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Episode 64: You're Breathing Wrong Right Now

Episode 64: You're Breathing Wrong Right Now

In one of our most popular shows of the last year, Dr. Matt Kogan came on to blow our minds about the connection between our oral health and the health of the entire body. 

Dr. Kogan is a biological, holistic and integrative restorative dentist. The goal at his practice in Cleveland, Ohio is to reduce the toxic load of each patient and create an oral microbiome that is diverse and supportive of long-term health. 

On this episode, he’s back and taking a deeper dive with Andrea on how common (though not normal!) things like mouth breathing can have insanely wide-reaching implications for health. 

They also discuss how he treats kids in his practice, what to do if you have mercury fillings (including why you should care about them in the first place) and gives his recommendations on the best supplements for your mouth.  

To connect with Dr. Kogan, visit his website or find him on Instagram

Questions? Ideas? Email us at or reach out on Instagram @DreEats or @BIOHMHealth.

Approximate Timestamps: 

  • Oral health and the systemic health of the body (2:39)
  • Children in dental practice (4:20)
  • Why mouth breathing is so detrimental and how to remedy it (9:52)
  • Mask-wearing and mouth breathing (17:29)
  • Helpful supplements for your mouth (18:43)
  • Why mercury fillings can be problematic (23:14)
  • Safe mercury removal (27:05)
  • Safer alternatives to mercury (31:17)
  • Hydrogen peroxide as mouthwash? (39:46)
  • How does posture impact my teeth? (41:24)

Mentioned On This Show:

BIOHM gut quiz


Andrea Wien: Welcome to The Microbiome Report powered by BIOHM Health. I am Andrea Wien, and today I'm bringing back Dr. Matt Kogan, one of our most popular podcast guests ever to chat with us in more detail about oral health. Dr. Kogan is a biological, holistic, and integrative restorative dentist with a private practice in Cleveland, Ohio. His practice utilizes treatment modalities such as advanced restorative dentistry techniques, including minimally invasive dentistry, ozone therapy, oral DNA testing as a screening tool for coronary artery disease, biocompatibility testing, safe mercury removal, fluoride alternatives, and much more.

After our last episode with Dr. Kogan, I received an email that really illustrates how important this topic is. I'll just read you a bit of it so you can see how powerful getting to the root cause of an issue can be. This listener says, "My best friend's mom was in and out of the hospital for over five years and nobody could figure out what was wrong with her. They even started questioning her and thought she may be making it all up at one point. She became suicidal as she couldn't handle the pain and suffering anymore. After more than five years, finally someone thought they should check her teeth. It was an infected molar in the back that caused all of her issues. Too many rounds of antibiotics, steroids, and horrific meds have changed her body so much and she's gained a lot of weight. But after removing the tooth and treating it, she's finally pain-free and healthy and on the road to recovery." Just completely mind-blowing.

So on this episode, we're diving deeper into the topics from our first chat and answering questions you've all sent me for Dr. Kogan. We talked about safe detox practices if you've been in the standard of dental care for years, including safe mercury amalgam removal, plus we get into protocols for kids and supplements that can be particularly beneficial for oral health. This one was another show that just blew my mind. I really believe it's information that everyone needs to hear. So I hope you enjoy the show. Dr. Kogan, thank you so much for joining us again.

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

Andrea Wien: So we did an episode a couple of months ago, and people really responded so well to it. And we wanted to bring you back on and ask some of the questions that we didn't have time to do last time. And we also got some listener questions from people that wanted more information about what we were speaking about. So for people who did not listen to the last episode, I would definitely recommend to go back and do that first, but can we give a quick overview on oral health and the tie to the systemic health of the body?

Dr. Matt Kogan: Sure. The oral cavity has a direct relationship with other areas of the body in relation to their systemic health. And a lot of times when we're searching for answers to common health questions, we forget to look in the oral cavity for answers. These can include hidden infections, dental materials that are causing inflammatory responses in the patients, and all sorts of other sorts of viruses or bacteria that are present that are causing problems elsewhere. And again, people sometimes forget to look at these areas and they come up empty handed when they are trying to find solutions for their overall health problems.

