Unlocking Longevity: The Microbiome Connection

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most in a natural way.

Hi everyone, welcome to another episode on the Holistic Dentistry Show. I'm your host, Dr. Sanda Moldovanova, and I'm very excited to talk today to Dr. Monisha Banot. We're going to be discussing mouth, gut, and travel— some easy ways to stay fresh and feel good on the go. Now, Dr. Monisha and I met a few years ago through our Mindshare Mastermind group, and she always impresses me with everything she does. She actually also, um, Does retreats. We're going to talk a little bit about that. She wrote a book called The Anatomy of Well-Being. The audiobook just came out, actually, of that. And I love audiobooks. It's a great way to sit in traffic in Los Angeles. But Dr. Monisha, I'm excited to talk to you. You're, you're an integrative pathologist turned longevity expert who's not afraid to challenge outdated health norms. Welcome to the show.

Thank you so much, Dr. Sanda Moldovan, for having me. I'm excited about this conversation and all the little tips and tricks we're going to be able to share with people.

Yeah, but I first want to kind of get people to know you. So tell us a little bit about how you went from integrative pathologist to longevity expert.

Yeah, absolutely. So it's not even going from integrative pathologist to longevity expert, it's going from pathologist. Actually, it's going from internist to pathologist to integrative pathologist, then to longevity expert, right? So it is an evolution of my medical career, I guess you could say. So I am a formally trained MD, medical doctor, and I started out taking care of patients in the hospital, in the clinic, doing the rounds, all of that. And I quickly realized, well, gosh, I'm not making them better. Um, it's really dissatisfying both for me and for them because all I'm doing is being a drug dealer and I'm just pushing all these meds on them. And so then I changed into pathology because I'm like, all right, maybe if I give them the right answer of what's going on in their body, that then they would get healthier. Like maybe I just need to give them more information. And pathology is really, it's a study of disease at the microscopic level. It's what's going on in the body that most people have no clue about. Most clinicians actually have no clue about, you know, the pathology training is really limited in medical school, just like a few months. And, but that is the root of all disease. So if you can understand how the body is connected, how disease actually creates itself in the body, then you can then like reverse engineer and reverse it. So I spent quite a bit of time doing that over decades. Like I spent a long time doing that. And then I realized, I'm like, okay, I've given them the answer, but why are these people still not getting healthier? Because, you know, I'm sitting in conference rooms and tumor boards and all this stuff with my clinicians that I'm like, all right, here's this surgeon and here's this radiologist and here's this clinician and I'm giving you all the answers, but now I'm seeing these same patients come back maybe 5 years later, 10 years later. And I'm like, okay, there's a missing piece to the puzzle. And that's where the integrative part came— comes in. So I trained in integrative medicine from the Andrew Weil Center for Integrative Medicine. I also trained in culinary medicine. So using food as medicine. And that's kind of where this whole picture comes together. And so Integrative Pathologist is basically that foundational education system that helps you live a very long, as much as possible disease-free life in our modern world. Because if you can understand how the human body works and your cells work, and I, and I talk a lot about the human cell and all the things that it needs in order to function, because that's what I've been looking at under the microscope for so long. I've been looking at what I call and patients' angry cells. And most people are walking around with these super, super angry cells. That is not a pathologic term. That is my term that I created to help people understand it. But there's changes that happen in these cells and stuff. And I think also from, you know, from what you do from an oral microbiome perspective, you know, we're getting biopsies from like the tongue because the dentist saw a tongue lesion. Or we're getting a biopsy from like this, like aphthous ulcer. We're getting all this stuff. Where does it end up? It ends up in the pathology lab. So I've been looking at this for like—

Oh yeah, I actually work with pathologists as well. I usually send my samples to UCLA Oral Pathology, but it's exactly right. Sometimes we do, you know, especially the mouth is such a dynamic place where there's such a high cellular turnover. So I do brush biopsies, kind of like a Pap smear, but for the mouth.

I also do, of course, like a cytopathologist, which I happen to be also board-certified cytopathologist.

It's one of my goodness. You've done it all.

