What Your Dentist Might Not Be Telling You About Your Health
In my latest podcast episode I again have the pleasure of chatting with our resident dental expert Dr John Roberts. This time we are also joined by our resident dental hygienist Annalea Staples. Once more we delve into the fascinating subject of oral health and its relationship with systemic health. We'll cover dental implants, fluoride, children's teeth, biofilms and lot's more.
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Transcript
Intro Speaker: 0:00
Welcome to functional medicine bite sized the podcast where Pete chats to experts in the field of functional medicine and health, giving you the listener pearls of wisdom to apply on a daily basis
Peter Williams: 0:19
so, welcome to this new episode of functional medicine bite sized and I have got the pleasure of introducing sort of resident or resident dental expert and of course, internationally known biological dentist, Dr. John Roberts, and soon to be internationally known and renowned dental hygienist Annerlea Staples Oh,
Annerlie Staples: 0:42
yeah. Good. Thanks. How are
Peter Williams: 0:43
you? Oh, good. Yeah. It's funny, we had to I had to cut this short because I gave such a crappy introduction before and I just wasn't happy with it. So this is our this is our second tape edit. So guys, look, I think this is a podcast, which is really about, you know, what's happening now in dentistry, which is massively exciting. But you know, where it's come, particularly in the last 10 years? And I think importantly, you know, what we want to do is that most people don't know this, this stuff is going on, you know, they're probably generally go into their dentist, and none of these associations or new techniques or discussions have been had, and I think we should have some of those tonight. So I suppose that sort of runs us in is where the hell do we start? John? What what do you think has been the most important breakthroughs in dentistry in the last 10 or 15 years that most people don't even know about?
Dr John Roberts: 1:34
Well, I think the exciting thing and you used the word already, we're just waiting for science to catch up with this. Because, you know, in my long, somewhat chequered career, I've been alternative, whatever that means, I've been holistic, looking at the whole body, I've been a functional dentist, I've been a biological dentist, I'd like to actually be a scientific dentist, because you know what, if you just stick to the science, that's what we should be doing. So years ago, we had to stay and treat the mouth only, we weren't allowed to mention that mercury comes off the fillings and causes problems to your health. But now the science clearly says gum disease influences the health of the whole of the body, which is why we collaborate so well with Anna Lee, and some of the products we'll talk about, and therefore we've broken that barrier between dentistry and the rest of the body, then we can start to talk about materials and mercury. And if we do DNA testing, and we can talk about the, the APOE4 protein, which you can do a scientific test. If you've got it, you're going to have more problems with mercury and your risk of Alzheimer's is higher, no scientific person is going to disagree, then we look at the airway and breathing and why the jaw should grow. And that's where it currently is. If I was to do dentistry again, before I say what I've done in the past, I would only do airway dentistry, to get the airway, right, the alignment of the teeth, right, the function of the lips, cheek and jaw in the mouth, right and your breathing properly. You don't have the dental problems, and we're fixing the dental problems, that airway dentistry, certainly with our youngsters, we should be able to solve.
Peter Williams: 3:22
So in a sense, John, what you're talking about there is almost like root cause dentistry, isn't it? I mean, it's very similar to Systems Thinking medicine, functional medicine is that the reality is you're always always going to be dealing with stuff that is going to consistently occur because you haven't dealt with the root causes.
Dr John Roberts: 3:38
100% and dentistry in its pursuit of straight white teeth, is ignoring basic biological, scientific ways that the mouth should work. So any dentistry we do is going to be a compromise on what nature was intending to give us. And there's lots of reasons why some of its modern living, you go back to Weston Price, but nearly 100 years ago, he showed you the indigenous tribes living you know, beautiful lives, loads of vitamin D loads of fresh fish, no processed foods, they have beautiful mouths. The mouths did wear out though. We now want mouths that are going to last and I've seen many people now who with good dentistry have got their teeth at 70,80, 90. And for the next generation of dentists and dental hygiene therapists like Anna Lee, their challenge is to get people to keep their teeth till they're 80 and 90. And so
Peter Williams: 4:36
I'm one of them, John as you know.
Dr John Roberts: 4:38
Where we are now is exciting, because we don't even know where we've come from Never mind mapping where we're gonna go going forwards. And that's the exciting thing.
Peter Williams: 4:50
And isn't isn't isn't the science showing that every tooth loss increases your risk of early mortality?
Dr John Roberts: 4:57
Absolutely. And dementia you know, it's always been there and give me an older person with their own teeth to use a reasonably poor example I was with my auntie 100 and and a half. And she's got most of her teeth. Now they're full of amalgams. So would it have been better if she haven't had the amalgams, I don't know. But you don't see healthier people. And I'm making a sweeping statement, if they have full dentures, you just don't see them as healthy dentists tries and masks things by putting implants in, which is really masking the loss of teeth. And remember, a dentures replacement is a substitute for no teeth implants replacement for teeth. But we've got to look at the metals and the materials and the cleansability. And I think we're now running into problems with implants, we were great we can put them in. But unless the person has the faculty to get them clean, and we share a few patients, they're having to come in and have their implants cleaned four or five times a year, because they're losing their dexterity, they're losing their cognitive function. And are those implants going to be causing problems with them going forwards? It's a sad fact. And whatever you commit to always ask for the downside of everything. But you know, what, if you have all your teeth, fitting together, breathing properly working, right, that's what we should be aiming for.
Peter Williams: 6:21
I know we've already talked about this on a different podcast. But I think the subjects are around implant plant failure, I think it's really important to just if we can just have a quick chat about that. The implant failure rates quite high, isn't it?
Dr John Roberts: 6:36
I don't think anyone's really admitting what it is. Because implants were always thought to be for life, and they're not. There are implant clinics now in our great city, Liverpool, they'll say 10 years, that's it. And then they have to be all taken out and put in again, because they know that the longer they're in, the more problems there are going to be, but they're seeing people in their 40s, who just take all my teeth out and put implants in and look at my teeth. I'm not saying our hero Juergen Klopp has implants in, but that will need more maintenance for the rest of their life. So an implant, you've got to look at the metals you're putting in the body, you've got to look at implants with other metals in the body, such as mercury fillings, because you put an implant in the mouth, you'll release more mercury from your mercury fillings. So I did implants. I stopped doing that a couple of years ago. But I wouldn't put mercury, I wouldn't put implants in if someone had mercury fillings in their mouth. Because you have that galvanism that electrical current between the fillings and the implant. So you'll be releasing more mercury. Okay, you shouldn't have any gold in your mouth with mercury.
