 Thanks everybody for coming. I just want to say I've been coming to these things. I think I missed the first one and It is my favorite place in the world to be and it's really because of you guys. So let's give you guys a big hand All right, so we there's two of us talking. So there's not a lot of time So we're gonna do like little Ted talks Hopefully mine doesn't turn into a Ted Geisel talk for those of you know don't know who that is. That's dr. Seuss So, okay First of all our friend Al Danenberg. He's been ill. He would have loved to be here. He can't make it So, you know our hearts and prayers are with him I just wanted to start by saying, you know, he was kind of my inspiration for what I'm talking about today So currently we're doing a study designed by dr. Al. It's We're gonna look for 50 Subjects With measurable gum disease We're going to do Swabs actually mito swabs to check their mitochondrial function and Oral microbiome swabs as well six weeks of either a placebo or a probiotic with vitamin K2 double-check the inflammation and Also the mitochondrial function and the oral microbiome We suspect we're gonna see changes in the mitochondrial function and The oral microbiome is probably going to change because we're affecting the GI microbiome. So that's sort of the Incentive for what I'm gonna talk about today All right, that's my fake book. I haven't written that Carb mouth maybe one day So the two things that I'm gonna talk about today We're gonna do an examination of the relationship between the oral and general gut dysbiosis Both of which seem to be initiated by the introduction of dense acellular carbo hydrates And then I'm gonna get into an explorate an exploration of some of the critical factors in the etiology of caries and perionontitis Okay So 23 centuries ago Aristotle tried to describe foods that caused cavities And then you look down at the guy in the bottom and that's about where we've gotten it's still very very confusing Here's an example if you look at the foods on the right You know, which one of those is actually gonna cause more cavities Is it the lollipop with all the sugar or is it the pretzel and There are factors that would say both Cause cavities, but one might be worse than the other and it's kind of a mystery and we'll get into that a little bit later So here's the general formula Okay, we have fermentable carbohydrates plus cariogenic mouth bacteria, so cariogenic just means cavity causing and Susceptible teeth and then that gets you your risk for cavities. That's really a bit of an oversimplification So throughout this little presentation, I'm gonna be clarifying that Okay, so this is what we're gonna end up with I'm not gonna keep the slide up there for too long I'm gonna come back to it and reconstruct it later on All right, so fermentable carbohydrates a All carbohydrates are fermentable Okay They can all be metabolized for energy by microorganisms so we've Been on this planet for three million years or so. We've only just recently Gotten cavities and we've been eating fermentable carbohydrates for a long time. So that's incorrect Okay It's interesting that I have a picture of an acorn You don't think of people as eating acorns, but we see squirrels eating them all the time And if you look at that thing, there's a lot of wood in there Isn't there you got to get through the wood in order to get to the carbohydrate inside? so arguably a Diet that's a whole foods diet is gonna be much better for you And I have a study down there that if you're kind of curious about it you can refer to that or You can read this book Tyrone finds corn in his That's a pretty good explanation right there you wrap stuff up in cellulose. It's hard to break down We don't get a sugar bomb in our mouth. Okay, so dense a cellular carbohydrate Right This is what we're looking at sugar all that sort of stuff by studying how Ultra-processing changes the properties of whole foods and how these foods affect the gut microbiome more useful dietary guidelines can be made and For those of you who don't know what dense a cellular carbohydrates are there's some of them Doesn't have to just be wheat flour. It could be tapioca starch Anytime you take the carbs outside of a plant cell It's that's a dangerous thing Okay, so plaque acid dense a cellular carbohydrate and tooth decay The mechanism is is this you get the a cellular carbohydrates in the mouth The bacteria in the mouth ferment the stuff it lowers the pH and the pH dissolves the minerals in the teeth It's that simple And when we're talking about gum disease You have plaque making lipopolysaccharides from the dense a cellular carbohydrates, and you get gum disease Lipopolysaccharides are also known as endotoxins. Okay, so on a local level. They're toxic to the gums and This is with the introduction of dense a cellular carbohydrates Endotoxins Okay, so humans are quite unique primates and lagomorphs Those those are like hairs and rabbits do have salivary amylase, but humans have multiple copies Okay, some people have I think two copies, and I think you can have up to about 15 So when you're eating that pretzel, okay, we've all done this You can't touch your teeth together for for sometimes 20 minutes to an hour because all there's all that doughy stuff Stuck to your teeth, and I think the the starch in Flowers amylopectin a if I'm not mistaken and that's considered to be a lower carrier genetic Substance however it stays there for a long time and now you're saliva and especially if you have more amylase Used