#1

Sorry for the poor sound quality. This one was a technical issue hell.

But, now I finally have a mechanistic model of how my mouth tries to stay healthy and repair itself, and how I am interfering with that process to my own detriment. Thanks to Dr Ellie.

Key learnings for me:

  • the mouth will heal itself from the damage done by eating, drinking, and bacteria de-mineralizing the teeth, but we often interfere with this process
  • keep the mouth closed and empty almost all of the time (this fits with the nasal breathing advice I’ve gotten); stop eating / drinking all day long (only drink with meals, ideally)
  • help the mouth remineralize after eating by de-acidifying the mouth (foods, xylitol, mouth rinse)
  • the night time is the most important time to have a healthy mouth: prepare the mouth for sleep, and keep the mouth closed during sleep (avoid dryness)
  • avoid or be careful with acidic drinks (citrus, apple cider vinegar, carbonated drinks, coffee)
  • xylitol is a key tool for de-acidifying the mouth after meals, and reducing bad bacteria that cause tooth decay and gum disease: mints, gum, etc.

…plus a ton more. This one is long as Dr Ellie is a storyteller, but I left it all in because it is all valuable for gaining a sense of how to take care of your mouth so your mouth can take care of you.

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#2

Super fast turnaround! Looking forward to it!

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#3

That episode was sooooooo valuable.

I was basically doing most things wrong!!

It’s all going to be different starting right now.

Thank you @Joseph_Lavelle

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#4

Based on the podcast shownotes, here are the assertions that Gemini 2.0 Pro Experimental considers misleading or incorrect:

  • Toothbrush Drying: While keeping a toothbrush clean is important, the claim that bacteria die when they dry is an oversimplification. Some bacteria can survive in a dormant state (spores) and reactivate when conditions are favorable. The 24-hour drying recommendation and needing two toothbrushes is excessive and not supported by mainstream dental recommendations. Good rinsing and allowing the brush to air dry is generally sufficient.
  • Glycerin in Toothpaste: The claim that glycerin “interferes with the natural repair” of teeth is not supported by scientific evidence. Glycerin is a humectant (keeps the toothpaste moist) and is generally considered safe in toothpaste formulations. There’s no credible research showing it blocks remineralization.
  • “Sensitive” Toothpastes: While stannous fluoride can block dentinal tubules (the tiny channels in dentin that lead to sensitivity), this is not a universally bad thing. It’s a legitimate mechanism of action for reducing sensitivity. The podcast presents it as a “quick fix” instead of a solution, but for many people, it is a valid solution for managing sensitivity. Other sensitive toothpastes use potassium nitrate, which works by desensitizing the nerve. Both are valid approaches.
  • Triclosan Concerns (Overblown): While the FDA banned triclosan from soaps due to concerns about hormonal disruption and bacterial resistance, its use in toothpaste is a different scenario. The amount of triclosan in toothpaste is very small, and the benefits (reducing gingivitis and plaque) have been demonstrated. The Colgate Total formulation (which used to contain triclosan) was extensively reviewed and deemed safe and effective by the FDA. The concern about chloroform formation from triclosan reacting with chlorine in tap water is highly unlikely to be significant in the context of toothbrushing. The concentrations are extremely low.
  • Flossing: The claim that flossing is unnecessary or dangerous is incorrect and goes against the overwhelming consensus of dental professionals. Flossing removes plaque and food debris from between teeth, where a toothbrush can’t reach. While it’s true that cavities and gum disease are bacterial infections, removing the biofilm (plaque) is crucial for preventing these infections. The risk of bacteremia (bacteria entering the bloodstream) from flossing in a healthy mouth is minimal. In a mouth with severe gum disease, there’s a slightly higher risk, but the benefits of disrupting the biofilm generally outweigh this risk. The advice to avoid flossing is dangerous.
  • Water Flossing: Water flossers can be a helpful adjunct to traditional flossing, especially for people with braces, bridges, or implants. The claim that they “damage fragile periodontal fibers” is not supported by evidence. They can be used incorrectly (too high pressure, wrong angle), but when used properly, they are generally safe and effective.
  • CloSYS: The claim that CloSYS creates oxygen that disrupts harmful bacteria is partially true. CloSYS contains stabilized chlorine dioxide, which can release chlorine dioxide gas, a strong oxidizing agent. It can kill bacteria. However, the claim that it does this “with no harm to healthy mouth bacteria” is an oversimplification. While it might be less harmful than some other antiseptics, it’s unlikely to be completely selective.
  • Listerine and Nitric Oxide: The claim that Listerine doesn’t harm nitric oxide production is misleading. While some studies suggest that some antiseptic mouthwashes (particularly those with chlorhexidine) can reduce oral nitric oxide production, Listerine can have an effect, though it may be less pronounced than with chlorhexidine. Nitric oxide is important for various bodily functions, including blood pressure regulation. The podcast’s dismissal of this concern is not entirely accurate.
  • “Crest Cavity Protection Regular Paste” Specificity: The extreme specificity about this one formulation of Crest toothpaste, claiming it’s uniquely effective, is suspicious and sounds like marketing. While the ingredients listed (sodium fluoride, silica, no glycerin) are common and acceptable in toothpaste, there’s no reason to believe this specific product is vastly superior to other fluoride toothpastes.
  • ACT Rinse and Mineralization: While a fluoride rinse will encourage remineralization, the wording that it will “naturally whiten your smile” is an overstatement. Fluoride remineralization helps strengthen and potentially repair very early stages of decay, which might appear as white spots. It won’t significantly whiten teeth that are already stained or discolored from other factors.

