Feel Better, Live More with Dr Rangan Chatterjee - #47 Why Good Health Begins in the Mouth with Dr Steven Lin

Episode Date: January 25, 2019

“If we have a problem with our tooth, it’s really a sign that things could go wrong later on” Many of us think of the dentist as a place we go when we have a hole in our tooth. The dentist fixes the hole and that’s the end of the story. But dentist, Dr Steven Lin, explains why oral health is really a message of what’s going on in the rest of the body. He believes that we can prevent diseases by understanding the signs and symptoms and recognising that chronic diseases don’t just happen overnight. He explains why good oral health is about so much more than just brushing and flossing – our breathing, our sleep and our nutrient levels all play an important role. We discuss the link between the oral microbiome and the gut microbiome. Steven also talks about the simple strategies that we can all adopt to improve our overall health. This is a really fascinating conversation - I hope you enjoy it! This episode has been brought to you by Zendium. Show notes available at drchatterjee.com/oralhealth Follow me on instagram.com/drchatterjee/ Follow me on facebook.com/DrChatterjee/ Follow me on twitter.com/drchatterjeeuk DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website. Hosted on Acast. See acast.com/privacy for more information.

People have this conception that we go to the dentist to get things fixed, but we're now painting out a much more functional and much more preventative model there. That's something I think that we're going to talk about today, the connection to gut health, the connection to our nutrient levels, our breathing, our brain, our sleep. It all starts in the mouth. And once you start looking at dental health from this perspective, it all starts in the mouth. And once you start looking at, you know, dental health from this perspective, it just becomes so much simpler. Hi, my name is Dr. Rangan Chatterjee, medical doctor, author of The Four Pillar Plan, and television presenter. I believe that all of us have the ability to feel better than we currently do, but getting healthy has become far too complicated. With this podcast, I aim to simplify it.

I'm going to be having conversations with some of the most interesting and exciting people both within as well as outside the health space to hopefully inspire you as well as empower you with simple tips that you can put into practice immediately to transform the way that you feel. I believe that when we are healthier, we are happier because when we feel better, we live more. Hello and welcome to another episode of my Feel Better Live More podcast. My name is Ron Gonchastry and I am your host. Before we start today's conversation, I would like to thank today's sponsor, Zendium Toothpaste, who are bringing you today's episode. Zendium is the first toothpaste brand that I have come across that aims to support the health of the oral microbiome. It contains

natural enzymes and proteins that aim to increase numbers of good bacteria in the mouth. Now, this is a topic that is really important that I don't think gets talked about enough. And I'm delighted to dive in deep today with my guest, Dr. Stephen Lin. Dr. Lin is a board accredited dentist and is well known for taking a root cause approach to dental disease. He's also the author of the fabulous book, The Dental Diet. Now, I really like Dr. Lin's progressive approach to dental health, and he is well known for using nutrition and preventive lifestyle strategies with his patients. On today's show, we discuss how good health begins in the mouth. We talk about how our oral health is connected to the health of the rest of the body,

as well as the link between our mouth microbiome and our gut microbiome. We discuss the various factors in the modern world that are negatively impacting our oral health. And importantly, we discuss what simple strategies we can all adopt to improve it. I really enjoyed my chat with Stephen, and I'm sure that you will too. So Stephen, welcome to the Feel Better Live More podcast. Hey Rangan, it's a pleasure. Thank you for having me. Hey, not at all. So guys, we are doing this conversation over Skype. Stephen,

I believe you're in Sydney at the moment. Is that right? I am. It's a very warm day here. We've had a very hot summer, so it's still light, a bit after 8pm, but yeah, it's been a good season so far. Oh, fantastic. I love that you're actually winding down for bed now, and I'm just starting my day. And so probably, you know, two different phases of our circadian rhythm. But I've been wanting to talk to you for a long time, Stephen. You've written a fantastic book called The Dental Diet, which I think is talking about oral health in a way that I've not seen it spoken about much before. And there's a lot of different areas that we could cover. And I think today what I'd love to focus on is the link between oral health and our overall systemic health.

Because I think a lot of people I see, they think about, you know, my teeth and, you know, whether they're going to decay or not. And, you know, they really focus on teeth and their oral health as being just about their oral health. But there's so much more to it than that, isn't there? just about their oral health. But there's so much more to it than that, isn't there? Yeah, like we kind of see the dentist as something we go to, you know, when we have a hole in our tooth and they fix it up and we're on our way and that's the end of that story. But oral health really is a message of what's going on in the rest of the body. And early on in my career, I became a bit disillusioned with working as a dentist because it was so reactionary. And this is something that you've really touched on, Rangan, and something that your work has really brought up is how medical professionals and dental professionals really have an opportunity to help their patients prevent diseases by understanding the signs and symptoms and understanding chronic diseases really don't happen overnight. And here's the really alarming thing is that dental diseases, for the most part,

are nearly all preventable, and they're all chronic. We're talking about tooth decay, gum disease, even crooked teeth in kids. These are all issues that are happening long, long before we present to the dental practice with a problem that ends up in a very expensive and painful treatment. And, you know, people have this conception that we go to the dentist to get things fixed, but we're now painting out a very, a much more functional and much more preventative model there to understand that, you know, a hole in your tooth is your body trying to tell you something. It's a deficiency. It's also an imbalance in your mouth. And that's something I think that we're going to talk about today, the connection to gut health,

the connection to our nutrient levels, our breathing, our brain, our sleep, it all starts in the mouth. And once you start looking at dental health from this perspective, it just becomes so much simpler. It's really changed the way I practice and, you know, on the road to writing my book, The Dental Diet, you know, nutrition is so simple when we look at it from the perspective of the mouth. Yeah, wow. It is really incredible to hear about that. And, you know, I just wonder, in your opinion, Ben, is it possible to have good overall health without good dental health? So let's look at it anthropologically because dental health, if you really kind of see where chronic disease pops up in society, and this was kind of my road into this whole way of thinking, is that chronic diseases happen in the mouth first.

