Dentist Shares How Your Mouth Predicts Fertility, Hormones & Autoimmune Risk Dr. Leedia Riman

I'm joined today by Dr. Lydia Reiman, a biological and integrative dentist who graduated from UCLA School of Dentistry and is on an incredible mission to help more women understand the connection between inflammation in their hormones, in their gut microbiome, and everything that's happening in their mouth. Today we're going to dive into the connection between inflammation and the oral microbiome, why women experience more mouth issues from. From hormonal changes, and how you can support your oral health from a holistic, comprehensive standpoint. Dr. Lydia, I am so excited to have you because I first heard about you from Ronit when you were at swim lessons together. And she came back and said, did you know that when you have higher levels of inflammation in your mouth, like gingivitis, that it increases risk of infertility? Can you explain what that connection is? Because that was the first time that I had heard about it and I was mind blown for sure.

Yeah, I'll never forget that moment. And that was like a beautiful connection with Rooney. So inflammation from gingivitis and specifically periodontal disease, where the gingivitis goes unchecked and becomes periodontal disease, which is irreversible, that has been linked to longer times for conception, like up to six months longer to conceive in men. That's been linked to lower sperm mo. Sperm counts and slower sperm motility. So, and. And then there is a specific bacteria in your oral microbiome called P. Gingivalis, and that's one of the bacteria that we check for when we look at the oral microbiome, when we check, when we do salivary testing. And that has been linked to miscarriages and has been found in the placenta of miscarriages. So there are so many links. And to me, like, to just. I love to simplify things, like, any source of inflammation is gonna make it difficult for your body to function and flow and harmony. And I think what we're missing is that the mouth is a huge source of inflammation and dysbiosis to the body. So, yeah, that's it in a nutshell.

So is inflammation, it's happening in the mouth, which is impacting the rest of the body, or is it that inflammation is happening in the rest of the body that's impacting the mouth?

I think it's bidirectional. I know it's bidirectional. But for example, when you have dysbiosis in your mouth or you do bleed when you are flossing and brushing, what does that tell you when you're bleeding. When you're brushing and flossing, that means that your gums are leaky. You have something called leaky gums. When you have leaky gums, you have leaky gut. So there's a. Your mouth is the first portion of your digestive system. So if you don't have balance in your mouth, your salivary flow, the, the quality of your saliva, the good and the bad of the bacteria, if there's no balance in that, everything that you swallow is going to also be imbalanced. Things are not going to be well digested from like the main portal. Like, so we have digestive enzymes in our saliva. So when you're not producing saliva, you're not digesting as well. So then that causes stomach issues. And 60, I believe it was like 55 or 60% of your gut bacteria is coming from your mouth. There are 700 species of bacteria in our mouth. So. And that is not harmonious. And I'm just talking bacteria. We're not talking candida here where there is viruses. So when there is an imbalance in your mouth, it's really impacting your entire body. And like when you're not eating well, that's impacting, like, your gut, but which is all. It's, it's, it's all a very intricate, beautifully connected system. I don't think one is 100% causal of another, but, but when you do have oral dysbiosis, it's just reflective of your whole body.

So for people that don't realize we have the gut microbiome, which I talk about a lot in relationship to nutrition and to supplements and the ways that we can improve that. And then you also have an oral microbiome, a vaginal microbiome. How much interconnection is there between your oral microbiome and your actual gut microbiome?

There's a huge connection. So almost every single one of my patients who has things like sibu, Sibo, ibs, Sorry, sometimes I list because of the concussion in my mouth. Right now I'm expanding and I'm still getting used to speaking with it. But when you're having gut issues, and I do a lot of microbiome testing and I check stool testing, and the similarities of certain things is incredible. I mean, this needs to be really heavily researched. But for example, I had a patient a couple of weeks ago, she's super young. She has a genetic cancer, a colon cancer. She said her mom has it, her grandma has it. So they all have the specific sort of colon cancers. And I'm Like, I wonder what your F. Nucleatum levels are. F. Nucleatum is an oral bacteria that is present in your body, but there's a strain that's present in your oral cavity and that has been linked almost causationally research wise to cause colon cancer and systemic inflammation. So I'm like. She's like, oh, I just took a stool test. Do you want to see it? I'm like, yes. So she was high in F. Nucleatum in her school tool. I'm like, let's test your oral microbiome. And we did. And she was high with F. Nucleatum in her oral microbiome. So I am obsessed with the oral microbiome because that's the root cause of all goodness and the root cause of all evil and disease. And I feel like it's very reflective of, like, what you talk about with the gut microbiome. They really are a mirror of one another. And the vaginal microbiome and the oral microbiome, they're both modulated, for example, by estrogen and hormones. And when the estrogen drops later in life, both microbiomes become imbalanced. And vaginally, women experience more UTIs, more yeast infections, and all that comes with that. And then orally, they experience more dysbiosis that leads to more recession, more gum disease, more decay, especially cervical decay, because that's where the gum and the teeth meet. So there are so many mirrors and parallels and there's so many, like, just, just that one patient example shows you. So I told her, I'd love to test your mom's and your grandma's microbiome when they come into town, please come. And like, I'm doing my, like, pseudo research in my office because I want to see this. Because everyone's like, okay, there's a genetic. I'm like, of course there is a genetic component, but there is a microbiome component that's familial, that's passed from generation to generation. And that's where we can, like, do major change. Like, we can shift the statistics by getting to the root cause of that.

Oh, I love this so much. And you talking about the fact that we pass on our microbiome even. I know this is a bit of a segue, but this is immediately where my brain goes when even just thinking about like all of the rashes and eczema and issues that so many friends that I have who have young kids are experiencing, where, of course, there's a level of that that you can't prevent, but they're, you know, we're passing on our microbiome. And so for us as women, it's so important to think about it for not only ourselves, but for children and for the microbiome that they then pass on that increase their risk of other diseases 100%.

