The Liz Moody Podcast - Ask the Doctor: Dental Health Edition—Fluoride, Whitening & How Your Oral Health Impacts Your Gut, Heart, and More with Mark Burhenne, DDS

Episode Date: July 28, 2021

We’re back with another Ask the Doctor episode. This was a VERY highly requested episode, all about dental health and oral hygiene. If you want more Ask the Doctor episodes, be sure to check out the ones on Happiness, Longevity, Hormones, Gut Health, Anxiety, and more. My guest today is Dr. Mark Burhenne, the creator and author of AsktheDentist.com and the #1 bestselling author of The 8-Hour Sleep Paradox. He is a family and sleep medicine dentist whose advice regularly appears on TV, radio, and magazines, including NPR and CBS News. He answers all of our dental health questions, including: how dental health is related to your whole body health how much of oral health is genetic and how much is what we do his thoughts on fluoride + his favorite fluoride alternatives his thoughts on oil pulling the safest way to whiten teeth how important flossing is really + the best time to do it his opinion of Waterpiking and tongue scraping why flossing & brushing can actually help your gut health why mouthwash is bad for you and what he recommends instead how to get rid of bad breath a 3-step plan to remineralize teeth the best supplements for teeth health if lemon water, ACV, or sparkling water are bad for teeth why snoring is actually bad for your health + exactly how to fix it I hope that you find lots of ways to tweak your routine for the better. I’d love to see any changes you’re making or thoughts you’re thinking as you’re listening, so please share on social and tag me—I’m @lizmoody and Dr. Burhenne is @askthedentist. PS: Have you snagged my Foodie preset pack? You can get all 8 presets, designed to make your food pics look as good as they taste, at lizmoody.com/presets. PPS: Healthier Together is officially a number one best-seller! You can get your copy on Amazon or at lizmoody.com/cookbook. Please keep sending me your creations on Instagram—they make me so happy! This episode is sponsored by Garden of Life, the only collagen I’ve trusted for years. To try it for yourself and let them know you found them through me, use this link to check it out (it won’t cost you anything extra): https://amzn.to/3hkzfnF This episode is sponsored by Kyoto Botanicals, makers of my favorite CBD. You can get a whopping 25% off your order (AND they always have free shipping!) by using the code “HEALTHIERTOGETHER” at kyotobotanicals.com. This episode is sponsored by Seed, the makers of one of my all-time favorite supplements. Their Seed Daily Synbiotic is a game changer—it contains both pre- and probiotics, survives INTACT all the way into your gut, AND contains the most studied and powerful strains of probiotics out there. You can get 15% off of your first month’s supply of Seed’s Daily Synbiotic by going to seed.com and using the code LIZMOODY. This episode is sponsored by Paleovalley, who make incredibly high quality supplements. If you’d like to check out their Turmeric Complex, Vitamin C, Neuroeffect, or any of Paleovalley’s other amazing products, head over to paleovalley.com and use the code LIZM for 15% off. Healthier Together cover art by Zack. Healthier Together music by Alex Ruimy. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello, friends, and welcome back to the Healthy You Together podcast. I'm your host, Liz Moody, and I'm a cookbook author and long-time journalist. Today, I am so excited to share another edition of our popular Ask the Doctor episodes, which comes highly, highly requested. If you're wondering what the heck Ask the Doctor episodes are, you must be new here. So first of all, hello, welcome. I am so glad you're here. My Ask the Doctor series was built around the idea that these incredible doctors have so much genius information

about transforming our mental and physical health, but the really great ones can be hard to find, tricky to get appointments with, and unfortunately quite expensive. On these episodes, I invite on the people in the world who are the absolute best in their fields, and I ask them all of my questions and yours about a topic. We have asked the doctor episodes about happiness,

busting weight loss myths, hormones, longevity, gut health, anxiety, skin care, and more, so definitely check those out if you are interested in those topics. Today we are covering dental health. My guest today is Dr. Mark Berhanna, the creator and author of Ask the Dentist.com, and the number one bestselling author of The Eighthours Sleep Paradox. He is a family and sleep medicine dentist whose advice regularly appears on TV, radio, and magazines, including NPR and CBS News.

As we talk about in this episode, dental health is about so much more than just your teeth and gums. Your oral health impacts your heart health, your brain health, gut health, and so much more, and we get into all of that here. We also cover his thoughts on fluoride, the safest way to whiten teeth, how to get rid of bad breath, a three-step plan to remineralize teeth, the best supplements for teeth health, why snoring is actually terrible for your health and exactly how to fix it, and so much more. This was a highly, highly requested topic, and I hope that you find lots of ways to tweak your

routine for the better. I would love to see any changes that you're making or thoughts that you're thinking as you're listening. So please, please share on social and tag me. I am at Liz Moody, and Dr. Berhanna is at Ask the Dentist. If you want to use this episode as the basis for a podcast club discussion, I am happy to zoom in for a few minutes to chat. Just email info at Lizmoody.com and put podcast club in the description. I've been doing a bunch of these and they are so much fun. So let me know if you want to do that with this episode or any episodes of the podcast. And if you have anyone in your life that you think would benefit from this information, if they're still using fluoride or oil pulling for 20 minutes or they have tons of cavities,

please, please, please send them the link for this episode. It is a great sneaky way to solve a loved one's bad breath issues. Maybe don't tell them that you're concerned about their bad breath specifically, but they will definitely get that info out of this episode. And if you were sent this episode by someone, first of all, I am sure that your breath is fantastic and they are just worried about your gums or something else entirely not related at all like that. And second, don't forget to hit that subscribe button so you don't miss out on future episodes of the podcast, including more of my thriving through anxiety series. I have the defined

dish coming up soon and I'm so excited to share that. An amazing how I learned to love my body episode with Katie Sterino and Ask the Doctor about stress relief and so much more. All right. I hope you love this episode of Ask the Doctor, Dental Health Edition. Dr. Berhana, thank you so much for taking the time to join me today. I am such a fan. Liz, thank you for having me. I'm honored. This is like one of the episodes I've done that I'm personally invested in. I'm one of those people who has had such dental issues over the course of my life. And I've been scarred by dentists. And every time I go to the dentist, they're like, oh my gosh, I like can't believe that the dentist you went to before did this, this, and this

to you. And it's just made me like so wary of all of that. But I know how important dental health is. So I'm hoping to get to the bottom of all of that and fix my dental health forever and all of my listeners' dental health. I hope I can fix all of that for you. A lot of patients have that story to tell. Most of us have some bad dental experience. I mean, I've had a few. I remember my very early dental experiences, and that sets you up for the rest of your life. So it's important to find the right dentist and stick with them.

Absolutely. For sure. We'll get into some dental anxiety questions later, but I'd love to just kick it off with, what do you think is the biggest mistake that people make when it comes to their dental health? Ignoring it. I mean, that just came right out.

Let me think about that a little bit. I think that's what it is. I think not ignoring it, but giving it less precedence or less weight in terms of your overall health. Because it's as big as anything. In fact, sometimes can be bigger than systemic issues

because it causes so many systemic issues. So my answer to that would be just giving it kind of, I think it's because we have separate visits. We have that medical visit with the physician. And then we just had that checkup with the dentist every six months. It's like a haircut. And I think people sometimes see it as just a teeth cleaning where really it should be a much bigger discussion.

So I think it's just it's not ignorance. It's just putting less weight on that dental visit and oral health. Well, and even the way the insurance is structured, it's like here's your medical insurance, which is necessary, and then you can add on dental insurance, which makes it feel like it's not of equal importance. That's a really good point. And dental insurance is not an insurance product, unfortunately. Yeah.

It doesn't protect you from catastrophic tooth loss or it limits. It caps out after, you know, each year at 1,500, and it should be part of medical insurance. So you're right. That's one aspect of how people see the medical and dental world, you know, separately. And really, there should be more collaboration between the two professions. Well, let's just dive right into it. What are, like, how is it related systemically to your body? I've heard stuff about like your gums are related to cardiovascular stuff.

What do you mean when you say it's, it causes systemic issues and it's symptomatic of systemic issues? Right. Both. That's well said. there's a lot a dentist, a well-trained dentist, experienced dentist can tell just by looking at the mouth in terms of other diseases in the body, and then vice versa. For example, periodomal disease, and you've heard this word a lot, it's the cytokine response. It is a cytokine response. It is an overreaction of the immune system to an infection in the mouth.

We can talk more about how that happens, but my point is that it's a overall inflammatory. response. And there are many different mechanisms how that gets into the body. But the short story is that a lot of diseases like Alzheimer's or heart disease, a lot of the bacteria that are involved in those diseases are oral bacteria. Well, how do they get there? Well, they get there from the mouth and they can get there through the bloodstream, through tissue via different mechanisms. But there is a connection. And then on the backside, as you inferred, we see, very, very example, gum disease, then a dentist, a well-trained dentist, will suspect many things. Mouth breathing, maybe sleep apnea, certainly metabolic syndrome or diabetes, that kind of thing.

So by kind of doing all of the dental health maintenance and taking care of your oral and dental health in the way we're going to talk about in all the ways in the podcast, you're not only making your mouth look good, you know, preventing mouth issues like halitosis, you're actually preventing or helping prevent things like Alzheimer's or heart disease? Exactly. Your dental visit, even though you're very healthy, perhaps, I mean, good oral health, assuming you have that, that dental visit every six months is basically treatment for your whole body. It's preventing a lot of different complications, comorbidities, diseases.

So it's important to realize that, that your dental visit is really, it's systemic care. Wow. That's like good motivation to go to the dentist for people who are maybe more nervous or just kind of like, whatever, I'll do it soon. That's like good motivation right there. And we need to motivate more people in this country because only 50% of the population sees us on a regular basis. I mean, that's a very low number. Yeah. And it's interesting because like we said with the insurance thing, like it is expensive to go to the debt. There's so many reasons. There's fear. There's price. There's just so many reasons. that it makes it more difficult to go to the dentist. It's true. With all of that said, how much of your oral health is genetic, would you say? And how much is based on what you're actually doing

and all of the things we're going to talk about on this episode? That's a great question. And I think a lot of people are resigned. They get a bad dental report. They've seen their dentist and they're like, oh, it's just I have bad tea. Even the dentist will chime in and say, you just have bad tea. The guy, you know, that came in before you had good teeth, and he was born that way. And that is incorrect.

