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作为一名专注于儿童和成人功能性牙医，我深知口腔健康对整体健康的重要性， 并非仅仅关乎一口洁白牙齿和清新口气，而是与肠道健康、大脑寿命、心脏健康、激素平衡以及男性和女性的生育力息息相关。许多人为了追求美白牙齿和清新口气，所采取的措施却往往适得其反，损害了口腔微生物组，甚至可能引发严重的心血管问题。因此，我们需要从整体角度出发，关注饮食、生活方式以及口腔护理产品成分，而非过度依赖各种产品。

建议大家像阅读食品标签一样仔细阅读口腔护理产品的成分表，了解每种成分的作用和来源。许多常见的牙膏含有十二烷基硫酸钠（SLS）或其衍生物，这些成分会破坏口腔粘膜，导致口腔溃疡。强效薄荷和精油虽然带来清新感，却可能损害口腔中的有益菌。反复出现的口腔溃疡也可能是肠道问题的信号，例如克罗恩病、腹腔疾病或肠易激综合征等。

牙齿处于持续的脱矿和再矿化过程中。进食后，口腔pH值下降，牙齿会发生脱矿；但唾液会自然地进行再矿化，恢复平衡。然而，现代人频繁的零食和饮料摄入，打乱了这种平衡，使口腔长时间处于酸性状态，最终导致龋齿。糖和精制碳水化合物（例如面粉）为口腔中的有害细菌提供养分，细菌代谢后产生的酸会腐蚀牙齿。因此，控制糖和精制碳水化合物的摄入，并减少进食频率（例如间歇乏食），对于预防龋齿至关重要。

健康的饮食习惯对口腔健康至关重要。我建议大家遵循全食物饮食，摄入优质蛋白质、各种蔬菜、适量水果、坚果、种子、橄榄、泡菜以及发酵食品。这些食物为口腔中的有益菌提供养分，维持口腔微生物组的平衡。

牙齿的洁白程度取决于光线在牙齿表面的反射和折射。使用含有羟基磷灰石的牙膏可以改善牙齿表面光滑度，使其看起来更白亮。虽然漂白剂可以快速美白，但会损害口腔微生物组。

服用抗生素后，应补充益生菌来重建口腔微生物组。经常使用含酒精和强效抗菌剂的漱口水会损害硝酸盐还原菌，影响心血管健康。保持唾液健康的关键在于充足的饮水、矿物质补充以及鼻呼吸。通过检测口腔微生物组，可以识别潜在的致病菌，这些致病菌可能导致多种全身性疾病。

大部分人都是口腔呼吸者，这与现代人的饮食习惯和生活方式密切相关。长期口腔呼吸会导致面部结构改变，影响鼻腔容积、鼻窦和气道，最终导致睡眠呼吸暂停等问题。 强烈建议大家尽量进行鼻呼吸。可以通过在睡觉时使用口部贴胶带、进行三分钟鼻呼吸测试等方法来改善呼吸习惯。

牙龈出血是炎症的信号，会影响全身健康，包括性健康。因此，使用牙线清洁牙齿间隙至关重要，可以预防龋齿和牙龈疾病。随着年龄增长，牙线可能无法有效清洁牙齿间隙，这时可以使用冲牙器。

口腔细菌可以转移到大脑、心脏和其他组织，直接导致或加重痴呆症、心血管疾病等疾病。牙龈疾病是许多全身性疾病的风险因素。臭氧疗法具有抗菌、抗病毒和抗真菌作用，可用于治疗牙龈疾病和牙周病原体。油拔法可以去除生物膜，具有抗菌和抗炎作用。

尼古丁产品中可能含有其他有害成分，会损害口腔微生物组，导致龋齿和牙龈退缩。咖啡会使口腔干燥并染色牙齿。建议大家尽量选择全食物，减少加工食品的摄入。使用羟基磷灰石牙膏可以改善牙齿健康和口腔微生物组平衡。

饮用水中添加氟化物并非一种高效的氟化物摄入方式，其长期安全性及有效性仍存在争议。研究表明，孕妇尿液中氟化物浓度较高，其子女的智商测试分数较低。

口腔健康会影响女性激素水平，包括月经周期、围绝经期和绝经期。

• 刷牙: 睡前刷牙比早上刷牙更重要。
• 使用牙线: 至少每天一次，最好睡前使用。
• 冲牙器: 随着年龄增长，可辅助使用冲牙器清洁牙缝。
• 刮舌器: 去除舌苔，改善口腔菌群平衡。
• 油拔法: 每周几次，使用椰子油或其他植物油。
• 鼻呼吸: 尽量进行鼻呼吸，避免口腔呼吸。
• 饮食: 选择全食物，减少加工食品、糖和精制碳水化合物的摄入。
• 口腔护理产品: 选择成分天然、不含酒精和强效抗菌剂的产品，考虑使用羟基磷灰石牙膏。
• 定期检查: 定期进行口腔检查，及早发现和治疗潜在问题。

口腔健康是整体健康的重要组成部分，我们应该从整体角度出发，采取积极的措施来维护口腔健康，从而提升整体生活质量。 切勿忽视口腔健康， 关乎着身体的每一个角落。

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Edit:2025.05.19<markdown>

Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Stacey Whitman. Dr. Stacey Whitman is a functional dentist with expertise treating both adult and pediatric patients. 语法解析

00:23

She focuses on oral health as a key feature of overall gut health and a powerful modulator of brain longevity, heart health, hormones, and fertility in both men and in women. Today, we discuss many of the common myths about tooth and gum care and how to use specific nutrition, breathing, and cleaning methods to repair cavities, whiten teeth, and freshen breath, while at the same time improving the oral microbiome. 语法解析

00:46

This is very important because as Dr. Whitman explains, most of the things that people do in pursuit of better tooth health and appearance and fresh breath actually damage their oral microbiome and indeed can lead to serious cardiovascular issues. So today we discuss how to brush, how to floss. I know we've all heard that we need to brush and floss, but Dr. Whitman explains exactly how to do those so that they are of the maximum benefit for our tooth health, gum health, and oral health generally. 语法解析

01:11

We also discuss the science and benefits of things like tongue scraping and oil pulling. And we discuss fluoride, which of course is a very controversial and timely topic nowadays. 语法解析

01:20

It's a very interesting conversation that I believe everyone, young, old, parents and kids need to be aware of. We also discussed treating things like tongue ties, deviated septums, canker sores and more. By the end of today's episode, you'll have the most up-to-date knowledge about how to take care of your oral health, both for aesthetic reasons and of course to reduce cavities and gum disease, and in doing so, how to support your brain and heart longevity. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. 语法解析

01:50

It is, however, part of my desire and effort to bring zero-cost to consumer information about science and science-related tools to the general public. In keeping with that theme, this episode does include sponsors. And now for my discussion with Dr. Stacey Whitman. Dr. Stacey Whitman, welcome. Thank you, Andrew. I'm super excited to talk about oral health from all perspectives. Your public-facing content, especially on Instagram… 语法解析

02:19

has completely transformed the way I think about this thing that I call my mouth, that people think of as their teeth and their mouth and their breath and their tongue and all this stuff, as a key site for evaluating and maintaining health of my brain, my body. And today you'll make it clear as to why that's the case. I'd like to just start by looking at this oral health thing through the lens of what I think most people think 语法解析

02:47

think of when they hear the words oral health, which is people want, it seems, whitish or very white teeth, depending on their preference. They want fresh breath, or at least to not have bad smelling breath. And they want their mouth to sort of feel good, right? The question I have is, what are some of the things that many, many people do in trying to have white teeth, fresh breath, that actually are very destructive to 语法解析

03:21

for our teeth and our oral microbiome. And if we go through that entry point into this conversation, then we can get into some of the specifics of why that is. So what's something that you see many people doing in terms of trying to have bright white teeth that actually is harming their teeth? Sure. Great question. 语法解析

03:41

Great way to start off. So I first want to commend you and thank you for including the oral microbiome and oral health as one of the pillars of health. That means a great deal and it has a lot to do with this answer. So unfortunately, we have been taught that we need to carpet bomb the mouth. We need to add astringents and alcohols and foaming agents and really strong essential oils and 语法解析

04:04

to clean, disinfect, and to freshen the breath. But we're really, what we're doing with these products is damaging our delicate microbiome, which can make things far worse. So much of oral health is a less is more approach. And 语法解析

04:20

It's not so product heavy. It should be more focused on diet and lifestyle, like anything with health. Unfortunately, dentistry has been separated and compartmentalized out of the body like much of medicine. You know, we're so specialized and subspecialized in dentistry is included in that. And we need to remember it's all interconnected. And what we're doing to the mouth, whether it be strong toothpaste, mouthwashes, certain gums, 语法解析

04:48

And even what we're eating and how we're breathing can really do a number on our oral health. And so it's taking a different perspective and it's a bit of a mindset shift to really get us back to optimization. So do you think that most of the common over-the-counter toothpaste, while they smell minty or pepperminty and taste minty and pepperminty, 语法解析

05:11

Are they effectively cleaning teeth? And are they causing any damage to teeth by virtue of what they have in them? It really depends on the ingredients. So I'd like people to start looking at their oral health care products like they're starting to look at food labels. We should be reading the ingredients and understanding why they're there and what they're doing, where are they sourced from. 语法解析

05:31

But certainly that I think so many of us feel it has to burn in foam to be effective. What is what is toothbrushing? What is it really doing? You're disrupting the biofilm, which is really the plaque or the bacteria that are adhered to your teeth. And so all these extra bells and whistles, it's sort of extra credit. But if you're perfectly imbalanced, we shouldn't need all these stripping agents and strong mints and things anymore. 语法解析

05:57

So, for example, sodium lauryl sulfate is a foaming agent, but it also can be really disruptive to the oral mucosa and can lead to oral ulceration. So that's a common ingredient that causes foaming that I would argue we do not need. Your toothpaste shouldn't foam, nor should it burn. Essential oils, we think, oh, those are… 语法解析

06:17

They're healthy, right? Well, many are very antimicrobial. And so they could be damaging the healthy bacteria in your mouth. So that's where that strong burn after many toothpaste, you really don't need that. And if your breath… 语法解析

06:33

is so bad or you have halitosis that you feel the need for that, then I would argue, well, let's dig deeper. Why is your breath so imbalanced? There's probably something else going on. So I really encourage people to start learning about their products, um, 语法解析

06:49

I think we just give dentistry and teeth, just we push it to the side. It's kind of an afterthought many times. And just like we're prioritizing skincare, shampoo, things that we're putting on our bodies, we need to be focused on the ingredients in our oral health care products too. Especially since we're literally putting it into our body, not just on the surface of our body. What was the foaming agent again? Sodium lauryl sulfate. Okay. 语法解析

07:13

And the problem is there's derivatives. So some cleaner versions might have coconut-derived SLS derivatives. Many people will do okay with those, but a common complaint I see in my office are oral ulcerations. And the first thing I think of is what's in your toothpaste? Does it have SLS or a derivative? Because we're all different and some people have more sensitivities and will react more to those. 语法解析

07:41

Or ulcerations, canker sores? Yeah. Or canker sores. Aphthous ulcers or yes. So if one gets a canker sore, what does that reflect typically? Is it… 语法解析

07:52

Let's assume the toothpaste doesn't have anything to do with it. Is that a disruption in the microbiome? Is it from a physical injury like a bite to the gum? It could be all. Okay. So it could be secondary to trauma, certainly. It can be viral related. So the herpes virus often will result in oral ulceration. 语法解析

08:11

It just be one. Yes. But also, and this is off, not on many people's radars, you know, the mouth is the gateway into the body and the mouth is the gut. I want people to start thinking of it that way. So what happens in the mouth can be a reflection of what's happening in the gut. 语法解析

08:28

And so a lot of times when I have patients that come in with recurrent aphthous ulcers or ulcerations, that can be a sign of Crohn's or celiac, IBS, like something going on deeper within that we need to be evaluating, food sensitivities, etc. I'd like to take a quick break and acknowledge our sponsor, 8Sleep. 8Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity. 语法解析

08:53

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09:05

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09:28

even colder in the middle of the night and warm as I wake up. That's what gives me the most slow wave sleep and rapid eye movement sleep. And I know that because Eight Sleep has a great sleep tracker that tells me how well I've slept and the types of sleep that I'm getting throughout the night. I've been sleeping on an Eight Sleep mattress cover for four years now, and it has completely transformed and improved the quality of my sleep. 语法解析

09:48

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10:04

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10:20

Today's episode is also brought to us by BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out entirely online. I've been doing weekly therapy for over 30 years. Initially, I didn't have a choice. It was a condition of being allowed to stay in school. 语法解析

10:35

But pretty soon I realized that therapy is an extremely important component to overall health. In fact, I consider doing regular therapy just as important as getting regular exercise, which of course I also do every week. There are essentially three things that great therapy provides. First of all, it provides a good rapport with somebody that you can trust and talk to about any and all issues. 语法解析

10:55

Second of all, it can provide support in the form of emotional support or directed guidance. And third, expert therapy can provide useful insights. With BetterHelp, they make it easy to find an expert therapist who you resonate with and can help you provide these benefits that come through effective therapy. Also, because BetterHelp therapy is done entirely online, it's very time efficient and easy to fit into a busy schedule with no commuting to a therapist's office or sitting in a waiting room. If you'd like to try BetterHelp, 语法解析

11:22

go to betterhelp.com slash Huberman. For this month only, March 2025, BetterHelp is giving you the biggest discount offered on this show with 90% off your first week of therapy. Again, that's betterhelp.com slash Huberman to get 90% off your first week. This would probably be a good time to talk about 语法解析

11:42

the whole concept that teeth can essentially build themselves and destroy themselves independent of sugar intake and other factors. So if you would, could you just briefly walk us through, you know, this whole business of mineralization and demineralization of teeth? Because I find this so interesting and later I'll share a little bit, full disclosure, 语法解析

12:07

I have a very complicated oral health history. And had I known what you're about to tell us, I think I would have spared myself a ton of pain. Potentially. I'm sorry to hear that, but we'll unpack that. You weren't my dentist, unfortunately. No. I have stories to share, too. We'll get to as well. I think many people do, and that's the problem. So 语法解析

12:31

So I wasn't taught this in dental school, interestingly enough. So this is something I learned later out in practice. And it's the concept that your teeth can naturally remineralize. 语法解析

12:45

if you have a small cavity. But let's start further back. So your teeth are constantly going through demineralization and remineralization. And this is very natural. And anytime we put anything into our mouth besides arguably neutral water, and this has to do with pH, 语法解析

13:01

So anytime we eat, our mouth is the beginning of the digestive system. So we release amylase, which is an enzyme that helps break down our food. And in doing that, the pH drops. This is how we start digestion. 语法解析

13:16

When that happens, we lose minerals in our teeth. The acid will leach out calcium, phosphorus, and minerals from our teeth. But the concern is we don't want it to stay in that acidic state for too long, in that demineralized state for too long. Because if we allow our body to do its thing, our saliva will naturally remineralize our teeth. This is all part of a healthy balance system. 语法解析

13:42

So our saliva is this golden elixir of our body and it contains immune cells and enzymes, but also the minerals that we should need if balanced to create that remineralization. So there's something called the Stefan curve. And essentially it's showing us how our mouth will become acidic and neutral and acidic and neutral throughout the day as we eat. 语法解析

14:06

The problem is in modern society, we tend to be snacking and grazing and sipping all of the time. So we're not giving our mouths enough of a break, enough of an opportunity to remineralize. So many of us are staying in the state of constant acidity and demineralization. 语法解析

14:25

But what's interesting is, so if you have a small cavity or lesion that hasn't yet truly cavitated, then a cavity means a hole. So if you look on an x-ray and I see a shadow on your tooth, it's called an incipient lesion. Those, if they're still in the enamel, those can expand. 语法解析

14:43

quote unquote, heal or remineralize. And this is where you would need to work with, let's say, a functional or biological dentist to understand how deep your cavity is. Once it becomes a hole, generally you do need some sort of treatment. But our body is meant to… 语法解析

15:00

For stability, you know, it knows what to do, but how you eat, how frequently you're eating, and then we can get into this, but how you're breathing and certainly the products you're using and your hygiene practices all factor in as well. So my understanding is that the minerals that make up teeth are not the same materials that are put into a lot of common tooth care products. 语法解析

15:23

So without getting into a discussion right now about fluoride in water, we will get to that conversation a little bit later. But in order to frame that properly when we arrive there, could you explain why it is that fluoride is in most toothpastes when basically we don't have fluoride in our teeth at birth, but there are other minerals in our teeth that are 语法解析

15:48

certain toothpastes have. And so why would we give an artificial substance to our teeth? Maybe you could explain demineralization, remineralization in the context of fluoride and these other minerals. So we have hydroxyapatite, which is essentially calcium and phosphorus in our teeth. And 语法解析

16:07

Our enamel is about 90% hydroxyapatite. The dentin, which is the layer below the enamel through the enamel, is about 60%. And our bone has hydroxyapatite too, about 60%. Our limb bones? Mm-hmm. All bone. 60% hydroxyapatite. Yes, which is calcium and phosphorus. Our saliva will also have calcium and phosphorus floating around too. 语法解析

16:29

So what fluoride does is it throws off the hydroxyl group in hydroxyapatite and so it 语法解析

16:39

changes it from hydroxyapatite to fluorapatite. So it restructures it a bit. When it does this, the bonds generally are considered stronger and the dental crystalline structure is more densely packed. So it's known to be more acid resistant. And so we can get into the history of how they discovered this, but essentially fluoride was put into toothpaste in about the 1960s. It became very popularized. 语法解析

17:06

So that is why many dentists love fluoride is that you're using it and it makes your teeth more acid resistant. And also it has some antimicrobial effects too. The issue I have, and we can unpack this more later, is that it's not super selective. So it's not only selecting anaerobes or pathogenic bacteria, but it potentially could be damaging beneficial bacteria too. 语法解析

17:29

So that's why toothpaste has fluoride in it. It also will lower the critical pH. So the critical pH is the pH of which your enamel will start to demineralize or degrade. And for enamel, it's 5.5. And then for dentin, it's closer to 6.5. So what fluoride does is it raises the pH resistance. I see. So for people that aren't familiar with pH, it's a measure of how… 语法解析

17:58

alkaline or acidic a given environment or something is. And so what you're telling me is that fluoride makes teeth ultra strong. It's not a mineral that teeth normally see. Like if a child never used fluoridated toothpaste or drank fluoridated water, they basically, unless they happen to drink from a stream with fluoride in it, their teeth would rely on hydroxyapatite to remineralize. 语法解析

18:27

But we put fluoride into toothpaste and into water, and that allows teeth to become even stronger and even more acid resistant. Yes. 语法解析

18:35

Some out there argue the enamel structure actually is weaker. This is very nuanced, but generally the dental community believes it's a stronger version of enamel. Some will argue when you look under scanning electron microscopy, the crystalline structure can be more wave-like and potentially the bonds could break more easily. But generally, you know, topical fluoride does work. 语法解析

18:59

However, it is no match for a poor diet, you know, so all of this really comes back to what you're eating. So it will make you less at risk for cavities, but it's not a shoo-in, like it's not for sure going to prevent decay. 语法解析

19:14

What are the times in each 24-hour cycle when our teeth are repairing themselves? So like in the middle of the night, provided somebody's asleep, they're not eating. They're not drinking unless they get up for a moment and have a sip of water or something. In between meals, they're not eating. I just sort of naturally intermittent fast. I generally eat my first bite of food somewhere around 11 a.m., sometimes a little earlier. But that's just habit. It sort of falls under this intermittent fasting kind of thing. So- 语法解析

19:43

I and many people have stretches of time of anywhere from three to 14 hours when we're not ingesting any food or caloric beverages. Is that when remineralization occurs? It's a tricky word. It's a tough one. Remineralization. We'll have to do it. Remineralization. Right. Oh, that's right. You put the accent. Remineralization. Thank you. That helps. You've said that before. Yes. Thank you. Thank you. 语法解析

20:09

Is that when our teeth repair themselves? Yeah, this is great. This is important. So generally after you eat, you know, as I mentioned, your mouth will become more acidic. After about 20 to 30 minutes, your saliva will naturally start to buffer. So it will start to rise and raise the pH up. 语法解析

20:27

I like to see us eating more on a schedule. So generally every two hours or so is when we'll get full optimal remineralization. The issue is we are a society on the go and we're grabbing crackers and chips and granola bars and we're eating and nibbling and sipping on Frappuccinos. So we never allow that remineralization to take its full effect. 语法解析

20:49

So yes, when you're not putting food or drink in theory in your mouth, your saliva, if it's optimized, and we should talk about that as well, will be remineralizing. But unfortunately, I do feel so many of us are just not in balance. You know, we're dehydrated, we're mineral deficient, we're calcium deficient, we're phosphorus deficient, and we're mouth breathing. So the pH is changing just from mouth breathing can make the mouth more acidic, right? 语法解析

21:17

And so there's a lot of factors at play. But in theory, if I can make one suggestion to someone out there who might be struggling with cavities, I want to know not only what are you eating, but how frequently are you eating it? And this is a great reason why from a dental standpoint, fasting, intermittent fasting, or, you know, time-restricted eating is a great way to combat dental decay. It's also better on gut health as well. You know, the migrating complex, the 语法解析

21:45

cleansability, just giving things a break and a rest is really important. I grew up hearing that sugar causes cavities. Does sugar cause cavities? And when we say sugar, of course, all the biologists and people with a nutrition background roll their eyes because sugar is a very broad statement, right? There are simple sugars, there's fructose, there's sucrose, there's glucose, there's 语法解析

22:11

All sorts of variation within the simple and complex carbohydrates. But when I'm saying sugar, I'm thinking about foods that taste sweet or that contain sugar that's masked by other flavors, just for sake of simplicity. Like added sugar. Like added sugar. I mean, now if you buy a cracker, typically, if you look at the package, there's some sugar in there, which is ridiculous, but that's a whole other discussion. Yes. Or we could just even say starchy carbohydrates. Fermentable carbohydrates is what I like to say. 语法解析