Andrea Wien: Great. Okay. And again, I would recommend if you're new to all of this, please go back and listen to our last episode. So we talked about this in the last episode just in terms of procedures that people may have had in conventional dental, and I think most people are willing to accept if they've listened to that show and the people I've talked to, that maybe some of the things they've had done have been harmful. So mercury amalgam fillings, root canals, but when we're talking about kids and how to take our kids from getting their first teeth through losing teeth, people are a little bit less likely to give in to, well, conventional dentistry might not be the answer. So when you're looking at kids in your practice, can you just walk me through what you're doing on the ideal approach versus what the common scenario is for a child that's going to the dentist in their first years of life?

Dr. Matt Kogan: I would generally like to start with really getting a great start which would involve the parents in preconception and conception because that's really where we can start to make changes and have benefits for this child even before they're born. So we like to work on preconception health of both of the parents in order to have the healthiest child they can have and have the healthiest birthing practices they can have. So if they come to me before and they say, "We're planning on having children," I would give them some pointers that they can do for themselves in order to optimize the health of this new baby that they're bringing into the world.

But if I get them as a child, we'll really start... There's two groups of children that we'll see. It starts with birth. And we'll take our vaginal birthed children and our cesarean section children. And they have key differences because the vaginal birthed children actually will... When they're delivered, they're exposed to a specific type of bacteria called bifidobacterium infantis. And this is actually the initial lining of the gastrointestinal track. And as that baby is being born, their mouth is open and that's their first exposure through the oral cavity all the way down through the colon. And these children present differently than scenario section children.

And we'll also do a history as to if they were breastfed from a well-nourished mother or were they formula fed right away? Did they receive any colostrum? These things will have an impact on how their dental health is presenting and what we need to do to keep them healthy or make them as healthy as possible. So in the child that has been well-nourished, has had a natural birth without intervention, breastfed from a well-nourished mother, they generally don't need a whole lot of intervention. We want to support that child. We don't want to break down their biodiversity in their oral cavity or in their mouth. We want to respect it. So we want to use products that will embrace that and not kill it off because that's a primer for their immune system.

On the flip side, if we see children that are having gastrointestinal issues or maybe inflammation in their mouth and their microbiome just isn't quite developed as we want it to be, we might recommend certain products or procedures that can kind of tip the scales from pathogenic bacteria or viruses or parasites into a state of health and wellbeing. And in my practice, we would do that through a lot of natural remedies. And we don't try to use antibiotics or fluoride, things that are really against life. We want to do things that support life through nutrition, through supplementation that can really help these children reach an equilibrium in their mouth that's healthy and they can develop a long life with healthy teeth and a healthy body.

Andrea Wien: So typically when kids are going to a conventional dentist, they might be doing things like getting fluoride treatments or sealants. What are we trying to do with those procedures that we can perhaps do with more natural interventions like diet, lifestyle?

Dr. Matt Kogan: So fluoride is an interesting one because the way that it's sold to parents is that it's an anticavity or an anticaries treatment. If you fluoridate your child, you will prevent cavities in them. People don't know that fluoride was really never approved for that use. Fluoride has only been approved as a desensitizing agent. So there's a little bit of a public misconception about what they're actually doing with fluoride. But if we take that example of fluoride and we apply it to the child, fluoride acts as a poison. So it's a surface kill effect on the tooth surface, which sounds good, but in my perspective, if we think about a poison, that's not really conducive to life and longevity and health.

So we have other alternatives. In that instance, if we thought someone was at high risk for developing a cavity or high risk with a sensitive tooth, I would choose to use a nutrient like iodine and replace a fluoride, which would be a difference in my practice compared to a conventional "practice." We want to use things that the body can assimilate, that can make that child strong and robust, and really end up creating a response where they don't end up having these deeper problems that you referenced later in life, like root canals and all these other things, whereas fluoride could have long-term effects that are not conducive to health.

Andrea Wien: So when I brought Miles in, Miles is my son for those listeners who don't know, and he's about 16 months now, you asked me some very interesting questions and one of them was around mouth breathing. And you also talked with me when I came in for my exam about mouth breathing. So I think a lot of people think mouth breathing is one of those things in our culture like, "Oh, maybe it's a little bit funny. Maybe the nerdy kid did it," but why is mouth breathing so detrimental? And how can we start to remedy this?

