Dhru Purohit Show - Functional Dentist Reveals the Connection Between Oral Health and Chronic Disease, and How to Actually Prevent and Reverse Cavities, Gingivitis, and More

Episode Date: August 7, 2024

This episode is brought to you by Birch Living, Bon Charge, and BiOptimizers.  The oral microbiome plays a crucial role in achieving true health and longevity. While science has only recently confirmed what many Ayurvedic practices, Functional Medicine doctors and biological dentists have long known—without a healthy mouth, teeth, and gums, overall body health suffers. Today’s guest is on a mission to revolutionize oral healthcare and educate listeners on how and why oral health can serve as a window into overall health. Today on The Dhru Purohit Show, Dhru sits down with functional dentist Dr. Staci Whitman to discuss the top signs that your oral health is in jeopardy, the root causes of common dental diagnoses, and the correlation between poor oral health and chronic disease. Dr. Staci shares her tips for optimal nutrition, eating timelines, and strategies to prevent oral dysbiosis and cavities. She also covers the top supplements for oral health and factors to consider when dealing with root canals. Additionally, Dr. Staci breaks down the research behind fluoride and explains why it’s considered so controversial.  Dr. Staci Whitman is a leading authority in functional dentistry. With a unique blend of scientific expertise and compassionate care, she's dedicated to creating a cavity-free world. Dr Staci is a triple board-certified in pediatrics, integrative dentistry, and naturopathic dentistry and is one of only five dentists in the world to have her Functional Medicine Certification from the Institute of Functional Medicine. She founded one of the country's leading Functional Pediatric Dental offices, where she takes a whole-body and holistic approach to her care. She co-founded the Institute of Functional Dentistry, launching in 2025, and lectures globally on Functional Dentistry and the Oral Systemic Connection. In this episode, Dhru and Dr. Staci dive into (audio version / Apple Subscriber version): Signs Your Oral Health Needs a Reboot (00:00:14 / 00:00:14) Root Causes of Oral Dysbiosis (2:10 / 2:10) Cavity Prevention (8:31/ 5:38) The Role of Diet in Dental Diagnoses (12:13 / 9:20) Top Factors That Impact Oral Health (14:43 / 11:50) Food and Drinks That Cause Decay and Promote Optimal Oral Health (22:52 / 18:20) Oil Pulling and Daily Routine (34:47 / 30:05) Hydroxyapatite and Sourcing from Reputable Sources (52:37 / 48:05) Key Supplements For Oral Health (54:49 / 50:17) What Causes Gum Recession (58:25 / 53:33) Root Canals and Their Association with Chronic Disease (1:03:32 / 59:00) Dr. Staci’s Hot Takes on Fluoride and the Importance of High-Quality Water (1:14:32 / 1:10:00) Also mentioned in this episode: FYGG toothpaste  Find a Functional Dentist  For more on Dr. Staci, follow her on Instagram, Facebook, or her website.  This episode is brought to you by Birch Living, Bon Charge, and BiOptimizers.  To get 25% off your Birch Living mattress plus two free eco-rest pillows, head over to birchliving.com/dhru today. Right now, BON CHARGE is offering my community 15% off; just go to boncharge.com/DHRU and use coupon code DHRU to save 15%. Upgrade your digestion with enzymes! Go to masszymes.com/dhrufree now for a free bottle of Masszymes for a limited time. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Stacey, welcome to the podcast. You know, when it comes to the topic of dental health and oral health, one of the top questions that I have and my audience has is, what are the top signs that our oral health is going in the wrong direction? And ultimately, if it keeps on going in that direction, it could be a major contributing factor to many chronic diseases that we know of. Yes, great question. Hi, Drew. Thank you so much for having me on today and talking about my passion. There's a few. I mean,

any time there's dysbiosis in the mouth, that's what we're looking for. The root cause of all oral disease is dysbiosis. And what is that? That means imbalances in your oral microbiome. We speak so much in the health and wellness world about the gut microbiome, but I think finally the oral microbiome is getting the attention it deserves. So what I look for, for as a practitioner are the usual suspects. Are you leaving with a diagnosis from your dentist? So do you have cavities, which is a sign of dysbiosis? Do you have gum disease? You know, when you brush your floss or your gums bleeding, that's a sign of inflammation. Have you been diagnosed with periodontal disease? You know, when you hear the hygienist reading out the little

numbers as she probes or he or she probes around your teeth, are they getting larger? That's a sign of not only inflammation, but attachment loss of your teeth, dry mouth, tonsil stones, ulcers in the mouth, there's quite a few things. So if you are in and out of your dental office, easy-peasy, no diagnosis, you're probably doing well. But if you go in and every time you seem to have a new treatment plan, you need a new cavity filled, you need to come back for a deep cleaning. if you're suffering from dry mouth, tonsill stones, halitosis, these are all signs of dysbiosis or oral disease. You know, as a functional dentist and someone who's looking at root causes

that are contributing to these, what are some of the root causes when it comes to some of the words that you mentioned? So let's start off with one of the basics, plaque buildup. Yeah. That happens over a period of time. You go to your dentist and they say that you have a ton of plaque or they're accusing you of not flossing, which some of you should be flossing, you're not flossing enough. Yes.

What are some of the root causes of that? Yeah. So plaque is biofilm. That's a really nice way to think of it. And biofilm is bacteria. We know we need beneficial or commensal bacteria in the mouth. So not all bacteria is bad. And I think this is a very important point that we can double down on later in the discussion.

But plaque, it will get. plaque, it will get advanced depending a lot on what you're feeding your microbes or your diet has a lot to do with it. So beneficial bacteria commensals, they love prebiotics. This is why we talk so much in my practice about the importance of a nutrient-dense diet, phytonutrients, eat the rainbow, is what I tell me by pediatric patients, because that's feeding your good guys. The bad guys, the anaerobes or the pathogens, they love fermentable carbohydrates. So think of all of these modern ultra-processed hyperpalibital foods that we love to consume. And the more we eat these foods, the thicker that biofilm can be and the more advanced the pathogens can get. Now, of course,

hygiene has to do with this. What hygiene is, brushing, flossing, even tongue scraping, it's removing and disrupting the biofilm so that those bacteria, don't have long enough to sit attached to your tooth or to your other structures to cause damage. And they cause damage by metabolizing and utilizing these fermentable carbohydrates and turning the byproduct into acid. And it's actually the acid that's causing the disease. It's the acid that's causing the hole in your tooth or the cavity. It's the acid that's causing the gum inflammation along with the endotoxins that they can release as well. So, mouth breathing also will affect the biofilm or the plaque.

pH is extremely important when it comes to oral health. We want to maintain an optimal pH. The critical pH of the mouth is 6.5. So anything under that is when enamel will start to degrade and breakdown. So we want to maintain, sorry, 5.5 is enamel. 6.5 is root structure. So we have to maintain a balanced pH. And if we don't, if we are living in a constant state of acidity, that will also contribute to a thicker plaque or thick old biofilm because we're creating this beautiful environment for these microbes to thrive in. So we're feeding them

too much of the wrong foods, essentially, if we're breathing through our mouths, changing the pH, if we're losing the integrity of our saliva, which is very protecting, and then our hygiene is substandard or suboptimal, that will increase our plaque buildup. You know, you mentioned cavities and all those things you talked about. Those all, I'm assuming, contribute to cavities. And the question that I got from my audience was, okay, so if those are contributing to cavities, are there any things that I can do naturally to reverse cavities? And of course, prevent them from happening in the future. Yes, you're speaking my language.

