How GLP-1s are Affecting Your Smile With Dr. Andi-Jean Miro

Summary

Gloss Angeles Podcast Summary

Episode: How GLP-1s are Affecting Your Smile With Dr. Andi-Jean Miro
Hosts: Kirbie Johnson & Sara Tan
Guest: Dr. Andi-Jean Miro, Cosmetic Dentist
Date: June 12, 2026

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Episode Overview

This episode dives into the intersection of dental aesthetics, oral health, and some of the hottest current wellness trends—most notably the use of GLP-1 medications (like Ozempic) and how they are affecting our smiles. Hosts Kirbie and Sara tap their own dentist (and jet-setting, in-demand cosmetic expert) Dr. Andi-Jean Miro for an energized conversation about oral hygiene routines, veneers, facial structure, TikTok dental trends, dry mouth, and how beauty, health, and diet intertwine at the level of your teeth and gums.

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Key Discussion Points & Insights

1. Essential Oral Hygiene: What Most People Miss

[01:30–03:58]

• Dr. Miro’s Core Recommendations:
  • Brush and floss twice daily
  • Switch to an electric toothbrush
  • Introduce tongue scraping for fresh breath and a healthier tongue
  • Try different tongue scraper types, but the material isn’t as important as consistency
• Dr. Miro:
  • “The mouth is the gateway to the body...the more we keep sugar on our teeth, the more cavities we're going to get, the more problems we're going to have.” [01:55]
  • Your tongue “recycles every 90 days,” so don’t worry about over-scraping. [03:35]

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2. How the Mouth Reflects Total Health

[04:41–06:48]

• Dentists can spot signs of overall health, acid reflux, eating disorders, or grinding just by examining the mouth.
• Stress is leading to more teeth grinding, causing facial changes and dental injury.
• Poor oral health can correlate with heart and circulatory system issues.

Quote:

“If you have problems in your mouth, you are going to see them in your heart, in your circulatory system, you’re going to have elevated numbers when you run your blood test… The mouth is really the gateway.”
—Dr. Miro [05:46]

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3. Anti-Aging & Cosmetic Dental Approaches

[06:23–12:28]

• Dr. Miro’s cosmetic dentistry focuses on using veneers and reconstruction to restore lost tooth structure and “reverse the clock”—especially in the lower third of the face.
• Dental treatments can often provide more immediate facial rejuvenation than facelift surgery.
• LA veneer prices range from $2,000 to $6,000 per tooth; total smile makeovers typically require at least 10 teeth.

Quote:

“What I do is I add height to the teeth… it restores the height and the volume in the lower third of the face. To me, this is the secret sauce that people are not talking about.”
—Dr. Miro [10:49]

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4. Hydroxyapatite & Enamel Remineralization

[09:13–10:33]

• Hydroxyapatite is trending as a remineralizing and whitening ingredient in toothpaste and oral care.
• Dr. Miro supports its use to “put fluoride and calcium back in the tooth” after bleaching.

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5. Diet, Drinks, and Erosion: The Acid Problem

[07:04–09:10]

• Coffee, matcha, and other acidic drinks erode enamel, leading to persistent wear and dental problems.
• Pro tip: Rinse with water after acidic drinks before brushing to neutralize pH.

Quote:

“Water first...Before we go in with a toothbrush… we want to neutralize [the acid]. We want to drink some water, get that back to normal.”
—Dr. Miro [08:21]

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6. Orthodontics: Braces, Invisalign, and AI

[17:14–23:05]

• Adult orthodontics (braces/Invisalign) are on the rise.
• Dr. Miro is cautious with Invisalign unless patients can wear them 23 hours a day and suggests fixed (especially lingual/inner) braces for faster, more reliable results.
• AI is increasingly used in dentistry for both patient education and in professional tools.
• Patients are using AI-generated images of “ideal” smiles, but Dr. Miro warns about differences between 2D images and real outcomes.

Quote:

“Invisalign is not going to like me, but… braces is a little bit more predictable in its movement. Invisalign, you can wear… and a year later we’re still going through revisions.”
—Dr. Miro [17:40]

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7. GLP-1s (Ozempic, Wegovy) & Your Smile

[23:05–28:13]

• Significant increase in patients on GLP-1s seeking dental care.
• Side effects: facial fat loss (“snatch look”), skin sagging, diet changes, erosion, dry mouth, increased risk of cavities, and more need for reconstruction.
• Less chewing/eating leads to more food stuck in teeth, decreased salivary flow, and higher cavity risk.
• “Zoom effect” post-pandemic: people more focused on smiles due to video conferencing.

Quote:

“The longer that you’re on these GLP-1s, the more side effects…especially when it comes to your volume in your face. [And] we’re seeing more erosion and wear and grinding. All of these things are just a recipe for disaster when it comes to your oral health.”
—Dr. Miro [23:40]

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8. Bad Breath, Medications & At-Home Solutions

[30:16–34:26]

• Dry mouth from meds (including GLP-1s) fosters bacteria and cavities.
• Key tools at home:
  • Waterpik (water flosser): especially useful for those on drying medications.
  • Electric toothbrush.
  • Xylitol-sweetened gums and candies—non-cavity causing, but toxic to pets and can be a laxative in excess.
  • ACT mouthwash (alcohol-free) is recommended.
• Beware “electric flosser” overuse, which can lead to gum recession.

