Instant Genius - Oral Health, with Dr Kami Hoss

Episode Date: April 3, 2022

Dentist Dr Kami Hoss explains how to take care of our teeth, debunking myths about plaque, cavities, fluoride and more. Once you’ve mastered the basics with Instant Genius, dive deeper with Instant Genius Extra, where you’ll find longer, richer discussions about the most exciting ideas in the world of science and technology. Only available on Apple Podcasts. Produced by the team behind BBC Science Focus Magazine. Visit our website: sciencefocus.com Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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a dentist in the US and author of the new book, If Your Mouth Could Talk, an in-depth guide to oral health. Kami explains how to take care of our teeth, debunking myths about plaque, cavities, fluoride and more. So thank you for joining me here today. I'm really excited to be reading your book and having the chance to talk to you about it. Maybe a straightforward question for our first one. What are teeth?

Our mouths, obviously we have a few things that mix of our mouth, right? We have our jaws, the upper jaw and the lower jaw. then inside the mouth we have for baby teeth we have 20 of them and for adult teeth there are 32 teeth that are really the parts of the mouth that we use to chew and tear the food and grind the food down to the small amounts that we could swallow it so the teeth are an important part of the mouth but they're not the only part of the mouth and that's actually unfortunate because a lot of people think of the mouth as just a collection of teeth and they also think of teeth as these dead objects that they just need to be polished and clean from the outside.

So they're kind of alive instead? Yeah. So other than the outside part of the teeth, which is made out of these structures called, this crystal structure is called hydroxyapatite. The rest of the teeth are very much alive. You know, we have the second layer, which is called dentin, which is more similar to your bone. The outer layer, enamel is really even harder than bone. It's a harder substance in your body. And then we have, of course, the inner layer, which we have nerves, and blood vessels. So your teeth are very much alive. And just like any other structure in your body that's alive, it requires nutrients, and it requires care, and it requires the calcium,

and it requires vitamins and minerals to grow healthy and to protect itself from the environment, the other harsh environment of the mouth. And that's really what's really, I think, missing from how we take care of our mouths today. You say the mouth is a harsh environment. Why is that? Yeah. So in addition to your teeth, obviously we have, you know, the gum structure that cover the bones that protect your teeth, to hold your teeth, they're called periodontium. And then we have a whole world of what we call the oral microbiome, which is a whole world of microbes in our body. Some new studies show that we have more microbes in and on our bodies than we have human cells. Somewhere between three to five times more microbes in our bodies than we have

human cells. So the health and the balance of those microbes are critical to our oral health and our overall health. So in our mouth, for example, we have billions of microbes, you know, somewhere between 5 to 100 billion depending on the oral health status of a person. And the health and the balance of those microbes could determine the health of the mouth, you know, take it from and defend the mouth to be super healthy to all the extreme of making it super unhealthy. And so when we think of the mouth, we should really think about the same. structures that form them out, which are the teeth and the gums and the bones, but also the oral microbiome. The microbiome, I believe, comes from, or it sort of starts off from when we're born.

Is that right? So we're born with microbes. And are they the ones we'll have for the rest of our lives? That's a great question. So fetus doesn't have any microbes in the body. They get introduced as the startup pack of the microbes as they go into the birth canal during birth. So that's their first exposure to microbes. The vaginal microbiome is actually evolved to be the perfect starter kid for that baby. And then the baby is exposed to more microbes during breastfeeding and just touching with mom and dad and siblings and all the other caregivers. So the baby's microbiome, which starts in the mouth and then as you swallow, it starts feeding and seeding the microbes in the gut. And then they all develop their own ecosystems. So the mouth develops.

and has their own microbiome mix, the gut has it, even in the mouth, different parts of the mouth are different microbiome, you know, microhabitats. And then, of course, older, as a baby gets older, within the first two or three years, that microbiome starts evolving and maturing. So those first few years, the oral health of that baby and the oral health of all the caregivers is critical to the health of the mouth of that baby, but also eventually the overall health of that child. When you're saying oral health, how can you define that for us? Okay, so when, you know, oral health is when you have a, when you have a mouth that the microbiomes and the microbes in the mouth, they're in a balanced state.