There are so many factors at play. There is a genetic predilection to getting cavities, but a lot of that could have been an epigenetic event, prenatal, perinatal, perinatal, postnatal. And then, but it's more about the environment. There's a, I mean, I'm not going to say that there aren't genes involved. There are genetic predilections to oral diseases. But the good news is that the biggest effect is our environment and how we take care of ourselves, what we eat, is our mouth closed or open when we're breathing at night especially. These are all epigenetic factors.

Certainly diet, there's supplements you can take. So it's a multifactorial thing. And typically, genes are involved in a lot of things. But like anything else, the good news is that a lot of this can be overcome and most of it is under your control. All right, that's very empowering. So let's get right into the stuff that's in our control. And I'm going to start you off controversial.

What are your thoughts on fluoride? I would love a full rundown of the pros and the cons. Yeah, I have lots of thoughts on fluoride. I just did a two-hour podcast on that topic. It's a complicated, even for a dentist. And again, when I say this, don't take it wrong. I am just a dentist. And dentists really don't know that much about fluoridation.

They're told that it's great for teeth and that it causes maybe one less cavity in the lifetime of a child. And some of that is true, but you really have to be a PhD, a biochemist. I mean, you have to have a different kind of background and training to really know what fluoride's all about. So this is my take on fluoride. Do not, if you are thinking of having a baby, do the research, but do you. My recommendation is do not ingest fluoride. This is before conception. Do not ingest fluoride then.

Don't ingest fluoride while you're pregnant. And don't have your infant drink fluoridated water because that is a systemic intake of fluoride. This is fluoride that's in the water. It's put into our water supply. We are the most fluoridated society in the world. We in the U.S. drink more fluoridated water combined than the rest of the world. And it's a big problem for, I think, the U.S. in general. So my take, and this is how I raised my daughters, and this is over 30 years ago, back then, for me, it was a lesser of two evils argument.

I just didn't know enough about it, but it didn't seem right. There was some talk about IQ, effects on IQ, bone density, osteosarcomas, later in life bone cancer, hip fractures, and, you know, effects on the mitochondria, which, you know, can affect. energy levels, a lot of that was discussed, but now we have studies. There's actually a lawsuit that at the federal level against the CDC, first time that the TSC, Tuxus Substance Control Act, has been brought to the federal level by some citizens. And the lawsuit's been going on for a year. And I've been following it very carefully. And I think the judge, Judge Chen is going to rule in the favor of the plaintiff, the defendant being the CDC. The CDC has not been able to argue their case very well.

They ironically hired the people that the tobacco lobby hired when the government was suing tobacco companies. So, you know, these rented white lab coats. And all they could do was try and tear down these studies that we have. And it was a very weak argument. So in general, I would say stay away from ingesting fluoride. And even if you want to take it from a lesser-of-to-evil argument, like I did 30 years ago, at worst you may get one more cavity. That's what the data shows. So my kids have no cavities. They ate well. We addressed a dry mouth and saliva issues early on. So it can be done. So I'm against fluoride. Now topical fluoride, and we can talk about that, but topical fluoride works, but we have other wonderful alternatives now to topical fluoride, which is in toothpaste and that little gel or foam that you're kid up until age 14.

has to kind of have their teeth sit in and a foam tray or get painted on, you know, it's a fluoride varnish. If that gets swallowed, that is problematic, especially in the early years up until age 10, to the young brain. So no fluoride. It's controversial. A lot of dentists would be shocked that I'm saying this.

But I think the tide is beginning to turn. I think we're at a tipping point soon. The rest of the world has looked at the data. I mean, there are only two countries in Europe that are fluoridated. So it's going to happen. But in the meantime, you're going to have to take action as a parent. Do you not have your child ingest fluorid. So that means like filtering your water.

And we'll talk about some alternative toothpaste and things like that. But filtering your water basically and then making sure your toothpaste is fluoride-free. Definitely. So you mentioned some other alternatives to fluoride, particularly in toothpaste. Can you talk about that? Absolutely. It's been around for a while. It's called hydroxyapitite.

It's a biomimetic material. In other words, it is in our teeth already. That is the major ingredient of our teeth. And it's available. It's inexpensive. It's not toxic. It can be swallowed. And it's been in use.

For example, in Japan for I think 40 years. It's become very prevalent in Europe. In fact, most of the hydroxyapitone, Whether it's nano or micro, that's the size of particles, that's made in places like Portugal and in factories. So it's kind of new to the U.S., but a lot of my viewers and readers, they're very excited about it, and they've tried it. It works. There are a lot of studies out on hydroxyapitite. It can easily be added to toothpaste.

The ideal amount is probably 15%, maybe more. Unfortunately, a lot of the toothpaste that are available right now, These are niche, you know, brands for now, although I'm expecting to see this with Colgate and Crest, even though they're still pushing fluoride. There isn't enough of this in there to be efficacious or it's not enough for a therapeutic dose. So make sure if you're using a hydroxyapitite-based toothpaste, call the company. Make sure there's 15% or higher in terms of concentration. The ones that I recommend do have that.

That's Risewell and Blanking. Boca. Boca. Thank you. And I use the boca. I use boca. It's the micro, it's the nano-sized. I love it. I have sensitive teeth. And it works. It absolutely works. It works better than the prescription strength toothpaste with an amount of fluoride in it that if it is swallowed, you have to rush to the hospital. Oh, wow. Yeah, exactly. That worked as well, but the hydroxy appetite works better, and I have peace of mind. I mean, that's the last thing I need or anyone needs is more fluoride. And the question is a lot of people ask. is fluoride absorbed through the oral mucosa, possibly, probably not systemically into the bloodstream, but it could be. But the great thing about the hydroxy appetite for it to work, for fluoride to work in the mouth,

you want to leave it in there as long as possible. So if you leave a very prescription strength toothpaste or gel of fluoride in your mouth and then put your night guard in and go to sleep, that's what we used to recommend, you are swallowing some of that fluoride because you're producing salivate. because you're producing saliva at night and you're swallowing it. But with the hydroxy appetite, you have peace of mind. So I brush with it before bedtime. I spit out, but I don't rinse with water because I want that layer of hydroxy

appetite to stay on my teeth. I put in my little oral appliance and I go to sleep. And I don't have to worry about swallowing a biomimetic material, something that is natural that dissolves in my stomach. And do you think that it's as, or do studies show that it's as effective as fluoride is for protecting your teeth long term for... Oh, yeah. The studies are very clear.

Yeah. It's as or more effective than fluoride, topical fluoride. All right. I'm going to tell my husband that. I use RISE well, and I like to do Rizwell because their floss also has hydroxyapatate in it. Yep. And I just like to order it all from one place. But I use that, and then he uses the Toms of Maine with fluoride because he's just so, he's had so many

cavities over the years and he's just really nervous to let it go, you know? Well, can I pick on your husband? Sure, yeah. Oh, good. Of course. Tell them that the Tom's of Maine, it was a very good brand back when it was a small niche product, but it was bought by a very large company.

I'm not going to mention who. And to make large batches of toothpaste, because obviously the volume went up when they did buy it, they have to add a lot of ingredients that help amulsify and congeal the product. And those amulsifier surfactants are actually doing a lot of damage to his oral mucosa. So he doesn't have to worry about the fluoride. He just has to worry about other things in that toothpaste.

So I would be very wary for him. I would tell him try and, you know, I mean, ideally there should be no surfactants or emulsifiers in toothpaste. Unfortunately, a rise well in boca, they have natural forms of it, but at least it's not a mass-produced product. So tell him that Tom's a Maine, I would recommend that he try boca or, and he will still get the benefits with the hydroxyapitide in these toothpaste,

the boca and the rice valve. He will get all the benefits and probably a little bit more that he does with fluoride and he won't have that breakdown of the oral mucosa with these strong industrial strength surfactants and amulsifiers. It's the last thing you want to do. It's the same thing with your skin. You don't want to use an emulsifier in your skin. Emulsification like oil pulling for 15 minutes. I mean that does break down cell walls. Okay. Well let me give me one second to get to oil pulling because we're going to talk about that too. But just to to wrap up the fluoride conversation. Also, when we go to, I was kind of taking a split approach where I was not doing fluoride

in my toothpaste, but when I went to the dentist every six months, I would let them do that like fluoride treatment, but we should be saying no to that as well and just trusting that our hydroxyaptite and all the other oral health things we're going to talk about in this podcast would be enough for us. Yes, that fluoride treatment, which the dentist can bill for to insurance, they pay up until age 14 or a varnish, a fluoride varnish, which is a stronger version of that for a kid that has a lot of cavities, that's not treating the root cause of why your kid's getting cavities. You're going to be doing that every time you come in and they're going to swallow that

fluoride and it's going to affect their brain and other parts of their body as well. So no, I would say no to that. I wish I had done that with my kids. They did get a little bit of that. Of course, we told them not to swallow. But I would recommend against that. And if your kid is getting a lot of cavities, seek out a dentist that is willing to discuss with you and treat you in the context of what is, let's not have any more cavities at the next visit. How can we accomplish that?

Okay. And oil poland. You mentioned oil poland. Are you pro or con oil poland? I'm pro. I mean, I'm pro anything that people get excited about, right? that has some benefit. It's an old Arivedic, as you know,

people like the old stuff. They like traditional. And that's great because a lot of what our ancestors did is good. What is good. But you can overdo it. Now, you can do the same thing with toothpaste and a toothbrush. Toothpaste is mildly abrasive. If you brush for 15 minutes,

you're going to do a lot of damage to your name. So it's the same thing with oil pulling. They recommend 15 minutes. Oil pulling is great with coconut oil on breaking down. If you have a pathogenic layer in your biofilm, which we used to call the black layer, then it will thin it out and it will thin it out without having to brush. And maybe, and I do believe this to be true, oil pulling gets into more than nooks and crannies that brushing does. But to oil pull for 15 minutes, I think you could be overdoing it.

