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Episode 46: Your Oral Health = Your Body's Health

The oral microbiome, when it's not balanced properly, can have a major effect on overall systemic health and the microbiome of the entire body.  
Episode 46: Your Oral Health = Your Body's Health

Maybe you’ve had this experience: you take your yearly trip to the dentist and as long as you’re not in pain or don’t have a cavity, you assume all is good. In most Westernized countries, dental care is regarded as separate from the overall care and health of the body, but as we’ll learn in this episode, nothing could be further from the truth. 

In fact, poor dental health can signal much larger problems - everything from heart disease to cancer, for example. And many of these problems are often much quieter (and therefore more overlooked) than throbbing pain or a chipped filling. 

On this episode, Andrea talks with Dr. Matt Kogan, a biological, holistic and integrative restorative dentist, about the shocking link between oral and systemic health. Dr. Kogan’s primary foundational focus is on the oral health and systemic health connection, recognizing that many systemic issues cannot be treated without addressing the oral environment. His goal is to reduce the toxic load to each patient and create an oral microbiome that is diverse and supportive of long-term health.

The two dive into why there’s such a strong connection between oral health and the health of the body, and chat about common dental procedures that may do more harm than good. They also discuss warning signs and what to look for in a healthy mouth, plus tips and tools for how to keep your teeth, tongue and gums happy. If you’ve never given your oral care more than a passing thought, this is an episode you simply cannot afford to miss. 

Resources mentioned on the show:   

   

On this show, you’ll learn:   

  • The connection between oral and systemic health (2:46)
  • Oral red flags versus a healthy mouth (8:02)
  • All about the tongue (14:08)
  • Common dental procedures that can be detrimental (16:29)
  • Alternatives to these common procedures (21:53)
  • What is ozone therapy? (25:37)
  • How to find a dentist who practices with these methods (29:07)
  • Regular day-to-day maintenance of the mouth (33:01)
  • Oil pulling – what it is and whether there are benefits (37:45)

BIOHM gut quiz 

Transcript: 

Andrea Wien: Welcome to The Microbiome Report, powered by BIOHM Health, a total microbiome company with products like a gut-testing kit and probiotics designed to address the critical roles of bacteria and fungi in gut health. I'm your host, Andrea Wien. And my guest today is Dr. Matt Kogan, a biological holistic and integrative restorative dentist with a private practice in Cleveland, Ohio. His primary foundational focus is on the oral health and systemic health connection, recognizing that many systemic health issues can not be treated without addressing the oral environment and oral microbiome.  

In addition to clinical practice, Dr. Kogan is currently completing his studies as a naturopathic medical doctor and uses treatment modalities from all areas to treat patients in a holistic and comprehensive manner. If you haven't guessed already by Dr. Kogan's bio, we're talking about all things oral health and dentistry today. This episode was really eye-opening for me, and I know that it will be for you too. I put a call out on Instagram for questions surrounding this topic, so I know there's a lot of confusion out there, and we're going to try to clear that up here today.  

On this episode, I speak to Dr. Kogan about the connection between oral health and microbiome and the overall health of the body. This one is really shocking. We're talking about things like breast cancer, certain types of heart disease, so really, really interesting stuff. We'll also talk about what to look for in a healthy mouth versus an unhealthy mouth, some common practices in dentistry that can be dangerous and detrimental for long term health, and Dr. Kogan answers some of your listener questions. There's so much more to talk about on this topic. So we've asked Dr. Kogan to come back and speak with us again. If you have questions for him, please email them to themicrobiomereport@gmail.com, or send them my way on Instagram, I'm @dreeats, D-R-E E-A-T-S. Enjoy the show.  

Dr. Kogan. Thank you so much for joining us.  

Dr. Matt Kogan: Thanks for having me, Andrea.  

Andrea Wien: So I am very excited to talk about oral microbiome. I think I thought people had a little bit better understanding of it than they do. And I put out some calls on Instagram and social media for questions, and what came back was really interesting. So we're going to talk a lot about the questions that people submitted, but I think one of the biggest things for me when I first started learning about oral microbiome was how intricately tied it is to the overall health of the body. So can we start there? Can you explain the connection between oral health, the oral microbiome and the systemic health of what's going on in our bodies?  

