382: The Impact of Oral Health on Overall Well-being | Dr. David Adame

Maya Acosta  00:00

Dr. David automate is a board certified orthodontist. Eight years ago, he took the advice of a physician that changed the course of his health. He will present interesting facts about teeth, saliva and oral flora, and how our oral microbiome influences our overall health. Let's listen in.

Dr. David Adame  00:20

And good afternoon, eight years ago, oh, actually, it's almost 10 years ago. Now, an event happened to me that changed the course of my life that she was talking about. And I'm going to just talk about that briefly, because I don't think I'd be standing here today. Had that not happened. And I was in that emergency room. It was four o'clock that morning, had an excruciating flank pain, but I'd had an eight year history of it. And my primary care physician told me just need to drink more water. I'll tell you what it is here in just a second. I had to go to urologist. And he told me yeah, you're doing the right thing, avoid oxalate foods. But a hospitalist came in and he had taken this CT scan. And there was this little guy right here. And everybody probably at the garage to know that's a kidney stone. But I was going to remind you that I had an eight year history of that I was passing them at my office. And everybody told me you just not you're dehydrated. I actually I've only been here a year I come from South Texas, real South Texas and McAllen it's even hotter there this summer that it was here. But you know, so I understand that maybe my urine was concentrated, they were saying and just drink to avoid oxalates because I had a calcium oxalate, there's many different types of kidney stones. But that's the more common one. And so I fit right into the plan. But I just kept having this over and over and over again. And this hospital is took enough time to sit with me he was a visiting hospitalist. He said the bad news is you got him on both sides, your kidneys in their full. So you got a whole family of kidney stones that are fixing to give you trouble and and then I forgot to say that it back home and Matt Callen. The guys down there us Hispanics tend to do what's called an A Brasil when they see you, they grab you and they hug you and they slap you in the back. And there's three or three of those guys I would avoid because even if I pass my kidney stone always had chronic low grade flank pain. And they were just constantly they're constantly there. So let's just do a quick anatomy. Here's kidneys. And there are these tubes that go down. And here's two stones in these tubes. Now and here under magnification, and I actually looked at mine, I got pretty interested in this over the years and I left he looked at mine and then they look like that. There's nothing smooth to him. They're not build the design of those kidneys in those tubes are not to transport that kidney stone out of your body. So what is it doing there? What is it doing there? And he finally told me what he was doing there. Nobody else. None of my other all health care for professionals had flunked the the exam with me. They didn't they weren't looking, they didn't look through the weeds to find out like he did. He said, Well, first of all I was at that time, if you look at my BMI, I was in the overweight category, not to get into all the different things that was either pre this or already that and my physician who was related to me, he is there while we can manage it, you'll be alright. You know who's my buddy, buddy? Don't worry about it. But I was really in serious trouble. And there's a lot of heart disease in my family. And that little physician hospitals came in and he said, your urine and I said is not yellow. What's wrong in my urine? He says it's acidic. is 5.0. And he and I said, Well, what is it supposed to be? He said their whole body's supposed to be neutral. It's supposed to be seven says I think that's your problem. I think that you're you have an acidic environment in your body. And it is the proper environment to for the body to try to neutralize that by producing more calcium. And anything in the area is going to calcify. He said I think that might be your problem. It just didn't make sense to me. He said all animal proteins are metabolized aesthetically in the body. All fruits and vegetables are the counter. They are metabolized as an alkaline and a light went off in my head but I just couldn't believe it was that simple. I just because I know lots of guys it ate like I did and I know how was basically your your carnivore there. I was unfortunately, big into the SAD diet, but so are a lot of my friends. And they weren't experiencing what I was experienced just wasn't convinced. So I went over and started looking into the literature. It was 2013 Right off the bat, right that same year I found this and this is for people. That nutrition for kidney stone disease is that these idiopathic oxalate stone formers are advised to reduce ingestion of animal protein. Right there is the article to eliminate or minimize oxalate foods and sodium The problem is oxalate foods are everywhere. Everybody, we're going to have some for lunch, I promise you oxalates are everywhere. And I started looking at I wasn't really having that many of the only thing I was really having there was a lot of oxalate was black tea that has oxalate but has very, very little, it's like saying banana has got a lot of potassium. It's got some, but there's so many more foods that have much more. And there's a lot of foods that had a lot more excellent. So anyway that they recommend it. So I went to the National Kidney Foundation, and they advise for people that are undergoing chronic kidney stones, the increase in fruits and vegetables, there was confirmation. And therefore are decreasing the they produce alkali, a decrease in the acid load of the body meat and cheese. And eggs do the opposite.

