The Functional Dentist: New Research Linking Bleeding Gums & Cancer! Your Oral Microbiome Can Kill You! If You Can't Get It Up, Brush Your Teeth! AI transcript and summary - episode of podcast The Diary Of A CEO with Steven Bartlett
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Episode: The Functional Dentist: New Research Linking Bleeding Gums & Cancer! Your Oral Microbiome Can Kill You! If You Can't Get It Up, Brush Your Teeth!
Author: DOAC
Duration: 01:35:22
Episode Shownotes
From cavities to cancer, dental problems to dementia, how the state of your teeth is connected to every aspect of your wellbeing. Dr Victoria Sampson is an award-winning functional dentist, researcher, and founder of the multidisciplinary oral health centre, The Health Society Labs. She is also the first dentist in
the world to link gum disease with worse COVID complications. In this conversation, Dr Victoria and Steven discuss topics such as, the shocking link between oral health and cancer, how your saliva can predict future dementia diagnosis, how bad breath is a sign of low fertility, and the right way to brush your teeth. 00:00 Intro 01:34 The Oral Microbiome 02:54 What Impacts Our Oral Microbiome? 03:33 2 Million Bacteria in Your Mouth 04:46 How Many People Have Oral Diseases? 06:19 Body Diseases Linked to Oral Microbiome 08:05 Steven Adjusting Chair? 10:18 Research Linking COVID-19 and Oral Hygiene 12:38 Can Your Oral Microbiome Kill You? 13:27 How Food Shapes Your Mouth 16:35 What’s a Wisdom Tooth? 17:54 Do Wisdom Teeth Need Removal? 18:39 Why Do We Need Dentists If Ancestors Had Good Teeth? 20:05 Is Everyone’s Microbiome Massively Different? 21:54 How Oral Health Improves Overall Health 23:54 Can Swallowing Saliva Make You Sick? 25:48 Inflammation and the Oral Microbiome Link 27:50 Rheumatoid Arthritis Strongly Linked to Oral Health 30:15 Heart Disease and the Oral Microbiome 33:02 How Oral Bacteria Filters Through Your Body 33:20 Erectile Dysfunction Linked to Oral Hygiene 35:28 Emerging Research: Breast Cancer and Oral Microbiome 39:25 Green Tea Benefits for Oral Health 40:44 Impact of Coffee on Oral Health 41:46 Effects of Hot Drinks & Sugar on Teeth 43:34 Link Between Brain Health & Alzheimer’s 50:11 Can Mental Health Be Seen in the Mouth? 51:12 Spotting Eating Disorders Through Oral Health 51:50 How Stress Affects Your Oral Health 53:26 Mouth vs. Nose Breathing: Health Impacts 57:08 Higher ADHD Risk in Mouth-Breathing Children 58:03 Kissing and Bacteria Transmission 59:04 Oral Sex and the Oral Microbiome 01:01:27 Switching to Steven - Transition 01:02:07 Oral Health and Fertility 01:06:33 Ads Break 01:07:32 Study Results on Oral Health 01:16:31 Best Time to Brush Your Teeth 01:17:37 Good vs. Bad Oral Products 01:26:18 Should You Spit or Rinse After Brushing? 01:30:48 Whitening Products: Do They Work? 01:33:52 Importance of Drinking Through Straws 01:34:45 Smoking and Vaping Effects on Oral Health 01:37:30 Last Guest Question Follow Dr Victoria: Instagram - https://g2ul0.app.link/BYodSLgymOb Website - https://g2ul0.app.link/1CuFnflymOb 🤐 👀 Psstt! Are you ready to finally reach your goals? - you can join the exclusive waitlist NOW for the limited run of our brand new 1% Diary here: https://bit.ly/1-Diary-Waitlist-YT-ad-reads You can learn more about the products mentioned, here: Saliva Test Kit: https://g2ul0.app.link/0HibFujjrOb Super Teeth Soft Floss: https://g2ul0.app.link/GH0TGntymOb Super Teeth Toothpaste: https://g2ul0.app.link/pU20AczymOb Super Teeth Dental Prebiotic: https://g2ul0.app.link/7rjRJUAymOb Bio.Me Supplement: https://g2ul0.app.link/UMvwbXDymOb BioMin Toothpaste: https://g2ul0.app.link/FTKSAwZymOb DR. HEFF´S Supplement: https://g2ul0.app.link/DrhMsy2ymOb Watch the episodes on Youtube - https://g2ul0.app.link/DOACEpisodes My new book! 'The 33 Laws Of Business & Life' is out now - https://g2ul0.app.link/DOACBook You can purchase the The Diary Of A CEO Conversation Cards: Second Edition, here: https://g2ul0.app.link/f31dsUttKKb Follow me: https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Join the waitlist for The 1% Diary - https://bit.ly/1-Diary-Waitlist-Megaphone-Ad-Reads ZOE - http://joinzoe.com with code BARTLETT10 for 10% off Learn more about your ad choices. Visit megaphone.fm/adchoices
Summary
In this episode, Dr. Victoria Sampson discusses significant research linking oral health to systemic diseases such as infertility, heart disease, and Alzheimer’s. Over 90% of oral diseases contribute to serious health issues, with gum disease being specifically associated with increased risks of erectile dysfunction and cancer. Dr. Sampson emphasizes the oral microbiome's critical role and the importance of saliva in predicting health risks. She advocates for improved public awareness around oral hygiene, its impact on overall well-being, and the connections to mental health and reproductive health, suggesting a collaborative approach among healthcare providers to address these intertwined issues.
Go to PodExtra AI's episode page (The Functional Dentist: New Research Linking Bleeding Gums & Cancer! Your Oral Microbiome Can Kill You! If You Can't Get It Up, Brush Your Teeth!) to play and view complete AI-processed content: summary, mindmap, topics, takeaways, transcript, keywords and highlights.
Full Transcript
00:00:00 Speaker_01
Is there a link between our oral health and our fertility?
00:00:02 Speaker_02
Yes. This is some of the newest research that's coming out. They found that over 90% of men who wasn't able to conceive with their partners had an oral disease. For those who got treated, there was a 70% improvement in pregnancy.
00:00:14 Speaker_02
Now, researchers also found that if a woman has gum disease, it takes them two months longer to conceive. And I'm the only one who's talking about it.
00:00:21 Speaker_00
And who are you?
00:00:22 Speaker_02
I am the saliva queen. Dr. Victoria Sampson is the trailblazing dentist whose data-driven research has uncovered the shocking link between our mouths and some of the world's most destructive conditions.
00:00:32 Speaker_02
More than 90% of diseases can be traced back to our microbiomes, and we now understand that having an imbalanced oral microbiome increases your risk of high blood pressure, heart disease, Alzheimer's, rheumatoid arthritis, and even men who have gum disease are 2.85 times more likely to have erectile dysfunction.
00:00:48 Speaker_01
Really?
00:00:49 Speaker_02
Yeah. And then another study also showed there's oral bacteria that can make cancer more aggressive and harder to treat as well.
00:00:55 Speaker_01
But what is it that causes all of this?
00:00:57 Speaker_02
Poor oral hygiene, sugar, stress, but also some of us genetically will have mutations which can cause disease. But there's ways to fix it. For example, I had a patient who had terrible arthritis and terrible gum disease.
00:01:08 Speaker_02
And when I treated the gum disease, her rheumatoid arthritis got better to the point where she was actually able to walk again. Wow. Yeah.
00:01:15 Speaker_01
So let's talk about what we can do about it. Is there any time where I shouldn't brush my teeth? Do I spit or rinse after I brush my teeth? Chewing gum? Coffee? Mouthwash? Good or bad for me?
00:01:25 Speaker_02
Let's go through all of that.
00:01:26 Speaker_01
So weirdly... Dr. Victoria Samson, what is the mission that you're on?
00:01:40 Speaker_02
My mission is to show people that the mouth is the gateway to the rest of the body. And if they really want to achieve full body health, it starts with the mouth first.
00:01:49 Speaker_01
I've never heard of the term oral microbiome really until I met you and went through all of your work and your research. And I think many people listening to this now also probably aren't familiar with that term and also the importance of that term.
00:02:03 Speaker_01
So if you had to make a case to someone like me, who's really unfamiliar with this subject as to why it's so important from a very top line perspective, what would you say?
00:02:13 Speaker_02
I think everyone knows that their gut has a microbiome. And for the past 10 years, we've always talked about how you can change your diet, probiotics, prebiotics for the gut microbiome.
00:02:22 Speaker_02
But what a lot of people don't understand is that the oral microbiome is the second largest and most diverse microbiome after the gut. It's also a lot easier to change, and actually it's been shown to have a massive impact on general health.
00:02:34 Speaker_02
So having an imbalanced oral microbiome increases your risk of oral diseases like gum disease and decay, but also can increase your risk of other systemic diseases like high blood pressure, heart disease, infertility, Alzheimer's, and it's something that is so easy to manage and balance.
00:02:53 Speaker_01
How many people does this impact? And how many people is it relevant to?
00:02:56 Speaker_01
So an understanding of my oral microbiome is going to help me in a number of ways as it relates to my overall health, but how many people does it really, really have an impact on?
00:03:06 Speaker_02
I think it depends on what you're trying to get out of the oral microbiome testing. I would argue that it benefits everyone. We all have teeth. We all have mouths.
00:03:16 Speaker_02
And everything that we do, every time we breathe, we eat, we drink, we kiss, we are impacting our oral microbiome every single time.
00:03:23 Speaker_02
And then every time we swallow or we breathe, that bacteria that is putting into our mouth will travel elsewhere to the rest of the body and cause problems elsewhere.
00:03:32 Speaker_01
You said it's the second biggest microbiome in the body?
00:03:34 Speaker_02
Yeah.
00:03:35 Speaker_01
How many bacteria are in my oral microbiome?
00:03:38 Speaker_02
So you have 700, approximately 700 different bacteria which make up 2 billion bacteria overall.
00:03:44 Speaker_02
And what's also very weird about the oral microbiome compared to any of the other microbiomes is that you've got lots of different environments or niches within the same mouth.
00:03:53 Speaker_02
So if you think about the bacteria that would like to live under the gums or at the back of your throat or on your teeth, they're all very different environments. Some are hot, cold, wet. And so you've got lots and lots of different
00:04:06 Speaker_02
parties of bacteria within the same microbiome in the mouth.
00:04:10 Speaker_01
Okay, and you mentioned a second ago that things like kissing, breathing, swallowing have an impact on my oral microbiome.
00:04:18 Speaker_02
Yes.
00:04:18 Speaker_01
In a significant way that I need to know about.
00:04:21 Speaker_02
Yes, so it's more about how often you're doing those certain habits. So, you know, for example, with kissing, the research has shown that you need to kiss more than 11 times a day for you to be sharing the same bacteria or microbiome as your partner.
00:04:34 Speaker_02
But also even the habits that we have, the air quality that we have, everything will dictate the environment that our mouths are living in and therefore what bacteria will live in our mouths.
00:04:45 Speaker_01
In the subject of oral diseases and things like tooth decay, how many people are impacted globally by oral diseases?
00:04:54 Speaker_02
So the World Health Organization has come out saying that 3.5 billion people have some sort of oral disease.
00:05:00 Speaker_02
And they've also found that 10% of our world population are suffering from severe gum disease, which makes gum disease one of the most prevalent inflammatory conditions in the whole body.
00:05:12 Speaker_01
This conversation around the oral microbiome, have you seen it developing over recent years? Have you seen it become more sort of pertinent to people in society?
00:05:22 Speaker_02
massively. I think I've been doing this for years. It's been something that I've loved. And no one really knew what I was talking about most of the time.
00:05:29 Speaker_02
They all thought I was a bit of a dreamer, even dentists, patients, they all thought, okay, well, it doesn't really matter, does it?
00:05:35 Speaker_02
But in the last year or two, I've had people traveling from all around the world just to get their oral microbiome tested, to understand more about what's going on in their body.
00:05:43 Speaker_02
And I think we're seeing a shift in the generations in terms of this new generation want to understand their health a lot more. So we're all sitting there wearing trackables, wearables, we're calculating how much sleep we have, how much we're eating.
00:05:57 Speaker_02
And for now, we're actually also wanting to understand our oral health. So that trust between a dentist and the patient is not necessary anymore.
00:06:07 Speaker_02
We want to actually understand what's going on in our mouths and actually be able to track things, see what bacteria we have, how much inflammation we have, our risk of diseases, and what we can do to change that.
