Ben Greenfield [00:00:00]: My name is Ben Greenfield, and on this episode of the Boundless Life podcast.

Katherine Dahl [00:00:04]: When you use a toothpaste with hydroxyapatite, that's biocompatible, meaning your body recognizes hydroxyapatite and it's able to incorporate it into the surfaces of your teeth, thereby helping to remineralize and strengthen enamel without the need for fluoride. Fluoride also strengthens enamel. It's been well studied for a very, very long time. But it is not organic to enamel and it can become toxic at high level, which is especially concerning for children. It's a hot topic recently that there is a correlation between levels of fluoride and decreased IQ in children. We don't just have fluoride in our toothpaste. It is usually added to drinking water in certain cities.

Cass Nelson Dooley [00:00:47]: It's a huge controversy. You know, when I was going through college, we were taught, you know, fluoride was the biggest, most successful public health campaign ever in the integrative and functional medicine world, in the biological dentistry world, they have had many critics of it and concerns about lasting health issues.

Ben Greenfield [00:01:06]: Welcome to the Boundless Life with me, your host, Ben Greenfield. I'm a personal trainer, exercise physiologist and nutritionist. And I'm passionate about helping you discover unparalleled levels of health, fitness, longevity and beyond. Well, I think I've become a little bit obsessed with the teeth and the oral cavity, if you want to call it that, your oral biome. I not only have now an infrared toothbrush, I have made by Biolite. I've got a pheno smart brush which you put in your mouth and it flosses and water picks and brushes all at the same time. I've got like eight different kinds of toothpaste, toothpicks, tooth floss. I have done podcasts with Dr.

Ben Greenfield [00:01:57]: Loud where I flew down to Phoenix and did lumineers for my teeth and all sorts of oral readjustments for my neck and my jaw and wore a mouth guard for freaking like two years. But with all of this immersive journalism into the mouth that I've done, I haven't really devoted a podcast to the idea of your oral care products and oral biome particularly, something I get a lot of questions about, which seems simple, but it's relevant, especially considering that I think I saw RFK on the news today talking about wanting to outlaw fluoride or something like that if they're elected, which I might be curious to hear yalls take on that. But it's toothpaste, right? Toothpaste and My guests today know all about toothpaste and a lot more. My first guest is Cass Nelson Dooley. She's a researcher, author, educator and lab consultant who has done everything from studying medicinal plants in the rainforest of Panama as a Fulbright scholar and also launching career in science and internal medicine. She studied ethnobotany, ethnopharmacology and drug discovery at the University of Georgia and at Aptotech. And she educates clinicians worldwide and has her own clinical practice and a company called Health First Consulting, which is a medical communications company. And my other guest, Catherine Dahl, is someone who has a pretty intense history of mouse issues, shall we say, that I want her to share with you because together with her father in law, Dr.

Ben Greenfield [00:03:32]: Dahl, who's a dentist of 40 plus years, they've discovered a lot about the biome through their own healing journeys. And I discovered both Cass and Catherine through this toothpaste company that I've been geeking out on called Super Teeth. Super Teeth. And so we're going to talk all about that and all about how you can have super teeth in today's show. So welcome to the show. And I know when I always have two guests, I need to throw the first question out to at least one of you. So I'm going to pick you. Cass and I would love to hear with your intense scientific journey into the oral microman beyond or the oral microbiome, I should say, how you got interested in all this and what your journey into optimizing the teeth has looked like.

Cass Nelson Dooley [00:04:13]: Thank you, Ben. It's great to be here. And yes, as you said, and thank you for that introduction. I started out in natural medicine. It runs in my family. We love taking the natural approach over medications when possible. So it ran in my family. But I got into drug discovery from medicinal plants.

Cass Nelson Dooley [00:04:36]: And it wasn't too long after I got my master's in pharmacy and biomedical science that I got my first job at Metametrix Clinical Laboratory. And they were the first ones to release a commercial DNA test for the gut microbiome. So they offered a lot of different test hormones, food sensitivities, you know, various, you know, various testing. But that was their big contribution to the integrative and functional medicine world. And they were, you know, they were eventually bought out by Genova. And it wasn't too long after that I moved on to have my own business, Health First Consulting. And I was approached to write on the oral microbiome. Well, my, you know, my knowledge base was really in gut microbiome and in functional medicine.

Cass Nelson Dooley [00:05:30]: Integrative medicine. But the oral microbiome is just a hop, skip and a jump away from the gut microbiome. I hope we'll talk about that more today. The oral gut connection. But. So that was really easy. And the oral microbiome topic was not only super interesting and super similar to the gut microbiome, which we all understood, but it was so it was easy to understand, but it was wildly popular. Dentists were interested in it, functional medicine practitioners were interested in it, and consumers have been interested in it.

Cass Nelson Dooley [00:06:03]: So I was approached by a publisher to write a book on it, Heal youl Oral Microbiome, and kind of the rest is history. You know, in the 10 years or so that have passed since I've been writing about it, there have been all these great new oral health products coming up, including, like the ones from Super Teeth that we'll be talking about today. And I had the pleasure of working with Super Teeth and Catherine over the years. So that's kind of how I landed.