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So the doctor was right. Could it be that simple. I still didn't believe it. So we went Dale and I went and we went to what's called plant stock just not far after that. We went and met each one of these guys. I heard him met him talk to him. I read all their books. And I came out of there so excited. I mean, I was pumped up. Long story short, ever since then I haven't had a kidney stone. You can come and slap me on the back, the chronic illness is gone. I'm going to talk about if I have enough time before we finish about taking too many X rays. I haven't gone back and taken a CT scan and I'll tell you why. If I can get to it today. But the marvelous thing is I went there to get rid of the kidney stones. But my flank pain has gone. All those chronic metabolic conditions are now going as well. A my my weight is normalized completely and all those other things I wouldn't expect it was the icing on the cake. So everything y'all have heard before. And we're Clapper said, I'm a living proof of that. I don't know if I'd be here today. Had that not happened to have not gone through the pain. Because it was just the iceberg right at the tip of the iceberg for me the canary in the coal mine. That was it was just screaming at me. There's more of this. It wasn't just my kidneys. It was my whole body. Here, of course, I'm preaching to the choir. Y'all know all about that. Let's talk about teeth now finding in the mouth. Whatever it is designed to eat. It's a simple question. Is there something about the anatomy of those teeth that give us a hint? What is the purpose of saliva? I mean, we see saliva, you know, we kind of take it for granted. What are we supposed to do? We should we have a lot of saliva? Are we talking about dry, dry mouth all the time? How about their oral microbiome, the GI guys get a lot more press where their gut and their microbiome, their biome. But we're not far behind. There's a lot of things happen in the mouth with with the bacterial, the bacteria and viruses, the whole environment. And it's very, very important. I hope I can explain it thoroughly. And we're gonna talk a little bit about fluoride, and the things, the pluses and minuses of it. Now, it didn't take a dentist to take this disk and move it and place it closest to the mammal that we're most alike. All right, that's a horse. That's a bear. And that's of course a tiger. You think we're in the right spot? I think so kind of just looks very, very similar. It's amazing. All right. So let's try this. flip these over, and we're going to put the skull on its back. And on this, this side is a deer on that side the dog. Now let's look at this carnivore how narrow the teeth are. And look at the whip on the other side of how wide the pre molars and the molars are on a deer. Now let's look at us. This is a human. What do we look like? We look very similar to this a little bit of difference in shape. But we have a lot of with to be doing a lot of side to side motions, not just cutting motions. So it's an open and shut case. I used to spend a lot of time but this is the one that just explains quickly. What a carnivore does. It's like scissors, it cuts the food and then it swallows it down is in Spanish There's a word called dry rot. In drag it means you're gonna just swallow it. My grandma used to get mad at me that I got school pero ye like a dog? Slow down. And I'm gonna prove she was right. Because we are supposed to slow down. We're all supposed to take our time we're supposed to let the saliva work, not eat like a dog. I was always in a hurry to get up and go and learn from her. So let's talk about saliva. Now real quick. There anecdotally, my own Dale and my experience within one month of changing our diet. All of a sudden, I noticed that I was spitting on myself. When I opened my mouth to eat. I was spraying myself. Now I'm an orthodontist, I'm I should wear a raincoat. Because all the kids when they come in, they open their mouth. They spray me all the time. All right. That's why we definitely got to work coats. They have very active salivary glands. As I got older. I don't ever remember spraying myself. But I just did it the other day. And I told them, I'm glad I did this again, because I felt it. And I just opened and I can feel the saliva hit and hit my wrist. The kids do that all the time. All of a sudden, I'm having more saliva. That's a benefit. And you'll see why it's such a big benefit. Anyway, I'll prove it. If you look at this article comparing that some Salaberry variables between vegetarians and omnivores, the vegetarians had a significantly higher secretion rate, then the omnivore group. Now why would that be? Is there something about fruits and vegetables? Well, fruits and vegetables are 90% Water. meats are 50%. And bread is about 35%. So I was having meat and bread. And all of a sudden I switched to fruits and vegetables. So do we need to drink a lot more? Well, I didn't drink water per se. I had a lot of Diet Coke. Now there is water and Diet Coke. But there's also caffeine. So whatever you