I have 5 medical board certs, but, but a cytopathologist is the one who's going to look at the brushing. So whether it's a pap smear brushing, an oral brushing. So yes, absolutely. Yeah.

And, you know, we look at luckily most of the time, you know, that is basically inflammatory cells. Inflammatory. I hear that a lot, right? On the reports. And you're right, those are the angry cells you're talking about. They're just inflamed cells.

Well, I mean, they can be inflammatory or they can be something else. So let me give you a little story here. Like, so we had, um, and this was an oral surgeon who, um, was, uh, patient came in and they had this like a small mass on their tongue, okay? And it was found during a dentist appointment because the dentist is like, you know, trying to move this tongue around to do what they need to do. And then they're seeing this lesion, so they get referred to an oral surgeon. So the oral surgeon's like, okay, we gotta, we gotta figure out what this is. And the last thing you want to do is cut out somebody's tongue without knowing what it is. So you take a sample, and the sample that's usually taken is if it's superficial, like you said, you can do a brush and you can brush off some of the cells. But if it feels more deeper, like a nodule, then you actually have to stick needle in it, like a fine needle aspiration. You're gonna put a little needle in it and you're gonna take a little bit of sampling out and you're gonna see what it is. So this patient had this done. It was actually in California. This patient had this done and it came back with a diagnosis of cancer. And so now this patient is scheduled to have a hemiglossectomy, right? Because if it comes back as a squamous cell cancer, half that tongue to make sure you have clean margins and everything gets taken out and it's a huge surgery and the patient has to relearn how to to eat. There has to be like, you know, therapy on how do you talk, all this stuff. And so I remember this because this was like maybe, I don't know, 5, 6 years back. And so when I'm prepping for being on call and working with the surgeon and stuff, because I work really closely with surgeons, I always review the previous case and I'm like, all right, let me look at this cytology and see, is it really like squamous cell carcinoma? Not just to look at, okay, is the diagnosis correct, but more so to make my job when the surgeon is in the operating room, I have less than 20 minutes to go, here's a clean margin, here's not a clean margin because he's taking these small pieces out. I always like to be prepared and see what I'm looking at. And so I'm looking at this case and I'm like, gosh darn it, I really don't think this is squamous cell carcinoma. I really don't think it is. So then I'm like, all right, let me take it to my colleagues because, you know, you always want to like double check because sometimes you're like, am I really like imagining this? Is it, is it or isn't it? So I take it to my, one of my colleagues and they're like, yeah, I don't think it is either. And I'm like, you know what I think it is? I think it's a lymphoma. And they're like, okay, well, go show it to the lymphoma expert. And I'm like, okay, let's go show it to the lymphoma— You know what it turned out to be? It ended up being a lymphoma, which meant that the person did not need to have surgery on their tongue. They could actually get another form of treatment.

Right?

So this is like, this is just a small example of, okay, when we get anything taken out of the human body, whatever it is, one, read your own report, get a copy of it, but two, it's Okay, to get a second opinion. Like, let's make sure we're doing the right thing, especially before we go remove body parts.

That's great advice for sure. So then how do you go from reading pathology reports to longevity expert?

Yeah, absolutely. So at the end of the day, how do we stay healthier longer? So this is all about like healthspan. This is not about lifespan. It's about how can we keep ourselves healthy? For a longer time? Well, from somebody who's looking at cells forever and ever, I can tell you there is a way to do it. And one of the key aspects that I have found is the microbiome influences our longevity in such a key way. And I have seen, like, you know, if I give you my biologic age, I'm working to surpass 11 years younger than I am. I want to get past that, but that's where I'm at right now.

And how did you do that? Now we all want to know this.

