From Root Canals to Root Cause - A Functional Medicine Approach with Dr. Eniko Loud and Sachin Patel

Hey, friends. Welcome to Perfect Practice Today with me, I have a very special guest and I know that you're going to be intrigued with everything that she has to say. In my preliminary conversation with her, I am getting goosebumps and I'm getting excited and I'm literally salivating to share this information with you because what she's going to share with you is going to impact you, it's going to impact the patients that you're seeing, it's going to impact your family members, and that is our oral health. And really going beyond oral health is what we're going to talk about today. So today My guest is Dr. Nico Laud. And she is a pioneer in the treatment of orofacial conditions. And she's really, truly reinventing the world of what it means to provide dental care. And she does it in a very holistic way and in a very extensive way using functional medicine. So she has an approach that goes beyond the mouth and that excites me because our mouth is truly a window into the rest of our body. And it's a great way to find for us to understand by looking in somebody's mouth where their health is going or perhaps where their health has been. She's focused on working on the whole patient. So if you ever have a chance to work with her in her practice, you'll know that she takes a whole body approach when it comes to your health and when it comes to your oral health, not just looking at the teeth, not just looking at the gums, but also looking at the biochemistry of the person, the genetics of the person, and also lifestyle factors that contribute to a healthy oral microbiome. She is very sought after. And because of both of our schedules, the universe finally conspired for us to meet today and have this conversation. We had to reschedule this a couple of times because of how busy we both are. So I'm so grateful and honored that she's joining me today. And one of the things I want to say about Dr. Nico is not only is she very humble and very kind and very wise.

She.

But she is actually very sought after by many names that we would probably recognize. And so the way I met Dr. Nico is through my mentor, Joe Polish. She was at a genius network meeting and he was talking about how wonderful her practice was. He actually shared a video of him going and having his experience at her practice. And that sparked an interest in me to invite her to come and share with our audience. She's also appeared on Ben Greenfield's podcast and that is an honor and a testament as well, because I know how rigorous Ben is with who he interviews. So to get on his podcast is a testament to the quality of the work and the impact of the work that you're having. So thank you. Dr. Lau, thank you for being here. Thank you for taking time out of your busy schedule and sharing your wisdom and your passion with us today.

Thank you so much. I'm so excited to be here.

Well, let's get right into it. What inspired you to not only become a dentist, but become a functional medicine trained dentist? Where did you see the gap in dentistry for you to take that additional training?

So I was originally trained in medicine in Europe and dentistry, so both. And I had this passion for seeing the person as a whole since I was a child. I have a family of doctors and I've been around medicine for a long time. So as I started practicing dentistry, I realized there's a huge disconnect between what the oral health is and the rest of the body. Almost like it's a separate identity. And then I got more involved in holistic dentistry and I still was searching for a lot more answers. And when I discovered functional medicine, it was like a complete paradigm shift. In dentistry, we're told that once you have gum disease, you have it for the rest of your life. Diabetes, the chronic condition, that once you have it, you have it for the rest of your life. And during my first session in functional medicine, that was all turned upside down. So I became so interested that I decided I will get certified in functional medicine so I can get fully immersed and get as much knowledge as I can. And as I was learning, I was applying functional medicine principles to my patients and I saw the interest people were having. They didn't just want to to deal with disease day in and day out. And so many people are so sick and they don't see their doctors that I started making an impact in my patients health with the documents and forms and dietary plans that we were discussing. And it just completely changed my practice and it made me be really excited about showing up every day for work because I felt like I was finally making a difference in people's well being.

I love that. You know, as I mentioned to you when we were not recording, I was actually planning on being a dentist because I love working with my hands, I love making people smile and you know, my path went a different direction and became a chiropractor, which I'm still working with my hands and still helping people feel better and helping them smile. But both of our journeys you know, led us to functional medicine to have this conversation, to look at the person from a more holistic perspective. Perspective. So what I'd love for you to do is perhaps share with me what are some insights that you can glean with your trained eye that paint a picture of what somebody's health is like in the rest of their body. Because we know that what we see in the mouth goes far beyond what's happening in the mouth, that there's a global effect of what you see there. So what are some of the telltale signs of maybe a systemic problem that we can see in somebody's mouth?