get, you're going to it's a diuretic, and it's gone. Your body can't use it. But fruits and vegetables that hang around a lot. And there's some animals that they'll say they don't even go to the water. And we had some deer on our ranch. They we would hardly ever see him at the wire. We wouldn't even take picture. All the plants that they're eating are full of water. On good good years when it rains a lot and the leaves are real juicy. They don't really don't. They know when to come in drink water. Now it seems like we think we have to drink a lot of water. Well, your body will probably much pretty much tell you but if you're doing this, you're getting a lot of water just from what you're eating. Let's talk about dry mouth. What are the causes of dry mouth? Well, of course dehydration. I think I was dehydrated. I really really was I was dehydrated. And there's of course medications. And a histamines. The other thing that was cured I forgot to mention was seasonal allergies. I was just this time of year especially for some reason I was worse in the fall than I was in the spring back in McAllen where I lived and I was just stuck on antihistamines. I had to have them had to have my to breathe. It was just uncomfortable. I switched to this diet. I haven't had them anymore. I hope somebody could explain that to me, but that is gone. That is completely gone. High blood pressure medication, antidepressants, all kinds of medications as we age is less than excuse while I'm aged. And I don't have that problem anymore. Now I think it's because as I've aged now 10 years hence I'm eating the right kind of foods and staying with that diet and my salivary flow is very, very good. Of course tobacco and alcohol autoimmune diseases La sjogrens is the attack of the body on the parotid gland which stops the salivary flow, the results or difficulty in swallowing taste that will talk about dental caries if it's dry in the mouth, and if you got the wrong plaque in your mouth, you're going to have rampant rapid decay. I was a general dentists first I saw several people, elderly that would come in with dry mouth and we're just drilling all day long on those people, fungal overgrowth as well.

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This is just to show that a carnivore their saliva is acidic herb for your basic cow. It's very alkaline and it's got Alpha amylase, which helps in the digestion or the initiation of digestion of starches and, and, and also complex carbohydrates of which we also have the same thing and I don't recommend anybody doing that. I see a lot of people kissing their dogs and there's just a lot of acid coming at you. Now let's let's compare a dog to through the salivary glands of a human. The dog has parotid and submandibular salivary gland which is down here, little one here and a little one there. And it produces saliva basically to keep them cool. So their saliva is produced and they pant and the waters produce. It's a great system for them. It's awesome. Now they do smell and so some more will be produced if they smell and they since they're going to eat just to make it a little bit slippier but it's not what we have. Look at the salivary glands we have, they're all over there. This is the parotid gland. If you ever had mumps, that's an old disease. Maybe somebody young was never even heard of that. We all had mumps growing up and that's that's an infection of that gland right there. The prodigal and we have submandibular glands. We got ones over here, we got all along. There's ducks, there's I mean, it's a car wash, ready to go. I happened to grab that I was putting braces on the other day. We have minor salivary glands I was putting these braces on, I hadn't been on there for this cheek retractor hadn't been on there for about a minute. And look at the bubbles of water. There's just south saliva coming out of the lip. Minor salivary glands. If you happen to Nick one of those, you can create what's called a mucus seal. And being orthodontist that happens to us a lot of people get hit in the mouth on a ball and didn't have a mouth protector. And then the brace itself will cut the duct that's allowing the excretion of the saliva. Now it's it's not communicating to the mouth, and it goes into the lip and gets caught right here. So that's saliva, that's right there, you got to go to a surgeon, they got to open that up. And they got to take the salivary gland out, go like this to your lip. right across there, you feel all the little bumps, those are all salivary glands, they're up in the upper lip on the inside of your cheek, in your soft palate, they're everywhere. So let's have the composition and the purpose, it maintains an oral, moist oral environment. And this is kind of you can see how watery that is. And it just creates the environment the slide things down that too. Now, as a baby, we use a lot of times you'll see what's called thick, ropey saliva, the younger you are, the more you're going to have. And it's a great, great plan. When you think about it, that child doesn't have all the teeth you and I have. But it still has