Prompt: IDENTITY and PURPOSE
You extract surprising, insightful, and interesting information from text content. You are interested in insights related to the purpose and meaning of life, human flourishing, the role of technology in the future of humanity, artificial intelligence and its affect on humans, memes, learning, reading, books, continuous improvement, and similar topics.
Take a step back and think step-by-step about how to achieve the best possible results by following the steps below.
STEPS
- Extract a summary of the content in 25 words, including who is presenting and the content being discussed into a section called SUMMARY.
- Extract 20 to 50 of the most surprising, insightful, and/or interesting ideas from the input in a section called IDEAS:. If there are less than 50 then collect all of them. Make sure you extract at least 20.
- Extract 10 to 20 of the best insights from the input and from a combination of the raw input and the IDEAS above into a section called INSIGHTS. These INSIGHTS should be fewer, more refined, more insightful, and more abstracted versions of the best ideas in the content.
- Extract 15 to 30 of the most surprising, insightful, and/or interesting quotes from the input into a section called QUOTES:. Use the exact quote text from the input.
- Extract 15 to 30 of the most practical and useful personal habits of the speakers, or mentioned by the speakers, in the content into a section called HABITS. Examples include but aren't limited to: sleep schedule, reading habits, things the
- Extract 15 to 30 of the most surprising, insightful, and/or interesting valid facts about the greater world that were mentioned in the content into a section called FACTS:.
- Extract all mentions of writing, art, tools, projects and other sources of inspiration mentioned by the speakers into a section called REFERENCES. This should include any and all references to something that the speaker mentioned.
- Extract the 15 to 30 of the most surprising, insightful, and/or interesting recommendations that can be collected from the content into a section called RECOMMENDATIONS.
OUTPUT INSTRUCTIONS
- Only output Markdown.
- Write the IDEAS bullets as exactly 15 words.
- Write the RECOMMENDATIONS bullets as exactly 15 words.
- Write the HABITS bullets as exactly 15 words.
- Write the FACTS bullets as exactly 15 words.
- Write the INSIGHTS bullets as exactly 15 words.
- Extract at least 25 IDEAS from the content.
- Extract at least 10 INSIGHTS from the content.
- Extract at least 20 items for the other output sections.
- Do not give warnings or notes; only output the requested sections.
- You use bulleted lists for output, not numbered lists.
- Do not repeat ideas, quotes, facts, or resources.
- Do not start items with the same opening words.
- Ensure you follow ALL these instructions when creating your output.
INPUT:
Transcript: most acidic drinks like kombucha and a lot of mineral waters perryer for example they're pretty low coffee wine iced tea my favorite those start off at a low ph and if you're drinking a lot of that you are forcing that critical pH to drop and your teeth are dissolving hear this all the time of practitioners mentioning this to their patient taking them off of mouthwash and 6 to 12 Days Later seeing a drop in blood pressure and sometimes getting off the high blood pressure medication this is a crime this should not be happening why not take advantage of that wonderful Wellness of being able to breathe your nose for the 7 to 8 hours that you're just sitting there doing nothing that's what mouth taping really is everyone should mouth tape I want to force all that air in and out so my co22 levels are perfect and my HRV levels go up my respiratory rate drops my resting heart rate drops when I mouth tape Dr B it's great to connect with you again A lot has happened in both our worlds since our last conversation it's been a number of years but I want to jump right in and we may have some overlap of our last chat but we got a lot of new stuff to get into and I think a good top- down approach keeping things really General to start is talking about the health of the oral cavity as a whole and the connection of that to the rest of the body no Jesse great to see you again it's been a few years and you're right there has been there's a lot of new information that the the the deeper you dig in oral health the the more pops up and and this happens almost weekly to me I see a new study and it's not necessarily a new study and it just hasn't been discussed and talked about and especially in you know how it connects to the rest of the body so thanks for having me on the show yeah the oral systemic connection still a very viable very exciting topic um uh you know what what we call it on our website uh it's what we how we refer to it is what happens in the mouth happens in the body and almost six maybe seven out of the Big 10 chronic diseases there is some oral bug or oral health involvement or issue even causal um for example if you read current studies that connect oral health or bugs in the oral microbiome in the mouth to alzheimer's they are now discussing causal relationships uh it's it's it's it's it's pretty clear that it is a it is a way to get um uh Alzheimer's um and of course it's multifactorial always but it's but it's a very preventable way and I think that's what's an that's the exciting part of it is oral disease gum disease cavities all of this can be prevented so so yeah uh lots to talk about uh definitely an intimate connection between oral health and systemic health and of course the big question always is why are they two separate entities when oral health when the oral cavity is part of the systemic part or system systems in the body well a lot of different areas we can jump into to start here let's let's go this way and talk about some of the biggest things you see people doing in the oral health realm that are sabotaging Health locally and Beyond yeah great question and it's very prevalent we're we're the thing I first think of and I shake my head as I do it or roll my eyes it's the things that we do twice a day the floss we're using the toothpaste that we're using the mouthwash that we're using all these oral care products are actually causing or increasing the incidence of of uh oral disease um and and it's like well why is that and that seems like a a big a very ridiculous statement to make because we've been doing it for so long but I mean uh everything we've thought about oral care products and since maybe the early 1900s late 1800s it has turned out to be wrong um we thought that disinfecting the germs in the mouth by doing that we would solve bleeding gums bad breath cavities we also thought that fluid would reverse the epidemic of cavities and in fact it hasn't it's actually on the rise uh and the question is is what are we doing wrong um uh and why are we now seeing this now and it's one reason Mo mostly We Now understand the mouth better more accurately and in a different way and that is hopefully having a fundamental whether you're a provider or a patient having a fundamental understanding of the oral microbiome that is what's new that's new information it is a way now that we can quantify y oral Disease by literally getting graphs and numbers uh I mean I just listened to a seminar um by two hygienists very well done um and they were talking about the old way again hygienists are on the front line for C uh seeing gum disease and the old way was to measure the pockets most people are used to hearing all those uh millimeter measurements it's supposed to be done once a year uh even if you're healthy and a 2 to 3 mm pocket is healthy uh anything greater than that you can get a 12mm pocket which indicates bone loss and severe rampant gum disease um bleeding points bleeding upon provocation even bleeding when you brush and you spit out you see a blood a little blood in the sink or blood in your floss these are all the ways that dentists professionals have been gauging oral health or oral disease well now we're looking at the bugs the bacteria the prevalence of which bugs are present and how they are interacting with other bugs we're actually getting numerical hard data on what is going on in the mouth and the beauty of that is that we're seeing it before the symptoms appear so the old way of practicing looking for the symptomology looking for these things I just discussed morphology of the gum tissue um number of cavities now we can see it happening before we it's the pro drone Al phase of disease because we are doing a kind of a high resolution scan of DNA analysis in the mouth and me a being able to measure the oral microbiome these bugs in the mouth uh we have a much better sense of what's going on in the mouth and it has changed the course of treatment and how we see uh oral disease and also how it translates to infecting other parts of the body so for somebody who hasn't really thought of the oral microbiome to this point whether they're somebody who is living a healthy lifestyle or not what is the first step given this the importance of this how does somebody go about assessing or is it just about making the changes we're going to get into and then assuming things take care of themselves what I'm getting at here is what is step one coming into this knowing the importance of the micro biome so then we can begin to build off that so first that's a great question first step is and and this is where the change needs to come first step is as a patient and I I'm a firm believer in The Advocates and the responsibility of a patient or of a person when it comes to healthcare you have to educate yourself it's like your financial well-being it's uh you know it's you have to take charge of that you cannot trust a professional um so really educating yourself and the beauty now is that you can do this online the democratization of healthcare obviously the internet one of the advantages of of the internet um allows us to do that and then finding a practitioner and that's the tough part and we can talk about that later is finding a practitioner that is up todate and and has read all the latest research uh understands and appreciates the oral microbiome so again back to what I said five minutes ago this comprehension and appreciation for the oral microbiome is key that is the big factor now in oral health if you don't know it if you don't get it if you don't believe in it or if your provider and it could be a combination of all of this if your provider is not coaching you on this whether it's your dental hygienist uh it can even be your dental assistant uh and certainly your dentist they need to be all on the same team and the problem with having said that is that most dentists are not up to speed I would say the majority of dentists are not um especially if they're older because this was not taught in the curriculum the the the no that this oral microbiome is key to oral health and even systemic Health this is a 108-year old notion and this and it it came after all the gut microbiome studies gut microbiome data first popped up after the turn of the century and uh and now of course I mean it's it's uh taking off and the oral microbiome is as important and connected to the gut microbiome so it is riding that wave but it's still not mainstream and so to be mainstream your dentist would have to be taking continuing education and reading the latest studies otherwise they are literally 15 to 20 years behind the times so that would be the first step um would be making sure your team and you're part of the team um and and someone you live with they have to be part of it too uh you know because there are factors there as well the epigenetic uh lifestyle factors uh you all everyone has to have this appreciation and awareness of the oral microbiome and then of course that filters down to which Oral Care Products would you choose based on that knowledge and that's going to change drastically your diet for example uh may change uh there are a lot of things in our modern diet that as they do for systemic Health anything with a for example with a high glycemic index or load uh that obviously is a bad food for us metabolically most gum disease is a metabolic disorder it's no different it's there's a cyto kind response there's infation um it it usually uh is related to BMI and trig elevated triglyceride levels oxitive stress that's why the gums recede so it would make sense that uh diets that affect you systemically are also bad for your oral health but now we know how it's connected we know that the oral microbiome requires uh Prebiotic Foods uh we don't want low acid levels in the mouth too frequently uh these are all things now that we can quantify and we understand the mechanism because we know who the big player is and these are these bugs and these are just I haven't really described what the oral microbiome is for people if this is a New Concept we are humans but we're actually more than that we're a super organism we are humans and then we have this other bunch of foreign or actually alien DNA it's not human DNA in us and it's bacteria its viruses fungi yeast cells and it's it's it's not just a little bit I mean it's it they actually outnumber us and they are in us in our mouth in our GI gut uh in our armpits probably in our brain there's probably a brain biome I mean it vaginally uh and all these biomes are helping us there's this Synergy between us as an organism and them I guess that would be the way to describe it um as an organism and without a biome we're done and what's interesting I just learned this we had a death in the family and I was researching death and as it turns out death is not very binary in other words when you stop breathing there's still a little bit of Life there the brain takes a while to slow down and then the last thing to go is the the biomes the biomes live on for about a month and they have a role to play and that is in breaking down the body uh is that connected to the organism of our planet and globally and and the environment I don't know but but so it's all very complicated very connected and awareness of this uh of of the oral microbiome is is very very important if you're enjoying the episode take a second and let me know by clicking like And subscribe below thank you so much and now back to the episode and it seems to me a good way we could approach this and you touched on this a little bit when it came to food and feeding that microbiome of the mouth we could talk about it from things we're going to do to make sure we're repopulating and keeping it healthy and then with all the different products that we're using things that we need to be aware of that could be killing that microbiome mhm and I think a good way maybe we approach this to start is talk about you specifically because you've been in this world for so long and you've evolved I'm sure your practices and what you do and I know you have some videos on online but they're getting a little bit older now let's let's talk about what you do in the morning product wise and then we can go about it from that perspective so we know what good products are what you're using what some of the harmful products are we can talk about as we go through and what might be damaging the microbiome and then we can move into other facets and impacts that you know things like food that are happening throughout the day that's a great way way to illustrate uh these Concepts uh is to just follow and lead and and I try and lead by example so uh this may not work for everyone of course the the biomes differ from person to person and for example if you're mouth breathing you may want to do a little bit more and I'll try and touch on that but given ideal circumstances you're you're pretty healthy and you want to remain healthy uh and most of this applies to people that already have some oral disease uh as you said you you you don't want to indiscriminately kill any part of the biome because you really don't know what you're doing uh because it's indiscriminate in other words a lot of those bad bugs so for example I have yeast cells right now uh Albans candida Albans in my mouth I have the EP pylori bug I've got s Mutan and the P gingivalis bug the S those are bugs for cavities and gum disease we all have those bugs in our mouth um we have the bug that