← Culture Apothecary with Alex Clark
Culture Apothecary with Alex Clark
The Real Cause of Cavities Isn’t Sugar, You Won't Believe What Is | Dr. Staci Whitman, DMD
01:24:54
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- [00:00]
A
Parents are always posting their toddler's teeth that have these like brown spots all over them. I mean they look rank and they're like, this is what's happening to my kids teeth. After switching to cleaner toothpaste, I think
- [00:10]
B
there some people are getting paid big. Fluoride is very threatened by some of these alternative toothpastes. They've taken a hit. I'm a board certified pediatricianist. I see 200 patients a week. I've been working, practicing for 20 years and I've never seen these things that you see in Facebook groups. Toothpaste does not cause cavities.
- [00:52]
A
Most people think cavities, bleeding gums, bad breath, even fertility issues start everywhere except the mouth. That's completely backwards. Today's episode might permanently change how you think about fluoride mouth breathing in kids and adults. The signs in your mouth that reveal something is off with your hormones and even how erectile dysfunction could start in the mouth. My guest is Dr. Stacy Whitman, one of the leading voices in functional dentistry. She's board certified in pediatric dentistry and functional medicine, co founder of the Institute for Functional dentistry, and she focuses on the oral microbiome, airway and sleep health, women's hormones and true whole body prevention. You can watch this episode on the real Alex Clark YouTube channel or culture Apothecary on Spotify. Make sure to leave a five star review and tell everyone why. This is your favorite podcast in the health and wellness space. Please welcome functional dentist Dr. Stacy Whitman to Culture Apothecary. You're a functional dentist. What does that mean? So.
- [01:51]
B
So a functional dentist takes a look at the root cause of your issues. So unlike traditional dentistry where we're putting out fires and we're dealing with end stage disease, like much of the medical system, we're looking upstream to see why. We're trying to unpack why. And it's a lot about systems biology so how the mouth is connected to other parts of the body.
- [02:11]
A
One thing that I do, Dr. Stacy, that apparently you are anti and against is 24, 7. I have a steropod on my toothpaste. I have that little P.O. that it makes my toothbrush taste minty and it allegedly kills germs. And I won't travel without it. And I always have it on my toothbrush on the counter. Why are steripods bad to have on your toothbrush?
- [02:34]
B
Well, it's covers in general. It's because when you take something wet and you cover it, it can't breathe. And so it can breed things like mold and bacteria. So you really want it to air out? Ideally.
- [02:46]
A
Okay. But it has little holes in it.
- [02:48]
B
I'd have to see it. So a lot of the holders are, they don't have holes. So yours might be fine. Okay, fine. And also with all of these recommendations, we're all bio individual. So are you having issues? You know, if someone is doing this and they keep getting candida or fungal infections, or they keep having gum disease or cavities, it could be they're inoculating themselves with bacteria, mycotoxins, mold, etc from their toothbrush. But if you're doing fine, Alex, just stick with it.
- [03:17]
A
Are we getting cavities because we're not brushing our teeth well enough or because we're eating too much sugar?
- [03:23]
B
The vill is big food, so it's beyond sugar. Everyone thinks it's just sugar, but it's actually our ultra processed foods. It's fermentable carbohydrates, it's all the preservatives, it's the dyes, et cetera. And why is that? It's for many reasons. So yes, sugar feeds bad bacteria which release acid and that leeches minerals out of your teeth. And that's how we get a cavity. But flour does the same thing in the mouth. But also everything we put in our mouth is going to shift the microbiome. We have an oral microbiome, so many people are familiar with the gut microbiome. We have an oral microbiome. It's the second most diverse microbiome in the body. And so if you're putting in things like food dyes, preservatives, artificial colorings, et cetera, that's going to shift to be a state that's more acidic generally. And bad bacteria love acidity. Okay, so if we're putting things that drop the PH in our mouth, we're going to have more bad bacteria. But also these foods are meant to be over consumed. And so we are constantly sipping and snacking all day long. There's something called the bliss point, which is that perfect blend of fat and sugar and salt that just makes it so we can't stop eating and consuming these foods. And every time we eat, the PH in our mouth drops. This is part of the digestive system. I want everyone to start thinking the mouth is the gut, it's the beginning of the digestive system. And the PH will drop, that is normal. And, but it's supposed to get an opportunity to rise back up again. So if we allow our mouth a chance to, to rest, essentially our saliva will naturally remineralize our teeth. And it usually can take 30 minutes to two hours. But what are we doing instead? We're snacking, we're sipping all day long. And so our mouth is staying constantly acidic. And so this is leading to the cavity epidemic. I need to say and mention cavities are the top chronic disease globally. More than asthma, more than allergies, more than eczem. And we've normalized it. 50% of children suffer from dental decay. And by the time you're an adult, that rises up to 90% of people have had dental decay. And gum disease affects up to as an adult in your 70s, up to 96% of the population. So if you looked at this as any other disease, which is preventable, by the way, we would be alarmed. We'd be talking at the rooftops and yelling about this. But we've normalized this in dentistry and in our lives. That. I just get cavities. My teeth are soft. It's a family thing. But really, it all goes back to our food.
- [05:57]
A
Wait a minute. Is having soft teeth, is that even like a legitimate excuse? Because that's like a Michael Scott quote.
- [06:03]
B
Yeah, I. We hear it all the time in dentistry. There are some people that have mineral deficient teeth. And actually, this is, I believe, a silent epidemic among children. So this is a whole other conversation. I can get into it a little bit now. We can pin it for later. But I am seeing, you know, I focus in kids and pediatrics, and I am seeing so many children, their teeth erupt, undermineralize, and it's due to nutrient deficiencies. And this can be epigenetic. So fat soluble, vitamin deficiencies, mineral deficiencies. Their teeth come in is something called hypoplastic enamel. That is a real thing. But when people say my teeth are soft, this runs in my family. Generally, that's not totally true. There are genetic, you know, polymorphisms that can be linked, but not to the degree that people are claiming. And really, it is generally a food issue. It is certainly a hygiene issue. It's how breathing. And I know you've had people on your podcast before to speak about how important it is to nasal breathe. And also it has to do with how our teeth develop and how healthy our saliva is. Our spit is really important for our dental health. And we are undernourished, we're undermineralized. We're not getting the appropriate nutrients that we need. And so your saliva isn't protecting your teeth as it should. But even starting in pregnancy, we're not giving our babies the appropriate Amount of nutrition needed to develop skeletal systems and dental. Dental development appropriately because of our nutrient deficiencies.
- [07:31]
A
So it's more likely that if you are chronically getting cavities, it's not that you suck at brushing your teeth, it's that you are choosing the worst possible foods.
- [07:40]
B
There's something else going on. We need to look upstream because, for example, I can have. This happens all the time. I have two siblings come in, even sometimes twins. And one eats very, very well and takes great care of their teeth. And one eats garbage and never brushes. And the parents are usually what gives because the child very often who's eating well and taking great care of their teeth, they'll get cavities. And it's the. The kid who isn't doing anything may not. And so what is that? And it drives parents crazy. You know, they're just so frustrated. So there's more going on. It has to do with their microbiome. It has to do with their gut and their oral microbiome. It has to do with how they're breathing. It has to do the foods that they're eating and how frequently they're eating them and their drinks. So we don't think of this, but many drinks are acidic, including some. Bottled water is acidic.
- [08:27]
A
What bot bottled water is acidic?
- [08:29]
B
Dasani is. Don't quote me on these numbers, but some of them are as low as 3 to 4 ph and we want to be up around 6 or 7 ph. That's really important to know.
- [08:38]
A
The water you drink could be causing your cavities.
- [08:40]
B
It could be. It could be dropping the acid. The. The pH in your mouth. Yeah. Making your mouth more acidic and especially if you're sipping on it all day.
- [08:47]
A
That is really interesting.
- [08:49]
B
If people want to know more about this, obviously we can use CHAT or AI, but you can go on Amazon and just get little ph strips and you can start testing your drinks. It's really important. We just don't think about. Everyone just thinks sugar, but it's actually acid. I want people to start thinking it's acid. That's the villain.
- [09:07]
A
Why do so many women get cavities in pregnancy?
- [09:09]
B
Mineral deficiencies, mineral depletion. You know, your babies do take a lot from you. And so if you're not optimized yourself, they will take it from mama. From your bones and your teeth. So many women have issues with what they're eating, you know, and so they might be sick, they might be vomiting, they might be eating more carbohydrate rich foods, kind of comfort foods that can do it. Some women have an exaggerated gag reflex while they're pregnant. So just brushing and flossing can be really challenging too. A lot of women suffer from gum disease when they're pregnant. This is because we do have estrogen receptors in our gums. And so when our hormones shift, there's something called pregnancy gingivitis. And up to 75% of women will suffer from this. It does usually go away after you've had the baby and you've been breastfeeding for a while and your hormones regulate, but you can get gingivitis. And it's because our hormone shift, estrogen, progesterone. So estrogen can affect the gums, make them inflamed. Progesterone can affect the ligaments around your teeth and your temple, mandibular joint. And so a lot of women will start getting TMD symptoms or headaches or they might notice their teeth shift. And this has to do with, you know, relaxin is released to help us give birth, and it affects the ligaments around your teeth too. So your teeth literally can shift a little bit or move. And some women will notice that their bite shifts and it's not in their head. This is a real phenomenon. And imagine if we supported and listened to women and educated on this instead of, you know, just saying, oh, it's fine, it's in your head. Brush and floss more.