And that's why I love focusing on pregnant women, for example, because there's nothing more amazing than a pregnant woman because she wants to do everything in her capacity to protect this child that she's growing. Right. They're very motivated. I mean, that got me motivated to make some major changes in my whole life. And I was overall healthy, but was I really healthy? Right. So pregnancy. Pregnant women who have a balanced microbiome, their children are 70% less likely to experience dental disease and decay. Wow. I don't know if that. Like, over 50% of children actually over in America, Dental decay and dental pain is one of the number one reasons for missed school days. Top four reasons. So let that sink in. So if we. We can just keep filling and drilling and filling. Well, I'm a great driller and filler, and that's what they teach you in dental school. You become a great technician, and that's wonderful. Right? And you can. I can. I taught my daughter how to give a shot, and she felt she drilled on a tooth, like, on a. Like a cadaver tooth. Like, you can teach that to anybody, but we need to, like, take a step back in the dental world. And really, why is this happening? Like, why did this child have decayed? I just did a home visit for somebody extremely reputable that you and I know. And I literally. So her son is getting recurrent cavities, and she messaged me. She's like, lydia, I'm so frustrated because I'm doing everything right. Like, mothers are doing everything right and what they know and their capacity. So I went and I didn't care to look at his teeth. That's the last thing I want to look at. I'm like, show me his snacks. Show me the pantry. Show me his meals. Show me the fridge. I have them. Open up the fridge. Show me his drinks. Let me see what kind of coconut water is he sipping on all day. Like, show me how you're a nanny or how you brush and floss his teeth. Show me. And after they showed me all of that, I did a very in depth home visit. I'm like, you're doing your best, but here's some shifts. And I made a shift in the snacking. Not the type, not Only the types of snack, but the frequency of the snacking, the meals. I mean, I am not a nutritionist or a dietitian, but I've studied that heavily. Definitely not in dental school, unfortunately. It's just a personal adventure I'm on. There's some patients, I send them over to nutritionists. We need to revamp your diet. And like, so I had the nanny, I'm like, the nanny needs to lay him down. For children under six years old, you need to lay them down to brush their teeth. Because at six years you're getting your first permanent tooth. It's called the, your first molar. The six year molar. You know what that tooth is called in the dental world? It's called the money tooth. You know why dentists make so much money from that tooth? Because it's frequently the first tooth that gets severe decay. You know why? Because when you're six, you're like, ah, I can do it by myself. And then. And you won't, you don't know to do a better job because you don't know that's when the six year molar is coming in. And that tooth frequently, it frequently gets decayed. So I had her lay him back, I sat down, I used love firmness in a loving way and I empowered them. But I told him, you need to get back there. We want to avoid. So he already has cavities in one of his six year molars. The other three are spared so far. So it's a lot more than just like, oh, let's go to the dentist and place a sealant and fill the cavity. It's, it's lifelong. Wow.

Oh my gosh. This is so, I mean, it's just so revolutionary and it makes so much sense, but it changes the way that so many people have experienced dentistry throughout their entire life. And were you also looking at the airway health for him?

100%. So I ask, how is he breathing at night? Does he have open mouth posture? I can tell just by like looking at him. Is his mouth dry? Does he snore? Does he grind his teeth? So I do a full airway assessment and I don't treat the airway, but I have people that I refer to to treat the airway so I'm able to kind of quarterback the treatment and so that the entire like holistic umbrella of oral health is addressed. So airway breathing, diet, nutrition supplementation if needed. Every single person I've seen that I've tested that has a dental cavity is vitamin D deficient. Every single one so we gotta look at that, because when we fix these imbalances, and of course, we gotta drill and fill and do the fixes, like there's room, there's time and place. Conventional dentistry, and I'm grateful for, can be done in a little bit of a gentler approach and a more conservative approach. But you look at all that and then. Then you give the parent a lot of value. Then the parent's like, oh, my God. Like, I didn't know the microbiome made a difference. I didn't know he's breathing, my kid. I thought it was cute for his mouth to be open. It's very cute when you see kids, like, they're sleeping with their mouth open. But that's actually really not cute for their health.

So also, one of the concerns that I have about my son is that he sucks his thumb. That also does the airway breathing, essentially.

So what thumb sucking is. You gotta just think everything is a pattern. So if he's frequently. And how old is he? Like five, how old is he?

One and a half.

Oh, okay. Your son's your baby. Yeah. At one and a half, he's very malleable. Like, you can shift the shape of his face. He's very malleable. So if he's chronically thumb sucking, over time, that is going to create a higher palate. And when your palate's supposed to be like this, but when it goes like this, it restricts the airway, because the roof of your mouth, your palate, is the floor of your nose. And then that starts interfering with breathing development. And so slowly, slowly work with an airway centric dentist, a behavioral specialist, to slowly wean him off of that.

So helpful. Can you say that again about the connection between the floor of your nose?

Sure. So the roof of your. So your palate is the roof of your mouth. So ideally, we want the roof of our mouth to be like a really nice, even, not oval, but like a dome. Right. But when you're chronically sucking your thumb, you're sucking your opacifier, you're chronically mouth breathing. What happens is that the roof of your mouth, like, dips up like that. So the roof of your mouth is the floor of your nose. So that constricts your nasal ability to breathe and impacts your airway. So I think I was a thumb sucker when I was younger. I have a higher palate, and I am constricted now as an adult. And that's why I'm expanding both of my kids at an early age, because it's a lot less aggressive, the expansion than it is now at my age of 41 years old. You can easily change the shape of their palate when they're younger, whether for the worse or the better.

And what are symptom improvements that you see when that happens?