causes uh pneumonia pneumoni um pneumonia it's it's always there but if in a symbiotic uh population instead of a dis biotic population these bugs are modulated and controlled they they are they are put they're not put down they're not disinfected they're not eliminated in fact eliminating them may actually make things worse but everything is working well and this is the problem or this is the easy part the easy part is just letting your body do what it does Best But and giving your body what it what it needs to do your best so my my regimen is based on that it's it's a very complicated thing even as a dentist there are a lot of things that can go wrong but if you feed your oral microbiome properly if you don't use the products that are trying to Nuke and take out all the bugs in the mouth then and and you disrupt the bofilm and reset it I'm going to give examples of all of this that's flossing and brushing um if you can stabilize the pH in your mouth for example I'll give you examples of how that may or may not happen if you can just let the body do what it's been doing for a long time I mean the record stands we're all here still right we're able to that our species is still going pretty strong right and otherwise we wouldn't be here if something went wrong but now we're interfering with that process and even so the body the homo sapien species is still pretty prevalent on this planet that's questionable how long that's going to last but we won't get into that so okay so first of all I make sure let me start with going to bed uh I try and brush in floss before I go to bed I do not brush with any minty uh essential oil toothpaste those are all neuros stimulants that could kind of you know engage your brain to the point where it's difficult to fall asleep essential oils are all bacterio cidal some are worse than others so I would not recommend having a toothpaste with anything that's bacterio cdal in it essential oils would be one of those so I would brush I always floss before I brush flossing breaks apart the the bofilm which otherwise is known as plaque in between teeth and then that allows the remineralizing agents these are minerals and toothpaste and I'm not referring to fluoride of course um uh to get to the areas that need this remineralization and then I will put my oral Appliance in I do have mild sleep apnea this prevents my jaw from falling back but the important part is I tape my mouth closed which is very easy to do I do it in the dark it's sitting right there I just peel off some rub it onto my lips cover my eyes make sure the room is dark make sure that the CO2 levels in the room are low around 500 that means open Windows uh if I don't open the windows my wife and I will fill up the room with CO2 our breathing rate goes up respiratory rate goes up and if I measure in the morning we're at 7 800 parts per million that's another topic we can get into um open window cool room get into bed go to sleep taping the mouth closed ensures that the pH of my saliva which is the backbone of the oral microbiome in other words the saliva is maintaining the pH so that these uh bacteria can function properly if the pH drops below I mean it depends and we can talk about this too but there's something called critical pH Dentin starts dissolving at a pH of 6.2 enamel starts dissolving leeching out of the tooth which is the beginning of a cavity at 5.5 pH doesn't take much to get there in fact if you have a dry mouth in the morning your pH is is likely below that and you've been demineralizing all night long and your oral microbiome the bugs are suffering they need that neutral pH they need the fluidity and the saliva flow uh they need all the proteins and ingredients and minerals in saliva so mouth taping other than for sleep and breathing that's where most of the attention goes to with u mouth taping it actually helps promote oral health by stabilizing for 6 to 7 hours in your day that's a huge period of time uh helps keep that oral microbiome healthy and stable and that way you don't wake up with bad breath or a sticky mouth take off the tape in the morning uh if I'm if I have a dry mouth uh if I'm dehydrated then I will first of all I will drink a full glass of water clean water it can be mineral water it can be distilled water with uh uh minerals and electrolytes added back in and then so I will hydrate uh if I feel I need some electrolytes I will put electrolytes into the water first thing you want to do is hydrate before you do anything else and then I will brush in the morning with hydroxy appetite based toothpaste because the teeth need a hit of minerals they've been saliva flow drops off in the middle of the night your saliva glands have a circadian rhythm by the way and they do go to sleep that's not quite the technical term but saliva flow drops off so even even though your mouth tape and that's why you want a mouth tape because the minute your mouth is open saliva flow is dropped after 20 minutes of breathing in and out of your mouth you're going to have a dry mouth and that's not good so so I will not floss in the morning um unless I feel I need to I'll brush before breakfast I don't have breakfast but before I if if you're going to have breakfast don't feel bad about that brush first thing you want to that bofilm has thickened up over the over the time that you've been sleeping it has altered a little bit because everything's been asleep and Slava flow has been decreased even though you've been mouth Taping that helps uh you want to break that up you want to break it up and reset it a little bit that's what brushing and flossing do it's a mechanical means of resetting the bofilm breaking it up preventing it from getting too sticky too thick and allowing it to do its thing the uh oral microbiome all these bacteria live in that bofilm there's a reason there's bofilm on a tooth it needs that that barrier and layer um it's an immune barrier essentially and it helps remineralize the teeth so and then I'll I go do my protein drink and I drink more water and then I usually uh go to the barn and get some work done and oral exercise uh that kind of thing and then I'll have lunch and after lunch I won't brush but I'll choose aloto gum uh because it's simp it's simple it's handy and remember after you eat Foods especially if they're processed foods or acidic Foods if you brush right afterwards it can be a cup of coffee I don't drink coffee but I drink a lot of green Iced Tea unsweetened um those are acidic drinks and brushing after an acidic drink or an event where you've eaten something and the bacteria are consuming that food let's say you eat saltine crackers at noon I wouldn't recommend that but if you do you don't want to brush for 30 40 50 minutes because there's an acid attack going on in your mouth the the biome and again these bacteria when you know they're like us when they see junk food they get excited and they can process it they can consume more of it and that via their metabolic process of consuming food food they excrete uh an an acid and that lowers the pH in the mouth so you don't want to brush after that so I choose aloto gum that helps stabilize the pH quickly and then remineralization will reoccur and then at dinner I'll do the same thing or I'll brush after dinner because I do not eat anytime after dinner we try and finish dinner by 5 well with the time change now 5:30 6:00 we're in bed by 93010 no meals water is fine um mineral water but no no food from dinner so I I can brush after dinner if it's a poo meal I typically brush afterwards if there's some carbs in there like even a yam or a potato uh I Will Wait a half hour and choose zotol gum and then I brush with an electric toothbrush I use a Sonicare um and I floss I use a slate flosser which is really more than floss so I use the Slate flosser first I'll use the uh uh Sonicare with uh a hydroxy appetite based toothpaste and then I'll read a little bit we'll watch some TV uh sit by the fire whatever all the lights are way way down if the lights are on they're red lights or non-blue lights and then we'll go to bed at 9:30 10 and then that process starts again so that's my daily routine other than diet we can talk a little bit about that but but uh that's my oral care routine and I do not use mouthwash and I wouldn't recommend using any mouthwash out there even if it's a homeopathic healthy quote unquote uh integrative mouthwash a lot of them have essential oils in it uh those are problematic and mouthwash in itself I mean save the money save the time during your normal day regimen of Oral Care focus on brushing and flossing mouthwash does nothing and if you're using an off-the-shelf mouthwash which 2/3 of Americans do North Americans do and 2third of those Americans also have high blood pressure there's a connection there uh that's the worst thing you can do a lot of people will use mouthwash before after a workout you're negating the benefits of the workout you are killing off oral microbiome that produces nitric oxide so there are a lot of dietary changes and lifestyle changes that you can make but that's kind of my what I consider to be my Oral Care regimen no mouthwash no toothpaste with surfactants and emulsifiers in it no fluoride because that causes brain issues and other bone density issues um and flossing and brushing that's it and oh most importantly sorry tongue scraping so I will scrape my tongue in the morning and I'll scrape my tongue before bed huge huge addition to the oral uh microbiome uh kind of uh nourishing feeding it regimen uh definitely scrape your tongue twice a day initially when you scrape your tongue it's going to take a lot of time you're going to see a lot of stuff coming off of it now I can get away with once every other day because when I scrape there's nothing there but if I see something there I'll keep scraping and I'll go back to twice a day so tongue scraping flossing brushing and staying away from products that are anything close to nuking the oral microbiome and mouth Taping that is the ideal was that too long of an answer perfect but I want to take time now and dig into all the nuances because I know for me I'm curious and I'm sure the listeners are as well and let's take it all the way back to the beginning you were talking about brushing and flossing before bed and you ended up coming around and overlapping after you went through your day which was great I think you used the word it was some kind of electric toothbrush you used that night which it was it ultra Sonic Sonic hair yeah Sonicare yeah is that different than in the morning no I always use the Sonicare I do have a manual toothbrush I use a radius toothbrush I won't travel with my Sonicare there's a there's a new study um that just came out I I I have this LoveHate relationship with the electric gadgets that we that have batteries in it that we end up throwing into the dump and these electric toothbrushes don't last a long time they can be too aggressive they can cause gum recession they can be used improperly most of us are using a manual toothbrush improperly if we use a an electric toothbrush improperly it just magnifies the damage that is done but there was a new study out actually it was the uh from the company that I think uh actually has the best saliva test or oral microbiome test and we can talk about that later but I've referred to it already oral microbiome testing is very important for a provider for a patient um that that was an interesting study they've done a lot of studies and again these are wonderful studies because all the other electric toothbrush studies most of them are funded by Phillips or or will B braa uh they're done by dental schools dental schools this is a great source of income for them so if they say too many negative things about these products they're not GNA this this will not be reoccurring income for them um and that's all True by the way and and it's difficult to get a good it has been difficult to get a good study on difference between which toothbrush is it Sonic is it oscillatory rotary or is it ultrasonic they have that category that doesn't work very well and then of course manual toothbrushes so uh there are a lot of variables there um but recently uh this study was very was very interesting it it did it did demonstrate that the electric toothbrush if used properly uh will increase the number of commensal bacteria in the mouth and that's a good thing uh you want that uh diversity of population too much diversity is actually bad in the oral microbiome but but uh most of us don't have that diversity and we need that and the Sonic Care actually was better than the oral be I used to rec I used to recommend Oral B for younger patients because it was great at removing stain and thinning the pelico great for kids after age 40 the Sonicare because it got in between the gums because the gums are receding and there's more chance for bacteria to get caught in there via biofilm or plaque uh but now I'm I'm I'm a fan of any Sonicare or or a knockoff they're they're all around 30,000 Cycles but make sure it is actually Sonic there are a lot of Brands out there that claim they're Sonic and they're not actually Sonic they're subsonic so so it needs to be about I think it's over 30,000 cycles per minute is the definition of Sonic make sure the toothbrush head is very soft and wellmade a lot of the knockoffs have a have a good brush you know the motor and all that but uh the toothbrush head the bristle softness and the end rounding softening polishing of the bristles is questionable so so yeah I mean the Sonicare they invented that category um and uh there you can you can buy a Sonicare at $40 and you can go up to $350 I would not recommend the high-end models you don't need them it's basically the same toothbrush all right we're really going to get into the weeds with each of these because there's a lot of detail with each step here as you talk about Sonic and the bristles being soft and you talked about contoured again we're going to get into the weeds here is there any natural bristles for those brushes and how do you feel about that versus a synthetic I'm assuming on all the electric toothbrushes as far as I've seen they've been synthetic so talk about that it's nylon it's nylon and that's a really great question I have not been asked that question I can tell you exactly how I feel about it I'm not happy about it I hate plastic um I try and eliminate plastic in my life uh floss is a a a big offender in that area but you can buy a silk floss it's more difficult to use um uh if you use floss and it has p in it those particles are breaking off even if it doesn't have posos in it the little micro Plastics are breaking off and where are they going you you are ingesting them it just adds to your posos load which is a whole another conversation it's so depressing and uh we need to address that uh but good toothbrushes are nylon bristles and then they end up in in you know the the dump and they don't biodegrade so toothbrush bristles Used to Be Wild boore bristles uh they have very coarse hair um that didn't work very well that can be very abrasive as well they didn't last very long um nylon can be very abrasive especially if it's a cheap toothbrush which I alluded to earlier if they just cut the bristles the toothbrushes are it's a nylon molten nylon in a mold it gets heated up machine comes and has a stack of nylon bristles it drops it in it cools quickly it grabs the nylon bristles and it goes off to be polished and packaged those bristles if they're just cut they're obviously cut evenly or now they have staggered bristles I'm not sure how they would make that they probably put in different sets of bristles at different heights and by the way those staggered bristles actually work better according to studies so if they're all cut at the same height they may not work as well but my point is is that the bristles each brist bristle needs a hemispherical end it's called end rounding or polishing and because a cut bristle is literally a cylinder cylindrical piece of nylon different diameters they have Nano bristles now but the edge of that cut bristle is sharp it's a right angle and nylon is very abrasive and that can do irreparable permanent damage to gum height gum recession Denton dense um can cause tooth sensitivity to the point where you can