If you look in society, how we first began to get conditions like heart disease, obesity, type 2 diabetes, they're really only conditions of the last, say, at the most 50 years. But dental diseases happen first. And so they're kind of like the canary in the coal mine of your body where if we have a problem with our tooth, then it's really a sign that things are going to go wrong later on. And so when you look anthropologically, we begin to get dental diseases once we eat the modern diet. So once we began the agricultural revolution roughly 12,000 years ago, that's when tooth decay pops up. In any other time, you know, the two million years we find human remains on Earth, there are no dental diseases. There's no tooth decay.

There's no gum disease. There's no wisdom tooth impactions. There's no crooked teeth. And that really is a telling sign that our dental health is so fundamental to our physiology. But then you look at how it plays out when the industrial revolution starts to pop up and tooth decay really comes up to its modern rates. And we live in first world societies, and we're still seeing kids hospitalized for tooth decay the uk and australia are very similar in those um uh those statistics and so we don't know how to manage our teeth and we when we

look at chronic disease like type 2 diabetes and obesity and sleep disorders they are all just the problem where we've forgotten how to manage the physiology of our body and it begins with the mouth and once you look at the the mouth and then run through the rest of the body it just becomes so much more simple yeah thanks for that steven uh in your book you do mention that um our mouth is the gatekeeper of our guts which i think is a really nice concept for us to think about there's a lot of talk these days about our gut health and our gut microbiome, these trillions of microorganisms and their genetic material that live inside our guts. And this is making its way into the mainstream popular media now.

But we're forgetting a little bit about another microbiome that exists in the body, the oral microbiome. And I wonder if you could explain to me what is the oral microbiome that exists in the body, the oral microbiome. And I wonder if you could explain to me what is the oral microbiome and how is it linked to the gut microbiome? Yeah, it's really funny, isn't it? Because you've really witnessed this change in this shift of consciousness of people waking up to the fact that, well, gut health is important. And it goes back to Hippocrates saying that the gut is the center of all disease. Medicine is starting to look back to this. But we've got,

for dentists, we spend our days up to our wrists in the oral microbiome. And if you look at the research, all of the gut health research has really only popped up in the last 10 years. Now, typically where we kind of, we brush our dental health to the side a little bit, the research into the oral microbiome has been much less, but it's been very revealing into what we've been doing in the mouth and potentially maybe being a little bit short-sighted. And that's the idea that we have a probiotic ecology in the oral microbiome that protect us against tooth decay, protect us against gum disease. And then they translate to our gut microbiome.

And so what happens is that when a child develops in utero, their digestive system, we now know there is a fetal microbiome, but we're not so sure on what that is. We now know there is a fetal microbiome, but we're not so sure on what that is. But as the baby enters the birth canal, their first introduction to bacteria in the world comes from the mother's vaginal microbiome. This is like a package that's sent via the mother's reproductive system that then seeds the newborn's mouth. That oral microbiome then becomes that first communication with the outside bacteria in the world. It then seeds as the child swallows saliva. We swallow thousands of bacteria every second from the oral microbiome. That then begins to become the child's gut microbiome. This then begins to flow between the child's gut and begins to seed their immune system. So what we find is in the first three to four months of life is that the oral and gut microbiome is very similar. But then as the child grows and develops, they become

separate. And the oral microbiome becomes similar, but it's like, I like to think of it as like a bodyguard is that it kind of, you know, it's like at the nightclub where you have people screened at the front. When we have bugs there protecting us and letting the good ones through and, you know, helping the digestive system, this is everything the oral microbiome is doing every day. And we've really put diseases in the mouth, like tooth decay and gum disease, down to infections of bad bacteria. Well, those bad bacteria actually live in good health. And so when we lose the habits that actually lose the ecology of the oral microbiome, that's when disease happens. That's when we lose the probiotic functions of bacteria. That's when we get the species that cause disease.

And actually tooth decay is what happens is that in the normal environment, bacteria actually use calcium from the saliva to build their plaque. And tooth decay happens when there's a depletion in calcium in the saliva and the bacteria are going into the teeth to retrieve the calcium. We're forcing them via the consumption of simple carbohydrates to eat our teeth. We say, well, it's an infection, but it's not. It's an imbalance of the oral microbiome. This science is all panning out you know probably quicker than we can really

clinically build applications to but what it all speaks to is that nutrition and daily lifestyle and not killing bacteria like we've been trying to for the last 50 years maybe you know a bit longer than that really is the long-term strategy of health yeah it's so incredible to think about this and it really it really mirrors what we're talking about in the guts we we for so many years we we've you know whether it's the overuse of antibiotics or the diets that we're consuming we're really changing the balance of those gut bugs and you know i i like to think more about instead of good bugs versus bad bugs it's more about there is a whole range of different bugs that live inside our gut. And if we adopt certain practices, we can help keep those bugs in balance.