Is it by Working on how did I actually reverse biological age? I think a significant part of it is optimizing the microbiome. So optimizing your lifestyle, right? So what I eat, what I put in my body, what I fuel it with, from nutrition to supplements, to sleep, to exercise, all of the lifestyle stuff that gets kind of skipped because we're like, oh, let me go up here instead of getting that foundation of the human body, right? That's how I did it. Um, but how do you go into focusing on longevity? Because what I have seen from a cellular aspect from, and this is both from cells under the microscope to clinical laboratory results, because as a clinical pathologist, so I have 3 medical board certifications in pathology, one being anatomic, which is looking at the tissue of the body. So whether you have a colonoscopy and you have a biopsy or breast biopsy, or even a big organectomy, like a lumpectomy or colon resection, whatever that might be. I look at that. But then there's also the cytopathology that we talked about. So like pap smear, body fluids, scrapes, that kind of stuff. And then the last one is clinical pathology, which I don't think people take into account, but anytime you go for a blood draw, that goes to the pathology lab, right? So every time you're getting your blood drawn, the pathologist is looking at it. And so that translates into numerical values, but What I have found is those numerical values that we set as guidelines and parameters, they're really waiting for more of your body to start functioning because their focus is on like, how can I target this with a medication? When we know, and we think about chemistry and the way the human body works, that these are all chemical reactions happening. And if we can look at all these cycles, which we now can, thanks to more advanced testing, functional types of testing, we can look at, all right, how is the body actually utilizing stuff and what's breaking down and what's not breaking down? And that's where I think the key really comes into extending your healthspan. It's like, all right, we got to use all the technology we have available, take the information, and then it's up to the individual if they want to address their lifestyle or not. But information is really valuable here.

Yeah. So, so you come to understand the microbiome in general, but how are the mouth and gut microbiome connected?

Well, in layman's terms, we basically have this tube, right? So a tubular structure from our mouth that goes down all the way to the anus. It's, it's, it's a hollow tube that has certain lining of tissue. So whether you're going from your mouth to your esophagus, to your stomach, to your duodenum, to your ileum, to your large bowel, and out. There's all specific lining there, but it is all connected, and that's, that's the super cool part, right? So think of your oral microbiome as basically the front door to your gut, right? It's like, hey, you open the front door, whatever you put in it is going to influence what goes down lower down. Now, the gut microbiome— the oral microbiome itself has its own kind of bacterial species that have been identified. I think there's something like almost 1,000 different bacterial species that can be seen in the oral microbiome. And that's different species. But at any given time, your mouth has about 6 billion bacteria in it. Can you imagine that? That's a lot. But here's the thing is bacteria are not bad. Okay. Bacteria are good if you have the right one. So same thing. Gut microbiome also has about, you know, it has about double the number of species. And we have about 37 to 40 trillion gut microbes in our gut, in our GI tract, by itself. So we actually have more microbes in our body than we have human cells. So imagine this, how do we keep our body healthy? It's not just looking at the cells, it's looking at the microbiome. And that is kind of like that, that circle, right? So basically whatever's influencing the mouth is gonna go downstream into the gut and influence that.

Yeah. And I know we were going to talk a little bit about travel. You know, it's a season for travel or towards the tail end of it anyway. But during travel, is the gut microbiome affected at all?

The gut microbiome is affected. The oral microbiome is affected. Okay. So let me give you a story this way. This way a person can really remember this. You're on a trip. You're, say, you're going on a vacation or you're going on a business trip. What do you do? The first thing you do is you grab some coffee at the airport. You ever seen those Starbucks lines? They're long, right? So you go, you grab your coffee at the airport, maybe you grab a sandwich, um, you're on the plane, you are exhausted, and you fall asleep with your mouth open on the plane for a few hours. You're just sitting there sleeping with your mouth open. Then you wake up and you got dry mouth, you got sticky teeth, you got bad breath, right? I would hate the person sitting next to that person on the plane, right? But this is literally most of the people on the plane. So I'm really giving you a vivid, vivid thing here, right? You know, like, you can imagine this. This is real. And most of us kind of think of this as, like, more annoying, if anything. But here's the bigger picture that I want you to realize: that when your mouth is drying out, which, you know, when I'm talking so much it does, which is why I have water here, right? So the bacteria that live there in a normal balance start to overgrow. So, and some of those bacteria don't stay confined to the mouth. They get swallowed, they travel down to your gut, and they shift the balance of your gut microbiome. So that's when people might start noticing, oh, I've got bloating, I've got sluggish digestion, or maybe even lower immunity after travel. They have even found that one of the main oral microbiome bacterias, like It's something like Porphyry— I'm not even going to say it. One of the gingivales, right? I've never been good at—

Gingivalis. It's Porphyromonas gingivalis. Yes.