Dr. Matt Kogan: That's a really good question. And I think this is one of the most important things that parents need to pay attention to. So, within your mouth and nose, you have one of the most powerful molecules for our health. And a lot of people have heard of nitric oxide. Some people are unfamiliar with it. But nitric oxide, it upregulates blood perfusion, strengthens your gut barrier, it increases your mitochondrial energy. And people don't know, but there's really two ways to boost your nitric oxide. One, you can breathe through your nose, and two, you can maintain healthy oral bacteria. And we can talk about how this relates to using mouthwash and other things, but...

So nitric oxide is produced by pretty much every type of cell in the human body. It's really important for blood vessel health. So it's a vasodilator, and that means it relaxes the inner muscles of the blood vessels. So it causes those vessels to widen. And nitric oxide then increases and it will lower your blood pressure, which we all know is good for health. When we get into what does mouth breathing do? Mouth breathing will actually bypass our ability to create nitric oxide. We create nitric oxide when we breathe through the nostrils. And there's a lot of studies that show even alternating nostril breaths will increase your nitric oxide.

So just imagine that we have a child from day one, they're only breathing through their nose. Well, that's just the... All we see is that kind of funny mouth open, take a video, but we're not realizing that we're bypassing our natural ability to create nitric oxide. And so I think mouth breathing at a young age is a red flag. It should be corrected as early as possible. And that is a huge indicator for overall health, including gut health, which doesn't get talked about a lot. And so in my practice, if we see mouth breathing at a young age, we typically intervene immediately to try to correct that.

Andrea Wien: And what kind of... I mean, I can speak to what we've done with Miles because he does do some mouth breathing at night and even during the day, but what are you looking to do in a child that is mouth breathing?

Dr. Matt Kogan: So in a child it's really... Obviously, you cannot rationalize with them. So we want to use appliances that will start to stimulate the musculature that is starting to tell the tongue where we want it to go in order to develop the palate. So the tongue typically should be resting behind your upper front teeth, but in children that mouth breathe, they'll rest their tongue typically under their lower front teeth. And so if we don't intervene early, we'll see a developmental issue with the maxillary palate or the upper palate. So we use a lot of appliances depending on the age, just to start stimulating the musculature to say, "Hey, this is where your tongue should go. This is where your lips should go. Your lips should be closed over this appliance, and it should be easy for you to do this. And when your lips are closed over this appliance, guess where you have to breathe from? You have to breathe through your nose. And that's where you're supposed to breathe, through your nose."

And so for a child, it's a very mechanical effort to say, here's a space for your tongue to go, here's where your lips go. And we know that that child's going to continue to breathe, so the only place for them to breathe is through their nose, and young children in particular respond very, very well to this sort of appliance therapy at a young age. The longer you go, you can't teach an old dog new tricks. As the habits get worse and worse, the reversal becomes more difficult. So early intervention with mouth breathing is I think one of the most beneficial things a dentist can provide you to your child at a very early age.

Andrea Wien: That's really helpful. And I think there's two points I want to make. One, and listeners will think I'm crazy, I have started to notice, I think more so in times of high stress, that I will find myself mouth breathing at night. Like I'll wake up and be parched or drooling on my pillow or something like that. And I've started to tape my mouth shut, which sounds insane, and my husband is like, "What is going on? This is the least sexy thing I've ever seen ever." But it's really helpful. And I do find that I get such a better night's sleep when I have my mouth taped shut. So is that something that you recommend people to do?

Dr. Matt Kogan: Yes, yes, absolutely. So I usually like to measure this using a high resolution pulse oximeter. And we run reports to make sure... I'm kind of a data guy. I like to know what I'm doing is working. But for adults, lip tape is one of the most beneficial things you can do from an overall health perspective and a dental health perspective. So I'm not surprised to hear that from you. And that's essentially what you're doing in this young child. A lot of times children will be diagnosed with ADHD or all these behavioral problems as they get older, and a lot of times the underlying issue is this improper breathing at night. And many, many times we will correct the breathing issue and whether it's a behavioral ADHD issue, whether it's a bedwetting issue, just simple hyperactivity, difficult falling asleep, those issues resolved by simply improving the breathing posture of that child.

Andrea Wien: That's amazing really. When you think about something that could be such a simple intervention instead of going to something like pharmaceuticals or behavioral training or anything like that, it's really mind-blowing and everyone should know that, right?