- [10:43]
A
When women are throwing up a lot in their first trimester with morning sickness, what should they be doing after they're throwing up?
- [10:48]
B
The worst thing to do is to immediately grab your toothbrush and brush. Oh, really? Which is what you would think you'd want to do. Why is that? Because when you vomit, you've put acid into your mouth. When you've put acid into your mouth, you will lose minerals out of your teeth, as I mentioned before. So that, that is a normal phenomenon where there's something called demineralization and remineralization. And this is a normal process that happens throughout the day if we're not sipping and snacking all day, and if our saliva is optimized. So after you vomit, the pH is going to be low because of stomach acid. So if you grab a toothbrush, you now have weakened enamel from that acid. And those toothbrush bristles can literally wear away your enamel, and that's irreversible. So you could be damaging your enamel. So what is better to do is to rinse with water, ideally with a little baking soda or even high quality sea salt like I like Redmond salt, because it's mineral rich. Just rinsing is good. And then wait 20 or 30 minutes before you brush. That's the best thing to do. Okay.
- [11:48]
A
I love this for pregnant women. So we need to have that like on our sink.
- [11:52]
B
I have a little bowl of baking soda with a lid on my sink because I do baking soda rinses a lot. This is a low cost, no cost way to neutralize or even create alkalinity in the mouth. Because remember what causes disease? Acid. So if you can raise the PH of your mouth, you're going to be in a much better situation. And so all those expensive rinses and things, a lot of them you don't need. Just water and baking soda. A little bit of salt can be antiseptic and very therapeutic too.
- [12:22]
A
What are your thoughts on homeopathy as a dentist?
- [12:25]
B
I use them daily in my practice. Okay. Yeah.
- [12:28]
A
Really?
- [12:28]
B
Yeah.
- [12:29]
A
So this is something interesting and I had to write this down. So I got all this and I'm probably not pronouncing these things right. Okay. But I just want to get your thoughts on this because I saw this and I was like, now that's interesting to ask. Dr. Stacy. According to moms who are into homeopathy, you can heal a cavity with this protocol. Calc floor, 12C cilicia and calc foss, a real food diet. Quinton, minerals and then concentrated butter oil directly on the tooth. Do you buy that you can use homeopathy to reverse cavities?
- [12:59]
B
As a functional dentist, yes, but with a caveat. So those are cell salts. They are part of my protocol too. It sounds like a western price protocol. A bit of what you're communicating.
- [13:10]
A
Totally. And also I probably said all of
- [13:11]
B
that wrong, but no, I think you nailed it. I don't know. I think it was great. I knew you're talking about. Yes, we can heal cavities. Okay. But here's the thing. It's really important that people don't just go rogue on this and do it without any guidance. So not all cavities can be reversed, remineralized or arrested. That means stopped. So if a cavity is still in the enamel, which is the outer layer of our tooth, you absolutely can reverse it, remineralize it, or arrest it if it's a little bit deeper to the next layer, which is called the dentin. It's a maybe. Okay. Now with kids, I like to time. When is that tooth gonna fall out? Because if it means the tooth's gonna fall out soon and. But if I did a filling, the child might Need a sedation or anesthesia? You know, I'd much rather give the parent the option to. Let's try these protocols. The thing with humans is nothing is perfect. We're all bio individual. So what would be most important with that protocol is I would wanna know, well, why did your child get cavities to begin with? Let's start there. Is it truly a hygiene issue? Have you not been flossing? Are they on Goldfish crackers all day? Which by the way are my nemesis. I think they're the top reasons for cavities in the world. More than soda and candy bars, it's these crackers and chips and pretzels and granola bars and fruit snacks and dried fruit. These things that we are marketed to as busy parents that we think are healthier, but they are actually meant to be over consumed, snacked on. They're sticky. You know, think about when you eat a handful of saltines or crackers. They're all through your teeth. They sit there all day and what are they doing? They're breaking down into acids all day and feeding pathogenic bacteria. And then you have a two or three year old. Hygiene's very challenging. It's hard to brush, it's hard to floss. Ask any parent out there. So those crackers are now sitting there maybe for a whole day or two days or three, or kind of indefinitely because the next day they just eat more crackers. So you can see how the cycle starts. So I need to know the why. Are they mouth breathing? You know, some of these things won't ever work if we don't really figure out the why. But I'm a big advocate for remineralization protocols. And there's different ones out there. That's a, that is great. You can also use iodine. Some people use hydroxyapatite, some people might use fluoride. We'll get into that. These are all personal preferences. But we also need to make sure we're hydrated, we're mineralized and we're, we're just optimized from a nutritional standpoint too. And when you get a lot of those things under control, you will see a big improvement in oral health, but a big thing for parents out there listening. So many dentists don't speak of this, but candida or fungus is a top reason for cavities in children is that in the tummy. It can start in the mouth and go to the tummy or vice versa. So testing. And so many dentists aren't testing. Now there are oral microbiome tests that you can do tricky in kids because kids microbiomes are very transient because they're constantly putting things in their mouth. But you know, you can do a gut mapping test too. So it's just something to think about. If your child keeps getting cavities and you're just at wit's end, why I wonder, could it be Candida? And many of these kids do show up with Candida.
- [16:33]
A
I was at a wedding recently and a mom came up to me. She listened to this show. She said, alex tooth pillow changed my family's life. She tells me that her 8 year old son was going deaf. They could couldn't figure out why. Doctor after doctor at one point they told her, you know what, it's probably just like an attention issue. He's just choosing to not listen to you. I love when they gaslight moms instead of investigating the problem, don't you? I'm joking. Long story short, her son was a chronic mouth breather. His body was constantly in overdrive trying to compensate, drying out his mouth, producing excess mucus and so that mucus was blocking his ears. Is that not insane? So nobody connected this. He started wearing a tooth pillow at night. It helped guide proper tongue posture and support nasal breathing, breathing while he slept. And now completely different kid. He's hearing just fine, not deaf at all. We have normalized things in kids that are not normal. Okay? Narrow faces, crowded teeth, snoring, bedwetting, mouth breathing, ADHD symptoms, chronic congestion, teeth grinding. They're common, but they are not normal. When jaws grow too small, it restricts breathing and affects development in ways that most doctors never connect. Tooth pillow works during the years that growth can still be guided. Ages 3 to 12 Helping support natural jaw development and healthy breathing. Start with a free virtual assessment. You're going to have airway dentists that figure out with you if it is right for your child. It may not be a tooth pillow. Airway dentist is going to review how your child is developing and help you understand what comes next. Visit toothpillow.com and get your child assessed for free by using code alex clark. That's toothpillow.com get a child assessed for free by airway dentist by using code Alex Clark. Last week I had allergies or a cold or the government was testing seasonal pollen warfare. I don't know, but my nose was a faucet was blowing it every six seconds. At one point I thought about just installing a kleenex holster like an old west sheriff. And then it happened. You know that moment when the skin under your nose turns into sandpaper. Raw, red, chafed. I kept putting random lotions on it. And then I remembered I was like, wait a minute. I have active skin repair. Active skin repair is non toxic and uses hypochlorous acid, which sounds scary, but it's actually a molecule that your body already makes as part of your natural immune response. When you spray it on your skin, it helps cleanse, soothe irritation, calm redness and support healing. So I started using it on my nose and in one day, almost completely healed. It is natural, it's non toxic, medical grade ingredients. You can use it on cuts, burns, rashes, sunburn, acne, prone skin, eczema, rosacea, literally head to toe. From pets to grandparents, over half a million happy customers, thousands of five star reviews. And now it lives permanently under every sink in my house, as well as my car and my purse. Go to active activeskinrepair.com use code ALEX for 20 off your order. This is something that you buy before you need it. Okay, it's active skin repair.com code Alex for 20 off. Now I'm seeing all the time in these crunchy mom Facebook groups, stuff like, okay, I put my whole family on, you know, cleaner toothpaste, and now we're all getting cavities. I'm so tempted to go back to fluoride. And I've always been like, no, it's not the fluoride. But then you just said, some people opt to use fluoride to help with their cavities. So now you're telling me something that is new to me. So can you explain, you know, what, what, what do you think about fluoride as a functional dentist?
