Introducing Cass: Researcher, Author, and Expert on the Oral Microbiome
Hi everyone, Dr.B here of askthedentist. com.I am very excited today to be here with my friend and colleague, Cass. She has written a fantastic book which I’ll explain more about later, but I’d like to introduce her a little bit. She was a researcher studying the pharmacology of medical plants at the University of Georgia and Epitech Incorporated. Cass consults with Genova Diagnostics and Metametrics Clinical Laboratories. She researches how to address the underlying cause of disease, not just symptoms, and that’s why I love Cass – she’s functionally minded. She wrote the book about the oral microbiome, which is a root cause for many things. She has over a decade’s experience teaching physicians about integrative and functional laboratory results.I’d like to learn more about that from Cass actually, and she is CEO of Health First Consulting LLC and, of course, she’s the author of this book here, which we’ll be talking about today.
Exploring the Importance of the Oral Microbiome: An Overview
Today will be kind of a 101 on the oral microbiome and why it’s so important. Anyway, thanks for joining us, Cass, and welcome. My pleasure, so happy to be here. Let’s keep it simple.I mean, I’ve been talking about the oral microbiome for quite a while. You’ve written the book on the topic, but I think it’s easy for us to forget how many people don’t know about the oral microbiome.I mean, it’s something new. Everyone knows, well not everyone, but a lot of people know about the gut microbiome, and now we’re talking about the oral microbiome. And I’m sure the questions are already beginning to start. What’s the difference and why is it so important? And does it relate to the gut microbiome? But I think most people today that are health-oriented, they know that the gut microbiome is huge in terms of well-being, how you feel, your psychology, how you interact with people, even your personality, and of course, all the other stuff, immune system, and overall physical biological health.
The Significance of the Oral Microbiome in Maintaining Overall Health
So, anyway, let’s talk about the microbiome. It’s super important. Just like you were saying, Dr. Burhenne. People are, that’s something that we’ve all seen on TV, we’ve seen the yogurt commercials, we’ve seen the probiotic commercials. We know that these good bacteria in our gut do so many great things for us. Well, it’s the exact same for the oral, the mouth. So, we have an oral microbiome. That is a collection of something like 20 billion bacteria. There are fungi and viruses in there too, and they live in harmony, helping us have good health as long as we kind of give them the basics of what they need to stay healthy. And this oral microbiome is fundamental to healthy teeth and gums. It’s important for systemic health. It has unimaginable connections with Alzheimer’s, cardiovascular health, diabetes, joint pain, rheumatoid arthritis, things you wouldn’t even expect. So there’s an oral systemic connection.
The Significance of the Oral Microbiome: Exploring the Relationship Between Bacteria and Human Health
Then there’s the immune system, which the mouth is where your body comes into contact first, or where your gut comes into contact first with the outside environment, and then everything happening in the oral microbiome in the mouth is being swallowed all day long into the gut, so it’s a major player for the whole body and for the gut and for the mouth. Let’s assume that most of us listening right now really don’t know much about any biome. Tell me about these bugs. Are these bugs human bugs? They are not us. It’s not our DNA. No, it’s not our DNA, and so I mean these are bacteria.I think everybody is familiar with bacteria, pathogenic bacteria. That’s what we’ve all heard about. You know E. coli, O15 or Salmonella, or some of these pathogenic bacteria. That’s what everyone hears about most.
Understanding the Benefits and Significance of the Oral Microbiome
Of course, you know, planet Earth is covered with bacteria. Every organism on Earth is covered with bacteria, and you know these are little single-celled organisms that actually something like 99% of them do not hurt us. They are either harmless or beneficial to us, so yeah, they cover our skin, they live in our mouths and our GI tracts and in every surface and orifice, and they have co-evolved with us and actually give us a tremendous amount of health benefits. So um, and most importantly, they protect us from pathogenic bacteria, so this oral microbiome or if we’re talking about the gut microbiome, these are good bacteria, billions of them, trillions in the gut that protect us from pathogenic bacteria, and no, they don’t share our DNA. They’re totally different, and yet we have, you know, some have called us a symbiont.