I see a lot of patients who seek me out just for this. Cavities absolutely can be arrested, which means frozen in time or reversed, remineralized. However, they have to be caught at the right time. And this is why we love preventative care. This is why we recommend to see a dentist regularly to have not only a physical visual exam, but also the appropriate amount of radiographic. exams because that's how we can see in between the teeth and see the structures down in the root and around the bone. So yes, you can arrest and remineralize. So what's important to understand is

our mouths all day long are in a constant state of either remineralization or de-mineralization. And this is normal. This is a normal process. So anytime we put things into our mouth other than a more neutral pH water, we will have an acid effect. So there's something called the Stefan Curve. And this basically just has to do with the alterations and pH in the mouth throughout the day. So every time the pH drops into an acidic state, we will lose some minerals from our teeth through the acid attack and pulling it out into our saliva. However, if we're healthy, if we're balanced if our saliva is optimal and if we are not snacking, grazing, and eating these ultra-processed foods all day, our saliva will naturally, through the calcium and phosphorus ions in our saliva and

appropriate enzymes, it will re-mineralize the teeth. So this happens all day. Now, the problem is when this state is in balance, when we are leaning more towards a de-mineralized state than a remineralized state. So we want to do things that help promote remineralization. That is through diet. That's through optimizing our salivary health through hydration and minerals and certainly how we breathe as well. And so there are a lot of protocols and products and things that we can use to help boost remineralization for those of us who may tend to find ourselves in an imbalance state. but I personally am utilizing a lot of these protocols in my office and I'm I'm avoiding a lot of treatment on fillings, you know, root canals, extractions, and anesthesia visits in my pediatric

patients. And to me, that's hugely important not only for the for the procedure, but the emotional experience because so many adults have trauma and emotional health issues because of how dentists have treated and arguably overtreated their teeth in the pediatric ears. So I think this is a really important conversation, especially in our pediatric population, where maybe we could be avoiding this overtreatment and creating these negative dental experiences for these kids. So I know you work a lot with kids, but let's say you have an adult coming into your office or at some point in time that you've experienced and you see that they have gum recession

and they keep on getting cavities and they keep on having plaque buildup that's there. From all those things, what can you tell us about their diet, either what they're eating or what they're not eating? Yeah, I mean, it's hard to make generalizations, but, you know, I would do an in-depth nutritional assessment and analysis with them, but I would either, I would be curious if they are eating more processed foods. The important thing to understand is not just sugar, flour is also a culprit. You know, even things, carbohydrates like rice and breads and pastas, crackers, chips, granola bars, these all can contribute and feed those pathogens.

And a lot of this has to do with frequency of how much we're consuming them. So I would want to dig deeper and understand are they eating more of a kind of a high-carb diet, essentially. but it's also important to understand that gut health impacts these things as well. So if they have intestinal permeability, if they have gluten intolerance, celiac, you know, CBO, this can all affect how we're absorbing our nutrients as well. And so a lot of dental health issues can be nutritional deficiencies. And that's something I think a lot of dentists are missing. It's not just about hygiene and diet.

There's a lot. This is why it's functional dentistry. and there's a lot of bidirectional relationships. So we really do need to dig deep into understanding the root cause, which it always is dysbiosis or microbial irregularities. But I don't think we can always say it's diet because I have lots of patients come in and adults too. And they're eating pretty clean. You know, they're doing pretty well.

Their hygiene's decent, but they still have oral health issues. And that's where we need to dig deeper and understand, well, is it an airway issue? Are you a chronic mouth breather? Because that certainly will contribute to oral dysbiosis. Do you have gut health imbalances? Do you have candida or H. Pylori in excess? That can affect how we absorb minerals, fat soluble vitamins, and how we're utilizing nutrition because that affects gum health. That affects our dental and tooth health as well. So what's really important is that initial intake with the patient. And mine's quite extensive. It takes patients quite a long time to fill it out, but it's really necessary to fully understand what's happening in that individual.

And we are all bio-individual, so why someone might have gum disease or cavities in dysbiosis could be very different than why someone else may. And so it's individualized medicine or individualized dentistry is really critical. Are there themes that you can take from different patients to sort of rank and order what you're seeing modern? Let's start off with adults. and then we'll talk about kids because I know you have a lot of expertise there. If you had to rank diet, mouth breathing, oral microbiota, if you had to rank all these different factors that contribute to poor oral health, which can contribute to poor overall health,

we're going to talk about that and some of the links that are there, if you had to rank them in order to your best degree, which we know is generalizing and every patient is different, their unique circumstances are different, what would you say would be number one, two, three, and so on? Yeah, I mean, oral microbiome is number one. This is why I really love salivary analysis. This is oral microbiome testing.

It's usually a spit test. There's many different companies out there doing this, and it really is, I'm hoping becoming standard of care in many offices, certainly more functional dentists are doing this. But you essentially test this saliva, and you can run chakra and metrogenomics. there's different ways to scan and assess for the full range and the raw data of what bacteria you have and you're trying to see what balance, what balance of healthy bacteria, commensal bacteria

versus pathogenic bacteria you have. So that's the first place to start because until we know what species of bacteria you have in your mouth or it could be fungus, candida is a big contributor too. And we know that bacteria and fungus work opportunistically in the mouth until we fully understand and what's happening in your body, it's really hard to create a treatment plan. So first, I say the oral microbiome. Secondarily, do you want to mention any names? Yeah, well, yes, absolutely.

The one I like to use is bristle. They do use shotgun metrodronatronomics, and they're really assessing for all 700. Now it's almost 800 species of bacteria and fungus and archaea and protozoa in the mouth. And they will link it too to gut health as well. because GI mapping can be important too. So bristle is what I use. I like it because consumers, it's direct to consumer also.

We obviously want a dental professional overseeing these things, but unfortunately not all dentists are on board with us. And so it's really nice that consumers who are interested in optimizing their help have access to this information. It's just now it's like what do you do with it and who do you go to to get protocol. So that's where you might want to look for a more biological, or functional dentist in your area. There's other brands, oral DNA, biome is one. There's more and more

coming out, but I personally use bristle. So I would say oral microbiome is first. Then I would probably say diet. You know, what we're consuming and eating, this is obviously how these bacteria feed and thrive. It's important to know we are born essentially with a pretty neutral mouth. We get inoculated with pathogenic bacteria from usually a caregiver, mom, dad, a family member. So these are transmissible, these bacteria. So we get these bacteria from someone in our community. And these pathogens, you know, generally if you're healthy, you're able to maintain a balance of these bacteria. But if we're feeding them, if we're overfeeding them, these ultra-processed foods, these fermentable carbohydrates, you know, sugar, flour,

and frequency of eating, they're going to thrive. And they're going to bloom and blossom and kind of take over. So there will be an imbalance. If you tend to eat more paleo or the Mediterranean diet, and I'm not advocating for any type of diet, but we do know if you tend to eat more, meats, fruits, vegetables, nuts and seeds, healthy oils, you are much less risk for dental disease. And so you're going to have a much more balanced microbiome. So after nutrition, I do think airway and nutrition's kind of tied together or equal, I would say, but how we breathe really matters too. So when you breathe through your mouth, the pH drops, you're creating an acidic environment and creating this perfect, you know, perfect world for these

pathogens to develop. So nasal breathing really is optimal. And I know you've had guests on speaking about the importance of airway before. If people are interested in this, the book Breath by James Nestor is a go-to to fully understand what I'm speaking of, but it is important for our microbial health to be breathing through our nose as well. And it helps with nitric oxide production. It helps keep our saliva imbalance so we don't get zero stomia or dry mouth. You know, mouth breathers tend to have more tonsil stones. They tend to have more halitosis or bad breath, too. And then all the way down is hygiene. I think hygiene's last. I hear some of these influencers, they tend to be more extremists, like the carnivore diet.

People say, I don't brush, I don't floss. I don't advise that. But the point is ancestrally, you know, we didn't have impeccable oral hygiene. And, you know, 10,000 years ago, we really didn't have a lot of cavities. You look at ancestral skulls, there wasn't a lot of decay. There was some bone loss or periodontal disease. But that means these species of bacteria are newer and our more modern society. And they're getting fed and multiplied.

and expanding and spreading through our diet. You know, we're really feeding them. Would you say that it's the same thing for kids? Is that order the same thing? It doesn't matter, whether it's for adults or kids. It's the same thing? Yes, I do. I think it is for kids.