- [19:55]
B
Yeah, I'll break all that down. So I see those posts also, and I find them to be very frustrating because toothpaste does not cause cavities, ever. I don't care what you're using. If you are eating optimally, if you're eating a more paleo diet or even a carnivore diet. And I'm not advocating for any types of diets. I'm just speaking factually about the cavity process. If you are eating clean and breathing appropriately and you're in balance, you could never brush your teeth and you won't get cavities. Our ancestors had very few cavities, hardly any. And go to the Natural History Museum and look at a skull. Do you see a bunch of fillings? Do you see cavities in the teeth? No, the teeth are pristine. Why is that? Because they were Foraging. They were hunters and gatherers. They were eating a natural diet. What changed? Why are cavities the top chronic disease now? We went from a hunter gatherer society to an agrarian society. So we started farming, started farming corn, soy, rice, we started growing wheat. And then the industrial revolution happened and we started mass producing food and milling and processing and pre digesting food. We stopped chewing. Okay, so think about everything now. Just kind of dissolves in the mouth and it has flour and has sugar and has additives. So this is why we have the cavity epidemic. So when I see these posts, I want to sit with that family and say, if you're blaming the toothpaste, you are missing something really important going on in your child. Because cavities are a sign of a metabolic imbalance. They are not about your toothpaste. Okay, so toothpaste is like extra credit. It can protect your teeth if you're not eating optimally. It can help ensure you won't get cavities. But it's not for sure, because if it were, with water fluoridation and all these fluoridated products out there, why are cavities still the top chronic disease in the world? And I will tell you, people are speaking about hydroxyapatite. And regardless of what you use, I don't see this in my patients. I see 6,000 patients a year and no one's getting cavities because they switch from one toothpaste to another. I see plenty of patients who use fluoride products that get cavities. I see patients that use non fluoridated products that get cavities. We're missing the point. Speaking of fluoride, I always have to break it down between systemic and topical. So systemic is water fluoridation, systemic is supplements, systemic is, you know, swallowing things. Okay, I am not an advocate for systemic fluoride at all. We have shown in the data that it doesn't even work. The latest Cochrane Collaborative came out in 2020 24, showing that water community water fluoridation only reduces cavities by such a small percentage. It's not even statistically significant. And so a lot of the data that we had previously is just inaccurate. Not to mention there are concerns with thyroid dysfunction, neurocognitive issues, IQ issues. We're not following the EPA's own guidelines for margin of safety, so we should be to protect vulnerable populations. The EPA's margin of safety is a 10x threshold. We fluoridate about almost five times that amount. And who are the vulnerable? It's pregnant women. It's infants and children with fluoride specifically, it's if you have iodine deficiencies, calcium deficiencies, if you are sensitive to fluoride, which that does exist, and then there's genetic polymorphisms, those patients shouldn't be exposed to fluoride. So there's an issue there, obviously there's a medical ethical issue that I. We're not getting consent. It is a medication. We're not getting consent. And, and we're not factoring in dosage based on weight. You know, we're just treating everyone the same. You might drink one glass of water a day and I drink two gallons of water a day. I'm obviously going to be exposed to a lot more fluoride. And the big thing for me that I think we need a lot more studies and research in is fluoride's antimicrobial. So what is it doing to the gut microbiome? And I would love to see more research going into that. There's some preliminary studies. I've read that it is concerning. It lowers diversity, it can create intestinal permeability, maybe ibs, ibd, et cetera. So can you imagine that we're just blanketly fluoridating the water and actually causing other health issues. And as a provider who said I'll do no harm and I'll prioritize the brains of the children I treat, I choose brains over teeth. Baby teeth fall out. They're important. They do fall out. You get one shot to grow a brain. Okay? So the burden of proof needs to be on the safety. We shouldn't have to prove it's unsafe. Okay. They need to prove it actually is safe, which they have not done. That's how I feel about systemic. Okay, okay. If you could tell I'm not a fan. And this includes supplementation, it also just doesn't work. Okay. We know that fluoride works topically, not systemically. So topical, that is toothpaste, those are rinses, those are varnishes that the dentist does at the office. I personally do not use fluoridated products. My kids have never been exposed to topical fluoride. I sometimes support patients and what they want to use. I do worry about topical applications if they're swallowed in young children. Now we're in the same issue of ingestion. How much is absorbed through the oral mucosa?
- [25:11]
A
That's what I'm wondering.
- [25:12]
B
Yes.
- [25:12]
A
Cuz I'm hearing what you're saying about swallowing, but then I'm like, okay, but using fluoride, toothpaste I'm like you're swallowing it.
- [25:17]
B
You could argue probably adults aren't, but certainly children are. So absolutely, I do not think you should be using it in children unless they're spitting. They have not seen a study maybe. Please listeners, if you find one, send it to me. But that looks at how much is absorbed through the oral mucosa, okay? Now it could be negligible and it's not an issue, but I just don't wanna risk it. And also I'm worried about what it's doing to my oral microbiome. You know, the advocates of it say we love it because it's antimicrobial, okay? But it's not selective. So it's killing bad bacteria, but also your good commensal bacteria. And we now know the microbiome is king or queen. Okay? We need to treat it with respect, we need nourish it, we need to support it, we need to start carpet bombing it and over prescribing antibiotics and you know, antiseptic rinses and alcohol, you know, alcohol rinses, et cetera and really start looking at how do we nourish and feed our microbiome. It's much more important. So if families choose to use topical fluoride, I am not going to tell you not to, but it is a discussion I have with my patients who are open to hear my opinions about it. The argument is access to care that some patients maybe don't have access to theobromine or hydroxylase, the appetite or some of these other remineralizing agents. And I do understand that. But again, topical fluoride is very accessible. You can get it at the dollar tree. But the thing with fluoride is it doesn't remineralize teeth, it actually just makes them more acid resistant. So to remember we talked about acid is what causes disease. So it might create a little armor around your tooth just to protect it a little bit more. But if you're chugging big gulps of Mountain Dew all day and talkies and you're going to get cav. Just period. It doesn't matter how much fluoride you use. Fluoride is no match for big food.
- [27:06]
A
I am personally anti hydroxy appetite. Here's why I started using hydroxy appetite toothpaste. When I switched away from fluoride, I started developing all of these black gray dots on my teeth and in between my teeth. I thought I had a cavity infestation from hell. I did not understand what was going on. I couldn't brush it Off I went to the dentist. They were able to polish it off well with a professional cleaning. But then I would use this toothpaste. It would come back. Finally, I switched to a xylitol based toothpaste. Zero issues, completely went away. I would love to hear your take on why this happened to me. And by the way, I don't say that people get so upset when I say I don't like hydroxy appate. They're like, so what? I can't use it. I'm not saying that. It might be great for you.
- [27:48]
B
We're all different.
- [27:49]
A
For me, it clearly was creating weird stuff on my teeth.
- [27:52]
B
I will say this. I have never seen an ingredient with that my patients use that have helped their teeth more than hydroxy appetite, generally speaking. Okay. But that being said, I have seen these reports and you. Spots. Yes, it's staining. Okay. And so you may be of a small portion of patients. But I need to know, and we, I don't, we don't want to name brands right now. We'll talk offline. But where did they source their hydroxyapatite from? What was the concentration? What were the other ingredients in the toothpaste? Waste. Okay. But you're staining and I have seen this. And it always polishes off. It's ex, it's extrinsic. So it's. But it's not, it's unsightly. Like we don't like that. And so that tells me there's probably some shift in your microbiome. So there's something called chromogenic bacteria, which is actually benign or even beneficial, but it's gray or brown. So your microbiome may actually have been healthier, but it didn't look great. Now a lot of times, patients, when they continue to use it for three to six months, your microbiome will reestablish. Just like when you have to do like a gut microbiome reset. It takes a while and then we do see that staining go away. But not always. And this is my point. We have to be very cautious listening to podcasts and listening to social media posts, because we're not one size fits all.
- [29:15]
A
Yes.
- [29:15]
B
And so what works for you may be very different than what works for me.
- [29:19]
A
And this is what I like about this show, is I've had other dentists on this show, they had different takes on fluoride than you. They were, they were all no fluoride at all, period. You're saying you have a nuanced take on it and people will hear that and they're like, well, I don't understand what I'm supposed to do because you had people with different opinions on. And I am saying no, this is what is so cool about it is because we're not one. One SIIZ fits all. This is the problem with the medical industry as is right now is we're trying to treat people like it's one SIIZ fits all. I need to have different experts that have varying levels of different expertise within the same I. We all agree on a more holistic way to live. That's at least that is the main thread throughout this show. Some people have different ideas of how to get there. But because everybody's different like me with hydroxy appetite not agreeing, I need to hear from somebody saying under, you know, explaining why that may not be ideal for me.
- [30:07]
B
Right.
- [30:07]
A
So like I have so many people in my audience that need to hear different things and something might work for someone that doesn't work for someone else. So that's why we have people that contradict each other slightly on the show.
- [30:18]
B
Yeah. You're going to hear people that say xylitol is terrible for you. I completely disagree with that. And there's no data to support that. It's. We can find anything we want kind of about anything from any side. Right. I like to take a very balanced approach to my recommendations because of that. Because I know not everyone has access to everything I'm talking about. Not everything works for everyone. But again, in my office, I generally don't promote fluoride. Okay. I don't use it personally because I have concerns with it from my family and for myself and I choose to avoid it it. But you may find that's all you have available to you or you may really be a believer in it. This is why I recommend for everyone to take the information they he hear and do a little bit of their own research and see what resonates with them.
- [31:06]
A
One thing that I see also speaking of these moms Facebook groups and I'm in these because I think it's fun, I think it's interesting.
- [31:12]
B
Oh, I'm in them too.
- [31:13]
A
The other thing is parents are always posting their toddler's teeth that have these like brown spots all over them. I mean they look rank and they're like, this is what's happening to my kids teeth after switching to, you know, cleaner toothpaste. Is this like what you're talking about with sustaining in the microbiome rebalancing?
- [31:28]
B
No, those posts, I just, I don't even Understand what they are. I think there some people are getting paid. I swear by big fluoride. Exactly. No, there are. This is a legit conversation happening to scare other parents. Yes. Really big fluoride is very threatened by some of these alternative toothpaste. They've taken a hit. Don't. Yeah, absolutely.
- [31:49]
A
I didn't even know that was real. I was just being funny.
- [31:50]
B
But that's interesting. No, I mean, I mean, listen. I don't know. I'm a board certified pediatric dentist. I see 200 patients a week. I've been working, practicing for 20 years. Okay. This is actually my 20th year anniversary this year of being a dentist. And I've never seen these things that you see in Facebook groups ever in your practice.
- [32:09]
A
So what is happening there?
- [32:10]
B
I don't know. I don't. I. Again, I'd have to do a full workup on them. I want to know what they're eating, what they're drinking, how are they breathing. Like have there been changes?