Dr. Matt Kogan: Sure. So somewhere along the way, the oral microbiome was detached from the rest of the body. And we're not sure where that link was separated, but it might just be because of the way we're trained in the United States that we have medical students and specialties focused on systemic health and dentists focused on oral health. But obviously, there's an intimate connection between the two. So as we progress and we've become more developed as far as understanding the gut microbiome, we have an understanding how the oral microbiome affects the gut and other parts of the body.  

In addition to that, there are a lot of players in the mouth that can adversely affect the microbiome systemically and cause problems downstream. So for example, you could have infection in the mouth that's unnoticed, causing a problem downstream, giving a systemic issue, and the physician may not think that this could be a consequence of something going on in the mouth, but what we find is that when we treat that oral infection, that the systemic problem will resolve. So the connection relates. We can take it to cardiovascular disease, to certain types of cancers even, we can take it to just low-functioning immune systems.  

The oral microbiome, when it's not balanced properly can have a major effect on overall systemic health and the microbiome of the entire body.  

Andrea Wien: So now, we know that the brain and the gut are intricately connected, and we have this gut-brain connection and they're talking to each other all the time. Is that something that's similar, that's happening? Let's say in a case of breast cancer, can the breast cancer actually affect the mouth or is it more so that something's happening in the mouth and that might be causing a type of cancer?  

Dr. Matt Kogan: It's a great question. So what can happen is, and we can get into a theory of infection called a focal infection theory. And what that means is, every tooth in the mouth has a blood supply to it, a nutrient supply. And if for whatever reason there's infection at the end of one of those teeth, the bacteria or the fungus or the virus, whatever is created in that environment will actually follow a pretty predictable drainage pathway through that side of the body. So in the instance of breast cancer, it's usually not the breast cancer causing the problem in the mouth, t's usually there's a focal infection, this area of toxicity in the mouth that's running downstream, actually potentially, and again, there's no because and effect here, but potentially causing or contributing to the toxic load in that breast causing a cancer to perpetrate.  

So usually what we'll see in those cases is we want to treat that oral infection, and hopefully that will give way to allow that cancer to heal.  

Andrea Wien: It kind of reminds me, and correct me if I'm wrong here, but we talk on the show, this analogy of a bucket, you only have so many things you can put in the bucket before it overflows. We talked about this in our show with autism, where there might not be one cause that's contributing to autism, but chemicals in the environment, food stress, all these kinds of things are adding to the bucket. And once that overflows, then you end up with this disease state. Is that something similar, like this tooth isn't the only cause, but it could be contributing to what's in the bucket?  

Dr. Matt Kogan: Yeah. And that's a really great point. And you will hear anecdotal stories of someone saying, "Well, I've had a root canal for a long period of time," or we'll say, "An infected tooth for a long period of time, and I'm in great health." And for some people that can manage that, their bucket, as you say, may not be filled. But in the wrong environment, in the wrong immune system, that bucket will tip over and it can actually cause a disease expression. So I think that's a great way of looking at it. And that is why you hear different stories from different people about how they respond to different dental infections and different dental procedures.  

So every individual is uniquely different and everyone will respond differently. I think the major problem here is that when people are experiencing systemic difficulties, a lot of times they're never given the opportunity to investigate what's going on in the mouth because sometimes oral health has turned into a mechanical state of wellbeing, nothing hurts you feel okay, so everything must be just fine. But unfortunately, a lot of times these infections are hidden and that's why they remain low grade chronic over a long period of time contributing to a chronic issue.  

Andrea Wien: Okay. So that's a good segue to talk about what are some red flags then, if I don't feel pain, if I'm not having cavities when I'm going to the dentist, I'm like, "Okay, I'm fine. I'm healthy." So what are the red flags that people should be aware of? And then what should we look for in a healthy mouth?     