Like, just like any ecosystem out in the, you know, if there's a forest, you know, there's a balance between animals and insects and plants. And so when there's a harmony and balance, everybody's happy. But when there's a disharmony and there's an imbalance, then things get out of whack. And then in the mouth is the same thing. We go from oral health when everything's in homeostasis, which, you know, is a really balanced, healthy state. You don't have any cavities. There's no gum disease. The good bacteria, quote-and-code in the mouth, defend your mouth and your body from the bad

bacteria. But then when there's an imbalance, for example, a lot of people in today, they use very overzealously, they use harsh oral care products. And for example, they use a mouthwash that kills 99.99% of the germs, which basically is like the most important antibiotic there is. And so imagine if I gave you, I said, hey, here's, this is, I found a solution to be super healthy. Just take these two antibiotics every day. It kills 99% of your microbes every day and you're going to stay healthy, not going to catch a disease. You would probably say, you're crazy, call me, right? But we do the same thing for our mouth and we just don't think about it twice.

I literally know people that take those mouthwashers that kill 99.9.9% of the germs on one hand, and then they also take probiotics for the mouth. And when I asked them, they're like, I don't know, I just saw the ad for this mouth wash. So I thought this is a good thing. And then I kind of heard that probiotics is also good for you. So they literally take microbes on one hand and then they take antibiotics on the other hand. So really the oral health care, unfortunately, in our society right now is a mess. And it's very obvious because the number one disease right now in the world is dental disease, you know, gum disease and cavities and other world diseases about primarily cavities, which we call dental care is, which is the disease.

that causes the cavities. It's a number one chronic disease in children. It's much, much more common than, you know, things like diabetes and asthma and things like that. So it's a really serious disease because I think the misconception to many people is that, hey, what's the big deal? I get a cavity. There's a hole in the tooth and the dentist can fill it. But a cavity is a symptom. It's not just something that the dentist can just fill, which is really even think about it. It's a very archaic way of providing healthcare. You know, we take out a piece of the body and that we fill it with something, and that piece will never grow back again, right? But I really, what I want the listeners to think about the mouth is when you get a cavity, that means that there's

an imbalance in the oral microbiome, which means there's an imbalance in your gut microbiome, which can impact really. It's linked, your oral health is linked to so many diseases and so many chronic problems. And so we should really take our oral health in a much, much more serious way. Absolutely. And we'll kind of go into a bit more depth into that a bit later. But I wanted to kind of pick up on, you mentioned mouthwash, which is actually something I regularly do. So we'll definitely changing that. But can you kind of guide us to how we should be cleaning our mouths? Yes, I'll be very happy to do that. By the way, when I say mouthwash, I meant antiseptic mouthwash is bad. So mouthwash, it's like, it's like if you ask me, hey, call me, Dr. House, if is mouthwash good or

bad, it's like asking is food good or bad? We have good food and bad. There are food that are excellent and they're very healthy and obviously we need food to survive and we need the nutrients from the food and there are food that are terrible makes us sick and makes us age faster and you know develop chronic diseases and all sorts of things right and it's the same thing with oral care products there are products that are excellent and we do need to take care of our mouths but then the products are terrible and the really the result is that we have a terrible oral health as a society in today in fact over the last 30 years none of the oral health has not gone better it's gotten worse right now.

And U.S. and U.K. numbers, whether they are the statistically are very similar, you know, so when I say these numbers, you know, it could be a little bit off when it comes to U.K. numbers, but they're very, very similar. About 50%, 50% of people over age 30 have gum disease. Half of people. 70% of people over age 65 have gum disease. If oral care products were working, we wouldn't be in this particular shape, right? So to answer your question, let me kind of back up a little bit.

So how do we take care of our mouths? Well, let me talk about how we take care of it today, right? The typical person, you know, gets up and, you know, has a coffee in the morning and it has a juice and some bagel or bread and eggs and whatever it is. There's a lot of acidic foods and usually, you know, foods. And then right after that, they go brush their teeth and they use, you know, a random toothpaste, you know. There's like two camps right now.

You're in the camp of fluoride and you think fluoride is the best thing. because dentists recommended and everybody recommended. And then there's this other group that has heard from, you know, they either see it on social media or their friend says, you know, fluoride is toxic. Florida is the worst thing in the world. They should never use that. So you're kind of in these two camps right now.