to call it Tylen You're gonna be breaking that stuff down into simple sugars So what's worse a lollipop that maybe sticks to your teeth? But it melts off pretty quickly or maybe a pretzel that stays there for a long time. These are interesting questions So more amylase does equal more sugar, okay, we just kind of touched upon that so basically you know salivary amylase becomes a problem when we eat that Processed carbohydrates, so even if they're complex carbohydrates, they can become simple sugars in the mouth The bacteria can actually hijack the amylase to help to get more sugar from the starch And they also use it sort of as a matrix to develop the biofilm and and also the bacteria do make their own Amylase as well. So all of this stuff causes a lowering of the pH and acidic environment and Basically melting away of the teeth Okay, so Weston a price, okay John Yudkin Thomas L. Cleave. These are all sort of pioneers that spoke about the introduction of modern foods and you know what it did to all of us So, you know, you see that guy on the bottom there with all of his tattoos But if he didn't have his tattoos his fleshiness is giving away what really what he's doing, isn't it? That's another way of putting it. Forrest Gump was pretty smart But to get technical and there's a lot of Mechanisms that go on this just happens to be one so basically DeLartig was a bit of more elaborate in Implicating the vagus nerve Leptin resistance Blunting, you know the satiety and there are a lot of mechanisms and we just I don't have enough time to really get into that today Okay So the present hypothesis suggests that it is a diet of high density carbohydrates that produce inflammatory microbiota changes in both the mouth and the gut When I was putting together this presentation, I was gonna maybe put a picture of the gut and It's interesting half of the pictures you you pull up Start here They don't include the mouth and it's amazing to me. We already talked about salivary amylase. Well, we're breaking down Carbohydrates in the mouth. We're digesting right here. Okay, so when you start with this Dysbiosis of the mouth with the introduction of dense a cellular carbohydrates, you're gonna get inflammation of the gums You're gonna get your teeth melting away What happens to the food after you swallow it last time I checked it goes down somewhere and it stays in your body for a long time so there's a definite change in the microbiome of the gut Some people argue the gut microbiome changes first Some people argue the mouth microbiome changes first Chicken or the egg. I don't know to me. It doesn't really seem that important but to me When you introduce this dysbiosis to your mouth rest assured excuse me it's in your gut and This little diagram. I had to pencil in the gum disease. It wasn't even on there People just seem to forget about the mouth, but all of these things occur. These are low levels of chronic inflammation That we have in our bodies Because of dense a cellular carbohydrate Changing our microbiome Okay, so here we go dysbiosis of the gut Pretty much means dysbiosis of the oral cavity the present hypothesis suggests that in parallel with bacterial effects of sugars on Dental and periodontal health a cellular flowers sugars and processed foods produce an inflammatory microbiota via the upper gastrointestinal tract That was said by our friend dr. Ian spread berry maybe three or four years ago I don't know if any of you guys saw that lecture go back to it. It's worth watching It's on YouTube I believe Okay, so now I'm gonna go through a couple of studies and There's really not a lot of research out there and it's really kind of all over the place But I'm gonna go through a few studies that are gonna connect the oral oral microbiome with Gut dysbiosis. So in this study here they did a bacterial analysis of obese women and 98.4% of them. This is oral microbiome had just the presence of one bacteria at levels greater than 1.05% of the total bacterial colony Was indicative of Obesity, so I mean that's close to a hundred percent They could find one germ in the mouth and predict whether the person was obese So that's pretty good, and I think more research needs to be done. Excuse me along these lines We may be able to Determine a lot of things just by a simple oral swab. It's really easy to do You know an oral microbiome swab test. It's a heck of a lot easier than a stool test I assure you anybody here ever do a stool test Not so much fun. Okay two more studies Results find that oral Buckle so that's the cheek microbiome reflects differences in the microbial ecology of participants with IBS that are overweight Okay, so they they could find patterns of overweight people with IBS in the mouth The second one the one on the bottom there Mounting evidence supports a major role of the systemic spread of oral Commensals and pathogens to distant body sites causing extra oral infections and inflammation What does that mean so the the germs in the mouth are getting into the body? So, you know, we're led to believe that the stomach acid is supposed to be high enough to kill all of the germs Maybe maybe not. I think that's something excuse me. Some of them do get through But there are other ways that these critters can get through if If you've ever seen severe gum disease the the the gums are just bloody and Not looking too good. So really what you have From this oral dysbiosis is a leaky mouth Okay, so that's a way that the lipopoly saccharides by the way are gonna get into the bloodstream