That's a. That's an amazing question. And because diseases of the body show up usually 7 to 10 years before symptoms manifest in the body, in the tongue. On the tongue. So, for example, if somebody will stick their tongue out and look in the mirror, they can see so much. They can see if they have food sensitivities, food allergies, vitamin deficiencies. Vitamin deficiencies can show up as cracks in the tongue, or digestive enzyme deficiencies can show up as cracks in the tongue. Food sensitivity show up with white and red patches. If somebody has a body that has systemic inflammation, their gums could be bleeding very easily, or when they're brushing, they'll see a little bit of blood in their saliva. One of the biggest indicators of disease is bad breath, and that could be coming from the tongue, from the teeth, from the gums, or even from the stomach. Those are the things that any person can kind of look in the mirror and detect if there's some type of imbalance that's going on in their body.

Wow. So, you know, tongue diagnosis is a part of Chinese medicine, Is that correct?

So did you take also.

And.

Yeah.

And Ayurvedic medicine as well, which I know is a budding passion of yours. So we'll definitely be. Be sure to go down that path and discuss that. What do people say after their first appointment with you, having seen you for the first time and maybe having gone to a dentist, a traditional dentist, we'll call it, for now, their entire lives prior to that. So I'd love for you to maybe contrast that user experience and the feedback that you get.

So our user experience, the first patient appointment is usually about an hour and a half and sometimes two hours. The biggest difference is, compared to other dentists, is that based on functional medicine models, there's a lot of listening. I listen to the patient's story. We gather information from the patient even before the appointment. So I know their Genetic background, their family background, their dietary choices, their environmental toxin exposures, their sleep, their diet, their exercise. So I review all that before I see the patient. And during the visit, I allowed the patient to really discover for themselves the connection. And during that exam, at the end of the exam, everybody's kind of blown away because nobody has ever given them the opportunity to discover for themselves what's really going on and help them see the bigger picture of what's really happening. Not just. I don't just focus on the mouth. We try to connect every part of their history with their oral health. That seems to empower patients. What I see very often is patients leave feeling amazing that they've never experienced anything like this. And they're very hopeful that finally there are answers to their questions.

How long do you foresee this being the standard of care in dentistry?

Well, the standard should be the standard of care. It's not the standard care. Most visits are like, in and out. They look at your teeth and, oh, you need a few crowns. And you're just, you know, you schedule for it. And in my practice, it's very important for me that patients are empowered and they're part of the process. It's just like in functional medicine. This is a partnership, and I'm mostly a coach to them, a guide on their journey. And I always tell patients we can go two ways. We can either go down the path of disease or they can go down the path of health. Most patients choose health, and we are holding their hand along that path, but they're still in the driving seat. They make all the decisions.

Yeah. You know, one thing you said about being able to look at somebody's tongue and be able to assess if there's certain deficiencies or problems going on. The cool thing about that, too, is that they can also see if things are getting better. So without having to run like, you know, blood work or lab work, it's a way for them to kind of self assess that things are moving in the right direction and validate the course of action that they're taking. Right. So now they have an explanation as to why things are the way they are. You give them some recommendations in addition to, obviously, their oral care recommendations, and now they have a way of assessing if things are moving in the right direction. I love having a feedback loop like that. And it's great that it's something as simple as looking at your tongue and being able to assess that things are working is a very powerful tool, actually, and something that we can very easily utilize as an assessment. Marker.

We also utilize. We created a report card. So every patient at the end of their appointment, a hygienist gets a report card where we check off certain markers of health or disease, and we categorize from green to red, like green being you're in good health. So people always know where they are in their journey, and they get the report card. And it created competition between patients and spouses, like who gets the best beta plaque scores. One of the things that happens in dentistry is they don't even measure plaque score. Plaque score is the amount of buildup of biofilm and bacteria on the teeth and in between the teeth and on the tongue that doesn't get measured anymore in most practices. And also bleeding scores. So according to a lot of the medical association, dental associations, 10% of bleeding score is considered normal. And I tell patients, if your armpits started bleeding when you were showering, would you be concerned? Would you run to the emergency room? And I don't know anybody that said I wouldn't be concerned. So that's. We set different standards, like in our. In our practice, zero bleeding score is what we aim for with our patients. And. And that really is what. How they can measure their success, how they can measure their progress also.

Hmm. So what would be like a norm? Like, so, obviously there should be no bleeding when you're brushing your teeth. Perhaps no bleeding. And I'll let you, you're the expert here. Should there be any bleeding when people floss their teeth?

No. There should be none.