eat certain things your teeth will ache uh it'll really interfere with your daily routine and your day and focus and concentration uh difficult to fix so you really have to be careful and then you put that on a osculatory toothbrush like the Oral B Brawn or or the ultra the Sonic a toothbrush that's vibrating and that just accentuates that wear so and then we brush incorrectly we do this sawing motion anyone that brushes in a movie or in a TV series I've I've uh clipped a lot of Clips uh I think I have one on YouTube of Natalie Portman brushing her teeth I think it was Black Swan incredible actress but I think they're all taught to brush aggressively because it's usually during a very emotional scene and but you don't want to brush that way uh you want to jiggle you want to vibrate you just with a manual toothbrush you just want to circular motion you don't see that on on um you know on on you know everyday media on how we brush and and that sawing motion really gouges and remember it's the same motion back and forth so over time this is something you do twice a day it will literally leave grooves from tooth to tooth all in the same direction and then once those grooves are established then every time you go back with brushing the bristles are guided into that Groove and that wear is potentiated made worse it accelerates so so to answer your question we do not have a good alternative to the nylon bristle and it is a plastic I wish it wasn't so I've tried uh you know natural versions of it the the best thing you can do is not to have to brush I mean our ancestors didn't brush they chewed on chewing sticks uh I think there are people out there that have an excellent diet they have uh very healthy saliva they're not mouth breathing uh they could literally get away with chewing zoto gum and never floss and brush I I have patients like that and but is that the norm no I mean as long as we have the food that we have even healthy diets a lot of our Foods I mean most of our foods are nothing that our ancestors saw they they we're too far gone from that hybridized wheat uh DNA changes uh quality of food even our fruits and vegetables are not what our ancestors were eating so so that that is why we now have this Band-Aid so remember every time we try and fix something in our society it's it's not the full step forward it's a half it's a full step forward and half a step back we've introduced microplastics and abrasion into our into our lives because of our chosen diet all right so what I think I'm hearing you say is when it comes to electric toothbrushes there's no perfect answer for the bristles in the head what what's the best we can do there and then take that over to manual and talk about what the best we can do there is if you're eating well um and you're pretty healthy you're not getting cavities you don't have a hosis your gums don't bleed I would recommend a manual toothbrush my favorite is the soft uh head on the radius toothbrush it is the handle is recycled made from recycled products you never have to replace the handle you're only replacing the the head I mean so that assuages half of our guilt half of the toothbrush ends up in the uh in the dumps um and it's safe I mean there it's a high quality bristle uh and um it if used properly make sure you're checking in with your hygienist bring your favorite toothbrush into your dental visit and there's always time at the end of that 1 hour cleaning visit the hygienist the good ones allow for that that's the oral hygiene instruction Ohi we have a term for it there's 10 minutes where we can discuss you know you Mr Smith you missed this area here's a patient mirror this is how I recommend you get in there that's the biomechanics of brushing everyone's got their blind spots when it comes to brushing and and then but bring your toothbrush so that they can see you in action bring bring your favorite floss and demonstrate to them what they're doing usually you're sitting up and you've got the patient mirror they're holding it for you and they're behind your shoulder your right shoulder typically and they're looking at it and they can comment and if you're over brushing they will catch it and I would say 90% of the time when that happens I mean when the patient comes in 90% of the time we have to take their arm and just say slow down uh if it's an electric toothbrush bring in a fully charged version of it and uh get a demo I think you'll be surprised they do have toothbrushes um in manual and now in electric that if you push too hard either the motor cuts out or an LED light flashes at you there is a toothbrush a manual toothbrush that has a a clutch on it and I remember them sending it to me um I'm not sure if it's in production or not I can find out I think everyone should try that toothbrush at least once when I picked it up and started brushing the clutch would break each time so even I was brushing too hard that the clutch which is it's a breakaway thing it snaps back and it resets it's very inexpensive um uh that clutch they've measured it breaks at a very certain hardness uh or or Force it's a Newton measurement uh and it's very specific and based on studies I would recommend that everyone try that once I would say probably 100% of the people that picked that up will be shocked the first time they use it like wow it only takes that much force to be brushing too hard and that's not I'm not talking about the motion of brushing I'm talking about how much pressure you're applying so that would be that would be important um did I answer your question talking I just want to close off on when somebody goes to the Sonic what's the best they can do with brush head in that case I would say if your dominant hand is your right hand use your left hand cuz you're going to be more delicate hold it like I don't have yeah I have a pen here uh don't hold it like this hold your toothbrush like this and and then my Sonicare has a as I'm brushing I'm facing the LED light in the mirror actually when it's dark which it typically is at night it just lights up the room um it's a red LED thank you Phillips for making it a red LED I don't need white LEDs at night um uh it lights up and then it tells me that I'm brushing too hard so it it modifies your behavior and that alone within weeks you've got it some for some people it will be days and that's a modified behavior that has ramifications for the rest of your life your dental bill will be less less sensitivity to your teeth uh better hygiene could be better systemic Health in general uh so so that's that's what you want to do you want to be brushing properly with a high quality head quality toothbrush um and um so brushing properly not pushing too hard and the right motion and that's kind of a rolling motion with an electric toothbrush you're going to pick it up it's got a nice broad oval head and you're going to lay it in the area you're just going to move it a little bit and roll it gently and then you're going to move on you're going to lift it off the teeth and do that again you're not going to scrub over back and forth and by the way that negates the effect of the Sonic bristles because then you're you're you're deadening that frequency by brushing back and forth so most people are brushing incorrectly with their $2 toothbrushes I mean it's very discouraging and uh but Sonicare is a great way to go based on these latest studies from bristle I was very impressed with that again it's the first time that a study was done based on the composition of the oral microbiome before all the other studies those dental school studies I was referring to it was based on bleeding points and pocket depths that's so intangible and indirect and there's so many more factors at play there where with the oral microbiome the oral microbiome changes within 3 4 days so uh that is more quantifiable it's more a more accurate way of looking at differences in the results of using different products and I know for I haven't had the Sonicare but I've had different electric toothbrushes over the years and when you go to replace the heads there's different choices and some of them have like Disney characters for kids and things like that when it comes to the Sonic is there a certain one though like a certain softness we're looking for certain bristle you mentioned the Contour good question again getting really specific for people out there that want to take this to the max no no I love it and it's a great question and it is in fact I just had to replace my heads and I went to Amazon and I was completely overwhelmed with the choices and I wanted to make sure I got the right thing so I had to do some research and then go to the Philips site and and find out that I so always get the softest toothbrush head you can get get extra look for extra soft look for gum brush or if you have peronal disease or a brush for sensitive teeth these are all brushes that have a softer maybe it's thinner a softer bristle so that it gives quicker when you apply Force um and then there's the and I alluded to this earlier there's the grouping of the of the bristles and that's confusing as well so if it's just a toothbrush that is cut and and the density pattern is even that's an old style toothbrush and there are a lot of them still out there uh I would go for a a a rolly rolling kind of some toughs are higher than the other that's they call that a staggered pattern it can be oval stick with a smaller toothbrush head if you can most people don't do well with the big brush heads CU they bump into anatomical features back here and they don't clean around their lower second MERS and upper second or third mullers if you still have them um and that can be a problem um and that staggered bristle pattern and grouping patterns all of those have scientific basis there are studies that support that so look for a complex pattern soft bristles the way to look at bristles if you're looking at a toothbrush let's say you're at your friend's house and you're borrowing a toothbrush and he gives you a cheap you know knockoff if you can see Shiny spots on the end of the bristles that is is an unpolished bristle they should be opaque and very dull they should not have a shiny finish so put put on your Loops or get your magnifying glass out you can see this under normal Lighting in a um in a bathroom look at the compare the shininess of the bristle the shaft to the end of the tuft and there should be a remarkable a noticeable difference it should be a matte finish and that's a great way to tell if you've got so staggered grouping different grouped bristles a lot of it gets gimmicky of course they've got a big grouping at the end to help poke in this spot and that spot try and ignore that but go extra soft grouping stagger bristles and pick a manufacturer that has uh is reputable and has been around for a long time and then of course really all of that is important but your Technique is the most important and try and get a toothbrush that warns you if you're brushing too hard whether it's manual or electric all right we went really into detail there with the brushes technique I love it too let's move into what goes on the brush toothpaste and I know you're a big fan of this and more recently I've become a fan as well hydroxy appetite so as we enter this part of the conversation let's talk about what that is and then the different types so hydroxy appetite is to to make it very simple is the material the framework the reason your teeth are hard and firm and are able to chew food and break down food and begin digestion make it allow to smile um that is the major ingredient in your teeth hydroxy appetite um it is biomic in other words it exists in nature it's in your saliva or it should be um it's a form of calcium it's a calcium hydroxy group it's got a hydrogen atom in it uh some phosphorus uh it probably varies a little bit that from person to person um based on diet how many electrolytes you have in your system how well hydrated you are and the foods you eat and also so pH and dryness of the mouth uh so but the point is is that it's natural and that's the micro version of it there's a big controversy between micro and Nano I'm going to get into that don't worry um everybody wants to hear about that but so that's the micro version it's natural they grind it up uh and they can put it into toothpaste and that's fine it it do if it's wellmade it dissolves into your into your saliva and it's there waiting for when you when you're teeth start demineralizing remember I talked about critical pH and it's it's not I mean so the neutral the pH of the mouth based on saliva in a healthy mouth is 6.8 to 7.2 it's typically just below seven 6.2 is when Denton starts uh it starts the process of dissolution in other words it starts dissolving Denton is the root structure of your tooth enamel starts at 5.5 most acidic drinks like kombucha and a lot of mineral Waters perryer for example not to pick on them but they're pretty low but there are several others U coffee wine iced tea my favorite those are start off at a low ph and if you're drinking a lot of that you are forcing that critical pH to drop and your teeth are dissolving calcium is being lost that's why you want it in saliva because when the critical pH recovers and goes beyond above the 6.2 the 5.5 uh then then uh what's the opposite of dissolution oh precipitation occurs in other words calcium gets put back into the tooth hydroxy appetite uh that's why it's well it's important to be well hydrated that's why it's important to have a lot of minerals in your system saliva is created by your saliva glands uh there's capillary blood flow and and capillary beds around your your saliva glands I mean saliva is very similar to blood minus the red blood cells and some other ingredients so it's a very important bodily fluid without it you would be dead you wouldn't be able to digest your food your or microbiome would be a mess you would get infections it's like having a bed sore uh you would have rampant gum disease and you would die from that uh sepsis or or or slower Alzheimer's high blood pressure heart disease cardiovascular events that kind of thing um so so hydroxy appetite is normal now there is a a so let me start off with by saying micro is groundup calcium but it's not very bioavailable in other words it can you can dissolve it into saliva but it's a big chunk of calcium even though it's dissolved uh and when it comes time to be brought to the tooth surface to be remineralized the chunks the the the molecular form of that calcium is so large that it won't fit into all these small demineralized areas and it won't remineralize those areas that's where Nano comes into play so Nano is under what is it 100 nanometers it comes in different sizes and shapes below 100 nanometers micro would be above that and by the way that's a line drawn in the Sand by scientists in fact the Europeans are thinking of changing that designation of what is considered to be Nano and what is considered to be micro so again it's it's just a Line in the Sand but to make micro into nanop particles which which they're 25x smaller something like that um you have to uh synthesize it you have to manufacture it so you grind it up even into smaller pieces but you can make the end result can be needle shaped it can be Rod shaped it can be more cylindrical shaped uh there they're different shapes and they different sizes and then there's the quality of the of the calcium you C these these hydroxy appetite uh companies are all over they're in Asia they're in Europe they're here in the US fewer than you would think I think there's one in Canada the best one is in Portugal if you want if you want to get into the weeds we can talk about that they make the best Nano and the safest version of Nano hydroxy atide but Nano has a bad it's a four-letter word right in in health care and Nano means it's something that is so small that it can get embedded in the body and it's for life well that's nano titanium that could be Nano Sil those are metals and other products that don't dissolve Nano hydroxy appetite let's just call it calcium Nano calcium the minute it hits cellular fluid or a bofilm or saliva it dissolves and it's in suspension the good news is that it dissolves into smaller pieces and when it's presented to that demineralized that