- [32:20]
A
So I have a theory. Maybe this has to do with this. This huge amount of adults in their 20s and their 30s that opt to not go to the dentist regularly. I feel like it's a mass problem. I have grown up always. I go to the dentist for professional cleaning every three to six months. I now I do every three. When I was growing up, my mom took me every six. But I go three and none of my friends go.
- [32:42]
B
Really?
- [32:43]
A
None of my friends. And I'm talk and like all of my friends are very into holistic health, all these things. They will go to a naturopath, they will do functional medicine, doctors, all the, all of, of this chiropractor will not go to a dentist. And I'm just like, why? I mean I just feel like I'm fine. I don't think I have any cavities. Do you see this? Do you feel like there's an epidemic of 20s and 30s just thinking they don't necessarily have to really go to the dentist unless they have like a glaring pain or problem?
- [33:09]
B
Yes. I mean I don't even know if I'd say in that age group. I think a lot of people don't go to the dentist. They don't take it seriously. And I think there's many reasons for that. I think there's true dental phobias, many of that dating back to when they were kids, which is actually why I went into pediatrics. I was an adult dentist and I couldn't take the chronic disease and I couldn't take how it was non stop And I couldn't take how I felt like I wasn't making a difference. And I couldn't take how everyone was terrified of me. And I'd say why? It was always a story going back to childhood. I was like, good Lord, we need to change this. I need to get upstream. And how, what is that? That's with kids, that's with educating parents. So I do love children, but that's not why I went into PDF matrix is because that's the most upstream that I can get. So I think what has happened, dentistry went one way and medicine went another. And because of that, the mouth is just separate outside of the body. We've done it with our eyes too, right? Just the, the separation from you go to the optometrist, your eyes are a different insurance plan. Like they're just outside of the body. That's ridiculous. So for anyone that says they're holistic and in a functional medicine, the mouse, the gateway to the body, it's the beginning of your digestive tract. The oral microbiome is the second most diverse microbiome in the body. And we now know about the oral systemic connection. That is the bacteria in our mouths can influence Alzheimer's, dementia, cancers including pancreatic cancer, colon cancer, breast cancer, cardiovascular disease, rheumatoid arthritis, autoimmune disease. It can impact your fertility. Erectile dysfunction can be coming from your mouth.
- [34:45]
A
What?
- [34:46]
B
Yes.
- [34:46]
A
What do you, what do you mean?
- [34:47]
B
Yeah. So the bacteria in our mouth influence nitric oxide production. So you'll see these posts perhaps about how we shouldn't be using alcohol based mouthwashes or astringents. Have you seen that? Like stop using Listerine. And that is because it wipes out the healthy bacteria in your mouth, but including the ones that support nitric oxide production. And that's why the studies show that there was an increase in blood pressure in patients that were chronically using these products. But also it changes is your vascular system and blood flow. Nitric oxide is very important for sexual health. It directly can influence erectile dysfunction. I mean, this is how the, the erectile dysfunction medications work. They boost nitric oxide and blood flow. That is crazy. But to me what I get, what gets people motivated, I think is Alzheimer's. So there was a, a very popularized study out of Harvard where they looked at the brains of deceased patients who've been diagnosed with Alzheimer's and 96 of them had P. Gingivalis in their brain. And that is a gum bacteria from gum disease. They had controls and all the confounding variables were taken care of. And there's no reason this bacteria should be in your brain unless you have gum disease. Because there's something called leaky gums. We've all heard of leaky gut intestinal permeability. Okay. If your gums bleed when you brush or floss, we call pink in the sink, you've now created low grade systemic inflammation. Okay. And we know inflammation is terrible. For us, that's like having a low grade chronic infection in the mouth, essentially. But now you've created a pathway through the bleeding gingiva for bacteria to get through into the circulatory system. And it can end up in different organ systems. It shouldn't. Plus they release endotoxins and basically these really terrible byproducts that can cause inflammation in distant organ systems, including leading to like, amyloid plaques and cow tangles in the brain. And so if you are not flossing and not brushing and not seeing the dentist, may I please tell you, you will have better cognitive outcomes. If you have a healthier mouth, you'll be less likely to have dementia and Alzheimer's. The other thing that dentists do that's important to go is oral cancer screening. Oral cancer is very prevalent and very under diagnosed in mess. And who can else can do that besides a dental hygienist or a dentist? Because you have to. A lot of times it's deep under the tongue or they're looking back in your pharynx. And those are things you want to catch early.
- [37:25]
A
I wonder if we're going to see an increase in oral cancers in young people because of vaping.
- [37:30]
B
Vaping and pouches, nicotine pouches.
- [37:33]
A
Really talk about that.
- [37:34]
B
So there's some case studies and there's more research coming out about this. And you know, nicotine is a neurotropic and people are using it for, you know, focus and cognitive performance.
- [37:45]
A
RFK loves it.
- [37:46]
B
Yeah. Be careful with the pouches because it's not necessarily the nicotine. It's. They do put additives in there, the flavorings. They can actually get by with putting a little sucralose in there and not reporting that. And so what happens is people are leaving them there, there way too long. Okay. Like some people will leave them there for hours and hours, and it's creating gingival inflammation. You can see recession, but it does create cellular changes too. And we also see an increase in cavities, like rampant cavities from these. And it's because it's shifting the microbiome.
- [38:18]
A
So patch not pouch patch.
- [38:20]
B
I mean they I I'm sure someone's created like a spray or just something that is quicker, mint even, but like to leave a pouch there for so long it's not something I suggest
- [38:34]
A
A listener DM me recently asking for advice because her insurance denied a claim for stitches stitches after birth. Apparently her cut was non emergent. I didn't realize that we're ranking lacerations now like Yelp reviews. Another woman messaged me saying that her insurance wouldn't cover lactation support because it was considered non essential non essential for a newborn. And this is exactly why I had Andy from Crowd Health on the podcast because the traditional system feels less like health care and more like a bureaucracy obstacle course. If you're in that season where pregnancy is on your mind or it's already happening, you're realizing fast that the way that you want to have a baby doesn't always line up with what insurance wants. With crowd health, pregnancy is treated as one health event. Prenatal care, labor and delivery postpartum with a three thousand dollar member commitment. That's your personal responsibility for the entire pregnancy. No guessing what's included. And here's the empowering part. You get to choose how you deliver hospital, birth center, home birth. They allow eligible funding for certified doulas, licensed midwives, pelvic floor therapy, lactation, breast pump, even necessary home birth supplies. It's members funding members transparent, human, aligned with how a lot of women actually want to give birth. You have the power to take control of your health care. Join Crowd Health to get started today for $99 for your first three months using code culture@joincrowd health.com that's joincrowd health.com code culture crowd health is not insurance. Opt out. Take your power back. This is how we win. Join CrowdHealth.com code Cold Cult Nature I just went to Disneyland and let me tell you, it's magical. It's also a nutritional crime scene. You walk 10ft and it's sugar seed oil. Something labeled beef inspired product. I'm standing there looking at a 19 corn dog thinking this is how civilizations fall. I wanted the rides. I wanted the ambiance. I did not want to leave feeling like I'd been deep fried. So I packed my own food front and center in my bag. Paleo Valley 100 grass fed fed beef sticks. They're totally organic. They're not gas station meat tubes with preservatives. Paleo Valley makes the only naturally fermented 100 grass fed and grass finished beef sticks in the U S. They use organic spices, no artificial junk. And the beef comes from cows raised entirely on grass pastures by family farmers here in America. And the big difference is they're naturally fermented instead of loaded with chemical preservatives. That means real food, better digestion, clean protein, steady energy. While everyone else is crashing, waiting in line for space Mountain, they've got flavors like original jalapeno garlic, summer sausage, teriyaki. And honestly, pulling one of those out felt like a power move in the park. If you want snacks that won't betray you at the happiest place on earth, head to paleovalley.com and use code ALEX for 15 off your first order. And you also want your kids to be able to avoid meltdowns. You need paleovalley.com code Alex for 15 off your first order. Keep these beef sticks in your purse. They've got chicken sticks too. Your kids, backpack, center console and your car or on your plane, carry on. When you start needing protein, having something good for you already on hand will prevent that. Drive thru visit. Free tip can birth control permanently change your oral microbiome?
- [41:43]
B
Yes, because it's influencing your bacteria. So when, when women's hormones shift, we do know bacteria shift and we a lot of times can get more pathogenic bacteria. But also a lot of those medications cause xerostomia, which is dry mouth, mouth. And remember I was saying that spit is the golden elixir of our bodies. I want you to start really cherishing and appreciating your saliva because it has enzymes in it, it has immune cells in it. It's the first line of our defense, like think things come into the mouth and our body needs to recognize is this foreign? You know, what do I do with this? So there's a lot of immune cells and your immune system begins there. And so with pregnant women too, that hormonal shift can influence your salivary health. And patients who have dry mouth, they do tend to get a lot of dental disease. We see this with our cancer patients and with patients too. Their disease skyrockets is because they lose their salivary health. And certain medications will do this too, like SSRIs and moot. You know, a lot of prescription medications cause dry mouth, so we need to be very cautious with that.
- [42:43]
A
Why do you advise people to never use whitening toothpaste?