No bleeding. Right. And no pain either. Right. Associated with either one of those. So what would that be a telltale sign of? I know you said chronic inflammation. I'm also assuming vitamin C deficiency, which can be caused by chronic stress and nutrient deficiencies. What other things would you want to rule out? If somebody has bleeding gums.

Sometimes malnutrition, and a lot of times it's a lack of proper care people have. Mouth breathing could be an issue. And bacterial overgrowth. Even if they brush and floss properly, sometimes bacteria can be transferred from a loved one who has periodontal disease or gum disease. If you share food items or kissing, that could be transferred to the patient, too. So that's something that usually doesn't get addressed. They could get inflammation in their gums from bacterial overgrowth on appliances they wear, like a night guard or retainers that don't get disinfected regularly or sometimes by not changing the toothbrush head often enough or disinfecting your toothbrushes. That's a lot.

Yeah. No There's a lot to unpack. So it leads me to a few more questions for you. So how often should we change or toothbrush?

I probably say every month or every other month.

Okay.

As long as you disinfect it. And you'll see the head depending on how somebody brushes. If they're really aggressive brushers, which is not a good thing because you can damage your teeth or gums with it, then you'll see the toothbrush heads kind of flare out or spread away. But I would say it'd be good thing to do every single month.

Every single month. Now you said toothbrush head. So are you suggesting people use an electric toothbrush or a hand powered toothbrush?

I like electric toothbrushes because they do the work for you even if you're not paying attention. I tell my patients, try to think of toothbrushing as a meditative practice. It's two minutes of meditation and you could say gratitude to your teeth and your tongue and your mouth and your head while you're doing it. Because most people just brush mindlessly and they're thinking about the day and they don't even realize they're not brushing certain areas because people tend to not brush certain areas. So these newer intelligent toothbrushes will actually show you if you missed an area and they'll, they'll prompt you to go back to that area. But oftentimes people forget to brush a whole area of their mouth consistently.

Is there a particular brand that you recommend that you care to share for toothbrushes?

Yeah, I like oral B. IO they have a small round head and it oscillates and it rotates. So it's very effective at removing plaque. That's just my preference over the years that I've seen.

Okay, so full disclosure, I'm that guy whose toothbrushes heads are all splayed out and I try to be a gentle brusher. So certainly there's room for improvement there from what I'm hearing. And then I'll go out and buy that toothbrush so that I can have even better dental health. You mentioned a few things. We talked about tongues. And what I'd love to do is I'd love to explore tongue ties. And I posted something recently about tongue ties. My son has a small one, my wife has one as well. And I think mine falls into the normal category. But when I posted it, it was such a controversial post. Like it triggered some people. And so I love for you as an expert to unpack that for us. What is a tongue tie? First of all, and how does that translate to good oral health, postural health, and all the other things that the tongue tie can impact?

So the way to know if you have a tongue tie is you go in front of the mirror and you open your mouth wide, and you should be able to take your tongue and put it to the roof of your mouth while your mouth is wide open. If you could do that, then more than likely you don't have a tongue tie. If you can't do that and you have to close your jaw and you see this, the soft tissue underneath your tongue that looks like it's pulling it down, tethering it down to your lower jaw, then you more than likely have a tongue tie. The implication of that is just like that. You saw you can't open your mouth wide, so it restricts opening of your jaw. It restricts the normal movement of your muscles of the jaw. What it can also do, we have this bone called hyoid bone. That's a floating bone. And the tongue has strong, strong muscles that are attached to that. So what can happen when there's a tongue tie? The hyoid bone is kind of pulled up and back, and it could restrict the airway size. It can also, when there's limited movement, obviously the head is connected to the rest of the body. So what it can cause is limited movement of the neck muscles or muscles that are more closer in the back. And tongue ties can even. They are linked to the anterior fascial plane, which is, we're sitting in the suit, called fascia. And it has an anterior part and a posterior part. The anterior starts at the chin and goes down the hips and knees and toes. And when the hyoid bone is not in the right position, that anterior plane can be pulled down and it can cause problems with the hips and knees also. So it's a postural issue. At the same time, it can affect swallowing in some people, it can affect speech. It's just think of it, if I use this analogy that I like. If your right arm was tethered down to your body, you couldn't really move it properly, and eventually the muscles would atrophy and you would lose complete, complete function of your. Of your arm. You'd have to figure out how to work around it. It's kind of like the same thing, and it's a very important part that doesn't get addressed properly. Also, as we age, the tongue tends to lose its muscular strength. So if there's a tongue tie, there's a chance that that tongue gets pulled even Farther back. And people can deal with sleep apnea, snoring.

