Episode 206:  Risewell & The Oral Microbiome with Dr. Derek Gatta

Hi and welcome to episode 206 of the Untethered podcast. Today we have Dr. Derek Gada joining us. Dr. Derek grew up in Newport, Rhode Island. He completed his undergraduate at Vanderbilt University and after finishing dental school at nova Southeastern University, Dr. Derek spent eight years in the Navy. He completed his residency in prosthodontics at Walter Reed in 2014 and currently maintains his private practice in Boca Raton, Florida. Quick Disclaimer all information, content and material of this podcast are the opinions other the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider. Welcome to the Untethered Podcast. I am your host, Hallie Balkan. I'm a certified orofacial myologist, feeding specialist and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, tethered oral tissue and airway space. I challenge you to keep an open mind and join my mission to get this information out to the masses. Let's get started. Derek, welcome to the podcast.

Ok, so great. Thank you for having me today.

Yeah, so I think we should tell everybody first, you are my dentist now that I live in Boca and I actually came to find you through a Facebook group for my community and someone said hey, my dentist makes his own toothpaste. And I was like wait a second, I might know who this is.

Yeah, it's an honor and a pleasure and thank you for letting us care for you.

Yeah, I love it. So I would love for you we're going to get into Rysol and all that fun stuff, but I would love for you to tell us a bit first about your own journey into dentistry.

Yeah, sure. So after finishing college I was looking for an opportunity in healthcare and as a young child I broke my front tooth. So I was horrified. I really discovered firsthand how a lack of self esteem and confidence is directly connected to your smile. And you know, my family dentist, great guy. My, my, my parents still see him up in Rhode island and you know, he has a great way about him. Blending the science and the art of dentistry really helped restore my smile. Along with another investment with orthodontics and braces. I felt more like myself and I really wanted to help transmit that good feeling to other people, really capture my love of science and the artistic side of dentistry really kind of fit my personality and migrated to South Florida, ended up going to dental school down here. I was on A Navy scholarship and helped travel the world with them. And after that, came back to South Florida to start my journey and practice down here.

I love that. So at what point was rise, well born. When did that come to?

So, as you may well be aware, in South Florida has very, very high dental IQ people, very health conscious part of the population, which is wonderful. And we had a lot of people complaining about having a lot of interesting or unknown chemicals and detergents in products, and they were very health conscious, looking for a better alternative. And in conjunction with that, my sister and her husband have been very open about some of the fertility challenges they've been having. And they were looking to start their own family. And they were talking to some of the IVF professionals and he's like, look, guys, you got to get healthier. You're spending a lot of money. We really want to increase the odds of you conceiving and being able, being successful and starting your family. And they're like, all right, we get it. The food stuff we can do throw out all the bad stuff and get healthier, starting with eating and nutrition. But looking at their beauty products and some of the products that not only go in your body, but on your skin and in your hair and what you're using for your oral healthcare, they're like, wait a minute, there's gotta be a better way. We applaud other companies who are trying to decrease the detergents and toxins in their toothpaste and in products. But if you're not using fluoride, you may as well be brushing with water, because that's one of the effective ingredients. And so we discovered hydroxyapatite. Excuse me, we didn't discover it, but we wanted to use it, incorporate it into the riseable brand here in family. And so we found an effective ingredient able to get rid of all the unnecessary chemicals and garbage that are in a lot of products that are out there. And so really, their journey to start a family and live a healthier, more well balanced life kind of led us to the journey of founding Roswell.

