The Functional Dentist: New Research Linking Bleeding Gums & Cancer! If You Can't Get It Up, Brush Your Teeth!

From cavities to cancer, dental problems to dementia, how the state of your teeth is connected to every aspect of your wellbeing. Dr Victoria Sampson is an award-winning functional dentist, researcher, and founder of the multidisciplinary oral health centre, The Health Society Labs. She is also the first dentist in the world to link gum disease with worse COVID complications. In this conversation, Dr Victoria and Steven discuss topics such as, the shocking link between oral health and cancer, how your saliva can predict future dementia diagnosis, how bad breath is a sign of low fertility, and the right way to brush your teeth. 00:00 Intro 01:34 The Oral Microbiome 02:54 What Impacts Our Oral Microbiome? 03:33 2 Million Bacteria in Your Mouth 04:46 How Many People Have Oral Diseases? 06:19 Body Diseases Linked to Oral Microbiome 08:05 Steven Adjusting Chair? 10:18 Research Linking COVID-19 and Oral Hygiene 12:38 Can Your Oral Microbiome Kill You? 13:27 How Food Shapes Your Mouth 16:35 What’s a Wisdom Tooth? 17:54 Do Wisdom Teeth Need Removal? 18:39 Why Do We Need Dentists If Ancestors Had Good Teeth? 20:05 Is Everyone’s Microbiome Massively Different? 21:54 How Oral Health Improves Overall Health 23:54 Can Swallowing Saliva Make You Sick? 25:48 Inflammation and the Oral Microbiome Link 27:50 Rheumatoid Arthritis Strongly Linked to Oral Health 30:15 Heart Disease and the Oral Microbiome 33:02 How Oral Bacteria Filters Through Your Body 33:20 Erectile Dysfunction Linked to Oral Hygiene 35:28 Emerging Research: Breast Cancer and Oral Microbiome 39:25 Green Tea Benefits for Oral Health 40:44 Impact of Coffee on Oral Health 41:46 Effects of Hot Drinks & Sugar on Teeth 43:34 Link Between Brain Health & Alzheimer’s 50:11 Can Mental Health Be Seen in the Mouth? 51:12 Spotting Eating Disorders Through Oral Health 51:50 How Stress Affects Your Oral Health 53:26 Mouth vs. Nose Breathing: Health Impacts 57:08 Higher ADHD Risk in Mouth-Breathing Children 58:03 Kissing and Bacteria Transmission 59:04 Oral Sex and the Oral Microbiome 01:01:27 Switching to Steven - Transition 01:02:07 Oral Health and Fertility 01:06:33 Ads Break 01:07:32 Study Results on Oral Health 01:16:31 Best Time to Brush Your Teeth 01:17:37 Good vs. Bad Oral Products 01:26:18 Should You Spit or Rinse After Brushing? 01:30:48 Whitening Products: Do They Work? 01:33:52 Importance of Drinking Through Straws 01:34:45 Smoking and Vaping Effects on Oral Health 01:37:30 Last Guest Question Follow Dr Victoria: Instagram - https://g2ul0.app.link/BYodSLgymOb Website - https://g2ul0.app.link/1CuFnflymOb 🤐 👀 Psstt! Are you ready to finally reach your goals? - you can join the exclusive waitlist NOW for the limited run of our brand new 1% Diary here: https://bit.ly/1-Diary-Waitlist-YT-ad-reads You can learn more about the products mentioned, here: Saliva Test Kit: https://g2ul0.app.link/0HibFujjrOb Super Teeth Soft Floss: https://g2ul0.app.link/GH0TGntymOb Super Teeth Toothpaste: https://g2ul0.app.link/pU20AczymOb Super Teeth Dental Prebiotic: https://g2ul0.app.link/7rjRJUAymOb Bio. Me Supplement: https://g2ul0.app.link/UMvwbXDymOb BioMin Toothpaste: https://g2ul0.app.link/FTKSAwZymOb DR. HEFF´S Supplement: https://g2ul0.app.link/DrhMsy2ymOb Watch the episodes on Youtube - https://g2ul0.app.link/DOACEpisodes My new book! 'The 33 Laws Of Business & Life' is out now - https://g2ul0.app.link/DOACBook You can purchase the The Diary Of A CEO Conversation Cards: Second Edition, here: https://g2ul0.app.link/f31dsUttKKb Follow me: https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Join the waitlist for The 1% Diary - https://bit.ly/1-Diary-Waitlist-Megaphone-Ad-Reads ZOE - http://joinzoe.com with code BARTLETT10 for 10% off Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Steven Bartlett?

  Is there a link between our oral health and our fertility?

• 0:02Speaker 01

  Yes, this is some of the newest research that's coming out. They found that over 90% of men who wasn't able to conceive with their partners had an oral disease. For those who got treated, there was a 70% improvement in pregnancy. Now, research has also found that if a woman has gum disease, it takes them two months longer to conceive, and I'm the only one who's talking about it.

• 0:21Steven Bartlett?

  And who are you?

• 0:22Speaker 01

  I am the saliva queen. Dr. Victoria Sampson is the trailblazing dentist

• 0:26Speaker 02

  whose data-driven research has uncovered the shocking link between our mouths

• 0:30Speaker 01

  and some of the world's most destructive conditions. More than 90% of diseases can be traced back to our microbiomes. And we now understand that having an imbalanced oral microbiome increases your risk of high blood pressure, heart disease, Alzheimer's, rheumatoid arthritis, and even men who have gum disease are 2.85 times more likely to have erectile dysfunction.

• 0:48Steven Bartlett?

  Really?

• 0:49Speaker 01

  Yeah. And then another study also showed there's oral bacteria that can make cancer more aggressive and harder to treat as well.

• 0:55Steven Bartlett?

  But what is it that causes all of this?

• 0:57Speaker 01

  Poor oral hygiene, sugar, stress, but also some of us genetically will have mutations which can cause disease. But there's ways to fix it. For example, I had a patient who had terrible arthritis and terrible gum disease. And when I treated the gum disease, her rheumatoid arthritis got better, to the point where she was actually able to walk again.

• 1:14Steven Bartlett?

  Wow.

• 1:14Speaker 01

  Yeah.

• 1:15Steven Bartlett?

  So let's talk about what we can do about it. Is there any time where I shouldn't brush my teeth? Do I spit or rinse after I brush my teeth? Chewing gum, coffee, mouthwash, good or bad for me?

• 1:25Speaker 01

  Let's go through all of that. So weirdly

• 1:34Steven Bartlett?

  Dr. Victoria Sampson, what is the mission that you're on?

• 1:40Speaker 01

  My mission is to show people that the mouth is the gateway to the rest of the body. And if they really want to achieve full body health, it starts with the mouth first.

• 1:48Steven Bartlett?

  I've never heard of the term oral microbiome, really, until I met you and went through all of your work and your research. And I think many people listening to this now also probably aren't familiar with that term, and also the importance of that term. So if you had to make a case to someone like me who's really unfamiliar with this subject as to why it's so important, from a very top line perspective, what would you say?

• 2:13Speaker 01

  I think everyone knows that their gut has a microbiome. And for the past 10 years, we've always talked about how you can change your diet, probiotics, prebiotics for the gut microbiome. But what a lot of people don't understand is that the oral microbiome is the second largest and most diverse microbiome after the gut. It's also a lot easier to change. And actually, it's been shown to have a massive impact on general health. So having an imbalanced oral microbiome increases your risk of oral diseases like gum disease and decay, but also can increase your risk of other systemic diseases like high blood pressure, heart disease, infertility, Alzheimer's. And it's something that is so easy to manage and balance.

• 2:53Steven Bartlett?

  How many people does this impact? And how many people is it relevant to? So an understanding of my oral microbiome is going to help me in a number of ways as it relates to my overall health. But how many people does it really, really have an impact on?

• 3:06Speaker 01

  I think it depends on what you're trying to get out of the oral microbiome testing. I would argue that it benefits everyone. We all have teeth, we all have mouths. And everything that we do, every time we breathe, we eat, we drink, we kiss, we are impacting our oral microbiome every single time. And then every time we swallow or we breathe, that bacteria that is putting into our mouth will travel elsewhere to the rest of the body and cause problems elsewhere.

• 3:32Steven Bartlett?

  You said it's the second biggest microbiome in the body?

• 3:35Speaker 01

  Yep.

• 3:35Steven Bartlett?

  How many bacteria are in my oral microbiome?

• 3:38Speaker 01

  So you have 700, approximately 700 different bacteria, which make up 2 billion bacteria overall. And what's also very weird about the oral microbiome compared to any of the other microbiomes, is that you've got lots of different environments or niches within the same mouth. So if you think about the bacteria that would like to live under the gums, or at the back of your throat, or on your teeth, they're all very different environments. Some are hot, cold, you know, wet. And so you've got lots and lots of different parties of bacteria within the same microbiome in the mouth.

• 4:10Steven Bartlett?

  Okay, and you you mentioned a second ago that things like kissing, breathing, swallowing have an impact on my oral microbiome.

• 4:18Speaker 01

  Yes.

• 4:18Steven Bartlett?

  In a significant way that I need to know about.

• 4:20Speaker 01

  Uh, yes, so it's more about how often you're doing those certain habits. So, you know, for example, with kissing, the research has shown that you need to kiss more than eleven times a day for you to be sharing the same bacteria or microbiome as your partner. But also even the habits that we have, the air quality that we have, everything will dictate the environment that our mouths are living in and therefore what bacteria will live in our mouths.

• 4:45Steven Bartlett?

  And in the subject of oral diseases and things like tooth decay, how many people are impacted globally by oral diseases?

• 4:54Speaker 01

  So the World Health Organization has come out saying that three point five billion people have some sort of oral disease. They've also found that ten percent of our world population are suffering from severe gum disease, which makes gum disease one of the most prevalent inflammatory conditions in the whole body.

• 5:12Steven Bartlett?

  This conversation around the oral microbiome, have you seen it developing over over recent years? Have you seen it become more sort of pertinent to people in society?

• 5:21Speaker 01

  Massively, I think. I've been doing this for for years. It's been something that I've loved. And no one really knew what I was talking about most of the time. They all thought I was a bit of a dreamer, even dentists, patients, they all thought, okay, well, it doesn't really matter, does it? But in the last year or two, I've had people traveling from all around the world just to get their oral microbiome tested, to understand more about what's going on in their body. And I think we're seeing a shift in the generations in terms of this new generation want to understand their health a lot more. So we're all sitting there wearing, you know, trackables, wearables, we're, you know, calculating how much sleep we have, how much we're eating. And for now, we're actually also wanting to understand our oral health.

• 6:02Speaker 01

  So that trust between a dentist and the patient is not necessary anymore. We want to actually understand what's going on in our mouths and actually, you know, be able to track things, see what bacteria we have, how much inflammation we have, our risk of diseases and what we can do to change that.

• 6:18Steven Bartlett?

  Last question before I ask you a more sort of personal question about yourself. What other diseases in my body or sort of implications in my body are linked and can be traced back to the oral microbiome?

• 6:29Speaker 01

  We now understand that more than 90% of diseases can be traced back to an imbalanced microbiome. If we zone into just the oral microbiome, it's got connections with infertility, heart disease, diabetes, Alzheimer's, rheumatoid arthritis, and the list goes on, erectile dysfunction. And what's also very interesting, going back to your question about, you know, has there been a new interest in this? In the last few years, we've actually been able to show that there is a strong connection and causation between the oral microbiome and general diseases. Whereas prior to, maybe five years ago, there was a lot of kind of, is this correlation? Is it just that, okay, there's the same risk factors with gum disease and with heart disease, for example, smoking?

• 7:14Speaker 01

  And now we're actually seeing that, no, it's not just correlation, there is strong causation between the two.

• 7:20Steven Bartlett?

  And who are you?

• 7:22Speaker 01

  I am Victoria Sampson. I'm a dentist. I do a lot on the oral microbiome. People call me the saliva queen, that's my name on the streets.

• 7:33Steven Bartlett?

  And what's your sort of, what professional experiences and education have brought you here today? And how long have you been doing that? How many mouths and how much saliva have you seen? Give me a sort of a big view on the wealth of experience you have on this subject.

