Dr Rupy: Your mouth isn't separate from the rest of your body. It's a key part of your airway, your microbiome and even your inflammation levels. So in this episode I'm joined by Dr Stacy Whitman, functional dentist, to explore the everyday habits and products that can make a real difference to your health overall, not just your oral health, but your entire whole body health. We talk through things like mouth taping. Yes, mouth taping, things that I thought I would never be talking about because I thought it was complete fad. Nitric oxide and why nasal breathing matters for oral health, sleep quality and overall physiology, when mouth taping might actually help, who should avoid it and safer step down options as well. We talk about why chronic mouth breathing affects the dryness of your mouth and the oral microbiome, gum health, cavities, bad breath, the airways and obviously your sleep as well, and long term facial jaw development, especially in kids. This is something that I'm super interested in, obviously having had a child very recently. We talk about ancestral diets and how that plays a role in jaw development and the dental impact of modern snack foods, plus the nutrients for dental health like vitamin D3, K2, calcium and vitamin C. And controversially, we talk through fluoride, and we're talking about fluoride in our water, fluoride in our toothpaste, what fluoride even is and what it's used for and why there is controversy around it, as well as practical oral health non-negotiables that matter alongside fluoride. Dr Stacy Whitman is a board certified functional and integrative dentist specialising in the oral systemic connection, how the mouth links to the gut, brain, hormones and airway health. She's also founder of Bloom Kids, a leading functional paediatric dental practice, co-founder of the Institute for Functional Dentistry and co-founder of Figg, feed your good guys, I think that's what it stands for. It's a microbiome friendly oral care line and they're delicious. I mean, I shouldn't be tasting them like that, but I've used them and they're really, really good products. I really hope you enjoy this podcast with Dr Stacy Whitman. She is a breath of fresh air, an incredible advocate for functional dentistry and I'm now a convert to mouth taping as you'll hear from today's conversation. Enjoy.
Dr Stacy: we're going to dive into this. Just talk to me about mouth taping, okay? My wife is a prolific mouth taper. She mouth tapes every night. Some influencer told her about it online and I just don't, I haven't looked into this myself. So please, can you just clarify whether this is something that we should be looking into, something that I should be doing, whether there's any research behind it and whether you recommend it?
Dr Stacy: Yes. Well, first of all, thank you so much for inviting me on to have these conversations. I'm team mouth tape or sleep tape or lip tape. I also, I agree with your wife. I can't live without it. I do it every single night. And it's, I think getting more attention in the mainstream media as well as some negative attention which I believe is unwarranted. So why is it beneficial? Humans are obligate nasal breathers. We were evolved and intended to breathe through our noses, but we aren't doing this much anymore. Up to 85%, some I've even said 90% of the population has some sort of dysregulated breathing, mouth breathing, it's on a continuum. And so what are the issues with this? Well, it can lead to cardiovascular issues, hormonal imbalances, immune health, you might see weight gain, mood disorders, you're not getting proper oxygenation in sleep, but also it can dry out your mouth and so you can get cavities and you can get gum disease and you can get tonsil stones and you can get halitosis or bad breath. So essentially all it's doing is keeping your lips closed so that you are reminded, essentially forced, if you will, to breathe through your nose. Now, I don't want people just doing this willy-nilly and there are some studies, especially out of the Breathe Institute in LA where they've done, they've created protocols based on data that you should can do a lip seal test. And so this is where you keep your lips closed and you're timing yourself to make sure you can comfortably breathe through your nose for three, maybe four minutes to make sure you don't feel panicked. You don't feel sympathetically overdriven. You don't feel forced to rip the tape off. If you do, you shouldn't lip tape. That means you have some sort of blockage, maybe a deviated septum, maybe an inflammation, inflamed nasal turbinates, maybe you have inflamed adenoids, tonsils, who knows the underlying reason, we'd have to unpack that, but you're not a candidate. And kids can do this too. You have to be working with an airway trained dentist, make sure you're screened and you're approved for this. But starting at the age of three, we can do this. Now with kids, we only want to do this temporarily. It's literally a band-aid until we unpack the issues of why your child is mouth breathing. But with adults like myself and your wife, my underlying issue is I have a jaw discrepancy. For me to correct this, it would require a jaw surgery. I had a significant facial trauma when I was a child. Everything's all out of alignment. So instead, I tape my lips. I will tell you because I have data, I have an Oura ring, I have a Whoop, when I sleep with my lips closed and I'm breathing through my nose, my sleep metrics are phenomenal. I'm hitting all my targets, my REM sleep, my deep sleep, and this is important for health. This is important for hormone balances, the glymphatic system kicks in, you wake up refreshed, rejuvenated. It slows aging process if you want to talk longevity. If I'm travelling, let's say, and I forget my lip tape, which I'm panicked if this happens, I sleep terribly because I'm constantly waking up, snoring, you know, I have dysregulated breathing essentially. And so I've been known to even take like a band-aid, just anything to make my lips stay closed. So I'm a big fan of it. You'll see more and more athletes are doing this while they train. There was the famous tennis player, her name escapes me right now, it kind of went viral. You see people out running on trail running with their lips closed because this is improving their cardiovascular health, their VO2 max, because they're forcing themselves to breathe through their nose, so they just get more conditioned this way too.
Dr Rupy: Wow, okay. I can definitely tell you're on team mouth tape and I'm going to get such an earful about this. So thank you.
Dr Stacy: You're welcome. You're welcome.
Dr Rupy: from my wife. I want to, I want to dive into a couple of things that you you said there. First of all, you mentioned facial trauma. What do you mind telling us about what what what was the history?
Dr Stacy: Oh, absolutely. Yeah, I was trying to impress some older boys and we had just been watching this BMX biking movie which was kind of popular in the 80s called Rad. And I was all excited to show off my skills of which I had none. And I don't really remember exactly what I was trying to pull off, but it was unsuccessful because I flew off my bike and I landed on the asphalt so quickly I didn't even, I didn't even put my hands down and I landed here. And if you see me up close, perhaps you can see I have some scars, but I knocked out, I avulsed permanent teeth, four permanent front teeth. I fractured all my bottom teeth and I broke my premaxilla and fractured my zygomatic arch too. So it was, it was disastrous, but there's always a silver lining because it is most likely why I went into dentistry because you know, I had these wonderful humans in my life that were so caring and nurturing and put me back together again and I wanted to continue on that favour to the rest of the world, you know. So, but it's put a lot of perspective on things too. Also, you know, how the body heals. So you can go through significant physical and emotional trauma and find ways to come out in a positive light. So that's what happened to me.
Dr Rupy: My word. And so, I mean, you've got great teeth. We're doing this via Riverside, but like you've got fantastic teeth.
Dr Stacy: Well, I have a good dentist in my back pocket. So, or two or three, it takes a team. Yeah, they can do a lot these days, but it's been a journey. I mean, you know, people have dreams about losing their teeth, right? That's like a recurring dream nightmare, I should say. It's a real thing. I think this is actually an important segue. The mouth has been separated from the body for so long. Dentistry's here, medicine's here. And dentistry tends to be the brunt of the joke. I mean, we're made fun of in movies and songs and everybody's afraid of the dentist and we're torturous and barbaric. But our teeth and our mouths are incredibly important. They're so important for our self-esteem, for, you know, sensuality, for confidence, for articulation, expression, mastication, digestion. If you've had dental pain, you know it is absolutely debilitating. So there's so much to the mouth that I think we don't give credit for. And then if we get more biological, you know, our immune system starts in the mouth, our metabolic health can be seen and and is a window here in the mouth. And we can get into that, especially, you know, one of my passions is talking about nutrition and food and how important what we put on our fork and on our plates influences every system in the body and that's foundational. I would argue breathing, how we breathe and how we eat are the keys to health and all the other things are extra credit. So, yeah, it's been, it's it's just an important aspect of health that is ignored and our whole goal is to get the mouth back into the body and to teach it really is the gateway into the body and what happens in the mouth doesn't stay in the mouth, you know, and you can't be healthy without a healthy mouth. Your mouth is the gut. It's the same tube. It's the entryway of your digestion system. So all these functional medicine doctors who I commend and natural paths who are treating the gut for various ailments, bravo, but if you are not looking at your patient's mouth and seeing do they have gum disease, do they have periodontal disease, do they have untreated dental infections, you will not be achieving optimised health. And this is what I say to all the people looking for human optimisation and longevity. I think a huge part of these conversations, they're missing oral health. They're missing oral microbiome testing. They're missing what's happening with the bacteria in the mouth and the the overall wellness of the mouth. And we can get into this later too, but you can see so many nutritional deficiencies in the mouth long before you see signs and symptoms in the body. You'll see them in the mouth. You like cracked lips, burning tongue, you know, white, pale gingiva and mucosa, ulcerations, all kinds of things that you can see in the mouth. And so the dentist have a very big role in things that we're missing. We tend just to be thought of as technicians, just tinkering away, like filling holes, but if you take a step back and look as more of a doctor, as a physician, you can really help unpack things for your patients. Like some dentists, you can tell a patient it might be pregnant before she knows or might be going through puberty or perimenopause or menopause based on what you're seeing in the mouth or maybe there's nutritional deficiencies. We can we can make assumptions about cancer status based on how the gums look too, you know, and sometimes refer out if we have concerns. So the whole point of this is that it is the gateway to the body and it's been neglected for far too long and I appreciate this opportunity to try to make it more front and centre.