Dr. Matt Kogan: I really think it is one of the most critical things to think about. And just as a side note to that, when we think about the immune system as it relates to the oral cavity and dentistry, the adenoids and tonsils in children are the first filter for any, whether it's an ear infection, a strep infection, whatever's going on in that child. Well, if that child is mouth breathing, just imagine the insult that those adenoids and tonsils are taking. So typically in our society, we don't do anything to really clean that area out. So the accumulation of byproducts, of all of these pathogens just ends up residing in these adenoids and tonsils. And by simply bypassing that through nasal breathing, you can really solve a lot of problems. And like you said, it's an easy intervention and the benefits I think are just endless.

Andrea Wien: The Microbiome Report is brought to you by BIOHM Probiotics, the first probiotic designed to balance both the bacteria and fungi in your gut. To check out BIOHM Probiotics, go to and use the code BIOHM10, that's B-I-O-H-M-1-0, to get 10% off.

I think too a lot of people, and I've heard this from Matt, my husband, and a few others, that now with everyone wearing masks, people find that they are mouth breathing more often. So I've had a lot of people telling me like, "I feel dehydrated at the end of the day. I have a headache from breathing through my mouth all day." So I think it's something that people should be aware of as we're all masked up right now because of COVID, that really to be more aware of continuing to breathe through your nose even with the mask on.

Dr. Matt Kogan: Yeah. And that is a different discussion. I do wish the mask issue did have some dental input because you bring up good points there. You do want a nasal breathe. I do have concerns with the masking and really the almost 24/7 masking every time we're out. That anaerobic environment or the non-oxygen rich environment, when you're breathing that through your mouth, you're at an even higher risk. I think there's even concerns nasal breathing, masking all the time, again, different conversation, but I have noticed that we're seeing more inflammation in patients that typically don't have inflammation. And I do relate that to just this kind of throughout the day requiring to mask up all the time.

Andrea Wien: Yeah, it'll be interesting to see and probably not interesting in a good way, what happens over the next couple of years. Okay, so last time we briefly mentioned supplementation. And I know, again, when I came in to see you, we talked about some supplements like cod liver oil, for example, that can be really helpful for oral health and just overall health. What types of supplements or overall nutrients, foods, things like that, are you recommending that people definitely incorporate when they're thinking about their oral cavity?

Dr. Matt Kogan: So you hit on cod liver oil, which I do think is one of the greatest dental supplements because when you think of dental supplementation, we really want to focus on the fat soluble vitamins, which I believe we spoke about. So that includes vitamins A, D, E, and K. Cod liver oil really takes care of the A and D component. It puts those two vitamins in nature's ratio with each other and it's assimilated well, children tolerate it well. So I would put that at the top of everyone's list. Vitamin A in its real form is very difficult to get in adequate amounts. Even with a wellness diet because of soil depletion and all these other factors, it's very difficult to get enough vitamin A. So cod liver is at the top of the list.

I usually do recommend a D3/K2 supplement as well, really depending on the child, depending on their development, but vitamin D is in itself a critical dental vitamin. And for overall health and immunity, you need to make sure that that vitamin D level is in appropriate range, which I would probably argue is higher than what a lot of standards will tell you is therapeutically okay.

Andrea Wien: Yeah, I was just going to say from a functional nutrition standpoint as well, we like to see that number between 60 and 80, and oftentimes on conventional blood work, it will say in the 30 to 40 range is adequate. And that really is just to keep someone out of a disease state, not for optimal health. So if you have had your blood work done recently, and people should be getting their vitamin D checked, I say at least every six months, because you can take too much also, which has happened to me. So you want to be checking that and making sure, but if you're in that 60 on the low end, 80 range, that's a good place to be.

Dr. Matt Kogan: That's a great point. And you do have to remember that with fat-soluble vitamins, they're not water-soluble like a vitamin C, so they do accumulate in your tissues, and you're right, you can become toxic. In the case of vitamin D, vitamin D toxicity presents with the same symptoms as vitamin D deficiency. So you do want to be in that 60 to 80 range. I would agree with that 100%. But speaking of vitamin C, vitamin C I think is an important daily supplements. I like sodium ascorbate for kids. Again, well tolerated. It's water-soluble so you don't have to worry about overdosing on vitamin C.

And then I do like trace minerals. I think mineral supplements are important and there's a variety of mineral supplements out there. And in kids that really depending on where they live and whether they eat sea food in the type of diet they have, iodine does play an important role in protection of the teeth, as well as again, overall health and overall regulation of the thyroid gland and all the other hormones that the thyroid gland controls. So we tend to be very deficient in iodine. So iodine is a supplement that I do like to recommend on an individual basis.