Ben Greenfield [00:06:28]: Here, you know, when you talk about the oral microbiome. Back to relevant news. I was reading today about a new study that was looking at the amount of bacteria on toothbrushes, like on your bathroom counter, for example. And the study noted that, yes, as we've probably already known, the bathrooms harbor a lot of bacteria, but that what they found on toothbrushes was not just bacteria, but also, I believe they called them bacteriophages. And these bacteriophages were actually helping the body to ward off infection and almost working symbiotically, I guess, with the bacteria on the toothbrush to diversify the oral microbiome. Did you see that?

Cass Nelson Dooley [00:07:13]: I haven't seen that yet. So bacteriophages are viruses that act on bacteria. They're like the viruses that attack bacteria. And it is another kind of, kind of deep sea ocean diving. You know, there are more bacteriophages on Earth than there are bacteria. So I think we know very little about bacteriophages. I'm not. I mean, I think we'll.

Cass Nelson Dooley [00:07:38]: I mean, I will always be blown away by what we discover. So, yeah, I mean, I'm interested. You know, I'm a little suspicious about toothbrushes. And dentists are very quick to tell us to put them in far from the toilet because they can get a little gross. But I'm not surprised that they found a lot of wild things on the toothbrush.

Ben Greenfield [00:08:00]: Yeah, wild things, but also things that I think made me a little less nervous about my toothbrush being like, face up on the kitchen counter. Because it's back to the whole like hygiene hypothesis, right? You don't necessarily want to pull your toddler away from the dog licking its face or you know, in our case, you know, petting the goat or picking up some kind of cat poop in the sandbox or something like that. Because within reason, these all diversify the biome and strengthen the immune system as it learns how to, how to ward off a lot of these pathogenic organisms it's experiencing in nature. When it comes to the oral microbiome, what are the things that people should be aware of or that you wish more people knew when it comes to the bacterial composition of the mouth and how that links to the gut, like you mentioned?

Cass Nelson Dooley [00:08:49]: Well, I think your point is really nice that, I mean, one of my favorite things that I argue for in much of what I teach and train is that, you know, all of the good bacteria, right? I mean, we, you know, historically dentistry has really approached the mouth like something that needs to be sterilized and then you're going to have good oral health. Well, of course that's not the reality. Just like with the gut, right? Something like 98% of the microbes in our mouths are friendly or neutral. You know, they can do beneficial things for us. It's really just like 1 or 2% that are pathogens. But really it's the pathogens or the disease causing microbes that get all the pressure, they get all the attention. No one's interested in the good guys that are always protecting us from pathogenic infection. So that's one of the biggies, I think is, and you know, when we talk about what to do, how to create a healthy oral microbiome.

Cass Nelson Dooley [00:09:53]: So for your listeners who haven't heard of the oral microbiome before, it's simply the microorganisms that live in the mouth, right? It can be bacteria, fungi, parasites, even bacteriophages like you were mentioning. And the majority of them are harmless or even healthy. They tune the immune system, they help protect us from infections, they help us make nitric oxide, which lowers blood pressure. So they do a lot of great things for the mouth. And it's not something that necessarily needs to be killed off. Which even though that's how we've done.

Ben Greenfield [00:10:34]: It historically, it kind of makes me wonder if there's a link between a hyper clean mouth, like someone who uses mouthwash all the time, just nukes, everything, whatever, like me, infrared like toothbrushes and the like, and high blood pressure. Because I think what you were Saying is if you nuke all these bacteria in your mouth that convert nitrates into nitric oxide, you could theoretically affect cardiovascular function.

Cass Nelson Dooley [00:11:00]: Oh, yeah. And it has been shown in the literature you can do that. You can take mouthwash that is chlorhexidine, which is like an antibiotic mouthwash, and you can give it to people and literally raise their blood pressure by killing the bacteria in their mouth with that mouthwash.

Ben Greenfield [00:11:17]: But I should note that I've seen other mouthwashes that are just like, essential oil based with peppermint essential oil, and things that don't involve antibacterial compounds. Those would probably be okay, right?

Cass Nelson Dooley [00:11:27]: I don't say unequivocally, yes. I think that we're still trying to figure it out. But I personally believe that when you're looking at mouthwashes that you'd like something that is neutral if your oral microbiome is healthy, and if you have dysbiosis, AKA cavities, gum disease, root canal infections, then you may need something that's a little bit more killing. But I agree with you that I think the herbal sources are going to be, you know, less damaging to the microbiome than an antibiotic source.

Ben Greenfield [00:11:59]: Okay, got it. And, Katherine, I'm jonesing to hear your story, but I just have to ask. While we're on the topic of mouthwash, this might be a question for Cass. I don't know. Or maybe, you know, Catherine, you know, I go to a lot of conferences, I sign a lot of books, I meet a lot of people. And some people just have, like, dragon breath, you know, whatever it's called. Halitosis. And obviously, if we tell people not to use mouthwash, we might be producing more people who have hints of halitosis.