Dr Rupy: Oh yeah, absolutely. I mean, like, I was taught a lot by your colleague, Dr Victoria Sampson, about the importance of dental health, oral health to the wider body and and some of these signs that we're going to get to. But what a journey. That's incredible that you went, you had that facial trauma and then that led you to dentistry and just bringing it back to mouth taping. So in your case, given your history and the the anatomical changes that you've had to endure, how is mouth taping helping you specifically and what what would you not be able to achieve without mouth taping in in your specific scenario?
Dr Stacy: Well, I have a bit of an underbite or that's how I was born and that wasn't fixed and then I kind of lost my upper interior jaw. So things just don't fit together the right way, okay? And they've masked it very well cosmetically, but my jaw just wants to pop open. So I by physically keeping my lips closed, I'm just making my jaws close. I breathe through my nose, which I can. I have a patent airway. I can easily breathe through my nose. I see it in my sleep scores. You know, I see that I'm hitting my targets for REM and deep sleep and my heart rate variability is more optimised. And we know these are pillars for health, like sleep and restoration is so important for health and longevity and these are important to me. I'm a pseudo biohacker, if you will. I dabble in it. I'm not obsessive about it, but I, you know, I want to age gracefully and have a healthy lifespan. And so the key metrics for me are, you know, how am I sleeping, how am I breathing, and what am I putting into my body? How am I, what information am I giving my cells, you know, every day, which is important. But the the lip tape helps me with oxygenation and and my my cortisol levels are improved, you know, less likely to have oral disease. And people who mouth breathe too, they tend to have weight gain and that partly is because of the hormonal imbalances that can be occurring. It also can impact sexual health, you know, erectile dysfunction is associated with sleep disorder breathing and sleep apnoea, cardiovascular health is the big one that most people know about too. And so if you are, if you are snoring every single day and mouth breathing, you know, it's not wild to say that your life expectancy will be lessened by how much we don't know, but it's it's really good to get it corrected. And so, you know, some people will say, oh, I'm so old, I'm in my 40s. It's like, come on, you're you're still so young. You have like maybe 60 more years of life ahead of you. So, yeah, and so a lot of people when they start breathing better, like a lot of the inflammation will go away, they'll lose weight, you'll see it in their face, they just start to shine and thrive again. And so we can't, you know, we're just not sleeping well enough. You know, doom scrolling and the blue light and you know, all that, all those hormonal imbalances and it's just, it's important. Just get back to the basics is my big mantra.
Dr Rupy: For sure. I want to dive into a bit more of the mechanism specifically, but the the outcomes sound amazing in terms of inflammation reduction, hormonal improvements, etc. Just before we do that, you mentioned the lip seal test. So that's basically where you just when you're not sleeping, you just, you know, cooking something, maybe a doctor's kitchen recipe or something like that. And you you know, you just put something on your mouth like a mouth tape or a plaster and you just time it for 60 seconds. And if you can breathe normally and you're not panicking, that's a, you know, you can go to two minutes and three minutes. Is that something that you would recommend everyone do before they even try buying one of these mouth tapes?
Dr Stacy: I think so. Yeah, you you know right away. Now, one of the strategies is to put a piece of paper between your mouth and hold it there because, you know, unintentionally as you're timing yourself, if you truly have nasal blockage, you may open the lips a little bit and breathe, but I think as long as you're strategic about it, yeah, a piece of tape. And I say when if you decide, I'm good, I'm going to do this, ease into it. Like tape while you're chopping vegetables in the kitchen, making a recipe for the doctor's kitchen. You know, keep it on for 15 minutes and then your favourite show, 30 minutes, leave it on and then a movie. Okay, great. Now you've done two, two and a half hours, you can tape overnight. And the thing is most of these tapes, they're either fabric, so you can breathe through them, you can exchange air, or there's a slit, which is nice. I I like the opening in the middle for off-gassing, that actually is pretty important and Patrick McKeown, who is a big airway guru, speaks of this, how important it is to off-gas. But also, some people will rip it off in the middle of the night. Like, you know, there's been no reported cases of negative outcomes from people lip taping. In fact,
Dr Rupy: What does what does off-gassing mean, sorry?
Dr Stacy: Releasing the like CO2 exchange essentially. So that, you know, we're exchanging during respiration process. So, you know, I think it intimidates people and it's just like everyone likes to hate on new things. But I will tell you, if you look at old Life magazine, this was a popular magazine in the United States in like, I think the 20s, 30s, 40s, they used to have bands that go around the head, which I think Kim Kardashian now has, just to keep the jaw closed. I mean, it's just, it's just a physical, physically trying to keep the mouth closed to breathe through the nose. So this is not, you know, ancestrally, we know women used to close their baby's mouths, you know, to to train the tongue to be up, the lips to be closed so that we become obligate nasal breathers. This isn't new, this isn't a new concept to keep your lips closed. But unfortunately, we are devolving and that's a phrase that was coined, I believe by James Nestor who wrote Breath. And if you're interested in all of this airway discussion, I do very much recommend his book. It is phenomenal. It's one of my favourite books of all time. I've read it multiple times. And it speaks all about this, the why, the how. He's such a creative writer. He kind of does an experiment on himself, which is very interesting. So he makes this topic which could be a bit boring, really fascinating. And I will tell you if you read it, you will never look at any of this the same way. You will never be able to go to a public place like an airport or a concert, you'll look around you and be like, wow, everyone's a mouth breather. And so we can get into the why. So, if you go to the Natural History Museum and you look at ancestral skulls, you will notice the jaws are very broad and wide and the teeth are perfectly straight. And we certainly did not have exposure to orthodontists and early airway expansion models, right? So why? Why why is this? We are the only species really that has these misalignment occlusion issues besides maybe our domesticated animals, okay? So what gives? Why are teeth crowded now? Why don't we have room for our wisdom teeth? Why is everyone narrow and palates are narrow? So we went from a hunter gatherer society to an agrarian society where we started farming and mass producing grains and rice, etc. And then the industrial revolution, we started processing and refining and adding flour and adding sugar. And now look at us with our ultra processed food world, we lost our ability to chew as much or not our ability, but we're just not chewing as much as we used to. So ancestrally, they estimate we chewed for four, maybe five hours a day. We were foraging, you know, nuts and seeds and roots and meat wasn't, you know, braised. And now everything's ultra processed. So gogurts and chicken nuggets and frappuccinos and all of these things, we don't chew. And so it's that that act of mastication and chewing that forced the jaws and the bone to grow outward. So in a battle between muscle and bone, muscle will always win. And your tongue is a muscle and your tongue lifts up, elevates and pushes out in the act of chewing, but also breastfeeding. And so this has been going on for 12,000 years and so we are shrinking, our faces are shrinking, our airways are shrinking, our jaws are shrinking. This is why we have so many breathing issues and our teeth are crowded. And this is why as a functional dentist, we talk about intervening ideally early with children so that we can get the face back growing optimally and that's usually with retainer therapy or expansion because we want to get the child back to how they should have been technically more ancestrally. So, yeah, we're just evolving. I mean, we're kind of just, it's unfortunate, but if we know these things, this is just meant to be educational, but when you know better, you you can chip away at it. It's not meant to be overwhelming, of course.
Dr Rupy: Yeah, absolutely. Yeah. I I completely concur with James Nestor's James Nestor's book. He's he's going to be on the pod in a couple of months when he's in London and it's it's a real eye opener. You know, nasal breathing opener. It's it's a, it definitely changed my perspective on how I breathe and I try and nasal breathe when I'm out and about. And actually, I'm imagining everyone who's listening or watching this, like whilst you're talking about it is is consciously like trying to nasal breathe at the moment. So whenever I'm like commuting, particularly if I'm on the train, like I I always have my mouth closed and I'm like breathing through my nose. But at night, I do struggle and I'm not too sure whether it's because I have like some dust or sensitivities to something in my bedroom, maybe it's the position that I'm in, like when I'm lying down, my nasal cavities fill up or something. I'm not too sure what it is, but I do struggle because when my wife gave me her mouth tape and I tried to use it, like I had to give up after 30 minutes because my my nasal passages were blocked. And that's why I kind of was hoping that this whole nasal breathing and mouth taping thing at night was just, you know, overblown, but I'm going to have to start again. And so for for someone who's listening to this who is like me and struggles to nasal breathe at night, are there ways in which you can titrate it up as well? There's certain other other gadgets that you can use to because I, you know, you're selling me on the benefits.
Dr Stacy: Okay, I'm going to help you. So, first of all, do you have an air filter in your bedroom?
Dr Rupy: Yeah.
Dr Stacy: Do you change the filter regularly?
Dr Rupy: Probably once a quarter. So maybe we need to change that a bit more often.