I love that. That was one of the things too, right when I was, we were planning to have our first child and I started to eat organic and I was like making a big deal about, you know, it was like one step at a time. But, you know, I joke that I'm, I'm kind of crunchy where, you know, we eat organic wheat grass fed, you know, dairy and meat products. We are very conscious of what we put on our body, in our body, even the cleaning Products in my home and you know, so on and so forth. And so it was really exciting. We were living in Maryland at the time when I discovered Risewell myself. My dentist actually was a. She's a. Want to say this biological dentist. So holistic dentist, biological dentist, airway centric, whatever you want to call it, all of the above. And they were carrying it in their office and. And my kids loved it. Did not. I have one child who's like a really picky eater, very sensory, sensitive to other stuff. And from the get go she was all about the mint, you know, the more minty flavor. Whereas my, my youngest is all about the cake flavor. She just. They love their toothpaste and we've used it now. I mean, I don't know when you guys launched this or when it became a thing, but I feel like we've been using it for at least three plus. Has it been at least three years? When did you guys launch it?

Yes. Yeah, about. About four years ago. So you're one of the early adopters. Thank you.

Yeah, I'm like. We've been using it, I wanted to say, since before the pandemic and like right before we started using it maybe. And it's. It's really been. My whole family uses it. So we love it. Can you tell us a little bit more about what hydroxyapatite is and why? You know, for people who maybe you mentioned, you know, if it doesn't have the fluoride in it, this is something that you would want to have in place of that. You know, how does that all.

Yeah, yeah, sure. So. So hydroxyapatite at its essential level is calcium and phosphate. So it's naturally occurring in your enamel. It's what your teeth and bones are already made of. So it's really wonderful that we have a remineralizer that exists in nature and it's not extra chemicals or detergents that we're throwing into your body on top of all the other endocrine disrupting stuff that's already in the environment and we're putting in our bodies. And funny enough, when we were doing research for this project, we realized that NASA goes back to looking at when astronauts are coming back from space in a zero gravity environment, the bone density changes and there are some physiological changes happening in a zero gravity environment. And they wanted to try and remineralize and restrengthen these astronauts that were coming back from their missions. And so they were the ones that really had had the idea to use hydroxyapatite to try and reinvigorate and remineralize any deleterious effect that had occurred in a zero gravity environment. And so when we picked up on that research, we actually discovered that companies in Japan, they've been using hydroxyapatite in their oral care products for decades. And it was really, really interesting to see that because it kind of gave us more proof of concept that I love being an early adopter, but people are already using this and it was wonderful to kind of see that. So we were like, let's incorporate this into our brand. And it's biomimetic, it's bioavailable, it's non toxic, it's already occurring in your body. So it just has a lot of wonderful advantages compared to other products that are out there.

I love that. And that's super helpful because I think a lot of people go like, what is this? How would it benefit me compared to what is out there? And so I think understanding some of that really just makes it more easily attainable for some of our listeners. I know who will be like, what is this? I never heard of this before. They've probably heard us talk about some of this because I've had a lot of different dentists on this podcast over the past three years. But when it comes to like cavities, for example, I've heard some dentists say, and I don't know your thought process on this, but if we feel like there's a tooth that's a little sensitive, or if we're concerned that maybe we're headed towards a cavity that they've said, you know, put the risal toothpaste on the tooth and leave it on, don't rinse it off afterwards. Like, can you. Is that something you recommend? Can you explain that if it is?