Oh, nasal breathing, of course, it has to be like, combined with things like myofunctional therapy to strengthen your orofacial muscles. One thing I talk to my patients a lot about, so we're always talking about like muscle mass, especially with my women patients. Like we take an in body test, we go over like muscle mass, body fat, visceral body fat. I check all that for them because they see me sometimes more frequently than they go to the gym. And I want them to work out and build muscle, et cetera. But we're always focused on building our biceps and our body muscle. We have muscles in our orofacial area that are extremely important to the function of the way that we speak, the way that we chew, the way that we breathe. Our tongue is a very strong muscle. So when your son's tongue is strong, it's going and, and in the right position in his mouth, your tongue, his tongue will allow him to grow properly. When the tongue is at the. I can't fully do it. Can you click for me like that? Yeah. So yours, you have such a beautiful wide palette. It's like, I could tell, like you have such a beautiful full arch, but your tongue goes all the, the roof of your mouth. That helps, especially in children, push the teeth out and forward and flatten out your palate instead of making it a, a higher arch.

So that's extremely helpful context. And then the, the improvements that you see in kids are what?

Yeah, nasal breathing, cognition, behavioral improvement. For sure. Improved cognition. I say before anybody puts your son or daughter on add, adhd, anti anxiety or antidepressant medication, I think it is malpractice to put children on these medications without an airway centric dentist or ENT evaluating their breathing. Because if they are having behavioral issues and they're not sleeping well all night and they're not properly oxygenated, because through nasal breathing do you get vagal nerve improvement, nervous system support, parasympathetic upregulation, like think what that does for a child. Right. And nitric oxide. And nitric oxide, extremely important for vasodilation and oxygenation of your whole body, including your brain. So if that's not being done before, we put these, our children on these chronic like long term medications that further dry out your Mouth, by the way, that's like another side effect that, that I feel is malpractice. And I. That's why I love shows like yours and other people who are talking about this. Moms need to learn this. It needs to be taught to them in a very simplified manner so it resonates and they can advocate for their children. So get that assessment first before you put your child on these medications. There's a time and place for them, but most of the time there is an underlying issue and if you catch it early on, it's so much easier to fix than it going into adulthood.

Yes. And even I don't know if you remember this, but when, when James, this was about a year ago that he had a like thrush infection that our doctor was recommending a antifungal for. And I was worried about disrupting the. His oral microbiome. And you had recommended ozone treatments for improving this. And I think that it speaks to. Right. Is that right? That's what you recommended?

Yeah.

And I think that it speaks to. Similar to the ADHD medication is like doing in.

A.

Doing a deeper dive into some of these things that are fortunately now thanks to dentists like you and other biologic and integrative dentists, where more and more dentists are learning these things that we have the access to this information so that hopefully you can seek a holistic approach to your care.

Yeah, 100%. And also I remember we spoke about this. It's also important to know, like, why did he get the thrush in the first place? Right. So there already is a dysbiosis there. And I believe that we need to start cleaning our baby's mouths. Remember, I think I spoke to you. Correct me if I'm wrong. We got to teach their. We got to clean their mouths before teeth come in. So there's a pre tooth thing. There's a swabbing technique that I teach all my new moms. It's not only to maintain their oral microbiome, but also to get your son and daughter used to getting their mouth cleaned. So that makes a transition to toothbrushing a lot easier once they start teething. So with children, there's a whole protocol that I use with my new moms for their children and during pregnancy to balance the microbiome not only for them, but for their children in utero and after, but also how to maintain that microbiome as their. I was nursing on demand for the first year. Like I was just, you know, but I wasn't worried about that. I Would clean his mouth every few days. I wouldn't say, I'd be lying if I said every day. My daughter was every day my first one. But when you have two others, you're like, of course. Everything just like, falls through. Also, I need to make like. So I have three kids. My first daughter was incredible with brushing, and I did the same thing with almost three kids. My second daughter hated brushing and I did the exact same thing with her. So sometimes it really depends on the kids. It's not just what moms do to, to balance, but I think it's really important to be very firm with your children because there is nothing worse than phobia. Introduction to the dentist due to a preventable cavity that was drilled and filled in a traumatic way that causes lifelong trauma. I'm seeing all the adults right now. Like, I don't have time to see kids anymore because of all the traumatized adults or like the adults that are very highly sensitive, very, very fearful of the dentist. And rightfully so because it is very traumatic. It's a very intimate area.

Yes. Wow. So helpful. Okay. I, I honestly could talk about kids oral health all day because I want all of your tips as a mom, but I do want to move on to being able to like tap your genius mind with better understanding the, the fluctuations that happen in women's hormones and how the hormonal shifts change the oral microbiome and then what you see as a result of that. Because I think a lot of women are completely unaware of this.

Yeah, 84%. They just came up with the statistics of menopausal women have no idea about the oral connection. 84%. It's. That's wild. But we're back.

I had no idea before meeting you.

Yeah, it's, it's. Yeah. My focus on women started a long time ago, 13 years ago when I was overseas. But I didn't make the connections until I got pregnant myself and had a, a whole dental infection that really impacted me.

And then can you explain, like, what that pro. Like, how did you end up figuring that out?

I'll just explain the story. Long story short, right out, right out of dental school, I was recruited by Saudi Aramco. It's a oil company overseas. It's the biggest oil company in the world. So there's a ton of Americans, Europe, Europeans living out there at this oil company. And they really needed a US trained board certified dentist that speaks Arabic and English. So I didn't expect them to recruit me because I had zero experience after my residency and they need like 10 years minimum experience. But my Dr. David Reynolds, he was my program director here at UCLA and he messaged me. He's like, Lydia, like, I. I've put in a huge recommendation. I was like one of his top students in the clinic. And he like, we had a great connection. And he's like, I think he would, like, I think could be such an asset here. Blah, blah. I'm like, but Dr. Reynolds, like, I have no experience. Like, I'm confident in my skills, but I have no experience. He's like, just interview and see. And long story short, they accepted me. And I was like, completely shocked. And I was like, okay, I'm going to Saudi. And I lived on the American base. It's not an American base. I grew up on an American base in Riyadh, but I lived on the Saudi Aramco compound for almost three years. And it was the best. Like, I. That's. And I saw 50% women, so they needed me for the women. Because women prefer women there, I think everywhere, but especially there.