cavity forming surface of the tooth whether it's on the root surface or on the enamel um it it gets taken up that much more readily probably even more readily than fluoride um and it's not as electr negative as fluoride but it has a smaller particle size so it's more likely to get groups of these little nanoparticles and by the way they should be rod-shaped uh they're very specific uh specs on what is the best Nano for safety and for efficacy um according to the Europeans there's no American Body that is making these decisions or or Canadian North American Body uh which is typical but um so these small particles are way more effective in fact I would argue that having micro in your toothpaste is a complete waste of time uh and there's calcium we've had natural toothpaste with calcium carbonate in it it's a different form of hydroxy appetite um and again these ions bond to they're electri they're uh they're attracted to each other via negative and positive charges opposite charges cationic bonding and that's what saliva is it's a cationic solution it's a super saturated solution of minerals and when it sees a positive charge then these particles are attracted to each other and pH has a lot to do with that and that's why when the pH goes above critical pH that electrical charge that equilibrium of dissolution to precipitation changes and it doesn't occur so if you're below that critical pH you're losing calcium in the tooth if you're above it you're laying down calcium the teeth are taking up that calcium and rebuilding themselves this is a natural thing the body has always been doing this our ancestors had this mechanism they were eating raw fruits and uh sorry raw vegetables maybe fruit on occasion some dates that would happen occasionally they would eat raw meats and then they would cook their meats and and a lot of dairy products fermented dairy products uh and and even compared to our current Meats selection and fermented products much much different even the vegetables were different they really were that mechanism worked fine they never got cavities there may have been some critical pH moments acid attacks in the mouth and then it was quickly reversed and healed and also they didn't eat as often as we did we snack constantly and that is so hard on this remineralization demineralization equilibrium because it's always trying to fix the it never has a time to rest that's why taping up your mouth at night is so important that's a 7-hour rest where the body has a chance to remineralize your teeth clean them brush them floss them thin that reset the bofilm tape up your mouth to keep the saliva in there add the hydroxy appetite I don't oh by the way important for oral care regimen don't spit out you can spit out but don't rinse after using a hydroxyapetite toothpaste so I just coat my teeth I use a nano uh manual toothbrush uh uh to it's like a squeegee I I get that toothpaste on there and then I put my oral Appliance on I'll spit out but I put the oral Appliance on there so my teeth are coated in oral in in hydroxy appetite all night long um that 7-hour window is wonderful for repairing your teeth if you're snacking all day long that that window doesn't exist you're always on this side on the demineralization side of the equilibrium if you're sipping on a diet coke even uh sugarless beverage or even a nice tea uh any snack any cracker for example Saltine cracker or even a healthy rice puff or something uh without industrial seed oils and it doesn't matter the bacteria are very active in the mouth and they are demineralizing your teeth so that's another reason intermittent fasting works well in the mouth so I would if you're going to snack on a Raw carrot don't worry about it if you're going to chew on some zoto gum don't worry about it but typically our snacks even any healthy Sports bar probably is is is causing an acid attack in your mouth and we snack on that at work we drink coffee at work I want to highlight what you're getting at here the fact that it's not necessarily the amount total it's the number of touch points and because of the modern way we snack and we drink we have touch points all through the day affecting that acidity causing the issue exactly so the frequency is more important than quantity so if you're going to have that birthday cake wolf it down quickly and don't do it again for a few days let the teeth recover so I want to get into some more Nuance before we leave the the hydroxy appetite piece you stated there the fact that the micro might actually be useless mhm the Nanos we're looking for I want to make sure we tease out the the scare for people you talked about the fact that when it comes to different you know Nano particles they can get lodged in the body is that the same thing when when it comes to hydroxy appetite what is the fear people have over that right it's a great question and there is a lot of it um I'm very surprised I I'm the first one to cave in I'm so paranoid about everything we put in our mouths in our bodies uh you know it's it's uh it's almost an an Affliction you know uh discussing and and uh filtering everything that goes in your body but the Nano first of all it's been considered this specific version this Rod shaped uh Nano version um and it's in a globular a fluid fluid uh it's made by a company called fluid Inova it's called nanoom that's their brand name for it and it is the only currently the only version of nanohydroxyapatite it's got hydrogen groups and water it's a little globul globular liquid version of nanohydroxyapatite and it dissolves very quickly it stays in suspens supension and it's readily available when the tooth needs it and if it does get out somewhere calcium dissolves I mean without calcium we we would be dead so there are some studies there there's a zebra fish study a zebra fish is not the same as a human being we have totally different protective mechanisms and even cell walls and and all of that so you can overcome a zebra fish very easily with so many different things even a hypertonic solution will K or or a or a uh yeah hypertonic solution of salt will kill a zebra fish um so there are a few studies out there they're old this is a product that was designed by NASA 40 50 years ago it's been in use by the Japanese and less recently by the Europeans for 50 years uh something would have come up there's some oral surgeons out there that say this is causing calcification of the pineal gland calcification of the pineal gland occurs with calcium period any calcium a calcium supplement it can occur with fluoride um and it's really about your calcium metabolism you should really worry about what any calcium that you take in can be from leafy green vegetables it can be from a supplement by the way I don't recommend calcium supplementation but I do recommend that you are you worry about your K2 levels the the amount of this vitamin that literally is the shepherd that's a great word I forget who used that term I loved it when I heard it it it takes the calcium to the right areas it takes it out of the bloodstream and puts it into calcifi tissues and that's where you want your calcium uh and it also takes calcium out of tissues that shouldn't be calcified or if it needs calcium it'll pull it it'll pull it out it'll also uh pull it out of bone marrow and and and you know the reservoirs of calcium calcium metabolism is second in importance to glucose metabolism if we don't get it right we're dead in the water so so I'm not worried about calcium at any size as long as it's U dissolved because calcium the every cell has calcium in it it needs it on both sides of the cell wall um so again it's approved it's been tested uh there's a group in the EU called the secs it's a scientific Council advisory Council these are very well-known scientists they have a three-year stint and then they're replaced I don't think they're paid to do this and their votes are silent so that they're not uh you know punished by the industry in case they know how they voted and they they approved this version and they were very clear that they're going to approve other versions and they're also that same committee that are trying to redefine what is a nano particle but if it's nano silver nano titanium dioxide that's in sunscreen once that gets out in the body it's it's toxic the body has to wall it off uh I agree agree with that there are nanop particles that should not be used and and we should not be exposed to uh microplastics are small enough to cause a lot of harm are they breaking down into nanosized particles I don't know um so it's safe it works well back to what you said at the beginning of this uh topic um micro uh you you were wondering you were commenting on the fact that I said micro is pretty useless it is um it it just doesn't work as well as Nano if you compare the two so I would want Nano and my toothpaste because it works so well I know it's safe um and you just have to use the right version of it and um and then and then you'll see the results uh if you have sensitive teeth a nano based toothpaste hydroxyapetite toothpaste will work within two to three days it'll be the best solution these people have been looking for a solution for a long time you know uh cadine pyrophosphates uh resin covers uh coverings fillings at the dentist most of that stuff doesn't work in 3 days a nano hydroxy appetite toothpaste will work because that's how quickly it remineralizes a micro won't do it ever uh now there are some toothpaste and I think this is very smart they have Micro and Nano in their formulation it's good to have Micro in saliva because it helps with the ionic stability and integrity of saliva saliva needs this ionic structure of minerals there are other things in saliva that are also important and the micro particles help maintain that uh but when it comes to remineralizing teeth they're Left Behind it's the Nano that does all the heavy lifting so uh I'm okay with Nano I've done so much research I'm probably the most paranoid person out there when it comes to health care probably not but but I'm up there uh and I've researched this my grandkids use it it works and I would rather have them use this and not get cavity which then later lead to bigger fillings and then crowns and then root canals uh so anyway it's it's safe it works just make sure you use the right version and make sure it's in a toothpaste formula that doesn't have other issues like surfactants and emulsifiers and things like that and then of course you have to thin and modulate and break down and reset the biome so that it can absorb these minerals okay so when it comes to the Nano benefits are going to be sensitivity REM mineralization I know whitening is a piece of that as well that's true we haven't talked about that yeah talk about that and then any other benefits I I missed you are well informed Jesse um um so whenever a patient wants to whiten their teeth I first of all I never bring it up I I don't think that's something a dentist should bring up because that's a very personal decision um and if they do bring it up I'll say let's try have you are you using a nano hydroxy appetite based toothpaste if they're not I would say use that for 6 weeks and let me know come back back and let me know it's inexpensive it works it's safe um and it's better than the whitening process that dentists use and and then there's the over-the-counter version which is even worse and more dangerous um let's try that first and as it turns out when Nano gets Incorporated back into the two structure the enamel the crystalline structure of enamel um it's an appetite structure that's a crystalline circular structure um it's a it's a mirror a fluoride actually is is very electronegative it it gets pulled into REM mineral remineralization Cycles as well but it's a wavy brittle surface and so it becomes a very dull finish nanohydroxyapatite on the other hand uh is a very smooth reflective it has high reflectivity so it's not necessarily the color that changes but the teeth become a lot shinier and a lot of people I would say at least 20% are satisfied with that result because it's it's really biomic it's the way our teeth were meant to look it's biomic is a material that is found in the body and that's what's being added to a nanohydroxyapatite toothpaste and that works well if you do want to whiten your teeth then you have to use a tray based system with a strong oxidizer hydrogen peroxide based and that has issues um it can damage tooth structure pulple tissue uh if overused and also this doesn't get discussed that often it's hard on the oral microbiome okay so I would try hydroxy appetite does have a whitening effect um and people are surprised by that um and the question is is how white do you want your teeth if you want them paper white I don't think hydroxypatite will work but that's because that's not what nature intended so then you'll but try that toothpaste for six weeks first um that that may do the trick there is a whitening effect and it's based on reflectivity and the surface structure less brittle smoother finish as opposed to uh fluoride fluoride could actually be could be making your teeth look dull uh believe it or not and also uh systemic Health if you're not a healthy person your pulp Chambers will be affected the the health of the tissue inside the teeth and your teeth will yellow from the inside out so what I'm hearing you say here is the teeth are porous and whether it be fluoride or the Nano hydroxy appetite they're going to take in these materials and with the fluoride it becomes more dull and it's going to be more reflective with the Nano hydroxy appetite as I'm picturing them take these up and why I'm going here is because a lot of people have used fluoride over the years you know I remember back when I was in school we do fluoride treatments I think it was weekly how long does that stay in the teeth whether it be the Nano hydroxy appetite or fluoride and again the reason I'm interested is how can we get that fluoride right out to put the better Nano hydroxy appetite in right that's a great question I I don't get asked that often um it's very likely that the hydroxy appetite will be replaced it will get demineralized and then remineralization will occur fluoride sticks a little bit better to teeth that's one point one pro that the fluoride activists really lean on and that's fine and it's true topical fluoride does work and it is it has a it dissolutes or comes out of the tooth at a lower critical pH so if you stay above that lower critical pH which you're more likely to do then you're less likely to lose that patch um but it came at a great cost and that was your IQ you know and other things uh uh it's it's a neurotoxin and arguably the fluoride that's in the tooth is the least of your concerns it's inert it's there it's not floating around in your bloodstream it's not getting past the blood brain barrier and causing inflammation in the brain so but it can dissolve out uh but the Nano hydroxy appetite itself is more likely again because it's like the rest of the tooth surface um where the cavity occurs is based on where the food is collecting where the bofilm is thickest and where it's dis dbio um so or it could be in an area that you're missing with a toothbrush or with floss and so if it's the same spot every time that over time will lead to a cavity because the tooth can't remineralize itself because it's always being fed this cogenic cavity causing food and it may be a dry mouth uh by the way kids have a higher critical pH which is mind-blowing to me I never knew that and this is an old study it's uh they don't tell you that in dental school so in other words kids are more prone to getting cavities because the demonization part of the of the equation starts earlier starts at a higher pH closer to neutral pH and that's why kids get a lot of cavities that's not the only reason but but uh if you're a ponist uh I can send you that study that is really mind-blowing so um but you can I think what you're trying to ask is can you get fluoride out of your teeth it's possible I wouldn't worry about it if it's there leave it there if it comes out you'll digest it and that'll be that and you'll replace it with Nano so stop using fluoridated products filter fluoride out of your drinking water don't use fluoridated toothpaste