22:40

But that gets kind of nerdy. So not directly. It's really acid that causes cavities. So what sugar does, and I like everyone to think of flour like sugar. This is also very important. Because the bacteria in our mouth, they thrive, the pathogenic bacteria, they thrive on sugar. But flour will act like sugar in the mouth. So they'll also thrive on flours. So the crackers, the bread. Even a good sourdough bread? 语法解析

23:08

Well, the issue is more contact time. So things that are really sticky and dried, I would argue. So crackers or toast. Chips. Chips. I mean, think about if you take a handful of goldfish crackers. I haven't done that in a long time, but imagine that. It's all throughout your teeth, in between the teeth, down in the grooves. It's sticky. It's dry. 语法解析

23:35

It's just a smorgasbord for the bacteria. And so what do the bacteria do when they metabolize the sugar or the flour? They release acid. And so if that food substrate is stuck against the tooth for a long period of time, and these foods are also hyperpalatable, so we're meant to be just snacking and grazing, hitting the bliss point, you know, and then we're going to have to eat it. 语法解析

23:55

grab a handful, go do something, come back, grab another handful. You're just constantly feeding that bacteria. So your mouth is staying constantly acidic. So it's truly the acid that causes cavities. But I would argue that sugar or flour is kind of the catalyst that feeds the bacteria to create that imbalance. 语法解析

24:15

Is it fair to say, I know you prefer the term fermented carbohydrates or trying to, for most people who don't think in terms of starches versus fiber or simple, although nowadays people are more versed in that sort of thing. I think of carbohydrates or foods for that matter, that if you put them in your mouth and you just kind of kept them there for a little bit, that they would dissolve. 语法解析

24:35

Like a cracker. Yes. Like a chip. Like rice. Pasta. Like a piece of pasta as opposed to like a piece of broccoli, which would get soggy, but it's got a lot of fibrous material so it doesn't dissolve in the mouth. And interestingly, broccoli or prebiotic fiber is what feeds broccoli. 语法解析

24:53

the good bacteria. So I work mostly with children now. And we can talk about why that transition happened. I used to work with adults, but I teach them eat the rainbow, feed the good guys. Okay. So we want to feed our healthy bacteria more than we want to feed the bad bacteria. And that's not to say you can't ever have fun, but 语法解析

25:14

and enjoy some fun foods, but it's all about balance. And so I think people don't realize the true root cause issue with dental disease is primarily diet. You know, we're so hyper-focused on 语法解析

25:28

fluoride and what's in your toothpaste and the mouthwash and all these products. But all of those things are really just masking the underlying issue, which is how are these bacteria behaving? What types of bacteria and in what ratios do we have them in the mouth? And how often are we feeding them? So I'm hearing this as a repeating theme that diet and lifestyle are going to be more important than drugs or products for keeping the mouth looking good and 语法解析

25:56

Yes. I mean, for example, I personally haven't used fluoride for many, many years and neither have my children just because I know there are other ways to prevent disease. And I have many of my patients that choose not to use fluoride or these products also. I think so many people have been taught you have to have fluoride. 语法解析

26:19

this product, fluoride, et cetera, to stay cavity and disease-free. But if you eat a clean diet, focus on just some of the pillars of health, that will translate into the mouth as well. Perhaps it's worth mentioning just what some of the facets of a clean diet are through your lens of what you consider a clean diet. Sure. 语法解析

26:40

So I'm not advocating for any one diet, and I do believe we're all different. So what works for some people may not work for others. But generally, what I suggest is really high-quality protein sources, a wide array of vegetables, fruit. I would argue you should limit fruit potentially, especially if you're a high decay risk, just because there is sugar, fructose. 语法解析

27:04

but I don't want to villainize fruit. There's so many healthy benefits of polyphenols and everything in it. So nuts, seeds, olives, pickles. I love fermented foods for gut health and then oral microbiome support too. So essentially a whole food diet, things that come from the earth and more from farms and less from factories, less things out of bags, arguably ultra processed foods. 语法解析

27:32

should be avoided as much as possible or minimized and then trying to stick to minimally processed or unprocessed foods. Is it fair to say that if one does that, either a child or an adult, that their oral microbiome will not only get healthier, but that their teeth will get whiter? And the reason I keep bringing this up is I think a lot of people want white teeth or at least not yellow teeth. Sure. 语法解析

27:56

having been involved in the public facing health education business for a little while now, I realized that nothing that is, um, 语法解析

28:07

encouraged to be good for us that takes away from the way that people want to look and feel about how they look gets much traction so what i what i like about what you're telling us is that all the things of eating mostly unprocessed or minimally processed foods those are going to be good for our entire body great that it's great for our oral microbiome probably is good for our whole body because of its effects on the microbiome and at least in part uh but what makes teeth white 语法解析

28:33

And will supporting the oral microbiome make our teeth whiter? Yeah. And by the way, there are some folks out there whose teeth need to be less white, in my opinion. Agree. Totally agree. Now we're being somewhat facetious, but not really. But I think most people would like to have teeth that would be characterized as mostly white. Yeah. We want to look good. I mean, I appreciate and respect that. I do think we've moved a little away from reality with some of that. So I agree with you. I think there are… 语法解析

29:02

teeth out there that could not be quite so bright, but you do you. I think everyone should do what makes them happy. So what makes teeth white? So interestingly, if you look at a baby tooth next to an adult tooth, and I get this call all of the time from parents saying, 语法解析

29:19

So the child loses their first baby tooth. The adult tooth starts to come in. And adult teeth are quite a bit darker than baby teeth, which are very white and bright. And they're worried. What's wrong with my child's teeth? They're so yellow. That's actually a very natural shade of enamel. 语法解析

29:34

And why is that? It all has to do with that crystalline structure and the mineralization. So baby teeth are less mineralized and the crystalline structure is a little more haphazardly arranged. It's not quite as organized. So instead of like Lincoln logs lined up, it's more like pickup sticks to some degree. Why is that? Baby teeth are meant to resorb, dissolve, and fall out. Okay, so this is why baby teeth are also much more susceptible to decay. Okay. 语法解析

30:00

So the whiteness is coming how the light reflects and refracts off the teeth, which is a lot of times why you hear if you use hydroxyapatite or even coconut oil is changing the surface modification. So it's changing the way light reflects and refracts off that tooth to make it seem whiter and brighter. 语法解析

30:20

Now, certainly with adult teeth, if you're using bleaching agents, you know, hydrogen peroxide or carbon monoxide, some of the stronger bleachings, that's actually penetrating into the tooth and changing the structure, pulling out stain. Do people do that? They gargle with hydrogen peroxide? Well, they do bleaching trays, essentially. I don't, well, people will rinse with hydrogen peroxide, yes. 语法解析

30:43

And it will make your teeth brighter and whiter, but I'm telling you it's going to do a number on your oral microbiome. So I suggest it in a very limited fashion. The only time I ever had a bad canker sore was because I gargled with 50% water, 50% hydrogen peroxide because an acupuncturist recommended it. He looked at my tongue and then he said, you should do that, you know, and then I did that and then, you know, 语法解析

31:11

four or five days later, I had this like nickel sized canker sore on the roof of my mouth. And I was like, ugh. And I will say, and I have no product affiliation whatsoever, but to any specific products, but by switching to hydroxyapatite containing toothpaste, my teeth, they definitely have gotten whiter. I drink a lot of yerba mate and coffee and I brush, but that was, it was 语法解析

31:36

It was sort of a progressive issue of my teeth dimming. So that's been great. I also used to get cavities fairly often when I was a kid. I'll talk about that a little bit later. But since switching to hydroxyapatite toothpaste, I've had stellar dental reviews, assuming my dentist is looking carefully. I believe he is, but we'll see. And to me, it just makes so much more sense. Like give teeth the mineral that they normally use to re-mineralize. Yeah. 语法解析

32:04

It just makes sense. It's biomimetic. It depends on how you look at life, I think. I prefer biomimetic materials personally. Again, it's a personal choice, but I agree with you. My patients who have switched to hydroxyapatite, and I'd like to point out not all hydroxyapatite toothpastes are the same. It depends on sourcing and the other ingredients that are in there. But generally speaking, their teeth… 语法解析

32:29

look healthier, stronger, whiter, and brighter. They just look more nourished, more hydrated. Their microbiomes look more balanced too. You're talking about kids and the fact that sometimes if their teeth are a little bit yellow, that's normal. One thing that I've been really struck by as the discussion around longevity seems more and more prominent these days is occasionally I'll run into somebody who's in their 70s or 80s 语法解析

32:55

even 90s. And it's very rare to encounter somebody in their 80s or 90s whose teeth are not like the color of this tea. And for those that are listening, it's like a very dark brown. I've never seen somebody, unless they're doing something highly artificial with bleaching, I've never seen somebody 语法解析

33:15

75 or older whose teeth aren't basically yellow to brown. And when you look at people when they're very close to death, their teeth often look very opaque. What is that? Is that a blood flow issue? Is it what's going on there? Yeah, it can be a zero stomia or dry mouth. So we definitely lose salivary capabilities as we age. 语法解析

33:37

very likely more mouth breathing. So mouth breathers will tend to have darker teeth because the teeth desiccate, they dry out. And over time you will experience mineral loss. Decades and decades of coffee, tea, wine will do it too. Well, I don't drink the wine, but I've been drinking coffee, tea since I was a little kid. I've been drinking latte since I was like five. It's good. Yeah. It's delicious. Yeah. Gotta live life. Yeah. But, um, 语法解析

34:03

Yeah, and so they're losing minerals too, you know, over time. Your teeth take a beating. I mean, we're living to be 100 now. That's a long time to maintain this non-shedding surface in our body, you know. And then it depends on the generation too, but some generations, especially as you mentioned, 70s, 80s, I'd wonder about tetracycline exposures when there's certain antibiotics that we don't use anymore that can, were known to darken the teeth, which is why they pulled them. 语法解析

34:32

from common prescription. That raises a question I'd never thought about before. So if one takes a course of antibiotics, 语法解析

34:39

typically the advice is to ingest low sugar kombucha, to have some Bulgarian or Greek yogurt, like repopulate the gut with healthy, with the substrates for healthy microbiota. We now know because you've told us that the mouth is the gut, which makes perfect sense. We are but a series of tubes. That's why I was teaching my developmental neurobiology class, but it's true. It's true. And embryology, you learn that we're basically born of a bunch of 语法解析

35:06

that are gonna do their thing in development, but the digestive tract obviously starts with the mouth. So is it the case that, 语法解析

35:17

therefore, that we should be repopulating the oral microbiome if we take a course of antibiotics? Yes. Yes. Very commonly, patients' parents will report, gosh, my child just finished this course of antibiotics and now their teeth are stained or their gums are inflamed or they just seem off. And it usually is because they've wiped out a lot of the healthy bacteria too. You know, it's all connected. So I do suggest my patients… 语法解析

35:43

If I have to write antibiotics, which I try to avoid, but sometimes we have to, that they do take a high quality probiotic and increase their probiotic rich fermented foods as well. So a high quality probiotic pill. Generally, yeah, because it's hard to get in enough, especially in kids, I would argue. You know, kids aren't usually eating a lot of sauerkraut and kimchi and vegetables. 语法解析

36:03

natto. But you could do kefir, yogurt, as you mentioned, low sugar, kombucha, et cetera. But usually a high quality gut probiotic will have some benefit to the oral microbiome, but they also do have oral probiotics to focus on the bacteria of the mouth. What about mouthwashes? Yeah. I've never liked them. 语法解析

36:26

Um, they feel they burn for one. And then I learned some years ago, and this is just kind of fun to cue to years ago. It must've been like eight, 10 years ago. I heard, I think on the Tim Ferriss podcast, somebody said, oh, you know, a mouthwashes will nuke certain chemicals that are essential for cardiovascular function. And. 语法解析

36:48

So don't use them. Don't use mouth strips. Don't use any of that stuff. And at that time, that was considered like clear, quote unquote, pseudoscience. Nobody would like alternative science outrageous. Now we know this is actually true. And this always, you know, this always delights me and scares me at the same time that many of the things that right now people go, oh, that's pseudoscience. I don't. 语法解析

37:13

like creatine seems to be a big thing right now. 10 years ago, it was only the gym rats that we're talking about. Now everyone's like creatine, creatine. So what's the story on mouthwashes and mouth strips and mints and things of that sort? That again, people just want to have fresh breath or at least they don't want to be the person with the bad breath. Sure. Yeah. 语法解析

37:31

So Listerine and those stronger rinses in particular, they generally contain alcohol, astringents, really strong antimicrobials. You know, it says kills 99.9% of germs. Well, I think we've learned we're over disinfecting. You know, this is why asthma is up, eczema. 语法解析

37:51

allergies are up in our children. We now are saying, get into the dirt, get exposed to microbes and things. So we're carpet bombing the mouth. What we've learned through the data, and you're right, there are studies to show that chronic habitual use of these mouthwashes, including prescription strength mouthwash, like chlorhexidine is a common one, 语法解析

38:12

It can damage the nitrate-reducing bacteria. So we have bacteria in the dorsum of our tongue, specifically that is essentially your tongue, that reduces nitrate to nitrite, which is a precursor to nitric oxide. Nitric oxide is a molecule that is really important for cardiovascular health and vasodilation and immune health. So if we're 语法解析

38:36

indiscriminately carpet bombing the mouth with these really strong astringents and rinses, we can be affecting our cardiovascular health. And there are studies to show it can increase blood pressure and potentially cause cardiovascular issues. 语法解析

38:50

So when I hear someone say, but my breath is so bad, you know, I have to use this multiple times a day, I immediately think, well, gosh, why is your breath so bad? It's normal to have bad breath after you eat a garlic, you know, garlic hummus or have a cup of coffee. 语法解析

39:07

But if it's chronic halitosis or bad breath, I'm curious, do you have periodontal disease, which is a chronic inflammatory issue in the mouth, which can have a slew of downstream effects, which we should discuss in a bit? 语法解析

39:21

Or do you have an infection? It could be a sinus infection, post-nasal drip. Do you have tonsil stones or tonsillar infection? Like what else is going on in your mouth where you feel you need this multiple times a day to even feel like you can present yourself in public? Really strong essential oils and mints. Again, you'd be cautious with that every once in a while. A 语法解析

39:45

throwing in a piece of gum or a mint, of course. It's really the habitual use of these things that can be damaging. I'd like to take a quick break and thank our sponsor, AG1. AG1 is an all-in-one vitamin, mineral, probiotic drink with adaptogens. I've been taking AG1 daily since 2012, so I'm delighted that they're sponsoring this podcast. The reason I started taking AG1 and the reason I still take AG1 is because it is the highest quality and most complete foundational nutritional supplement. 语法解析

40:15

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40:24

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40:52

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41:16

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41:45

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42:02

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42:21

Okay, so those are some don'ts. What are some things that we can do to improve the chemistry of our saliva and our mouth? And just in full disclosure here, won't be the disclosure most people are anticipating, what I'm trying to get at here is 语法解析

42:36

all the chemical aspects, the chemistry of the mouth. Because when I think about biology, just because of my training, I think, you know, you've got chemical forces and you have mechanical forces. Like there's stuff that literally like moves or you could, you know, chip a tooth or things that you shouldn't do to protect your teeth. And then there's how to create the right chemistry environment. So that's really what we're talking about here. And I'm trying to figure out, you know, how could I have 语法解析

43:01

The best possible saliva. Yeah. I want to be the person with the best possible saliva. Good spit. Don't underestimate your spit. It's true. It's the golden elixir of your body. So if I were to put spit into like a… 语法解析

43:16

under the microscope or and then also take some of my spit and put it in mass spec and separate out all the goodies that are in there. Just give us a sense of the kinds of goodies that are in the spit because it just looks like a bunch of clear liquid to people. But blood looks like just a bunch of red liquid and there's a lot of stuff in there. There's so much in it. It's so important. So it has bacteria. 语法解析

43:36

viruses, fungi, like all kinds, protozoa, hopefully in the right ratios. So we want beneficial bacteria. We all have about 5% pathological bacteria. However, at that ratio, those may not be pathological. Like they're symbiotic at that point. We are still unpacking and learning more about the oral microbiome. 语法解析

44:00

But essentially, you'll have bacteria. There's hormones. There's free cortisol. There's hormones. Cortisol is in our spit, folks. Yes, absolutely. There are enzymes for aid in digestion. There are immune cells and there are minerals floating around too. So think about how important saliva is to chew. 语法解析

44:19

If you have dry mouth or you're sick, you can't chew and swallow your food. And this is why a lot of elderly people have a very hard time eating certain foods or if you've undergone cancer therapies and things. Once you get xerostomia, dry mouth, your teeth can degrade so quickly. So your saliva is so important. And so how do we keep it healthy? Hydration. 语法解析

44:41

You know, so many of us are dehydrated. I would argue we aren't getting enough minerals either. So, you know, I suggest to some kids, I can tell in a child's mouth if they're hydrated or not by the way their saliva looks. If it looks more… 语法解析

44:55

thick and ropey and mucousy, they're dehydrated. If it looks like water, it's healthy. This is without any tests. So put a pinch of salt in your water or some electrolytes. That can really help with bioavailability and absorption. 语法解析

45:11

How you're breathing is incredibly important too for your salivary health. So if you're mouth breathing, you will have less saliva. You know, your mouth's going to dry out. The pH will drop and you're going to be in trouble. You know, dry mouth leads to cavities. Dry mouth leads to gum disease. So and then the foods we eat, of course, too, we want to have a mineral-rich diet. So many of us are mineral deficient. We're magnesium deficient. We're fat-soluble vitamin deficient, particularly vitamin D3, K2, K3. 语法解析

45:41

So I think it is good. I like the idea of test, don't guess. You know, if you have the capability to work with a doctor to see where you are with some of these things, to know if you need to supplement or not or how you can change your diet. 语法解析

45:56

Sorry to interrupt, but would I test my saliva specifically? Is there a good saliva test out there? That would be a different test. This would be more of a blood test. Like a standard blood test. A standard blood test. But there is salivary analysis, and we should discuss the importance of testing your oral microbiome. I think just like so many of us test our gut microbiomes now, you know, GI mapping, stool tests to understand what's happening in the gut. Right. 语法解析

46:20

There's salivary analysis now, and this is what a lot of functional dentists are working toward. I do salivary analysis and biomarker analysis in my practice. 语法解析

46:30

We can tell a lot through a patient's saliva and what ratio and types of bacteria are there, as well as fungus and viruses and things as well. So if you have the capability, if you really want to optimize your health, I suggest testing your oral microbiome because there are certain keystone pathogens that you may have 语法解析

46:51

that you're unaware of that can lead to many downstream issues. And we can jump into this now, but the oral systemic connection is really blowing up now in how oral bacteria, specifically pathogens, can contribute to Alzheimer's and dementia and fertility issues, pregnancy issues, cardiovascular issues, autoimmune disease, rheumatoid arthritis, diabetes, obesity, mood disorders. 语法解析

47:17

cancers. It goes on and on, all coming back to the bacteria in our mouth. Amazing. I really want to not just double click, but really dive into that. No pun intended. I do want to just ask because a subset of listeners will be interested in how they could get their saliva tested. Yes. I've never had my saliva tested. I will say that based on your teachings online, I've made an effort to drink more water in addition to 语法解析

47:45

massive amounts of yerba mate and small amounts of coffee. I've made an effort to, well, I switched to a hydroxyapatite containing toothpaste, which has been terrific for all sorts of reasons. I've 语法解析

48:01

really emphasized nasal breathing. That's something I was into before through the sports performance world because my friend Brian McKenzie, who's a human performance expert, was really big on this a while ago. And the healthiest my breathing and cardiovascular function ever was for me was when something I don't suggest people do unless it's their profession. I was boxing for about a five-year span and I had a fitted mouthpiece and I would do my running, my road work with my mouthpiece and breathing through my nose. 语法解析

48:29

um and that taught me to like really how to breathe correctly through my nose and it translated to switching to nasal breathing when i slept i didn't sleep with the mouth guard in um but i think that breathing through the nose is just so important for the reasons you're describing james nestor's described and i will share this little factoid and then i'll and then i'll um and then i'll shut up and and nasal breathe um 语法解析

48:55

A friend of mine who is a physician at UCSF, he told me that the methamphetamine addicts that come in have terrible teeth. Everyone knows this. Meth addicts have terrible teeth. But do you know why it is? He works with the School of Dentistry. It's because they're mouth-breathing. I've worked with that population before. Meth doesn't actually deteriorate the teeth. It's the fact that they're mouth-breathers. 语法解析

49:17

And so I find this fascinating. And then of course the book Jaws, which was published by Paul Ehrlich and Sandra Kahn, my amazing colleagues at Stanford. 语法解析

49:25

years ago. And by the way, when they published that book, people said, oh, this is pseudoscience. This is crazy. You're saying nasal breathing epidemic of, you know, fear mongering. Well, it is. We now know this is a real thing. It's an epidemic. So how do you encourage kids and adults to switch from mouth breathing to nasal breathing? Yes, this is a big part of my practice. So we need to understand the why, just like anything. Why are you a mouth breather? 语法解析

49:54

So humans are obligate nasal breathers where we are meant to be breathing through our nose. Unfortunately, so many of us are mouth breathers. They estimate up to 50% of the population now breathes through their mouth. I personally think that's an underestimate with what I'm seeing at my practice. So why is this? So the theory is that… 语法解析

50:17

Ancestrally, we used to chew and masticate up to four hours a day. This act of chewing, it pushes forces out. It was actually what grows the face, the lateralization of the tongue, the tongue elevating. It would grow the jaws wide, the sinuses wide, including breastfeeding. We now flash forward 10,000, 12,000 years. 语法解析

