The Weekly Thread: why oral health is critical for longevity, understanding your mouth’s microbiome, and why you shouldn’t depend on any “thing” for your happiness.

Oral health, and its importance and overall impact on total health, is an area I’ve been diving deeper and deeper into over the past couple years. 

Did you know that poor oral health is linked to an increased risk of Alzheimer’s?

And that those with periodontal disease (gum disease) have a 2-3 times greater risk of having a heart attack and all cause heart disease?

This week I’m going to kick off a multi-week segment and deep dive on oral health where I break down what actually causes tooth decay and gum disease, how to avoid it, and how to improve your overall oral health, and not just reduce your risk of tooth decay and gum disease, but other far more serious diseases as well. 

Which oral health type are you?

You can probably fit most people, this includes you if you’re reading this, into 1 of 3 categories when it comes to how you view oral health. 

1️⃣ The first is probably somewhat maniacal about it. You brush often throughout the day, floss very frequently, maybe rinse with an antiseptic mouthwash multiple times per day, and are no stranger to whitening strips. 

2️⃣ The second is more of a middle ground type of person when it comes to oral health. You brush 1-2 times per day, probably floss, but infrequently (as let’s be honest, creating the habit of consistent flossing seems to be about the most difficult thing in the world), and maybe rinse with an antiseptic mouthwash in the AM or PM. 

3️⃣ The third doesn’t place much of an emphasis on oral health. If you get a cavity, eh, you can just get it filled. You brush, maybe even floss very sporadically, but nothing is consistent enough. 

As you can probably assume, the third type is least ideal for oral health, however, you might be surprised to find out that there’s a good chance that the first person, the individual who is maniacal about their oral health, may also be doing more damage than good with their habits. 

I’d like to throw a fourth type of person into the mix. This is probably the most uncommon of all the oral health types, but hopefully will be a growing segment of the population. This type of person views their mouth as its own unique, living bacterial environment, complete with its own organ system (each individual tooth has its own connection to nerves and blood vessels), and maintaining its health and subsequent homeostasis is a major component of overall health and wellness. (More on this later)

In fact, Dr. Andrew Huberman of Stanford University, and of the wildly popular Huberman Lab Podcast recently added “Oral Health” as one of his “8 Pillars of Mental & Physical Health”, and was a tremendous resource in providing further and deeper insights into a subject matter I was already learning and becoming more passionate about. 

DISCLAIMER: This should come as no surprise to you, but I feel like I have to mention it; I am not a dentist, nor do I proclaim to be one on the internet. As with all of the information, research, and thoughts I share with you via “The Weekly Thread”, I am merely a human optimization enthusiast, sharing information with you, and sometimes lending my own personal insights. All information shared is just that, purely informational, and is not intended as advice. You are an intelligent adult capable of making decisions based on your health that are best for you, and I am merely sharing with you, and trying to arm you with more information to make the best decisions on your health for yourself. Okay, let’s dive in…

Your Teeth Are Always in a State of Remineralization or Demineralization

This is a see-saw, an either/or scenario, there is no middle ground. 

As you can reasonably assume from the sound of it, you probably want your teeth in a state of remineralization versus demineralization. 

If you were making that assumption, you would be correct. 

Hydroxyapatite is the biomineral that bonds bone and teeth.

Your teeth are essentially held together by a combination of minerals known as hydroxyapatite, that form very strong bonds, thus helping to maintain the integrity of your teeth. 

When your teeth are in a state of demineralization (de-min), these bonds are being weakened, thus making your teeth susceptible to decay. This is how cavities are formed. 

Conversely, when your teeth are in a state of remineralization (re-min), these bonds are being strengthened, thus maintaining the integrity of your teeth, and preventing tooth decay. 

In fact, if you have minor cavities (meaning they haven’t gone too deep, and down into a layer beneath the enamel called “dentin”) you can actually repair and reverse cavities through remineralization. 

So clearly, you want to keep your teeth in a state of remineralization. 

Since you are either in a state of re-min or de-min, and there is no middle ground, to be in a state of re-min, you must therefore, avoid a state of de-min. 

The Root Cause of Demineralization

The short answer is a net acidic environment in your mouth. 

This goes well beyond not drinking lemon water, coffee, tea, or wine. 

Not eating or drinking acidic foods or beverages thinking you’re going to all out prevent demineralization of your teeth would be like putting a band-aid on a giant, gaping open wound, and expecting it to heal. 

The goal is a net positive of time spent in a state of re-min versus de-min. 

Hypothetically speaking, let’s say your mouth is in a state of re-min for 14 hours, and subsequently in a state of de-min then for 10 hours, that theoretically results in a daily net positive of time spent in a state of re-min, and should mean no net tooth decay. 

Using the above example, let’s say you spend 30 minutes sipping an acidic drink like coffee or tea. Yes, you are creating an acidic state in your mouth, and thus a state of de-min potentially, however, it’s only for a more brief period of time. I’ll get more into what to do and what not to do in future segments. 