or mouthwash and you won't I mean you've you've cut it right there I mean there's no way to keate fluoride out of your teeth um just by using Nano hydroxy appetite over time your teeth will be very strong and you won't have to worry about the fluoride that's already in your teeth remember when you're ingesting fluoride as a kid and your teeth are forming in the gum line in the Jawbone the enamel organ which is the pulp tissue of the tooth it's getting fluoride from fluoride's in your bloodstream and it's systemic and it's being taken up by the enamel organ and so you've got fluoride most of us that were drinking fluoridated water like I did unfortunately I grew up in San Francisco and I checked they had fluoridated water when I was around and it was high it was 1.3 parts per million they've dropped it now down to 7 they've haved it um um the fluoride was was running around in my brain and my body and the enamel organ was picking up the fluoride when it saw it in the bloodstream got into the pulp tissue and it was part of the lattice work and the Matrix that it was laying down to form the tooth so if you're trying to get rid of fluoride and you've grew up on fluoride you've got it deep inside your teeth but it's inert you don't have to worry about it once it's there it's there it's like deeply embedded in that concrete bed you're you're never going to see it again as we talk about different things that that are applied to the teeth that are at least staying there for a period of time it gets me thinking about glycerin and toothpaste and I don't know if this is fact or fiction but I've heard that when toothpaste has that in it it's actually clogging up the teeth and not allowing the fact that they're poorest to do what they need to do right so is that something we need to be aware of in a void or what do you think yeah it's important to talk about all this and it's a it's a it's a I don't want to call it a rumor it is a something you see on the web it has one source I forget his name uh it was a professor from Purdue in Indiana um great University um not sure what his background was it wasn't in microbiome or in dentistry it was some other area chemistry or something he had a PhD and he kind of on the side said some interesting things about oral health some of it was correct some of it was correct it was before knowledge of the oral microbiome um he had good instincts but then he talked about glycerin interfering and acting as a shield and uh preventing the again he was all about removing plaque 100% which is not what you want to do you want bofilm bofilm is a good thing back then they were calling it plaque and then it would get incorporated into the bofilm layer I'm using the more current term and would interfere with mineralization he didn't quite say that but it was bad for the teeth it was a coating and in fact that's not true uh we know this I mean glycerin is 100% immediately water soluble it's used as a thickening agent in toothpaste it it it was glycerol is a from vegetable oils in the early days now of course it's all synthetic um in some ways that's better because they didn't use chemicals trying to you know distill it down from vegetables um but it's pretty harmless uh if you can avoid it I would say absolutely um avoid it if you can but I'm not I'm not too concerned about it I've done I've done a podcast episode on that uh this gentleman retired to Arizona he has like a little manual and in that manual it's 10 pages handwritten I think or old typewriter face you can find it on the web I have scoured the the planet uh for data on glycerin glycerol in all areas whether it's shampoo or anything like that and the stuff he says about glycerin is not true and again he has no scientific data on it and he has no studies on it so I don't I don't want to diss him he said some very interesting things uh but this was a professor that was had a different background that on the side probably had some dental issues and he was kind of a interesting guy that had some ideas and and uh he came up with some interesting Concepts but uh this is not scientifically based and you don't have to worry about glycerin important we talk about it I know for years I was avoiding it and I think that's what drew me to Earth paste and I think that's one of the toothpastes you have on your website yes I've since switched to a hydroxy appetite toothpaste I don't think the earthpaste has that in it you can correct me if I'm wrong it doesn't it doesn't in fact they added um clal silver which worries me I love I love the consistency the packaging the concept of bentonite clay with minerals in it uh bentonite clay has a lot of good things about it um you you can there you can use benty clay that has lead in it which is ambient natural uh levels of it you can also find a pharmaceutical grade of benty clay that that has lead at such a low level that you don't have to put the lead warning on there but adding colloidal silver to something that you put in the mouth that gets absorbed through the oral mucosa that can get into the blood supply I mean silver it's probably not high enough concentration to worry about but it the benefit isn't and and if you're going to leave out hydroxy appetite and there's no remineralizing agent in that just doesn't make sense so that's my reset toothpaste uh uh it's kind of like if you don't want there are a lot of people out there suffering the majority of us are suffering from typical toothpaste because of the emulsifier and the surfactant these are soaps and detergents anionic agents is the industry term for it that are there just to make big batches of toothpaste so that it's profitable even more profitable because when they mix it in big batches it's very hard to mix toothpaste and get all the ingredients to to mix to begin with and stay mixed when you put them in the tubes and then for them to have that even consistency it's like the McDonald's of of toothpaste you want each tube to be exactly the same so you put in all these chemicals and and that actually irritates and dries out the oral mucosa the oral mcosa is like the lining of the gut it's porous it does let things get through to the blood supply to systemically like fluoride and infections and and you and people get a lot of mucosal irritations canker sours and ulcerations and and it's very painful and so that it would a great that's a great way whenever a patient has geographic tongue or any kind of uh kind of um erosive kind of um condition in the mouth I always tell them to stop using all Oral Care Products because that's usually where it's coming from or at least it's irritating it and preventing the body from healing itself but um so but the clal silver I was disappointed that they added that uh it it worries me a little bit they add it because it has an antibacterial effect bacteriostatic is the term and uh it's simple it's cheap and you know Redmond That's the basis of their all their products I love most of their products uh because they're near a mine near the Great Salt Lake and uh I've been to their to their headquarters I think it was in Utah somewhere was it St George I think and incredible company uh great concept but but it's all based on what's coming out of the ground and that is isn't you know adding stuff to that isn't the right thing what they should be doing is adding Nano hydroxy appetite to their formula and from preparing for this interview and chatting with you today one thing that becomes really apparent is the fact you mentioned the fact the choal silver is going to kill bacteria this ties back to the essential oils earlier when you're talking about those the fact that that isn't the goal anymore that seems to me again from talking to you and and listening to your work and and preparing that that's an old school kind of mentality where we're trying to kill and and overpower the microbiome in the mouth and now your approach is more gentle and working with what we have and and creating an environment there where things can flourish naturally I mean there's no gentle version I I worry about the word gentle because it's still a way of trying to disinfect the mouth it's a complete 180 degree turn of no attempt at disinfecting the mouth it's nourishing feeding providing optimizing and that's why toothpaste should really be like food there should be a Prebiotic in it there should be minerals in it these are all the things that it should it should be reversed saliva you should take saliva and reverse engineer it and put it into tube that's ideally what toothpaste should be but that's not what toothpaste is it has all sorts of chemicals and other things and you look at toothpaste and you know when I look at food ingredients if I see three or four words I don't even need to read it I know it's good food but then you see the fine print and the big paragraph you know that that's a very manufactured food it's the same thing with toothpaste a lot of toothpaste manufacturers have to add all these Botanicals and there's no evidence that those things work in fact neem oil uh which is an old arotic I mean uh there are other things too uh cinnamon oil I there's a very well-known uh influencer in New York that used a um a homeopathic uh toothpaste and it just had cinnamon oil in it and he couldn't talk for two weeks after using it he reached out to me and it was I felt so bad it was the essential oils and they are bacteriocidal and so all these Botanicals and cute wonderful things it's not a face cream and even that doesn't work on Cosmetics there's no science behind it so and there is a skin microbiome I would be very wary on what you put on your skin so but the skin inside the mouth is even more fragile it's one cell thick this epid dermis is permeable but it's got multiple layers and it's more of course because it's on the outside so be very careful what you have in your toothpaste toothpaste should have very few ingredients it should have a lot of water and aqua um you know it it it should have no surfactant and emulsifiers in it how do you do that probably bonite clay which is wonderful it's absorbent it's uh it has a great taste and feel and structure to it uh hydroxy appetite certainly stay away from fluoride uh um but yeah it's there's a a a lot to know about oral care products and probably the best oral care product if you're healthy is none at all um you know and maybe you know maybe just a chewing stick or a little zotol gum and I have patients that do that and they've been doing it for decades and they're fine but you should see their diet well I think we're saying the same thing less is more and it's very fragile there and we don't want to go in there pretending we know better and we're trying to overpower with things like essential oils and different things that are killing bacteria right even gentle even a gentle version of that is still suspect and we should be very aware of it again we need to do that 180 and look at it completely differently and the other thing about Earth Pace that I always worried about was the fact that it was so coarse or at least it seemed that way and especially I've gone back and forth manual toothbrush electric when I'm using electric I always felt like is this doing more than good with that Clay on there and just blasting away at the enamel how do you feel about that it is thick um I'm not so worried about it uh what I do worry about is RDA uh relative dentinal abrasivity that's a measurement of how abrasive the toothpaste is overall so it could be it could be the clay it could be silica it could be aluminum Alum aluminate alumin silica they're all sorts of things that they put in toothpaste to up the abrasion and especially if it's a whitening toothpaste that's how they're getting you to think that this is working they're using a very abrasive toothpaste to remove a lot of the stain and so when you look in the mirror that's what that's what it's all about they're selling you something that you want so obviously when you look in the mirror and you go oh my God that works they you're going to buy it again but they're not selling you something that you need that's something that is safe and that's the problem that's that 180 that we need to do so just look at RDA if you like a toothpaste and it's not published anywhere and there are if you go online and look for relative dentinal abrasivity index you'll see a lot of sources um you'd be surprised how high it gets um anything under 50 is fine uh I like under 35 but and by the way there there is a bentonite clay based toothpaste that's coming out uh end of this month and it doesn't have that clay like feeling uh it's a great binder it's a great way of holding all the ingredients together um and but sometimes the Clays dry out a little bit or they get a little chunky and you feel like uh I wouldn't go by that I mean you could take a piece of acrylic just go down to TAP plastics get some cheap acrylic take your toothpaste with a brush and you know Mark an area with a little um marker and take some toothpaste take a very take a whitening toothpaste and brush for about 10 minutes of that of that U piece of plastic and then take a very safe toothpaste and you'll see the difference uh you'll see gouges and scratches in in the plastic so um it's uh but RDA if you like a toothpaste reach out to them if they tell you it's a company secret proprietary information move move along that's um they they should readily it should be readily available in their FAQ uh go with 50 or lower and you'll be fine you quickly mentioned there whitening and stains and we did touch on whitening when it comes to the hydroxy appetite the Nano it got me thinking about oil pulling how do you feel about that in the sense of using say a coconut oil swishing it around your mouth for Whitening purposes and Beyond oil pulling is there's nothing wrong with it uh I'm a big fan of arotic medicine I call that uh multi-generational um observational uh health care and in a way I did that in my career I I've been working for almost 40 years and there are a lot of things that I discovered On My Own by observing even multigenerational in other words they kids that grew up and then then had kids and and so there's a there's a you don't need to have scientific data necessarily uh oil pulling has some good data uh I think it's overdone a little bit um I think we a lot of the questions I get are can I just oil pull and not see my dentist and I have bleeding gums I have gum disease I'm just going to oil pull and that'll take care of it no oil pulling does not reverse gum disease it doesn't heal in a dis biotic mouth uh if your oral microbiome is off there are other things you need to do but it's great at preventing uh dispos by thinning the bofilm because of the one ingredient in uh coconut oil uh lorc acid it's great at Naturally thinning the bofilm I wouldn't Swit for 15 minutes that can overdo it a little bit but that's when you really feel the difference and again everybody wants to recommend something so that you go back to it and buy their product because they want you to feel the glean you know the clean uh that's overdoing it I would say oil pulling two to three minutes a day I think I when you asked me early on in this interview about what my protocol was I did mention if I had a very dry mouth I will oil pull for a few minutes in the morning it's a great way to reset and and moisturize the mouth so I'm all for it in terms of whitening uh not a big benefit there not a big benefit there I mean nor nor should there be there's just no mechanism there for it to occur does it remove staining probably not got it when it comes to hydroxy appetite and the remineralization how far have you seen that take people like somebody with a small cavity using that tooth face over a period of time is it more just to prevent cavities or can we actually have reversal that's a really good question and a lot of people get cavities full-on cavities they get the diagnosis from the dentist I'll even look at the X-ray sometimes and then they think just by eating better and using a toothpaste that I would recommend that that will all go away and that that is unfortunately not possible when you when the Decay reaches that dentinal enamel Junction that's where the enamel ends and the Denton starts uh there is no remineralizing that ever uh you have to