You could be taking down too much of the biofilm just as you can with brushing. I don't think you can floss too much, but no one seems to be trying that, including myself. But yeah, I mean, oil pulling is fine. Of course, you can't swallow the oil afterwards. I would be careful which oil you use. I think olive oil, which doesn't seem to be too popular, or coconut oil, which is the more popular one. I think for three to five minutes, depending, for example, I'll oil pull sometimes in the morning. If I've had a cold or some allergies, I couldn't mouth tape, which doesn't happen too often, thank goodness.

My mouth is dry in the morning. Just go to a three or four minute oil pulling session, and you're going to feel great. That thick layer that was created by drying of the oral mucosa with your mouth open, that will thin out that potentially pathogenic layer of the biofilm. Again, plaque or biofilm, I prefer the newer term biofilm. that or the pellicle, I don't know if you remember that term, the pellicle was the skin of your teeth.

There's that expression where I just got by it by the skin of my teeth. What that expression says is it's a very thin, invisible layer. It was a close call, right? Huh. So the biofilm, if it gets too thick and too organized, then the bacteria that are in that micronitch of the oral microbiome, in other words, that's one area of the oral microbiome, and each area is slightly different,

then those bacteria can prevent nutrients from saliva, like phosphorus or calcium, actually hydroxyapatite, from getting from the saliva to the tooth that's trying to remineralize itself after that drying event or that acid attack from food. So I don't want to make it too complicated, but our Western diet has really had an effect on the bile foam,

and it has thickened it and made it more pathogenic. That's essentially in a nutshell what we're fighting with when we use a toothbrush floss and abrasive toothpaste and oil pulling. Oil pulling is what our ancestors did. They didn't have toothbrushes. They couldn't embed nylon bristles into a nylon handle or wouldn't handle. They just didn't have that technology. They had a bite stick.

They would chew on something to produce a lot of saliva flow and they would oil pull. So with coconut oil, the reason a lot of people like it is because it's like antiviral, anti-bacterial, all of that. Is it killing the good bacteria in your mouth in addition to the bad bacteria? So that's a really good question. And that's the question you should ask. What you just said is wonderful. That's the question we should ask whenever we put anything in our mouth, especially when it comes to oral hygiene. A lot of toothpaste do that. We have studies that indicate a lot of these sterilizing and, well, they use the word disinfection, the disinfecting mouthwashes, which I get bombarded with on all my dental emails from dental magazines.

It's hilarious. How to get your patients to disinfect your mouths. I mean, we don't, that's the question you have to ask. If it's being marketed in such a way, disinfecting the mouth is the wrong approach because you are creating a dysbiosis. And the studies are there. We've had them for 15 years. In fact, using mouthwash with alcohol in it or triclosan, detergents, pesticides,

they're all in there. take your poison, that actually produces bad breath because it's killing or allowing certain bacteria to become pathogenic, in other words, more numerous than they should be, and suppressing the commensal bacteria, the friendly bacteria. And when that relationship goes awry, then these bacteria can't work together to produce pleasant smelling breath, nutrients that your teeth need. These bacteria are part of the immune system. they protect you, even from like a cancassore to an oral infection, gum disease.

It's amazing what the oral microbiome can do if it's healthy, not dysbiotic, but healthy, optimal. So, yeah, that's the question you have to ask yourself. So to answer your question, coconut oil is a very mild bacteriol. In fact, I would pick coconut oil over most of the essential oils. Essential oils are quite strong. I've had a lot of, actually a health influencer. I like to tell the story. Big following on Instagram.

He tried a homeopathic natural toothpaste. It had cinnamon oil in it. And he had a reaction to it, was burned. And of course, his microbiome was out of balance for about two and a half weeks, just from using the cinnamon-based oil toothpaste. So, yeah, when it comes to coconut oil, it's a very mild, emulsifier. I would say it's very low on the antiviral scale,

but it is mildly bacteriocidal. But if you're using it for 15 minutes, I'm more worried about the disruption of cell walls. I mean, not the bacteriocidal effect. But when you disrupt a cell wall, that is bactericidal in a way. In other words, it is taken out that cell. So I'm not too concerned,

but it's what I'm trying to say is that question that you just asked is the question you want to ask. How strong is it? What kind of damage is it doing in my mouth? And even natural stuff. Even the natural stuff, yes. Explanation of like why natural isn't always the thing you want in your mouth, you know? Right, right.

And a lot of the natural stuff is not tested. I mean, to give Colgate and Crest a lot of credit, they're testing. But I don't think they're really looking for the right thing. And it wasn't until recently, maybe, that they are aware of the oral microbiome. They've actually been defeating what the oral microblame does with all their products, you know, since the inception of these products. But I think they're going to turn around. I think the market, again, they will watch what happens. And when people stop buying fluoridated toothpaste with triclosan in it, which is a antibacterial detergent or soap, then they will shut down their plants.

I think Colgate actually geared up and bought and manufactures their own trachlacin. which I think now is not allowed in California. California is kind of leading that. They've gotten rid of microbeads. In toothpaste, they've gotten rid of, they've outlawed trachlacin. So eventually these companies will see the light, and they will start putting in hydroxyapitite, and they'll be using more naturally derived surfactants

or altogether eliminating surfactants. That would be great. Well, and then it would be widely available and probably at more accessible prices too. Yes, exactly. And we need that. We really do need that. So just to summarize, oil pulling is a yes, but for, and especially if you've slept with your mouth open because you're sort of rehydrating your mouth and that's important for your microfilms, your microbiome, but don't do it for more than three to five minutes. Yeah. I think it's on a needed basis, but you can overdo it. A lot of people do it for whitening. Do you think that it's helpful for tooth whitening?

It can be, but not in the ways that they think. If you compare it to the ways that a dentist whitens your teeth, professional whitening, that uses an oxidizer, essentially hydrogen peroxide. What oil pulling does is it by removing or thinning the pellicle, the bile film, the plaque layer, it changes the optic nature, the reflectivity of the tooth. So their teeth will reflect light a little bit more. They will look a little shinier. And since they reflect more light, they will look a little bit more.

wider. Sometimes oil pull in can remove stain, although if it's heavy, very integrated stain, then it will not do that. The good news is that hydroxyapotide, and in effect, I recommend this now, instead of going to the oxidizer, the hydrant

proxide methods, which is expensive and potentially damaging to teeth, again, if overused, I tell patients, use a hydroxyapotide-based toothpaste for six months and tell me if you're happy with that degree of whitening. And that And again, that changes the reflectivity of the tooth in a different way.

Instead of removing the plaque and thinning the plaque and making the tooth a little bit more mirror-like because you're seeing the real tooth surface, what it does is it's filling in a lot of the pits and holes in a rough surface, which fluoride actually promotes. Fluoride will recalcify a tooth with a wavy surface. And that actually captures light. but the hydroxy appetite actually makes it smoother and more mirror-like, and that will sometimes make your teeth look very white. So there are a lot of different ways of thinking of whitening,

and the safest way would be to use the hydroxyapitite tooth-based. Is there any way, too, that you would recommend to dramatically more whiten your teeth, like the in-office treatment or... Yeah. I used a hydrogen peroxide rinse, like it's called brushing rinse. I used it for a really long time, and then I noticed it was irritating my gums, And then I kind of like had this whole thought similar to the coconut oil that I was asking, which is like if this is killing the bacteria in my mouth, is it killing the good bacteria

of my oral microbiome too? And I stopped. But that made my teeth so white. And I used the hydroxyapatite toothpaste, but like my teeth were like movie star white with the hydrogen peroxide. And I missed it a little bit. Well, I think your teeth are great, by the way. You're very white. But I mean, again, whitening is a personal decision.

If your dentist says, oh, you should whiten your teeth. I think that's a little bit forward. It's a personal decision and there is no medical need to whiten your teeth. But to answer your question, if you do want to... So this is why the product that dentists sell, the professional whitening system, which I'm not against, this is why this product exists. People are going to a wedding or they know that there are going to be a lot of photographs taken at an event or they're going out on a date. I mean, and most people have maybe a week or two notice, some less. and that's why we have the in-office procedures.

But if you load a custom-made tray that is just shaped around the teeth and does not touch the gums, and you put in a hydrogen peroxide-based carabami peroxide gel is what we call it, and it's at least between 8 to 15 percent, you will get a oxidation of the tooth. You will get a much wider tooth. That is an intrinsic color change of the tooth. And it's dramatic. So that does work. It's not necessarily permanent, but you don't have to be as aggressive each time.

Every five years, maybe you do a little bit. So that's a good product. Again, it can be overdone. And you are taking a strong oxidizer and a cytotoxic material. That's why your gums were very sensitive. They were burning. You were necrosing the outer layer of your gums, which potentially could cause gum recession. And so the cost of whitening your teeth, it comes at a great cost.

Unfortunately. Also, hydrogen peroxide, there are some studies, not conclusive, that connect hydrogen peroxide use to oral cancer. And again, you'd probably have to use a lot of this stuff to get there. So, yeah, these products exist. They're relatively inexpensive, and you can whiten your teeth. My problem with all of this is that this is an unnecessary procedure. when did we become dissatisfied with slightly yellow teeth? I mean, that's the natural color of teeth. They're kind of whitish. It's an off white.

Why do we need to have paper white teeth? I don't understand that. Most of my veneer cases, we're always talking them down a few shades so that they look natural. And it's based on skin color as well. A lot of people, there's a lot of variation of tooth color. So it's a complicated topic. But in your case, I would not recommend whiten your teeth that way because that hydrogen peroxide ingredient goes everywhere.

Yeah. The tray. That's why a professionally monitored method, i.e. a dentist, not a little kiosk in a shopping mall. Some states that's legal. Have a dentist do it. Make sure the tray does not touch your gums. Show them, have them show you how to load the tray so that the gel doesn't. come pouring out of the edges.

There's an easy way to do that. And just keep the gel inside the tray for half hour at a time. That way, only the teeth get the oxidation of you know, byproduct of that reaction of hydrogen peroxide when it comes into contact with the tooth's surface.