right from the mouth And now you got low levels of chronic inflammation throughout the body And you're sick I think I got one or two more Okay, so this was in pediatric Crohn's disease patients In this one it was a little bit more general They just found that there was a decrease in the diversity of the the oral microbiome in in these particular patients and then one more in mice They observed that Mice That had colitis I think they induced it The composition of the bacteria present in the oral cavity and saliva changed as well Okay, so we're we're seeing a pattern here where we can See changes in the bacteria of the mouth as they pertain to disease states So I think there's a lot of work that needs to be done here, but this is really really really promising So this is kind of my little pipe dream You know for oral microbial microbial analysis could it be a proxy for a stool test wouldn't that be nice? Proxy to determine whether you have other systemic diseases early detection of gut dysbiosis before it happens and Of course, maybe even if we find a couple of germs in there Maybe it's going to determine that you will have some kind of gum disease or cavity if you don't watch out So that's pretty cool stuff Love Yoda Okay, so back to my formula So we went over fermentable carbohydrates, it's really dense a salient the fiber carbohydrates in my opinion excuse me So the karyogenic mouth bacteria I Also have a problem with that because we all have karyogenic bacteria in our mouths right now But we all aren't getting cavities right now. So that's a little bit incorrect And and here's a little proof. So you cannot inherit Cavity-causing germs from your parents, you know, this is this has been discussed a thousand times at the AHS over the years That you know when you go through the birth canal you get inundated with your mom's germs so yeah, most of us get our Oral microbiome from our mothers and fathers, but they can have mouths riddled with tooth decay And that's not necessarily what happens with the kids Okay, so they did a twin study here and what they really determined it's it's the oral environment later on okay, so germs become karyogenic cavity-causing Because you change their environment which changes their behavior the analogy that I like to use is you know We all have probably have a good friend or two They're as nice as pot excuse me as nice as pie and then they get a couple of drinks in them and they get real angry, right? So, yeah, it just gave them the wrong substrate and their behavior changed And then you know as it pertains to gum disease I'm gonna get a little more involved in this in a minute, but None of our paralytic ancestors had tooth decay or gum disease We know this because there are thousands and thousands of Fossilized skulls that we have available and I think Kevin's gonna probably talk more about that later, but We can study Tartar and plaque that's thousands of years old paleo microbiology. It's kind of a cool thing they can actually go in there and and look at the DNA and and Figure out what the bacterial colonies we had in our mouths years and years and years ago So they found two changes The first one was 10,000 years ago when we started farming and that's some pretty good dentistry over there for however many thousands of years ago that would be considered Prosthetic dentistry for its day. It's pretty good, but when we started taking Carbohydrates out of the cell that's what we did when we started farming we introduced the dense acellular Carbohydrates into our bodies and this is the result. So what they saw was that there was an uptick of strep mutants That's one that that Creates a lot of acid The second change was during the Industrial Revolution because we further processed flowers and we added sugars and You know, this is one of the sufferers I think he had one tooth and they and his dentures were not wooden by the way, okay I got a rush. I got a minute left. Okay susceptible teeth. We all have susceptible teeth anybody can get a cavity anywhere anyhow Yes, some people do have stronger teeth than others But it was never a factor in the Paleolithic era our teeth are plenty strong enough if we don't put this stuff in our Bodies, okay a couple other things Frequency how often this stuff gets in the mouth is Very important frequency and sequence so baby bottle decay everybody know what that is You can take very watered down Juice or even milk and lactose is actually very low on the karyogenic scale But if the baby is suckling that thing all night long within weeks, there'll be no teeth left It's an it's unbelievable Okay, and then retention we talked a little bit about that before when stuff sticks to your teeth It's able to be broken down by our salivary amylase and also It's just there as a substrate for the bacteria in the mouth to do their dirty work Okay Before when I showed you all those different things ranging from candies, I don't know bagels and pretzels That's been looked at and what they've really determined is that consumers, you know, we really can't figure out Which one is worse? Is it the lollipop? It's just it's just it's a little too Confusing but Joe Pesci put it better All right, the acorn got to get to the acorn there were people 15,000 years ago that were in Morocco northern Morocco, and they were eating acorns and That's the teeth they got from it They weren't using sugar They figured out a way with stone tools, I guess to refine the carbohydrates from acorns Into a cellular dense a cellular carbohydrates, and