Hello, my name is Bita Fox. I’d like to dedicate this podcast to dentistry seen through the lens of a holistic dentist. What is holistic dentistry? Well, it’s not a speciality. It’s more of a niche dentistry really. It’s seeing things differently, it’s forward thinking, and seeing the patient as a whole. As a holistic dentist, I focus on three things in a nutshell. The culprits leading to metal toxicity, to bacterial toxicity, as well as structural issues. Today, I’d like to go back to basics, and talk about the oral landscape, where the oral microbiota live, and where it all starts.

This is so fundamental that I feel grasping this aspect, allows for a much better understanding of tooth decay and gum disease. The mouth is host to over 700 different bacteria species, which translates to approximately two billion bacteria in numbers. Increasingly we’re seeing robust studies show, that good oral health not only prevents the most common disease in the world, namely tooth decay, but it also prevents gum disease, and other infections in the jaws, which in turn are known to impact on the cardiovascular system, on our brains, as well as on our immune system.

So early days in the dental history, the trend was to focus on number of bacteria burden, the amount of plaque, which later came to be more of a qualitative analysis and interest. We learnt that certain bacteria like streptococci mutans are linked to tooth decay for instance, while other types of bacteria closely linked to gum disease. It just all became quite refined, and certain bacteria were linked to certain lesions, and certain diseases. The oral microbiome is generally very well studied, simply because it is so easy to derive data from it. However, the oral biome just doesn’t seem to interest people much, if you compare it to the microbiome of the gut.

The oral microbiome is not too dissimilar actually, to the gut microbiota, in that, they’re both extremely diverse. The global market of probiotics aimed at the gut, is a multi-billion business. But I discovered when I was looking for oral probiotics, that it is indeed a small market. The research around this type of probiotics is very scarce, let alone robust and well-funded research-wise. So why isn’t it enough to just remove the plaque such as brushing or flossing? And why is it that some people in spite of their best efforts, still get tooth decay or gum disease for that matter? This also begs the question, is it not enough to have hygiene sessions with the hygienist? Surely this should be enough.

The answer is that, it appears that gum disease for instance, can worsen in spite of someone’s best efforts, and often regular hygiene visits. Sometimes, its constant need of dedication can impact on the patient’s compliance, and discourage the patient from keeping up with the prescribed regime really, that the dentist has prescribed for them.

The trouble is, by simply removing the plaque and calculus, also known as tartar, we’re also removing the good bacteria. Unfortunately, we cannot be selective in our physical removal of this plaque or tartar. The good goes with the bad, and we know the bad must go. I like to draw a parallel with the gut, and the treatment of candida for instance, overgrowth of candida. Firstly, and ideally, what should forego the procedure, is a good cleanse, by maybe a few colonic irrigations followed by the anti-candida remedies, that a naturopath perhaps would have prescribed. This step does all the killing of the bugs.

Note, the oral equivalent might be a scale and polish by the hygienist, and a few days of mouthwash rinsing… By the way more on mouthwash rinsing, and my angle on it later. Both the oral and the gut procedures mentioned, eliminate bacteria, and in both cases, the good go with the bad. In the anti-candida protocol, we would have followed the advice of our naturopath. And we will then maybe wait a little while, not very long, but yes, just a little while, and then start replenishing our gut with good bacteria. And so we follow some instructions in that, we eat lots of probiotics, immerse our diet in lots of veggies and lean proteins, while keep to moderate amount of complex carbs. We keep to colors of the rainbow in our salads, and so on. All this wonderful stuff, contributing to good bacteria in our gut.

Avoiding sugar of course, is a must in an anti-candida protocol. And yes, all these sound choices that we make, would complete the picture of a really balanced gut biome. And of course, it’s not always easy. And the outcome of restoring a gut microbiome, isn’t always successful for various reasons. And it’s all about the root cause really, why it happened in the first place. Dental [ridging 00:07:15] for the gut lining to be wrecked, is one of my favorite subjects. And I will be talking about that later in a different episode of my podcast.

So the idea with the anti-candida protocol, is to kill as much candida as possible. It’s actually healthy to have some level of candida, but anyway, this is not the podcast where we’re going to talk about that topic really, but the idea is to kill off as much as possible, but of course the good goes as well. And then to not leave room for candida to come back in, or indeed worse, perhaps really nasty bacteria, finding a foothold in the gut landscape. So that’s the whole idea, we’re then replenishing with good bacteria so that bad stuff cannot grow back in there again.