- [42:46]
B
I wouldn't say I never suggest it, but just buyer beware. So I want everyone to feel good and feel confident and I understand that having bright white teeth is part of that and I like that too. Too. Just be aware that bleaching with peroxide, so carbonide peroxide, hydrogen peroxide, that does release reactive oxygen species. It's basically oxidative stress. This isn't good in the body. And so that can shift the microbiome. And if you overuse these products, you could also be causing permanent nerve damage. So people that have sensitivity after they bleach, that is a red flag that you're causing minor nerve damage, like a minor trauma to your teeth. And so imagine if you're doing this in and day out, you're overdoing it. I've seen these tik tok challenges where they're just basically swinging hydrogen peroxide for these super white bright teeth that don't even look human. I just think, oh, my gosh, you're going to have so many root canals in the future. So just be careful. I'm not saying never. Like, I don't like charcoal toothpaste because it's abrasive and it can wear away your enamel. I'm okay with bleaching. I just want people to not overdo it and listen to their body. If you're using it and it hurts, hurts if it's too sensitive, back off on it. Find a lower dose of the bleaching agent or maybe find alternatives, you know, more natural, like baking soda and water, going for cleanings more frequently. You know, there are different ways to have brighter white teeth. The problem is we're so used to filters and we're inundated with veneers.
- [44:17]
A
I am so anti veneer. Yeah, I'm anti veneer. It's not even that they look like crap. Most of them do.
- [44:23]
B
They do.
- [44:23]
A
The other thing that I don't think anyone is thinking about is you're shaving down your real tooth and interfering with the meridians. Am I wrong? Am I off base?
- [44:32]
B
Is this conspiratorial sounding? No, no, it's not. I'm not a huge fan either. But I will say there are providers out there doing very quality veneers and being very ethical and functional about them, but they're few and far between.
- [44:45]
A
Who, who are some of them? Can you name any of them?
- [44:47]
B
Well, I know Dr. Victor in LA. I launched the Institute for Functional Dentistry, and he's on faculty and we can put him in the show. Notes for people can go flood his office. And anyone he's trained with, either his mentors or who he's training, he's. And he does beautiful veneers. But I do see this too. Like, unfortunately, it's usually Kids and they go because it's cheap and they get their teeth like just filed down in nubs and then have veneers put on and that is malpractice, quite honestly. Those teeth will all need to be root canal. So I'm not a huge fan either. I prefer natural teeth. However, some people, they've really worn down their teeth or they don't like the shape shapes of their teeth. And again, I want everyone feeling good about themselves because mental health and how our confidence impacts our health too, it's worth the extra money to find someone who really knows what they're doing and just know anything you put in the mouth, it is going to shift the microbiome. Nothing lasts forever in dentistry. Nothing. Fillings, crowns, veneers, they're going to need to be replaced. So if you're 25 years old and you're having veneers put on, on, they're going to need to be replaced once, twice, maybe three times in your life. So just be aware of that. So if you can get by with maybe just bleaching and brightening, maybe getting some invisalign, like just straightening your smile a little bit and avoiding veneers, that is what I would suggest. But I agree with you, there's some really bad veneers out there and so many. I feel like the more wealthy people get, the brighter and whiter their teeth get. Have you noticed that like some people, their teeth are so, so white.
- [46:25]
A
Is there a non toxic way to whiten your teeth?
- [46:27]
B
There are brands like Luminu. Use more herbs like herbal medicaments in a blend that can work. You know, there's strawberries are supposed to brighten and whiten your teeth because really, because of the acids. It's very mild, gentle acids. But again, I just like baking soda. I'm a huge fan of baking soda. So like make a slurry and you can brush with it and it's not going to be the Hollywood white blinding, but it can brighten.
- [46:52]
A
I think natural white bite is prettier anyway.
- [46:55]
B
I agree.
- [46:55]
A
So is flavored kids toothpaste problematic?
- [46:58]
B
Ah, it's evil. Especially because mo. Okay, so most of these flavored toothpaste I have found are the fluoridated type. They're the bubble gum and they're, you know, they have cartoon characters on them and I, I think that's just outrageous. It's, it's terrible marketing to a vulnerable population. And those are the kids who shouldn't be using it because they're going to eat it and swallow it and ingest it like candy and have to call poison control. There is a poison control label warning on fluoridated products for a reason. If over consumed, it does act as a poison. Kids will vomit sometimes. I have kids after those trays I used to do in fluoride varnish, which I've really moved away from. I don't really offer it now in my office. They get sick, they get nauseous. That's a real thing. It's because they're swallowing that and it's a, it's a mild poison to them. But yes, you want to be careful with natural flavor. Sorry artificial flavors and things. And the whole flavor industry is so, so sketchy. So much is proprietary and there are flavorings, it's kind of like the mafia that are actually cleaner but they won't release the ingredients. So then you have to go through like EWG or a similar thing to reverse engineer to see if they're clean or not. So if you can use natural flavors, that's best. But the problem is essential oils, which would be natural flavors. They can act antimicrobial in the mouth. So overusing that them can cause some of the same issues we were talking about with antiseptic and al alcohol based mouth rinses. They can just carpet bomb. So you just want to be cautious, you know. But I, I'm very opposed to like the bubble gum they used to put like these sparkles in, in the kids toothpaste which were microplastics. They were literally little beads of plastic.
- [48:40]
A
I didn't even know that. Yeah, I was not a disciplined flosser until probably a couple years ago now. Now when I became one, it dramatically changed my life. Dramatically. Like I couldn't even believe. I just thought that was annoying thing that you guys had to say or something. For some reason I just thought this is not a legit thing. Like why do they always care about flossing? And then I started doing it. I think that my gums were a major source of inflammation in my body.
- [49:04]
B
Absolutely.
- [49:05]
A
And once I started regularly flossing, I think the inflammation in my mouth went down and I just felt better everywhere. Can you speak to flossing and why you cannot roll your eyes when your dentist asks you about it.
- [49:15]
B
I love that you just said that. Thank you much. I feel so validated. You're spot on. So I always tell the kids at my practice and I'm really speaking to their parents too. If I was on a desert island and I had to pick between a toothbrush and endless Floss. I would always pick floss because I think it's profoundly important, because your gums are a barrier, okay? They're a barrier from the outside world to the inside world from all those microbes getting inside your body. And you want them to be healthy. And we want to reduce any source of inflammation in the body because you'll have better health outcomes. Chronic inflammation can lead to autoimmune disease, it can lead to cancer, it can lead to mood disorders, you know, arthritis, all of these things. So you're right in, in feeling that way. I will tell you, if I go on a camping trip and I don't, I forgot my floss and I don't floss for a few days, I feel inflamed. I really do. And I don't believe it's in your head. So when your dentists say that, what we're looking at is inflammation, but bleeding too. And if you, you have bleeding gums, you know, week after week, month after month, decade after decade, you're more likely to have all these inflammatory issues, including the things we spoke about. So, you know, not only autoimmune issues, but then the bacteria can lead to the Alzheimer's and dementia and cardiovascular disease, fertility issues, sexual health issues, cancers, etc.
- [50:37]
A
So if your gums bleed when you floss your teeth, that could be causing your infertility?
- [50:42]
B
Yes, there's a lot of data around that. So women, let's not only blame women. So I'm going to go, I'm going to talk about both partners. Two to tango. So women, there's studies that show women who have gum disease can take two to seven months longer to conceive. And this is because that inflammation and the bacteria can influence ovulation and implantation and your cycle in general. Okay. Because of inflammatory mark markers, men who have gum disease are more likely to have issues with sperm count, sperm mobility, sperm motility, again, because of inflammation. This is crazy. It's crazy. And fertility clinics aren't really talking about this. For every fertility clinic should be doing an oral microbiome test, which is salivary analysis. It's spit. It could not be an easier test. You don't need a poke, you don't need a blood draw. You spit in a tube, you send it out, you get the microbiome. We look to see do they have gum disease, bacteria, periodontal bacteria, or not. And if they do, they need to go to a dentist and get cleaned up and get on a protocol. And some of these bacteria are so virulent, they're there's something called spirochetes. They're corkshoe shaped and they actually will like, embed and impregnate into tissue. So no amount of brush flossing is going to get them out. Sometimes you need antibiotics, but then it's like one and done, and then we start fresh and then we rebuild, of course, and we want to avoid antibiotics, but it's if. If you're not addressing this, they have serious downstream effects.
- [52:06]
A
So does bleeding gums automatically mean you have gum disease?
- [52:09]
B
Yes.
- [52:10]
A
Okay. And gum disease is responsible. It can lead to all those other health issues.
- [52:13]
B
Wow.
- [52:13]
A
Okay.
- [52:14]
B
So if you have pink in your sink, that's a huge, literal red flag in your face that you need to do something differently. Now. Important to note, so many patients get shamed and blamed that you're not flossing and brushing enough. But what else could cause bleeding gums? Vitamin C deficiency. Remember scurvy? Okay, Dennis, aren't talking about this. Nutritional deficiencies, zinc deficiency. B vitamin deficiencies can lead to bleeding gums, too. Chronic mouth breathing, gut dysbiosis. So this is where functional dentistry we. We don't just say hygiene. We don't just say brush, floss, and use fluoride. We have to look at the human and the system's biology of it and to really understand. And I see so many patients, patients that they really. Their teeth come in, they're so clean, you know, and they're. They're like, I brush and floss all the time. Their gums bleed. So I'm looking like for more nutritional airway. If you have ill fitting, like a crown that doesn't fit right or a filling that's broken, or the margin that can cause gum disease too. So we need to really look at the.
- [53:18]
A
Why is it a good idea for a dentist to check your vitamin D levels?
- [53:21]
B
Yes.
- [53:22]
A
Do you do that with your patients?
- [53:23]
B
Yes.