Hmm. Now, I heard this, and maybe you can confirm if this is true, that the tongue is, you know, gram for gram is the strongest muscle in the body. And so if that's the case, a tongue that's tied up or not moving correctly fascially, there's going to be restrictions. And of course, this muscle is quite powerful. So it's not just a small effect that it's going to have. It can have that global effect that you're describing. And what's interesting about the hyoid bone is the hyoid. There's a muscle called the omohyoid, which runs from the hyoid to the back of the shoulders. So very structurally connected to our postural muscles in our neck and shoulders as well.

Yeah. And we do these 3D cobium scans on patients where you can actually see the position of the hyoid bone before frenectomy and after frenectomy. It's very interesting to see it, how the airway opens up really fast. And after frenectomy, my husband is an oral surgeon, so he performs it with laser. You could see immediately the tongue. Although the tongue is numb, it finds its way to the roof of the mouth instantly, and the jaw relaxes. And sometimes people feel an instant relaxation through their body.

Yeah. One of the people that commented on the post said that as soon as they had their frenectomy done, that they melted into the chair. So they went from having a very stiff, rigid posture to instantly melting into the chair. Chair. And their husband, who is normally massaging them and trying to get the kinks out of their shoulder, came and felt their neck and said, this is a completely different neck.

Yeah. So you just never know what triggers what.

Right.

And how severely it affects someone. Some people are adaptable, some are not. One of the things that I always like to include with frenectomies, and I think it's an important thing to do, is myofunctional therapy before and after. Because if the muscle hasn't been functioning at its full potential through the myofunctional therapy exercises, you're already preparing the muscle for what is going to have to do once the release is done. And then after that, it's important to do the exercises because it can retie tongue ties, can. Can scar down if the exercises are not completed.

Now, if somebody tends to be prone to keloids, would something like that be contraindicated for them? Or are there any contraindications to having a frenectomy done.

I'm not really aware of that. I'm not aware of any contraindication, especially since it's done so safely with laser and the healing is really fast. Couple days and patients are better.

Yeah. Another fun fact about the tongue and please, if I'm saying anything that's incorrect, please correct me. Is that the tongue is the fastest part of your body to heal, is that correct?

Yeah, the mouth heals really fast.

Okay, awesome.

Tissue generation is extremely fast.

You know, one thing that you said before we started recording was broken teeth. And you know, teeth can be cracked. Teeth can then develop issues like infections, and then you eventually need a root canal. But why did those teeth break is really the million dollar question. And not many people answer that question. So I'd love to get your breakdown on why teeth break and what that could be an indication of systemically in the body.

So in dentistry, we deal with two different things, bacteria and forces. It's pretty simple. Bacteria are the ones that can cause gingivitis, bleeding, gums, infections, but the forces are the ones that are not usually addressed. 90% of the patients that come in never even knew that they had an overloading of forces on their teeth. So it can start with an accident trauma where the jaw gets displaced. It could start with orthodontic treatment where there's rapid movement of the jaws and the jaw joints get almost pulled out of their socket, and then the teeth don't fit properly or the teeth are moved fast. And now the jaw joints cannot keep up with the position of the joints. Oftentimes as dentists, we are placing crowns and fillings, and the mouth is an extremely dialed in proprioceptive system. So if you put a crown in that's maybe a few microns, like a few hairs taller than it should be, that instantly creates a muscle activity that is very different than the patient used to chewing. So it can create a destructive muscle chewing pattern. When the jaw starts moving now to the opposing side to try to avoid that crown that's a bit higher, what that does is starts moving the jaw joints out of their socket in an abnormal way. And if the patient just gets adjusted to it, like most people say, or dentists say, well, just you'll get adjusted to that crown. You'll get used to the bite. Well, they do get used to it. But that pattern of moving out of the way of that tooth that's higher than the rest of the teeth will start causing wear on the teeth on the opposing side. So if this pattern Keeps going on for many, many years. Even orthodontic treatment with the tooth. A tooth is moved too fast or moves in a place where it's not in alignment, it will cause the same type of jaw joint movement. So when this happens, the forces are not distributed evenly. So we are meant to close our teeth and all the teeth to touch at the same time in tiny little dots, tiny little spots. Not that I see you clenching. I'm testing, testing it. You have beautiful teeth. So nature creates beautiful anatomy. And nature is always intelligent. And every tooth has a very spec anatomy. It's designed to slice the food. It's designed to guide the food from the front of the mouth to the back continuously and from the outside in. So it's very well engineered. And this engineering requires even distribution of forces. So we chew up and down, not side to side. Most people chew side to side and that will overload one or the other joints. And those are the things that cause broken teeth, cracked teeth, because as the forces are not distributed evenly, certain teeth will become overloaded. And those are usually the back molars. And then people go in, oh, I have a cracked tooth, I need to have this fixed. And the dentist will put a crown on it. The pain doesn't go away. They come back a couple of months later. Now they need a root canal. The pain still doesn't go away. And then later on the tooth becomes extracted. All because nobody addressed a joint position. And you as a chiropractor, you'll probably appreciate that most patients that we examine, they have functional remodeling or degenerative joint disease that has never been diagnosed and that all comes from the teeth. So this is an epidemic that nobody's really talking about. That is a bigger cause of tooth loss than infections.