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9. TikTok Dental Trends: Legit or Lies (Rapid Fire)

[35:54–41:03]

• Oil Pulling: Hard NO—no substantial benefit seen.
• Charcoal Toothpaste: Hard NO—too abrasive, can erode enamel (“If it’s gritty, you don’t want it.”).
• Tongue Scraping: Big YES—advocating for it.
• Mouth Taping: Yes, can potentially help airway development; optional for bruxism.
• DIY Teeth Filing: Absolutely not—leave to the professionals.
• Hydrogen Peroxide Rinse: Cautiously OK, especially after surgery.
• Fluoride-Free Toothpaste: Fluoride is important in the right doses for strengthening teeth, especially for children; fluoridation makes a difference.

Quote:

“Dentistry should not be one of [the procedures] you do abroad.”
—Dr. Miro on dental tourism [12:48]

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Notable Quotes & Memorable Moments

• “Good dentistry is expensive. Bad dentistry is more expensive because it’s going to cost you [more] over and over again.” —Dr. Miro [12:48]
• “If you have cavities, you probably have something else going on in your body.” —Dr. Miro [05:46]
• “I like to call it a smile lift. When you do your teeth, you’re adding volume, and all of this portion acts like a rubber band. You stretch the rubber band and your lips start to show a little bit more. You need less fillers in the future as well.” —Dr. Miro [25:52]
• “Every patient is different, so there is no one answer for everybody.” —Dr. Miro [22:09]

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Practical Takeaways & Recommendations

• Rinse with water after acidic drinks—don’t brush immediately! [08:21]
• Electric toothbrushes and water flossers are highly recommended for most, esp. on medications. [32:14]
• Don’t DIY dental work (especially filing or “at home” TikTok hacks). [39:21–39:26]
• Fluoride and hydroxyapatite are both beneficial in toothpaste; charcoal and overly abrasive formulas are not. [36:54–37:54]
• Visit your dentist every 3–6 months—more frequently with dry mouth or meds. [27:53–28:13]

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Suggested At-Home Oral Care Upgrades (If You Have $100)

[41:14–42:22]

• Over-the-counter whitening strips (with proper remineralization after)
• Waterpik/Water flosser
• Electric toothbrush
• Alcohol-free mouthwash (like ACT)
• Xylitol-sweetened gums/mints for dry mouth

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Overall Vibe

The conversation is frank, fun, and informative with plenty of beauty-world context, social media anecdotes, and real technical wisdom delivered in Dr. Miro’s straightforward, approachable style. Listeners will come away with a clearer understanding of how trends (GLP-1s, dental TikToks, and more) are quietly changing the landscape of oral and facial beauty—and why your smile is more than just what teeth whitening can fix.

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For anyone considering cosmetic dental work, on a GLP-1, or just wanting better breath and brighter teeth: bookmark this episode!

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“Teeth in general have a massive effect on your overall appearance. And I think that more than ever, people are really conscious of this.”
—Dr. Andi-Jean Miro [25:52]

Transcript

[Narrator/Host]

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[Dr. Andy Jean Myro]

G l a m los angeles hi, kirby. Hi, sarah.

[Sarah]

Welcome to los angeles. We have a special guest here today, our personal dentist, Dr. Andy Jean Myro. We're so excited to have you. Thanks for coming.

[Dr. Andy Jean Myro]

Thank you for having me. I'm so excited for this.

[Sarah]

We know you're super in demand flying from LA to New York. We're very, very happy to have you here. We're going to talk all things oral hygiene, dental care, veneers, whitening, bad breath. We need to get into it. So let's start with walk us through what an actually good oral hygiene routine looks like morning and night. Like, what are most people skipping and not doing that? They absolutely should be.

[Dr. Andy Jean Myro]

You know, the mouth is the gateway to the body and a lot of people don't brush or floss the amount that they should. And I think one of the biggest things that you have to consider is how much the food you eat really can change your teeth. You know, now more than ever, we have sugar in a lot of things. And the more that we keep that sugar on our teeth, the more cavities we're going to get, the more problems

[Sarah]

we're going to have.

[Dr. Andy Jean Myro]

So I always say, you know, brushing and flossing two times daily is necessary. I've actually added in tongue scraping now and I think that, that I've seen such a big difference in my own breath and I recommend it to my patients. But being really good about having an electric toothbrush is always better than a manual. And being really good about daily, day and night, kind of being good in your schedule about how you are taking care of yourself is everything.

[Kirby]

What's your favorite tongue scraper?

[Dr. Andy Jean Myro]

You know, I've been trying a few different Ones I'm not, like, particular to one brand, to be very honest with you. I like to try different things, especially because I'm in this industry and my patients are trying all of the things. So I've kind of hopped around. I don't have one that I particularly love yet.

[Sarah]

Like the ones that, you know, you kind of scrape or the two. Two.

[Dr. Andy Jean Myro]

I like the two. Yeah.

[Kirby]

Okay, so the two handles, Copper.

[Narrator/Host]

Sure.

[Kirby]

Okay.

[Dr. Andy Jean Myro]

Works well. Some people don't like the copper, though. Some people prefer a different material. So I think it really just depends on you. But as long as you're doing it, I think that that's a positive.

[Sarah]

How do you know you're doing it correctly? Like, sometimes I feel like, did I scrape too much? Am I like, taste buds gone?

[Dr. Andy Jean Myro]

You know, it's actually funny. Your taste buds, they recycle every 90 days, and so you can't do this too much. I wouldn't worry about, like, over scraping. I think, if anything, just adding it to your daily regimen is. Is important. It's going to. You're going to see a big difference in your breath, and just the coloring of your tongue will change as well.