Peter Williams: 7:40
So what you're saying is, is that the more metals that you have in your mouth, the more likely you're going to set up in a sense an electrical current.
Dr John Roberts: 7:49
Undoubtedly, and that, you know, that's 150 years old. Okay, that science is 150 years old.
Peter Williams: 7:57
And what about because obviously, I'm, obviously I've got , I like to think I've got a good idea with regard to oral systemic health. So if you've got someone who systemically is highly inflamed on a poor diet, is that or just a poor lifestyle? Does that accelerate the implant failure rate?
Dr John Roberts: 8:17
I'm gonna say, almost certainly, I can't categorically say because every person is different. But it becomes a lot more challenging to our resident hygiene therapists expert here, because she's the one that seeing people every three months, just to keep the implants clean. Because once you get infections in implants, there's only one way it's gonna go.
Peter Williams: 8:38
So let's bring the expert in. And he can we can we talk about this? Because you are probably seeing implants all the time, aren't you? What is the difference that you see once implants have gone in.
Annerlie Staples: 8:49
So we know that patients that are susceptible to gum disease around teeth and patients that have had a history of gum disease around teeth certainly are more susceptible to that developing around dental implants. So before placing implants, we like to ensure that the lifestyle factors that you were talking about and so on, brushing, cleaning, and so on, is at a really good high standard before we then go and put implants in so that they're in a position for them to be able to care and maintain for those implants as much as they can at home.
Peter Williams: 9:21
I know you you've certainly in the last 18 months started to use genetic testing to give you an indication of maybe someone who's even more at risk. Do you want to just chat about some of what you've potentially found there as well and and how more personalised you can get with that.
Unknown: 9:41
Yeah. So I think certainly when we see a patient as one of our routine oral health kind of visits whether it's the first time or they're coming back for a follow up appointment, we always will have a discussion around anything that could potentially impact their oral health. So obviously there'll be the questions around brushing and cleaning. But we'll also look at things like, you know, diet, nutrition, lifestyle, and anything that I suppose can can impact it. And the point of that is so that we can perhaps, modify or see if there's anything in that they can be doing to enhance their oral health. And another more recent element that we can bring to that are some tests that we can do that can give us a bigger picture, a more detailed picture, perhaps of what is going on? Yeah, so there is the DNA smile test is great, because we know that particularly with gum disease, there are certain there's definitely a genetic factor involved, there are certain genes that make someone susceptible to getting gum disease. So we know there's certain, you know, genetic elements that makes someone more susceptible. So if we have that information, and that data, we know potentially how, how closely we might need to monitor a patient, it doesn't mean that yeah, they're definitely going to get gum disease. But perhaps if they have some of these, some of these, you know, genetic things that have been flagged up in this test, it means we need to be much more cautious. We need to look at lifestyle a lot more, and be a lot more focused so that we can prevent problems happening down the line.
Peter Williams: 11:18
So it's very much I'm gonna use word i don't like it's I find it a bit fluff, but it's very much holistic dentistry here, isn't it? You know,
Dr John Roberts: 11:29
It's looking at the whole person. And it's not only how dentistry affects the person's health, but how the person's health affects the dentistry? Absolutely. I mean, you can put the best implant in the world. And believe me, I've done some and then when it doesn't work the way you want it you think, was it me? Or was it the person that actually owns the implant? Was it the person that owns it? And we all as, as practitioners take it personally? What more could I have done? Yeah. And sometimes you're taking on the fact that they don't care for it as much they don't spend as much money on I'll continue using these cheaper brushes or whatever, you invest 2/3/4 thousand pounds on one implant sometimes. And yeah, you'll be cleaning it with something you bought at Costco with respect to Costco, you know, you got to invest in looking after it afterwards.
Peter Williams: 12:18
So based on both of your experiences here, and I think, based on where the world's going is, you say, I mean, that dentist that is doing a whole Liverpool team, John must be doing well. But let's assume and I absolutely agree with you, because even if we look at the data with regards to gum disease, and diabetes, gum disease, and obesity, they're completely bi directional relationships. So if you're diabetic control gets worse, your gum disease gets worse, you know, if your gum disease gets worse, your diabetic control gets worse. You know, it's just a classic example. And I think you're dead righ. I think what we're looking at I mean, this is the thing that I think about all the time, is that, surely you probably want to be much, you would hope that these people who are having full mouth implants, because you've got the money, because I mean, I don't know how much a really good full mouth implant would cost but (star at 20,000 and go upwards) Right. Again, it's a massive chunk of money. I mean, with such high failure rates. You know, I mean, I don't know whether those conversations are being had. I don't I don't know.
Dr John Roberts: 13:19
I think that's where you'll find more and more they'll say, right? The onus goes back on the patient. We, for example, a lot of other practitioners, unless you're having hygienist every three months, they're not even guaranteed. (right) Because you've got to show us and we had a conversation with a lady who's moving down south, she can't make it up here. You've got to show us you're having regular hygiene visits. Otherwise, I mean, and she was having full ceramic implants, you know, we can't say come back three years down the line if you're not having your teeth cleaned, because it's your responsibility, you've spent the money. It's a but like having a car, you don't take it to the service people and say it's not working when you don't look after it. Well, in many
Peter Williams: 14:01
ways, it's also like me having a type two diabetic patient where you've done a really good work a workup for, you know, the blood sugar levels are stable, you're very happy where they're at, but then they leave you for a certain period of time and they've got to put work in Haven't they? Why is it that implants cause more trouble then what is it about that process as opposed to natural teeth.