Dr Stacy: Yep. So I might try to clean it monthly. You'll be surprised and and pretty disgusted of what can accumulate on your bedroom air filter. I mean, think about like skin cells and we won't go there. But so dust mites and pet dander are two of the biggest triggers for inflammation. So I prefer no pets in the bedroom, which I know is hard for some people, but may I just suggest this as an experiment? What if you just tried it for a couple of weeks, okay? Because if all of a sudden your inflammation goes down when your cat's not laying on your head, and then you have to make that decision. We're only here to educate. You decide what's right for you, okay?
Dr Rupy: Basically what you're saying, Dr Stacy, is I'm now going to have to sleep in another room because there's no way my wife is not going to sleep without our dog Nutmeg. So,
Dr Stacy: Well, there is a movement of couples sleeping in separate bedrooms. You guys do what you need to do. So anyway, you know, the other thing, so air, so maybe you just clean your air filter more. Making sure you're dusting enough, like pulling the bed back, dusting, you could you could get hypoallergenic bedding because of the dust mite situation too. The, you know, anyway, so the other thing is nasal cleansing. So I believe in sinus hygiene as part of oral hygiene is connected. So whether that's neti potting or like the NeilMed saline or a xylitol spray, you just want to clean the passages. I would really prioritise that every night. The other thing you can do, there are nasal strips. You see some of the influencers wearing them. That might help you a lot, just enough pressure to kind of open. Try to maybe elevate the bed a tiny bit. Those are the first things I would try. Dairy, gluten, these are common sensitivities that can lead to inflammation in the body. So I like to try all of those things first to help triage the patient and then if not, then we go into maybe some more inflammatory triggers in the in the body. But it can be also structural, right? So if I take a human face and I narrow it, if you will, what's going to happen to the septum? The septum is going to deviate. So everyone thinks a deviated septum is because you broke your nose during basketball when you were a kid or fell out of a tree. No, it can be from a high narrow palate. If your palate is too narrow, your tongue can't fit up there. That's where it's supposed to live. Your tongue is supposed to be elevated up and essentially like kind of suctioned up there and have enough tone to stay there throughout the night. So if your palate's too narrow, your tongue can't fit, where is it going to go? It's going to slip back into your airway and this is where you can get some redundancies and some loud breathing or snoring, okay? Or if during the day, it's going to push out, like a tongue thrust. Think of Napoleon Dynamite if people are familiar with that movie, just that look, that forward head posture, the long narrow face, the dark circles, like he's not thriving, he looks ill, right? And that is from open mouth breathing. And it changes the way your your jaw grows too. So you grow long and narrow instead of broad and wide, essentially. And we want big broad wide jaws and this is what Weston Price spoke about too. He's kind of the, he's credited as the true the first functional dentist, I would say. He was a dentist in the 20s and the 30s and he travelled around the world and did some preliminary studies and they they get controversial because some of his methods and materials weren't optimised, but look at the time that it was in. But he looked at ancestral tribes to say, why are their teeth so healthy compared to the Western civilisations where decay at that point was rampant, okay? Why are their teeth so healthy, pristine, their jaws are wide and open and straight and beautiful? It was their diet. They were eating a whole food diet. They were getting enough fat soluble vitamins, they were getting enough minerals in their diet, they were nasal breathing. And so this becomes this vicious cycle of our environment leads to pollutants, which leads to inflammation, and then what we're eating leads to inflammation and we're not chewing it enough, and we're not getting enough nutrients. Our food is not nutrient optimised. And so he has amazing work and then he his work was modernised by Dr Stephen Lin, who's a functional dentist out of Australia. So that's a great book he wrote called The Dental Diet if people are interested in this. I think it's fascinating because I don't think we appreciate how how important it is for all of these components to come together, sometimes even preconception. And cavities and gum disease are the top chronic diseases globally in children and adults, surpassing asthma and eczema and allergies, dental decay. And it's mostly preventable and a lot of it happens just because our teeth aren't developing properly because we are chronically vitamin D deficient, we are chronically magnesium deficient, mineral deficient, phosphorus deficient, vitamin K2, all of these important things that need to come together to optimise calcification and bone and tooth development. And so his work's really important.
Dr Rupy: Yeah, absolutely. I want to talk a bit about the food specifically that could cover the basis for some of those vitamins and minerals in a bit, but I feel like I'm sold on mouth taping, so I'm just going to work a bit harder. And anecdotally, like I do, I'm pretty sure I'm a mouth breather at night because my mouth is dry in the morning. And you mentioned earlier that dryness in the mouth is a bad thing. Like what what's going on in the mouth that is not optimised when you are mouth breathing and your your mouth is dry? Like what what's happening there?
Dr Stacy: Pathogenic bacteria love low pH. They love acidity. And many of them just love environments that are dry. And so they'll proliferate and thrive. So when you breathe through your mouth, the pH will lower because you've lost the buffering and protection of your saliva. So a very important thing for us all to start to appreciate is your spit. Your spit, your saliva is this golden elixir of your body. Without it, we would just crumble. Think about if you are familiar when we age, you know, a lot of patients start to get decay and bone loss and dry mouth. If you're undergoing cancer therapy, certain autoimmune diseases like Sjögren's, your teeth just dissolve. I mean, literally, it's because you've lost the protection of your saliva. Also think how important it is for chewing and mastication and swallowing and speech. If anyone's had dry mouth before and they're trying to talk or swallow, you can't. You can't do that successfully. So your saliva is so important. It has immune cells in it, it has digestive enzymes in it, it has so much communication, it has all the minerals in it that are needed to strengthen your teeth. So if you breathe through your mouth, you lose your saliva and so your teeth are no longer protected and so they you can get rampant decay, not to mention bad breath, halitosis, and then tonsil stones too, which can develop for similar reasons. So there are different niches in the mouth where different families of bacteria live essentially. So your tongue will have different bacteria than your actual tooth surface, than your tonsils, then down around your gums. And but but most all of these, they're anaerobic, they don't like oxygen, they like dry environments, acidic environments. So, yeah, it's really bad for oral health.
Dr Rupy: And so something you could try, I'm just going to try to help us strategise here for you. So, there is a tape called MyoTape. It was created by Patrick McKeown, who's a Buteyko breathing expert. He's really big in the airway space. He's amazing. You should have him on. Patrick McKeown, he's incredible. But his tape, MyoTape, it's open in the middle. It's like completely open. So it acts almost like a girdle. He and he likes that because he's the one that really says you have to be off-gassing, okay? And I love that for kids especially. It just feels safer. But maybe you try that because I mean, it might help you, but it also could be you truly have a blockage. And so maybe, I mean, I think Victoria's sister is doing some of this airway stuff. You should get a consultation perhaps. There's like
Dr Rupy: She she recently did a tray for me because I've been told by a bunch of people that I've my teeth are slightly darkening, probably because I'm a big coffee person like we were talking about earlier. So yeah, I'll ask her about that next time I'm in.
Dr Stacy: Yeah, so James speaks about the homeoblock in his book and that's what the the the appliance that he used. They're now doing other things called Marpes. There are different things that adults are doing. It just depends on one's level of commitment. Like how much if it is determined it is skeletal structural, there are solutions, but like how committed is the individual to doing this? And my recommendation would be just think about your lifespan, you know, if if it might be an 18 month commitment, but you plan to live another 70 years, maybe it's good to get back to breathing optimally. You know, I I the reason, you know what I mean? So it just it depends. It's bio individual what people want to do, of course, and what their needs are. And that's why a proper consultation is good.
Dr Rupy: And what I mean, like talking going back to some of the benefits that you were talking about earlier, I mean, who wouldn't want those? I mean, I can certainly see it like from the the mouth's perspective, if my mouth is less likely to have a reduced pH because it's less dry, because my saliva isn't being dried out and I'm I'm maintaining that barrier, that's going to be a good thing. But you were talking earlier about, you know, reducing inflammation, improved hormones, the improvement in cardiovascular disease. I mean, there's so many benefits attributed to this one action, which is why I'm going to try and nail it by by doing some of the things that you said earlier. Is there a is there a key mechanism? Is there something like that you can hang your hat on like this is one of the key reasons as to what has such drastic impacts across different parts of your health?
Dr Stacy: Yeah, I would say if I were to narrow it down to one thing is inflammation. So when you when you when you breathe through your mouth, you're going to have more systemic inflammation. Your body has to work harder, you're less oxygenated, so you get about 20% less oxygen. This is very important in children. Think of brain development. I mean, so their brain is getting less oxygen, their hormones aren't optimised. This is why a lot of children maybe have prolonged bedwetting. It's because diuretic anti-diuretic hormone is released in deeper stages of sleep, so that's repressed, so they tend to bed wet. They also have smaller stature generally. That's because growth hormone is released during these stages of sleep. A lot of times when the kids get their airway corrected, parents will come back, you know, and say, oh my gosh, they had the biggest growth spurt. It was crazy. I witnessed this with my own daughter. I mean, she grew like three inches once we got her airway corrected and it's a journey. It's not overnight. You chip away at these things. And that's why it's really important to work with someone that you train with, but I say especially as we age, it's inflammation. Yeah, it's inflammation is the key.