Do it right after you've had a cleaning. That's when your biolfilm is at its thinnest and that's when the tooth is at its most vulnerable in terms of the whitening gel. There are all sorts of a little trick. So doing that occasionally, is fine, but people that whiten their teeth constantly, I think they need to re-evaluate what is,

what's a good look for them. And a lot of these people have terrible gums. They're smiled. They have crooked teeth. But, you know, they want to, they want to be thin before they're fit kind of thing. You know what I mean? Does charcoal toothpaste help with whitening,

or would you recommend that? Charcoal toothpaste, if it's done professionally by a good company, that measures the abrasivity of their particle, if it's from coconut husks and it's properly done, that does have some absorption, not absorption, adsorption. Charcoal has some absorption. That's how it works in the gut, you know, when you're feeling poorly. And so, yeah, I mean, it's not a miracle whitener, but it can, it whitens by removing stain in some cases. So there are a lot of great charcoal toothpaste out there. I've tried them. And yes, the new, the new white is black, I guess,

and all the marketing claims. I mean, you've got to get over the fact that it's black toothpaste. But, yeah, I think it's fine. I would try it. Are there any brands that you like that aren't? I'm worried about the abrasive effect. Yeah, I agree. Disrupting things because of the abrasive effect.

Hyperbiotics makes a great charcoal toothpaste. I think it's on my affiliate store on our website. But if it isn't, you can, it's available on Amazon. So hyperbiotics makes some great oral products. So their charcoal toothpaste is well done. I get asked all of the time about which CBD brands I recommend. And honestly, I have like two or three companies reach out every week asking to work together. But I wanted to find a brand that I really loved and could stand behind before recommending it to you guys,

which is why I am so excited to share Kyoto Botanicals with you. Kyoto Botanicals has a few incredibly important things going for them. They own and operate their hemp supply chain from seed to bottle and hand produce every bottle they sell to deliver products with unmatched consistency and quality. They believe that every single ingredient matters and should contribute to your overall health, which is why they only use USDA certified organic oils to deliver flavor with benefit. Their products only have organic single source plant extracts, not lab developed flavors and colors.

So you get whole plant benefits as nature intended. Finally, their hemp is grown according to strict organic and biodynamic standards, and they only use organic coconut MCT oil as a carrier. They have a few different products, but my favorite ones are their tinctures. The breathe one is lemon ginger flavored and it helps ease mild anxiety caused by everyday stresses, promotes a sense of calm, and it helps with digestion thanks to the ginger. The warmth one has cinnamon and turmeric to help manage inflammation caused by an active day and to help reduce exercise-induced inflammation.

Finally, the restful one is minty and it helps to promote relaxation and support healthy sleep patterns. My personal favorite way to take the tincture is to put a few drops under my tongue and let it sit for about 30 seconds before swallowing. That way, the most active compounds get straight into your body. They always have free shipping, which I love, and then you can get a whopping 25% off your order by visiting Kyoto Botanicals.com and using the code healthier together, like the name of this podcast. Again, that's K-Y-O-T-O-T-A-N-I-C-A-L-S-K-O-B-T-A-L-S-K-O-B-Tan-O-B-Tan-O-B-Tan-T-O-B-T-E-O-T-E-E-L-E-L-E-L-E-L-E-L-E-L-E-L-L-E-L-L-T-E-E-E-R-E-E-L-E-E-L-E-E-L-E-E. Is that, like, How important is it? Well, they, I mean, some dentists are, they try and be cute and they say,

it's just floss the ones you want to keep, right? You've heard that one before, I'm sure. And I think that's a little, I think it's too facetious and shaming. And there's a lot of shaming that goes on in the dental office, by the hygienist, by the dentist, by your spouse or partner, right? I mean, this is a easy thing to do. You can shame your child and scare them. I mean, a lot of kids have bad dull experiences because they go in.

already in shame because their parents have said, oh, you ate that little cookie, well, you're going to get a cavity. And then your dentist is going to drill it out and it's going to hurt. I mean, this still happens today. And it's just how we view all of this. So I think flossing has to be introduced early on to a child, even before brushing, I would say.

I mean, let me back a little bit. adults should be brushing their children's teeth up until age five to seven, depending on the child. And parents always scratch their head on that one, going, well, I stopped at age three. But flossing is something that they can play around with. And of course, they're not going to do a great job. And flossing always before brushing, of course. But flossing is important. Now, if you're a carnivore, 100%, and you're eating a lot of organ meats and you're not eating any carbs,

even cellulose, like from vegetables, maybe like our ancestors did. Maybe they had a little treat when they were in their nomadic mode and they came across a tree or a bush and they could eat something on that. But they didn't floss. They didn't brush. We've got incredible fossil history, not fossil history, but archaeological history of their jaws and their teeth. And they didn't get the oral diseases that we do. And they didn't have floss and brushing. So the answer to your question is, is if you're eating the Western modern diet or the industrialized diet, whatever you want to call it, yes, you need to floss once or twice a day.

And depending, let's say you had some goldfish crackers, knowing what I know, I don't eat them anymore, but if I were to eat something, a meal like that, I would sneak away and floss right away. Because it's like just thinking it's like carbs between your teeth. Exactly. And it just thickens up the plaque layer and the bacteria go nuts. They love it. And the wrong ones like it, the strep mutants and all these bugs that we don't want to become pathogenic, they grow in numbers. That's fun. I have the same taste as a strep mutant in terms of foods that I enjoy.

Right. Yeah. Yeah. Anyway, so I don't know if I answered your question, but I think flossing is very important. but I don't like all the shame that is associated with it. And you mentioned you should floss before brushing, of course. That was a big question that I got. Before it is better.

Yeah, before it is better. Most dental professionals agree with that. And if they don't, they just don't have an opinion on it. And I've thought about it for a long time. Flusing does open up the embrasures. These are the little corners or spaces that are created by teeth that are hopefully well aligned up against each other, that's an area that you could brush and break up, but the floss really does a better job so that when you come in with your toothpaste, hopefully it's hydroxy-apitite-based

toothpaste, there's more likelihood of the remittalization effects of the hydroxy appetite in all those little nooks and crannies. And to be frank, that's where a lot of these cavities start. So if you're not flossing before brushing, you should definitely start doing that. And if I had to choose, like if I was only going to do it once a day, is it better to do it? do it in the morning or at night. This is another thing that I really don't like people, patients getting hung up on floss whenever you feel like it. And because that just makes it easier.

I mean, ideally, maybe brush before you go to bed. But here's the thing. A lot of people are tired before bed. They're worried. They want to get to bed quickly. They just don't feel they have the time. I got into the flossing habit late, probably after dental school. actually ironically.

And the way I did it is I stashed a little flostics everywhere. And so I would have one by my desk underneath the cushion of the couch, in the car. I mean, and as you're sitting there, you're going, oh, there's a flosser right there. What do I do? Well, you pick it up. But before bed was not conducive to my lifestyle. It was difficult. I would brush.

So I think it's really, that's why I say that. Floss whenever you want to. if you, but floss, floss before you brush. And if you can do the both together, that's great. So if you're flossing after lunch, I'm okay with that. I'm not concerned. Okay. And what about water picking?

Do you like that as well as better than, is it worse than flossing? Yeah, so for a long time in my career, I was against it. I was so worried about the damage that a water pick could cause. As it turns out, it didn't happen often enough to really to worry about. And then the studies came out. They're probably already 15, 20 years old. And the studies indicate that a water flosser, water pick, is the kind of generic term now. That's actually a brand name.

It works. And if you're comfortable with that, I mean, it's one more gizmo that you have to plug in and clean and on your bathroom countertop or wherever you keep it. And it will break down. It's a pump. And it may last a year or two. And I like to keep things simple. So I like to keep things small and portable. But if you want to use.

use it at home, it's hard to travel with. I'm all for it. If you have a bridge or an implant, even better. So the water pick is a great device. And can it be used in lieu of flossing? Most of the studies say yes, but that makes me a little nervous. I just like how far the floss can get down there and the mechanical aspect, the debridement of the side of the root surface is you see shape the floss. And then you come in with the toothbrush, which for me is more of a carrier for the hydroxy appetite toothpaste. And that's the best ingredient you can in it, you can have in your toothpaste because it actually rebuilds your toothache.

So I'm still a big fan of flossing. But if the water pick works well for you, let's face it, a lot of people can't floss. It takes a lot of coordination. It's difficult. It can be difficult on the fingers. I'm a big proponent of a floss stick because that makes it easier for people. That way you don't have to put your hands,

wash your hands first because essentially when you're flossing, you're putting your hands in your mouth. So there are lots of different ways of accomplishing that. Flossing is still my favorite, but it's not for everyone. And the good news is that the studies are pretty good on the water thing. What about tongue scraping? Tongue scraping is important. And again, I didn't get this in my dental education. We spoke a lot about the tongue, but not about tongue scraping.

So if you're suffering from bad breath, if you want a healthier oral microbiome, if you're getting a lot of cavities, that could all be from the lack of treating your tongue. It's that important in the oral hygiene regimen. So tongue scraping is huge. I highly recommend you do it. The cons on that are that a lot of people gag. The good news there is that you can retrain that.

It's something you may want to do anyway, so that when you're at the dentist, you have less fear and anxiety at the dentist. You can work your way out of that gag reflex slowly by moving the tongue scraper further back, by fixing mouth breathing issues if you have that. But tongue scraping is one of my favorite things to do, and you feel really good afterwards.

And once you see what comes off of your tongue with a tongue scraper... Or smell what takes comes off of your tongue. Absolutely. Yeah. I mean, I try and motivate people in many different ways. And one of my favorite ways, especially with kids, is I had them scrape their tongue in the office, and then I put what comes off the tongue scraper on a golf, And then I put it into a little Ziploc and I have them take it home.

Oh, God. And then I have them open it up with the parent present because it could be a biohazard, who knows, and then just have them smell it. And that's because that's a wonderful way to motivate some of these kids. But tongue scraping is wonderful. You may bleed a little bit in the beginning. Don't be alarmed by that. Use whatever you feel comfortable with.

But definitely don't use the tooth-fresh to tongue scrape. That doesn't work. it doesn't scrape, it brushes. There's a lot of stuff that collects on the tongue, and that is one of the micro niches of the oral microbiome. And if it's awry and it's feeding a dysbiotic kind of population of bacteria to the rest of the mouth, then all the flossing and brushing in the world is not going to help you.