50:42

Okay, so we had the agricultural revolution. We went from hunter-gatherer society to agrarian. Then the industrial revolution, we started milling and processing everything. Everything's soft and mushy now. We used to chew four hours a day. We now chew four minutes a day. 语法解析

50:58

So there's very little – there's atrophy essentially. We slurp our food. We slurp our food. It's like that movie. What was that futuristic movie with the little robot? I hated that movie. Oh, I cried during that movie. I hated that movie. I was so worried that it was true and here we are. Yeah, they're just slurping their food, lying on recliners. Here we are. They've outsourced pretty much everything. Yes. Yes. So this is – 语法解析

51:21

many generations of this happening. We're essentially shrinking. James Nestor phrases it, we're dis-evolving. Okay, so faces are shrinking, jaws are shrinking. This is why we see so much crowding in teeth. If you go to the Natural History Museum in New York, Washington, D.C., look at the ancestral skulls. The teeth are pristine. There's no decay. And all 32 teeth, including the wisdom teeth, fit perfectly into the dental arches. 语法解析

51:50

So that was not that long ago in human, you know, our trajectory. So what has happened? It's our food. It's how we're chewing. It's how we're breathing. And so if this structure shrinks, the nasal volume shrinks, the sinuses shrink, the airway shrinks, our tongue has no room in our mouth anymore. So it either sticks out, tongue thrusts, or it falls back, you know, and it's obstructing us. 语法解析

52:15

So there's so much sleep disordered breathing, dysregulated breathing and sleep apnea now that's not getting diagnosed. So if we look at children early and they come into me and I can see it as they walk in, they generally will have forward head posture because they're trying to open their airway, okay? Forward head posture, they have dark circles, that's called venous pooling. That's a sign of inflammation, secondary to mouth breathing. Okay. 语法解析

52:43

You can see more of the whites of their eyes, so it has to do with their visual plane. 语法解析

52:49

So forward head posture, the droopy eyes from inflammation, you see more of the sclera, the white of the eye. They just look congested and sick. They just, and their mouth's open. And those kids have major airway issues, and we need to understand why. So it is generally either a hard tissue issue or a soft tissue issue. So what would the hard tissue issues be? That would be the size and shape of the jaws, the size and shape of the palate, right? 语法解析

53:16

The position of the jaws, you know, is your jaw set back? Is it forward like a bulldog? And do you have a deviated septum? You know, they asked me, 75% of humans can have some sort of deviated septum. And people think that's ridiculous. It's not just from getting in a fight and getting your nose broken. So think of it this way. If your palate is narrow and I smushed your face like this, 语法解析

53:45

the septum has to go somewhere. And so it will can't. Okay. So that's what creates the deviated septum. And so if we expand a face, and this is what early functional orthodontists, and this is what I'm doing in my practice or doing in these younger kids, you put in a little retainer, 语法解析

54:01

that can help expand the face and the septum straightens, and now we can breathe better. So that's hard tissue. Soft tissues could be enlarged adenoids, enlarged tonsils, oral motor dysfunction, low tongue tone, low tongue positioning too. 语法解析

54:18

How much plasticity is there of the sinuses? So let's say somebody has a partially or severely deviated septum and they could get surgery. And I want to talk about some of the different surgeries. There's a balloon expansion thing that online, it looks really cool. I'd like to try this. I really want this to happen to myself. Yeah, they put the balloon up there, they inflate the balloon. And it's guided. Yeah. They do one that's guided. Yeah, they numb it and then they take it out and the… 语法解析

54:45

You know, this kind of thing. Well, is actually the appropriate way to do it, both in and out through the nose. But if somebody makes the effort to nasal breathe, so maybe they mouth tape at night or I'm a big fan of shifting from any mouth breathing to nasal breathing by mouth. 语法解析

55:03

insisting that I nasal breathe while I do any cardio unless I'm pushing really hard and then I need to bring mouth breathing into it. But I've noticed just because I can measure snoring through sleep on an eight sleep, I can measure snoring that way. But even if you don't do that, there are other ways you can measure snoring with an app or someone can tell you you're snoring. So this isn't about a product per se. But if I force myself to nasal breathe during cardio workouts, especially kind of zone two, zone three stuff, 语法解析

55:29

translates to less mouth breathing and snoring and sleep. So the question is, do the sinuses actually dilate? Or if you have a deviated septum, do you need it surgically or somehow otherwise repaired? It depends on your age. So most facial development is done around the age of 10. 语法解析

55:47

So the issue I would say with traditional orthodontics, which is when you wait for all the baby teeth to fall out and then you put braces on, you can't control the modeling of the face, the midface, the jaws, which is why we now are starting with functional therapies as young as three or four years old with retainers. So… 语法解析

56:10

In the middle of our palate is a suture filled with cartilage. And so with kids, it's really easy to manipulate and change facial development. If you make the jaws wider, not only is it improving airway, but the teeth will come in straight. Now they have room. The reason they come in crooked is there's not enough room for them to come in. It's important to know the floor of the mouth, the roof, sorry, the roof of the mouth is the floor of the nose. 语法解析

56:35

So if you expand the palate, the sinuses will get wider. The septum is going to upright. Everything's connected. Now, as an adult, it's really hard to manipulate bone structure just through 语法解析

56:50

posturing and habit. There are myofunctional therapists, which they're the best, and they're really important in this conversation. Think of them like physical therapists for breathing, teaching you to keep your lips closed, your tongue up. All of this musculature is really important, toning it. If you don't use it, you lose it. 语法解析

57:11

So if you're a mouth breather, your tongue will lay low. Your tongue's a muscle. It will get weak. It will get flaccid. So we want to strengthen these muscles to help with lip seal and nasal breathing. But as an adult, if you do have a skeletal discrepancy, usually you need some sort of intervention. You're not going to just be changing it through lip taping or how you're training or myofunctional therapy. And there are more conservative ways now besides chiropractic 语法解析

57:37

true jaw surgery. There's an appliance called the Homeoblock, which I know is what James Nestor used. You can read about it in his book. That will actually start to change facial structure. There's less invasive treatments. There's an MSC appliance. It's a maxillary skeletal expansion device. 语法解析

57:56

It does put these little mini screws in your palate, but it will pop the suture. And adults in this is, you really would have to want this because you're struggling so much. And people who aren't breathing well, they're struggling. I think it's the most important thing for health is how you're breathing and how you're sleeping. And with children, if they're not breathing appropriately and they're waking up a lot, which is why it would be interesting to get some sort of product 语法解析

58:24

on you. I'm just curious. Do you get into deep sleep? Do you get into REM sleep? I do. Great. Yeah. I'm measuring deep sleep and REM sleep through the eight sleep or both. My 语法解析

58:36

Deep sleep is great provided I get to sleep by about 10:00, 10:30 because that's when I capture the deep sleep window. If I go to sleep around 11:00 or midnight, I lose out on some deep sleep even if I sleep longer. And my REM sleep's really solid these days. I'm struck by how convincing the data are about nasal breathing improving brain function. There were a couple studies that showed that if people either mouth breathe or nasal breathe in a laboratory study, 语法解析

59:06

Um, the nasal breathers have better memory recall. Um, but those were of odors. So everyone said, well, okay, of course it's a voters and you're breathing through your nose. And so you can remember those odors. So they've now run these studies on with other types of memory and brain function. And it's just very clear that you oxygenate your brain better and you, 语法解析

59:23

You think better, your cognition is better, your memory is better for everything, not just odors. So you get 20% more oxygen when you nasal breathe. And this is really important for children in these formative years of brain development. And this is why we're seeing studies showing that children who mouth breathe have sleep disorder breathing. They have behavioral issues and many are getting diagnosed with ADHD and ADHD. 语法解析

59:48

arguably potentially put on medications when really if we'd screened them for airway issues, potentially we could have avoided some of this. And it also has to do, we're not getting into deep sleep. The glymphatic system's not kicking in, hormone function's not kicking in. So a lot of these children, growth hormone is impaired, antidiuretic hormone is impaired if they're not getting into deep restorative sleep. So this is why we see bedwetting 语法解析

01:00:14

Some signs to look for in your partner or your children is tossing and turning, clenching, grinding, snoring or noisy breathing, sleeping in really odd positions like craning the neck because they're trying to open their airway, spinning around the bed. You know, the child's legs are in and the body's like out of the bed. The bedsheets are everywhere. And then certainly waking up unrested and then noticing behavioral issues, too. 语法解析

01:00:41

All you have to do to convince the male half of the audience to focus more on nasal breathing is to tell them and to not use mouthwashes is to tell them that being a mouth breather will give them sexual dysfunction or will will. 语法解析

01:00:58

predispose them to sexual dysfunction and they'll start working on their nasal breathing. Because of nitric oxide. Because of nitric oxide. So the paranasal sinuses is what will help produce nitric oxide too. So if you're breathing through your mouth, not your nose, you're not getting enough nitric oxide, which is very important in sexual health. But also we know men who have gum disease are 2.85 times more likely to have erectile dysfunction as well. Wow. So no bleeding gums. 语法解析

01:01:24

We do not want inflamed bleeding gums. Flossing is something we haven't touched upon yet, but it's incredibly important, not only for cavity prevention, but gum health. Pink in the sink, any amount of bleeding is a sign of inflammation and it doesn't just stay in the body. It can impact the entire system. So please take your gum health seriously if for nothing else and for your sexual health. 语法解析

01:01:50

Great message. So to shift over to nasal breathing, if somebody's really struggling with this, are you a fan of mouth taping? Yeah. You want to make sure you can do so safely. So with kids, I always suggest they get screened by an airway-focused dentist or potentially an otolaryngologist or an ENT. For adults, there is a task that you can do. It's the three-minute task. Can you breathe through your nose safely? 语法解析

01:02:18

without panicking or feeling sympathetically challenged for three minutes. So you can either put water in your mouth, put a piece of paper, tape your lips, and literally time yourself. And if you can breathe through your nose successfully, then you, in theory, can safely lip tape. There are different tapes that you can do that are open in the middle so you can still off-gas or you feel less… 语法解析

01:02:42

It feels less invasive. And what I suggest if people are interested in it is just start five minutes while you're chopping vegetables for dinner and then move up to 30 minutes while you're watching a show and then watch a whole movie for two hours. And then if you've been able to tape that long, you can do so at night as well. I will tell you, it is one of the top things that I have done to improve my health. And I do see it with my wearables and my sleep data. 语法解析

01:03:11

Recently, I had the privilege of giving a talk at Stanford with Renee Fleming. It's like one of the world's greatest opera singers alive today. And I said, what are some things that you do for your breathing? Because I end up talking a lot for the podcast. And she gave me some lung and diaphragm strengthening exercises. But then the one that she suggested for breathing. 语法解析

01:03:32

emphasizing nasal breathing because there's a lot of nasal breathing that's done quickly and subtly in order to maintain air pressure in the lungs and for her craft, which I know very little about, but is instead of like doing weight training for the neck, it's kind of a fun one. It doesn't make the neck big. So people who don't want a larger neck will appreciate that. But 语法解析

01:03:51

to exercise the internal muscles of the neck. And the way you do this is something called kiss the sky. The boxers will actually know this, the old school boxers. It looks ridiculous, but I'll do it 'cause I look ridiculous on this podcast all the time intentionally. So you look up at the sky and you pucker like you were a puffer fish. 语法解析

01:04:07

Oh. For 15 seconds per side. Interesting. And she said it builds the strength and the neural control over the internal muscles of the neck. So again, no widening or thickening of the neck, but on the inside. And it makes it much easier to take deep breaths through your nose. It probably increases the amount of resistance so that you can fill your lungs more easily. So I've been doing a little bit of like kiss the sky and it looks completely ridiculous. It's kind of a yoga move too. Yeah. 语法解析

01:04:32

and you just like really like lip smack as if you're gonna kiss this guy from side to side 15 seconds per side a couple times per day or just whenever you remember it and i mean her voice is amazing like her speaking voice and her uh posture and everything so um i borrowed that one from her you can do a lot to improve your airway health through 语法解析

01:04:51

breathing rehabilitation. So I think that is a big part that's missing in these conversations with airway health. You know, we talk about, well, you need to see the airway trained dentist. You need to see the myofunctional therapist, the orthodontist, the ENT. That's a lot. Just the scheduling of that alone makes me want to take a nap. But it is. It's a lot to unpack airway issues. If parents are out there, there's two books 语法解析

01:05:14

Three, I'd recommend if you're very interested in this since it impacts so many people, certainly Breath by James Nestor, Jaws, as you mentioned, by Sondra Kahn, and Sleep Wrecked Kids by Sharon Moore. If you're a parent. What's the title again? Sleep Wrecked. 语法解析

01:05:29

kids. Sleep wrecked, W-R-E-C-K. Yes, by Sharon Moore. So it will just help you screen and understand why we're worried about these things more. But yeah, we can't overemphasize airway health, especially in our children, you know, and catching it early and intervening early is really important. Great. 语法解析

01:05:52

In trying to maintain airway health and healthy saliva. And now I'm obsessed with saliva. It's like, cool. It's got all this stuff in it. I was thinking it's just like we know blood has all these goodies in it. We test blood. We know skin microbiome. We know that, you know, women go to an OBGYN. They get pap smears. They get, you know, I mean, they. 语法解析

01:06:13

We know if you've ever raised a kid or changed diapers, you can tell a lot about somebody's health by the fluids that they emit and that they have within them. I'd like to place saliva on the list of critical things to pay attention to. But chewing gum, is this good for our breathing and for our saliva or not? I'm not a big gum chewer. What do you think? 语法解析

01:06:36

Is it good, bad, neutral? Yeah, I think it's time and place can be very beneficial. So where I like it is if because I will say, hey, parents, you really need to avoid crackers and chips and granola bars. And they say, what do I feed my kid? You know, and. 语法解析

01:06:56

So if we've missed the window of how to introduce food to children, or they just favor those type of foods, what's a good strategy if you're out on the go to minimize decay risk and increase salivary health? 语法解析

01:07:08

chew some gum, particularly xylitol gum, because xylitol will inhibit bacterial proliferation. It will reduce strep mutans, which is the bacteria that causes cavities. Big fan of xylitol. So offering a piece of xylitol gum after an exposure to some of these snack foods, these fermentable carbohydrates, is great. It will loosen the food. It will increase salivary health. 语法解析

01:07:33

Some people like it to strengthen, you know, mastic gum. I always get asked about that. You can overdo it. You know, I worry about temple mandibular dysfunction. I have bad experience with mastic gum. I was buying it. I love the kind of the primordial aspect of it. It's like a tree sap that you chew on. It comes in this beautiful paper package and 语法解析

01:07:55

you know, no plastics or anything. You get it going in there and you feel like you're really like working it the same way my bulldog, Costello, would like work. He used to like teeth on like bricks and like he was just, and you feel great. And then all of a sudden you'd go, and your jaw would kind of stick. And then later you're like, whoa, like my jaw really hurts. Or you feel something pop up in your joint. Yeah, it'll give you that. 语法解析

01:08:16

You know, these days the young influencers are so obsessed by this. It'll give you a little bit of a golf ball hypertrophy of your jaw. That's not why I was doing it. But boy, does it make your jaw feel sore. Yeah. Yeah. I'm not a big fan. I like to just explain it. Think of a baseball pitcher. I mean, how many of them go on the disabled list because they're overusing their shoulder? It's a similar joint, you know, rotation. Yeah. 语法解析

01:08:42

If you're – we're only meant to chew really for sustenance. That's how we were evolved. So if you're chewing gum all day, it's very likely wearing down the cartilage in your joint. So I'm not a huge fan of it. I just – 语法解析

01:08:56

personally don't love gum chewing, but I think time and place too. So especially from a cavity standpoint or hydration, you know, increasing salivary flow, but just, I would just chew it for a couple of minutes, throw it out. You don't need to be chewing it for an extended period of time. But chewing food is good. Yes. 语法解析

01:09:14

Yes, thank you. So the issue, as we mentioned, is, you know, we are slurping and smushing our food. I don't, to me, almond butter is like never existed in nature. Like the idea that you would take like, I mean, almonds are so delicious, right? But that you would like, like. 语法解析

01:09:33

grind them up and put them into a paste. Like to me, the texture is so aversive. Well, you do that in your mouth. You're supposed to do that through chewing. Just the fact that like peanut butter, like to me, these things make no sense whatsoever. It's Go-Gurts and applesauces and fruit snacks. Baby food. Baby food, exactly. It's for animals and people without teeth. 语法解析

01:09:52

Exactly. So I'm not advocating in one camp or the other. There can be a mix, but you know, there's blended food that's offered or you can do more of a baby led weaning, which is eating more real foods. Obviously, please be smart about this. Don't give choking hazards to your children. There's a lot of information out there that you can look on how to safely prepare food for your child, but chewing is… 语法解析

01:10:15

incredibly important for facial development. Well, I was thinking for adults. I was kind of making fun of the fact that adults are eating like kids, like they're like slurping their food. Chicken nuggets and French fries. And yeah, we need to chew. When really asked what's gone on with the airway, why does everyone, why are faces shrinking? It's chewing. We've lost chewing. And then arguably breastfeeding too. We've moved away from exclusively breastfeeding too. 语法解析

01:10:40

What are the numbers on that? I don't know the numbers on that. How many people? I don't know either. I don't know. But it's certainly, I think it's making a resurgence. And a lot of people, though, are doing a blend. You know, we do what we need to do. I mean, a lot of women are working and everything. 语法解析

01:10:55

So it's important to know if you're not able to breastfeed or it doesn't resonate with you or you are working and having a pump that there are fixes. Okay, so this isn't dire, but just working with someone to catch these issues early. And also, unfortunately, even if we're doing all the things correctly, introducing hard foods are child's 语法解析

01:11:16

chewing and they're nasal breathing and we're breastfeeding, it's hard to combat generations and generations of dis-evolution essentially. So a lot of humans are needing intervention now. I'd like to take a quick break and acknowledge one of our sponsors, Function. Last year, I became a Function member after searching for the most comprehensive approach to lab testing. 语法解析

01:11:37

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01:12:02

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01:12:22

I'd been eating a lot of tuna while also making an effort to eat more leafy greens and supplementing with NAC and acetylcysteine, both of which can support glutathione production and detoxification. And I should say, by taking a second function test, 语法解析

01:12:34

that approach worked. Comprehensive blood testing is vitally important. There's so many things related to your mental and physical health that can only be detected in a blood test. The problem is blood testing has always been very expensive and complicated. In contrast, I've been super impressed by function simplicity and at the level of cost. It is very affordable. As a consequence, I decided to join their scientific advisory board and I'm thrilled that they're sponsoring the podcast. 语法解析

01:12:58

If you'd like to try Function, you can go to functionhealth.com slash Huberman. Function currently has a wait list of over 250,000 people, but they're offering early access to Huberman podcast listeners. Again, that's functionhealth.com slash Huberman to get early access to Function. Earlier, you mentioned Function. 语法解析

01:13:18

the many different systems and diseases of the body that the oral microbiome has been directly linked to. I would say in science and medicine, there are direct effects, like this mediates that, and then there are indirect effects, you know, like if 语法解析

01:13:34

Fire alarm goes off in the middle of the night. Your sleep isn't good, but fire alarms don't regulate sleep. They just can modulate your sleep. But my understanding, and I'm not deep in this literature, but my understanding is that we now have fairly conclusive evidence that certain bacteria from the mouth make its way to the brain or heart or other tissues and directly infect. 语法解析

01:14:00

increase either the occurrence or the susceptibility of dementia, cardiovascular disease. That this isn't just a, you know, oh, you broke your ankle, so you move less, you move less, your heart gets less healthy, your heart gets less healthy, your brain gets less healthy. This is kind of what I'm trying to make. But that the bacteria in our mouth, bad bacteria, can cause real problems for the brain and heart. Yes. And many other systems too. 语法解析

01:14:25

So much research. So they're finding 57 diseases are linked back to oral dysbiosis or oral pathogens, which is quite a lot. And different species can affect different parts of the body. So what does this all come down to? It comes down to gum disease. So it's important to note about 80% of the global population suffers from some sort of gum disease. 语法解析

01:14:50

That's huge, you know, and about 10% of the population will have severe periodontal disease, which is chronic bone loss, tissue loss, and this is where we get tooth loss too. So it's sort of a continuum process. 语法解析

01:15:06

But these all have one thing in common. It's the type of bacterial species that live in our mouths and when they get out of balance. So there's something called the red complex. These are the five bacteria that most influence gum disease and dysbiosis that can affect the heart and other organ systems. The big contenders, P. gingivalis, F. nucleatum, T. denticola, 语法解析

01:15:31

There's AA and then strep mutans too can affect the heart as well. But why do these bugs, how do they get where these other organ systems are and what are they doing? So I like to term this leaky gums. So we've all heard leaky guts. Mm-hmm. 语法解析

01:15:50

So let's say we're just in dysbiosis and probably because maybe our oral hygiene isn't the best as well as some other things. So we're not flossing, let's say. 语法解析

01:16:01

and our gums bleed, okay? That's a sign of inflammation, but you've now have created a vector, an opening in the skin, in the mucosa, where bacteria can get into the circulatory system, catch a free ride and end up in places they shouldn't be. And that creates an immune response, so an inflammation, okay? And then also these bacteria release endotoxins, okay? They can create cytokine storms, all kinds of things. 语法解析

01:16:28

So the body doesn't like these bacteria to end up where they shouldn't. So heart disease, for example, if you have gum disease, you're twice as likely, two times as likely to have cardiovascular issues. If you have gum disease, you're three times more likely to have stroke. A lot of this is correlative, not quite causal yet, but some of these are looking… 语法解析

01:16:50

to have more influence than others. And there's more research that's needed. Fertility is a big one that I like to speak about. So women who have gum disease can take two months longer to get pregnant and to conceive. And there are studies that show in couples that can't conceive that 90% of the men show some sign of gum disease. And once they go in and get it treated, they 语法解析