And if we adopt, you know, the unhelpful practices, then actually those, that balance changes and those, you know, the so-called bad bugs, which are actually already there, but, you know, they're sort of kept in check when the balance is good. That's when things start to go wrong. And it sounds like you're saying that that is literally mirrored in our mouth with the oral microbiome. I know one of the things that really struck out to me when I read your book is that we've got this narrative, don't we, that sugar is bad for our teeth. And I think many of us think that, you know, we eat sugar and that sugar sort of directly goes onto

our teeth and damages it. Now that is, I'm guessing, overly simplistic. And in your book, you say that simple carbs, such as flour or refined sugar, don't cause as much damage to our teeth as we think and what did you mean by that we'll see yeah it comes back to this idea of ecology and we've actually got exactly what do you mean by that that's right yeah so if we think of um so the oral microbiome, the bugs that live in your mouth. It's like a rainforest. And so a rainforest has a normal balance. It has a normal plant and animal population. And when everything is in balance there and you have the right species there,

there's enough food for the plant eaters, for the carnivores, and the whole system revolves around. Now, when the same thing happens in our mouth, when we have those bugs that defend and they keep those potentially harmful bugs in line, then when we have simple carbohydrates, what happens is there's a defense mechanism. So what will happen is that our oral microbiome is very, very smart. It will actually release acid when we eat simple carbohydrates. And the idea of that is that it will release calcium from our teeth so that the oral environment does not become calcium deficient. But what happens,

if you keep eating simple carbohydrates, then there's no calcium in that salivary and there's obviously only a limited amount of calcium in the teeth. And what eventually happens is that those bugs have to go into the teeth. So the simple carbohydrates do cause uh tooth decay but it's not a matter of it's sticking to teeth and and um you know eating away at the surface it's a loss of balance of those probiotic species in the oral microbiome wow so it's really it's incredible for me because i you know i i sort of i'm not an expert in the oral microbiome. I talk a lot about the gut microbiome, but the principles are, are really identical, aren't they? Which, which in many ways would make sense, you know, that the body is interconnected. And the more we learn about different body parts, the more we realize actually it's the same factors or similar factors that are

good for your teeth and your oral microbiome are going to actually be good for your gut microbiome and your overall health. Which, you know, although it sounds surprising on many levels, it sort of makes sense, doesn't it? Why would it be any different? So I'd love to understand what are some of the factors now in the modern world that are causing and wreaking so much havoc on the oral microbiome and therefore on our you know on our on our tooth health but also our overall health sure and so when we think about our teeth we kind of think of oh you know you need good oral hygiene good brushing and flossing but really the best defense and the best way you can invest in good dental health is via good nutrition. And there are harmful factors that we eat in the modern diet, and these are the simple carbohydrates.

They do feed the decay-causing bacteria, which eventually will overrun your oral microbiome and cause decay. So simple carbohydrates, sugar, simple flours behave very similarly in the oral microbiome. It's metabolized very similarly. On that, when people, because many people do consume these sweet treats, these simple carbs. Can you mitigate some of that damage by rinsing your mouth, let's say, straight afterwards or by brushing your teeth? I mean, what's going on there? Or is some of the damage already done? You can definitely mitigate via a water rinse, but the best way to mitigate is by the nutritive factors

that protect against tooth decay. And these are the fat soluble vitamins that run the immune system inside the teeth. Now, teeth have an immune system which runs in the osteoimmune system just that runs all of the skeletal system, the bone density. And so your teeth then can protect you against decay

if you have enough of these nutrients. These are vitamins A, D, and K2. So the mitigating factors are really important because we've lost these from our diet. When you don't have the defensive factors and you feed yourself with the disease-causing factors, eventually disease wins. So that's the big message for teeth is that if you eat the nutrients that fuel your osteoimmune system,

fuel protection against tooth decay, that's your long-term way to have good oral health. I love that. So it's not just about removing the bad stuff in some ways. It's also about increasing the good stuff. So actually, you're more robust, you've got more of those factors that, you know, when you it means that you're much more robust when you inevitably get exposed to some of those bad foods, because I think the reality is for many of us, with the best will in the world. Sugar is so endemic now in the modern world. It's everywhere. If you are eating out, if you're traveling, you're constantly being exposed to that temptation. Much of the food that we buy now, particularly if it's highly processed foods, will have sugar in it. So I guess what you're saying is that, sure, try and avoid those things

as much as possible. Try and minimize those foods foods but you can go a long way to mitigating the damage of consuming them if you ensure you're getting enough of these fat soluble vitamins so i assume you're talking about vitamin a vitamin d and k2 uh as critical nutrients which as they are for your gut for the immune system that lives inside your gut it would obviously be the same in your teeth. Absolutely. And so both for the oral microbiome, so the protective factors that help those bacteria defend against potentially harmful bacteria. But then the inside, the alive cells in the dentine of the teeth, these are cells that come from your bone marrow.