Yes.

And. And I thought it was just there, but now that I've come back to the States, it's even here. Like, even me, I have my personal preferences. And so I was like, what is it about these. So it's a very affluent country, and socioeconomic statuses are. Is that in everyone that I was treated, has treating, has money, has access to care. Everyone is vitamin D deficient. I didn't make the connection because I wasn't taught this in dental school or residency. And their teeth are destroyed. And there. They have a lot of children, they don't pay attention to nutrition, et cetera. And I'm like, what is it? What is it? What is it? Anyways, fast forward. I come back home, I meet my husband, we get married, I get pregnant, and I get something called hyperemesis gravidarum. I was vomiting seven to 14 times a day, every day for like seven months. It was very, very bad.

You poor thing.

It was, it was. It was awful. And I got a really bad dental infection around that implant that I just showed you where I'm missing the tooth. Okay. And it was pussing. And I was, I think, six months pregnant. And I. I got really scared because it's like, of course, like, oh, my God. So my brother, God bless. So he's also a dentist. He's my dentist. He's the only one I let touch me. Him and our fellow partner surgeon, they took out the crown. They cleaned it out for me, and they closed it. And I was walking around with no front tooth because I had such a strong gag reflex. I couldn't even put the apparatus I showed you before this. Yeah, from Beverly Hills. It was very sexy. It was a great look. My priorities though, when you're pregnant, like, who cares, right? But so that's when I. And then I had Julia and I got really, really depressed after that. Like, it was just a huge shift for me. My pregnancy was a tough one. I was depleted. I didn't focus on nutrition, I didn't focus on my nervousness. I didn't do anything that I did now with my third pregnanc and I got go on a Facebook group like at 4am I'm like nursing and I was crying. Like, I'm like, I can't be the only hysterical woman going through this postpartum with a missing tooth and sensitive teeth. My teeth got really sensitive. So I write in a forum and within two hours I had like hundreds of women, this is midnight. Hundreds of women by like nine o' clock saying, I lost a tooth for pregnancy. I got a root canal during my pregnancy, after my pregnancy had seven cavities that I. He needed to fill. My gum receded in like five areas. So painful. I had surgery and I'm like, oh my God. It's like that moment. And then I started, I go on pubmed and I read every article under the sun about this and I'm like, there is a connection here. We cannot be treating men and women the same. And historically in conventional practice we do. And that's really, really harming not only our women, but our children and everyone. Because you're passing on your microbiome to your husband. If you, if you know intimacy, that that's what happens, right? We get their microbiome and you share yours and then you're kissing and you're feeding your kid. So it's a one big happy frenzy. And then I started really getting into the microbiome and the root cause of things and hormones and that the impact of chronic inflammation in the mouth and how it had like things on diabetes, Alzheimer's, cancers, etc, and I'm like, oh my go God. We, we have to, we have to change the way that we do things.

Because like you said, the connection is so clear. It's not that there's like a lack of a connection there, it's the lack of information and as you said, it's lack of training that dentists are getting in dental school. Like, it's, it's so alarming to see something like so obvious, isn't mainstream care.

100%, especially with the microbiome. Like, we didn't have a class on the micro. Like, we had a biochemistry class, we had a microbiology class, and we learned about bacteria, but we didn't learn about the oral microbiome as dentists.

Yes, yes, yes. I mean, same in school as a dietitian, we didn't learn about the gut microbiome. And I remember, like, even in 2014, when I was at the Cleveland Clinic, when I would be speaking to different physician groups, saying, once you understand the science on the gut microbiome, you can no longer ignore the role of nutrition, because nutrition is one of the most influential factors on the composition of your gut microbiome. And of course, that also then is completely connected to the oral microbiome, which I want to talk about in a second. But I, I want to touch back on. I deviated you a bit with your personal story, but I want to talk about how women's mouths change, going through, like, perimenopause and menopause, and what specific symptoms they should pay attention to.

That's one of my favorite topics to talk about. And so our oral cavity, we have mucosa. Like, this is. This is what mucosa is. This is what allows our lips to move. This is what gets infected. So there's two types of mucosa in the mouth. So there's the loose, the unattached, and there's attached mucosa. That's what protects your teeth. You want your mucosa around your teeth to be very well attached, and the mucosa and the rest of your mouth to be unattached so you can talk, speak, chew, and function. Our vaginal tissue has the same exact unattached mucosa, Both stratified, squamous, embryologically, they come from the same area. They're both hormonally driven, and they have the same hormones. They have estrogen and progesterone receptors, same as the vaginal mucosa. So there's a huge oral vaginal connection with regards to mucosa, and they both function very similarly physiologically and histologically. Incredible. Okay, so I'm prefacing that because as our estrogen progesterone start to dip in perimenopause and menopause, we are seeing such clear changes in our vaginal tissue. And that's what a lot of doctors are talking about, but no one's talking about clear changes that we have in our oral tissue, which are. Is it. Which is a reflection. So first Thing dryness. So many women complain about vaginal dryness as the estrogen drops. Drops, Right. And that vaginal dryness leads to a lot of other symptoms. You have also oral dryness. So we have two sets of glands in our face, in our oral cavity, we have the parotid gland, the big ones. These are the main ones. There's a lot of other little grands, submandibular and parotid. We have alpha and beta estrogen receptors lining the crap of our glands. And when that estrogen drops, the quality of your saliva drops and the quantity of your saliva drops. Your saliva is the golden elixir in your mouth. It bathes your teeth, it keeps you moist and wet, and it keeps things flowing smoothly. And it allows you to digest your food and it protects your gums and your teeth, etc. So when you have dry mouth, whether it's from a medication or a hormonal drop, what happens is that that immuno immune system in your mouth, it goes away. So I have so many perimenopausal women and menopausal women that come. Oh, random cavities. Dr. Liddy, I have never had a cavity in my life and now have like four cavities along the gum line or in the teeth, in between the teeth. Things like burning mouth syndrome or tingliness in your tongue. That is a huge one. About, I think 20% of menopausal women experience that to a certain degree. Estrogen is neuroprotective. We need it for our neurons to function properly. Same thing in our mouth. So that burning tongue is due to that decline of the estrogen. And also it has been associated with B vitamin deficiency. Okay. Then we look at our mucosa that's also lined with estrogen receptors. So when that drops, estrogen modulates the ability for two things. Your collagen to repair your mucosa and for your bone for your osteoclasts to work in balance. Why does that matter? A lot of women in perimenopause and menopause come in with all of a sudden extreme bone loss, especially in the front area of the teeth. And early tooth loss of teeth that never gave them a problem or much recession that is causing them a lot of pain because there's nerve exposure in your root. All of that, a huge modulation of it is estrogen and the drop of estrogen. Combine that with the microbiome and any parafunctional habits. Combine that with nutrition and psychological impacts of that hormonal shift, it becomes a perfect storm for so much to go on in the mouth.

