Dental Directory - Ask the Dentist

Doing our part to slow the spread by staying home and keeping our bubble small. How are you spending your holiday?

Pastured pork ribs, Brussels sprouts with duck fat and cold smoked bacon with lemon zest, and a Caesar salad #christmasmeal #paleochristmas

Day after Halloween: a patient pulled out their crown with a sticky caramel. Photo shared with their permission of course. Be careful out there, folks!

What’s in a dentist’s candy stash? Dark chocolate (70% minimum, work your way up to 80%) Xylitol gum that’s free of sugar and aspartame to encourage saliva production and remineralization (see my stories for the one I recommend) Keto Cups (growing up I used to LOVE Butterfingers and PayDay bars, but these are more satisfying and taste better)... Some things you won’t see me doing... Passing out toothbrushes - better to wait at least 30 minutes before brushing since enamel is weak after the acid attack from candy. Engaging in candy worship culture - I’m putting all my energy behind dressing up, carving pumpkins, and watching the Great Pumpkin Charlie Brown movie with my 3 year old granddaughter. I want her to have lasting memories of the fun we have together, not the candy binge. Eating dried fruit as a healthier substitute for candy. Better to just eat the real thing IMO. Dried fruit is super concentrated in sugar and just as sticky as some caramels - a double whammy for teeth. Make sure to drink tons of water tonight (buffers the acid attack on teeth) and HAPPY HALLOWEEN!

Christmas Eve in California means sunny skies and firing up the pizza oven! Toppings will include heirloom tomatoes from the garden + mushrooms + pasture raised pork, buffala cheese + pasture raised egg Wishing health, gratitude and REST to everyone!

What could possibly be better than a delicious, satiating, nutrient-dense breakfast that includes the proper ingredients to balance your microbiome? Nothing. That’s why I’ve created this Microbiome Omelet so that you can fuel your body with the right foods to keep you healthy, happy, and thriving! Serrano peppers: Serranos contain capsaicin, the compound that gives the peppers their spice factor and anti-inflammatory properties. And in relation to the microbiome, a recent ...study found that capsaicin can prevent microbial dysbiosis. Shiitake mushrooms: Shiitakes are rich in vitamins and minerals, including niacin, vitamin B6, and pantothenic acid. Additionally, research has shown that shiitake mushrooms have antimicrobial effects that can lower the amount of gingivitis-causing bacteria in the oral microbiome, while still protecting beneficial bacteria. Leeks: Leeks help fight inflammation and infection and are a great source of vitamins K and A. They also contain prebiotics that feed beneficial bacteria and help to balance the microbiome. Cilantro: Cilantro has detoxifying and antibacterial compounds that can help balance the oral microbiome. Ghee: Packed with fat-soluble vitamins, such as A, E and K, ghee can help reduce leaky gut (which is often related to an imbalance in the oral microbiome) and IBS symptoms. Recipe: 1 Saute the vegetables in olive oil until slightly brown and add liquid or coconut aminos and set aside. 2 Thoroughly wash fry pan used for cooking vegetables. Put fry pan back on stove and add ghee. 3 In a small bowl, lightly stir eggs (do not mix yolk and egg white completely). Pour in egg mixture. Add 4 slices of cheese onto eggs, if desired. 4 Add veggies and cooked pork on top when eggs are almost fully cooked and fold over omelet. 5 Top with basil pesto and cilantro and add sea salt and pepper to taste!

I'm going live with Dr Steven Lin to talk about my book, functional dentistry, and the connection between grinding and sleep. Join us!