And your decision is not based on science or facts or studies most basically on these positions that people take, you know, unfortunately without having any backup from a scientific perspective. So let's just say use a fluoride or non-fluid, you know. And if it's non-fluoride, you don't even know what's in it. You just say, you know, grab something that says natural on the tube. And, you know, it must be good, right? Because it says natural.

Now, if I ask that person, well, what's in that tube? Is it good for your teeth? What does it do? They're like, nobody knows because to your surprise, I mean, when I say these people, really, they get shocked. You would think that dentists would know what's in a toothpaste. But we don't. That's not what we get educated. When we go to dental school, we learn about how to drill cavities and we fill them.

right and how to straighten teeth and put braces on we don't know what's in a toothpaste maybe we've had you know an hour of class just go through these like hey this provides foam but we have really I have a group dental practice filled with world class pediatric dentist orthodontist general dentist and I've asked and I'm on the board of UCLA dental school and I've asked you know dozens of experts in oral care and I say what's in your tooth face and they're like I don't know fluorite like what is it in the fluoride I don't know what does the fluoride do I really don't know comey and so there's this unfortunately lack of education and information about what's in our toothpaste. So again, going back to that story, so you have your breakfast and then you think, well,

I need to brush my teeth to get the food out of my teeth. So you go brush your teeth with this random toothpaste. And then you're like, well, I need to have a fresh mouth. So, you know, I've seen this ad on TV that you need to, you know, even though you hate the taste and it can barely keep it in your mouth, let me switch this for like 30 second and a minute. And because it has this strong mint flavor, obviously my mouth is at least. going to smell minty for like 30 minutes or an hour before it gets dry again and then I have to

use it again, right? That's typically what people currently do. And flossing maybe, if I'm going to see my dentist in the next week, maybe I'll start flossing a little bit. I got to tell you, when I ask my dentist friends, they tell me flossing is the number one subject that their patients exaggerate or, you know, lie about when they ask them about it. But anyway, so how it should be done, though, is this. When you wake up in the morning, the plaque is built up overnight. And by the way, plaque in itself is not a bad thing. Black, you know, again, it's just the way the oral microbes stick to your teeth.

And we do want to keep it at a very thin, healthy, orderless, clear layer of it. So we don't want to disinfect it with this really harsh antiseptic mouthwashes or antibacterial toothpaste. Because, again, we're just trying to keep it clean. So let me kind of, I'm going to give you a little analogy before I, explain how the process of the way you should take care of your mouth, which I think is going to clear things for you and your listeners. So think of your mouth as a garden and your oral microbiome as the beautiful flowers and the vegetation and the plants in the garden. Okay. So how do you take care of your garden? Well, you usually probably trim it, right, to make sure it gets the sun where it needs to

and you water it and you give the nutrients to the soil, right? Yeah, pull out a few weeds here and there. Yeah, okay, that's perfect. If there's a wheat here and they grows, what do you do? Do you pour acid all over your garden or you just take out those weeds selectively? Yeah, just pull them out. Yeah, you just pull them out. If there's a disease on a particular plant, you don't kill all of your plants, right? You just take care of that one diseased plant. But we don't do that in our mouth, right? Even in healthy people, when they have no oral diseases, they still disinfect. They think they need to scrub and disinfect them out because that's what we're told. But as you can see at the result, because 70% of people have gum disease, that means that what we're currently doing is not working. So how do we take care of it? Well, if this was a garden, you know, the trimming of the branches is kind of like brushing and flossing. You want to keep the plaque at a low level. You don't want to completely get rid of all the plaque because your plaque actually, the bacteria in the mouth, when they're healthy balanced position,

they actually help with remuneralization of your teeth, which I'll explain later. and so and they help to keep you healthy from all sorts of ways and they help you have a fresh breath and they're you know the microbes in the mouth start the process of making uh the reducing the nitrate into nitric oxide which is a miraculous molecule in our body that helps with with our blood vessels to dilate and so that it's a it's a it's an incredible thing that our microbiome is has evolved alongside us and it helps us in all sorts of things but we can get to that in a bit. Let me back up a little bit about how we take it up the mouth.

