I've suggested could be really healthy

01:31:19.000 | for swallowing for the gut microbiota.

01:31:21.000 | But again, I want to be very clear,

01:31:23.000 | do not swallow high salt concentration fluid.

01:31:28.000 | We're talking about a swish and then a spitting it out

01:31:31.000 | as a way to improve the overall milieu of the mouth

01:31:35.000 | to get the pH right, to promote the proliferation

01:31:37.000 | of healthy microbiota components.

01:31:40.000 | Okay, so we've talked about some commercially available gums

01:31:43.000 | and mints containing xylitol.

01:31:45.000 | We've talked about some commercially available toothpaste,

01:31:48.000 | indeed some toothpaste that almost fall

01:31:51.000 | into the very boutique category

01:31:52.000 | because they have all these things that are known by dentists

01:31:55.000 | and periodontists would be great for oral health,

01:31:57.000 | but those can run some cost, right?

01:32:00.000 | And so I do think it's important that we also talked about

01:32:03.000 | the use of just baking soda with a soft toothbrush

01:32:05.000 | and some water and gently brushing the teeth

01:32:08.000 | as a great way to disrupt the biofilm and clean your teeth

01:32:11.000 | and a high salt solution as a swish and spit

01:32:14.000 | followed by, you know, swish and spit with clear water,

01:32:18.000 | clean water, no salt in it

01:32:20.000 | as a essentially very low cost or zero cost mouthwash,

01:32:25.000 | far and away different from the heavily scented

01:32:29.000 | alcohol-based antiseptic mouthwashes

01:32:31.000 | that are commercially available

01:32:32.000 | and that we know are basically not good

01:32:35.000 | for our oral microbiome.

01:32:36.000 | In addition, I'd like to point out

01:32:38.000 | that those alcohol-based mouthwashes

01:32:40.000 | that many people in the world use

01:32:42.000 | are also known to reduce the amount of nitric oxide

01:32:45.000 | that's produced in the oral cavity

01:32:47.000 | and that's very important

01:32:49.000 | for the production of nitric oxide elsewhere in the body.

01:32:52.000 | Why is that important?

01:32:53.000 | Well, nitric oxide promotes vasodilation,

01:32:56.000 | not just within the blood vessels

01:32:59.000 | that line and feed the oral cavity,

01:33:01.000 | but also the throat, also in the nose,

01:33:03.000 | also in the brain, also in the heart.

01:33:05.000 | So what we're talking about here

01:33:06.000 | is a substance that is indeed increased

01:33:09.000 | when we, for instance, nasal breathe.

01:33:12.000 | We know that dramatically increases nitric oxide.

01:33:15.000 | We're talking about a substance

01:33:16.000 | that when the oral microbiome

01:33:18.000 | is preserved in its healthy state

01:33:20.000 | tends to increase in production.

01:33:23.000 | And we're talking about a substance

01:33:24.000 | that's really good for small capillary vein

01:33:27.000 | and arterial health

01:33:29.000 | because it allows for the passage of blood,

01:33:31.000 | both for the delivery of oxygen

01:33:33.000 | and other nutrients to tissues,

01:33:34.000 | but also the removal of waste products from tissues.

01:33:37.000 | So we don't want to do anything that reduces nitric oxide

01:33:40.000 | unless there's some specific medical condition

01:33:43.000 | that leads us to want to do that.

01:33:45.000 | So for most people,

01:33:46.000 | increasing nitric oxide

01:33:47.000 | or keeping nitric oxide levels stable

01:33:49.000 | is the state that we want to seek.

01:33:52.000 | And these alcohol-based mouthwashes

01:33:54.000 | are known to deplete the production of nitric oxide.

01:33:57.000 | So there's yet another reason

01:33:58.000 | to avoid the use of these alcohol-based,

01:34:00.000 | more typical over-the-counter mouthwashes.

01:34:03.000 | By the way, this is not a scare tactic against mouthwashes.

01:34:07.000 | I'm sure that if you use mouthwashes,

01:34:09.000 | you're still producing some nitric oxide,

01:34:11.000 | but I think nowadays, many, hopefully all of you

01:34:15.000 | are interested in doing whatever you can

01:34:17.000 | to improve your mental health,

01:34:18.000 | physical health and performance.

01:34:20.000 | And if there are things that you are doing

01:34:21.000 | that are inhibiting those in any way

01:34:23.000 | that you potentially want to at least think about those,

01:34:26.000 | maybe remove them from your protocols,

01:34:27.000 | especially if there's a cost to them that you can remove.

01:34:30.000 | In other words, you can save on costs.

01:34:32.000 | So again, lots of reasons to move away

01:34:34.000 | from the alcohol-based standard antiseptic mouthwashes

01:34:37.000 | aside from the improvement in your breath

01:34:40.000 | that, by the way, can be better achieved

01:34:42.000 | by supporting the oral microbiome.

01:34:43.000 | Other ways that we've discussed,

01:34:45.000 | there's really no clear advantage

01:34:47.000 | as to why one would use one.

