How To Improve Oral Health & It’s Critical Role In Brain & Body Health

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Key Takeaways

• Oral health is so important, that Huberman is adding it to the 6 pillars (now 7) of mental health, physical health, & performance (the others are: sleep, sunlight & light exposure, nutrition, exercise, stress management, socialization/connection)
•  “Oral health is inextricably linked to all aspects of brain and bodily health both in the short term and long term and is perhaps the most overlooked aspect of mental health and physical health.” – Andrew Huberman
• Cavities are not caused by sugar or food – they’re caused by bacteria that feed on sugar (and carbohydrates, even complex carbs like oatmeal)
  • The bacteria is communicable and can be spread by kissing, sharing drinks, etc. but is unavoidable
• Key point: The time your mouth is net acidic or net alkaline, and the time you are in a demineralization or remineralization state is the driving factor that dictates the degree to which cavities have a chance to form
• The dose makes the poison with overall fluoride ingestion
  • At low doses: was discovered to replace some of the hydroxyapatite bonds in teeth and make them strong
  • At high doses: there are concerns about potential thyroid health and brain health disruption
• Consider removing alcohol-based and antiseptic mouthwash from your oral care routine!
  • They deplete components of the mucosal lining of the mouth and disrupt healthy components of the oral microbiome
• Can chewing gum or mints kill cavity-causing bacteria? Yes, if they are xylitol-based
• For overall oral health, avoid: alcohol, smoking (anything), stimulants, dipping tobacco, sugar, acidic foods, or anything that changes the pH of saliva
• Simple tips for better oral health: (1) keep the mouth as basic as possible (or less acidic); (2) keep the mouth moist by nasal breathing as much as possible; (3) going stretches without food or drink for periods can promote saliva production that’s the right pH for remineralization
• Brush with a soft bristle brush! Be sure to brush your gums too
  • Brushing your tongue? Consider using a separate brush to avoid cross-contamination of bacteria
• Home option for non-commercial toothpaste: baking soda and water mix will effectively remove the biofilm
• Home option for non-commercial mouthwash: high salinity solution (salt & water), rinse, and spit – don’t swallow!
• We should all brush & floss 2-3x per day but if you’re going to do it just once, nighttime is best (not morning as you might think)
  • Very little saliva is produced at night

Introduction

Dr. Andrew Huberman, Ph.D. is a Professor of Neurobiology and Ophthalmology at Stanford University School of Medicine. His lab focuses on neural regeneration, neuroplasticity, and brain states such as stress, focus, fear, and optimal performance.

In this episode of Huberman Lab, Andrew Huberman discusses the importance of oral health for dental health, microbiome health, and general physical and mental well-being. Learn science-supported protocols for strengthening teeth and gums, best practices for oral hygiene, and the relationship to overall health and longevity.

Host: Andrew Huberman (@hubermanlab)

7:13 – Oral Health Quiz

• Which category do you best fall into?
  • 1: brush & floss 2x every day and make an effort to keep teeth clean, like them clean, enjoy fresh breath, and maybe use mouthwash or gum
  • 2: a little more passive about oral care; mostly brush & floss once per day; sometimes go to the dentist; maybe brush 2x per day but rarely floss
  • 3: extremely diligent about toothcare and oral health; aware of how to keep oral microbiome healthy, etc.
  • Most people either fall into category 1 or 2
• If you are in category 1 or 2, you might be keeping your teeth clean and white but might be depleting other areas of your oral health
  • Interestingly, more is not better when it comes to oral health – some in category 2 might be better off than some in category 1

14:38 – Anatomy & Physiology Of Teeth & Mouth

• Enamel: the outer layer of teeth; it’s not white, it’s translucent
• Dentin: below the enamel; cavities form from the outside, in
• You can repair cavities that have started to form – your teeth are constantly in a state of either demineralization or remineralization
  • Remineralization is good; it’s the process by which the enamel adds new minerals that form robust chains that may potentially fill in cavities that have started to form (especially if cavities haven’t reached the dentin layer)
    • You can support remineralization by keeping saliva healthy (more on this later)
  • Demineralization is bad;
• The amount of saliva produced in the mouth & mineral content of saliva determines pH of your mouth and whether the mouth is in a state of demineralization or remineralization
• Next to teeth, you have gums (gingiva) which provides an important role in keeping the teeth stable and in place
  • The gums form a barrier between the oral cavity and bone and into the bloodstream of the body
  • The gums are effectively a seal between the oral cavity, bone, and bloodstream; because your mouth is a moist, warm environment, it’s ripe for bacteria to thrive
• Keeping the saliva healthy (and pH right) is critical to fighting off bacteria, & recovering from cuts or burns
• By supporting tooth health, you also support gum health which is critical to warding off bacteria from entering the bloodstream