The Essential Symbiotic Relationship between Humans and Oral Microbiome
It’s like we’re, you know, it’s a symbiotic relationship, humans and bacteria, and we and it’s mostly all good things. So these are bugs that are hitching a ride, essentially. Yeah, and the two of us together, you know, us as an organism, these bugs as an organism, that essentially makes us a super organism. Yes, and this is not a war that’s going on in our mouth or our gut. This is a symbiotic, as you said, kind of relationship that without these bugs, I think we would just be dead.I mean, they produce a lot of vitamins, a lot of nutrients. They help our immune system. Yeah, our immune systems would be shot or exhausted. So that’s important to realize that these are important bugs. These are not bad bugs, even though they’re not ours, and so it’s not like we’re infected.
The Impact of Disinfecting the Oral Microbiome: Study Reveals Potential Side Effects
I think in dental school and in medical school, at least when I went to dental school, we always talked about these infections and that we had to disinfect the mouth. And so, a perfect example of how, you know, if we try and kill off these hitchhikers that are in our mouth with mouthwash, let’s say we use a very strong alcohol-based mouthwash or something that’s bactericidally based, and we use that continually. There’s a study out there, of course, that that causes bad breath. They can also elevate your blood pressure. So that’s a perfect example. What’s going on there? We aren’t being kind to these communal bugs that we’ve taken a ride with.I mean, is that a perfect example of how we need to look at the oral microbiome in a friendly sort of way, in a cohesive kind of communal way? Tell me more about that study. Absolutely.
The Role of Oral Microbiome in Regulating Blood Pressure
Well, what they learned was, I mean, you know what the study showed is that the oral microbiome helps keep our blood pressure regulated, okay? Something like 25% of the nitric oxide that we produce, so nitro.I mean, let’s not get into the biochemistry too much, but nitric oxide is a really important molecule that helps lower blood pressure, helps calm down, open up all the blood vessels, and it turns out that we can’t make it by ourselves. We need bacteria to do a critical biochemical step for us, and these oral microbes do it. They do it for us. They take the food, the vegetables we eat. Beets are a perfect example. When you chew up those vegetables and greens, and especially beets, your oral bacteria can make nitric oxide, and this helps lower your blood pressure. So what the researchers found was when you take mouthwash, which is kind of like hitting your mouth with antibiotics, killing bacteria, killing the good bacteria too, blood pressure increases.
The Role of Diet in Nurturing the Oral Microbiome for Cardiovascular Health
So this is a huge finding that the bacteria in our mouths that nobody’s paying much attention to and trying to probably kill more than not are actually having a fundamental role in our cardiovascular health. So talk about how, I mean, a lot of people are aware that the gut microbiome can be nurtured by diet. Is that the same for the oral microbiome? Oh yes, absolutely. It’s my number one favorite thing to say to do for the oral microbiome and the gut microbiome, and it is one of those nice things about diet. Maybe people are tired of hearing it over and over again, but you know, you are what you eat, and this applies to your microbiome too. You know, your good bacteria are what you eat. So that’s right.
The Importance of a Whole Foods Diet for a Healthy Oral Microbiome
Diet is just one of these transformative things, and let’s be specific right about what the diet is that builds a healthy microbiome in the gut, in the mouth, everywhere in the whole body that is going to be a whole foods diet, no packaged processed foods, no sugar, vegetables heavy and plant-based, heavy in plant foods, vegetables. You know, I always mention kind of moderate to easy on the fruits, but those are great too, and lean meats, lean organic meats. Is there anything I’m missing there? No, I mean, it’s the same story. Whatever you hear is good for the gut, for your body, for overall health. You know, I had a beet and arugula salad. In this case, that’s what I was picturing and tasting. You know, if I want to feed my oral microbiome right. You know, some olive oil, of course.I mean, it’s really that’s what people need to understand. The mouth is not this little vacuum over here that has different parameters. What’s good for your body, of course, is good for the mouth.