that's the result not too good So the paleo diet, you know paleo cookies now No, okay real quick. I got to go through this on my time is up This is the real formula dense a cellular carbohydrate Any oral microbiome we all have one you can't not have one. That's all you need You need teeth anybody here no teeth. You're in the wrong lecture room The food has to be retained on the teeth for a time because brushing and flossing works That's why we recommend it The frequency we win over that and I don't have time to get into it But the quality of your saliva and the salivary flow is very very important This is my future bestseller. We got wheat belly and grain brain. Why not carb mouth? That's really what it is if I had to simplify it. I know my time is brief You can I'll be happy to send the slides to you. That's my email address. That's my website I usually put up a blog once a week. Thank you Thank you very Okay, John Lennon my favorite beetle This is our second annual. I'm Kevin Boyd by the way pediatric dentist and I want to be anthropologist not not quite there yet, but in training This is the second time we've done this last year was sort of a hiatus and this year. We're resuming it We don't have one of our founding members Alvin however He will be saying a few words to you in a minute, but this is a sum of his contributions to dentistry and to the Paleo health care movement Guys, it's Al Dannenberg. I wish I were there in person. I'm here in video I'm here in spirit, but unfortunately not in person. I have some medical issues that are Traveling, but I wanted to say a couple things two years ago The two docs and myself were part of the first dental panel That was presented at Ancestral Health Symposium, and it was awesome The audience loved it. We had great questions, and I'm sure this one is going to be even better The most important thing today. I think is that there's so much research that's going on with the gut microbiome the oral health and Overall chronic disease and it's so intricately and intimately related Dentistry is just the perfect profession to speak of these matters because Who's the physician of the mouth dentists are so if we can get the word out and let People understand how important the gut is to the mouth Which is so critical to the rest of the body We are in great shape, and we're making a real dent in the medical profession have a great seminar I know you guys are going to do a wonderful job. Let me know how things go. I am excited for you And I wish I were there, but have a great one. Let me know take care That's great. So, you know anybody here so inspired Send him, you know a note saying how you were glad to hear from him And we're going to try to beam him in next year and just encourage him You might you might actually help increase the quality and quantity of his life This group means so much to him. So glad we could do that. That was nice. That turned out great He just gave me that well, okay. This isn't working. So let's try that last year. I did a similar thing or two years ago and and Scott and Alvin did and I talked about the shrinking face and I wasn't quite as much As far line my research as I am now is that what affects the face affects the airway? And I'm going to develop that concept a little bit Shortly after the Montana meeting last year. I went to Salt Lake City and spoke at the International Society of Evolution Medicine and Public Health and developed this whole concept from them after this meeting Two years ago. So I this this group means a lot to me every time I come here Just through networking and and speaking and the questions that it really helps me advance my own curiosity and Things that I can contribute to the science of this on the lecture circuit This is something that I took out in the lobby in Boseman, Montana And that guess what is a habitual nose breather probably from birth And probably while mom was carrying This woman and man when they were babies they also The mothers probably were nose breathers because we found out that just like the flight attendant says put the mask on yourself before You help your kid The placenta is very selective for oxygen mom gets priority It's the only nutrient that mothers get priority for because if a mom dies the baby dies so babies Throughout our whole 300,000 years of anatomically modern human history have learned in utero to to not only survive With low O2 relative to you know what we get when we're on the outside world But the the PO2 in utero is actually Thinner than the air on top of Mount Everest and actually a mile above Mount Everest And that that's a study that was done in the 1800s by Sir Barcroft in England Why is this important? Why am I so intrigued about this and Michael Mew is and Mariana Evans is and There's several people that are really pursuing this because it not only makes a difference in how we look But it makes a difference in how the brain grows and what we commonly call attention deficit disorder often is These kids early on before maybe they're diagnosed I have comorbid malocclusion that can preclude them breathing habitually through their nose So that's kind of the basis of the thesis that that I'm working on I'm a visiting scholar at Penn, and I'm also now an assistant professor of anthropology at the University of Arkansas under Jerry Rose Mentoring a PhD student who wants to She spent time in my office looking at my data on how I clinically apply anthropological theories to clinical practice And also that's what we're doing at the