[Kirby]

Jaclyn Hill, very popular beauty influencer, posted a video recently where she talked about her oral hygiene routine and said, people are not taking care of their oral hygiene enough. You need to be flossing. And this is like table sticks. We're like, yeah, no shit. Like, we've heard this a million times.

[Sarah]

Yeah.

[Kirby]

But she was, like, going really hard on the tongue. Scraping. Yeah. And she said her biggest flex is that her tongue is pink. Like, if she stuck her tongue out, there would be no white, there would be no nothing. And I literally was, like, holding my. I was like, oh, my God. What do you mean? And it was. It was a flex to see a perfectly pink tongue on, like, an adult

[Sarah]

and not a baby or a child.

[Narrator/Host]

Right.

[Kirby]

So when you're looking at somebody's entire mouth, are you looking at their tongue and going, okay, the. The tongue is telling me a lot.

[Dr. Andy Jean Myro]

You know, that is such a good question. You can find so much information by just opening your mouth. I can tell about your daily habits. I can tell if you're drinking more coffee. I can tell if you have acidic foods. I can tell if you have acid reflux. I could tell if you have had an eating disorder. All of these things are present in your mouth. And I think one of the biggest ones that we're not talking about right now is how much people are grinding their teeth and the grinding of their Teeth actually has so much more repercussions. You see facially a lot of changes. As you grind your teeth, you'll see the masseters, that's this muscle right here, start to get bigger on one side. I think that just with the amount of stress our society is in post all of the world problems, people are grinding more than ever. And so we're seeing a lot of people come in with fractured teeth, broken teeth, we're recommending guards, we're rehabilitating people's mouths because the mouth is the gateway to the entire body. If you have problems in your mouth, you are going to see them in your heart, you're going to see them in your circulatory system, you're going to have elevated different types of numbers when you run your blood test. It is a very common thing to understand that if you have cavities, you probably have something else going on in your body. So the mouth is really the gateway. And I think so many people don't think about it, especially when it comes to beauty. They don't understand that if you change your teeth, you can change the way your face looks.

[Kirby]

Totally.

[Narrator/Host]

Yeah.

[Dr. Andy Jean Myro]

And that to me is kind of what I love to do. And the artistry of what I do as a cosmetic dentist, I can take somebody and I can reverse the clock. And that to me it's so much more powerful than plastic surgery because it can happen in a matter of two to three weeks. You can completely reverse the signs of aging if you reverse the signs of aging in the teeth in the oral cavity.

[Kirby]

I want to go back to health.

[Narrator/Host]

Yeah.

[Kirby]

You were talking about, you look at somebody's mouth and you can tell if they have things from an eating disorder to acid reflux. For women, specifically women, what is the most common issue you see in our mouths and what is that most commonly tied to health wise?

[Dr. Andy Jean Myro]

Again, it comes down to what you are eating and drinking. We don't think that the matcha and the coffee and all the carbonated drinks that we're drinking have an effect on our teeth, when in actuality, our teeth are the hardest structure in our body. And so we are putting acid on them. We are engaging in activities like vaping that changes the dynamics and the PH of our mouth. If you change that dynamic, you can get more cavities. I've seen a lot of patients, particularly in Los Angeles and New York, that have pitting of their enamels, little holes on the back of their teeth. And that comes from acid, acid reflux, acidic drinks, all of those things they're damaging in the long term, and people don't realize it.

[Narrator/Host]

Right.

[Dr. Andy Jean Myro]

You're sipping on your Celsius all day, and you don't realize the effects that it can have in the long term. The more that we get rid of our enamel, we can't get it back. And so for me, I look towards restorative options. I put veneers on, I put bonding on to restore the tooth to give it back to you.

[Sarah]

So if we are drinking our Celsiuses, I'm a big kombucha person. Coffee, matcha, what have you. Should we then just brush our teeth immediately after?

[Dr. Andy Jean Myro]

That's a great question. So many people get this one wrong. After you've had an acidic drink, you should be drinking water. Water first. If we have an acidic drink, we take our PH in our mouth down to the acidic levels before we go in with a toothbrush, which is actually like a hard medium, and start brushing our teeth. I think the biggest thing is we want to neutralize that. We want to drink some water, get that back to normal so that when we're brushing, we're essentially not brushing away the acid. That's a big one because a lot of patients come in that have had eating disorders that have had acid reflux, and my job is to give them back what their body has dissolved. Tough stuff, but really fun.

[Sarah]

No, that's good to know. So just like, rinse your mouth.

[Dr. Andy Jean Myro]

Rinse your mouth first before you're brushing.

[Sarah]

Okay.

[Kirby]

I have two questions. Yeah, I want to follow.

[Dr. Andy Jean Myro]

I love these questions, by the way.

[Sarah]

Grill you with all these questions.

[Kirby]

Dr. Andy, you mentioned enamel, and I've been seeing the rise in an ingredient called hydroxyapatite. Am I saying that properly?

[Dr. Andy Jean Myro]

You are.

[Kirby]

Can you tell the listeners a little bit more about what that is? Why we're seeing a lot more of it when it comes to oral care that you can get at the store and whether it's something that you personally approve of, Is it necessary?

