How to Improve Oral Health & Its Critical Role in Brain & Body Health

Welcome to the Huberman Lab podcast where we discuss science and science based tools for everyday life. I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today we are discussing oral health. Now, when most people hear oral health, they immediately think tooth health and appearance and presumably fresh breath or lack of bad breath as well. And while of course tooth and breath, freshness, whiteness and health is a critical component of oral health, today you will learn that oral health, including the oral microbiome, the health of your palate, your tonsils, indeed the entire oral cavity, is an extremely important component of general bodily health. So much so that today we are going to add a seventh pillar to to the so called six pillars of mental health, physical health and performance. This is not a trivial step to add a seventh pillar to these six pillars. If some of you have been listeners of this podcast for a while, you may recall that the six pillars of mental health, physical health and performance, that is the six things that everyone needs to invest specific protocols into each day are in no particular order, by the way, sleep, sunlight and light exposure generally, which by extension also includes dark exposure, nutrition, exercise, which we could also call movement, both cardiovascular exercise and resistance training, stress management and relationships, and social engagement, including relationship to self. And today we are going to add oral health and microbiome health. And I suppose we could generally call this oral and gut health, because as you know, if you think about it, your mouth, your oral cavity and your gut are contiguous with one another. We are going to add oral and gut health as the seventh pillar of mental health, physical health and performance. Because as you will learn today, there are so many aspects of oral health and daily protocols for oral health that extend to cardiovascular health, to metabolic health, and indeed to brain health, and to staving off diseases in all of those bodily compartments. I cannot overemphasize enough how much oral health influences your general bodily health. So today you will learn about oral biology and health. We won't go too deep into the biology, but we will go deep enough into the biology that you will learn some incredible things, such as your teeth have the ability to literally fill back in cavities that have formed, provided those cavities haven't gone too deep into the teeth layers yet. You will learn that saliva, while most people think of it as just spit, is an incredible substance fluid that contains all sorts of interesting and important things that allow you to rebuild the strength of your teeth and indeed to support the health of your oral cavity. And gut, microbiome and body generally. So saliva is super interesting and important and today you're going to learn many, many protocols, including zero cost protocols, protocols that will actually save you money, as well as some low cost protocols to both restore, improve and maintain oral health and in doing so, maintain and improve your overall bodily health. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is Matina Matina Makes Loose Leaf and Ready to Drink Yerba Mate I often discuss Yerba Mate's benefits such as regulating blood sugar, its high antioxidant content, the ways that it can improve digestion and possible neuroprotective effects. I also drink Yerba Mate because I love the taste. While there are a lot of different choices of Yerba Mate drinks out there, I love Matina because again, they have the no sugar variety as well as the fact that both their Loose Leaf and their canned varieties are of the absolute best quality. So much so that I decided to become a partial owner in the company. Although I must say, even if they hadn't allowed me to do that, I would be drinking Martina is the cleanest tasting and best Yerba Mate you can find. I love the taste of brewed Loose Leaf Matina Yerba Mate and I particularly love the taste of Martina's new canned cold brew that zero sugar Yerba Mate which I personally help them develop. If you'd like to try matina, go to drinkmatina.com Huberman Right now Matina is offering a free 1 pound bag of loose Leaf Yerba Mate tea and free shipping with the purchase of two cases of their cold brew yerba mate. Again, that's drinkmatina.com huberman to get the free bag of Yerba Mate, Loose Leaf Tea and free shipping. Today's episode is also brought to us by by Roka. Roka makes eyeglasses and sunglasses that are of the absolute highest quality. I've spent a lifetime working on the biology of the visual system, and I can tell you that your visual system has to contend with an enormous number of challenges in order for you to be able to see clearly under different conditions. Roka understands this and designed all of their eyeglasses and sunglasses with the biology of the visual system in mind. Now Roka Eyeglasses and Sunglasses were initially developed for use in sport and as a consequence you can wear them without them slipping off your face while running or cycling, and they're extremely lightweight. Roka eyeglasses and sunglasses are also designed with a new technology called Float Fit, which I really like because it makes their eyeglasses and sunglasses fit perfectly and they don't move around even when I'm active. So if I'm running and I'm wearing my glasses, they stay on my face most of the time. I don't even remember they're on my face because they're so lightweight. You can also use them while cycling or for other activities. So if you'd like to try Roka glasses, go to Roka. That's r o k a dot com and enter the code HUBERMAN to save 20% off your first order. Again, that's r o k a dot com and Enter the code Huberman at checkout. Today's episode is also brought to us by Helix Sleep. Helix Sleep makes mattresses and pillows that are of the absolute highest quality. I've spoken many times before on this and other podcasts about the fact that sleep is the foundation of mental health, physical health and performance. One of the key things to getting a great night's sleep is to make sure that your mattress matches your sleep requirements. The Helix website has a brief two minute quiz that if you go to it will ask you questions such as do you sleep on your back, your side or your stomach? Do you tend to run hot or cold during the middle of the night? As well as some other questions allow you to determine the optimal mattress for you. When I took the quiz I personally matched to their dusk mattress, Dusk which has allowed me to significantly improve my sleep. So if you're interested in significantly improving your sleep, go to helixsleep.com Huberman take their brief two minute quiz and they'll match you to a customized mattress and you'll get up to $350 off any mattress order and two free pillows. So again, if you're interested in trying helix, go to helixsleep.com huberman for up to 350 dol two free pillows. Okay, let's talk about oral health. This absolutely critical aspect of not just having fresh bright teeth and no cavities and fresh breath, or at least lack of bad breath one would hope, but also total body health. As I mentioned a little bit earlier, oral health is inextricably linked to all aspects of brain and bodily health, both in the short term and in the long term. And it is perhaps the most overlooked aspect of mental health and physical health. So today I'd like to start off with a quiz. I'm going to ask you which of the following three categories you believe you best fall into. Okay, the first category is those of you out there who brush and floss every day, probably twice a day, and who make some effort to try and keep your teeth clean, who like the feeling of your teeth being clean, and who pay a fair amount of attention to whether or not your teeth are getting whiter or not getting whiter, maybe whether or not your breath is fresh or not fresh. Maybe. Okay, these aren't requirements for being in this category, but maybe you're somebody who also uses a mouthwash or uses mints or gums in order to try and keep your mouth smelling and looking fresh and your mouth clean. Okay, so this first category does not require that you do all of those things, but let's just make a basic requirement of participation in. In this category, that you routinely brush at least twice a day and that you floss at least once a day. Okay? If you fall into that category, you are in category one. And by the way, if you're in category one and you do those things and you do a bunch of other things like tooth whitening, and maybe you go to the dentist especially often more than the recommended twice per year, that still puts you in category one. Okay, second category are those of you out there who are, let's say, a bit more blase about