The Role of Oral Microbiome in Dental Problems: Imbalance of Bacterial Flora Linked to Common Dental Issues
And of course, if the mouth is off and you have inflammation in your mouth, which the majority of us do have in this nation, in this country, probably the world, then it’s all related. So that’s great advice. So it’s not complicated. Good diet. You’ll feed the oral microbiome. Yes, good diet, good microbiome.I wanted to mention something, Dr. Burhenne, when we were talking about, you know, what you know, why the oral microbiome is important. This is actually, you know, probably obvious to dentists, but I think to the average person, like me, this was not obvious before I researched the topic, which is almost all of the major dental problems are due to an imbalance of the bacteria, whether it’s a pathogen in the mouth, so whether it’s a pathogen taking over or opportunistic bacteria taking over. So, let’s just list the examples, and you might be able to add here: cavities, gingivitis, gum disease, root canal infections, bad breath.
Rapid Shifts in Oral Microbiome and the Impact of Diet
You know, all of these are pretty much by definition an imbalance of the oral microbiome. Would you agree with that? Absolutely, or dysbiosis. How quickly can the oral microbiome be helped shifted? Diet alone? Yeah, that’s a great question.I can’t tell you, like, I can’t put a number on it with a reference for you, but I would guess within one month you would see, well, within one month you would see changes, and probably within three months it might be transformative.I would agree with that, yeah, because bacteria grow extremely fast.I mean, their doubling time is just like, so even when you get hit with antibiotics, it’s not that you’re without bacteria, it’s just that they’re growing back in the wrong community. The wrong communities are growing back rapidly after antibiotic use, so anybody, I mean bacteria grow extremely fast, like nothing like anything our minds can capture. Yes, and especially in the mouth.
The Impact of Oral Microbiome Reset Program on Mouth Healing and Overall Oral Health
I mean, the mouth has a lot of areas that heal very quickly. You know, by default, they have to. We have an oral microbiome reset program on askthedentist. com, and it’s a 30-day reset, and most people will see a difference late into the third week. Assuming everything is, you know, that there’s dry mouth has been addressed, that they’re not using dental products that are killing and putting down the oral microbiome, and of course, they’re eating an oral microbiome-friendly diet, and the changes are the taste in the mouth, the viscosity of the saliva, the smell of your breath, and bleeding gums.I mean, if you have gingivitis, you can reverse gingivitis if you treat the oral microbiome properly. So, but I would agree with you, I think it’s, I think noticeably you can see it in four weeks.I typically tell patients six to eight weeks, and then, of course, if you do that for the rest of your life, I mean, the implications are profound.
The Connection Between the Gut Microbiome and Oral Microbiome Explored
There’s probably a second wave of wellness that happens at the six-month marker. So you just become a lot more resistant to anything that can happen in the mouth, and also, it helps seed the gut.I mean, to talk about the connection between the gut microbiome and the oral microbiome.I find that very fast. Yes, so, I mean, well, I mentioned earlier, some parts of it are just purely mechanical, and I feel like in medicine, we’ve detached the mouth from the gut, but I mean, this is all one continuous line. So, of course, all the microbes in the mouth are, I mean, we’re swallowing them in saliva all day long. Now, in theory, not all of them are going to reach further down in the gut alive, but many of them can, and there’s something like a 45% overlap between the gut microbiome and the oral microbiome.
Exploring the Role of Oral Microbiome in Health and Recovery
So, of course, you know, I always wonder, well, chicken or the egg, which one is setting up the stage, and I would argue that it could be the oral microbiome since it’s at the front of the line.I agree with you. We’re biased in terms of diversity of the bacteria. The mouth is second only to the gut in the biological diversity of the microbiome. So, in the mouth and the gut, we’re talking about a lot of biological diversity of bacteria, which is a measure of health. So what other tips can we talk about? One I always go to is mouth taping. If you are sleeping with your mouth open at night and you are able to tape your mouth closed, it’s safe. We have lots of information on ask the dentist about that. That’s one thing that will really speed up the recovery of your oral microbiome if that is you, and if you’re able to mouth tape.