00:06:18 Speaker_01
Last question before I ask you a more sort of personal question about yourself. What other diseases in my body or sort of implications in my body are linked and can be traced back to the oral microbiome?
00:06:29 Speaker_02
We now understand that more than 90% of diseases can be traced back to an imbalanced microbiome. If we zone into just the oral microbiome, it's got connections with infertility, heart disease, diabetes, Alzheimer's, rheumatoid arthritis,
00:06:46 Speaker_02
And the list goes on, erectile dysfunction. And what's also very interesting, going back to your question about, you know, is there been a new interest in this?
00:06:55 Speaker_02
In the last few years, we've actually been able to show that there is a strong connection and causation between the oral microbiome and general diseases. Whereas prior to maybe five years ago, there was a lot of kind of, is this correlation?
00:07:08 Speaker_02
Is it just that, okay, there's the same risk factors with gum disease and with heart disease, for example, smoking. And now we're actually seeing that no, it's not just correlation, there is strong causation between the two.
00:07:20 Speaker_00
And who are you?
00:07:22 Speaker_02
I am Victoria Sampson. I'm a dentist. I do a lot on the oral microbiome. People call me the saliva queen. That's my name on the streets.
00:07:33 Speaker_01
And what's your sort of, what professional experiences and education have brought you here today? And how long have you been doing that? How many mouths and how much saliva have you seen?
00:07:42 Speaker_01
Give me a sort of a big view on the wealth of experience you have on this subject.
00:07:47 Speaker_02
Um, so originally I trained as a dentist, um, and that's six years of training. Um, I would say I was a pretty traditional conventional dentist as I graduated. Um, I'd done some training, um, at the Karolinska Institute during my university.
00:08:04 Speaker_02
And the Karolinska Institute is the best dental school in the world. But they're very focused on the mouth-body connection, on testing saliva.
00:08:13 Speaker_02
And what they thought was that, you know, you go to your doctor and you have a blood test, why don't you go to your dentist and get a saliva test? So from even dental school, I had this in the back of my mind, but I still didn't have the training.
00:08:25 Speaker_02
And so I just became a dentist. I was working half NHS, half private. And then as time evolved, I then shifted to fully private. And then when COVID happened, I started doing a lot of research and all the dental practices were closed across the country.
00:08:43 Speaker_02
And I thought that was crazy because basically the government was saying dental practices or dentistry is not a necessity. So I thought that was insane. And so I decided to do a lot of research.
00:08:55 Speaker_02
And I wrote a paper which was connecting oral health with COVID complications. So what we found was that patients who had poor oral health or gum disease were at a much higher risk of COVID complications.
00:09:09 Speaker_02
And then that evolved into me doing some studies with universities and hospitals. But the issue was that we couldn't go into hospitals and check people's teeth and gums because they had COVID.
00:09:22 Speaker_02
So instead what we did was we would collect their saliva and we would take it to the lab and we had this beautiful snapshot of what was going on in a patient's mouth at that moment in time just from their saliva.
00:09:33 Speaker_02
So we did a lot of research and we found that COVID sufferers or patients who had gum disease we're nine times more likely to have COVID complications. But also what I took from that was that, why aren't we using saliva more regularly?
00:09:46 Speaker_02
Why don't we use this in more commercial aspect and for our patients? So after that, I devoted a lot of time into developing oral microbiome testing.
00:09:56 Speaker_02
We had gut microbiome testing, you've got urinary microbiome, you've got every single microbiome has a test, but the oral microbiome didn't really have one.
00:10:04 Speaker_02
So I built one of the first oral microbiome tests in Europe, and that was a couple of years ago, and then now have come out and kind of left and created my own one about a couple of weeks ago.
00:10:17 Speaker_01
That research you mentioned, specifically the research paper which was titled, could there be a link between oral hygiene and severity of COVID infections? was the first research paper to link gum disease with worse COVID complications.
00:10:32 Speaker_01
And I was reading that it was the most cited research paper by the, one of the sort of dentistry publications?
00:10:39 Speaker_02
Yeah, yeah. So the British Dental Journal is one of the most cited and viewed articles. And what it also helped do was the World Health Organization and SAGE picked that up.
00:10:50 Speaker_02
and they said, oh wait a second, I think that oral health is really important for general health and also we should reopen dental practices. So this also paved the way for dental practices reopening later on.
00:11:01 Speaker_01
What's going on there? Can you explain that to me like a 10 year old? So if I have a bad or a unhealthy oral microbiome, I'm nine times more likely to end up in ICU with COVID complications. What's the link?
00:11:16 Speaker_02
So there's a few. So the first one is inflammation. So COVID, we know it releases a lot of inflammatory markers. So it's what we call the cytokine storm. So it's essentially the storm of lots and lots of inflammatory markers.
00:11:30 Speaker_02
And gum disease separately is essentially inflammation of the gums. And so what gum disease does is it releases lots of inflammatory markers from the mouth elsewhere to the rest of the body.
00:11:40 Speaker_02
So then when you add those together and you have your cytokine storm from COVID and you've got your inflammatory markers from gum disease, it's just adding petrol to the fire. So you're just making that cytokine storm even worse.
00:11:52 Speaker_02
But then on the separate side, it's also bacteria. So if you look at the autopsies and the research of COVID patients, most of them didn't die from the virus itself. No one really died from COVID-19. They died from complications.
00:12:06 Speaker_02
So the number one complication was actually a bacterial infection. So imagine your body, you've got COVID, you are really unwell, and your immune system is on absolute overdrive.
00:12:17 Speaker_02
This is the prime time for bacteria to come into your body and to cause what we call a bacterial super infection.
00:12:23 Speaker_02
And so actually, when you look to the autopsies of a lot of these patients, they had oral bacteria from their mouth traveling to their lungs and causing bacterial super infections, which would result in things like pneumonia.
00:12:35 Speaker_02
And that's actually the cause of death for most patients.
00:12:38 Speaker_01
You don't really think that your oral microbiome can be fatal, can kill you.
00:12:44 Speaker_02
And even, I think, as a dentist, we weren't really taught how important bacteria was or how important the mouth was for the rest of the body.
00:12:55 Speaker_02
The only one that we ever learned, and a lot of people would know this one, is that if you have heart surgery, you can't actually have a hygiene for about six months after the heart surgery.
00:13:07 Speaker_01
A dental hygiene.
00:13:08 Speaker_02
Yes. And the reason for that is because you're at a very high risk of something called infective endocarditis. So this is oral bacteria which travels down to a faulty heart valve and can actually cause death.
00:13:20 Speaker_02
So we know that, but we never really look at it for other diseases or other problems.
00:13:26 Speaker_01
I wanna take a step back before we go through the links between oral microbiome and all of these diseases. But also, I really wanna also talk about what we can do about it, because I've got so many questions around.
00:13:36 Speaker_01
I've got all of these products down below my chair, from mouthwashes to toothpaste, to all these kinds of things, which I wanna talk about as well.
00:13:43 Speaker_01
But just taking a step back to something that one of my guests previously was telling me about, I think it was James Nestor. He was telling me that the mouth itself and the jaw, because of processed foods, is an abnormal shape.
00:13:56 Speaker_01
And when I say abnormal, I mean in relation to how it was supposed to develop, because we're eating so many processed foods, which are designed to be easy to chew. The mouth itself and the jaw have changed. Is there any truth in that?
00:14:08 Speaker_02
Yeah, 100%. So there was a man called Weston Price and he was a dentist and he basically suspected that. And he was like, this is strange.
00:14:18 Speaker_02
Why is it that people who are more industrialized and westernized areas have higher levels of decay and they have loads of crowding? So they had basically lots of crowding of the teeth and smaller jaws.
00:14:32 Speaker_02
And so he basically traveled around the world and he looked at lots of different tribes, villages, countries, and he compared the teeth of for example twins. One twin would be in a very industrialized westernized area and the other one was not.
00:14:49 Speaker_02
And what he found was that in the twins who were in these non-industrialized areas, they were eating harder foods, they were having less sugar, and actually their jaws developed a lot better.
00:15:00 Speaker_02
So they didn't have crowding, they had perfect teeth actually, and they had no decay, compared to the children or the twins who are in more industrialized areas.
00:15:10 Speaker_02
And it is because our food now has become so processed, a lot of children are not having hard foods, and so we don't develop the jaws and the muscles at an early age. And so the teeth haven't changed size.
00:15:21 Speaker_02
The teeth are exactly the same size as they were previously. But what we're seeing is that those teeth don't have any space to grow anymore. And that's when we're getting crowding.
00:15:30 Speaker_01
And can you see that in any of those models?
00:15:32 Speaker_02
So yeah, in this model, you can actually see at the very back, so a lot of people will have wisdom teeth. And one of the biggest issues at the moment is that a lot of people have impacted wisdom teeth.
00:15:43 Speaker_02
So this is basically, imagine your teeth are all upright, your wisdom tooth is coming out at a completely horizontal angle, and it's pushing on the rest of the teeth. It's an absolute nightmare as a dentist to take out.
00:15:54 Speaker_02
It's even more of a nightmare for a patient to have to endure. But also we're seeing that there are a lot more impacted wisdom teeth in the last 30, 40 years than there were previously.
00:16:05 Speaker_01
Because the diets have changed.
00:16:06 Speaker_02
Because the diets have changed, a lot more children are needing orthodontic treatment now as well, just because they have crowded teeth, teeth are overlapping, and so they need braces to straighten those teeth out.
00:16:17 Speaker_02
If you think about cavemen, cavemen didn't have dentists, they didn't have braces, they didn't even use toothpaste, but they didn't die from gum disease or decay or crowded teeth.
00:16:28 Speaker_02
So it's been something in our industrialized or more kind of westernized diet that has changed that.
00:16:35 Speaker_01
My wisdom tooth is coming through on my left side at the moment, and I think actually also my right side at the same time. And I'm 32 years old now. So I'm like, why the hell am I growing teeth at 32 years old?
00:16:44 Speaker_01
I thought I was on my way out or something. So I got two questions just before we crack on, which is what the hell is a wisdom tooth? Why is it called a wisdom tooth? And why is it coming through at 32 years old?
00:16:55 Speaker_02
So we have teeth erupting at different times of our lives. So usually you have your baby teeth, they will erupt up to the age of about six or seven years old.
00:17:06 Speaker_02
And then you have your adult teeth coming through and usually they will stop erupting around 12 years old. And then you have nothing, you're chilling, you have nothing, nothing, nothing, nothing until about maybe
00:17:18 Speaker_02
18, 19 years old, and that's where you start to get your wisdom teeth. The name behind wisdom teeth, from what I understand, is because it erupts when you're older. It's when you have more wisdom and you're more wise.
00:17:30 Speaker_01
So I'm wise now.
00:17:30 Speaker_02
So you're just very wise.
00:17:31 Speaker_01
Okay, makes sense.
00:17:33 Speaker_02
And so some people will get it at 18. Some people don't have any wisdom teeth. Some people will have wisdom teeth which erupt perfectly and are all completely fine.
00:17:41 Speaker_02
And others will have their wisdom tooth erupt at 32 years old and maybe be a little bit impacted or cause problems. So they're also very strange teeth. They're very unpredictable the way that they are.
00:17:54 Speaker_01
Is there any evolutionary basis for why we need them? There must be some kind of evolutionary reason for them.
00:18:00 Speaker_02
Not that I understand what is also happening is that apparently, and this is some research, is that less people are having wisdom teeth because more children or adults are getting their wisdom teeth taken out.
00:18:14 Speaker_02
And as evolution goes, eventually some people are actually not having wisdom teeth at all because their ancestors haven't had wisdom teeth. So why would they have wisdom teeth? But overall, no, there's no real, need for wisdom teeth.
00:18:28 Speaker_02
I never like to take them out unless needed because, I mean, more teeth, the better. And you never know if you have to have something taken out, then we can use your wisdom teeth for something.
00:18:39 Speaker_01
If I were to look at my ancestors from 500 years ago, you said they don't have dentists, they don't have toothpaste and all those kinds of things, but you also said they don't have tooth decay.
00:18:49 Speaker_01
Does that not therefore mean that I shouldn't need a dentist and I shouldn't need toothpaste or mouthwash or floss?
00:18:56 Speaker_02
If you had a caveman diet, then potentially you might not need toothpaste, floss, or even a toothbrush.