• 7:47Speaker 01

  So originally, I trained as a dentist, and that's six years of training. I would say I was a pretty traditional, conventional dentist as I graduated. I'd done some training at the Carolinska Institute during my university, and the Carolinska Institute is the best dental school in the world, but they're very focused on the mouth-body connection, on testing saliva. And what they thought was that, you know, you go to your doctor and you have a blood test, why don't you go to your dentist and get a saliva test? So from even dental school, I had this in the back of my mind, but I still didn't have the training, and so I just became a dentist. I was working half NHS, half private.

• 8:31Speaker 01

  And then as time evolved, I then shifted to fully private. And then when COVID happened, I started doing a lot of research and all the dental practices were closed across the country. And I thought that was crazy because basically the government was saying dental practices or dentistry is not a necessity. So I thought that was insane. And so I decided to do a lot of research and I wrote a paper which was connecting oral health with COVID complications. So what we found was that patients who had poor oral health or gum disease were at a much higher risk of COVID complications. And then that evolved into me doing some studies with universities and hospitals.

• 9:14Speaker 01

  But the issue was that we couldn't go into hospitals and check people's teeth and gums because they had COVID. So instead, what we did was we would collect their saliva and we would take it to the lab and we had this beautiful snapshot of what was going on in a patient's mouth at that moment in time, just from their saliva. So we did a lot of research and we found that COVID sufferers or patients who had gum disease were nine times more likely to have COVID complications. But also what I took from that was that why aren't we using saliva, you know, more regularly? Why don't we use this in more commercial aspect and for our patients? So after that, I devoted a lot of time into developing oral microbiome testing.

• 9:56Speaker 01

  We had gut microbiome testing, you've got urinary microbiome, you've got every single microbiome has a test, but the oral microbiome didn't really have one. So I built one of the first oral microbiome tests in Europe and that was a couple of years ago and then now have come out and kind of left and created my own one about a couple of weeks ago.

• 10:17Steven Bartlett?

  That research you mentioned, specifically the research paper which was titled, Could There Be A Link Between Oral Hygiene And Severity Of COVID Infections? Was the first research paper to link gum disease with worse Covid complications. And I was reading that it was the most cited research paper by the, one of the sort of dentistry publications.

• 10:39Speaker 01

  Yeah, yeah. So the British Dental Journal is one of the most cited and viewed articles. And what it also helped do was the World Health Organisation and Sage picked that up. And they said, oh, wait a second, I think that oral health is really important for general health. And also we should reopen dental practices. So this also paved the way for dental practices reopening later on.

• 11:01Steven Bartlett?

  What's going on there? Can you explain that to me like a 10 year old? So if I have a bad or a unhealthy oral microbiome, I'm nine times more likely to end up in ICU with Covid complications. What's the link?

• 11:16Speaker 01

  So there's a few. So the first one is inflammation. So Covid, we know, it releases a lot of inflammatory markers. So it's what we call the cytokine storm. So it's essentially the storm of lots and lots of inflammatory markers. And gum disease separately is essentially inflammation of the gums. And so what gum disease does is it releases lots of inflammatory markers from the mouth elsewhere to the rest of the body. So then when you add those together and you have your cytokine storm from Covid and you've got your inflammatory markers from gum disease, it's just adding petrol to the fire. So you're just making that cytokine storm even worse. But then on the separate side, it's also bacteria. So if you look at the autopsies and the research of Covid patients,

• 12:00Speaker 01

  most of them didn't die from the virus itself. No one really died from Covid 19. They died from complications. So the number one complication was actually a bacterial infection. So imagine your body, you've got Covid, you are really unwell and your immune system is on absolute overdrive. This is the prime time for bacteria to come into your body and to cause what we call a bacterial superinfection. And so actually, when you look to the autopsies of a lot of these patients, they had oral bacteria from their mouth travelling to their lungs and causing bacterial superinfections which would result in things like pneumonia. And that's actually the cause of death for most patients.

• 12:38Steven Bartlett?

  You don't really think that your oral microbiome can be fatal, can kill you?

• 12:44Speaker 01

  No, and even I think as a dentist, we weren't really taught how important bacteria was or how important the mouth was for the rest of the body. The number, the only one that we ever learnt, and a lot of people would know this one, is that if you have heart surgery, you can't actually have a hygiene for about six months after the heart surgery.

• 13:07Steven Bartlett?

  A dental hygiene?

• 13:08Speaker 01

  Yes, and the reason for that is because you're at a very high risk of something called infective endocarditis. So this is oral bacteria which travels down to a faulty heart valve and can actually cause death. So we know that, but we never really look at it for other diseases or other problems.

• 13:26Steven Bartlett?

  I want to, I want to take a step back before we go through the links between oral microbiome and all of these diseases. But also, I really want to also talk about what we can do about it because I've got so many questions around it. I've got all of these products down below my chair, from mouthwashes to toothpaste to all these kinds of things, which I want to talk about as well. But just taking a step back to something that one of my guests previously was telling me about, I think it was James Nestor. He was telling me that the mouth itself and the jaw, because of processed foods, is an abnormal shape. And when I say abnormal, I mean in relation to how it was supposed to develop because we're eating so many processed foods, which aren't, you know, which are designed to be easy to chew. The mouth itself and the jaw have changed. Is there any truth in that?

• 14:08Speaker 01

  Yeah, hundred percent. So there was a man called Weston Price, and he was a dentist. And he basically suspected that. And he was like, this is strange. Why is it that people who are more industrialized and westernized areas have higher levels of decay? And they have loads of crowding. So they had basically lots of crowding of the teeth and speller jaws. And so he basically travelled around the world and he looked at lots of different. Tribes, villages, countries, and he compared the teeth of, for example, twins. One twin would be in a very industrialized, westernized area and the other one was not.

• 14:49Speaker 01

  And what he found was that in the twins who were in these non-industrialized areas, they were eating harder foods, they were having less sugar, and actually their jaws developed a lot better. So they didn't have crowding, they had perfect teeth actually, and they had no decay. Compared to the children or the twins who were in more industrialized areas. And it is because our food now has become so processed. A lot of children are not having hard foods. And so we don't develop the jaws and the muscles at an early age. And so the teeth haven't changed size, the teeth are exactly the same size as they were previously. But what we're seeing is that those teeth don't have any space to grow anymore, and that's when we're getting crowding.

• 15:30Steven Bartlett?

  And can you see that in any of those models?

• 15:32Speaker 01

  So, yeah, in this model, you can actually see at the very back, so a lot of people will have wisdom teeth. And one of the biggest issues at the moment is that a lot of people have impacted wisdom teeth. So this is basically, imagine your teeth are all upright. Your wisdom tooth is coming out at a completely horizontal angle and it's pushing on the rest of the teeth. It's an absolute nightmare as a dentist to take out, it's even more of a nightmare for a patient to have to endure. But also we're seeing that there are a lot more impacted wisdom teeth in the last thirty, forty years than there were previously.

• 16:04Steven Bartlett?

  Ah, because the diets have changed.

• 16:06Speaker 01

  Because the diets have changed, a lot more children are needing orthodontic treatment now as well, just because they have crowded teeth, teeth are overlapping, and so they need braces to straighten those teeth out. If you think about cavemen, cavemen didn't have dentists, they didn't have braces, they didn't even use toothpaste, but they didn't die from gum disease or decay or crowded teeth. So it's been something in our industrialized or more kind of westernized diet that has changed that.

• 16:35Steven Bartlett?

  My wisdom tooth is coming through on my left side at the moment, and I think actually also on my right side at the same time. And I'm thirty-two years old now, so I'm like, why the hell am I growing teeth at thirty-two years old? I thought I was on my way out or something. So I got two questions just before we crack on, which is what the hell is a wisdom tooth? Why is it called a wisdom tooth? And why is it coming through at thirty-two years old?

• 16:54Speaker 01

  Um. So we have teeth erupting at different, it's kind of times of our lives. So usually you have your baby teeth, they will erupt up to the age of about six or seven years old. Um. And then you have your adult teeth coming through and usually they will stop erupting around twelve years old. Um. And then you have nothing, you're chilling, you have nothing, nothing, nothing, nothing until about maybe eighteen, nineteen years old. And that's where you start to get your wisdom teeth. The name behind wisdom teeth, from what I understand, is because it's, it erupts when you're older. It's when you have more wisdom and you're more wise.

• 17:30Steven Bartlett?

  So I'm wise now.

• 17:30Speaker 01

  So you're just very wise.

• 17:31Steven Bartlett?

  Ah, okay, makes sense.

• 17:32Speaker 01

  Um. And so some people will get it at eighteen, some people don't have any wisdom teeth. Some people will have wisdom teeth which erupt perfectly and are all completely fine. And others will have their wisdom tooth erupt at thirty-two years old and maybe be a little bit impacted or cause problems. So they're also very strange teeth. Um. They're very unpredictable, the way that they are.

• 17:54Steven Bartlett?

  Is there any evolutionary basis for why we need them? There must be some kind of evolutionary reason for them.

• 18:00Speaker 01

  Not that I understand what is also happening is that, um, apparently, and this is some research, is that less people are having wisdom teeth. Because more children or adults are getting their wisdom teeth taken out. And as evolution goes, um, eventually, some people are actually not having wisdom teeth at all. Because their ancestors haven't had wisdom teeth, so why would they have wisdom teeth? Um. But overall, no, there's no real need for wisdom teeth. I'd never like to take them out unless needed, because I mean, more teeth.

• 18:33Steven Bartlett?

  The better.

• 18:33Speaker 01

  The better. And you never know, if you have to have something taken out, then we can use your wisdom teeth for something.

• 18:39Steven Bartlett?

  If I were to look at my ancestors from five hundred years ago, you said they don't have dentists, they don't have toothpaste and all those kinds of things. But you also said they don't have tooth, tooth decay.

• 18:49Speaker 01

  Yeah.

• 18:49Steven Bartlett?

  Does that not therefore mean that I shouldn't need a dentist and I shouldn't need toothpaste or mouthwash or floss?

• 18:56Speaker 01

  If you had a caveman diet, then potentially you might not need toothpaste, floss, or even a toothbrush. And there's a lot of argument as to, you know, there's a lot of people out there saying, no, you don't need to use any toothpaste, you don't need floss, anything like that. And, fine, go ahead, do that, but only if you are going to be eating, you know, meat, raw meat sometimes, and you're only drinking water, and you're not having anything in your diet which has any sugar or carbohydrates in it.

• 19:26Steven Bartlett?

  I mean, doesn't that speak to what the perfect diet is supposed to be? Can't we tell what the perfect diet is supposed to be by looking at the mouth?

• 19:32Speaker 01

  Yeah, so another issue is that with a lot of the food that we eat now, they have a lot more sugar in them, and that will impact the acidity of your saliva. And essentially, what decay is, is you have sugar, or you have some sort of carbohydrates, and you've got this bacteria in your mouth, and they feed on that sugar. And as they feed on that sugar, they release acid. And if that acid is left there, then it can cause demineralization of your teeth, and that demineralization will end up with decay.

• 20:04Steven Bartlett?

  Okay, so let's talk about the personal oral microbiome. Is my oral microbiome different from, say, Jack's over there, and from my girlfriend's?

• 20:14Speaker 01

  Yes, massively.

• 20:16Steven Bartlett?

  Massively different?

• 20:17Speaker 01

  Yes, maybe massively, I would say. So, one of the issues that I used to have was, I was doing lots of oral microbiome testing, and I would have, you know, let's say you and your girlfriend do an oral microbiome test, and both of you, I would see your results, and they would come out pretty much the same. Because we're only looking at certain bacteria, we can't look at all seven hundred. So we would look at the top twenty bacteria that caused problems. So I'd look at both of them, and then I would look inside your mouths, and one of you, I don't know, in this case, had raging gum disease and terrible, terrible oral health. And the other person would be completely fine. So then I realised that actually it's not just bacteria that causes disease or problems.