Thank you. Yes. I've never been good at the microbiology names of these things, but I know they're there. So this one is associated with gum disease. But guess what? It's also been associated with inflammatory bowel disease and metabolic changes because it's found further down also in the body, right? So that morning breath that you're getting after a flight, It's actually a red flag for what's going on in your microbiome. It's communication. It's cell communication. Your body's basically been disrupted.

Yeah. Okay. So what can somebody do? Okay. This happens to them, obviously, you know, we're traveling. We're not going to stop that. But are there some maybe herbs or foods that can support oral and gut health that you recommend packing?

Absolutely. Absolutely. So yes, we're not going to stop traveling. I'm a big traveler. I'm always traveling. So what do you want to do? First of all, you want to hydrate, right? So let's just start simple. Keep in mind, your coffee, your tea, your alcohol will dehydrate you. Okay? So if you choose to drink that, make sure you're doubling up even more on your water, maybe even with a little pinch of salt in there or electrolytes, because we do get disrupted that way. Other thing is, Besides foods and herbs, I wanna keep in mind is the circadian rhythm often gets disrupted when we're traveling, especially across time zones. And circadian rhythm has been linked with disrupting that microbial diversity by about 40% in 24 hours. So that means that the microbiome you left New York in, by the time you get to California, well, actually it wouldn't take 24 hours to get to California. Let's say you're going from New York and you're going to Bali.

Okay.

I know that takes that long, right? By the time you get there, your microbiome is disrupted because your circadian rhythm got disrupted.

Ah, I see.

So, so what do I do? So here's some things that you can pack with you and bring with you, right? So ginger, ginger is great. You know, even if you like, I know ginger chews became really popular, but even if you take like freshly sliced, like 1-inch ginger slices, And you can freeze them and then that way you have them, but chew on those. What that does is one, they're antimicrobial. Two, they support your digestion, especially if you're eating when, like foods that you don't normally eat, and it can help improve oral circulation.

All right.

So ginger is a number one. Number two would be something that maybe people have not heard of. It's called tulsi. Tulsi is also known as holy basil. It's an Ayurvedic herb. I'm a big fan.

I grow tulsi in my garden.

Yes, yes, exactly. My mom has them in her garden too. This helps with immunity and it also balances oral flora. Okay, so you can do tulsi tea, like tulsi tea is available. You can, you know, grow your own tulsi and make your own tea from it. So that would be another herb. I think one more I can give you is green tea. Green tea is very easily accessible, right? So green tea, the egogalectin catechins in it can help nourish the gut microbiome and it can inhibit like oral pathogens. So like the bad stuff because of the catechins in there. And so those would be like my key herbs. I think I saw like in a dental journal that having the catechins from green tea can reduce oral bacteria, like the bad ones, by like 60%. Which is kind of neat to know. So easy, have some green tea. You can even make like a sachet with your own stuff. You know, definitely if we're kind of talking more about the oral microbiome, like if we're talking about gut issues as well, I often give people, uh, CCFT, which is basically cumin, coriander, fennel. And that really helps with bloating and digestive issues, which, you know, people tend to have when they fly. Um, so you can kind of mix all of these together. Those would be my key herbs. I think some other tricks. That I might recommend to people is, and I don't know if you do this, Dr. Sanda Moldovan, do you do tongue scraping?

I do, actually. It's part of our 3 steps to optimal oral health.

Yes, absolutely. So tongue scraping is a key step, and it's actually something we use in Ayurveda. So tongue scraping would be a must. So when do you want to— there's terminology for it. It's called I'm not even going to give you the Ayurvedic word for it, but you really want to do this immediately upon awakening, before water or food. And what you're going to find is that the amount of accumulation of mucus or whatever that's— you're scraping your tongue, right?

Yeah.