starting to sample some of the foods that we well, there's not enough teeth to break it down. So it'd be nice to envelop it a little more comfortably. So they got this big gelatinous mass of saliva that they swallow what a design it is. So that they can take that food and go ahead and go go in there. It's very rare for adults to have saliva like that, right? We see it in kids. I mean, I'm I'm trying to, it's like spaghetti sometimes. How much are we supposed to produce? This is an important slide. They say I mean, we're supposed to produce between six and eight cups a day. Maybe for y'all to go to Starbucks. A grande is two cups. So do the math. If one cup is eight ounces, and there's eight cups, if you're really good, if you're eating the way we're all supposed to be rich 64 ounces of saliva that is produced every day. Now, if that's a Vitamix, guys, y'all ever do that the full, full Vitamix 64 ounces do you have to drink 64 ounces of water what I already said most of the fruits and vegetables habit, right, so you don't have to drink 64 ounces. But you do need to drink a lot more than I surely had to drink a lot more than what I was drinking. And that hopefully is visual for you. Let's get down to the nitty gritty a very important slide. This is the tongue and the these are the different taste buds that are on this tongue. Some of them are toward the front of the tongue. And then some are on the on the side of the tongue and some of the circum ballet are in the middle. Let's take this a little closer, because it's very, very important. Now how many of y'all have ever stuck your tongue out to taste something just a little bit, you grab a little taste of that. Well, that's this Salaberry guy. Right here, this little guy right here, the very front of our tongue. The tastebud, which is this big guy on the left, there's a taste pour is it is at the very surface of the tongue. So it doesn't take a lot for it to get to the necessary information. Now this, Facebook has got all kinds of cells in it. It's amazing. The more I read about that, the more I'm just amazed some of those go to our brains, some of it go to our stomach, some of them are going to the immune everything information that's coming in our body that comes from just a simple taste of what where the information is processed in our in our body in order to do something that's coming up next, are we going to swallow that or we're going to spit it out. Now usually when you tasted it you want to know if you want to cut Continue eating that somebody is going to taste good or not. But sometimes you do taste it, and it goes into the next level. So we're over here now. It's coming in you tasted, you swallowed it. And now it goes in what I call the fiords of the tongue. It's gotta go down here. Because the tastebuds Can you see that? That bud is on the down in the crevice of that tongue. So a beard dry mouth, it never gets in there. So I'm wondering when I was young, and I was very, very picky eater. And I would just drag on though my food, whether they ever got it in there, you know, and I was picky because my body didn't ever have a chance to develop a direct cognize that food and to do the things that I'm going to show you that the body does to make it more palatable for us to have it now further bent down the road, the circum valet, which is way back here, and you all been told to scrub the back of your tongue. Have you all been told that? Well, I'm going to tell you not to do that. If you're eating the right foods, if you're eating the right foods, the right bacteria is back there. It's the one that should be there. It's the one that needs to take the information from these little birds, it's got to get in here. And it's got to evaluate what you just ate. And it's going to process it. And look what happens. Let's talk about it next. So one of the first things are involuntary or voluntary. So we decided we put it in a mouth and we process it in our brain. And our memory processes it and you can voluntarily turn around and spit it out. I can remember the first time I had caviar, and I didn't know what it was. And I put the whole thing in my mouth. And I was looking to do that somewhere. The first time I did, I was looking for somewhere and it was at a unfortunate at a party and I had to get out of the way quickly because I did that. I don't know if you've ever ever taken just to give you kind of an idea is a similarity. An analogy anybody has ever taken the first puff of a cigarette. What did you do? coughed. An amazing how our body senses something, this is the same analogy. Except the coughing was probably involuntary. They got down too far. And the body wanted to get rid of it. A body was telling us right off the bat, we shouldn't shouldn't have that. Now as we get further back, there's going to be some involuntary motions of it that goes down and the messages come from that that tastebud and it goes further down and since senses that we need to initiate something to get rid of it permanently. And it's not voluntary anymore. You can't do it. Sometimes you wish you could and it's gone. Has anybody ever had that sensation where I know I'm gonna throw up your head that you know, it's preparing you get over to the bathroom, right now it's telling you get your legs can go. Because it's going to involuntary, get rid of that. And that's all things that have started with a saliva, diluting that information, getting it into those pores and sensitive to all the centers that need to know. It's an amazing body that we have one of my favorite slides, anybody do this to the little kid. They want they want them to taste that lemon because you just can't wait to take a picture that