Dr. Matt Kogan: It's a great question too. And I'll try to layer this answer a little bit for you. Some surface things that people can pay attention to are things as simple as bleeding gums, inflammation in the mouth. Any sort of inflammation, I would say, could contribute towards a chronic degenerative state in the body. We want healthy, firm tissue. The mouth is really a gateway into the body, so when we're flossing and brushing, we don't want to see any inflammation, we don't want to see any bleeding. That's just a basic thing to look out for. Another thing I always like to look for is just the tissues in the mouth, including the tongue.  

The tongue oftentimes will give you a map into that patient's overall health, whether the tongue is smooth, whether there's a coding, whether there's fissures, these all can give us insight into the disease or health state of that patient. Beyond that, when we get into, "I'm not feeling anything." I would tell people to take a good look at their dental history. Some people had trauma, they got hit with a ball when they were young and they ended up needing a root canal procedure, so they have a so-called necrotic or dead tooth in their mouth and they don't feel anything and they're happy, but that needs to be evaluated in a proper way to make sure that that infection is resolved, and again, not contributing to a systemic issue.  

There are very specific ways in which that can be evaluated, but they need to seek out the right person in order to evaluate that correctly. So I would say overall tissue health is critically important, bleeding, decay, of course, if people are experiencing cavities, you go to the dentist, they're saying, "You have a cavity, you have a cavity, you have a cavity," then we need to look further into what's going on with this patient as a whole. What nutritional imbalances are there? What's going on with their gut? We sometimes forget, but it's important to remember that the oral cavity is part of the gut and it's the entryway of the gut, so we need to look at it that way.  

And in the absence of all those things, that person probably has a pretty healthy oral cavity.  

Andrea Wien: Now, when you're looking into someone's mouth, can you tell based on what's happening, let's say something with their tongue, or maybe you do see inflammation, are those tied to specific nutrient imbalances? Like, can you say, "Okay, when someone has X, they're probably low in vitamin A," or is that a little bit too granular?  

Dr. Matt Kogan: That's a good question. As far as being specific, it could be difficult, but there are definitely conclusions you can draw. So one thing, tooth decay is extremely common. And when you're dealing with tooth decay, you can be pretty certain that there is a vitamin D issue. There's most likely a fat-soluble vitamin issue, which are A, D, E, and K. I'd say the majority of Americans, even those that really pay attention, that eat on processed food, organic diets, most are still deficient in vitamin A without supplementation. So fat-soluble vitamins are really critical in supporting the teeth and keeping decay under control.  

So if someone is really decayed, that's really the first thing I'm looking towards, is nutritional imbalances, gut imbalances, and probably offering some supplementation. Then there's things that are iatrogenic, which means that it was done to the patient by previous health care provider. So they went in for a procedure and something happened, and as a result of that, they're now in a state that is not conducive to health, or something was put in their mouth that is not conducive to health, or they have a dental material in their mouth that they are sensitive to, or potentially allergic to.  

I'll tell you in my practice, I can't tell you how people will come in and we'll go through an extensive history as to what materials or what allergies do you have, what food sensitivities do you have. And they'll say, "I can't wear any cheap costume jewelry. I'm allergic to nickel." And we'll look in their mouth and they'll have nickel dental restorations in their mouth. Well, just imagine that that's in their mouth against their tissue. No matter what that patient does as far as brushing or flossing and doing all the dietary nutritional things that they can do, they're never going to resolve to a full state of health with something that they're allergic or sensitive to sitting right in their head.  

So we need to take an overall look at these patients and look at them truly comprehensively, total body approach in order to resolve these issues. Because a lot of times, "the good patient" who goes to the dentist and does everything, as they're told, sometimes that dental work could actually be contributing to problems for them.  

Andrea Wien: That's so interesting and so eye opening to be able to even start to put those pieces together and say, "Okay, something that you thought you were doing that was very health supportive could actually have the opposite effect." But I want to come back to the tongue, because this is such a big piece and as you mentioned, it can give a map of the body. I think in Chinese medicine, the tongue is a very big focus of oral health and systemic health. And I know for myself personally you mentioned like white coatings on the tongue, fishers on the tongue. I know if I go off the rails a little bit, have sugar or maybe have a weekend with my friends where I'm drinking alcohol more than I typically would, I notice that on my tongue, you do wake up feeling gross in your mouth. 