Yeah, absolutely. So. So one of the great advantages of a hydroxyapatite is increasing your contact time. And so maybe during the day it may not be practical, but at night, right before bed, once you're finished with your routine, take a little dab, put it on any of those precarious lesions that your dentist may have been mentioning to really help increase the contact time while you sleep. Or if you have a night tray, put it in your night tray. Really helps put it right up against those areas. And the research is really positive looking at the remineralizing effect of hydroxyapatite on precarious lesions. And now we're really just looking at the pre cavity lesions that are still in enamel. So just the anatomy of the tooth for a second. You got the pulp in the middle, where the tooth gets the nerve and blood supply, the dentin is the next layer, then you have the enamel, the enamel is the outer layer. And that's what's very deceiving about cavities, unfortunately, is that the enamel layer does not have any nerve endings. So when that decay is happening in the early stages, you won't feel it. And that's why it's very misleading too. When you go to a dentist and they say, oh, you have cavities, like, well, gee doc, I don't feel anything. You sure? Well, that's why, because in the initial stages you won't feel anything. Now by the time you feel something, that's when the decay is spread to the dentin. The dentin is a softer material, so the decay spreads faster. So at that point, the filling or restorative material they would use would have to be a little bigger because it's spread at that point. And also, when you look at the physiology of the decay process, a lot of it depends on ph, so the acidity level in your mouth. And so there's a theory that describes when the ph is below 5.5, when you have an acidic environment, essentially after you eat a meal, that creates the right conditions for the bacteria that we all have in our mouth. Naturally occurring, it starts to ferment those sugars, creating the acids that then demineralize and weaken the tooth. So the cavity forming process is dynamic, meaning the tooth can demineralize and then it can remineralize. And saliva is a great buffering capacity as well. So saliva contains that, the supply of calcium and phosphate needed to remineralize and recharge that enamel structure and prevent that acidic attack from spreading. And that's why having a supply of hydroxyapatite or, you know, eating milk and cheeses, having that calcium and phosphate right up against that tooth is really helpful and also trying to minimize your exposure to acids. When I was in the military, I had a lot of patients that were working crazy shifts, crazy hours, and thank you for their service. They're wonderful human beings, but they worked crazy hours under a lot of stress. Always a state of hyper vigilance. A lot of them were just consuming many of those energy drinks that are highly acidic, highly charged with sugar. And yeah, they taste great and get you pepped up, but man, that stuff just blows through your enamel. You gotta be so careful. So I really encourage people, use a straw, use the diet kind, or try and wean yourself off them completely if you can, because that Constant exposure of acids just has such deleterious effects for your, for your fragile enamel.

Yeah, that's, that's amazing. And it just makes me think about, you know, the products out there and just being a mom, you know, put my profession aside who's trying to just understand the science and understand the impact of like, all these different toxins that, you know, we think we're doing so well. And then all of a sudden a new study comes out and something tells us that this isn't healthy for you anymore. That's not healthy, or this causes cancer, this does that. It's, you know, it's never like the impact of toothpaste on my teeth. Right when I thought I was doing the best for my teeth. And then I started to learn about everything you're talking about here compared to what is out where it's really been, I think eye opening for me to even understand that there are healthier products, healthier ingredients, more naturally recurring, you know, things in our body that we can use. So I love all of this information because I think it's, it's just very helpful to understand, you know, the science behind it. Is there anything else that you know from. You've mentioned research now, have you guys done your own research or have you really focused on research from other companies who've been using this for, you know, decades?

We've been using research that's currently available in the profession from institutions, the organizations that are out there as a small startup, funding for these research projects or millions of dollars. And although we're growing and getting traction and a lot of attention, we're not quite there yet. But the research is readily available and we can share those research packs out there. But it is rewarding because we want to make sure that we follow the science and if the science change, we can change our formula. But the stance on hydroxyapatite is really encouraging as a remineralizer. And look, we're not against fluoride. Fluoride works. But you know what? Metal fillings work. If you want metal fillings, they work. I think we're at a point in time where there are better, better options that you'd want to be putting in your body. And I think we've kind of come a long way with, with the ingredients in our toothpaste as well. And, you know, I love my dental colleagues and the dental education I got was just great. And I'm very appreciative for all of that. But with like any government institution or large academic body, they're slow moving and they want to be cautious. And whatever they introduce in the curriculum, it's got to be backed by decades and decades of research. And you know, that might not be there for hydroxy appetite, but the research that we do have is very, very positive and promising as a remineralizer. And I think as it gains more and more traction, you'll see that introduced into the curriculum more and more. But you know, sometimes fluoride is kind of like a religion. It's like you're, you're, you're either, but you're a believer. And yes, it helps to remineralize, but at what cost? When you look at the back of a traditional toothpaste tube, you know, it says call poison control if you swallow too much. Well, how much is too much? And you know, should not, should not be used for children under six. Like. Oh really? Well, that's, that's when kids are maybe have some of the worst dietary habits possible. When they're chomping snacks and fruit juices.

And swallowing your toothpaste.