Ben Greenfield [00:12:26]: After listening to this episode. But what I've always wondered, because sometimes I'll just get the cat out of the bag. I judge people. I'll smell their breath, and then I'll look at their skin, I'll look at their gut. Sometimes I'll see bloating, acne, eczema. I think, personally, there's gotta be some link between bad breath and the bacterial composition of the body as a whole. Because in my opinion, it seems to be tied frequently to people who seem to have some, at least on the outside, health issues. Am I onto something with that?

Katherine Dahl [00:13:00]: Absolutely. I mean, that's something I learned through my health journey, is that the mouth is not isolated. It's systemically part of the body. And the bacteria that live in our mouth don't just Stay there. They can make their way through the body down to the gut by way of swallowing saliva, through the oral mucosa. And so specifically with halitosis, you know, you're talking about bacteria usually that live in the tongue and the throat, that break down proteins, they release volatile sulfur compounds. That is usually typically what causes bad breath.

Ben Greenfield [00:13:31]: Yes, sulfur, sulfur, dragon's breath, Exactly.

Katherine Dahl [00:13:35]: That's usually probably what's. What's that initial shocking bad breath, however. Absolutely. Any sort of dysbiosis that's going on in the body, which is again, something I learned through my story, is going to present itself in symptoms, the symptoms that you mentioned, and perhaps different microbial dysbiosis around the body, that those symptoms are gonna present themselves there first. But it is all systemically connected.

Ben Greenfield [00:13:59]: Yeah, everybody's gonna be buying a tin of Altoids now. The next time they go to one of my parties or book signs, they'll be like, oh, Ben's judging me. We heard it on the podcast. He's smelling, he's sniffing. That was the one saving grace of the N95 face mask days. So, Katherine, what is your story?

Katherine Dahl [00:14:18]: My story actually starts in the gut. I know I'm in the oral health industry, but it starts in the gut, really. About 12 years ago, I had my first daughter, and shortly after having her, I got mastitis, which is an infected milk duck from breastfeeding. So my doctor put me, my OBGYN, put me on an antibiotic, and I didn't know any better because I didn't know anything from anything about health at that point back in 2012, early 2013. So I took that antibiotic and I felt great immediately. And then a few days later, I actually contracted C. Difficile, or C. Diff, which.

Katherine Dahl [00:14:56]: Are you familiar with C. Diff, Ben?

Ben Greenfield [00:14:58]: Yeah, People like die of that, don't they?

Katherine Dahl [00:15:01]: Yeah. Yes. Which is not so fun with a two month old. It's an infection that causes severe inflammation in the colon and you basically can't keep anything in your sieve system. So with a two month old, I'm nursing, I'm, you know, first time mom, and I'm also severely underweight and I have a debilitating infection. So I quickly learned, I got like a crash course in microbiome health. And thankfully my father in law, who is brilliant, he's a, he's a dentist, but just a, just a brilliant individual, he realized immediately, you've got dysbiosis in the gut. I had to go on medication, but I also started a probiotic because what had happened was that antibiotic had completely wiped all of my beneficial bacteria out of my gut like we were just talking about.

Katherine Dahl [00:15:53]: And without that beneficial bacteria there to keep me healthy, opportunistic pathogenic bacteria began to overgrow. So I ended up with C. Diff. And so I started on that gut probiotic. I changed some things about my diet again, got that crash course and gut microbiome health and so began my holistic health journey. Fast forward about six years. I had my last kiddo and I went in to see my father in law for my regular checkup and he was like, what is going on? You've got severely inflamed gums that are bleeding, you have several watch spots, cavities. What are you doing? And really embarrassing when your father in law is your dentist.

Ben Greenfield [00:16:42]: Who did my son marry? Geez.

Katherine Dahl [00:16:45]: Yeah, right. So we took a look at what I was doing and just like you said earlier, I was using mouthwash, I was using an alcohol based mouthwash. I was also using toothpaste with sodium lauryl sulfate, which is very harsh on the oral microbiome and fluoride. And we also weren't eating well with small kids. You know, you're grabbing a packaged food, you're not taking the time to cook nutrient dense meals. But really and truly, what was, what the standout issue was was I was basically using an antibiotic in my mouth like I had done six years ago for my gut. And I had completely wiped out the beneficial bacteria in my mouth, scorched earth if you will. And then those opportunistic pathogenic bacteria had overgrown and thus began the symptoms.

Katherine Dahl [00:17:35]: So we changed everything I was using and we started down the rabbit hole of beneficial bacteria that are specific to the oral cavity. And we started Super Teeth, which is an oral microbiome based company. All of the products that we make, dental probiotics, toothpaste with oral prebiotics in them are specific to keep it fostering a healthy environment in the mouth.

Ben Greenfield [00:18:01]: You said something interesting there, that they were oral specific probiotics or something like that. So I couldn't just take a probiotic that was designed for gut health and maybe sprinkle some of that on my toothbrush.