Wow. So, I mean, it's so crazy, the connection. And also then speaking to why all these women have these experiences and no one is communicating why that's happening. I actually just went to the dentist and she's a friend of mine and a conventional dentist, and they said that I have. I've been having just some like, sensitivity in the top right teeth that I've never had before. And they said, oh, it's because you have recession in your gums. There's not much that we can really do for it. It just happens when you're aging. So what. That's the hard part sometimes for me is that, you know, I'm 35 and so many other women who are postpartum, but also could be in that early window of perimenopause where. How do you. How do you know and like, what do you do about it?

That's such a great question. And, and it's. You're so young. Like you're, you know, I. 35 is extremely young. We see the severe recession. It also has to do with pregnancy, by the way.

So pregnancy can make recession worse.

Yes, absolutely. It can bring on recession big time. So what happens during. Can we talk about pregnancy first and then I'll answer your question? Yes. So what happens during pregnancy? Kind of like the opposite of what happens during perimenopause and menopause. Like, your hormones are buck wild. They're. They're very high, like, you know.

Yes.

High levels of estrogen, high levels of progesterone. And that makes your mucosa and your gums very sensitive to the average amount of plaque that you have in your mouth. So if I'm pregnant and you're not, and we eat the same thing and we have the same amount of plaque, which will never happen. But, like, we're comparing apples to apples, as a pregnant woman, I would have a much heightened inflammatory response because of the high levels of estrogen. You're just more sensitive in your entire body. You're more sensitive to smells, you're more sensitive to sleep. You're more sensitive to everything when you're pregnant, including inflammation in your oral cavity. So that's why it's so important to talk to pregnant women about not only nutrition, but for them to see the dentist. Because you're able to nip things early. If you're able to keep that biofilm in your mouth in check while you're pregnant. Especially, like, if you were sick like me, I was getting cleanings every month or Else I would have ended up with tons of cavities and issues. Like, I'm just so grateful I ended up with one cavity after three pregnancies and two areas of recession. If I hadn't been doing what I was doing, it would have been a lot more. More and a lot worse. Worse. So we got to keep that biofilm in check. And sometimes when you're pregnant, you fall asleep on the couch and you're not brushing and flossing, right? Like, it's. It's, you know, and what are you doing that nausea? You're eating, like, saltine crackers and pretzels, which are the worst things for you. But you're in survival mode. So you can't tell pregnant woman not to do that if that's, like, what's getting her through the days, right? So I think there needs to be a huge compassion component in dentistry for pregnant women and to really align with the season of life and supporting them to come out with the least amount of damage by educating and supporting them during that process. So something as easy as, like baking soda water, mouth rinses. So if you're experiencing motion sickness or extreme nausea, rinsing with baking soda, even if it's a few seconds, it will neutralize that acidic spike from the saltine cracker, from the vitamins, from the. Sorry, not the vitamins, from the vomiting, from the nausea, from the mouth breathing as well. Like, you increase your amounts of mouth breathing, like, as you're getting bigger and as something called pregnancy rhinitis happens towards your third prime trimester, and the progesterone makes your nose extremely stuffy and you're unable to properly breathe through your nose as you're. As the pregnancy progresses. And that really impacts so many more women than we think. So focusing on nasal hygiene, for example, clearing out your nose, like spending the time clearing out your nose, that to me is almost more important, if not as important as oral hygiene, nasal hygiene. So I really focus on that with my pregnant woman. And then when it comes, to answer your question, with recession, when that estrogen and progesterone spikes up and inflames and you have plaque on your mouth and that on your teeth, and that further expands and you get a cleaning later, what happens is that that gingival tissue kind of dies down because it no longer has that high level of estrogen and progesterone, and it's not as sensitive to the plaque, and that causes sometimes recession because it recedes a little more than the balance of where it was prior to the Pregnancy. So taking a proactive approach during your pregnancy is extremely important. That's why I focus on these seasons, like from puberty to menopause. Puberty, egg freezing, ivf. So many of my friends froze their eggs. Pregnancy, postpartum, perimenopause, menopause. Those are seasons in a woman's life that we need to honor and really, really cater to. Because if we get it in check, then. Then it. She. Ha. It becomes easier. And in the rest of the seasons.

Wow. I wish so badly that I had understood this even just two years ago, because you're right, you do. You're so tired. And I feel like even during my second pregnancy with James, when McKinley was, you know, with being getting pregnant three months postpartum with him, I was just so depleted that there were so many times that I would go to bed, like, without washing my face or brushing my teeth. I mean, I wasn't trying to make a habit of. But there, like, the level of exhaustion is real. And had I fully understood those connections and knowing that, you know, it not only then impacts it at that time, but then also knowing that you want to have a strong foundation going into the changes that are going to happen in perimenopause and menopause. And so the more proactive that you are, the fewer issues that you actually experience. It's. I mean, you are such a genius. I love this approach and I love this conversation so much. So you think that my recession is likely from pregnancy and like being postpartum and not as much from just like aging as I was talking?