Why is nobody talking about this? That's the question I have. Just going further upstream, is it too challenging to address? Is it something that is not compensated in the profession? Is, is there just a lack of awareness like where, where, where do you see this stemming from? From a kind of system wide standpoint, system wise.

I think there's a big disconnect between there's so many schools of thought on the bite forces and the joints that most people don't really agree, or there's just saying, oh, just put the patient in night guard and they'll be fine. It's still the name it, blame it and tame it type of approach in most cases. And it would require the dentist to stop and start asking better questions like, why is this happening to my patients? You start Seeing patterns and wanting to learn to fix it. I think that's the biggest problem. There's such disconnect in the different schools of thought, and everybody is pulling in different ways. I work within a group called OBI Bio Aesthetic Dentistry. And this is really the main focus of helping discover root causes of dental diseases, is really finding out why somebody's teeth are breaking down, why the teeth look like they aged 20 years. And once we restore the natural anatomy, what you have like a beautiful teeth, and teeth have certain lengths, certain anatomy. Once you restore that, you immediately the face becomes rejuvenated. So people are 10 years younger. But the focus is not aesthetics, the focus is really function. Because when you have restore somebody's dental function, their jaw joints function, the muscles relax. When you don't have to clench and grind to try to fit your teeth together, you don't have any more jaw joint pain or muscle tension. When you wake up in the morning, all those are signs that there's imbalances. Then people's faces relax and their posture changes, and they're tenders younger because their lip position changes also.

So many benefits, so many benefits. You know, this prompts another question for me, because I know there's a lot of people, people close to me as adults, who are having certain procedures done to, like Invisalign, for example. And as you're saying, you're talking about this delicate interface between the top teeth and the bottom teeth. How do things like cosmetic procedures like orthodontics or things like the Invisaligns, how does that impact what we just talked.

About? Invisalign or orthodontics can definitely impact it. If the dentist doesn't have a knowledge of what a stable bite should be or doesn't have the knowledge to see tooth wear or the patterns of tooth wear, it could actually perpetuate even more disease or not be really a solution where our society, we're so focused on aesthetics. So oftentimes I see patients that had veneers placed on the upper teeth because they had so much wear, or the teeth were like broken or breaking down, and because of that, they end up with even more wear on their lower teeth. So. I think the most important thing would be to find someone that could really diagnose and see if somebody has dental wear or why is the crowding happening? Or after the crowding is corrected with orthodontics, to make sure that they have a stable bite, that all their teeth are touching at the same time as they're moving left and right, there's no. Teeth that are in a way that could affect their joint health and their long term dental health. Because in a healthy bite, oftentimes in orthodontics, they shape the front teeth down. But look at your teeth. You have beautiful anatomy to your teeth. So when you slide forward, your front teeth touch, but the back teeth don't. And when you slide left and right, your eye teeth are longer and they, because of that, you can disengage the back teeth. So that's normal function. Oftentimes there's a trend now to get everything straight across, but that's not health. Like your teeth look healthy and the height is supposed to be longer.

Yeah. You know, that's so funny because I've always wanted to, I've always wondered what it would look like if I shaved it down and had perfectly level teeth. And what a great thing to hear that that's actually how you want them. So thank you. I just made my day. Yeah. So, so things, so where like, so there is a big push on cosmetics. Right. So my, my, a friend of mine, I'll just call him a friend because I don't want to identify this person. But they're, they actually have very crowded teeth and so they're having a invisalign procedure done. And so while the cosmetics might improve, the mechanics may not necessarily improve. So what do you do in a situation like that where somebody cosmetically is happy but mechanically isn't? How do you correct that? Is there opportunity to fix something like that?