The problem with testing an oral microbiome in a pediatric patient is their oral microbiomes are very transient because they're putting things from the outside world in their mouth so much that you can take an oral microbiome test at 10 a.m. and get all of these certain species, and the next day it could be very different. So I do still think the oral microbiome is the most important part, but testing, we just haven't gotten there yet of how to actually test and create a database for the pediatric population. You know, I want to go back to diet for a second. You know, you talked about it's not that rice and carbs and pastas are bad foods.

it's the frequency and somebody building their entire sort of diet landscape around these. You were calling it sort of a high carb diet. So if you had to, what would you say are, you know, we've talked about foods, but also a lot of my audience is wondering drinks-wise. Yeah. What are the most damaging food and drinks? And is there anything, if you do end up eating these things, are there any protocols or suggestions, right brushing xylitol anything else that you can do afterwards to minimize the damage of them

on your oral health yeah i love this question because there can be the purest philosophies and then there's real life if you're a parent or human out there navigating the the landscape that we currently live in chips crackers pretzels granola bars those types of foods to be the biggest contributors of cavities. I think so many people associate oral disease with sugar and soda and candy bars, but really it's these other foods that are contributing as well. And I think a lot of people aren't aware that they can be almost as bad. Some would argue worse. And it has to do with frequency of eating. So if we allow our mouth a time to remineralize, as I discussed, and what does that mean? Well, remuneralization usually will start 40 minutes after you've consumed a food that lowers the pH or a drink. However, it all depends on your health. How optimizes your saliva? How much of that food did you consume over what duration of time? So we really like to see patients trying to eat on a two-hour schedule. And this goes back to the Stefan curve. So that means you have a healthy breakfast, ideally high in protein. So you see.

stay so satiated, then you have maybe two hours later a snack, and then two hours later lunch, and then two hours later, a snack, and then two hours later dinner, and then maybe a bedtime snack. And this is especially for kids that need to eat frequently. The problem is chips, crackers, granola bars, they're meant to be over consumed. You know, you grab a handful, you eat some, you go do something, you come back, your brain says, ooh, I want more of that. the bliss point kicks in and you grab more. And so you're constantly keeping your mouth in a state of acidity. So timing of eating and eating frequency really does matter. So trying to eat more in a schedule, this includes drinks. So so many of us will sip on a drink for hours, you know, whether it's a

frapuccino or even a coconut water or kombucha. And these things including coconut water and kombucha, they have sugars in them. So we are creating an acidic environment in the mouth. So it's really important to try to consume things in a shorter duration of time. And then allow the mouth time to rest. And we speak a lot of this with gut health too. Like we need time to allow for digestion and not to overload the system. And the mouth is the same.

You know, the mouth in the gut are kissing cousins. There's bidirectional relationships. This really is the gateway to the body, the mouth. It's one tube, and so a lot of things we discuss with gut health really apply to oral health as well. The modern world, your kids out and you're out and you're eating crackers or chips, they're delicious. I understand that. So there are ways to strategize how to reduce your risk. One is, of course, to consume a lot of water after, but you can kind of meal plan, if you will.

And so you're going to eat your fermentable carbohydrate first, but then eat, let's say, a slice of apple or a carrot or celery or something crunchy that's going to dislodge that food substance from the grooves of your teeth and from in between. It will increase salivation, so it will rinse food particles off. This will help neutralize the mouth and raise the pH. And another strategy is cheese. If you can do dairy, cheese buffers and neutralizes the mouth. You mentioned xylitol.

Thank you for mentioning xylitol. There's so much data. So many studies on the benefits of xylitol for oral health. So chewing xylitol gum or xylitol mints after we've consumed kind of a heavy carb or more sticky carb meal can be really important. And the thing is, too, it is about consistency. So, for example, if you eat a piece of bread, it tends not to stick in your teeth as much as dried bread, which is crackers.

So it's how long is that contact time to the tooth that allows the bacteria to have their feeding frenzy, if you will, and allow more acid to be released. And again, that's where the imbalance comes from. So if you are eating something and you're finding it's kind of all throughout your teeth and sitting there for long periods of time, that's not ideal. So you need a strategy to help remove those food particles, whether that be adding one of the foods I mentioned, drinking a lot of water, after chewing xylitol gum, or maybe you go and floss and brush. And it is important to try not to brush immediately after eating. Again, this is getting a little purist again, but, you know, we eat. Our teeth will be demineralized for a short period of time.

I mentioned that kind of 40 minute mark. So ideally, we want to wait 30 or 40 minutes before we brush because our enamel will be a little bit weaker and we could be brushing away some of our enamel in creating sensitivity or even wear and erosion on the teeth. You know, I'm somebody who will typically have like one cup of coffee in the morning. I might have some green tea, probably like two cups of green tea or like a puer tea or Earl Grey, you know, and I am definitely guilty of nursing those teas for like long periods of time or kind of, you know, my sister and I, my sister.

years, they make fun of me, but they do the same thing, is I often have like three or four cups on my desk at any time. One might have coffee, one might have tea, one might have water. Am I damaging my dental health, my teeth by just kind of constantly sipping throughout the day and not giving my mouth a break to sort of rest and remineralize? Yeah, that's a good question. I mean, I do the same. I go out to eat and I have like four drinks in front of me. It just depends on you. Like what is your salivary health like?

That's really important. What is your overall microbiome state? So and also tea, I mean, are you adding sugar to your tea? Then yes, I'd be concerned with that. Is it just black tea? You know, it's still not ideal. But your body might be doing fine with that. So we can be overcautious too.

But I think if you're someone that you have sensitivity, you have enamelware, your dentist says you have erosion, you're really prone to disease, then I would be more cautious. But you can really rabbit hole in some of these things. And we also need to enjoy life a little bit, too, of course. So, you know, if you're concerned, I would just try to mix it up, which is what I do. So I might have my carbonated mineral water and my tea, but then I have my regular filtered water and I just kind of make sure I sip and swish in between. This goes with lemon water too. A lot of people drink lemon water in the morning.

I do also. But a lot of it's contact time. How long is it in the mouth? So literally, what is your swallowing mechanism? Do you put a liquid in your mouth and then swallow it immediately? Or do you tend to hold it in your mouth and kind of swish it around, feel safe? that way. But I would argue if you've been doing this and consuming these foods this way and you tend to get great dental checkups, you're probably fine. But if you are high risk and every

time you go in, you have some issue that you need to address, I would dig deeper into these frequencies of exposures, absolutely. And like you said, it's about focusing on the most important things, and that's why we have you here. And then there might be some things in the weeds or technicalities that are just interesting to learn about. But in all areas of our health, if we can focus on the majors, we're going to be doing better, not that it's about being better than anybody else, but if we compare ourselves to the average population that has just terrible oral health and is suffering, and that's increasing their risk of, you know, Alzheimer's, of heart disease. We're going to have you talk about that in a second.

You know, just nailing the basics is a major leap forward because a lot of people aren't even doing that. So I appreciate you being on our podcast today to help us understand, you know, what's major and what's like getting a little bit in the weeds, which you've already been doing a great job on so far. I'd love to tease up the next question that I have. You know, you've talked a lot on social media about how you're a fan of xylitol and how it can be a powerful tool to help us. stay in great dental health or oral microbiome. Like that, are there any other natural remedies? This is a top question from my audience. Are there any other natural remedies that people can use to prevent or even reverse things

like plaque, cavities, and gingeritis? Yeah. Well, being aware of your nutritional status is really important. So vitamin D3 and K2 are paramount for oral heart. health. And there are, there's a lot of data that shows people who are more more prone to cavities do tend to have low vitamin D levels. And we know so many of us have low vitamin D. And it's really hard to be optimal. And of course, functional medicine has a different standard of what is optimized, you know. So you need to work with your doctor. But we really want to be optimized in vitamin D3 and K2.

I find that's very hard to do, whether through the sun or through diet. So I do like to see patients supplemented as needed with a high quality supplement. The same goes with magnesium. So magnesium is extremely important for dental health. It's also important for sleep health and brain health and immune function. So I like a lot of my patients on magnesium because we're also deficient in magnesium. And magnesium is very important for building enamel and keeping teeth mineralized. So I think understanding that.

Now, if you have gum disease, you know, what are you getting enough collagen? Are you getting enough protein? What's your vitamin C status? B vitamins are very important. Zinc and other minerals as well. So I always start there, like nutritionally, are you optimized? It's important. And so maybe you need a really great multivitamin or maybe you need to to eat a little more nutrient-dense, you know, organ meats or something.

Desiccated organs can be really helpful. And so the work of Weston Price is something many functional dentists follow. And that basically focuses on fat, soluble vitamins and minerals for dental optimization. So other things that you can do naturally, I mean, people will get into talking about probiotics and prebiotics. So prebiotics, of course, are going to come from our diet. But there are oral probiotics that can really help as well. I'm a big fan also of oil pulling. Is there any truth to oil pulling?