So keep that analogy of the garden as I'm kind of going through this. So you wake up in the morning, I would use a, instead of using an antiseptic mouthwash, you can use an alkaline mouthwash that actually restores the pH. One thing that we didn't talk about is the pH of the mouth. So let me kind of explain how critical this is. Your mouth is normally neutral around a 7 pH. By the way, pH is just for those listeners who want a little bit more information, is the measurements that we use to measure the acidity or alkalinity of a solution.

Okay, seven is neutral, and as you get closer to one is very acidic, and it gets closer to 14, it's very alkaline. So seven's usually like water, right? That's right, exactly. Now, and that means like natural water. Even bottled waters, unfortunately, these are a lot acidic. And it's an easy way to check that. You can get a pH strip, and you can check your solutions,

you know, your juices or drinks that you drink, including the bottled waters. There are some bottled waters that are specifically alkaline. I prefer either a pH-balanced water or slightly alkaline water. And I prefer the same thing with your oral care products because the way you get cavities or you get oral diseases is when that pH becomes acidic. So how do you get a cavity?

Before I kind of explain how you should be taking care of it. The way you get cavity is your mouth, again, it's at neutral around pH 7. just about every time you put food in your mouth or a drink, your pH of the mouth drops to below 5.5 pH approximately because it becomes acidic for two reasons. One is the enzymes that the mouth produces to start digesting the food and from the foods themselves. Once the acidity level, which is about 5.5, remember I said the enamel is made out of this crystal called hydroxyapitite?

Some of that small amounts of that hydroxyapatite minerals start dissolving over. from the enamel in that acidic environment. Also, as the mouth becomes more acidic, the bacteria that love acid, which are quote-unquote the bad bacteria, they're the ones who thrive in that environment. And what do they do? They eat that food, you know, let's just say sugar, it's like simple carbohydrates, and they extricate more acid. And so that creates this cycle of acidic environment in the mouth. And so anything below 5.5, something happens we call demineralization of the teeth, which means these hydroxy appetite crystals start dissolving away from the teeth into the saliva. And then when you stop eating, within 30 minutes or an hour,

then the saliva bates the teeth back with these minerals and it raises the pH back to neutral, and then these minerals get absorbed back into the teeth. And as long as there's a balance and you don't eat a lot of bad food and you don't eat too frequently, there's a balance between this demineralization and remineralization, and you don't get a cavity. However, if you do, if you eat a lot of bad foods, you know, again, bad foods means sugar and processed foods and simple carbohydrates and all those types and acidic foods, or if you do these too frequently, when there's more demonelization and remunization, and you get these holes in the teeth called cavities.

That's how cavities form. And so what, and by the way, it's not just what's in the food, it's also missing in the food that's really critical for oral health. For example, as I said, we need nutrients for our mouth to grow healthy, for our teeth to protect themselves against this acidic, harsh environment. And for example, you need calcium and vitamin D and vitamin K2 and vitamin A, and we can discuss that later. So going back to that routine of morning routine, again, you want to get up in the morning, you want to restore your pH. So I would use an alkaline mouthwash to kind of get loosened the food particles and the plaque that's in your mouth. And then I would recommend using a floss first,

to clean between teeth. And again, floss has to be, make sure it's a safe floss. You know, some flosses, unfortunately, are made out of ingredients or products or, you know, the flosses themselves, or they have waxes that are petroleum-based or they have Teflon. And so you need to check those to make sure there have been studies that show that people that use those types of flosses, they have higher amounts of some toxicities in their blood. But there are a lot of safe, you know, flosses. I want to make sure that everybody knows there's fluses, you know, they're either nylon or, you know, silk and they're perfectly, and you can use bees wax, which is very, very healthy to use. So use floss then. Then you use a tongue scraper

to make sure your tongue is clean because that's also a source of a lot of microbes that can cause bad breath and they can even interfere with taste. And then you want to brush your teeth with a toothpaste that, again, it's slightly alkaline, and it has safe and effective ingredients. And those are two different things, right? They need to be completely safe, but they also need to be completely effective because otherwise you're wasting your resources and money