01:17:14

then their fertility conception improves by 70%. That's significant, you know? And it's not only gum disease, but just any oral infection. 语法解析

01:17:25

P. gingivalis is being linked to Alzheimer's and dementia. You know, these bacteria end up in the brain, they cross the blood-brain barrier, and they create amyloid plaques and inflammation in the brain. And so there have been studies, many studies now, one big one was out of Harvard, where they sampled the cerebral spinal fluid in the brains and saw that in these plaques, they had 语法解析

01:17:47

P. gingivalis of almost 100% of the patients. And when they tested them against other patients who had passed away without dementia or Alzheimer's, they didn't see any P. gingivalis. So there's a lot of association and links right now that we need more research on. The other to be aware of is cancer. And this is why I love people to consider oral microbiome testing. I personally have a friend who we tested her oral microbiome and she was through the roof with F. nucleatum. 语法解析

01:18:16

pretty asymptomatic otherwise, but F. nucleatum is linked to increased risk of pancreatic cancer, breast cancer, and colorectal cancer. I mean, we swallow 2,000 times a day, and we know some of these bugs, these bacteria, they can live through the stomach acid and make their way down into the gut. 语法解析

01:18:36

Pancreatic cancer is, sorry to interrupt, I must say I've had a couple friends die of pancreatic cancer. And while I wouldn't want any cancer, that's the one that I really wouldn't want because so many of them are deadly. I have someone really close to me dealing with it right now. He actually just had his pancreas removed prophylactically because it was pre-cancerous. The Whipple procedure. Yeah. Yeah. If they catch it early enough, it goes anterior to posterior. And if 语法解析

01:18:59

If you catch it early enough, they can lop off the anterior portion. The Whipple procedure is its call. But even a colleague of mine, a brilliant bioengineer a few years ago who had the Whipple done and he was progressing well. And then he passed away about a year and a half ago. Yeah, pancreatic cancer is – Don't want it. No – 语法解析

01:19:20

And so if you could just test your spit, you know, it's a simple test. It's a and I can give some of the tests that I like in the show notes, but you just spit into this little vial and mail it off and then they send back your results with you. I mean, that's pretty amazing. You do need to find a dentist who can then guide you. What do you do with this information? Yeah. 语法解析

01:19:43

A lot of these pathogens, they do need antibiotics. They're very virulent. They're spirochetes. So they're corkscrew shaped and they can just impregnate and wedge into tissue. And so sometimes we really do need to be pretty heavy hitting with how we treat them. So antibiotics. What kind of antibiotics are used to treat these things? It's usually an amoxicillin type of blend that they'll use. Okay. Radical idea that's going to get me in trouble with my more natural health audience. But I speak to… 语法解析

01:20:11

Those are their more pharmaceutical, more nothing, don't take anything. What is the argument against once every three years as a healthy adult doing a round of antibiotics to kill off 语法解析

01:20:27

unhealthy bacteria, replenishing the microbiome in various tissues. Just preventatively? Yeah, just preventative, like kill off what might be living in the mouth, like kill off what might be living in the prostate. I learned recently that, you know, the prostate doesn't have the same sort of immune system protection. And so a lot of men, you know, 语法解析

01:20:44

while they don't have UTIs, they have a prostatitis and they basically just need to do a 21 day or 31 day round of antibiotics. And everyone will be like, oh, you're spreading MRSAs with that or something. No, but you can protect against a number of different cancers related to the prostate and things like that. 语法解析

01:21:00

Why don't we do this as a regular practice? Like every three years or so, you just kind of hit the system hard for about a week, kill off a bunch of bad stuff and a bunch of good stuff, and then replenish the good stuff. Yeah, it's a good question. I mean, I think it's harder to repopulate the gut and the oral microbiome than one might think. Right. 语法解析

01:21:18

I like a less is more approach. I think there's better ways to kill off bad things like ozone therapy is being used a lot. I use ozone in my office. Tell me more about ozone. So ozone, it's O3. Okay. So it's a very unstable molecule. I use it in gas form or water. You can use it as an oil. It's carried usually in olive oil or hemp oil or flax oil. 语法解析

01:21:43

And so it's antimicrobial, it's antiviral, it's antifungal. And so what I'd use it for is to treat gum disease and periodontal pathogens, but then also under fillings or under sealants or if I'm doing a pulpotomy or kind of a root canal procedure. Because otherwise we're just blasting water everywhere. Wait, so is this oil pulling? This is the basis of… I use it as a gas. It comes out of a machine and I use it in a wand as a gas. 语法解析

01:22:12

Very localized. I got to try this. But what's the deal with people swishing olive oil and oil pulling? I know this is big in some of the – I don't even know what to call it anymore. What used to be alternative and it's now mainstream. It sounds like music in the 90s, right? Indie medicine is now mainstream. They sold out, right? I'm just joking, folks, but not really. There's so many mimics between the health – 语法解析

01:22:40

and kind of music and art. Like what used to be niche becomes trendy and then becomes mainstream. Everyone's cool with it now. Yoga, breath work, resistance training used to be niche. Swishing olive oil, spitting it out. Acupuncturists love this. Mm-hmm. 语法解析

01:22:57

alternative medicine types like this. Is there any truth to it? Does it relate to ozone? It can. So you can find ozonated oils on the market for oil pulling. So this is an ancient Ayurvedic practice. Going back to ozone though, just killing off mycotoxins and bacteria, this 语法解析

01:23:15

can get kind of controversial, but a lot of naturopaths will use gas ozone either rectally or they'll use the IV too. You have to go to someone who knows what they're doing. Rectal ozone? Yes. To get all the way up to the oral microbiome? No, it would affect more like the gut area, the pancreas, the liver, et cetera. Nothing shocks me anymore. It's used a lot with mold elimination, mycotoxin elimination. You know, I get a lot of questions nowadays about… 语法解析

01:23:41

mold toxicity, especially people in Austin. I don't know if you know this, but like it's either theory or real that lots of people who live in Austin or used to live in Austin think they have mold toxicity. Because of a lot of new building architecture. They say a lot of the new buildings are too… The heat cold variation and the moisture. I don't know. I don't know if this is true or not, but you know, the last thing you ever want to do is tell somebody who thinks they have something that they don't. And I'm sorry, I'm not saying they don't. I just… 语法解析

01:24:10

I hear this a lot. I've known a number of people that have left the city of Austin because they couldn't deal with the mold. Interesting. Molding can be scary. I mean, we see it affect the teeth. The teeth will just start degrading too in some of the kids who have tested really high in mycotoxins. So rectal ozone. Yeah. Wild. Wild. 语法解析

01:24:28

Well, hey, listen, it's the digestive tract. I mean, you know, we're a health science podcast. 语法解析

01:24:45

It used to be with sesame oil. More people do it with coconut oil now. I oil pull a couple of times a week occasionally. So what does that practice look like? So I put a spoonful of organic raw coconut oil in my mouth, let it melt and just swish it around as I'm 语法解析

01:25:00

you know, dawdling around in the morning. Nasal breathing. Nasal breathing. Yeah. Don't spit it into your sink. It will clog your sink. Spit it into the trash can. So what is it doing? Well, it's dislodging the biofilm as you're swishing. Okay. Lauric acid, which is in coconut oil, is antimicrobial. 语法解析

01:25:17

It can help with lymphatic stimulation and it has some anti-inflammatory properties too. And a lot of people report it makes their teeth look brighter and whiter. I mean, you do have great teeth. Well, I'll tell you the story why. I mean, it's in your profession to have great teeth, but I walked in and I met you for the first time in person. I was like, wow, you have really, really nice teeth. They're not real. I had facial trauma. Should we get into that? Yeah, let's get into that. So when I was 10, it's why I became a dentist. When I was 10… 语法解析

01:25:46

And I was my I was trying to gain the attention of my older brother's friends who are very into dirt biking and BMX biking. And we had just watched the movie Rad. And I thought I would impress them. And they were all doing tricks out in the neighborhood. And long story short, I fell off my my bike and landed on the asphalt in a vault and knocked out my teeth. And I broke my pre maxilla. And you can see the scars still. But. 语法解析

01:26:13

But this is part of my story and it's why I became a dentist because I was in and out of dental offices and oral surgeons and orthodontists. 语法解析

01:26:21

And at the time, I was an art theater kid. I loved working with my hands. But as time went on, I thought, well, gosh, I don't want to be sleeping on couches in New York City. I need to make sure I make a living. What am I going to do? And I really love science. And I thought, well, how do I work with my hands? And it was dentistry. And dentistry can be a little creative and artistic, too. So these are not real. 语法解析

01:26:45

But thank you. Well, you're welcome. And thanks for the full disclosure. They look very natural. Yeah. Unlike some people's falsies, you know, or whatever. What do you call them? I call them falsies because I've got, you know, I've got a tooth that was kind of chipped in half from getting hit. Honestly, dumb, you know, insensitivity. 语法解析

01:27:03

If you're going to box, make sure you're getting paid a lot of money. And you wear a mouth guard. Yeah, and wear a mouth guard. There are better martial arts where you can go full blast, like Brazilian jiu-jitsu, where you stand less of a chance of brain injury, let's just say. So as a neuroscientist, I can't support boxing. But I remember the movie Rad. I remember the backflip at the end. I remember the whole thing. I think I was trying to do that. I don't know what I was doing. Anyway, didn't land it. 语法解析

01:27:29

Yeah. Well, you landed it, but on the rock, but, uh, you can get implants. Um, people have flippers. We were talking about hockey players earlier. You'll see them flipping their flippers around with their fake teeth. So a flipper is a retainer with fake teeth on it. There's about a lot of different things you can do, but what's interesting, I was part of making my teeth. I sat in the lab and helped. So I wanted them to look 语法解析

01:27:56

not quite as contrived, I suppose. Well, they look very natural. Yeah, thanks. And today we're learning all the ways in which teeth are just part of this whole ecosystem that's so critical. I have to ask, and we will come back to some things related to avoiding really horrible diseases by way of taking better care of one's oral health, nicotine. These days, 语法解析

01:28:21

Everyone knows or should know that smoking, vaping, dipping and snuffing, and yes, I did say vaping, are all terrible for your health. The vapers will say it's not carcinogenic, cancer causing. And I'll say remains to be made really clear, but the whole popcorn lung thing is clearly problematic. 语法解析

01:28:42

But nicotine doesn't cause cancer. It's the delivery mechanism. Yes. But these days, a lot of people realizing the cognitive enhancement, if you will, I don't even like the phrase, the stimulant effect of nicotine are using nicotine pouches in particular, gums, let's set patches aside for the moment, and mints and things of that sort for the stimulant effect. 语法解析

01:29:13

It's an unusual stimulant because it also relaxes one self a little bit at the same time. So it's kind of that like, you know, that sweet spot. And I confess I will occasionally take, you know, one or two milligrams, very low dose. Most pouches are anywhere from three to eight pouches, milligrams rather. I'll take, you know, like one to two milligrams of nicotine in the form of a gum. I'll just chew it, you know, and then take it out. Nicotine is a vasoconstrictor. 语法解析

01:29:41

What does nicotine do to the oral microbiome? Are you going to make me quit nicotine? I don't feel addicted, but every addict says that. The first step is admitting the issue. So I don't want to villainize anything. No, you can villainize it. So I agree with you. I don't think it's the nicotine itself. 语法解析

01:30:01

But like the pouches, for example, are becoming very popular. So what else is in those? And there's a really interesting case study that maybe we can link it for people to look at and I'll share it with you later. And then I have colleagues who are reporting this all throughout the globe. But one brand in particular, it will have mannitol and maltodextrin in it, which are sugar alcohols and different carbohydrate compounds. 语法解析

01:30:30

And they market them as sugar-free. Well… 语法解析

01:30:34

Products are allowed to have trace amounts of sugar still in the product, very small amount and still be called sugar-free. And the issue with these products is the duration of action, the contact time. And you're supposed to leave them in for 20 to 30 minutes. Am I correct? That's right. So it's quite a long time to have that up in the mucosa, along the bone and along your teeth that potentially has… 语法解析

01:31:00

Okay. So it's like if you're sucking on a hard candy. But also we're seeing changes to the cellular structure up in that area. So you can see leukoplakia, which is like white patching, which can be precancerous. So this is why I just like everyone to get checked out. 语法解析

01:31:18

And we are seeing bone loss and gum recession. Again, anytime you put anything into the mouth, it's going to change and shift the microbiome. And that could be a filling. That could be a piece of gum. That could be a toothpick. Anything, you know, arguably besides neutral pH water. And so this case study… 语法解析

01:31:41

This gentleman was going in, I believe he was in his mid-50s. He started using these pouches and had always had very wonderful dental checkups with x-rays and went in regularly. And maybe he missed one appointment. And after 15 months of use, the x-rays are outrageous. He has rampant decay along the side where he had the pouch, very likely from 语法解析

01:32:07

potentially that trace amount of sugar, the microbiome changes. I mean, it looked like mothball chunks taken out of his teeth and he lost some teeth. Wow. So this isn't to scare people, but if you're going to choose to use these, I just say know the risks and make sure you're getting checked regularly at your dentist. Don't just ghost your dentist because if they're starting to see cellular changes, recession or early decay, then you may say, gosh, I should really cut back on this. 语法解析

01:32:36

Or maybe if somebody is really adamant about taking nicotine, they should just take a milligram or two milligram pill of nicotine. Yeah. Or a patch. Right. You scared me with leukoplakia. Yeah, because growing up, we were all told, you know, no one really dips in Northern California, but, you know, like don't dip because – and then I saw these pictures of leukoplakia. Jaw recession. Jaw recession, and it's pretty vile, and so you – 语法解析

01:33:01

the design to scare you. It scared me sufficiently. I never wanted to chew tobacco anyway, but good to know. Coffee. Do I need to stop drinking coffee? Okay. Thank you. You're from Portland after all. Yeah. How could I possibly say that? Okay. Yeah. Yeah. You wouldn't be able to return home. Coffee's great. I mean, it will dry out the mouth a bit, just counteract it with hydration and it will stain your teeth. So go in regularly for cleanings and you may want to 语法解析

01:33:29

I mean, if that bothers you, there are ways to bleach your teeth or lighten your teeth. Hydroxyapatite is a wonderful way to improve the brightness and whiteness of your teeth and oil pulling as well. Or you can use heavy hitter bleaches to just don't overdo it. Everybody's overdoing everything now. And bleaching too much can damage your teeth. It can… 语法解析

01:33:54

cause chemical harm to the pulp or the nerve over time. And some people will get spontaneous abscessing or need root canals. I mean, these are people who are really like bleaching all the time, the people who you need sunglasses to look at their teeth, and it's just not really a natural aesthetic. But some people are into that, but just know what the risks are. That's what I would say. 语法解析

01:34:15

The two things I've done in the last couple of years that have completely transformed my oral health, says my dentist, and how I feel are, first of all, I switched. A few years ago, I would say really about 14 months ago, I just said, that's it. I'm not eating processed foods again. I'm just not going to do it. So I eat meat, fish, eggs, fruits, vegetables, and I eat some rice, oatmeal, and vegetables. 语法解析

01:34:40

sour a good sourdough bread butter olive oil I just which is not to say that I won't have a slice of pizza someday but I just I was like that's it like I'm kind of over it 49 years old I've eaten enough of that stuff I'm kind of like bored with it anyway I hear you and what was interesting is I used to get a lot of tartar buildup a lot um despite brushing and flossing on the um what are the lower front teeth called incisors yeah and it was and they'd scrape it away it's a non-issue 语法解析

01:35:05

now. It's completely gone. Yeah. So we have minor salivary glands on the floor of our mouth, and that is a common place people will see calculus or tartars, those lower teeth. That's where you'll feel your hygienist scraping a lot. But I wonder if it's because you increased your K2 in your diet, which helps with calcium metabolism. And I supplement K2, but I was doing that before. And then I switched 语法解析

01:35:30

And I have just full disclosure because there's nothing to disclose. I have no financial relationship to the toothpaste that you make or the toothpaste that Gator Dentist makes. I don't know who. I actually know his real name, but he hides as Gator Dentist. I love Gator. Gator Dentist. But I switched from fluoride-containing toothpaste, not because of fear of fluoride, but excitement about hydroxyapatite. So I switched to using your toothpaste. And I occasionally, well, I routinely switch back and forth with Gator. 语法解析

01:35:58

where I think it stands for no BS, which is Gator Dentist to tablet product. Yes. So I use them and neither of them pay me. I pay full price. They don't send it to me. I purchase it like anyone else. And that's made a tremendous difference, says my dentist, by a 语法解析

01:36:14

no cavities whatsoever. I was constantly battling this when I was a kid and a bunch of oral health issues. And I don't want to waste our time talking about those right now. Maybe we'll return to them a little bit later, but my teeth and oral microbiome never felt better. It's just remarkable. It's just remarkable. And I have a family member who has some gut issues, like just digestion issues, and it's unclear what's going on there. And I'm inspired to 语法解析

01:36:41

try and help them address that through the oral microbiome by switching to hydroxyapatite and- And test their oral microbiome. That'd be very interesting to know what's going on in there. Because I think you're swallowing- Is there a best test? Sorry, is there a best test? Like if, because a lot of listeners are going to say, okay, I want to, 语法解析

01:36:58

if they have the disposable income, they're gonna wanna test their oral microbiome. - Yeah. - Is there one that your office uses or that? - I use either the SILHA test, which is more just biomarkers. So it's a- - How do you spell that? - S-I-L-L-H-A. - Okay. - This is done in an office. It's just testing basic biomarkers. So I use it a lot as an educational tool. 语法解析

01:37:19

It will show the pH, the acidity, if there's leukocytes, if there's red blood cells, inflammatory markers. So a lot of parents, this is so new to them when I'm talking about this. But it prints out in a graph form for them. It's a cheek swab? Spits. 语法解析

01:37:34

So kid or adult will spit in their own… Yeah, kids usually won't spit until about four, just physically. It's hard. Kids spit until four? Yeah, it's hard. Okay. Anyway, but I really like tests that use shotgun metagenomics because you're looking for the whole array of bacterial DNA. Okay. 语法解析

01:37:51

And so my favorite is bristle, like a toothbrush bristle, and it's direct to consumer. So because the issue is I can talk about all of these things, but sometimes it's hard to find providers that are offering them. So I really love people to be able to get the tools themselves. 语法解析

01:38:06

in their home. So Bristle is a company that people can… It's an oral microbiome test, yes. And it's really user-friendly. Their interface is wonderful and they will give guidance and protocols. Are you affiliated with them? I should probably ask because some of the audience will… I am actually, yes, I am. That's fine. As long as people know. They're oral probiotic. We 语法解析

01:38:27

We have a collaboration with their oral probiotic. But regardless if it's Bristol or not, you look for a test that's using shotgun metagenomics. Shotgun metagenomics. Yes. There's PCR testing too. And a lot of biological dentists will offer something like oral DNA is the most popular. 语法解析

01:38:44

The issue with that is it's really only looking at the top 12 pathogens, periodontal pathogens, which is important, but there can be a lot of other information that you're missing. So it's a great place to start and your dentist may offer that. Again, it's oral DNA and I have no affiliation with oral DNA. Great. Thank you for that. 语法解析

01:39:04

I think some people want to test their oral microbiome and other things in their mouth. And there's more and more popping up. The oral microbiome is really blowing up. So for those who are looking for investment opportunities, I'd say look toward the oral microbiome. It's kind of what the gut microbiome was doing a decade plus ago. 语法解析

01:39:27

Yeah, I feel like oral microbiome is so much more tractable. I mean, switch to nasal breathing, get away from alcohol-containing mouthwashes, you know, consider a hydroxyapatite-containing toothpaste instead of fluoride, which brings us to fluoride. Mm-hmm. 语法解析

01:39:40

Let's talk about fluoride. I've already been accused of being a sunscreen denier. No, I actually believe that sunscreen exists. I do occasionally use zinc oxide sunscreen a little bit. I prefer a physical barrier because I'll wear a hat or something if I, you know, I don't tend to burn very easily, but if I feel like I might burn, I use a physical barrier. I'm being somewhat facetious here because people will say all sorts of things, but I did an episode about water. 语法解析

01:40:11

a little bit about oral health, certainly not the depth or expertise that you're providing today. So thank you. And I said, yeah, fluoride does a bunch of things. My question was and remains, why are we drinking fluoride? But this relates to, okay, I'll tell this story briefly. It's not as cool as your story. I was taken to a dentist when I was a kid. 语法解析

01:40:34

And they put me, they put these like a, like a mouthpiece with fluoride gel in it on the top and bottom. And they sat me in a little wicker chair in front of a TV with cartoons. And I hated it. It tasted awful. And it kind of like had this sour thing. So I was probably six or seven. So I drank it. I just sucked it up, drank it down, turned around, barfed all over the wicker chair. Oh my gosh. 语法解析

01:41:03

Fluoride is a poison, but everything is a poison at high concentrations. So most everything is a is a fluoride is a poison, excuse me, high concentrations. So I don't have anything against fluoride, but it is a poison. Then the question becomes if something is not dangerous in a small dose or concentration, what? 语法解析

01:41:23

What are its cumulative effects? This is what I have issues with. People say, oh, going through the x-ray machine, no big deal. But what if you fly 150 times a year? Is it cumulative? And so like the logic of the sort of pushback from the traditional, if I will, community sucks. 语法解析

01:41:40

Like, they're just not logical. These are my colleagues sometimes too, right? Just you go to the dentist to get an x-ray. They're like running behind the next wall. With a lead. Put you in a lead shield. And then they're like, oh, no, it's no big deal. Well, how many, you know, maybe how many times a year can you do this before it becomes a deal? So my question is, what is the rationale for putting fluoride in water, in drinking water, given that the contact time in the mouth is so short? Mm-hmm. 语法解析