28:51 – Cavity Formation, Bacteria, Sugar, Acidity

• Cavities are holes into the enamel; if they make it to the dentin layer, they need to be drilled and filled
• We want to keep teeth in a state of remineralization by keeping pH such that saliva supports remineralization
• Cavities are not caused by sugar or food – they’re caused by bacteria that feed on sugar (and carbohydrates, even complex carbs like oatmeal)
  • These bacteria then produce acid that burrows down into the tooth
  • More surprisingly, the bacteria is communicable meaning you can get it from kissing, sharing bottles or food, etc. – almost all adults carry this bacteria
  • The bacteria will either take your teeth from remineralization to demineralization or will capitalize on the demineralization state  
• Acidity is bad for the mouth; we want the mouth to be as alkaline as possible
• Key point: The time your mouth is net acidic or net alkaline, and the time you are in a demineralization or remineralization state is the driving factor that dictates the degree to which cavities have a chance to form
• No one can avoid having your mouth be acidic at times or eating a food the bacteria can feed on and produce cavities – the key is trying to reduce the amount of acid

35:10 – Understanding Remineralization & Fluoride

• Bonds that form while teeth are in remineralization are particularly strong
• Hydroxyapatite: the naturally occurring mineral responsible for remineralization bonds and healthy teeth
  • These bonds are very strong but not indestructible – acid breaks these bonds
• Fluoride was discovered to replace some of the hydroxyapatite bonds in teeth and make them strong
• It was decided that the addition of fluoride in drinking water and toothpaste would be useful because it creates super-physiologically strong bonds – BUT – there is a debate about fluoride
  • Some believe fluoride can disrupt thyroid health, brain health
  • The dose makes the poison
  • In California, people want fluoride removed from drinking water; at the same time, parents in Buffalo, NY are suing for lack of fluoride in drinking water
  • If you are concerned about fluoride in drinking water, filter water
• We would be better served if we focused more effort on the remineralization state of our teeth and the health of our mouth to reduce the likelihood of them becoming a health hazard

43:58 –Don’ts Of Oral Health

• Bad for your teeth, bad for your mouth, bad for your brain and body:
• Alcohol (don’t consume more than 2x per week; try to consume zero)
  • Alcohol puts the mouth in a demineralization state and kills some healthy cells of the mouth
• Stimulants (anything that increases epinephrine and norepinephrine)
  • Stimulants change the pH of saliva so the mouth is more acidic and teeth are pushed into a state of demineralization mode
  • Stimulants encourage mouth breathing because the mouth becomes drier; this also pushes the mouth into a demineralization state
  • Stimulant examples: modafinil, Adderall, caffeine, etc., and of course harder things like meth
• Smoking cigarettes, cannabis, and vaping
• Dipping tobacco
  • Can be pro-cancerous to the gum tissue and can cause degradation of gum tissue and even underlying bone
• Sugar
  • Try to rinse your mouth after sugar intake or better, brush
• Acidic foods
  • Some people & dentists suggest drinking acidic drinks like lemon water with a straw
  • The amount of time the milieu of the mouth is acidic is what causes damage
• Eating anything changes the pH of saliva; having a period you’re not eating or drinking anything can promote remineralization