Addressing Mouth Breathing and Improving Nasal Breathing for a Healthy Oral Microbiome
Now, if you can’t mouth tape, obviously you are a mouth breather and you cannot breathe through your nose, and that needs to be addressed as well. So it’s a great differential diagnosis for knowing that, and whether you can’t tape or not, it doesn’t matter. You still have to fix the nose if you want to fix your oral microbiome. So, in other words, in a little bit of a sound bite, if you want fewer cavities, you have to be able to breathe through your nose. What other things would you add to that? They can get on top of their breathing, make sure that their microbiome isn’t being washed over in oxygen all the time. We talked about diet. Diet’s huge. That, to me, that’s number one. We can, let’s see, well-done oral hygiene, right?I mean, I always include that in terms of brushing and flossing, and that, to me, is kind of foundational. And then it gets a little bit more tailored to what a person needs and what’s really going on with them.
Signs of Oral Dysbiosis: Identifying Imbalances in the Oral Microbiome
So, and remember, we talked when we said diet, we’re talking about an oral microbiome-building diet. How would someone know, let’s say someone’s been listening and they’re like, well, what about me?I mean, how do I know if I have an oral dysbiosis of the oral microbiome? Well, I mean, for, and you may be able to chime in here, but I mean, my thoughts would be anybody who’s had a lot of dental work, anybody who has any issues when they go to the dentist whatsoever, childhood cavities, so, I mean, again, I feel like a broken record, but cavities, bleeding gums, bad breath, gum disease, loose teeth, loss of teeth, bleeding gums, and you might want to look at your family. Did your parents struggle with these things? Do your children struggle with these things? Because it runs in families, whether it’s the genetics or the microbiome. So, kind of looking around and trying any of those issues would be a sign that, okay, the microbiome is out of balance.
The Importance of Oral Microbiome in Dental Health
It needs help.I mean, as a dentist, I would say a lot of patients don’t come see me.I know there’s a big group of people out there that will not see a dentist on a regular basis, and so if you have tooth pain, bad breath, gum disease, bleeding gums, blood in your sink when you spit out or on your floss, these are all signs. So essentially, any kind of oral disease means tonsillitis. Tonsillitis came up in our question and answer, and that’s another one, sore throat, dry mouth, bad taste in the mouth, metallic taste, ulcers, potentially ulcerations. Exactly, the mucosa, which is the oral mucosa. It’s very fragile. It’s one cell thick.I mean, that needs these bacteria to maintain it and regrow it and protect it. So I have patients that come in and they’re always asking me why, you know, my husband or my wife, my kids, they don’t get cavities, they don’t even brush and floss, and but I’m always in here getting work done, and my answer, I think now, is your oral microbiome is different.
The Connection Between Oral Microbiome and Heart Disease
That’s it. You may be brushing and flossing, but if you’re not feeding it correctly, I mean, the difference is in the basis of that. Is that there’s a difference in your microbiome. Your oral microbiome is not the same as that other person who may not be brushing and flossing as much as you are. So, that’s really the way to know.I mean, is there anything systemically that would set that would indicate that there’s something wrong with the oral microbiome?I’m curious.I don’t know. Well, I mean, heart disease. There’s a pretty strong connection.I mean, I wouldn’t, I the only time I would rule out a role of oral health in heart disease is if, you know, your checkups are just perfect. But I mean, oral pathogens are implicated in heart disease. It’s pretty, I mean, it’s not 100% evidence, you know, grade A evidence, but it’s approaching that. Yeah, I think the way I would answer that, I was just thinking about it, is that it would be comorbidities of that. In other words, you would have Alzheimer’s.