your oral and tooth care. Those of you that perhaps just brush your teeth in the morning so that your breath is fresh, you can clean out that kind of sticky feeling in your mouth that's accumulated overnight, that sometimes brush and maybe floss at night, but, you know, a lot of times you fall asleep without doing that, or you don't feel like doing it, or perhaps that don't really floss at all. Okay. That perhaps go to the dentist once every six months, maybe a little less, maybe once a year, once every couple years. So while there's a bunch of different things that could put you into category two to. Let's make a basic requirement for belonging to category two. That you brush your teeth once a day, but not twice a day on a regular basis, or that you brush twice a day but that you rarely floss. Okay, that would put you into what I'm calling category two. And then, of course, there's the third category that maybe some of you out there fall into. And this is the category of people who are extremely diligent, not just about Tooth care, but also about oral health generally, about maintaining the microbiome of your mouth, about making sure that your gums are very healthy, about making sure that your soft palate and hard palate is very healthy, about making sure that, yes, your teeth are clean, that they're devoid of as much bacterial buildup and other stuff in there that can cause cavities. But also that you're paying careful attention to your oral microbiome and the overall milieu of your health in the mouth and the fact that your mouth is linked to all these different aspects of brain and cardiac and metabolic health, okay? If you fall into that third category, great. But let's be honest. Most people, I would argue 95, maybe even 98% of people or more, fall into either category one or category two. So as you're hearing this, you're probably thinking, okay, well, if I'm in category one, I'm good, right? I go to the dentist twice a year. I brush and floss, use some mouthwash. I even brighten my teeth. I, you know, I make sure that if I had a sugary meal, I'll rinse out my mouth. I try not to drink acidic foods. Things that we'll discuss today as to whether or not they actually have relevance for cavity formation or not. But guess what? If you are in category one, as I described it, or category two, chances are you are doing things to really deplete and disrupt your oral health. That's right. Even if you're paying a lot of attention to tooth health, chances are, if you're like most people out there simply because you don't have the latest information on what oral health really is and how to best support it, chances are you are doing things that, yes, might be keeping your teeth white and clean and you're not getting cavities, or you're not being told you have cavities that need to be filled when you go to the dentist twice a year or more, but that you are disrupting your oral health in ways that are depleting other aspects of your brain and bodily health. And I'm not here to scare you. I'm just here to tell you that if you're in category one, okay, you're clearly doing some things that are beneficial for you, but that there's some additional things that you can do and a few things to avoid doing that very likely will improve your overall bodily health very quickly. And the good news is those things are also zero or low cost, or in some cases, can save you substantial cost. Now, if you're in Category two, chances are you are depleting both your oral health and your overall bodily health. But here's what's interesting. Some of the folks in Category two that are not doing as much for the, let's say, hygiene and freshening and whitening of their teeth actually have a healthier overall oral microbiome. That's not always the case, but often it can be the case. So what you're going to discover today is whether you're in Category one or Category two, there are some wonderful and easily accessible practices that are well backed by science. And by the way, in preparation for this episode, I also consulted with no fewer than five dentists, including a pediatric dentist. I talked to a periodontist. I talked to people who fall into the functional dentist category. I talk to people with a bunch of different orientations who are all heavily qualified to talk about and to make recommendations about oral health and tooth health, et cetera. And what I'm going to deliver today is essentially the overlap in the Venn diagram of what they all agreed on. I'll highlight a few differences that they each had and that several of them had. They do fall into different camps, but I was positively surprised how much overlap or consensus there was in terms of protocols for tooth and oral health. And by the way, if you're in that third category of the person that's doing a lot for their tooth health and appearance and breath, et cetera, but also oral health and microbiome, I'm sure that today you'll also learn some new health practices and some things that will allow you to expand on your already terrific practices for oral health. So let's get into the material about oral health, focusing first on tooth anatomy and health and some a little bit about mouth anatomy. I promise to not go into this in too much depth, but we really need to have a firm basis, a foundation of understanding of what the mouth cavity really consists of. And I'm not just going to throw a bunch of names out there for sake of nomenclature. I don't need to cloud your hippocampus with that sort of information unless it's functional information, but it is critical functional information for the rest of our discussion, where we'll talk about ways that you can really build up the strength of your teeth, even if cavities have already started to form, and how to really get your saliva to be the best, healthiest saliva for your overall mouth and for your gut and for your brain, your heart, et cetera. Okay, so let's talk just briefly, I promise, briefly about the anatomy and a little bit of the physiology of this stuff. Okay, the teeth. We're all familiar with what teeth are. We have the tongue, the tonsils in the back of the mouth. We have our soft palate, hard palate, gums. Let's talk a little bit about how all that fits together, centering around the thing that most people think about when they think about oral health, and that's the teeth. It's just a good jumping off point for us. Your teeth are layered structures. Like pretty much every structure in your body is a layered structure. It's just the way those structures form. Cells are born at one location. They migrate out and form stacks or layers. Those different layers have different cell types, and your teeth are no exception. So while there are different kinds of teeth in your mouth, teeth have an outer layer, which is the enamel. The enamel, believe it or not, is not white. It is translucent. Light can make it through, but it's not transparent. It's not like a clear window. It's translucent. Light can make it, but it's a bit opaque. Okay. Beneath the enamel is a structure called dentin. Dentin is important for today's discussion because, as it turns out, cavities form, not surprisingly, from the outside of teeth inward, and cavities, as the name suggests, are holes that bacteria burrow down through the enamel, and if you're unlucky, make it down to the dentin. Our goal, meaning your goal, is to engage in daily protocols. That's right, daily protocols that are simple and fast and zero or very low cost, that allow you to avoid the formation of those cavities. Yes. But also that can allow you to fill in those cavities. This is one of the most important things to understand about oral health that, frankly, I didn't know until I started researching this episode and talking to all these experts in the field, which is that you can repair cavities that have started to form. That's right. Your mouth environment, based on its chemistry, and some things that are mechanical, but mostly based on its chemistry, in particular, how acidic it is or how basic it is, is always in a state of what's called either demineralization or remineralization. Now, those words are hard to say, and they're especially hard to say fast. So demineralization, remineralization, it's a little bit of a tongue twister. Today. I'm going to use a shorthand that's a convention in the dentistry field, which is demin or remin to refer to demineralization or Remineralization. Remineralization is good. It is the process by which, within the enamel, and to some extent in the deeper dentin layer of the tooth, but especially within the enamel, there can be the addition of new minerals that form very robust, essentially chains of crystals. Okay. If you've ever looked at a crystal of any kind under a microscope or you've seen a picture of it, they are incredibly well organized. They form a lattice of very