00:19:04 Speaker_02
And there's a lot of argument as to, you know, there's a lot of people out there saying, no, you don't need to use any toothpaste, you don't need floss, anything like that. And fine, go ahead, do that.
00:19:14 Speaker_02
But only if you are going to be eating, you know, meat, raw meat sometimes, and you're only drinking water, and you're not having anything in your diet which has any sugar or carbohydrates in it.
00:19:26 Speaker_01
I mean, doesn't that speak to what the perfect diet is supposed to be? Can't we tell what the perfect diet is supposed to be by looking at the mouth?
00:19:32 Speaker_02
Yeah, so another issue is that with a lot of the food that we eat now, they have a lot more sugar in them and that will impact the acidity of your saliva.
00:19:42 Speaker_02
And essentially what decay is, is you have sugar or you have some sort of carbohydrates and you've got this bacteria in your mouth and they feed on that sugar. And as they feed on that sugar, they release acid.
00:19:55 Speaker_02
And if that acid is left there, then it can cause demineralization of your teeth. and that demineralisation will end up with decay.
00:20:04 Speaker_01
Okay. So let's talk about the personal oral microbiome. Is my oral microbiome different from, say, Jack's over there, and from my girlfriend's?
00:20:14 Speaker_02
Yes, massively.
00:20:16 Speaker_01
Massively different?
00:20:17 Speaker_02
Yes. Maybe massively, I would say. So one of the issues that I used to have was I was doing lots of oral microbiome testing, and I would have...
00:20:28 Speaker_02
Let's say you and your girlfriend do an oral microbiome test and both of you, I would see your results and they would come out pretty much the same because we're only looking at certain bacteria. We can't look at all 700.
00:20:38 Speaker_02
So we would look at the top 20 bacteria that cause problems. So I look at both of them and then I would look inside your mouths and one of you, I don't know in this case, had raging gum disease and terrible oral health.
00:20:51 Speaker_02
And the other person would be completely fine. So then I realized that actually it's not just bacteria that causes disease or problems. It's how your body responds to that bacteria and the strains of bacteria that you have as well.
00:21:04 Speaker_02
So for every bacteria, there'll be multiple strains. And some of those strains can be really aggressive and really horrible for your mouth. And other strains are completely fine and are not gonna cause you any problems.
00:21:15 Speaker_02
So when I developed my test, what we did is we looked at strains. So we looked at the strains of certain bacteria and we would be able to differentiate between patients who had the really bad strains and the really good strains.
00:21:26 Speaker_02
But then also we looked at the ratio of good and bad bacteria in someone's mouth, so their diversity, as well as their genetic mutations and also their inflammation.
00:21:35 Speaker_02
So when you put all of it together and it's like a puzzle piece, then you can actually have a better insight into someone's oral health.
00:21:43 Speaker_02
So I guess my answer is that everyone's oral microbiome is a little bit different, but it's also how your body responds to that microbiome and bacteria that really dictates whether or not you're going to have disease or problems.
00:21:54 Speaker_01
So you could be someone who takes care of their teeth really, really well, but still have a bad oral microbiome relationship with the rest of your body effectively.
00:22:03 Speaker_02
And I see it every day. And we have a lot of patients who suffer from terrible gum disease. And they come to me and they brush three times a day. They've never touched a cigarette. They have immaculate oral hygiene.
00:22:13 Speaker_02
They eat very well, but they have terrible gum disease. And for those patients, they might have genetic mutations that predispose them to gum disease and to inflammation.
00:22:22 Speaker_02
So even the smallest amount of bacteria, their body responds in a very aggressive and inflammatory, destructive way, which can cause disease.
00:22:31 Speaker_01
When I was speaking to, I think it was Tim Spector, about the gut microbiome, he was telling me that the gut microbiome turns over, i.e. the bacteria dies every couple of days or weeks or something.
00:22:42 Speaker_01
How often does the oral microbiome die, turn over, and why does that matter?
00:22:49 Speaker_02
So what's interesting or different between the oral and gut microbiome? The oral microbiome, if someone doesn't go in there and mechanically disrupt the bacteria and the plaque in your mouth, then that bacteria can stay forever.
00:23:02 Speaker_02
So the gut, what happens is you've got something called peristalsis, you've got movement, so the bacteria moves, it changes, it regenerates, there's turnover. In the mouth, so the teeth are the only non-shedding surfaces in the whole body.
00:23:16 Speaker_02
So imagine if you never had a shower in your life, you would still self-wash because the skin cells would shed. But if you never brushed your teeth, then your teeth are not shedding. They're going to stay like that.
00:23:30 Speaker_02
So that bacteria will just keep on growing and growing and growing and growing, and you'll get this really thick plaque. So that's why actually the oral microbiome, you need to mechanically remove that bacteria.
00:23:42 Speaker_02
And that's why brushing your teeth is super important or using the correct toothpaste or et cetera, going and seeing your hygienist because you need to mechanically remove that bacteria quite regularly.
00:23:53 Speaker_01
Okay. And the two ways I was reading in your work, it said that the two ways that oral health impacts overall health are by the spreading of bacteria. And the other sort of central issue is it causes inflammation.
00:24:04 Speaker_01
So on this point of spreading bacteria, I'm always concerned, this is a bit of a superstitious thing, but anytime that I'm sick, I'm always like, part of me is like, don't swallow.
00:24:14 Speaker_01
Because in my head, I think if I'm sick in my mouth or if I've got like a sore throat or something, I'm like, if I swallow it, the rest of my body is gonna get sick. It's super superstitious, but is there any truth to any of this?
00:24:27 Speaker_02
So not from just being sick like a common cold. And it's actually really interesting. I had a patient yesterday and bless him, he's very young, seven years old. And he had exactly that same mindset.
00:24:38 Speaker_02
He just randomly woke up one day and he said, this is kind of gross. Why am I swallowing my saliva? There's all these bad bugs and gross things in my saliva and I'm swallowing it every day and it's traveling to the rest of my body.
00:24:50 Speaker_02
at seven and so what he ended up doing was refusing to swallow his own saliva and so he would basically just dribble and he would just wipe his uh the saliva off with a sleeve or he'd carry a towel with him and just wipe it so bless me a big rash around his his
00:25:07 Speaker_02
his face. And it was a bit of a weird moment for me because I was like, you're kind of right.
00:25:14 Speaker_02
Like, I mean, it is a bit weird, especially as a child to sit there and think like, yeah, you've got 700 different bacteria, 2 billion bacteria overall, and then you're swallowing it and it can travel elsewhere to the rest of the body.
00:25:25 Speaker_02
So yes, in short, yes, bacteria from your mouth, when you swallow it, it can travel elsewhere to the rest of the body. However, a lot of the bacteria dies. So the acid in the stomach can kill a lot of the bacteria.
00:25:38 Speaker_02
So it's only the really, really bad bacteria that are able to survive and cause problems. And that's why it's so important that you have a good oral microbiome and you balance it well.
00:25:47 Speaker_01
And the other central way that it can cause negative impacts to your overall health is via inflammation. What is the link between inflammation and my oral microbiome?
00:25:59 Speaker_02
So it's something that we call low grade chronic inflammation. And imagine so you've got this delicate balance of bacteria in your mouth, which is your microbiome.
00:26:08 Speaker_02
And we all have bad bacteria in our mouths, but most of us hopefully have better levels or higher levels of the good bacteria. So there's always that balance. And what happens in an imbalanced oral microbiome is that shift changes.
00:26:22 Speaker_02
So you get higher levels of bad bacteria and you don't have enough good bacteria. These bad bacteria, firstly, yes, they can travel elsewhere to the rest of your body as you discussed. The second is that they can release inflammatory markers.
00:26:34 Speaker_02
So they basically release inflammation and this inflammation can travel from your mouth to the rest of your body and contribute to inflammation elsewhere.
00:26:42 Speaker_02
So for example, if you had rheumatoid arthritis and then you had inflammation from your gums, that inflammation from your gums is making your arthritis in your wrists worse. So it's contributing to it.
00:26:55 Speaker_02
Now what's also interesting, and that's why it's called low grade chronic inflammation, is often you wouldn't even know that you have it. I have so many patients who say, oh, you know, my gums bleed, but that's normal.
00:27:05 Speaker_02
If your eye bled or if your foot was bleeding every day, you would be worried and you would think actually there's inflammation here, there's a problem here.
00:27:14 Speaker_02
But so many people have bleeding gums and they don't understand that bleeding gums is a sign, it's your gum screaming to you saying that I have inflammation and that inflammation can travel.
00:27:24 Speaker_02
And then the third mechanism as well, so there's one more, is it's damaged to your blood vessels.
00:27:30 Speaker_02
So again, the same bad bacteria in your mouth, it releases these enzymes, these toxic enzymes, and they can travel through the rest of your body, through your blood vessels, and they can actually damage your blood vessels.
00:27:41 Speaker_02
So these blood vessels are not able to dilate and constrict as well as they used to.
00:27:46 Speaker_01
On that point of arthritis, I read a stat which I believe is true.
00:27:50 Speaker_01
I think it actually came from some of your research that said people with rheumatoid arthritis are eight times more likely to develop gum disease than patients without rheumatoid arthritis.
00:27:59 Speaker_02
Yes.
00:28:00 Speaker_01
Which is shocking.
00:28:01 Speaker_02
Yeah, so there's a really strong bi-directional relationship between rheumatoid arthritis and gum disease.
00:28:07 Speaker_02
So that means that if you have really bad rheumatoid arthritis, you have pretty bad gum disease, and if you treat your rheumatoid arthritis, your gum disease will get better, and vice versa.
00:28:17 Speaker_02
If you treat the gum disease, your rheumatoid arthritis will get better. And that was actually one of the first patients that really got me on my journey of the mouth-body connection. So like, yeah, I was doing the saliva testing. I got it.
00:28:31 Speaker_02
You know, I was like, okay, cool. We are quantifying oral health. We're tracking things. But even me, I wasn't really fully sold on this whole mouth-body connection, how our mouth is connected to the rest of the body.
00:28:43 Speaker_02
So I had a patient who was sent to me by her functional medicine practitioner and she had been seen by four or five different practitioners.
00:28:52 Speaker_02
She had terrible rheumatoid arthritis and she went to the spinal guy and he was the first guy to ever ask her, have you ever had your teeth checked? What's happened? And she said, Oh,
00:29:03 Speaker_02
I've had a few teeth taken out in the last year or two, about six teeth, but you know, it's just, it is what it is." And he was like, I don't think that's normal.
00:29:11 Speaker_02
So he sent her to me and he was like, can you do your saliva stuff that you do and see if there's anything going on there? And we did do a saliva test.
00:29:19 Speaker_02
We saw that she had super high levels of inflammation, of collagen breakdown, high levels of bad bacteria. And what was the most important was that when I treated her gum disease, she had terrible gum disease, and that's why she was losing her teeth.
00:29:33 Speaker_02
When I treated the gum disease properly and aggressively, yes, her gums healed, but more importantly, her rheumatoid arthritis got better to the point where she was actually able to get off steroids and medication and be able to walk again.
00:29:47 Speaker_01
Wow.
00:29:47 Speaker_02
Yeah.
00:29:49 Speaker_01
By treating her gum disease?
00:29:50 Speaker_02
Yeah.
00:29:51 Speaker_02
And I think that, you know, sometimes as a dentist, we treat a lot of gum disease and we treat a lot of things and we don't necessarily see the systemic consequences because the patient doesn't come back or, you know, or it's such a small impact that you don't necessarily see it.
00:30:07 Speaker_02
But this was the one time where I was like, wow, like what we do is actually really, really insightful and really important.
00:30:15 Speaker_01
And you mentioned alongside that inflammation also has an impact on cardiovascular functioning and health. I believe it's the case that cardiovascular disease is the biggest killer in the world, from what I understand.
00:30:26 Speaker_01
So I was wondering if you knew any of the stats that show the impact or the increased likelihood of me having a heart attack or a stroke or something based on my oral microbiome.
00:30:38 Speaker_02
So the research has shown that if you have gum disease, you are at a 20% higher chance of high blood pressure.
00:30:46 Speaker_02
But also they are now saying that up to 30 to 40% of cardiac issues in hospital can be traced back to an oral bacteria causing problems in the heart valve.
00:31:01 Speaker_02
So the reason for this connection, so yes, inflammation, but also going back to that third mechanism I told you, which was about the vasoconstriction. So the blood vessels constricting and dilating.