It feeds on vitamin D. It feeds on vitamin A and K2. Without those nutrients, which if you nearly look at our modern diet, and we've stripped them all out, low-fat diets take these nutrients away by definition. Fat soluble means fat. When you eat a low-fat diet you take these nutrients out and you know we are taking away our defense systems here and if you look at um studies there was a study by a guy um a dentist that went around the world in the 30s he looked at 14 um

traditional diets and all the people there they didn't have any tooth decay at all. They didn't have any tooth decay. They didn't have any gum disease or impacted wisdom teeth or crooked teeth. What he found was that in every single society around the world, they ate diets 10 to 20 times richer in fat-soluble vitamins. And that's what we've taken out of the modern diet. We know that we've been told to stop eating fat and it's actually pushed us into an epidemic of dental disease and subsequently systemic chronic disease as well so let's dive into some of these foods

that we could be talking about then so we're looking about we're talking about eating foods that are rich in these fat soluble vitamins that are going to help support the immune system in our mouth so what foods are you talking about so these are your grass-raised dairy so your butter your um your creams your full cream um dairies from grass-raised um cows so you have to check that because if the cows don't get the grass and sunlight, they don't convert to the fat-soluble vitamins and you don't get those nutrients. But your cheeses and so forth, they do provide this if the cows are grass raised. Egg yolks, organ meats, that's one thing that people have taken out of their diets. And if you look at

nearly every traditional culture, they nearly all have dishes with organ meats. And that's because these are the richest in fat-soluble vitamins. Fermented foods are rich in K2. And animal products with, this is one thing about fat-soluble is that the active forms of vitamin A, D, and K2 only all come from animal products. So we need to understand that well-sourced, organically raised animal products, full fat, are the foods that provide defense to dental disease. Wow. Okay. So there's obviously a growing movement to eating more plant-based foods.

Lots of people now are choosing to go vegan for health reasons, for environmental reasons. And I know listeners of my podcast are very wide-ranging. I've got low-carb advocates who listen to this. I've got people who follow vegan diets who listen to my podcast. Paleo, all kinds. And I very much like to be inclusive because as a doctor, I want to make sure that whoever comes in, no matter what their ethical or cultural preferences,

that I can help them navigate, uh, this sort of, you know, navigate their way to good health, um, in accordance with what they wish to do. So I guess the question is, you mentioned, um, some well-sourced animal products which are rich in these fat soluble vitamins are you seeing in your practice or do you know across the world are societies where they're consuming less animal food let's say these blue zones for example and um you know there's one in california in loma linda where these these guys seem to be a pretty good health to a ripe old age um and they eat vegetarian diets i'm just wondering do you see this as a potential issue or can people who choose to go vegan or vegetarian mitigate that

and get those fat soluble vitamins in other ways because you mentioned fermented food so i guess fermented foods don't always have to be animal based yeah that's right well exactly so they are plant-based and plant-based foods are important to feed the oral and gut microbiome um with fat soluble vitamins we uh you know we we do have to be you, when we understand the physiology, vitamin A from retinol. And so the conversion factor there is in your orange carrots and colorful red capsicums, for instance. Certain people only convert a very small amount of that beta carotene to retinol in the body. So if you eat a carrot, you're going to get a very, very small amount of vitamin A. carotene to retinol in the body. So if you eat a carrot, you're going to get a very, very small amount of vitamin A. And so if you eat a slice of liver from a grass-raised cow or, you know, a well-sourced animal product, then you're going to get the retinol. And that's the

active form that then converts into the body. K2, K1, sorry, goes from green vegetables, so your kales and other green vegetables. Now, when a cow eats grass, it converts the K1 to K2 in its digestive system, and then its dairy produces K2. K2 also comes in MK, sorry, there's two forms of K2, MK4, which is animal source, and MK7, which is the bacterial source, which comes from your sauerkraut, your Japanese nata, which is a fermented soy. So you only get the really active forms from animal products. So what I tell my patients is that some people can work with a vegan diet better than others. And the important thing, especially consideration in the UK, Rangan, is sunlight. If we don't get full sunlight or

you're in a period of winter like it is now when we're recording this in the UK, you need to get your D3 from your diet. And if you're not, then you need to supplement. So I think vegan and vegetarian, depending on their genetic conversions of vitamin A, vitamin K1 and dietary forms of vegetarian forms of D2, they can live healthily, but they need to be careful about getting those active forms. And one thing is that supplementation of B12 is important because you can't get it from plant-based foods.

And it's just about understanding the physiology. And everyone should be included in this. We're moving forward in understanding what humans should eat. And so this is an open discussion. As long as we understand all the information, I think people can make informed decisions themselves. Yeah, absolutely. I think that's such a really key point, isn't it, for people? It's for a variety of reasons, people make certain dietary choices.

And as healthcare professionals, we want to help support all of them, use the best science, use our clinical experience to help guide them so that, you know, whatever they choose to do, they can be healthy. And I think it's a great point, you know, you're talking about well-sourced animal products for those people who choose to eat animal products. And for those people who don't, potentially just need to keep an eye on it, be a little bit careful, ensure that they are getting enough of these fat-soluble vitamins. As you said, natto, that Japanese product can be very beneficial. And, you know, supplementation sometimes is quite controversial in the medical field. And I don't share that view.