Dr John Roberts: 14:23
The bottom line is an implant is has a screw in it, that you screw and tighten into the bone. And you have depending on the design, a two or maybe three millimetre smooth collar that the gum holds tight to. And that's the same thing with gum disease. The gum holds tight to the tooth, it holds tight to the implant, but the moment the gum pushes away, and the bacteria or food get into the thread, there's this journey down the thread. And it's very, very difficult to stop the bacteria just going and going and going down the thread and you can't regrow the bone that easily. All you can do is to use cleaning dentists used to cut the gum, clean it by hand, that really doesn't work either. And we have fancy machines we've got around us, airflow. We're not exclusive. So many people have that. Lasers can go down, you can get lasers in toothbrushes now you can get ultraviolet lights in toothbrushes. But the moment that thread starts to go, you're having problems. So
Peter Williams: 15:31
I'm going to put you both on the spot here. Let's assume that a certain 50 or 53 year old male is deciding that, you know, he's probably might be going through the andropause. And rather than buy the Harley Davidson and head off into the world, I might get a new set of teeth. So as I'm looking 20 years younger, would you recommend that if my if my teeth are generally okay.
Dr John Roberts: 15:58
I would say as I hopefully I'm an example of age gracefully, because I'm not a big fan of these people coming in and wanting nice white teeth again and everything we age gracefully. I mean, it takes me a long time to dye my hair this colour. But you know, we're trying to make something we're not. Teeth will wear a little bit, it's trying to stop excessive wear, gums will recede a little bit, it's trying to stop it. And coming back to the dentistry. You want to do dentistry to help that person age more slowly, rather than try and fake it and give you beautiful straight teeth again, it doesn't work. And I'm only smiling because that's where everyone's making their money, but come back in 10 years time. And you know what? It's showing the signs of age that you wish, why did he do it?
Unknown: 16:52
Ultimately, there's no replacement for your own tooth, nothing will ever be as good as your own tooth. So if we can keep your own teeth healthy, then that by far is the best.
Dr John Roberts: 17:07
So you're you're asking, is it better to have an implant than nothing at all? Probably yes. Okay,
Peter Williams: 17:14
and what would be the reason for that John? Right,
Dr John Roberts: 17:16
the big thing is, and this comes down to what style of dentistry I want to do, if you have your teeth, you've got a good bite, stable bones, open airway, if you start losing teeth, you start overloading the remaining teeth, so the wear becomes more and more. So 28 teeth all fitting together should be fine. The moment you lose one or two here, you don't see it, you know, you overuse the other teeth, they wear, your jaw then closes, you don't breathe as well. So you start snoring at night and this snoring or potentially sleep apnea, because you don't have the supporting teeth to support the structure of the face. Then you're going into problems. The trouble is dentists are throwing implants in, in a mouth, thats already worn down. And if you've got to put implants in, build it back up again build it to the height that the teeth were 10/15 years previously. But they don't they just want to do the dentistry where they are.
Peter Williams: 18:16
So obviously, you know me and you John, a big Liverpool supporters. You know, we're both born in the city. Do you think Jergen's are a bit big then? Because I always look at it. And I think Jergen's look a bit a bit too big and long to me.
Dr John Roberts: 18:27
It wouldn't be my style of doing it. But you know, what, he's got a big airway in there hasn't he, he's got lot's and lot's of room . The problem is, and I've lectured on this, I think it's nice. I was invited by a Spaniard to do this. We put implants in, because we want to put implants in. But we don't even consider the airway. So when we Yeah.
Peter Williams: 18:48
So can we get onto that? Because I think this is another major, I had, from a referral from you, probably a couple of years, one of the myo-facial therapists in the in the society of myo-facial therapists, I did a lecture to them a couple of months back. And I had no idea just how well developed a society that is, so can we can you just briefly explain the importance of that aspect? Cause I think that's where we're going as well, the importance of, you know, having a strong jaw muscles that work correctly. And, you know, like, like you found with me, John, I have a very small airway, don't I? Yeah. So can we talk about why that's problematic or why that can be problematic?
Dr John Roberts: 19:36
Do you want to start? (Yeah) I mean, Annie's good at this because Annie works with the kids. And there's the older people like us. But if you get it right in kids, you don't have the problems when you're our age. So Annie can start and I can pick up with the older people.
Unknown: 19:50
So myofunctional therapy is essentially looking at training the muscles of the head and neck so that will include the tongue, the lips, cheek, neck muscles. But ultimately, we're aiming to have, I suppose correct habits if you like. So we want to be swallowing the right way, we want to have the tongue living up in the roof of the mouth, we want to have the lips together resting. And you could argue most importantly, breathing through the nose. So those are kind of the four main things that we're aiming for with with myofunctional therapy, and through lots of different exercises, and there's loads of different programmes and things, devices that can help us achieve those things. We're aiming to establish those good oral health habits, I suppose, if you like those good myofunctional habits. So as John was saying, it's really good to start early on as part of this preventative approach this this root cause approach, if we can use myofunctional therapy to help develop and grow the jaws, so there's certainly a genetic element, when it comes to the size of the jaws and that kind of thing. But there's this thought that we can enhance that genetic element through getting the tongue up into the roof of the mouth. So if the tongues living in the roof of the mouth and we're swallowing the right way, it's a strong muscle, so it's going to help grow that upper jaw. And if we can do that, when children are young, and whilst they're still growing, we're hopefully going to maximise the amount of space that the adults who then have to come into. And as the adult teeth come in, they're coming in in the right place with lots of space. As we've already mentioned, it means the teeth are going to be fitting together the right way the bite is going to be right, it's future proofing and protecting the airway as as we grow into adulthood.