- [53:24]
A
Why? Why is that? I don't know. I've never heard of that until I went and saw your colleague and friend, Doct Logic, also practicing in Portland, Oregon, where you are. And he checked my vitamin D levels.
- [53:33]
B
I was like, why?
- [53:34]
A
You're my dentist, so can you explain that?
- [53:36]
B
So vitamin D deficiency is one of the top reasons for cavities. There's tons of research about this. So what do you need to have a healthy tooth? You need vitamin D3, you need K2, you need magnesium, you need calcium, you need phosphorus, you need minerals. Okay, so the data shows chronic vitamin D deficiency is going to impair calcium metabolism and how essentially you utilize mineral just in Vitamin D does a slew of other things too, including affect our sleep and arguably how we are breathing at night. And so we do see patients with chronic cavities, recurring cavities. They do tend to have chronically deficient vitamin D. And what's interesting, back in the early 1900s, before the whole water fluoridation thing happened, which was in the 1940s, Dennis used to talk about this. They used to talk about vitamin D. They would suggest that patients go out, out into the sun and eat more vitamin D rich foods to up these levels because they, they knew it was associated with cavities. But in came big pharma. I mean, fluoride is pharma. And all of these going, getting back to the basics just kind of disappear. But it's all throughout the literature. In fact, I did a little pilot study at my office where I would test all the children undergoing general anesthesia, which, which I hate doing, but sometimes they need it, okay. When they're in pain, they have infection. And I did a finger spot test and they all were chronically deficient, every single one of those children in my operatory. And if I just met them earlier, you know, I met them too late, I think we could of course, correct it, but a lot of them were in the single digits or the teens. And we really want to be, to be optimized. If you, you know, follow functional medicine protocols up around 60 to 80 nanometer nanograms per milliliter. Um, and you know, conventional medicine will say, ah, you're in the teens or twenties, you're fine. That's very deficient. That's like house plant level, you know, so it can really impact your teeth. So, you know, knowing your labs is important if you suffer from disease.
- [55:35]
A
Is there a certain ingredient in conventional toothpaste that could actually be causing your canker sores?
- [55:40]
B
Yes, Sodium laurel sulfate or its derivatives. So sodium laurel sulfate, it's SLS is what you'll see. See, it's the foaming agent. So a lot of people think that their toothpaste needs to burn and foam for it to be working. This again is manipulative marketing from our toothpaste manufacturers. But that foaming is very aggressive on the oral mucosa, and it can strip it and it can cause ulcerations or canker sores. And SLS was originally used as a derivative in floor cleaners, just for reference. So your toothpaste really doesn't need to foam, and I believe it shouldn't. That's my opinion. It can take a lot of Getting used to people. It's just like when we change our shampoo, right? It takes some time. Your hair needs to adjust, just like your microbiome maybe needs to shift a little bit. Okay. So we have to give it time. But a lot of times, people will notice their mouth actually feels so much healthier once they get off that foaming. So. But if you do suffer from chronic ulceration, I would look at your toothpaste ingredients, rule out sls. I also would look toward do you have Crohn's or celiac or gluten sensitivity? Many people think gluten sensitivity, celiac. These issues, they have gut manifestations. A very small percentage actually do. Most are in the skin or we'll see in the gums or the mouth. So the mouth is one of the first places that we can diagnose celiac or Crohn's.
- [57:06]
A
The toothpaste that I use is called zebra, and that's the xylitol toothpaste. It doesn't foam or anything. And so when people try it, sometimes at first, when they're used to conventional toothpaste, that's like the number one thing that I get told in my DMs. They're like, I don't understand this. Nothing's happening. Like, it's not foaming. Like, I feel like it's not working. I'm like, you've got to get over this. Like, you will get used to it, and it is the best ever. And then once they're used to it, they're like, oh, I love this. But, yeah, I hear that a lot. And I'm like, you've got to get over that. It's just a marketing tool. Just like when you've got these chemical cleaning products that people are used to using, and they're like, well, my house is clean because I smell the chemicals. And that is a terrible sign. You should never be able to smell. Your house is clean. You should smell nothing.
- [57:45]
B
We know that we are over disinfecting everything. This is why asthma and allergies and eczema are up. We didn't want kids back playing in the dirt getting exposed to these microbes.
- [57:57]
A
But this is all marketing that your products have to smell or they have to foam or they have to burn the crap out of your mouth. Like, that's not how they're working.
- [58:04]
B
That's right.
- [58:05]
A
Some of the people that I know in my life, life, and I love them dearly, and they eat very clean. I know their diets. They are very, very good about Real food only zero ultra processed food. And they still have rank breath. So what is happening there?
- [58:21]
B
So there are people you can be on a plane or in close proximity on an elevator and you just have to like take a step back because it's that offensive. That's very likely. Periodontal disease is what you're smelling. Some people refer to, to it is kind of smelling like mothballs. I don't know if that resonates. So that's a big red flag that they have these bad gum disease pathogens, these periodontal pathogens that are the ones that can lead to Alzheimer's and dementia and all the things we talked about. So they really need to get worked up. They need to test their oral microbiome and there are direct to consumer tests now that you can test at home. You can just bypass your dentist.
- [59:02]
A
What are those called?
- [59:03]
B
Bristle is the one I really like. It uses shotgun metagenomics. It's has a really awesome interface for consumers, for people that maybe don't have a dentist that can read and interpret and even know what we're talking about right now necessarily. But you'll see, like is it, is it lighting up with these periodontal pathogens? My mother in law, for example, incredibly healthy. She's 82, she swims every day, she does yoga, she's plays pickleball. Like, like it's going out of style. She's a farmer by choice. It's kind of just her hobby. So she walks like literally 30,000 steps a day. She's incredible. She can plank long than I can. Wow. I tested her and she had, she had great checkups at her dentist and she was really high in F. Nucleatum. F. Nucleatum is a bacteria associated with colon cancer. She has a history of colon cancer in her family. So I did a whole protocol on her to eradicate that. And you never get it to zero necessarily. But we reduce her pathogen load significantly. She never would have known had we not tested her microbiome.
- [60:04]
A
How'd you do that? Lessen the pathogen oxygen load?
- [60:06]
B
The protocol I used with her, we use hypochlorous acid, which was a, is a rinse. We use baking soda in a water pick. I upped her nutritional level. We used prebiotics and probiotics that I knew were targeting her oral microbiome and her gut microbiome too. So that was a more gentler approach. And then I wanted to retest before I did antibiotics. Had it not moved, I probably would have done antibiotics in her. But it Actually did shift her that protocol. And a lot of it was, I think the interdental washing, water picking. With some of these agents, you could use iodine. People use ozonated water, ozonated gas. Different functional dentists will do laser therapy too. That can help with, with gum healing. You can use oregano oil, colloidal, silver, just you want some sort of antimicrobial, but not for too long. And this is where essential oils can be really beneficial too. But again, not forever. This is an acute issue. So we want to just use them for a set amount of time and then kind of move away from that.
- [61:06]
A
Why do some people get more plaque than others?
- [61:09]
B
That can be dehydration, Certainly it can be hygiene. Okay, let's assume it's not. So that can be dehydration, that can be mouth breathing, that can be mineral deficiencies. And also if they eat a high carbohydrate or fermental carbohydrate diet. So again, people who tend to eat paleo or carnivore or they're not eating a lot of carbohydrates, they're not going to get plaque. They really don't have plaque. It's the biofilm is created when those bacteria which eat fermentable carbohydrates, they thrive and they flourish and they can grow and they're sticky and they stick to your teeth. And so people who eat a lot of these foods, breads and pastas and cereals and chips and crackers and all that, they will tend to get more of plaque.
- [61:54]
A
There's that nursery rhyme about that old lady who lived in a shoe. And I always think, what was happening in that shoe? You know, it smelled insane. No ventilation, 30 kids. Probably one bar of soap from 1912. That woman needed dry shampoo. She needed help. And that's why I love Primally Pure. Because some of us are trying to avoid living in a metaphorical shoe. They're all natural. Dry shampoo is elite. Second day hair, third day hair. You apply a few shakes right at the roots, blend it with your fingertips and. Or a makeup sponge. You can also sleep in it for extra like cleaning while you sleep. And then you wake up and you look brand new. It uses oil absorbing clays for texture and volume and organic essential oils that actually support a balanced scalp and healthy hair growth. No chemicals, real ingredients. So if you want peak performance, apply Primally Pure Dry shampoo before bed. Let it absorb overnight. They even have one for dark hair with organic cocoa powder. So brunettes aren't walking around looking like George Washington, which has happened to me before. And yes, blondes, you're covered too too. I cannot get enough of their natural lip balms by the way. That's another thing. If you haven't tried it, leave a trail of them everywhere I go. The car, the purse, the studio. I successfully broke my lineage addiction with these. Laneige is terrible for you. These are amazing. These are so much better because you ingest whatever you put on your lips. So why are we eating synthetic fragrance all day? And oil byproducts? Primally Pure's lip care is clean. It's nourishing. It actually works. They're Christian and conservative owned, small batch, toxin free. Their gift bundles are a great way to try out their stuff if you've never never had them or you want to bless somebody on their special day. They've got barrier supporting tallow balms, cult favorite natural deodorants, clean candles. Gifts that are thoughtful in luxury without a luxury price. Use code Alex Clark@PrimlyPure.com for 15% off. That's code Alex Clark@PrimlyPure.com For 15% off Listen up you sad caffeinated skeletons. Modern life is sucking the B vitamins right out of you. Stress, caffeine, hormones, low sleep, restrictive diets, WI fi everywhere. It all depletes B vitamins. Add in years of birth control, intense workouts, alcohol or gut issues and suddenly your body is waving a tiny white flag. And how does that show up? Well, fatigue that you can't fix with coffee, brain fog that makes reading emails feel like advanced calculus, mood swings, anxiety, hair and nail problems, even low sleep quality. Some of us are walking around thinking that this is normal. It is not. Your body is screaming for help. This is why I take Utsy Naturals B complex every day. It's family owned. It's us made with clean filler free ingredients sourced from their own 100 acre herb farm in Wisconsin. Totally clean. They are the best people. All their supplements come in beautiful glass bottles too. Yay for less. Plastic supplements and vitamins from Utsy Naturals are my number one choice. Start with their high quality BE complex. Also pair it with the youune if you want full coverage for your immune system. Youun is two little capsules that I take daily when I'm traveling during cold and flu season or I'm just going to be around lots of people. It is my secret weapon. Get all your clean supplements without nasty fillers@utsy.com utzy.com utzy.com use code alex that's utzy.com utsy.com code alex to save on all of your clean supplements. What are the top catastrophic mistakes that parents are making when they find out that their child is a mouth breather?