Dr Rupy: It makes a ton of sense, especially as, you know, we we've spoken about before in the podcast about the the impact of inflammation systemically across the body. I want to talk a bit more about kids as we we've sort of danced around this. I got a one year old.
Dr Stacy: Are you too? I didn't know that.
Dr Rupy: Yeah, I got a little one year old, Raphael. He's a handful. He's probably the reason why my sleep's been all over the, he is the reason why my sleep's been all over the place over the last year, which is why, you know, I want to try and get to mouth taping given that it can improve your REM and your deep sleep and I got a a ring that I I use to to measure my sleep quality as well. I'm pretty sure he's mouth breathing at the moment. How early would you say it is for appropriate to actually A, have them sort of assessed and B, using techniques like mouth taping in kids. And I I appreciate this is a bit of a controversial area given that we're dealing with with children, but you know, in your clinical experience, how how do you assess them and is this something that you would use?
Dr Stacy: Yeah, so I'll just pretend you're coming to see me as a patient. So you're coming to see me, new patient Raphael. He's one. Okay, so when these are the questions I would ask you. So does he mouth breathe? Do you notice him doing it during the day or is it mostly just at night?
Dr Rupy: Absolutely. Yeah, he does it during the day. I'm pretty sure he's. You can hear him coming down the corridor. He just started walking.
Dr Stacy: So you can, okay, so he's he's noisy. So you can audibly hear him breathing. Okay, this is important. So breathing should be silent, okay? So he's one. Okay, so I would then ask, and we don't need to get all into this. I just will say, like I would then ask, I want to know about the mom's pregnancy, I want to know about the delivery, I want to know was it traumatic, was it rushed, was he early, was he in the NICU, the PICU, were there any environmental exposures, mold, lead, etc. I would want to know how breastfeeding went, was it challenging, did you work with an IBCLC? Did he ever need chiropractic work or craniosacral work? Did he ever have imbalances because of the birth experience? I also, it's important to know, was he born, what position was your wife in when he was born and was he caesarean? And this gets into osteopathic medicine, but women really, we were meant to be like ideally like squatting and having the child come through the birth canal and out and down and now we lay on our backs, come out this way. And so that doesn't integrate a lot of our nervous system optimally and a lot of the bones in the skull, etc. So does he did he have torticollis? Did he have any imbalances that way? So that'd be the first thing I would ask and I would observe him this way too. And so at the age of one, these are things I might suggest in triage. So it sounds to me like he has inflammation. If he's loud breathing, there's inflammation and we need to say why? Where is it coming from? Is it in his environment? Is it a sensitivity to the pet, Nutmeg? Is it, and I know we don't want to go there, but it's something to think about, or is it a food sensitivity? Is there a gut health imbalance of some sort, you know, intestinal permeability, something that's leading to inflammation in his little body. So how do we unpack that? And this is sometimes we need to work with a naturopathic doctor or a functional medicine doctor. Sometimes a simple stool test can be profoundly beneficial. But I would look at him structurally too. I would see, do I think he has a tongue tie that maybe was missed or does he have low muscle tone, muscle imbalances? Is he narrow? Does he have a high palate? Are his teeth tight or crowded? And so at the age of one, what can we do? So there is an appliance called a Myo Munchee. It's this medical grade silicone appliance and it is put in the mouth, ideally in the morning and at the night. I I suggest parents do it, it's habit stacking. So do it when you read a story together. Most parents are already reading a story to their children. I say, and I'm sure the company would not agree with this, but if you can't do it in the morning, let's beggars can't be choosers, just do it at night. And you work up to this, but what is it doing? It's retraining him to breathe through his nose. So a lot of times, especially if kids get sick and they start to mouth breathe, that's great. Our mouth is our backup mechanism for breathing. Yay. But we need after the illness is gone, we should get back to nasal breathing, but sometimes we create a bad habit. And so one, it can remind our brains, oh yeah, that's what that's for. I'm supposed to breathe through my nose. And it creates like a more positive neuro feedback loop. Plus it's training the muscles. This is called the orbicularis oris muscle and the tongue, it's strengthening all these muscles that might be weak. So this is the appliance, the Myo Munchee. So I'd probably suggest that you start using that. I would recommend the nasal clearing. So I like Xclear is a brand I like. It's a xylitol saline rinse, but I like xylitol, it acts as a prebiotic, it will change the pH and and keep things flushed and moist. So I might start doing that. And then I would look at body work too. Like maybe he needs to see a paediatric chiropractor or craniosacral therapist. And also it can be a neurosensory integration. So sometimes they need to reboot the system. We've just lost our way and and forgotten how to nasal breathe and so this can be more systemic that way. And then also maybe working with a naturopath. So I would have to guide the the family on triaging. He's too young for expansion or a retainer. But when kids are really struggling, we I'm fortunate enough to have a paediatric functional orthodontist in my town, my city that will treat kids as young as three and a half or four if they're really struggling. What does really struggling mean? They're up a bunch of times a night. The family is impacted. It's creating stress in the family. No one's thriving. The child's struggling, maybe they're starting to show signs of ADHD and imbalances. And we do see this in kids when they're chronically sleep deprived, they're getting less oxygen. There's a lot of data on this. It can mask itself or appear as ADHD. Like like really loud noises and tags bother us and like we're startled easily and so it's neurosensory integration. So with the young, young kids, I like body work. So that's the first approach there, knowing that we that we might be chipping away at other things structurally as he gets older and it's more appropriate. But for me, I'd want to know why is there inflammation? Why is he breathing so loud? Like what what is that? And are there ways that we can correct it? And then, you know, people will talk about, well, what about an ENT and look at the adenoids and the tonsils? Yes, fair, but my question is always the root cause. Why are they inflamed? Where is the inflammation coming from? If we can fix that, will the tissues kind of shrink and resolve and get back to more of the status quo if you will. So that's how I would start with you. So regarding taping kids, he's not old enough. I don't recommend taping children. Again, the data kind of says around three. I wouldn't do it till four, but this is after the child's been very screened and cleared and I'm they they've seen an ENT usually. I won't recommend it unless they've been cleared by an ENT. I know they can breathe through their nose. It's more just a reminder at night as we are embarking on our expansion and retainer journey. And then also what's really important in in these younger ages, there is something called myofunctional therapy. At one, I think he's too young. Some may disagree, but myofunctional therapy essentially is physical therapy for the muscles of the face and the tongue and retraining the tongue to be up and breathe through our nose and keep your lips closed and it can help address muscular imbalances. So it's like physical therapy essentially. I find it very hard in younger kids. And then families, it's expensive, it can be and families get frustrated and it's because we just started them too young. So again, this airway conversation, it's like peeling back the layers slowly. I know everyone wants overnight results. There's a phrase called fix by six. So ideally, we want, I don't think everything needs to be fixed by six. I think it's a little misrepresented. It's just unrealistic, but the idea is we want to really be getting things going and churning while a child is four, five, six years old, which is very opposite of traditional orthodontics. Traditional orthodontics is, wait for all the baby teeth to fall out, the child's 12 or 13, throw some braces on, line the line the teeth up so they're straight. Oh wait, there's not room for some teeth. Let's pull them. And now you there's there's a joke, four on the floor. It's like when you just extract four premolars to make everything fit. And then what do you do? You have to pull and retract everything back and you make a small jaw smaller. And the scholarly debate here is that conventional orthodontists will say, it's fine, my patients are fine. And my argument is, are you following up with them in their 30s, 40s and 50s? Like, do these patients now have sleep disorder breathing or sleep apnoea? And I will tell you a lot of parents just by report, just speaking to them will say, oh yeah, I struggle breathing and oh yeah, I had teeth pulled. Correlation is not causation, but there is there is data behind this as well. So this isn't, I'm just not pulling this out of nowhere. So we want big wide jaws. Again, go back to ancestral being, like big wide jaws, the teeth have room, everything lines up, your tongue has room to fit and be where it's supposed to be so you can breathe through your nose. Yeah, and like we find a lot of these kids too have micronutrient deficiencies because, you know, they're just not absorbing nutrients optimally because of the inflammation. A lot of times these kids too, they get pegged picky eaters. And everyone thinks it's it's by choice, but I want to share something with you. So if a child has a tongue tie, let's say, or if they have low muscle tone or their jaws don't fit together the right way to chew their food properly or their their tongue just isn't behaving like it should, they're they're going to feel like they're choking, okay, when they eat certain foods. They're like carrots and meat and really crunchy foods that we associate with being healthy, those foods are threatening to a child because we at the end of the day always want to protect our airway, right? That's a that's a protective reflex that we have. So these kids instead, they want the chicken nuggets and the fries and the yogurts and gogurts and the crackers and the, you know, they want those things because they feel safer to swallow and chew. And so when I have a child coming in as picky eater, you know, I I I always say to the parent, listen, this isn't because they're just being stubborn or it might not be. It usually isn't. Usually there's some imbalance in the body and this is where myofunctional therapists come in or early airway orthodontist too and it really can help a child. But we do need to chip away at it.