Katherine Dahl [00:18:14]: Well, hey, at least you knew that it had to be sprinkled. So the delivery system is super important, right? Because when we swallow a digestive probiotic, it's going to go down to the gut where it's going to go to work there for digestional health. But for an oral probiotic, the delivery system needs to be dissolvable in the mouth. And then, yes, the actual, actual strains of bacteria are different. So microbiomes around the body have different types of bacteria in them. And the ones in your mouth and ear, nose and throat are different than the ones throughout the rest of your body.

Ben Greenfield [00:18:46]: So when it comes to the pathogenic bacteria in the mouth, before we address maybe, I actually want to get a lot more into toothpaste in this oral probiotic type of approach. You hear about cardiovascular disease, Alzheimer's, et cetera. As a matter of fact, that doctor I mentioned who's been on the podcast a couple times, the dentist, Dr. Nico, she, whenever I go into her clinic for a cleaning, she does a salivary swab. And the first time that I did it, even though my results have remarkably improved after implementing some different types of approaches, many, I think, similar to what we'll talk about on the show today. Those levels, like, they went from like red to green, right? Which in this case a good thing as far as the bacteria that contribute to things like cardiovascular disease, Alzheimer's, et cetera. But I would imagine this goes beyond just like the nitric oxide that we talked about, like, how could something like bacteria in the mouth contribute to a dementia like condition? Like, draw that link for me if you can.

Cass Nelson Dooley [00:19:48]: Sure, I can help with that one. And we're, and you know, this research is just unfolding as it's, it's unfolding as we speak. It's a very hot topic. But let's start with your point about cardiovascular disease. You know, having gum disease increases your risk of heart attack and stroke by 50%. And that's those bacteria, right? Because gum disease, let me just remind our audience, gum disease is really just a dysbiosis of the mouth that is aggravating the immune system. And the immune system goes into attack and in the process, it damages your own bones and teeth in the process and the tissues connecting them. So that's really all gum disease is.

Cass Nelson Dooley [00:20:34]: But so if you have, there are specific pathogens that we know are likely to trigger heart attack and stroke. And they can be like, for example, they have been found in atherosclerotic plaques. So you can actually find the same bacteria, those pathogens that can live in the mouth, in the arteries, in the plaque lining vessels. There's different theories about how this happens. It's also possible that all this inflammation in the mouth that's caused by those pathogens is just coursing through your bloodstream too, creating kind of inflammation throughout the body. That is then a stress on the cardiovascular system. So, you know, if you think about, if you think about the blood access to your teeth, basically anything that's happening in your mouth has a direct line to the heart and to the cardiovascular system.

Ben Greenfield [00:21:33]: Yeah, that, that's why you can dissolve lozenges in your mouth. Right? What is it? Ketamine therapy. Right. You don't swallow the ketamine or get an IV sometimes they just put like a lozenge in your mouth and it gets absorbed through that buckle membrane, you know, similar to like a rectal capillary delivery of a suppository. So just because something is in your mouth and you haven't yet swallowed it doesn't mean it's not getting very effectively, sometimes even more effectively, into your bloodstream.

Cass Nelson Dooley [00:21:59]: Absolutely. And actually even just brushing your teeth, does it just eating releases, like, because this is just like we think about the gut barrier. Right. I heard you talk about leaky gut in one of your other podcasts. The same thing goes with the mouth, right? It's, it's. This is part of the gut. The mouth is part of the gut. And just like the gut lining, we have a mouth lining, and that lining is porous.

Cass Nelson Dooley [00:22:23]: Like, some things can get through, you know, some things can't get through. But if you have a lot of inflammation in your mouth, if you have dysbiosis, then more can get through. But even in people who are healthy that don't have any dysbiosis in the mouth, every time you brush, every time you eat, every time you go to the dentist, whatever's in your mouth is going to flood into your bloodstream. And this has been known for something like 75 years.

Ben Greenfield [00:22:49]: They even have those fascinating studies with glucose rinses in cyclists and endurance athletes where you don't swallow a carbohydrate solution, you simply swish it around in your mouth and spit it. And that's an ergogenic performance enhancing aid. This is likely not as much a factor, I think, of a bunch of glucose getting absorbed through the buccal membrane. Just because that's only a few calories. Right. It's not like it's going to give you a distinct performance enhancing result. But they suspect that it's causing neurotransmitter regulation, meaning the brain has detected the taste of something sweet, assumed that calories would follow, and then adjusted the central nervous system in such a manner that you're not limiting muscle activity or having as high a rating of perceived exertion during exercise. So there's even like a, like a neurotransmitter central nervous system response to certain things that we.

Ben Greenfield [00:23:44]: We taste or flavors in the mouth.

Cass Nelson Dooley [00:23:46]: That's super interesting.

Katherine Dahl [00:23:47]: So interesting.

Ben Greenfield [00:23:49]: Yeah, it is. So when it comes back to, you know, you're talking about Super Teeth and the toothpaste, I looked at the label, you know, especially a few times before this podcast, and know what I was getting into. Obviously, probiotics, and I believe also prebiotics feature heavily. So how does that actually work? Like, what's the process and how do you choose the probiotics? And what's the idea of putting those into super teeth?