I think well-targeted supplementation, when you know why you're giving it, I think has a very valuable role to play for some people. And what you said about beta-carotene, I think is super interesting. And just to sort of reiterate the point for people listening, the sort of precursor to vitamin A in the body is something called beta carotene. And you get that in things like, as you said, carrots,

but also here in the UK, we have a lot of orange sweet potatoes. They contain beta carotene. But there are a few genetic snips, these variations where a lot of people, particularly the European descent, can't actually convert very well that beta carotene into the active form of vitamin A. And I've read quite a few studies on this. And actually one study showed, if I can find it, I will put it in the show notes to this podcast that actually if you consume an avocado with the uh the carrot or the or the sweet potato you can enhance absorption of beta carotene by about sorry you can enhance the conversion um to from beta carotene to the active form of vitamin a by

about six fold i don't know if you've seen that paper steven if you haven't i'll send it to you it's really really interesting to see it. Yeah, and it speaks to something that's very important. Something about fat-soluble vitamins too is that digestively they need to be converted into the lipoproteins that carry them around because remembering that our blood and our body is 70% water-based, that our blood and our body is 70% water-based. So fat-soluble nutrients have to be converted in the digestive system into little fat packages, which we call blood cholesterols or lipoproteins, and that's what carries our fat-soluble vitamins around.

So when you eat a fat-soluble vitamin, it needs to be carried with fat. It's a great point, Rangan, and it's not very well known that to absorb these nutrients, you need to eat fat with them. Yeah, absolutely. Obviously, the diet, as you say, is a key problem here. You're talking about the simple carbohydrates, the refined sugars, the flour-based products that many of us these days are consuming day in, day out. many of us these days are consuming day in, day out. That is clearly something we all need to keep an eye on, try and minimize those and improve and increase the intake of these other foods that can be so helpful for our body's immune system. Is this a particular problem in children, would you say, in the sense that their teeth, their immune systems are developing,

in the sense that their teeth, their immune systems are developing, and it's often our children who are eating so much sugar and so many refined carbs these days. Is that an area we really need to be focusing on potentially more than with adults, or does it affect all of us? Look, I think it affects all of us, but children particularly, because they're going through such a big developmental leap, you know, during those, you know, right from birth. There's so much going on.

And this is something that I've really begun to appreciate only in the last five years of my practice, how much craniofacial growth, you know, how much it changes up until 12, like a child, you know, when the adult teeth start, you know, really start to form the dentition, these are systems hungry for nutrients. And if we feed them nutrient-deficient breakfast and sugar-filled cereals with white flour and vegetable oils and all these inflammatory products,

that's a body that is just – it's screaming for nutrients. And there's one – I think we've talked so much about the harmful nature of sugar. That's one thing. But let's really talk about how we nourish our kids. And teeth really show us that. You look at a full mouth x-ray of a child – of a six-year-old, for instance, and you'll see all of those adult teeth. They look like a shark in the image,

and you'll see all those adult teeth lining up for space to come into the adult dentition. And that child has to grow in that next three to four to five years for those teeth to come in. And I'm seeing so many problems now because we're not getting the right fuel for this to happen. Yeah, wow. now because we're not getting the right fuel for this to happen yeah Wow as well as diet what are these other components in the modern diet the way we're living now that are affecting our oral health and the two things that come to mind immediately are does a lack of sleep affect our oral microbiome and does too much stress affect our oral microbiome? Short answers are yes and yes. But these two are very, very important points for dental health. And one point that I get through in the dental diet is the most important nutrient that we can

eat. The one that you can only last minutes without is oxygen. And the mouth and teeth show us whether we're distributing enough oxygen to the body. And one big factor in this is that mouth breathing, one, it harms the oral microbiome because it dries the salivary and decreases the immune defense of the mouth. But two, it also stunts and doesn't deliver oxygen efficiently like nasal breathing does. And so this relates to how we sleep. So the way we breathe in the day then translates to how we sleep. So we go to sleep and we mouth breathe through the day. I can guarantee you also mouth breathe when you go to sleep and this then can then translate into sleep disorders like sleep apnea um upper airway resistance syndrome people that grind their teeth people that snore people

that um eventually end up pausing their breathing when they're sleeping and there's only one thing that we have to do when we sleep is breathe and that's to oxygenate oxygenate the brain and this is something that you know that you really um you know elucidate so well you know in your books around how important sleep and rest is but if we don't breathe correctly you know your body is fighting for oxygen and we can see the effects in in the in the teeth and mouth of a child to an adult and the conditions flow on from not getting that proper rest. Yeah, well, it really is incredible how interconnected all these factors are. And, you know, I remember reading a little while ago that if we get insufficient sleep,

then the amount of natural killer cells in our body's immune system go down by up to 70%, which is really incredible because natural killer cells are part of our body's innate immune system. We're born with that. It's how we fight off infections and viruses. And simply by not sleeping enough, they go down by 70%, which, you know, just is incredible. And I don't think it's, you know, it's not rocket science to kind of figure out what are those downstream consequences going to be if we're chronically sleep deprived. It's also really fascinating for me to see literally how our oral bacteria mirror what's going on with our gut bacteria. I think that's something that is very much underappreciated. And it's something we all really need to be thinking about more and more.