How do you do it? And why do you like it? Oil pulling is taking a spoonful of oil and don't get caught up in how much. Take what feels good in your mouth, putting it in there, letting it melt, and swishing around with it. Now, you'll see that Aravadic protocols to switch for 20 or so minutes. I think that is excessive and not really doable in many people's morning routine. So I oil pole with a raw organic coconut oil for a few minutes, not every day, but a few times a week. It's one of those things you can't knock it until you try it.

I do find my mouth feels more lubricated. I feel more hydrated. My teeth feel cleaner. I feel less biofilm on my teeth. And they look a little whiter, too. That might be, you know, my impression, but there is some data. There really is some data out of India on oil pulling. And so this is an ancient, erratic practice.

So this is many thousands of years old. And, you know, the premise is that it reduces toxins and bacterial load, which it does. So instead of using a conventional mouthwash, which I know you've spoken about this before on your podcast, the concerns with studies and traditional mouthwashes and the strong alcohol. and a stringent nature of them, how they're carpet bombing our oral microbiome and damaging bacteria that can affect nitric oxide levels and that can affect heart and blood pressure. And there's a lot more information out there about conventional mouthwashes and why to stay away from them. And partly it's because they're not selective. They're killing good bacteria and bad. And we really want to double down on supporting and nourishing our healthy bacteria.

So oil pulling can be sort of a supplement to those of us out there that like to swish with something, but we're trying to steer away from conventional mouthwashes. And I really love baking soda and water, maybe with a little sprinkle of salt, too, that has an antiseptic property. Baking soda will neutralize and buffer the mouth. It's called sodium bicarbony is the technical term, and we have bicarbonate in our saliva. So it's just kind of supercharging or boosting our salivary health. And so for people that want to just do one more thing, those are great things that you can rinse with. Other things, like if we really want to get into healing cavities, I'm a huge fan of hydroxyapit.

So hydroxy appetite, it's really been around since the 70s. And other countries have kind of doubled down on this becoming. of fluoride replacement. So what is hydroxyapitite? Hydroxyapitate is what our enamel is made up of. Our enamel is made up of calcium and phosphorus ions that are bonded together through ionic bonds, and they create this really beautiful, very organized crystalline structure. And so what happens when we get a cavity is that crystalline structure is damage. And over time, that actually creates a hole in the tooth. So what fluoride traditionally has done, if there's an imbalance, it goes in and it changes that hydroxyapotite to something called

floor appetite, which makes it more acid resistant. But those of us that believe in biomimetic or biocompatible materials, hydroxy appetite has become a really wonderful fluoride supplement because it's going in and it's basically correcting those original hydroxy appetite bonds. So it basically hydroxyapatite can help remineralize and arrest cavendial. it kind of supercharges the saliva. It can whiten teeth and it can help with sensitivity as well. And so that is part of my protocol when a patient comes in and they have an appropriately sized lesion that we're trying to arrest or reverse. I will prescribe or recommend they use a hydroxyapotite toothpaste. The other thing I really use a lot in my office is ozone. So ozone is antimicrobial.

It's antifungal, anti-bacterial, it's antiparacetic, and you can get it now in oils or in gas that the dentist will use. But what ozone does is it kills bacteria. So it can be this nice balance for killing bacteria, reducing bacterial load, and then remineralizing teeth. So it's kind of a one-two punch. And at my office, I'll do a lot of ozone and hydroxy appetite. And we kind of will tell the patients to alternate those. So one night, apply some ozone oil directly on your cavity. If it's a cavity in between your teeth, put it on your floss, get it up in between.

Don't rinse, don't eat, go to bed. The next night, put a blob of your hydroxyapitite, or there's actually a hydroxyapotite varnish now, which is professional strength. Put that on the lesion, leave it there. And you kind of alternate. We found a lot of success that way. Some patients get very into homeopathy and cell salts. And, you know, so there are ways to modulate the microbiome, you know, boosting hydration is really important. Taking extra minerals can help with this too.

So it can be quite layered and nuance and it sounds, I know, so overwhelming. But truly, if you just double down on your diet and make some strategic changes to your hygiene and products you're using, a lot of patients find a tremendous amount of success. When do you do it? Do you brush first and then? oil pull? Do you do it in the morning? Do you do it in the evening? What's your recommended protocol? Yeah. So I will only do it a few times a week. And the reason is it is antimicrobial. And so I don't want too many antimicrobial agents in my mouth because, again, we don't want a carpet bomb. That whole kills 99.9% of germs mentality really needs to go. We want to support and nourish the healthy

bacteria and in doing that it will crowd out the bad bacteria so but i will pull a few times a week and i tend to do it in the morning and i will do it sometimes i usually do it first thing so i wake up and i put it in and i'm pitter pattering around my bedroom i might make my bed or open the when you know whatever i'm doing turning off the white noise and etc um the key is don't spit it down your sink it can clog your drain so spit it into the trash can And then I usually will floss and brush after. Now, I'm a dental professional, so I floss multiple times a day. I really just want people flossing once a day.

And we can get into flossing. I'm very passionate about flossing. But that's my routine. Now I will usually go, and like you, I make my coffee, and I have my whole routine, and I eat something usually pretty high in protein. I often will then go to work. So this is now after 20, 30 minutes after I've eaten, and then I might brush again.

Again, this is a dental professional who takes oral health to the extreme. But I think if you were just to do a routine, you would oil pull and maybe brush after. That is what I would recommend. Great. Yeah. And on the oil pulling, again,

you mentioned, you only are doing it a couple times a week. It's not something you're doing it. Three or so. I think some people do it daily. I just, number one, don't have the capacity to do that. But I think you can get tremendous benefits just from a few times a week. Yeah, yeah. We want to find the 80-20.

We want to find the things that we can do that make the biggest difference. Because if we followed every single thing out there, we would all go nuts. You would just be doing protocols all day, which. Some people do, but not all of us. I mean, the 90-minute morning routine just is not realistic for a majority of the thing. So, yeah. You mentioned something else.

You mentioned baking soda. Uh-huh. How is that incorporated? Are you using it daily? Some people use baking soda instead of, you know, toothpaste. So talk about how you use it. And if there's any corrections that you want to make out there to how you see sometimes people, you know, using it.

Yeah. I don't think people misuse baking soda. A lot of people worry about it being too abrasive, but it's abrasivity index is pretty, it's pretty low once you mix it with water. Because how abrasive is something is how it could damage the enamel. So the way I use it, I put it in my water pick. Or you could create like a slurry with water and rinse with it at night. So this is what I do. I'm a big believer in interproximal tooth cleaning.

What does this mean? Flossing. And if someone said you're going to be on a desert island and you have to pick, you can only either brush or floss. What would you pick? I would always pick flossing. I would always pick flossing. And this is because this is where I see the most disease.

This is where I see the most cavities in both kids and adults. It helps with gum health. anerobes love areas of low oxygen, so they love to hide in between the teeth and wreak havoc. But I think, you know, if you're dealing with a younger patient, flossing alone is fine, but as we age, we do tend to get recession, some gum loss, some bone loss, and that is normal to some degree. And so flossing isn't quite getting the job done as much as we need to. So I personally alternate. I floss one night and the next time. I water pick or water floss. And there's a lot of data to support that water picking really is

comparable to flossing. I have a lot of patients who are special needs or they're orally sensitive or they just can't floss, but they find a water pick to be more fun. It gets them excited about it and it will allow them to do some introproximal cleaning. So when I'm making my water floss liquid, I add water and I add some baking soda into it. So that I do get that buffering and neutralization benefit. And I do that at night. I'm going to give you guys a shout out. You guys have a fantastic toothpaste because I know you're not going to mention it now. You'll probably just mention at the end, but people are listening now. So I'm going to mention it. It's called FYGG, Feed Your Good Guys. I'm not affiliated in any other way than just I'm using it. I love it. And so I want to give you guys

a shout out. So that's a toothpaste that's made out of hydroxy appetite. And just a quick little mention, you guys are focused also, because there's, you know, now seeing this product on the market a little bit more, you're focused on making this more similar to like saliva and taking out a lot of the bad ingredients, emulsifiers, et cetera, you know, things like that, that could be potentially harmful for the oral microbiome. Is that, did I get that right? Yeah. I mean, pretty darn close. Thank you. So yeah, it's called fig, like the fruit. Feed your good guys. And we really are an oral microbiome focused oral health care line. That's our main goal. And we have added prebiotics and amino acids into it at the appropriate ratio to modulate the microbiome. So that's,