strong, often, although there are weaker crystals too, very strong bonds and structure. It's like the structure of a really well formed building. Okay. Remineralization is the process of putting minerals back into that crystal structure. And it's actually possible to fill back in those cavities that bacteria have started to form, especially when those cavities have burrowed down into the enamel but have not yet made it into the dentin layer of the tooth or teeth. Okay. This is very important to understand. It's especially important to understand the context of the fact that typically, not always, but typically, if you have a cavity formed at one tooth and let's say it's just halfway or three quarters of the way through the enamel layer, that if you have cavities elsewhere in your mouth, chances are that they are at the same depth or level. Not always, but chances are. And that's great news. If those cavities have not yet made it into the dentin layer, why is it great news? Well, I don't know about you, but I don't like having my teeth drilled. I don't like having cavities drilled and filled. I had a very traumatic childhood with respect to dentistry and oral health. I'll talk about it a little bit later in the episode. It's not that I had tons and tons of cavities. I actually had this other issue where my adult teeth came in behind my baby teeth. I had all my baby teeth pulled. I had to get a bunch of injections of Novocaine in my mouth. I didn't like getting injections into my mouth, so I opted to have any cavities I had drilled without Novocaine. It's not because I was a tough little kid, although that definitely toughened me up. It was because I hated having syringes in my mouth. I might have even bitten a dentist or two or three. I don't bite the dentist anymore. I thank the dentist, by the way. I think dentists are wonderful. Regular cleanings are wonderful. We'll talk about frequency of cleanings. But here's the point. If you are somebody who enjoys Getting your teeth drilled, well, then I don't know what to say. But if you're like most people out there with proper wiring of your neurology, well, then you don't like getting your teeth drilled. And you can avoid it in many cases by remineralizing that enamel layer of your teeth. Now, if you there's demineralization down to the deeper dentin layers of the tooth, then most often you're going to need it to be drilled, drilled and filled, as they say. Or as some people say, which is a bit more cynical, drill, fill and bill. Because you get charged for that or your insurance gets charged for that. Okay, back to some tooth anatomy and mouth anatomy. Talked about the enamel layer of the tooth on the outside. I told you that it either can demineralize demon or remineralize reminiscence. This is a key point. Your teeth are always in a state of either Demin or Riemen. That's right, either Demin or Riemann. It's not both at the same time. It's one or the other. And it is largely dependent on the pH, that is the acidity of your mouth, which is largely dependent on how much saliva you're producing and the mineral content of that saliva. Keep that in mind. I think it's a very important point. Now, another key point is that next to your teeth, right, you have your gums, the gingiva, as it's called. Now, the gingiva provides a really important role in keeping the teeth stable. We don't often think of it like that, but even though that stuff seems gummy and soft, it is soft tissue. It is very important for fixing the teeth to the bone. It's not just about the roots that extend down into the jawbone below. The gums are very important for keeping the teeth where they are. There's actually a little ligament, too, between gums and the teeth that resides a little bit deeper. But the gums form a critical barrier between the oral cavity and the deeper layers of what eventually is bone and into the general blood flow or bloodstream of the body. Now, this is so important to understand that the gums are a seal around the tooth. This is why when you go to the dentist, they're paying attention with that little pick. They're paying attention to how high or hopefully low the tenting is. The little recesses or pockets of gums along the. Here I go. Yes, I have my mouth. Yes. I'll try not to do that during today's episode. Point to my teeth so much so that you can't understand what I'm saying, that the gums are providing a seal between the oral cavity and essentially the bone and the general bloodstream. Now, this is so critical because let's just take a step back and think about the oral cavity and what a remarkable place it is. Think about it. This is a gaping hole in our body. Okay, we have some other gaping holes in our body, but those tend to be sphincter based holes. Yes, I realize there are probably some chuckles as soon as you say sphincter, like. Yes, the anal sphincter. Okay, we're anatomists, we're biologists, we can talk about that. Stay shut. Stuff is generally not going up there. And if it is not very often. Okay, your nasal passages, yeah, those are holes. But, you know, there's a lot of stuff there. There's mucus to catch stuff. There's a crib reform plate, there's a bone. There's a bunch of things that act as barriers between the nasal cavities and the brain, which sits right behind it, the olfactory bulb. And yes, we have eyes and, you know, we have the outside of the eyes and there's a, you know, a susceptibility there, but we have our blink reflex. There's a. Also an ocular microbiome. There's a bunch of things there. But think about just this gaping hole in the front of our face that we use to eat and speak and breathe. Okay? It's a huge hole and as a consequence, it's filled with bacteria from our outside environment all day long. All day long, sometimes at night. Although we're going to talk later about the critical, critical need to be a nasal breather at night and not a mouth breather. Not just for sake of staving off sleep apnea, but also because turns out that dryness of the mouth is one of the ways that you really can throw off your oral health in major ways. In fact, it's one of the leading causes of tooth decay in people like methamphetamine addicts or if you see people that are mouth breathers, their oral health and their teeth generally, but certainly their oral health is severely depleted. So you've got this big hole in front of your face and you're talking and eating and moving about during the day. Even if you're a nasal breather, when you're not talking or eating and all this bacteria is getting in and it's a really moist environment and it's really warm. So the combination of bacteria, moist and warm, means that this thing is like a petri dish for growing stuff that could potentially be really bad for us. But it has this incredible feature, which is that if the ph is right, then the bad stuff is killed off. Doesn't make it into our system, doesn't disrupt our oral health or our bodily health. It also has a critical feature, which is that the bacteria that are good for us proliferate and supports the sealing process of the gums against the teeth and tooth health and tongue health and palate health, etc. Okay, so the oral cavity is amazing by virtue of how vulnerable it is, but also how robust it is. And the way it stays robust is by keeping the saliva healthy. Now, there are other ways too, but that's one of the main ones, and it's a huge portal into the rest of the body. And if the oral cavity isn't amazing to you already, based on what you've heard thus far, think about this. If you get a cut on your arm or your hand or your shin, unless you're one of these remarkable people, that always heals up without a scar. As long as you're about 25 years or older, typically you'll form a little bit scar, there'll be something noticeable there. The oral cavity also can take cuts and burns and things like that. Unfortunately, those things occur, but with rare exception, heals up with nearly zero scarring. Sometimes there's a scar, but nearly zero scarring, which is remarkable. Why? Well, it's basically an open wound with a bunch of bacteria in it, and it's warm and it's moist. So clearly there's something special going on in this thing that we call the oral cavity. Indeed there is. And it's anchored in the fact that if we treat it right, you can encourage remineralization. How do you do that? By keeping the saliva healthy. How do you do that? By supporting the proper bacteria within the mouth and making sure that you're eliminating the bacteria that you don't want or at least limiting those bacteria. And today we're going to talk about how to do that. And by virtue of doing all the things that support tooth health, you're also going to support gum health. Okay. Those gums are critical because they form that barrier that if it gets too big, if those pockets, those recesses get too big, and you're not taking