University of Pennsylvania. So As last year we we were two years ago, we had Steven Gunet who helped us moderate and Brett is helping and we've gotten all kinds of help today that I didn't Wasn't aware of so thank you all for for all the support Next month in Boston. I'll be speaking at the oral medicine toxicology group which is you know, I can't even pronounce it I'm substituting for Michael Gelb because he couldn't come and this is where I was looking at Scott's Vita and you know, he's really involved with functional medicine So this is an area where I have been developing this lecture for them and I adapted it for today's talk So instead of assessing pre apnea in the pediatric dental patient, you know, and then what to do with it clinically I'm just going to talk about pediatric sleep apnea sort of as a Western disease a non communicable disease that is Seems to coexist with cultural industrialization This is what I'm going to tell you for 20 minutes that jaws and faces are intimately connected to the airway and That Orthotropics orthodontics dental facial orthopedics. It's the ortho, you know that latin or greek for correct John Mu is the one who really turned me on to this about 20 years ago or 15 years ago And actually got me access to the Roman skulls at the British Museum that he had access to when he developed And Mike you can fill in the blanks on that Of when he actually developed this in the 50s and 60s but I was able to really look at some of the same Roman skulls and Have since looked at thousands of other skulls and in pretty much Provided a lot of support for his orthotropic hypothesis One of the things I found is that it works in kids while they still have their baby teeth two to six year olds and I found literature from Medical and dental literature from over a hundred years ago that seemed to validate this protocol that we use in Chicago and elsewhere Observational studies again as opposed to random controlled trials don't poo poo at observational studies Oh, show me the random controlled trials bullshit, you know, you need observational studies before you can run random controlled trials How do you think they discovered you should wash your hands before you deliver babies? How do you think Einstein, you know came up with the theory of relativity? These were all observations the Broad Street pump in cholera in England It was observations that led to major breakthroughs penicillin observational studies are what drove The these major breakthroughs in medicine and in humanity Here's a paper from 1912 the relief of nasal obstruction by orthodontia a plea for early recognition and correction of faulty maxillary development Do you how many papers I have like this that go back to the late 19th century all the way up through about World War two? something happened at World War two and Anthropologists have come up with some really good Speculations as to what happened which we can go into it Q&A if you want The back of the face is the airway the front of the airway is the face Okay, jaws and faces are intimately connected the craniofacial complex the respiratory system Okay, and that's what we now call the craniofacial respiratory complex Michael Mu was the first to publish on craniofacial dystrophy I Have suggested that if there's craniofacial dystrophy there's often comorbid respiratory dystrophy, so I would like You know in this that we've gotten this in three textbooks now that have recently put chapters on what's called the craniofacial respiratory complex This is from 1922 30 months of age being considered the most favorable time to begin expansion of children I Mean you are you are considered a heretic if you want to treat kids before the age of seven Which is the American Association of orthodontists says that is the age when children should first first be observed Observed for their first orthodontic evaluation, but usually not treated till between 11 and 13 That's what's common in the Western world right now England and in America especially I am really trying to persuade and be diplomatic I've now got the editor-in-chief of the American Journal of orthodontics and dental facial orthopedics Engaged on in a dialogue on this nada nada Debate it's a dialogue and he is Responding to what I'm saying that that age should be way before seven seven years old is a geriatric patient in my pediatric practice I've got kids coming from all over the country Just like Mike's got people coming to him from all over the world that are seeking this treatment because conventional Thought is to not do that yet. This is a two-year-old. This is John Muse design of a stage one bioblock appliance I Use this on kids, you know if they got 20 teeth, I'm gonna start expanding them Both parents have to be on board if one parent is Negative I'm not going to treat I refuse both parents have to Understand and at least be neutral to positive that this is in the best long-term health interest of their kids And it is validated by a hundred years of observational studies Normal does not mean healthy Normal blood pressure 120 over 80 right for whom a given population Average amongst Americans by the American Heart Association How about these guys look at the differences there? That's probably genomic that we all descend from this group This is the croissant and in Africa. We we shared 99.9% if not more of their genome Everybody who got out of Africa about 70,000 years ago descended from this tribe Spencer Wells and the genographic project watch that video. It's incredible and he