Katherine Dahl [00:24:13]: Streptococcus salivarius. M18 is the prominent bacteria in our probiotics. And M18 is very interesting and very unique. It has specific jobs, specific benefits for the oral microbiome.

Ben Greenfield [00:24:28]: And what did you call it again?

Katherine Dahl [00:24:30]: So it's Streptococcus salivarius and then M18.

Ben Greenfield [00:24:34]: And even though it has the word streptococcus in it, a lot of people just automatically think strep throat, run away. Like, this is a good bacteria.

Katherine Dahl [00:24:41]: Yeah, Streptococcus is a bacteria that is present in the mouth. And Cass can speak way more into the science behind all of the different Streptococcus bacteria. I'm the expert in the good one, which is M18, which was actually recently discovered. Honestly. It was introduced to the market in 2012, and so it's fairly newly discovered. And what they've discovered is M18 produces Salivaricin M. Salivaricin M is an antimicrobial protein, or a positively charged molecule that protects the host from infection. And it M18 specifically inhibits the growth of strep mutants.

Katherine Dahl [00:25:23]: So strep mutants, strep mutans. That is a bad Streptococcus bacteria. That's the one primarily responsible for cavities. So this beneficial bacteria, it was studied that not a lot of us have sufficient amounts due to our diet, due to stress, due to environmental factors we don't have. Most of us do not have enough M18 in the mouth to protect us from tooth decay. So this is a bacteria that we all need more of. It's in a dehydrated state in a table, like I said, a dissolvable tablet. It also produces urase.

Katherine Dahl [00:26:02]: So urase interacts with the urea and your saliva to balance your ph, which is super important for a healthy oral microbiome. And then it produces dextronase. Dextronase breaks down dextrin. Dextrin is an extracellular bacterial polysaccharide produced by Bacteria through the fermentation of sucrose, something that plaque is rich in. So dextrinase breaks down dextrin, which helps reduce plaque buildup. So it's like a powerhouse of a beneficial bacteria that we all need more of.

Ben Greenfield [00:26:33]: And is that the only bacteria in the toothpaste? The only. Do you call it bacteria or probiotic?

Katherine Dahl [00:26:38]: So two different things. So the. So the probiotic is the dehydrated live bacteria. Because if you hear about a probiotic, toothpaste, be leery. Because bacteria die, they don't survive for a long time. When they become wet, they have to be dehydrated. So our toothpaste has prebiotics, which I know Cass will talk a little bit more about as well. Prebiotics are the energy source for probiotics.

Katherine Dahl [00:27:06]: So our toothpaste has prebiotics, our probiotic has bacteria. We've got Lactobacillus pericaceae and Lactobacillus reuteri. So the combination of those three 33 milligrams is what we have found to be the perfect amount taken one to two times daily for the oral microbiome.

Ben Greenfield [00:27:26]: Okay, I think people might be getting confused at this point because it sounds like you're talking about two different things. You're saying that there's toothpaste and there's something else that you're using in addition to the toothpaste?

Katherine Dahl [00:27:35]: Yes. We have dental probiotics. That's our flagship product.

Ben Greenfield [00:27:39]: You mean the tablets that you dissolve in your mouth? Okay, so the toothpaste doesn't have the probiotics in it. It has that streptococcus in it. And then the tablets have the probiotics in it.

Katherine Dahl [00:27:51]: So Streptococcus salivarius M18 is a probiotic.

Ben Greenfield [00:27:54]: So which ones are actually in the toothpaste?

Katherine Dahl [00:27:56]: The toothpaste is just prebiotics. It's chicory root, inulin.

Ben Greenfield [00:28:00]: Okay, so when you brush your teeth. Sorry if I sound like a dummy here.

Cass Nelson Dooley [00:28:04]: Nope.

Ben Greenfield [00:28:04]: When you brought. When I brushed my teeth with my super teeth, because I didn't know this, I thought the toothpaste had the probiotic in it. No, that's. That's putting into my mouth the prebiotics that then after I brush my teeth, I'm supposed to be popping one of those tablets at. The probiotic from the tablet is getting fed by what's left over in my mouth from the toothpaste.

Katherine Dahl [00:28:22]: Exactly.

Ben Greenfield [00:28:22]: Now, what if I'm swishing my mouth or, like, swallowing the toothpaste? Like, is it just gone or am I supposed to keep some of the toothpaste residue in my mouth? How's that work?

Katherine Dahl [00:28:30]: You don't always need to. You shouldn't technically rinse after brushing. You'll hear dentists say that. So that the active ingredients can stay longer in the mouth, but there is always residue left over. So even if you do rinse, as long as you're not using a mouthwash, you should have residue left over from the toothpaste in your mouth.

Ben Greenfield [00:28:52]: Okay. And maybe this will help clarify either Katherine or Cass. Walk me through a day, like from when you get up in the morning, after your meals, before bed, whatever, of how you're combining the tablets with the toothpaste. Just so I understand the best practices here, this is a selfish question because I have both products, but maybe I've been using them incorrectly.