Andrea Wien: And with Miles, I will give him those little seaweed snacks and he loves them. So I think that's a nice way too. If you don't want to be giving your kid a bunch of supplements, finding some of these foods, the cod liver oil is more of, I guess, a food than a supplement in some ways, but finding some of these things that do have that inherently in them can be really helpful. He loves to just chew on those things.

Dr. Matt Kogan: Those are great for children. and I can speak from experience, we use those a lot and they are addicting and they are good. And I think they check that box. So I would-

Andrea Wien: Yeah. Well, even their tagline on some of those, I think the sea snacks ones are strangely addicting and we can attest to that.

Dr. Matt Kogan: They really are. So, yeah, that would be a great... Yeah, my primary focus is really on nutrition. So you mentioned that as well. Fermented foods, sauerkraut, even kombucha, these foods that are alive, sprouts. Any sort of sprout is really going to fill in these voids of mineral supplementation. So you don't always have to go buy a supplement for everything. You can use healthy, organic, unprocessed foods to fill in these gaps. And that I would say is always the first priority.

Andrea Wien: Yeah, absolutely. Okay, let's switch gears a bit. So we talked last time about some procedures that are harmful, but we didn't get into really mercury fillings and why those are so detrimental and then some safe alternatives and also some detox. So just kind of give the listener an idea of where we're going. So let's just start with why mercury fillings can be problematic.

Dr. Matt Kogan: All right. So on a basic level, we have to understand that mercury fillings or silver fillings as they're called, they contain 45% to 55% elemental mercury. Elemental mercury is the most toxic nonradioactive element on earth. So that's where we have to start with this discussion. Then we have to talk about how mercury reacts with our body. When does it become harmful and where does it become harmful? So when we put it in teeth, there's a temperature dependency on mercury. And really mercury is dangerous when it turns into a vapor. So when we put this mercury filling into a tooth, there will always be a vapor released from this. And it will be increased whether we have a cup of coffee, whether we brush it, all these things, whether we grind our teeth, and you'll have an increased output of mercury.

Now, it depends how much mercury there is, it also depends what else is in that patient's mouth, and it depends where it is in the mouth. But mercury has a tendency to act on the neurological system. So that's why you'll see that the symptoms associated with exposure to mercury are generally neurological. So there a lot of mental and emotional symptoms, and then there's physical symptoms that come with it. So mercury will damage a lot of the cells in the central nervous system. They call those astrocytes, and it will also interfere with the uptake of neurotransmitters. So the neurotransmitters that we think of like dopamine or serotonin or acetylcholine, norepinephrin, these all play a pivotal role in our mood regulation, they play a pivotal role in our neuronal health as to how our nervous system develops. And so once this gets into our central nervous system, it becomes very difficult to get this out.

So I would tell anyone don't think of this discussion as a color, silver filling or white filling. Think of this as a health decision as to what you're making. And the first recommendation is just don't have a mercury filling placed into your mouth. Now, if you have a mercury filling in your mouth, there are things you can do to detoxify. And with me, I'll generally work with a physician on this to take care of some of the detoxification, and we'll do some of the detoxification as well. What people have to be careful about is you have to be careful detoxifying from mercury and mercury fillings while you still have mercury in your mouth. So the first recommendation is to find someone who will take the time to remove these fillings in the safest manner. And these include protocols that really go to great lengths to try to reduce your exposure to this mercury particular matter or this vaporization.

And think about when a dentist takes a high-speed drill to a mercury filling, it's stirring up mercury in a vapor form, it's going to interact at the lung interface, it will maybe take two trips around your bloodstream, and then it will kind of lock into that organ system wherever it is. So whether that mercury ends up in the brain or the central nervous system or wherever it may be, now the challenge becomes how do we get get this out? And that is a much more difficult situation. So my first advice would be don't have it placed. Second advice would be, we have to be aware that when we drill this out, there is a major risk to creating a massive exposure to mercury in that period of time. So-

Andrea Wien: Now, are there any... Just a quick question before we move on. Are there any organizations that people can look for a dentist that knows how to do a safe removal?