• 20:58Speaker 01

  It's how your body responds to that bacteria and the strains of bacteria that you have as well. So for every bacteria, there'll be multiple strains. And some of those strains can be really aggressive and really horrible for your mouth. And other strains are completely fine and are not going to cause you any problems. So when I developed my test, what we did is we looked at strains. So we looked at the strains of certain bacteria. And we would be able to differentiate between patients who had the really bad strains and the really good strains. But then also we looked at the ratio of good and bad bacteria in someone's mouth or their diversity, as well as their genetic mutations and also their inflammation. So when you put all of it together and it's like a puzzle piece, then you can actually have a better insight into someone's oral health.

• 21:43Speaker 01

  So I guess my answer is that everyone's oral microbiome is a little bit different. But it's also how your body responds to that microbiome and bacteria that really dictates whether or not you're going to have disease or problems.

• 21:54Steven Bartlett?

  So you could be someone who takes care of their teeth really, really well, but still have a bad oral microbiome relationship with the rest of your body effectively?

• 22:02Speaker 01

  Yeah, and I see it every day. And we have a lot of patients who suffer from terrible gum disease. And they come to me and they brush three times a day. They've never touched a cigarette. They have immaculate oral hygiene. They eat very well, but they have terrible gum disease. And for those patients, they might have genetic mutations that predispose them to gum disease and to inflammation. So even the smallest amount of bacteria, their body responds in a very aggressive and inflammatory destructive way, which can cause disease.

• 22:31Steven Bartlett?

  When I was speaking to, I think it was Tim Spector about the gut microbiome, he was telling me that the gut microbiome turns over, i.e. the bacteria dies every couple of days or weeks or something.

• 22:42Steven Bartlett?

  How often does the oral? Microbiome guy turnover and why does that matter?

• 22:49Speaker 01

  So what's interesting or different between the oral and gut microbiome? The oral microbiome, if someone doesn't go in there and mechanically disrupt the bacteria and the plaque in your mouth, then that bacteria can stay forever. So the gut, what happens is you've got something called peristalsis, you've got movement. So the bacteria moves, it changes, it regenerates, there's turnover. In the mouth, so the teeth are the only non-shedding surfaces in the whole body.

• 23:15Steven Bartlett?

  So that Non-shedding surfaces.

• 23:17Speaker 01

  So imagine if you, if you never had a shower in your life, you would still self-wash because the skin cells would shed. But if you never brushed your teeth, then your teeth are not shedding. They're going to stay like that. So that bacteria will just keep on growing and growing and growing and growing and you'll get this really thick plaque. So that's why actually the oral microbiome, you need to mechanically remove that bacteria. And that's why brushing your teeth is super important or using the correct toothpaste or et cetera, or going and seeing your hygienist because you need to mechanically remove that bacteria quite regularly.

• 23:54Steven Bartlett?

  Okay. And the, the two ways, I was reading in your work, it said that the two ways that oral health impacts overall health are by the spreading of bacteria and the other sort of central issue is it causes inflammation. So on this point of spreading bacteria, I'm always concerned, this is a bit of a superstitious thing, but any time that I'm sick, I'm always like, don't, part of me is like, don't swallow. Because in my head, I think if I'm sick in my mouth or if I've got like a sore throat or something, I'm like, if I swallow it, the rest of my body's going to get sick. It's super, super, superstitious, but is there any truth to any of this?

• 24:27Speaker 01

  So not from just being sick, like a common cold. And it's actually really interesting. I had a patient yesterday and bless him, he's very young, seven years old. And he had exactly that same mindset. He just randomly woke up one day and he said, this is kind of gross. Why am I swallowing my saliva? There's all these bad bugs and gross things in my saliva and I'm swallowing it every day and it's traveling to the rest of my body at seven. And so what he ended up doing was refusing to swallow his own saliva. And so he would basically just dribble and he would just wipe his, the saliva off with a sleeve or he'd carry a towel with him and just wipe it. So bless him, he had a big rash around his, his, um, his face. And

• 25:09Speaker 01

  It it was a bit of a weird moment for me because I was like, you're kind of right. Like, I mean, it is a bit weird, especially as a child to sit there and think like, yeah, you've got seven hundred different bacteria, two billion bacteria overall, and then you're swallowing it and it can travel elsewhere to the rest of the body. So, yes, in in short, yes, bacteria from your mouth, when you swallow it, it can travel elsewhere to the rest of the body. However, a lot of the bacteria dies. So the acid in the stomach can kill a lot of the bacteria. So it's only the really, really bad bacteria that are able to survive and cause problems. And that's why it's so important that you have a good oral microbiome and you balance it well.

• 25:47Steven Bartlett?

  And the other central way that it can cause negative impacts to your overall health is via inflammation. What is the link between inflammation and my my oral microbiome?

• 25:59Speaker 01

  So it's something that we call low-grade chronic inflammation. And imagine, so you've got this delicate balance of bacteria in your mouth, which is your microbiome. And we all have bad bacteria in our mouths, but most of us hopefully have better levels or higher levels of the good bacteria. So there's always that balance. And what happens in an imbalanced oral microbiome is that shift changes. So you get higher levels of bad bacteria and you don't have enough good bacteria. These bad bacteria, firstly, yes, they can travel elsewhere to the rest of your body, as you discussed. The second is that they can release inflammatory markers. So they basically release inflammation. And this inflammation can travel from your mouth to the rest of your body and contribute to inflammation elsewhere.

• 26:42Speaker 01

  So, for example, if you had rheumatoid arthritis and then you had inflammation from your gums, that inflammation from your gums is making your arthritis in your wrists worse. So it's contributing to it. Now, what's also interesting, and that's why it's called low-grade chronic inflammation, is often you wouldn't even know that you have it. I have so many patients who say, oh, you know, my gums bleed, but that's normal. If your eye bled or if your foot was bleeding every day, you would be worried and you would think, actually, there's inflammation here, there's a problem here. But so many people have bleeding gums and they don't understand that bleeding gums is a sign, it's your gum screaming to you, saying that I have inflammation, and that inflammation can travel.

• 27:24Speaker 01

  And then the third mechanism as well, so there's one more, is it's damage to your blood vessels. So again, the same bad bacteria in your mouth, it releases these enzymes, these toxic enzymes, and they can travel through the rest of your body, through your blood vessels, and they can actually damage your blood vessels. So these blood vessels are not able to dilate and constrict as well as they used to.

• 27:45Steven Bartlett?

  On that point of arthritis, I read a stat which I believe is true. I think it actually came from some of your research that said people with rheumatoid arthritis are eight times more likely to develop gum disease than patients without rheumatoid arthritis.

• 27:58Speaker 01

  Yes.

• 27:59Steven Bartlett?

  Which is shocking.

• 28:01Speaker 01

  Yeah. So there's a really strong bidirectional relationship between rheumatoid arthritis and gum disease. So that means that if you have really bad rheumatoid arthritis, you have pretty bad gum disease. And if you treat your rheumatoid arthritis, your gum disease will get better. And vice versa. If you have, if you treat the gum disease, your rheumatoid arthritis will get better. And that was actually one of the first patients that really got me on my journey of the mouth-body connection. So like, yeah, I was doing the saliva testing, I got it. You know, I was like, okay, cool. We are quantifying oral health, we're tracking things. But even me, I wasn't really fully sold on this whole mouth-body connection, how our mouth is connected to the rest of the body. So I had a patient who was sent

• 28:44Speaker 01

  to me by her functional medicine practitioner, and she had been seen by four or five different practitioners. She had terrible rheumatoid arthritis, and she went to this final guy, and he was the first guy to ever ask her, have you ever had your teeth checked? What's happened? And she said, oh, I've had a few teeth taken out in the last year or two, about six teeth. But, you know, it's just, it is what it is. And he was like, I don't think that's normal. So he sent her to me, and he was like, can you do your saliva stuff that you do and see if there's anything going on there? And we did do a saliva test. We saw that she had super high levels of inflammation, of collagen breakdown, high levels of bad

• 29:24Speaker 01

  bacteria. And what was the most important was that when I treated her gum disease, she had terrible gum disease, and that's why she was losing her teeth. When I treated the gum disease properly and aggressively, yes, her gums healed, but more importantly, her rheumatoid arthritis got better, to the point where she was actually able to get off steroids and medication and be able to walk again.

• 29:46Steven Bartlett?

  Wow.

• 29:47Speaker 01

  Yeah.

• 29:49Steven Bartlett?

  By treating her gum disease.

• 29:50Speaker 01

  Yeah. And I think that, you know, sometimes as a dentist, we treat a lot of gum disease and we treat a lot of things and we don't necessarily see the systemic consequences because the patient doesn't come back or, you know, or it's such a small impact that you don't necessarily see it. But this was the one time where I was like, wow, like what we do is actually really, really insightful and really important.

• 30:15Steven Bartlett?

  And you mentioned alongside that inflammation also has an impact on cardiovascular functioning and health. I believe it's the case that cardiovascular disease is the biggest killer in the world, from what I understand. So I was wondering if, if you knew any of the stats that show the impact or the increased likelihood of me having a heart attack or a stroke or something, based on my oral microbiome?

• 30:38Speaker 01

  So the research has shown that if you have gum disease, you are at a 20% higher chance of high blood pressure. But also, they are now saying that up to 30 to 40% of cardiac issues in hospital can be traced back to an oral bacteria causing problems in the heart valve. So the reason for this connection, so yes, inflammation, but also going back to that third mechanism I told you, which was about the vasoconstriction, so the blood vessels constricting and dilating. So these toxic enzymes, which are being released by the bacteria, they travel through the blood and they basically stop the blood vessels

• 31:20Speaker 01

  from being able to widen and lots of blood to travel to the heart and also to constrict. And that also is one of the biggest connections with heart disease.

• 31:30Steven Bartlett?

  I found this stat, which might well be from your work or someone else's. It's from the study called the association between perodontitis and blood pressure highlighted in systemic, systemically healthy individuals.

• 31:41Speaker 01

  Not mine, but.

• 31:42Steven Bartlett?

  And it found that people with gum disease were twice as likely to have a heart attack and three times as likely to have a stroke than those without inflammatory gum disease, which is absolutely staggering.

• 31:53Speaker 01

  Yeah. And then another study also showed that when you treated someone's gum disease, their levels of CRP, and CRP is an inflammatory marker that you can check in your blood, the levels of CRP significantly reduced. And for a lot of patients who suffer from heart conditions, they will get their CRP quite regularly checked through blood testing. And so this is a way of reducing their inflammation is just by having a simple hygiene. And I've even seen, particularly in America, there's a lot of cardiac surgeons and doctors related to to heart health who are now actually working with dentists because they understand that if they work together, then they're going to have far better results for their patients.

• 32:36Steven Bartlett?

  And this is, this is that swallowing thing we're talking about. This is because you're swallowing that bad bacteria.

• 32:41Speaker 01

  Yeah, and your heart valve, imagine if it's been, it's faulty, imagine you just had surgery. I always think of it like it's sticky. It's like Velcro. So it's really prone to infection and problems. It's just like if you fell over and you had a scab and you were rolling around in mud all the time, you would get bacteria going into that scab and causing problems. There's the same thing with your heart valves.

• 33:02Steven Bartlett?

  Doesn't the bacteria just travel on its own anyway? Because I feel like it's in my mouth. So I feel like it, I don't know, these are living organisms. Don't they just like find their way down, even if I don't swallow?

• 33:11Speaker 01

  Yeah, even through your blood and also through your gums as well. So you can swallow your bacteria, breathe it, or it can go through your blood.

• 33:20Steven Bartlett?

  At the start of this conversation, we're talking, you mentioned the sort of implications for your cardiovascular system. And one of the things you said was erectile dysfunction. And that was slightly alarming to me as a man.

• 33:30Speaker 01

  Yep.

• 33:31Steven Bartlett?

  Who's trying to stay away from erectile dysfunction. What is, what is the research that supports this idea that my oral microbiome can have an impact on my erectile functioning?

• 33:40Speaker 01

  So men who have periodontal disease are 2.85 times more likely to suffer from erectile dysfunction.

• 33:46Steven Bartlett?

  2.8 times?

• 33:48Speaker 01

  Yeah.

• 33:48Steven Bartlett?

  Is, I'm pretty sure that's 280%, isn't it?

• 33:51Speaker 01

  Yep.

• 33:52Steven Bartlett?

  Okay, so what is this periodontal disease?

• 33:54Speaker 01

  Gum disease.