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but let's let's see what is that child doing? It's an involuntary response. Because there are buffering compounds that are present in the saliva. That neat, it senses the baby, this salivary glands is already telling that child I need to produce more saliva. So I'm going to grimace and I'm going to work on the muscles that are around those salivary glands. And I'm going to make them dump it out quicker. Okay, quickly dump it out so that I can minimize that reaction or minimize that taste. And it also does it for sweet or bitter and salty it. It does it for all of that it's an amazing body that way have you ever had. Have you ever had a lemon and you since it happened? It's kind of a real weird sensation. That's that the fibers that are aired pumping it, they're pumping it, getting it out, getting it out. It's an amazing, amazing body just to be complete, you know, there's not the mouth but you can smell things and your salivary glands can produce you can even see him. You can see it at a distance and all of a sudden, you sense that the salivary flow. One of the of course the biggest purpose is to envelop it to take your time my grandma was right chew your food, spend time enjoy it, let the body understand what it has. And you also don't want to abrade the body Have you ever got home and started chewing something and notice there's something in the food. Alright, so gives you time to grab it and take it out or if you do it too quick, and that goes further south, and then you start to abrade things. And so if you didn't take the time, the way it is built for us to take time to chew, that's what our teeth are made for they time and chew it really important slide is called demineralization and remain colorization. Very, very important, and I hope I explained this correctly is probably not a more important slide than this one, after eating high levels of acidity, okay, like, like, if you had a lot of citrus food, something like that, if you're squeezing a lot of lemon on your food that we have, which we like to do if you had a lot of acidity. So what the body does it leeches calcium to, to buffer it, to create a neutral environment. Remember what the what the hospitalist told me your body wants to be 7.0. And it's going to do everything it can. So we we the teeth are full of calcium, so it's what else our bones or our foods, so it's going to get it from somewhere, it's going to do its best. Well, the best source, if there's a lot of acidity in the mouth is the body will neutralize it. It'll take some of the tooth to do it. But I'm talking microscopically, I'm not taking chunks. The problem is if what else can get stuck to the tooth plaque. And if it's the type of plaque, that's the wrong plaque, which I'll explain in a second, then it it continues to leach it and leach it unleash it, the plaque doesn't eat the tooth, the tooth dissolves itself to neutralize the acid, that's when the whole comes in, then you get a cavity. And as an orthodontist, I'm really concerned about it because it's all around the bracket. We don't want to take the brackets off and all of a sudden we got all these ghost looking things around your teeth, where they are the calcium has leached off off the tooth, it's horrible. So this is a really important slide to show that the body that happens naturally. So the saliva wraps around that food and wipes against that the tooth and then the tooth, the the acidity of it leeches the calcium out to neutralize it. Okay, so let's say you eat it. Now another source is coffee, dark tea, hibiscus tea, those are all three very acidic liquids. So when they get washed over that tooth, that tooth neutralizes it. So calcium comes out, I'm talking microscopically. But when you stop eating, and you go in through the rest mode, the back the sad the saliva have already sent that message into those pores through the higher centers that come back and have started to leach calcium and phosphorus from the rest of the body. And while you're resting, and you stop chewing, the saliva is higher concentrated in calcium and phosphorus. Amazing. So whatever came off, automatically comes back in, it automatically does. So it's neutral. What a designer, whatever came out, you stop eating, and you're quiet. Let the saliva flow in your covers it no problem. The problem is if your gum chewing in between If and I'm a proponent to tell you, it's probably not a good thing the body needs to rest. If your gum chewing and