So you do have to do that. I'm not going to say daily, but I would start out daily. And after a while, I gauge it by scraping the tongue. You can feel the difference. And when you feel that little difference, you start scraping. And if nothing comes off the tongue scraper, I'll wait a few days. But initially, you're going to scrape your tongue for about five to ten minutes until that kind of beige, yellowish fluid turns clear or the blood goes away.

That's how long it's going to take to clean your tongue properly. And it may be a little uncomfortable in the beginning. Not painful, just uncomfortable. And of course, the gag reflex is very uncomfortable. So that could be a deterrent. So definitely, it's great. And for people who are listening to it, like, what is tongue scrapy? It's literally, you can just Google a tongue scraper.

They're under $10. It's usually just like a curved piece of metal. There's also plastic ones that are kind of like Y with a line across it shaped. Yep, exactly. And it's just like a manual handheld thing. You just run across your tongue exactly like it sounds. And it pulls. It sounds like all the bad bacteria off of your tongue.

Is that it in a nutshell? Exactly. And it's that simple. And, you know, I have videos on YouTube on how to do it. We've got an explanation of why you should tongue scrape. We've got an affiliate store with recommended products. These are inexpensive products that could literally last a lifetime. You will not be throwing these things away into the dump.

You'll be using them for the rest of your life. And I think here's the best part about tongue scraping. It makes you feel better about yourself. I mean, I'm not talking about physically. Obviously, there'll be some physical efficacy there, you know, for the oral microbiome, which has systemic, but your breath smells better. You taste foods better or the foods taste better to you. You have more of a sense of taste.

Your smell may be better. And you just have a, you're just a little happier. Seriously. Tongue scrape and see how you feel that day, maybe the day after. And you will feel better. Your self-confidence will go up a few notches. I guarantee it. So can you put this like all into like ideal.

mental health routine for me? Are we, we're waking up, are we tongue scraping and then flossing and then brushing and then oil pulling if we want to oil pull? I mouth tape at night, so I don't wake up with the dry mouth. As I said before, if I had a cold or some allergies, or if I had a lot of alcohol the night before, I was out with dinner with friends, that will dry at your mouth. So I will oil pull that morning, and I will do that first thing. So oil pulling and flossing are similar. Flossing is better at exposing all those little nooks and crannies that you want the hydroxy appetite to get to, which is what's in your toothpaste. So oil pulling first, flossing in the morning, perhaps if you had a very dry mouth, and then

using your toothpaste. And this can be before or after breakfast. I'm not a stickler on either, although I used to say after breakfast, but everyone's rushing to work or to school after breakfast. And I think there are some advantages to brushing before breakfast. When I worked as a magazine editor, I wrote more than a thousand articles about turmeric because pretty much all of the doctors that I used as sources kept recommending it or citing it is one of the supplements

that they would personally take. Here's the background. Turmeric is one of the most powerful ways to fight inflammation. In a nutshell, there are two types of inflammation. acute and chronic. Acute inflammation can actually be a good thing. It's one of the ways that your body heals and repairs itself. But when that system goes haywire, we get chronic inflammation, which essentially makes your body feel like it's constantly under attack. The vast majority of doctors I work with cite chronic inflammation is one of the root causes of so many of our modern

ailments. And research links inflammation with heart disease, diabetes, autoimmune conditions, cancer, arthritis, and gut issues like Crohn's and ulcerative colitis. I am never going to sit around and tell you that a supplement will cure everything that ails you, but if you're looking for a turmeric supplement to help get your inflammation under control, I am extremely impressed with paleovales. To increase the bioavailability of turmeric, you need to consume it with black pepper, which most people know, and fat, which many people forget about. Paleo Valley's turmeric complex has black pepper and coconut oil to maximize absorption,

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Vitamin C is my ultimate favorite supplement for skin health and a neuro-effect mushroom powder that Zach loves for increasing energy and focus. So definitely explore their website. If you'd like to check out the turmeric complex, the vitamin C, the neuro effect, or any of Paleo Valley's other amazing products, head over to paleo valley.com and use the code Liz M for 15% off. That's paleovalley.com and code Liz M for 15% off your order. And if you have any questions, feel free to hit me up on Instagram.

I love chatting about this stuff. Now let's get back to the episode. What about the like, I've heard that you build up all this bacteria in your mouth overnight and then if you just go and drink a bunch of water or have your breakfast, you're essentially flushing that all into your gut and that you want to do all your oral health stuff before you consume anything in the morning. Is that not true? You can. For example, the E. Pylori, that bug can build up at night, especially if you're mouth breathing. And then that would mean, remember, you're swallowing hundreds,

hundred trillion bugs a day and in all that saliva that you're producing, a liter, a liter and a half of saliva. So in the morning, yes, if you have a meal, a lot of that stuff that formed overnight is going down the hatch to your gut microbiome. Absolutely. But it's also something I didn't get into, but glossing and brushing and trying to get your biome in good shape before you eat, that helps digestion. A lot of these bugs are there to help digest certain foods, for example. So I'm a big fan, but after getting to know the oral microbiome, and it makes sense to brush before breakfast. Okay. Can we talk about gut health and the like microbiome and how that impacts oral health and the oral

microbiome? Like, I just want to kind of get into it from both directions because I know that our oral health can trickle down to our gut in the ways that you said, but also our gut health, like when a lot of people who struggle with halitosis, often that starts in the gut, doesn't it? Yes, it can. You're right. It is bidirectional. The oral microbiome is connected to the gut microbiome. Remember, the oral microbiome is second in size and importance, I think. Well, certainly in size, but importance, I think, to the gut microbiome, because it is seeding the gut microbiome.

And we all know how important the gut microbiome is, hopefully. Thank goodness, that is an amazing discovery. And I think we're learning a lot more about our bodies. And these are bugs, bacteria, viruses, protozoa actually that that exists in our body. There are more of them than there are of ourselves. And so we are a combination of these two entities or organisms and the combination of the two forms a superorganism. That's how I see myself. So if I don't take care of my oral and gut microbiome, I'm going to be running on empty. I'm a dysbiotic and a dysfunctional organism because I've ignored this other organism in me that is actually there for a purpose. I mean, these bacteria produce vitamins and enzymes, nutrients, nitric oxide, all these products

that helps in digestion. And it's a big part, probably bigger than we've thought, bigger than our actual immune system in our blood. It's part of the immune system. It's protecting us from the outside environment. And all these years, we've been just knocking down the oral microbiome, the disinfectant. and chemicals and pesticides, and it's amazing how much we've gotten wrong for so many years. So there's that connection.

Now, the other connection that you were referring to is, you know, if the gut microbiome is off, you know, it's the chicken or egg kind of thing, right? If the gut microbiome off was that the oral microbiome that did it and, you know, there is that connection. So there's also the vagal connection. But I think what you asked and what I'm trying to say, is that it's interconnected beyond what we even know. It's just like meshed all together.

And it's sending feedback back and forth in their feedback loops and it could be hormonal, it could be neural. It's beyond that with the gut microbiome, of course. You know, there's that feeling that people have. There's something to be said for that. It's all connected. And the pathways are not just bi-directional.

It's probably a radial, circular, three-dimensional kind of thing. And we don't understand. understand it all. I mean, we really, we're just kind of on the cusp of all this right now. And the more we know about it, I think the better off we will be. But at least we now know to how and why we should take care of our biomes. And the oral microbiome is a big player. Does that make you want to do, like, I'm curious about your thoughts on probiotics internally, like for your gut. And if that would impact your oral microbiome in a positive way and also your

thoughts on there's a whole new spate of products coming out that's actually probiotics designed for your mouth? Yes. That's a huge market. You're going to be seeing a lot more of that. There's the probiotics and the prebiotics. I'm a big fan of prebiotics. I rinse and swish with prebiotics before breakfast because I think my biome is doing fine and I

don't need to add more bugs. And I think if you have a dysbiosis and you're adding a lot of bugs, because you haven't really fixed the root cause of your dysbiosis. adding the bugs is going to be a waste of time and money. Okay. So I think adding bugs and giving them the food, giving your your biome, whether it's your gut microbiome or your oral microbiome, giving them the food so that that biome can survive and sustainably on its own.

I think in many ways, if I was on a desert island and I was given a choice of pro and pre, I'd ask for the pre. Of course, it's probably hanging from the trees on the island, right? I'm in the pre, right? But I don't want to dis probiotics. I'm just saying that a lot of people and a lot of companies are big on the probiotics, and you're just adding a lot of potentially good bacteria to a really bad environment. That's just going to continue being bad because those bacteria, once they join,

once they come into the neighborhood, they're beat up and killed or pushed out. I mean, so I'm a big fan of prebiotics. And I think whatever prebiotics you're taking for your gut, you could potentially swish with. So like literally when you say that, are you taking like ground flax, you know, like that type of thing that people would use for like cillium and you're swishing that around your mouth? I don't think that's digestible enough at that point. I think your stomach has to break that stuff down. I use a product from pure encapsulations. They don't make it.

They sub it out because they know better because they have a, they do a lot of research and they, it's a patented product from Germany and it's a combination of, it's a very fine powder. It dissolves readily in water. It's a combination of aligosaccharides, blueberry, cranberry, pomegranate,

and a lot of other little prebiotics that are easily digestible. So the minute it hits the gut, it's already being taken up by the bacteria. I mean, they can consume it right away. That I swish with. I don't have any data on that working, but there's a lot of supporting

kind of ideas that would indicate that that's something that doesn't hurt and could help. All right. you would do that. Like, we haven't, we've kind of alluded to mouthwash, but in general, most mouthwashes one would buy would be decimating your oral microbiome, even if they're essential oils, right, as we discussed.

Exactly. I don't use mouthwash. Mouthwash is just, it's just a quick band-aid with a little essential oil in it. It gives you kind of a minty, fresh breath for 10 minutes, and then, you know, it all comes back. In fact, most of these mouthwashes, there's a study out there that it supports the notion that it actually elevates your blood pressure because it's knocking down the nitric oxide that your mouth is trying to make. That's a gas that is made by the bacteria in your mouth. So it's amazing what mouthwash does and doesn't do. And most of it, all of it's bad. Don't waste your time with

mouthwash. But you're right. I mean, rinsing with a prebiotic or oil pulling is kind of my mouthwash. That would be something I would recommend. What about other stuff for bad breath? Like, oil pulling or not oil point, tongue scraping seems like your number one for bad breath. Yes. Definitely. Yes. Is there anything else you would try if somebody has bad breath or would you just be like, go tongue scrape and come back and talk to me if you have an issue later because I'd be very surprised?