01:42:08

And then what's the cumulative effect of bringing fluoride into the gut over and over? And then earlier you said something, and I've never thought about this. The bones contain hydroxyapatite, 60%, I think you said? Mm-hmm. 语法解析

01:42:22

60% of your bone minerals are made from hydroxyapatite. Fluoride infiltrates the minerals of the teeth and replaces it. So is fluoride going into our bones? Skeletal fluorosis. Okay, so I'm not trying to paint a scary picture here, but frankly, and people can probably tell, my blood pressure goes up a little bit when people say, oh, you know, you're anti-fluoride. I'm not anti-fluoride, but I just don't get the logic. It doesn't make sense. You're thinking critically about it. Like why would I continually bombard my system with fluoride? 语法解析

01:42:51

At the level of the gut, at the level of my bones, if it's good for me, tell me it's good for me. But they're saying, oh, it's so that poorer populations don't have decaying teeth. Sounds like a good argument, not even counter-arguing it. But I can't piece together the logic. And like most public health arguments, I feel like neither side is right. 语法解析

01:43:13

explicitly clear about what exactly they're arguing about. And that's part of why I have this podcast to try and get clarity on things. I'll do my best. Yeah. And please don't worry that you're going to offend anyone because I'll offend everybody. And they've already said anything they 语法解析

01:43:29

Everything they possibly could. And they'll say more. So I'm not afraid to open up these topics anymore. I appreciate that. And I'll take the heat. Well, I will get it too. Don't worry. I've already, I have thick skin at this point. But you have great teeth and they don't. And I haven't had a cavity for multiple decades and haven't used fluorine. And Portland isn't fluoridated. Portland is not fluoridated? It is not. So let's talk about that. So fun story. Okay. 语法解析

01:43:56

Back in 2011, 2012, I was working on the pro-water fluoridation campaign, volunteering in Portland, picketing and handing out educational flyers because I thought we needed it in our water. 语法解析

01:44:12

And this is because that's how I was trained. And I just never questioned it. I never picked up a journal to look at the other side. I thought anyone speaking out against water fluoridation, that's the Tin Hat Brigade, that's the Woo-Woo Caucus, all the things. I was that person. The Woo-Woo Caucus? Yeah. That's pretty funny. I like that. So I went to a debate in Portland. Yeah. 语法解析

01:44:38

pro versus against. I don't like those terms, but it's just the easiest way to describe it. And I was sitting kind of on the pro side and just waiting to see these pseudoscientists come out to speak. And 语法解析

01:44:51

And I was so profoundly impressed with what they said and also had no idea that there were any concerns with with fluoride. I'd never been taught that in dental school, the endocrine disruption, the neurotoxicity, the skeletal fluorosis. I knew about dental fluorosis, but I at that point was of the mindset, well, it's just aesthetic, you know, but your teeth are stronger and the microbiome issues, too. 语法解析

01:45:18

So it didn't take long. I just started rabbit holing and there's so much literature. And this, again, this was quite a while ago and more and more data and literature is coming out to question the practice. So it's important to go back to the history of water fluoridation. I'll try to be brief, but… 语法解析

01:45:34

In the early 1900s, there was a dentist in Colorado Springs, Frederick McKay, who noticed his patients had mottled brown spotted teeth, but they were really strong. They weren't getting decay. And so this kind of spread and they started kind of trying to understand the why. And they realized there was a really high concentration of fluoride in the natural water supply that this community was drinking. 语法解析

01:46:00

And this just kind of spread like wildfire with very little evidence-based medicine to back it because this was in the early 1900s. Now it was like the 1930s. So no long-term safety studies or efficacy studies. And it was put in as an experiment in Grand Rapids, Michigan in the mid-40s. 语法解析

01:46:20

After about a decade or so, they noticed that caries rates, cavity rates were going down. And so based on this observation, it just went like wildfire throughout the United States. And I believe about 80% of the United States is fluoridated. So the pro-advocates, if you will, will say it's the greatest public health movement of the century because decay was such an issue. It's important to know dental decay is the hardest 语法解析

01:46:47

top chronic disease globally in children and adults. It's almost entirely preventable. I think we've just normalized it. You just get cavities, but I'd like to point out we're one of the only species to get dental decay. Wild animals don't get decay. Our domesticated animals do because of what we're feeding them, the kibble, you know, processed animal food. And 语法解析

01:47:10

So here we are. So it's been controversial from the beginning. You know, epidemiologists, endocrinologists, neuroscientists have always challenged it, saying this is a bad idea. It's a highly reactive element. You know, the fluoride ion can interfere with iodine uptake and, again, skeletal fluorosis, neurotoxicity, etc. So… 语法解析

01:47:34

About seven years ago, there was a federal trial in Northern California, but it was federal. The people versus the EPA. It was a TASCA trial. 语法解析

01:47:45

And this has been ongoing for the past seven years. And basically, they were saying, where is your safety data, EPA, on the long-term effects of water fluoridation? So the idea was that if we put it in the water, it's not a very efficient way to get fluoride to people, but eventually it will make itself into the saliva and have a topical effect coming out through the saliva. They used to think… 语法解析

01:48:09

systemically, it was actually incorporating into the developing teeth and children, making the enamel stronger that way, but that's been debunked. 语法解析

01:48:18

So now it's most likely still a topical benefit, maybe a little bit of a systemic benefit, touching the teeth. And we do know fluoride really needs to work topically. We don't need to be ingesting it. And that is all through the data. And they're teaching that in dental schools now too. Okay. But this is the easiest way to get fluoride to the masses because 语法解析

01:48:40

caries or cavities are such an issue. Now, my first comment on this is we're not addressing the root cause of dental decay, which is our food. It's all the ultra-processed foods. Again, we didn't really see dental decay in humans until the agricultural revolution, the industrial revolution, and now the ultra-processed food craze that's been happening the past many decades. Is that right? So if we look at skeletons from dead people, obviously, well, you can look at skeletons alive. 语法解析

01:49:09

people, skeletons and dead people, uh, from dead people that, um, died prior to 1900. How are their teeth? 1900, they still have, they would have decay. But if you looked at about 10,000 years ago, um, very little, you know, unless they lived in an area with a lot of fruit abundance or honey, like where are you getting your sugar from? You know, and you go pick some berries on a bush, you're competing with the animals and the birds. You didn't, 语法解析

01:49:36

have much opportunity to overconsume sugar. But, you know, there was the sugar trade and then we just, sugar was a sign of wealth and royalty and people's teeth just rotted out and it was because of our diet. So that's the root cause issue that no one's talking about. You know, we're just saying, let's slap fluoride on it. 语法解析

01:49:56

How about we educate and teach people what is really causing cavities? But anyway, okay. So the task of trial was going on and the judge, Judge Edward Chen, was waiting for this National Toxicology Program's report, which was under the Department of Health and Human Services. And this is, it reads like a soap opera, to be honest with you, right? 语法解析

01:50:20

And it kept getting delayed and postponed and they wouldn't release it. And finally, under the Freedom of Information Act, he said this needs to be released. And it said there is a strong correlation between increased fluoride consumption and IQ issues in children. And so with that, he took this information and he made his ruling. Now, this was after years of expert testimonies as well, OK? Yeah. 语法解析

01:50:48

saying there's an unreasonable risk to current water fluoridation practices in the United States. This was his ruling that just happened late last year. I mean, this is very new. And EPA, you now need to fix this. You need to regulate this better. 语法解析

01:51:04

What people will argue is a lot of the studies they were looking at that are showing lowered IQ in children or neurocognitive issues, it was at 1.2 or 1.5 milligrams per liter. That was the concentration. The United States, we now do 0.7 milligrams per liter. But that's per liter. Okay, so how many liters of water do you drink a day? This is the controversy here. 语法解析

01:51:31

So, for example, the American Academy of Pediatrics generally recommends pregnant women drink two to three liters a day. You might be cooking with fluoridated water, making your pasta, making your soup. How do we really know how much someone's getting exposed to? What's their body composition? How much do they weigh? What are the other outside sources of fluoride? Are they swallowing their toothpaste? 语法解析

01:51:57

Fluoride is in many pharmaceuticals because it helps increase bioavailability, especially SSRIs and Prilosec. A lot of these have fluoride in them. Really? Yes. Ultra processed foods will have fluoride. So the factory that's making your Rockstar energy drink or your Hi-C or, you know, whatever you're consuming, they're not using reverse osmosis. 语法解析

01:52:22

to filter the water. So you're getting fluoride that way. It's naturally found in green tea and black tea. And this is not to make people worried about green and black tea. I still consume them. It's more to say, how are we really understanding how much is exposed to? 语法解析

01:52:37

And so they were finding that pregnant women, they follow, there's many studies now, but a famous one was the Rivka Green study out of Canada, and they followed about 520 mother-child pairs. They tested urinary fluoride in the mother per trimester, averaged it, and then followed these children to the age of three or four and did IQ tests and found that 语法解析

01:53:00

that mothers who had higher concentrations of urinary fluoride, the children tested lower on their IQ tests up to five to seven points. And that's on par with lead. Okay. On par with lead. On par with lead. Yes. And so that was in 2019. There's been so many more studies now. So the judge ruled EPA, you need to regulate this better. 语法解析

01:53:22

In that amount of time, there was a meta-analysis that came out that further supported the NTP report by JAMA Pediatrics. And this is very controversial for these editors to be putting out, by the way, so I commend them. And also a Cochrane report came out, Cochrane Collaborative, which has said—this, again, was very recent— 语法解析

01:53:44

Looking at all the data from water fluoridation, water fluoridation isn't reducing decay like we thought it was. It's only reducing decay by about one quarter a cavity per person. One quarter of a cavity per person. So that's not statistically significant. So people will say, well, what gives? Why were cavity rates going down when we added fluoride to the water? Well, 语法解析

01:54:11

It's hard to say. Maybe they were already just going down due to education, more access to dental hygiene and toothbrushing, flossing. But also we now have fluoride everywhere in our toothpaste. So fluoride was put in the water in the 1940s. It wasn't added to our toothpaste until the 1960s. Now it's everywhere. We get fluoride everywhere. Rinses, the varnishes that made you vomit everywhere. 语法解析

01:54:38

at the office. And by the way, that's very common. That's very common. And it's because a lot of those fluoride varnishes, number one, fluoride, you know, it does have a poison control label on it. You're not supposed to swallow it. But these varnishes also have polyurethane and hexane derivatives in them. It's what makes them so sticky. 语法解析

01:54:56

I still loathe going to the dentist. I think it's because of that early association. So it's very controversial. And unfortunately, we've lost sight of the science is getting buried in politics right now. And it really upsets me because… 语法解析

01:55:11

It's not a political issue. We just need to look at the data. And I feel like we're losing sight of the scientific method. And we you know, the American Dental Association, the American Academy of Pediatrics is doubling down on saying we have to put fluoride in the water. 语法解析

01:55:26

And for nothing else, I think it's important to know 97% of the world does not fluoridate their water. This is a very United States controversy. Many countries removed it and found, I think it was Denmark, Germany, Japan, Italy, 语法解析

01:55:42

they have very low decay rates. And why is this? Well, they educated their population on what's really causing decay and also made fluoride toothpaste accessible. And I have Danish relatives. They have very nice teeth. If you told me that there's no fluoride in the drinking water in England… 语法解析

01:55:56

I might be like, well, you know, sorry, my English friends, but that's the stereotype, right? That their teeth are bad. I don't think that that's true any longer. I think that that was true at one point. I think they're crowded and crooked too. And a lot of that has to do, I think, with facial development as well. I think we see a lot of Western European, they do have that kind of 语法解析

01:56:21

dysmorphic face, if you will, probably from nasal breathing, who knows why, industrial revolution, allergies, mouth breathing, et cetera. Why does it seem more prevalent there? 语法解析

01:56:31

So that's the take, the quick take on it. And so I just think it should be a personal choice. You know, if you want to use fluoride, you can go out to the store. I mean, you can get fluoride toothpaste at the dollar store now. They give it out for free at many clinics. To me, I just think it's a medical ethical issue. We're mass medicating a population without their consent. 语法解析

01:56:55

And then the even bigger issue for me is no one's talking about this, nor can I find any literature on it. What is it doing to the gut microbiome? Because it is an antimicrobial. So that would be a wonderful study, NIH, if you're listening. Can we test people that live in fluoridated areas versus those that don't? Can we follow them? Maybe it's a prospective cohort study to just see how their microbiomes are different. 语法解析

01:57:22

Because it just doesn't make sense to me. And why would we ingest something systemically with all these potential risks when we could just use it topically or actually talk about what's really causing decay? If fluoridation worked… 语法解析

01:57:37

And cavities wouldn't be the top disease in our country, in our children. And many worry, well, if we take it from the water, decay may go up. And it may. I mean, there's been they did this in Calgary, Canada, where decay rates went up. But then if you actually look at the data, the decay rates were already going up. 语法解析

01:57:56

when they removed it, but they only show you the data that they kind of want to show you for that. So, but again, it's a risk benefit analysis. I mean, I think dentists tend to be too focused on teeth. And so you mentioned like, if they say it's good for me, I'll do it. Well, good for what? Good for your teeth or good for your whole body or good for your brain. And I think that should be an individual choice. Are you, for as a parent, do I want to choose one quarter less cavity teeth 语法解析

01:58:26

in my child or do I want to preserve their optimal brain development? I mean, the data that show deficits on par with what one sees with lead exposure, that's the most striking thing to me. Yeah, and I'm a dentist. I was trained to fix teeth. I can fix a one-quarter cavity in a tooth. I can't fix a developing brain. We have one shot to develop a brain. We have one shot to grow a face. You know, it's really important. 语法解析

01:58:55

I really appreciate you taking us through the full arc of the history of it. I think it's extremely important that people take that in so they can start to form their own opinions. And you pointed out a number of logical flaws in just the way the whole system is arranged right now, which is this mass manipulation. 语法解析

01:59:19

treatment of everybody with a potent chemical, especially given the amount of water that people drink and cook with, et cetera, without their consent. And without a risk assessment. So your low decay rate, I might be a really high decay rate. You don't need anything extra. Your diet, your balance, your microbiome is great. 语法解析

01:59:42

I'm not eating well. My hygiene's terrible. You know, we can't just blanketly be treating everyone the same. We're supposed to be doing risk assessments. 语法解析

01:59:51

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02:00:12

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02:00:38

I also drink Element dissolved in water during any kind of physical exercise that I'm doing, especially on hot days when I'm sweating a lot and therefore losing a lot of water and electrolytes. They have a bunch of different great tasting flavors of Element. They have watermelon, citrus, etc. Frankly, I love them all. If you'd like to try Element, you can go to drinkelement.com/huberman to claim a free Element sample pack with the purchase of any Element drink mix. Again, that's drinkelement.com/huberman to claim a free sample pack. 语法解析

02:01:07

Okay. So I think that pretty much puts fluoride in a, not in a box, let's say on the shelf for all of us to look at. I think this is going to be a very important aspect of public health in the year to three years to come. 语法解析

02:01:22

with this new administration and Bobby Kennedy paying a lot of attention to fluoride. And I really like what you said about trying to remove the political aspects of this. If this becomes a blue versus red, left versus right thing, we're never going to get to the heart of the matter. And that would be really sad. And the ones that would really suffer would be kids. The children. So a nonpartisan look at this, which is, 语法解析

02:01:51

How I heard everything that you said just seems really critical. Where are they getting the fluoride? So water fluoridation, the fluoride that they get is a byproduct of the phosphate fertilizer industry. And it's called hydrofluorosilicic acid. 语法解析

02:02:14

So as a byproduct of the phosphate fertilizer industry, it's considered a hazardous waste and it's very expensive to dispose of. But they have found that if diluted in theory and put, it's an acid, first of all. So if it's put into our water system, it is so diluted that it becomes safe. But I will say it, you know, everyone can go. 语法解析

02:02:38

researchers and look at themselves, but it does come in like cement bags with skull and crossbones on the front. And they do have to wear hazmat suits to put it into our water. They're supposed to titrate it. And I think what's interesting, you know, we're supposed to target 0.7 milligrams per liter. I've been involved in some educational campaigns and have tested communities surrounding Portland. 语法解析

02:03:02

It's very hard to keep it in range, you know, and so there are some communities testing as high we've seen as 2.2 milligrams per liter, which definitely falls into, based on the science and literature, more concerning zone for neurocognitive issues and other issues. 语法解析

02:03:17

health issues. So if you're concerned, you can call your local water bureau, municipality. I will say I don't think the federal government's going to have much control over this. It would be nice if the EPA stepped in. They have appealed, by the way. 语法解析

02:03:32

But it will come down to more like on the state level and local level. And we're already seeing states like Florida and Utah have run it through and initially done a, we're going to ban this as a mandatory thing in our state. And I think it's North Dakota, Kentucky. There's other states picking this up too and other communities that are removing it or not adding it to their water. So it's an interesting time. 语法解析

02:04:00

to observe all of this. Super interesting. I will resist the temptation to ask questions about why it sounds like mostly red states are the ones doing this as opposed to blue states, although Portland… 语法解析

02:04:12

is in a blue state. Portland's traditionally… Blue city, for sure. Blue city. Yeah. Right. Blue city in a… Red state. Oregon went red this last election? The cities make up… It's kind of like many states. So Eugene, Portland, Bend tend to be pretty blue. And I think the surrounding is… 语法解析

02:04:34

It's more conservative. But no, it's shifted a bit, but not enough to shift out of voting liberal. All right. Well, we'll do another episode in 2090 about politics. Meanwhile, back to the oral microbiome and otherwise. I'm very interested in the relationship between oral health and what you described as fertility, pregnancy and hormones. 语法解析

02:05:01

And obviously hormones can be about men or women. But let's talk about oral health and fertility. What, if any, knowledge is there about how the oral microbiome or oral health would be impacting fertility? 语法解析

02:05:15

Egg health, fertility, ovulation, ovarian reserve. Is that sort of the level that the regulation of fertility is thought to occur? Like what's known about the link? Yeah. So again, it ties back to that translocation and creating an immune response and inflammation as well as the endotoxins that are released. 语法解析

02:05:36

With men particularly, they're seeing increased sperm challenges with sperm motility and sperm mobility as gum disease and periodontal pathogens increase. And again, it probably has to do with the inflammation. And with women, you know, we can show that women take about two months longer to become pregnant. It does affect pregnancy. 语法解析

02:06:00

ovulation, egg quality, but also we know it can lead to miscarriages and low-term birth, low-weight birth, preterm birth, and just pregnancy complications as well. And so we are finding oral bacteria in the placenta. You know, we're finding there's different microbiomes everywhere now. The breast has a microbiome, the placenta has a microbiome. 语法解析

02:06:25

And so oral bacteria can end up in many of these places and just create that cascade of inflammatory events. And so certainly it's an exciting time to be alive because of all the research happening. And right now it's 语法解析

02:06:38

Again, not causal. There's a lot of correlation, but I would love to see fertility clinics focusing more on oral health. Like how amazing would it be if they started testing the microbiome of patients and if they realize they're really high in P. gingivalis or F. nucleatum and they eradicated or lessen that bacteria. I mean, I'd be interesting to see how pregnancy and fertility outcomes would change and possibly improve. Great. 语法解析

02:07:04

What are some of the mechanical as opposed to chemical things that we can do to improve our oral health? So we were all taught brush and floss twice a day. I even have a colleague who can be caught in the bathroom brushing his teeth after lunch. So he's brushing three times a day. I don't know what motivated that. I do that too. Do you? Okay. Great. So what's the deal with brushing? When, let's say… 语法解析

02:07:33

Kind of like exercise. Let's say if someone were going to only brush once a day, better to brush in the morning or at night? Obviously, people should brush twice a day or more. But if one could only brush once or twice a day? 语法解析

02:07:46

Would it be morning or night? Yeah, I guide parents on this a lot because brushing a child's teeth can be challenging. Nighttime is always the most important. One, you're removing the food particulate matter from the day away. You're disrupting that biofilm so that you're not sitting, sleeping all night, 8, 10, 12 hours if you're a child with that sticky tissue. 语法解析

02:08:08

potentially dysbiotic biofilm on your teeth. And then you add in maybe your mouth breathing, that's going to shift the microbiome and drop the pH more. So it's really nice to go to bed with clean teeth. So I suggest focusing on the nighttime. What does drive me a little bonkers is the fact that we tend to focus so much on brushing, but we leave out flossing a lot of the 语法解析

02:08:31

So thank you for mentioning that. If you read children's books, you'll see they all say go brush your teeth, but never floss. So we need a revamp there. But most cavities that I see in children, and this translates to the adult population as well, are in between the teeth or interproximally in the molars. And it's really common. So a lot of parents will bring their kids in. 语法解析

02:08:54

They think they've been doing everything correctly. They haven't been flossing quite yet. And we take x-rays for the first time and the children have eight cavities, which sounds like so many, but it's really common because we have eight molars. 语法解析

02:09:06

And so it happens between the teeth where you're eating those goldfish crackers, those pretzels, those chips. They get stuck in between the teeth. The bacteria come to feed. The acid gets released, and it just sits there hour after hour, day after day, arguably week after week if you're never flossing. So I really like flossing to be part of the routine too. Again, if you can only do it once a day, that's great. That's fine. Do it at night. I like to floss first. Then 语法解析

02:09:33

Then brush. You're dislodging the food in between and kind of brushing it away. There's actually studies to support this too, that order. However, beggars can be choosers. Just do it. You know, some people get a suction cup mirror. They'll do it in the shower. Some people do it in their commute in the car. I'm not going to be picky about it. 语法解析

02:09:51

I will also say as we age, flossing doesn't always cut it by itself. So think about a little string of floss. You know, we want to put it between the teeth and they suggest you do a C and a backward C. You're scraping the sides of the teeth to disrupt that biofilm. 语法解析