Exactly. And when they, and yeah, when they can't control their, they're swallowing muscles fully. So you just got to be careful and that the price of that is potentially fluorosis, like when you swallow too much fluoride, that gets incorporated into the enamel structure and makes it more kind of that modeled unattractive appearance. Unfortunately, that happens and with providers with all best of intentions to prevent cavities, you guys just got to wonder at what cost and are there better alternatives that are out there on the market?

Yeah, no, that's, that's absolutely, that's correct. And you know, working with a lot of children in my own practices that we do feeding therapy, we do orofacial myofunctional therapy. These kids and adults, we work with adults with myo stuff as well. You know, they don't have great control over their tongue. They don't have great control over the liquids in their mouth and swallowing. They may not have a medically complex system swallowing disorder, but they still, as far as the oral phase, you know, bolus prep and swallow goes, they really have very little control. And they're going to swallow probably most of what enters their mouth. We have to teach a lot of them what spitting is. We have to teach them we brush teeth and then spit. We don't just swallow because it, you know, it hits the back of the throat and that triggers the automatic swallow. And all of a sudden here we are. So it's, you know, it's one of those things where just As a private practice owner, I've always thought of how can we avoid certain foods. So a lot of people in therapy practices will use foods as rewards and I've never been big about that because I don't like to reward children's food, period. But also a lot of them tend to be not the healthiest options that we use earlier enticing to children. Here's a piece of broccoli. Great job. Yay. So yeah, it's just I get so excited about these kinds of things because as you said early on, it's not just about the food that we put in our body, which is obviously a very important component, but about the products that we put on our body and in our mouth as well. Beyond food. So as a dentist, do you do like nutritional counseling or do you talk about the impact of nutrition on the oral cavity or anything with patients?

Absolutely, yeah. I think there's work from the 1930s by Dr. Weston Price, who is kind of like an anthropologist slash, Indiana Jones slash. He was definitely a dentist, but he was a dentist that was doing incredible work out in the field. He took time away from his practice and wrote this incredible book. And a lot of it revolves around nutrition and looking at the comparative mouths of native populations that are away from the western diet and how the introduction of the western so called diets that are high in refined carbohydrates, sugars, unbleached flowers or bleached flowers, and the disaster effects that had on the nutrition of these native populations. And he's got great photography and was funny how, you know, science comes times full circle. I mean he was telling about this almost 100 years ago and we've seemed to have strayed and drifted from that. But yeah, absolutely, food is medicine and really looking at. And again, I don't want to be the fun police. Look, you only live once you got to enjoy your life. But just understanding the consequences of high sugars, high acids, and also everything you eat really reduces to pretty much three things. You got fats, proteins and sugars. And so even things that you may not think are cavity causing agents, you know that they could be not just sugars, cookies, sweets, but also things like crackers and salty type foods and carbohydrates, they all reduce the sugars. Not saying you can't enjoy your life and have them, but just, you know, floss afterwards, be a dental nerd, keep a toothbrush and floss at work. I mean, you really want to clean out that sludge after every meal and don't let it Sit between your teeth. But yeah, we, we definitely talk about nutrition and what people can do to mitigate some of these risk factors. And it's really unfortunate that in 2023 it's still such a highly prevalent but yet preventable disease that affects just millions of people around the world. So I think they're just better alternatives and hopefully more and more practitioners are getting the word out there on nutrition because that is kind of the bedrock on preventing this disease.

Yeah, I'll have to see what my daughter says when she comes home from her pre K class today because they, her school has a dentist coming. So here we were, we went in to celebrate Shabbat and her birthday and I gave them all little mini cupcakes and I'm like, they're food dye free. I got them in whole dentist. The dentist is coming next. He's going to love this. I was like, I'm going to leave before he enters.

Oh, that's funny.

But it is, I believe. And I saw my friend too, who my colleague that we used to go to when I lived in Maryland, the biological dentist was in her daughter's preschool today too, giving talks to all the children in her kids class and everything. And then I said, oh, it's dental, I guess like dental health awareness month or something so appropriate that we're recording today.