Dr Rupy: Absolutely. Look, as you were talking, there were just like alarm not alarm bells, like little green ticks going off in my head in terms of like Raphael's history, like the the the birthing process and all that kind of stuff. And it really just speaks to functional training. And there's probably a bunch of people listening to this like, whoa, my dentist has never spoken to me about any of this stuff. Like, where is Dr Stacy trained? Like what what what is this sort of this sort of new way of of treating patients? And it's it's very functionally orientated. And you know, I I did my functional medicine training nearly 10 years ago now and it's, you know, sort of imbued through like what we do here at the Doctor's Kitchen, my clinical practice when I was still working as a doctor. But there hasn't been this for dentistry up until very recently. And we were talking off air about how you're starting something with this because I don't think people have come across all the things that you've talked about just there and it's very recognisable to me, but I don't think to a lot of people they they would have put those dots together.
Dr Stacy: It's a, I mean, I can get into the story quickly. I I essentially went through dental school and graduated and I was really miserable. I was depressed. I hated my career. I hated dentistry. And I almost left the profession. It was because I felt like I wasn't really making a difference. That we were just filling, I don't mean to be demeaning at all. I'm just telling you how I felt. I felt I was just filling holes, I was putting out fires, but these patients kept coming back and the fires were re-engaged and I didn't have time to figure out the why or to like essentially health coach them. It take like you know functional medicine, antecedents, triggers, mediators, we have to get way upstream. I need to spend a lot of time understanding your history, your biology, your emotional state, what are your triggers, etc. And so I just didn't like it. I I didn't, I liked working with my hands, but I at some point you get good at the fillings, you get good at the crowns and I was like, there has to be more to this. So instead of leaving the my career because I had so much student loan debt, this is true. I I honestly almost moved to New Zealand and all I wanted to do was like surf and snowboard and like maybe wait tables. And I was like, you can't, I was like, you can't, you can't do that, Stacy. First of all, that is immature. You're an adult now and you have too much debt. So I was like, okay, well, how do I salvage this career? I'm going to go into paediatrics. And it wasn't because I love children. I do love children, of course, but this is not why I love children. And in fact, it's really funny in dental school, I had never, I never was around children growing up. The first baby I held was my own daughter, if you can believe that. I know. And I like, we had a paediatric rotation in dental school and I always would like slip out to the bathroom because I was just intimidated by kids. I didn't know how to act around them. So anyway, I went into paediatrics initially because that's upstream. That is as upstream as you can get. I was like, this is how I'm going to make a change. I need to change this chronic disease. So many adults have true deep rooted trauma from the dentist. I mean, really deep rooted trauma from experiences at the dentist that were traumatic or painful or emotionally, they they weren't heard and like sometimes it borders assault, to be honest with you, from childhood. So I went upstream, did paediatrics, but the problem is I became board certified in paediatrics and I graduated, but now it was even worse because if anyone is familiar with paediatrics, either medicine or dentistry, it's high volume. So now it was like even faster. I was seeing more patients a day to you know, and it was just it kind of backfired. And that's when I said, I need to take a step back and I kind of need to just take a risk here and like recreate a model, the practice model. And so I opened my own practice and as for where did I get educated, it's been incredibly piecemeal. It's reading books, it's been flying across the country to shadow with someone who's practicing differently and maybe more biologically. I got my ozone certification, I became certified as a laser dentist, I got my international certification in health coaching. I just I just chipped away at it, but then what really changed things for me was functional medicine. And so I too became certified. I'm a certified functional medicine provider through IFM and there's only a handful of us dentists in the world that are. It was extremely challenging. And I realised what's really missing is medicine. Dentists don't get enough medicine. We are instead put in simulation labs and clinic to learn to fix teeth, to be little micro surgeons, but we don't get enough of the how to connect the dots, understanding hormone pathways, understanding gut health and metabolism and bioenergetics and metabolic health and that is so profoundly important. And so I really believe number one, dental school is too short. I think it should be part of medical school and a specialty. And number two, we need two types of dentists. We need surgeons and technicians and we need physicians, you know, we need we need data. Dentists don't run labs. Like who has ever done a what dentist has ever done a vitamin D test on you? Well, if you look at the data, decay is significantly linked to vitamin D deficiency. It's one of the first things I think of if a child comes in with rampant decay. What's their vitamin D status? What is their micronutrient status? What is their oral microbiome like? What is their gut microbiome like? There's things that are very important that tie back to the mouth, but we have no metrics or data, you know. So, anywho, that's a long-winded answer to say, so now this is what I would say is functional dentistry and I did not coin that. Again, I would argue Weston Price was the first original functional dentist, but the issue is there is no training program. And just like like many things that we see on social media, anyone can call themselves anything and there's no accountability and there's no standardisation and who suffers are the patients and the followers, okay? Because you trust this person as a health expert, then you realise they have no credentials or certifications to be speaking in the way that they are. And so it became very important to me and others that I are in my world to create a standardised program because I can be on this platform and thank you again and we can speak and we could speak for hours and it's so interesting, but then patients and your listeners are going to say, this is super cool. I want a dentist like this. Who do I go to? And there's there aren't many. Like you're so lucky to have Dr Sampson, right? Like she's like a unicorn out there. So we need more of her and we, you know, and so we're we are working and have created the Institute for Functional Dentistry, which we're allied partners with the Institute for Functional Medicine. What does that mean? That means that they the students, the dentists and the hygienists and the assistants, whoever wants to take it, they're going to get functional medicine training first. And then we're going to build up to functional dental training. How does this all, how does the functional medicine tie in to the dentistry? And we've recruited about 40 of the top functional biological dentists in the world to be on faculty. It's a residency level program. It'll take 18 to 24 months to complete. You will become certified in functional dentistry, but then we hope to create this little global army of providers that think differently and can talk to you about airway and oral microbiome and gut microbiome and your hormones if you're going through perimenopause and what that means for your oral health and etc. And so I'm very excited about it. And I do think as we're we're learning that traditional medicine and dentistry, there's a time and place, but it's failing us in many ways. You know, like cavities and gum disease should not be the top chronic diseases still with all the advancements in technology and better access to care and more education around oral health, but they still are. And it's so much more than just brush floss and use fluoride, okay? We're missing the the body's component and the systemic component to it. And so we need to look at things more from a macro level.
Dr Rupy: And even from my perspective, you know, just us talking about my son and, you know, his breathing character and what could be the cause of that. Even I'm like, well, I need to see someone who has that training and that in-depth understanding of functional dentistry so I can be making sure that we're making the right decisions because of the potential downstream effects. Not to fearmonger anyone else, but like, you know, I think the more all the professions understand the the value of going upstream, the better. And sort of dentistry's been left behind in this conversation, which is why I'm I'm really keen to have these conversations. We we've talked a bit about breathing as as it pertains to dental health and we're going to skip, you know, the brushing and and fluoride for now, we're going to come back to that. But you you've sort of alluded to diet in a in a big way. What are the kind of, I mean, the first thing that people are going to ask us are, okay, what what do I need to eat? Like what's the diet? Is there a is there a dental diet that I need to be aware of? How how do you navigate this in clinic and what are the key foods that you think are missing from the modern diet that could be contributing to dental issues?
Dr Stacy: This goes back to Weston Price's work certainly and then again Stephen Lin's book Dental Diet speaks to it too. So, it's getting back to the basics. It's all the things you speak of too. So less ultra processed foods, more whole foods. I mean, truly, it's that simple. So I teach my paediatric patients less things from factories, more things from farms, okay? We say eat the rainbow because I want to teach them about phytonutrients. That's why I say that. I want to teach them each different colour does something different for their body and to be mindful of that every day. So it's essentially an ancestral diet, you know, and I'm not in any camp or or I would even argue paleo, but it's true. So what causes disease in the mouth? It's fermentable carbohydrates. Everyone blames sugar. Sugar is part of the conversation, but it's also flour. Flour acts like sugar in the mouth. So all the crackers and the chips and the granola bars and the fruit snacks and the dried fruit, it's it's also texture, like really sticky things. Those are wreaking havoc. And then that's not even to mention the preservatives, the food dyes, the artificial flavouring, just the additives. What are those things doing to the oral microbiome? We have data about what they're doing like artificial sweeteners, what they're doing to the gut microbiome and now, you know, there's more research coming out about the oral microbiome, but our microbes are the kings and queens of our body. We're more microbial than we are human, right? And so we need to be feeding them and what do healthy bacteria thrive on? They thrive on prebiotics and fibre, okay, and polyphenols and phytonutrients. So we we over consume food, these hyper palatable foods are meant to be eaten and snacked upon and sipped on all day. And so not only is that causing a problem from what the actual food is, but every time we eat, a digestive process starts and the pH of our mouth drops and our mouth is acidic. And so if you're constantly grazing on crackers all day or sipping on that kombucha all day, even though we think it's healthy, but it's the time and so your mouth's constantly bathed in acid and acid leads to disease, okay? So timing of food matters too, but going back to nutrients, we're missing fat soluble vitamins. I mean, there's so much, there's so many stats right now to say how chronically vitamin D deficient we are, how chronically magnesium deficient we are and mineral deficient. Our soil is depleted. Like even if you eat the healthiest food, our food is changing, our nutrient levels change, our soil has changed. This is where regenerative farming comes in, which I applaud. And so because of that, we need to fill in the gaps, you know, and so I don't like to willy-nilly prescribe supplementation, but I have found most patients need vitamin D supplementation, K2, they work together, and magnesium and minerals. Like those are the big ones for dental, as well as trying to make sure our kids are exposed to whole foods. So I am, I'm I I love breastfeeding if if it resonates with a woman and she can. I do like a more of a baby led weaning or kind of whole food introduction to your child, less purees, please be safe about this and make sure you know what you're doing and work with your doctor, etc. But, you know, my kids ate what we ate. If I made stir fry at the age of your son, you know, I would chop it up and throw it on the table and they would eat it and this this is very good for motor development too and it was totally messy. But I will tell you, my girls are 10 and 12 now and they really have amazing palettes. We just didn't bring these foods into the home. They were not the goldfish crackers and the cookies and the they weren't in the home. They ate berries and carrots and meat sticks and cheese sticks and eggs and nuts and seeds and hummus and, you know, fruit, those type of things. Now, flash forward, they're going to friends' houses, they're after soccer, getting snacks I don't love, but their foundation, those first formative years are there. And so they still eat very healthy even though they're experiencing in the ultra processed food world now. I would say too, we don't eat enough fermented foods. A lot of ancestral diets are very focused on fermenting. And so I would give my girls little shots of sauerkraut juice. We would naturally ferment pickles. That was a fun like experiment for my kids, like a science experiment. Get your kids into the kitchen. It's so important. Go to the farmers market, have them touch the food and pick out the purple broccoli and let them get in the kitchen and chop it and play with it and be exposed to it and do art projects with food. This really works. It's exposure. It doesn't always have to be eating. Like make stamps with the broccoli and have them paint with it or do put little toothpicks and make structures. Just get them exposed. Have them meet farmers, have them understand where their food comes from. This sounds kind of like cliche and hokey, but it's really important. We've lost our way. We've lost our way, I think. It's just so it's like we're over convenient. And this is trashing our health and specifically my focus is is trashing your oral health. I mean, my nemesis are goldfish crackers. And I don't care. I don't care if they're organic.