02:10:09

But as we age, we all lose a little bone. So you get this little pocket where that string isn't cleaning the bacteria out of, and that's where a water pick can come in. And so if you really want to be an overachiever, I do love a little water picking too. I personally will alternate. So one night I might floss. 语法解析

02:10:27

The next night I might water pick. This works really well in patients that can't put their hands in the mouth. Maybe they have like an aversion to that sensory. Children often will struggle with flossing. So water picks can be fun. You can do it in the bathtub so it doesn't get totally messy or in the shower. They make cordless versions. 语法解析

02:10:45

Um, but I can't overemphasize how important flossing is that interproximal cleaning, it stimulates the gum tissue and, and you're less likely to have gum disease as a result. What about those little toothpicks with a little sling of floss across, um, you know, the, the hard picks that, uh, floss picks, floss picks. They're great, especially in kids. Um, 语法解析

02:11:10

It's the only way to floss a child's teeth, first of all. So I want parents, as soon as teeth touch, they should be flossing. That could be the anterior teeth. Our jaws are shrinking. Our teeth are crowded. It's rare for me to see a child with space in their front teeth. That is how we should be developing because adult teeth are wider than baby teeth. They need more room to come in. But very often we're crowded. So anywhere teeth touch, we should be flossing. But usually around the age of two and a half, 语法解析

02:11:37

The molars are in touching. And parents look at me like I'm crazy, but we really should be flossing. And so if you start some of these behaviors early, it becomes easier and easier. We know kids that floss become adults who floss. But also floss picks are fine for adults too. You know, some people have big hands. It's hard to get floss. Yeah, I have to use them. I can't get into my hands into my mouth. They're fine. Yeah. 语法解析

02:12:02

Okay. You just want to try not to just go straight up and down, just kind of angle, angle if you can. Okay. And then maybe a water pick too. And I was told by my dentist, soft toothbrush, because I tend to get in there and like, I'm hearing all this stuff about how the, you know, oral health is so important for the brain and for 语法解析

02:12:20

And that could lead some people, including me, to get in there and just start like scrubbing and scrubbing and trying to get everything out of there. And that's not the right approach. Brush stroke, very gentle. So you want to do gentle circular movements. You don't want to wear away your enamel. This is also important. Many people will eat and then run to the bathroom and brush their teeth. 语法解析

02:12:40

Every time we eat, our teeth demineralize a little bit, right? Remember I mentioned it takes about 20 or 30 minutes for that remineralization to begin. So if you're immediately going to brush, your bristles could be damaging your enamel and creating… 语法解析

02:12:56

just wearing it away and creating little marks and it could lead to sensitivity recession. So if you can try to wait 20 or 30 minutes after you eat or drink to brush, this includes with vomiting, the same thing. So we all want to brush our teeth after we maybe get sick. 语法解析

02:13:13

Try to just maybe rinse your mouth, maybe with a little baking soda. A lot of this is perfect world, okay? And I get it, but just I like people to have the information. You said marking, and I meant to ask something earlier, not to return us to the fluoride conversation, but you said that the person who initially had the idea to include fluoride in treatment of 语法解析

02:13:36

tooth decay, noticed that kids' teeth had dark spots on them. Does fluoride cause darkening of the teeth? It can. So I believe it was his pediatric and adult patients. It was just this whole community had these spotted teeth. So that is something called dental fluorosis. Spots and markings on the teeth can be many different things. One is fluorosis. One could be hypoplastic enamel. I think we should touch on that. But 语法解析

02:14:04

So, fluorosis can be mild, moderate, or severe. When it gets more severe, that is where it can be dark, spotted, orangey, brown. Mild fluorosis usually is more bright or white. You often see it on the incisal tissue. 语法解析

02:14:17

tips or on the cusp tips of the molars. It's not a very attractive feature. It's not. And it is a sign that you've had excessive fluoride, you know, and I will say 40% of teenagers now have dental fluorosis. That very likely means they also have some degree of skeletal fluorosis as well. So for all the, um, 语法解析

02:14:41

challenges that the debate around fluoridization of water has. I am willing to bet a significant amount of my savings that 语法解析

02:14:56

This issue will end up being the linchpin issue. It might seem crazy, right? Like here's the substance that may or may not be safe that we're ingesting for various reasons. And there's a history there, which you beautifully described. But having been in this public facing health education game for a little while now, for the typical person who's like, yeah, whatever, I've been drinking water and I feel fine or my kid feels fine or there's nothing I can do about it now. They're 15. Maybe they're, you know, 10 IQ points down from where they would be. 语法解析

02:15:24

But if you tell people, what I find so interesting about human psychology, if you tell people, did you know that fluoride not only might have some neurodevelopmental impact, it's probably getting into your bones. 语法解析

02:15:35

just like it's getting into your teeth. But you know those spots on your teeth that are those white spots or dark spots that are really unattractive? That's because of fluoride. Now you've got everybody. Aesthetics. Aesthetics. And it's either a shame or whatever that this is the way that people are. But the moment that people realize that something that 语法解析

02:15:57

either is good for them or was intended to be good for them might be bad for their long-term health. You sort of got them hooked, but these long-term correlations are very hard to motivate human behavior. But those white spots, nobody wants those. Dark spots on the teeth, nobody wants those. And I'd be willing to bet that 语法解析

02:16:16

That becomes one of the key issues. And if people go, oh, listen, it's actually making my teeth uglier, maybe stronger but uglier, I bet you this becomes a wedge in the conversation. That will come from the public, but I will tell you, I have dentists, when I speak, as I do, about water fluoridation and fluorosis specifically, say, well, 语法解析

02:16:37

Well, it's just aesthetics. At least their teeth are strong. Like they're making the decision for the patient. And I think that's not our right as providers to make that decision for someone. But it's really common. Fluorosis is very common. I've even seen more recent data saying as high as 60%, but 40 is kind of the standard number that we go with of teenagers with fluorosis. There is something called hypoplastic enamel. 语法解析

02:17:03

this is something I'm very passionate about. This is under mineralized enamel and I believe it's a silent epidemic in children. I see more and more children whose their teeth erupt and they're mottled and chalky and some are so severe they're crumbling. And I've seen a big uptick in this and my 语法解析

02:17:22

my 20 year career. And the data is starting to show this as well. And so unfortunately, so many parents, their kids will get decay. It's really common and they get shamed and blamed. Like, what are you feeding them? You're not brushing and flossing their teeth. You're neglecting them. Or they're told to stop breastfeeding because that's what's causing the issue. But it's really that the teeth, the enamel didn't form properly and it's not as acid resistant. It's more fragile. It's more pickup sticks than the Lincoln logs. Okay. 语法解析

02:17:51

And I believe and colleagues globally agree that it's very likely due to all the mineral deficiencies that we're seeing globally and the vitamin D deficiency that we're seeing globally. You know, we're inside all the time. We're not outside all the junk light that we're getting the blue light. 语法解析

02:18:09

It can also be from environmental toxins, high fevers, viruses. But it's a real concern. And so many children are having to undergo general anesthesia now to get their teeth fixed. The study I read said about 100,000 to 150,000 a year. 语法解析

02:18:26

for a preventable issue. You know, there's risks to general anesthesia. And this is where I do love to consider a more conservative approach. Like, can we remineralize these teeth? Are there strategies that we can do to even just kick the can so the child's older so they could sit for treatment 语法解析

02:18:43

so that we're not putting so many children under anesthesia? Because I don't think we have the data for all the long-term potential cumulative effects. And we talked about this earlier. It's not just one exposure, right? It's not just one exposure from an x-ray or one exposure from fluoride or one anesthesia exposure necessarily, but it's that cumulative effect that we don't have enough data on. Going back to this relationship between the 语法解析

02:19:13

oral microbiome, oral health and hormones. And focusing specifically on female hormones, the menstrual/ovulatory cycle that occurs each month, as well as perimenopause, menopause. About half of our listeners are women. I'm curious 语法解析

02:19:37

Are there certain phases of the menstrual cycle or certain phases of perimenopause, menopause or prior to it in which women should pay particular attention to their oral health? Is it like is there a known association with like a, you know, when estrogen is rising or falling that the oral microbiome tends to be more vulnerable and they perhaps should spend a bit 语法解析

02:19:59

more attention on their oral health? Yes. So we see it both ways, rising and falling. So around puberty, we'll see changes to gum health. So a lot of young girls will have more gingivitis or gum inflammation. And, you know, and certainly if they're on oral contraception, that can change things too. And they'll go into the dentist and be accused of maybe not brushing and flossing appropriately, but it's really a hormonal issue. So it's important to know that. 语法解析

02:20:26

as well as women who are pregnant. Pregnancy gingivitis affects 50 to 70 percent of women. 50 to 70? It's a lot. Wow. Yeah, and it usually goes away once you have the baby and you've gotten through some breastfeeding and hormones regulate. But it's important to know that you can also have relaxin. It helps us perpetuate 语法解析

02:20:47

prepare for childbirth, but it can shift teeth. We have a ligament around our teeth, much like we have ligaments in our pelvis, and that periodontal ligament is impacted by relaxin. So you can see teeth shift and move. And women may sometimes say, my bite is different now. My gum health is different. So it's very important preconception, and certainly during pregnancy, to be really on top of your oral hygiene as best as possible and see a dentist regularly. And then perimenopause and menopause 语法解析

02:21:15

there's a whole slew of issues that happen to women from an oral health perspective with hormonal shifts, you know, decreases in estrogen and progesterone can impact collagen synthesis, so more TMD, more headaches, certainly gallbladder, 语法解析

02:21:30

gum inflammation, dry mouth, burning mouth syndrome, more bad breath, taste changes too. And so what if it's just so powerful to be able to have these conversations with women rather than just say, well, just use this product, brush and floss more. Maybe we could talk, speaking of it from a hormonal lens, like is hormone replacement therapy appropriate for you? Or how can we help support you in other ways? Maybe you should see the dentist every two or three months instead of every six months. 语法解析

02:21:59

And also just the mental health component to say, hey, this isn't something you're neglecting. This is a change your body's going through. And so how can we support you from a dental community? Yeah, thanks for that. More and more I'm getting asked questions on social media and elsewhere about, you know, like, how is this different for women versus men? And in particular, different phases of the cycle and perimenopause, menopause and postpartum. 语法解析

02:22:24

essentially the entire lifespan. So appreciate that. Yeah. I get burning mouth question a lot too from my community. What's burning mouth? Sounds awful. So your mouth feels metallic and it truly feels burning, almost like itchy, I think. I haven't experienced it, but that's how it's described to me or kind of like a dry mouth. 语法解析

02:22:43

It can be a sign of zinc deficiency or vitamin B deficiencies. And we can see changes in those with perimenopause and menopause. I think it's important to know the mouth is the gateway into the body and we can see nutritional deficiencies in the mouth as well. So cracks in the corner of the lips can be a zinc deficiency. It's the same with white striations on the line or your fingernails. That can be a zinc deficiency. 语法解析

02:23:09

B vitamins can be burning mouth or geographic tongue is something people experience. What is geographic tongue caused by? I don't have it. I have a family member who has it. It's permanent because they're quite – 语法解析

02:23:24

you know, far along in their life now and still have it from childhood? We're told in dental school it maybe has changed, but it's benign, you know, and just tell patients to avoid citrus and acidic foods. It is cross-linked to latex allergy and psoriasis. So it's an autoimmune issue. It can be a sign of 语法解析

02:23:46

nutritional deficiencies, usually zinc, B or iron. And also it can be a sign of celiac, Crohn's or gut issue. Again, it's all connected. And so a lot of times when kids see me, I will send them to a functional medicine doctor or naturopath to just make, to rule that out, you know, and there's genetic dispositions too. Yeah. 语法解析

02:24:09

As we progress further along in this conversation, these ideas pop to my mind that I'd never thought of before, like because I don't tend to use them like lip balms, lipstick. I don't use lipstick. I don't use lip balm. I suppose I've put like one of those sunscreens when I went skiing or snowboarding years ago on my and now I'm wondering, like, was that just a terrible idea? 语法解析

02:24:33

I mean, it's good not to burn. People are going to use, but I suppose specifically like lipsticks, are they safe for the oral microbiome? Well, I don't think it's getting into your, I mean, hopefully you're not eating it that much. But I mean, we need to be mindful of our products. You know, there's petroleum-based products, alcohol. 语法解析

02:24:50

A lot of lipsticks, lip balms, they have nasty ingredients in them. We're learning more and more. And, you know, they're not necessarily as regulated here from a cosmetic standpoint as they might be in the EU. So read your ingredients. But a lot of petroleum-based products will actually… 语法解析

02:25:07

cause more dryness, you know, and it has a reverse effect, which is why people get addicted to Chapstick. I think they just, their lips dry out more. But when I see chronic dry lips, I'm thinking dehydration and are you mouth breathing? Because when you mouth breathe, all the tissues dry out. So if a kid comes in with chronically dried lips, I do wonder if they're a mouth breather. Another way to 语法解析

02:25:28

assess if you have a mouth breather on hand is, are you always asking someone in your life to chew with their mouth closed, especially kids? So when we're chewing, we have to breathe. So you should chew, lips closed, breathe through your nose. But if you can't because of an obstruction, deviated septum, inflamed nasal turbinates, you'll have that kid, those mouths always open and they tend not to chew enough. They kind of mash food and swallow it because they've 语法解析

02:25:57

They're worried about oxygenation. They feel like they're going to choke. These kids tend to get picky eaters because they stay away from meat, carrots, apples, things you have to chew a lot. And they eat more chicken nuggets, mac and cheese, because you can just mash it and swallow it. That can be a sign of oral motor dysfunction in adults and kids. So if you have a hard time chewing with your mouth closed, that's something you can explore and get help with. 语法解析

02:26:20

Should we be able to chew equally on both sides of our mouth? You should chew equally on both sides of your mouth. So if you're chewing just on one side, not only will you get hypertrophy of the muscle on that side, but it can cause a shift, especially in kids, of the way you're growing. But I would want to know why. Why are you chewing that way? Is your occlusion or your bite off? Are you avoiding a tooth because you're in pain? Yeah. 语法解析

02:26:43

It can be a bad habit. There's ways to retrain, but everything should be symmetrical. So you should kind of chew, chew. Your tongue should move the bolus of food to the other side, chew, chew. So if you can't do that, it can be a sign of oral motor dysfunction too. Maybe your tongue doesn't have good range of motion or mobility. Maybe you have a tongue tie or low tone. So there's a lot that can go into that. And this is where seeing a myofunctional therapist could really help. 语法解析

02:27:09

You said it, so I'll have to ask. Tongue tie. A few years ago, this was a controversial area. Tongue tie being the stretch of skin between the bottom of the tongue and the bottom of the – what is it? Bottom of the – Floor of the mouth. Floor of the mouth. Uh-huh. Thank you. And this idea that in babies it should be caught. Other people say it shouldn't be cut. Mm-hmm. 语法解析

02:27:28

And then everyone starts looking at it. I mean, I think mine just seems to have naturally torn back some distance. But, you know, what's the deal with tongue tie? Should it be cut? We're going into all the controversial conversations here. I'll take the heat. So… 语法解析

02:27:45

That's called your frenum. Okay. So we all have a frenum. It's the band of tissue that attaches our tongue to the floor of the mouth. We also have a labial frenum. And sometimes you have little buccal frenums up here in the vestibule. Near the cheek. If you put your finger up in your mouth, you'll feel. Oh, yeah, yeah. 语法解析

02:28:04

You may have them, you may not. When they dried my teeth out for something once, they pull it back and you see it's, yeah. It's like webbed. Yeah. So the whole thing with this conversation is all about function, okay? So does your tongue and do the oral structures function appropriately? In which case, you're good, you know? What's hard is… 语法解析

02:28:26

something to be mindful of, you can't diagnose anyone from a photo on social media. So I see a lot of parent blogs who are saying, my child has a tongue tie, my child has a lip tie. You can't tell, we have to look at function. So is it impairing or impacting breastfeeding? Can the tongue not lift appropriately? It's all about lifting, elevating and lateralizing. So many think tongue tie impacts you 语法解析

02:28:53

sticking your tongue out. We don't care as much about that. What grows the face and the palate in utero and then beyond is that tongue lifting, elevating, and spreading that palate almost like an expander, like an orthodontic expander. 语法解析

02:29:09

And so if it can't lift, that's the first sign. And that means it can't pull in the breast tissue and breastfeed appropriately. Babies might have a lot of reflux. Women will have pain. Okay. So that's one of the first things we look at. But then as children get older, we look, well, is there a tongue tie that is potentially leading to mouth breathing? So when your lips are closed and you're breathing through your nose, your tongue 语法解析

02:29:36

should be up at the palate and it should have enough tone to stay there, ideally while we sleep too. But if your tongue is tethered, it can't lift up, your tongue's going to lay low. 语法解析

02:29:47

And you're going to have more of the Napoleon Dynamite look, okay? So that open mouth forward head posture. That's just because the tongue can't lift. Many times when people have tongue tie, their palates are narrow too because in utero, the tongue wasn't up to grow the face optimally. And this runs genetically in families as well. 语法解析

02:30:08

the predisposition. So then the next thing we look at is speech, you know, and is it impacting speech or is it impacting chewing and swallowing? So if all of those things are fine, if it looks like there's a tongue tie, but you're thriving, you're doing great, assuming you're not compensating and using other muscles and now having other downstream effects like shoulder pain, headaches, postural issues, you're great. 语法解析

02:30:34

But if a child is having issues and you've gone through the right screening and had the risk benefit discussion with the parents, I do think a phrenectomy is indicated, you know, and I myself have had one and it benefited me a lot. My issues were 语法解析

02:30:51

neck strain and a lot of shoulder tension that really there's a lot of fascial tissue that's impacted with a tongue tie or can be. And so it helped me a tremendous amount. But nothing's one size fits all and we're all different, you know. So this is where you do want to work with someone with additional training to see, you 语法解析

02:31:08

If you have a tongue tie, how are they assessing that? And then is it impairing function? And then do you actually need a procedure done? Sometimes just working with a myofunctional therapist or different body workers, a chiropractor, a craniosacral therapist, an osteopath can be enough to create balance again. So it's not always a surgical intervention. In your case, was it a general anesthesia or a local anesthesia? I had my tonsils out also very recently, just a few years ago. 语法解析

02:31:36

because I had chronic tonsillitis. And so I knew I had a posterior tongue tie, and I just told the surgeon, just go ahead and do it. I'm already getting my tonsils out. Sure, you're already in there. Yeah, already in there. But for most people, it would be a general anesthesia? Usually, no. Usually, it is local. 语法解析

02:31:58

It's really not bad, especially they're using lasers now for their procedure. It's pretty straightforward. Yeah. That can cauterize as you make the cut. Exactly. You do want to generally suture and you want to make sure you're working with a myofunctional therapist before and after for optimal outcomes. It's like, think about if I went in for a knee replacement, I wouldn't just walk into the operating room. Here's my knee. Usually there's physical therapy before and after to make sure you're optimized. And so it's the same with a tongue release. Yeah. 语法解析

02:32:27

Peptides and red light therapy. Now we're in the sort of specialized next sort of cutting edge of health and self-directed health or medicine. 语法解析

02:32:42

self-directed slash working with a professional like yourself, oral health care. So can red light therapy, like shining red light and near infrared light, so long wavelength light into the mouth, provide any benefits for a person that doesn't have any other issues, like they just want to maximize their oral health? Is that something… 语法解析

02:33:03

that can be helpful. What else is it potentially helpful for? Yeah, it certainly couldn't hurt. I haven't seen any solid data on that, but it would reduce inflammation, improve blood flow, you know, so I'm not opposed to it. It's wonderful post-surgery, you know, so if you have wisdom teeth out or a periodontal surgery, 语法解析

02:33:24

A lot of dentists and specialists are using red light therapy extra orally or intra orally to help expedite healing, collagen synthesis, etc. 语法解析

02:33:33

Um, peptides are newer and exosomes as well that are being used, particularly in root canal therapies and maybe cavitation surgeries and things. Um, again, just to help with inflammation, healing, collagen synthesis. Um, it's pretty cool. It's very cutting edge and it's very new and there's very few out there doing it right now. There's a couple in LA that I know are, so I can share names, but, um, 语法解析

02:33:59

The idea is to regenerate tissues, specifically with peptides. It can, when put down in the pulpal chamber, potentially can help build up the dentin within the tooth and maybe help increase vascularization, get some more vitality back to the tooth too. So it's pretty cool. All right. So we'll stand by on that. Yeah, stand by. Should… 语法解析

02:34:21

We'd be concerned about metal fillings, whatever. I don't know what material they use for the other fillings. And sometimes they'll use, quote unquote, sealants. Like they'll see a pit, they'll put some sealant in there. And retainers are made from plastic. Now everyone's worried about plastic. So what gives? 语法解析

02:34:38

So the best dentistry is no dentistry. I will always say that. So that's why we always want to take a preventative lens as best we can. But that's not the reality since 90% of us have suffered from some sort of dental disease in our life. So mercury fillings, this can get controversial. I think the first thing to do, I don't love mercury amalgam fillings. And they were recently banned in Europe. 语法解析

02:35:05

I think if you're getting a new filling, I would try not to have mercury placed. That would be my recommendation. Try to use a composite, ideally a ceramic-based biomimetic material. But if you have existing mercury fillings, amalgam fillings, and you're concerned, the first thing to do is get a test, get a blood test to see what are your mercury levels. 语法解析

02:35:27

If they're within normal, I wouldn't worry too much. If you have mercury toxicity or mercury through the roof, then you probably should have that conversation with your dental team and your medical team to see, could this be coming from my fillings? And certainly if a filling is breaking, damaged, it needs to be replaced, maybe considering not doing an amalgam metal filling. So that's kind of my stance on that. Yeah. 语法解析

02:35:54

composite fillings, you know, they are plastics essentially. Most are BPA free, but that is a bit of a marketing idea. You know, there's still other plasticizers in there, Biz GMA, et cetera. So I do really like ceramic based materials if you can find them. Nothing is perfect. You 语法解析