It’s a difficult year to practice gratitude. Dentistry got hit hard. I miss my daughters and my granddaughter. I miss my friends, concerts, travel... Friends and neighbors had to evacuate and lost their homes in the Glass Fire. Many loved ones have passed away this year too. I’ve seen a lot of suffering - both in those who’ve had the virus and also those who’ve made sacrifices by staying at home and not seeing loved ones. Something I’m reflecting on today is how the practice... of gratitude is ever more important during this global pandemic. Despite the shutdowns and the virus, we launched The Functional Dentistry Directory in March and have connected hundreds of functional dentists globally with new patients seeking this type of care. I’m grateful for all of you - your questions and your interest which make this platform what it is. The opportunity to share knowledge and reach an audience beyond my practice here in California is something I had never imagined. I’ve been fortunate to connect (virtually) with new and old colleagues who are advancing the field of functional dentistry, and who have made this career I love so much new, exciting and meaningful again and again. I am grateful to know you and learn from you. Apologies, I know I’m missing some folks in this list @drvictoriasampson @doctor_staci @mrjamesnestor @dhrupurohit @drmarkhyman @cassnelsondooley @sarah_k_hornsby @fuel_my_smile.dds @roneshsinhamd @corylrodriguez @ebrahimianintegrativedentistry @drkarafitzgerald @organic_olivia @dr.danenberg @fluoridealert @codykriegeldds Above all, I am grateful to my wife and high school sweetheart @roseannelizabeth and this incredible life we’ve built together - challenges and all. What are you grateful for?

Teeth are ALIVE! This may come as no surprise to you, but I like to remind my patients of this, because it's a reminder that we have the opportunity to NOURISH our teeth with the foods we eat. Teeth are not inanimate. After they erupt, they are dynamic and can just as much be harmed physiologically as they can heal and grow new tissue. We talk a lot about the OUTSIDE environment to keep teeth healthy - like pH, acids, dry mouth...but it's also important to remember tha...t what we eat affects the tooth's ability to be able to remineralize itself as well. Cavity prevention is dependent on a diet that is rich in the nutrients that teeth need: Magnesium Vitamin K2 Calcium Vitamin D3 Vitamin A Get the right nutrients on board, and your teeth will be strong enough to fight off decay and remineralize themselves. Start to cut out fermentable carbohydrates and processed foods that increase the acid attacks in the mouth, and you enable your teeth to better defend themselves and remineralize. For more cavity prevention tips, check out my downloadable guide, where I outline everything I know about how to prevent and even reverse small cavities (LINK IN BIO). Now, I’d like to know: What foods on this list surprised you? Drop me a comment See more

Time for an upgrade to your dental routine. Here are three easy, high impact swaps you can make (join my newsletter to get the rest of my tips for healthy dental swaps!) 1 Instead of fluoride, why not try #hydroxyapatite, which is proven in studies to be just as effective but is safe enough to swallow? I recommend it for everyone, and especially for sensitivity, cavity prevention, or whitening. 2 Instead of fumbling with floss, why not try a flossing stick? I’m a...ble to floss one-handed, while scrolling Instagram, when using a flossing stick, which means I’m way more likely to floss at the end of a long day. 3 Instead of mouthwash, which disrupts the balance of healthy bacteria in the mouth, try mouth tape at night. It’ll help to reset the oral environment by keeping it moist, and help prevent cavities because a tooth bathed in saliva is a happy tooth. And a moist mouth helps promote a healthy #oralmicrobiome. What swaps have you made? And have you noticed any changes? See more

For all the moms who ask if they should stop breastfeeding because of cavities risk, check out this study which found... Breast milk components inhibit growth and attachment of bacteria such as the caries pathogen S mutants Breast milk likely affects establishment of the oral and gut microbiome The oral microbiome develops from sterility at birth into one of the most heavily colonized parts of the human body ... Breast milk does not make a child immune to cavities. Infants exclusively breastfed are not immune to decay. But studies like this one are demonstrating that breastfeeding has a tremendously important role in establishing the oral microbiome, the second largest microbial community in the body after the gut. Every time we swallow, we are seeding our gastrointestinal tract with bacteria, fungi and viruses from the mouth140 bullion per day, to be exact. The finding that the oral microbiota differs between breast-fed and formula-fed infants, with a potentially more health-associated oral flora in breast-fed infants, indicates the value of prospective longitudinal studies where health outcomes, primarily early childhood caries but possibly also gut microflora and associated health conditions, are evaluated. See my blog askthedentist.com for more info on how breastfeeding impacts dental health, including a great guest article by lactation consultant @sfwombyn and also see today’s stories takeover by oral microbiome researcher and mom @cassnelsondooley for some great tips See more