Peter Williams: 21:41
So again, clearly the way you speak here, it's something that you guys have been doing for a very long time. But how many people listening to this, they're gonna be like, I had no idea that this is the way they would do. And what happens, John, do they just go end up being at an orthodontist, and they take a load of teeth out, or
Dr John Roberts: 21:58
I've got to be careful because - Yeah, well the standard of care is if there's not enough room take teeth out. Our standard of care is that if there's not enough room. Why isn't there not enough room, which is usually either an imbalance between lips, cheek and tongue. So when you swallow, everything gets bigger, or they've had ill- advised extractions when they were young, often because they've got sugar in the diet, and they've had baby teeth out both of them damage caused by dentists. And if I was to say there's a fantastic book for anyone who's had teeth out, called Six foot Tiger, which is your tongue, in a in a, in a three foot cage, which is teeth out, everything's made big, there's not enough room for the tongue. So the person starts opening their mouth to breathe, they lie on the back, the tongue goes back, they'll either start snoring, or worse still they get sleep apnea, people will say, but I sleep well. But what they do is they then clench their teeth every night so I can snore, prepared to have a tooth together, can't, so the people are coming in have got headaches, pain behind the eyes, neck and shoulders. And Dentistry has been doing that for 30/40 years, but we never realised it was a result of protecting your airway. So airway dentistry is like the top of Everest, there's a hole hill to get to get there. But if the teeth are in the right place, and they fit together, you don't get the gum recession, you don't get the wear. People, sorry to be a fanatic about this, when you bite together and you push it your forwards that should be the same angle as your jaw joint. So everything looks after each other, the moment you take teeth out and put them where you think they look straight. It doesn't fit the body. And one of our favourite things is we look at the jaw joint, everyone calls it the TMJ or temporomandibular joint it isn't. It's teeth, muscles and jaw. And if the teeth are in the wrong place, the muscles are overworking and the jaw has been pushed out of place to get the teeth to fit together. And when we gave that lecture before lock down, my title, of my lecture was I'm not interested in your white bits. Because if you get the muscles comfy, the jaw joint in the right place, that's where the teeth should be, and the teeth last longer. If you have to build an implant in the implant will work longer. And if the teeth are in the right place, it's easier to clean. You don't have all these horrible food tracks with 1001 different gadgets for every gap. So you go back to how you were designed and try and achieve that which you do with kids and what Annie is really good at.
Peter Williams: 24:36
So how do how do they come to see you Annie? How do they get referred to you? Because, you know, as I said to you, you know, you know my story, no real problems with my teeth at all until 45. And then I had to have that tooth out and then I get told I've got periodontal disease and like, holy shit, well, you it was asymptomatic to that time and you've never said anything else, you've always said I had good teeth. so how does that process work? Then? Are they referred to you? Or is that just well informed parents that seem to find you out?
Unknown: 25:07
Honestly, I think, from what we see, a lot of the time parents perhaps had problems themselves. And therefore have gone away and done a bit of reading a bit research and found out about this and gone, oh, hang on a minute, I've got a five year old child, I really want to make sure that they don't have to potentially go through what I've had to go through and the pain and discomfort and the problems that it caused me. So I think I don't know, what do you think?
Dr John Roberts: 25:31
I've had 2 kids today, that they're seeing us because the parents say, I don't want them to have teeth out. I don't want to have all the fillings. And you can say, with a certain degree of maturity, I can deliver 28 teeth in a straight line fitting together well, with a functioning airway, mouth, and breathing. And even if you just get them to swallow properly and breathe through their nose, nature gives you that not ideally, and there's a lot of cooperation. And it doesn't work in every case, because it is a bit of a hassle for parents every day to do the swallowing exercises, the breathing exercises, the kids got to wear the Myobrace or whatever brace they're wearing. But if we get it right, it's Stunning. Stunning.
Peter Williams: 26:19
I think it's not just that, is it? I think what you're looking at then is that saving yourself a lot, a whole host of hassle. And 1000s of 1000s of pounds in future treatment. You know, I think that's the other thing to think about.
Dr John Roberts: 26:31
Because if you look at if you come away from the gum disease people, you go to the sleep snore people, which is massive in America. And this is where if you look at Dale Bredesen, for example, and what his work he's doing with with dementia and Alzheimer's is right up there, breathe properly, sleep properly, don't snore, and get rid of sleep apnea. Yeah. And that, in some way has been caused because of uninformed dentistry when we didn't know. But now we have the science, we're still choosing to ignore the science because we do it the way we've always done it. Sure.
Peter Williams: 27:06
So that's how and look, I think I think medicine is the same on this. John, I think healthcare is exactly the same is there's a lot to lose, if suddenly you go, you know, you choose the blue pill, as opposed to always choosing the red pill. And you know, that's the that is where it is. But as I said to you, you know, the reason why I think this has exploded, particularly in the last 10 years is the some of the scientific papers coming out. I mean, you just can't ignore them.
Dr John Roberts: 27:30
No, it was really that breakthrough when we suddenly there's a guy, he's down in Birmingham way. That's when we first started, looking at this link between gum disease and systemic health. Yeah. And then once we were able to talk about that, rather than just treat locally, we realise we're having a systemic effect because preterm low birth weight babies, yes, absolutely. The risk factor for a stroke, number one is you've already had a stroke. I think the second one is whether you've got gum disease, smoking, you know, so all the facts are there. But we've been brainwashed into thinking, Oh, it's smoking and high fat diets or whatever. No, it's this low grade chronic infection that is ticking away that if you peeled all the gum disease from around a tooth and put it on the back of your hand, you'd have a big ulcer on the back of your hand, but you wouldn't walk around just festering but because it's in your gum. And we have, as you've seen these fancy fancy 3d X rays where you can really see the gum disease getting between the roots. And then you need the modern technology, be it lasers, be it biocidin, be it all sorts of irrigation, ozone, you know, whatever the dentist has. But you've got to get in and get those areas clean. And you've got to work with the hygienist or accept. And it we all do this. We accept. We give it we give you a bit of our health, because we can't be bothered to do it. Yeah, yeah.
Peter Williams: 29:02
So let's think let's talk about some of those new hygiene techniques Annie, let's let what what do you feel has made some, whether it's new techniques, whether it's new methods, what seems to be the sort of, well, let's talk about what what are you favouring at the moment.