Dr Rupy: Just just for the UK listeners, these goldfish crackers are like these little cheesy goldfish shaped crisps. We call them crisps. So yeah, and they're like they just basically turn into mush in your in your mouth and it coats the inside and it's like starchy and really not nice, but they're very popular in America.
Dr Stacy: Because they're so popular and people use them to like appease their children, they're used to keep kids entertained. But I think they're one of the top reasons for decay because to your point, yes, they're like wallpaper glue. They just stick all over the teeth and that is your your pathogenic bacteria are thriving off that. They love it. And then hygiene is hard in little kids. I'm sure you're experiencing this. It is challenging to brush a kid's teeth. They don't like it. That's normal. It's normal for kids not to love their teeth brush. Then add to that when I'm going to tell you, you need to be flossing your kids' teeth if the teeth are touching. You have to be, especially if you're eating any modern food like that, because most cavities we see in kids are between the teeth. Especially when the second molars come in, which is like around the age of two and a half or three, you have to be flossing every night. I can't emphasize it enough if you're eating crackers especially. But if you're eating an ancestral diet, I worry a lot less about hygiene. I'm not that concerned with it. So it's true. I mean, I see these guys on social media, these carnivore dudes and they're like, I don't even brush and floss. And you're like, you know, you think you're like, that's really gross. But also, I kind of get it. Like nothing you're eating is going to cause decay. It might cause malodor from food degradation between your teeth and stuff, but it probably won't cause disease at all. And you know, our ancestors, most people don't realise ancestrally, humans didn't have decay. We really didn't. You would see some of it, of course, especially in areas like tropical climates where there was more fruit or more honey, but think about how hard it would have been if you were foraging, you were competing with all the animals for those berries, okay? And it was a limited season. Very little decay. Decay skyrocketed after the industrial revolution. It skyrocketed after sugar and flour and the processing happened. This is a modern disease. Ancestrally, we didn't have it. Think about wild animals, the wolves, the deer, the tigers, they don't get decay. They don't. Who who does get decay? Our dogs and our cats, our domesticated pets because of their kibble, because of their food. And so when you when you shift this way, again, you have you take the information and you do with it what you like. And if you're like, oh wow, hygiene is so hard in my kids, I'm going to double down and be a little more strict with their diet. I'm into that. Or if you're like, nope, goldfish crackers work for our family, we love them or crisps, then you have to be really on top of hygiene. You have to be very focused on it.
Dr Rupy: Absolutely. I love that. So on precious the diet, ensure that they are not grazing the whole day. Make sure you're including starches and these crisps as well as, you know, all these other very easily digestible foods as part of your strategy to remove or limit as much as possible, fermented foods. You mentioned ancestral diet.
Dr Stacy: Water, water. Water throughout the day. Because a lot, sorry to interrupt, but the the other thing that sneaks in are drinks. And so we don't realise how damaging our drinks are. You know, people talk about how juice impacts blood sugar. You know, a cup of apple juice equates to, you know, four or six apples. Like you would never be able to eat four or six apples because of the fibre content, but there's no fibre, it's stripped. So not only is it causing blood sugar disregulation, but it's it can lead to rampant decay. So eating on eating and drinking on a schedule. I like every two hours. Like breakfast, two hours later, a snack where your child sits down and mindfully eats their snack in one setting and then they go on and to play. And then lunch and then afternoon snack. So on a around a two hour schedule. And if you focus on protein and satiating foods, your child should stay full and satisfied. And if not, throw in a cheese stick or a meat stick or, you know, but a strategy is if you have to eat crisps or crackers or things like this, eat them first and then offer a crunchy cucumber or carrot or pepper or apple because that chewing mastication and salivary content will help wash away and then water throughout. That's what I want throughout the day is ideally water, not juice, not kombucha. These are special drinks. They should be consumed with meals in very small amounts and even sparkling water and people get super mad at me about this. I drink sparkling mineral water. It's great, but I try to drink it with a meal, but no, it's acidic. So the acidity of your food and drink matters too. And this is where kombucha and coffee, like you just need to think it's not just sugar, you guys, it's also acid and it's the frequency and the texture of the things you're drinking and eating.
Dr Rupy: Yeah, yeah, I love that. I'm feeling kind of smug right now because we're doing some really good stuff with Raphael. Like, I mean, he was born C-section and luckily, you know, he took to breastfeeding. He eats what we eat. We we did baby led weaning. We had a friend of mine, Charlotte Sterling Reed, come on the pod and she's like a a baby led weaning expert. And so she talked us through stuff and and you know, he eats everything now. He just and he has he has snack time, which is where like, you know, we give him fruit and and hummus and all that kind of stuff. We make everything from scratch and you know, we're we're very lucky. Like we have the time and the inclination to do all these things for our son and I I realise for some people, the time is just not there and they have to make sacrifices and it's a trade-off. But I love the way you frame that because, you know, if they do need these foods or you have to sort of appease them with snacks that you're not 100% happy with, you just got to be on it on it with your your flossing and your hygiene as a way to mitigate that as much as possible. In the sort of realm of ancestral diets, there's also a bit of a focus on things like organ meats and you know, I know Weston Price was a big fan of like going back to basics and getting some of these. Are you a fan of those from from some like the nutrient perspective? Is that great for oral health too?
Dr Stacy: Absolutely. Yes, 100%. Yes. It's just the micronutrient content that it's it's mother nature's multivitamin. And so people say, well, how on earth do I get my kids to eat this? I mean, if you start early, there's some very great liver recipes out there. I you know, what I do, I still do this. I will take like half, you know, high quality burger meat and mix it with like an organ blend if people eat meat. The other thing when kids are little or even now, you can take capsules and mix them into your scrambled eggs or mix them into your smoothies or just, you know, there's desiccated capsule form too if if organ meat's not for you. I'll be honest, I it's not like I'm a complete fan of the taste of liver, okay? So, but I try to sneak it in even to myself. If I'm making like chili or something, I'll try to put in more of an ancestral blend of the the beef. Or just take capsules. But yeah, I love the micronutrient content of it and I think it's it's very important. And then the other thing I'll say too, don't think your kids won't like something. Like give them an opportunity to try it and this goes to me with flavour and flavouring. So once your child's eating food, slowly incorporate in different flavours like curry and cinnamon and turmeric and garlic and like don't be afraid. Like this early exposure, including like starting at one, it's truly shaping their palette, you know, and so that and I don't mean this can sound overwhelming to parents who maybe have a six, seven, eight, 10 year old and they're like, yeah, fat chance. It's not that the window is lost, but it will be more challenging to get your child to accept certain foods. So the earlier we can introduce them to these flavours and concepts and textures, the better. But all hope isn't lost if you have an older child, like sometimes what I think helps is getting them into culinary arts. I think like sign them up for a summer camp cooking class. It you once you start getting into cooking, you realise how much is this beautiful blend of art and science. And I most people once they aren't intimidated by it and that's where an instructor can help or a group setting, it really does feel so natural and like you you provide so much love for your the people around you by preparing something in the kitchen. And I don't need to tell you this. I know this is what you speak of, but it's so important. I mean, I I love cooking. And my kids do too and even they and they might say like, come help me with dinner and they'll be like, mom, you know, but by the time I get them in there, we have a good time, we put on music. It's such a wonderful warm bonding time too. So if you have older kids, I'd say that's your angle. Don't you're not going to eat raw oysters right now, okay? But look into getting them in a class to get them excited or get them see if they can do like a little externship on a farm for a couple of days, you know, and the farmers would love that, but it's just a really good experience for them. I think it gives them a little bit of grit too, right? So,
Dr Rupy: Absolutely. We we've even started Raphael doing the micro herbs at the moment. I mean, he's got no idea what he's doing, but just, you know, the the the process of grabbing a watering can and then putting it on the little window sill bed and and watching them grow is pretty cool. And we did these mashed sardine fritters the other day, which are which are great because you're getting the entire bone in the sardine itself because they're soft enough for him to consume whole. So you're getting a whole bunch of those nutrients as well if you if you just eat fish. So,
Dr Stacy: Mashed sardines are where it's at. That's a brilliant recipe. So people, think of like, I I do this too. So think of chicken salad or people do egg salad. It's sardines. And what you do is you mix it with celery and a little onion and like pickles. And most kids really love it and they can scoop carrots and celery into it or even crackers. If I'm not trying to villainise crackers, but you have to understand, I go to I go to war against the food industry every single day and I am so angry about it. But, you know, they they do make seed crackers and so seed crackers won't cause decay. It's truly seeds. So something to think about, but yeah, the sardines, that's a brilliant food. It has so much nutrition in it and calcium, which is so important for bone development and tooth development.
