Realfoodology - 49: Health Starts in the Mouth with Dr. Steven Lin

Episode Date: August 4, 2021

Did you know that we have an oral microbiome?  On today’s episode, author of “The Dental Diet” and the world’s foremost functional dentist, Steven Lin joins me for a fascinating episode on all things related to the mouth and oral health.  We learn all about the oral microbiome, how it’s related to gut health, the disconnect between dentists and general doctors, foods to promote oral health, foods and products to stay away from, how to find a functional dentist and so much more.   Check out Dr. Steven Lin: www.drstevenlin.com https://www.instagram.com/drstevenlin

On today's episode of the Real Foodology Podcast. I think if we were out, you know, connected to nature and eating, you know, foods that are connected to nature as well, you don't get oral disease and you don't get oral disease in any biological system. You don't find it except in zoo captured animals. That's the only time you find it. You don't find any dental disease anywhere in nature except for then. And so that's a reality that we just don't really kind of talk about is that dental disease is only industrialized modern society and

in pets and animals that live with us too. Otherwise, it doesn't happen. Hi, guys. Welcome back to another episode of The Real Foodology podcast. I'm your host, Courtney Swan, the creator behind Real Foodology, which is of course this podcast. It's also an Instagram and a food blog, and I am so happy that you're here. If you guys are enjoying this podcast, please, please, please take the time to rate and review. It really helps me. It really helps get this podcast out onto more ears. And that's ultimately the goal because I want to spread this message of health and I just want everyone to feel great in their bodies and learn about how they can do that. So on today's episode, I talked to Dr. Stephen Lin.

He is a functional dentist who is actually based in Australia. We got connected on Instagram. I have been really blown away by what I have been learning this last year about the connection with our oral microbiome and our gut microbiome. And he is one of those people that has really opened my eyes up to a lot of this. Also, if you guys follow Organic Olivia on Instagram, she really opened my eyes up to this this last year just because with her parents having COVID and there've been a lot of studies coming out that there's actually a connection to COVID and the oral microbiome. So there are actually studies that show that opportunistic oral pathogens from the mouth can travel from the oral microbiome to the lung microbiome. And studies showed that having patients brush their teeth three times a day could reduce the risk of hospital acquired pneumonia. And of course, talking about pneumonia, they're not COVID, but there is this connection there with this Prevotella bacteria. And he and I briefly talk

about that. And I just, I just find all of this so fascinating. I also am struggling to understand why it has taken us so long to look at the connection with our overall health and our oral microbiome. You know, it's, it's pretty wild that we've only really in the last, you know, 10 plus years have become aware of the microbiome in our gut and its importance in the role that it plays in our health. And of course, you know, disease and all of that. But now we have this new component that we, that a lot of people aren't even really talking about. We haven't even really made the connection yet that we have this microbiome in our mouth as well. And if you think about it, everything really starts in our mouth and what goes into it.

So, and it makes sense. You know, your gut health really starts at the mouth because you're always swallowing your own bacteria. And there's, of course, that direct connection there. So we dive into all of this and we talk about the oral microbiome, things that you can do to protect it, foods that may wreak havoc on it, foods that can help it, and just lifestyle factors in general that are really affecting our oral microbiome. This is such a fascinating, such a fascinating episode. And I'm so excited for you guys to hear it. This is really exciting. Organifi now has kids stuff. They just released two kid products. One is called Easy Greens, and it's a refreshing green apple juice where kids

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neurohacker N E U R O H A C K E R.com slash real foodology for an extra 15% off your purchase. Thanks to neurohacker for sponsoring today's episode. So I realized after I got off the call with Dr. Steven Lin that I completely forgot to ask him to tell you guys where you can find him. So I just want to shout out his Instagram. If you guys want to follow him, he is a great follow. He is Dr. Steven Lin. That's S-T-E-V-E-N-L-I-N on Instagram. And then his website is drstevenlin.com. And of course I will add these to the show notes so you guys can find him. Definitely give him a follow. He's a great follow on Instagram. So with that, let's just get into the episode. Hey, how's it going?

Oh, brilliant. It's morning here about to start our clinical day. Wow. That's amazing. What time is it there? It's nine o'clock. Yeah. So yeah, I normally do an interview at eight o'clock. It's Friday morning here. Yeah. So we'll fit this one in before we start seeing patients. Yeah. But I've been following your work. I love what you've been doing. Oh, thank you. I really appreciate that. Thanks a lot. I'm so glad that you came on. I've actually, I was looking for a dentist that I could bring on to talk about this, but I wanted it to be someone that really knows the importance of preventative healthcare. And I found your Instagram and I love your work as well. And I was like, we got it. I got to get you on. We got to have a convo. Yeah. It's interesting. You know, um, there's, I mean, teeth can show you a

lot, right? It's yeah. So, and it's all connected to what we eat. So prevention is key. Yeah. Well, and it's so interesting, like, cause you know, I've been in health for a really long time and this concept of the importance of oral health as it pertains to gut health is a really new concept to me. I mean, I, and it's not to say that, you know, I go into the dentist twice a year for cleanings and brush and floss every day. Like I take care of my teeth and it's a huge priority, but I never even thought about the connection to chronic diseases and gut health to our oral health. So I really want to dive into that. Can we start kind of with the basics about that? Yeah, absolutely. I mean, that's kind of, that's a whole huge enigma

in our healthcare system that we've disconnected one oral care from the rest from systemic medicine. So why doctors and dentists, they really do work very separately in society. And that's been a product as to why, for instance, you had this disconnection, you'd go to your dentist for a clean, and it was this other thing you would do, you know, important to scrub your teeth clean, right? And that there was no real thought or, you know, connection as to how it potentially flowed on to issues that you could have in the rest of your body. But the literature for that has been around for quite a while now, you know, we've known the connection between periodontal disease and heart disease for quite now,