00:31:12 Speaker_02
So these toxic enzymes, which are being released by the bacteria, they travel through the blood and they basically stop the blood vessels from being able to widen and lots of blood to travel to the heart and also to constrict.
00:31:26 Speaker_02
And that also is one of the biggest connections with heart disease.
00:31:30 Speaker_01
I found this stat, which might well be from your work or someone else's. It's from the study called the Association Between Periodontitis and Blood Pressure Highlighted in Systemically Healthy Individuals.
00:31:41 Speaker_01
Not mine, but... And it found that people with gum disease were twice as likely to have a heart attack and three times as likely to have a stroke than those without inflammatory gum disease, which is absolutely staggering.
00:31:53 Speaker_02
Yeah. And then another study also showed that when you treated someone's gum disease, their levels of CRP, and CRP is an inflammatory marker that you can check in your blood, the levels of CRP significantly reduced.
00:32:06 Speaker_02
And for a lot of patients who suffer from heart conditions, they will get their CRP quite regularly checked through blood testing. And so this is a way of reducing their inflammation is just by having a simple hygiene.
00:32:18 Speaker_02
And I've even seen, particularly in America, there's a lot of,
00:32:23 Speaker_02
cardiac surgeons and doctors related to heart health who are now actually working with dentists because they understand that if they work together then they're going to have far better results for their patients.
00:32:36 Speaker_01
And this is that swallowing thing we're talking about, this is because you're swallowing that bad bacteria.
00:32:41 Speaker_02
Yeah, and your heart valve, imagine if it's been, it's faulty. Imagine you just had surgery. I always think of it like it's sticky. It's like Velcro. So it's really prone to infection and problems.
00:32:52 Speaker_02
It's just like if you fell over and you had a scab and you were rolling around in mud all the time, you would get bacteria going into that scab and causing problems. It's the same thing with your heart valves.
00:33:02 Speaker_01
Doesn't the bacteria just travel on its own anyway? Because I feel like it's in my mouth. So I feel like it, I don't know, these are living organisms. Don't they just like find their way down, even if I don't swallow?
00:33:11 Speaker_02
Yeah, even through your blood and also through your gums as well. So you can swallow your bacteria, breathe it, or it can go through your blood.
00:33:20 Speaker_01
At the start of this conversation we're talking, you mentioned the sort of implications for your cardiovascular system. And one of the things you said was erectile dysfunction.
00:33:27 Speaker_01
And that was slightly alarming to me as a man who's trying to stay away from erectile dysfunction. What is the research that supports this idea that my oral microbiome can have an impact on my erectile functioning?
00:33:40 Speaker_02
So, men who have periodontal disease are 2.85 times more likely to suffer from erectile dysfunction.
00:33:47 Speaker_01
2.8 times? Yeah. I'm pretty sure that's 280%, isn't it?
00:33:51 Speaker_02
Yeah.
00:33:52 Speaker_01
Okay, so what is this periodontal disease?
00:33:54 Speaker_02
Gum disease. So it's kind of, I would say it's a bit of a spectrum. So the early stages of periodontal disease or gum disease is just gum inflammation. So that's that patient who's brushing their teeth, spits in the basin and sees blood.
00:34:08 Speaker_02
So that's the early inflammation. If they don't get that checked out and sorted, that will just continue and continue and continue to what we call gum disease.
00:34:18 Speaker_02
And that's where, yes, you've got inflammation, but actually you have really high levels of bad bacteria now. And this bacteria is essentially eating away at the gums and also your bone. And it's now become irreversible.
00:34:30 Speaker_01
I'm going to have a swig of this.
00:34:39 Speaker_02
And then at the very end of the spectrum is people who are losing their teeth, having really terrible gum infections, and all of these kind of mouth-body connections that we're talking about.
00:34:49 Speaker_01
Okay. And can you just explain, again, as if I'm 10, how that gum disease, periodontitis, is it called? Has an impact on my penis. I don't understand. I don't understand the link. It makes all of my blood vessels
00:35:03 Speaker_02
Exactly.
00:35:04 Speaker_01
Yes.
00:35:04 Speaker_02
So it essentially stops your blood vessels from dilating. And so you've got reduced blood flow to your penis. And therefore.
00:35:14 Speaker_01
Okay, so this is an emergency, this stuff. This is really important.
00:35:17 Speaker_02
That's the one statistic. Whenever I have a man in the chair and he's like, oh, I don't want to brush my teeth. I'm like 2.85 times more likely to have erectile dysfunction. They usually will go straight to the bathroom to brush their teeth.
00:35:27 Speaker_01
The other thing, it's true, but also the other thing that I read in your research, which I found really, really shocking. is the link between my oral health, my oral microbiome, and cancer.
00:35:41 Speaker_01
I was reading specifically about female breast cancer, which I know affects a lot of women. What is the link there between breast cancer, cancer generally, and our oral microbiome?
00:35:52 Speaker_02
So this is, I would say, some of the newest emerging research that's coming out. So with breast cancer, I didn't know this before this research came out, but your breast has its own microbiome.
00:36:04 Speaker_02
So that tissue within the breast, different bacteria are able to grow. And what they found was that in women who had breast cancer, they had high levels of certain oral bacteria in their breast microbiome.
00:36:17 Speaker_02
So the oral bacteria is called Fusobacterium nucleolatum, and they compared the breast microbiomes of patients who didn't have breast cancer versus those who had breast cancer.
00:36:27 Speaker_01
So what's a breast microbiome?
00:36:30 Speaker_02
Just the collection of bacteria in your breast.
00:36:32 Speaker_03
OK.
00:36:32 Speaker_02
Yeah. I didn't even know there was a microbiome in your breast either, but apparently so.
00:36:37 Speaker_02
And so when they compared a healthy woman, her breasts, to a woman who had breast cancer, the woman who had breast cancer had very high levels of the specific oral bacteria called Fusobacterium nucleatum in their breast.
00:36:53 Speaker_02
There's also been research on colorectal cancer. And actually, Apple News came out with something a couple of months ago, which was nice to see them kind of just spreading the word. But what they found was that in patients who had colorectal cancer,
00:37:09 Speaker_02
more than 50% of them had the exact same oral bacteria from the breast cancer study, that Fusobacterium nucleatum, in the colons. And what they found was that oral bacteria made the cancer more aggressive and harder to treat as well.
00:37:26 Speaker_01
I was reading about a study in mice that linked that oral bacteria to tumour growth. Are you familiar with that study?
00:37:33 Speaker_02
Yes, and it's that specific oral bacteria, so the Fusobacterium nucleatum, which has been shown to accelerate tumour growth within mice, but also for colorectal cancer and breast cancer as well.
00:37:47 Speaker_01
And what's your belief there? I know this research is fairly new, but do you think there is a causal relationship, a significant causal relationship between the health of our oral microbiome and our probability of developing some form of cancer?
00:37:59 Speaker_02
I wouldn't yet say causal. I think that for most cancers, it is multifactorial and there are a lot of things that can impact whether or not you get the cancer and how aggressive the cancer is.
00:38:13 Speaker_02
I do think that oral health and some specific oral bacteria are risk factors and can definitely increase the aggression of those cancers or even the initiation of them.
00:38:28 Speaker_02
There's also been research, and I think I'm waiting for the research to be published, on what they're doing is they've created an antibiotic which only kills that oral bacteria that I was talking about, so Fusobacterium nucleatum, and they are going to be issuing that
00:38:43 Speaker_02
antibiotic to those patients who have the colorectal cancer, which has the oral bacteria, to see whether or not it slows down their progression or improves their prognosis.
00:38:54 Speaker_02
So if I see those results and it shows it, then there's for sure a strong causative link between the two. But for now, I would say that it's multifactorial and it's definitely a risk factor.
00:39:04 Speaker_01
That oral bacteria that you're describing, you called it Fusobacterium?
00:39:08 Speaker_02
Yeah.
00:39:09 Speaker_01
What is it that causes that? Is it something that I'm eating? Is it a lifestyle choice I'm making?
00:39:14 Speaker_02
Multiple things. Poor oral hygiene. Some of us genetically will have higher levels of it. It's what we eat. It's who we're kissing. It's what we're breathing in.
00:39:24 Speaker_01
Does my girlfriend have it?
00:39:27 Speaker_02
So we'll have to see.
00:39:28 Speaker_02
But it's, and that's the thing, that's the beauty of being able to test these things now is that you can actually see, and also what's strange is that green tea, you know, something so simple is extremely effective at killing Fusobacterium nucleatum.
00:39:42 Speaker_02
So it's just knowing those types of things, being able to do the test, knowing the right treatment plans and recommendations based from that, we know green tea is good for us. And now we can really understand why.
00:39:53 Speaker_01
Okay, that's interesting. You have actually tested Jack over there, right? And you said to me before we started recording that he's got a ton of that Fusobacterium.
00:40:01 Speaker_02
Yes, he does, yeah.
00:40:02 Speaker_01
And it's really getting out of control, is what you said.
00:40:04 Speaker_02
It's really badly out of control, yeah. So I've... I've given him a big vat of green tea as a gift.
00:40:12 Speaker_01
Green tea?
00:40:13 Speaker_02
Yes.
00:40:13 Speaker_01
Green tea. This guy's going to edit that out. This is the problem. Green tea?
00:40:24 Speaker_02
Yeah.
00:40:25 Speaker_01
That's good for my oral microbiome.
00:40:26 Speaker_02
Yeah, really good. Stains, but really good. It's anti-inflammatory. It helps with what we call oxidative stress. So this is basically stress for the body. And it's antibacterial. So it actually is very effective at killing Fusobacterium nucleatum.
00:40:43 Speaker_01
What is your opinion of the impact that coffee has on my oral microbiome?
00:40:48 Speaker_02
I'm slightly biased because I love coffee, but there is no negative impact of coffee on the oral microbiome directly. Coffee does dry your mouth out and so you have reduced saliva and that can actually cause problems for the oral microbiome.
00:41:07 Speaker_02
So the saliva is super important in your mouth. It provides all of the food, the proteins, everything for the bacteria in your mouth. So it's kind of like this delivery service.
00:41:17 Speaker_02
You're delivering, it's traveling around, providing all the food and bacteria, sorry, food to the bacteria. And that's what keeps the good bacteria alive and happy.
00:41:27 Speaker_02
So when you have a dry mouth, let's say you're drinking lots of coffee or you're very nervous or you are on antidepressants, for example, which are a big one, then you just don't have as much saliva.
00:41:37 Speaker_02
So those bacteria don't have as much food, and those bacteria die, and then you get bad bacteria growing in replacement.
00:41:45 Speaker_01
What about tea? We're a nation of tea drinkers in the UK.
00:41:49 Speaker_02
Similar, so it also does dry your mouth not as bad as coffee, but otherwise no problems other than staining.
00:41:55 Speaker_01
What about if I put loads of sugar in it? Because a lot of people put a lot of sugar.
00:41:58 Speaker_02
OK, yeah. No, no, no. Never. No, no. So actually, sugar in your tea is even worse than you having a biscuit, for example. So because the sugar dissolves in your hot tea and the tea is hot, when you drink it, it can actually cause more problems.
00:42:14 Speaker_02
Another thing with sugar is I have a sweet tooth. I love sugar. But it's about how you eat your sugar. So let's say if you have your hot tea with five lumps of sugar in there.
00:42:24 Speaker_02
and you're sipping it over an hour or two, that's where you start to see a lot of problems. So actually, you need to be having a sugar attack, so just all the sugar in one go.
00:42:34 Speaker_02
And that way, your mouth has all the sugar in one go, and it's able to neutralize the saliva and get back to a good state as quickly as possible.
00:42:42 Speaker_02
Every time you sip your tea with sugar, what happens is that the saliva has to go from acidic, back to neutral, acidic, back to neutral, acidic, and then it starts to just not work properly and the saliva just stays acidic and that's where you start to see decay.
00:42:56 Speaker_01
So you want to just down the tea?
00:42:58 Speaker_02
down the tea or I don't know if you're an M&M guy, have all your M&M's in one go, don't snack on M&M's every 10 minutes.
00:43:05 Speaker_01
What about other drinks like, I don't know, Coca-Cola's and these other sort of fizzy drinks that might have artificial sweetness in, things like that?
00:43:13 Speaker_02
So they're not as bad as your natural sugars, but for example, something like your Coke or Fanta or whatever, it's also very acidic and it can actually cause erosion as well.