and it could be actually causing you more harm and good. So that would be the sequence of how you should be taking your mouth in the morning. So you brush your teeth at the end, you do all those things, and then you brush your teeth. Yeah, because what you do, want to get the plaque away from your teeth first and your tongue, and then give the nutrients from the toothpaste to do its magic. The toothpaste that I like to use have a few ingredients that I love. One, instead of using an antiseptic oral care products, I prefer to use what nature usually provides, which is prebiotics. So prebiotics is a comp, it would be nutrients that

feed the good bacteria, you know, the helpful microbes, and starve the harmful ones. And that's really what the way nature does it. In fact, when a baby is born in breast milk, the third most common ingredient is this thing called HMO. And for years, we knew that the babies can't digest it, but we didn't know why it's there if it's such a huge abundance of this in breast milk. And now we know it's food for microbes. It's actually pre-biased. So even breast milk, which is the most perfect food for babies, is designed to not only feed the cells of the baby, but feed the microbes to make sure that baby has healthy microbes as this microbiome is evolving and maturing.

And so you said kind of things that nature gave us. So is that, do you go for more of those natural toothpaste products as opposed to the ones with fluoride in? That's an excellent question. I wouldn't really, I do use fluoride sometimes, I do recommend it, I should say, for some patients. But let me kind of explain to you. That's a great question. I think there's this misconception that just because a product says natural on it, it must be good.

But it's not. In fact, I find that more and more natural products are not only not safe because they just remove some toxic ingredients and replace it by other things that should not be in the mouth. But they also not effective in helping to have a healthy mouth. Let me give you an example. Many natural toothpaste, they just take out the fluoride and they put essential oils. Essential oils don't belong in the mouth. The most common essential oils that I've seen is like peppermint oil or eucalyptus or tea tree oil in the mouth. They not only can decimate the oral microbiome, they're very potent antibacterial ingredients. But they can also have much, much more even more dangerous. for example, peppermint oil should never, ever be using young children. It can cause airway issues and really life-threatening breathing problems.

And so essential oils really don't belong in the mouth. Now, there are a lot of other ingredients that are absolutely amazing. I mentioned prebiotics as one. Xylitol and erythitol are these what we call sugar alcohols, but it's a terrible name because there's no sugar in it and there's no alcohol in it. But what they do, they do a couple of things. raise the pH of the mouth. So that's a, as I said, that's one thing that they do to help the mouth to stay healthy. But they also act as prebiotics. They feed, for example, the

xylitol, the bacteria in the mouth digest the xylitol and doesn't have room to take up the regular sugar and is effectively starved with that. So those are some of the ingredients I love in oral care products. Another product that I love to use in orochia products, that's been a standard, a gold standard in Japan for 30 years. And it was approved in Canada in 2015 as an anti-cavity ingredient is called hydroxyapitite. Remember the hydroxy appetite that I mentioned that is actually 97% of your enamel is made out of it. So they formed synthetic version of it.

It was actually invented by NASA in 1970. So it's been around for 50 years. It's been extensively tested. And it's shown that it could reminalize the teeth. And in U.S., the only anti-cavity ingredient that FDA has approved is fluorite, and there are a couple different fluoride. compounds. And I'm going to explain Florida in just a minute. And I think it's probably the same thing in UK. But for those people who don't want to use a fluoride product, and there's a reason for it,

and I can explain why I would recommend fluoride versus in what situations I would recommend and what situations I wouldn't. But for those people who don't like fluoride or they don't want to take it, hydraxia appetite is really a viable option for those, you know, for those fluoride-free products. Going on to the fluoride side, because this is such a controversy, and I want to definitely discuss that so your listeners can be educated about what is about fluoride, you know, that there's such a big controversy. If it's good, you know, which dentists say, FDA says, first of all, why is there such a controversy? And if it's bad, why do all the dentists recommend it or a lot of the dentists recommend it? So let's talk about it.