02:36:16

Regarding retainers, I get this question a lot too. Acrylic retainers, those are the pink retainers. What's interesting about those, methyl methacrylate can have gluten in it. So if you are celiac, there have been case reports of teens especially who have 语法解析

02:36:36

They keep having GI distress or rashes because celiac often can come out in the skin and they can't figure out why. And it ties back to their retainer. So just be aware of that. 语法解析

02:36:48

And then people will ask, well, about Invisalign. And again, nothing's perfect. Usually, most of these retainers and things you're only wearing for a short period as you're trying to correct your airway issue. So lesser of two evils. I mean, I'm a big airway advocate. I want people breathing optimally. That is the most important. 语法解析

02:37:10

important thing for your health, in my opinion, is optimize oxygenation and breathing and rest and recovery. So, you know, I am an advocate for expansion and some of these materials and products for short durations if necessary. So we can't take all the risk out of everything, right? And this is why the host is 语法解析

02:37:32

making sure your immune response is optimized, your detox pathways are open, your phase two liver detox is optimized. You know, that's ideal. So, yeah. Cruciferous vegetables, sulforaphane supplementation, maybe. Dandelion. The same things that were recommended in the microplastics episode that I did that other people have touched on. So things like sauna sulforaphane. Yes, binders. Cruciferous vegetable intake should help. 语法解析

02:37:59

bind to some of the microplastics that surely we are ingesting. Everyone has them. So you just try to minimize your exposure. And then sealants, I am an advocate of sealants. They really do reduce cavity risk. They're usually put on the molars and the grooves and the fissures of the back teeth. But again, I use sealants. 语法解析

02:38:22

So I use spectrometry to make sure I'm not sealing in bacteria. So it's an image that shows me if there's like caries or cavity there, I'm using ozone to make sure I'm killing the bacteria. Sometimes I'll use my laser, which helps disinfect too, to open the groove up. And then I'm using ceramic based materials too. So I think it depends on your risk as well. If you're low risk, you're not eating a lot of these ultra processed foods, you're probably okay. 语法解析

02:38:49

But a lot of kids, you know, we have control over our children's diets only to a certain point. And then they go off to middle school and start eating the Takis and the Doritos. And, you know, they make maybe some bad choices. And so if you want their teeth as protected as possible, I'd suggest sealants. A somewhat unpleasant topic, but something that I've heard repeatedly, and I don't know if it's true, is that dentists, more than people in any other profession, are 语法解析

02:39:21

commit suicide at very high rates. And then there's this very dark joke that people make, well, you know, their hands are always in other people's mouths, so they don't have anyone to talk to, you know, like, or, you know, like, or, and then I always think, well, the logic's wrong there. They actually could talk as much as they want. It's the patients that can't talk. So, you know, set, setting aside that kind of like, you know, gallows humor, which I don't, it's not my style of humor. Um, 语法解析

02:39:45

Do dentists kill themselves more than people in other professions? Yeah. Thank you for bringing this up. I think it's important to talk about. Dentists do have a really high rate of depression, anxiety, and yes, suicide too. I always heard this too, even before I became a dentist and it's a really hard profession. And so we tend to be the brunt of the joke, you know, we're in the song, there's songs like I'm Afraid of Dentists in the Dark, you know, by Vance Joy and like 语法解析

02:40:14

Steve Martin playing the eccentric dentist in multiple different movies, I think. Little Shop of Horrors. Little Shop of Horrors, Horrible Bosses. There's like a crazy dentist. There's always like horror movies have dentists. I mean, we are the brunt of the joke a little bit. And so that's hard. And unfortunately, there are just so many negative childhood experiences at the dentist. And this is partly why I went into pediatrics is that 语法解析

02:40:41

I was an adult dentist for many years. I felt very dissatisfied with my career because I just felt like I wasn't making a difference. You know, dental disease is so prevalent. And unless we're talking about it from this root cause lens, we're not going to move the needle. But it's very hard when you get in the system to get out of it. You know, the way our appointment times are set up and the overhead is crazy and the student debt now and the pressures and the things with dentists is… 语法解析

02:41:09

We are the clinicians, but we're also kind of the CEOs of our businesses. Like many of us have private practices. So you're wearing two hats. So when you're done with treatment all day and seeing patients all day, then you're sitting in front of the computer and you have people to help you, but you're trying to manage the business. And we didn't go into school for that, you know, looking at spreadsheets, HR issues, et cetera. And many of us are in solo practices. So it can be very lonely. 语法解析

02:41:37

But also, we tend to be more type A personalities, perfectionists, and dentistry is hard. There's a lot of unknowns. There's a lot of variables. 语法解析

02:41:48

you know, I can put a filling in your mouth, but I can't guarantee that you're going to brush, floss, follow my rules, not, you know, not eat ultra processed foods. You're breathing through your nose, what's your microbiome like? So then you're doing all of these things that I've instructed you not to do. And then you come back because the filling fails and we're the ones to blame for that. And don't get me wrong. There's all very variations of providers out there and there's people doing excellent work and people doing not so excellent work. 语法解析

02:42:16

But I do think it's important for everyone to know that many dentists are having a hard time with work, especially post-COVID, I would say. There's a lot of pressures. Dental insurance is very challenging. You know, it's not truly insurance like medical insurance. It's really a benefit package. 语法解析

02:42:35

package. And so you tend to only get $1,000 or $1,200 a year, and then everything else is out of pocket. And so people kind of look at us like that's kind of a scam, you know, like it's so expensive. But what they don't realize is many of these dental supply companies, they have essentially monopolies on us. Like our equipment is outrageously expensive. And 语法解析

02:42:58

And prices keep going up and up and up. But what isn't changing are insurance reimbursements. OK, so where does that delta come in? And usually it's coming out of the dentist's pocket, too. So it's why corporate dentistry is taking over in a lot of ways, kind of what happened in medicine. But I would just say be kind to your dentist there. 语法解析

02:43:18

Just recently, this is very timely, but I don't know where this came from. Maybe it was like a TikTok thing, but there were letters being mailed. Specifically, I saw in the Pacific Northwest, Oregon and Portland that dentists were receiving these hate letters saying dentists are scumbags and they should all kill themselves. So I think it's important for people to know what we kind of deal with behind the scenes, you know, and to just 语法解析

02:43:46

be kind to your dentist. And I would say if someone doesn't resonate with you, if their personality doesn't resonate with you, 语法解析

02:43:53

Just go find a different dentist. And I do want to understand there is a lot of post-traumatic stress disorder from patients who truly fear the dentist. It's usually from experiences in childhood. And that's what I wanted to change, too. I just said it doesn't have to be this way. We can make dentistry a very positive place, a safe place, so that children go into adults without dental disease, but also that find the dentist to be a safe, comfortable place to go. 语法解析

02:44:18

So I mean, some people, if you're really that fearful, you know, maybe considering therapy or, you know, some sort of anxiolytic, like do you need something to help you feel calmer at the dentist? But I encourage everyone to go to the dentist, don't avoid the dentist, but also trying to understand it. It is a challenging profession. It really is. And there's a lot of unknowns and there are some mental health challenges out there too. Well, thank you for being a, um, 语法解析

02:44:46

an incredible ambassador for dentistry and no small part that comes from your like obvious kindness and goodness and also the rigor with which you approach it. So the two are certainly not incompatible. You're proof of that. Thank you. I wonder if now would be a good time for us to just 语法解析

02:45:07

sort of summarize the top 10 or top 12 things uh there are a bunch of don'ts maybe we can leave those out like avoid sugary uh starchy flowery foods that get stuck between teeth that kind of thing um but maybe i'll fire off a few and you can tell me what i'm missing um be a nose breather not a mouth breather unless you're eating or speaking 语法解析

02:45:30

Keep your mouth shut, basically. Right? Absolutely. Or you're exercising really hard and you need to suck for some air. Or you're scuba diving and you would drown otherwise. Eat non-processed, minimally processed foods. We're hearing that over and over again these days. Brush twice a day. Floss twice a day. Water pick if you can. Yeah, that's loading a lot onto people. I would say floss at least once a day. 语法解析

02:45:56

Flossing twice a day is extra credit. Great. Yeah, because a lot of people don't floss. So we want to start out reasonable. Before sleep. Yes, ideally. So it's brush, then floss. Floss, then brush. Floss, then brush. But however you can do it. No, no, I didn't get it wrong on purpose. I also like tongue scraping. We forgot to talk about tongue scraping. Yeah, so I want to add in these things. So… 语法解析

02:46:24

maybe oil pull three times a week, put some olive, coconut oil in there, swish it around, practice your nasal breathing while you're doing it, spit it out, but not in the sink. Not in the sink. And why, why just a few times a week? I don't know if I was clear on that. It's because coconut oil is antimicrobial. So I'm erring on the side of caution because it will target more anaerobic pathological bacteria, but it's, 语法解析

02:46:49

Less is more. We don't want to disrupt the oral microbiome too much. So just a couple times a week. You don't need to do it daily. Great. Soft toothbrush. Be gentle. Avoid alcohol-containing mouthwashes for all sorts of reasons. Pay attention to the fluoride debate. Yes. Consider hydroxyapatite if you're concerned. Great. I love these hydroxyapatite toothpastes. Yours and Gator Dentist's one. Love them. 语法解析

02:47:16

I don't get paid a dime for it. I pay my own money for them. I really love them. I think they're so much healthier now. I just like them too. I like that I can, they taste good. I don't actually rinse afterwards. We didn't talk about that, but ideally you don't rinse after you brush. Correct. So think about if you were a big advocate for sunscreen or a lotion, you put it on, you immediately jump in the shower. 语法解析

02:47:41

You're washing it all off. So it's the same with your toothpaste. There is a duration of action that it takes for maximum efficacy. So if you're brushing for two minutes and spit and rinse… 语法解析

02:47:51

All that goodness is getting rinsed down the drain. So it really should. You can still spit. People get confused by this. You can still spit, but try not to vigorously rinse everything off. You do want to try to sit on the teeth and in your saliva a little bit. Avoid nicotine. And alcohol. And alcohol. Hydrate well. Yes. Keep your… Electrolytes. Keep your… Electrolytes. Keep your saliva… 语法解析

02:48:16

Yes. Especially for older people. Yes. Yeah. The nasal breathing during sleep, we can double click on that one because that's how to get your sleep right. Because I just check so many boxes. I'd say optimized minerals and fat soluble vitamins. This is kind of Western price stuff. I'm trying to think here if there's anything I missed here. 语法解析

02:48:40

Well, we could say tongue scraping. Tongue scraping, excuse me. I do like tongue scraping. So again, Ayurvedic, you know, Chinese medicine, we'll look at the tongue from a health standpoint. If you have a white coating on your tongue, that's a sign of dysbiosis. You could have candida. This is important to touch upon. 语法解析

02:48:59

Strep mutans gets blamed for cavities so much with kids especially, but with children, we really need to be focusing on fungus too. So candida is really prevalent in early decay in children. No one's screening for this or treating it. Candida loves sugar, you know, and this is also with diabetics. We're seeing a bidirectional relationship with gum disease, periodontal disease, and diabetes. 语法解析

02:49:22

insulin resistance and blood sugar imbalances too. But so tongue scraping, and it will do a better job than your toothbrush. People always ask because it is removing the biofilm as the toothbrush is kind of moving it around. 语法解析

02:49:36

So it's taking off that film of bacteria. I know it's kind of gross, but they tend to be anaerobic. And that can help with nitric oxide production too, because the good bacteria on the tongue tend to live down more in the crypts. 语法解析

02:49:53

So you don't want to scrape too hard, but just get that film off. You'll also notice improvement in your taste perception, too, because you're getting food remnants and things off as well. I wouldn't want that. Yeah. Oh, I love it. Once you start tongue scraping, you usually, most everyone's a big advocate for it. Thank you so much for this really extensive and exceptionally clear voyage. 语法解析

02:50:15

through oral health. I am sure that people are going to take away many, many things that are actionable. And I really appreciate that you've been such a strong advocate for pointing out that oral health is not just about teeth. It's not just about breath. It's about that, but it's also about your whole digestive tract and about brain health and about heart health. And, um, 语法解析

02:50:39

We have a lot of control over this particular aspect of our body as opposed to like heart health, which we have to get to indirectly unless we're a heart surgeon. Yes. Or gut health, which we have to get to indirectly unless we're a gastroenterologist, right? What other biofilm do you have access to? I mean, it really is a window into the body. So if you have gum disease or cavities, that is a sign of a metabolic imbalance in your body. Right. 语法解析

02:51:04

So not to make you panic, but I just want people to take it seriously that it is a window into other things that could be happening deeper within the system. Well, I absolutely love the work that you're doing. I couldn't think of a better person to bring on here to educate us all. And like I said, you've given us so many valuable tools and we will provide links to all the incredible resources that you're continuing to put out into the world. So thank you for doing that. Thank you for coming here. Thanks for, it's clear that this is a 语法解析

02:51:31

labor of love for you. It's not just about like cleaning teeth or something. So yeah, that you're people probably can't see. Well, certainly if they're listening, they can't see the, the incredible extensive notes that, 语法解析

02:51:44

Dr. Whitman brought with her and her incredible handwriting. Goodness gracious, what beautiful handwriting. Thank you. So I could read it later. Not all doctors have bad handwriting. No, they notoriously have bad handwriting, but yours is certainly offset whatever failures of handwriting the other physicians have. This was really fun. Thank you so much. Thanks. Well, we'll do it again. And I'm really grateful for you coming on here today. Thank you. Thank you. 语法解析

02:52:10

Thank you for joining me today for my discussion with Dr. Stacey Whitman. I hope you found it to be as interesting and useful as I did. To find links to Dr. Whitman's work and the various resources we discussed, please see the show note captions. 语法解析

02:52:22

If you're learning from and or enjoying this podcast, please subscribe to our YouTube channel. That's a terrific zero cost way to support us. In addition, please follow the podcast by clicking the follow button on both Spotify and Apple. And on both Spotify and Apple, you can leave us up to a five-star review. And you can now leave us comments at both Spotify and Apple. Please also check out the sponsors mentioned at the beginning and throughout today's episode. That's the best way to support this podcast. 语法解析

02:52:47

If you have questions for me or comments about the podcast or guests or topics that you'd like me to consider for the Huberman Lab podcast, please put those in the comments section on YouTube. I do read all the comments. For those of you that haven't heard, I have a new book coming out. It's my very first book. It's entitled Protocols, an Operating Manual for the Human Body. This is a book that I've been working on for more than five years and that's based on more than 30 years of research and experience. And it covers protocols for everything from sleep to 语法解析

02:53:14

to exercise, to stress control, protocols related to focus and motivation. And of course, I provide the scientific substantiation for the protocols that are included. The book is now available by presale at protocolsbook.com. There you can find links to various vendors. You can pick the one that you like best. Again, the book is called Protocols, an Operating Manual for the Human Body. 语法解析

02:53:37

And if you're not already following me on social media, I am Huberman Lab on all social media platforms. So that's Instagram, X, Threads, Facebook, and LinkedIn. And on all those platforms, I discuss science and science-related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the information on the Huberman Lab podcast. Again, it's Huberman Lab on all social media platforms. 语法解析

02:53:59

And if you haven't already subscribed to our Neural Network Newsletter, the Neural Network Newsletter is a zero cost monthly newsletter that includes podcast summaries, as well as what we call protocols in the form of one to three page PDFs that cover everything from how to optimize your sleep, how to optimize dopamine, deliberate cold exposure. We have a foundational fitness protocol that covers cardiovascular training and resistance training. 语法解析

02:54:20

All of that is available completely zero cost. You simply go to hubermanlab.com, go to the menu tab in the top right corner, scroll down to newsletter and enter your email. And I should emphasize that we do not share your email with anybody. Thank you once again for joining me for today's discussion with Dr. Stacey Whitman. And last but certainly not least, thank you for your interest in science. 语法解析

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Edit:2025.05.19<markdown>

00:00 - 欢迎与嘉宾介绍 今天的嘉宾是 Stacey Whitman 博士，她是一位功能性牙科医生，擅长治疗成人和儿童患者。

00:23 - 本期主题概览：口腔健康的重要性 Whitman 博士将口腔健康视为整体肠道健康的关键特征，并且是影响大脑寿命、心脏健康、男女激素及生育能力的强大调节因素。本期节目将讨论：

• 常见的牙齿和牙龈护理误区。
• 如何使用特定的营养、呼吸和清洁方法来修复蛀牙、美白牙齿、清新口气，并同时改善口腔微生物组。
• Whitman 博士强调，许多人追求牙齿健康、美观和清新口气的方法实际上会损害口腔微生物组，甚至可能导致严重的心血管问题。

00:46 - 具体讨论内容 节目将深入探讨：

• 如何正确刷牙和漱口：不仅仅是“应该刷牙漱口”，而是具体如何操作才能最大化益处。
• 刮舌和油拔法：科学依据和益处。
• 氟化物：这是一个备受争议且时下热门的话题。
• 其他口腔问题：如舌系带过短、鼻中隔偏曲、口腔溃疡（口疮）等的治疗。
• 最终目标：让听众掌握最新的口腔护理知识，不仅为了美观，减少蛀牙和牙龈疾病，更为了支持大脑和心脏的长期健康。

01:40 - 播客声明与赞助 Huberman 教授强调，此播客独立于他在斯坦福的教学和研究工作，是他向公众免费提供科学及相关工具信息的一部分努力。本期节目包含赞助商。

01:50 - 与 Stacey Whitman 博士的对话开始 Huberman 教授感谢 Whitman 博士的到来，并提到她的公开内容（尤其在 Instagram 上）彻底改变了他对口腔（牙齿、口气、舌头等）的看法，认识到口腔是评估和维持大脑及身体健康的关键部位。

02:47 - 常见口腔护理目标与误区 Huberman 教授提出，大多数人对口腔健康的期望是：

• 牙齿洁白（或非常白）。
• 口气清新（至少没有异味）。
• 口腔感觉舒适。 他询问 Whitman 博士：人们在追求这些目标时，哪些常见做法实际上对牙齿和口腔微生物组有害？

03:41 - Whitman 博士：口腔护理的“地毯式轰炸”误区 Whitman 博士首先感谢 Huberman 教授将口腔微生物组和口腔健康列为健康支柱之一。

• 错误观念：我们被教导要对口腔进行“地毯式轰炸”，使用收敛剂、酒精、发泡剂和强效精油来清洁、消毒和清新口气。
• 实际危害：这些产品会损害我们脆弱的口腔微生物组，可能使情况变得更糟。
• 正确方法：“少即是多”的理念，更应关注饮食和生活方式，而非过度依赖产品。
• 整体观：牙科不应与身体其他部分割裂开，它们是相互关联的。强效牙膏、漱口水、某些口香糖，甚至饮食和呼吸方式都会对口腔健康产生重大影响。需要转变观念以实现优化。

04:48 - 牙膏的有效性与潜在危害

• 看成分：像看食品标签一样阅读口腔护理产品的成分表，了解其作用和来源。
• “灼烧和起泡”迷思：许多人认为牙膏必须有灼烧感和大量泡沫才有效。但刷牙主要是为了破坏生物膜（牙菌斑）。
• 月桂基硫酸钠 (SLS)：常见的发泡剂，但也可能刺激口腔黏膜，导致口腔溃疡。Whitman 博士认为这是不必要的。牙膏不应起泡或有灼烧感。
• 精油：虽然被认为是健康的，但许多精油具有很强的抗菌性，可能会损害口腔中的有益细菌。强烈的灼烧感是不必要的。
• 口气问题根源：如果口气非常糟糕（口臭），需要深究原因（如口腔微生物组失衡），而不是依赖强效产品掩盖。
• 优先关注：应像关注护肤品、洗发水一样关注口腔护理产品的成分，因为它们是直接进入身体的。

07:13 - 口腔溃疡（口疮）的原因 口疮可能由多种因素引起：

• 创伤：如咬伤。
• 病毒相关：如疱疹病毒。
• 肠道健康反射：“口腔是通往身体的门户，口腔即肠道”。口腔溃疡可能是克罗恩病、乳糜泻、肠易激综合征（IBS）或食物敏感等更深层肠道问题的反映。

11:42 - 牙齿的再矿化与脱矿

• 自然过程：牙齿会经历持续的脱矿和再矿化过程。
• 脱矿：当我们进食时（除了中性水），口腔 pH 值下降（唾液中的淀粉酶开始分解食物），酸性环境会导致牙齿中的钙、磷等矿物质流失。
• 再矿化：如果给予足够时间，唾液（含有免疫细胞、酶和矿物质）会自然地使牙齿再矿化。
• 斯蒂芬曲线 (Stephan Curve)：描述了进食后口腔 pH 值的变化。
• 现代问题：频繁 snacking（零食）和 grazing（少量多次进食）使口腔长时间处于酸性脱矿状态，没有足够时间再矿化。
• 早期蛀牙的修复：尚未形成真正洞穴的小蛀牙（初期病损，仍在牙釉质内）可以通过再矿化“愈合”。一旦形成洞穴，通常需要治疗。
• 影响因素：饮食方式、进食频率、呼吸方式、使用的产品和卫生习惯都会影响这一过程。

15:00 - 氟化物与羟基磷灰石

• 羟基磷灰石 (Hydroxyapatite)：牙齿的主要成分（钙和磷）。牙釉质约含 90%，牙本质约 60%，骨骼也约含 60%。唾液中也含有钙和磷。
• 氟化物的作用：氟取代羟基磷灰石中的羟基，形成氟磷灰石 (Fluorapatite)。
• 氟磷灰石的特性：通常认为其化学键更强，牙齿晶体结构更致密，因此更耐酸。氟化物也有一定的抗菌作用（但非选择性，可能损害有益菌）。
• 氟化物与临界 pH 值：氟化物能降低牙釉质开始脱矿的临界 pH 值（牙釉质通常为 5.5，牙本质接近 6.5），使其更能抵抗酸性环境。
• 争议：一些观点认为氟磷灰石的晶体结构在微观下可能更易断裂，但主流牙科界认为它更坚固。
• 饮食关键：外用氟化物有效，但无法对抗不良饮食习惯。