for quite a long time now, there is a correlation between people that have severe gum disease, they're more likely to have heart attacks and strokes. And for instance, so cardiovascular disease is known to be connected to the mouth. We know, for instance, that certain oral bacteria in your gums travel straight to the heart and can cause an autoimmune-like reaction. And this is something that dentists are aware of that they need to screen in their medical history form because if they do a certain type of cleaning it will release a bacteria that'll go to the heart and cause an infective endocarditis so this has been known that's pretty serious right that's a pretty direct serious connection right so it's pretty crazy that we've just kind of gone to that

level and said well you, these patients need antibiotics and then that's it. You know, dentists for the most part have been trying to, you know, say that, the mouth is important too, but I do think there's been some, you know, some ways that we've been looking at the mouth as being a little bit too mechanical and just looking at teeth and isolating what we see in the mouth. And, you know, it is a little bit of mechanical and just looking at teeth and isolating what we see in the mouth. And, you know, it is a little bit of a difficult picture. But then when you start to see really for as I began to see the work from the Human Microbiome Project coming out, which is 10 years ago, you know, this was really painting the picture as to, you know, you're literally

swallowing thousands of bacteria every second. It's moving into your digestive system. And then these bacteria are speaking to your immune system. And then all of a sudden you've got this connection. And then you look back in the literature and gum disease, for instance, you know, it appears exactly in line with other autoimmune conditions. So when you have an autoimmune condition, in the literature, it shows that your risks of other issues, other autoimmune conditions in the body go up. So if you have rheumatoid arthritis, you'll often have potentially thyroid issues, or the big one is Sjogren's syndrome, which is dry mouth. And so this often connects to other risks of autoimmune conditions, digestive issues and so forth. But periodontal disease sits right in there.

So you also have your immune system eating away literally at your body in a certain part. And gum disease sits right in the same category, yet we don't categorize it as an autoimmune condition. And so I think that's a really, really big misalignment in what we're, what we're thinking about, you know, in terms of, you know, Hey, you're going for your clean every six months for these bleeding gums, but this bleeding gums, uh, you really is a part of a, a disease condition that will potentially, um, you know, flow onto an autoimmune conditions. And that's what periodontal disease is. So when you start off with, with bleeding gums and gingivitis,

you have inflamed gums. And then if it stays there long enough, the gums begin to slot the weight and affects the ligament that holds the tooth to the bone. And then the ligament itself begins to slough away. And so this is a collagenous relationship between the gums and the bone that begins to slough away. And then what happens is your bone then begins to degenerate. And so this is the body eating away its own tissues, the same mechanism as an autoimmune condition anywhere else in the body, yet we've not made that connection. And yet we know now that autoimmune conditions are seeded in the gut. We understand that intestinal permeability is a big factor there.

So why aren't we looking at this permeability both in the mouth and the gut and why we aren't connecting these things. And so it's this really strange disconnection we've had, but the links are so powerful because the amazing thing about the mouth is it really does show us how, you know, how targeted we can get in terms of understanding our health for oral disease, but also too for, you know, for understanding disease processes later on in the body.

Wow. I mean, that is a lot to take in. It's so interesting. And like I said, I really, you know, as we start to talk about it and we dive into it, it makes sense because like you said, you know, it really starts in the mouth, what you put in your mouth, we're swallowing bacteria, it's going down into our gut. It's just, it's a wild, it's a new concept for me. So, and you know, I was reading right before we got on this call, there's a study on Science Daily about the connection between brushing your teeth and Alzheimer's, which I had never heard before. So apparently the bacteria that causes gingivitis can move from the mouth to the brain. Yeah. So one of the, it's really fascinating, you know, one of the big connections that they've found, you know, both in mice and human studies is that they, the Alzheimer's brain does seem to harbor this oral bacteria. And so, and we find it, um, and it's, it's the most

common, uh, oral bacteria you find in gingivitis. So porphymonia is gingivitis. And so it causes, um, it causes bleeding gums. And so it's, we, we find that's the one that dentists are trying to clean off your teeth every six months. And, and it, what seems to happen is that it colonizes um you know there are certain connections to other other diseases like it'll colonize the liver it'll colonize um you know for in other places in the body too because and what seems to happen is the oral microbiome so the the bacterial colonies that live in the mouth is like a it's like a director of what's happening um because it's listening so much to, to the environment. So it's saying, Hey, this is happening out in the environment.

This is what we need to be doing downstream in the body. And then when you get dysfunction in, in the mouth and so chronic inflammation now, which is a huge factor in, in, in dementia and Alzheimer's disease is first picked up in the mouth. So you have, um, you know, periodontal disease, which is chronic inflammation. This is feeding back signals that is the same process as what's happening in the brain. And the other interesting thing is that we, this is a little bit kind of less known,

is that they're actually finding the bacteria climb up the cranial nerves. And so they'll actually climb up the nervous system. And so if you look at a picture of the cranial nerve connection to the teeth, which is, so the trigeminal nerve, which goes straight to the brain, then what's likely happening is that there is a bacterial highway between the mouth and the brain. And there's actually, there's research from the 60s and 70s that showed that teeth will absorb certain aspects or nutrients or molecules from the mouth. What they did is they injected a radioactive dye both into the bloodstream and into the oral environment. And they can follow the dye from the mouth into the

bloodstream and vice versa. So there is a permeability happening between the teeth and the bloodstream. And we know this happens, it's, we've not explored it at all. So teeth are literally absorbing things and acting more like an organ rather than a kind of inanimate object. Wow. I've never heard that before. So does that mean that there's something going on? Because I think about, for example, in the gut, when you have leaky gut, that is not supposed to happen. Is this something that maybe the teeth enamel has been broken down or is this just, we never knew that this was possible and it's just something that happens with our teeth? No, yeah. It's something that seems to go wrong. So they showed in that research that they could change the