[Dr. Andy Jean Myro]

So it's actually funny. A few years ago, my mentor, Dr. Michael Apa, came out with a product called Appa Beauty. And Appa Beauty, we had a whitening product, and we were one of the first in the industry to use hydroxy appetite to remineralize your teeth, but also to whiten your teeth. And, you know, hydroxyapatite is an important part of remineralizing the tooth. Essentially, it's putting a lot of the fluoride and calcium back into your tooth. And when you're bleaching your teeth, you're Essentially etching or using acid on your teeth to make it look whiter. The hydroxyapatite will remineralize the tooth, but make it look wider and make it stronger in the long term. So I fully approve of hydroxyapatite. I think we're going to see a lot more of that in the future and a lot more beauty products as well. So that's exciting.

[Kirby]

Totally. Okay, let's go back to anti aging via the mouth. What are some things that you're doing in your practice, whether it be through veneers or reconstruction, that's actually helping with things like maybe the lower to mid face. Would love to hear a little bit more about this.

[Dr. Andy Jean Myro]

So one of the things I specialize in is enhancing your smile, enhancing your face using porcelain restorations. You know, we get into this nitty gritty of like, what is a veneer? And do we have to drill a tooth down? When in actuality, in a lot of those cases where people have worn their teeth down, their lower third of their face is collapsed. And what I do is I add height to the teeth. Now a lot of times we have to do every single tooth in your mouth when we're doing this because essentially we are adding a little bit to each tooth. And what that does is it restores the height and the volume in the lower third of the face. To me, this is the secret sauce that people are not talking about. And I think the majority of people think that a facelift is what you need, when in actuality, if you get your teeth done, you and you do that other procedure, you're actually gonna see the max benefit. And we work with a lot of plastic surgeons, we work with a lot of incredible celebrities, incredible entrepreneurs that, you know, go through both procedures. And I think the immediacy of how quickly we can change your teeth, it's so much different than doing a facelift. A facelift is a year recovery. You do your teeth and you have them in under a month and you look younger, you feel younger, and it's very little downtime. And I think when you're looking to do something or enhance your face, I think when you deal with the hard tissue, which is the teeth first, you're going to have better soft tissue results with the plastic surgery every time.

[Kirby]

In la, a plastic surgeon quoting a facelift could be anywhere between 100 to 500k, right? We've heard it run the gamut when it comes to restoring your teeth or getting veneers. I know it is really dependent on the client in the case that you're working on. But can you give us a range of what people should be expecting in LA specifically?

[Dr. Andy Jean Myro]

You know, L. A, there's always a range. I always say good dentistry is expensive. Bad dentistry is more expensive because it's going to cost you. Over and over again, we're seeing the advent of people traveling abroad, going to Mexico, going to Turkey, and. And doing these beauty treatments abroad. Dentistry should not be one of them. And I think that, you know, people are looking for options because they can't afford the amount of dentistry that they need in LA. You know, it could range from something like $2,000 a tooth, all the way up to $6,000 a tooth. And when you talk about rehabilitating a smile, you're talking minimum 10 teeth. So I think, you know, that range will differ depending on the experience, how many cases that person has done. I think that dentistry overall is a really complex thing because you don't understand a lot about the person doing your dentistry. For many years, right, we've seen this. This old adage where people come in and they've been going to a dentist for 20 years and they have no problems. But then they come to see us and there's a lot of problems. And I think that that's why I educate dentists. That's why it. One of my passions is teaching this type of dentistry abroad, because dentistry will only get better if we all, as dentists, come together and align in our values for the patients. But dentistry is expensive. And I think, you know, when you're looking at these beauty treatments, like getting a facelift and you're getting quoted $350,000, is the extra $100,000 that you're going to spend on your teeth really make a difference for you? And at that level, I don't think. But I think that there's the right provider for everybody. And I really preach that if you're going to do this type of dentistry, it's a marriage, okay? I am with you from now till the next time you do these teeth, hopefully 15 to 20 years from now, and hopefully after that as well. And so early on in my career, I would take on patients that would stress me a little bit. And now I'm really selective about who I allow into our practice, because these people become our family. At our practice, we see them every three to six months. We see them go through life experiences. Getting married, getting engaged, getting divorced, having kids. You know, you build relationships with your patients and you grow with them. And I think that, to me, is one of the Most fun parts of being a dentist is no matter how much you do the same thing every day, the people are what makes it fun. Yeah.

[Sarah]

And I feel like when we had lunch, we were talking about this because I was asking like, you know, there are some patients that come in to see you and they're asking for like really unrealistic looking teeth. They bring in a picture of a celebrity. The face shape is totally different. If you put those teeth on this patient, you know, it would be giant, it'd be half their face. Something else you mentioned was you're seeing patients using AI to, you know, doctor up their teeth. They bring it to you and they're like, this is what I want. So how are you dealing with that?

[Dr. Andy Jean Myro]

Well, first of all, I'm obsessed with AI and I think I spend my weekends building apps for other dentists in AI for this reason. I think if you're not using AI, you are going to be behind in a few years. And it's, and it's happening really rapidly. I've had in the last couple of weeks, people come in with AI generated images of themselves and, and come in during the consult with that. And I think that's really interesting because I've always been anti renders. I think that a 2D render of something, it's not realistic in the same way that I would create your smile. There's certain limitations to that render and so I always caution patience. And I say, you know, that is a great example in the 2D world, but in the three dimensional world, I think we can get close to it, but we have to be realistic in our approach and we have to understand that there's a difference between these two things. But I think for educating patients, it's really great. I think it's probably more applicable in something like changing your hair color or, you know, that would be more realistic versus like, what will you look after a facelift in AI? I don't think that that's as realistic.