care of the bacteria in your mouth, meaning you're not getting rid of the bad bacteria. Those bacteria worm their way down into the deeper recesses near the roots of the tooth, sometimes into the tooth. We'll Talk about that. And can get down into the bone and then can cause serious, serious issues. This is so called periodontal disease. And periodontal disease is associated with all sorts of really bad stuff, including Alzheimer's. Okay? This is not just some wellness culture. Woo science, leap to Alzheimer's. There's literally evidence that the specific bacterias that cause recession of the gums can cross the blood brain barrier if they make it into the general circulation and potentially cause plaques and tangles, some of the hallmark features of neural degeneration in Alzheimer's. Okay, probably not the only cause of Alzheimer's, but potentially one of the major causes. This is a new theory, but it's one that a lot of people are starting to pay attention to. And it's also very clear that bacteria make it down into these deeper recesses near the roots and into the bone, that you can end up with issues related to cardiac health and certainly metabolic health. Okay, so again, the goal today is not to scare you. It's not to spend too much time on all the terrible things that can happen, but rather to emphasize the positive, which is that if you do the right things at the right times, especially if you do them on a regular basis, that you can really improve the health of your total oral cavity and your teeth and your breath and all the other stuff that people care about for aesthetics and interpersonal interactions will flourish as well. I'd like to take a brief moment and thank one of our sponsors, and that's AG1. AG1 is a vitamin mineral probiotic drink that also contains adaptogens. I started taking AG1 way back in 2012. The reason I started taking it and the reason I still take it every day is that it ensures that I meet all of my quotas for vitamins and minerals, and it ensures that I get enough prebiotic and probiotic to support gut health. Now, gut health is something that over the last 10 years, we realized is not just important for the health of our gut, but also for our immune system and for the production of neurotransmitters and neuromodulators, things like dopamine and serotonin. In other words, gut health is critical for proper brain functioning. Now, of course, I strive to consume healthy whole foods for the majority of my nutritional intake every single day. But there are a number of things in AG1, including specific micronutrients that are hard to get from whole foods or at least in supply sufficient quantities. So AG1 allows me to get the vitamins and minerals that I need, probiotics, prebiotics, the adaptogens and critical micronutrients. So anytime somebody asks me if they were to take just one supplement, what that supplement should be, I tell them AG1. Because AG1 supports so many different systems within the body that are involved in mental health, physical health and performance. To try AG1, go to drinkag1.com Huberman and you'll get a year supply of vitamin D, 3K2 and five free travel packs of AG1. Again, that's drinkag1.com Huberman okay, let's talk about how cavities form, because I think this is the major question that people ask when asking about or thinking about oral health. As I mentioned before, cavities are literally holes. They're fenestrations, as the nerds call them. Nerds like me call them little fenestrations, little holes down into the enamel that if they make it down to the dentin layer of the tooth, most likely do need, need to be drilled and filled and presumably billed. Okay, but your goal, I think all of our goal, is to try and keep our teeth in a state of remineralization by keeping the pH, that is the relative acid, alkaline balance of the mouth, such that the saliva supports remineralization. Now let's think about how a cavity actually forms. Turns out that no specific food, not even sugar, causes cavities. Cavities are not caused by sugar. Cavities are caused by bacteria that feed on sugar. And now that's not just a little bit of a twist in the mechanism. That's a critical point. There's no specific food, not even pure sugar, not even like a hard candy, like a delicious Jolly Rancher. I used to like those when I was a kid. That gets stuck in your tooth that causes cavities? No, no. It's the bacteria that feed on sugar that then produce acid that burrows down through, that degrades, that demineralizes the tooth in this very focal area that we call a cavity. Okay? Now if that isn't surprising enough, get this. The bacteria that causes cavities by eating sugar and releasing this acid. While there are several of them, the major one is called streptococcus mutans, or what I'll call strep mutans for short. Strep mutans is not something you're born with. It's actually a communicable bacteria. That's right. You give it to one another through how? Sharing of glasses, sharing of bottles, kissing on the mouth, etc. Now, I am not here to tell you not to do any of those things. I'm certainly not here to tell you that, however. And by the way, in researching this episode, I did learn that there is a specific category of person out there. Typically they are a dentist or married to a dentist that have opted, believe it or not, to never kiss their children near or on the mouth so as to help their children not get streptococcus mutans. Because almost all adults carry it. Not all, but it's communicable like a STI or like a flu or like a cold. It's communicated between individuals. We are not born with it. Now that's a whole area of, let's just call it biosocial ethics, decision making that I think most people are not going to be too concerned with or at least act on. Because let's face it, most people are not going to change their overall behavior of kissing or usage of bottles or glasses in order to avoid getting strep mutans. Most people in the world have strep mutans or will have get strep mutans. And it lives in the mouth, okay? It just resides there. Strep mutans is there and it's hungry. What's it hungry for? Sugar. When there's sugar present, it eats it. It produces acid. The acid produces cavities, taking teeth from a state of remineralization to demineralization or and by the way, this is really important, if your mouth is already in a state that's more demineralization mode, so to speak, well, then it will capitalize on that and it will cause cavities much faster, okay? So keep in mind that acidity is bad for the mouth. Does that mean that you should never consume a lemon? Or and by the way, yes, I'm guilty of every once in a while I'll chew a lemon slice or drinking water with lemon in it, or carbonated drinks or sodas or tea or anything that has acidic flavor. No. Likewise, should you completely avoid ingesting any kind of sugar? Because strep mutans love sugar. No. Turns out strep mutans like sugars in the form of complex carbohydrate sugars too. So if you eat pasta or rice or oatmeal and some bread every once in a while, as I do, I'm an omnivore. I eat meat and fish and eggs and also starches and vegetables and fruits. I'm an omnivore, as most people are. Well, then strep mutans has an opportunity to eat the sugars that come from those other carbohydrates. Does that mean that if you were to have a zero carbohydrate diet, no sugars, no starches, et cetera, you would reduce the opportunity for strep mutans to consume sugar and release acid? Maybe. Maybe. However, most people won't do that. And strep mutans is a very clever, maybe even diabolical bacteria. And if you are on a zero carbohydrate, zero sugar diet, there's some evidence of that. Strep mutans will figure out ways to feed on other components of food in order to create this acid, to then create cavities in your teeth. So the key thing to understand here is that cavities form not from foods, not from sugars per se, but from strep mutans and other bacteria that eat those sugars and create acid. Hence the critical need to keep your mouth as alkaline as possible. Which does not mean that you can never drink some lemon water or coffee. Coffee or tea. Here's the key point that everyone needs to remember, because this dovetails beautifully into how often you should brush and floss and when you should brush and floss. Specifically, the key point is the degree to which your mouth is in a demon state or a Riemann state. And the degree to which cavities have the opportunity to form is dependent on the amount of time, the amount of time in which your mouth is net acidic or net alkaline, the amount of time that you are in a demineralization mode or remineralization mode. Okay, so it's the amount of time no one, no one can avoid having their mouth be acidic every once in a while, or ingesting a sugar or a food that strep mutans can feed on and produce acid. The