Yeah, definitely. After they've had their teeth corrected, we would help the patient get an appliance, an orthotic device that would help align their joints, would help their joints relax into the most stable position. And then we would analyze the bite to see what tooth position or bite is best for that patient to keep their musculoskeletal system in balance. And then at that point, if they have tooth wear, we literally just add back the enamel that's missing. With dental materials that will stabilize the bite. Oftentimes when somebody has crowding because the teeth are overlapping in an unusual way, there is unusual wear. Also, some teeth will be shorter, some teeth will be wearing down sideways. Once that's corrected, they're still not going to meet properly. More than likely with adding back dynamo that's missing, you can restore the natural form of the tooth structure.

Okay. So where there's a will, there's a way. I love it. One of the things we talked about, we talked about the tongue, we talked about, about the positioning of the tongue. You Briefly talked about mouth breathing. And one of the things I'm noticing from my experience, and certainly your experience is far more extensive than mine in oral health, is that there's an epidemic of children having their teeth being overcrowded and going to dentists and the dentist pulling those teeth. I'd love for you to share why that's happening. And then perhaps what are the options for somebody who might be listening to this instead of pulling those teeth? Because I can't imagine we're born with too many teeth as the premise here. So there's something going on that's deeper rooted that we might need to address. What would that be?

So Weston Price did a lot of studies on dental diet and teeth. And anytime processed foods were introduced in a population's diet for seven generations after that, dental crowding would appear. So some of it is the diet of the parents and genetics and the environment that triggered these dental crowdings, because the teeth, the jaw doesn't grow big enough to fit the teeth. It could also be mouth breathing early on in life. And that's one thing that parents should really pay attention to. If their children are sitting in front of the TV with their mouth open or if they're snoring a lot of times, inflammation, inflammatory foods, dairy sugar that is given to the child will create their tonsils, make their tonsils swell up. So then they end up with mouth breathing. And then when they mouth breathe, the muscle pressure will create this narrow jaw. I'm not a big fan of extracting teeth because what I see later on in life, a lot of children, adults that as children had teeth extracted now later on, they deal with sleep apnea and other issues, which is very difficult to treat as you know it. So there's myofunctional therapist that people can find that work on helping the muscles and overcoming these mouth breathing issues and really working with the child's diet, in a family's diet to make sure that they reduce the amount of inflammatory foods or eliminate them completely. I went to a conference not long ago and there was a pediatric dentist, pediatrician actually, that was showing us that 80% of the cases when children have these enlarged adenoids and they are mouth breathing, when they eliminated dairy and sugar, they improved within a couple months, so they didn't need to have the adenoids removed. That's another thing. I think they have a function too, because they're the largest lymphatic system next to the gut. So really focusing on root causes and trying to find a myofunctional therapist that can help work with the child early on to control muscle function. And an orthodontist that understands how to expand the jaws and. And just kind of promote the growth. But that won't happen if the diet is not improved. Also.

Yeah, funny story about my son. And, you know, he's 12 right now, so not old enough to beat me up if he hears this. But I'll share his story because I think it can be helpful for a parent who's listening and definitely will highlight what we're discussing here. So he eats really healthy as a byproduct of, you know, being in our household. And when we went to the dentist, one of the first things they told us is he has tons of cavities. And we're like. We were just, like, baffled. We're like, what the heck? Like, he doesn't eat sugar. He's, you know, he's eating super healthy. We hope he's getting all his nutrition. And it turns out that he was a mouth breather, and that's what was causing a lot of his dental issues. But we didn't even know about mouth breathing when he was that young and didn't even really take it into consideration. It wasn't until about four or five years ago that I started paying attention. I'm naturally a nose breather, but it was only recently that I, you know, in the last four or five years that I even started paying attention to that. And then when James Nestor's book came out, you know, that really hit home for me and many of my colleagues as well, that the implications of mouth breathing go far beyond the mouth. Right. The effect it has on nitric oxide on the oral microbiome and, you know, the stress response and all of those things. But, you know, with him, it turns out that that was one of the key contributors. And as a result of that, you know, we mouth tape him now every night, and we've raised it to his conscious awareness. So when he's playing sports or, yeah, if I ever catch him mouth breathing, which is pretty rare nowadays, then I bring it to his attention and it's something that, you know, I think all of us should pay attention to. If we care about someone, we should pay attention to the way they breathe because it's a very. It's a great, you know, almost diagnostic tool. You can almost predict what conditions or dysfunctions this person might have based on whether they breathe through their nose or through their mouth, predominantly. The other thing with him. Thank you. So the other thing with him was his. His pal, his upper palate. Was smaller than it should be. So we had a palatal expander put in to expand his palate sideways. And now we have another one to push his, you know, his crown, like, make his crown so it's a little bit more full. And that can affect breathing. Right. So it could be restrictive for people, you know, to breathe if they have a small palate to breathe through their noses, which then forces them to breathe through their mouth. And it's. It kind of just becomes this really cyclical thing, and they get trapped in that. The other thing I wanted to ask you about is wisdom teeth. So, you know, if people's teeth are crowded with, you know, just kind of their first set of teeth that come in, and now they're have. They have four wisdom teeth coming in. Is it normal to have our wisdom teeth pulled under ideal circumstances, or should we have a big enough jaw where all the teeth fit as they're supposed to?