00:43:26 Speaker_02
So this is essentially where the outer layer of your tooth, so the enamel, is just worn away from having lots and lots of these fizzy drinks.
00:43:33 Speaker_01
Okay, so it's not going to cause decay in the same way, but it might change the acidic balance, which then decays my tooth, which makes me more susceptible to when I eat sugar, to having a problem.
00:43:45 Speaker_01
So going back to what we were talking about, the implications of an oral microbiome on the rest of my body, brain health is one thing that I was really curious about.
00:43:52 Speaker_01
We've had lots of conversations on the show about Alzheimer's and dementia, and just general sort of optimal cognitive performance as I age. It's something I'm thinking a lot about. I want to have a sharp brain.
00:44:01 Speaker_01
It's quite important because of what I do. So is there a link between my oral microbiome and my cognitive and brain health?
00:44:08 Speaker_02
Yes, so if we look at actually just the occurrence of Alzheimer's and gum disease or oral health, a lot of research has shown that if you have gum disease for more than 10 years, you have a 70% increased chance of developing Alzheimer's.
00:44:29 Speaker_02
So that was a study that was done on over 20,000 people and they followed them for 20 years and they saw, okay if you had gum disease at baseline, whether or not you get Alzheimer's at 10 years or 20 years, So a 70% increased chance of it.
00:44:44 Speaker_02
They've also done a lot of research where they've been looking at oral bacteria. And what they found was that there are certain oral bacteria, so one called P. gingivalis. That's one of the worst oral bacteria, I would say, out of all of them.
00:44:59 Speaker_02
So this P. gingivalis is able to travel from your mouth
00:45:02 Speaker_02
to your brain, it's only quite close by anyway, and what's unique about this bacteria is it's able to cross the barrier in your brain, so the blood-brain barrier, and it releases these toxic enzymes.
00:45:15 Speaker_02
So these enzymes are called gingipanes and they're imagining these like horrible firefighter things and they can break down neurons, they can break down a lot of brain tissue.
00:45:26 Speaker_02
And so when they looked at the cerebral spinal fluid and the brain fluid or tissue of Alzheimer's sufferers, they found that 97% of them
00:45:34 Speaker_02
had these toxic enzymes, these gingipanes, in their brains compared to zero for the patients who did not have Alzheimer's. So this is, you know, the first study shows, yes, there's some sort of correlation, but there's a lot of other risk factors.
00:45:48 Speaker_02
The second one, which is looking at your gingipanes, is showing that there's definitely a strong causative factor between the two. And then another study, which was very interesting, was looking at cognitive decline.
00:46:02 Speaker_02
So, okay, fine, you have Alzheimer's, unfortunately, is it too late? Should you stop brushing your teeth or what's the point?
00:46:10 Speaker_02
And so what they did was they had patients who had Alzheimer's and they checked their cognitive function and they also checked their oral health.
00:46:18 Speaker_02
And then six months later, they reviewed them and they found that the patients who had gum disease had a much more rapid cognitive decline than those patients who didn't have gum disease.
00:46:29 Speaker_02
So again, it's still important if you do get Alzheimer's that you maintain your oral health, that you have someone help you brush your teeth because your cognitive decline will be faster.
00:46:40 Speaker_01
How do they unpick that from other causal factors that might be going on, like bad food choices?
00:46:46 Speaker_01
Because in my head I was thinking, well, if someone's drinking sugary fizzy drinks every day, they're more likely to have gum disease, but maybe also that the chemicals within that fizzy drink are impacting their chances of dementia.
00:47:00 Speaker_01
Maybe they're also... someone that has an unhealthy lifestyle. Maybe they're more sedentary. If they're eating bad things, maybe they're more sedentary. And maybe it's that that's causing the rapid cognitive decline versus the gum disease itself.
00:47:11 Speaker_01
Is it possible to untangle all of this?
00:47:13 Speaker_02
I mean, it is very difficult. I think that for those types of things, either you're right, diet, lifestyle is super important. And we know that Alzheimer's is again, multifactorial. I think it's really about the quantity of patients that they check.
00:47:27 Speaker_02
So they need to be looking at a huge number of patients, and they did, to check whether or not there is a strong correlation between them.
00:47:38 Speaker_02
Also, going back to the gingive pain study, so the one about the bacteria, that shows it's not diet or lifestyle or nutrition, it is a specific oral bacteria that has traveled to the brain and released these enzymes, which are then breaking down neurons.
00:47:53 Speaker_02
So there, there's definitely a strong causative effect.
00:47:57 Speaker_01
That is fascinating. It's really, really fascinating because dementia and Alzheimer's still seem to be a bit of a mystery.
00:48:03 Speaker_02
It is. And I work with a team for Alzheimer's and what they've done, similar to what you were saying, is that they've kind of separated all of the causes of Alzheimer's that we know, or the risk factors.
00:48:17 Speaker_02
And thankfully they've put oral health as one of them as well. And I think from all of the other risk factors, so, you know, for example, if you have the genetic mutations. You've got the APO4 or any of those mutations.
00:48:31 Speaker_02
You can't change that, unfortunately. Some of us have mutations, which means that we are at a much higher risk of getting Alzheimer's in the future.
00:48:39 Speaker_02
But something like that oral bacteria, P. gingivalis, and those gingipanes, you can get rid of P. gingivalis really easily.
00:48:45 Speaker_02
Again, if you tested it, you can even test for gingipanes, and then you can get rid of the bacteria before it starts causing problems.
00:48:54 Speaker_01
The test that you offer, does it test for gingive pains? It does, yeah.
00:48:56 Speaker_02
So we're the only ones on the market who do because that was something that I thought was super important.
00:49:02 Speaker_02
What's the point in us telling you that you have a bacteria if we can't tell you that that bacteria is being really bad in your mouth and causing a lot of problems?
00:49:11 Speaker_01
And people think I'm joking, but you have actually tested several members of my team, including myself. So I am actually going to find out the results today.
00:49:17 Speaker_01
On the subject matter of the brain, is there a link between my mental health, depression, anxiety, and my oral microbiome?
00:49:27 Speaker_02
So again, there's been a lot of research. I think it's difficult for something like mental health and gum disease, which, you know, the chicken and the egg, which one came first?
00:49:40 Speaker_02
Because one of the issues is if you have a decline in your mental health, you are less likely to take care of your oral health, and therefore that can exacerbate issues. So there has been a lot of research to show that, you know,
00:49:53 Speaker_02
there's a correlation between poor mental health and poor oral health. But in my personal opinion, that causative connection is not there yet. There's also been some research with things like schizophrenia.
00:50:05 Speaker_02
But again, it's the jury's still out, in my opinion.
00:50:10 Speaker_01
Are you able to tell the state of someone's mental health by looking at their oral microbiome, in your view?
00:50:16 Speaker_02
You can know if something's up. Like for example, I had a patient relatively recently. I've been treating her for five, six years now. And I know that she takes good care of her teeth. She takes good care of herself.
00:50:29 Speaker_02
And a few weeks ago she came in and she was not taking care of her gums or her teeth at all. Everything was an absolute mess in there. And so I did pull her aside and I was like, what's wrong? Like something's happened here.
00:50:41 Speaker_02
And I think it is quite a big, sign for a lot of people. It's the first thing that they kind of let go of is their oral health.
00:50:50 Speaker_01
And is that because of, you know, they start certain self-soothing behaviours because they're stressed in other parts of their life.
00:50:56 Speaker_01
So if they're having a bad time in their relationship or work and they're stressed, they might start eating sugar more or smoking or drinking more. Or just not brushing their teeth.
00:51:04 Speaker_02
Or just not brushing, like with this woman, she just wasn't brushing her teeth anymore. Another thing that we can also see, I mean, it's kind of a bit on a tangent, but also eating disorders as well. So things like bulimia,
00:51:17 Speaker_02
or even sometimes anorexia, you can see in the mouth. So there's a lot of times where we'll see young teenagers and I'll know that they are bulimic because they have certain issues in their mouth which they shouldn't have.
00:51:29 Speaker_02
And that again is a telltale sign.
00:51:31 Speaker_01
Is that because the stomach acid is coming through their mouth?
00:51:33 Speaker_02
Yeah, so they get a lot of erosion on their teeth. And then in some cases, you can also get these marks on the roof of your mouth. So if they're trying to force themselves to vomit, then you can see that.
00:51:44 Speaker_02
And that's something that, you know, you have to pull the patient aside or tell their mother and explain that to them as well.
00:51:50 Speaker_01
And is there a relationship between stress and my oral health? So if I'm more stressed and my cortisol levels are higher, is that going to make everything in my mouth worse?
00:51:58 Speaker_02
Yes.
00:51:59 Speaker_01
Even outside of the lifestyle choices I might make in such a state?
00:52:02 Speaker_02
Yes, just that stress will increase your inflammatory markers, your inflammation. It also will dry your mouth out and all of those things will be linked.
00:52:13 Speaker_02
We do a lot of testing at my clinic and so one of the tests that we look at is collagen breakdown. So we have lots of different types of collagen all over our bodies. and our gums are made up of a certain collagen.
00:52:25 Speaker_02
So we look at an enzyme called AMMP8, and this enzyme is responsible for breaking down that specific collagen. So we test that enzyme all the time with our patients.
00:52:36 Speaker_02
It's a really nice way of knowing whether or not someone is about to have gum disease, how much collagen breakdown is happening from a biomolecular level. So I had a woman, very healthy, always been fine.
00:52:49 Speaker_02
And then she had her collagen breakdown tested, and her levels were through the roof. Her gums looked fine. She didn't look like she had any problems, but I've never seen such a high level in my life.
00:53:00 Speaker_02
And so, you know, I'm trying to think of what could be causing it, all of that. And she'd lost her baby a couple of days before. And that type of... intense stress on someone's body can have so many effects and impacts on the rest of your body.
00:53:15 Speaker_02
And that was one of them. When we retested her six months later, she was back to normal again. But you can see even your mouth, you know, stress can really impact you.
00:53:25 Speaker_01
On this subject, I was thinking about, I mentioned James Nesta earlier, who was telling me about the research of how the mouth has changed shape because of the foods we're eating and how that's caused a bunch of downstream implications for us.
00:53:38 Speaker_01
One of the other things he also mentioned was about mouth breathing and nose breathing. And there's a lot of people that have become incredibly interested in whether we should be breathing through our mouth or our nose.
00:53:50 Speaker_01
And I was wondering if you had a perspective on that. And also the other thing that he mentioned to me was that there's a link between mouth breathing and things like ADHD. What is your point of view?
00:54:03 Speaker_02
I completely agree with all of that. So actually my sister, she is an orthodontist. So she works at our clinic and we run it together with our mother and she is very, very hot on mouth breathing.
00:54:18 Speaker_02
And what she mainly does is she basically tries to stop children in particular from breathing with their mouths open. And what she has found is that most of her patients who come to her are mouth breathers. They often have some sort of ADHD.
00:54:35 Speaker_02
They have some sort of attention deficit. They are bedwetters. They grind their teeth a lot of the time. And they have a whole cascade of other problems. And she can treat it then, and it's relatively easy.
00:54:50 Speaker_02
She would argue that it's very difficult, but to me, I think it's easy. I'm like, yeah, there we go. You can do what you do. And because the jaws of a child are very malleable, so they haven't fully solidified, so you can still move things.
00:55:01 Speaker_02
You can get the teeth to meet. So if you get the teeth to meet correctly, then the child won't want to breathe with their mouth open.
00:55:09 Speaker_02
The annoying thing is that a lot of adults are mouth breathers because their teeth do not meet correctly or their jaws are in the incorrect position.
00:55:17 Speaker_02
And at that point, it is quite difficult to move the jaws into the correct position or to get the teeth to close in a way so that the lips are at rest and you breathe with your nose instead of your mouth.
00:55:29 Speaker_02
But again, I see those types of patients because they all come to me with a lot of other problems. So again, same thing. A lot of them have suffered from long COVID. A lot of them have inflammatory conditions, are always tired.
00:55:44 Speaker_02
A lot of them chronic fatigue. There's a lot of connections now between mouth breathing and those types of issues as well.
00:55:52 Speaker_01
Is there a link between the health of my oral microbiome and whether I breathe through my nose or mouth? Because James was explaining to me that the nose is effectively like a filter system.
00:56:01 Speaker_00
Yeah.