Katherine Dahl [00:29:09]: Oh, you only have two. We've got three. Ben.

Ben Greenfield [00:29:12]: Oh, geez, you're holding out on me. All right, just fill me in. Walk me through the process. I'm listening. Right now. I know I need a healthy biome. I've decided I'm going to toss all my mouthwash. So walk me through the Super Teeth Protocol.

Katherine Dahl [00:29:24]: So the Super Teeth Protocol, the regimen, as we call it, is just a toothpaste, a floss, and a probiotic. So you're going to most dentists, and us as well, recommend that you do floss first, because flossing will disrupt. Will do manual disruption to the biofilm, maybe even more so than brushing, and especially in between the crevices of your teeth. So you're going to floss with a floss that is not thin and waxy. It's actually one that's going to remove the plaque. Our floss has prebiotics in as well to deliver those good guys in between the teeth. Then you brush with a prebiotic toothpaste, and then after flossing and brushing, that's when you pop a probiotic in your mouth. And the bacteria in the probiotic should be left.

Katherine Dahl [00:30:11]: That's what should be left undisturbed for about 20 minutes. We recommend no drinking water, no eating for, again, 20 to 30 minutes after taking a probiotic.

Ben Greenfield [00:30:21]: Which kind of makes sense because you're assuming probably you've eaten already. You floss, you brush your teeth, you pop a tablet. It's unlikely you're going to turn around and eat again.

Katherine Dahl [00:30:29]: Right, Exactly. And you shouldn't. And we do recommend night time. If you're only going to do a probiotic once a day, we do recommend at night because it is the Longest time that it will be left in your mouth undisturbed. And it also helps stimulate salivary flow, which is super important at night as well. But that is how the regimen works.

Ben Greenfield [00:30:47]: Okay, this is good to know. I need to go do a little reboot here. So the other thing I noticed in the toothpaste is hydroxyapatite, which sounds very appetizing. Do you use that instead of fluoride? I know, I'm a dad. Dad jokes all day long. Do you use that instead of fluoride or what's the purpose of the hydroxyapatite?

Katherine Dahl [00:31:10]: We do. Yep. Yep. So, fun fact. Hydroxyapatite is a naturally occurring calcium phosphate mineral. It makes up 70% of the dentin in your tooth, which is the second layer, and 97% of the tooth enamel. So when a baby has a tooth underneath the gums that has not erupted yet, it is made. The enamel is made up of 97% hydroxyapatite.

Katherine Dahl [00:31:36]: It's already there, present in the tooth. There is no fluoride found native in the tooth. So when you use a toothpaste with hydroxyapatite, that's biocompatible, meaning your body recognizes hydroxyapatite, and it's able to incorporate it into the surfaces of your teeth, thereby helping to remineralize and strengthen enamel without the need for fluoride. Fluoride also strengthens enamel. It's been well studied for a very, very long time. But it is not organic to enamel, and it can become toxic at high levels, which is especially concerning for children. Several studies have been performed over the years, and like Cass said, it's a hot topic recently that there is a correlation between levels of fluoride and decreased IQ in children. So, hydroxyapatite discovered in the 1970s in Japan, and we are now realizing we should be using this instead of fluoride to remineralize our teeth.

Ben Greenfield [00:32:39]: But is fluoride really an issue if you don't swallow, like the toothpaste?

Katherine Dahl [00:32:43]: I mean. Yeah, just as you said. I mean, the oral mucosal lining sends so much through the body that it's going to absorb. Also, we don't just have fluoride in our toothpaste. It is usually added to drinking water in certain cities.

Ben Greenfield [00:32:57]: Yeah. So do you think this is why RFK announced. I think it was like yesterday that he. That if he had whatever office he's going to have, I forget what it is. And for the Make America Healthy campaign, that is a reason he would want to remove the fluoride from drinking water, because of the impact you're talking about on things like children's IQ.

Katherine Dahl [00:33:17]: Yep. And actually just recently, you know, so there was a federal judge in California that just recently, I'm talking what, Cass, maybe in the last month, two months, maybe, ruled against the EPA, the Environmental Protection Agency, ordering them to take action on the levels of fluoride in drinking water. So it's timely.

Cass Nelson Dooley [00:33:38]: It's a huge controversy. You know, when I was going through college, we were taught, you know, fluoride was the biggest, most successful public health campaign ever. I mean, that's probably what all of us heard at some point. You know, adding it to water was the thing that has saved everybody's teeth. But you know, in the integrative and functional medicine world, in the biological dentistry world, that was, you know, they have had many critics of it and concerns about lasting health issues, neurotoxicity, different things. So I mean, I don't presume to know the answers about it all personally. I think there's a lot of research on both sides. But it, you know, I think it bears questioning should it be added to the water supply, which, you know, people can't control or make choices about.

Cass Nelson Dooley [00:34:25]: So, you know, it's a complex topic.