Yeah, go dental. Yay.

It's funny too because just as I've gotten more into the airway space and the myofunctional therapy space and not just the speech pathology, speech, you know, articulation, language and just in feeding even beyond that into tether, bone, tissues, airway and myo. More and more dentists that I've met in this space, it's really been very eye opening to me because I feel that I know joke all the time that dentists are going to be like the pediatricians of the future, so much of our health starts in our mouth. And if we're not looking at what we're eating, how we're chewing, where our tongue rests, if we're nasal breathing, if our lips are closed, you know, all of these things that I'm sure you know well as a dentist. But that seems to be the root cause of so many health issues with our kids these days, whether it's, you know, adhd, they're exhausted because they're mouth breathing and they get, they've disrupted sleep and sleep disorder breathing and all these other things that we're just, we're seeing such an uptick and inflammation of tissue surrounding mouth breathing and all These issues, you know, I just, I, I keep saying it and I'm like, maybe it'll become, it'll come true ten years from now. You know, you guys will be the pediatricians of the future.

You make a great point. I mean, a lot of people see us more per year than they see their, their primary care physicians. So we're actually at a wonderful point to intervene and really help get these people to the right specialist. Especially in your field too. I mean, I'm not sure exactly when a breathing or tongue position condition might be considered a problem versus just normal development. And I don't see children, so I guess that's not really my specialty. But absolutely. In regards to mouth breathing, absolutely. We should be encouraging nose breathing for youngsters and just people as a whole. As the palate and teeth are developing, that gentle pressure of your tongue up in the palate when you're breathing through your nose, that helps to gently continue to expand the arch and really try and get that beautiful alignment of a nice horseshoe arch for the development of the adult teeth when you're breathing through your mouth, when your mouth is open that tongue drops, there's no pressure on the palate. You're just getting that gentle force of the lips and musculature on the outside of the face pushing and crowding the arch that leads to malocclusion. Higher incidence of needing orthodontia later on. Also, your nose is designed for breathing. It's better to filter and warm the air and keep pathogens out of your throat in those regards. Also looking at people that are higher incidence for decay, mouth breathing is a contributor for that because when you dry out your saliva, you don't have that protective reservoir of calcium and phosphate that's continuously bathing the enamel, helping to remineralize any weakened spots. And so from a cariology standpoint, breathing through your nose is the preferred method as well. And I know there are products out there like mouth tape, and I'm not sure what your philosophy and some of these different techniques are. You're probably a better expert than I am, but I do talk to people about mouth breathing as well to try and address that and seek attention where appropriate.