00:56:02 Speaker_01
There's a certain temperature in there. Yeah. There's like sinuses and stuff which have some kind of mucus which helps to catch bacteria. So if I'm breathing through my mouth, am I more likely to have an unhealthy oral microbiome?
00:56:14 Speaker_02
100%. So exactly the same thing. You've got a filter in your nose, and so it will stop a lot of bad things from coming through. But the mouth, there is no filter. I mean, you breathe it in, it goes straight into your lungs.
00:56:26 Speaker_02
So there's no way of stopping anything. A lot of people now are starting to mouth tape, and that's become kind of trendy and cool. Not the easiest thing to do. It seems a bit weird to tape your mouth at nighttime.
00:56:41 Speaker_02
But for anyone who's worried that they breathe with their mouth open, mouth taping, in my opinion, is a really nice way of just like testing it out and seeing whether or not you do breathe with your mouth open, because you'll do some mouth taping and you can see whether or not you sleep better.
00:56:54 Speaker_02
So if you have a wearable, you can see, oh, wow, my oxygen levels are so much better, I had such a deep sleep.
00:57:00 Speaker_02
And if that's the case, you might be more inclined to straighten your teeth or sort out the reason that you're breathing with your mouth open.
00:57:08 Speaker_01
I took notes of a study which kind of is interconnected to the point we're making about mouth breathing, which said in a six-year study of 11,000 children, it was found that children who suffered from sleep disorder breathing were 50 to 90% more likely to develop ADHD-like symptoms than were normal breathers who breathed through their nose correctly.
00:57:29 Speaker_01
which is absolutely staggering, 50 to 90% more likely to suffer from ADHD-like symptoms just because they breathe through their mouth at night and have disordered breathing.
00:57:40 Speaker_02
It's mainly to do with also oxygen being delivered to your brain. So there's not as much good oxygen, like real rich oxygen, filtered oxygen, traveling to the brain. And so that's basically not allowing your brain to function as well.
00:57:55 Speaker_01
You mentioned kissing earlier on.
00:57:56 Speaker_02
Yes.
00:57:58 Speaker_01
I'm still supposed to kiss my partner, right?
00:58:00 Speaker_02
Yes, I hope you do. Many times.
00:58:02 Speaker_01
You said, if I kiss her more than 11 times a day or something, then our oral microbiomes synchronize in some way.
00:58:09 Speaker_02
Yeah, so there is passage of bacteria from you to her and her to you.
00:58:14 Speaker_02
They have also shown that, for example, they did a study where one partner chewed lots and lots of probiotics, so like good bacteria, and then had a super long smooch with their partner and actually was able to transfer nearly 60 or 70% of that good bacteria
00:58:33 Speaker_02
into their partner. So it's not necessarily long lasting. I wouldn't say that, you know, if you kiss someone once on a night out that you are going to terribly impact your microbiome, it's fine.
00:58:43 Speaker_02
You can go and kiss, but it's more for long term partners. If you're kissing regularly and for a long time, then yes, your microbiomes will start to be quite similar. Another factor as well is that obviously your lifestyles are probably pretty similar.
00:58:56 Speaker_02
You're probably using the same toothpaste, eating the same food. So it's difficult to fully put it on just kissing. But yeah.
00:59:03 Speaker_01
What about oral sex and the implications that will have? So if we're, if me and my partner are doing oral sex on each other, is that going to impact our oral microbiome?
00:59:12 Speaker_02
Yes, so actually there's been a few case reports which have shown, there's one in particular and I've had a patient as well who had this, a woman who had a new partner and she liked to perform oral sex on him and then she came to me because she was complaining of very inflamed gums and she was getting gingivitis.
00:59:34 Speaker_02
And, you know, it's not something I really ask. Like, I'm not going to be like, how's your, how's your sex life going these days? Like, so I didn't ask it, but she kept on coming back to me. No, my gums are still inflamed.
00:59:43 Speaker_02
No, my gums are still inflamed. And then she asked, she was like, is it maybe because I have a new partner? I was like, okay, maybe you guys are kissing a lot. And she was like, no, no, no, no. And then she explained to me.
00:59:52 Speaker_02
And then I was like, okay, fine, why don't you go and test and ask him whether or not he has any issues. And it turns out that he was having recurrent urinary infections.
01:00:01 Speaker_02
And so actually they were transferring bacteria and she was having inflammation in her gums because she was pregnant. yeah, performing her oral sex. So yeah, there is transfer. Again, I wouldn't be scared and say never do it.
01:00:16 Speaker_02
I once made an ex-boyfriend do an oral microbiome test just to check and just to make sure everything was okay.
01:00:22 Speaker_00
You made him do it?
01:00:23 Speaker_02
Yeah. I don't, it's not a prerequisite anymore, but it was at the time. I was like, ah, let me see.
01:00:30 Speaker_01
Let me just make sure. Of course it is. Of course it is. You must think that when you meet people, you must think, God, I wonder what their oral microbiome is saying, like in a romantic context, because you know the significance of it.
01:00:38 Speaker_02
Yeah, I think it's a, you know, I spend a lot of time and energy making sure my oral microbiome is very nice and balanced. So I wouldn't want anyone messing that up for me. So it's important.
01:00:48 Speaker_01
Are you in a relationship now?
01:00:49 Speaker_02
Yes, I am.
01:00:49 Speaker_01
Have you tested their oral microbiome?
01:00:51 Speaker_02
I've been trying to, but he won't let me.
01:00:54 Speaker_01
You've asked him.
01:00:55 Speaker_02
Yeah, of course I have.
01:00:56 Speaker_01
And what did he say? Mind your own business.
01:00:57 Speaker_02
But I did give him an oral microbiome test. So hopefully he'll just use it. I said, you can even use a fake name. I don't care. I don't, I'm not going to test. I'm not going to check it. I just want you to do the test for me.
01:01:08 Speaker_01
For you?
01:01:09 Speaker_02
For me. Yeah.
01:01:10 Speaker_01
And what's his, what's his rebuttal? He's like, I don't.
01:01:13 Speaker_02
He was like, what happens if you break up with me if I have a really imbalanced oral microbiome? And I was like, I hope that our relationship is stronger than just your oral microbiome, but there's ways to fix it.
01:01:21 Speaker_02
And that's the beauty of the oral microbiome is that it's actually pretty easy to fix and to change.
01:01:27 Speaker_01
If his results came back and he had a terrible oral microbiome, one of the worst you've ever seen.
01:01:31 Speaker_02
Yeah.
01:01:32 Speaker_01
Are you less likely to kiss him that day?
01:01:35 Speaker_02
That day, yes.
01:01:36 Speaker_01
There you go. Don't do the test, my friend.
01:01:38 Speaker_02
No, no, no.
01:01:39 Speaker_01
Don't do the test.
01:01:40 Speaker_02
That's a yes.
01:01:41 Speaker_01
There's no upside to him doing this test. I completely understand.
01:01:43 Speaker_02
And then I would go and creep into his bathroom and change all of his oral products.
01:01:47 Speaker_01
This is what he's scared about.
01:01:48 Speaker_02
Personalize everything for him and then...
01:01:50 Speaker_01
You've done that already?
01:01:51 Speaker_02
I already have, yeah. He tests everything out for me as well, because I get a lot of products sent to me, so I'm always getting him to try things out for me as well.
01:01:59 Speaker_01
Okay, so no blowjobs if they've got issues down there?
01:02:03 Speaker_02
Yeah.
01:02:04 Speaker_01
Okay. And we don't really know if they've got issues down there unless they admit it or do some kind of test?
01:02:08 Speaker_02
Yeah.
01:02:09 Speaker_01
Okay. What about fertility? Is there a link between our oral health and our fertility?
01:02:14 Speaker_02
Yes, so if we look at men to start with, there was a study done and they found, so they looked at a group of subfertile men, so men who weren't able to conceive with their partners, and they checked all of their mouths and they found that over 90% of these men had some sort of oral infection or dental disease of some sort going on.
01:02:39 Speaker_02
they split the group into two, half the group had the treatment that was needed, so I don't know if they had gum disease or decay, they got it fixed, and the other half were left to their own devices.
01:02:51 Speaker_02
After eight months, there was a 70% improvement in their success for pregnancy, the men who'd had their oral infection sorted, and they had a much better improvement in their sperm quality and motility as well.
01:03:06 Speaker_01
And what did they do to those men in that group where they saw the significant improvement?
01:03:10 Speaker_02
So for example, if the man had gum disease, they would treat it with hygiene. Or if they had an infected tooth, maybe they would take it out or do a root canal or et cetera. They would just have to treat that infection.
01:03:23 Speaker_02
So I speak a lot about gum disease all the time, but actually there's so many other oral diseases like decay or toothache or all those types of things that can also contribute inflammation and problems.
01:03:35 Speaker_01
In that study, six months after that, their sperm had improved by 20% and after eight months, 50% of their wives were pregnant.
01:03:42 Speaker_03
Yes.
01:03:43 Speaker_01
That is staggering.
01:03:44 Speaker_03
Yeah.
01:03:45 Speaker_01
What about women though? Is there a similar sort of result as it relates to women's fertility?
01:03:50 Speaker_02
Yes, so researchers also found that if a woman has gum disease, she is less likely to ovulate and also she's going to have issues with conception.
01:04:02 Speaker_02
So they found that women with gum disease, it takes them two months longer to conceive versus a woman who doesn't have gum disease. But once the woman has conceived, the issue is still not over. She still has to maintain her gums.
01:04:15 Speaker_02
So firstly, a lot of women will have pregnancy gingivitis. So this is basically super inflamed, puffy gums because of all the hormones. And so they should be going very regularly to see their hygienist.
01:04:27 Speaker_02
But also what the research has found is that women who are pregnant and have gum disease are at a much higher risk of preterm birth. So premature babies, low birth weight, and also preeclampsia as well. So they did a study in Malawi.
01:04:42 Speaker_02
It was on 10,000 women. So Malawi has the highest rate of preterm birth in the world at just about, I think, just under 20%. And preterm birth is a big issue for governments, for hospitals. It's really expensive.
01:04:59 Speaker_02
You need to keep the woman and the child in the hospital for a lot longer. But also that child will have a whole myriad of problems afterwards as well. So weirdly, Wrigley's, the sugar, the chewing gum company, sponsored this study.
01:05:13 Speaker_02
They went to Malawi, they had these 10,000 women, they split them up into two. 5,000 of those women were given sugar-free chewing gum, toothbrush and some toothpaste, and the other half were left alone.
01:05:24 Speaker_02
And they found that there was a 20% reduction in preterm birth in the woman who'd had the sugar-free chewing gum compared to the woman who hadn't had it.
01:05:36 Speaker_02
So something so cheap and so easy, like chewing gum, was able to actually reduce the risk of preterm birth for these women. How and why? So if you look into the research a little bit more, I'm going to get your chewing gum now. Yes.
01:05:51 Speaker_02
So sugar-free chewing gum has been shown to stimulate your saliva, so it helps with what we were talking about earlier, saliva is super important and it provides all the good food for your bacteria.
01:06:05 Speaker_02
But then also if it's sugar-free, let's say it's using xylitol, that's naturally antibacterial, so it's killing a lot of the bacteria in the mouth.
01:06:13 Speaker_02
And what they found is that there are certain oral bacteria that can travel down to the placenta and can also cause problems there and essentially increase the chance of preterm birth.
01:06:25 Speaker_01
You sufficiently convinced me that saliva is an important thing, and I actually did one of your tests. Let me go grab the results.
01:06:31 Speaker_00
Okay.
01:06:33 Speaker_01
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01:07:57 Speaker_01
Here are the results. I've not actually seen them yet, so this is exciting. I'll give them to you so you can explain them to me. So this is the test that I did, right? Yes, you did.
01:08:13 Speaker_01
The test I did contains this little kit that basically in the middle of the office one day, someone came up to me and said, Steve, can you spit in this? And I said, sure. And then they took my spit away. And it turns out it was upon request from you.
01:08:31 Speaker_02
Yes, exactly. I wanted your saliva. Just to check to make sure if I could do this interview.
01:08:37 Speaker_01
So this is the test that I did. I spat in this little thing, sent it off back to you, you ran the test. How long does it take to do this test?
01:08:45 Speaker_02
It would probably take you about two minutes to do it yourself and then you get the results three to four weeks later.
01:08:51 Speaker_01
What did you find out from doing my test?