01:34:49.000 | And there apparently are a number of disadvantages.

01:34:52.000 | Now, earlier, we talked briefly about canker sores.

01:34:54.000 | They are really uncomfortable.

01:34:56.000 | And there are a lot of theories as to why canker sores form.

01:34:59.000 | And there are a lot of products and theories

01:35:01.000 | as to how to get rid of canker sores.

01:35:03.000 | Well, indeed, there are some ways

01:35:05.000 | that we can prevent the formation of canker sores

01:35:07.000 | and accelerate their healing.

01:35:09.000 | And that actually has to do with promoting

01:35:11.000 | the health of the gut microbiome.

01:35:13.000 | So there's a clear link between gut microbiome

01:35:15.000 | and oral microbiome in a way that can either promote

01:35:20.000 | or reduce the formation of canker sores

01:35:23.000 | and can actually help heal canker sores.

01:35:25.000 | And to my knowledge, the best way to support

01:35:28.000 | a quote unquote healthy gut microbiome

01:35:31.000 | is to consume at least one to four servings

01:35:34.000 | of low sugar fermented foods per day.

01:35:36.000 | I mentioned what some of those are a little bit earlier.

01:35:39.000 | I also did an entire episode about gut microbiome.

01:35:41.000 | We've hosted expert guests on the microbiome,

01:35:43.000 | including Justin Sonnenberg from Stanford School of Medicine.

01:35:46.000 | And for sake of time, I can just briefly list off

01:35:48.000 | the things that are known to promote a healthy gut microbiome

01:35:51.000 | and that would indirectly support the healing

01:35:53.000 | and prevention of canker sores.

01:35:56.000 | And those are consuming one to four servings

01:35:59.000 | of low sugar fermented foods per day, for instance,

01:36:03.000 | consuming enough prebiotic fiber.

01:36:06.000 | So consuming enough fiber in the diet

01:36:08.000 | through fruits and vegetables,

01:36:09.000 | or perhaps supplementing prebiotic or probiotic fiber.

01:36:13.000 | And in some cases, if somebody is really dysbiotic

01:36:15.000 | or if you've been taking antibiotics,

01:36:17.000 | actually taking a pill form or capsule form probiotic.

01:36:21.000 | But it's not something that I recommend

01:36:23.000 | people take consistently and I certainly don't.

01:36:25.000 | I think by ingesting those low sugar fermented foods

01:36:28.000 | on a regular basis, by trying to make sure

01:36:31.000 | that you're getting enough sleep each night, this is key.

01:36:33.000 | Probably should have mentioned this earlier in the episode,

01:36:36.000 | but one of the folks who I have great respect for

01:36:39.000 | in the public health discussion around dental health

01:36:42.000 | is Dr. Mark Berhein.

01:36:44.000 | He goes by Ask the Dentist on Instagram.

01:36:47.000 | He's actually a retired dentist,

01:36:49.000 | but he's been deeply involved in the kind of evaluation

01:36:52.000 | of the consumer product space as it relates to dental

01:36:55.000 | and oral healthcare for a number of years.

01:36:57.000 | And Mark Berhein, in addition to discussing

01:37:01.000 | all the various topics that we've talked about today,

01:37:03.000 | such as xylitol and fluoride yes or fluoride no,

01:37:06.000 | et cetera, et cetera,

01:37:07.000 | has also been a big proponent of people paying attention

01:37:10.000 | to that first pillar of mental health,

01:37:12.000 | physical health and performance, which is sleep.

01:37:14.000 | And pointing out that when people get fewer

01:37:16.000 | than their necessary allotment of sleep each night,

01:37:20.000 | so typically most people need six to eight hours,

01:37:22.000 | some people need more, some people need a little less,

01:37:24.000 | but getting at least six to eight hours

01:37:26.000 | of quality sleep per night,

01:37:27.000 | which supports the health of the gut microbiome

01:37:29.000 | and oral microbiome and thereby indirectly supports

01:37:34.000 | the health of the entire brain and body.

01:37:36.000 | So Dr. Berhein and others have talked about this,

01:37:39.000 | but I really appreciate that he's championed

01:37:41.000 | the importance of sleep among other things,

01:37:44.000 | but certainly sleep as a way to support the oral microbiome.

01:37:48.000 | So we've talked quite a bit about teeth and gums,

01:37:51.000 | a little bit about mucosal lining and throat.

01:37:54.000 | One thing that we haven't talked very much about

01:37:57.000 | is the tongue.

01:37:59.000 | Your tongue is obviously a very important component

01:38:03.000 | of your mouth.

01:38:04.000 | And as I mentioned earlier, different niches,

01:38:07.000 | different locations within the mouth

01:38:08.000 | have different microbiota living on them,

01:38:11.000 | both good and quote unquote bad,

01:38:14.000 | meaning ones that we'd like to promote the proliferation of

01:38:17.000 | because they reduce bad breath and promote oral health

01:38:19.000 | and all that good stuff and quote unquote bad bacteria

01:38:23.000 | because they make our breath smell bad

01:38:25.000 | and because they deteriorate the various tissues

01:38:27.000 | of the mouth.