Yeah, no, you brought up a couple great things. So we do expect that at birth, a baby can rest with their tongue up on the palate, lips together, their gums are going to be slightly apart. Future teeth will be slightly apart at rest with their, you know, nose nice and patent. Obviously at birth, some children are still being suctioned and things have to clear for A couple of weeks. But ultimately we really should be nasal breathers with their tongue up and our lips closed from day one. And we are finding, at least from some of the research and some of the things being done that these children who are not are. Well, there's two sides of the puzzle here. So some of my colleagues were doing some research out of UPenn, I believe, like Dr. Kevin Boyd and Mariana Evans. I don't know if you're familiar with them. They've been studying prehistoric skull and also talking similarly about, you know, like the Weston A. Price conversation epigenetically, what's happening with the shape of the bones and our orofacial structures. And we are seeing it shrink, our jaws are shrinking, bottom line, right. Just put it simply. And then we have that further collapse when the tongue is on the floor of the mouth and it's not up there helping to shape the palate. They're not nasal breathing, but, you know, they're not getting all the benefits that you just explained are helpful when we nasal breathe. And so we always say, you know, your tongue is that palate expander for your mouth, and when it doesn't function as one, then things tend to collapse. We might have those high, narrow palates. We get these babies at birth who are having trouble breasts and or bottle feeding because their tongue is not where it's supposed to be. Their palate's not shaped properly to help with the proper suck, swallow, breathe. And so we're actually. You're seeing a lot of uptick at birth. And sometimes they'll. They'll feed well for three, four months and then we'll get a phone, a frantic phone call from a parent who's returning to work or all of a sudden things just kind of fell off the bandwagon and the baby's reflexes are integrating and now things are not so automatic anymore. And now the baby has to actually volitionally feed. And we have these issues. So we specialize a lot in that, in the work that I do and in the courses I teach and everything. But we're also. We also know that with the tetherball tissues, which is always been around and it's a big hot topic, some people believe in it, some people don't. But we do see the impact of those as well, because it's pulling the tongue to the floor of the mouth and we can't shape the palate because it can't rest in the palate. Palate, you know, that causes functional impact. And here we are. So, yeah, there's Definitely a major role there. And then we, you know, I have colleagues, and I always say, I'm not a dentist, so I don't move bone. I don't claim to move bone for a living, but I have a lot of colleagues will say these children or these infants and toddlers who had struggles with this at birth tend to turn into. I mean, obviously things can happen and derail your nasal breathing as well throughout your life, but these individuals tend to turn into sometimes teens with adhd. Sometimes it's harder to perform in school with sleep. They turn into adults with sleep apnea. Sometimes, you know, they have sleep apnea younger in life. And we're, we're seeing more children, preschool even with obstructive sleep apnea because of enlarged noise and tissues. And, and these kids are, you know, they just, they've got the venous pooling, they look exhausted, and it's no wonder. They're acting out in preschool and in their classrooms and they're not doing well in school. They're not getting restorative sleep. They're a mess. So, I mean, we would all be the same way. So it's. Yeah, it's very interesting. And then on the, the mouth taping topic for adults, I'm very pro. Whatever you want to do for yourself, and I think some adults will do it and say it's very helpful. I have other adults who've told me they feel like they're suffocating when they've tried to do that and they couldn't manage it. And so I always say with mouth tape with the confirmation that you have a patent nasal airway. So if that means you need a, like, CBCT scan or something just to confirm that your septum is not block like, for me, I just had nasal surgery not a year ago, about 10 months ago for deviated septum. And it wasn't deviated in the front, it was back left. And I actually, being in this space, had no idea my nasal airway was without the cbct. And I had expansion and then braces as a kid. I went into adult expansion as an adult with trying to, you know, really more dental, you know, expansion, trying to make some more room for my tongue and had a tongue tie police and all the things. And at the very end of it, I went, you know, I really wish I had dressed my nose first because I think that that was a barrier for certain other things I did. I probably could have had a lot more success. But my sleep, when we read the raw data with the. I had a colleague of Mine, Ken Hooks on the podcast, and he read it on a podcast and went through everything. And I've been missed for so many years because everyone said, oh, you don't have sleep apnea, you're fine, you're fine, you're a female, you're fit, you're young, you don't have sleep apnea. But I have uars. I have upper airway resistance syndrome, which is newer. And my body was never going into REM sleep. Like it would go into REM and boom, like I would pop out of it. But I wasn't actually fully becoming awake, so I had no idea. I was just tired all the time. So anyways, all that to say, you know, I always caution people, I say I'm all for it because I think it can help train. But on the flip side, I also have patients who say, you know what? I don't want to wear something every night for the rest of my life, whether that's a CPAP or mouth tape or whatever. And so we do work with a lot of kids and adults through myofunctional therapy to help train the orofacial structures to actually rest, you know, properly so that you don't have to use those things at night, barring all other things are addressed, you know, and then allows for that structurally so long answer.

Yeah, no, a lot of good points there. And airways becoming a big topic in dentistry as well. There are dental, I don't know the exact abbreviation, but the academy of Dental Sleep Medicine is that dentists pursue to try and get their credentialing in that, in that topic and field. And it's definitely an up and coming part of dentistry that people recognize, like, oh man, we've been missing this for years. It's time to get on board and really help first identify and diagnose these people and get them to the right people for treatment. Because as you mentioned, I can only imagine the amount of money it costs to society and lost production, sleep, health, relationships, jobs, productivity, everything for a lack of quality sleep.