The Importance of Addressing Oral Microbiome for Disease Prevention
Well, it’s too late to work on your oral microbiome. You would have heart disease, high blood pressure. You would contract diabetes. So, the point is, is that you have to address the oral microbiome early on if you don’t want to get all these diseases that are linked to oral health. Is there anything else you want to add?I mean, this is just oral microbiome 101, right? We don’t want to get too complicated. Next time we chat, we are going to talk about the oral microbiome and your children and pregnant women, mothers, parents, breastfeeding, breastfeeding. And there’s, we’re gonna get a little bit nerdier there because there’s a lot to know there, and some of it is well, the good news is that it’s all fixable, but it can be scary as well. So, I think people, I think parents, even young couples that are thinking of having children will want to listen to that. So, but is there anything else you can add to what we’ve been talking about, oral microbiome 101 in general? What?
The Importance of Oral Microbiome Testing and Available Options
Sure, well, two other things that we didn’t talk about when we were talking about, you know, what can you do if you have dysbiosis of your oral microbiome? One thing we didn’t talk about yet, and maybe we can nerd out on it another time, would be testing. So, there is oral microbiome testing. You can find out if there are bad bugs that have basically taken over and gotten overpowered your good bugs. So, there’s testing to help really kind of figure out what’s happening. That’s helpful. For example, OralDNA Labs is one that is in the U.S. and can be used, which is your favorite test right now for the oral microbiome?I’ll link to it. Yeah, I think I would just go with OralDNA Labs.I’m interested in the one in the UK.I think it’s a better test, but since it isn’t available here yet, we’re gonna have to wait.I couldn’t even get it done myself. Oh, darn. Yeah, no, that’s a good one, and that’s, yeah, that’s in vivo laboratory. So, we will eventually, hopefully, eventually have that in the U.S.
The Role of Antimicrobials in Shifting the Oral Microbiome Safely and Effectively
The other thing I wanted to mention is that you can shift the microbiome in the mouth with antimicrobials, but those really are to be used cautiously and carefully and really under medical supervision. So, everything we talked about was more on the gentle side of gently shifting the microbiome, which really is the way to do it, right? But, um, you know, if you have a lot of acute symptoms in the mouth, um, antimicrobials might be needed. You know, carefully, short-term, and there are sprays, there are not, you know, pastes, there are different things that could be used temporarily to try to get bacterial overgrowth under control. One last question: since we’re living in the COVID era and there’s been lots of talk about pre-existing conditions, there was a study out of England.I’ve spoken to one of the researchers, Victoria. She’s wonderful, Dr. Victoria Sampson. So essentially, oral health is a risk factor for COVID, along with obesity, immune suppression, hypertension, high blood pressure.
The Oral Microbiome: A Surprising Risk Factor for COVID-19
Yeah, and I think a lot of people may be surprised by that. How, and I think it’s one of the biggest risk factors personally. However, that remains to be seen. Tie that in for us. So, oral microbiome risk factor for COVID. What? Yeah, there.I mean, why didn’t we think of this earlier? That’s what I was thinking too. Yeah, yeah.I mean, even I didn’t quite connect that before the study came out, so I really appreciate that you sent that newsletter out. But, um, so this makes perfect sense, and I mean, we do know that there’s, first of all, uh, these microbes in your mouth can be, you know, have a connection with your lung health.I mean, this microbiome in your mouth, these microbes can get into your lungs very easily. And so, if you have dysbiosis in the mouth, I mean, this is established. Although I didn’t write about it too much in my book, is that you can have more risk for pneumonia. You can have more risk for respiratory illnesses.
The Role of Secretory IgA in Boosting Oral Microbiome and Immunity
This is what’s happening in the mouth. Now, also, the something called secretory IgA is a really important immunoglobulin in the mucosal lining, all through the gut, but it’s heavy in the mouth, and that fights pathogens and destroys pathogens and allergens. And if that level is low, you are going to be more susceptible to infections. Right, so boosting that microbiome in the mouth boosts SIgA, as we call it, and that helps raise your immunity. So, I mean, those are the two things that I’m thinking about. Of course, I mean, I could go and go and go. Yeah, and we will. We’re going to be seeing, we’re going to be talking a lot more with you, Cass, and I look forward to it. But that’s SIgA. We want more of that SIgA, and we do that in a nutshell. We eat well, we keep our mouth closed, keep it moist, keep the saliva flowing, and see a dentist. And so, a lot of people have a question. Well, you know, my dentist doesn’t talk about the oral microbiome. What’s going on there?