1:03:23 – Proper Teeth Brushing & Flossing

• Purpose of brushing teeth: break up biofilm layer that allows bacteria to thrive
  • You can remove biofilm and plaque with brushing; tartar is the harder stuff that forms and has to be scraped by a dentist
  • Tooth polishing makes the surfaces of teeth smooth to make it harder for biofilm to form so bacteria can’t adhere as regularly
• Critical tip about timing of teeth brushing: you produce much less saliva overnight; if you’re going to brush & floss just once per day – nighttime is the best time (not morning)
  • Of course, 2-3x brushing & flossing in 24hour period is best
• Tips for proper teeth brushing
  • Use a soft toothbrush
    • You’re far more likely to cause harm to your gums with anything harder
  • Don’t apply too much pressure if using an electric toothbrush; brush teeth and gums lightly – there’s a lot of blood flow to gums
    • Brushing gums lightly can promote less sensitivity
• Flossing: Flossing is about removing food products from between the teeth
  • Tip: glide down the side of the tooth, get down underneath the gum, use circular motion, and lift up
  • If gums bleed when you floss correctly, try to floss 2x per day; if you can only floss 1x per day, make it at night not in the morning
  • A Waterpik is better than more typical floss

1:14:23 – Xylitol: Changing The Chemistry Of Your Mouth

• Xylitol: artificial sugar, very low-calorie sweetener; interestingly, when bacteria eat xylitol, it dies
  • Xylitol inhibits the proliferation and growth of mouth bacteria; it also reduces inflammation of gum tissue
• Chewing xylitol mints or gum after meals can be a big step toward improving the chemical milieu of the mouth and inhibiting the proliferation of cavity-promoting bacteria
  • Xylitol gum further increases the production of saliva
• Xylitol may also have positive benefits on the gut microbiome
• Side effects: no known side effects but don’t overdo it
• Check out: Zellies’s Xylitol

1:22:38 – Toothpastes & Mouthwashes

• Toothpaste with or without fluoride? It depends on your comfort level with fluoride
  • If you are seeking a non-fluoride toothpaste, most contain hydroxyapatite and/or xylitol – check out Biöm
• Most all mouthwashes (especially those with alcohol) are terrible for oral health! They deplete components of the mucosal lining of the mouth and disrupt healthy components of the oral microbiome
  • Consider whether they’re helping or harming, and their role in your oral care
  • Be cautious about mouthwashes with alcohols and antiseptic (sometimes prescribed)
• Alcohol-based mouthwashes are known to reduce or deplete the amount of nitric oxide produced in the oral cavity which is important for the promotion of vasodilation in the oral cavity and throughout the body
• Home option for non-commercial toothpaste: using baking soda and water would scrub off biofilm and is safe for the enamel of teeth
  • Some use a mix of baking soda, water, and hydrogen peroxide instead of mouth wash but this is not a good idea! Hydrogen peroxide is too abrasive for the mouth cavity and can cause canker sores or mouth ulcers
• Home remedy for non-commercial mouthwash: swish a high salinity solution with just salt and water – be careful not to swallow!

1:34:52 – Relationship Between Gut Microbiome & Oral Microbiome

• There’s a clear link between gut microbiome and oral microbiome
• The best way to support a healthy gut microbiome is to consume 1-4 servings of low-sugar fermented foods per day
• Getting enough sleep each night is critical to support the health of the gut microbiome, oral microbiome, and overall brain & body

1:37:47 – Tongue Care & Toothbrush Care

• Tongue scraping can be a good idea but lightly brushing may be better than scraping
• Tip: use a separate toothbrush to brush your tongue than you use to brush your teeth
  • Why? You want to prevent cross-contamination of bacteria across areas
• Bacteria are growing on the toothbrush when it’s wet – try to rinse after using and not let it touch anything else

1:41:38 – Teeth Sealants, Metal Fillings, Root Canals

• Sealants are a better alternative to having deep cavities in teeth
• If cavities get down to dentin layers, they’ll likely need to be drilled & filled
  • Ask how deep the cavity is next time you get one – you may be able to remineralize without filling it with some home practices
• Old-school lead fillings are bad! Silver fillings may contain mercury but the practice is to leave them in and try not to disrupt them (even by chewing a hard candy or sticky gum)
  • Metal fillings will cease to be used in Europe soon, maybe the U.S. as well
• Root canals are needed when a cavity drills too deep in the tooth

1:48:43 – Dentist Visits, Daily Routines, Oral Health

• Going to the dentist 2x per year for routine cleaning makes sense to remove existing bacteria plaque and tartar – but the real work happens at home between the appointments
• Aside from reconstructive surgery or periodontal procedures, regular dentist appointments are really about establishing a baseline level of oral care

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Notes By Maryann