Yeah, I don't know what the number is, but I know there's a really high incidence of divorce over like snoring and sleep and people ending up in different rooms and just relationships. It's pretty interesting. So you guys can save a whole bunch of marriages too?

Yeah, absolutely. We do it. All right. I love it.

So, yeah, that's, you know, I think it's really important though, this message, you know, surrounding the oral microbiome surrounding, you know, what we're putting in our body on our, you Know, on our bodies, the ability to nasal breathe, all of these things. I'm excited. I think it's a very exciting time. I think we have a lot more work to do in educating the general public because it's just not the normal conversation. And even in one of my groups, one of our members just posted a question earlier today and said, you know, I sent this patient to an ENT and they, the parent came back and said, oh, well, my child's mouth breathing. The ENT said, that's normal. Some people just mouth breathe. And I was like. She was like, I feel embarrassed to even ask this question. Am I missing something here? She's like, it's not normal, right? I'm like, no, no, it's not normal ever to mouth breathe.

We got some work to do. Yeah.

So I was like, okay. All right.

Well, it's interesting you mentioned like the oral systemic connection and the oral microbiome and I think a lot of times too, the previous philosophy and I have a tremendous amount of respect for what came before us. But yeah, I think a lot of it was just scorched earth policy, just bacteria bad, kill it at all costs, douse it with alcohol, just sanitize complete sterility. And I had read a book several years ago called 10% human, looking at how, how much bacteria, like the healthy, good bacteria that's in our, in our system and comprises a huge function of our digestive tract and stomach and really helps us in so many ways that we're really only now becoming aware of. And, and look, absolutely, antibiotics save lives. If you have a acute systemic infection, you need them. But to willy nilly be prescribing antibiotics for all those years that, you know, maybe in some cases we didn't always need to. And it was usually look at the best of intentions, just be proactive and defensive and gotta make sure we were taking care of people. But yeah, it really disrupts the whole system when you're the scorched earth killing everything. And that's, that can lead to other host of conditions, whether it's GI imbalance or clostridium difficile or just other things. So I think as providers, we're becoming much more conscious of antibiotics that we're prescribing and realizing the balance of good, good healthy bacteria and really to respect that and not, not just kill it at all costs.

Well, and you know, I know that obviously our gut, we have a big impact with antibiotics and these medications and everything. How does that impact the, you know, our oral cavity? Are you Are there also big changes when we're taking antibiotics, like things that.

We should be aware of in the mouth? Yeah, yeah. So when you're looking at the use of antibiotics, there are opportunities where if you've got a periodontal infection, so infections in the gums that attack the soft tissues usually starts with gingivitis. Gingivitis is gums that bleed. When it progresses on and it's left untreated, it progresses to periodontitis. That's irreversible bone loss. So you definitely want to intercept and stop that process from happening. And yeah, there are some, some antibiotic cocktails that you can use locally right in the gums to help some of those little, little infections here. But absolutely, there's an interplay of the healthy bacteria in the mouth as well. And really examining the products you're putting in your mouth. Again, there's this scorched earth policy of kill everything at all costs. Probably not the best approach. And a lot of these products that were out there were just heavily concentrated with alcohol as an ingredient. And absolutely, alcohol kills, but at what cost? It kills a lot of your healthy microbiome as well. And really looking at that interplay of keeping that balance, because when things get out of balance, that's when you can see the rise of the deleterious bacteria from the ones like strep mutans that lead to the decay in the cavity causing process or the periodontal or gum pathogens that lead to the breakdown of the soft tissue support around the mouth here. So I would recommend not using an alcohol based mouth rinse. For sure. I think that's fine. That really isn't necessary to have something quite so harsh. Not only does it kill everything, but it really excessively dries out your oral mucosa. And so that, that, that is another negative consequence of that as well. So just really be mindful about all kinds of beauty products and foods, but your oral hygiene products as well, because it's, it's actually going inside your, your mouth here. So you don't really need detergents. You don't really need sodium Laurel sulfate, which is a foaming and suds agent that causes suds and bubbles. You don't need bubbles. And I know sometimes people comment on us, oh, your toothpaste doesn't bubble. It's like, yeah, because we took the chemicals out. You don't need it. Crazy idea. But your mouth is highly absorbent and you don't want those things in your mouth.