permeability of the teeth. So normally there would be an outflow or inflow of the material. So they would have the radioactive. They could change it via glucose. Yeah, so the consumption of glucose and into the oral environment. So when you change the bacterial environment, so the bacteria will then direct what's happening in terms of the absorption of the tooth. So the tooth, um, needs to know how much simple carbohydrates in the mouth,

because what happens is certain bacteria begin to metabolize the simple carbohydrate, and then it will change the pH and the mineral balance of the tooth. So the tooth needs to know that, and then it, it, it probably needs to compensate. So that's why it will change its permeability to either absorb or excrete something um and so this is all happening through diet so that's just one variable so you can imagine all the other different different variables that would affect that one being you know primarily that they also find that

the um parotid gland one of the major saliva glands releases a hormone. So the brain will actually tell the teeth, you know, whether to mineralize or demineralize or what it needs to do in terms of, you know, storages of nutrients and then release hormonal hormonal messages to tell the saliva and the, the, the enzymes and all everything else happening in the mouth to basically maintain tooth structure or saying the body needs something or something along those

lines. This is so interesting. I haven't heard any of this. I'm a little like blown away right now. I also wanted to mention something too that I found was really interesting. I don't want to go too much into detail, but I'm curious if you have read this. So this last year I've been following Prevotella a lot because apparently there's a connection between Prevotella and possibly COVID. And I just thought it was so interesting because they were saying that people, that patients that brush their teeth three times a day could reduce the risk of hospital acquired pneumonia because there's apparently a connection there

with opportunistic oral pathogens from the mouth that can travel from the oral microbiome to the lung microbiome. And I was like, that's when I really started paying attention to all of this. Yeah, that's one thing that's crazy that we've really not spoken or had a broader discussion on this because there's a well-known connection between oral bacteria and chronic obstructive

pulmonary disorders. We know that the oral environment affects our susceptibility to lung disorders. Just reading the literature, it really makes it so simple, right? We know that there's a lung microbiome and that the oral microbiome communicates with the lung microbiome. So we have this connection. And so the link between oral disease and what's happening with bacteria is that you lose diversity. The same things happen in the lung. And so you get this colonization by certain bacteria. And Provotella is one of the main periodontal disease bacteria.

And there's actually a periodontist in Los Angeles that's been publishing on this, on the connection between gum disease and potential COVID complications. So the fact that we're not screening everyone, this is a really simple measure to understand, hey, this is what dentists do. We can understand your oral inflammation, your risk factor with your gum pocketing. And with a simple oral imaging, like a radiograph or a CBCT,

we can see your, and, and mark your gum disease. And then, you know, there really is a, quite a strong link there to risk factors for, for respiratory disorders. So, you know, it's there. I, I really don't know why, It's this disconnection again between oral medicine and systemic medicine. I really think it's one of the big things we need to make because functional medicine and a lot of the work that other body workers, everyone else, naturopaths that are trying to bring the body to work together, if they don't have a good picture of what's going on in the mouth, you're really just missing such a big, significant part. And we have such a complete picture there when we just pull it all together under one umbrella as a functioning system that we are. Yeah. So what's

causing this oral dysbiosis? So someone that has this Prevotel or whatever it is, how is that happening? Are there things that we're doing? whatever it is, like how is that happening? Are there things that we're doing? Is it our diet? Is it lifestyle factors? Is it all of the above? Imagine having a metabolic coach in your pocket that you could access at any point, any time in the day, whenever you want. That's what Lumen is. Lumen is the world's first handheld metabolic coach. It's a device that measures your metabolism through your breath. And on the app, it lets you know if you're burning fat or carbs and gives you tailored guidance to improve your nutrition, workout, sleep, and even stress management. I have so many podcast episodes about metabolic flexibility and why it is so incredibly important for your overall health

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sitewide. That's fromourplace.com, code realfoodology. Our Place offers a 100-day trial with free shipping and returns. Yeah, it's all of the above. So, I mean, your mouth really is the input from your environment. So the big connection we see between dental disorders is that you don't see it anthropologically, you know, when we eat, you know eat diets that don't have processed food. So dental disease really only popped up 12,000 years ago around the agricultural revolution when we began to farm grains and so forth, or when we began to record that we farmed grains. So there really is a connection between what we eat. And they've actually measured plaque samples of people that live before and after.

So they would say hunter-gatherer societies. And you find more diverse oral bacteria and colonies in these plaque samples compared to what we have today in modern society. So when you lose this diversity, it's the same with gut microbes. So when they go to the Hadza and when they go to tribes that have been connected to modern society and industrialized processed food, then you find these gut microbial environments that are so diverse and so connected into the environment, but also too, they're resilient because they've got all of the different species and factors that contributed to health of their

ancestors. And when we eat them on diet, that we begin to lose this diversity. And it's associated with nutrients. One of the big factors in oral disease are fat-soluble vitamins, and it's associated with nutrients. One of the big factors in oral disease are fat-soluble vitamins and that's vitamin D and their support factors. And so when we eat low-fat diets, which we have, and when we introduce harmful foods like sugars, refined grains, refined vegetable oils,

then these change our oral microbes and it increases the susceptibility. So I think that brushing and flossing and all of these kind of modern techniques we use to manage the oral microbiome, they have a role, but they really don't look at the underlying processes that we have that have made sure that we've had no dental disease for the vast majority that we've lived on planet Earth. And so when we're thinking about this, we need to be thinking about getting back to what humans have eaten for the majority of time that we've walked on planet Earth.