key is to try and reduce the amount of strep mutans and reduce the amount of acid in the mouth. That's the best way to reduce cavities and even reverse cavities that have started to form. Now, in a moment, I'm going to tell you about fluoride, because I know there are a lot of questions about fluoride, but in order for you to understand what I say about fluoride and to make the best decision about fluoride, both in drinking water and toothpaste, etcetera, for you, you have to understand the remineralization process just a little bit. Just a little bit. So a little bit of chemistry here, a little Bit structural biology. And this will be fun, I promise. Promise. Even if, you know, no biology, no structural biology, no chemistry, you're going to like this part. And it's very simple. Those minerals that form the crystals within the enamel and some of the deeper layers of your tooth or teeth rather, those crystals form through a specific type of bond. And those bonds are very strong. Think of them like Lego chains. But these are not, you know, just conventional Lego chains. These are Lego chains that when they stick, when two pieces come together, things are tough to pull apart. They're not indestructible, but they're tough to pull apart. And they're also special because unlike a string of Legos, like a single string of Legos, these bonds that form during remineralization of the teeth are interdigitated with one another, or rather are at angles with one another that make those bonds especially strong. Any architect or somebody that understands structural biology will understand that bonds can be weak or strong depending on whether or not they're linear, whether or not they're crossed, whether or not they're in lattices. There's a whole bunch of interesting, you know, angled forces, stuff that the architects will understand and the, the construction workers will understand at a very intuitive and, and, and concrete level, no pun intended. And on and on. But just think about it. A bond is only as strong as the number of different points at which it can resist shearing and pressure. So the way that these remineralization bonds form is through the addition of specific minerals at specific angles. And the naturally occurring mineral that's responsible for the majority of these bonds in the enamel and teeth is called hydroxyapatite. What a great name if you're talking about oral health, right? Because we use the mouth for a lot of things. You can think of the small list or long list of those things. There are many of them, you know, depending on who you are and what you like to do with your mouth. But the point being that we do indeed eat with our mouth. Appetite is part of eating. So you just remember hydroxyapatite bonds, and they are very strong, but they're not indestructible. Acid can actually break those bonds. That's the demineralization process. Now, fluoride is a substance that is not a vitamin, it's not a mineral, it is not an essential nutrient. But that in the last century, it was discovered, can actually replace some of the hydroxyapatite bonds in teeth and actually make those bonds hyper strong, supraphysiologically strong. Now, we'll talk about the safety considerations with fluoride in a little bit because there are some safety considerations. But it was decided en masse in the United States and Europe that the addition of fluoride to the drinking water and to many toothpastes or tooth powders would be useful because it creates these super physiologically strong bonds within the minerals of the teeth. And indeed it does. It does. Fluoride gets between those Lego pieces and makes them extra, extra strong. And this is why fluoride is added to the drinking water. But, and this is very important to emphasize, but nowadays there's a really polarized debate about fluoride because some people out there believe that fluoride can disrupt thyroid health, might even be disruptive for brain health. Certainly if fluoride levels are too high in drinking water or any substance, it can be very dangerous. It can be a poison. But of course the dose makes the poison right. Fluoride itself may not be poisonous at very low levels. But there are really two camps now that have formed. And I'll just illustrate those two camps by virtue of what's happening right now. Right now in the state of California, there is a major lawsuit against the government because people want fluoride removed from the drinking water because of the long list of bad things that excessive. I want to highlight excessive fluoride can do for bodily and brain health, especially in kids, but also in adults at the very same time. Meaning right now there is also a major lawsuit, this one in Buffalo, New York, from mostly parents who are suing the city of Buffalo, saying that there was not enough, maybe even zero, fluoride in the drinking water for some period of time, and as a consequence, consequence, their children's teeth or oral health or both is depleted and they are suing for damages. Okay, so this is a really polarized camp. Now, I did a full episode of the Huberman Lab podcast all about water, and I talked about fluoride levels, which levels are thought by the CDC to be safe, which levels are not thought to be safe. I talked about some of the theories as to how fluoride might disrupt function of the thyroid and some considerations there. Please check out the timestamp in that episode. I link to that timestamp in the caption for this episode. But the important point here is that if you are at all concerned about fluoride in the drinking water, the simple answer is to just filter the water that comes out of the tap. If you're concerned about fluoride, then I suppose you'd probably want to avoid Toothpastes that have fluoride. Indeed, there are some. I will provide links to some of those in the show. Note captions for this episode. There are a variety of these zero fluoride toothpaste that have started to accumulate. But keep in mind that when fluoride is introduced into the bonds of the minerals of the teeth, they do make the teeth really, really strong. But. And all the dentists I spoke to emphasize this point, the bonds that form are not the natural bonds. Now, the fact that they're not the natural bonds doesn't necessarily mean that they aren't good for us or that they're bad for us. But the bonds that form when viewed under what's called electron microscopy look different. They look wavy, they're not smooth bonds. And they do increase the resistance to different forces, including cavities or acid that would create cavities. To be specific, they make the teeth stronger structurally. So resistance to chipping, et cetera. But there is a growing concern about excessive fluoride, which, by the way, if you drink a lot of tap water, you're going to be exposed to more fluoride than if you drink less tap water. That just kind of stands to reason. But people don't really talk about this, right? When you talk about x amount of fluoride by concentration in a given liter of water or gallon of water, you also have to ask, well, how much tap water are you drinking every day? Okay, you have to ask that question, right? It's not simply the concentration, it's how much you're ingesting overall. And that's something that's much harder to control for. Again, in the water episode, I talk about ways to eliminate or reduce fluoride in the drinking water, if that's a concern of yours. But if you want to know why there's fluoride in drinking water, it's because government's figured out, hey, well, if we want to reduce tooth decay, what's the simplest low cost method to do that? Well, it's to put fluoride in the drinking water. And you now also now know why there's fluoride in a lot of toothpaste. But given the concerns about thyroid health, potential concerns about brain health, now you also know why many people, including some dentists that I spoke to, are not big fans of fluoride, both for children and for adults. So you just have to make a decision for you. I'm not here to tell you what to do. You, you just have to decide are you pro neutral or against fluoride. In your drinking water? And if so, are you going to filter? Are you going to completely avoid drinking any water, maybe even cooking with any water from the tap and on and on? But now you know why fluoride is in drinking water and fluoride is in toothpaste. If you're somebody who's concerned about fluoride in either or both of those sources, well then what you really want to think about, and what most of us probably should be thinking about anyway, is trying to increase the remineralization state of our teeth and mouth in ways that don't create the opportunity for any other health hazard. And I will say this as well, which is that there's some data, not a lot, but some data, that fluoride might not be so great for our oral microbiome. And as we'll soon