Yeah, no, I'm laughing because when My husband first switched over, he was like, well, it's not as minty and it doesn't, like, do the same thing as the other one. I was like, yeah, because it's not going to kill you. So maybe, you know, you should use this one instead of that one. I mean, it had to be like, really drastic with him to get him to change things sometimes. So, you know, it doesn't actually do that necessarily, but I know. So, yeah, it was, it was interesting because he was just like, it doesn't. It does not as minty and it's not. And I don't taste the cake batter.

Give him the kids cake batter one day.

I know. I'm like. I was like, does it matter what it tastes like during or. I mean, it tastes minty during, though. Do you have to have the minty, like staying after? Does it have to foam in your mouth? Does it have to like, it's still working? And he's like, are you sure? I'm like, I'm pretty sure. Otherwise, I'm pretty sure that, you know, Jen wouldn't have given this to us. To you.

So even though it says kids on the, on the package, adults can still use the kids flavor because the only, the only difference is the flavor. So if the minty is too strong, use the cake batter. And also we've got some, some fun surprises on different flavors and products coming out in the next several months here that we'd like to unveil soon. So keep an eye out as that for, well, as well for people that, you know, might think it's too minty or they want different options.

Yeah, no, that's awesome. Because my daughter's about to turn five and I was actually. She was sitting there yesterday and she's like, I don't want the minty one that Lily uses. I want to keep using this. I was like, okay. And I was like, maybe I should look into, like, whether I need to switch her. So that's really helpful to know because we can just keep her on the cake batter. That's perfect.

Absolutely. Absolutely awesome.

So is there anything else you want to share? Obviously tell us where they can buy, you know, the product and everything, but anything else we did not cover today that you want to talk about?

I thought that was super thorough and helpful for, for, for everybody out there. And just thank you for allowing our, our audience to connect with your audience. I think there's a lot of Syner 2 communities and we're just excited to have the space and share time with you. So I mean, currently we're direct to consumer through our website. So RiseWell.com is the best place to find us. We're in some select retailers like Nordstrom's and some select fine markets like Credo and I think in California and Manhattan. And also we're in about select 500 select premium dental offices across the country. So see if your local person is offering it. We are, but those are, that's where people can find us. And of course the we have a blog and we really try and contribute to the, to the information out there on social media for oral hygiene and oral health. So you can follow our blog and newsletter and really we'll try and keep people updated with the science that's coming out. But it's exciting stuff.

That's awesome. And that's RiseWell.com right?

It is Perfect.

Perfect. Well, we will have that in the show notes and we'll link everything to this so they know how to find you and where to buy the toothpaste and all the other products that you guys offer. So I'm excited to hear about the future, the future flavors and what's coming down the pipe. So keep, definitely keep us posted. Although I get your texts and email so I'm sure I'll see it as soon as it's launched.

Yeah, we will. We got some fun surprises coming out for the community.

Awesome. Well, thank you. This has been so much fun. Derek, I appreciate you joining me.

All right, take care. Thanks again.

Thanks for listening to this podcast. If you want to hear more of these Myo Tots, Airway and feeding related episodes, be sure to leave a review on Apple podcasts or pledge a small amount on Patreon patreon.com the Untethered podcast. If you found value, others you know in this space will too. So be sure to share this episode on your social media platforms and join us over on Facebook, on my Facebook page at halibalkin Biz, on Instagram at Alighbulcan and you can head over to theuntetheredpodcast.com to grab a copy of the show Notes where you can also subscribe to be kept up to date on the latest podcast episodes.