Unknown: 29:20
So, I suppose something it's, it's not overly new because I do. We've done it at the practice for many, many many years. But we are currently using a system called guided biofilm therapy. And essentially what that is, is prevention is kind of at the core of it. So when it comes to particularly brushing and cleaning, we can disclose what we call biofilm in the mouth. A biofilm is like a slimy sticky substance. If you picked up a rock in the bottom of the river, it would have biofilm on it you can feel that and ultimately when we brush and clean our teeth, we're wanting to remove or disrupt that biofilm. We're never going to have one no bacteria in the mouth, that's not what we want. We want a good healthy balance. But if the certain areas of biofilm are sticking around and they're not being moved or brushed or cleaned away, that biofilm can grow, and that's when we can get nasty bugs that come in and settle down and cause problems, you know, it's triggering inflammation or getting holes in teeth and so on. So the idea of this guided biofilm therapy is that we can turn this biofilm into a different colour, so we can visually see it and we can show patients, they can see where it is, we can, in their mouth, give them the tools and the techniques and the, you know, empower them to show them that this is how you can remove it and clean it. It also is really helpful for us then when we go around and we remove the biofilm, we can see exactly where it is, where we're doing a good job and removing all the biofilm. And the equipment we use is something called an airflow or you can there's lots of different types of air polishing devices we call it. But that's really great at removing the biofilm but being super gentle on the gums and the tissues. Not to
Peter Williams: 31:04
There's certainly nothing wrong with traditional, I don't know what you'd call it scraping or what when you go to the hygienist. Probably what most of us get for, but I actually have had some guided biofilm, and it's a bit of a different experience for sure. It's surprising that you realise Oh my god. Alright. That's that's the horror show when you see it. So it's almost like you almost have like a blue dye, I think mine was like almost like a blue dye and it really sort of almost shows those places. And then it makes it a lot easier to it. Well, I think what it's doing, isn't it, it's making, what's the word, you would use.....
Dr John Roberts: 31:39
What you're doing is you're making the invisible visible? Yeah, you can educate someone, and then you can say the choice is yours. And that's the whole thing.
Peter Williams: 31:50
Yeah, I think the reason why we were talking so heavily about this is very simply isn't it is that a local disease like gum disease has very systemic consequences of every single chronic disease. And that generally is because some of those bacteria are really highly pathogenic. And when they get into the body, either because your gums are bleeding, or you've got gum recession, then they cause a whole host of problems, you know, something I'm hugely interested in, particularly around early stage Alzheimer's, because some of those oral pathogens have been highly implicated in potentially being, in effect causal mechanisms, not only of the blood brain barrier been broken down, but also of just getting into the brain, and then that brain's immune system has to respond and attack. And that's where you get all these sort of neuro inflammatory processes that go on. But you're trying to always go to the root cause, aren't you? We're trying to always go there. And, you know, this is the key thing about how how it's almost like it's full circle again, isn't it? It's like, well, if you want to deal with cardiovascular disease, you already have Alzheimer's, you want to deal with it, then this is a real big mechanism that you've got to think about.
Dr John Roberts: 32:57
Yeah, years ago, we used to, and we have a couple of microscopes here where you actually take some plaque, put it on a slide and put it on a microscope on the TV. And you can see without them having names on them, the good bacteria, and you can see the spyrochaetes, which are the ones that get into your blood and cause the harm. You can even find amoeba in the mouth. Anyone who tells me you can't, they don't know what they're talking about. You can find amoeba, an amoeba, anywhere else in the body is a potential, It's a potential harmful illness. But they say amoeba in the mouth, oh, it's not causal, and actually have their own life cycle. They come out certain times of the day, but it is getting back to this biofilm. And if you can disrupt the biofilm, either and the thing is, it's very dated to go to the dentist every three months and have your teeth cleaned. Someone else is doing the job for me. I'm not taking responsibility. Sorry, they're your teeth 365 days a year we clean them for perhaps three or four hours a year. The rest of the responsibility is you so this is why you know you've got a little brush for this a little brush for that water picks, whether you're going to use products which we like and we acknowledge are expensive but by biocidin it breaks down biofilms we have all our water lines, we have to clean our water lines to break down the biofilms more bacteria there and in the past, I haven't used by biocidin because it breaks down the biofilms in your arterioles in your kidneys now I take biocide in every day as a systemic to keep all the tubes in my body flowing better.
Peter Williams: 34:41
So let's get let's get into that because it'd be great for to have some recommendations from this water picks generally good?
Unknown: 34:49
Yeah, I quite like water picks particularly if there are some fiddly areas. So if you've got maybe implants, bridges, crowns, awkward wisdom teeth, or generally if you struggle with dexterity than water picks can be great. Sometimes they're not quite as good a replacement for something physically getting in there, whether that be floss or a brush, but they're, they're a good addition, on top of something like that. And there's certain, you know, certain areas that there might be a little bit. A little bit of extra added benefit.
Peter Williams: 35:20
But clearly flossing and interdentals. Absolutely.
Dr John Roberts: 35:22
Yeah, flossing is somewhat old fashioned. You can actually see harm being done by flossing, because it's not. Whether you're flossing, it's whether you flossing appropriately Yeah, correct technique. correct technique is everything. So people say, Oh, I'll go and buy an electric So can you just explain how that works then? And because because toothbrush, not unless you're shown how to use electric toothbrush, because people can, again, they're substituting their responsibility. I've got electric toothbrush, that'll do it. No, you have to be shown. Right. And I mean, the new things that you won't even have seen yet. But there are toothbrushes now that have red lights in for healing and mitochondria stimulation and healing UV lights in to actually kill the bacteria. So whether you use it manually, or whether you have it as electric, you're stimulating the healing. At the same time, as your cleaning up the bugs and the biofilm, it really is going and there's going to be many more things where you bite in and it cleans. we have things we can we're allowed to, we have a protocol for using ozone. So we can produce ozonated water and clean around because ozone will kill bugs brilliantly. you guys also use lasers as well to to kill bacteria, don't you? So can you explain that? Because again, listen mate as you know, as you say, you know, I can go, I've got a lovely dentist at the top of the road, but none of this is ever in the conversation. Now, ozone is just antibacterial period, okay, instead of chlorinated water ozonated. And it's safer because you're not being poisoned by the chlorine. But there's another story. So ozone has been around for centuries, we just don't use a lot of ozone and incorrectly used ozone can be harmful. But it can, for me, sterilise teeth. It can sterilise when we take teeth out. It can be used and cleaned around pockets. So once Annie has cleaned all the teeth, and done her job, if you then rinse a socket with ozone, you really are disinfecting the socket. And then lasers, they have a variety of things, you've got some lasers with red lights that are quite harmful. But you can put them down the side of a tooth and that will kill the bugs. That's what they do. You got other lasers, water lasers, which are a lot more expensive. There's quite a few people down in London, who have got them. And that laser bursts the water. And so you have this ultrasonic pool or bath of water that makes the water explode. So you're actually using the laser to explode the water. And that exploding water cleans and disinfects further than you can get with some of the manual instruments, you use those in round implants and stuff. So there's different lasers for different jobs. And then, as I say, we were approached a couple of weeks ago by a company actually out of Liverpool, well the Wirall, that are now importing toothbrushes that have a red light in for healing for 30 nanometers, which is you know, ladies have face masks with lasers on to stimulate and get the face healing. It has UV light, which we know UV light is sterilising. So at the same time as you're brushing your teeth, you're stimulating healing and you're doing it now it's very low level, it isn't going to get rid of your problem. But every day, you can be stimulating those areas to heal. And that's that's your scientific. And there's lots of dentists who are using lasers now. So if you Google London, there's some absolutely there's one lady who I was I started my laser journey on, she is now probably the world expert. And she is brilliant. But that's all they do. And we're saying, Well, you need a bit of nutrition for your healing. We haven't talked yet about diagnosing what bugs are living in your mouth. Because you know what, sometimes you just have nasty bugs living in your mouth, like unwanted squatters, and you just can't get rid of them. You know, this is where your expertise where we literally bow deference to you. You're sort of saying, Look, if you've got the nasty bugs in the mouth, you've got to deal with it. And, dare I say sometimes you're going to have to use antibiotics to get rid of the bugs, and then move good bugs back in so you've got all these bad bugs, good bugs, which is we're seeing in the gut we're seeing on the skin. We're seeing, I mean, even London has a different microbiome. Well.