is going to this and this and this the body doesn't know that's gum just like it didn't, didn't recognize processed food, it didn't know it's gum. All I know is that something's chewing, and I gotta keep pumping, pumping the saliva, I don't have time to re minorites because I gotta get slide in there, because there's more food in there. So I would recommend don't gum to let the body rest and you read calcifies itself an amazing system, you're going to see something that fluoride is going to say that it does all of this in just a second it doesn't we don't need it, because we do it on our own right there. Anyway, the there's bacterial properties that we have also antibacterial, anti virus, anti fungal, all of those things happen in the saliva itself a little bit about our microbiome just real quickly, that what I'm going to touch on is that there are the biome of the mouth is amazing. And I'm going to talk about the progression of disease toward disease or, or health of the mouth. And there's one, I need to talk to you about this. This slide was done from skeletons from 3000 years ago to present day. This is the important slide that I'm going to say. So I don't know if there was there wasn't any dentists 3000 years ago. But what this shows is that the cavity ECE for for 100 teeth, from the year 3000 BC to 1850. Words five to seven was the average cavities per 100 teeth. When we hit the 1850s, which is right here it went, it went to 25%. So 25% of our teeth are decayed in modern day, because it's something that happened in 1850 1850 and toured this way. But before without any dentists, we didn't have any cavities. And that's coming off of these skulls right here. So here is a caveman type of skull, and there's there is harder right there that can get analyzed. And let me just show you again, from a different perspective. These are not cavities. These are these teeth are wearing down as they age. Now they will break them. And when when there is a break in this in this tooth, like you see the breaks, then there's small cavities that do occur there. But all the skulls that were examined, there was no infected teeth. There was no abscesses. There were minor minor decays. So a spectrophotometer is a way to get a color fingerprint of anything. So Dr. Alder did an amazing study that he compared the skulls to the bacteria of skulls from 3000 years ago, just like what you saw it a modern day. And what I want to just say about this graph, as you can see up until 1850, no matter what food that we ate, the bacteria of those skulls was the same. The micro biota, the microflora of caveman, were all the way to 1850 was the same even though you farming, you did all this stuff, the plant foods wherever they the bacteria didn't change, it was very diverse. What happened was in 1850, when we had the second biggest change, instead of just farming, we went to processing our food, and all of a sudden the bacteria changed in the mouth. And they went from a very nice bacteria for us very low disease, making no gum disease to one word, the red part, you see the red cable, the red straight stripes, their color, those are full of bacteria since 1850 that cause dental decay, and cause dental gum disease. So that's what happened. So when we change the foods, the process, all before those bacteria were in our mouth, but they're in very, very small quantities. We changed the food just like you changed the food in your gut. And all of a sudden the bag bugs grew. Now we got dental disease, fluoride, we're talking about advertising as a marketing. They'll always say, well, we can we can re floor data tooth, we could do all the remineralize the tooth, we can do all of these things. But don't forget this slide that I showed you, but we do it naturally. So you really don't need the fluoride. If you're eating the foods that you should be eating, and most everybody, I would hope everybody is here. So when you go get your teeth clean, which I think you should do, they're gonna ask you do you want fluoride? They're going to charge you for it. When they ask you that, tell them no, I don't need it. I don't need the fluoride.

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And just to show you the reason why is fluoride just fluoride says it improves the cavity rate by 50%. Well, it improves 75% If you just get on the right foods. So it even beats fluoride is not equal to it's better, better than fluoride. And there's some problems with fluoride. I will just say that today. Fluoride is everywhere. I was part of the community, the industry group, and we went in San Antonio in the 70s. And we beat on their desk and said we need fluoride in the water. Back then there was no fluoride anywhere. The problem is we were successful. Now, everybody's got fluoride. So everything you see, not just in toothpaste at oral hygiene products, it's in processed food everywhere that they process water into something. It's got fluoride in it, so there's no reason to use it. It's too much. Okay, I think I'll stop by his

Maya Acosta  34:18

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