Well, you mentioned earlier that there are some forms of halitosis or bad breath that come from the gut. But if it was conventional halitosis that was occurring because of film, biofilms in the mouth, this is what I recommend to my patients. I would, first thing, I would make sure you mouth tape. every night. The minute your mouth falls open at night, even if you can nose breathe, your mouth will fall open at night. Not sure why, but it does. It could be the way we sleep in our beds. It could be pillows. I don't know. But that's going to dry at your mouth. It's going to start changing your oral microbiome. Just a few minutes of that will do it. And if your mouth

is open for a few hours at night, you're going to have that morning breath. It could be anything from just slight morning breath to really bad, bad breath. So start with mouth taping. Then when you wake up in the morning, tongue scrape, floss, and brush, and after you've brushed, or you don't need to absolutely brush, it could just be flossing and tongue scraping. If you didn't have time, you could skip the brushing. I would rinse with and keep it in your mouth, swish with it, a prebiotic. I think that's going to help reset the oral microbiome.

But you want to do that after you've thinned the bile film, which thickened in the middle of the night, especially if you were mouth breathing. So short answer, mouth taping, tongue scraping, maybe the prebiotic rinse. That would be my full-on attack on bad breath. And within six weeks, you should have an idea whether that works or not. What about gum, especially like the xylitol gums that are saying they're making your teeth

healthier as you chew them. Is that true? Yeah, so xylitol is an interesting wood sugar. I mean, it's been around for a while. I prefer the natural form of xylitol. It's made from, I think, Birch or something. But they have a synthetic version, which is just, it's completely synthetic. And that worries me a little bit.

So if you're using the right form of xylitol, xalitol actually is very selective and discriminant. And we always want something that is very, if we're going to go after a bug in the mouth, and xolitol does, it inhibits by not killing the same, by affecting its stickiness. In other words, how it's able to stick to teeth. It inhibits the adhesive ability of the strep mutant bug,

which is the big cavity book, S mutants. Oh, I mean, that's the first thing in Italian dental school. That's the big villain. And so if you can affect the stickiness of that bug and not affect any of the other bugs, I'm all for xolitol. I mean, that's going to suppress xolitol in a very kind of selective, targeted way without really killing the bug,

but just by making it less sticky. I think that's wonderful. Okay, so if we find, are there gums that you would like or recommend? I had a gum chewer, and I'm worried about people chewing too much. It's pretty hard on the muscle domestication, the jaw joint.

Most of the gum churers, I know, chew all day long, and that worries me a little bit. If you wanted to chew a gum after meal, was xolitol in it, I highly recommend it. I don't know of any good natural brands. Okay.

It's hard to say. I may have one on my affiliate store. I don't know. But I think I do. But make sure if you do chew gum for 10 minutes after a meal, the solitol is great. Make sure it's the natural version, not the synthetic version. What, in your opinion, is the best way to repair teeth enamel

or to remineralize its teeth? Hydroxyapitite and the proper diet and preventing a dry mouth. Those three things are very important. It's really about the oral microbiome. You have to work on your oral microbiome. You have to feed it the right foods. You have to monitor it. You have to find a dentist that can help you do that.

If your oral microbiome is off, you are going to be getting cavities almost every time you're going to see a dentist. Your kids will. That's the only way you can do this. You can remineralize a tooth, but you can't remineralize a tooth in a dysbiotic environment. So if you haven't addressed the, it's not a miracle cure. But if you have a small cavity and you fix the dysbiosis, your oral microbiome is at its optimal best. You're not drying out your mouth at night, able to breathe your nose, the nitroxide levels are high, everything's tuned up just fine, then that small cavity can be reversed by applying on a contact basis, brushing with hydroxyapotite. The tooth is dynamic.

It's like bone. It has the ability to fix itself and remineralize, just as it has the ability to de-mineralize. So you can reverse that. If the cavity is too deep, then there is a point of no return. And that's when you need a good dentist. That's where a well-trained clinician, which most of us are in the U.S., I mean, they can work wonders. They can make your tooth look fantastic.

Are there supplements? I've read online that, like, cod liver oil, and vitamin D are incredible for cavities. Are there any supplements that you would recommend for teeth health and oral microbiome health? Codilib oil. My grandchildren get codlover oil every day, very high in K2. Calcium, I don't think you need to add to anyone's diet. In fact, it can be problematic, especially a lot of women, postmenopausal women that are taking

calcium and not K2 or vitamin D. That calcium is just running amok inside their system and ending up on the linings of their blood vessels on the walls that are blood vessels. You can get a lot of K2 from your diet. I think it's pretty much impossible to get enough D3 depending on where you live. So we definitely, the important triad there is vitamin A, D3, and K2. That's going to give you optimal bone health and it's going to allow you to mobilize calcium that you get from your diet in a very efficacious way. I mean, it's going to be put down in all the right places. And that includes your teeth and the jawbone. A lot of people in the wellness world drink apple cider vinegar or

lemon in water. Is that going to cause long-term damage to the teeth? And if so, is there any way, like, can we just do that and rinse with water afterwards to mitigate it? I think you're talking about my wife every morning. I see that. And I cringe a little bit. Though the answer is, yes, you can do that. But you have to be very careful. For example, you don't want to brush right afterwards. You want to rinse with water. I would, and she does this very well. She takes a little swish of Pellegrino and keeps it her mouth and swishes with it for a minute or two. And that right away, so she gulves it down, gets it down very quickly. If you can bypass the teeth, which is nearly impossible, but don't swish with that. Of course. Don't brush afterwards. Keep the

water in there. Neutralize the acid. That should be fine. I'm not worried about that. It's a great health habit. It does help liver health and does aid. And if you want to lose weight, that's a great way to go. And then she has her coffee afterwards and it doesn't affect the taste of the coffee. So I'm all for it. I think it's great. But a lot of people will brush afterwards. After you vomit, for example, you never want to brush. You want to put water in your mouth right away and neutralize the pH. It's a low pH. You want to bring it back up to about a seven. And water does that almost instantly. wishing with water after any health habit like that is perfectly okay. As long as you don't brush within a half hour of having, for that matter, having had your coffee or your apple cider

or vinegar rins. Can you brush before like a half, like if I wake up, brush do my whole oral routine, can I do lebed water within a half an hour after that or no? Well, I would, the most important thing, if you were to do one thing, would be the water right after the apple cider vinegar vinegar rinse. You've got to neutralize that pH right away. And it can do a lot of damage. I mean, it can literally make your teeth sensitive. It won't harm your gums. Oral microbiome, I think, is okay. But it can dissolve enamel and deaden. Okay. So the water right after is the most important thing. What about sparkling water? I've heard that sparkling water can be really damaging to teeth. Is that a myth or is that true? I think it's generally it's a myth. The minerals in mineral water,

I think are excellent. I think on the whole, I mean, look what the Europeans do. When they drink their wine, they're always sipping on mineral water. When they have their coffee, they always have a mineral water there. That water typically will be a pH of seven or higher, unless it's an artificially carbonated water, which will be more acidic. And that neutralizes the effects of the meal,

the acid attacks from eating bread or having coffee or drinking wine, drinking wine. That's a low pH. That's an acidic pH. So I think drinking carbonated water is brilliant. I think it's great. Do you get enough minerals from ingesting carbonated water? Probably not, but it's a start.

And if you like the taste of it, I think it's great. And so that only references, though, like actual mineral water, not like LaCroy. Yes, exactly. There are flavored mineral waters. They sweeten it. And Pellegrino, I know, has a, they add, you know, orange juice, you know, to their mineral water. And yeah, so that, it's just mineral water. Okay. So if you want sparkling beverages, you would recommend mineral water versus consuming like a

La Croix type beverage. Absolutely. But I would make sure that your pH is at least seven or higher. And the pH on these things will vary. You'll see. It's surprising. So you just literally like go get those little like fish tank tests and test your water at home. You can. You can also get a pH tester. They're a little bit more expensive. They're more accurate. But I would get a, you can get pH paper, get it in its narrower range, the overall range because it tends to be more accurate and get the acidic version. So if there's an acid there, it will show up. Perrier water is quite acidic. It's amazing.

All right. As opposed to Pellegrino. And there are other versions. There's the German one. I forget what it's called, the white label. I mean, it's amazing how the pH will vary on these water. So if you drink a lot of mineral water, which I would recommend, make sure you know the pH of that water and stick with it.

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I write about this in my book. A, the first chapter is, why would you want to listen or read what a dentist has to say about sleep? And then we get right into, you know, what are the early science? We have a lot of lists. My daughter and I wrote this book because after I, my wife and I discovered that we had sleep apnea, we were just so shocked as to how much misinformation there was, even among medical professionals. She has a nursing background. I have a health background.

And even we could navigate kind of the process of getting help. So snoring, I think, is the big one. Snoring is not cute, it's not funny. Even if your kid does it, grandpa does it. It doesn't matter what age and when, if it's infrequent or constant, snoring needs to be addressed.

What that tells me, what that should tell you is that your airway is able to collapse and narrow and even close up completely. What does that do? That wakes you up. Obviously, your body won't let you stop breathing or it won't let you suffocate slowly.

So snoring is the big one. There are other things. There are a lot of unique things that your dentist can see that your physician can. In fact, I always argue that a dentist can recognize sleep apnea decades before a physician came. No offense to the physician. They're just not trained in that area. There are some oral signs and symptoms, which I'll go through, that are very clear to a dentist. And could be clear to a patient as well.

So if you have a scalloped tongue, if you're mouth breathing, if you have a very dry mouth, if you're getting a lot of cavities. You can't take your tongue and push it up and pressurize the top of your palate with your mouth open. These are little things that if you read about or if you, you know, I have long checklists in my book that will alert you to the fact that you may have sleep apnea. But snoring, I think, is the big one.