The amount of that that you see there, we in Ayurveda consider it something called ama. Ama translates to toxic. Right? So think of it as like oral toxins. And when you start doing this and you go from having like a lot of stuff on the scraper to like nothing, and then you pay attention to your health at the same time, you will see the difference between when you've got like a very thick coating on your tongue or a lot of ama or toxins building up versus not. So you want to basically take this and go front to back about 5 to 7 times and rinse between strokes, right? So here's the thing. You're not I'm just gonna go like this and put it back in, right? And send it deeper down. You wanna rinse between the strokes to do it right, to help remove toxins that can accumulate overnight. So that would be one thing. And you know, one, one of the main causes of bad breath that we see in individuals is the sulfur compounds that can be made by the bacteria. So this is a great way, uh, something easy you can do. I mean, these are found everywhere now, you know. That you can do that to reduce both bad breath and improve your microbiome.

Now, if you have a lower— like, if you don't have that much ama coming out, is that a sign of good health?

It's a sign of better health. Absolutely. Better health. Okay. It's kind of like this, like, like there's a few things that we can see the strength of our oral gut. Let's just say our microbiome that connects from the oral down to the gut. One of them would be tongue scraping. The other one would be your stool, right? So seeing if there's undigested food in your stool. And the quickest, easiest way to see how well you digest is eat a tablespoon of sesame seeds and see how long it takes for you to pass that in your stool. If you're not seeing those sesame seeds show up for a couple of days, your digestion is sluggish.

I see.

Yeah, yeah. So these are just like things that, you know, you don't need to go to a doctor to go, oh, here's something wrong here. The other one that I recommend is after the tongue scraping is oil pulling. Do you do oil pulling?

Yes.

What do you feel about it? I'm curious.

Good, good question. So oil pulling from my studies on Ayurveda, and I looked at some articles for the Indian universities on oil pulling, you have to do it for 20 minutes to really be effective for the oil to actually turn into a soap. And it helps with gingivitis. But looking at that compared to a water flosser or Waterpik, when you're using it properly, that only takes about 90 seconds, let's say about that. So it's a lot faster way to achieve actually better clean.

I, I would say do both, but I agree for the people who are in the American lifestyle of everything needs to be done in under 5 minutes, oil pulling probably will not be your go-to. But if you're a person who spends the first, like, 15, like in the sun, walking the dog outside your house before you run off to work. Then oil pulling is like the perfect thing to take on your walk when you're walking the dog, right? Then you don't even need to talk to your neighbors. You kind of put it in 1 to 2 teaspoons of either sesame or coconut oil in your mouth, and then you're nourishing those oral tissues. You're kind of lubricating that dryness, which happens overnight. We get drier, right? You're influencing that.

Ayurveda traditionally use sesame oil.

Both sesame and coconut. Yeah, yeah, yeah, yeah. I like coconut because it has lauric acid in it. So for antimicrobial, I use that and, and it's just, it's kind of easier. You put it in a jar in your bathroom and it's not like liquid, you know, unless it's 100 degrees. But it's just like this nice solid thing that's easier to scoop out. Travels much better than sesame oil. So those would be the two. And like I said, you can do it while you're going and walking your dog. And by the time you get back, it's like, okay, it's already done. So that's kind of another thing.

Like, so we were talking about travel. Do you do other things like travel rituals that support long-term health? Yeah.

Yeah. So absolutely. So when we think of a ritual, it's, it's really, to me, it's something intentionally you are doing that you're waking up or you're doing in the evening, whatever time. Like you basically put this together. So an oral health travel ritual would look like waking up, scraping your tongue, oil pulling or water flossing as you would, you would prefer, whichever, you know, then having a full glass of room temperature water to rehydrate, right? That would be kind of like a ritual, right? Because you're doing this practice again and again, you're intentionally doing it to optimize your microbiome. It's really, you know, creating this. Cellular kind of communication in your body, right? You're getting in touch with what does my body need, and you're paying attention to it instead of like running from, oh, I just brushed my teeth and I'm out the door, right? And not paying attention there.

What else is in your carry-on besides the oral health products? Like maybe overall health that helps you stay fresh and grounded and gut healthy?