Ben Greenfield [00:34:29]: I just like to create irreducible complexity. I think they should just add lithium to the water supply to assist with cognitive function and that'll combat the IQ, reducing effects of the fluoride. So we've got fluoridated lithium infused water. I want the may how position that RFK is going to get. Just watch me go. Okay, so how do you sweeten the toothpaste? Because I know a lot of people are concerned about what kind of flavoring agents are used or how they get that wonderful bubblegum esque flavor. And some toothpaste. What do you guys use and what should people be thinking about when it comes to flavors?

Katherine Dahl [00:35:05]: Yeah, so we use xylitol. Xylitol has been well studied, well documented for oral health benefits. It's a sugar alcohol that's non digestive by pathogenic bacteria. So it in a sense starves the bacteria. We know that bacteria eat sugar and that's their energy source. Xylitol, it is non digestible by these bacteria, so it starves them and it kills them. And xylitol has been able, it's shown to reduce the amount of pathogenic bacteria, the acid, by up to 90%. So not only does it sweeten, but it's also in there as an active ingredient as well to improve oral health.

Katherine Dahl [00:35:48]: And it also stimulates salivary flow. We haven't talked too much about ph yet, which is a big thing with our products as well. But it stimulates salivary flow, which is super important for balancing ph.

Ben Greenfield [00:35:59]: That's the second time now. Third time you brought a ph. Why?

Katherine Dahl [00:36:02]: Well, so basically a healthy mouth is going to have a balanced pH. Cass does an excellent job and maybe I shouldn't steal the mic from you on this one. You can add to it as well. In her book talking about how the microbiome is like a delicate rainforest and the bacteria that live there all live in symbiosis and in harmony together with this certain ph level. When that ph is disrupted, you're going to cause dysbiosis to start to occur because an acidic ph fosters an environment for those opportunistic pathogenic bacteria to overgrowth. So kind of like in a rainforest, if you're going to mess with that delicate balance, the bad guys can take over and you're going to end up with plants that you don't want in certain areas and dying off of species that you do want. So ph is really important, which are our probiotics are also, like I had mentioned earlier, the urase that M18 produces, balances, neutralizes acid.

Ben Greenfield [00:37:08]: What do you think, Cass? She right? Anything to add?

Cass Nelson Dooley [00:37:11]: She's right and I'm so glad you like that part of the book. I forgot all about it. But you know, what I was going to add there is that when you have dysbiosis and those unhealthy bacteria are rising to power and starting to take over, they produce more acid. So it turns into this vicious cycle where as your microbiome becomes imbalanced, those bad bacteria that are taking over make lots of acid and then they create this situation that bad bacteria like. And so that. And that's the case with cavities. Right? The acidic environment in the mouth damages the tooth and that enamel, and then those bacteria can create little, you know, pits and damage the teeth. In that acidic environment, the teeth can never remineralize.

Cass Nelson Dooley [00:38:00]: They can never kind of rebuild themselves or heal from that environment.

Ben Greenfield [00:38:06]: All right, cool. So. So my wife needs to take it as a compliment the next time I tell her her mouth is a rainforest.

Katherine Dahl [00:38:11]: Exactly.

Ben Greenfield [00:38:12]: Sounds like. Sounds like something out of like Song of Solomon in the Bible. Okay, so the other thing. So I was just going through your label with a magnifying glass. CoQ10. It's kind of funny. I'm actually having beef heart tonight for dinner and that's super rich in CoQ10, fantastic for the mitochondria, but I've never seen it talked about in the context of oral health.

Katherine Dahl [00:38:34]: Yeah, so, I mean, oxidative stress occurs to your gums in gingivitis. CoQ10 is an antioxidant. So research has demonstrated therapeutic effects of topical CoQ10 in the treatment or prevention of gingivitis. It can help reduce inflammation, it can help repair damaged tissue. Of course, CoQ10, as you eat it and as you have it as a supplement will go through the body and the bloodstream, which is helpful as well. But we've added it to our toothpaste for that topical element, straight to the gums.

Ben Greenfield [00:39:07]: Okay, so basically you're fighting oxidative stress, and that's for gum support.

Katherine Dahl [00:39:11]: Yes.

Ben Greenfield [00:39:12]: Okay. Now, probably easier too than just like chewing on heart beef jerky all day. The piece that actually did confuse me on the label was glycerin, because I've actually heard, and correct me if I'm wrong, which obviously I might be, since you have it in your toothpaste. I've heard that that might actually impede 2, 3 mineralization, glycerin. But yet you've got it in your products.

Katherine Dahl [00:39:37]: Yep. You and everybody else. So I fully expected this question, and I'm really glad you brought it up. This is what you call misinformation. Misinformation has been circling the Internet regarding glycerin since 1996. It dates back to a retired chemistry professor, Dr. Gerald Judd, who published a book called Good Teeth Birth to Death, in which he argued that glycerin is a harmful ingredient in toothpaste because, like you said, it coats the teeth and prevents them from absorbing minerals. They need to stay strong.

Katherine Dahl [00:40:08]: If you actually go through his book, there are no studies and there are no references to this theory. It is a theory, and in fact, we talk to chemists and of course our manufacturer, with chemists on staff that say, all say glycerin is highly water soluble. So as soon as it touches the mouth saliva, it dissolves immediately and releases anything it's tied to, such as all the active ingredients in our formula.