The Need for Dentists to Embrace the Paradigm Shift in Oral Microbiome Understanding
I mean, I have mine, but I know you’ve talked to a lot of professionals, dentists, a lot of physicians. You consult with them, you help them interpret their lab results. So why is it that dentists are not doing this? Is it their education? Is it something that they don’t want to believe in?I mean, is it too complicated for them? Is it too new?I mean, you know, I’ll be interested to see what you say too, but for me, it’s a paradigm shift. This is a paradigm shift. We’re all getting on board with this, that this microbiome is an another organ of our body that is essential to health, and I don’t think what we talked about earlier, that one pathogen, one disease, one pill kind of model, it’s outdated now. It’s not what we want to be doing, right?
The Paradigm Shift in Dentistry: Recognizing the Importance of the Oral Microbiome
Many dentists have been trained in that model of just like kill the bad guys, kill the bad guys, and they forgot about 99% good guys that actually protect us from those pathogens. It’s the dental curriculum, and it is, and I’m not saying this in a bad way, but it is an indoctrination. It has to be for you to be a good clinician, same thing with physicians. And the oral microbiome is how old?I mean, late middle 2005. Right, right. Yeah, and it takes 10 to 15 years for this to sink in, and but I think finally, that paradigm shift that you’ve mentioned is happening. The tipping point, we’ve passed that, and the research is coming, and you know, COVID has really kind of enlightened us in terms of how important oral health is. So, anyway, and normal people care about their oral health, and they’re taking it to their dentist and talking about it. So, I mean, everybody is part of this paradigm shift.
Importance of Finding a Functional Dentist for Managing Your Oral Microbiome
They are, and so the reason I ask that question is, well, how do you find a dentist, and there are many of them that can have this discussion with you, test your oral microbiome, help you with it, advise you, and notice the changes that you’ve made.I mean, these are all important things, and this is foundational. In other words, you can have fillings filled and crowns done and root canals done all you want, but if you want to stop that cycle, you’re going to need to see a functional dentist. So, just to let you know, we do have a list of functional dentists. It’s a locator list. If you go to askthedentist. com and type in “find a dentist,” you will find a dentist that will be able to talk to you about all of this, and I think that’s really important.
Exploring the Importance of the Oral Microbiome: A Conversation with Dr. Cass on Dental Health
So, if you don’t want to be one of those patients that every time they come in, they have dental work done, or if you want to be that patient that comes in maybe once a year, gets a clean bill of health after a 50-minute session of cleaning, I mean, that’s what you need to address the oral microbiome. So, Cass, thank you so much for spending time with us again. It’s all in this book. If you want to read about it, it is very approachable.I do recommend it to practitioners as well. It should really be required reading in dental school or just slightly before dental school. Once you get that acceptance letter or email these days, actually, then that book should be in the mail, and it should be required reading on the first day of dental school. There should be a short quiz on the oral microbiome because it is foundational, so important. So, that would be amazing. Thank you so much for having me, Dr. Burhenne. Pleasure, and it’s so much fun talking about the oral microbiome.
Exploring the Impact of the Oral Microbiome on Parenting and Child Health
There are very few people I can talk to about the microbiome and agree on most of it. So, next time, Cass, when we get you back, we’re going to talk about, again, as I mentioned earlier, about parenting, about how the oral microbiome can affect your child. And this is going to be a lot of great advice, prenatal, postnatal, perinatal advice, and what to do if, for example, you can’t have a vaginal birth. And we’ve got all sorts of information on how to deal with that. So, again, let’s figure out how to get our kids on the right track. Exactly. Thank you again for joining us, Cass, and we’ll see you again soon. Thank you.
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