01:08:54 Speaker_02
Well, let's go through your results. So we found that you have quite a diverse microbiome. So that means that you have a nice ratio of good bacteria versus bad bacteria. And this has been compared to healthy and diseased subjects.
01:09:10 Speaker_02
So you are really right on the top of the bell curve. So very good with that. So happy. Then we predict your... Diverse is better. Arguably, yes.
01:09:21 Speaker_02
Then what we have is we've created this algorithm that predicts your risk of certain issues or diseases in the mouth. So those are things like bad breath, gum disease, decay and general inflammation. So your risk of bad breath was low.
01:09:36 Speaker_02
You didn't have a high risk for that. Gum disease was medium. So slight, maybe there's a bit of inflammation going on there. Your risk for decay was also medium.
01:09:48 Speaker_02
and your risk for general inflammation, so this is inflammation throughout the rest of your body, was quite low. And then if we zoom in, we then look at your good bacteria.
01:09:58 Speaker_02
So we're also quite unique because we thought that it was unfair that a lot of tests don't look at the good stuff. So we look at all of the bacteria which has been shown to be the most beneficial in a microbiome.
01:10:09 Speaker_02
So for you, you had pretty much high to very high levels of good bacteria, which is great. No problems with that. And then we look at bad bacteria. So we actually look at
01:10:22 Speaker_02
about 500 different bacteria, but then we zoom into the top 20 bad ones, which are really associated with things like gum disease, decay, bad breath.
01:10:31 Speaker_02
So for you, out of all the bacteria that we looked at, you only had quite high levels of one bacteria, which was bad for you. And so this bacteria is very strongly associated with basically a lot of buildup of plaque in your mouth.
01:10:46 Speaker_02
So having not looked in your mouth, I have no idea about your dental health or anything like that. I would assume that basically you're a bit overdue on a hygiene maybe. Maybe there's a lot of plaque buildup going on from that result.
01:11:00 Speaker_02
But the rest of the bad bacteria, so all of these ones we're talking about... The erectile dysfunction ones. The erectile dysfunction ones, fine. Your P. gingivalis is fine. You know, F. nucleatum. Those ones were actually very good.
01:11:13 Speaker_02
Then, also on top of that, going back to the Alzheimer's, so we look at those virulence factors associated with P. gingivalis, and you had none of those virulence factors, which is also really good.
01:11:24 Speaker_01
Okay.
01:11:26 Speaker_02
we look at your genetic mutations. So we've identified about 10 different genetic mutations which increase your risk of decay and gum disease. So for the decay out of the five genetic mutations we looked at, four out of five of them you hatch.
01:11:41 Speaker_02
So that means that you, and maybe you have stopped it, but you are at a higher chance of having a sweet tooth of having more acidic saliva.
01:11:51 Speaker_02
On top of that, it might be that you, if you're stressed out or you're really unhappy, some people will run to the casino, others will run to the bottle.
01:12:00 Speaker_02
And for you, you might actually be someone who goes and has a chocolate bar and actually enjoys sugar.
01:12:04 Speaker_01
No comment.
01:12:05 Speaker_02
On top of that... None of your business. Let's say you've had your sugar because you are stressed out or whatever. You also have been shown to have a genetic mutation, which means that your taste perception is lower.
01:12:17 Speaker_02
So you need two bars of chocolate, not just one.
01:12:20 Speaker_00
No comment. No comment.
01:12:21 Speaker_02
To make you feel happier.
01:12:22 Speaker_01
That's the end of this broadcast. That's the end of this episode. I'll give you my card afterwards. Close the file. Close your document. How dare you? No, I mean, it all squares with reality. So please do keep going.
01:12:35 Speaker_02
So that's your decay situation. In terms of gum disease, again, we look at certain mutations. So there are some mutations that can triple your risk of gum disease. They can increase the amount of inflammation that you release from your mouth.
01:12:50 Speaker_02
So imagine there are some people who even the smallest amounts of bacteria, they may have great hygiene, they have a few small bad bacteria in their mouth, they have mutations, which means that they respond in a very,
01:13:02 Speaker_02
hyper-inflammatory and very aggressive way and they will be at a very high chance of gum disease. So in your case you had one mutation and I would say out of all of the mutations for gum disease it was the best one. So it basically means that you have
01:13:20 Speaker_02
genetically you're more predisposed to bacteria collecting around your gums.
01:13:25 Speaker_02
So you might be someone who actually needs to go really regularly for a hygiene and it's kind of annoying because you keep on getting build up or they keep telling you to come back because actually genetically you have that in your saliva.
01:13:38 Speaker_02
Then afterwards, we give you personalized recommendations.
01:13:41 Speaker_02
So we tell you based on everything that we've seen, the bacteria, your mutations, what your input from the questionnaire, we tell you what toothbrush would be good for you, what supplements you should be taking, what toothpaste, floss, everything basically, even chew sugar-free gum, all of those types of things to improve your oral health and rebalance your microbiome.
01:14:03 Speaker_01
And you could tell all of that just from me spitting in a tube once?
01:14:06 Speaker_02
Yes. And then at the very end, we have a list of all of the detected organisms.
01:14:11 Speaker_02
So like I said, we look at the top 20, which we know are really bad for you, but actually sometimes in some patients will have like weird bacteria, really high levels of weird bacteria.
01:14:21 Speaker_02
So I had one patient, she had really bad breath and her gums were kind of okay, her teeth were okay, there were no problems, but she was like, I don't know what's going on.
01:14:28 Speaker_02
So she did the saliva test and she had 40% of her oral microbiome was made out of one bacteria. So I was searching this bacteria. I was like, I've never heard of this bacteria before. It is extremely prevalent in dogs. So then I got back to her.
01:14:43 Speaker_02
I'm like, do you have any dogs? And she was like, yeah, yeah, I have four or five dogs at home. And I was like, do you kiss your dogs? She was like, yeah, of course I do. They're my babies.
01:14:51 Speaker_02
So she was kissing her dogs, and she was getting transfer of bacteria from her dogs into her mouth. And that was what was making up her whole microbiome.
01:14:58 Speaker_01
And that was giving her bad breath. Yeah.
01:15:01 Speaker_02
So what I did was I gave her a treatment, a recommendation. And no, I gave all of her dogs. I said, you need to take this specific, not medication, it's like a supplement. So it basically stops like buildup of plaque in dog's teeth.
01:15:17 Speaker_02
So I was like, your dogs have gum disease basically. So they need to be treated if you want to get better. And after everyone got treated, her bad breath went and so did her dogs as well.
01:15:28 Speaker_01
So are dog owners more likely to have bad breath?
01:15:31 Speaker_02
If you are smooching your dog, then yeah, kind of. And your dog has gum disease.
01:15:35 Speaker_01
If you're kissing your dog?
01:15:36 Speaker_02
Yeah.
01:15:36 Speaker_01
Okay. Interesting.
01:15:39 Speaker_01
So what are the very, having seen my results, but generally from seeing the thousands and thousands of results that you've seen, what are some of the easiest things that I could do to help correct that situation and have perfect oral health and a perfect oral microbiome?
01:15:57 Speaker_02
So what we've done is if you were to do the test, you would have all of the personalized recommendations for you.
01:16:02 Speaker_02
So we tell you to have green tea, to have honey, all of those types of things which have been shown through research to benefit your microbiome in your case specifically.
01:16:13 Speaker_02
But if we were just talking about someone who hasn't done the microbiome test and wants to just make sure that they have as balanced of a microbiome as possible. Diet is obviously very important.
01:16:24 Speaker_02
So what we're talking about that sugar attack, making sure that you only have one sugar attack a day. You're not having sugar consistently because it does alter your saliva pH, the type of toothpaste that you're using. I like to keep it simple.
01:16:37 Speaker_02
You don't need to We don't need to make things super complicated. You don't have to spend that much money. Having the right toothpaste, right toothbrush and the right floss is honestly as much as is the most necessary thing that you need.
01:16:51 Speaker_01
Okay. So in terms of brushing, you give some sort of practical advice around when we should brush. What is that? And is there any time where I shouldn't brush my teeth?
01:17:00 Speaker_02
You should never brush straight after anything acidic or sugary. So what you end up doing is grinding the sugar or the acid into your teeth. So actually you should wait 30 minutes until you brush your teeth.
01:17:13 Speaker_01
That's interesting, because when I eat something sugary, I feel like I need to brush my teeth to get rid of it.
01:17:17 Speaker_02
Yeah, no, no. So you want to wait 30 minutes.
01:17:20 Speaker_02
So instead, you can chew some sugar-free gum, or there are lots of pastels that we use, so I use chewable mints, and you can chew one of those, and it will actually neutralize your saliva really quickly, so that you don't have that acid causing the demineralization.
01:17:37 Speaker_01
And you said that I should brush my teeth first thing in the morning and last thing before I go to bed? Yes.
01:17:42 Speaker_02
Okay, just because that's the sort of biggest window, I guess, that's the best way to... Yeah, the most important time to brush your teeth is right before you go to bed, because you spend two minutes spreading all this lovely goodness on your teeth,
01:17:55 Speaker_02
And then when you go to sleep, going back to saliva, when you sleep, your saliva flow reduces massively. So all of a sudden, these bacteria are left to their own devices.
01:18:04 Speaker_02
And if you don't have good toothpaste there, then they can cause a lot of problems.
01:18:08 Speaker_01
And do I spit or do I rinse after I've brushed my teeth?
01:18:11 Speaker_02
Spit. So you should never rinse your mouth out with water after you brush your teeth. So brush, brush, brush, spit into the basin, and that's it.
01:18:19 Speaker_02
Reason being, again, going back to my sunscreen analogy, imagine you spend two minutes putting all this lovely sunscreen all over your skin to then just go and have a shower right before you go into the sun.
01:18:30 Speaker_02
So with the toothpaste, you spend two minutes putting all of that on your teeth. And then if you rinse it, then you're actually removing all of that goodness from your teeth and gums. And it's kind of like you haven't done anything.
01:18:42 Speaker_01
Toothbrushes. Yes. Which toothbrush should I use, this one or an electric one?
01:18:48 Speaker_02
I generally prefer an electric toothbrush. Why? Usually they kind of do the work for you. So it just means that patients have better oral health because most people don't know how to brush their teeth properly, actually.
01:19:01 Speaker_02
We're never really taught or trained, or we get taught by our parents. Our parents don't really know. They've been taught by their parents. So a lot of people don't actually know how to brush their teeth, number one.
01:19:10 Speaker_02
Number two, we often don't brush for as long as we think that we are. So we're meant to brush for two minutes. The average is 20 to 30 seconds, and we think that we're brushing for two minutes, but we're not.
01:19:21 Speaker_02
So with an electric toothbrush, it times you, and then also a pressure sensor.
01:19:24 Speaker_02
So the electric toothbrush often will have a pressure sensor, which will show you whether or not you're brushing too hard or you're brushing at the right pressure, and that will reduce your chance of recession.
01:19:34 Speaker_01
Can you show me on one of those tooth models in front of you, the area of the mouth and teeth that people most often overlook?
01:19:41 Speaker_02
Yes. Can I have your tooth?
01:19:43 Speaker_01
Yes.
01:19:45 Speaker_02
So I would say the area that people usually struggle with the most is the insides of their very back bottom teeth.
01:19:53 Speaker_01
So inside, where, next to my tongue?
01:19:55 Speaker_02
Basically, yeah. Just near your tongue, basically. What a lot of people will do is they'll kind of, they'll go on the inside and they brush their teeth like this. Okay.
01:20:03 Speaker_02
Whereas actually you want to get your elbow up and you want to brush a lot more at like a 90 degree angle when you're getting there.
01:20:10 Speaker_01
It looks like you're brushing the gums a little bit.
01:20:11 Speaker_02
A little bit, yes. You actually do want to brush the gums a little bit. And then when we're on the outsides of the teeth, we want to kind of brush at a 30 degree angle. So rotational movements and at a 30 degree angle.
01:20:22 Speaker_02
So not straight like a 90 degree, but kind of towards the gum margin. And by doing circular movements, we're essentially kind of massaging the gums and getting rid of the bacteria from under the gum and then flicking it out.
01:20:34 Speaker_01
OK.
01:20:34 Speaker_02
Yeah, so just like that. And then I always tell everyone, it's really important to kind of have a method behind your toothbrushing. So don't go like brush and then go there and then up there, you know, because you'll never brush properly.