• 33:55Steven Bartlett?

  Okay.

• 33:55Speaker 01

  So it's kind of, I would say it's a bit of a spectrum. So the early stages of periodontal disease or gum disease is just gum inflammation. So that's that patient who is brushing their teeth, spits in the basin and sees blood. So that's the originally, you know, the early inflammation. If they don't get that checked out and sorted, that will just continue and continue and continue to what we call gum disease. And that's where, yes, you've got inflammation, but actually you have really high levels of bad bacteria now. And this bacteria is essentially eating away the gums and also your bone. And it's, it's now become irreversible.

• 34:31Steven Bartlett?

  I'm gonna have a swig of this.

• 34:34Speaker 01

  For your erectile dysfunction.

• 34:37Steven Bartlett?

  Fucking hell.

• 34:39Speaker 01

  And then at the very end of the spectrum is people who are losing their teeth, having really terrible gum infections and all of these kind of mouth-body connections that we're talking about.

• 34:49Steven Bartlett?

  Okay, and can you just explain, again, as if I'm ten, the, how my, how that gum disease, periodontitis, is it called? Has an impact on my penis? I don't understand. Like, I don't understand the link. It makes all of my blood vessels.

• 35:02Speaker 01

  Exactly. Yes, so it essentially stops your blood vessels from dilating. And so you've got reduced blood flow to your penis.

• 35:11Steven Bartlett?

  Okay.

• 35:11Speaker 01

  And therefore, doesn't work.

• 35:14Steven Bartlett?

  Okay, so this is an emergency, this stuff. This is really, it's important.

• 35:17Speaker 01

  That's the one statistic, whenever I have a man in the chair and he's like, oh, I don't wanna brush my teeth, I'm like 2.85 times more likely to have erectile dysfunction. They usually will go straight to the bathroom to brush their teeth.

• 35:27Steven Bartlett?

  The other thing, you know, but it's true, but also the other thing that I, I read in your research, which I found really, really shocking, is the link between my oral health, my oral microbiome and cancer.

• 35:40Speaker 01

  Yep.

• 35:40Steven Bartlett?

  And I was reading specifically about female breast cancer. And which I know is, affects a lot of women. And what is the link there between breast cancer, cancer generally, and our oral microbiome?

• 35:52Speaker 01

  So this is, I would say, some of the newest emerging research that's coming out. So with breast cancer, I didn't know this before this research came out, but your breast has its own microbiome. So that tissue within the breast, different bacteria are able to grow. And what they found was that in women who had breast cancer, they had high levels of certain oral bacteria in their breast microbiome. So the oral bacteria is called fusobacterium nucleatum. And they compared the breast microbiomes of patients who didn't have breast cancer versus those who had breast cancer.

• 36:27Steven Bartlett?

  So what's a breast microbiome?

• 36:30Speaker 01

  Just the collection of bacteria in your breast.

• 36:32Steven Bartlett?

  Okay.

• 36:32Speaker 01

  Yeah, I didn't even know there was a microbiome in your breast either, but apparently so. And so when they compared a healthy woman, her breasts, to a woman who had breast cancer, the woman who had breast cancer had very high levels of the specific oral bacteria called fusobacterium nucleatum in their breast. There's also been research on colorectal cancer. And actually, Apple News came out with something a couple of months ago, which was nice to see them kind of just spreading the word. But what they found was that in patients who had colorectal cancer, more than 50% of them had the exact same oral bacteria

• 37:13Speaker 01

  from the breast cancer study, that fusobacterium nucleatum, in the colons. And what they found was that oral bacteria made the cancer more aggressive and harder to treat as well.

• 37:26Steven Bartlett?

  I was reading about a study in mice that linked that oral bacteria to tumor growth.

• 37:32Speaker 01

  Mm hmm.

• 37:32Steven Bartlett?

  Are you familiar with that study?

• 37:33Speaker 01

  Yes, and it's that specific oral bacteria, so the fusobacterium nucleatum, which has been shown to accelerate tumor growth within mice, but also for colorectal cancer and breast cancer as well.

• 37:47Steven Bartlett?

  And what's your belief there? I know this research is fairly new, but do you think there is a causal relationship, a significant causal relationship between the health of our oral microbiome and our probability of developing some form of cancer?

• 37:58Speaker 01

  I wouldn't yet say causal. I think that for most cancers, it is multifactorial. And there are a lot of things that can impact whether or not you get the cancer and how aggressive the cancer is. I do think that oral health and some specific oral bacteria are risk factors and can definitely increase the aggression of those cancers or even the initiation of them. There's also been research, and I think I'm waiting for the research to be published, on what they're doing is they've created an antibiotic which only kills that oral bacteria that I was talking about, so Fusobacterium nucleatum. And they

• 38:41Speaker 01

  are going to be issuing that antibiotic to those patients who have the colorectal cancer, which has the oral bacteria, to see whether or not it slows down their progression or improves their prognosis. So if I see those results and it shows it, then there's for sure a strong causative link between the two. But for now, I would say that it's multifactorial and it's definitely a risk factor.

• 39:04Steven Bartlett?

  That oral bacteria that you're describing, that you called it Fusobacterium?

• 39:08Speaker 01

  Yeah.

• 39:09Steven Bartlett?

  What is it that causes that? Is it something that I'm eating? Is it a lifestyle choice I'm making?

• 39:14Speaker 01

  Multiple things. Poor oral hygiene. Some of us genetically will have higher levels of it. It's what we eat, it's who we're kissing, it's what we're breathing in.

• 39:24Steven Bartlett?

  Does my girlfriend have it?

• 39:27Speaker 01

  So we'll have to see. But it's, and that's the thing, that's the beauty of being able to test these things now, is that you can actually see. And also, what's strange is that green tea, you know, something so simple, is extremely effective at killing Fusobacterium nucleatum. So it's just knowing those types of things, being able to do the test, knowing the right treatment plans and recommendations based from that, we know green tea is good for us. And now we can really understand why.

• 39:53Steven Bartlett?

  Okay, that's interesting. You have actually tested Jack over there, right? And you said to me before we started recording that he's got a ton of that Fusobacterium?

• 40:01Speaker 01

  Yes, he does, yeah.

• 40:02Steven Bartlett?

  And it's really getting out of control, is what you said?

• 40:04Speaker 01

  It's really badly out of control, yeah. So I've, I've given him a big vat of green tea as a gift.

• 40:12Steven Bartlett?

  Green tea?

• 40:13Speaker 01

  Yes.

• 40:13Steven Bartlett?

  Green tea.

• 40:16Steven Bartlett?

  This guy's gonna edit that out, this is the problem.

• 40:23Steven Bartlett?

  Green tea?

• 40:24Speaker 01

  Yeah.

• 40:25Steven Bartlett?

  That's good for my oral microbiome.

• 40:26Speaker 01

  Yeah, really good.

• 40:27Steven Bartlett?

  How?

• 40:27Speaker 01

  Stains, but really good. It's anti-inflammatory. It helps with what we call oxidative stress. So this is basically stress for the body. And it's antibacterial. So it actually is very effective at killing fusobacterium nucleatum.

• 40:43Steven Bartlett?

  What is your opinion of the impact that coffee has on my oral microbiome?

• 40:48Speaker 01

  I'm slightly biased because I love coffee.

• 40:50Steven Bartlett?

  Okay.

• 40:51Speaker 01

  But there is no negative impact of coffee on the oral microbiome directly. Coffee does dry your mouth out. And so you have reduced saliva and that can actually cause problems for the oral microbiome. So the saliva is super important in your mouth. It provides all of the food, the proteins, everything for the bacteria in your mouth. So it's kind of like this delivery service, your delivery, it's travelling around, providing all the food and bacteria, sorry, food to the bacteria. And that's what keeps the good bacteria alive and happy. So when you have a dry mouth, let's say you're drinking lots of coffee or you're very nervous

• 41:31Speaker 01

  or you are on antidepressants, for example, which are a big one, then you just don't have as much saliva. So you, those bacteria don't have as much food and those bacteria die. And then you get bad bacteria growing in replacement.

• 41:45Steven Bartlett?

  What about tea? We're a nation of tea drinkers in the UK.

• 41:49Speaker 01

  Similar, so it also does dry your mouth, not as bad as coffee, but otherwise no problems other than staining.

• 41:55Steven Bartlett?

  What about if I put loads of sugar in it? Because a lot of people put a lot of sugar.

• 41:58Speaker 01

  Okay, yeah, no, no, no, never, no, no. So actually, sugar in your tea is even worse than you having a biscuit, for example. So because the sugar dissolves in your hot tea and the tea is hot when you drink it, it can actually cause more problems. Another thing with sugar is, I have a sweet tooth, I love sugar, but it's about how you eat your sugar. So let's say if you have your hot tea with five lumps of sugar in there and you're sipping it over an hour or two, that's where you start to see a lot of problems. So actually, you need to be having a sugar attack, so just all the sugar in one go. And that way, your mouth has all the sugar in one go and it's able to neutralize the saliva and get back to a good state as quickly as possible.

• 42:42Speaker 01

  Every time you sip your your tea with sugar, what happens is that the saliva has to go from acidic back to neutral acidic, back to neutral acidic, and then it starts to just not work properly and the saliva just stays acidic. And that's where you start to see decay.

• 42:56Steven Bartlett?

  So you wanna just down the tea?

• 42:58Speaker 01

  Down the tea, or I don't know if you're a M and M guy, have all your M and M's in one go, don't snack on M and M's every 10 minutes.

• 43:05Steven Bartlett?

  What about other drinks, like, I don't know, you know, Coca Colas and these other sort of fizzy drinks that might have artificial sweetness in, things like that?

• 43:12Speaker 01

  So they're not as bad as your natural sugars, but for example, something like your Coke or or Fanta or whatever, it's also very acidic and it can actually cause erosion as well. So this is essentially where the outer layer of your tooth, so the enamel, is just worn away from having lots and lots of these fizzy drinks.

• 43:33Steven Bartlett?

  Ah, okay, so it's not gonna cause decay in the same way, but it might change the acidic balance, which then decays my tooth, which makes me more susceptible to when I eat sugar.

• 43:42Speaker 01

  Exactly.

• 43:43Steven Bartlett?

  Having a problem. Okay, got you. So going back to, we were talking about the the implications of an oral microbiome and the rest of my body, brain health is one thing that I was really curious about. We've had lots of conversations on this show about Alzheimer's and dementia and just general sort of optimal cognitive performance as I age, something I'm thinking a lot about. I wanna have a sharp brain, it's quite important because of what I do. So is there a link between my oral microbiome and my cognitive and brain health?

• 44:07Speaker 01

  Yes. So if we look at actually just the the occurrence of Alzheimer's and gum disease or oral health, a lot of research has shown that if you have gum disease for more than 10 years, you have a 70% increased chance of developing Alzheimer's.

• 44:29Speaker 01

  So that was a study that was done on over twenty thousand people and they followed them for twenty years and they saw, okay, if you had gum disease at baseline, whether or not you get Alzheimer's at ten years or twenty years, so a seventy percent increased chance of it. They've also done a lot of research where they've been looking at oral bacteria. And what they found was that there are certain oral bacteria, so one called P. gingivalis, that's one of the worst oral bacteria, I would say, out of all of them. So this P. gingivalis is able to travel from your mouth to your brain, it's only quite close by anyway. And what's unique about this bacteria is it's able to cross the barrier between, in

• 45:11Speaker 01

  your brain, so the blood-brain barrier, and it releases these toxic enzymes. So these enzymes are called gingipains, and they're, imagine these like horrible firefighter things, and they can break down neurons, they can break down a lot of brain tissue. And so when they looked at the cerebrospinal fluid and the brain fluid or tissue of Alzheimer's sufferers, they found that ninety-seven percent of them had these toxic enzymes, these gingipains, in their brains compared to zero for the patients who did not have Alzheimer's. So this is, you know, the first study shows, yes, there's some sort of correlation, but there's a lot of other risk factors. The second one, which is looking at your gingipains, is showing that there's definitely a strong causative factor between the two.