01:38:28.000 | I looked pretty extensively into this issue

01:38:30.000 | of tongue scraping, and it's an interesting one.

01:38:33.000 | And every licensed dental healthcare professional I spoke to

01:38:37.000 | in preparing for this episode agreed that yes,

01:38:41.000 | it can be a good idea to scrape the tongue.

01:38:44.000 | And each one of them cited the fact that

01:38:46.000 | a number of unhealthy bacteria can build up on the tongue

01:38:49.000 | across the course of the day and throughout the night,

01:38:51.000 | much in the same way that biofilm can build up on teeth,

01:38:54.000 | although through a different process, different bacteria,

01:38:56.000 | and that scraping the tongue or brushing the tongue

01:39:00.000 | can be advantageous for removing that bacteria.

01:39:03.000 | What was interesting is that several of them pointed out

01:39:05.000 | that lightly brushing the tongue

01:39:08.000 | may in fact be better than scraping the tongue

01:39:11.000 | because they argue that,

01:39:13.000 | especially when people use those steel tongue scrapers,

01:39:16.000 | that few people know how to use them with sufficient force

01:39:20.000 | to remove the bacteria,

01:39:22.000 | but not so much force that they don't damage the tongue tissue

01:39:25.000 | and the tongue is a very fragile, soft tissue.

01:39:27.000 | So the recommendation that they relayed to me

01:39:30.000 | was to suggest once or twice a day brushing of the tongue.

01:39:35.000 | But here's an important point.

01:39:37.000 | They all suggested that you use a separate toothbrush

01:39:41.000 | to brush your tongue than you would to brush your teeth.

01:39:46.000 | So if things weren't complicated enough already,

01:39:48.000 | I'm talking about using a separate toothbrush.

01:39:50.000 | Why? Well, they gave two reasons.

01:39:52.000 | One is they want to prevent crossover of the bacteria

01:39:55.000 | between those two different tissues,

01:39:57.000 | especially if one is brushing the tongue too vigorously.

01:40:00.000 | You don't want to introduce bacteria

01:40:01.000 | from your tooth brushing onto your tongue.

01:40:04.000 | Of course, you can rinse it in between,

01:40:05.000 | but the ideal situation is to use a separate toothbrush

01:40:08.000 | for the purpose of brushing the tongue.

01:40:10.000 | So that opened up a whole exploration and discussion

01:40:12.000 | about toothbrush care.

01:40:14.000 | We could probably do a whole episode

01:40:15.000 | all about toothbrush care, but we won't.

01:40:17.000 | Suffice to say that when you brush bacteria

01:40:19.000 | off your teeth or tongue,

01:40:22.000 | and presumably the toothbrush gets moist

01:40:25.000 | if by no other means,

01:40:28.000 | certainly by means of your saliva being on it,

01:40:30.000 | then you rinse it off.

01:40:32.000 | And then even if you were to dry it off with a clean,

01:40:35.000 | some sort of clean towel or something like that,

01:40:37.000 | and you set it out,

01:40:38.000 | a lot of bacteria are going to proliferate

01:40:40.000 | on that toothbrush.

01:40:41.000 | So this opened up a whole discussion about,

01:40:43.000 | should you cover your toothbrush

01:40:44.000 | or let it dry out in the air?

01:40:46.000 | Should you use UV irradiation

01:40:49.000 | to sterilize your toothbrush?

01:40:50.000 | And frankly, it took us, me,

01:40:53.000 | down the rabbit hole of toothbrush care so far

01:40:56.000 | that at one point I just screamed like,

01:40:58.000 | "Uncle, like enough."

01:40:59.000 | I think one has to decide how much bacteria

01:41:03.000 | they are willing to tolerate

01:41:05.000 | living on their toothbrush in between toothbrushings.

01:41:08.000 | Anywhere from zero where you use a new toothbrush

01:41:10.000 | or toothbrush head every single time you brush,

01:41:12.000 | that seems unreasonable,

01:41:13.000 | or at least economically unreasonable for most people,

01:41:15.000 | versus replacing it once a week

01:41:17.000 | versus once every two weeks.

01:41:19.000 | Really, there's no specific recommendation I can make.

01:41:22.000 | All I can say is be aware

01:41:23.000 | that bacteria are growing on the toothbrush head.

01:41:25.000 | Try and avoid contact between the toothbrush head

01:41:28.000 | and any unsanitary surfaces.

01:41:30.000 | Try and rinse and dry off the toothbrush head.

01:41:33.000 | All these things are recommendations that were relayed to me

01:41:35.000 | and that just make good common sense.

01:41:38.000 | Now, prior to this episode,

01:41:39.000 | I put the call out on social media

01:41:41.000 | for questions about oral health.

01:41:44.000 | And one of the questions

01:41:45.000 | that came back from many hundreds of people

01:41:47.000 | was what about fillings?