Remember, if fluoride was a perfect ingredient, there wouldn't be any controversy, right? And if it was terrible, we wouldn't be using it either. So just like everything else, it has pros and it has cons. There's a few things about fluoride, which is wonderful, and there are a few things that you need to watch out for. So fluoride, it definitely, the way it works, by the way, just so you know, when you remember that demileralization stage, when the pH gets reduced to about 5.5, a few of those, a little bit of the hydroxyappetite in the enamel gets dissolved away during the process that will be called de mineralization. In the presence of fluoride, those mineralization, those mineral minerals bond with fluoride and form a new mineral called floor appetite.

So, and then when the fluor appetite gets back absorbed into the teeth, when the pH gets raised, floor appetite doesn't get dissolved until the pH reaches 4.5 instead of 5.5. So it's more resistant to acid attacks. And that's why fluoride makes your teeth stronger. Now, why all the controversy? because when you take too much fluoride, especially when there's a young child in box. So the younger the child is, because there are a couple of things. One is they ingested more, you know, if you use toothpaste that has fluoride,

just kids when they're younger, they don't have their reflexes, their swallowing reflexes matured enough and they swallow more toothpaste and mouthwash. That's why in U.S., we don't recommend, I'm sure it's the same thing in the UK. We don't recommend any fluoride mouthwash for kids under age six. For typically, and if they ingest too much, like let's just say there's a water fluoridation in your area, or you just are using too much fluoride in your toothpaste and in oral care products, there is something we call dental fluorosis, which is discoloration and abnormal development of the enamel, which has become extremely common in our society.

And so extremely common. Some numbers are saying about half of the kids are in the population now have some degree of fluorescence. And also some studies that suggest that too much fluoride can cause toxicity and neurotoxicities in the bodies. And so the way I look at fluoride is if you're an older person and at a higher risk, you know, let's just say you get a ton of cavities and you have a daily soda habit, yes, fluoride is right for you. But if you're a younger child, you know, you're a two-year-old or a three-year-old and don't have access to a lot of acidic foods or sugary foods and you have a lower risk of getting cavities, I would not recommend fluoride for those patients. is because of all these risks. But for someone like E or I, we probably don't have that kind of same level of risk. That's correct.

But again, I would really look at those two things, age and risk. The younger you are and the lower risk you have for cavities, I would recommend you use hydroxyapetite instead of fluoride. And the older you are and the higher risk for cavities, I would recommend adding fluoride to that mix. By the way, these are not mutually exclusive ingredients. you can have a product that has fluoride and hydroxy apathy, because they work very differently.

Hydroxy apatote, or especially specifically nanohadroxy appetite. So there are two versions of hydroxy appetite. There's a nano version and there's a microversion. The nano ones mimic the enamel even further. And so some of the studies show that in addition to remunization, they can help with dental sensitivity, because they kind of really fill in the nooks and crannies of enamel and dentin. and they can even naturally want in teeth over time

and kind of slightly reverse the aging process that happens or the damage that the teeth have from bleaching agents. You mentioned flossing, and I wanted to ask about trying to floss on a daily basis is very difficult. But also, he mentioned some of the different types of string you can get, but there are a lot of water flossers now. Is that something that can be used in place? Are they easier to use better, worse?

Any floss is better than no floss. Let's start from there. So if you absolutely hate the floss, which I completely understand. I mean, as I said, that's like the number one area that I always have to talk to people. And people just hate flossing. It's not a secret. You know, we all know it. Dentists know it. And why should they like it? You know, those typical over-the-counter floss is terrible. You know, you have to wrap it around your finger. And it so it almost cuts your, and it completely stops the blood flowing from your, through your fingers, right? And then when you want to floss, especially if you don't floss often and use a low-quality floss, it snaps between your teeth and then makes your gums bleed.

By the way, bleeding gums is not normal. So if your gums bleed during brushing and flossing, you either have gum disease and you need to get it checked, which could be very serious, or you have harsh or care products. You know, it's the floss or the toothbrush is terrible. You know, a toothbrush needs to be soft bristles or ultra-soft bristles. and a floss has to be a high quality. So everything you put in your mouth or the mouths of your children have to be incredibly of high quality. Remember, again, if we review what's on a label of a food.

We want organic food or get the foods that are healthy and vegetables. But we don't even think twice about what we put in our mouths twice a day, you know, the oral care products. So we should spending a lot of time and energy educating ourselves about what's in our toothpaste, what's in our mouthwash. How are the bristles made? How is the floss made? Is it safe? Is it effective? Again, those two things are critical.