• 45:55Speaker 01

  And then another study, which was very interesting, was looking at cognitive decline. So, okay, fine, you have Alzheimer's, unfortunately, is it, is it too late? Should you stop brushing your teeth or what's the point? And so what they did was they had patients who had Alzheimer's and they checked their cognitive function and they also checked their oral health. And then six months later, they reviewed them and they found that the patients who had gum disease had a much more rapid cognitive decline than those patients who didn't have gum disease. So again, it's still important, if you do get Alzheimer's, that you maintain your oral health, that you have someone help you brush your teeth, because your cognitive decline will be faster.

• 46:39Steven Bartlett?

  How do they unpick that from other causal factors that might be going on, like bad food choices? Because in my head, I was thinking, well, if someone's drinking... Sugary fizzy drinks every day, they're more likely to have gum disease. But maybe also that the chemicals within that fizzy drink are impacting their chances of dementia. Maybe they're also someone that has an unhealthy lifestyle. Maybe they're more sedentary. If they're eating bad things, maybe they're more sedentary. And maybe it's that that's causing the rapid cognitive decline versus the gum disease itself. Is it possible to untangle all of this?

• 47:13Speaker 01

  I mean, it is very difficult. I think that for those types of things, you either, you're right, diet, lifestyle is super important. And we know that Alzheimer's is again multifactorial. I think it's really about the quantity of patients that they check. So they need to be looking at a huge number of patients, and they did, to check whether or not there is a strong correlation between them. Also, going back to the gingival pain study, so the one about the bacteria, that shows it doesn't, it's not diet or lifestyle or nutrition. It is a specific oral bacteria that has travelled to the brain and released these enzymes, which are then breaking down neurons. So there, there's definitely a strong causative effect.

• 47:57Steven Bartlett?

  That is fascinating. It's really, really fascinating because dementia and Alzheimer's still seem to be a bit of a mystery.

• 48:03Speaker 01

  It is, and I work with a team for Alzheimer's. And what they've done, similar to what you were saying, is that they've kind of separated all of the causes of Alzheimer's that we know, or the risk factors. And thankfully, they've put oral health as one of them as well. And I think from all of the other risk factors, so, you know, for example, if you have the genetic mutations, you've got the APO4 or any of those mutations, that's, you can't change that, unfortunately. Some of us have mutations, which means that we are at a much higher risk of stuff, of getting Alzheimer's in the future. But something like that oral bacteria, P gingivalis, and those gingival pains, you can get rid of P gingivalis really easily.

• 48:45Speaker 01

  Again, if you tested it, you can even test for gingival pains, and then you can get rid of the bacteria before it starts causing problems.

• 48:53Steven Bartlett?

  The test that you offered, does it test for gingival pains?

• 48:56Speaker 01

  It does, yeah. So we're the only ones on the market who do. Because that was something that I thought was super important. What's the point in us telling you that you have a bacteria? If we can't tell you that that bacteria is being really bad in your mouth and causing a lot of problems.

• 49:11Steven Bartlett?

  And people think I'm joking, but you have actually tested several members of my team, including myself. So I am actually going to find out the results today. On the subject matter of the brain, is there a link between my mental health, depression, anxiety and my oral microbiome?

• 49:27Speaker 01

  So again, there's been a lot of research. I think it's difficult for something like mental health and and gum disease, which, you know, with the chicken and the egg, which one came first? Because one of the issues is if you have a decline in your mental health, you are less likely to take care of your oral health. And therefore that can exacerbate issues. So there has been a lot of research to show that, you know, there's a correlation between poor mental health and poor oral health. But in my personal opinion, that causative connection is not there yet. There's also been some research with things like schizophrenia. But again, it's the jury's still out, in my opinion.

• 50:10Steven Bartlett?

  Are you able to tell the state of someone's mental health by looking at their oral microbiome, in your view?

• 50:16Speaker 01

  You can know if something's up. Like, for example, I had a patient relatively recently. I've been treating her for five, six years now. And I know that she takes good care of her teeth. She takes good care of herself. And a few weeks ago, she came in and she was not taking care of her gums or her teeth at all. Everything was an absolute mess in there. And so I did pull her aside and I was like, what's wrong? Like, something's happened here. And I think it is quite a big sign for a lot of people. It's the first thing that they kind of let go of is their oral health.

• 50:50Steven Bartlett?

  And is that because of, you know, they start certain self-soothing behaviours because they're stressed in other parts of their life. So if they're having a bad time in their relationship or work and they're stressed, they might start eating sugar more or

• 51:02Speaker 01

  Or just not brushing their teeth.

• 51:03Steven Bartlett?

  Smoking or drinking more, okay.

• 51:04Speaker 01

  Or just not brushing, like with this woman, she just wasn't brushing her teeth anymore. Another thing that we can also see, I mean, it's kind of a bit on a tangent, but also eating disorders as well. So things like bulimia or even sometimes anorexia, you can see in the mouth. So there's a lot of times where we'll see young teenagers and I'll know that they are bulimic because they have certain issues in their mouth, which they shouldn't have. And that again is a telltale sign.

• 51:31Steven Bartlett?

  Is that because the stomach acid is coming through their mouth?

• 51:33Speaker 01

  Yeah. So they get a lot of erosion on the, on their teeth. And then in some cases, you can also get these marks on the roof of your mouth. So if they're trying to force themselves to vomit, then you can see that. And that's something that, you know, you have to pull the patient aside or tell their mother and explain that to them as well.

• 51:50Steven Bartlett?

  And is there a relationship between stress and my oral health? So if I'm more stressed and my cortisol levels are higher, is that going to make everything in my mouth worse?

• 51:58Speaker 01

  Yes.

• 51:59Steven Bartlett?

  Even outside of the lifestyle choices I might make in such a state?

• 52:02Speaker 01

  Yes. Just that stress will increase your inflammatory markers, your inflammation. It also will dry your mouth out and all of those things will be linked. We do a lot of testing at my clinic. And so one of the tests that we look at is collagen breakdown. So we have lots of different types of collagen all over our bodies and our gums are made up of a certain collagen. So we look at an enzyme called AMMPA and this enzyme is responsible for breaking down that specific collagen. So we test the collagen, that enzyme all the time with our patients. It's a really nice way of knowing like whether or not someone's about to have gum disease, how much collagen breakdown is happening from biomolecular

• 52:45Speaker 01

  level. So I had a woman, very healthy, always been fine. And then she had her collagen breakdown tested and her levels were through the roof. Her gums looked fine. She didn't look like she had any problems, but I've never seen such a high level in my life. And so, you know, I'm trying to think of what could be causing it, all of that. And she had lost her baby a couple of days before. And that type of intense stress on someone's body can have so many effects and impacts on the rest of your body. And that was one of them. When we retested her six months later, she was back to normal again. But you can see even your mouth, you know, stress can really impact you.

• 53:25Steven Bartlett?

  On this, I was thinking about, I just mentioned James, James Nester earlier, who was telling me about the research of how the, the mouth has changed shape because of the foods we're eating and how that that's caused a bunch of downstream implications for us. One of the also, one of the other things he also mentioned was about mouth breathing and nose breathing.

• 53:44Speaker 01

  Yes.

• 53:44Steven Bartlett?

  And there's a lot of people that have become incredibly interested in whether we should be breathing through our mouths or our nose. And I was wondering if you had a perspective on that.

• 53:54Steven Bartlett?

  And also the other thing that he mentioned to me was that there's a link between mouth breathing and things like ADHD. What is your point of view?

• 54:03Speaker 01

  I completely agree with all of that. So actually, my sister, she is an orthodontist. So she works at our clinic and we run it together with our mother. And she is very, very hot on mouth breathing. And what she mainly does is she basically tries to stop children in particular from breathing with their mouths open. And what she has found is that most of her patients who come to her are mouth breathers. They often have some sort of ADHD, they have, or some sort of attention deficit. They are bed wetters, they grind their teeth a lot of the time, and they have a whole cascade of other problems.

• 54:46Speaker 01

  And she can treat it then, and it's relatively easy. You should argue that it's very difficult, but to me, I think it's easy. I'm like, yeah, there we go. You can do what you do. And because the, the jaws of a child are very malleable, so they haven't fully solidified. So you can still move things, you can get the teeth to meet. So if you get the teeth to meet correctly, then the child won't want to breathe with their mouth open. The annoying thing is, is that a lot of adults are mouth breathers because their teeth do not meet correctly or their jaws are in the incorrect position. And at that point, it is quite difficult to move the jaws into the correct position or to get the teeth to close in a way so that the lips are at rest and you breathe with your nose instead of your mouth.

• 55:29Speaker 01

  But again, I see those types of patients because they all come to me with a lot of other problems. So again, same thing, a lot of them have, a lot of them have suffered from long COVID, a lot of them have inflammatory conditions, are always tired, a lot of them chronic fatigue, you know, there's a lot of connections now between mouth breathing and those types of issues as well.

• 55:52Steven Bartlett?

  Is there a link between the health of my oral microbiome and whether I breathe through my nose or mouth? Because James was explaining to me that the nose is effectively like a filter system.

• 56:01Speaker 01

  Yeah.

• 56:01Steven Bartlett?

  There's a certain temperature in there.

• 56:03Speaker 01

  Yeah.

• 56:04Steven Bartlett?

  There's like sinuses and stuff which are, have some kind of mucus which helps to catch bacteria. So if I'm breathing through my mouth, am I more likely to have unhealthy oral microbiome?

• 56:14Speaker 01

  Hundred percent. So exactly the same thing. You're, you've got a filter in your nose and so it will stop a lot of bad things from coming through. But the mouth, there is no filter. I mean, you breathe it in, it goes straight into your lungs. So there's no way of stopping anything. A lot of people now are starting to mouth tape and that's become kind of trendy and cool. It's not the easiest thing to do. It seems a bit weird to tape your mouth at nighttime. But for anyone who's worried that they breathe with their mouth open, mouth taping, in my opinion, is a really nice way of just like testing it out and seeing whether or not you do breathe with your mouth open. Because you'll do some mouth taping and you can see whether or not you sleep better. So if you have a wearable, you can see, oh, wow, my oxygen levels are so much better. I had such

• 56:59Speaker 01

  a deep sleep. And if that's the case, you might be more inclined to straighten your teeth or sorts out the reason that you're breathing with your mouth open.

• 57:08Steven Bartlett?

  I took notes of a study which kind of is interconnected to the point we were making about mouth breathing, which said in a six year study of 11,000 children, it was found that children who suffered from sleep disordered breathing were 50 to 90% more likely to develop ADHD like symptoms than were normal breathers who breathed through their nose correctly, which is absolutely staggering. 50 to 90% more likely to suffer from ADHD like symptoms, just because they breathe through their mouth at night and had disordered breathing.

• 57:40Speaker 01

  And it's mainly to do with also oxygen being delivered to your brain.

• 57:44Steven Bartlett?

  Right.

• 57:44Speaker 01

  So there's not as much good oxygen. Um. Like real rich oxygen, filtered oxygen, travelling to the brain. And so that's basically not allowing your brain to function as well.

• 57:55Steven Bartlett?

  You mentioned kissing earlier on.

• 57:56Speaker 01

  Yes.

• 57:57Steven Bartlett?

  Um. I'm still supposed to kiss my partner, right?

• 58:00Speaker 01

  Yes, I hope you do, many times.

• 58:02Steven Bartlett?

  You you said if I kiss her more than eleven times a day or something, then our oral microbiomes synchronize in some way.

• 58:08Speaker 01

  Yeah, so there is um passage of bacteria from you to her and her to you. They have also shown that, uh, for example, they did a study where one uh partner chewed lots and lots of probiotics, so like good bacteria, and then had a super long smooch with their partner and actually was able to transfer nearly sixty or seventy percent of that good bacteria into their partner. So it's not necessarily long lasting. I wouldn't say that, um, you know, if you kiss someone once on a night out, that you are going to terribly impact your microbiome. It's fine, you can go and kiss, but it's more for long term partners. If you're kissing regularly and for a long time, then yes, your microbiomes will start to um be quite similar.

• 58:53Speaker 01

  Another factor as well is that obviously your lifestyles are probably pretty similar. You're probably using the same toothpaste, eating the same food. So it's difficult to fully put it on just kissing, but yeah.

• 59:03Steven Bartlett?