01:20:47 Speaker_02
So always start, let's say on the left hand side, go do all the outsides and then do all the biting surfaces and then do all the insides and then do the same on the top teeth as well.
01:20:56 Speaker_01
And that model there, you've got another model in front of you, which is like a see-through model. What does that show us?
01:21:02 Speaker_02
So this is to show you what an implant looks like. A lot of people don't know what implants look like and how it looks like if it was within your jaw, also what all the roots look like.
01:21:12 Speaker_02
And then also, if you look on the other side, you can see this tooth, which has the black within it. And it's got like a red bubble at the root of it.
01:21:20 Speaker_02
So this is a tooth that's had a root canal done to it and has an infection at the roots of that tooth. So that's an abscess. And a lot of people don't actually know what that looks like.
01:21:30 Speaker_02
they only feel toothache, but this is what toothache is actually in their jaw.
01:21:33 Speaker_01
When our teeth get teeths, is that the right word? Is that a plural? When our tooths, what's the plural of teeth? It's teeth, isn't it? Just teeth, yeah.
01:21:41 Speaker_01
When our teeth get stained, what we often do is we'll take some sort of whitening toothpaste or we'll go to a dentist or a hygienist or something and ask them to whiten our teeth. Now I've always been a bit scared of that because
01:21:54 Speaker_01
there must be a cost to this whitening industry. Should we be whitening our teeth? Is there any healthy way to whiten our teeth?
01:22:01 Speaker_02
Yes, so you've got two different types of staining. One which is extrinsic, so that's basically your coffee, your tea, your smoking, super easy to get rid of.
01:22:11 Speaker_02
You just have to go to your hygienist and get a hygiene done and they'll get rid of the stains pretty quickly. Or you can try a whitening toothpaste.
01:22:19 Speaker_02
Be very careful with a lot of those whitening toothpastes because they can be quite abrasive and damage the enamel actually. So it's kind of like exfoliating your teeth, but your teeth don't grow back.
01:22:29 Speaker_02
So if you keep on exfoliating and getting rid of that surface layer of enamel over a long amount of time, that can be quite an issue and quite problematic.
01:22:37 Speaker_01
You get sensitive teeth.
01:22:38 Speaker_02
Yeah, sensitive teeth and then the underlying tooth will start to shine through and that's quite yellow. So you actually start ending up doing the opposite of what you wanted to do. Then whitening, so you should do that professionally.
01:22:51 Speaker_02
Don't go and buy some over-the-counter online thing. because a lot of the time either they don't have the right percentages and they can actually damage the teeth and the gums really badly. So you want to get that done professionally.
01:23:06 Speaker_02
If you get it done by a good brand, and even within the professional world, there are some whitening products out there which are really bad for the teeth and others which are actually really good for the teeth.
01:23:16 Speaker_02
So we use one in particular, it's called Enlighten, and the whitening for one day is the equivalent of having a Coca-Cola. So thinking about it, I mean, I'm sure everyone has had a Coca-Cola in their life.
01:23:30 Speaker_02
Having a Coca-Cola every day for, let's say, five or six days is okay in the grand scheme of things. It's not going to massively damage your teeth at all.
01:23:38 Speaker_01
Okay, so there are safe ways to do it. Yeah. Okay, good. And is there any way to remove plaque yourself without having to go to a dental hygienist?
01:23:45 Speaker_02
So you can try a water flosser.
01:23:46 Speaker_01
I've just bought one of those things, but it doesn't feel powerful enough. Because when I go to the hygienist, I don't know what they're using, but it like... It's so strong that it blasts my mouth off. My mouth feels so different after.
01:23:59 Speaker_01
And I wanted to know if I could buy one of those for my home. But I think it's a little bit dangerous.
01:24:05 Speaker_02
Well, the reason I think that the water flossers are not that high intensity is because people can damage their teeth if they don't use it correctly.
01:24:12 Speaker_02
So kind of know there are some supplements that you can take to reduce the amount of plaque that builds up. And that actually does work quite effectively.
01:24:23 Speaker_01
I mean, there were two more there. There's a couple more things there that you have in your pile that we not talked about.
01:24:27 Speaker_02
These are probiotics. Okay. So going back to our microbiome, probiotics are basically good bacteria. So not everyone needs them, but a probiotic essentially will put good bacteria into the microbiome.
01:24:41 Speaker_02
And if it's got the right environment to live in, then it will continue to grow there basically.
01:24:45 Speaker_01
If you're eating the right things. Exactly.
01:24:47 Speaker_02
If you're eating the right things, you've got prebiotics, you know, all of those types of things, then this will be really effective. So these are two different options. This is a mouthwash.
01:24:55 Speaker_02
And again, on the microbiome test that we've created, Oralis One, we look at all the levels of good bacteria, and then we'll recommend a probiotic based on what good bacteria you are missing. So a lot of us are actually genetically, we've been born
01:25:09 Speaker_02
without certain good bacteria in our microbiomes. And so this is really lovely to supplement them. So this is, it's a mouthwash, but it's in a powder form.
01:25:19 Speaker_02
So you take a teaspoon, you mix it with some water and that activates the probiotic and then you rinse it around and you swallow it. So it's a kind of a two-in-one for your gut. This is a pill. So it's a tablet, you chew it and then you can swallow it.
01:25:33 Speaker_02
So this is super easy to, and I love these as well, very easy to use.
01:25:39 Speaker_01
Victoria, what's the most important thing that we haven't talked about today that we should have talked about today?
01:25:45 Speaker_02
The only thing that I think you haven't mentioned that your viewers might benefit from is the use of straws. Straws are very, very important to use for sugar and also for acid. So drinking through a straw actually helps you bypass all of your teeth.
01:26:00 Speaker_02
So if you're having something acidic or really sugary or even something staining, then it bypasses the teeth and goes straight to the back of your throat so you can swallow it.
01:26:09 Speaker_02
So this helps reduce your chance of decay of tooth wear and also staining as well.
01:26:13 Speaker_01
But specifically if it's bad for you, because I'm sure there's some things which are good for the oral microbiome that you do want to be in the mouth.
01:26:19 Speaker_02
Yes, so if you're taking your probiotics or whatever, then of course those are great. Like for example, I'm human, I like a nice Coca-Cola once in a while and I'll drink it through a straw.
01:26:30 Speaker_02
Or if I have alcohol, I'll also drink that through a straw as long as it's not wine. What about smoking and vaping? So yeah, smoking and vaping, neither of them are good for the oral microbiome.
01:26:43 Speaker_02
It goes back to dry mouth, so smoking will dry your mouth out and then you don't have the saliva and the saliva can't do what it wants to. It stops vascularization, so it stops blood flow to your mouth.
01:26:56 Speaker_02
And so a lot of smokers actually will not have bleeding gums. That doesn't mean that they don't have gum disease, but because they are smoking so much, the blood vessels are already really tight and constricted from the nicotine.
01:27:10 Speaker_02
So they don't ever get bleeding gums, even though they have gum disease. And then the third thing is that actually we know that smoking is very strongly associated. It's one of the biggest risk factors for gum disease.
01:27:21 Speaker_01
If someone's now curious about their own microbiome and the work that you're doing, what is the sort of easiest entry point to learn more, to get themselves checked or to, I don't know, to resolve some of the issues that are causal or a consequence of having an unhealthy microbiome?
01:27:39 Speaker_01
Where do they start? How do they find you?
01:27:41 Speaker_02
We have a clinic in central London called the Health Society. We opened about a year and a half ago now. And our aim was to put the mouth back into the body, to explain to patients exactly what's going on in their mouth.
01:27:53 Speaker_02
And we can do that through microbiome testing, other saliva tests. We look at your blood glucose levels, your vitamin D levels. We've got packages. We have an infrared sauna. We have a nutritionist.
01:28:04 Speaker_02
And the idea is that we're working all together because one of the,
01:28:08 Speaker_02
issues I was seeing was that patients, they want to understand what's going on in their mouth and they want to optimize it, but they don't understand a lot of what dentistry is all about.
01:28:18 Speaker_02
We used to live in a world where the dentist would say, okay, you need two fillings and you've got gum disease and you're not brushing your teeth. And that was the end of it. And you would just listen to them and you get your work done.
01:28:27 Speaker_02
But now we are trying to essentially decode dentistry and explain it in a way that patients can understand. So I would say, if it's unbiased, but come over, come to the clinic, we can explain everything.
01:28:39 Speaker_02
Or you can do an oral microbiome test and you can actually understand yourself what bacteria, what genetic mutations you have, what inflammation you have, what products you should start using.
01:28:48 Speaker_02
And then based on that, decide on what dentist you want to go to for any treatment if needed.
01:28:52 Speaker_01
What if I'm in Australia or Canada or New Zealand or America, what can I do?
01:28:57 Speaker_02
So we're actually rolling out the oral microbiome test to all of those countries. So you can actually buy at the moment through that. You just have to email us. But otherwise, I'm not the only one.
01:29:08 Speaker_02
There are other people who are doing this type of dentistry and are thinking in this type of way. So you would have to do a little bit of research, but I guess maybe follow me on Instagram and I can give some top tips.
01:29:20 Speaker_01
I'll link all your website, your social channels below. And if anyone wants to send you an email, you might get a couple of emails warning you now. So you've got to be careful what you wish for. But I'll put all those details below.
01:29:32 Speaker_01
We have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for. And the question that's been left for you is, what is the most important relationship in your life and why?
01:29:49 Speaker_01
This is going to cause you problems. Yeah, I know.
01:29:54 Speaker_02
I would say my mother. I think that is the most important relationship for me. I think she has been One of my biggest mentors. She's been my biggest cheerleader, my supporter. She's hard on us, but that has led to me being the person that I am.
01:30:14 Speaker_02
And I think that if I don't have a good relationship with her, then I can't have a good relationship with other people. She's taught me respect. She's taught me how to handle myself around people. So yeah, I guess a big up to my mom.
01:30:29 Speaker_01
Is she Iranian?
01:30:31 Speaker_02
She is, yeah.
01:30:31 Speaker_01
She's Iranian? Yeah. And your father?
01:30:34 Speaker_02
He is French-American.
01:30:35 Speaker_01
French-American. And if we sit here in 10 years' time, what are you hoping the world looks like as it relates to the oral microbiome, people's understanding of it, the regulations? What are you hoping for? If you could wave a wand.
01:30:47 Speaker_02
I am hoping that the mouth is put back into the body in the sense that dentistry and medicine are fully integrated within each other.
01:30:55 Speaker_02
So you can go to your dentist and you can get a saliva test, and that could flag up issues with your heart or diabetes, and you will go and see your diabetologist. And we link everything together.
01:31:09 Speaker_02
Also, my other dream is that people start testing their saliva and they understand that, you know, blood is not the only way that we can understand things that are going on within our body.
01:31:19 Speaker_01
Dr. Victoria Sampson, thank you so much. I find this so unbelievably fascinating, in part because I've never heard about any of this stuff before.
01:31:26 Speaker_01
And I do this job, you know, I've done it quite a few times now, so I've spoken to a lot of health experts that talk about the brain or infertility or the gut microbiome, but never one that...
01:31:37 Speaker_01
looks at the body and our overall picture of health through the front door or the lens of our oral microbiome. And so it's really, really inspired me.
01:31:45 Speaker_01
And I think sometimes on this podcast, I just love having these conversations because sometimes you just need a little bit more information about the importance of something to make even a small change in your life.
01:31:55 Speaker_01
And as it relates to our microbiomes, our oral health,
01:31:59 Speaker_01
our brain health and all of these things, even a small change can have a big downstream impact when we're talking about areas of our health where things compound over time and can either compound for us or against us.
01:32:10 Speaker_01
And so thank you so much for doing the work that you do and shining a light on this. Your work has been really seminal in sort of driving the conversation, but also turning the lights on to the state and importance of our oral health.
01:32:21 Speaker_01
I'm sure that if we sit here in 10 years time, you would have impacted many, many, many millions of people.
01:32:27 Speaker_01
And that overall picture of health through the lens of the oral microbiome, because of the work you're doing and the message you're putting out there. And that is quite something. So congratulations. Well done. And thank you.
01:32:37 Speaker_02
Thank you so much. Thanks.
01:32:41 Speaker_01
You probably shouldn't be sharing this yet, but you are our Dyer of a CEO community, so I wanted to give you a small first look at a product that we're about to launch exclusively. This is the 1% Diary.
01:32:52 Speaker_01
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01:33:03 Speaker_01
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