In a world where health concerns increasingly revolve around gut microbiomes and environmental toxins, there's a critical but often overlooked gateway to our overall health – our mouth. As we explore the fascinating science of oral health, we discover that what happens in our mouths doesn't stay there; it impacts our entire body in profound ways.

Check out this video from Dr Andrew Huberman & Staci Whitman

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The Oral Microbiome: Your Health's First Line of Defense

Your mouth isn't just a place for chewing food and forming words – it's a complex ecosystem hosting billions of microorganisms that form what scientists call the oral microbiome. This collection of bacteria, fungi, and viruses plays a crucial role not just in your dental health, but potentially in your brain longevity, heart health, hormones, and even fertility.

"The mouth is the gateway into the body and the mouth is the gut," explains Dr. Stacy Whitman, a leading functional dentist. "What happens in the mouth can be a reflection of what's happening in the gut." Most surprisingly, what many conventional approaches to oral care get wrong is the fundamental approach. The harsh, antimicrobial products we've been taught to use – from alcohol-containing mouthwashes to strong minty toothpastes – may actually be damaging our delicate oral microbiomes. 

Demineralization vs. Remineralization: The Key Process You Need to Understand

Our teeth are constantly going through a natural cycle of demineralization and remineralization. When we eat or drink anything besides neutral water, our mouth becomes more acidic as part of the digestive process. This acidity temporarily leaches minerals from our teeth. Under ideal conditions, our saliva – which contains calcium, phosphorus, and other minerals – naturally remineralizes our teeth once the pH returns to normal.

This typically happens about 20-30 minutes after eating. The problem? Many of us are constantly snacking and sipping throughout the day, never giving our mouths enough time to remineralize: "We're not giving our mouths enough of a break, enough of an opportunity to remineralize. Many of us are staying in a state of constant acidity and demineralization,". This is why even small cavities that haven't yet formed a hole can potentially "heal" through proper remineralization – if we create the right conditions.

The Fluoride Debate: What You Need to Know

The inclusion of fluoride in water supplies and dental products remains one of dentistry's most controversial topics. While traditional dentistry has long praised fluoride for strengthening enamel and fighting decay, emerging research raises important questions about its effects beyond our teeth. Fluoride works by converting the hydroxyapatite (calcium and phosphorus) in our teeth to fluorapatite, which is more resistant to acid.

While this can indeed make teeth stronger against decay, recent scientific developments have raised concerns: "The Tsaska trial was going on and the judge was waiting for the National Toxicology Program's report, which was under the Department of Health and Human Services... and it said there is a strong correlation between increased fluoride consumption and IQ issues in children," Dr. Whitman explains.

Studies have found that mothers with higher urinary fluoride concentrations during pregnancy had children who tested lower on IQ tests – effects comparable to lead exposure. While the United States has lowered fluoride levels in water to 0.7 mg/L, questions remain about cumulative exposure through water, food, and dental products.

Interestingly, 97% of the world does not fluoridate its water, including countries with very low decay rates that instead focus on education and diet. 

Practical Steps for Better Oral Health

So what can you do to improve your oral microbiome and overall health? Here are evidence-based recommendations:

1. Rethink Your Oral Care Products

• Avoid harsh antimicrobial mouthwashes that can disrupt your beneficial bacteria and potentially impact cardiovascular health.
• Consider hydroxyapatite toothpaste instead of fluoride, as it contains the same minerals naturally found in teeth.
• Skip the SLS (sodium lauryl sulfate) in toothpastes, which can cause oral ulcerations in sensitive individuals.

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2. Optimize Your Diet

• Reduce fermentable carbohydrates (processed flour, added sugars) that feed harmful bacteria
• Eat prebiotic-rich foods like vegetables to feed beneficial bacteria
• Consider time-restricted eating to allow proper remineralization between meals
• Ensure adequate mineral intake, especially calcium, phosphorus, and magnesium

3. Perfect Your Oral Hygiene Routine

• Brush gently with a soft toothbrush twice daily
• Floss at least once daily (ideally before bed)
• Consider tongue scraping to remove biofilm and improve nitric oxide production
• Try oil pulling with coconut oil 2-3 times weekly to help balance oral bacteria
• Wait 20-30 minutes after eating before brushing to allow remineralization to begin
• Don't rinse after brushing – spit but leave the beneficial ingredients on your teeth

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4. Focus on Breathing

• Practice nasal breathing during the day and while sleeping
• Consider mouth taping at night (if you can safely breathe through your nose)
• Address structural issues like deviated septums or tongue ties with appropriate professionals

5. Test Your Oral Microbiome

Consider testing your oral microbiome with tests like Bristle that use shotgun metagenomics to identify potential pathogens before they cause problems.

Special Considerations for Women's Oral Health

Women face unique oral health challenges related to hormonal fluctuations:

• Puberty and oral contraceptives can increase gingivitis risk
• Pregnancy causes gingivitis in 50-70% of women
• Perimenopause and menopause can lead to dry mouth, burning mouth syndrome, and TMJ issues due to hormonal changes affecting collagen synthesis

"It's powerful to be able to have these conversations with women rather than just say 'well, just use this product, brush and floss more,'" notes Dr. Whitman.

The Future of Oral Health Care

The field of oral health is undergoing a revolution as we better understand the oral microbiome and its connections to overall health. Rather than focusing solely on fluoride and antimicrobial approaches, the future lies in supporting a balanced, healthy oral ecosystem.