I think it's. I can almost bet it's from pregnancy. Unless. Unless you have malocclusion, unless you're picking at that particular tooth that has the recession on. Like, there's other I there. I don't think you have these parafunctional habits. Right. Like, you have to do a full assessment. But almost every single pregnant woman postpartum has not every single one, but like maybe 90%, which is a huge amount, experience some sort of recession. Wow. Or multiple teeth. And some of them are painful and some of them aren't. Like, our body just is so beautiful. It knows how to heal itself sometimes. But sometimes it needs more support.

And I've never even heard anyone talk about this. So what do you recommend for? I don't want to, like, spend so much time on recessions, but quickly. Are there, like, easy things that someone can do?

I think anyone who has any recession, you need to double down on your hygiene at home and in the office. So we do ozone cleanings in the office. We infuse ozone gases after we clean your teeth. And in what we call. It's a guided biofilm machine where we actually stain your biofilm. We tell you how old your biofilm is based on that stain and then we remove all the staining. Okay. So it holds us accountable to make sure that we're doing a good job and also kind of educate not Kenya. It's a great educational tool for you to see. Hey, you're doing a great job here. But here you need, you need to spend a little more time, right? From a hygiene perspective, I would. I think everybody should be, especially women, but everybody should be getting cleanings every three to four months. This whole six month thing is bs. I don't agree with it at all because things. Wow. All through the crack. Okay. For everybody, including children. All right, so that's number one. And then your hygiene at home, like things like scraping your tongue, balancing your microbiome, mouth taping, if you're able to, to preserve all the goodness in your mouth overnight. Because we don't produce new saliva overnight. Night coconut oil pulling. And also focusing on your nutrition, getting adequate vitamin C, omega 3 fatty acids. So a new Reese. I don't know how new it is, but I just recently read this article that people who supplement with omega 3 fatty acids, their periodontal pockets decrease by 20 to 30% just from.

I'm not surprised.

I'm not surprised. But that's never been researched before. I've never read that before. And I'm a debt. Who's reading? So we need more research and then make sure that your, your, your vitamin D levels, and not only vitamin D levels, K2 levels. Because you need K2 and D3 to uptake that calcium and put it in the right place of the cells. Also, let's be properly hydrated, like really hydrated. Not just water, proper electrolytes, minerals. So it's such a, it's. So I need you, like, for the dental world. You're a dietitian. And like, we've just been separated. Right.

I'm actually just thinking about that right now because I, you know, I have run thousands and thousands of nutrient deficiency tests in the last 10 years or 11 years of working in functional medicine. And I never, I can say for, like, it is extremely rare for people to not have nutrient deficiencies. And so often people think that if they're eating a healthy diet and they're eating mostly whole foods, that it means that they don't have nutrient deficiency. And so this is why I've always been an advocate for supplementation, high quality supplementation and better understanding your own personal levels. But I never, you know, like fully equated it to some of these things that you're talking about from an oral health standpoint. So the, the nutrients matter and like eating these nutrient rich foods. And then I would also imagine that since, you know, like having more diversity of plants and those sorts of things impact your gut microbiome, that that also plays a role in your oral health. Is that right?

Right? 1,000%. Yeah, yeah, yeah. So before people for, we do we extract like an infected root canal for example, or an infected wisdom tooth. I can extract it today, but most of the time I don't extract it today. If you come into my office, I'm like, listen Bridget, you need to prep your body. So the next four weeks we're going to make some changes. We're going to cut out gluten, processed dairy, sugar, and we're going to focus on high quality meat protein, omega 3 fatty acids. Let's take a micronutrient test. Let's see any severe deficiencies. I prefer not to touch your tooth until your vitamin D is kind of leveled out because that'll optimize your healing. Take your vitamin C every single day. So we create this protocol, we get them healthier. But you know what? That happens. Not only does it make it better for their mouth, it makes their whole body right. Of course, we go hand in hand like that. That's like my biggest thing is that I, I need that. I need that relationship with the OBGYN world. I need it with the nutrition and dietitian world. I need it with the psychiatry world. Like and like it's, it's so important. So when we, when we get their nutrition and their micronutrients, I wouldn't say like 100% balance because it's takes time. If you have an infected root canal, I'm not going to wait a year to remove that tooth because that's also force a source of imbalance in your, in your mouth. But we kind of prep them and then, and then I remove the tooth and then we place that implant and then what we use, what we do is we draw their blood. We use PRF to inject around the surgical site and they heal beautifully with the ozone and the lasers. And that's the whole like holistic approach. Not holistic voodoo Google. Like people really have. The holistic world has a bad rap. And I know why. Yes, of course, I totally know why. Like there's, it's, I'm not gonna even talk about.

Yes, yes, yes. I'm on the same page with you.

So I, I, I, I think, I think east needs to meet west. And I think that holistic W H O L E istic, biological, functional, integrative. You're looking at everything. And when you balance this, it's going to help you balance this. And when you balance this, it's going to help you balance this. And it's a domino effect. And I always tell my patients, if you have a cavity, that means you're metabolically, you need help. Like something needs help. A cavity. Mouths Our teeth tell us so much about what's going in the body. It's wild and it's fascinating to me. And that's why I'm obsessed with, I.

Imagine you could probably detect perimenopause early. You could probably understand like inflammation and maybe even like autoimmune disease because that, you know, like naturally the whole body inflammation is higher, possibly even like digestive issues or imbalances there. These are surfacing in the mouth 100%.