- [65:09]
B
Panicking. Take a breath. I do see this a lot. I'm so thankful for social media, for educating, but I do think it's can elicit a lot of fear and anxiety and moms who all, you know, we just care about our babies more than anything and sometimes I think we're looking for something to be wrong, but maybe it isn't or, or we want it fixed immediately and that isn't always available. And so just take a breath. I think ignoring it is also equally as bad. You know, I was actually when I flew down here, there was this little two year old next to me. When she finally fell asleep, asleep, she was snoring so loud, her mouth was wide open. The first thing I thought is my goodness, she has inflammation somewhere and is a chronic mouth breather. And the parent, you know, a lot of times we think that little snoring is so cute and we just dismiss it. And this happened with my own daughter. This is why I became an airway focused dentist. My daughter, who's now almost 13, was just like that little girl and I didn't even know, I didn't, I didn't even see it. And then I look back at photos and every photo her mouth open. This is how I went on my airway journey and got more certifications and trainings. So don't ignore it. Any amount of snoring really isn't typical. Of course if your kids are sick, it's going to be different. You know, they're going to be breathing through their mouth, but they should get back to nasal breathing. And so if it is chronic, try to find the why. When young, young kids, where is the inflammation coming from? Like if someone says their adenoids are big or their tonsils are big, I want to know why. Why is the why is that inflammation happening? Listen, not just go straight to surgery. Magnesium deficiency, iron deficiency, vitamin D deficiency can all impact sleep quality, quality and even how we're sleeping. It can be structural. Do they have a high narrow palate? Do they have a missed tongue tie? Do they have low tone? I, I really love body work, like chiropractic work and cranial sacral work can really help too. It just, it. There's so many variables about airway that we need to work up, but I don't want parents ignoring it. And then the other thing I think is buying appliances online without any work up because they want to have a solution. But I caution you, any appliance out there that says they're the, the gold standard we just spoke about earlier, nothing is one size fits all. We're all different. And so what might work for one child may not be what your child needs. And so this is why trying to find somebody who is trained in this to, to get you on the right path is my recommendation.
- [67:39]
A
What age is imperative to act on correcting mouth breathing in your kid as
- [67:43]
B
soon as you realize it.
- [67:44]
A
Okay, so like, is there like a too young age? Like, they're two years old, is that too young?
- [67:48]
B
There are always things that you can do, but it h. It. It's strategic. So in an infant, for example, if they're having a hard time latching or breastfeeding or they're mouth breathing, well, that is where we can work with an ibclc, a lactation specialist. Maybe we can get some body work done, or maybe that there is a tongue tie that we need to address. Okay, so that's kind of the young, young years. Then as they get older, you know, if it's chronic mouth breathing or is it low tone, is it low muscle tone? And there are appliances, something called a myo munchie, which literally is helping with muscle tone. That's kind of it. People want it to change the shape of the skull and the jaws, and it doesn't really do that. It might a little bit, but it's very hard to correct. Generations and generations of human skulls shrinking. So I'll go on a little tangent here. So just like ancestral humans that didn't have cavities, we also didn't have so many airway issues. We had nice broad, wide jaws. We didn't have crowding. Okay, again, look at that skull. The next time you go to the Natural History Museum. The teeth are so straight, the wisdom teeth have room. Why was that? The anthropologist theorized it's because we used to chew for hours and hours a day because we were foraging. Okay. Now we chew for minutes a day. So that act of mastication, or chewing, it actually pushes everything out. This starts with breastfeeding, but it lateralizes. It grows the face broad and wide. Now it's been 12,000 years of not much chewing. And so you can't undo that amount of time. We're kind of dis. Evolving. And James Nestor speaks about this, who I believe you've had on your podcast before, that the human face is shrinking. Instead of broad and wide, we're growing long and narrow, and that not only creates crowding, but it makes our sinuses shorter. It can deviate the septum and you just lose all this beautiful, beautiful real estate for airway health. If your child truly has skeletal issues, we do like to get little retainers in there to help grow the face wide and broad and expand. They're called expanders. The palette. This all has to be timed on when it's appropriate for your child. It has to do with their behavior, it has to do with their need. But we do know most facial developments done by 10. Okay, so when do I like to start? I like to start the conversations as soon as I meet the child. Maybe they need to see a chiropractor, cranial sacral therapist. Maybe they need to see a myofunctional therapist. And we do a functional orthodontist where I am, thank goodness. But most children won't tolerate these appliances till they're about four or so. And so between four and six or seven, I definitely want to get started. And there are silicone appliances which I see marketed a lot. I, I think those are good, not great. And they're case dependent. Most kids who really are constricted, they do need a little bit more more. And they can be removable appliances or fixed appliances. And again, this is not one size fits all. So this is why you really should be working with someone who you trust and who has the training.
- [70:48]
A
What is worse, pacifiers, thumb suckers or sippy cup users?
- [70:52]
B
They're all not great for oral development. It all has to do with intensity, duration and frequency. So if you just passively set your thumb in your mouth and then it falls out, out, probably not a big deal. But if you're like Maggie Simpson, like, you have to pop it out a lot of force and you do it all day long, those kids are going to have probably major skeletal deformities. So it just depends. Thumb's tricky because you can't take it away. You can take a pacifier away.
- [71:22]
A
What do you mean?
- [71:22]
B
We can't just chop it off? Chop it off. Pacifiers are fine in those early months, all right? It gives moms a break. And that's called non nutritive sucking. That's very normal. That's developmentally normal to have that, that sucking reflex that usually disappears around six months old. So I do like between six and eight months old up through a year. That is when I want you to take the pass right away if your child benefits from one. So if you're beyond a year, it's a, it's, we, we have to have a talk. I want it gone. Okay. So again, if you're listening, please don't panic, but some kids will go right back to the thumb. So then I, you have to think about why does this child, child have this sucking reflex pass a normal developmental point. Why are they still doing it? And a lot of times it's tongue tie. A lot of times it's like a neurocognitive reflex that didn't sync. So you can have something called retain primitive reflexes. And this is where chiropractors and cranial sacral therapists can come in. They can have muscle balance and muscle tone issues. So again, we want to get, get to the reason why. And it's hard to, it's hard to unpack. And so sometimes you have these conversations. But you can't expect like an overnight fix in your kids necessarily. But I think the biggest thing with pacifiers is please try to have it gone the latest by the age of one, ideally more six to eight months. Thumb is trickier some I really want to know the why are they a thumb sucker? Still pass those that month, that month of six months or so. And then sipping be cup. You know, I haven't seen a lot of issues with sippy cup personally. I mean we're taught that even in dental school we're taught like sippy cups are bad, but it's, it has to do with intensity, duration and frequency. Again. Okay. Yeah.
- [73:12]
A
Do kids just grow into straight teeth?
- [73:14]
B
Not usually. I, I, I have been surprised, but usually, if so in baby teeth, we should see space in the front, we should see space in between all the front teeth. If your child has no space, they might have beautifully straight teeth, but they're probably going to be crowded because adult teeth are bigger and wider than baby teeth. So I have been surprised before, but usually if I see no space in primary teeth or baby teeth or certainly if I see crowding already in baby teeth, they're going to be crowded and they usually don't grow into it.
- [73:45]
A
Are kids losing baby teeth later than they used to?
- [73:48]
B
I see it both ways. I actually see it, it kind of the opposite that they are losing them earlier and just like they're getting menses earlier and they're going through puberty earlier. And I blame endocrine disruptors. And I have a concern like when kids lose teeth really, really early. It's, it's, it makes me a little uneasy. Like why, why biologically are they doing this now? There are variables to everything, right? And so when did your child first, first get their, their first baby tooth? Most get them around six months old. Was it earlier? But it's just something to think about. The endocrine disruptors are concerning now. If it's late sometimes that can be, not always. Don't panic. It can be a sign of thyroid imbalances too.
- [74:33]
A
Okay, we know about airway and palate expanding devices for kids, but is there a device for adults?