But certainly if you don't think that being tired during the day or wanting to nap is a normal thing, I used to think that was normal. I thought it was a process of aging. When I fixed my sleep apnea, I don't nap anymore. I don't yawn anymore. It would be a very, in fact, when I yawn, I make a note of it. It's like, wow, that's unusual, where I used to yawn every day.

So there are a lot of little things that we take for granted that we think are normal, like getting up in the middle of night and going to the bathroom. That's not normal. That's not an aging bladder. That's probably related to a lot of apneas that are creating a lot of pressure, getting past the apnea's in your chest. which has an effect on your blood volume, which makes you want to dump blood volume,

which fills up your bladder quickly, more quickly. Wow. So it's hard to say, I mean, because I'm in the realm of sleep. I'm a sleep dentist, and it's hard for me to go back to where I was as a layperson when it came to sleep. But I think snoring was the one thing that I ignored too long. My dad snored, my mom snored, I snored.

My kids told me I snored. my wife snored. She told me I snored. I told her she snored. Well, we did that for like 10, 15 years. I mean, that was stupid. It was foolish. So I think snoring would be my best answer to that.

But there are a lot of other things, you know, craving carbs. When you have a bite of like a croissant or a cookie and you feel like you need another one or you just craved it to begin with and you just can't get rid of that craving, to me, that was sleep apnea. neck pain. I thought it was an occupational hazard being a dentist. I got rid of my neck pain. After I tried all the Pilates and physical therapy in the world, I got rid of it by fixing my sleep.

I was lifting my head off the pillow nightly to open my airway. I got rid of my neck pain. So there are a lot of signs and symptoms of grinding is a big one. If your dentist tells you're a grinder and you're breaking your teeth and you're getting a lot of crowns and your teeth all look very serrated and flat, then that's a good sign that perhaps your airway is collapsing. There's a connection between grinding, bruxing. We now call it sleep bruxism.

We've differentiated between daytime grinding and nighttime grinding. So we've given them different terms. There's sleep bruxism and there's daytime bruxism. You can be grinding during the day because you're stressed. But at night, that grinding is probably you're trying to manage your airway in some way by grinding. It happens. The bruxism event occurs right as the apnea is ending. is it the grinding that is repositioning the highwood bone or activating the muscles of the airway

via the muscles of chewing and clenching and grinding we don't know but it's enough to know that those two are are connected so if you're a grinder you have TMJ scallop tongue mouth breathing dry mouth i mean all of these things snoring of course is the big one there's a lot of stuff out there that should indicate to you that you have a sleep issue But it should be your dentist or your physician that catches this early, as early as possible. Okay, so let's say I'm listening and I'm like, check, check, check, check. I have so many of those. Where do I start?

Especially if I don't have necessarily access to a physician or dentist who's paying attention to these things. I've literally never once in my life had a dentist mention airway issues. I would get online. I would read books on it. I would buy an app. get an app on your phone for snoring. I would buy an aura ring, for example. That's my favorite device for sleep.

It's a $300 investment. Well worth the investment. I would start measuring my sleep, even before I spoke to a physician. And these devices and the snoring apps and quizzing your sleep partner, asking them, what do I do in the middle of night? Am I tossing and turning? Am I snoring? Am I making noises?

How often do I get up in the middle of night to go to the bathroom? That you should know already. But some people don't recall that, which is amazing. And just be fair to yourself, be honest with yourself, and just admit that this is me. That's the first step. The second step is convincing your dentist or your physician, which may be difficult to do. But if you come in, like with my book or a checklist and a test that is available online called the Epworth test, that's a questionnaire.

if you fail that, if you get a 10 or higher on that, as you answer the questions, these are all things that will force your physician to initiate the next step. And the next step, and this is the big one, the PSG, the attended sleep study. That's what you want. You want a qualified analysis of your sleep, and you want to know how many apnea's, how many times you wake up, how many interruptions, to what degree do you have sleep apnea? And why? Do you have central apnea's?

that's a neurological form of amnius. You want to figure all that out. So it's all about getting that PSG, the attended sleep study. There's a lot of pressure on the insurance companies and the physicians not to prescribe that, as well to prescribe something lesser, and that is a home study, and those typically under report, according to the studies. So get a PSG. Even if you, personally, I think everyone should be tested every five years for sleep.

It would save us so much money in the long. in the long run. And I think eventually we'll get there. There are some countries that do that, by the way. I think parts of Italy and Iceland, they're testing at an early age, and they test everyone that comes in to see the doctor. So what do they do if you get the sleep test? Like, I'm sure if I had a sleep test, it would be like, you're waking up. You're like, I got in a surfing accident years ago and I can't breathe in my nose very well. So I'm sure they would be like you're not, you're not breathing well. What would they do to fix it? It's complicated. It's a very, you really need a good dentist, you need a good E&T, a sleep MD specialist.

You may need a neurologist. You really need a good team. And unfortunately, not a lot of teams exist under one roof. It's the patient, what I see, or one of the providers building that team for the patient. So you really have to put all that together. So, for example, for you, with the surfing accident, you probably broke your nose. nose, I would refer you to an E&T. And they would do a nasal endoscopy.

They would do a modified Mueller's maneuver. And they would look at how much of that blocked or that lack of nasal patency, the ability to breathe your nose is contributing to any sleep issues. I would also refer you to a physician. This would be a physician that knows me well and knows that I'm batting a thousand on picking out who has sleep happening, who doesn't. because they get in some organized medical clinics, managed health care clinics, they get penalized for, you know, prescribing the sleep study, which is a $3,000 to $4,000 test at a sleep clinic.

They get penalized for prescribing too many of those. It's unbelievable, but that does happen. I have proof of that. And so that they're wary of doing that. So if you're thin and you look healthy and you're not complaining on any, you don't know what to complain about. In the words, I'm napping, going to the bathroom the middle of night. I do feel tired, but you think that's normal. That patient will not get screened.

They will not get the sleep study. And you're already developing the early signs of heart disease, Alzheimer's, metabolic syndrome, oral issues. I mean, that's all beginning in your 20s and 30s. and you're eating improperly because you have these urges to eat foods that give you energy. So it's important to get screened early, and it's all about getting that PSG. I wish there was some way. And the medical world has improved on this. There are organizations out there that are promoting the collaboration between dentists and physicians working together.

We provide one of the modalities of therapy, that's the oral appliance, which holds, prevents the jaw from falling back and you go into deep sleep or pushing it forwards. The E&T is, of course, we do nasal surgery, turbinates. There are oral maxillofacial surgeons and positions that will do jaw surgery. So there are all sorts of methods of fixing this. You can also get a machine that pushes air into you. It's a mask that you have to wear at night. It's not very popular.

But in some cases, works wonders. And that can breathe for you as well. So it's a multifactorial. This is why most people don't get good care when it comes to sleep because the professions are all kind of, you know, not confused, but not well coordinated, not organized all under one roof. And, you know, in dentistry, it's really not taught that in dental school and medicine. They harp on it. But it really is very confusing for the patient.

And again, that's back to the book. That's why I wrote the book, just to try and consolidate all this and tell the patient, what to expect, what to look for, and how to know whether they need to get all this work done. So it is still a very confusing landscape for the patient and even for some of the providers. Are there low-hanging fruits for these sleep issues? Like you mentioned that you got a different pillow and that helped. And I know that you're a huge proponent of mouth taping. So just, I think in an ideal world, everybody would sort of follow the three-step plan that you just mapped out.

but a lot of people don't have access, means, resources. They live in parts of the country where that's not available to them, et cetera. And so I'd love to just give people a few actionable things they could do at home. So I'm very wary of all the sleep hygiene kind of discussions, pillow, dark room, air filter, you know, sheets that will cool, cool your bed, open windows, sleep in a separate room from your snoring sleep partner. I mean, those are all important things. But spoken of in an isolated way, you could be missing some big items like a collapsing airway. And all the sleep hygiene in the world will not correct that.

And you could be, I see people, patients, friends, family working for years, even decades on these items when they really have a bigger issue, that if they fix that, the sleep hygiene wouldn't be as necessary. But to answer your question, to give people one action item that they could do living anywhere in the country, I would order something like the aura ring. I have no affiliation with them at all. I've never spoken with them, but I love their products. And I've consulted, well, I've had a lot of patients by the ring. So I'm very familiar with the feedback that the ring is giving. And these are patients that I have ordered sleep tests for. and so I know their PSG.

So I'm comparing the gold standard to their aura ring results, and it's pretty close. So for $300 for the next five, 10 years before the battery runs out, perhaps, you're going to get a great, honest kind of view of your sleep. And then based on that information, you can take some steps. So I'm not going to get in. I just don't want to talk about sheets and where to sleep. Well, I'm curious about mouth taping.

Like, that's a thing that you talk about a lot. Yes. That is designed to help with sleep airway issues, yeah? And it does, but it's not a cure for sleep apnea. So if you have full-on collapse of the airway, mouth taping will not help. Mouth taping will help a borderline patient. It will help the patient that potentially could breathe through their nose, but hasn't done so for a long time.