I call it teeth sweaters, you have that biofilm like on the teeth that you just... they're a little fuzzy, but I noticed that. And so when I'm eating in a health supportive way, my tongue is pink, I don't have that coating. When I'm brushing my tongue, which we can talk about, it's a much better situation. So things can happen really quickly. Can you talk about what people should be looking for? You mentioned a few things on the tongue, but how they should really be taking care of the tongue and what they should be looking for day to day.  

Dr. Matt Kogan: You're right about that. And this goes back to traditional Chinese medicine. So sometimes we have to look to our ancestors for some wisdom. In fact, farmers way back when, when their animals would die, they would look in their mouth to get an overall picture of what their health was like and they would always look at their tongue also. So a healthy tongue is a non fissure tongue, it's not too bright red, but it's not too dull. We can look at the veins underneath the tongue, we don't want any blood pooling there. You don't want any coatings on the tongue. You don't want white coatings or surprisingly brown or black coatings or green coatings. These can all be signs of issues.  

And we can't relate these to one particular condition. If we see a fissure straight down the tongue, a lot of times that will show us that there is a gastrointestinal imbalance. We use it as a tool, just as a window into, what is this patient? What is their current state right now? You bring up another great point about the fact that the taste buds regenerate quickly, so your tongue is something you can look at on an every two-week basis, because it will regenerate in that short period of time. So if someone is in a disease state and they start to heal themselves, about every two weeks, they will notice that their tongue is changing.  

As a general rule, the deeper the fissures, the more numerous that there are of them, usually that indicates more of a degenerative process going on. There's exceptions to every rule. So we use it as a tool, but when you start improving these patient's overall health, the tongue will change, and it's pretty remarkable to see that  

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So when we talk about the conventional dental procedures that people go through, can we talk through a few of the things that are very common that might actually be dangerous and detrimental based on what you were saying previously?  

Dr. Matt Kogan: Yeah, I'll give you probably the top three most controversial ones. One of them is dental amalgam, which is mercury amalgam dental fillings, or restorations. That is a conventional dental material that's used children, they're slowly outlawing it in other countries, not here in the United States. We still remain supportive of using this material, but that's done in the conventional setting. And that issue becomes complicated because that material in itself is a problem from a health standpoint and a dental standpoint. But when you start mixing that material with other dental materials, you can actually exacerbate this problem into something far more complex than it was initially.  

So that's one that I would say in a conventional dental setting, dental mercury fillings would be not a health and wellbeing restoration other than mechanically keeping the tooth in place. The second thing I would say that could be detrimental, and this is controversial as well, is root canal treatment. Root canal treatment is essentially when a tooth becomes infected and the dentist or the endodontist who is a specialist in root canals will actually go in and remove the nerve of the tooth in hopes to seal off that infection from the rest of the body. However, teeth are very complex anatomically, depending on the tooth, and we briefly touched on the drainage patterns of these teeth.  

So the issue with root canals on a surface level is that, let's say we have someone that has a toothache and they're just in agony from this toothache and they have an infected tooth. Well, they're ready to do anything to get out of pain. So they go to their dentist and they say, "You have an infected tooth, and we're going to do a root canal." Well, that patient's happy because they're not feeling anything after that procedure, but that's also not a great thing because when you're not feeling the symptom, you could still have a low grade chronic infection that's a focal infection spreading to the rest of the body. You still have a nutrient supply to that tooth and that too is encased in vital bone.  

So these turn into very tricky situations. And many times in the conventional world, you'll have a root canal done. And again, we talked about earlier, you have no symptoms, you don't feel anything, so you come in and you get your teeth cleaned or whatever you're doing, and you're happy as can be because everything feels okay. But really and truly, underneath that tooth, you have this infection that every time you bite down or every time you agitate that tooth, you have some toxic bacteria amongst other things that could be spreading, if you will, to other areas of the body causing a distant problem, that you're not thinking about that tooth anymore because you're not feeling it. 