 So reeling this back in, the goal is to have a net positive of time spent in a re-min state on a day-to-day basis. 

The biggest culprit of causing an acidic environment in your mouth, and thus a state of de-min, is a specific bacteria called Streptococcus mutans, or Strep. mutans.

Sugar Does Not Directly Cause Tooth Decay

We’ve always thought, and probably been told that sugar causes tooth decay. 

This is not directly the case. 

You see, as so many of these nasty pathogens that can live inside us do, Strep. mutans LOVES to consume sugar. 

And when you feed it with sugar, and this goes for any carbohydrates, including healthier options like whole grains, starches from potatoes and roots, and fructose from fruit, it produces an acidic gas, which then creates a net acidic environment in your mouth, and thus puts your teeth into a state of de-min. 

This is the biggest cause of demineralization, and thus tooth decay.

Like your gut, your mouth has its own microbiota

A microbiota is the specific microorganisms that live in a particular site or habitat.

In other words, a microbiota is a specific bacterial environment. 

Your mouth is its own unique bacterial environment, much like your gut, and your skin as well. 

As with all microbiota, there are good bacteria, in the gut, we refer to these as “probiotics”, and there are bad, or potentially harmful bacteria often referred to as “pathogens”. 

Strep. mutans for example, is a harmful bacteria that we want to keep at bay. The more pathogens, including Strep. mutans, are held in check, the less potential damage, or even disease, they can cause. 

Just like in your gut, your skin, and all other unique microbiotas of the human body, the way to keep harmful, potentially pathogenic bacteria in check, is with an abundance of beneficial bacteria that help maintain homeostasis.

When you lose homeostasis, you then have dysbiosis. 

Dysbiosis is an imbalance between the microorganisms in a particular system. 

We typically use the term dysbiosis when the imbalance is for the worse, and there is an abundance of potentially harmful or pathogenic microorganisms in a system. 

And again, just like in the gut, and on your skin, you want to avoid dysbiosis in your mouth’s microbiota, as that can increase the likelihood or rate at which tooth decay, gum disease, and plaque buildup can occur. 

Remember at the very beginning of this segment when I mentioned the links to poor oral health and increased risk and rates of Alzheimer’s and all cause cardiovascular disease?

Well, a major cause of this link is a result of the plaque that can build up in your mouth as a result of poor oral health. 

What is plaque exactly?

A substance that forms when food and organic matter in your mouth combine with yup, bacteria. 

Your mouth is a direct entry point for most things into the body, so if you have an increased amount of plaque in your mouth due to poor oral health, you better believe that it is making its way into your body and going systemic; thus creating potential plaque buildup in your blood vessels, your brain, and also introducing a host of potentially pathogenic bacteria into your bloodstream. 

TAKEAWAYS

As we close out the first part of this segment, and move into the “what to do’s” and “what not to do’s” next week, there are two critical takeaways and points to understand. These takeaways provide the foundation and understanding of the distinction between “true oral health” and simply “oral care”:

• Your mouth is always EITHER in a state of remineralization or demineralization. There is no middle ground, and the goal is to have a net positive of time spent in a state of remineralization on a day-to-day basis. Ideally, through this understanding, you can take measures and create habits that over time, continually increase the amount of time your teeth spend in a state of remineralization on a day-to-day basis. 

• Your mouth is its own, unique bacterial environment called a microbiota. As with all microbiotas, a loss of health, or homeostasis occurs when potentially harmful microorganisms begin to increase in abundance and take over in what is known as dysbiosis. When dysbiosis occurs in your mouth, the rate at which tooth decay, gum disease, and plaque buildup can occur increases. This can have ramifications far beyond your mouth health, and can increase risk of more serious diseases. Therefore, maintaining homeostasis, and an abundance of beneficial bacteria in your mouth is your best line of defense against dysbiosis. 

I do not depend on you for my happiness 

This is an effective, and can be a very powerful exercise. 

Simply walk through your house, and you should be able to look at everything you own, think about not having it, and be able to say:

“I do not depend on you for my happiness”. 

This is a great way to gauge the perspective you have in life, your purpose, and where your priorities lie. 

Push yourself, look at some of your most expensive, most cherished “things”. 

Sure, some of these things may bring you happiness and joy in various ways, or may even have some sentimental value, but, the question is, could you still be happy, or find that joy elsewhere if you didn't have them?

If you want to go deeper on this, you can think of your loved ones. 

If you lost a child, a spouse, which I know, is a terrible, tragic thought (luckily this is just an exercise on purpose), moving beyond the obvious heartache and tragedy, could you still be happy?

Sad, devastated, missing them tremendously, no doubt. 

But could you still find happiness and joy in life, despite the heartache and tragedy with time?

Sometimes the heaviest of thought experiments can be the most impactful. 

The actual thought of losing a loved one can make you love them a little harder in the moment, and the thought of losing or not having your things, can help provide some greater perspective on what’s truly important to you.