It reactivates the nose. If you stop using your nose, you lose the function. you lose smell, the tissue becomes more inflamed, the cilia that are moving in there and whisking mucus back and forth inward and downwards. All of that stops and that just means you're going to get more colds, more of a histamintic response when you have an allergy, and that just makes the airway through the nose that much smaller, which in turn will affect your sleep. Your breathing rate, your respiratory rate will go up if you're breathing through your mouth, and that affects your sleep. The or a ring, by the way, measures all of this. So yes, mouth taping, I mean,

it started out for me as a diagnostic. I would recommend patients. I would show them how to mouth tape. I would have them go home. I'd want to see them a week later, or I would call them, talk to him, text him, whatever. And I would say, what did the mouth tape do? And if the mouth tape improved their sleep, well, that told me a lot, that they could breathe through their nose. If the mouth tape failed, then I know that they could not breathe through their nose. So for me, it was a diagnostic, a very easy and expensive diagnostic, and patients liked it. But after that, for a lot of people, it became a big help to their sleep. It does help. It can make you sleep better if you're a borderline patient when it comes to it. But if you're always collapsing and you have

full-in-sleep apnea, breathing through your nose during the day and at night will help, but it doesn't fix the collapsing airway. You all know that I love smoothies. I could talk about them for days. I share smoothie recipes pretty much every week on my Instagram, and one of the things you all ask me about all the time is protein powder. Specifically, what do you do if you hate the taste of protein powder? And look, I get it. The vast majority of protein powders taste nasty. I only have three or four proteins that I reach for regularly, and one of my favorites is

Garden of Life grass-fed collagen. One serving of collagen has 18 grams of protein, which, when added to my green smoothies with some healthy fat like avocado, is critical in keeping me full through leaven. lunchtime. Bones can accumulate all sorts of heavy metals and toxins, which is why the most important thing with collagen is to buy it from a really high quality source. Garden of Life has been the only collagen that I've trusted for years. I don't want to throw any other brands under the bus, but the stories I've heard from in the industry about where their cows come from are pretty terrible. And some brands don't even know. Not Garden of Life. In addition to regularly testing for

heavy metals and all of the other bad stuff, they actually source their collagen from cattle herds that are much smaller and more traceable. While you can't really buy organic collagen, Garden of Life is the closest that I've found. The cows are raised to strict standards and aren't fed grass that contains any form of herbicides, pesticides, or glyphosate. Beyond all of that, it is one of the most affordable collagens on the market with a much more reasonable price point than other leading brands, which is important to me since I use it in my smoothies a number of times a week. Because it's flavorless and dissolves so well, you can mix it into pretty much anything, from tea to overnight oats, to my cookie dough bites. It's just like a magical little powder that you

can use to amp up the protein of pretty much anything. And yes, studies do show that it can help with joint health, hair, skin, and nails, which is great. My nails truly grow obnoxiously fast now, but the main reason that I love it is that it's a one-ingredient protein powder, which I feel like people don't appreciate enough. You can find Garden of Life grass-fed collagen at Whole Foods or on Amazon, but the best way to support this podcast is to click the link in the show notes. It won't cost you anything extra, but it helps let Garden of Life know how you found them, and I massively appreciate it. If you have any questions about protein or collagen or Garden of Life, hit me up on Instagram. I am always happy to chat. All right, let's get back into

the episode. So for those borderline patients, or people without sleep apnea. Can you just talk about mouth taping for a little bit? Like, what are you doing? What is it helping with? Why would we stop breathing through our nose at some point in our lives? Like, should everybody be mouth taping pretty universally, et cetera? Well, to answer that question, I would say everyone should mouth tape just to see if they can do it. I mean, it's a great way for a patient to know whether they can do that. I mean, can you get enough oxygen? I mean, I know people that are on a stair machine and they've mouth taped and they're just doing a slow walk and they're able to get all the air they need through their nose. And that's a

great sign. A lot of people, the minute they start exercising their mouth is open. But I would say everyone should try mouth taping while sleeping. And it may be difficult in the beginning. You may have to get your heart rate down. We may have to meditate a little bit. But by breathing through your nose, you are changing your blood chemistry. You're changing the pH with your chemistry. You're changing what the base of the brain sees in terms of what it needs to see that determines your respiratory rate, whether it's a slow respiratory rate or a sped-up respiratory rate. CO2 is an important chemical. We're told that in dental school, and I think in medical school, too, that it is a toxin, that CO2 is bad. I mean, carbon dioxide is the chief hormone of the entire body. It's produced by every tissue

and it acts on almost every organ. Carbon dioxide is, it's a fundamental component of living matter, even more so than oxygen, but we're always told that oxygen is important. So it's really about the oxygen and the O2 mix. You're not going to get the right O2 oxygen and CO2 mix if you're breathing through your mouth. It's just not going to happen. It's going to make you excitable. It's going to raise your sympathetic tone.

It's going to thicken your saliva. It's going to alter your biofilms. in your mouth. I mean, it has a huge effect. So I would, yeah, mouth taping for sure. Everyone should try it and make sure that they can do it. I would sleep for a month with mouth tape and make sure it doesn't affect your sleep.

If it does affect your sleep and your tape is still on, that means you're able to breathe your nose, but you're not getting enough air. You're not able to do it well. And then I would go see an ENT. If you can mouth tape and your sleep is the same or better, I mean, if it's unaffected, then you're probably okay. If you wake up with the dry mouth in the morning, that's not normal.

Your mouth should be moist in the morning. That means your mouth was open at night. It may have just fallen open or you can't breathe through your nose at night. So it falls open. And the reason your mouth gets drier in the morning than it does during the day, A, you're drinking during the day, you're sucking on a mint or chewing gum, and also your saliva flow is decreased at night. That's part of sleep.

That's the difference between your parasympathetics pick in. And so saliva, the saliva glands are not turned off, but they are shut down to a degree. So if your mouth is open and you're breathing, you're going to wake up with a really dry mouth. Okay. So for somebody like you, you've obviously like dealt with and fixed all your sleep issues. You still sleep with mouth tape every night. I read like some orthodontists you had on your site said that even if she takes, takes that for like a half an hour, she always mouth tapes.

No, I do. My wife and I mouth tape every single night. It has become such a habit. And what I'm worried about is that even though I can nose breathe, I've never had to head surgery or turbinate surgery. I've always been able to do that well, thank goodness. My wife did have to have some surgery for that, but we still mouth tape, even though we can nose breathe, because inevitably my mouth will fall open at some point in time. And during that period of time, and I've tested this, my breathing rate goes up. I don't want my respiratory rate to go up, which means my heart rate goes up. I don't want that to happen at night.

I also don't want to get cavities. And that's another reason I'm mouth tape every night. I do not want to get cavities. I don't want to get gum disease. I am protecting my oral microbiome by preventing that pH change at night. And as I get older, it's going to get tougher because we produce less saliva as we get older. So just to, and just to clarify to anybody listening, mouth tape is, like super simple. It's literally just the act of taking a small piece. I just bought

surgical tape at CVS and I take a small piece and I tape my upper lip to my lower lip and that's the whole thing. Is that what you do or do you get the like pre-purchased mouth tape things? So I buy the pre-purchased mouth tape because it's, I have some facial hair and it's kind of a gummy stickiness where if you rub it in, it holds well. But the minute I open my mouth, even if I were asleep, it comes off in case, just to allay any fear. They make mouth tape for children, which I love. It's called myotape. You can get it on Amazon.

That's M-Y-O, myotape. And it's like a girdle. It just, it girdles the lips and keeps them closed, but it doesn't cover the airway. They have that for adults as well. Some adults need that. By the way, if I seen adults, a patient, and I mention mouth-taping to them, and they kind of give me this panicked look, I know right away,

and they do instinctually that there's no way they're going to put tape over their mouth. They're the ones that are gagging at the dental visit. They can't breathe through their nose. So if I'm working in their primary airway with water and spit and everything and rubber dams and all that, and that's the only airway they have to breathe,

those are the gaggers. Those are the people that are phobic at the dentist. So if you're afraid of the dentist, definitely look at your ability to breathe, through your nose and see if that's where it's coming from. That's where a lot of gagging comes from. We talked about that earlier. So, yeah, mouth taping can be a game changer, and it's easy to do.

It's inexpensive. They make tape, just designed for mouth tape. I would stick with those. Somna Fix is a great brand. It looks like the shape like the lip. It has a little vent in it. But for children, I do recommend mouth taping for children because they're developing and growing.

And if they grow up sleeping with their mouth open, they will have. a different face and airway opposed to if they grew up with a closed mouth while sleeping. I'm not exaggerating. And so if you are afraid of taping your child's mouth shut, of course, asphyxiation and all that, which has never happened, then use the myotate. It was developed by Patrick McKeon. He's one of the premier breathing experts in the world, and he's out of Ireland. And he developed his tape, I think it's patented.

It developed for adults as well, which I thought was a good move because a lot of adults cannot cover their mouth. It would make them panic. Think about it. If you're sleeping at night and you're suffering from apnea, that's where your airway stops, I mean, it occludes or collapses, and you stop breathing for 30 to 60 seconds. I mean, imagine holding your breath for that long. What happens? Well, you start panicking. Yeah.

I mean, your body knows that it's not breathing. That is a fighter flight response. And imagine that happening to 30, 40, 70 times an hour at night. You're going to wake up pretty freaked out, very anxious and subconsciously, it's all about the mouth and the breathing. And if you see them as a dental patient, they're going to be very protective of their mouth. They're going to want to keep that airway unobstructed and they don't want you to block it. So that is ingrained in us. That is a subconscious thing that over time, it's a form of PTSD.

interesting well if people wanted more from you you've mentioned your website a few times that's ask the dentist.com correct is there any other places you would like to direct people yeah i would ask the dentist dot com certainly um the book just type in my last name berena uh in amazon if you think you have any sleep issues or you want to see how sleep is is related to dental issues dental problems and a visit to your dentist. We love everyone in our following on Instagram. That's a lot of fun doing that, little videos and tidbits. And that would be also Ask the Dentist.

Twitter, Ask the Dentist. Trying to think what else there is. Oh, I do have a podcast. The podcast has begun. We haven't advertised it yet, but we've got a few episodes out there already. And again, that would just be Ask the Dentist. Anywhere where you listen to podcasts,

any software if you type in as the dentist, you'll see us there. Amazing. Well, thank you so much for sharing all of this incredible information. I really appreciate it, and I know that my audience does too. I really appreciate being on your show, and I saw that you didn't have anyone with oral health. I'm flattered and honored to be your first oral health expert that you interviewed. Thank you, Liz. Appreciate it. I hope you loved this episode of the podcast. I learned so much from Dr. Berhanna, and I made so many changes in my routine and I'm so excited to hear what you did too so definitely tag me on social

I am at Liz Moody and he is at Ask the Dentist we would both love to hear from you and if you loved this episode of the pod or any other episode I would so appreciate a quick rating or review on whatever podcast platform you use. There's a great way to help other people find the podcast and it is very very appreciated by me. If you're new this is your first episode of Healthier Together, don't forget to subscribe so you don't miss out on future episodes and for everyone else I love you for hanging around for spending this time with me. It's really special to get to do this with all of you to get healthier together. I will see you on the next episode of the podcast. The mattress that you sleep on is one of the highest exposures that you have. Like if it's off gassing, you're breathing

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