  What about oral sex and the implications that will have? So if we're, if me and my partner are doing oral sex on each other, is that going to impact our oral microbiome?

• 59:12Speaker 01

  Yes. So actually, there's been a few case reports which have shown, um, uh, there's one in particular. And I've had a patient as well who had this, a woman who um had a new partner and she liked to perform oral sex on him. And then she came to me because she was complaining of very inflamed gums and she was getting gingivitis. And, you know, it's not something I really ask, like, I'm not going to be like, how's your, how's your sex life going these days? Like, so I didn't ask it, but she kept on coming back to me. No, my gums are still inflamed. No, my gums are still inflamed. And then she asked, she was like, is it maybe because I have a new partner? I was like, okay, maybe you guys are kissing a lot. And she was like, no, no, no, no. And and then she explained to me. Um. And then I was like, okay, fine. Why don't you go and test and uh ask him whether or not he has any issues?

• 59:57Speaker 01

  Um. And it turns out that he was having recurrent urinary infections. And so actually, they were transferring bacteria and she was having inflammation in her gums because she was. Yeah, performing her oral sex. So yeah, there is transfer. Again, I wouldn't be scared and say never do it. I once made an ex-boyfriend do an oral microbiome test, just to check and just to make sure everything was okay.

• 1:00:22Steven Bartlett?

  You made him do it?

• 1:00:23Speaker 01

  Yeah.

• 1:00:25Speaker 01

  I don't, it's not a, it's not a prerequisite anymore, but it was at the time I was like, let me see.

• 1:00:30Steven Bartlett?

  Of course it is. Of course it is. You must, you must think that when you meet people, you must think, God, I wonder what their oral microbiome is saying, like in a romantic context, because you know the significance of it.

• 1:00:38Speaker 01

  Yeah, I think it's a, you know, I spend a lot of time and energy making sure my oral microbiome is very nice and balanced. So I wouldn't want anyone messing that up for me. So it's important.

• 1:00:48Steven Bartlett?

  Are you in a relationship now?

• 1:00:49Speaker 01

  Yes, I am.

• 1:00:49Steven Bartlett?

  Have you tested their oral microbiome?

• 1:00:51Speaker 01

  I've been trying to, but he won't let me.

• 1:00:54Steven Bartlett?

  You've asked him?

• 1:00:55Speaker 01

  Yeah, of course I have.

• 1:00:56Steven Bartlett?

  And what did he say? Mind your own business?

• 1:00:57Speaker 01

  But I did give him an oral microbiome test, so hopefully he'll just use it. I said, you can even use a fake name. I don't care. I don't, I'm not going to test. I'm not going to check it. I just want you to do the test for me.

• 1:01:08Steven Bartlett?

  For you?

• 1:01:09Speaker 01

  For me, yeah.

• 1:01:10Steven Bartlett?

  And what's his, what's his rebuttal? He's like, I don't.

• 1:01:13Speaker 01

  He was like, what happens if you break up with me if I have a really imbalanced oral microbiome? And I was like, I hope that our relationship is stronger than just your oral microbiome, but there's ways to fix it. And that's the beauty of the oral microbiome is that it's actually pretty easy to, to fix and to change.

• 1:01:27Steven Bartlett?

  If his results came back and he had a terrible oral microbiome, one of the worst you've ever seen.

• 1:01:31Speaker 01

  Yeah.

• 1:01:32Steven Bartlett?

  Are you less likely to kiss him that day?

• 1:01:35Speaker 01

  That day, yes.

• 1:01:36Steven Bartlett?

  There you go. Don't do the test, my friend.

• 1:01:38Speaker 01

  No, no, no.

• 1:01:39Steven Bartlett?

  Don't do the test.

• 1:01:40Speaker 01

  That's a yes.

• 1:01:41Steven Bartlett?

  There's no upside to him doing this test. I completely understand.

• 1:01:43Speaker 01

  And then I would go and creep into his bathroom and change all of his oral products.

• 1:01:47Steven Bartlett?

  This is what he's scared about.

• 1:01:48Speaker 01

  Personalize everything for him and then.

• 1:01:50Steven Bartlett?

  You've done that already?

• 1:01:51Speaker 01

  I already have. He tests everything out for me as well because I get a lot of products sent to me. So I'm always getting him to, to try things out for me as well.

• 1:01:59Steven Bartlett?

  Okay, so no blowjobs if they've got issues down there?

• 1:02:03Speaker 01

  Yeah.

• 1:02:05Steven Bartlett?

  And we don't really know if they've got issues down there unless they admit it or do some kind of test.

• 1:02:08Speaker 01

  Yeah.

• 1:02:09Steven Bartlett?

  Okay. What about fertility? Is there a link between our oral health and our fertility?

• 1:02:14Speaker 01

  Yes. So if we look at men to start with, there was a study done and they found, so they looked at a group of subfertile men. So men who weren't able to conceive with their partners. And they checked all of their mouths and they found that over ninety percent of these men had some sort of oral infection or dental disease of some sort going on. They split the group into two. Half the group had the treatment that was needed. So I don't know if they had gum disease or decay, they they got it fixed. And the other half were left to their own devices. After eight months, there was a seventy percent improvement

• 1:02:55Speaker 01

  in their success for pregnancy, the men who'd had their oral infections sorted. And they had a much better improvement in their sperm quality and motility as well.

• 1:03:06Steven Bartlett?

  And what did they do to those men in that group where they saw the significant improvement?

• 1:03:10Speaker 01

  So for example, if the man had gum disease, they would treat it with hygiene. Or if they had an infected tooth, maybe they would take it out or do a root canal or et cetera. They would just have to treat that infection. So I speak a lot about gum disease all the time, but actually there's so many other oral diseases like decay or toothache or all those types of things that can also contribute inflammation and problems.

• 1:03:35Steven Bartlett?

  In that study, six months after their sperm had improved by twenty percent and after eight months, fifty percent of their wives were pregnant.

• 1:03:42Speaker 01

  Yes.

• 1:03:43Steven Bartlett?

  That is staggering.

• 1:03:44Speaker 01

  Yeah.

• 1:03:45Steven Bartlett?

  What about women though? Is there a similar sort of result as it relates to women's fertility?

• 1:03:50Speaker 01

  Yes. So research has also found that if a woman has gum disease, she is less likely to ovulate. And also she's going to have issues with conception. So they found that women with gum disease, it takes them two months longer to conceive versus a woman who doesn't have gum disease. But once the woman has conceived, the issue is still not over. She still has to maintain her gums. So firstly, a lot of women will have pregnancy gingivitis. So this is basically super inflamed, puffy gums because of all the hormones. And so they should be going very regularly to see their hygienist. But also what the research has found is that women who are pregnant and have gum

• 1:04:31Speaker 01

  disease are at a much higher risk of preterm birth, so premature babies, low birth weight, and also preeclampsia as well. So they did a study in Malawi, it was on 10,000 women. So Malawi has the highest rate of preterm birth in the world at just about, I think, just under 20%. And preterm birth is a big issue for governments, for hospitals. It's really expensive. You need to keep the woman and the child in the hospital for a lot longer, but also that child will have a whole myriad of problems afterwards as well. So weirdly, Wrigley's, the sugar, the chewing gum company, sponsored this study.

• 1:05:13Speaker 01

  They went to Malawi, they had these 10,000 women, they split them up into two. 5,000 of those women were given sugar-free chewing gum, toothbrush and some toothpaste, and the other half were left alone. And they found that there was a 20% improvement, or 20%, sorry, reduction in preterm birth in the woman who'd had the sugar-free chewing gum compared to the woman who hadn't had it. So something so cheap and so easy, like chewing gum, was able to actually reduce the risk of preterm birth for these women.

• 1:05:42Steven Bartlett?

  How and why?

• 1:05:44Speaker 01

  So if you look into the research a little bit more, you're going to get your chewing gum now.

• 1:05:50Steven Bartlett?

  Yes.

• 1:05:51Speaker 01

  So sugar-free chewing gum has been shown to stimulate your saliva. So it helps with what we were talking about earlier. Saliva is super important, and it provides all the good food for your bacteria. But then also, if it's sugar-free, let's say it's using xylitol, that's naturally antibacterial, so it's killing a lot of the bacteria in the mouth. And what they found is that there are certain oral bacteria that can travel down to the placenta and can also cause problems there and essentially increase the chance of preterm birth.

• 1:06:25Steven Bartlett?

  You sufficiently convinced me that saliva is an important thing, and I actually did one of your tests. Let me go grab the results.

• 1:06:31Speaker 01

  Okay.

• 1:06:33Steven Bartlett?

  Every single time you eat, you have an opportunity to improve your health. That's why I love Zoe, because it helps me to make the smartest food choices for my body. As you guys probably know, Zoe is a sponsor of my podcast. I'm also an investor in the company, which is important to say. I invested in the company because Zoe combines my health data with their world-class science. Using these two things, Zoe guides me to better health every single time I make a food choice and eat, which means I have more energy, better sleep, better mood, and I'm less hungry. And the best part about Zoe is that it's backed by their recent clinical trial, something called the method study, which is the gold standard of scientific research. I started Zoe just over a year ago now, and I've been able to track my progress week after week, so I can learn how to be even smarter the week after.

• 1:07:17Steven Bartlett?

  And if you haven't joined Zoe yet, I'm going to give you 10% off when you join Zoe now. Just use the code BARTLETTEN at checkout.

• 1:07:26Steven Bartlett?

  And here are the results. I've not actually seen them yet, so this is exciting. I'll give them to you, so you can explain them to me.

• 1:07:35Speaker 01

  Okay.

• 1:07:36Steven Bartlett?

  So this is the test that I did, right?

• 1:07:38Speaker 01

  Yes. Yep.

• 1:07:43Steven Bartlett?

  The test I did contains this little kit that basically in the middle of the office one day, someone came up to me and said, Steve, can you spit in this? And I said, sure.

• 1:07:55Speaker 01

  Yep.

• 1:07:55Steven Bartlett?

  And then they took my spit away.

• 1:07:57Speaker 01

  Yes.

• 1:07:58Steven Bartlett?

  And it turns out it was upon request from you.

• 1:08:01Speaker 01

  Yes, exactly. I wanted your saliva.

• 1:08:03Steven Bartlett?

  Yeah.

• 1:08:03Speaker 01

  Just to check to make sure if I could do this interview.

• 1:08:07Steven Bartlett?

  So this is the test that I did. I spat in this little thing, sent it off back to you, you ran the test. How long does it take to do this test?

• 1:08:15Speaker 01

  It would probably take you about two minutes to do it yourself, and then you get the results three to four weeks later.

• 1:08:21Steven Bartlett?

  What did you find out from doing my test?

• 1:08:24Speaker 01

  Well.

• 1:08:24Steven Bartlett?

  Okay.

• 1:08:25Speaker 01

  Let's go through your results. So we found that you have quite a diverse microbiome. So that means that you have a nice ratio of good bacteria versus bad bacteria. And this has been compared to healthy and diseased subjects. So you are really right on the top of the bell curve. So very good with that. So happy. Then we predict your.

• 1:08:47Steven Bartlett?

  Diverse is better.

• 1:08:48Speaker 01

  Arguably, yes, yeah.

• 1:08:49Steven Bartlett?

  Okay.

• 1:08:50Speaker 01

  Then what we have is we've created this algorithm that predicts your risk of certain issues or diseases in the mouth. So those are things like bad breath, gum disease, decay and general inflammation. So your risk of bad breath was low. You didn't have a high risk for that. Gum disease was medium, so slight, maybe there's a bit of inflammation going on there. Your risk for decay was also medium. And your risk for general inflammation, so this is inflammation throughout the rest of your body, was quite low.

• 1:09:24Speaker 01

  And then if we zoom in, we then look at your good bacteria. So we're also quite unique because we thought that it was unfair that a lot of tests don't look at the good stuff. So we look at all of the bacteria which has been shown to be the most beneficial in a microbiome. So for you, you had pretty much high to very high levels of good bacteria, which is great. No problems with that. And then we look at bad bacteria. So we actually look at about 500 different bacteria, but then we zoom into the top 20 bad ones, which are really associated with things like gum disease, decay, bad breath. So for you, out of all the bacteria that we looked at, you only had quite high levels of one bacteria, which was bad for you.