I've like things like Shrogan's, which is, it's an immune condition, lupus lichen plan in the mouth. I work closely with an incredible periodontist. I send him so many cases. I'm like, what is this? Because I'm sure and the patient doesn't know about it. And they're like, oh my God. Or like just looking also at salivary flow and salivary quality and how. Because I've just looked at so much saliva in my life, I can tell when things are starting to dry out or to slow down. So I tell the patient, they're like, ah. I have like, been like, having that little, like, bitter metallic taste in my mouth and having a hard time chewing. Like, is that why I'm like, yeah, so let's. And then we go down hydration. And if I think it's an autoimmune condition, I have them go get tested. So when you have periodontal disease, and this is what I tell a lot of my patients, like, for example, if you have a family history of diabetes, I think that's, they say, yeah, it's genetic, but I think it's microbiome. It's microbiome and nutrition. So you're two to three times more likely to develop diabetes if you have uncontrolled periodontal disease.

So there. It's actually so interesting because I was just, you know, I talk a lot about in the blood Sugar resets the connection between the microbiome and blood sugar, because so many people think that to normalize their blood sugar, they just need to eat low carb. But you actually have to have some forms of carbohydrates in order to help to fuel the microbes that help to support your metabolic health. And some of them, you know, like beans and lentils and sweet potatoes, especially when the sweet potatoes are colds, that increases the resistant starch. Like these help to increase the, you know, production of more of your healthy gut bacteria that increase the production of your short chain fatty acids, which help to decrease, you know, whole body inflammation. And so there's a direct connection. Tim Spector actually was just talking on this on a panel that I went to where he said in the. The latest research that they're showing that they can predict a person's blood sugar response with 85% accuracy based on the composition of their gut microbiome.

Wow. I believe it.

Okay, I want to get into. To finish us off. This has been so amazing. I want to get into getting your take on a few things that seem like they're more of, like, the future of dentistry, and maybe you think they're the here and now. But the first, you mentioned ozone. Can you explain why ozone is so important?

Ozone is an incredible disinfectant. Of course, if used properly, you know, it can be dangerous, like most things, right. If you drink even too much water, you can hurt yourself. So ozone is three oxygen molecules that are extremely unstable, but when they are dissipated in, like, for example, your gums or in the body in a safe area, it becomes a peroxide. So it's a gas that becomes a peroxide. And it's very disinfecting. It disinfects parasites, bacteria, viruses, candida. It's incredible. It also upregulates your immune system in the area where it needs upregulation. Right. So ozone. So we have this procedure that we do routinely called the root canal prevention procedure, where you have a really deep cavity and it's very close to the nerve. And sometimes you do need to do root canal. Okay. And you use ozone as well. If you go to a practitioner who does the root canals, they need to be using ozone. But. But ozone has been shown and we actually have it on video. I can send it to you where it's like hardening the tooth structure. It's incredible. So it disinfects and hardens at the same time. There was another case that I had. I was this one patient. She was seeing the specialist in me. And I was doing ozone cleanings for her. And the specialist calls me one year later and she had pretty severe periodontal disease. And he was like, what did you do? I'm like, I thought I did something wrong. Cause the way he asked me was very like intense. I'm like, what? Like, did I do anything? Like, I'm sorry if I did anything wrong. Like, he's like, no, she like has no signs of periodontal disease anymore. Like she has full attachment. I'm like, it's the ozone. And he was a very conventional, like he's a very caring, conventional specialist. And he's like, I think he just convinced me to get an ozone machine. Like, it's incredible the power of ozone. I had another patient, she's been dealing with yeast all of her life. Life. Oral yeast, gut and vaginal non stop. So I did an oral microbiome test. She came back with a candida called C. Crusi. And that is a very long standing, stubborn candida. You don't want that in your mouth at all. I put her on a protocol. She was coming in for ozone insufflations every single week. So we did two ozone cleanings one month apart. I retested because I want to see if this is working. No more candida came up in her arm. Wow.

So you have a machine in your office. People can. Can get a home o ozone machine as well. Right. To add where it basically like does it in your water.

Yeah. So there are two types of machines. So I ozonate my fruits and vegetables. So there's a. It's a small, dinky little machine that produces very low grade ozone. That's how I make like ozonated rinses or I ozonate my fruits and vegetables. But also there's a company, and I'm sure there's a bunch of companies. I'm not endorsed by them. And I. I don't have like, I just have a bunch of their units because they're easy. They're in America. It's called promolife. And you can buy a home ozone machine. And I know a lot of people who like do like vaginal insufflations and rectal insufflations. And it helps reset the microbiome in your vagina. And it's so powerful. Ozone is so powerful.

Yes.

But please use it under, you know, supervision. Supervision. Like I'm pleased. Like that's obvious.

But sometimes say that this is not medical advice or it's not medical advice. Yes, Ozone. The future of ozone. Yeah, I mean I personally have even just done. I recommend it for so many people that have autoimmune disease, not just orally, but like systemically. If you know, like there's the HOCAP machine, one of my favorite biohacking machines that has ozone and the number of people. Because like you said, it's not just antibacterial, it's not just antifungal. It has the antibacterial, the antifungal, the antiviral viral capacity. So it's like you don't even necessarily need to go down a million different rabbit holes of like what the potential cause could be. You know, if it's a more complex case or you're getting like a lot of conflicting information where it's like it's just treating everything.

Yeah.

You know, parasitic.

It's an anti parasitic. So we've been able to avoid so much antibiotics in our clinic because we use ozone.

And then I've also used olive oil with infused ozone. Ozone infused olive oil. Have you, do you ever recommend something like that?

Absolutely. Like There's a. Called Puro 3 or living libations. They have gum oil, ozonated oil. I know it's now starting to come into skin care. When my daughter had eczema, I would make ozonated oil and I'd, I'd wash the final wash on her body, make it ozonated, not oil, water. And then I would put ozonated oil to treat the barrier for the eczema. There are. So it's, it's a very, very, very potent product and it's helped so many. But obviously like if you have something underneath your gums causing the dis. Ease, you need to get rid of the root cause and then the ozone will help with the healing.