01:41:49.000 | What about metal fillings?

01:41:51.000 | What about sealants?

01:41:52.000 | Are they safe?

01:41:53.000 | Well, most dentists will tell you that sealants are safe.

01:41:56.000 | They are now made from compounds

01:41:57.000 | that are generally not thought to cause any major issues.

01:42:01.000 | To be honest, I did not do a deep dive

01:42:03.000 | into the chemical composition of different sealants

01:42:05.000 | because it turns out

01:42:06.000 | that different dental practices use different sealants.

01:42:09.000 | I'm sure that if I looked hard enough,

01:42:11.000 | I could find some really bad stuff in sealants.

01:42:14.000 | I'm sure I could also find some reassurance

01:42:16.000 | that at the concentrations and conditions

01:42:18.000 | that they're introduced to teeth,

01:42:19.000 | that they are a better alternative

01:42:20.000 | to having deep cavities into the teeth.

01:42:22.000 | And that actually gives me an opportunity

01:42:24.000 | to raise something that I perhaps said earlier,

01:42:27.000 | but I want to reemphasize,

01:42:28.000 | which is I've been talking about how you can remineralize

01:42:31.000 | the teeth and how that's critical

01:42:33.000 | if you want to maintain and build up your tooth

01:42:35.000 | and oral health.

01:42:36.000 | But it's very clear that if the cavities get down

01:42:40.000 | into the dentine layers of the tooth,

01:42:43.000 | that in most cases,

01:42:44.000 | there is no remaining opportunity to remineralize the teeth

01:42:49.000 | using the sorts of practices we're talking about today.

01:42:53.000 | And that indeed it's very likely

01:42:55.000 | that those cavities need to be drilled and filled.

01:42:59.000 | Now that's not always the case.

01:43:00.000 | And this is one reason why I highly recommend

01:43:03.000 | that if you've listened to this episode,

01:43:05.000 | and if you're here at this point in the episode,

01:43:07.000 | then you've listened to the episode,

01:43:09.000 | that you talk to your dentist,

01:43:10.000 | ask them if they say you have a cavity,

01:43:12.000 | how deep are these cavities?

01:43:13.000 | Do you think there's an opportunity

01:43:14.000 | for me to remineralize the teeth

01:43:16.000 | if I do the following things?

01:43:18.000 | And if they tell you, look,

01:43:19.000 | you have a cavity or cavities

01:43:21.000 | and they're simply too deep into the tooth

01:43:23.000 | that you can't remineralize your teeth and fill those in,

01:43:27.000 | well, then you should trust them.

01:43:29.000 | They're the dental professional.

01:43:30.000 | If you don't, then you should find a different dentist.

01:43:32.000 | However, they may be surprised and who knows,

01:43:35.000 | pleasantly surprised for you to say,

01:43:37.000 | hey, I heard that you can actually remineralize teeth

01:43:39.000 | and if I've got a cavity,

01:43:40.000 | but it's still not through the enamel layer,

01:43:42.000 | if I'm really diligent and use some Xylitol

01:43:45.000 | and maybe some hydroxyapatite and avoid certain things

01:43:48.000 | and do certain things discussed in this episode

01:43:50.000 | that I could remineralize and fill in those cavities.

01:43:54.000 | That said, there of course will be situations

01:43:56.000 | where you need to get those cavities drilled and filled,

01:43:59.000 | especially if they make it

01:44:00.000 | into the deep, deep layers of the tooth

01:44:02.000 | and you do not want those cavities to persist

01:44:04.000 | and for bacteria to proliferate

01:44:07.000 | in those deeper layers of the teeth

01:44:08.000 | and down into the bone that is oh so bad

01:44:11.000 | for reasons we talked about earlier,

01:44:12.000 | not just for your mouth and your teeth,

01:44:14.000 | but for your general health and brain health included.

01:44:18.000 | So for that reason, and also because, you know,

01:44:22.000 | the history of dentistry was such that, you know,

01:44:24.000 | in the early part of the last century,

01:44:26.000 | if you had a toothache and a cavity, what did they do?

01:44:29.000 | They pulled the teeth.

01:44:30.000 | They extracted the teeth.

01:44:31.000 | Then at some point,

01:44:32.000 | this business of filling teeth became industry standard

01:44:36.000 | so people would get metal fillings.

01:44:38.000 | Now the types of metal fillings that people had

01:44:40.000 | and have depend on when they got those fillings.

01:44:43.000 | There were, believe it or not, lead fillings.

01:44:45.000 | This is not good.

01:44:46.000 | You don't want lead in your body for all sorts of reasons.

01:44:49.000 | It is terrible for brain health.

01:44:50.000 | That's why it's now illegal to contain in paints

01:44:53.000 | and many household goods.

01:44:54.000 | You don't want lead fillings,

01:44:56.000 | but some people had lead fillings or silver fillings

01:44:58.000 | or a combination of lead, silver and other things

01:45:01.000 | and many metal fillings that were given

01:45:04.000 | and sometimes are still given depending

01:45:07.000 | on where you live in the world and country

01:45:09.000 | and the kind of healthcare

01:45:11.000 | and costs that you have available to you contain mercury.