Peter Williams: 39:54
Everything I think if we're learning anything, he's just just how, how we're sharing the world with lots of Lots of other stuff, you know, and how, what's interesting about about the mouth for me is that it's the second most diverse bacterial environment in the human body. So there's a lot going on there. And, you know, I think this, I think this is what you know, we have, we have a few products that we really like one of them is a is an American toothpaste, it's really expensive. But it does seem to be the real real deal. And it's a combination of different herbs. And I think why that is important for me. And I think this is another sort of evolvement of dentistry and Anna, you'll be better probably the me and John on this is that it's not destroying a healthy, but it's not destroying a healthy microbiome in the mouth. Because these things don't destroy it, they enhance it. And I think that's another part of, you know, dentistry, that is I think is incredibly important is that you're we're using natural products, so that we don't throw the balance of the of a good microbiome off.
Unknown: 41:01
I totally agree. And I think that's a big part of how we can educate patients about this, you know, microbiome, you see a lot of these, you know, adverts on telly, and you go to the supermarket, you know, this mouthwash kills 99% of bacteria in your mouth, and we see bacteria, as you know, as the bad guy and this really negative thing. And we want to, you know, kill all of it. But actually, what we're looking for is a really healthy balance. So even you know, kids from a young age, we see bacteria is this really negative thing? And we think, oh, yeah, the stronger it is, if it burns, that's a good thing. No, it's not, we want to be really kind and really gentle to this microbiome. Because if we look after that, in return, it's going to really look after us. If we've got that balanced microbiome, we're not going to get inflammation in the mouth, you know, gum disease, holes in our teeth, it's not going to happen, because we've got that, that that balance in there.
Peter Williams: 41:53
And that there are a few things here that we know that genetics play a part environment plays a part, but boy does does diet play a part on this one as well. So I suppose there's always two aspects. And you know, what I'm sort of leading this into, it sort of leads us into, I suppose our toothpaste and what do we choose? And probably the fluoride conversation. I think it's probably one we should have a chat about because the literature on fluoride for the job that you want it to do for me, I don't see, it does the job as far as I see it in the literature. What were you guys out with with all of this?
Annerlie Staples: 42:28
Can I go first? Yeah,
Dr John Roberts: 42:30
I've been brought up with with fluoride. And my tutor at university was a professor of epidemiology looking at numbers and they clearly showed that fluoride in the toothpaste years ago would reduce the amount of decay. Now that we look at the figures, what it does is delays the amount of decay it doesn't reduce it. Fluoride, I do believe alters the shape of teeth, which actually makes them more cleansable, which is an interesting thing. So it has, it interferes with the growth of the tooth. For me, you don't need fluoride in a toothpaste, and definitely not in water. If you have a good diet and a good cleaning regimen. fluoride in the water is a bit like putting suntan cream in the water to stop me getting sunburned. It's rubbish, brushes on brushes off again, and you don't want it absorbed into the body. If though you have a child who's coming in with decay, majority of the time, and there's never 100% but if we're talking about the vast majority, if you've got a good diet, and you're you're not snacking all the time, you're eating food and maybe a bit of cheese afterwards. If you if you can do dairy, you're not gonna get the decay, we see people who don't have decay. And don't use fluoride toothpaste because they've got that balance right? Our difficulty is they come in, and oh, well granddad gives them sweets, we're busy, they're snacking, you won't let us brush your teeth and they got holes in their teeth. What am I going to do? Well, fillings at the moment are either going to have mercury in which we just don't use have been using for 30 years. And therefore the some of the fillings got fluoride and fluoride only stays in the filling for a few days and it leaks out. But you can recharge the filling. If you use a fluoridated toothpaste, I still will recommend to those individuals because I'm not being holistic or alternative now, I'm actually caring for the individual who's in front of me. I will give people antibiotics because that's the right thing at that moment, and that's where I don't want to be labelled one thing or another. There is a lot of research now about these hydroxyapatite toothpastes. And just recently there's been some published research and it's going to come out in the next couple of weeks. So if it's what the what they said today, 8th of March, you know, within two weeks, there's going to be some research that's questioning the carcinogenesis if I said that right, of some of these hydroxyapatites. I'm not saying they are or they aren't. There's some people who aren't using them because they say that could be harmful kidneys. And I know fluoride is harmful to your pineal gland, and other tissues. So it is using the best of what's around there. But to substitute a hydroxy apatite, that doesn't have the research that fluoride has, in my eyes. At my age, in my practice, I would go for the fluoride. But it's a compromise. And I can't look at you honestly and say a hydroxyapatite toothpaste is going to do the same as a fluoride toothpaste. And I don't think the research is there yet. Okay, I stand to be corrected, please send me the information. But I don't want it tested on a test tube, I want it tested in a mouth for 5 years
Peter Williams: 45:47
So if I can just sort of think about that what you're saying is, so if you have a particular patient that is susceptible to holes in the teeth, then decay, yeah, fluoride would be a good choice, even though we know there may be some pros and cons to it. Yeah.