And many times the dentist isn't thinking about it either: again, you're not complaining about it. So that's the second thing, the third conventional procedure, that again, very controversial but it's not health promoting would be a fluoride in the dental office. Fluoride is regarded as a developmental neurotoxin. This may apply more to children, but a lot of people don't know as well that fluoride is snuck into many dental restorative materials. So you can go in and you have a cavity and they say, "We're going to put a filling in your tooth," and they'll place maybe a composite or a white filling in this case, and that could release fluoride for the life of that restoration.  

And again, you may not know that, but here we have a neurotoxin that could be released into your oral environment, absorbed into your mucosa, causing pretty significant problems. Again, potentially, we all know about the thyroid gland, which loves iodine, and Americans are naturally deficient in iodine just because of the way we eat. But fluoride belongs to the same chemical family as iodine. It's a halogen on the periodic table, but fluoride is more reactive, so it will displace iodine, I'm sorry, out the thyroid gland. We've seen an epidemic of thyroid issues in the younger population. These are conventional treatments that all should be looked at carefully and really informed consent needs to be had before agreeing to one of these procedures.  

Andrea Wien: Yeah. I love what you said about fluoride displacing, the way that I think about it and Josh could tell us, who we've had on the show previously talks about it, is you only have a certain number of parking spaces in the body, parking spaces being the receptors for this iodine. And if those parking spaces are all filled up with fluoride, well, there's nowhere for those cars to park. So it's a nice way to think about, there's a limit of how much your body can handle. I want to talk now about what to do in place of those because I can hear people saying like, "Okay, great, but I have a cavity." Or, "I am taking my kid to get dental work done and they're going to do a fluoride treatment." So what are the alternatives? What can we do in place of these procedures when someone does have an issue, like a lot of pain from a tooth that's dead?  

Dr. Matt Kogan: Okay. We will start with your first comment about fluoride, taking my kid to get a fluoride treatment. Again, I think everything needs to be looked at on an individual basis. If we have a healthy young child developing normally, hitting milestones, eating a nutrient-dense diet, unprocessed fruits, for the most part, of course. I know this is real life, and anyone with children knows they're going to have snacks here and there, but overall a well-balanced child, that child should not experience dental problems. They should not be at risk for dental decay. So I always focus the attention on nutrition first because we tend to look at these things as an outside in, cause and effect, where there's sugar on the tooth and the problem's coming from the outside, but all the teeth have blood supply to them providing nutrients.  

So nutrition is critically important, and that goes back to the fat soluble vitamins. Supplementation is number one at focusing on diet and unprocessed fruits is absolutely critical, with extra emphasis vitamin D status. So that's number one. If someone is at high risk for decay, they're relying on fluoride treatments. We have to recognize that fluoride is a poison, so fluoride is acting as a kill substrate on the surface of the tooth. But again, if we go back to the periodic table and just basic science here, we know that fluoride is the most reactive. And then under that we would have chlorine, which we don't want to put in a child's mouth.  

And then we have bromine, well, we don't want to use that either. And below that we're going to have iodine. Well, iodine is a nutrient, and iodine is just as efficacious as preventing "dental decay" from the outside as fluoride is. So my recommendation would be, let's use a nutrient and not a neurotoxin, not a poison. I think that will be better for everyone involved and I think they'll have better results. So that would be an alternative to a fluoride treatment that I would consider in that situation. We talk about the toothache, the dreaded toothache, and this gets into a bit of complexity, but there's different ways to do different procedures.    

So I think a lot of people think that a root canal, is a root canal, is a root canal. I do have a threshold for this where I feel that a root canal should really be considered only in a healthy individual and it should be done. It may be an unconventional way, so by finding someone who will do this using other methods, I use a lot of ozone. I don't personally do root canal treatment in my office, but I work with an endodontist who will approach this situation in a very unique way, a very different way from cleaning out these teeth than a conventional method. So we will use ozone in gas form because it's a very potent disinfectant and it will get through all the tubules of the tooth.  

If we could just think for a second about the anatomy of a tooth, there's a large nerve in the tooth and conventional root canals are done by going into that nerve, whether it's one, two or three or four, depending on what tooth it is, and mechanically cleaning it out, putting sodium hypochlorite in there, which is bleach, but there's these accessory canals in the tooth that provide nutrients to the tooth, and they can be infected as well. So we need to disinfect an entire tooth if we're going to do a root canal. Well, a gas is a great way of doing it, and ozone gas is a great way of doing it because again, it's so safe, there's no side effects and there is no toxicity related to it.  