01:45:15.000 | Now I asked several dentists about this and said,

01:45:19.000 | well, if somebody has a metal filling

01:45:21.000 | that likely has mercury in it,

01:45:23.000 | do they need to have that metal filling removed?

01:45:25.000 | And all of the dentists I spoke to said it depends,

01:45:28.000 | but generally the practice is to leave those fillings in

01:45:31.000 | and try not to disrupt them.

01:45:33.000 | Now, they also provided a important recommendation,

01:45:36.000 | which is if you have metal fillings that contain mercury

01:45:39.000 | or that you think might contain mercury

01:45:41.000 | to avoid disrupting those fillings

01:45:43.000 | through the use of things like mastic gum.

01:45:45.000 | We haven't talked too much about mastic gum.

01:45:47.000 | I've used mastic gum before,

01:45:49.000 | not for long periods of time.

01:45:51.000 | It's a very thick gum.

01:45:53.000 | You know, the original use of mastic gum

01:45:55.000 | and the kind of origins of mastic gum

01:45:57.000 | are like a tree sap kind of substance that you chew on

01:46:00.000 | so as to strengthen your jaw, et cetera.

01:46:02.000 | I don't use it any longer.

01:46:04.000 | I use it for a short while.

01:46:05.000 | It doesn't taste like much of anything.

01:46:07.000 | Some people believe there are certain anti-inflammatory

01:46:09.000 | and other health benefits of mastic gum.

01:46:11.000 | I haven't really explored mastic gum

01:46:13.000 | in enough depth or detail to comment on any of that,

01:46:16.000 | but a number of dentists said,

01:46:17.000 | well, if you have metal fillings chewing

01:46:19.000 | on things like mastic gum or, you know,

01:46:23.000 | hard candies where you're really chewing on that hard candy,

01:46:26.000 | which by the way, you're supposed to suck the hard candy,

01:46:28.000 | the Jolly Ranch, you're not supposed to chew on them,

01:46:30.000 | but that some people will do that.

01:46:31.000 | They'll just naturally chew on those,

01:46:32.000 | can actually disrupt and liberate some of that mercury

01:46:36.000 | and that would be bad.

01:46:37.000 | And keep in mind also that when mercury

01:46:39.000 | is contained in a metal filling,

01:46:40.000 | it's not really bioactive in that mode,

01:46:43.000 | but if it's liberated,

01:46:44.000 | then it can get into the bloodstream

01:46:46.000 | and potentially cause other issues.

01:46:47.000 | So this is a somewhat controversial topic,

01:46:49.000 | so much so that in certain countries,

01:46:51.000 | and I believe in the EU, somebody checked me on this,

01:46:53.000 | but I believe that in the not too distant future,

01:46:56.000 | metal fillings will no longer be used in the European Union,

01:46:59.000 | perhaps elsewhere in the world.

01:47:01.000 | They're sometimes still used in the United States.

01:47:03.000 | There's a lot that's changing in this landscape

01:47:05.000 | around fluoride, around metal fillings, et cetera.

01:47:08.000 | So it's very dynamic landscape right now.

01:47:10.000 | I think suffice to say that

01:47:11.000 | if you have metal fillings currently,

01:47:13.000 | try not to disrupt them in a way

01:47:15.000 | that could liberate that mercury.

01:47:16.000 | However, if you have them

01:47:17.000 | and you're really concerned about them,

01:47:18.000 | talk to your dentist, ask what the various options are,

01:47:21.000 | see whether or not they could be replaced

01:47:22.000 | with something safer,

01:47:23.000 | and if the process for replacing them

01:47:25.000 | is really worth the trouble.

01:47:27.000 | And again, to just go back to the larger point

01:47:29.000 | of whether or not you should get cavities filled,

01:47:31.000 | whether or not you need that root canal,

01:47:33.000 | that was a very common question.

01:47:34.000 | A lot of people said, do we really need root canals?

01:47:36.000 | Do we really need to drill cavities

01:47:37.000 | to drill cavities?

01:47:38.000 | You know, my observation based on now having talked

01:47:40.000 | to a number of different practitioners in this space,

01:47:43.000 | really pay a lot of attention to the peer reviewed research,

01:47:45.000 | the old school practices, the new practices

01:47:48.000 | and where everything is headed is that, you know,

01:47:50.000 | there are indeed instances where people need root canals.

01:47:53.000 | There are many cavities

01:47:54.000 | that are just too deep into the teeth,

01:47:56.000 | that remineralization of the teeth

01:47:58.000 | through the sorts of protocols

01:47:59.000 | that we're talking about today is not going to cut it,

01:48:02.000 | that they really need to be drilled and filled.

01:48:05.000 | And of course, we hope those dentists are doing that

01:48:08.000 | as little as is required to maintain dental health.