They have to be safe, but they also need to be effective. Back to your question on the flossing. Yeah, there are lots of flosses out there that are fantastic, you know, that there are these flosses that kind of soft and they expand when you put them between the teeth and they remove the plaque even more efficiently. You want to make sure that they could be made out of silk, nylon or polyester. those are all great materials. The materials that I would not recommend,

Teflon is a brand name by P-T-F-E, P-F-O-A, P-F-A-P-F-A-S, you know, these are ingredients that are potentially toxic to the body. Wax, you want to make sure that it's beeswax, which, you know, if you don't, if you're comfortable doing it without wax, it's perfectly fine. And if you do want to have a wax,

you know, beeswax is one of my favorite waxes, which is very healthy. I would definitely make sure that you don't have a petroleum-based wax, which is very common. And then, of course, you want to make sure that in all of your oral care products, the flavors and the colors are all, you know, if there is a flavor, it must be natural because we don't want to have artificial colors and flavors, which could cause other problems in our health as well. One other thing on the floss, because you ask me, so, so there, I would, I would, I would categorize floss in three groups. One is the, the floss that you wrap around your fingers, right? It's like the traditional floss. And again, those are the ones that you could, you know, make sure that are safe and effective. There's the second group which are called flossers.

Flossers are those flossers with a handle, right? That people who have difficulty using a regular floss, there's these disposable flossers that, yeah, they come with a handle, and then there's a little bit of piece of floss. Now, those are perfect for people who usually can't use a floss, or they don't have the dexterity or for younger children. I prefer the original floss because you can use a cleaner part of the floss for every contact area.

But again, because any flossing is better than no flossing, flossers are my second best choice. And my last choice, if those two don't work for you, is the water flosser. And the water flosser is better than no flossing, but it's not as good as regular flossing because it really doesn't get in between the teeth, right? It does try to, you know, squirt the, and with the pressure of the water, get the plaque and the food particles away from your teeth. But it really doesn't get into those really hard-to-reach areas that are regular floss

get. So, but if you, if that's what you like and you just hate flossing and it's, it's the choice of water floss and no floss, please use the water floss. So I've also heard that you could eat an apple after having some food and that will do quite a bit of the job that flossing would normally do. When you eat food, including apple, but really eating food, but apple is a good example. It does cleanse the teeth as you're chewing, right? Because it's just kind of rubbing against the teeth and he's cleansing it. It doesn't really. replace the part of the floss, but it could actually replace a little bit part of the tooth brushing itself because it's literally, you know, rubbing against your teeth. And that's why

if you say, hey, Dr. Hoss, if you had to pick brush or floss, which would be your first choice, I would pick floss. Because just like you mentioned, when we eat just with food, our teeth are getting cleansed, it's the areas between the teeth that's really hard to get to. And that's why I would use the floss first. And another reason why I would say floss first is because if I if you floss, then you're likely going to brush anyways. If you tell you brushing, you're probably not going to floss. So finally for this episode, because we'll talk a lot more about these things in the second episode, but if there were kind of three pieces of advice you wanted to give to a listener

as to kind of a better treat their mouth, what would your three things be? So my three pieces of advice to people about how to take care of their mouth is one, please think of your mouth as part of your body, right? The mouth is not a separate entity. How you treat your mouth will impact everything else in your body as well. And the second thing is make sure you keep your dental visits, but that's only twice a year. So how you take care of your mouth, the other 365 days out of the year is also incredibly important. And that's my third device.

Make sure that you use oral care products that are safe, effective, and they, work together and complement each other to make sure that you have a healthy mouth. Thank you for listening to this episode of Instant Genius. That was Dr. Kami Horse. If you want to know more about oral health, check out Kami's new book, if your mouth could talk. Or, to hear him tell me more about dentistry and the state of our mouths, head over to Instant Genius Extra,

available only on Apple Podcasts. And for more science and tech stories, check out the latest issue of BBC Science Focus magazine. copy in store or visit sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal. Name Audio believes you can have digital precision with analog warmth. Alongside French acoustic specialist Focal, Name creates high-end audio systems,

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