talks about this What does normal mean in terms of occlusion? These are from orthodontic journals guess what they studied to determine what was normal? Anthropological specimens that predated industry Okay, this used to be part of dental education the University of Virginia's medical school in the 20s required third-year a third-year medical students to take a course in orthodontics because of the commonly understood connection between respiratory health and Occlusion so all of these erupted third molars ahead of the you know the condyles here I Don't know if this works. Well, you can see this is the ramus and though the wisdom teeth are always ahead of it in lateral view You don't even get with some teeth anymore So I'm just gonna blast through these but the orthodontic of medical literature is loaded with specimens That inform clinicians during their training that come from pre-industrialized museum specimen When does when does problems start? Ontogeny the development of the individual from conception to death Phylogeny the that is the development of our species when did malocclusion first enter our species and one? When does it usually enter in from an ontological? Logical perspective perhaps in utero these are fetal skulls from a four or five hundred years ago You know stillborn fetuses that didn't didn't make it or or Infants they all look like John Mu did orthotropic sonam They all and if you look at an ultrasound of any of you who have children if you look at your mid gestational ultrasound You'll very seldom find a chin that sits right underneath the maxilla So that's you know from an ontogeny perspective and this is actually a kid. I'm treating the mother Brought and she was I was treating four or five of her kids and she shows me an ultrasound I said looks like I'm making you another patient And it's like I wonder if there's a connection all that was seven years ago, and we've since accumulated. Oh, maybe 200 Mid-gestational ultrasound some kids that I'm treating for retronathia and there does seem to be a connection But it seemed that's observational. It's not scientific yet. So I'm not making any proclamations on a n equal 100 These are things that we show we understood the nature of respiration and Failure to thrive or or intra uterine growth restriction look at this and That what what this says is people are always telling me that smoking causes low birth weight talk about a win-win win You know Easy labor slim baby full flavor of Winston. So if this is out, oh my god You should hear the interviews with these MDs that work for the tobacco lobby and it's like some women want to have small babies So anyway phylogeny is when it enters now I imagine several hands will go up knowing the right answer to this But when I give this to physicians and dentists I very seldom get one hand coming up and it's usually not right So this is something that needs to be incorporated into Grade school. How about it? So it looks like I got five minutes So I'm gonna really move through this that the jaws and faces got narrower. They got retrusive and they got longer The last major milestone in the seven million years of hominin evolution is the emergence of modern humans or Homo sapiens People who for the first time fundamentally looked and behaved like us While a date of around 200,000 years ago was frequently given for this dynamic There is still substantial debate regarding the timing as something that was an ongoing process rather than a single point in geological time Anatomically it is widely recognized that facial size reduction or Gracalization or feminization as it is sometimes called as well as facial Retraction or key to finding traits for our species So anyway, I found literature a cause for lesson Proneathism from the orthodontic literature from 1881 Okay, so this was understood as long ago as that that our faces But that I think the retraction was just something that was academically interesting to people They didn't understand the connection or at least on a broad scale of Its relationship to malocclusion and airway So, you know, I'm saying that it's you know, breastfeeding has a lot to do with an ancestral patterns of nursing and weaning But also papoosing look at that kid in the papoos the posture of that head and neck So it wasn't just the nursing and weaning, but it was also things like that and also The type of pressure that's exerted by click-talking Which is what a lot of African and the people that were Related to do that's kind all kinds of pressure early in life. This is one of our ancestral Museum skulls and you can look at the difference of the position signs of mouth breathing the chin recedes Mothers will accuse children of inattention. They didn't call it a DD, but this is from I don't know. Yeah 1908 look at this So I'm gonna buzz. These are just some cases You can see that you know that the airway is Retrusive it's black and narrow like that that means that kid has a very narrow and poorly shaped airway when you bring the chin forward You open up the airway, and we don't just look at physical signs, but behavioral On the top those are all those yeses are behaviors that track with risk for sleep apnea and sleep apnea is a Pre-predisposition to ADD and they all come back. No, so now orthodontic criteria success criteria It's not just physical changes, but behavioral changes I'm just you know, how much time do I have not much okay three minutes We've also discovered an algorithm from about 30 years of research at Harvard and elsewhere Where