Yes, makes so much sense. Okay. And then I want to get your take on mouth taping. You mentioned it briefly, but mouth taping.

Mouth taping is non negotiable for me. I think if you are breathing through your mouth, you need to shut your mouth under night. You'll live longer and you'll be happier in the morning and you'll make everybody around you happier. It's such an underrated like low hanging fruit tool that we can use and that's. I get that the question a lot on Instagram, like Dr. L. I can't travel to you. I, I can't. You know, we don't have access to this type of care. There's so many things that you can do to optimize your oral health. Like you don't need to be going to a biological, holistic, or functional dentist. And like, the beauty about like podcasts and the Internet and Instagram, the access to information is like right at your fingertips, literally. Right. So things like mouth taping, things like ozonated oil pulling, things like tongue scraping, that will only improve everything, not only your mouth, but your whole body. If you're not breathing through your nose and mouth breathing, there is no way that you can optimize your health. Like, figuring that out is should be your number one goal before you fix that cavity, before you get that cleaning. And that's how important it is because I think fixing the cavity and the cleanings are extremely important. But that cavity is going to recur, that inflammation is going to increase. If you are chronically mouth breathing. So mouth tape only. If you can breathe through your nose, make sure you go to a trusted ENT to check that. There's no any, like, physiological disruptions like adenoids, noise, tonsils, et cetera. Because you don't want to be taping your mouth if there's structural issues. Of course, but. And that's why I get all my patients on a nasal hygiene protocol. Whether you're mouth breathing or not, it's just good to spend some time, clear out your nose a few times a week. You'll thank me for that later.

Okay. And then you said tongue scraping. You're a big fan of. And do people do that first thing in the morning? Do you do it before you brush your teeth?

Such a great question. Yes, first thing in the morning. If I had to choose between brushing and scraping, and I do both usually in the morning, but there's some days where I only have time for one, it's going to be scraping, and you do that before you eat. So ideally you wake up, you scrape your tongue, you brush your teeth for a couple minutes, and then you start your day. Please don't eat or drink before you clear out the biofilm on your teeth and your gum, your gums and your tongue.

And this is helpful for bad breath, right?

So helpful for bad breath. Because what is bad breath? Bad breath is dysbiosis. Bad breath is your body telling you, hey, there's a gut issue or there's an oral issue, and it's usually a mixture of the two to things like bad breath, tonsil stones, guaranteed oral dysbiosis. So get to the bottom of that. Things like salt water rinses for that are really good for tonsil stones. But getting the microbiome balanced is key for both of those issues. Take Bad breath very seriously.

Because like you said, then imbalances in your microbiome can then be, can be a warning sign essentially of an increased risk of Alzheimer's disease and different cancers and those sorts of things where it's like seeing the manifestation as a symptom in your mouth. But if you continue to, you know, ignore it, then it can lead to the ramifications of, you know, those, those harmful bacteria and then coconut oil pulling. I actually saw this great biological dentist in Cleveland, Dr. Matt, who had given me a coconut oil that is infused with mint. And so it made the coconut oil pulling like such a nicer process compared to just like doing it with coconut oil. Is that something that you recommend as well?

Totally. As long as the mint isn't like a strong essential oil. We just, I just want people to be care careful with essential oils and their mouthwashes or you know, oral care products because that can disrupt the microbiome. But if it makes it more reasonable for you, it makes it more pleasurable for you. So for example, to be honest, I cannot oil a pill. I, I, I get a gag reflex. It makes me want to vomit. That's just one oral hack that I will never be able to do and I don't do it. So I do other things in excess to, to make up for that. But coconut oil pulling is incredible. If it, if it has ozone in it, it's even more incredible. But it tastes a little nasty with the ozone. So if it's a little mint infused, it can make it a lot more tolerable.

Yes, exactly. And the benefits of oil pulling.

Pulling benefits. So our, so the oil, what it does, it pulls in all the bad bacteria. Because the bad bacteria is hydrophobic. Hydrophobic. Yeah, exactly. Because the coconut is hydrophobic. The coconut oil oil is hydrophobic and the bad bacteria is hydrophobic. So what it does, it just pulls it in and, and then you swish, swish, swish and you see the consistency of the oil becomes very, it becomes, if you coconut oil properly between like five and 20 minutes, minutes, you're going to see the consistency of the oil change. Please do not spit that oil in the sink. Spit it in the garbage can or the toilet because you don't want that microbe. Like you don't want all that bacteria in your sink.

Yes, yes, yes. So if someone's an overachiever and is trying to add a lot of layers to their morning routine, would you do tongue scraping then oil pulling? Then brush your teeth.

So I say with the oil pulling, do it when When, Whenever it floats your boat. There's nothing. Okay, specific time for it, but tongue scraping, brushing, flossing. You want to be an overachiever. Tongue scrape, floss, then brush, then go. Start your day, have your lemon water, have your breakfast. But start it on a clean slate because we are detoxing throughout the night. Right. A lot of bacteria is on our tongue, especially if you have a white film on your tongue, getting it properly, and ideally a copper tongue scraper, but even if you have a stainless steel one, it's fine. And you take it out and you see the gunk that comes out, out. It's pretty wild and it's very. For me, it's very not amusing, but it's very satisfying to see all that stuff come out. And I'm like, oh, thank God I didn't swallow any of that stuff. Because as soon as you start eating, you're going to be swallowing all of that.

Okay. This has been such a amazing episode to connect inflammation, the oral microbiome, hormones, everything. Dr. Lydia, thank you so much for being here with us. I know that you had sent over some show notes, some links that will include in the show notes for where people can access your genius, like your kids course, and people can find you on Instagram @Doctor Lydia L E E D I A. There's no.in the middle of that, just Dr. L E D I A. Thank you so much for being here and I will see you all next time.

Thank you for having me.