"Myofunctional therapy" is one of the most undersung heroes in dental and sleep health. Many people don't even know what it IS, much less why it matters. This therapy is an exercise in learning proper lip, tongue, facial, and airway posture. For instance, myofunctional therapy is HUGELY beneficial for re-learning correct tongue posture after a tongue tie release. Problems that myofunctional therapy can address are problems that I discuss with adult readers and patients of...ten. No one is too old for myofunctional therapy, but if it's utilized for children, it can make a lifelong difference in oral health and sleep quality. Want to know what to do next? Watch my full hour-long interview with Sarah Hornsby. If you have kids, I guarantee this will be a must-watch video! The description includes links to several resources provided by Sarah, including a way to set an appointment with her and her team. https://youtu.be/_7Gy064f4BA

Good sleep position is all about following the position of your spine and airway. Having your neck positioned poorly can leave you waking up achy and tired, both from bad posture AND disordered sleep breathing. So, for the best sleep, position your pillow and head so that your neck and the top of your head are in a straight line with your spine. Oh, and make sure to sleep on your side, not your back or stomach. How do you sleep?

I talk about mouth taping quite a bit, and it's one of the topics I get more questions about than any other! Above are some of the questions I hear most often. This habit is certainly one that takes some getting used to! But I'm telling you now, the benefits are WORTH IT! Check out my article for many more details: https://askthedentist.com/mouth-tape-better-sleep/

Ever heard your mouth's pH is too acidic? Beyond diet, I've developed a mouth rinse that can help you raise the level to a more oral health-friendly number. Calcium carbonate, baking soda, and blue green algae are all ingredients that support a more alkaline pH. Xylitol is a remineralizing agent, so it's a good thing to add to your saliva for strong teeth. WHEN should you use this? Rinse with this in the morning AND/OR after eating sugary, acidic, high-carb, or highly pro...cessed foods. It can help rebalance the acidic pH otherwise left behind by those kinds of foods. Should you REFRIGERATE this? Yes, it will keep for about 16 days (16 servings) in the fridge. Don't leave it on the counter. Is the XYLITOL required? No, if you'd like to leave it out or replace it with your favorite sweetener, it's not vital to the pH balancing benefits of the mouth rinse. I'd love to hear about your results and what DIY you'd like me to try next! Here's the link to the full recipe: https://askthedentist.com/diy-ph-balancing-mouth-rinse/ See more

Toothpastes and mouthwashes are often not made with the oral microbiome in mind. For instance, think about how many products openly advertise their "antibacterial benefits"? Mouthwashes are, generally, not all that useful. However, if you like to continue the habit with something healthier, I do like @risewellco's formulation just make sure to use it AFTER brushing, not before. Toothpaste, on the other hand, can offer some great benefits, if you pick a good one. Here's... what I look for in a toothpaste: AVOID: FLUORIDE: neurotoxin, harmful particularly if swallowed, may interfere with oral microbiome TRICLOSAN: pesticide + hormone disruptor SODIUM LAURYL SULFATE: can cause canker sores ARTIFICIAL COLORS: linked to hyperactivity in kids; NO, your toothpaste doesn't need to be blue!) TITANIUM DIOXIDE: limited evidence of increased cancer risk HIGH ABRASIVITY: can cause microabrasions in enamel HYDROGEN PEROXIDE: increased cancer risk at high concentrations; unnecessary in toothpaste TETRAPOTASSIUM PYROPHOSPHATE: ingredient meant to prevent tartar formation that does not work ACIDS: may decrease pH of the toothpaste CARRAGEENAN: can cause stomach discomfort, especially in people with existing gut problems "ANTIBACTERIAL" ON THE LABEL: antibacterial ingredients do not support your oral microbiome LOOK FOR: HYDROXYAPATITE: to strengthen enamel and support remineralization ERYTHRITOL/XYLITOL: to support remineralization and prevent plaque formation COCONUT OIL: to reduce inflammation BAKING SODA: to support alkaline pH ORAL PROBIOTICS: good for DIY toothpaste to add a boost to the oral microbiome PREBIOTIC INGREDIENTS: to give the good bacteria food to feast on GREEN TEA: to support gum health and overall oral health ALKALINE pH (7.0 or higher): an alkaline toothpaste is required for a healthy mouth Not sure about manufactured toothpastes? Try a DIY recipe! Here's an article on what to avoid in toothpaste, plus some DIY options: https://askthedentist.com/diy-toothpaste/ See more