- [74:39]
B
Yes, there is. There are different devices. There's one I really love called a marker. Marpy M A R P E. So back in the day, if you wanted expansion, you usually had to have jaw surgery. It's very invasive and with fluid with side effects and questionable outcomes. So a marpi, it's not, not invasive, it's just less invasive. So it's little mini screws, they truly are tiny that go up in the palate. We used to think an adult palate can't expand, but we know now it can. And I've seen incredible cancer cases with this. So you, but you have to find someone who knows what they're doing. So it's called a marpy. There's something gentler called an ALF appliance and a lot of cranial sacral therapists and chiropractors like this. But it's slower moving and you don't get as much skeletal change. I, I, I don't think as you do with a marpy per se. So it, again, it just depends on what do you need, how, how much change you need. Homeo block is something that's been used before an adult. So there are ways to fix your airway issues too, as, as an adult. And I really suggest that people look into that, that, you know, the book Breath by James Nestor will definitely motivate you. We are still so young. We're living longer lives. And I really believe the most important foundational way to achieve health is how we sleep and how we, we breathe, period. More than food, more than exercise, more than anything, it's that restoration and it's oxygenation. Okay. Once you get your airway fixed, once you get your sleep fixed, so many of your health issues may not go away, but they'll get a lot better.
- [76:23]
A
Everybody is looking to reshape their jaws. Okay. This is a huge epidemic. You've got teen boys on tik tok who are hammering their jaws with hammers right now.
- [76:33]
B
I don't know if you've seen that.
- [76:34]
A
Yeah, they're trying to like break their jaws into being like, you're joking. More.
- [76:39]
B
I Don't know.
- [76:40]
A
Sexier, I guess. So crazy. Yeah. It's a huge thing. And then people are loving mouth tape.
- [76:46]
B
Yes.
- [76:47]
A
So I want to know if mouth tape actually works to change the shape of your jaw.
- [76:51]
B
I mouth tape every night and I have, gosh, maybe for five years. And I do it because my jaw, during the day I don't mouth breathe, but at night when I relax, my jaws aren't lined up appropriately. And I had a really terrible bike accident when I was 10 and I have facial trauma. I'm kind of a mess, so I'm not going to go through jaw surgery. So I mouth tape because it just makes my lips not come apart and I breathe through my nose and I wake up feeling like a million bucks. And I love it. Once you're an adult, it's not going to change your face shape. Like in theory, maybe in kids. But I don't want everyone just going and taping their kids. The kids need to be cleared that they don't have airway obstruction too. But you can tape a child over the age of. Of 3. But please work with an airway focused dentist.
- [77:38]
A
I have a friend who mouth tapes her kids.
- [77:39]
B
Yeah, I.
- [77:40]
A
They have an airway dentist and all that.
- [77:41]
B
Yes. I mouth taped my daughter as we were unpacking her. Other issues because I. We have one chance to grow a brain. Okay. When you breathe through your mouth, you get 20% less oxygen to the brain. You. It impacts your hormones. So growth hormone is released in deep restorative sleep. You'll see more bedwetting in kids who mouth breathe because antidiuretic hormones hormone helps you not pee during the middle of the night, is released in deep restorative sleep. So I want kids breathing through their nose. It releases nitric oxide, which we talked about earlier. That helps with inflammation, cardiovascular health. Your nose filters, it humidifies it, it has immune cells in it. It's really important to breathe through your nose. So I wanted her breathing through her nose as we were trying to unpack some of the other things, expansion, myofunctional therapy, etc, but we had to make sure her nose wasn't blocked. Okay. And so that was really important. So I would say melt tape doesn't really change the shape. I don't want anyone hammering their face. Please. I. The first thing I'm going to do when I leave this podcast and I'm going to look that up because I haven't seen that one. You know, I hear, I see people mewing.
- [78:48]
A
It's all. It's the same group.
- [78:50]
B
Yeah.
- [78:50]
A
Now they've moved on to hammering.
- [78:52]
B
Okay, well, all right. Yeah, I don't know what to say about that. I mean we're dealing with, with this, the skull and the jaws and the muscle. So there's, there's soft tissue and hard tissue. So hard tissues, bone and teeth and soft tissues, muscle, lymphatic system and myofascial adhesions and things. So I think a lot of this is just trending and won't have a lot of long term benefit.
- [79:21]
A
Is it better to brush your teeth before or after coffee?
- [79:25]
B
This really confuses people. Everybody wants exact protocol protocols with like the morning routine especially. I get hammered on this on Instagram a lot. So I want people brushing their teeth. Whatever works for their schedule. Aside from the fact that anytime we eat or drink, especially coffee, our mouth is acidic. Okay. Just like how he's talked about vomiting, your mouth is acidic. So you have lost some minerals in your teeth. Your enamel is a little bit weaker. This is normal. This is part of the digestive process. This is demineralized. Your saliva, if it's healthy, is going to remineralize those teeth and it will be fine. But we have to give it time to do that, which can take 20, 30 minutes, up to two hours. So if you're going to brush after, please don't do it immediately after. Because your enamel is weaker, the bristles from your toothbrush could be damaging your enamel. So wait 20 or 30 minutes and then you're safe.
- [80:22]
A
I am somebody that likes to brush my teeth after I eat. Yeah, that grosses a lot of people out. But a lot of people are like, I. The first thing I do when I wake up, I have to brush my teeth. I can't stand it.
- [80:30]
B
And I'm not, I, I'm not either. And it's, this is one of those things. I again, I get hammered on it because people want an exact answer and I'm like, it's different for everyone. You do what works for you. I just want you brushing in the morning. I don't need to brush my teeth right away because I'm also nasal breathing. So I find mouth breath breathers want to brush right away because they have like this biofilm and their mouths dry and they just kind of feel gross when they wake up. I don't feel that way because I'm breathing through my nose. You know, my lips are closed all night. So I tend to brush after breakfast too. But I wait, I wait a little bit after I eat 20 or 30 minutes. I'm not timing it, by the way, like, these are general protocols, right? But I don't brush right away because I don't want to damage my. My enamel.
- [81:17]
A
Are electric toothbrushes always better or are you concerned about the microplastics? Because they're usually plastic bristles.
- [81:24]
B
Well, all toothbrushes really are plastic bristles.
- [81:26]
A
So what do you use?
- [81:27]
B
I use a normal toothbrush and I know I can't take out all the microplastics in my life.
- [81:33]
A
So you're not using an electric.
- [81:34]
B
I use electric. Yeah. Yeah, but all toothbrushes are plastic. I mean, there is bore. I think it's boar hair you could use. Exactly. So you know what I mean.
- [81:45]
A
I don't know about that.
- [81:46]
B
Elephant eyelashes. I don't know. Like, again, if that is a huge concern for you, I get it. But I also don't believe in. I think perfect's the enemy of good. So I try to eliminate plastics from other areas of my life. Like, I don't eat out of plastic. I don't drink out of plastic water bottles if I can help it. Of course, if I'm traveling, there's nuances to these conversations, but. But I like electric toothbrushes.
- [82:13]
A
Let's do some rapid fire questions.
- [82:16]
B
Okay.
- [82:16]
A
Charcoal toothpaste. Helpful or harmful?
- [82:18]
B
Harmful.
- [82:19]
A
Oil. Pulling. Legit or placebo?
- [82:21]
B
Legit.
- [82:21]
A
Tongue. Scraping. Fat or essential?
- [82:23]
B
Essential.
- [82:24]
A
Xylitol Gum. Every day? Yes or no?
- [82:27]
B
For how long? How long are you chewing it?
- [82:30]
A
Let's just say 20 minutes.
- [82:33]
B
Too long? No.
- [82:36]
A
Salt water rinse Is underrated or useless?
- [82:38]
B
Underrated.
- [82:39]
A
Coconut oil for teeth. Yes or no?
- [82:41]
B
Yes.
- [82:42]
A
Dry mouth at night. Harmless or dangerous?
- [82:44]
B
Dangerous.
- [82:44]
A
Can people hire you as their dentist?
- [82:47]
B
Yes, I'm still taking new patients. I'm working Portland, Oregon. I was doing online consultations, but I had to pause for a moment because I just couldn't keep up with it. But the good news is we are training more people to think, hopefully in practice, like I do and others like me at the Institute for Functional Dentistry. So many people maybe have heard of the Institute for Functional Dental Medicine. Functional medicine's foundational. It's definitely what dentists don't receive. And so we are trying to get a little army of dentists globally out there thinking and practicing this way from a systems biology approach. And we just launched. So stay tuned. But soon there's going to be a database where you can find dentists that practice from a functional mindset.
- [83:30]
A
What's your Instagram?
- [83:31]
B
It's @Doctor spelled out Stacy with an I.
- [83:35]
A
If you could offer one remedy to heal a sick culture, physically, emotionally or spiritually? What would it be?
- [83:41]
B
I would say prioritize what brings you joy. I think we're missing a lot of joy from our lives and we're running amped up and with so much anxiety. And just remember, it's your community. It's the people you surround yourself with that can have profound health benefits too. And don't forget to have fun.
- [84:02]
A
Well Dr. Stacy, I'm so excited to have you on Culture Apothecary.
- [84:06]
B
Thank you Alex.
- [84:06]
A
Thanks for coming out. I've got to meet you for the first time when we marched at Kellogg's, so it's been a long time coming. The last year has been insane and so I'm happy that you finally came on.
- [84:17]
B
Thank you for having me. It was really fun.
- [84:21]
A
What toothpaste do you use? I'm so curious. Now leave a five star review and let us know. New episodes come out every Monday and Thursday at 6pm Pacific, 9pm Eastern with new expert guests. Anywhere you get your podcast, you can find the show on Instagram at Culture Apothecary and me at Real Alex Clark this content is for informational purposes only and is not intended to be taken medical advice. Always consult with a qualified healthcare professional regarding any questions or decisions related to your health or medical care. I'm Alex Clark and this is Culture Apothecary.