← The Neuro Experience
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- [00:00]
A
I'm Louise Nicola, and this is the Neuro Experience. I found a study showing that women with gum disease take, on average, two months longer to conceive. But it gets worse. The bacteria P. Gingivalis has been found in placental tissue of women who miscarried. I mean, I'm talking bacteria in the gums of these women. I have received DMs from women who have spent years trying to conceive. And their reproductive endocrinologists are running every single test except for checking their oral microbiome or the oral health. So I need you to tell me right now, what's the link here?
- [00:39]
B
We are working on changing this. Like, imagine if fertility clinics were oral microbiome testing and asking couples about their oral health. That's really what we need to move toward. So the studies that you're referring to is from the University of Western Australia. And it looked at. It was a cohort study, and it looked at 3,800 women, and it did find, on average, it took about two extra months to conceive when women had active periodontal disease.
- [01:06]
A
So cohort is where they track them over time, correct?
- [01:09]
B
Yes. And so why is that? So periodontal disease is a chronic state of gum disease. And so that involves certain pathogens, P. Gingivalis being one of them. And there's something called leaky gums. We've all heard of leaky gut and intestinal permeability. But now I want everyone to think of leaky gums. So do your gums bleed when you brush and floss? That's a sign of inflammation. That's also now a way, a vector for this bacteria to get into the circulatory system, where they release exotoxins and have cytokine release, and they cause inflammation, they can cause DNA fragmentation, and it can impact our fertility, endocrine disruption. And this includes not just with women, but men also, it can impact sperm mobility, sperm motility, sperm count. And so imagine if we started looking and testing patients, oral microbiomes to see do they have these pathogens. And you wouldn't know necessarily until you test. And just like we're getting into gut mapping, I really would like us to move toward oral microbiome testing, too, because we know there's so much connection between the state of our mouth and the state of our other systems.
- [02:24]
A
A few years ago, I came across a study linking pingivalis periodontal disease to Alzheimer's. And we saw that it went from the gum through the vagus nerve and then into the brain, the vagus nerve is the tenth cranial nerve. And that's the idea that I know. But how are we seeing that pathogen go from the gum all the way down to the placenta or the ovaries and causing these issues?
- [02:48]
B
So the circulatory system is what we know as now in the lymphatic system. I would not be surprised if they're catching a ride on certain nerves as well, just like the vagus nerve with the brain. But it's not only the bacteria themselves, but it's their exotoxins, it's their byproducts that they release as well. So the cytokines interleukin 1, interleukin 6, TNF alpha, which cause inflammation downstream. And so it's not only the bacteria themselves, but it's the things that they create, and it's the things that their cell wall are creating, too, and lipopolysaccharides. So these things really do wreak havoc on the system and can end up in places they shouldn't be.
- [03:29]
A
So then at the end of it. And the root cause is always inflammation.
- [03:33]
B
Inflammation, yes.
- [03:34]
A
And so these inflammatory cytokines and biomarkers are going into the circulatory system, which can obviously go and lodge in different organs. But when we're talking about reproduction as a whole, it's interfering and causing, like, an inflammatory cascade in those areas which can make it harder to conceive.
- [03:55]
B
That's exactly right. Yes. Yes. And impacting egg implantation. And you mentioned pregnancy outcomes, unfortunately, miscarriages and just having more challenges in pregnancy as well. And then we cannot forget about the male counterparts. I feel like women get blamed for a lot of this, but it is impacting sperm mobility and motility as well, because not only is it inflammation, but how is that inflammation impacting our hormone health and endocrine disruption?
- [04:25]
A
I think we should start with something basic, which is what exactly counts as oral health. Is it just brushing and flossing, or is there more going on inside the mouth that people don't realize? I think, why don't we have a complete map of what oral health is?