Andrea Wien: For those who don't know just to jump in really quickly, what is ozone?  

Dr. Matt Kogan: Ozone is three molecules of oxygen put together. So it's a very unstable molecule that wants to land on electron or land it to oxygen off the second it hits solution. So that's what makes it so great. It will actually take its charge and provide its oxygen to something that is positively charged pathogen. So if we have a virus or a parasite or a bacteria or fungus, whatever it might be, those are positively charged. Those organisms or those pathogens thrive in the presence of no oxygen. We call those anaerobic pathogens, and in the mouth, those are the bad things, even in the gut, those are the bad things.  

Ozone, the great thing about it is it will essentially take care of those pathogens simply by putting them in an oxygen-rich environment. And by doing that, the good guys or the commensal bacteria, they're unaffected because they thrive in the presence of oxygen. So you're simply delivering through ozone, you're delivering oxygen to an area in order to either eradicate pathogens or support the commensal bacteria.  

Andrea Wien: Okay. Yeah, that makes a lot of sense. Great.  

Dr. Matt Kogan: And just that being said, ozone can be used in numerous forms, but we'll save that. With the root canal, if someone is going to have a root canal, it is imperative that it is followed up on appropriately. And this is my social contract I have with my patients, "Look, we're going in, we're going to do this root canal, but we need to understand that there's a chance that this is going to fail at some point in time. And when this fails, we're not going to know it. So we're not going to have a symptom like the first time saying, 'Hey, my tooth is hurting.' That's most likely not going to happen the second time."  

So we have ways now of imaging these teeth, three dimensionally through a cone beam, which is similar to a CAT scan. And I would tell anyone that's had a root canal for a long period of time, if their dentist or their practitioner's not recalling that root canal on a fairly frequent basis through this imaging, then nobody can tell them with certainty, whether that root canal is reinfected or not. So I think that is an alternative, unfortunately, in my opinion, that should become a standard way of imaging, but it's not right now. When you take a two dimensional dental X-ray of a root canal tooth, there are many false negatives that you will see.  

So you can go in, take an X-ray, the dentist can say the root canal really looks great, but then we will go take this three dimensional cone beam and sure enough, we'll see infection on it. So I think that's absolutely critical to have what's called the CBCT of any root canal tooth. And in anyone with cardiovascular disease or coronary heart disease, I think having a cone beam is absolutely critical as an alternative, just because of the intimate relationship between vascular disease and oral infection. So that's really the way we can rule oral infection out by having a three dimensional image of those areas  

Andrea Wien: Are most dentists going to have that technology at their office or should people be searching out a certain type of dentist that knows about this and is willing to do these procedures?  

Dr. Matt Kogan: They will have better luck if they're searching for what's called a biological dentist. A biological dentist is going to pay extra attention to the connection between systemic and oral health. They're going to pay extra attention to bio-compatible materials, mixing and matching different metals, creating circuits in your mouth that could disrupt the energy flow in your body. So I would say to seek out a biological dentist and they will get you on track in this direction. Otherwise, you'll get into more of a mechanic-type situation where something just breaks and we fix it structurally and you have your tooth there, and that's the extent of it.  

So I think you really need someone that's going to look at everything and take a lot of time on the front end, do a lot of data collection in order to best serve the patient. Any place that's pushing you in and out really quickly, I think that's going to be a problem because really getting into this out of deep level, it takes a lot of time and that's really what's required.  

Andrea Wien: Well, and it's certainly a mind shift for people who have never had this type of experience before. Usually, you go to the dentist, you're like, "Wow, the cleaning was so fast, I was in and out." And that's like the mark of the good dentistry. So I think it's also a paradigm shift for people who are hearing this to say, "Okay, because I'm now learning that the mouth is so important in all the other aspects of the body, let me give it the time that it is needed to really make sure that everything that's going on in there is okay."  