[Sarah]

A couple years ago I got braces for the first time, which I loved, and it was amazing. You know, like you said, it's life changing. I feel like I'm starting to hear more people get adult braces, clear liners, like Invisalign. I feel like I know so many people, especially in la, who are on that. Do you feel like more adults are getting braces now more than ever? And why do you think that is? If so?

[Dr. Andy Jean Myro]

Oh, this is going to get juicy, guys. It's going to get juicy. Dr. Andy is rubbing her legs like invisalign is not going to like me, but it's okay. So listen, there are different things about Invisalign that I love and there are things that I am frustrated by. Invisalign essentially is a company that provides aligners to dentists. It's up to the dentists to follow through and make sure that the teeth are moving the way that this computer is telling them. I have unfortunately seen many, many patients that were either non compliant with their Invisalign. Whether they've gone through it, they were compliant during it, but then didn't wear your retainers after, or they started Invisalign, but they can't wear it 23 hours a day, which is a lot. I know, because I wore it for a week and I was lisping and I was spitting on patients. And to me, that's not realistic. So if anybody is looking to do Invisalign, the thing that I do to them is I say, I'm going to make you this aligner, and for the next two weeks, I want you to wear it 23 hours a day. If you can do this, then we'll go down that route of doing braces. For me, I'm really doing pre restorative braces. So I will move teeth before I veneer them in. In order for me to be a little bit minimally invasive. That's my goal. I don't want to touch teeth. So if I can move them and then veneer them, I'm going to be way less invasive. Invisalign as a brand, and there have been many clear aligners, brands, you know, it's. It's become more popular because they're advertising it and patients are coming in and asking, you know, can this help my jaw? Will this make my jaw pain better? And in the right hands, in an orthodontist hands a specialist embraces. Yes. In a general dentist, hands really hard. Because you're not trained to move teeth. You're trained to fill cavities, restore smiles. And so I've always been somebody that if there's a specialist in a particular niche, I'm always going to refer to them. I use braces more than I use Invisalign. Braces is a little bit more predictable in its movement. Invisalign, you can wear Invisalign and the doctor, and I'm sure that maybe you've experienced this, they'll say, oh, it's going to be three to six months, and then it's a year later and we're still going through These revisions, the way that I see this as a problem in my patients. When you start the Invisalign or you start the braces and you don't finish it, you've already committed to wearing retainers for life after I do your restorative work. So if I do your veneers and then you don't wear your retainers, your teeth will shift. And so, you know, I think when people are looking to do this type of cosmetic work and you're looking to feel better about your smile or something in your face, I think the biggest thing is understanding what is the right option for you based on what you have. And I think going for consults in different places will help you develop that idea.

[Sarah]

So do you recommend outer braces? So I got in inner braces.

[Dr. Andy Jean Myro]

I like the inner braces.

[Sarah]

Do they exist anymore? Because the company that I got them through, I think they went under. So I don't know.

[Dr. Andy Jean Myro]

I'm not surprised. It's a little bit more rare to get the ones that are on the inside.

[Sarah]

Right.

[Dr. Andy Jean Myro]

But in my clientele, that is something that is the most important thing. We want to do these beauty treatments, but we don't want the world to know about it. And so for me, lingual braces, where they put them on the inside of your teeth, is a great option. We do it a lot with actors and actresses that are filming. They can't be walking around with retainers in their mouth. And so I think that a face fixed option for braces is always better than something that will come in and out. It's on your teeth. You're going to have more success in a faster amount of time with fixed braces versus something like Invisalign.

[Kirby]

I had braces growing up. Yeah. Only on my top four teeth. I also had a herbs appliance to fix my bite. I had a overbite. So, okay, bars, all the good stuff is the only option if we needed a second round, is to do braces.

[Dr. Andy Jean Myro]

Not necessarily.

[Kirby]

Okay.

[Dr. Andy Jean Myro]

I think that there is definitely a group of human beings that do braces three or four times, like in their lifetime. I think the patients that I will see are patients that do braces three or four times, and then they're just not getting the result that they were promised. That's hard for me because you've invested all this time, all of this energy, you've moved your teeth many times and now you're still at this point where you hate your smile. Now the only option is to veneer things or put something over your tooth. I think, you know patients, and the beauty of what I do is every patient is different, so there's no one answer for everybody. I think that if you're doing braces, there's usually a reason. What are you hoping to achieve? Is it just alignment? Is it positioning your teeth so that facially you look different? I think those things will determine which route I take on a patient down.

[Kirby]

Truly, GLP1s are everywhere right now. Everyone's taking them for one reason or another. Right. And whether you agree with that or not, listeners, they're a thing. And I'm sure that you see a lot of that come through in your practice. So are you seeing that impact on your patient's oral health, like dry mouth, enamel erosion, changes in diet? Like, what would you want people on a GLP1 tirzepatide, semaglutide, whatever it is? What would you want them to know about their oral health?