And it's something we all really need to be thinking about more and more. It's how these little lifestyle choices we make every day improve our oral health, our systemic health. They improve, you know, a few weeks ago I had a scientist, world leading scientist from King's College London, Sandrine Touré, who actually is a neuroscientist. And she talks about how as adults we can grow new nerve cells and again how do we do it it's the same lifestyle fantasies that we talked about that you're talking about for your for your oral health that i talk about for our overall health she talks about for growing new brain cells which i think there's a lesson in that isn't there is that actually there is a there are certain habits that we are meant to do day in day out for our overall health

absolutely and you know our bodies will tell us in you know different ways and in different manners but it comes down to the same factors and you know it there's really no escaping it that you know your day-to-day habits will affect your health in the long term and you know i think that kind of ownership of of how powerful our uh we can really be over our bodies can be really life-changing and you know it might be a long road and you might have to you know start um you know on a difficult difficult lifestyle change but it's going to benefit you your body will thank you for it yeah absolutely well look there's obviously lifestyle factors that we can change um if we talk about gut health there's clearly been a um you know just so much growth in the research in terms of what potentially

different probiotic species might be doing for our gut health whether it's to do with our stress resilience. There's some really great papers from Professor John Quine at University of Cork in terms of how some probiotic species, when taken by mouth, will lower our stress response to a stressful situation, whereas others appear to have no effects, which I think really is teaching us that actually we probably don't know as much as we want to know yet, but certainly we know that there is a strong link. There are some probiotic products on the market which now are having more and more research, which really are showing that actually there could be some good clinical outcomes by taking certain probiotic species for certain conditions. And that really excites me. I, until recently, wasn't aware about oral products that were also looking at the same thing.

And over the last few months, I've become aware of a brand called Zendian who are sponsoring today's episode. appear to be one of the only companies that I've come across who are actively trying to you know make a product a toothpaste that actually improves the health of our oral microbiome and that really excites me because I kind of feel that you know once one company starts you're going to get a whole range of other companies also starting to compete and actually you know and I wonder whether you see maybe in five or ten years time or maybe, we're going to have lots of sort of almost probiotic-type toothpastes. Absolutely. And they are starting to come on the market. You know, if we think about how we treat our –

and the goals we have of oral hygiene every day, it has been purely antibacterial. And from everything we've talked about, Ranga and Neo, I think people listening to this will talked about rungan you know i think people listening to this will start to realize that you know you really have to try to foster healthy bacteria in your mouth and that's you know the a lot of the products are now introducing prebiotics which are special fibers that feed those probiotic species to help try and grow a diverse and healthy balanced oral microbiome. There are probiotic toothpaste out there, which in terms of the technology, I think we're still a little bit off this, but in terms of

delivering live cultures for a toothpaste, but they are coming. I think within the next few years, we're definitely going to see an explosion. And I would definitely really encourage people to be mindful of this. When you're walking down a supermarket shelf and picking up a toothpaste, think about how you're treating your oral microbiome because it's translating to your gut microbiome. It's the same principles. And we know the connections there from an unbalanced gut microbiome. And actually, Rangan, there was a study late in 2017 that showed the people who use alcoholic mouthwashes every day

increase their risk of prediabetes. And so I think the mechanism there is that you reduce the diversity in the oral microbiome, translates to the reduction of the diversity of the gut microbiome. And then we know that that then links to type 2 diabetes. And so we're seeing the oral systemic link in action here via the mouth and the bugs that live in them. Yeah, that's incredible. Just to be really clear on that, you were saying that the use of, one study showed that the use of alcohol mouthwashes

was what correlated with an increase in prediabetes? Yeah, yeah. Daily use of alcoholic mouthwashes. Yeah, I mean, that's incredible. And it's really this whole idea that actually for many years we've tried to kill bugs. We've tried to be antibacterial. Bugs are bad.

We need to kill them with mouthwashes, with the overuse of antibiotics, with sprays everywhere we go on our table and our bathrooms, all this kind of stuff is all designed to kill bugs. I don't understand where that has come from, but we start to understand that actually that has been a little bit short-sighted in some cases. And that's incredible to see that just using alcoholic mouthwashes might increase your risk of prediabetes, which really goes to show the link between our oral health and our overall systemic health. Absolutely incredible for me to hear that. And I guess, yes, it's about lifestyle. Yes, it's about doing the things that we can to improve our oral health. can to improve our oral health. I'm trying to find more and more research on this, and I think it is early days, but I did see one study which suggested that after 14 weeks of use of Zendium, as opposed to another sort of non-natural toothpaste designed for the microbiome, there was a significant increase in a certain amount of the microbiome species that are considered to be

good. And that's quite exciting. I'd love to see more research. I'd love to see more, you know, more bigger trials conducted so that we can really get an understanding of that. Well, that sort of excites me. And in many ways, it might be that we're we're at that point in you know looking at the oral microbiome that we were with a gut microbiome maybe five ten years ago where you know research was exploding and then lots of companies came in to try and make products that we could use to help us yeah and if and think about ranga too something that's going to happen quite um in the near future future. You think about how difficult it is to sequence the gut microbiome and understand what's happening there. Well, saliva is accessible

every day. And we are starting to sequence, obviously taking genetic information from saliva. But a full sequencing of the oral microbiome may, in the not too distant future, and I think it will, give us a full picture of what's happening in the oral microbiome may in the not too distant future and i think it will give us a full picture of what's happening in our gut microbiome and other risks of chronic diseases elsewhere so i think that's you know really the future where we see the mouth as a connected part of the body and we you know make sure that we treat it all together and not in isolation yeah that's incredible to think that think that we could sample our oral microbiome and get a window into the rest of the body.