if a you know a child should have space for a nickel between each baby tooth That means there's room for the tongue so when we say no space between baby teeth We know there's not room for the tongue for no other reason not to straighten them They're not they don't even have to be crooked But we expand these kids and we give them tongue space that is really the killer argument for this And when you show parents on what happens when you make room for the tongue and what what happens to the airway It's very it does no harm It does no harm it can help in so what if they need more ortho down the road It's just like a kid who has nearsightedness Are you gonna tell a parent of a three-year-old whose kid is nearsighted? You know what they're gonna be a good candidate for glasses someday Why don't we give them to them when they're like driving a car then you only have to pay for them once That's how ridiculous medically indefensible it is to say that you should delay orthodontics because a kid only has baby teeth If anybody has children or first-order second-order relatives grandkids kids You may be the first person to recognize ask the parent watch and see if the kid is snoring And you might be the person to really help that kid avoid a problem. Okay, so I'm done I got more but Got to end here so we can do some questions I'll take the prerogative of the moderator right quick and ask a question or make a comment and see what you think We talk a lot about mismatch and central health, but we shouldn't forget that You know, there are five other reasons in Evolutionary medicine for why evolution as powerful as it is cannot sculpt perfect organisms Okay, and one of those is you know the arms race race with pathogens and especially Scott your Presentation Seemed to key in on the fact that perhaps the mismatch effect of consuming dense acellular Carbohydrates is has sort of tilted the playing field toward more virulent pathogen Bacterial species in the the buccal cavity the mouth so you see how it mismatch intersects with another Major category like arms races with pathogens Does that make sense? Yeah, and I just want to I was rushed for time before I wanted to mention one other thing the germs for gum disease have never changed We've always had them, but we never had gum disease so again is It the germs or is it the environment that we give the germs I Argue, it's the environment we give the germs Dense acellular carbohydrates are just one thing there are lots of other things like I said that was a Ted Geisel talk we really I had to You know ignore a lot of things but salivary flow is is very important and if you're not sleeping properly Okay, you're exhausted. You're tired. You're stressed. You're not gonna have salivary flow Even if you have a nutrient-dense diet, you're not gonna so if in other words if the quality of your saliva is okay But it's not flowing You're not gonna heal your mouth and yes, you can heal demineralization also mouth breathing during Poor sleep mouth breathing is it dries the mouth? So that's a really good point We're gonna try to keep our answers short so we can get more questions in but that that's a great question And it is it's a combination same thing with cavity, you know carries organisms They've been with us forever They even use them to track migrations out of Africa strep mutants is the primary Kuriogenic bacteria and a guy named Paige Caulfield at Alabama actually Brett Alabama Track he uses that to track migrations because those bacteria have always been with us. They've just never been pathogenic I mean lactase deficiency isn't pathogenic till you drink milk. So it's the environment in the genes Yeah, in the interest of time, let's do try to get through as many of these questions from the audience as we can one big one I was go ahead and get Out of the way here, what about the Based on the Western price Western prices work people have asked about that they're about is there some magic or subcune nutrient in The diet some component of diet ie vitamin K2 for instance that has a big role and Dental alignment and all that and because I've heard that claim We've all heard that claim from the Western a price people, but you guys seem to say that it is Hugely multi-factorial it's not they're gonna be Just as simple as one key essential micronutrient, right? Yeah, I did that's one thing that Western price didn't get everything right neither did Darwin and you know I've heard it say that Jesus didn't get everything right, but that doesn't work in some parts of the country. So You know so dark Darwin got things wrong price did Einstein did The vitamin K thing is a little bit far stretched and you know, it's it's the chewing of the food and that that I think you passed up What do you think Scott? Absolutely, so not to diminish though the importance of all of these pioneers Because they made steps in the right direction And we all know that you can't build a perfect body unless you have all of the nutrients you you deserve so yes All of the nutrients are important. We just put the spotlight on some Nutrients and we try to connect the dots and we're pretty bad at it actually Okay, you might you got anything with the vitamin K study. I've been hunting for the sort of evidence behind the Western price foundations of Malocclusion being related to the constituents the bits in the diet and I've hunted Wanted to keep an open mind and ask people to present their data So I hunted down with several I won't mention our names from the Western Price Association