[Dr. Andy Jean Myro]

I'm gonna tell you this, and I think you will now notice it more in the general public. People that are on these GLP1s, the first sign of. Of actual IT working, you're gonna see your face start to get a little skinnier. You're gonna see your cheeks, especially in this area right here, start to go in a little bit. What happens when you're on these GLP ones is you're losing cheek fat, you're losing collagen, you're losing elastin, and you're going to start to get this little bit more like, you know, snatch look. But what that snatch look does is it makes you look older, your skin starts to sag, you start to have a little bit more extra skin. And so we're seeing patients in their 40s getting facelifts, and I think that that will continue. The longer that you're on these GLP ones, the more side effects that we're seeing for them, especially when it comes to your volume in your face. Now, when we start to look in your mouth, there's a lot of. A lot of things that we're seeing as well. And I think, you know, erosion is a big sign of this. People are eating differently. They're eating different foods. The foods that they are eating might not be the best foods when they're eating them. And we're seeing more erosion and wear and grinding. All of these things are just a recipe for disaster when it comes to your oral health. And so what I do essentially, is I'm building the teeth outwards. I'm adding volume to the teeth to essentially add more horizontal Volume so that you don't look as vertical, you don't look as sunken in. This is going to be very prevalent in this next 10 years. We're going to see it more and more. And, you know, we have more. GLP is coming on, on the market now more than ever. And I think the side effects of them are talked about a lot less than the benefits. Right. Everybody wants to lose weight. Everybody wants to feel good. I totally understand that. I understand why people come to see me, right? They hate something about their smile. They're talking to other people and they're covering themselves well. What I do is I give them a solution. I veneer their teeth, I change their smile, I change their volume. What's going to happen to all these people that have lost all this weight and then have these side effects? They're going to have more beauty treatments in the future. And so, you know, I just caution people because one of the biggest things that I look at when I'm doing the teeth is I'm looking at your face and I'm trying to enhance your face. And so if you are a little bit chubbier in your cheeks, I'm not building the teeth out a lot because it's going to make you look heavier. I'm actually slendering the teeth a little bit, trying to tuck them in so that it doesn't draw attention to the wideness of your face. You know, there's a lot that we can do with the position of the teeth that can affect that soft tissue. I like to call it a smile lift. When you do your teeth, you're adding volume. And all of this portion acts like a rubber band. You stretch the rubber band and your lips start to show a little bit more. You need less fillers in in the future as well. So, you know, teeth in general have a massive effect on your overall appearance. And I think that more than ever, people are really conscious of this. And I'm seeing a big boom post Covid of people coming in that were on Zoom for many years, and they, you know, have saved up a little bit of money because they were working from home during the pandemic. And we call it the zoom effect. When patients started coming in after the pandemic because they were staring at themselves in a camera in these meetings on Zoom for years. And I think it prompted people to do something about what they disliked.

[Kirby]

So I have a question, though. So obviously, like, you talk about the aesthetics and the reconstruction, are you able to talk about the oral hygiene of one's mouth if they are on a GLP1. I think, like, a lot of listeners are maybe not in the market to come in and get a smile reconstruction at this point, but they may be on a GLP1. So orally, hygiene wise, what should they recognize is going on in their mouth if they're on one?

[Sarah]

It's funny because when I was in the office and Charlene, who we love, was, you know, cleaning my teeth, we were talking about this, and she was like, I can tell because you're not eating as much, and then things get more stuck in your teeth because eating obviously helps kind of get those things out. Yeah. And so she was like, I can just tell immediately.

[Dr. Andy Jean Myro]

It can affect a lot of things, like your salivary flow. It can affect, again, erosion on your teeth. That's the number one thing that we're seeing. I think when you are eating less, maybe you're thinking like, oh, I. I didn't eat so much, so I don't have to brush. Maybe home care becomes second nature. I think if you're on these GLP1s, in general, whether you're on them or not on them, you should be seeing your dentist every three to six months. That is a staple. And I think some people in this world, you know, even getting their teeth cleaned is a big. A big venture. Like, either they're scared or they, you know, have had bad past traumas with dentistry and they're fearful that they're going to be hurt when they're in the chair. I think our practice and, you know, we. We have built this practice from being one practice in New York City to being four practices on two different continents. And I think it's serving a population of patients that are not just looking to enhance their smile, but they're looking to take really good care of their teeth. So I would say the first thing is an electric toothbrush coming in for your cleanings, making sure you have a dental office that is really noticing and notating things that are going on from treatment to treatment. So I don't know that you guys know this, but in your charts we have little watches on certain things. If we're seeing them. And the next time you come, we look at those things again, we make more notes. I think with the advent of AI, we're notating this even more. And so we're taking digital scans of people's teeth and we're seeing how much erosion or wear of the teeth is happening. I think in general, if you're wearing your teeth down, if you're a grinder, you should Be wearing a guard. You should be wearing a mouth guard. Now they have mouth guards with AI chips in them to see how much you are grinding your teeth. I mean, the possibilities are incredible right now in dentistry, and the options are even greater. So if you're not taking care of your teeth, I mean, in this day and age, with all the things that we have, I don't know.

[Kirby]

Okay, so Ozempic breath is something that comes up a lot where people are saying, oh, I see smell because I'm on these weight loss drugs, and then it comes out through my breath. What are the leading causes of, of bad breath, especially as you get older?

[Dr. Andy Jean Myro]

Well, one of the biggest ones is the medications that we're taking. You know, a lot of medications will cause dry mouth. Dry mouth will essentially foster bacteria growth. So if you don't have saliva, your bacteria that you put into your oral cavity, if you're biting your nails or you're putting food in your mouth, it comes with a certain level of bacteria, and saliva is what clears that bacteria out. So when we're on medications, a side effect of them is dry mouth. And so what we'll see is we'll see food staying on the teeth. The more food stays on the teeth, essentially, you're giving the bacteria sugar to create cavities. And so we're seeing more cavities and faster development of those cavities on patients that are on these medications as well. And that goes for all medications. Any medication that has a side effect of dry mouth, a lot of high blood pressure medications, diabetes medications, you will see these side effects in the gums as well. If you're on these high blood pressure medications, you'll see inflammation in the gums as well. So I think, you know, if you are on any type of medication, you should be going to the dentist. The frequency at what you go will depend on how much medications you're on. Are you more prone to those cavities? Have you had cavities in the past? These things also play a role.