this is what we're doubling down on with our, with our brand identity. if you will, but we also do have hydroxyapatite because we know most of us need a little boost of remuneralization. And hydroxy appetite, it's really exploding in the research and data. Again, I mentioned it's been around since the 70s. The Japanese and the Italians have been using it since then. It's pretty new to the United States and it's definitely still, some dentists are still warming up to it. But yes, we've removed all the emulsifiers, all their surfactants, all the essential oils, which many people think essential oils, that sounds natural and healthy. Well, unfortunately, essential oils are strong antimicrobials. So if you're using this every day,

it can be damaging to your healthy bacteria. So we really want to move away from daily usage of antimicrobials. Now, this is important to know if you, this is where oral microbiome testing comes in. You may have some pretty significant pathogens in your mouth. Pigeon Javallis is a big one. That's the one that's linked to Alzheimer's and many other of these downstream systemic issues, and we can get into that in more detail. But you may need more tailored, more aggressive therapy. So you may need antimicrobials for a short duration of time in stronger, stronger medicinal therapies, even sometimes antibiotics. But I do. don't like strong antimicrobials like essential oils every day. So that's twice a day,

every day is your routine toothpaste or product. So yeah, thanks for the shout-out. We're really excited. We actually have a varnish, which is professional strength. I mentioned that earlier. So we actually won an award as best new product is the Celerant Best in Class Hygiene Award from the RDAH group, which is a hygienist group. And this is what I'm using with my patients to arrest and reverse cavities. And it's pretty incredible what it's doing. And we have comparative and clinical trials coming out soon, too, that I'll be happy to share with everyone. A couple quick questions on hydroxyapatite.

We wrote a newsletter long ago about this before you guys had launched your product, just talking about how I shared my own N of one experience, which was when I, I, was feeling a lot of gum sensitivity because I started having some recession, which I learned from my biological functional dentist, Dr. Roshian here in L.A., love her. She was telling me, I had a lot of recession on my left teeth in my lower left teeth. She was like, your right dominant hand and you're brushing too hard. You need to switch to an electric toothbrush. And then also let's like, you know, get you off of like some other things as well. And then I naturally came across like hydroxy appetite. So I started using that. And my anecdote that I had shared with my audience was

I noticed my teeth sensitivity in my lower left area. Like I drink coffee or cold things, anything on extreme temperature. When I started using hydroxy appetite, like that went away pretty much completely. And I ran out and we went traveling. My wife and I were traveling for like a month or two. And I didn't have the toothpaste available to me. It wasn't easy. to get where we were at in Europe and stuff a couple years ago. And I remember that gum sensitivity coming back. And I was like, oh, man, this is so weird. And I came back and I went back to using my toothpaste and it went away again. And I was like, okay, I think there's like something definitely there for me. And I wrote about that experience. So how is it that hydraxy appetite

helps with the sensitivity that sometimes people feel with their teeth? Yeah, that's actually a valid finding that's supported by research and there's a lot of white papers on that too with how it reduces sensitivity. That's actually one of the most amazing things about hydroxyapotite is that's what people will notice. So hydroxyapatate, especially if you're using the nanoparticles, and I do want to be clear, it's really important where you source anything from, whether it's your supplement or your food, but also your hydroxy appetite and your nano. it can actually occlude and penetrate into the tubules because they're so small. So it's calcium and phosphorus ions that are getting into the tubules of your teeth,

which think are like the pores of your teeth. And then it's occluding and blocking. And so that is going to help with sensitivity. You know, what you're feeling is nerve sensitivity from cold or hot or various stimuli acidity in the mouth. And so it's profoundly beneficial. And I would say, Drew, you should try the varnish to down in there just to see if it will stay away from being bothersome longer. We're seeing some really great results with that. But yeah, that is a legit finding.

So another follow up on that. You mentioned, you know, sourcing and being mindful of it. You actually had a really interesting gentleman. I think his name was Ryan Nolan. You guys did an Instagram Live. Yes. And I kind of went down the rabbit hole of like looking at his kind of. I thought you guys did one on xylitol and all of its all the research around zylitol.

I thought it was very fascinating. It echoes a lot of the same things you said here that xylitol can be, you know, an appropriate part of, you know, a hack, a natural quote unquote remedy, chewing some xylitol gum after like a higher carbohydrate meal or just as a way to like dislodge and returning the oral microbiome to like a healthier state, et cetera. and the type of, it's not sugars, but the type of compounds inside of it, don't feed the bad bacteria. Yeah, they inhibit bacterial proliferation. So they inhibit the biofilm from forming essentially.

Got it. Yeah. So another video separate from xylitol that Ryan made that I marked down as a question to ask you, is that he said, hey, listen, some nano-hydroxy appetite, you got to be careful where it's sourced from because there can be some heavy. metals associated with this. That's the first that I'd heard about this. Have you heard about this? And what's the skinny that our audience should know about it? It's kind of the Wild Wild West. And some manufacturing practices are substandard. And the FCCS in the EU, which is the oversight

committee for consumer safety, they were looking at nanohydroxyapit. They started some studies about eight years ago to see, because they were noticing it was kind of blow. up in Europe. So they said, hey, is this safe in consumer products? So they started researching doing their own data, doing their own studies. And there was one nano in particular that they set aside because it was showing no concerns. It wasn't showing any concerns with penetrating epithelial linings or creating calcifications. And so that is now become the standard. And it has to do with particle size, shape, aspect ratio. This gets real nerdy quickly, but also the quality of it to make sure it isn't rampant in heavy metals. And so unfortunately, there are some

nanosufacturing facilities in other countries where people are sourcing their nano from where they have tested really high. So you just want to make sure you're asking your brand, where are they sourcing from? And I personally would only use a brand that's sourcing from and using Ninoxim. It's N-A-N-O-X-I-M. And I'm happy to link, we can list all the brands that I know of in the show notes for your audience. We need the FDA to get involved, obviously. So we need some standardization here in the United States too.

So this is where you just want to follow brands that are using ethical and transparent practices. A couple of things you mentioned that I just want to get a chance to, tease out, right? Do you feel comfortable making any recommendations of where you want people at home? Again, check with your doctor and your practitioner, but where should they be shooting for when it comes to their vitamin D? Because you mentioned vitamin D, vitamin K2, very important for teeth health and our dental health overall. So where do you like to see those numbers or what have you heard if you feel comfortable mentioning to our audience? I think, you know, traditional medicine, I've seen be okay with a range between 20 to 40. I've even had patients come in

that are in the teens and their primary care. I was like, oh, you're fine. I like to see it more optimized up around 60. My doctor is even liking me to get up closer to 70 to 80. So that's hard. And we only know with testing. And so I do really like people to go and at least annually have a vitamin D test. Now the problem is it's often not covered by insurance. So you really have to advocate for yourself and ask for it. But I'd say 60 is a great place to shoot for. I do see, and this is by no means saying how anyone should eat, but I do see an uptick in enamel defects in formation in children whose mothers were either vegan or vegetarian or they're being raised that way. And all my whole point with this is just to make sure if you are eating this way, make sure you're really optimal in vitamin D and magnesium because it will affect your child's dental development.

Yeah, I grew up vegetarian. I had super poor dental health and I was on braces and I was getting cavities all the time and just the whole nine yards. And obviously at that time, I'm just turned 42. There wasn't as much of awareness as there is now. I'm no longer, as my audience knows, I'm not vegetarian or vegan, but I think at least there's a lot more tools and resources, but it's still, unfortunately, something that you still see pretty commonly, even for people who are semi-educated. So again, we're not advocating for one thing or another, but buyer beware. Yeah, and just no, I was vegan for many years too. I was vegetarian and I went vegan and it had effects on my health. We've heard the story before.

And I thought I was doing all the right things. But what I wasn't really doing was testing myself enough. I just wasn't getting those metrics and those data points. So that's the most important part. Just know where you are. So I mentioned my experience with gum recession. I want to ask you, in my case, it was pretty cut and dry. I was actually eating a very clean diet.

I wasn't eating a high carb diet. I wasn't afraid of carbs. I was to have them at appropriate times. I was brushing. I was flossing. I was doing other stuff. And in my particular case, it was just that I was brushing too hard and simply switching to an electric toothbrush.