Oh yeah, so I definitely have some herbs like cumin, coriander, and fennel. So like little, like, loose herbs that I will, you know, turn into— like, all I need is hot water, you know. And nowadays at Starbucks, they're just giving you like the biggest container of hot water ever.

Oh wow.

Shake my herbs in there. Um, I like that. I also like having like certain veggies. Like, I'm a big fan of having like cucumber because cucumber is super hydrating and you know, the only thing we get on airplanes is like salty pretzel, salty, like this just stuff that is just going to make us more dehydrated. When we're more dehydrated, our microbiome is like screaming at us. So you can even chew fennel or cardamom. I know when— I don't know if you've ever gone to an Indian restaurant and noticed that on your way out there's this like kind of little tray of herbs and it's usually like fennel or cardamom and people just take like a spoonful of it. Yeah.

At the end of the meal. Yeah.

Yeah. At the end of the meal, like you don't want the sugar-coated one. Okay. But you want the other one that's just the herbs. And the point of that is one, to help freshen the breath after you've had like a very flavorful meal. And then two, to also help the digestion further along. Right. So other thing is when you're traveling, I know a lot of people— this is so funny because I talked to patients about this all the time. And you know when they put like little garnishes on your food, like whether it's like a parsley sprig or it's a mint leaf on dessert or all that kind of stuff, I always see people just taking it off and putting it to the side.

And I'm like, actually eat that.

I know, purpose is to eat it. And it's just become this thing where I see people just move and I'm like, no, that's the best part. So eat the herbs. Eat the herbs.

Yeah, perfect. I love it. And you are actually also organizing the longevity retreats. And we're going to put a link for those retreats down in the show notes. Tell us a little bit about that and why did you decide to organize retreats? I know it's an endeavor.

Yeah, yeah. So my longevity retreats, it's really kind of a space for, um, to really immerse yourself into these health practices and rituals and, and kind of give yourself some time to feel like what a healthy body feels like. In fact, most the attendees have said within, like, after the first night of sleep and just like that first meal in the next morning, they feel like a whole different person. And it's, it's more about reminding people that, hey, your body can heal and you just need to start to listen to it and how to listen to it. So each of our retreats are different longevity-themed retreats. Our next one is a women's wellness one in the beautiful islands of the Azores, which is called the Hawaii of the Atlantic. It's like halfway between New York and Portugal. It's a Portuguese-owned island. But really, it gives you time and space to focus on your health and your well-being, learn some new things. I don't know about you, but every time I go to a conference, I come back more like pumped and inspired, and I'm like, all right, I can, I can do this for another 2 months until the next trip. So I do find retreats are really rejuvenating, and it's kind of like an adult playground, right? Like, we send kids off to summer camp and they get to learn all these things, but the parents are still so busy, like, working and, and not spending time for them to develop themselves. So I do like to think of, like, my Longevity Retreats as an adult playground. Like, let's just Remember what it feels like to feel good.

Oh, I love it. A lot of people need that because we go, go, go, right? We don't take enough time for ourselves.

Yes.

And you're also giving us an ebook, which is a free download, Removing Toxins and Optimizing Gut Health for Vibrant Well-Being. There's so many gut issues in the world. I would encourage everyone to look at that. That's just great information coming from you.

Yep, absolutely. And then my audiobook for The Anatomy of Well-Being is now out. So definitely, if you're not ready to read like 95,000 words that I've written in this very thick book, the audiobook is now available. So do check it out. It's on all the platforms, on Audible, Apple, wherever audiobooks are available.

Amazing, Dr. Monisha. Any last minute words of wisdom before we close the show?

I think my last minute is that I want people to start focusing more on cell care. So hashtag cell care over self-care. I mean, self-care is great, but start focusing on how you take care of yourselves every single day because you can literally change your health with your next meal, with your next exercise, with your next restful sleep, and it can create this trajectory. So let's just focus on cell care as self-care.

Yeah, I love that. So important. Thank you so much, Dr. Minisha, for joining us today. And everyone, thank you so much for listening. Until next time, keep smiling.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @drsandamoldovanova. This is Dr. Sanda Moldovanova, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.