And we also need to be thinking about other inputs into the mouth. And one big one is breathing. And so you mentioned the connection to respiratory disorders well one of the biggest problems that people have today is we breathe through the mouth and that might be a habit during sleep but it also is is a daytime habit that translates to sleep now mouth breathing during sleep is an unconscious habit, and it's a really kind of big area in dental medicine now where we look at sleep in the airway and so forth because people that struggle to breathe through the nose,

they have these oral diseases in far bigger proportion than people that breathe through the nose properly. And one of the big things is actually the dental arch doesn't develop. So kids that breathe through the mouth are at more risk of crooked teeth. And it's one of the main causes of crooked teeth than kids that breathe through the nose. And yeah, we get the oral dysphosis. Yeah, we get the swollen adenoids and tonsils that kids have now. And they have the lymph tissues removed from the airway because they can't breathe.

They're snoring at night. Well, this is all a connection to how our oral environment is interfacing one with how we breathe, one with how the bones develop, and then all the nutrients that coalesce together to come together to create us as a healthy human being. Wow. That's so interesting. I have a girlfriend who recently started taping her mouth when she goes to sleep at night so that she can just breathe through her nose. That, I want to try it. I have to be honest, it gives me a little bit of anxiety because I'm like, I don't know if I could fall asleep with my mouth taped shut. So I went through the same process, right? Yeah. I was finding that I was getting some low level snoring and like getting some kind of vibration at the back of my maxilla here,

which is kind of a risk factor in the Asian population. We get the jaws that are a little bit back here and then I didn't, I'm missing some low wisdom teeth. So my jaw probably isn't quite as forward. So my airway isn't as supported as what it needs to be. But what happens is that you get this vibration in the airway and it gets worse because when you sleep, the brain needs to do all of these different things to recalibrate the body, needs to calibrate the gut, all the different endocrine organs and so forth. If it's managing the airway, it becomes a process that gets worse and worse. And so what happens is it starts to lose the ability to manage its own blood pressure

and also to increase the risk of other conditions like, I mean, this is a big link to outside dementia because the brain cannot clear its glymphatic system if we're not breathing correctly. And so what happens is that when we're breathing through the mouth, it really is survival breathing. And so the brain's in autonomic fight or flight survival. So when you're pushed into survival mode, it becomes an anxiety response. And so the airway really is an anxiety response in that sense that, you know, if you have a constriction of the airway, it makes you feel like that.

So it's a process to overcome it. So you can try it. But if you feel anxious about it, it means you might need to do some work in terms of connecting to nasal breathing and supporting the airway. And so the big thing too, is that we have a bony architecture of the nasal area, which is the nose, but we also have a musculoskeletal architecture of, of the neck, which is really important during sleep, right? Yeah. And one of the big risk populations for, for the sleep issues, you know, women who are, you know, narrowly with narrow kind of necks and, and who are slim built because you've got small, small airways to start with. So if there's a slight amount of constriction, you get these what's called upper airway resistance syndrome. And that's where we

have teeth grinding. We have gut issues that the gut doesn't quite work. And we have, there's a connection to anxiety, depression, and also teeth grinding and so forth because we're in this low level of restorative sleep. So we're not reaching the deeper levels of REM and sleep because the brain's constantly working on the airway. And the way to do that is there's a big connection to tongue posture and how the tongue muscles work to support the airway during sleep.

So if the tongue is up, then the airway is supported. It's connected to how we sit and how we swallow and how we put our tongue to the roof of the mouth as posture instead of being lower and sometimes moving forward during swallowing. So there's all these things that we kind of need to do to reconnect to breathing through the nose at night. And so I went through the same thing. I would rip the tape off unconsciously for three months because I'd find it like in the blankets and stuff because my brain was going, no, no, this isn't,

you know, I'm not used to this. This is survival now. But then as you begin to reprogram the respiratory senses and, you know, how the gases are exchanging, everything begins to settle down and then you start to sleep with it taped on. But if not, then there's something else going on in these areas. Yeah. So is there also a connection with breathing through your mouth at night and dysbiosis of the oral microbiome or is it more just about-

I mean, absolutely. Yeah. There's, I mean, studies not quite there yet, but there is, we've got some early research on how mouth breathing affects the oral microbiome. One thing about the, even the evidence and the research into the oral microbiome is still quite limited. So we're only looking at about, you know, probably, you know, eight to 10 species, that kind of range, you know, and, you know, kind of thinking, formulating or, you know, oral therapeutics and so forth. But when you look at the research compared to the gut microbiome, it is minuscule what we're looking at in the mouth. And I really, really think that, you know,

we need to have a really big focus shift to the mouth in order to understand this gut microbiome stuff. Because what I've seen in terms of research, looking at gut microbiome issues and probiotics and so forth, is it's really kind of paused. I haven't seen a lot of progress in the last kind of three to five years because I think it's stuck because we're not understanding the whole system. We really need to look at what's going on in the mouth. And the interesting thing is that during the development, so when a child develops in the womb, we know very, very little about the fetal microbiome. So what happens is that during birth,

the vaginal microbiome is delivered to the mouth of the child. And then this begins to seed what becomes the gut microbiome. So breastfeeding then becomes the bacterial transfer between mother and child. The first connection is between the mouth. And they find that the oral and gut microbiome in the first three to four months of life is very similar. And then what happens after that is it begins to diversify. So the oral microbiome acts like kind of a bodyguard and it's testing what's in the environment and saying, right, you're going to go through, you're going to go through. And

then the gut microbiome then becomes the big master center where the immune system is seated. And that basically becomes 80% of how we interact with the world and how we react to both infectious, but also chronic diseases too. We talked about autoimmunity. This is where it all comes from. Intestinal permeability is a lack of the management of the microbial community in the gut. Are we seeing how this is all connected to firstly, what's coming in through the mouth and then the gut as well but then so back to mouth breathing then we have all these changes the connection to um the uh the vagus nerve in the in the um uh in the brainstem so the vagus nerve connects down through the back of the throat but