But I guess you probably would say as a dentist who really does take this rounded approach, this root cause approach to dentistry, which is great because I've not come across that many dentists who really are like you trying to dive really deep down into these root causes. I hope, Stephen, that the work you're doing with uh your research with the book the dental diet is going to hopefully inspire more dentists to start looking at the mouth um through a new lens is this something you're seeing since your book has been out are you finding that there's a lot of conventional dentists who are interested in what you have to say yeah look um you know the the functional dentistry uh area which was what i call it is growing it's small um but we as a community

you know we are really and it's really encouraging to see my book all around the world in dental offices and dental practitioners with the same minds knowing that they see this in their patients and that patients want answers. They don't just want those same old treatments. And your work, Rangan, has really pushed this forward because this is a collective conversation happening and we're not just isolated to fixing teeth. conversation happening and we're not just isolated to fixing teeth. Um, and what you're doing, you know, helping people reverse type two diabetes, you know, the same thing happens, uh, with periodontal disease and these kinds of things as well. They're chronic problems in them, in the, in the mouth and body. And I think we're waking up to this. I think we're having a collective growth in consciousness and the people really are seeing that their lifestyle and, um, you know, how we treat ourselves and that our body is trying to tell us things when we get a hole in our tooth or if our gums are bleeding.

It's probably one of the best signs. The easiest ways to pick up gut inflammation is via gingivitis. It's the same system. We're seeing inflammation. If your gums bleed, start thinking about your gut as well. It's the same thing. That's what I always do with my patients. You know, we talk about that in the book and the connection between the oral microbiome and the gut microbiome.

It's one amazing system. And, you know, once you start looking at it like that, it really does help. Yeah, absolutely. Absolutely. And I think that will make a lot of sense to listeners of this podcast. I just want to touch on pregnancy. Do you know if the oral microbiome changes during pregnancy? Is it something we need to be almost more aware of and maybe pregnant mothers need to really be focusing on their oral health when they're pregnant?

Yeah, it absolutely does. And so, I mean, what happens, you know, with the gut microbiome, we get shifts in the gut bacteria as soon as we fall pregnant and our bacteria basically begin to prime the body to begin to create a baby in the miracle of life but so what happens in the mouth is we have the same process is that we have um what's really interesting around it is that the woman's body is prepared to become much much more elastic so the collagen balance is then um played with by by the sex hormone balance which is controlled by gut bacteria we know the connections connections between sex hormones and gut bacteria. And so when we have different balances of estrogen and progesterone, we find that the collagen then makes the joints in the body much more flexible, preparing the woman to grow a child and then give birth. Well, in the mouth, we see a higher risk of gum disease. And it's actually normal because your body has to have this level of inflammation, this cell turnover.

So you will have a little bit more bleeding gums here and there. And if you see your dentist, they can keep track of that. But it can go too far. And so periodontitis or gum disease during pregnancy is very common. disease during pregnancy is very common and it can increase your risk of preeclampsia and small birth weight and a number of birth complications if the process goes too fast. So it's a very delicate balance that what we should know is that your gut and oral microbiome before conception gives you that platform. So before you conceive, you should be thinking about

having your body in balance and in harmony so that it can go through this process to build a human being yeah i mean that's incredible and really it's something that doesn't get spoken about enough this whole idea of preconception um and it's something i'm going to try and get an expert on to talk about on the podcast at some point are you getting people coming in more to talk about preconception are you seeing this as a growing field? This is something that we're trying to grow actually, because what we're finding is that so we can intervene in the newborn development of the mouth, you know, right from checking tongue ties to breathing, you know, their craniofacial growth begins long even before they're born.

And so there's even studies that show that, for instance, sleep apnea during pregnancy can affect the growth of a fetus. So if you're not breathing correctly when you're pregnant, because as we put weight on into the third trimester, it becomes more difficult to breathe. And sleep apnea during pregnancy, we know there's a higher risk of that. We know also that in low oxygenated areas, so if you're in high altitude, women, they have smaller babies. And so if we're restricting our fetus of oxygen and other nutrients by definition, the baby takes that into account.

This is epigenetics in motion. And so everything we do during these periods and even the period leading up does impact the baby. And we can make lifestyle choices quickly to rectify that, but I think we need to understand it. And I really agree, Rangan. It needs to be a conversation that we need to have because it's not an area that we are focusing on, that people are really aware of. Yeah, absolutely. And I think it's really important to say for people listening, it's not about feeling guilty about this.

I mean, the more I learn, the more I sort of think back to when my wife and I were trying to conceive with our children. And, you know, I could think of a million things that we could have done differently. And really, I just want to make sure that people don't feel bad about that. We're all doing the best that we can. This is about growing our knowledge base. It's about understanding what we can do, even once our children are born, to help their teeth, what we can do to help our own teeth, but then also spreading awareness so that if we've got friends, family, our own children, when they're ready to conceive, that we can hopefully share this new knowledge to improve overall health. And I think that's the point I'm sure you'd agree with, Stephen. Absolutely. And, you know, I think people can take these kinds of things, you know, to heart because obviously, you know, we think

about our children, we care about them deeply, but, you know, it really is just about sharing knowledge. And, you know, it really is just about sharing knowledge. And, you know, the great thing about the human body is that it is so resilient and that we can bounce back. And once we learn these things, we can really move forward to, you know, to ensure a healthier future. Yeah, absolutely. I mean, many people who listen to this might know the story about my son who I've not really gone into on this podcast when he was six months old and the issues that we had. And, you know, I spent years feeling guilty and I've spent years trying to wish that those things hadn't happened. But in many ways, you know, they taught me a lot and I think, okay, well, things have happened. But now what I can do is really focus on improving my health,

improving his health as much as possible to make sure that he's got the best chance to live the life that he wants to live. And it's amazing to see how resilient we are and how quickly we do bounce back. On the topic of pregnancy, just very quickly, Stephen, I just thought that many mums, many pregnant mothers, their taste buds change in pregnancy. And I guess a lot of them will crave a lot of these sugary simple carbohydrate treats and i wonder actually if this is an area we really need to focus on yeah i mean i think overall we definitely this is a period we should be nourishing our body as much as possible and um the the thing is too is such a load on a pregnant woman's body.