It solved largely. Now, I still have, you know, that same gum recession. We stopped it, right? I haven't sort of regrown that. I don't know if there are any ways to do that. That'd be like a part two question. But for people that are listening at home who are dealing with gum recession, besides brushing too hard, what else could be contributing to that?

And are there things that they can do at home to fix it slash stop it? I love this question. I think this is one of the most overlooked reasons for gum recession. And this is your occlusion or your bite. So if your bite is off and you're putting too much force or pressure in one area of your mouth, you will start to splinter away your enamel. It's called ab fraction. And that can cause attachment loss.

So that's an important thing. Is your bite stable? And then we can really rabbit hole down this because your bite has so much to do with your neuro-properoception and neural feedback and your vagus nerve. You know, are you sympathetically overdridden or you parasympathically overdridden? Just general alignment. A lot of it starts in the head and the skull and the jaws and the occlusion. So that's a place to look. If you have certain species of bacteria, you know, if you have peridonal pathogens in your mouth, that could affect attachment loss.

Also, a history of orthonics. Most people who've had some sort of orthonics, you know, you're moving these teeth through bone. And if you push them too far out toward the cheeks, if you will, you're going to get some attachment loss through that. And so it could be a combination. I have some recession and it's due to past orthodontics. But those are things I think not enough people are speaking of. And for gum health, I really want optimize vitamin C protein, which I know you speak a lot about and have a lot of gas on. But I will also agree really prioritizing protein and collagen in your diet is important.

And I would say B vitamins also, you know, the whole array. And so if you have methylation issues, if you have MTHFR, various gene snips and you have a hard time getting. optimized in some of these B vitamins, you know, you want to kind of double down on that with your doctor too because that can affect your gums. Now, growing back gums, we're not there yet. We're not there yet. But I do know, you know, there's researchers out there working on all these things. So hopefully one day. Yeah. Well, all the more reminder that if you have any gum recession, now is the best time to jump in, start practicing some of these things, cleaning up your diet, you know, brushing and flossing more regularly, not brushing too hard using the right type of toothpaste,

you know, preferably a clean source of hydroxyapitite, potentially using things like xylitol. And then, of course, you know, finding a functional dentist. I think your business partner has a website and I don't know if there's other directories out there that you point people to. Yeah. I'm in a back pedal and then come back to that. One tip, if you brush too hard besides an electric toothbrush, that will, also have brain health benefits is tries to start brushing with your non-dominant hand.

I recently started doing this. There are some preliminary studies that show it maybe helps with dementia risk and Alzheimer's risk just because you're utilizing your brain in a different way. But you'll be more gentle. It's super awkward, but it will help make sure you're not brushing too aggressively. So just give it a try. It will make it more fun. Makes oral hygiene more fun. So yes, Dr. Mark Burhanna is my business partner. He is Ask the Dentists, as many people may know, if you follow him on social media. He is a great website as well. He has a functional dentist directory.

We can link in show notes. And there's many wonderful providers, and I have seen a big shift in movement this way. I'm personally working on with some other functional dentists who are IFM certified, which I am also, to create the Institute of Functional Dentistry. And so that's in the works. This will be a training program, a lot like IFM, where dentists can go and actually get a certification in functional dentistry. This thing, this doesn't exist so far. And so that's why it's really hard. You might see that this person's a holistic dentist.

This is a biological dentist, integrative, functional. But then you go and maybe they don't quite meet your expectations. It's just because there's no standardization. So I'm working with some other colleagues on trying to create a standardized program. And, but in the meantime, you know, hit up the functional dentist directory. And, you know, look at websites, read reviews and, you know, word and mouth is important. But I think that's one of the best bets. You can also look, if you're interested in more airway focused dentists, which this could be a whole other podcast.

We didn't quite dive into airway. But you can look on the AEO, just the American Academy of Oral Systemic Health. they'll have more functional dentists but also a lot of functional dentists are airway focused. The Breathe Institute, which is in L.A., it's a training program that focuses on airway health is important. And the American Academy of Pulmonary Science and Medicine, AAPMD, I'll get the link. But that's where a lot of airway trained dentists will put their credentials as well. So we'll make sure we have all the resources for you. Great.

I'm going to jump around a little bit. I want to talk about root canals. They're a hot topic on YouTube. They're a very polarizing topic. Are there dangers to root canals? And is there any link to root canals gone wrong and chronic disease or potentially even our lifespan? Yes. There was a movie that came out called Root Cause.

That's where a lot of this comes from. So I'm not a post. to anything, I don't think anything's black and white. I think root canals are a great option for some people that want to save their teeth. The challenge is not all root canals are performed the same. The techniques aren't the same among providers and the materials aren't the same. And also, the human attached to the tooth with the root canal isn't the same. So patients that are more prone to autoimmune diseases or just metabolically imbalance, which we know many, many people are. You know, if you have diabetes or blood sugar imbalances, you're not going to be super

successful with root canals. They probably are going to fail. Your body just doesn't have the immune support and integrity to keep this treated tooth in balance. But I do think they're a very viable option. The problem is you want to be finding someone ideally who is using more cutting edge technology. Now, this isn't accessible to everyone, but I would say you want to find someone who's using lasers and ozone. They're starting to use peptides now in root canals, which is really cool, because you're just going to ensure that that tooth is as stable and devoid of harmful bacteria as possible. That's the concern, is that we're leaving sort of a dead order. in the body, which becomes this breeding ground for pathogens. And it is true. Like some root canals are

extracted and you culture and biopsy and it is rampant with some pretty nasty things. One thing also, if you have root canals, is to get them checked fairly regularly with 3D imaging. So many dentists just do the regular x-rays. You really want to CBCT scan, I would say maybe every five years, because a lot of failures or obsessing periapical radial lucencies is what they're called is picked up on a 3D image only. The other thing too is, you know, I think there's a lot of sensationalization and fear. If you are a healthy human and you're thriving and everything is going well in your life and you have root canals, you are probably just fine.

But if you find you have these underlying medical issues that no one can help diagnose. You know, maybe you have some strange rashes and or brain fog. I mean, a lot of this is just by case reports, I think it's worth exploring. But I'd be very cautious of Dennis who say every root canal is going to kill you and give you cancer and needs to come out. I just think that's a little too much. Because many humans have root canals. And so that's just creating fear. And I, I, I think just being empowered to know what could go wrong and then finding the right people to help you monitor your root canal tooth. Now, if you have a tooth that might need a root canal, you don't have uncurrently, maybe you choose instead to extract it and do an implant. But here's the

thing. Implants aren't, they don't feel safe either. Like they have issues. Sometimes you have reactions to the ceramic or the metals that are used. Sometimes your bone integrity isn't healthy enough and they fail. So nothing's without risk. And so you just personally need to do a risk assessment. But if you have current root canals, please don't panic. Please don't panic. Just get them checked and make sure you're kind of staying on top of it.

And I'm sure if you go to the website, so we'll link to the show notes and you find a functional or biological dentist in your area, they can help you decide, especially if you don't have a root canal yet, you can get some second opinions. Is the root canal a best option? Or can you do a different thing? You know, you're balancing everything out there. Second and third opinions are so important for everything. If you go to 10 different Dennis, you probably are going to get 10 different opinions.

I mean, that's truthful. The other thing is important to know, there are baby root canals on primary teeth and children. And these are very different than adult root canals. A primary tooth root canal is called a pulp audit. it's a vital root canal, you actually keep the tooth alive. And so that's a big distinction, too. You're not killing the nerve supply completely and the blood and vascular supply. The tooth is still getting nutrients. It's kept viable. And I do like to save teeth in the pediatric patients I teach because once you lose teeth, you know, it's harder to chew. It's harder to eat nutrient dense foods. Mastication,

digestion is impacted. I think an adult population, It can affect self-esteem. It can affect mental health. And there's some studies now that show as we lose teeth in the back, it can contribute to dimension Alzheimer's either. And they're trying to unpack the why. Is it the pathogens or is it something to do with proprioception and how that feedback is being triggered up to the brain? So nothing's black and white. I just think nothing's black and white. We're all different. And so just work with somebody that I think has a balance to would be my recommendation. Let's pull on that thread a little bit more. Tell us at our audience about some of the ways that our oral health is connected to other aspects of our health, especially certain incidents of chronic disease. What do you know about? Yeah, so the oral systemic connection is very well documented in research and just more

and more research is coming out as we are learning more about these specific pathogens and microbes and how they work together. Essentially, if your gums bleed, so I like to say if there's pink in the sink, if you spit out and there's blood, that's a sign that your gum health is compromised. That now is a way for bacteria in your mouth, pathogens or even commensals, to get into your vascular system, your blood supply, your lymphatic system, and they just catch a free ride and they end up in organ systems they shouldn't they can end up in the heart they can end up in the brain they can affect fertility um they can end up in your joints and and lead to arthritis and autoimmune diseases and so it's really important to maintain gum integrity this is a lot like

leaky gut right so it's it's the same concept of leaky gut there's leaky gums so you really want that's a barrier from the outside world into the inside world. So these bacteria, not only do they end up where they shouldn't, but they do release toxins, endotoxins, lipopolysaccharides, that can create an inflammatory response, a cytokine response, and it's being linked to, you know, cardiovascular disease, Alzheimer's, dementia, mental health imbalances. It can impact fertility.