learn, the oral microbiome is critical for our oral and overall health. I'd like to take a quick break and thank our sponsor, InsideTracker. InsideTracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you reach your health goals. I've long been a believer in getting regular blood work done for the simple reason that many of the factors that impact your immediate and long term health can only be analyzed from a quality blood test. A major problem with a lot of blood tests out there, however, is that you get information back about metabolic factors, lipids and hormones and so forth, but you don't know what to do with that information. With InsideTracker, they make it very easy because they have a personalized platform that allows you to see the levels of all those things, metabolic factors, lipids, hormones, et cetera. But it gives you specific directives that you can follow that relate to nutrition, behavioral modification, supplements, et cetera, that can help you bring those numbers into the ranges that are optimal for you. If you'd like to try InsideTracker, you can go to InsideTracker.com Huberman to get 20% off any of InsideTracker's plans. Again, that's InsideTracker.com Huberman so in a moment we are going to get into what to do, the to do's, the behavioral to do's, and some of the other to dos for trying to keep your mouth in the best possible remineralization State, the best pH for tooth health, for gum health, for avoiding periodontal disease, maybe even for reversing some aspects of tooth and periodontal sickness. Because indeed you can do that if you shift your mouth to the correct ph if you're putting it into that remineralization mode. Okay. However, before we get into the to do's, I think it's very important to discuss the do nots that every dentist and periodontist I spoke to agreed on. The quick list, as I'll call it, of bad for your teeth, bad for your mouth, and therefore bad for your brain and body are, not surprisingly, perhaps, alcohol, which by the way, I did an entire episode about alcohol. It's one of our more popular episodes. I'm not here to tell you to never drink if you're an adult who's non alcoholic. But the cutoff seems to be two alcohol based drinks per week, beyond which you run into trouble. And yes, zero is better than any. But here when we say alcohol is not good for oral health and for tooth health, what we're talking about is the disruption that alcohol creates to the microbiome and the way that it alters the ph of your saliva and places the mouth and the teeth into a demineralization state that's very clear. It also kills certain cells of the mouth. Some people, I remember this in college would say, oh, you know, if you've got a, you know, you've got a like scratch in the back of your throat, you're getting sick, you know, you should drink. That's what they said you should drink. It's going to kill that thing off. Well, guess what? It does the exact opposite. It kills off a bunch of things that you want, like the cells in and around the mucosal layer of the mouth that are actually going to provide immune support and eliminate those bacteria or viruses that are making you sick, et cetera. So alcohol is bad. I'm not saying you shouldn't drink at all if you're a non alcoholic adult. You have to decide for you. But just understand that if you're drinking alcohol that you want to pay extra attention to your oral health and your tooth care practices, especially on the days around that alcohol consumption. And if you're somebody who doesn't want to drink alcohol now you have yet another reason to not drink alcohol. The second thing on the no fly list or the not good for us list for sake of oral health are stimulants. Now of course, things like methamphetamine, which are, you know, severely deleterious addictive drugs for all sorts of reasons, they kill dopaminergic and other brain neurons, they are highly addictive, and on and on, but also stimulants like Adderall, Vyvanse etc, those stimulants, basically any drug that increases epinephrine and norepinephrine, so called adrenaline and noradrenaline, there are the other names for those, are going to have a negative effect on oral health. Does that mean you should stop those medications if you've been prescribed them? No, it means that you should do some other things to try and offset the negative consequence of stimulants. Why would stimulants cause such disruption in oral health? Well, there are really two reasons. There's a chemical reason and there's a mechanical reason. The chemical reason is that. But stimulants change the PH of your saliva, making the mouth more acidic, which makes strep mutans and other bacteria more capable of creating cavities down into the teeth. They take your mouth and your teeth from that remineralization state, or as I've been referring to it, mode, to that demineralization. Demon mode. Demon mode. That's a way to remember it's bad. Demon mode. Demon mode, not good. Maybe in a video game, demon mode is good. Demon mode, not good for the mouth. Demon mode, demineralization mode. So there's a chemical reason why stimulants disrupt the oral health milieu and cause disruption in tooth health and degradation. Demon of the enamel of the teeth and deeper layers of the teeth. And this is profoundly evident in meth addicts. But the other reason, and this was a reason that was shared with me by a physician, an MD from University of California, San Francisco, who interacts by virtue of his profession with a lot of methamphetamine addicts who have terrible teeth, is that stimulants encourage mouth breathing. Watch a meth addict or watch somebody who's on a high dose of stimulants. And they tend to mouth breathe because of the shifts in autonomic nervous system function. They tend to be mouth breathers. So it's the drying of the mouth that also shifts the mouth from that remineralization mode to demineralization mode. So if you do take stimulants by prescription, I would hope not methamphetamine or illicit drugs. But if you take prescription stimulants, and by the way, things like Wellbutrin, Modafinil, they do qualify as stimulants, even though modafinil is a little bit of a special case. Any drug that increases norepinephrine, epinephrine, any stimulant, and yes, indeed, coffee. We'll talk about coffee as well. And tea Will make the saliva more acidic and make your oral health potentially less good. Mouth breathing. Bad for oral health, bad for teeth. Bad, bad, bad. There's just no question about it. So today's discussion I'm calling oral health, but that includes oral airway health. And I've talked before on this podcast about the fact that if you can be a nasal breather, be a nasal breather, please. As long as you're not speaking, as long as you're not eating, try and breathe through your nose. If you're exercising, exercising really hard, like you're running really hard, fine. Mouth breathe. I don't think there's any evidence that staying in nasal breathing mode all the time while exercising is best for performance. In fact, to the contrary, there are times when you need to mouth breathe and there are sports where you need to exhale through the mouth, specifically certain martial arts, for instance. So not saying don't ever breathe through your mouth, but as much as possible, try and keep the oral cavity moist and closed. This is critical. So stimulants dry out the mouth. They increase the acidity of the saliva. That's bad. Smoking cigarettes and yes, also cannabis. And yes, vaping does this too. It's so funny anytime I talk about smoking being bad, people like, well, what about cannabis? Well, I did an episode about cannabis. Cannabis does have certain medical uses that are very interesting, and there's good evidence for those. But for many people, cannabis is not a good idea. You can check out that episode to decide for you. Then people ask, what about vaping? Vaping's not as bad as smoking, right? That's what they say where they're sort of asking, saying, hoping, wishing, fantasizing. And the truth is that vaping is terrible for your oral health as well. Is it as bad as smoking? Probably not. But it's bad for a bunch of other reasons that offset any gain or gains you would get from vaping instead of smoking. So just know that if you're a smoker or a vaper, or if you vape rather, that you're going to want to pay extra attention to some of the other protocols discussed and that we will discuss going forward in order to try and support your oral and therefore your whole body health. Okay, so we've got alcohol, stimulants, smoking, vaping, and by extension, dipping tobacco. Frankly, not good for oral health or tooth health. In fact, they can be pro cancerous to the gum tissue. It's well established. And they can also cause degradation of the gum tissue and even some of the underlying bone. If you tend to do it on the same side all the time or