Dr Rupy: Totally. I feel like we could definitely talk a lot about recipes. There's a a seed cracker that I put in my latest book and we have it on the Doctor's Kitchen app where it's literally just flax and chia seed that's soaked in hot water and then we add like a bunch of mixed seeds to it, a little bit of flavouring, tiny bit of salt, and then you lay it flat on a sheet and you cook it for about 45 minutes and I kid you not, like it come it's like a cracker. It's it's amazing and it's got great texture and you you put it in dips and stuff and yeah, it's he's a little bit too young to have that right now because of the the seeds, but like he's he's definitely going to be on those when he's older for sure.
Dr Stacy: I need that recipe. Please. Yes, please.
Dr Rupy: I'll send you the recipe. I want to talk about a couple of things before we close. These are kind of controversial though, so I I know and I know you probably want to give the nuance to it, but we're going to talk about fluoride fluoride in water and reverse osmosis filters as well. Full disclosure, I now have a reverse osmosis filter in my house. We made that decision after I tested the quality of water in my house and I wasn't happy with it. But, you know, rewind like 5, 10 years ago, I just thought these reverse osmosis filters were a complete waste of time. I'd love your opinion on them, but before we get into that, fluoride in water, is this a good thing for our teeth? Is this something that we should not be scared of? Like what what what is the story around fluoride in water because it's very polarising.
Dr Stacy: Yes, it is. I like to start this with a story. So I was traditionally trained as every dentist is and needs to be and I was taught that fluoride is the panacea for dental decay and everyone needs fluoride or they would suffer their whole lives from dental decay. And I would say this is absolutely not true. But so I graduated, I still felt this way. I was very opinionated about it and very judgmental of patients who said otherwise and I know better than you and I'm the I'm educated, I'm the expert. And then in I live in Portland, Oregon and the water here is not fluoridated and it was up for vote again and I gosh, the year I think was 2012. Is that right? Yeah, it was. So I volunteered for the pro water fluoridation side and I was picketing and I was handing out buttons and I was saying, fluoride, fluoride, we need fluoride in the water. And so I because of my involvement, I sat in on a debate and it was like kind of the pro versus the against side and I was sitting on the pro side and I was looking over at those who were about ready to speak against it and I just thought, gosh, you tin hat brigade, you woo woo scientists, like you are ruining human health. How dare you? And they got up and they spoke and they said things I had never heard before, all backed by data and science. My jaw was to the floor. I had this pit in my stomach. They were so articulate. They weren't crazy at all. These were scientists, educators, dentists, epidemiologists, etc, okay? So I went back and I had, you know, an identity crisis and I sat in front of PubMed and I just couldn't stop. And my philosophy and thought all about systemic water fluoridation has completely changed because of the concerns with neurotoxicity and also we we now know that fluoride works primarily topically, not systemically. Also, fluoride's antimicrobial, so it's and it's not selective, so it can be damaging your gut microbiome. We need less of that in modern society, not more, and it can be damaging your oral microbiome. What are the long-term effects of that? You know, it's a very reactive ion, it can compete with iodine, it can lead to thyroid issues, it can lead to fluorosis of the teeth, but also skeletal fluorosis. I mean, the list goes on and on and on. And so at that point, you know, I I'm a paediatric specialist at the end of the day and I represent the health and welfare of children and I have to do no harm. And after reading that, I could no longer say confidently that this won't harm a child. And everyone's going to say dose makes the poison, okay? But the problem with water fluoridation, we can't dose it. Someone drinks this much water, a cup a day, someone drinks is an athlete and drinks a litre a day. Someone has kidney dysfunction, they shouldn't even have fluoride because or they have calcium metabolism issues or they have iodine deficiency or there's actual patients that are fluoride sensitive or intolerant or there's genetic polymorphisms that impact detox pathways we don't even know about or pregnant women and foetuses are more vulnerable or infants who are drinking fluoridated water formula, you know, formula with water, more vulnerable. What are the cumulative effects? This is the issue. It's not one's arguing one glass of water is going to cause this. It's the cumulative effects day after day, week after week, month after month, year after year. And we know especially in children, fluoride is not excreted 100%. It's excreted maybe 50%. The rest is stored in calcifying tissues. Yes, the teeth, but also the pineal gland and the bone. And it's excreted only 80% in adults. So it's a nuanced conversation. To me, it seems common sense and logical, but people get so triggered by it. But I will also tell you, the media is misrepresenting the data. So there was a federal trial, it was essentially the people versus the EPA. It went on for seven years. The judge made his verdict now, gosh, a year and a half ago, and he said there's an unreasonable risk to current water fluoridation practices in the United States. And he said to the EPA, the Environmental Protection Agency here in the United States, you need to do something differently to protect the vulnerable populations. The EPA expert under oath said, what is the margin of safety of water fluoridation? And he said it should be 10x. And that means to protect vulnerable populations, okay? And to spare you all the nuanced numbers, we fluoridate in this country about four and a half times what that window should be. So we're over fluoridating based on their own margin of safety. So that's an issue, okay? Then the issue is, okay, well, what if we lowered it to that level? Well, there's no data to support that that's even doing anything. And then actually, the Cochrane Collaborative came out recently with a new report that said current water fluoridation practices are only reducing decay by a few percentage points and that's not statistically significant. And this is not what the mainstream media is picking up. They will not reference that latest Cochrane Collaborative report. They reference the Cochrane Collaborative report from about a decade ago where it said it reduces decay by 25% and that is old data and that needs to be thrown out. I'm so tired of it. We have to be following the science and the updated science, whether it fits our narrative or not. There are so many studies that show, you know, links to neurodevelopmental issues, neurocognitive issues in kids, not to mention all the thyroid issues and the the osteo the bone health issues and things too. So the list goes on and on and on. And if you're practicing, you know, to protect a patient population, we don't have enough safety data on this. This was something that was brought into our water system based on observational data in the 1940s and has since, in my opinion, been disproven to work. And then even on top of that, even if you believe it does work, at what risk? So why are we choosing teeth over brains? So with the neuro neurodevelopmental issues, it can lower IQ in children up to four to five points. That's on par with lead, okay? It's it's pretty wild. And so as someone that's an advocate for kids, yes, I care about their teeth, but I care more about their brains. I mean, I will die on that hill because I'm a dentist. I can fix teeth. I was trained to fix teeth. And so your child might get one quarter, well, that's the that's the latest stat by the way, one quarter more cavity in their life if they don't drink fluoridated water. That which is by the way, you throw that out. That's not statistically significant. And you're going to hear dentists say, if we take it out of the water, cavities are going to skyrocket. This is not true. We are one of the United States is one of the last countries to fluoridate their water. I'm not sure what's happening in the UK. Many countries around the world have either removed it or they never put it in and especially the Scandinavian countries are a very good example of of countries to look at. The decay rate did not go up. Now, I agree that we need to implement more education and more systems and then this is where the conversation about topical fluoride comes in because fluoride can work topically to make your teeth more acid resistant. Remember I spoke about how it's actually acid that's the problem. So it makes it gives your teeth a more a bigger coat of armour. But I'm going to tell you, people rely too much on fluoride. Fluoride is no match to big food. So if you're eating Doritos and cookies and goldfish crackers and crisps and kombucha and soda and all of these things and that's your diet, you will get decay. I don't care how much fluoride you drink or put on your teeth. It's just it's because it's going to be out of balance, okay? It's just it's an extra layer of protection, but it's not perfect. And my argument too is if fluoride was so wonderful, why are cavities still the top chronic disease globally in the world where, you know, especially in the United States, let's say the United States where, you know, 75% of the population is exposed to fluoridated water, why do we still have a cavity epidemic? It doesn't make any sense. It's a failed system. It didn't work. Back to the drawing board, you guys. And where do we really need to focus our attention on? Tackling big food, getting healthier foods access to healthy food to families, teaching them how to prepare it. You know, maybe you could argue a topical fluoride program in the school system. That's what they do in Japan. The kids rinse with with a fluoride rinse every day and their decay rate is extremely low. Now, yes, they have a very great diet and this will be the argument of the pro. Well, Japan eats healthier. Yeah, I I understand that. How do we get Americans to eat healthier? Why do we keep masking the problem? Like let's let's work together collaboratively. We all want the same thing. We want healthier kids, we want healthier people. Let's work together and stop fighting about this. If you want to use fluoride toothpaste, go for it. I don't and haven't, how old am I now? It's been like 25 years, no cavities. My kids have never had fluoride, no cavities. Why is that? Good genes? No, it's not genes. It's our diet, it's our hygiene, it's how we're breathing. I focus on these things. So cavities, you know, and you're going to hear dentists say too, I can tell if a patient drinks fluoridated water based on how their teeth look. There's no data to support that. That's anecdotal. In fact, the World Health Organisation even shows that fluoridated countries have no different decay rate than ones that aren't fluoridated. So there's just so much misrepresentation of data in the agencies. It's infuriating and the mainstream media is a lot to blame for it. And so this is where I empower you listening, you have to do your own research. I really mean that. Like you need to go look yourself on PubMed, even if you're not great at reading research, go look for yourself. To me, any possibility of a brain development issue or a neurocognitive issue or something on par with lead that I'm going to be giving to my children daily that they might be swallowing and absorbing through their oral mucosa, that's a hard no for me when I know there are other strategies that I can implement to prevent decay, arguably more successfully.