It can impact pregnancy outcomes. rheumatoid arthritis, autoimmune diseases. You have to remember, too, you're swallowing about 2,000 times a day. And a lot of those bacteria are pretty resilient. They can actually withstand the stomach acid and get down into our intestines and kind of wreak havoc down there. So potentially leading to gut dysbiosis, you know, sievo, et cetera, et cetera. So it's all about the microbes. Again, going back to what I said earlier, dysbiosis.

or imbalances in bacteria is the root cause of all oral disease. And I think we're learning more. It's truly the root cause of most systemic diseases, too. Fascinating. Love your microbes. That's the point. Like, don't take them for granted. Don't take them for granted.

You know, we spent a lot of time talking about the types of foods and the type of poor hygiene and other things that contribute to poor oral microbiome, oral microbiome. You also mentioned earlier in the interview that fermented foods can help create a beneficial oral microbiome. Are there any other foods, or even within the class of fermented foods, are there particular types of fermented foods or dosages or things that you want to recommend to our audience? So, yeah, we'd love to hear your thoughts on that. Yeah. Pre-biotics. I think prebiotics are more, more important than probiotics.

And so it's the same for gut health. So artichokes and asparagus are really important. And kimchi and nato and kiefer, you know, be cautious with kombucha, I'll say, because it's usually really high in sugar. So by any of these fermented, naturally fermented pickles, these are fun experiments that you can do with kids is like make these. foods in your home, even as adults, like it's really easy to ferment foods naturally, and this means without vinegar, to really boost the bacterial benefit. So I can't upsize prebiotics enough.

Now, in our modern diet, I think perhaps we don't get enough, which is why using a prebiotic toothpaste might be helpful, or there's many prebiotic powders and supplements now just to kind of supercharge and make sure we're getting enough of prebiotics. As for dosaging, I personally, I personally try to have a spoonful of some sort of fermented food every day. There's so many out there now, whether it's pickled beets or pickles, kimchi, sourcrow. So I think that's really important, not only for gut health, but for oral health too. So I'm really focusing on garlic and onions and all of these things that we know are considered prebiotic fiber are really important for oral health too. Let's talk a little bit about fluoride and especially drinking water, fluoride in the toothpaste.

Another, probably the most hot topic, controversial thing in dentistry. And you see a lot of people, especially on social media, traditional dentist saying, you know, the people that are talking about integrative health and how dangerous fluoride is, they don't understand. And then the other side saying their thing, what is your perspective? And what do you want our audience to know about the potential dangers of fluoride? Yeah.

This is a hot topic. So I think it's important to know I was traditionally trained, which meant I was trained to recommend fluoride to everyone and support water fluoridation without question. And I did do that. And I admittedly really just took it at face value. I never did any research. I actually picketed in Portland, Oregon, which is where I'm from, on the pro-fluoride committee.

This was about, gosh, 12 years ago for water fluoridation. And what changed my mind is I was still in residency, and one of my faculty members had come back from the fluoride debate. and he looked sort of like a deer in headlights and sat down. This is a gentleman in his mid to late 60s who had been a huge Florida advocate his whole life. He sat down and said, I have never listened to the other side and I have never looked at the research. And I respected this gentleman a lot. I still do. And I said, gosh, neither have I.

So I started researching. more about fluoride and the concerns systemically. And where I think dentistry is missing the mark is we're hyper-focused on dental health and oral health. And I think we can all agree that fluoride absolutely, if used topically, I'll say, and I'll get to more of that in a moment, if used topically, it can make teeth more acid resistant, so less susceptible to these acid attacks and cavities. but what is it doing to the rest of the body? You know, fluoride is not an essential nutrient. It's considered a neurotoxin in many groups,

and the Lancet even came out with that many years ago. Now, of course, dose makes the poison, and this is the rebuttal, but I think it's important to separate fluoride from there's systemic fluoride, and then there's topical. And I'm going to push tropical off to the side for a moment and focus on systemic. So that means water fluoridation and supplementation. So even though we have

created a dose of fluoride in the water, we can't factor in how much someone's exposed to. So you may drink a liter of water a day and I may drink five liters of water a day. Our body weights are different. The way we metabolize things are different. Our susceptibility to things are different. And we know not all fluoride is excreted. In children, only about 20% of fluoride is excreted. In adults, it's more like 50 to 60%. Where does the rest of the fluorite go? It's stored in calcifying tissues.

That can be bone, teeth, or the pineal gland. This is where you hear all the pineal gland stuff. And so you could argue no harm, no foul until there is. And it's at what point and what threshold are there concerns? So dental fluorosis is a top concern, and that is when you get too much fluoride and you have spots and modeling on your teeth, and there's mild, moderate, and severe. But that doesn't mean it's only affecting the teeth. It means your skeletal system likely has some degree of skeletal fluorescence.

There's a lot of data now showing how it can impact thyroid health. It competes with iodine, and so it can significantly impact thyroid health, and a lot of endocrinologists will speak about this. and also now ample data about neurotoxicity and IQ reduction in young children who are exposed to too much. And the most vulnerable populations are pregnant women and babies actually who are being given formula used with fluoridated water. And of course, their little bodies are so small and vulnerable. And they're getting, you know, five, seven, eight bottles of fluoridated water a day. that can be concerning. So the other point that's important to know is when you actually look at the data from

the World Health Organization and you actually plot it on a graph, cavities have been decreasing at a pretty steady rate even before fluoride was put in our water back in the 1940s. And so if you look at fluoridated countries versus non-fluidated countries or floridated communities versus non-florated communities, the cavity rate is really coming down at the same rate. That's a point that's missed. There's very little data to show its efficacy, and certainly there's essentially no data to show its safety. And that's an important thing to note as well. And so there is a federal lawsuit. It's the people versus the EPA. And essentially, the people have said, listen,

You've never done a long-term safety study on water fluoridation. And this has been going back and forth since 2020. We're actually waiting for the judge's final decision right now. Floreate has been removed from other countries. We are one of the only countries that still fluoridates our water. There are still some others, but a lot of Western Europe doesn't. Japan doesn't. I think people don't realize that a majority of the world doesn't fluoridate their water.

So I think it's really important. And I think what we need to look at with specifically water fluoridation is risk and benefit. So if a patient is a high risk for cavities, you know, why don't they just use fluorid toothpaste? They use it topically, which we have shown through the data, fluoride actually works mostly topically, not systemically. Why are we risking all of these other health issues when there's so much data behind it? And so this is, we'll see how the judge rules. There was the National Toxicology Report was released under the Freedom of Information Act. The judge had to request it because it was a report by the Department of Health and Human Services that wasn't released to the public. And at the very end of the report, they said based on the lack of evidence, we must say no amount of fluoride is safe in our water. Now, that report has since been pulled, the American Dental Association got very upset by this, and now they're reworking it, and this is what the judge is supposedly waiting for, is their new verbiage? And who knows what that means? Are they just going to reduce the amount of fluoride in our water? Are they going to make it

state-dependent and not federal? I don't know. Or is he going to say to take it out altogether? What's really interesting about the trial is the judge at the very beginning said dental community, I don't really want to hear from you. I understand dentists love fluoride for cavity prevention, but I want to hear from the other scientists, the endocrinologist, the neuroscientist, the neuro-scientist, the epidemiologists, I want to hear from all of these other experts. And if you actually take the time, and I have done this, to listen to all the testimonies and read the research of the counter side, it's concerning. And I've heard you say this on your podcast before. The burden of proof really should be on safety.