- [04:40]
B
So, unfortunately, dentistry has gone one way and medicine has gone another. And just like much in medicine, we compartmentalize things. And so the mouth has been considered outside of the body by so many, and I think it becomes an afterthought. And I'm encouraging everyone to get the mouth back into the body and really consider it the gateway of health. What you see in the mouth can be a reflection of what's happening inside the system. Okay, so like everything, nutrition and optimization with nutrient dense foods, whole foods, and making sure that your body's working effectively and efficiently is paramount. And I think people forget how important nutrition is for oral health. So that's where I always like to start with my patients. Are you optimizing fat soluble vitamins? Are you optimizing minerals, calcium, phosphorus, trace minerals, magnesium, D3K2? All of these things are necessary to have optimized health. Then we go into airway and breathing. How are you breathing? People who mouth breathe, they have a lower PH of their mouth. It's acid that's actually causing disease in the mouth. Many people blame sugar. It's actually acid. How are they breathing? What is your ph? What is your salivary health like? No one thinks about spit, but spit is the golden elixir of your body. It is so important for digestion. It's where digestion starts. Think of swallowing. It's priming digestion. In the gut, it is filled with immune cells and enzymes and in minerals that help with remineralization of the teeth. But it also protects the teeth. So people who have dry mouth from either mouth breathing, perhaps they're undergoing cancer therapy, they're on certain medications or as we age that can impact oral health as well. So I want to talk about breathing, I want to talk about spit and saliva hydration. And I also then go to hygiene. So hygiene's lower on the list and we can go into the details.
- [06:47]
A
That's so interest.
- [06:48]
B
Yes. For example, the carnivore group sometimes say, I don't floss and brush. I don't need to. I am not recommending this. But to, to a degree they're correct.
- [06:59]
C
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- [09:52]
B
Causing disease is ultra processed foods. So pathogenic bacteria in our mouth, they love fermentable carbohydrates, they love flour and they love sugar just to simplify it. So they consume and metabolize that and they release acid as a result. So if you're not feeding them these types of foods, they can't survive in the mouth and you will most likely have more commensal bacteria or healthy bacteria. So Paul's correct in saying if I eat mostly, you know, meat and vegetables, some fruit, I know he does a little honey now, you're going to be pretty, pretty set. And if you look back ancestrally, 10, 12,000 years ago, we really didn't suffer from cavities as a species. Go to the Natural History Museum, look at ancestral skulls. We have to remember 10, 12,000 years ago is not that long ago in human existence and evolution. And so why is that? It's because of our diet. We weren't eating a lot of sugar and flour and processed foods. Occasionally we might find a berry, bush or tree, but it was limited. Right. It was very seasonal, and so we weren't exposed to a lot of sugar. And so teeth were quite pristine. Domesticated animals get cavities, but wild animals do not. Why is that? It's diet. Again, I'm not recommending this because I do think you would have food lodged in your teeth that would degrade, that would probably not smell great. But you may not have certainly a lot of cavities. You may still have some gum disease. So I am. I want to be clear. I want everyone flossing and brushing. But my point is it's not as important, I think, as traditional dentistry makes it out to be. I think these other things are more important. What we're eating, how frequently we're eating, and that makes a big difference. So too. So I can go into that. So we are a society on the go and we snack and eat and graze and sip all day long. Every time you eat or sip or snack, you are changing the PH of your mouth. That's the acid or the base base level for people that may not know what ph refers to. And also you are changing the microbiome. Anytime you put anything into your mouth, there will be some alteration in the microbiome. It's the terrain theory. So if you're in balance, things sort themselves out and you stay in a state of harmony and not disease. But if things are imbalanced, it can tip the scale and you can end up with oral disease, cavities, gum disease, bad breath, tongue coating, et cetera. So we want to make sure that we are optimized in those ways.
- [12:34]
C
First, every time you eat, you change.
- [12:36]
A
The oral microbiome, but it evidently goes back to baseline after a while.
- [12:40]
B
That's right. So every time we eat, the ph drops in our mouth. It's that acidity that will pull some minerals out of our teeth. That's called demineralization this is a normal process. So our teeth are constantly demineralizing and remineralizing all day long, assuming we give our saliva a chance to push these minerals back into our teeth without being disrupted. So it's just like we know we're not for optimal gut health, we shouldn't be eating constantly. It's the same with your mouth. So I really like people to eat on a schedule, okay? Ideally every two hours or so. Now this is why we want to focus on satiating foods, protein, heavy foods. But unfortunately, especially with kids, we snack and think of these hyper palatable foods. Now the bliss point, you know, we are over consuming Goldfish crackers, Doritos cracker, you know, chips, granola bars, fruit snacks. And they're meant to be over consumed, right? The bliss point is that perfect blend of fat and salt and sweet that the brain just can't get enough of. And I'm guilty of it too. Like I, I eat a Dorito.