cut it out remove it and fill it um so the trick is is to know to what degree how deep is that cavity typically on an X-ray you can pick that up although an x-ray is misleading an x-ray will only show about 25 to 40% of the actual amount of decalcification so when you see the lesion let's say it's an incipient lesion very small cavity you may have to double or triple the penetration and if that does reach the enamel uh the Denton then you know it's a call you have to make as a provider um but you can remineralize small lesions uh that are engageable with those little picks that we use on the grooves of the teeth or in between the teeth that are visible in x-rays uh with a nano based hydroxy appetite uh soon there will be on a market a you know the varnish that we get up until age 14 every kid gets their teeth clean and then they get that thing painted on their teeth it has an insane uh concentration of fluoride on it that of course goes right to the brain um uh that is will be replaced now with a new hydroxy appetite based varnish with L Arginine and prebiotics in it it tastes better uh no more fluoride face we call it fluoride face when they taste that they're just like you know or or they vomit on you that's very common in dentistry um that's how bad it tastes it also has hexane in it and propene glycol and all these crazy ingredients but a so a very prescription strength version uh 8 to 10% of Nano hydroxy appetite most toothpastes are 1 to 2% uh painted on your teeth after a cleaning can also help and also ozone if the dentist is on top of their game they can apply ozone oil so there are a lot of protocols and regimens um that are in place that will uh help remineralize teeth the the question is how deep is the lesion and who's your provider what specific Brands can we recommend given that most people aren't going to take what we just said and analyze every toothpaste to that level what what would you recommend to people it's a great question and it's always changing um and you know our recommendations always change but uh first of all no offense to the big corporations but what they're making is absolute crap and it's actually causing harm uh in in for example elevating your blood pressure I mean the fact that this is still going on is just ceases never ceases to amaze me um so I will never recommend any of the major brands because they're all making toothpaste essentially the same based on a model from the early 1900s late 1800s it's kind of like uh you write about PSE Sudafed uh all these decongestion uh that have been pulled from the shelves of pharmacies this is over-the-counter decongestion that was all approved in 1938 and again there was no it was just observational uh cor you know um and it's been pulled because it never worked uh in fact it was just a placebo effect for the people that swore by it and there's no point in taking a lot of sudit ofed uh uh you know to um because it has side effects for something that doesn't work uh fluoride is the same in toothpaste a lot of these products and soaps and detergents the thinking is based on Old science pre- science actually so I can't recommend any of those Brands I mean I try because they're readily available there are just as there are food deserts there are toothpaste deserts uh in the US you can get most anything mailed to you A lot of people in Canada get a lot lot of emails and Instagram um DMS about I can't get what you're recommending in Canada and I feel bad and then the other thing I feel bad about is that these toothpaste cost twice as much the ones I recommend than the big corporations and I'm not recommending it because they are more expensive I'm not involved with these Brands uh maybe I have an affiliate with them at best um but um that's what's required to make a healthy toothpaste and so these Boutique brands that I do recommend I'm going to uh name a few uh it costs more to make but thank goodness they're making at least they offer a choice I always tell PE people if they're price sensitive just use half as much it's going to be the same it'll have the it'll have a much uh better effect just by using half as much of the good stuff as any amount of the bad stuff um so um so my go-to have for a long time have been bokeh and um rise well I knew the founder of bokeh he's moved on he sold the company to uh another company um and it looks like they're keeping on with the same formula and I don't like their new whitening toothpaste but you know that's just uh another discussion uh rise Well's been doing a great job that is actually uh a dentist that came out with that formula and it's nice to have a dentist behind it um and that's a good formula they they've just recently gone to Nano they held off on Nano bokeh was the one that brought nanao to the market and allowed America to try Nano hydroxy appetite so I have to give James the founder of that company a lot of credit um and uh he just looked at the data uh his parents owned a dental supply company so he was kind of in the industry but no no Dental background other than that and he looked at all the data that was uh available at the time this was about 8 years ago and then he saw that NASA had developed Nano hydroxy appetite for zerog life and bone density issues and all that and then he saw that and this is all on the web you can look this up that a Japanese company 50 years ago bought the license to use it and put it in their toothpaste and they've been using it ever since um with great success the Europeans uh have been using it recently and now America has it via these Boutique brands do you see it in Crest and Colgate and cadine and all the big Brands no will you ever see it you will uh they probably will buy these small boutique Brands but only when there's a big enough market for it so trust me they are watching everything I'm saying and other dentists and influencers just saying and they're looking at the market uh I've had conversations with phds at Colgate very frustrating circular argument discussions um and they're sticking with their formula because it makes them a lot of money I mean a lot of money it's easy money it costs Colgate 30 40 cents to put a box on the shelves at Target and what does it sell for5 $6 but then all the damage it does uh it's almost like the food industry they don't care they provide something that makes you sick um so uh bokeh again great brand uh rise well great but they do use emulsifiers and surfactants uh some feedback on bokeh people complain about irritation I've had that for from day one um uh rise well taste not not my favorite but it's a a great brand and they just added Nano uh great for kids kids love rise well so your kid from day one should be using rise well toothpaste for example I mean not not Crest or a Colgate um and then uh good news is that everything I've been saying about toothpaste I've Incorporated along with my business partner Dr Stacy she's a pediatric IM IMF IM f certified dentist in Portland and then my daughter the three of us have put together a toothpaste called fig FY GG feed your good guys and it is an oral microbiome friendly toothpaste without emulsifiers and surfactants with a Prebiotic and Nano and micro in it so everything you've been hearing me talk about is in this toothpaste so I'm very excited there are choices coming and are we going to are any of these Boutique Brands going to take down Colgate and Crest no we are providing an an a uh we're giving the consumer a choice an educated consumer a choice for a better a better Destiny and oral health and even systemic health and uh and these mouthwash companies that are pushing Listerine and I mean it's really I'm surprised they're not being sued in fact I think there will be lawsuits there will be lawsuits uh I hear this all the time of practitioners Dental practitioners mentioning this to their patient taking them off of mouthwash and 6 to 12 Days Later seeing a drop in blood pressure and sometimes getting off the high blood pressure medication these are in borderline cases but but this is this is a crime this should not be happening this should be brought to the Forefront these studies that are in place are already 15 20 years old we keep seeing them pop up we understand now nitric oxide the noos synthes pathway and how the oral microbiome is a big part of that and how as you get older that's really the only way you can produce uh this endogenous Prebiotic and vasodilator in the body and we're knocking it down by swishing with this crappy product that has other problems as well twice a day in it and it has no benefit in fact it's slowly killing you so so my my recommendations are always I mean these are usually small Brands because they understand now not all small brands are safe A lot of them loaded up they they don't have Nano hydroxy appetite they stay away from that they listen to all the hype there's no scientific discussion or examination of the studies they put in EOS uh they put in other things Botanicals and they think they've got a great product they're really just making a fancy fluffy face cream for inside the mouth well congrats to you guys on the new toothpaste did you say a month that'll be available to the public end of the month yeah we're going live in a in a uh I mean probably by the time you air this it will be available it'll be fig.com FY g.com I'm very excited uh I know my followers will be they've been chomping at the bit to to get something that Dr breno or Dr Stacy I mean we both are on the same page on this something that we can unequivocally say oh God this is what I'm using at home so yeah I'm excited that's awesome and will that be available in US Canada how far will you guys ship yes so we are working hard on getting a availability in Canada um Canada has some strict tariff rules and shipping is expensive up there uh what we've been told we ship out of Salt Lake City out of Utah um we are going to enter the EU Market we're going to enter certainly Mexico and Canada officially at some point because we do I mean again we're in touch with with a a huge audience that knows about toothpaste and and knows what they want a lot of these Boutique brands are don't have that feedback and that connection and so we are trying our best because we get a lot of people going these are moms with kids they they they needed bokeh they needed rise well and it was hard for them to get or it was very expensive to get up there so as far as I know and don't hold me to this but anyone can reach out to me on Instagram as these things change I'm happy to get back to you our fulfillment center will ship to Canada um I just don't know what shipping will be we do have the USPS uh option for shipping United States Postal Service which is the cheapest like third class uh mail maybe it takes four weeks but it could be very inexpensive and we're not going to charge you anymore uh because you're in Canada so I I hope it is available right off the bat but um if you see the website and you're excited you want to buy some reach out to me um we'll see what we can do we're working on that for I I spent a lot of time in Canada got friends in Canada I went to UBC in Vancouver uh University of British Columbia um you know it's uh you you definitely need this stuff okay well for people out there who say it's before they have access to what you created here what toothpaste are you using because it sounds like until this you know what you're clearly saying here is the fact that there isn't a perfect toothpaste on the market yes we've come a long way you said eight years since the hydroxy appetite but you know there just isn't a perfect one out there so what are you using until this that's a great question well the immediate answer of course is I'm using my own to right and that that's been now for the last two years because I've been testing it and you know testing means in my mouth in my family's mouth in other people's mouths uh checking to see what it does when it sprinkles on the sink and does it stain clothing does it make a mess on the mirror what's the consistency like after 3 months um all of those things but but again bokeh and risell um those are the recommendations that I had made very proud that we stood behind them and helped them start uh I still if you can't get our toothpaste I would still recommend them because they are way better than what's available on the on the on the you know the the big corporate choices that you see in Safeway and and CVS and and Target and and all that so although I think bokeh and risell may be available in Target so it's it's happening it's changing I mean the options are more available yes they are more expensive but I would argue that in the long run it's less expensive you'll your dinner dental bills will be much less and you'll be happier so so yeah so I used I liked bokeh more than I did rise well but my grandchildren used uh rise well um uh because they liked the uh the flavors uh I really liked the flavoring that James did in the beginning very unique flavors and I do not like an overpowering burning mint spearmint I mean I'm I guess I'm sensitive to that I mean we have a mild mint flavor it's just a a hint of mint it tastes like food it's uh I I live here in wine country in Napa Valley and everyone's talking about the nuances of like of the of the uh vegetables and the sauce on your plate and how it goes well with wine and you know they there there flavor wheels that are available underneath your place mat I mean just the nuance and the complexity of things and that should be available in toothpaste I really do I I really do think that because this is something you do twice a day I actually look forward to using toothpaste that that's important I look forward to using floss after I started using the the Slate flosser um you know it's to to make a habit stick you have to be you have to it has to be enjoyable right so the the big the big toothpaste companies what how can that be palatable I don't get it it burns it makes you wrinkle up your face you want to spit it out uh you want to rinse out right afterwards again you don't want to rinse with a hydroxy appetite toothpaste you can spit out I actually swish a little bit um I think toothpaste should be less thick than what we typically get again it's reverse engineered saliva should be very viscous by the time you've done brushing for two minutes it should be very viscous I would I walk around the room and I swish with it and then I spit it out but I do not rinse with water as I said at night I put in my Appliance cuz I want that hydroxy appetite in place as long as possible with fluoride you shouldn't be using fluoridated toothpaste but if you are spit it out right away rinse out your mouth to get rid of that stuff I mean anyway it's uh tooth the toothpaste Market is changing and I'm very very excited to be part of it on many different ends supporting other brands and getting the word out that need to do this 180° turn it's time let's move into floss you've mentioned the Slate flosser and before you also mentioned silk and I think when you mentioned that one you said it's a little bit tricky to use talk about how you incorporate both of those into your routine so before slate came out again I from day one I've been very concerned about uh floss and nylon particles breaking off this goes back 25 years ago and I'm not sure I mean as a dentist you're always wearing Loops you know we floss patients teeth I floss my own teeth I would see little fragments break off in the old days we used to see little micro beads in patients gums again I'm I'm wearing a a 4.6x magnification surgical telescope on all my patients um and it's amazing what you can see again you can't treat what you can't see but we would literally my hygienist would see it as well we would see these little red micro beads they're tiny almost in visible to the naked eye they were putting that into toothpaste to make it Sparkle it's not quite a microplastic but it's between a microplastic and a chunk of plastic and this this has now been outlawed in California thank goodness um but just for looks so there are a lot of things that show up that we can see if we have magnification strands of floss chunks of floss would break off where does that go um the body has to wall it off sometimes you can have a foreign body reaction action I've seen