Well, ideally, we should have a big enough jaw. Some people do, but most of the time people don't. So that's why they become extracted, because they come in sideways, and then they become a food trap, impossible to clean, and they cause gum disease and inflammation. So they end up being extracted. But oftentimes there's not enough throne.

Okay, In India, one of the things, and you might be aware of this, but when we went to India for the first time when I was about 8 years old, well, I actually went when I was much younger. I went when I was six months old, but I don't remember any of that. But I do remember when I went when I was 8. And every morning someone would come by, or at least once a week, I would say they would come by and they drop off a bunch of sticks and branches, and they'd be cut into about the length of a toothbrush, so about 8 inches long. And then people start chewing on them, and then they would turn the branch into. Into bristles, the head of the branch into bristles, and they'd brush their teeth with it. And I always thought that was so, like, you know, barbaric and so weird and. And. And, you know, so strange, right? Because us, we're so civilized, we brush our teeth. But it turns out that my parents, grandparents, and my great grandmother, I met her, none of them had braces. None of them had their wisdom teeth pulled. They all have perfect teeth. They didn't even have dentists or orthodontists, to be quite frank. And looking back, I'm wondering how much of that chewing had to do with their Jaw development. I'd be curious. I've never asked a dentist about this, so I'd be curious about your kind of functional perspective on the benefits of something like that.

That's amazing. You noticed that you made that conclusion because that's very important. A lot of times in orthodontic treatment, there was this movement where they created this appliance that would vibrate, and people can bite and chew on it to stimulate the movement of the teeth much faster, or sometimes when people use chewies to chew on in orthodontics to help facilitate the movement of the teeth. So if the bone is not loaded through chewing forces, it literally resorbs, it degenerates. So if a tooth is removed, there's no more force on a bone. The bone will just recede. That's why people with dentures, if you take the denture out, their whole face sinks in because there's no more bony support. So chewing and physical stimulation is very important, especially of harder foods. With our diet in the United States and the processed foods, the foods have become softer and softer. So we're not. Well, they knew their stuff in India.

Yeah. So we're not getting that mechanical stimulation of the jaw. And it's really fascinating for parents. If you give your child a toothbrush, the intuitive thing to do is not to brush it. The intuitive thing for them to do is start chewing it.

Chewing it.

And maybe there needs to be some sort of device that's created that promotes at least two minutes of chewing and biting down on something that. That does that for you.

Well, they have these myo munchies. So myofunctional therapists use these devices that make children chew and bite on. And they have to do it for a certain amount of time, several times a day, to help stimulate that. So they do have some of that already.

Oh, wonderful. Is that something that you have to see the provider for? Is that something you can do online?

I think some of it can be purchased online, but it's best to see a provider because then you know what exactly to get. Myofunctional therapists are specialized. There's different types of appliances for different stages of life and for different problems. So I would refer to a specialist.

Okay, wonderful. So I would love to know what is the evolution of your practice? You seem so far ahead in terms of looking at the whole person, looking at their whole health. And I know that there's a next level of evolution that you'd like to have in your training and in the services that you'd offer to your clients. I'd love to hear more about that.