then into the gut and so when you have the the vagus nerve dysfunction, which actually activating the vagus nerve is nearly all, you need to activate the oral posture and so forth. And when you breathe incorrectly, you're not activating the vagus nerve by definition. So starting to see that there's these really interesting, such fundamental connections between the physiology of what's happening in the mouth and then what's happening in the rest of the body. Yeah. You know, as, as we dive more into this, I just find it so fascinating that for so long, we, we really looked at just like specific parts of the body and we weren't making the connection that everything is all so connected. You know, you brought up the vagus nerve and

there's that, um, the vagus nerve that goes directly from the brain to the gut. And it's why we call it gut the second brain, because there really is that direct link there. And it's interesting. I've never even thought about our mouth also being connected as part of that. It's almost like a super highway. Oh, it's a superhighway. And the mouth is such a key to understanding, you know, the activation of the vagus nerve, because the back of the throat is where all the vagus nerve innervation happens. And that's, it's actually activated through deep swallowing. And it's this connection between the back of the tongue and the soft palate. And you can kind of touch, if you touch the roof of your mouth and slide it right back to the soft palate, you'll feel the soft palate.

That's where the back of your tongue needs to connect when you're swallowing. And it's a very, very difficult response or muscle response when you haven't done it before. And so what happens is that the tip of your tongue hits the, the area behind the front teeth behind the palate. That's kind of the spot where the tip of the tongue, then as the tongue rolls up and back, it actually has the back of the tongue should seal against the,

the soft palate. It's a very difficult thing to do. And one exercise I get patients to do is we we we stand right um straight against the wall with with the chin tucked right in so that the um the occipital uh bone here is is is straight and then you can actually access it because most people just can't do it and what should happen is when you get into that position when your shoulder's back flat against the wall and you have your your your neck in, you should hear the, the clearance of, of the, um, of, of the, the, uh, the back of the tongue. And I'll, I'll see if I can make the noise, but I don't know if you could hear that, but I could hear it. Yeah. Yeah. So that's what,

that's the sound that your tongue should make because it's sealing out the soft palate. And what's happening when you're doing that is that you're activating the vagus and glossopharyngeal nerve, which are critical for beginning the gut digestive process. Now, all of the salivary enzymes in the mouth, you know, it's probably up to 20, 30, you know, maybe even up to 40% of digestion begins in the mouth because it's breaking down all of the, the initial proteins and all of the, um, all, all the, the, the factors. And, you know, we've began to say that teeth are absorbing things. You know, I think that's, you know, the reason why Chinese medicine has, have you seen the meridian charts of teeth in Chinese medicine? So, I mean, I think it's, it's due to, it's actually the teeth are giving up, they call it energy lines and chi, but they're also giving up physical nutrients as well. And taking in certain teeth will take certain nutrients to certain organs. And so the digestive process is

literally happening in the mouth that you activate and connect to through this vagus nerve, which then goes on, turns all these different organs as well, which you have to physically activate too. Yeah. So, and that swallowing process, which you do every 20 seconds, it connects your posture. It connects you to those deeper parasympathetic autonomic nervous responses that you just don't have access to otherwise. I mean, this is fascinating. I also was thinking, as you were describing that, I wonder how many people are driving, listening to this right now and like trying to emulate it. Yeah, it's a hard one.

It took me a while. Yeah, but so you kind of practice it with, so tongue sealing. So it kind of looks like, like, and so, yeah, yeah, yeah. So that's it. It feels ridiculous. Yeah, it feels like,

but the thing is like once, so the thing I really felt that helped is because I'm, I'm a dentist, right? So a lot of time we spend time looking down, I find that, and you're, you're working on a computer, you know, podcasting and so forth. Like when you're sitting the way to support your, your cervical posture is tongue posture. And so, you know, we have such an epidemic of forward head tilting now,

which does affect how our risk factors for mouth breathing. So people with forward head posture are usually breathing through the mouth because they feel uncomfortable being upright because the nasal airway is closed out because the tongue's not out of the airway because we're not supporting this muscular part of the airway.

So when the tongue's up, we feel okay being upright. And that's why I think you see ancestral cultures really focusing on the sit up straight kind of message to kids that was kind of there. It's because it supports their airway and it helps all these neural systems be in line that really does, you know, begin with our oral postures. It's really fascinating, the connection.

Yeah, that is really fascinating. So I want to go back a little bit to the bugs that live in our mouth. What role do these bugs in the oral microbiome play in our health? Like, do they help regulate any sort of functions in the body? Obviously we talked about digestion a little bit. Are there other things that they regulate? Yeah. Well, I mean, there's a big connection between hormones and what's happening in the mouth. So when you fall pregnant, you see a shift from conception in the oral microbiome. And so what happens during pregnancy is that during the different trimesters, there's different shifts in the oral microbiome and you see a general shift towards a mouth environment that is like a type two diabetes environment. And the reason for that is because the mouth and the hormones required need more cell turnover.

And so in type 2 diabetes, we lose the diversity of oral bacteria. We find both oral and gut bacteria that create the metabolic dysfunction. But in pregnancy, we need it. So you see that shift in the oral microbiome and so what they're doing is it's regulating hormonal changes they're regulating metabolic changes they're regulating metabolism they're you know they're regulating you know probably or you know a lot of this is because the oral microbiome research really is so limited. We really need to go a lot further into detail with this, but you find the different connections with how certain bacteria, so for instance, they'll colonize the liver or they find it in certain areas like in pancreatic cancers, you find certain bacterias and also in the appendix as well,

oral bacterias that happen in dysfunction. So when you get problems, you're finding this strange link between bacteria that should be regulating the mouth going elsewhere as well. So they are doing everything. I really think that the gut is far more complex and difficult to understand beast, but it's a projection of what's happening in the mouth. So I think if we get a hold of the, the, the species that are living in the mouth, which are far more simple

than the gut, and then having these, these links to risk factors for other diseases, which we do, then it's such a great and easy screening tool. Yeah. I'm curious because they're so connected, are they pretty similar bacteria colonies that live in our gut and our mouth or are they pretty different? Yeah, they're similar, but the gut has a lot more diversity, a lot more diversity. So yeah, you get all these different types of bacteria that are involved in the different fermenting

of certain foods and so forth in the colon. But yeah, so the mouth is much more simple and you find certain species. Lactobacillus species are really important. That's one area in the oral microbiome that's been more studied where we see they've studied fermented milk cultures and so forth. So lactobacillus species seem to defend against oral disease. And so that's one role of oral bacteria is that they actually defend against tooth decay and gum disease.