A study published recently investigated why sleep apnea is associated with early-onset Alzheimer's disease. That's the disease that took my mom, so this topic is very close to my heart. The study, published in JAMA Neurology, found that amyloid plaques a classic sign of Alzheimer's were found in the brains of patients with sleep apnea. Using PET and MRI scans, they were able to see the parts of the brain that were most affected when sleep is interrupted.... Participants of this study did not self-report cognitive and sleep difficulties or excessive daytime sleepiness. It's a cruel irony that the part of the brain (precuneus) that is affected most by poor sleep is telling the body that all is well! What are signs of disordered sleep breathing? (If you know you're at risk for Alzheimer's, DO NOT IGNORE these signs!) Apneas, or periods of time when you stop breathing at night (your partner may help report these) Snoring Gasping for air while you sleep Multiple arousals during the night (like going to the bathroom several times) Waking up tired Dry mouth (due to sleeping open-mouthed) Frequent tossing and turning Teeth clenching and/or grinding (bruxism) Morning headaches Falling asleep too fast (within 5 minutes or less) Daytime sleepiness Falling asleep unintentionally throughout the day What do you do when this happens? Check out my book for a full breakdown of how to work with the various specialists that can help get to the root of your issues: https://askthedentist.com/the-book/ See more

Vitamin K2 is one of the most confusing supplements I recommend people take for strong teeth and bones. So, let's remove the mystery. Vitamin K2 is NOT the same as vitamin K1. Unlike K2, vitamin K2 has no unsafe upper limit that's ever been tested. (Translation: you don't "overdose" on vitamin K2.) The easiest food sources to find of high vitamin K2 foods are mostly grass-fed/pastured animal products like eggs, meats, and cheeses. HOWEVER, the Japanese fermented so...y food natto actually contains the highest concentration of vitamin K2 of any food. It's just hard to find outside of Japan! Vitamin K2 supplements are made with two very different strains: MK-4 and/or MK-7 (some supplements contain only one; others contain both). MK-4 is a synthetic vitamin K2. Because of its very short half-life, MK-4 must be taken in much larger doses than MK-7. The "therapeutic" dose of MK-4 is 4500 micrograms/day, and it must be taken 3 times a day for therapeutic benefit. MK-7 is a natural vitamin K2 from natto. Effective daily dosage is between 90-120 micrograms/day, and you only need to take it once a day for therapeutic benefit because it has a longer half-life than MK-4. Vitamin K2 should always be taken with vitamin D3 (either in the same supplement or two different supplements). Too much or too little of either one, especially if you take calcium supplements, can cause health issues. Because many federal agencies limit vitamin K1 intake (due to overdose issues) and have yet to distinguish these separate nutrient dosages, some countries do not allow the sale of MK-4 supplements with more than 120 micrograms. But for MK-4, that's only 2.6% of the recommended daily therapeutic dose. That's why MK-7 is often the preferred choice. If you're as fascinated by this science as I am, I encourage you to check out Kate Rheaume-Bleue's book "Vitamin K2 & The Calcium Paradox". https://askthedentist.com/product/calcium-paradox/ Quicksilver Scientific D3+K2: https://askthedentist.com/product/d3k2/ Relentless Improvement Vitamin K2: https://askthedentist.com/product/vitamin-k2/ See more