that where someone comes in I I typically can recognize it just by talking to a patient on the phone it's usually a piece of popcorn the hull of a popcorn just based on on the questions I asked how quickly did it come up the pain was it throbbing does it get worse when you lie down um does it feel better when you floss it just for a few minutes that is a foreign body reaction due to a particle a foreign particle that is not dissolving and the body overreacts and sends all the blood to that area and if it's a popcorn kernel you put a you tie a double knot into floss and you drag it through there a few times the pull comes out and the pain is gone almost immediately if it's a piece of plastic from a toothbrush or floss that's more difficult the body freaks out when it sees that and that has to be fish out I have fished out small pieces of plastic and and they're more difficult to see uh the Teflon floss which I liked in the beginning 30 years ago when it came out I thought oh this is brilliant it was uh cortex gortex came out with the product they used the p FTE it's a Teflon based product um they sold it to Oral B I think proor and Gamble and you don't want to be using Teflon uh small pieces do break off and you're ingesting that Beyond microplastics uh and micr Beads uh and then just pure nylon floss uh is is a problem uh the Slate flosser uses a uh pfree uh floss those are good I've looked into it very inert uh and durable so you can you can use it many many times uh if you really are paranoid and you want to paranoid in the good sense I'm not saying in a bad way uh and you really are working on being clean and and trying to avoid every single contamination use the radius floss uh again I mentioned the radius toothbrush uh this is a natural product it is made by silk worms and it's biodegradable the case unfortunately isn't uh wish it didn't come in a a plastic case it should come in like a paper waxy paper case that will break down in in in the landfills um but uh if something breaks off it's a protein uh it's silk uh there's no foreign body reaction so is it more difficult to use than a Teflon floss yes flossing is a very difficult thing to do for patients it takes a lot of dexterity and and coordination and it can be painful uncomfortable and a lot of people have floss phobias um uh that's why the Teflon floss is good I mean it works for people so radius floss is more difficult to use I would argue that the Slate flosser is the best thing out there right now even though it's not silk um because it's easy to use it's really a GameChanger it's more than floss uh it has these patented little silicone hairy silicone gum sweeps it really cleans as well and it vibrates at 12,000 cycles per per minute um it is uh it was invented by a dentist up in Washington uh Dr Snyder um I just have to hand it to him I wish I had thought of it it is really an amazing device it is one of the great big leaps in oral hygiene care for Home Care again it's plastic it has batteries in it I understand that but but if you if you have oral disease this is something you need to get on and theoretically it would it could last a long time the batteries come out and you can recycle your batteries so it doesn't have a rechargeable battery which I like and the batteries last for months uh but the the design of it is amazing and and again I'm not associated with him I don't own any portion of his company but I just like it so much that I and we use it at home everyone in the family uses it and we love it it's I my go-to was a floss stick unfortunately made by lisine company but it helped a lot of people because people can't wrap floss around and or they're not willing to put their fingers in their mouth they find it difficult a floss stick is is a is a great way to go and there's nothing wrong with using a floss stick this takes it one step further the Slate flosser it's a it's a rigid bigger circumference handle the head doesn't flex and it really those gum sweeps make a it's it's more than just flossing so use the Slate first then use an electric toothbrush use Nano hydroxy appetite toothpaste you you you're really gaming the system that way in a in a great healthy way you've got me convinced how long you been using the this late instrument it's been about four months and I'm I I really stay excited about things and uh I've got two of them and my wife has one she is just Bonkers about it she is the oral hygiene queen always has been and she can't even look at floss it's like if she she's got to have this nearby and when we get low on the little replacement head she gets very nervous she needs to have like a hundred in the cupboard behind us anything below 100 is too low so we know for you before you go to bed you put the toothpaste on your teeth spit out but don't rinse and then you put your Appliance in for for your sleep apnea yep tape your mouth MH and just to clarify those two different things there before sleep I think even for a while I was confused I thought the Sleep tape help with sleep apnea but you explained earlier that's to help with saliva during the night well it it can help with sleep happening that's a whole different category and that was how I originally got on to sleep tape because it to me it was a differential diagn diagnostic tool uh it was very difficult once I got my sleep medicine Dental sleep medicine uh training uh I really wanted to cut to the Chase and so when I asked my typical middle-aged male patient do you snore and the answer was always no I don't snore my wife does but you know and then I got the real story from the wife it's like oh my God he's a he's a you know and I I could tell that there was a sleep disorder breathing issue based on other things dentists can see sleep apnea decades before a physician can because we're looking at different things we're trained differently but it was it would be it was a way to convince the patient that they had a breathing disorder and it started off with the snoring so if there were I mean in a nutshell if the tape stays on and it's on in the morning and they slept better that means they were forcing all the air through their nose that helped them greatly uh sympathetic tone parasympathetic tone obviously it helps with oral hygiene and the oral microbiome but that's a different category um if the tape was still on but they tossed and turned a lot that means they couldn't they were compliant they could keep the tape on but they couldn't get enough air through their nose to sleep properly they were you know suffering from a little hypoxia uh they were over breathing CO2 Etc um and then and if the tape comes off obviously you can't breathe through your nose and that is related intimately with sleep disorder breathing so for me it was a tool but then later it became something that patients were like oh my God this is wonderful uh I told I finally convinced my husband to mouth tape the snoring one away or they started feeling better it's not a cure for sleep apnea uh but it's a great diagnostic tool and for borderline cases upper Airway resistance syndrome and even for people that don't have sleep apnea it's better to secure the mouth close it and again why not there so many benefits to breathing through your nose from the cavity and gum disease perspective in oral microbiome but also from a sense of well-being deeper sleep lowering your respiratory rate this is all measurable by the way uh from an Ora ring Ora ring is sensitive enough to pick up between not mouth taping and mouth taping mouth breathing nose breathing but why not take advantage of that wonderful uh Wellness of being able to breathe your nose for the seven to eight hours that you're just sitting there doing nothing right that's what mouth taping really is everyone should mouth tape uh I I mouth tape even though my mouth stays closed I think but I don't want to take that chance I want to force all that air in and out so my co22 levels are perfect and my h r v levels go up my respiratory rate drops my resting heart rate drops when I mouth tape and I can breathe through my nose just fine what I'm trying to tease out though is the difference between that Appliance and the mouth tape which you're doing both so mouth taping what I'm gathering here for people that might have a bit of snoring or their breathing is slightly distorted this might be enough for them and you've mentioned and I know in your book you talk about the fact that you have mild sleep apnea so you need this other layer this this actual mechanical thing that goes over your teeth and holds your jaw forward as you're sleeping as well exactly and so I I need that device uh um and as I get older I'll probably rely more on it um I've just recently lost 15 pounds I think that helped uh because your tongue can gain weight your Airway can gain weight and can become more constricted um but again as you get older the tone of the airway is it doesn't get any better um but there are cases borderline cases where if you can redirect the air that goes in and out and steer it through the nose the nose is a baffle it slows things down it slows down the velocity of air that goes past the airway and back out it humidifies the air uh in such a way and so much so that baffle that that restriction uh and also changing the co22 mix so that you're breathing rate drops all of that makes it less likely for the airway to collapse and once it does collapse in your and your mouth breathing and your mouth is very dry and saliva flow is down when those two sides of the airway stick together they're going to stay stuck together until you break them apart with an apnea with a sudden Awakening or or an arousal and so moistening the air slowing it down with a borderline case for someone that is just a a light snore and then when they do start snoring and the mouth Falls open the airway gets sticky uh breathing rate is higher respiratory rate is higher uh there are cases where that is the cure now I'm not asking patients to to be to be determining that on their own get a sleep study get an aura ring uh track your sleep and if your sleep partner says you're snoring deal with it right away it's not funny it's not cute it is a sign of um of of narrowing Airway and uh there's actually a great product out of Toronto Toronto I think it's Toronto yes it is Toronto called Nora n o r a and I'm going to put them on my store soon haven't gotten around to it yet but it's a device that I tried and I took out my oral Appliance and it's a little air bladder all the devices are far away by a plug 6 feet away from the bed there's just a plastic tube and a little microphone by the bed and when it hears you snore it fills up the air bladder that's in inserted into your pillow and it changes the positioning of your head um and that's enough where instead of going into a full apnea or staying in a state where you're you're having long apneas in other words you're not breathing for 30 45 50 seconds this readjusts you quickly and and subtly um and for certain patients this this is wonderful it really works well um and so that's a device that I'm going to be recommending soon and that is available in Canada by the way uh all of North America I think it's available all over um but so it's it's I know where what you're trying to do and everyone's looking for that absolute like should I tape should I do this and again it's multifactorial find someone on your team I would argue that it should be a dentist a sleep trained dentist Physicians are a little obtuse on this uh based on their training no offense um um and we can see it sooner so we can treat it earlier so that you don't gain all the weight and get all the comorbidities of sleep apnea that come over time with uh you know not breathing properly suffering from sleep disorder breathing and having an Ahi of 5 10 15 74 interruptions per minute of waking up and suffering and brain fog and all of that brain damage um it gets someone in you on your team that can address this in its early stages and talk about things things like Norah or mouth taping and and uh again if you're not sleeping well you're going to wake up with this huge appetite your leptin and gin hormones are affected uh these are the same hormones that they're playing with with these uh weight loss medications um and um you're G to you're going to gain weight and you're going to look for energy because you're tired the brain fog in very fermentable carbohydrates uh junk food breads crackers snacks sugar uh sweetened beverages all of that so don't start down that road um I wish I had caught my sleep happening earlier I talk about that in the book uh but I didn't know the other device most of us don't know I saw on your website was this suction cup for your tongue yes how does that compare to the I've seen your device in a video that actually goes over the teeth and holds the bottom jawo yep is the suction cup of the tongue does that do something similar obviously it's a different mechanical way of holding things but does it have a similar end result that's a great question um the quick answer is no but uh that's called the TRD the tongue retention device and I like those I I would have them stocked in my office the one I chose to stock was out of Canada actually came in two different sizes and so what my device does it's rigid it has these mcferson strut rigid uh devices they're telescopic things that I can move my chin forward I can stretch open but when I go to relax when I let go of the chin you know the jaw will fall back especially as you go into deep sleep the muscles relax um the struts you know bind or Bang into each other I they're they're fixed in length they're adjustable side to side and in telescopic length and that prevents the Jaw from falling back if the jaw doesn't fall back then the tongue is in a forward position when you go into deep sleep the tongue will roll up into a little ball it's very complicated many people have different tone and different positioning of the tongue they have different muscle memory this this is all the M functional aspect of things and the tongue can gain weight as well it can marbleize and fat it can get bigger it can block the airway but by holding the jaw forward and this is not for everyone uh again I would screen my patients by sending them to an sending a camera down their throat doing a modified Muer maneuver that's in the book and I would want to see the difference based on the camera and the ENT I actually had to train him to do this it's it's a mu's maneuver which is what they do but then it's modified for the sake of a dentist so they would look at the the airway but then I would want to see the airway with the the chin supported and the chin all the way back I would want those two extremes compared and he would give me a percentage in the three different zones naso lenal ferx and where so knowing where the blockage is and how much of a difference there is between being fully protruded and fully retruded gave me a sense that I would I was always working on the right patient case selection and 99% of the time it worked if you don't do that kind of pre-election then it may only work 66% of the time these are numbers that you see in studies so so uh it's not for every one and there are some side effects sometimes but the TRD is a great way to get the tongue out of the way the jaw can still fall back but when you place this it's got a soft silicone flange that sits between the lips and the teeth so it's held in place it's like a shield there's there's an airway through it you can still breathe through it if you want and then there's a a bulb that goes inside the mouth with an opening in it and if you force your tongue in there and push out all the air it's a suction cup and then your tongue is caught in this forward position ideally it should be up on the roof of your mouth but for those people where the tongue curls up and balls up and goes to the back of the naso fing or lower V fings then then that's a good thing that could also make a difference and it's cheap I mean they cost nothing you can get them on Amazon I think for 30 bucks um I mean I would always do it in conjunction with a provider but if you're willing to try it and then make sure you're tracking that uh there are simple apps that just listen to your snoring does it affect your snoring if the snoring