And the way they do that is they inhibit the guys that cause dental disease. So caries, so streptococcus mutans, for instance, is a well-known bacterial species that appears in tooth decay. Well, it's inhibited by lactobacillus species that we get from our diet that are present in the mouth. And they just release little acids that just tell them to settle down and don't eat away at the tooth. And so when you actually, this is actually going towards a more complex definition of tooth decay in the mouth, because we see it as just, oh, you put sugars in and we have acid excretion, and then you have breakdown of the

tooth enamel. It's far more complex than that. What's happening is that over time, you're depleting the diversity in the microbiome. The resources that the bacteria have is decreasing and then you're getting a loss of protective species. Then you get the disease-causing species rise up and then cause the metabolic issues that then need the minerals and actually go into the storage of minerals in the tooth. So they eat away at the tooth because the oral environment is depleted. Interesting. So a lot of the, would you say that there's similar factors involved that wreak havoc on our oral microbiome, similar to what wreak havoc on our gut microbiome? Would it be kind

of similar things like pesticides, obviously, and antibiotics? Yeah, it's the same thing. Yeah. I think the mouth might be a little bit more resilient in that sense like we probably don't see the symptoms as and as much um for whereas you know long term um well first of all there's a big connection between what's happening in the mouth and the gut to start with so So what happens is that when you have certain, for instance, antibiotics during pregnancy will known to increase the development of stained tooth enamel. And it's because the teeth don't form, the mineral balance doesn't form under the

gums. Because they need that good bacteria. Yeah, exactly. Well, totally. And they're finding that bacteria are really, really critical in the formation of bones. So you're starting to see the research that certain connections between gut bacteria and bone formation, that they're literally running this process. And so the same thing happens in the gums and teeth. Yeah. It's that simple, right? Yet it's kind of been a complex way to get to it. But so when you take, when a mother takes tetracycline antibiotics during pregnancy, you get this dark staining of the teeth. And so that, that's a direct, you know, kind of impact that the mouth sees. Now in non-celiac gluten intolerance, you see mouth ulcers.

And so you get these little pop-ups between the mouth and the gut that, and you actually, because the average diagnosis for celiac disease, you know, was up to about 11 years. It's probably much shorter now because people are becoming more aware of it. But if we picked up that the gluten intolerance and celiac disease associates with childhood tooth enamel formation issues, then you would spot that that kid isn't digesting very well. And then you would potentially pre-diagnose non-celiac gluten intolerance before it ever became celiac disease. And so what the kids have is they have

this softened brown enamel. And the likelihood would be that we don't have research on this yet, but they would have the signature oral microbiome changes that are shifting towards an autoimmune reaction to gluten in the gut. And so, you know, the mouth can access this screening kind of area, but then the same things that affect the you know it's the same system you know it's crazy that we talk about it separately right like I know yeah it's literally the same thing like this is your gut right here you you you can put your finger into it it's that's a great way of of putting it yeah well it's it's literally what it is um you know, and I just don't know how we've come to the point where we've been so mentally disconnected, say the mouth and the gut. It's the same thing. Yeah. Directly connected.

Yeah, totally, totally. And like, it's a big leap we need to make because it just breaks down so many difficult to understand processes when we start to see the manifestations in the mouth and then how we heal them, you know, conjointly. Did you know that coffee is actually hindering your productivity? I know it's mind blowing. I, so for people listening, what are some signs and symptoms that something is off? Maybe they have dysbiosis of the oral microbiome. What are things to look for? Yeah, look, the things to look for, the general feeling, your teeth are quite, you have a lot of kind of symptoms associated with teeth. So sensitivity and kind of the feeling that your teeth are uncomfortable in a way. That's a sign that, you know, it can be a sign, there can be many causes of that, but it's a sign that the trigeminal nerve to that tooth is firing.

And so the brain's getting this message that something's not quite up. And, you know, with my patients, you know, we'll always talk about nutrients in those instances. So with tooth sensitivity, I'm thinking vitamin K2 because there are proteins in the oral environment that the tooth actually absorbs and that helps it to mineralize and control its responses. So I think that's not in all cases, but if you're seeing these kind of symptoms in the mouth, you need to be thinking about what your body's trying to tell you because you're designed to be showing this. Your cranial nerves are all designed in this way.