18:35 - 牙齿修复（再矿化）的时间

• 餐后：进食后约 20-30 分钟，唾液开始缓冲，pH 值上升，开始再矿化。
• 理想间隔：大约每两小时，如果口腔得到休息，就能实现最佳再矿化。
• 现代障碍：持续进食、饮用含糖饮料、脱水、矿物质缺乏（钙、磷）、张口呼吸（导致口腔酸化）等都会阻碍再矿化。
• 对策：从牙科角度看，间歇性禁食或限时饮食有助于对抗蛀牙。

20:09 - 糖与蛀牙的关系

• 直接原因：是酸导致蛀牙，而非糖本身。
• 糖和面粉的作用：口腔中的致病菌以糖为食，而面粉（可发酵碳水化合物，如饼干、面包、薯片）在口中作用类似糖。
• 过程：细菌代谢糖/面粉后会释放酸。如果这些食物残渣长时间附着在牙齿上（尤其是黏性、干燥的食物），口腔就会持续处于酸性状态。
• 关键：是酸导致蛀牙，而糖/面粉是促进细菌产生酸的催化剂。

21:17 - 饮食建议与牙齿美白

• 可发酵碳水化合物：易在口中溶解的食物（饼干、薯片、米饭、意大利面）与富含纤维的食物（如西兰花，其纤维能喂养有益菌）相对。
• “吃彩虹，喂益菌”：多吃能滋养有益菌的食物。
• 饮食是根本：牙科疾病的根本原因是饮食。过度关注产品（氟化物、牙膏、漱口水）往往治标不治本。
• 清洁饮食：高质量蛋白质、多种蔬菜、适量水果（高蛀牙风险者需限制）、坚果、种子、橄榄、发酵食品。选择天然食物，减少加工食品和超加工食品。
• 清洁饮食与牙齿美白：
  • 成人牙齿天然比乳牙黄（乳牙矿化程度低，晶体结构不同）。
  • 牙齿白度与光线反射折射有关。羟基磷灰石或椰子油能改变牙齿表面特性，使其看起来更白。
  • 漂白剂（如过氧化氢）能渗透牙齿改变结构，去除色渍。但用过氧化氢漱口会严重损害口腔微生物组。
  • Huberman 个人经验：改用含羟基磷灰石的牙膏后，牙齿变白。
• 老年人牙齿颜色：可能因口干症、长期张口呼吸、色素沉积、矿物质流失、四环素牙等因素导致牙齿变黄褐。
• 抗生素后：服用抗生素后，应像补充肠道菌群一样，通过益生菌（口服/肠道）和发酵食品来恢复口腔微生物组。

32:04 - 漱口水的危害

• 成分：如李施德林等强效漱口水通常含酒精、收敛剂、强效抗菌剂（“杀死99.9%细菌”）。
• 过度消毒：破坏口腔菌群平衡，可能导致哮喘、湿疹、过敏等问题增加。
• 硝酸盐还原菌：长期使用漱口水（包括处方漱口水如氯己定）会损害舌背上将硝酸盐还原为亚硝酸盐（一氧化氮前体）的细菌。
• 一氧化氮的重要性：对心血管健康、血管舒张和免疫健康至关重要。
• 潜在后果：可能导致血压升高和心血管问题。
• 慢性口臭：应找出根本原因（牙周病、感染等），而非依赖漱口水。强效精油和薄荷糖也应谨慎使用。

42:21 - 改善唾液化学成分

• 唾液的组成：“身体的黄金甘露”，包含细菌、病毒、真菌、激素（如皮质醇）、酶、免疫细胞和矿物质。
• 唾液的重要性：对于咀嚼、吞咽至关重要。口干症会导致牙齿快速恶化。
• 保持唾液健康的方法：
  • 水合作用：确保充足饮水，可加入少量盐或电解质帮助吸收。
  • 鼻呼吸：张口呼吸会减少唾液，降低 pH 值，导致口干、蛀牙和牙龈疾病。
  • 富含矿物质的饮食：许多人缺乏镁、脂溶性维生素（尤其是 D3, K2）。
• 检测：“检测，而非猜测”。可通过血液检测了解矿物质和维生素水平。

44:41 - 口腔微生物组检测

• 唾液分析：可检测口腔微生物组（细菌、真菌、病毒的种类和比例）。
• 关键病原体：某些口腔病原体与多种下游疾病相关，如阿尔茨海默病、痴呆、生育问题、妊娠问题、心血管疾病、自身免疫病、类风湿关节炎、糖尿病、肥胖、情绪障碍、癌症等。
• 推荐检测：如果想优化健康，建议检测口腔微生物组。

47:17 - 鼻呼吸的重要性与张口呼吸的原因

• 鼻呼吸的益处：Huberman 提到鼻呼吸改善大脑功能（记忆力），氧合更好（增加20%氧气摄入）。这对儿童大脑发育尤为重要。
• 张口呼吸的成因：
  • 人类是专性鼻呼吸者，但高达50%以上的人张口呼吸。
  • 进化因素：祖先每天咀嚼4小时，促进颌面部宽阔发育。现代人咀嚼时间大幅缩短（约4分钟），导致面部和颌骨萎缩（“退化性演变”）。
  • 结构问题：颌骨缩小导致鼻腔容积、鼻窦、气道缩小，舌头空间不足，易后坠阻塞气道。
  • 儿童张口呼吸的体征：头前伸姿势、黑眼圈（静脉池，炎症表现）、眼睛下垂、口常开。
  • 硬组织问题：颌骨大小形态、腭部大小形态、鼻中隔偏曲（腭部狭窄可导致）。
  • 软组织问题：腺样体肥大、扁桃体肥大、口腔运动功能障碍、舌肌张力低/位置低。

49:54 - 纠正气道问题：年龄与方法

• 儿童期：面部发育主要在10岁前完成。早期功能性矫治（如3-4岁使用矫治器）可扩大面部，矫正鼻中隔。腭顶即鼻底，扩大腭部可使鼻腔变宽。
• 成人期：难以通过姿势和习惯改变骨骼结构。肌功能治疗（呼吸和舌头姿势的物理治疗）有帮助。可能需要器械（如 Homeoblock, MSC 装置）或手术干预。
• 睡眠呼吸障碍的影响：影响深度睡眠、REM睡眠、淋巴系统排毒、激素功能（生长激素、抗利尿激素 -&gt; 遗尿）。
• 睡眠呼吸不良体征：辗转反侧、磨牙、打鼾、奇异睡姿、醒后疲惫、行为问题（与ADHD相关）。
• 一氧化氮与男性健康：张口呼吸减少一氧化氮产生（鼻旁窦也产生一氧化氮），影响性功能。牙龈疾病也与勃起功能障碍相关。
• 口贴：使用前确保能安全鼻呼吸（3分钟测试）。逐渐适应。Renee Fleming 的“吻天”练习可锻炼颈部内部肌肉，辅助鼻呼吸。

58:24 - 口香糖与咀嚼食物

• 口香糖：
  • 特定情况下有益：餐后嚼木糖醇口香糖可抑制细菌（特别是变形链球菌），增加唾液。
  • 不宜过度：马斯蒂克树胶 (mastic gum) 等硬质口香糖过度咀嚼可能导致颞下颌关节紊乱 (TMJ)。只嚼几分钟即可。
• 咀嚼食物的重要性：
  • 现代人食物过于软烂（果泥、酱料）。婴儿辅食也应引入需要咀嚼的食物（注意安全）。
  • 咀嚼对颌面部发育至关重要。母乳喂养也对颌面发育有益。
  • 即使个体努力，也难以对抗数代人“退化性演变”带来的影响，许多人需要干预。

01:11:37 - 口腔微生物组与全身疾病（深入探讨）

• 约57种疾病与口腔菌群失调或口腔病原体相关。
• 牙龈疾病：全球约80%人口有不同程度牙龈疾病，10%有严重牙周病（骨质流失、组织丧失、牙齿脱落）。
• “渗漏性牙龈” (Leaky Gums)：细菌通过发炎出血的牙龈进入血液循环，引发免疫反应、炎症，释放内毒素。
• 具体关联：
  • 心血管疾病：牙龈疾病患者风险增加2倍。
  • 中风：风险增加3倍。
  • 生育能力：女性怀孕时间延长2个月；患牙龈疾病的男性与不育相关，治疗后受孕率提高。
  • 阿尔茨海默病/痴呆：牙龈卟啉单胞菌 (P. gingivalis) 与之相关，在淀粉样蛋白斑块中发现。
  • 癌症：具核梭杆菌 (F. nucleatum) 与胰腺癌、乳腺癌、结直肠癌风险增加相关。我们每天吞咽唾液约2000次，细菌可到达肠道。
• 预防性抗生素与臭氧治疗：
  • Huberman 提出定期抗生素的想法，Whitman 认为恢复菌群比想象的难，倾向“少即是多”。
  • 臭氧 (O3) 治疗：气体、水或油剂形式。抗菌、抗病毒、抗真菌。用于治疗牙龈疾病、填充物下消毒等。具有选择性。

01:18:36 - 油拔法 (Oil Pulling)

• 古印度阿育吠陀疗法。可用含臭氧的油。
• Whitman 博士有时用有机生椰子油进行油拔：含一口融化，漱口（同时鼻呼吸），然后吐入垃圾桶（避免堵塞水槽）。
• 作用：漱口时去除生物膜；椰子油中的月桂酸具有抗菌、抗炎作用，刺激淋巴。牙齿可能看起来更亮白。建议每周几次，避免过度干扰微生物组。

01:22:12 - Whitman 博士的个人经历 10岁时因自行车事故导致面部创伤，牙齿脱落，上颌骨骨折。这段经历让她频繁出入牙科诊所，并最终选择了牙科作为职业（结合了科学、动手能力和艺术性）。她的门牙是修复的。

01:25:46 - 尼古丁产品（烟袋、口香糖）

• 关注点：并非尼古丁本身，而是传递方式中的其他成分。
• 尼古丁袋：某些品牌含有甘露醇、麦芽糊精（糖醇/碳水化合物），虽标为无糖但可能含微量。
• 接触时间长：通常在口腔黏膜停留20-30分钟。
• 案例：有用户使用15个月后出现大面积蛀牙和牙齿脱落。
• 风险：可能导致白斑（癌前病变）、骨质流失、牙龈萎缩。
• 建议：若使用，需定期牙科检查。药片或贴片可能更安全。

01:27:56 - 咖啡与牙齿漂白

• 咖啡：可以饮用。但会使口腔干燥（注意补水）、牙齿染色（定期洁牙，使用羟基磷灰石牙膏、油拔法）。
• 牙齿漂白：过度漂白会损害牙齿，对牙髓造成化学损伤，可能导致牙髓自发性坏死。

01:33:29 - Huberman 教授的口腔健康转变

• 停止食用加工食品后，牙垢堆积问题消失（可能与K2摄入增加有关）。
• 改用含羟基磷灰石的牙膏后（Whitman 博士和 Gator Dentist 的产品），牙科检查结果良好，无蛀牙。

01:36:14 - 口腔微生物组检测方法

• SILHA 测试：诊所内进行，检测生物标志物（pH、白细胞、红细胞、炎症标志物）。
• Bristle：直接面向消费者，采用宏基因组鸟枪法测序（Whitman 博士与之有合作）。
• OralDNA：PCR检测，主要针对12种牙周病原体。
• 口腔微生物组是快速发展的领域。

01:39:04 - 氟化物讨论的引入

01:39:40 - 水中氟化：历史、科学与争议

• Whitman 博士的转变：曾支持水中氟化，后经辩论和研究改变看法。
• 历史：20世纪初，科罗拉多斯普林斯的牙医 Frederick McKay 发现当地居民牙齿有棕色斑点但蛀牙少，因当地天然水中氟化物含量高。
• 推广：20世纪40年代中期在密歇根州大急流城作为实验，发现龋齿率下降，随后在美国迅速推广（目前约80%地区水中氟化）。被支持者誉为“世纪最伟大的公共卫生运动”。
• 争议伊始：神经科学家、内分泌学家等一直对其安全性提出质疑（内分泌干扰、神经毒性、骨骼氟中毒）。
• 联邦诉讼 (People vs. EPA, TASCA)：法官等待国家毒理学项目 (NTP) 报告。
• NTP 报告（经信息自由法案公布）：氟化物摄入增加与儿童智商问题存在强相关性。
• 法官裁决（2023年底）：目前水中氟化措施存在“不合理风险”，EPA需加强监管。

01:51:04 - 氟化物剂量、累积效应与全球视角

• 剂量争议：支持者称研究中氟浓度（1.2-1.5 mg/L）高于美国现行标准（0.7 mg/L）。但个体摄入量差异大（饮用量、烹饪用水、其他来源如药物SSRI/奥美拉唑、加工食品、茶叶）。
• Rivka Green 研究（加拿大）：母亲尿氟浓度高，儿童智商测试低5-7分（与铅影响相当）。
• JAMA Pediatrics 荟萃分析支持NTP。Cochrane 报告：水中氟化仅使每人减少约0.25颗蛀牙（统计学上不显著）。
• 龋齿率下降原因：可能是教育普及、卫生改善、牙膏中含氟（1960年代开始）。
• 作用方式：氟化物主要通过局部接触起作用，无需摄入。
• 现状：ADA、AAP仍支持水中氟化。但全球97%地区不进行水中氟化。许多国家已取消，龋齿率仍低（得益于教育和含氟牙膏普及）。

01:55:11 - 氟化物：伦理担忧与对肠道菌群的影响

• 应为个人选择。涉及医学伦理：未经同意大规模用药。
• 未知影响：摄入的氟化物对肠道微生物组有何影响？需要研究。
• 质疑：为何要全身性摄入，而不采用局部使用或解决根本原因（饮食）？

01:57:22 - 氟化物：风险效益与牙医视角

• 若水中氟化有效，龋齿不应仍是主要疾病。
• 取消氟化短期内可能导致龋齿率上升（如卡尔加里，但数据复杂）。
• 风险效益权衡：牙医可能过于关注牙齿。0.25颗蛀牙的减少 vs. 大脑发育风险。Whitman 博士：“我可以修复0.25颗蛀牙，但我无法修复发育中的大脑。”

01:59:04 - 水中氟化物的来源与剂量控制问题

• 来源：氟硅酸，是磷肥工业的副产品（危险废物）。
• 处理：理论上稀释到“安全”水平。但添加时需穿戴危险品防护服，包装袋上有骷髅头标志。
• 剂量控制难：难以精确维持0.7 mg/L。某些社区检测值远高于此（如2.2 mg/L）。
• 行动：EPA已上诉。行动主要在州和地方层面。一些州正在禁止强制氟化。

02:01:22 - 口腔健康与生育/激素（女性）

• 口腔细菌易位 -&gt; 免疫反应和炎症。
• 男性：牙龈疾病与精子活力/运动能力问题相关。
• 女性：牙龈疾病使受孕时间延长约2个月；影响排卵、卵子质量；与流产、早产/低体重儿相关。
• 胎盘中发现口腔细菌。
• 生育诊所应关注口腔健康。

02:05:15 - 刷牙与牙线：时间与方法

• 夜间刷牙最重要：清除当日食物残渣，破坏生物膜。
• 牙线至关重要：多数蛀牙发生在牙缝间（尤其是臼齿）。
• 顺序：先用牙线，再刷牙（松动食物，然后刷掉）。
• 频率：每天至少使用一次牙线（理想情况是晚上）。
• 水牙线：对老年人或牙缝较大/使用牙线困难者有益。可与牙线交替使用。
• 牙线棒：可以使用，尤其适合儿童或手大不便者。牙齿一接触就应开始使用牙线。

02:07:04 - 刷牙技巧与餐后等待

• 软毛牙刷，轻柔打圈，避免磨损牙釉质。
• 餐后/呕吐后等待20-30分钟再刷牙：此时牙齿脱矿，立即刷牙会损伤牙釉质。可先用水或小苏打水漱口。

02:11:10 - 氟斑牙与牙釉质发育不全

• 氟斑牙：轻则白斑，重则深色、橘棕色斑点。是氟化物过量的标志。
• 40-60%青少年有氟斑牙，可能伴有一定程度骨骼氟中毒。美观问题是重要驱动因素。
• 牙釉质发育不全 (Hypoplastic Enamel)：矿化不足，牙齿斑驳、白垩状，易碎。是儿童中的“无声流行病”。
• 原因：可能与矿物质/维生素D缺乏、环境毒素、高烧、病毒有关。
• 后果：导致蛀牙，需全麻下治疗。应考虑再矿化策略。

02:14:41 - 口腔健康与女性不同激素阶段

• 青春期：易患牙龈炎。口服避孕药也可能影响。
• 怀孕期：妊娠期牙龈炎（50-70%）。松弛素可能导致牙齿移位。孕前和孕期口腔卫生极为重要。
• 围绝经期/绝经期：雌激素/孕激素下降影响胶原蛋白合成（颞下颌关节紊乱、头痛）、牙龈炎、口干、灼口综合征、口臭、味觉改变。
• 灼口综合征：可能是锌/B族维生素缺乏。
• 口角炎（唇角开裂）：锌缺乏。
• 地图舌：良性，与乳胶过敏、牛皮癣、自身免疫相关。可能是营养缺乏（锌、B族、铁）、乳糜泻、克罗恩病的信号。

02:19:13 - 润唇膏、口红与慢性唇干

• 注意成分（凡士林、酒精）。某些产品可能导致更干燥（如长期依赖润唇膏）。
• 慢性唇干：提示脱水、张口呼吸。

02:24:09 - 闭口咀嚼与挑食

• 应闭口咀嚼，用鼻呼吸。
• 张口咀嚼：是气道阻塞的信号。儿童可能因此囫囵吞咽，变得挑食（避免难嚼食物）。是口腔运动功能障碍的信号。
• 双侧均等咀嚼。单侧咀嚼会导致肌肉肥大、生长不对称（儿童）。原因可能是咬合不正、疼痛、习惯或口腔运动功能障碍。

02:26:20 - 舌系带过短 (Tongue Tie)

• 舌系带 (Frenum)：连接舌头与口底的组织带。唇系带、颊系带也存在。
• 关键看功能：是否影响母乳喂养（舌头抬高、伸出、侧向运动）、言语、咀嚼吞咽。
• 舌头抬高促进腭部发育。舌系带过短导致舌位低、张口呼吸、腭部狭窄。
• 若无功能障碍（且无代偿导致的其他问题），则无需干预。
• 若有问题，可能需要舌系带切开术 (Phrenectomy)。术前术后需肌功能治疗。通常局部麻醉，激光操作。

02:27:09 - 红光治疗与肽类

• 红光治疗：减少炎症，改善血流。适用于术后（如智齿拔除、牙周手术）。
• 肽类/外泌体：较新，用于根管治疗、骨腔手术等。帮助消炎、愈合、胶原蛋白合成。可能再生牙本质，增加血管化/牙髓活力。属于前沿技术。

02:31:36 - 金属填充物、封闭剂与保持器

• 最佳牙科治疗是没有治疗。
• 汞合金填充物：Whitman 博士不推荐。欧洲已禁用。新填充物应避免。若已有且无问题/汞水平正常，不必急于去除。若破损/汞水平高，则需与医生讨论。
• 复合树脂填充物：塑料（多数不含BPA但有其他增塑剂）。首选生物仿生陶瓷材料。
• 保持器：
  • 丙烯酸（粉色）保持器中的甲基丙烯酸甲酯可能与麸质相关，影响乳糜泻患者。
  • 隐适美 (Invisalign)：为改善气道而短期使用，通常利大于弊。
• 优化排毒途径（十字花科蔬菜、桑拿、吸附剂）。
• 窝沟封闭剂：推荐使用（减少臼齿窝沟龋风险）。Whitman 博士使用光谱法确保无细菌封入，并用臭氧、激光、陶瓷材料。视风险而定。

02:34:21 - 牙医的心理健康

• 牙医群体抑郁、焦虑和自杀率较高。
• 常被开玩笑，许多人有负面童年牙科经历。
• 若不从根源解决问题，难以获得职业满足感。
• 高昂的运营成本、学生贷款、身兼临床医生和企业CEO、独立执业的孤独感。
• A型性格、完美主义者。许多变量不可控（如患者依从性）。
• 新冠疫情后压力增大，牙科保险问题（更像福利包而非真正保险）。
• 耗材公司垄断，成本上涨而报销停滞。
• 曾有针对牙医的仇恨邮件事件。
• 呼吁：善待牙医。若对牙医恐惧，可寻求帮助（心理治疗、抗焦虑药）。找到与自己合拍的牙医。

02:39:21 - 总结：十大口腔健康要点

1. 鼻呼吸（而非口呼吸）。
2. 食用未加工/最低限度加工的食物。
3. 每日刷牙两次。每日至少使用牙线一次（理想情况是晚上，先用牙线后刷牙）。水牙线可选。
4. 刮舌苔。
5. 每周油拔2-3次（如用椰子油，吐入垃圾桶）。
6. 使用软毛牙刷，轻柔刷牙。刷牙后不要立即漱口。
7. 避免使用含酒精的漱口水。
8. 关注氟化物争议，考虑使用羟基磷灰石产品。
9. 避免/限制尼古丁和酒精。
10. 充分补水（含电解质）。
11. 优化矿物质和脂溶性维生素（D3, K2）摄入。
12. 刮舌苔：去除生物膜，有助改善菌群失调（如念珠菌、变形链球菌），改善味觉。

02:45:07 - 结束语 口腔健康是身体的窗口。牙龈疾病或蛀牙是身体代谢失衡的信号。

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Edit:2025.05.19

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