Dr Rupy: Yeah, yeah, I I completely hear you on that. I think I was definitely in the zealot pro fluoride camp a number of years ago, but now, you know, in the face of the information, people like yourself, chatting to other functional dentists, I'm certainly of the opinion that it's not helpful and the risk benefit ratio is just not in its favour. So, you mentioned topical fluoride there, which I've had personally because I've I've got gum recession that Dr Victoria is taking very good care of. What about in toothpaste? So if you're not using a fluoridated toothpaste, what toothpaste are you using and and why would you say that's better? I mean, aside from the fact that you're exposing yourself less to fluoride, which is in the atmosphere, I guess, so, but yeah.
Dr Stacy: Mentioned, like in certain patient populations or in certain situations like yours with maybe you have root exposure more because of recession, topical fluoride can be great. I just want people to know there are alternatives and they work just as well based on the data right now, okay? And that's what dentists, some dentists don't even know this, you guys. So, it's a personal choice, all right? But but but I would caution you not to use even topical fluoride in kids that can't spit. If they're swallowing their toothpaste, I worry about the cumulative effects. In an adult, you can brush with it, you can apply it, you can spit it out. Your absorption is probably, it is true, it's probably pretty low, negligible. I would argue if you have a history of thyroid issues in your family or kidney disease, you know, maybe you want to be more cautious because I can't tell you what the cumulative effects are because to your point, you're getting it in other places. I have to mention this. So what they also forget in the conversation is the halo effect. The halo effect is the cumulative amount of fluoride from all exposures. It's not just toothpaste, it's not just your rinse, it's not just the varnish. It's in processed foods. If your food is made at a factory that fluoridates their water and it's a drink or it's soup or or what have you, it's going to have fluoride in it. There are certain foods that do have small amounts of fluoride more naturally. Green tea is one. Now, the thing with green tea is there's other things in the green tea, the polyphenols and the and the nutrients in it to to kind of bind the fluoride and make it really not bioavailable or harmful. That's left out of conversations too. But this is the big one. This is one of the top ways people are exposed to fluoride, pharmaceuticals. Up to 70% of our pharmaceuticals have fluoride in them. There it's a binding agent that helps with bioavailability. So a lot of antidepressants, SSRIs, Prilosec have fluoride in them and people take these prescriptions every day and they don't even know, they don't even know that they're getting fluoride exposure. So you should look it up, see if your medication maybe has fluoride in it. So, yeah. So the halo effect is very, very important. But, okay, so what can you use besides fluoride if you're worried? And I would say, why do I not use it? I'm less worried about neurocognitive issues for me because I am spitting it out, but I'm worried about microbiome issues because it's antimicrobial and I want a diverse microbiome and I don't want my healthy bacteria damaged. So there's something called hydroxyapatite. There's micro and nano hydroxyapatite. This has been around since the late 1970s, early 80s. And it's been shown to work just as well as fluoride toothpaste for remineralisation and decay prevention. Theobromine is also an ingredient that has really great results. It's it's a compound found in the cacao for chocolate essentially. It can have remineralising effects. You'll see some brands out there with that. Xylitol, you know, it acts as a prebiotic and so it can influence the bacteria in the mouth to make it a more healthy environment for remineralisation too. So there's different things out there to use besides just fluoride. Some patients mix and match, they rotate. You really have to do what's right for you, but I encourage you, again, don't just listen to your one dentist because they may be were like me and they haven't done their due diligence because they're too busy or they're just too opinionated and stubborn about it, which I was. If I hadn't sat in that debate, who knows what would have happened. So I wouldn't just listen to your one dentist as much as you love them or your hygienist as much as you love them or that news outlet as much as you trust it. Like you have to do your own research and then take that and make your own decision what's best for your family. And then leading to reverse osmosis, I'm a fan. My home is also has reverse osmosis. And so this is filtering the water, it's filled out, filters out any fluoride if you have it, chlorine, bromine, etc. The bummer is it leaves your water pretty flat, neutral without minerals. So you have to make sure you're putting minerals back into your body. It's very, very important. Most of our water now is mineral deficient. I mean, think about how we used to drink from streams and rivers flowing over the rocks. We were getting a lot of trace minerals from our water, not anymore. We kind of nuke our water for safety reasons, which is great, but you have to get more minerals back in and reverse osmosis really, really creates a more, a less ideal water for you from a mineral standpoint. So I do recommend, yeah, supplementing.
Dr Rupy: Absolutely. You mentioned nano and micro hydroxyapatite. Is there a is there a preference between those two or?
Dr Stacy: I prefer nano. I find it works better clinically. The data supports that as well, especially if you are trying to arrest or reverse decay. So yes, if you have a small cavity, you can heal it. People poo poo this, you can. Your teeth naturally demineralise and remineralise throughout the day. Every time you eat that acid I spoke about, the pH lowers, that's part of the digestive process. Minerals are pulled out of your teeth. This is also very normal, but if we allow our mouths a chance to rest, which is why I like every two hours schedule, the saliva in your mouth will naturally buffer and raise the pH, it will push minerals back into your teeth and so this is like a very normal process. When we've lost too many minerals, and we actually get a hole in our tooth, that's called a cavity, a cavitation. But there's something in between that's more it's called an incipient lesion. It's like we've lost a lot of minerals. So generally on X-ray, we'll see a shadowing, but there isn't a hole yet. That is a perfect situation where you actually can remineralise it. You can push minerals back in and eventually that shadowing on the X-ray can fill back in with minerals and go away or in kids a strategy sometimes I have, depending on how old they are, when is the tooth going to fall out? Like let's say it's a baby tooth, I'll try to arrest the decay. I'm just trying to freeze it in time. Sometimes it might even be a hole, but you can sometimes arrest these because let's say I have a child that just they would require general anaesthesia to fix that tooth, but that tooth's going to fall out in a year. I mean, risk benefit, right? Like let's try to arrest it, slow its progression until the tooth naturally exfoliates. And I will tell you, this is what I'm known for in my office and why people do come see me is my arrest and remineralisation protocols and I'll tell you they work and what works best is nano hydroxyapatite. Micro, I think's great from a preventative measure, but I don't think it works as well as I wish it did from even from a prevention standpoint. But, you know, if you're a low risk patient, I think micro might be fine, but if you're like, well, I do like those crackers and I do sip on sugary coconut water all day and I'm not going to change that habit, you know, you just have to be truthful with yourself and I think you need nano hydroxyapatite. And nano hydroxyapatite is what is more comparable to fluoride toothpaste products.
Dr Rupy: Wow, Dr Stacy, there's so many other questions I've got, but I've got to stop it there.
Dr Stacy: I'll come back. I'll come back. I'll come back. I'm in London next summer. I'm in London next summer.
Dr Rupy: Please. Yeah. Are you? Really? Okay, we should we we will 100% do a part two because honestly, there's like jaw exercises, hormonal health, testing your oral microbiome, all that good stuff. So let's definitely do a run two, but thank you so much. This has been wonderful for me. You're awesome. You're just you're fantastic. Like your passion for the subject. I've learned so much today. I'm going to be mouth taping. My wife's going to be like doing a little victory lap around the around the bedroom. I might not be sleeping in the same bedroom anymore because of my dog, so thank you.
Dr Stacy: Nutmeg, poor Nutmeg.