Dr. Matt Kogan: Yeah. That's a great point. And I think that you bring up a funny point about the cleaning that I can relate to. People want to get in and out of the dentist, which is understandable. I can't tell you how many people were going back to those patient stories where the nickel allergy. I have many patients that they adhere to a strict gluten-free diet, dairy-free diet. Most of the cleaning materials that are used conventional dentistry have gluten in them, have all these preservatives that people are trying to avoid. And then they go to the dentist, they have a cleaning, they have all these things pulling them out.   

They go, "But that was so fast, it was a great experience," but they're unaware as to what they just had because no one's talking about it and no one even knows what they're using in the dental operatory. A biological dentist should know exactly what's being used all throughout their office in order to minimize the toxic load or in your analogy, filling up that bucket. My goal is always to minimize the amount of toxins that are going into that bucket. So whether that's taking out a mercury filling in a safe way or not putting one in, my goal is focused on of course, doing exceptional dentistry for that patient, but also in a health promoting safe way.  

So yes, that takes longer, but when you educate people on what's going on, they're very receptive to this sort of treatment because again, education is everything, and a lot of times they just don't know, they're going off of what you said. They come in, they come out, they had a good experience and that's it, but they don't know that they were just given something that they avoid in everyday life otherwise.  

Andrea Wien: Yeah, absolutely. People are going to the dentist, maybe once a year, people stretch that out a little bit, but they're taking care of their teeth every single day. So we had some questions on Instagram just about general mouth maintenance, if you will. So we have a question, should we be using mouthwash? We had another question about, should you be brushing your tongue? How to best take care of your tongue. And then we had a question about toothpastes and specifically toothpaste with essential oils, is that not beneficial for the microbiome of the mouth? So can you just talk about regular day-to -day maintenance?  

Dr. Matt Kogan: Sure. Mouthwash, again, everything should be individualized, but in a healthy individual nutrient-dense diet, no chronic issues, healthy guy, normal bowel movements, again, even as a dentist, I want to know about bowel movements, regular, I stay away from mouthwash. There's very little benefit to it. We are talking about a balance here, a balance between the good and the bad, the good bacteria, the bad bacteria. If we have a biofilm in the mouth that's healthy, we're always going to have bacteria in the mouth, but if it's supportive bacteria, we don't want to use mouthwash that's going to " kill" the good and the bad, and potentially alter that pendulum over to the side of the bad.  

So I stay away from mouthwash in a healthy individual. There are some indications in the state of disease where we would want to use some mouthwashes, and I'll tie this into your question about essential oils. If we're going to use essential oils, I like using them in a mouthwash form. So if I'm going to use a mouthwash, it's going to be a no-alcoholic, and it will be made up of organic essential oils. But that is correct that it can shift the balance of bacteria, good and bad in the mouth when you're doing that. So again, healthy individual, I would stay away and I would just focus on nutrition, brushing and flossing, that sort of thing.  

Toothpaste, unfortunately, in my opinion, the commercial toothpaste, the Colgates, the Crest, those, I don't find those to be health supporting in any way. There are two types of toothpastes that I would recommend to people. One would be a clay-based toothpaste. And again, you need to be careful about what brands you get, you need high quality ingredients, but clay or bentonite clay will act as a detoxifying agent. So it will actually pull things out instead of putting things in. A lot of the fluoruridine toothpaste, again, they're putting poison on the teeth. We want to pull toxins out, not necessarily put other things in.  

So I do like clay-based toothpaste, they're safe, people don't get into trouble on them, they won't alter the oral microbiome. So I am a fan. However, some people can not get used to brushing their teeth with a clay-based toothpaste. So in that case, I recommend, again, an organic toothpaste with no fluoride, no sodium lauryl sulfate, which is a foaming agent. So it won't foam like a traditional toothpaste, and they can pick whatever toothpaste they would like, but I would stay away from all the harmful ingredients in the commercial toothpaste.  

Andrea Wien: Do you have two brands, one clay one and one other one that you could share with people?  