• 1:10:08Speaker 01

  And so this bacteria is very strongly associated with basically a lot of buildup of plaque in your mouth. So having not looked in your mouth, I have no idea about your dental health or anything like that. I would assume that basically you're a bit overdue on a hygiene, maybe. Maybe there's a lot of plaque buildup going on from that result. But the rest of the bad bacteria, so all of these ones we're talking about.

• 1:10:33Steven Bartlett?

  The erectile dysfunction one.

• 1:10:34Speaker 01

  Your erectile dysfunction one's fine, your P. gingivalis is fine, you know, F. nucleatum, those ones were actually very good. Then, also on top of that, going back to the Alzheimer's, so we look at those virulence factors associated with P. gingivalis, and you had none of those virulence factors, which is also really good.

• 1:10:54Steven Bartlett?

  Okay.

• 1:10:55Speaker 01

  Then we look at your genetic mutations. So we've identified about 10 different genetic mutations which increase your risk of decay and gum disease. So for the decay, out of the five genetic mutations, we looked at four out of five of them you had. So that means that you, and maybe you have stopped it, but you are at a higher chance of having a sweet tooth, of having more acidic saliva. On top of that, it might be that you, if you're stressed out, or you're really unhappy, some people will run to the casino, others will run to the bottle, and for you, you might actually be someone who goes and has a chocolate bar and actually enjoys sugar.

• 1:11:34Steven Bartlett?

  No comment.

• 1:11:35Speaker 01

  On top of that.

• 1:11:36Steven Bartlett?

  None of your business.

• 1:11:38Speaker 01

  Let's say you've had your sugar because you are stressed out or whatever, you also have been shown to have a genetic mutation, which means that your taste perception is lower, so you need two bars of chocolate, not just one.

• 1:11:50Steven Bartlett?

  No comment.

• 1:11:51Speaker 01

  To make you feel happier.

• 1:11:52Steven Bartlett?

  That's the end of this podcast. That's the end of this episode.

• 1:11:54Speaker 01

  I'll give you my card after.

• 1:11:55Steven Bartlett?

  Close the file.

• 1:11:58Steven Bartlett?

  Close your document. Have a day. No, I mean, it all squares with reality, so please do keep going.

• 1:12:05Speaker 01

  So that's your decay situation. In terms of gum disease, again, we look at certain mutations. So there are some mutations that can triple your risk of gum disease. They can increase the amount of inflammation that you release from your mouth. So imagine you, there are some people who, even the smallest amount of bacteria, they may have great hygiene, they have a few small bad bacteria in their mouth, they have mutations which means that they respond in a very hyper-inflammatory and very aggressive way, and they will be at a very high chance of gum disease. So in your case, you had one mutation. And I would say out of all of the mutations for gum disease, it was the best one.

• 1:12:47Speaker 01

  So it basically means that you have genetically, you're more predisposed to bacteria collecting around your gums.

• 1:12:54Steven Bartlett?

  Okay.

• 1:12:54Speaker 01

  So you might be someone who actually needs to go really regularly for a hygiene. And it's kind of annoying because you keep on getting built up or they keep telling you to come back. Because actually genetically, you have that in your saliva.

• 1:13:06Steven Bartlett?

  Uh huh.

• 1:13:08Speaker 01

  Then afterwards, we give you personalized recommendations. So we tell you based on everything that we've seen, the bacteria, your mutations, what your input from the questionnaire. We tell you what toothbrush would be good for you, what supplements you should be taking, what toothpaste, floss. Everything basically, even chew sugar free gum, all of those types of things to improve your oral health and rebalance your microbiome.

• 1:13:33Steven Bartlett?

  And you could tell all of that just from me spitting in a tube once?

• 1:13:36Speaker 01

  Yes. And then at the very end, we have a list of all of the detected organisms. So like I said, we look at the top 20, which we know are really bad for you. But actually, sometimes in some patients will have like weird bacteria, really high levels of weird bacteria. So I had one patient, she had really bad breath and her gums were kind of okay, her teeth were okay, there were no problems. But she was like, I don't know what's going on. So she did the saliva test and she had forty percent of her oral microbiome was made out of one bacteria. So I was searching this bacteria, I've never heard of this bacteria before. It is extremely prevalent in dogs. So then I got back to her, I'm like, do you have any dogs? And she was like, yeah, yeah, four, four or five dogs at home. And I was like, do you kiss your dogs? She was like, yeah, of course I do. Like they're my, they're my babies.

• 1:14:21Speaker 01

  So she was kissing her dogs and she was getting transferred bacteria from her dogs into her mouth. And that was what was making up her whole microbiome.

• 1:14:28Steven Bartlett?

  And that was giving her bad breath?

• 1:14:30Speaker 01

  Yeah. So what I did was I gave her a treatment, a recommendation. And no, I gave all of her dogs, I said, you need to take this specific, it's not medication, it's like a supplement. So it basically stops like buildup of plaque in dogs' teeth. So I was like, your dogs have gum disease basically, so they need to be treated if you want to get better. And after everyone got treated, her bad breath went and so did her dogs as well.

• 1:14:57Steven Bartlett?

  So our dog owner is more likely to have bad breath.

• 1:15:01Speaker 01

  If you are smooching your dog, then yeah, kind of. And your dog has gum disease.

• 1:15:05Steven Bartlett?

  If you're kissing your dog?

• 1:15:06Speaker 01

  Yeah.

• 1:15:06Steven Bartlett?

  Okay, interesting. So what are the very, having seen my results, but generally from seeing the thousands and thousands of results that you've seen.

• 1:15:15Speaker 01

  Yeah.

• 1:15:16Steven Bartlett?

  What are some of the the easiest things that I could do to help correct that situation and have perfect oral health? And a perfect oral microbiome?

• 1:15:27Speaker 01

  So what we've done is, if you were to do the test, you would have all of the personalized recommendations for you. So we tell you to have green tea, to have honey, all of those types of things, which have been shown through research to benefit your microbiome in your case specifically. But if we were just talking about someone who hasn't done the microbiome test and wants to just make sure that they have as balanced of a microbiome as possible. Diet is obviously very important. So what we're talking about, that sugar attack, making sure that you only have one sugar attack a day. You're not having sugar consistently because it does alter your saliva pH. The type of toothpaste that you're using, I like to keep it simple. You don't need to, we don't need to make things super complicated. You don't have to spend that much money.

• 1:16:11Speaker 01

  Having the right toothpaste, right toothbrush and the right floss is honestly as much as is the most necessary thing that you need.

• 1:16:20Steven Bartlett?

  Okay, so in terms of brushing though, you you give some sort of practical advice around when we should brush? What is that? And is there any time where I shouldn't brush my teeth?

• 1:16:30Speaker 01

  You should never brush straight after anything acidic or sugary. So what you end up doing is is grinding the sugar or the acid into your teeth. So actually, you should wait thirty minutes until you brush your teeth.

• 1:16:43Steven Bartlett?

  That's interesting, because when I eat something sugary, I feel like I need to brush my teeth to get rid of it.

• 1:16:47Speaker 01

  Yeah, no, no. So you want to wait thirty minutes. So instead, you can chew some sugar free gum. Or there are lots of pastels that we use, so like I use like chewable mints. And you can chew one of those and it will actually neutralize your saliva really quickly. So that you don't have that acid causing the demineralization.

• 1:17:07Steven Bartlett?

  And you you said that I should brush my teeth first thing in the morning and last thing before I go to bed?

• 1:17:11Speaker 01

  Yes.

• 1:17:12Steven Bartlett?

  Okay, just because that's the sort of biggest window, I guess, that's the best way to.

• 1:17:16Speaker 01

  Yeah, the most important time to brush your teeth is right before you go to bed. Um, because you spend two minutes spreading all this lovely goodness on your teeth. Um, and then when you go to sleep, going back to saliva, when you sleep, your saliva flow reduces massively. So all of a sudden, these bacteria are left to their own devices. And if you don't have good toothpaste there, then they can cause a lot of problems.

• 1:17:38Steven Bartlett?

  And do I spit or do I rinse after I've brushed my teeth?

• 1:17:41Speaker 01

  Spit. So you should never rinse your mouth out with water after you brush your teeth. So brush, brush, brush, spit into the basin and that's it. Reason being, again, going back to my sunscreen analogy. Um, imagine you spend two minutes putting all this lovely sunscreen all over your skin. To then just go and have a shower right before you go into the sun. So with the toothpaste, you you spend two minutes putting all of that on your teeth. And then if you rinse it, then you're actually removing all of that goodness from your teeth and gums. And it's kind of like you haven't done anything.

• 1:18:12Steven Bartlett?

  Toothbrushes?

• 1:18:13Speaker 01

  Yes.

• 1:18:14Steven Bartlett?

  Which toothbrush should I use? This one or an electric one?

• 1:18:17Speaker 01

  Um, I generally prefer an electric toothbrush.

• 1:18:20Steven Bartlett?

  Why?

• 1:18:21Speaker 01

  Um, usually they kind of do the work for you. So it just means that patients have better oral health. Because most people don't know how to brush their teeth properly, actually. We're never really taught or trained, or we get taught by our parents. Our parents don't really know, they've been taught by their parents. So a lot of people don't actually know how to brush their teeth, number one. Number two, we often don't brush for as long as we think that we are. So we're meant to brush for two minutes. The average is twenty to thirty seconds. Uh, and we think that we're brushing for two minutes, but we're not. So with an electric toothbrush, it times you. And then also a pressure sensor. So the electric toothbrush often will have a pressure sensor, which will show you whether or not you're brushing too hard. Or you're brushing at the right pressure and that will reduce your chance of recession.

• 1:19:04Steven Bartlett?

  Can you show me on one of those tooth models in front of you? The area of the mouth and teeth that people most often overlook?

• 1:19:11Speaker 01

  Yes. Can I have your toothbrush? So I would say the area that people usually um struggle with the most is the insides of their very back bottom teeth.

• 1:19:23Steven Bartlett?

  So inside, where, where, next to my tongue?

• 1:19:25Speaker 01

  Basically, yeah, just near your tongue, basically. What a lot of people will do is they'll kind of, they'll go on the inside, they brush their teeth like this. Okay, whereas actually you want to get your elbow up and you want to brush a lot more at like a ninety degree angle when you're getting there.

• 1:19:39Steven Bartlett?

  It looks like you're brushing the gums a little bit.

• 1:19:41Speaker 01

  A little bit, yes. You actually do want to brush the gums a little bit. And then when we're on the outsides of the teeth, uh, we want to kind of brush at a thirty degree angle. So rotational movements and at a thirty degree angle. So not straight like a ninety degree, but kind of towards the gum margin. And by doing circular mo- uh, movements, we're essentially kind of massaging the gums and getting rid of the bacteria from under the gum and then flicking it out.

• 1:20:04Steven Bartlett?

  Okay.

• 1:20:04Speaker 01

  Yeah, so just like that. And then I always tell everyone it's really important to kind of have um a method behind your tooth brushing. So don't go like brush and then go there and then up there and you know, because you'll never brush properly. Um, so always start, let's say, on the left hand side, go do all the outsides and then do all the biting surfaces and then do all the insides and then do the same on the top teeth as well.

• 1:20:26Steven Bartlett?

  And that model there, you've got another model in front of you, which is like a see-through model. What does that show us?

• 1:20:32Speaker 01

  Um, so this is to show you um what an implant looks like. A lot of people don't know what implants look like um and how it looks like if it was within your jaw. Also what all the roots look like. And then also, if you look on the other side, you can see um this tooth, which has the black within it.

• 1:20:47Steven Bartlett?

  Yeah.

• 1:20:47Speaker 01

  Um, and it's got like a red bubble at the root of it. So this is a tooth that's had a root canal done to it and has an infection at the root of that tooth. So that's an abscess. Um, and a lot of people don't actually know what that looks like. Um, they only feel toothache, but this is what toothache is actually in their jaw.

• 1:21:03Steven Bartlett?

  When our teeth get teeths, is that the right word? Is that a plural? When our tooths, what's the plural of teeth?

• 1:21:09Speaker 01

  Tooth, yeah.

• 1:21:10Steven Bartlett?

  Yeah. When our teeth get stained.