often at all. So that's not good. We already discussed that sugar is not good for oral health. Does that mean you can never ingest sugar? No, of course not. Enjoy the sweets you enjoy every once in a while. Enjoy a nice pastry, you know, do as you will. If you're somebody who never eats those things, great. But then understand that any carbohydrate, any starch, provides a sugar that strep mutants can eat and create acid and demineralize your teeth, create cavities, that is. So avoid sugar in excess. And if you eat sugar, try and rinse your mouth after. And ideally you would brush, maybe even floss after. Okay? I do know those people that after every meal they're running. Even in the middle of the day, they run to the bathroom and brush their teeth and floss. And that's great, but most people don't do that. So swishing water, rinsing your mouth out again, plain water, maybe with a little bit of salt in it, is going to be beneficial. We'll talk about mouthwashes later, just to give you a little window into where we're headed with that. Most mouthwashes, terrible, terrible for your oral health, especially alcohol based or antiseptic based mouthwashes, except under certain conditions, prescribed or otherwise. Okay, so if you eat any sugar, and frankly, after you eat anything, it's a good idea to try and clear as much of that food product from your mouth. You may not think you still have food in your mouth and teeth, but trying to, you know, swish some water, maybe spit it out, maybe swallow it, that's up to you. Are you a spit or swallow? Not my business. Don't want to know. Don't tell me, don't put in the comments, comments, just decide for you. But sugar and other food products residing in the mouth for long periods of time, not good. And similarly acidity foods that are acidic. So certain things like citrus fruits, which I love. I love oranges. I have an orange tree in my backyard now and I absolutely love it. I love oranges, grapefruit, I just can. I love the peel. I even eat the peel sometimes. It's so delicious. And no one's telling you not to eat acidic foods or to avoid acidic drinks like lemon water or carbonated lemon water. Some people are really extreme and they decide to just use a straw when they drink those things. In fact, the dentist I spoke to said yes. Could you ask people please, if they're going to drink acidic drinks? To try and use a straw. But then I said, well, you know, a lot of straws, they disrupt the environment. Most people aren't carrying around metal straws or, you know, and what about the turtles? This kind of thing. And they said, well, okay, here's the real truth. The real truth is it's the amount of time that the mouth is exposed to that acid. So if they're going to drink it, drink it over the course of 5, 10, 15, maybe 20, 30 minutes and then be done with it. Rinse out the mouth with a little bit of water and try and clear out that acidity. It's not about completely avoiding acid foods or sugary foods or acidic drinks. It's about, again, limiting the amount of time that the overall milieu of the mouth is acidic because of this whole demon Riemann thing. Strep mutans, and the acid created by strep mutans that can derod the teeth. And the fact that if your mouth is kept acidic for long periods of time, you're going to provide the opportunity for faster and deeper development of those cavities. And keep this in mind, again, anytime we talk about demineralization, the formation of cavities, remember, it's like a seesaw. It's either demon or Riemann, but not both. So anytime you're demineralizing your teeth, you're also not remineralizing your teeth. Your teeth, okay, so really avoid alcohol, stimulants, smoking, vaping, sugar, mouth breathing, acidic foods, acidic drinks. But many of us, most of us can't avoid any sugars, any acidic foods. The other things can be avoided, but some of us are prescribed these drugs and need these drugs. Some people like a drink with alcohol in every once in a while and it's perfectly fine for them or they've deemed it perfectly fine for them. In that case, try and rinse the mouth. Try and keep the milieu of the mouth as moist and as basic or alkaline, rather less acidic as possible. So to translate this a bit more to the real world, if you're somebody like me who loves tea, I drink cold brew, zero sugar, Yerba mate, that's my favorite source of caffeine. I also like a nice black double espresso or coffee every once in a while. It's fine to drink that, but you don't want to sip on those sorts of things all day and you don't want to sip on them for hours and hours. And if you're going to combine those things with some acidic foods or with Any kind of food. You know, try and get your meals done, wrap them up and rinse your mouth and move to the next part of your day. And that actually segues into a really important point that came about when researching this episode that if I had to highlight, boldface, underline and light up. One particular protocol that I think most everybody is not thinking about is that there are certain times in the 24 hour circadian period in which your mouth makes the maximum amount of saliva okay, and that the saliva has an opportunity to be the optimal pH, that is chemistry for encouraging remineralization of your teeth. And that's during the daytime and especially through the middle of the day. Now, there are a couple things that can disrupt that. For instance, eating anything, I don't care if you're carnivore or vegan, whatever, omnivore, when you eat, you change the PH of your saliva and you're introducing those sugars that the bacteria can feed on. So one thing that became very clear to me when researching this episode, talking to experts, reading manuscripts, and also reading some really interesting books about remineralization opportunities for the teeth is that having a stretch of time of maybe two, four, six hours or more where you're not eating anything or ingesting anything that's acidic in terms of liquids can be very beneficial. Now, this is a vote in support of so called intermittent fasting. This is something that I practice typically by eating my first meal somewhere around 11am every morning, sometimes earlier. I'll sometimes have a little breakfast at 9 if I particularly hungry, but typically I eat my first meal around 11am or noon, and then I eat my last bite of food by about 8pm not everyone likes to do intermittent fasting, and I realize for sake of weight loss, it's probably interchangeable with caloric restriction generally. And there's a lot of debate as to whether or not intermittent fasting is going to extend lifespan, whether or not it's better for metabolic health and simple caloric restriction. I don't want to get into that debate. Frankly, it's a barbed wire debate that's been carried out on this podcast and elsewhere before and I think, think is it ongoing? I think is the the best way to couch that debate. But in researching this episode, it became very clear that we have an amazing opportunity during the day, especially in the morning and throughout the day, to create a lot of saliva that's the right PH to support remineralization of the teeth, provided that there isn't a lot of food or acidic liquids. In the mouth at that time. So at least to my mind, this is an interesting opportunity to place intermittent fasting, which again, or even just gaps between meals, not constantly snacking or sipping on acidic beverages throughout the day, as an opportunity to create that healthy milieu during which the teeth can remineralize and the overall oral health can improve. Now, does that mean you should never eat or drink anything during the middle of the day? No, I'm not saying that. I'm saying that if you're going to do those things, try and clear them from your mouth as I described before. Now, many of you will probably say, hey, during the middle of the night, I'm not eating or drinking anything. For some of you, that might be the only time that you're not eating or drinking anything because you're asleep. One would hope you're asleep. But here's the interesting thing. Every cell, tissue and organ in our body is on a 24 hour circadian clock. I think many of you have heard me say that in the context of viewing morning sunlight and other protocols that I, you know, suggest on the Huberman Lab podcast. But here's the interesting and important point. In the middle of the night, indeed, you're not ingesting any food or fluids, presumably, but your saliva production is dramatically reduced. Again, dramatically reduced. And as a consequence, if there's food, or rather food opportunity for strep mutans and other bacteria to feed on and create acid to erode your teeth, the saliva necessary to offset that, to combat that, is simply not present, or at least not present at the same levels that it is during the day. So this is a sort of two pronged