Oral ulcers are really a big sign that something's going on in your gut. If you get consistent aphthous ulcers or kind of blotching ulcers or so forth in the mouth, that's a good sign, you know, you've got something going on in the gut, you know, and the whole kind of chronic inflammatory gut disorder spectrum, you know, IBS and so forth. I think you could probably pick up these conditions earlier in the mouth and you really need to heal them conjointly. So if there's any gum disease or perio issues, you need to do that alongside any kind of gut healing protocol. I see so many gut healing protocols that don't consider the mouth and you're just swallowing disease again and wasting all the time and money

and so forth spent on supplements and testing to really not get where you should. White patching can be oral-like and plainness. And so that's an autoimmune condition. It's very subtle though. You don't have any other symptoms besides these white patching sometimes on the tongue, sometimes on the side of the mouth, like it's like a line on the inside of the cheek. That's an autoimmune condition. And so if you've got that in the... Yeah, it's a really simple one and it's reasonably common to our oral-like complainers. So white patching, if you have that, then you really should be thinking you're in the big risk category for leaky gut because that autoimmune condition will put you in the risk category. And maybe there's something else going on that you could identify before it

becomes a full-blown disease. And yeah, so the other things are like dry mouth. The big one is dry mouth in the morning. So sleep's a really big factor that the mouth can help us kind of connect to. So if you have dry mouth in the morning, it means you're not breathing right. And that you really need to start thinking about how you're using your respiratory system in order to, because the other thing too, is if you're trying to one, heal the teeth or the gut, you really need to close this and let the saliva and let the digestive systems work as it should. Because if you're breathing through the mouth, it is completely changing that environment that's not designed to be that way. Interesting. So what are some things that people can do in order to protect their oral microbiome? Are there certain foods that feed them and that are good for it?

What are things we can do? Yeah. So, I mean, like if we follow what humans have eaten, you know, for the vast majority and what has produced healthy teeth, you find that we have the foods that are ancestrally and traditionally prepared and cultured. So traditional foods like that are based in organ meats, really the reason why our ancestors ate those foods, because it's so rich in fat soluble vitamins.

And there was a dentist that went around the world to look at this, how ancestral cultures treasured these foods and, and ate foods rich in fat soluble vitamins. And these really are nose to tail organ meats associated with the animal products because animal products have the activated fat soluble vitamins. You don't get them from plant foods. So the teeth really direct us towards animal foods because they provide the highly bioavailable nutrients that support the osteoimmune system. So vitamin D goes straight to your bone marrow. So vitamin D starts signaling your bone marrow to create a strong immune system and strong teeth and strong

bones. And so when we don't have enough of this system, which is supported by vitamin K2 and vitamin A, then you begin to get the dysfunction in firstly your teeth. And then later on in life, you get the osteoporosis because the bones have depleted because we don't have these nutrients. And so these foods are, you know, I say organ meats, everyone probably cringes about it, but the reason why, you know, I talk about it is because you don't get that high concentration of nutrients from any other food.

And that's why our ancestral cultures all treasure these foods. So the other thing is like egg yolks, grass-raised, dairy is great because it's got all the fat-soluble vitamins, the heavy fat, fatty cuts of meat, fatty fish, these are the things that carry the fat soluble vitamins that really support your oral and osteoimmune system. So is there a world in which, because you were talking about our ancestors really didn't deal with the issues that we're dealing with today. If hypothetically, if someone had a really super clean diet and they were eating all, you know, a bunch of organ meats and good healthy fats, would they not have to brush their teeth? Well, I think the perspective of brushing is that we really need to put it as to how modern it is. You know, I think there's a role for brushing. I think, you know, in today's society, you know,

we're surrounded by, you know, packaged food and chemicals. Sugar. Totally, totally, you know. And so I think there's a role for oral hygiene because it helps us manage, you know, and that's the kind of society we live in today is that we have the ability to be able to modify a biohack or whatever you want to call it, our physiology. But the perspective is that these are really, really modern techniques.

And if you look at how modern disease is, the rates of it today, it really hasn't worked that well either. And so the real way to, to prevent these conditions in kids. So one thing I see in parents a lot, which is really tragic is that they've brushed, you know, like crazy, or they've tried to maintain the kids oral hygiene, and then the kids still has cavities. And it's like, well, you know, there's deficiencies here that go back to, you know, before to conception and during pregnancy that we are, we're lost from this connection to food. So I think if we were out, you know, in connected to nature and eating, you know, foods that are connected to nature as well, you don't get oral disease and you don't get oral disease in any biological system. You don't find it except in zoo-captured animals. That's the only time you find it. You don't find any dental disease anywhere in nature except for then.

And so that's a reality that we just don't really kind of talk about is that dental disease is only industrialized in modern society and in pets and animals that live with us too. Otherwise it doesn't happen. Wow. I mean, as humans, we've just really ruined, we've ruined a lot with our industrialization, our health, the planet. Now we're messing with animals. Yeah. That's fascinating. I've never heard that before. So for people listening, this is a bit more just about what you do. How does someone go about finding a really good dentist? Yeah. So look, the world of kind of, like I call it functional dentistry because like it's blended with functional medicine in terms of the principles of understanding root

causes and then using oral medicine techniques alongside, you know, I really think, you know, I'm kind of working on getting this, this method and this, these techniques out to, to the, to the world. But so with, with dentists, you know, the, the world of biological dentistry, holistic dentistry the other angle on it is airway dentistry. So these dentists are more trained they've gone out to do more training than um than you know what was taught to them you know just in straight dental school um and they they they practice in ways and what you'll find is they'll they'll use little

bits like they'll they'll do certain um so certain dentists won't use certain filling materials and so forth because we're thinking about the biocompatibility to the mouth. That's one big thing that's really coming out is that there is a big issue with certain things we put in the mouth like metals and so forth that do affect not only the oral biome, but also the systemic biome as well. So certain dentists will consider this and there's a great kind of selection of biocompatible ceramics now that are a little bit more expensive, but these kind of restorations are far more compatible to the biology of our body.

And then there's the dentists out there that are considering the airway. And so the big one that I really have to kind of, you know, tell people to consider is that how your kids are breathing and sleeping, because that will have the biggest input into not only the development of their dental arts, so whether they need braces and crooked teeth, which we can prevent, but also too, it will set up their architecture for how they breathe and sleep during their life.

If people breathe and sleep properly, then it really does consolidate how all the things that we have to cope with. If you sleep well, for most people, they'll be resilient to it if they can breathe and sleep properly. Now, dentists, if they're airway focused, they will use approaches, one, to prevent braces in kids. So getting kids to breathe through the nose using a set of devices and exercises.