Dr John Roberts: 46:06
And it's hard because we work with practitioners saying you shouldn't use it. But I'm not going to watch that child's decay advance. And I've been around so there's been other companies that have had aloe vera in the toothpaste and this in the toothpaste, and they come in, and then six months in the year, they haven't changed the diet, they haven't changed the cleaning and they've got holes in the teeth. And people pay good money. And they've travelled to see me. I've got to deal with what's appropriate for them and their mouth, not fall to the dogma of you can't do this, you can't do that.
Peter Williams: 46:40
I think John what you're saying here is classically, what we would see your from a point of view of, I think many people think you're either on one side, you should be on one side or the other. And that for me is nonsense. That's not good medicine, good medicine is is that regardless whether it's my patients or your patients, there's always a compromise on every single situation. And so you've got to make the best choice on the compromise in that situation. And you know, I think that's why I was asked is that if you have susceptible patients who are susceptible to holes in their teeth, is fluoride a good choice for that job? And the answer is clearly we probably say yeah, it probably is.
Dr John Roberts: 47:15
You You're with me on that? Yeah. Yeah, yeah, you can give people choices. Yeah. But if they make a choice for their children, and they don't then choose all the other things about not giving the sugars and giving them raisins because, yeah, you know,
Peter Williams: 47:32
Do you think they know that though? I think this is the always the key, isn't it? I mean, it never surprises me that they don't get it. You know, but what I suppose the question was, well, why would why would they be so informed a lot of them. You know, I just,
Dr John Roberts: 47:46
We all we all choose to read certain books and advance our education in certain directions. And really, we should embrace diversity. Because we'll get kids who are just not interested in all the holistic sides. They just want the best thing for their kids. And I have no problem saying, this will work for your child. And you see Annie, you do the brushing, cleaning, we develop the jaws, we get everything to fit together. And then you know what, when it's all humming, you can drop the fluoride, because everything's working the way nature intended. But that instant stop that block. Now, equally, I've said, I don't relate these high fluoride varnishes. They're dangerous. Never use them in 40 years. But I used to be able to give kids vitamins and fluoride. And we used to get fluoride in the milk, which was stupid because if you overdose on fluoride, you take milk. fluoride in the water? No, because if it helped, which I don't believe it does, it's harming older people. Absolutely. 100%
Peter Williams: 48:47
Stupid question. But is fluoride water soluble or not?
Dr John Roberts: 48:51
Yes, it is, because it's sodium flouro-silicate. Yeah, because there's naturally occurring fluoride, which is in Hartley pool, and where they did some of the research and trend leading did it in America, which was naturally fluoridated. But we have a byproduct, I understand from the the aluminium industry, which is some fancy form of fluoride that if you don't dissolve it in the water and say it's good for your teeth, I'm gonna get in trouble for this. You've got to dispose of it carefully. So they say it's good for you and dissolve it in your water. So I've been to the plant years ago, and that supplies the water to Birmingham, he's got a big bag being shaken into the water, and it gets diluted to the one part per million they say it's good for you, and people are drinking it. But even if it worked in a six year old child, by the time you're 18, by the time you're 50/60/70/80, that has diddly squat use on your teeth. And in fact, it's getting absorbed into your bones. And if you look at the figures on testicular cancer in young man, if you look at the figures of fractures in older people, and this is where the anti fluoride people are a lot better than me. I'm not anti fluoride. I'm just saying use fluoride correctly and appropriately, rather than mass blanket. So I don't fall into any camp. It is individualised health care with the appropriate materials. Yeah.
Peter Williams: 50:12
And, you know, I think the reason why, obviously, we've we've been connected for for quite a few years is that I believe what you're doing in dentistry is what is what systems medicine that we do the functional medicine, it feel it's very, very sort of feeling like dentistry is, is a whole pursue, and you've got to think about the whole patient, you know, and what they're doing. Annie, what are the, what are the, give me an idea of because I mean, as you say, I mean, you're doing some amazing stuff, you know, you're doing that you're doing oral bacterial testing, and you're doing the genetics as well. And you're making recommendations around various lifestyle aspects as well that contribute to to, hopefully better results, which it will do. I mean, can you just give us an idea? I mean, you know, what, what you've seen over the last couple of years, and you know, how all that's been put together? And, you know, some of the success stories that you've seen with that?
Unknown: 51:06
Yeah, yeah, no, definitely, we've seen quite a few patients, where we'll look and analyse, I suppose their lifestyle, we'll have some of the results come back from these tests, there's a couple of cases that spring to mind. One was, quite a young, young girl, late 20s, had quite a bit of gum disease, which when you see in gum disease at that age, that's instant, kind of red flag. Something's going on here. And it's not good. And we need to act quickly. Because to be losing, gum that's holding the teeth in at such a young age is quite worrying.
Peter Williams: 51:42
So would you assume on that that would be very sort of strongly genetically led on that one?
Unknown: 51:49
You would certainly think so, that certainly was our first, I suppose thought when we, when we first I suppose came across that, although we knew there were a number of of lifestyle, potential implications as well. So very high stress, which we know is a really big one with gum disease as well. Ex smoker. Again, smoking, we know there are huge links with gum disease and how rapidly the progression of gum disease can happen as well as with smoking. So yeah, so we did DNA tests, the DNA Smile test to look at the genetics. And really interestingly, it wasn't the genetics, it came back. And it certainly the genetics that we test for, that have quite a bit of evidence with susceptibility to gum disease, none of the major ones were really coming back. But then when we did microbiome or bacterial tests, yeah, a couple of red flags there. So I suppose it helped us in the sense that we knew we really had to focus on that bacterial element getting that microbiome right, getting on top of that. So using the things like dentalcidin toothpaste, and homecare with brushing and cleaning, we knew had to be spot on and since the results have been fantastic. We've gone from a really, really inflamed mouth to perfectly healthy gums they're tight, they're pink, there's no more bleeding or inflammation in there. And that's purely our maybe take a little bit of credit with maybe like 5% is the treatment that we've done, but the rest of it is just lifestyle changes and modifying lifestyle.