protocol. On the one hand, I'm saying you might consider trying to introduce maybe an hour or two hour or longer stretches during the day in which you're not ingesting any food, and if you're drinking anything, it's not acidic, or if you are to try and rinse away that acid as much as possible. So plain water would be great, avoiding carbonated lemon water would be great. But if you like those things, and indeed I love those things, I love carbonated lemon water. I love things like yerba mate. Indeed, the yerba mate I like is cold brew, zero sugar, but has some lemon and ginger in it. Okay, that's fairly acidic, but then drinking it down either pretty quickly or if you're going to sip on it, then rinsing it away with some water and not doing that throughout the entire day. And indeed I tend to drink my caffeine early in the day and not so much throughout the day. Maybe a little bit of mate in the afternoon sometimes. Okay, so that's one aspect of maintaining or encouraging the correct PH of saliva to remineralize your teeth. Right? Create these windows of opportunity where there's a lot of saliva for long stretches of time during the day, as long as possible, while still making it compatible with your nutrition needs and your hydration needs. Of course, the other prong or the other aspect of this protocol is that at night when you go to sleep, you need to know you're not producing very much saliva. And that's the critical time to make sure that there is as little opportunity as possible for strep mutans and other bacteria to feed on sugars or other food products and thereby to create acid that creates cavities. And so this is a very important protocol that every single dental and oral health care professional I spoke to supported and indeed champions, which is if there is a most critical time of day or night to brush your teeth and floss and clean your teeth, it's at nighttime. It's at nighttime. Why am I saying this with such whispered importance? Well, I think there are many people out there, in particular people that fall into that second category that I mentioned at the beginning of today's episode, that wake up in the morning and brush their teeth, maybe even use mouthwash, maybe floss and do a bunch of things to try and get their mouth clean and fresh, especially if they're going to interact with other people during the day and to get rid of all the kind of stickiness and morning breath, that kind of thing, but that at night they're finishing dinner, maybe having some dessert, doing some work and passing out without brushing their teeth or flossing or simply getting too lazy to brush or floss. And by the way, I'm going to raise my hand and just say, for many years I was in that category. I know, Ew, gross. But I was in that category. I had high motivation to brush and floss, or at least a brush in the morning, very little motivation to do it in the evening. Every professional said, if you're going to brush and floss just once per 24 hours, and that is not what they recommend, by the way. But if you were going to do it just once, the critical time, the most essential time to brush and floss and clean the mouth and get the milieu of the mouth correct for tooth care and mouth overall oral health, is at night before you go to sleep, because you already know the mechanistic backbone for this argument, because at night you're producing far less saliva. And if there's any food product there that the bacteria can feed on, the saliva isn't there to combat that, because it's a constant battle between acidity and alkalinity. Your saliva is coming in and trying to save everything, and the strep mutans is trying to destroy your teeth. And the acid is the weaponry they use. And what fuels that weaponry, what provides them more ammo to destroy your teeth are sugars and acidity. So if you were going to brush or floss, and ideally you do both only once per 24 hours, it would be at night before going to sleep. Indeed. So much so that I would say that nighttime brushing and flossing is perhaps one of the most important things that we can do for overall oral health care. We'll talk about what to do, what to use for brushing and flossing in a few minutes, but that's absolutely essential. I do not want that to be translated into, you only need to brush or brush and floss once per 24 hours. Every professional I spoke to and all of the data point to the fact that doing it twice per 24 hours is best, or perhaps even three times per 24 hours. But let's be honest, most people are not going to brush and floss three times every 24 hours. Some will, but most won't. And now, of course, I've been saying brushing and flossing, but I haven't talked about the incredibly extensive landscape of how to brush and floss. So now let's take ourselves back to being little kids, right, when we were taught to brush our teeth in a particular way. You know, you're supposed to spend a certain number of minutes, set a timer, supposed to floss in a certain way. Every time we go to the dentist, they tell us to floss in a certain way, do this, not this. What do the data really say? What are the modern health professionals in dental and oral health really suggesting we do when it comes to brushing and flossing? And fortunately, here there's a near uniform consensus. There's always that outlier, that person that says to do things a little bit differently or no. There's in fact, one person very prominent in the dental health space that is not a fan of flossing, but they are really the outlier. The vast majority of dentists out there all say the same thing. You need to brush, you need to floss, you need to do it twice a day or more, and you need to do it Correctly. So now let's talk about what correct brushing and flossing really is. Okay, so I'm not going to demonstrate how to brush your teeth, but one very actionable protocol that was told to me by all the dental professionals I spoke to was use a soft toothbrush. Now, this one hurts, or I suppose hurts less anyway, it hurts my heart a little bit because I enjoy very much using a medium or hard toothbrush and really like scrubbing back there, especially in the teeth, in the back. It just feels good. I feel like I'm doing something good. I get into the backs of the teeth, the fronts of the teeth. I don't know. I actually enjoy brushing my teeth, especially lately. Don't ask me why, but I do. But every single one of them said that that very vigorous brushing with medium or hard, as they're called, bristles, really disrupts the interface between the teeth and the gums in ways that's not healthy for the gums and actually makes. Makes tenting of the gums and those pockets, those recesses, as they're called, far more likely to form. And every single one of them said, if you are regular with your brushing, and especially if you're brushing and flossing regularly, that a soft toothbrush that is one that's moved in a circular motion on the fronts and backs of your teeth for all your teeth, and that is gentle, you're not providing a lot of pressure, is going to be the best way to break up that biofilm layer each and every time and promote the best tooth and overall oral health. So I suppose manufacturers who are making medium and hard toothbrushes maybe give us some rationale for that, you know, because the dental professionals that I spoke to, and again, I spoke to, a fair number of them, all said the same thing. Soft toothbrush, not just better, soft toothbrush best. Likewise, if you use an electric toothbrush, which I now do, sometimes I switch back and forth, but use an electric toothbrush. It was recommended that you not provide too much pressure, that you really try and keep the tips of the bristles on the teeth and gums. And yes, it was also suggested that people brush their gums. This is interesting for people out there who have tooth sensitivity. One of the major suggestions from people in the dental and periodontal field, at least the ones I spoke to, was to actually brush your gums lightly to increase circulation of blood and other nutrients to the deeper portions of the tooth that actually extend into the bone. Now, there is a tremendous amount of blood flow to the gums. Anyone who's you know, sort of nicked their gum with a while. While flossing or with a toothpick can tell you bleeds very readily. And that's not a good thing. Right. You don't want to create bleeding of the gums. We'll talk about bleeding of the gums during flossing in a moment, by the way, so don't jump the gun just yet. I said jump the gun, not jump the gum. By the way, if you are brushing your gums, make sure you're using a soft toothbrush. If you're using electric toothbrush, make sure you're going very lightly on the gums. And because there's so much blood flow to the gums, it does encourage a lot of circulation to some of the deeper cavities of the tooth, as it turns out, as.