Dr. Matt Kogan: Yes. So there is the main organization that I would look to. It's called the IOMT, and that stands for the International Academy of Oral Medicine and Toxicology. And they have a certification program where dentists can go through and essentially show this organization that they've taken the steps in order to do this in a different way, to take out mercury in a different way. And they should have a directory of certified dentists that people can look to in order to have this done.

Andrea Wien: Okay, great. That's really helpful because I think sometimes people will talk to a dentist... My dad, for example, has silver fillings and he's gotten some of them removed and not done in a way that I would recommend where a dentist is just going in and drilling and taking them out. And so I think sometimes people will hear from their dentist, "Oh, it's totally safe the way that I do it," but knowing exactly what steps should be taken can be really helpful for people.

Dr. Matt Kogan: One thing I always tell people, if the room doesn't look like you're going to outer space, they probably haven't taken the precaution that I personally believe is necessary. Really the only thing exposed in your bodies should be that tooth. And there really needs to be proper ventilation, proper air filtration that can handle the toxic effects of mercury. People don't realize that way back in the day when we had those old school thermometers that had mercury in them, and they'd have them in the school buildings, and if the thermometer dropped on the floor at one end of the school building, they would have to clear the entire school out until that building registered zero in mercury.

But if we take that same measurement tool through the mouth when we are drilling out mercury, people would be astonished to find the levels of mercury in the air when you're drilling this stuff out. And again, if you're inhaling that and bringing it to the lung interface where it's going to distribute to the rest of the body, you're looking for a problem that could be much more difficult to resolve down the road than it would be just to do this in maybe a safe way from the onset.

Andrea Wien: Yeah, it's really just shocking. And the FDA actually just came out after so many years of saying that mercury amalgams were fine, they just came out and ruled that actually in some populations, which we could argue on the show it's all populations, but they limited it to some populations who may be at high risk, pregnant women, elderly, and children, that they are harmful. So I think it's interesting now that the FDA is even starting to put some things out there and it's hitting the mainstream.

Dr. Matt Kogan: Yeah, I have to say, I always follow that very closely, and I was surprised myself because I actually watched those hearings. They webstreamed them and I didn't have much confidence, but I think this is an issue. This is a over 100 year argument that we're still having. And when they actually came out and one of their recommendations was children, especially if they're under six years of age, and they also said pre-existing neurological diseases such as multiple sclerosis, Alzheimer's, or Parkinson's, that used to be really sacrilegious to implicate those conditions with mercury. And so I think the tide is turning a bit on this. I still think it's going to be a slow turn because there are bureaucratic organizations that want to protect these interests. But that being said, I was happy to see those recommendations come out.

Andrea Wien: Yeah. And we also had a past guest, Josh Gitalis, did a whole video on this, fairly short, a few minute video about just how chemicals come into our environment and how long it takes, roughly 20 years, for them to go through the process of whether or not they're safe. And he talks specifically about these mercury fillings. So I'm going to link to that for people who are interested in seeing that at in our show notes page. Okay, so let's move on to safe alternatives. So people might be listening to this and saying, "Great, but I need to have my tooth filled. I had a cavity, what can I do instead?"

Dr. Matt Kogan: Okay, so there are so many great alternatives nowadays that people have the options for. And people can really take this however far they want to. And I really base, as a clinician, I base these decisions based on the overall health of the patient. So I'm always looking at the big picture. If someone presents to me and they're healthy, they haven't been on antibiotics throughout their whole life, they're vibrant, they eat well, they exercise, generally we'll try to use dental materials that are inert. One thing that people don't know is a lot of these dental materials have fluoride in them and they will constantly produce fluoride as they're in the mouth. So I'll use materials that are fluoride-free, that don't have bisphenol A or BPA, that don't have phthalates. And these include filling materials and also ceramic materials.

Now, in the population that presents with more complex medical histories and more complex dental situations, there is testing that you can do in order to check your sensitivities or your immune response to dental materials. This can be done with a simple blood draw, or you can have your blood taken, and we essentially take that sample of blood in a laboratory and we match it to every dental material that we could possibly use, including implants or filling materials or ceramics. And it will come back with a very lengthy report saying, "Andrea, you are either sufficient for this or not sufficient."