01:48:11.000 | I also would hope that dentists are talking

01:48:13.000 | to their patients about ways

01:48:16.000 | that they can improve their oral health.

01:48:17.000 | And indeed there are a lot of cases reported online

01:48:19.000 | where people will go in, get x-rays and an exam.

01:48:23.000 | They'll talk about all these cavities that they have

01:48:25.000 | and then they go home and they do a bunch of practices

01:48:26.000 | and they are able to remineralize their teeth

01:48:28.000 | and to essentially reverse those cavities.

01:48:30.000 | And I certainly don't doubt those stories,

01:48:33.000 | but it's simply not always the case

01:48:35.000 | that we can remineralize our teeth

01:48:37.000 | and fill back in our cavities.

01:48:38.000 | If those cavity recesses are too deep into the teeth,

01:48:41.000 | they need to be drilled and filled.

01:48:43.000 | Now that raises a final set of questions and points,

01:48:45.000 | which is, do we really need to go to the dentist

01:48:48.000 | twice a year, every six months?

01:48:50.000 | That's the general recommendation.

01:48:51.000 | And this was a tricky one to ask dentists

01:48:54.000 | because of course dentists are highly incentivized

01:48:57.000 | to see their patients.

01:48:58.000 | And I'm not somebody that believes that everything is a,

01:49:00.000 | you know, is an attempt to make money,

01:49:02.000 | but look, when money's involved, things can get complicated.

01:49:05.000 | Now, what was really great is that the feedback I got

01:49:08.000 | from dentists was very balanced.

01:49:10.000 | I mean, I must say that the community of dentists

01:49:12.000 | seems like a really wonderful community.

01:49:15.000 | I don't know how they treat each other,

01:49:16.000 | but they were very kind,

01:49:17.000 | very generous with information with me.

01:49:19.000 | And at the end of this episode, just before wrapping,

01:49:21.000 | I'll refer you to a couple online oral health

01:49:25.000 | and dentist educators that I think are providing

01:49:28.000 | some really useful content on a consistent basis.

01:49:30.000 | And I'll provide links to those in the show note captions.

01:49:32.000 | But here's what the consensus was.

01:49:35.000 | This business of going to the dentist twice a year

01:49:38.000 | makes sense.

01:49:39.000 | It makes sense from the perspective of

01:49:42.000 | quote unquote routine cleanings,

01:49:44.000 | but everyone acknowledged that those routine cleanings,

01:49:46.000 | while they can remove tartar that's built up,

01:49:48.000 | that would be very, very difficult

01:49:50.000 | for people to reverse or eliminate at home.

01:49:52.000 | And while they can identify cavities

01:49:55.000 | and tell you how far a cavity has developed

01:49:57.000 | into the tooth, et cetera,

01:49:58.000 | every one of those dentists agreed

01:50:00.000 | that those routine cleanings

01:50:01.000 | are not actually going to help remineralize your teeth

01:50:05.000 | except to the extent that they remove existing bacteria,

01:50:08.000 | plaque, and tartar.

01:50:10.000 | And so all of them said that they wish for

01:50:13.000 | and that they really strive in their own practices

01:50:15.000 | to promote more oral health daily protocols

01:50:18.000 | of the sort that we've talked about today,

01:50:20.000 | which I think is just great.

01:50:21.000 | I think obviously I believe in medical professionals

01:50:24.000 | providing routine care.

01:50:25.000 | I also believe in each and all of us doing things

01:50:28.000 | for our health, not just oral health,

01:50:30.000 | but sleep health, mental health, physical health, et cetera,

01:50:33.000 | to try and not just maintain,

01:50:34.000 | but really bolster our brain and body against disease

01:50:39.000 | and also to bolster our vitality to feel really great,

01:50:42.000 | energetic, focused, sleeping better, et cetera.

01:50:44.000 | So it was refreshing to hear that they feel that way as well.

01:50:47.000 | And in addition to that,

01:50:49.000 | all the dentists I spoke to said that, you know,

01:50:52.000 | setting aside situations of like reconstructive surgery

01:50:57.000 | for the mouth or periodontal surgery,

01:50:59.000 | which often is needed if those recesses into the gums

01:51:03.000 | and gingivitis and worse have started

01:51:05.000 | to really develop and proliferate.

01:51:07.000 | All of them emphasize that the twice a year dental visit

01:51:11.000 | is not just about getting the cleaning.

01:51:13.000 | It's really the checkup to evaluate

01:51:15.000 | how those daily practices are emerging.

01:51:17.000 | So it's sort of like going to the doctor

01:51:19.000 | for a checkup on your BMI, on your blood pressure,

01:51:22.000 | but also things like blood tests,

01:51:24.000 | things that typically we don't do at home

01:51:26.000 | unless we're accessing those through particular sources.

01:51:29.000 | But all of them emphasize

01:51:30.000 | that going to the dentist twice a year

01:51:32.000 | is not just about those cleanings.