goes away with a TRD you have accomplished something you're less likely to have apneas again verify that with a sleep study an a ring is a great way to measure sleep you're going to get more deep sleep typically people will drop into deep sleep but then the AA ring will show you this in a graph how long is that bottom Blue Bar in other words you want it to be as wide as possible up to a point because the body will get you out of there naturally out of that deep sleep but if it's just a little blip and then you bounce out of it and then you bounce back into it those are all apneas you're you're trying to get into deep sleep but once you're in deep Sleep these muscles and REM different type of deep sleep all these muscles let go and then you can't breathe and you're and then you wake up and that's an apnea so you can see all this represented it's a it's like a stage play It's like a Broadway show there's certain things you need to see in terms of timing and all that uh and by the way the the biggest just want to throw this in there something I've learned over time I talked about it in the book but didn't really emphasize it as much as I wish I had probably the most important thing other than getting a sleep study and verifying your ability to breathe through your Airway nose breathing mouth breathing all of that that's those are the that's the anatomical portion of puzzle piece in sleep apnea but in terms of lifestyle and hacks and sleep hacks the biggest one by far far is going to bed within minutes of the same time every night and waking up I would wake up naturally but what will happen is that if you go to bed within the same minute I mean set an alarm to go to bed and make sure you're in bed we try for 9:45 and we're pretty good on that and I typically wake up wide awake to where I can't go back to sleep within minutes of the same time that's without an alarm clock it could be still be dark right now it's because of daylight savings it's very dark and that is your body that's your circadian rhythm your circadian rhythm is quite strong if you let it be that way but if you don't go to bed and you've been blinded by blue light and you go to bed late you're not going to be able to catch up on any sleep because you've missed that first stage of deep sleep and even Rim later but it's staging it's all about staging so that is the biggest sleep pack I think going to bed within minutes of the same time every single night and if you do make a change make it slow over a period of 2 to 6 weeks and again that's why everyone gets crazy during daylight savings time I mean car accident rates go up uh death rates industrial accidents all of that people get tired that one hour makes a huge difference it's big even 10 minutes makes a difference you've brought up aing a few times and you brought up a sleep study I'm a big fan ordering as well is that technology now at a place where it replaces an actual sleep study going in and getting all the wires hooked up and going through the whole riger rule or is it is there still more benefit you can get from doing a full-on sleep study that's a really important question to to have an answer to and I love the a ring I'm not associated with them in any way um um and I'm on my third version um and the software is getting better the algorithm is getting better it's a great company uh they take it very seriously they have studies that compare their study essentially that's what it is it's a sleep study every night on your ring that they're doing um and they compare their study to a PSG which is the gold standard the poly sonography which is where you go into an office a like a clinic it's not a hospital typically and they observe you and they do as you said hook you up to a wiring harness from your chest to your feet to um you know brain wave patterns your head scalp and then they measure you um and they do get a lot of data from that and the data that Ora ring is not getting are the brain wave patterns and so Ora ring claims that they're within 97% of a PSG I would argue that that 3% that they haven't matched is probably some very important data brain wave patterns and um maybe they're working on that uh I don't I love their product I recommend it to everyone but if you've never had a PSG let let's say if your sleep scores are 95 and higher and your Readiness scores are excellent and all that you probably have nothing to worry about and if you're not snoring and you've verified that you're mouth taping you're healthy overall if you feel like taking a nap during the day that's not normal I'm 65 years old I don't nap anymore I used to nap a lot cuz it was there and I would just give into it I would nap for 10 minutes I napped on the side of a glacier locked in with crampons and an ice ax on Mount Shasta cuz I was tired and I napped for 10 12 minutes felt great and kept climbing I mean that was my norm and I was healthy I was climbing mountains and skiing and mountain biking and you know doing eight night 8 day traverses above Tree Line in the sieras in the middle of the winter I mean these are all very demanding things but I was always tired sleepy tired that's gone going from 12 apneas per minute which is considered to be mild um mild moderate and severe to zero apneas based on many psgs and I had a lot of them because I helped develop a product that was later bought by Google um and worked on their algorithm uh was a new way of measuring sleep touchless um and so we were comparing that technology to PSG so I was being wired up a lot so I've had a lot of of these attended sleep studies um and um it's still an important study to get you can still Garner a lot of data from it and again aing is great it's something that you should be looking at every night every morning my wife and I compare results you know we say hi honey you know good morning how'd you sleep and uh we'll compare scores and that's kind of our morning routine uh in the very and if someone didn't sleep well well well did I snore last night did I keep you up and vice versa and was the temperature wrong are we using the wrong comforters for the season you know all those things that this is important and did we go to bed too late uh you know when we're streaming TV and that time comes and we're in the middle of a show we're good it goes off and we go upstairs we turn on our red lights brush our teeth and we go to bed this is probably the most important Health modification behaviorally speaking that we have made in our lives and we were both very healthy to begin with uh but evidently not as healthy as we thought and this really took it up a a bunch of notches so I would say I would and again I say this in the book and I know it's a little unrealistic but I put it in there just to be a radical and get the ball moving and I think they do this in Iceland and Italy I spoke to someone in Iceland everyone should get a sleep study at a young age get a Baseline and I treated a lot of I treat a lot of infants for sleep we can catch it way back then Physicians aren't doing that of course even pediatric uh maybe a pediatric ENT with a lot of good continu education is catching it but they're not getting the referral from the general it has to pass it has to go from a dentist or a general physician to get to that person so there's a there's that threshold or that that uh kind of firewall which is not good um but everyone should have a sleep study at some point in time if you haven't had one get one the problem is is getting one and getting your insurance to pay for it because if you're not sick and you're thin and you don't complain about napping and and all that and you read the book you read it twice and you know that in my book I said here's the Epworth test they're going to give you it's a written test just fail it this is how you fail it get a 11 or higher on it and tell them you fall asleep at the wheel when you're picking up the grandkids or the kids get that PSG and again the they're incentivizing Managed Care uh Medical Care to not do that test it costs a lot of money um I actually set up a system in in my area in the Silicon Valley um where if patients didn't have insurance I had a way first of all I had a way of porting that patient directly to the sleep study I bypassed the primary care physician I did it legally and I worked with the owner of the clinic who was a very uh outh trained sleep physician and he listened to what my issue was I I was seeing a lot of sleep apnea but they were always getting bounced back and then 10 years later they would be like I have sleep apnea and the physician recognizes it and but it was too late I mean not too late it's never too late but but it was it unnecessarily late uh because they were suffering at that point they had gained weight or had a fib or something but um uh and we worked out a system where I wouldn't I would fill out the form that that he would fill out give to the insurance plan but I wouldn't sign it I would give it to him he trusted me enough and you know um after two to six months you realized that I was batting like 970 980 and I'm convinced those other cases were so borderline that they were hard to pick up um and we kept after him but um and then they would get the sleep study insurance would pay for it and again that was the only way they could get it because these were healthy individuals they were like me they were thin and healthy and um or kids they really push back on kids because they think they're just going to grow out of it um so that worked well but then I negotiated a cash price it was down to 1,00 so normally insurance companies pay about between three and $5,000 for that sleep attended study the Sleep the attended sleep study uh I got them down to a cash price of$ 11,100 so for those people that didn't have insurance they could they could get that sleep study so sleep studies are important still to answer question I think everyone should check in every decade if they're healthy obviously more frequently than that in another words if your dentist is making that device for you and he thinks he's done go get tested again and verify that that device is working if you're mouth taping and you think you're better and that your sleep apne is cured which is doubtful uh depending on what level of sleep apne you have verify that don't rely on the aura ring look at those Rin wave patterns get a PSG get some good data it's important got it we'll end on this so you get your sleep study done everybody ideally should be taping their mouth there's different benefits they're going to get whether or not they have sleep issues and then we've talked about the one that holds the mandible forward the device that you use the one that suctions the tongue the the common one is the CPAP machine which uses air right is there any other devices people are using if they have sleep apnea the the Nora device um I if you have a full-on uh diagnosis of sleep apnea I wouldn't you could still use it along with other AIDS um there's a lot of hybrid approaches uh or or combination approaches like some what worked well for me are I had a patient who had a Ahi of 74 little old lady delightful great sense of humor dead tired right had lots of heart disease issues she was in her 70s she had an Ahi of 70 4 that's 74 that's more than I mean 74 times a a a minute she was waking up imagine someone waking you up that often she was wasn't getting any sleep the doctors gave up on her she couldn't wear a CPAP CPAP there's no CPAP that would actually fix that you'd have to blow her up like a balloon toe to prevent those apneas so so uh I she wanted her her son was the CEO and he healthy guy had mild sleep apnea and he said oh you got to my mom is going to come in to see you you can cure her and I I couldn't but I made a deal with her and I had her sign the chart I said listen if I can get you down with an oral Appliance it won't fix you completely it won't get you to zero or below five because you're just too far along and your Airway is just too narrow um then uh will you try the CPAP again and actually I told her about an APAP which is a more modern has better feedback is better than a CPAP and she says sure I'll do it so it took us about 3 months I made her the device titrated it adjusted it and I said listen uh it's time for a sleep study this is the best I can do uh and she was protruded she was able to wear it and put it in and you know it requires a lot of patient management and help and all that but she did really really well she was very motivated um and so she did the sleep study we got it down to 19 apneas which is a complete failure in Dental sleep medicine it should be five or less uh uh but we got her down to 19 and I said listen 19's pretty good I in fact I'm surprised I was hoping for mid 20s now it's time to try the APAP so we got her the APAP I directed her to a different uh CPAP uh provider these are the Sleep Technics there's some that just throw it at you and say you're on your own but there's some that are really work with the people and she got onto the APAP and now she has a an aptia with the two together she has to wear the oral Appliance but the APAP is working for several reasons one is that the airway is already open so the pressure is way lower again an APAP or a CPAP blows you up like a balloon it pushes pushes air past the constricting Airway with the positive pressure it balloons up your Airway and keeps that pressure assuming your mouth is closed you have to mouth tape sometimes with an APAP and CPAP that's a different story and that positive pressure keeps the airway open and you can sleep better so the two together again every person's different but so there are many different Therapies a CPAP alone has very low compliance after one year only 30% of people can stay on the CPAP and typically those people are forgotten by the medical system they're like we've done everything we can you got to wear it and the patient doesn't wear it and then they go in next year for another test and have you been wearing it I've tried you know they haven't if you're a pilot in Europe or a heavy machinery operator your CPAP is wirelessly sending information to your provider making sure that you're wearing it it's like a breathalyzer right it's verifying that that you're doing that and I think that's great the pilots Union here in the US has not allowed that they're against that uh cpaps are not comfortable uh they have a lot of side effects they're blowing a lot of air on you people that where cpaps have a higher Decay rate there a lot of dry air in there the hum humidifier may not work uh it's uncomfortable it leaves marks on your face it prevents you from moving around although you shouldn't be moving around if you're in deep sleep so so that is again again something that was developed in the' 60s I think it was here here at Stanford and uh it's not perfect so but there are a lot of things there's a lot of hybrid options that if you do a little bit of this a little bit of that and the person whether it's a dentist medical uh dentist physician team working together that can be fixed and again every person's different but it's something you really need to fix it is life-changing uh if you can get deep sleep and REM and sleep well you're a different person and your your destiny your whole life it'll be two different paths remarkably different from from each other if you are getting good deep restorative sleep all right well important we went deep into that we covered a wide range here congrats again on the new toothpaste we're going to link everything up in the show notes the toothpaste your book your social media Dr B really appreciate round two this was great I'm sure we'll do it again thank you absolutely if there's a round three in the future I'm in uh please Count Me In and Jesse congratulations on your podcast it's uh you've got some great names and I learn a lot just from listening to a lot of the people you interview so good luck and thank you for having me on again Jesse thanks Dr B emphasizes the importance of the oral microbiome stick around here for my chat with Dr Davis he goes deep into the gut microbiome you don't want to miss this I'll see you over there it would be hard Jesse to find diseases modern diseases that are not either initiated or EX masturbated by the microbiome look what we're doing with roriz