And in someone that's really compromised with chronic illness, I think this is a great thing to do because we don't want to tax that immune system any more than it needs to be. But the reality is, there's really no way to know because even if I'm using something that's good for 95% of the population, I need a way to discern where that 5% is and I don't want to make that person worse. So this biocompatibility testing is a great tool we have for people that are really sensitive and really need to know, "Hey, is my immune system going to start to produce an inflammatory response to this, or am I going to be able to use pretty much what's safe for everyone and get by okay because my immune system isn't taxed to begin with?"

Andrea Wien: And if someone wants that test, it's called biocompatibility testing?

Dr. Matt Kogan: It is. And there are a few companies... I don't want to give a company name. There are a few labs that do a nice job of this, but if they find a biological dentist, they will be aware of this and they'll know how to handle this situation.

Andrea Wien: Okay, sounds good. So if people have been in the regular care of dentistry their whole lives, what might they need to do to get back to optimal health? So this is... I'd love to talk about detoxification and how the body goes through detox and what that looks like.

Dr. Matt Kogan: All right. And that's a great question too. And I see that a lot. I think the first thing they really need to do before they do any sort of detoxification is to really take a really comprehensive look at the diagnostics. And what I mean by that is if they've been going through, well, we'll call it conventional dentistry, they may present with no issues, but we need to make sure that there is the absence of infection, the absence of infected root canals, absence of cavitations, or essentially osteonecrosis in the jaw, an infection in the jaw maybe where a tooth was removed, possibly in childhood, possibly a third molar or a wisdom tooth that's harboring this infection creating these problems.

Once we identify that there either is or there are not these problems, then we get into the detoxification phase. And detoxification is usually phased out. So the first thing in my practice is we need to put out the fires. So big things that we see in the conventional system are root canals without adequate follow-up. If that root canal, for example, has a chronic subclinical infection, meaning there's no symptom associated with it, we need to identify that and we need to treat that issue before we've talked about detoxification, because if we start to go through a detoxification process and that infection is still producing these toxins through the rest of the body, the patient will get frustrated and they will not improve.

So we need to eliminate those stressors on the immune system, rid ourselves of infection, start improving the environment of the oral microbiome, and then start talking about reseeding it, replenishing the soil, opening up our detoxification pathways, whether that's the kidney pathways, the liver pathways. And we do this a lot through supplementation and a lot of work with our physician colleagues, but we generally do not do that until those initial efforts to remove the gross pathology are taken care of. And then we see the greatest benefit to detoxification.

Andrea Wien: I think too, and something I talk to patients about when they come to me and I've seen across the board and some people do it well and some people don't, and you've touched on it, we have to make sure that those pathways of detox are open. So I'm never doing a detox with someone who's constipated, right? Because what's the point of liberating all of these toxins out of the muscles or the fat tissue or wherever they might be stored, putting them into the body, sending them out to be flushed down the toilet and then having them get stopped up and reabsorbed into the body?

So it's making sure that you're drinking enough water, you're going to the bathroom regularly every day if not multiple times a day, making sure those things are in place, and then secondarily, making sure we don't have any lingering gut issues going on, the microbiome is in a good place. We talk about leaky gut. Leaky gut essentially is the wall of your intestine breaking down and letting whatever is in your gut into your bloodstream. So similarly to the constipation, why would we liberate everything, send it down through the gut to be eliminated and then have it get reabsorbed back in? So making sure we don't have leaky gut.

If we have leaky gut, we can also talk about blood brain barrier, so leaky brain, liberating toxins like heavy metals and mercury. If those are getting into the bloodstream, then they're crossing over and getting into the brain where they're much harder to liberate. So there's all of these pieces that need to be done before someone says, "Well, I'm just going to start detoxing."

Dr. Matt Kogan: Absolutely. Bowel therapy is very, very high and it is the most important organ for detoxification, for immune regulation, for nutrition neurotransmitters. Primary source of toxicity, chronic infections and inflammation, it's always in the bowel. Always in the gut. So that really drives my protocol. I always follow like a basic four-step protocol where first we want to, like I talked about, we want to remove the bad bugs, the allergenic foods, the contamination, the mercury fillings, toxic chemicals. We want to get all that cleaned up. The junk food, all the medicines, the antibiotics, we want to clear that up, remove those. Then we want to restart replacing maybe with digestive enzymes. Then we want to restore that friendly bacteria that we talk about. And then we talk about regenerating and repairing. So if you go straight to regenerate and repair but you haven't removed any of the bad bugs or replaced the enzymes, then you're just going to hit another dead end.