01:51:34.000 | It's also about establishing

01:51:36.000 | what the baseline level of health is

01:51:38.000 | in one's mouth and teeth and having that on record

01:51:42.000 | and in a very detailed way

01:51:44.000 | so that one can check back routinely twice a year

01:51:47.000 | and discover whether or not in fact

01:51:49.000 | they could get away with perhaps one cleaning a year

01:51:52.000 | because you're so diligent about your brushing, flossing,

01:51:54.000 | xylitol, not being a mouth breather and on and on.

01:51:58.000 | Or perhaps if you're not being very good

01:52:01.000 | about those protocols or, and this is important,

01:52:03.000 | if you have some of the genetic variants

01:52:05.000 | that create an over-proliferation of certain bacteria

01:52:09.000 | that predispose you to gingivitis

01:52:11.000 | or that predispose you to excessive buildup of tartar,

01:52:14.000 | this is the reality

01:52:15.000 | that some people have genetic variations

01:52:17.000 | that create a susceptibility to certain things,

01:52:21.000 | both bacteria and other conditions in the mouth

01:52:23.000 | that make it such

01:52:24.000 | that those people perhaps need to go to the dentist

01:52:26.000 | not just twice a year,

01:52:27.000 | but perhaps four times a year or six times a year.

01:52:30.000 | Indeed, there are some individuals

01:52:32.000 | for whom either because of lack of diligence to protocol

01:52:35.000 | and/or genetic issues

01:52:38.000 | actually need to go to the dentist every single month

01:52:41.000 | for major cleanings.

01:52:42.000 | But fortunately, if we are diligent

01:52:45.000 | about these daily protocols, nighttime protocols,

01:52:48.000 | and we really are paying attention

01:52:50.000 | to the components that can create healthy saliva

01:52:52.000 | and remineralize the teeth

01:52:54.000 | and that can fill in any cavities that begin to form

01:52:57.000 | and we're staving off the production of mutans

01:53:00.000 | and we're scraping away that biofilm on a regular basis,

01:53:03.000 | that we are going to prevent the need

01:53:05.000 | for so many routine cleanings.

01:53:08.000 | And even if we are still getting

01:53:09.000 | those two-year routine cleanings,

01:53:11.000 | you know, for those out there that are fortunate enough

01:53:13.000 | to have that covered by insurance

01:53:15.000 | or can afford it,

01:53:17.000 | well then all the better

01:53:19.000 | because as I mentioned at the beginning of today's episode,

01:53:22.000 | oral health is not just about

01:53:24.000 | having clean, straight, white teeth and fresh breath.

01:53:27.000 | It's not just about that.

01:53:29.000 | All of those things are great to have,

01:53:30.000 | but oral health is about all of that

01:53:33.000 | and it's also about reducing cardiovascular disease.

01:53:36.000 | It's about reducing irritable bowel syndrome.

01:53:39.000 | Yes, I know that we haven't done an episode about this yet,

01:53:41.000 | but I get oh so many requests

01:53:43.000 | to do episodes about irritable bowel syndrome

01:53:46.000 | and other colitis type, you know,

01:53:49.000 | bowel and gut issues that people have

01:53:51.000 | and it's so clear that oral health

01:53:52.000 | and promoting oral health

01:53:54.000 | has been linked to promoting positive gut health as well,

01:53:57.000 | maybe even reducing and possibly eliminating

01:53:59.000 | some of the symptoms of irritable bowel disease

01:54:01.000 | because again, the mouth and the gut

01:54:03.000 | are contiguous with one another.

01:54:05.000 | They're related and a lot of the bacteria

01:54:07.000 | that can cause things like gut issues

01:54:10.000 | are making their way into the body,

01:54:12.000 | not directly through the gut,

01:54:13.000 | but through the oral cavity

01:54:15.000 | because of the richness of blood flow to that region.

01:54:17.000 | So again, today we've talked about

01:54:19.000 | a lot of different protocols

01:54:20.000 | ranging from cost saving to zero cost to low cost to,

01:54:24.000 | let's just be frank,

01:54:25.000 | higher cost products and protocols

01:54:27.000 | such as water picks, et cetera.

01:54:29.000 | The point of today's discussion was essentially threefold.

01:54:33.000 | First of all, to really tamp down in our minds

01:54:36.000 | the importance of oral health,

01:54:38.000 | not just tooth health,

01:54:39.000 | but oral health on the whole

01:54:41.000 | because of its relationship to brain

01:54:43.000 | and body health on the whole.

01:54:45.000 | So much so that I'm placing it right up there

01:54:46.000 | next to the other six pillars of sleep, nutrition,

01:54:49.000 | movement, stress modulation, relationships,

01:54:51.000 | and light as the seventh pillar

01:54:53.000 | of critical to attend to on a daily basis

01:54:57.000 | in order to promote our mental health,

01:54:59.000 | physical health, and performance.

01:55:01.000 | The second point is that there are many things

01:55:03.000 | that we are probably doing currently

01:55:06.000 | that we could do differently

01:55:08.000 | either by doing them more or perhaps less

01:55:10.000 | or eliminating them altogether.