- [13:50]
A
Yeah, you gotta have the whole bag.
- [13:52]
B
The bag's empty, you know, and so it's teaching not only about what foods to eat, but how to consume them and to eat them more on a schedule and not just constantly be grabbing a handful, spread out over time. The mouth needs to rest to allow the saliva to do its work, to remineralize the teeth. And so what is a cavity? It's a state where there's been too much demineralization to the point where so many minerals are lost in your tooth, it forms a hole or a cavity, Cavitation is a hole. And this can unfortunately happen fairly quickly with the modern diet with the frappuccinos and you know, these energy drinks, which are not only maybe high in certain sugars, but also the ph is really important of our drinks because that's acidity.
- [14:38]
A
You know, years ago, I remember a dentist telling me every time you eat, you should brush your teeth. And I thought, well, I'm not going to brush my teeth like ten times a day. Is that a wrong thing to do?
- [14:47]
B
This gets a little purist. But you know, as I mentioned, every time we eat, we do lose some minerals from our teeth. That's a natural process. So if you're going and brushing right away, the bristles from your toothbrush can actually be damaging your enamel a little bit. It can scrape away kind of that fragile enamel on the outside of your teeth. So you don't want to brush right after you eat. I suggest patients wait about 20 to 30 minutes so at least they can get that hardening effect from Their saliva, so the bristles of their toothbrush aren't flaking away enamel. And over time, you do that day after day, year after year, you're going to get sensitivity and permanent enamel loss.
- [15:23]
A
I've heard you say that we swallow on average 2,000 times a day.
- [15:28]
B
Yes.
- [15:28]
A
And you've mentioned that our saliva is really important for everything. So let's unpack that as well, because I think that that's super interesting, because dry mouth is a. It can be an underlying symptom for many, many chronic diseases, in fact.
- [15:46]
B
Absolutely. And hormonal changes in women, too. So what does it do? It lubricates, it protects, it has immune defense in it. It will remineralize our teeth. As I mentioned, it has enzymes that break down our food. Okay. So that's part of the digestive process, but it's also seeding and sending signals to the gut. And this is still. We need to be studying this more. But imagine if you have pathogenic bacteria in your mouth and you're swallowing 2,000 times a day, what is this doing downstream to the gut microbiome? Okay. And so if with my functional medicine colleagues and my naturopathic colleagues, if they're trying to clean up a patient's gut, I always ask, are you looking at their mouth, too? And so the mouth is the gut. We need to start thinking of it that way and treating them together. If we're suffering from disease in one or the other, because they're bidirectional, and a lot of it is from the salivary health.
- [16:43]
A
How can you even test if you have a bad oral microbiome? Is there something spit?
- [16:51]
B
Yeah, you test your spit. So salivary analysis. And so there are more and more tests coming out. This is blowing up. We're at the forefront of it. But the oral microbiome is really coming center stage, which I'm excited about. More progressive dentists have been doing this for years looking for specific pathogens in the mouth, especially if you suffer from periodontal disease. Because when you have these pathogens, no amount of oral hygiene is going to eradicate them. We have to look toward nutraceuticals and sometimes pharmaceuticals. And we also now there are tests that are direct to consumer, which is really cool.
- [17:28]
A
Oh, that's amazing.
- [17:29]
B
Yes, yes. There are a few brands I like. More and more are coming out. The ones I do prefer use Chaka and Metagenomics because they're looking for not just certain pathogens, but bacteria, viruses, protozoa, the whole shebang, you know, and including all their DNA they're also seeing. What are they doing? How are they interacting with each other? And then how is it impacting gut health? For example, sometimes you'll see H. Pylori in the mouth or Candida in the mouth, but you also see it in the gut. You have to treat both.
- [18:13]
D
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