of these groups and The only one study that was produced for my consumption was this one with vitamin K And it's shown that if you have I think it was guinea pigs was it who were made completely Vitamin K deficient and they had stunted growth in fact the growth was stunted in both the maxilla and the mandible to equal amounts interesting But it was stunted now the problem is here I think we're going with confusing pathology with physiology and that's the problem having a vitamin deficiency is a pathological situation but I would say that the facial forms of Everyone in the audience here have not grown correctly based on an ancestral model So here we've got a situation where you're you're healthy. None of you have got vitamin K deficiencies It's a very rare to have a significant vitamin K deficiency. It's in everything So I've yet really to find good evidence against to support this Consistituancy, okay, Mike. We got a move. Go. Sorry. You've got a whole stack of questions there. Yeah So many good questions from the audience. I wish we had more time for this I'm a lot of the questions centered around the idea. Okay Other than trying to avoid dense acellular carbohydrates is a big part of the diet What can one do and like things like Invisalign they you know current Oral rinses and things, you know, how how are that how's that going on effect? No knows breathing is key as young and as early in life as possible. That is my contribution But that's like we have three dentists up here. I've got one thing I want to attack But that doesn't mean that's the only thing that is the problem So what do you think Scott? Well, it starts with maternal and paternal nutrition and behaviors It's got to start there Once the child is born as you can see sometimes there it's already there or retranathia with it where the Jaw is back. So afterwards, it's critical that you identify What is going on with facial form before they have teeth and then once they have teeth? Yes, I mean the paleo diet, yeah, I I'm not actually in the business of recommending any specific diet But you got to stay away from processed foods and you got to get the nutrition however You can get those nutrients into your body. You should be doing it and they should not be processed Related to that Someone asked though is if it's possible. They're they're about to have like a probiotic Or introduce probiotics to the oral cavities and we were people are experimenting with probiotics prebiotics also Yeah, to me it's like if you have if you're running a little zoo and you want to make it a bigger zoo and a nicer zoo and Get lions and tigers and bears But all you have are our rabbit pellets Those bear, you know, you're not gonna feed them. They're not gonna look and and if you have a zoo that's full of deer And all you have is me So yes, you can introduce bacteria probiotics. That's all well and good, but the environment that They want is really what brings them in I have a fish tank, you know finding Nemo a medentist I have a fish tank in my office I didn't put any algae or whatever in there, but it got in there and it's growing how I don't because it's a good Environment for it so that the bugs will get there, but you got to have a healthy environment Okay, so that is food and don't smoke of course All bets are off if you smoke Tobacco or anything else What about teeth hot whitening products certain things like that you would think that that would might change the oral microbiome excessive brisket like someone mentioned xalatol and things breath man's oral care in general How might that be interacting with us? It's already disrupted or altered xalatol is getting a lot of attention in the pediatric dentistry community And I've never been pro any one nutrient I've been really down on sugar, but there's some impressive Information data that's coming out about xalatol. So stay tuned. I agree What about gum gum recession? Same with or without a periandotitis. You could get gum recession I'd like Mike's Mike's opinion because he's an orthodontist and Commonly that is a problem an ortho So we're holding lots of teeth out of the balance zone with retainers permanently now You should imagine the teeth sit there between cheeks and the lips tongue on the inside That's how it should naturally happen. That's how our ancestors had straight teeth if you need to wear retainer You're holding your teeth out of the balance zone. You could do that with a retainer You can't hold the gum and the supporting tissue out of the balance zone And I want to mention It's probably a word few of you have heard it's called an abfraction So some of you may notice up by your gum line. You touch. It's very sore. There's a little notch there That's generally from the teeth colliding together if they're not aligned or if you're a grinder or You know a real heavy gum chur and you put the lateral forces on the teeth You can actually lose enamel up by the gum line and you can get recession and an Still yet another reason to get your children's jaws in the room for their tongue early in life because it prevents Don't problems a lot of them start in an early childhood So don't if your instinct says my kid needs their jaw expanded and the orthodontist doesn't want to do it Find someone who will this should all be preventable at all the decay the gum disease the orthodontics and The subsequent sequelae should all be preventable amen totally So we have to end on that or we're gonna cut into someone else's time. Okay. All right. Thank you guys. Thank you. Thank you