And what Gemini thinks is generally accurate (with caveats):

  • Saliva’s Importance: The podcast is correct that saliva is crucial for oral health. It contains minerals (calcium and phosphate) that help remineralize teeth after acid exposure, and it has buffering capacity to neutralize acids. This is fundamental dental science.
  • Acid’s Role in Decay: Acidic environments do demineralize teeth, making them vulnerable to cavities. This is a core concept in understanding tooth decay. Frequency and duration of acid exposure are key factors.
  • Mouth Breathing and Dry Mouth: Mouth breathing does lead to dry mouth (xerostomia), reducing saliva’s protective effects. This increases the risk of cavities and gum disease.
  • Xylitol’s Benefits: Xylitol is a well-researched sugar substitute that doesn’t contribute to tooth decay. It can stimulate saliva flow and, importantly, Streptococcus mutans (the main cavity-causing bacteria) can’t metabolize it. This reduces the bacteria’s ability to produce acid.
  • Topical Fluoride: Topical fluoride (in toothpaste, rinses, and professional treatments) is widely accepted and proven to strengthen enamel and make it more resistant to acid attacks. It helps incorporate fluoride ions into the tooth structure, forming fluorapatite, which is more resistant to demineralization than hydroxyapatite (the natural mineral in teeth).
  • Brushing Technique: Proper brushing technique is more important than the specific type of brush (manual vs. electric), as long as the brush is in good condition and reaches all tooth surfaces. The emphasis on gum massage is also reasonable, as it can improve circulation.
  • Avoiding Abrasives: Harsh abrasives can damage enamel over time, especially with aggressive brushing.
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#5

I’ve been following a Dr Ellie ‘light” protocol for many years after first seeing an article about her in our local newspaper (when it really was printed on paper!). I gave up on the expensive Closys, and only occasionally use the fluoride rinse, but I do use xylitol mints several times a day. I also brush when I get up and after dinner, not more frequently.

My gums never bleed, and stopped receding.

Yes I also floss - I mean you can see the food in between the teeth!

A caution with xylitol is that some of us simply can’t stomach it. It gives me terrible digestive problems. So I chew up the mints and swish and spit it out, like mouthwash.

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#6

@RPS You and me both.

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#7

The oral-cardiovascular health axis

From Fullscript newsletter:

“Emerging research highlights the critical yet often-overlooked link between oral and cardiovascular health. A Japanese case-control study found that Streptococcus anginosus was significantly more abundant in the saliva and gut of stroke patients. S. anginosus was linked to a 20% higher risk of stroke. A 25-year observational analysis of 6,000 US adults linked flossing to significantly lower risks of ischemic and cardioembolic stroke, as well as atrial fibrillation, independent of brushing and dental visits. Though preliminary, these studies reinforce the importance of oral hygiene in supporting cardiovascular health.”

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#8

Just here to report I ordered the funny little toothbrush she recommends.

After my first use, I said WHOA, that felt aggressive and my mouth was slightly tender. I thought, huh, well maybe I’ll use this once per week.

Fast forward, I have used it for several days in a row and I love it! The tenderness only happened once. Had an expert not recommended it, I would have assumed this was ‘dangerous’ to use on gums because dentists always say to use a soft toothbrush. To try to describe it, I’d say the bristles move as if they are kinda soft, but the bristles are rougher

I’ve used a sonicare for decades and always worried it might be too hard on my gums and contribute to recession, but based on this, I guess it doesn’t? I’d at times use my Nimbus ultra silky soft brush to brush my gums because it felt great and safe.

I have experimented a couple of times with flossing after I brush instead of prior just to see if it really does do all the flossing you need, and it seems to. But alas, I don’t trust it and will continue to floss.

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#9

Do you have any links? I suffer from receding gums and I would love a solution.

#10

Joseph had a link to her website up somewhere, but I don’t see it now?

If you listened to the podcast, you’ll hear a lot of her good advice for your whole routine. I have no idea what specially helps receding gums, but I imagine it’s just having a healthy mouth in general?

I bought the toothbrush

And the clyosis

You’ll see the exact products she recommends here:

I can’t deal with traditional minty flavors because I’m too used to the hippy dippy toothpastes I’ve been using for over 30 years, so I didn’t consider the other products. If you are open to them and not anti-fluoride, I’d consider buying all of it. If you do, buy the exact versions she mentions (also shown on her website)

If you haven’t listened yet, I think it will be worth your time. She’s a joy to listen to.

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