And so the one thing that keeps people motivated is saying, "Look, when I remove this source of toxicity, I am starting to improve." That encourages them to go to the next step. Well, maybe I should start restoring my bowel in different ways. So I agree. I think that detoxification efforts are really set for most people in the gut. Obviously there are circumstances where people are so toxic in heavy metals, they may consider culation therapy, however they may do that, to rid themselves of these metals. But it really, like you said, it starts in the gut and you have to have these pathways open in the liver, in the kidneys, or you will just reabsorb these same chronic infections that have been burdening the system for so long.

Andrea Wien: Okay, let's move on to some listener questions. So we put out a call last time for questions and we had quite a few come in and we'll just touch on a few of them because I know we're running out of time. We talked about mouthwash last time. And someone was asking this time that they use hydrogen peroxide in lieu of mouthwash. Is that okay or is that something that you would not recommend?

Dr. Matt Kogan: All right, so I just want to clarify quickly on mouthwash. We talked about nitric oxide earlier. Mouthwash destroys bacteria in the mouth that can contribute to cavities, other dental issues, but mouthwash kills all types of bacteria. So that includes the beneficial bacteria that we want to keep around and the beneficial bacteria that produces nitric oxide. So there are bacteria in the mouth that convert nitrate to nitric oxide, and that is... We spoke about the importance of nitric oxide. So to answer the question on hydrogen peroxide, there is a benefit in the right situation for, I would say 1% food grade, organic, non-GMO peroxide, although again, I think in a healthy individual, I'm not so sure how necessary it is, but there is a place for it.

Andrea Wien: Okay, that's great to know. Any signs maybe that you're overdoing it with that?

Dr. Matt Kogan: Yeah, I really would base this on tissue health, gum health consistency, whether there's bleeding. If you start to notice that the gum tissue is starting to look irritated, which it can with peroxide, then you need to back off.

Andrea Wien: Okay, sounds good. Another question we have, someone read an article that posture can really affect teeth. So they were wondering if you could expand on this because everyone's sitting over their computers these days, hunched over their screens. Are you seeing this in your practice that posture can really impact our tooth health?

Dr. Matt Kogan: Yeah, and that's interesting because there's a lot of research that started to be done in this and there is something to be said for this. So the listener has a good point. Really, when you talk about posture, when you have poor posture, what happens is the tongue will actually go into improper posture as well. And we touched on how important that tongue posture is. Well, when the tongue then falls into the improper position, the tongue supports the neck and the spine. So it's kind of this vicious cycle of poor spine posture affects the tongue posture, which is now affecting the dental health and the overall health of this patient.

What they're finding is that when the tongue is in the improper position, we're starting to mouth breathe, we're developing jaw pain, and we're developing neck pain. So we're creating this cycle of now we're tipping this person into a mouth breathing state, we're reducing their nitric oxide, we're stressing the system. And so by just fixing their posture, which could help put the tongue in the right position, we could prevent this cascade of events from happening.

Andrea Wien: That's so interesting. And really when we come back to it, the stuff's so simple. It's the basics that we always talk about, but just actually following through and doing them. Okay, time for one last question and we'll look ahead. Any idea how far we are from regrowing healthy teeth from stem cells?

Dr. Matt Kogan: So I have heard that that's always been around. And how far we are, quite honestly I don't know. They are always talking about that. Journal articles will pop up every once in a while where they're talking about that. I don't see that on the immediate horizon, to be honest. Do I think that will happen in the future? I think there's probably something to be said for it, but I don't think that's in... That's not imminent.

Andrea Wien: Okay. All right, good to know. Well, Dr. Kogan, thank you so much. This has, again, been an amazing conversation and I'm sure people have gotten so much out of it. So we really appreciate it. If people want to find you, of course, they can go to your Instagram, your website. We'll share all of that in the show notes at So you can find it there. And thanks again.

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

Andrea Wien: Thanks so much for tuning in. If you haven't already, I hope this show will convince you to leave us a rating and review. It really makes a big difference. And personally, it makes my week. So I've included a clickable link in the show description to make it easy for you to do so. You can also check out our show notes at And I want to remind everyone that BIOHM is offering a 10% code on any product on their website to podcast listeners. That code is BIOHM10. Thanks again. I'm Andrea Wien, and I'll catch you next time.


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