[Kirby]

Obviously, going to the dentist is the best option, but, like, we need to hear some at home remedies. Okay, so what are we doing at home that can help with dry mouth? What are some things at home that we should be aware of if we notice that our gums are inflamed? Obviously, flossing is a big part of

[Sarah]

that, but we talked about tons. Tongue scraping?

[Kirby]

Yeah, tongue scraping. What, like, what can people do at home?

[Dr. Andy Jean Myro]

The next biggest thing that I love is a water pick. A water pick essentially replaces flossing. Everybody thinks that they're a great flosser, right? Everybody's like, I'm flossing. You guys are great because you have our amazing team that has taught you how to floss. But when in actuality, people are flossing wrong. And using a water flosser, essentially is shooting water into the in betweens of your teeth. Anything that you miss with the actual floss, you're gonna get with the water flosser. So I think for. For patients that are on these medications, you will see a big improvement in your gums with the water flosser as well. That would be a high recommendation, along with an electric toothbrush and obviously all the things that we've chatted about as well.

[Kirby]

How do you properly floss?

[Dr. Andy Jean Myro]

Oh, my God, I wish I had some floss right now. Should I get over there and start flossing? We were talking about this because I

[Sarah]

asked you, because I'm obsessed with my little electric flosser, and you were like, I don't know if that's cutting.

[Dr. Andy Jean Myro]

You have to be careful with the electric flossers because sometimes they vibrate, and you can actually put them into your in betweens of your teeth, and it will vibrate away the gum, and so you'll get recession if you do it too much. So it's like you can't do it too little, can't do it too much. You have to find the right happy medium with these things. But when it comes to flossing, essentially, people think you just go in and out, when in actuality, you have to go in and hug the tooth on one side, and then you come up and then you hug the tooth on the other side, and then you come and pull the floss up. And so I think that, you know, again, good knowledge of this, of how to learn, really comes from your practice, your. Your hygienist, your team. But for me, I think about the parents that I treat in my practice and trying to instill really good home care so that they can then teach their kids good home care. Because that really is the biggest problem and that we see now is kids with tooth decay. Rampant tooth decay from sugary snacks, Sugary foods like this will change the course of their life. If they lose teeth at an early age, it will change how their face develops, the amount of volume on their face, everything.

[Sarah]

Yeah, that's like Kate and Zoe have, like, five toothbrushes and, like, 10 toothpaste, because I want to make it fun for them. All the different colored flossers. Quick question. Tell Me favorite mouthwash or mints or gums that we can be using on a daily basis.

[Dr. Andy Jean Myro]

Yeah, I liked Act. Act is a great mouthwash. It doesn't have alcohol in it so it's not going to dry you out. You know, I like sugar free mints and sugar free gums. You really don't want to be chewing a sugary gum because again, it's putting sugar in your mouth and bacteria need that to create cavities. So for me I'm really focusing on lots of water for, for patients that have high cavities because you really just want to clear all of that out of your mouth as well. You know, there's a lot of also sugar free candies like that I'm seeing in the world now that will help kids as well. Sugar free candies that clean your teeth. That's what everything should be. There should not be that level of sugar in children's smell. Appetites. We're not built for it.

[Sarah]

Is it that with the xylitol, is that what you're looking for?

[Dr. Andy Jean Myro]

Yes. Xylitol is not going to cause cavities. So that type of sugar, the bacteria that cause cavities, it doesn't eat it. So xylitol is always better than a regular, you know, processed sugar.

[Kirby]

Just be aware if you have animals.

[Dr. Andy Jean Myro]

Oh, right, right.

[Kirby]

Oh, xylitophytes.

[Sarah]

Also, I was just thinking, doesn't it make you use the bathroom a lot if you eat too much?

[Kirby]

Does it?

[Dr. Andy Jean Myro]

It does.

[Sarah]

That's the sugar free candy at Trader Joe's.

[Kirby]

So don't like or your dog will die. Just. I'm just kidding. Obviously. Okay, let's go to rapid fire. These are some tick tock trends. Are they legit or are they lies? So we're going to run through a few of these viral dental trends, Dr. Andy, and you're going to tell us whether it's a yes or a hard no. First up, oil pulling.

[Dr. Andy Jean Myro]

Hard no.

[Kirby]

Why?

[Dr. Andy Jean Myro]

You know, I really, I'm learning more about oil pilling since I moved to LA because the trends between New York and LA are very different. The patients are different in their demands and they're definitely different in the things and the questions that they're asking. More and more of my patients are doing oil pulling. I'm seeing it more and more, but I'm not seeing that their mouths look substantially better than patients that are not. And so this is more just me in my practice noticing the difference. So I'm not sold quite yet, but I'm sure I could do A little more research on this, for sure.

[Sarah]

Okay. Charcoal toothpaste, guys.

[Dr. Andy Jean Myro]

No, hard. No. You know, charcoal toothpaste. One of the things about them is they have all these abrasive particles inside them. We don't want to brush our teeth with something abrasive. And so they actually have a measurement of how abrasive your toothpaste is. Because using a hard abrasive toothpaste toothbrush and an abrasive toothpaste, you can actually erode your teeth and wear away your enamel. And so for me, I'm always thinking about a softer toothbrush, a toothpaste that doesn't have those heavy particles. I love Sensodyne. I think Sensodyne creates great toothpastes. I think there's an advent of a lot more now coming on the market with less additives in them. I'm looking at those as well. But I think when you're looking at your toothpaste, you, if it is gritty, if you have a lot of grit in it, you definitely don't want to be using it on your teeth.