This somehow fluoride has gotten like a haul pass to say, no, no, no, we need to prove it's unsafe. I think that we need a mindset chef. Like, prove to me that it's safe because at the end of the day, I can fix a cavity and a tooth, but I can't fix a developing brain. And if you look at the actual data, the study show it really is only reducing cavity risk by 0.6. That's half a cavity per tooth per human. In fact, a study out of Australia had it at 0.3. So again, risk benefit.

When we know, again, it's really important to emphasize. No one is getting cavities from lack of fluoride. It's from all the other things we spoke about earlier in the show. It's the diet. It's how we're breathing. It's our oral microbiome. You can do so many things to keep your oral health optimized without the use of this potential neurotoxin and endocrine disruptor.

So that's sort of the systemic thing. And I think it's also important to know the FDA has never approved fluoride as cavity prevention. It is approved only for off-label use, and it's considered a desensitizer. So that's okay. Like a lot of things in medicine and dentistry we use off-label, but some of the pushback I get from Dennis with hydroxyapitite is they say it's not FDA-approved. And my counter argument is, neither is fluoride for what you're using it for, right? So then we go to systemic fluoride, sorry, topical fluoride. This means toothpaste, rinses, the varnishes they put on at the dental office. This is where I think it's a personal choice. You have to decide for yourself if this is something you want to use. I personally use hydroxyapitite, as does my family, because the data shows it's comparable to fluoride, actually newer data and more is coming out.

it seems like every week to show it's outperforming fluoride. It's biomimetic. It's calcium and phosphorus, essentially minerals. And we're not worried about the neurotoxicity effects. There's no poison control label on it. You know, fluoride has a poison control label on the tube. So you just have to decide, is that something you're comfortable using? And also know that your cavities aren't from lack of fluoride. Fluide might help prevent some, but it's something. else going on in your body. To me, this is like getting a headache every day and taking ibuprofen and saying, well, my ibuprofen helps me not have a headache. Well, we want to know why do you have a headache every day. So along with all the other fantastic recommendations you've given us,

would you add to that list for people who are genuinely concerned about fluoride in the tap water along with all the other stuff that we know that's there, microplastics, you know, PIFAs, et cetera, that one of your other recommendations would be to get a high quality water filter in your home. Yeah, and there's many different units now. I mean, reverse osmosis can be sort of the gold standard, but I do worry about mineral deficiencies with that. So you have to make sure you're taking more minerals.

Can I ask a question about that? Just real quick, since I have you, you know, like an expert in the space, are we really worried about people not getting minerals from tap water, if you're that reliant on minerals in your tap water, is your diet and kind of core routine so off? You know, that was always the question that I had. Yeah, I would say, yes. My answer would be yes. But unfortunately, there are many people on this planet. They're just not able to optimize health for various reasons. Socioconomic, just exposure to healthy foods, food deserts, education levels, etc.

So some populations, they do get some minerals through their water. Absolutely. These arguably, so this is the issue with water fluoridation as well. I'm going to go back to that. So the editor-in-chief of JAMA Pediatrics did a 12-minute podcast. It's super easy to listen to. Everyone can listen to it. And at the end, and it was really neat because he was just riffing with this other editor

talking about this study that showed that systemic fluorid reduces IQ. It was really interesting and very honest and raw how they were unpacking the studying. At the end, they both concluded they could no longer recommend fluoridated water to pregnant women and young children. And then they said how this is so unfair is to families that can't afford bottled water or filters. Those are the most vulnerable populations. And then to speak of plastics, so now we're drinking bottled water. Microplastics is this whole other conversation. And what's important to say about microplastics in teeth, there's something called hypoplastic enamel. It's when the enamel just doesn't even form correctly. So the teeth erupt and they just crumble.

This can be baby teeth or adult teeth. And I'm personally, my end of one is I'm seeing a huge optic in this, but the data is starting to support it too. And what can it be linked back to mineral deficiencies, fat soluble vitamin deficiencies, but also this gets overwhelming. melogenesis or enamel formation is impacted by hormones and microplastics as an endocrine disruptor is affecting hormone. So it's affecting our tooth development too. So this can get very overwhelming, but this is where we really need to advocate for ourselves, talk to our Congress people, and if able, filter your water. Absolutely. So, you know, I like reverse osmosis. Not everyone can do that in their homes. There's a lot of brands clearly filtered.

a really great one. Again, I don't have affiliation to them either, but they have an, you know, on the counter unit, they have a picture. You want to be very careful because a lot of them might market that they filter really well, but they may not be filtering out fluoride, you know, if that concerns you. So I can give some other brands, but those are, those are some of the units that I use. I use a multi-pure system. I have it at the sink and also a home unit too. And that's why I actually have in my office as well. Stacey, we've covered so much information over here. We've talked about are there natural ways to address cavities, stopped dental plaque, receding gums, and also things like ginger vitus.

We talked about the important role that diet plays for good and for worse when it comes to our oral microbiome. We've talked about the importance of airway and nasal breathing. Of course, added to that is if people have undiagnosed sleep apnea that's also going to make their oral health head in the wrong direction. We talked about your optimal brushing protocol along with oil pulling and some of these other things we can do as bonus tips to take our dental routine to the next level, including flossing. Sorry, I just want to add tongue scraping. Oh, please, please. Just cleaning your tongue. It's important.

Cleaning your tongue. Yeah. Yeah, which is something that coming from an Indian family who had all different Argy Vedic remedies, I never remember doing oil pulling or seeing people doing oil pulling. So when I first heard of oil pulling, I was like, okay, I never really saw that. Maybe that wasn't in my family, but tongue scraping, people were always tongue scraping. I had a tongue scraper. I had a copper tongue scraper since that.

as early as I could brush. Oh, that's cool. It didn't do a lot to reverse the damage that my vegetarian diet and not having supplementation. And I wasn't eating a healthy vegetarian diet. It basically meant, you know, Mountain Dew, honey buns, hoos, cupcakes. Carbiterion. Carbiterion, right, carbotarian.

But I have been tongue scraping. And I've never dealt with, I've never, I'm married now, but I've never, ever, ever had anybody tell me that I had bad breath, which. I really appreciate. So maybe tongue scraping is part of that. We learned about the dangers of fluoride, the right and wrong way to go about root canals and how we have to also be wary of some of the fearmongering that's there. And most importantly, we learned about this network of incredible dentists that are out there like you that are looking at things completely differently and helping patients make the right decisions, these functional and biological dentists,

and we'll have some links to the show notes where you can go on different websites like Ask the Dentist and Find Directors. And of course, we gave a shout out to your fantastic toothpaste that you guys have created, Fig, for your good guys. And we have a link for that in the show notes as well. I have no affiliation. I just use it and I like it. So I'm happy to recommend it.

Stacey, is there anything else that we missed here that you wanted to touch on as we wind down for today's interview? Oh, man, it's just so much. So I want mostly to say you're all doing an amazing job. Try not to get overwhelmed and stuck in the weeds. Nutrition is everything. Like, truly. So if you focus on your nutrition, that will help support your microbiome. That's going to help support your hygiene. Make sure you do see your dentist regularly. And I think it's okay. If one doesn't resonate with you, it's okay to shop around a little bit and get the second and third opinion. I think that's really important. So you can, can be an advocate for yourself. But I just want to say thank you for being interested in oral health and in science, Drew. It's really been a lovely talk. Absolutely. Where can people go to follow you? And if you wouldn't mind mentioning again your guys' website, if they want to check out the toothpaste. I do have a website, Dr.stasy.com. That will be in the show notes. Some people like to come see me in person. I am accepting new patients. I am at No Po Kids Dentistry.

that stands for North Portland. I'm in Portland, Oregon. I am going to start online consultations again soon. So stay tuned for that. But I do a lot of education on Instagram, and I'm getting more on TikTok and YouTube as well. And that's Dr. underscore Stacey. And then, yeah, fig, FYG, is feed your good guys. And this is because we have the probiotics and the amino acids.

And that's fig, FYG. We'll have all those linked to in the show note. Dr. Stacey, thank you so much for being on this podcast. Yeah, it was super fun. I really appreciate it. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app.

And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend. Share it with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter, and it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset, to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step

protocols for whole body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-O-H-I-T dot com and click on the tab that says, try this.