01:55:11.000 | Things like considering whether or not

01:55:13.000 | these antiseptic alcohol-based mouthwashes

01:55:16.000 | are good for you or not.

01:55:18.000 | They're not, they're bad for you in my opinion,

01:55:20.000 | but you can decide for you.

01:55:22.000 | How often do you brush, when you brush,

01:55:24.000 | whether or not you decide to use xylitol, et cetera,

01:55:28.000 | as ways to improve your oral health

01:55:31.000 | and of course in doing so the strength of your teeth,

01:55:34.000 | the brightness of your teeth,

01:55:35.000 | the freshness of your breath, et cetera,

01:55:37.000 | but through some means that I think for most people

01:55:40.000 | they weren't aware of.

01:55:41.000 | I certainly wasn't aware that we could remineralize

01:55:43.000 | our teeth at any moment by changing the acidity,

01:55:46.000 | the chemical milieu of our mouth

01:55:48.000 | and that there are very straightforward

01:55:50.000 | cost savings, zero cost and low cost ways to do that.

01:55:52.000 | And then the third point is that today's discussion

01:55:56.000 | by no means was exhaustive, right?

01:55:58.000 | You may be exhausted, but it was by no mean exhaustive,

01:56:01.000 | meaning we simply don't have time to go down the rabbit hole

01:56:05.000 | of all these other promoted health practices,

01:56:08.000 | such as for instance, oil pulling.

01:56:10.000 | A lot of people out there believe that if you take olive oil

01:56:12.000 | and swish around your mouth and spit it out,

01:56:14.000 | that that's good for your mouth.

01:56:15.000 | And indeed some dental healthcare professionals,

01:56:17.000 | I should say licensed dental healthcare professionals said,

01:56:20.000 | yeah, I think there's some benefit to that.

01:56:21.000 | There's the whole story about vitamin D

01:56:23.000 | and whether or not we're getting enough vitamin D

01:56:25.000 | can indeed impact our tooth health.

01:56:27.000 | So make sure your vitamin D levels are sufficient.

01:56:30.000 | Make sure you're getting some sunlight.

01:56:31.000 | Again, this ties into some of the other six pillars.

01:56:34.000 | Am I suggesting that everyone do oil pulling?

01:56:36.000 | No, I don't think the peer reviewed evidence

01:56:39.000 | on oil pulling is sufficient to suggest that people do that.

01:56:44.000 | But as a practice, considering that it's, you know,

01:56:47.000 | essentially near zero costs, you know,

01:56:49.000 | taking a little bit of olive oil

01:56:50.000 | and swishing around your mouth and spitting it out

01:56:52.000 | a couple cents maybe, you know,

01:56:54.000 | if that's something that you feel benefits you, great.

01:56:56.000 | If you are aware of some terrific peer reviewed research

01:56:58.000 | on that and you want to put a link to that

01:57:00.000 | in the comments on YouTube, great.

01:57:02.000 | Please send them my way.

01:57:03.000 | I'd love to review them.

01:57:04.000 | But my point is that there are a lot of different practices

01:57:06.000 | that have been promoted, including oil pulling

01:57:09.000 | and a bunch of other things

01:57:10.000 | that start to get pretty far into the esoteric,

01:57:12.000 | which doesn't necessarily mean that they don't have merit.

01:57:15.000 | But today I've really tried to focus on the major ones,

01:57:18.000 | the ones that relate to what most everybody could

01:57:21.000 | and should be doing, like brushing and flossing, rinsing,

01:57:25.000 | getting the oral microbiome healthy,

01:57:28.000 | reducing the amount of strep mutans

01:57:30.000 | and the opportunity of strep mutans to create that acid

01:57:32.000 | that's going to deplete the enamel of your teeth

01:57:34.000 | and lead to tooth decay,

01:57:36.000 | trying to limit the amount of recessing of the gums

01:57:40.000 | and periodontal disease.

01:57:42.000 | And for all the reasons that we talked about before,

01:57:45.000 | keeping a healthy mouth, including healthy teeth,

01:57:49.000 | healthy tongue, healthy gums, healthy palate,

01:57:51.000 | and all the rest is oh so important,

01:57:54.000 | not just for your mouth, not just for speaking

01:57:57.000 | and smiling and looking the way you want to look,

01:58:00.000 | but also for your heart, also for your gut,

01:58:05.000 | also for your, believe it or not, your skin.

01:58:08.000 | Didn't have time to go into this,

01:58:09.000 | but it directly relates to skin health

01:58:11.000 | and for your brain health.

01:58:13.000 | So I strongly suggest that all of us take a look

01:58:15.000 | at what we are currently doing for our tooth and oral health

01:58:18.000 | and consider what modifications are best for us.

01:58:21.000 | If you're learning from and/or enjoying this podcast,

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02:00:13.000 | Thank you once again for joining me for today's discussion,

02:00:16.000 | all about oral health.

02:00:17.000 | And last, but certainly not least,

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How to Improve Oral Health & Its Critical Role in Brain & Body Health

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