[Kirby]

Tongue scraping.

[Dr. Andy Jean Myro]

I'm becoming an advocate for tongue scraping. I'm loving it now.

[Sarah]

Okay, great.

[Dr. Andy Jean Myro]

Mouth taping while you sleep. This is a great one. So now more than ever, I'm looking at people's airway and the way that they breathe. Mouth taping is actually helping in the development of your airway, and so I'm not opposed to it. Just find a mouth taste that you like. Some of them completely cover your lips. Some of them have a little hole there. I'm a little claustrophobic. So for me, it's a no. But a lot of patients that I've worked with love it. So does it their own?

[Sarah]

Does it help with your grinding, too?

[Dr. Andy Jean Myro]

What it helps with is it helps to. To keep your lips together. It can help with your grinding. If you're a grinder, though, I recommend wearing some sort of appliance, because if you're grinding, it's a function of the way your masseters are, and we could put Botox there, but it's a temporary fix. Eventually, you'll continue grinding again. And so for me, I think the protection of a guard. You're grinding the guard versus grinding your teeth.

[Sarah]

So sorry. Do you wear a retainer and a mouth guard? Sometimes.

[Dr. Andy Jean Myro]

So you wear a retainer or a mouth.

[Sarah]

Okay, okay.

[Dr. Andy Jean Myro]

Retainer is typically thinner, and a mouth guard will be a lot thinner, thicker.

[Sarah]

Right. Okay.

[Kirby]

Okay. Facial fitness gum.

[Dr. Andy Jean Myro]

Oh, that's like chewing your gums and build up your muscles. I've heard of this before. I don't have enough experience with it, to be honest with you, but I am seeing it a lot on TikTok.

[Sarah]

Okay, I think we know we're gonna say DIY teeth filing hard pass.

[Dr. Andy Jean Myro]

Do not be taking a nail file and using it in your mouth. Let's just leave this to the professionals, guys.

[Kirby]

Listen, if Maxine, the squirrels keeper can take her to the vet, get her teeth filed down every four months and has amazing dental care, we can go to the dentist to get our teeth filed. We do not need to be doing that at home.

[Sarah]

Correct?

[Kirby]

Okay. Hydrogen peroxide as a rinse.

[Dr. Andy Jean Myro]

You can do it. I don't see bad side effects from this. A lot of times after surgery, we recommend this for patients. It's more of a homeopathic thing where we're just killing the bacteria that is sitting in the oral cavity.

[Sarah]

I see this a lot. I mean, Kirby and I get pitch this all the time, but I see this a lot too, with like kids, toothpaste and tooth products. Fluoride free.

[Dr. Andy Jean Myro]

Fluoride free. Here we go. I'm gonna start drama on TikTok. Fluoride is good in certain levels. You know, I come from New York where they fluoridate the water. And the idea is that we're giving kids that are underprivileged fluoride to help them make their teeth stronger. You know, tooth decay needs a couple of things to happen. Fluoride essentially will reduce the amount of tooth decay that you have. It will make your teeth a little bit stronger in the right doses. In higher doses, like if you're taking a tube of toothpaste and you're eating it, you can have a lot of bad side effects. But for me, a small pea size amount on your toothpaste is not going to hurt you.

[Kirby]

Great. Fluoride all way.

[Sarah]

Yep.

[Kirby]

Bring us the fluoride. All right. If somebody came to you with a 100 budget to upgrade their oral care routine, what would you tell them to buy?

[Dr. Andy Jean Myro]

Oh, I love that. You know, I think the over the counter bleaching strips sometimes get a bad rep. But I have found that if patients come in for a cleaning and then they use those at home strips, you're going to get a really nice result. Say you've, you know, can't have time to come into the office. Putting those strips on before you have an event will always make you feel a little better, make your teeth a little whiter. I have some patients that are called bleachaholics, you know, who you are that just are obsessed with bleaching their teeth, when in actuality, the more you bleach a tooth, the whiter it becomes, but the weaker it becomes. And so a lot of what I will promote with tooth whitening is just making sure you're using remineralization things after. So staying away from acidic foods after you bleach your teeth, that's a really big one because your teeth are the most porous that they are right now. If you have acid, you could actually erode the teeth faster. If you're whitening your teeth for like

[Sarah]

a week after I get my teeth whitened, if I drink coffee, I'm literally like chasing with water. So I'm just drinking coffee, chasing with water.

[Dr. Andy Jean Myro]

So proud of you. We've taught you well how, if you

[Sarah]

are using a crest white strips, which I know is like so popular, how often can you be using that?

[Dr. Andy Jean Myro]

So you can do it every day. I mean, obviously follow your instructions on the package, but it really depends. A lot of these companies, they'll say to you, you can do it once a day for an hour and do it for four days for the best results. So it really depends on the level of bleach that that strip has. And a lot of these over the counters, they're not going above a certain percentage. That's why you come into the office to get your teeth brightened, because we can put a higher percentage of bleach that gets faster results on your teeth.

[Kirby]

So amazing. Dr. Andy, thank you so much for coming on Los Angeles. We were thrilled to be able to pick your brain and hopefully this helped everybody listening and watching.

[Dr. Andy Jean Myro]

My pleasure.

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