And there is an ocean of research at our fingertips, when it comes to replenishing the gut. As I mentioned earlier, multi-billion markets offering us a variety of probiotics, they’re classified even into different groups, types of probiotics, aimed at restoring gut health. The same can’t be said about restoring the oral microbiome. After a thorough and successful hygiene program with your dedicated hygienist, and periodontist perhaps, a specialist, you have had removal of many bacteria, good and bad. You further advised to get rid of more bacteria by using mouthwashes and so on, and just kill off that last bit of bacteria and plaque, unfortunately is often an alcohol-based mouthwash we’re talking about, when we say mouthwash.

And so yes, more killing of bacteria, of what’s left off, and yeah, in the end, not many bacteria left, good and bad have gone. I am of course, exaggerating here, as much as I’m simplifying a picture here, that’s displaying a static situation, and the mouth is very much a dynamic landscape. The net effect however, is that, we lose the good with the bad, as much as the diet plays a huge role in how the gut is replenished after all the candida killing, so does the diet for our oral landscape after an intense hygiene program.

Here’s where I see a missing link in the prevailing way of dealing with things. We need to be replenishing the oral microbiome at this delicate time, with what we want to have there, a variety of good bacteria. I can’t see why this would not be possible using similar tactics as we do with the gut. A healthy diet, and this well-researched probiotic aimed at oral microbiota. By maintaining a good hygiene regime, still visiting the hygienist, especially in gum disease cases, and importantly brushing well using a good technique interdental cleaning.

And by that, I mean one size does not fit all. We all have our unique gaps, unique anatomy. So following professionals instructions in what method and technique is best for you is what is all about. All of that has to be followed by being generously provided with the good bacteria, so that the person susceptible to tooth decay doesn’t welcome back high numbers of streptococci mutans for instance. And the person with gum disease, does not grow back in high numbers of the Bacteroides and Treponema species, for instance.

People with gum disease are particularly interesting from a holistic angle, as they are three times more likely to be diabetic, three times more likely to be obese, three times more likely to suffer from heart disease, and more likely to develop Alzheimer’s disease. So all of a sudden, we’re not just talking about risk of losing teeth. Sadly, I sometimes hear, “Well, we’ll have implants to replace the gum-diseased tooth with.” There was a time even 10 years ago, that study after study was showing that implants have 100% success rate, with the best prognosis dentistry has ever seen. Of course, now we know better. We know this not to be true, and I think there’s so much more to be learnt and discuss within the arena of the dental industry.

I will go into more detail about implants and implantology, and they are not all doomed at all. But as I said, I will discuss this further in other episodes. When it comes to its success, we will need to gain far more in-depth knowledge about osteoblastic and osteoclastic activity in that particular patient, as much as a better understanding of auto-immunity before we can even begin to talk about the prognosis of the implants in real terms. I personally think based on my anecdotal observations, that its prognosis has more to do with the host response and the epigenetic makeup of the person. More on epigenetics and host response to come in other episodes.

Basic advice I’ll give to all my patients, visit the dentist regularly, visit the hygienist regularly. If you have the luxury of being offered ozone and, or laser treatment for the treatment of your gum disease, you’re in for a treat. Brush your teeth, using a good technique, your hygienist is best placed educating you in this in-depth. Clean between your teeth, using a floss or interdental brush. This is a big misconception in my opinion, in the holistic arena, it’s good to remove the plaque. It’s just that the good goes with the bad, and you need to replenish with the good. Scrape your tongue, this is a good habit to adopt. Avoid alcoholic mouthwashes, try a good and potent herbal mouthwash like PerioBrite for instance, and moreover avoid using mouthwashes, unless you’re treating an acute condition, like acute inflammation. You don’t really need a mouthwash, unless there is an acute condition.

Use toothpaste and mouthwashes that are free from SLS, sodium laureth sulfate. This is known to be carcinogenic. And this is a harsh foaming agent, that is too destructive to the oral microbiome as well. I have seen bad reactions of the oral mucosa that has disappeared, where I happen to advise my patient to stop the use, and the lesion has just vanished when they did so. Nutrition, it’s vital to so many functions in the body, and the oral cavity is no exception.

Use a probiotic aimed at the oral microbiome. This is luckily a growing market in this arena. Going back to flossing or interdental cleaning. I often receive questions about this. People have this kind of skepticism amongst the holistic patient base. And I think it stems from the fact that the good and the bad goes. And of course, we want the bad to go. Excessive plaque. I’ve seen this so many times, people not doing this, not removing the plaque, and not cleaning, thinking that this is… This can’t be a good thing. And the damage done is in fact even worse when you don’t remove it.

So the key here, the message with this podcast is, please have this removed, clean your teeth, but we must replenish with the good bacteria as well. There is so far no technique that distinguishes in the cleaning perspective, that distinguishes the good from the bad. So please, do replenish with good bacteria, and keep it going, keep the motivation up. And I hope that you’ve enjoyed this podcast.

Last Updated: July 19, 2021

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