Dr. Matt Kogan: I can. So clay-based, there are two brands I can give you. One is Uncle Harry's, is the brand. And the other one is Krista's. And Krista's I know is out of California, Uncle Harry's, I'm not sure where they're out of, but they do have a great children's paste also, which I really like. As far as bottled in a tube of toothpaste, Dr. Bronner's is a good toothpaste. It was independently lab tested, the original flavor, and there's nothing harmful in there. However, it does contain glycerin, which for your listeners is a story in itself, it's slightly controversial, although it is a nice toothpaste for a more traditional feel of a toothpaste, if someone wants to just take out of a tube.  

Andrea Wien: Yeah. You gave me actually the Uncle Harry's, and whew, it is an intense toothpaste. So for anyone who is thinking about trying that out, be ready because it was very intense. I like it, but it really took some getting used to, and I think my mouth was like, "What is this?" After using not conventional toothpaste, because I've been a little bit more savvy than just using the Crest and the Colgates of the world, but yeah, it was quite a shift.  

Dr. Matt Kogan: They do make an original without... Uncle Harry's will have some with essential oils, so I don't want to contradict myself, but they do make original formulations that don't have it. So you want a less intense experience you can go with like the children's or one of their regular toothpaste.  

Andrea Wien: Yeah. I might recommend to start out with that. And then one of the other questions we had here was about oil pulling. And I know people might not know what oil pulling is, but can you describe what that is and whether or not there's benefit there?  

Dr. Matt Kogan: Yes. So oil pulling is, I'm going to relate it to using coconut oil, although different oils have been used. It's an ancient remedy or method to detoxify the mouth essentially. And so what you do is, I'll use the example of coconut oil, but you essentially swish with coconut oil for up to 20 minutes. And coconut oil is a very good detoxifier, again, similar to clay where it will pull things out of the tissues. And I would highly recommend oil pulling. I have numerous patients that we have seen just incredible results by oil pulling. It is a commitment. I do give a disclaimer to it where if you have metal in your mouth, so if you have mercury fillings in your mouth, the oil because mercury is temperature dependent, so as you heat up your mouth by swishing this oil, you will have additional mercury release.  

So I tell people just as a personal opinion, if you have a lot of mercury in your mouth, one, I'd like to see possibly getting that remedied carefully, but if we're going to keep it in, then most oil pull for five minutes, spit it out, swish again for five minutes, spit it out, where someone without metal can go for a longer period of time. As far as a detoxifying remedy, it's really a great thing to do and I highly recommend it.  

Andrea Wien: It makes sense that these oils, we talk about on the show all the time, just in terms of the foods you can eat that can help bust up biofilms and get in to those pathogenic strained in the gut. And so we talk about coconut oil and olive oil and things like garlic, having those antibacterial, antiviral properties, and that's exactly what we're creating when we're doing oil pulling.  

Dr. Matt Kogan: Exactly. One analogy I give to people a lot of times is, God forbid someone's having a heart attack and they go to give medication, where do they put it? They put it right under their tongue because it's so quickly absorbed into the system. So whenever we're doing something like oil pulling, sure, we're having our great effect right in the oral cavity, but it really it's a total body treatment because you're getting absorption through the entire body. So that's where you get a great benefit from oil pulling, but that's also where you can get a negative if you have mercury or something toxic in the mouth, and now you're potentially redistributing that metal to somewhere else in the body where you don't really want it to be  

Andrea Wien: Dr. Kogan, this has been really eyeopening and we thank you so much. We definitely need to have you back on for part two because I have a lot more questions about mouth breathing and detoxification and supplementation. So let's definitely get that set up, but this was a first great round to answer some of these questions. If anyone has more questions, we will have him back on. So feel free to send us a note at themicrobiomereport@gmail.com, and we will certainly add those questions to the list, but until next time, we thank you so much and have a great day.  

Dr. Matt Kogan: Thanks for having me, Andrea.  

Andrea Wien: Thanks so much for listening. Don't forget, you can send questions for Dr. Kogan for our next episode to themicrobiomereport@gmail.com or hit me up on Instagram @dreeats. This episode has been powered by BIOHM Health. That's B-I-O-H-M. You can check them out at biohmhealth.com. And you can connect with Dr. Kogan at kogandmd.com. Kogan is K-O-G-A-N. He's also on Instagram @matthewkogandmd and on Twitter @kogandmd. I'm Andrea Wien, and I'll catch you next time.   

 

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