It's such an experience they go through. And all the changes we're talking about, all those bacteria that are changing, all those hormonal changes, all those metabolic changes, it may – we don't really know exactly what causes these things. But it may kind of bring up these kind of cravings for, you know, for instance, a sweet snack or something or a sweet drink. And, you know, as long as we have solid foundations in, you know, what we know is going to nourish the baby from the future, you know, we probably should, you know, think about, you know, strategies, you know, there's ways you can replace those cravings with, you know, There's ways you can replace those cravings with maybe a healthier option and still feel like you get that satisfaction. But I think it's definitely something that we should at least be talking about so that people know what they need to be feeding their child and maybe some strategies as to how to mitigate some things. You know, and a sweet treat here and there is fine rung.

And that's, you know, we're not here. Yeah, it's not going to, it's really the defensive factors that are the big key. You know, as long as you're getting them, your body will do the work for you. Yeah, I think that's a really nice message to end this podcast on. It's really, yes, try and minimize those things while possible, but really focus on

those fat-soluble nutrients that actually are going to help beef up your immune system so that it's more resilient in the face of whatever onslaught it's facing. That can be done with these lifestyle factors. That can be done with choosing the right foods. And maybe it's worth it for people to consider some of these more modern progressive toothpastes like Zendian. Zendian, the one I know a little bit about,

has got these natural enzymes and proteins which are found in the mouth. It's also got a lack of foaming agents, parabens, triclosan, things like that. Some of those nasties which we're now seeing may have a damaging effect on our overall health and our microbiome health. So there's many things that people can do from this. Stephen, I would highly recommend people get your book, The Dental Diet. I think it's fantastic. Where can people find you? Are you online? If people want to connect with you and ask you questions, where can they find you?

Yeah, so they can find my website at drstephenlin, S-T-E-V-E-N-L-I-N.com, D-R, and on social media at drstevenlin. And we share a lot of functional dental and oral health information there. And they can also find my book, The Dental Diet, on Amazon. Oh, fantastic. Well, look, guys, if you're interested in Dr. Lin's work

and everything we spoke about, stay on the show notes page to this episode of the podcast, which is going to be drchatterjee.com forward slash oral health, O-R-A-L and health. You're going to see everything me and Dr. Lynn have spoken about. I'm going to link to articles that Stephen's written, some blog posts that he's written,

and his website and his book and all his social media handles. I hope you guys enjoyed the conversation, Stephen. I really enjoyed chatting to you. And as we said before we went on air today, there's a very interesting topic of craniofacial growth as children and this whole issue of how many kids are needing braces these days and what we can do to prevent that. We didn't have time to go into that today. We're going to do that very soon on the podcast. So guys, if you're interested in hearing that, do let Stephen and I know on social media and we'll make sure that we find some time to record that episode for you steven enjoy your australian summer i'll get back

to the british winter and i will talk to you again soon thanks rongan thank you very much for all your work and i really appreciate everything you do mate thanks. Thanks, buddy. That concludes today's episode of the Feel Better Live More podcast. I hope you enjoyed the conversation and do tag myself and Dr. Lin on social media to let us know what you thought of today's show. I think that our oral health really does not get discussed enough in the context of our overall health. Many of us think that our teeth and our mouths are separate from the rest of our bodies, but the reality is very different. There is a strong link between our oral health and our systemic health. Conditions such as gingivitis and other periodontal diseases are strongly associated with a variety of systemic

conditions such as type 2 diabetes. If you want to find out more about this thing, do visit the show notes page for this episode at drchastity.com forward slash oral health. On that page, I've detailed everything that Stephen and I have discussed today, but also put up a few papers that you may find interesting. One in particular is by Phil Marsh from the Department of Oral Biology at the University of Leeds, discussing the importance of the oral microbiome in our overall health. So do check it out if you are interested in learning more. A big thank you to Zendium, who are the sponsors of today's show. The relationship between

our oral microbiome and our systemic health is an exciting new area of research. And Zendium, who are the sponsors of today's show. The relationship between our oral microbiome and our systemic health is an exciting new area of research. And Zendium appears to be one of the very first companies that I've come across to study this link. You can find out more about them at zendium.co.uk. If you do enjoy my weekly podcasts, please do consider leaving a review, which really does help to support the show. please do consider leaving a review which really does help to support the show. You can also help me spread the word by taking a screenshot right now and sharing with your friends and family on your social media channels or you can simply tell your friends about the show. Your support is very much appreciated. That's it for today. I hope you have a fabulous week. Make sure you hit press subscribe and I'll be back next week with my latest

conversation. Remember, you are the architects of your own health. Making lifestyle changes always worth it because when you feel better, you live more. I'll see you next time. Thank you.