They might use a myofunctional therapist, which you can look up to, which they're the people that teach tongue posture and so forth alongside dental arch development. And really thinking about how this whole system works together with the airway. So they're the kind of main two more common dentists out there. They're airway focused or their holistic biological. And then the third prong that, you know, is probably a little bit rarer is the functional medicine aspect where we're really thinking about nutrients, you know, and, and, you know, further testing in terms of, you know, the thyroid,

such a big connection to the, to the mouth. So, so comorbidities that affect that we see in the mouth and the gut and then healing the whole system together. So that really is, it's a little bit rarer to be honest. It's in development and currently doing a few things to try and help it get out there, but you'll find dentists, great dentists that are kind of attuned to many or some of these areas and you'll be able to work with them, you know, and there really are some great solutions out there when you, when you find how to address, you know, certain oral conditions that do connect to the rest of the body.

Yeah. That's fascinating. I wish you lived in LA or, well, I might be moving to Austin, but I would love to come see you. I would love for you to be my dentist. Do you think there's a, do you think toothpaste, like specific toothpaste will mess with our microbiome? Cause we know there's a lot of things that can mess with the microbiome. Will it like mess with the pH if it's not a great toothpaste? Yeah, absolutely. So when we're, when we're introducing, um, uh, broad spectrum antibacterials into the,. We know that they decrease diversity. That's the reason why we put them in. Now, you have to remember when we began to introduce these things into supermarkets and for people for daily use, we didn't know how complex and how critical the bacteria in our mouth and gut are.

So these things are by definition, broad spectrum antibacterials. So anything that says it kills all the bacteria in the mouth, you want to stay away from, you know, unless you're treating a specific infectious issue in the mouth, in which case certain antimicrobials will help for a certain period. But you don't want to be putting these things in your mouth all the time because it will kill the diversity of the oral biome. And this includes mouthwashes. And mouthwashes are nearly a straight out kind of no

because they're nearly, for the most part, all broad-spectrum antibacterial. And you really want to be harboring bacterial diversity instead of killing them all off. And so most of these products, and if you look into the research too, the mechanisms of alcohol, the mechanisms of certain peroxides, chlorhexanes,

we don't know what they do. They literally don't know the mechanism. And we know that all of some of these bugs parasites chlorhexanes we don't know what they do they literally don't know the mechanism and we know that they that all some of these bugs will are killed off when we when we put them in but we don't know how or what so that means it's doing many many other things that we just don't understand yet and there's some preliminary studies on alcoholic mouthwash use daily and how it just, it depletes the oral microbiome diversity, which then can increase the risk of pre-diabetes.

So they found that pre-diabetics were more, more likely to use alcoholic mouthwashes daily. So these, these things in the next few years, we're going to find some really, really powerful papers coming out showing that there is a big connection because we've kind of just hit the level of understanding now that all of this is connected. And then the researchers are on their way now to putting the connections together. Cool. So are mouthwashes totally off the table? Are there any ones that are good? I mean, look, so, I mean, I, I, I find, you know, anything more natural is, is going to

be, you know, if you essential oils, um, you know, are okay, but that you got to remember most of them are antibacterial as well. So you probably don't want to use them all, all the time. Right. So it's probably okay here and there. And, you know, I like the fresh kind of taste as well. And it was really kind of big disconnection for me to stop using conventional paste when I did because you lose that really kind of like medical grade mint freshness, right? I miss that too because I use a natural toothpaste and I'm like, oh, what I would do for some like fresh minty Colgate, you know?

It's not the same, right? Yeah, it really isn't. Yeah. And so there are, you know, kind of natural. And the other thing actually to watch out for are artificial sweeteners in gums and certain mints. It is a load of, and we know the artificial sweeteners and those ingredients really do change. They mess with the gut bacteria and they really are likely to be changing the oral microbiome as well. Not so much research on that, but from the mechanism, we can kind of draw that out. Wow. Well, this has been amazing. Before we wrap up, I want to ask you what I ask everyone that comes on. What are some of your health non-negotiables? So meaning like no matter how busy your day is, no matter, you know, no matter what, these are things that you do for

your own personal health. It can be, you know, diet related, exercise, meditation, whatever it is. Yeah. I mean, so I've got so many of them, but I've also got young kids. So it's kind of like my balance is very, very, very thin at the moment. But so for me, when weekly, I need to, I'm trying to connect to sunlight. And so, you know, we're talking about the vitamin d connection i find that you know once we um have our circadian rhythm connected our bodies are so much more connected into what we um you know what we uh you know how how our endocrine system is supposed to work and so morning sunlight was a huge game changer for me. Rising with the sunrise.

That one was just, you know, life-changing in terms of how I noticed my body just being in tune with circadian rhythms and so forth. Daily, you have to have a grass-raised animal food product. You know, it might be, you know, whether it is, you know, it's a fatty cut of meat at the minimum. I try to eat liver once, twice a week if I can. Sometimes I don't because obviously the preparation is a little bit. Yeah, it's hard. Family doesn't love it either. Yeah, and the other one is try to get broth as well. Yeah, so the constituents of those foods,

so the really, really high-dose nutrient-dense foods, you have to fit them into your daily routine. And you can probably compensate here or there otherwise, but if you're not getting those really precious foods, then your body's likely will move into depletion. Yeah, that's, I mean, it's super vital. Well, thank you so much.

This has been so great. And I think it's going to be such an amazing resource for my audience. So thank you so much for coming on. Thanks so much, Courtney. It was a pleasure. Thanks for listening to today's episode of the Real Foodology podcast. If you liked this episode,

please leave a review in your podcast app to let me know. This is a resident media production produced by Drake Peterson and edited by Chris McCone. The theme song is called Heaven by the amazing singer Georgie, spelled with a J. Love you guys so much. See you next week.