• 1:21:13Speaker 01

  Yes.

• 1:21:13Steven Bartlett?

  What we often do is we'll take some sort of whitening toothpaste or we'll go to a dentist or a hygienist or something and ask them to whiten our teeth. Now, I've always been a bit scared of that because. There must be a cost to this whitening industry. Should we be whitening our teeth? Is there any healthy way to whiten our teeth?

• 1:21:31Speaker 01

  Yes, um, so you've got two different types of staining. One, which is extrinsic, so that's basically your coffee, your tea, your smoking. Super easy to get rid of. You just have to go to your hygienist and get a hygiene done and they'll get rid of the stains pretty quickly. Or you can try a whitening toothpaste. Be very careful with a lot of those whitening toothpaste because they can be quite abrasive and damage the enamel, actually. So it's kind of like exfoliating your teeth, but your teeth don't grow back. So if you keep on exfoliating and getting rid of that surface layer of enamel over a long amount of time, that can be quite an issue and quite problematic.

• 1:22:07Steven Bartlett?

  You get sensitive teeth.

• 1:22:08Speaker 01

  Yeah, sensitive teeth and then the underlying tooth will start to shine through and that's quite yellow. So you actually start ending up doing the the opposite of what you wanted to do. Then whitening, so you could, you should do that professionally. Don't go and buy some over the counter online thing. Because a lot of the time, either they don't have the the right percentages and they can actually damage the teeth and the gums really badly. So you want to get that done professionally. If you get it done by a good brand, and even within the professional world, there are some whitening products out there which are really bad for the teeth and others which are actually really good for the teeth. So we use one in particular, it's called Enlighten.

• 1:22:49Speaker 01

  And the whitening for one day is the equivalent of having a Coca-Cola. So thinking about it, I mean, I'm sure everyone has had one Coca-Cola in their life. Having a Coca-Cola every day for, let's say, five or six days is okay in the grand scheme of things. It's not going to massively damage your your teeth at all.

• 1:23:08Steven Bartlett?

  Okay, so there is safe ways to do it.

• 1:23:09Speaker 01

  Yeah.

• 1:23:09Steven Bartlett?

  Okay, good. And is there any way to remove plaque yourself without having to go to a dental hygienist?

• 1:23:15Speaker 01

  So you can try a water flosser.

• 1:23:17Steven Bartlett?

  I've just bought one of those things, but it doesn't feel powerful enough. Because when I go to the hygienist, I don't know what they're using, but it like, it like, it's so strong.

• 1:23:25Speaker 01

  Yeah.

• 1:23:26Steven Bartlett?

  That it like blasts my mouth off. My mouth feels so different after.

• 1:23:29Speaker 01

  Yeah.

• 1:23:30Steven Bartlett?

  And I wanted to know if I could buy one of those for my home. But I think it's a little bit dangerous.

• 1:23:34Speaker 01

  Well, the reason I think that the water flosses are not that high intensity is because people can damage their teeth if they don't use it correctly. So kind of know there are some supplements that you can take to reduce the amount of plaque that builds up. And that actually does work quite effectively.

• 1:23:53Steven Bartlett?

  I mean, what are you, there were two more there. There's a couple more things there that you have in your pile that we not talked about.

• 1:23:57Speaker 01

  These are probiotics.

• 1:23:58Steven Bartlett?

  Okay.

• 1:23:59Speaker 01

  So going back to our microbiome, probiotics are basically good bacteria. So not everyone needs them, but a probiotic essentially will put good bacteria into the microbiome. And if it's got the right environment to live in, then it will continue to grow there, basically.

• 1:24:15Steven Bartlett?

  If you're eating the right things.

• 1:24:16Speaker 01

  Exactly. If you're eating the right things, you've got prebiotics, you know, all of those types of things, then then this will be really effective. So these are two different options. This is a mouthwash. And again, on the microbiome test that we've created, ORALIS ONE, we look at all the levels of good bacteria and then we'll recommend a probiotic based on what good bacteria you are missing. So a lot of us are actually genetically, we've been born without certain good bacteria in our microbiomes. And so this is really lovely to supplement them. So this is, it's a mouthwash, but it's in a powder form. So you take a teaspoon, you mix it with some water and that activates the probiotic and then you rinse it around and you swallow it. So it's a kind of a two in one for your gut.

• 1:24:58Speaker 01

  This is a pill, so it's a tablet, you chew it and then you can swallow it. So this is a, this is super easy to, and, and I love these as well, very easy to use.

• 1:25:08Steven Bartlett?

  Victoria, what's the most important thing that we haven't talked about today that we should have talked about today?

• 1:25:14Speaker 01

  The only thing that I think you haven't mentioned that your viewers might benefit from is the use of straws. Straws are very, very important to, to use for sugar and also for acid. So drinking through a straw actually helps you bypass all of your teeth. So if you're having something acidic or really sugary, or even something staining, then it bypasses the teeth and goes straight to back of your throat. So you can swallow it. So this helps reduces your chance of decay of toothwear and also staining as well.

• 1:25:43Steven Bartlett?

  But specifically if it's bad for you, because you, I'm sure there's some things which are good for the oral microbiome that you do want to be in the mouth.

• 1:25:49Speaker 01

  Yes, yeah, yeah. So if you're taking your probiotics or whatever, then of course those are great. Like for example, you know, I'm human, I like a nice Coca-Cola once in a while and I'll drink it through a straw. Um. Or if I have alcohol, I'll also drink that through a straw as long as it's not wine, but.

• 1:26:05Steven Bartlett?

  About smoking and vaping?

• 1:26:07Speaker 01

  Um. So, yes, smoking and vaping, neither of them are good for the oral microbiome. Um. It goes back to um dry mouth. So smoking will dry your mouth out and then you don't have the saliva and the saliva can't do what it wants to. It stops um vascularisation, so it stops blood flow to your mouth. And so a lot of uh smokers actually will not have bleeding gums. That doesn't mean that they don't have gum disease, but because they um are smoking so much, the blood vessels are already really tight and constricted from the nicotine. Um. So they don't ever get bleeding gums, even though they have gum disease. Um. And then the third thing is that actually we know that smoking is very strongly associated, it's one of the biggest risk factors for gum disease.

• 1:26:51Steven Bartlett?

  If someone's now curious about their oral microbiome and the work that you're doing, what is the sort of easiest entry point? To learn more, to get themselves checked or to, I don't know, to resolve some of the issues that are causal or a consequence of having a unhealthy microbiome. Where where do they start? How do they find you?

• 1:27:11Speaker 01

  We have a clinic in central London called the Health Society. Um. We opened about a year and a half ago now, and our aim was to put the mouth back into the body, to explain to patients exactly what's going on in their mouth. And we can do that through microbiome testing, other saliva tests. Um. We look at your blood glucose levels, your vitamin D levels, we've got packages, we have an infrared sauna. We have a nutritionist and the idea is that we're working all together because one of the issues I was seeing was that patients, they want to understand what's going on in their mouth and they want to optimise it. But they don't understand a lot of what dentistry is all about. We used to live in a world where the dentist would say, okay, you need two fillings and you've got gum disease and you're not brushing your teeth. And that was the end of it. And you would just listen to them and you'd get your work done.

• 1:27:57Speaker 01

  But now we are trying to essentially decode dentistry and explain it in a way that patients can understand. So I would say, I'm biased, but come over, come to the clinic, we can explain everything. Um. Or you can do an oral microbiome test and you can actually understand yourself, what bacteria, what genetic mutations you have, what inflammation you have, what products you should start using. And then based on that, decide on what dentist you want to go to for any treatment if needed.

• 1:28:22Steven Bartlett?

  What if I'm in Australia or Canada or New Zealand or America? What can I do?

• 1:28:27Speaker 01

  So we're actually rolling out the oral microbiome test to all of those countries. So you can actually buy it at the moment through that. You just have to email us, but otherwise, you know, I'm not the only one. There are other people who are doing this type of dentistry and are thinking in this type of way. So you would have to do a little bit of research, but I guess maybe follow me on Instagram and I can give some top tips.

• 1:28:50Steven Bartlett?

  I'll link all your website, your social channels below. And if anyone wants to send you an email, you might get a couple of emails at one you now. So you've got to be careful what you wish for, but I'll put all those details below. And we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for.

• 1:29:09Speaker 01

  Okay.

• 1:29:09Steven Bartlett?

  And the question that's been left for you is what is the most important relationship in your life and why?

• 1:29:19Steven Bartlett?

  This is going to cause you problems.

• 1:29:20Speaker 01

  Yeah, I know.

• 1:29:24Speaker 01

  I would say my mother. I think that is the most important relationship for me. I think she has been one of my biggest mentors. She's been my biggest cheerleader, my supporter. She's hard on us, but that has led to me being the person that I am. And I think that if I don't have a good relationship with her, then I can't have a good relationship with other people. She's taught me respect. She's taught me how to, you know, handle myself around people. So yeah, I guess a big up to my mom.

• 1:29:59Steven Bartlett?

  Is she Iranian?

• 1:30:00Speaker 01

  She is, yeah.

• 1:30:01Steven Bartlett?

  She's Iranian, right. And your father?

• 1:30:03Speaker 01

  He is French American.

• 1:30:05Steven Bartlett?

  French American. And if we sit here in 10 years' time, what are you hoping the world looks like as it relates to the oral microbiome? People's understanding of it, the regulations? What are you hoping for, if you could wave a wand?

• 1:30:17Speaker 01

  I am hoping that the mouth is put back into the body in the sense that dentistry and medicine are fully integrated within each other. So you can go to your dentist and you can get a saliva test and that could flag up issues with your heart or diabetes. And you will go and see your diabetologist and we link everything together.

• 1:30:39Speaker 01

  Also, my other dream is that people start testing their saliva and they understand that, you know, blood is not the only way that we can understand things that are going on within our body.

• 1:30:48Steven Bartlett?

  Dr Victoria Sampson, thank you so much. I find this so unbelievably fascinating, in part because I've never heard about any of this stuff before. And I do this job, you know, I've done it quite a few times now. So I've spoken to a lot of health experts that talk about the brain, or infertility, or the gut microbiome, but never one that looks at the body and our overall picture of health through the front door or the lens of our oral microbiome. And so it's really, really inspired me. And I think sometimes on this podcast, I just love having these conversations because sometimes you just need a little bit more information about the importance of something to make even a small change in your life. And as it relates to our microbiomes, our oral health, our brain health, and all of these things, even a small change can have a big downstream

• 1:31:33Steven Bartlett?

  impact when we're talking about areas of our health where things compound over time and can either compound for us or against us. And so thank you so much for doing the work that you do and shining a light on this. Your work has been really seminal in sort of driving the conversation, but also turning the lights on to the state and importance of our oral health. And I'm sure that if we sit here in 10 years' time, you would have impacted many, many, many millions of people and their overall picture of health through the lens of their oral microbiome because of the work you're doing and the message you're putting out there. And that is quite something. So congratulations. Well done. And thank you.

• 1:32:07Speaker 01

  Thank you so much. Thanks.

• 1:32:11Steven Bartlett?

  Probably shouldn't be sharing this yet, but you are our diary of a CEO community. So I wanted to give you a small first look at a product that we're about to launch exclusively. This is the 1% diary. If you know me, you'll know that one of the most uttered phrases in the walls of my office is the 1% mindset. It is a philosophy, a mindset and a habit that has absolutely changed my life. And if you ask me, it is the reason that this podcast has grown in the way that it has. By understanding the power of compounding 1%, you can absolutely change your outcomes in your life. It isn't about drastic transformations or quick wins. It's about the small, consistent actions that have a lasting change in your outcomes. So two years ago, we started the process of creating this beautiful diary,

• 1:32:56Steven Bartlett?

  and it's truly beautiful. Inside, there's Lots of pictures, lots of inspiration and motivation as well, some interactive elements. And the purpose of this diary is to help you identify, stay focused on, develop consistency with the 1% that will ultimately change your life. We have a limited number of these 1% diaries. If you want to do this with me, then join our waiting list. I can't guarantee all of you that join the waiting list will be able to get one, but if you join now, you have a higher chance. The waiting list can be found at thediary.com. I'll link it below, but that is thediary.com.