So I've explored functional medicine and I still found some areas that are maybe not addressed in the patient's psyche and just the subtle energies. And I recently started studying Ayurveda and I'm so excited about it because it's a really ancient science. And at the beginning phases of this, where we're learning lifestyle and there's so many things that can be done in a simple way to calm the nervous system and to care for oneself, that doesn't really cost anything. I'm just excited on this journey to introduce Ayurveda to the practice, to really merge what functional medicine is. So amazing at the structure that you can provide the patient on the healing journey and then the ancient wisdom, Ayurveda, and to really address the emotional and spiritual parts of a patient also. So I'm really excited about that. I think it's gonna really benefit a lot of people.

Do you know your dosha? Have you done that yet?

Yes, I did. I am mostly pitta and then vata secondary.

Oh, wow. That's an interesting combination. My wife is a vata and I'm a pita. That's awesome. So, you know, there's a few Ayurvedic principles that I'd love to get your perspective on, if you don't mind. One of them is oil pulling. What are your thoughts on oil pulling?

Oil pulling is really beneficial. I try to find lots of studies on it. There's not many. It mostly works by the effects of the herbs and it works by the fact that oil has a higher surface tension, so it traps bacteria. And I recommend a lot of times to people that have dry mouth because it lubricates the mouth so it nourishes the tissues. I think it's a wonderful thing to do.

Is there a particular oil that you recommend? I know I've seen sesame oil, I've seen coconut oil. You mentioned herbs. Is there a particular herb infused oil that you suggest?

There's so many on the market. We usually use biobotanical research, dental cybin. It's not necessarily oil, but it works as oil pulling or coconut oil. Coconut oil is pretty universal now that I'm learning Ayurveda. Everybody has to have their own specific oils and herbs. So I don't want to comment on that. I'm smarter when I'm done with the training.

Okay, well, we'll interview. We'll have to do a part two because there's so much to unpack here. So I love what you do. I want as many people to, you know, hear your passionate interview as possible. But you know, obviously, you obviously work with people in your practice and I'd love for you to share a little bit more about your practice and how people can get in contact with you should they decide to make an appointment. And next time I'm in the Phoenix area, I am definitely going to come by and check out your office and, and I think I should make an appointment. So I'm going to try to coordinate my schedule and your schedule or your team schedule to see if that can be accommodated because you've shared a lot of things that have been on my mind and it's really hard to find someone that we know, like and trust that is willing to have such an open dialogue and conversation about something that is so important. It goes way beyond the cosmetics and aesthetics. It's really about the mechanics and the biochemistry of good oral health that plays such a huge role in our health. So thank you for the work that you do. And how can people make an appointment? How can they come see you and set up a time to have such an in depth consultation?

They can go on our website. Do you want me to just give out the phone number or.

Yeah, you can share your website. Phone number is fine as well.

Phone number is 480-563-4141. You can get a hold of us that way or on our website wholehealthdentistryaz.com and you can request an appointment there. Also, we usually start with an interview where we get to know you better over the phone and that is free. There's also my website, there's the mini course where you can watch more videos, more in depth about some of the things that we talked about on more detail about different subjects, about microbiome, about oral health and breathing and sleep apnea and chronic disease conditions.

So that would be amazing. We'll be sure to post those links and the information on how people can get ahold of you and work with someone from your team or yourself. What an honor it's been. I thoroughly enjoyed our conversation. I'm so looking forward to seeing you in person again when I come out to Phoenix. And thank you once again for the work that you do. It's so needed, so much important. I do have one more question which is are you training other dentists? Because dentists who are listening to this might be curious about that.

Well, right now I hired an associate, she's been with us for about eight months and I am training her okay. To help me take care of patients because there's been a huge need since the podcast and the people are starting to realize, hey, there's a bigger picture here.

So, yes, amazing. So I'm looking forward to that. I would love to see thousands of dentists trained with your wisdom and your passion and your knowledge. So thank you again for the work that you do and for those of you that are listening, I hope you had something to chew on, no pun intended, with this information. Take a look in your mouths. Take a look in your clients mouths. A good dentist who's trained in looking at the whole health of the client can make a huge difference. And you know, if we're doing all this amazing work on our clients, trying to work on all the other parts except the mouth, but the mouth is not healthy. It's not going to allow us to get the results that we want for our clients. So it really behooves us not to look more closely into their oral health and provide them with, you know, a meaningful solution in that regard. So thank you, Dr. Nico.

Thank you.

I'm so grateful for our time today and grateful for the work that you do.

I'm grateful for our time together. Thank you so much.

Thank you, thank you.