Peter Williams: 53:30
Isn't that really interesting in that. You know, I think I mean, what do you I mean, you I know you guys have obviously, John, you've been in practice for a very long time, a very established practice, and maybe your patients slightly more bias to, you know, because they trust you. And they trust Annie, but do you, are you seeing a real heightened increase of people going? Yeah, okay, that sounds that makes sense was yeah, cause I'll do that test it or is it still quite a lot of resistance?
Dr John Roberts: 53:58
Just recently, economically, I think everyone is just going a bit. As you say, dentalcidin. For me. I think it's fantastic value for money, because you can almost see if someone uses it and they come in there is the plaque in the mouth is It is that good. People are often motivated when they've got a lack of something when they when they when they are when they've got disease. Why is this happening? Once they get over the justifying phase? Oh, yes, but yes, but it's like, okay, well, this is where we are mate to use your language. What are we going to do about it? give people choices. And you know what, it's always about giving people choices, you know, dentists, perhaps don't give as many choices as we should do. And I have a patient who had terrible clenching, grinding, all sorts of stuff. He chose to lose weight, he went off, he saw someone else came back, three stone lighter, not clenching, grinding, not snoring any more healthier, happier person. So, but you've also got to go to a dentist and accept that saying, right You do have excess chubbiness under here, that's going to be an influence to you and your health. And if you breathe through your mouth at night, you're going to make it more, you're going to have more problems with the gums. Interestingly, there's some lectures I've been to in America where they're saying that dryness you get in the back of your throat, is creating inflammation on a daily basis. So breathing through your mouth creates inflammation, breathing through your nose, promotes healing, and we can get into taping your mouth to breathe properly, it'll help your gums. And interestingly, we will talk about taping your mouth, if it's done guided, not just go and take your mouth open. But if you tape your mouth, you don't breathe through your mouth, your teeth don't stain. Because if you lick a mirror, not something we do every day and dry it you have that film on a mirror. And then if you drink tea, and coffee or red wine, that film stains, which is what a lot of people get staining on their teeth. That's the staining part of it. If you don't breathe through your mouth as much you don't dry as much saliva on if you clean it properly, you don't get the staining. So for us, staining on teeth is telling you someone's breathing through their mouth. And then that opens up that healing conversation. So look, we're already an hour in, and we could probably write a book about it and probably will do in later years, what would be the sort of key bits of advice
Peter Williams: 56:22
that you would give people who are listening to this, who, you know, probably have the relationship that I have with my dentist and that is, you know, it sort of sometimes I think about my dentist, it's a bit difficult to tell them, you know, how far ahead we are and what we've done. And, you know, we've developed this, and we've developed that because I feel a bit of embarrassed about it. But you know, if people are listening in I mean, what would be your what would be your sort of, what would be their clinical pearls that we can sort of go away from today? What would be what be yours, John,
Dr John Roberts: 57:00
For me, I absolutely believe teeth are for a lifetime. And it is how you care for them. What you do with them, which is clenching and grinding, which is an airway thing. And unfortunately, the previous dentistry that's been done, will stop you doing that. So I can see, I've seen a couple of five and six year old kids, I've seen a 10 year old kid, I said to mom, those teeth, the kid was eight years and 11 months, I said, you're gonna keep those teeth for 91 years and one month. And we should be able to do that that's got to be a goal. And everything else is a compromise. And we know how to do it and will only get better in the future. That's mine
Peter Williams: 57:46
Nice, one, Annie?
Unknown: 57:48
Mine would be Prevention is always better than cure. So and you don't need to spend a lot of money when it comes to prevention. Anyone can get the basics right at home? Yes, sometimes it takes a little bit of guidance. And hopefully your dental team can help you through that. And but getting the nutrition right, getting the brushing the cleaning, right? Breathing through your nose. That's something that you know, everybody can do at home, you know, the myofunctional habits and so on. But yeah, teeth are for a lifetime. And in getting the habits right and as early as possible, means we can hopefully have the best outcome
Peter Williams: 58:30
and you never get sick or looking in people's mouths, I'm assuming.
Dr John Roberts: 58:33
Yeah, every day. I don't. There's lots of things around dentistry and the bureaucracy, which are awful, but put me in front of a patient, allow me to perform because like you I'm a scouser. I'm a performer. I love telling a story. But the person's mouth tells me a story where they've been, where they are now. And I can tell them a story of where they're gonna go, if they choose to listen, and I'm not right all the time. But I'm often not very often wrong.
Peter Williams: 59:03
I mean, well, I think that's a good place to leave it. And there's no doubt that there's more. I mean, there's so much on this subject, as you say, I've developed a real sort of area of interest here. So guys, as I said to you, if you're okay to continue to be the resident experts on all of this, we're good to go. We'll get another one going perhaps in a couple of months.
Dr John Roberts: 59:24
It's a privilege for us because it enhances our skills by doing this. And we'd appreciate feedback from whoever nice if possible, bad stuff sent to her. But yeah, we appreciate it because we reach more people this way. Thank you.
Peter Williams: 59:41
Do you remember when we started this, we started this by I got invited to that conference didn't I , John, that you would that you organised. I tell you what always resonates with me, Annie. I mean, I can't make that long ago. That's like five or six years ago. You obviously you came up to me after my lecture and you were so pumped up. You know, I was really excited about oh my god, you know, this is where it's going and look you've done. You know, that's kind of cool isn't it is that you know, you're walking that walk and now and now look where you are doing all this with regards to, you know, as you say the resident expert on my podcast, that's a good start. So, guys, listen, I really appreciate as you say, it's eight o'clock.
Dr John Roberts: 1:00:23
It's a pleasure. Yeah. All right. All right, guys.