Ben Greenfield [00:40:37]: So why is it that it's in there? Exactly.

Katherine Dahl [00:40:39]: So it has four different benefits. It's preservation. So it keeps our formula from drying out in the tube texture, of course, because most individuals do prefer to brush with something that is pleasant. It's a binder though, too. So it helps equally distribute our active ingredients and keeps them bound together. And finally, it is bacteriostatic, so it helps dehydrate bacteria within the tube and keep them from growing.

Ben Greenfield [00:41:07]: So glycerin is doing a lot. And as you're talking about the texture of the toothpaste, you know how I was saying, I have one of those smart brushes. It's called the Feno. It's kind of a newer brush. Have you guys seen that?

Katherine Dahl [00:41:20]: Yes, I have.

Ben Greenfield [00:41:21]: Okay. You should look it up. Google. You put the whole thing in your mouth, and it basically does the equivalent of water picking, flossing. The first few times I use it, there was blood all over it because it was just going into areas of my gums I hadn't even gotten to before. But the toothpaste that it comes with, it's a foaming toothpick. And you mentioned sodium lauryl sulfate, so that makes me think, like, is a foaming toothpaste healthy, or can they do that without sodium lauryl sulfate? Because I need to go look at the label now.

Katherine Dahl [00:41:51]: I'll let Cass speak. I only know of sodium lauryl sulfate. And there's another sulfate, too, that is an active foamer. Cass, do you know of a different one?

Cass Nelson Dooley [00:41:58]: Yeah, I think there's another one, has a similar name. It's not sls, but it has a similar name.

Ben Greenfield [00:42:03]: Similar risk, though, too, you think?

Cass Nelson Dooley [00:42:07]: Not the same risk, to my knowledge, but you're right. I mean, I would be looking at that toothpaste, because if you could use a healthier toothpaste with your new toothbrush, that could be really good.

Ben Greenfield [00:42:19]: I was just going to say Hammitt is one of my buddies who kind of like, invented the brush, but I've been testing it out for about a month, and there are some things that do cause a little bit of friction in terms of my own stance on health. Like, it has wifi enabled in it, so you kind of like a wifi in your mouth, which is for the smart tooth scan that they do and then the toothpaste. I'm. I'm. I'm hoping Hamlet listens to this because he's. He's constantly tuning in. I'm sure he'll make some adjustments. But ideally, they wouldn't have a foaming agent like I would imagine.

Ben Greenfield [00:42:49]: I could probably just try it with some super teeth on there, and then the disabling the wifi would be really nice to be able to do also.

Katherine Dahl [00:42:56]: Yeah, that is super interesting. Yeah, sodium lauryl sulfate is pretty harsh on the oral microbiome. So I wouldn't assume that a company that has all these gadgets and proactive approach to oral health would do something damaging to the microbiome. So clearly he probably has something else. But sodium lauryl sulfate was big in my healing journey.

Ben Greenfield [00:43:17]: Just to interrupt you real quick, you'd be surprised because the biohacking industry is full of stuff like this. Like red light beds. You lay in a red light bed. What do you think is powering the red light bed and where all that power is concentrated? It's right underneath you. Right. So you're basically lying on a giant EMF pad. Ideally you could decouple the EMF that's under the light pad and have a controller that sits next to it. But you know, so people are all like, optimize your mitochondria and your biology.

Ben Greenfield [00:43:44]: And then you lay in the red light bed and you're laying on a giant bed of EMF simultaneously. And granted it's only for like 20 minutes and it's less than, you know, a bunch of wifi routers, but it's still something I think more manufacturers in the health industry need to think about. Like think more holistically.

Katherine Dahl [00:44:00]: Yeah, my father in law, I mean he is in his 70's and he did not grow up as a whole. He did not, was not trained as a holistic dentist, which we do not fault him for because it was not really a thing way back when. But I do really appreciate his sometimes less is more approach to things because we can over, we can overdo it. I mean flossing and brushing will manually break up the biofilm. And of course a water pick is great. But the more harsh we are with this delicate rainforest, I mean it kind of goes against the way it was created.

Cass Nelson Dooley [00:44:35]: So and I think we do, we want to think about what is in conventional toothpastes, you know, like SLS and cant fluoride. You know, some of these common ingredients are not only. I mean something like fluoride is actually, it is toxic to cells in the mouth. I mean for people who have like mouth sores or inflammation in the mouth that won't heal, they need to look into the toothpaste and the oral hygiene products that they're using. I mean even, you know, floss has toxins in it. PFAS that are found in Teflon pan.

Ben Greenfield [00:45:13]: So no kidding, really, that, that's how they make some floss slippery. They have PFAS in there.

Cass Nelson Dooley [00:45:19]: That's how Glide is made. There is Teflon in the floss so that it will glide between teeth. So it's really like on us as consumers to be educated about those risks that are everywhere at the grocery store. You know, we assume they're safe and they're healthy, but they aren't that way all the time. I mean, they'll catch up eventually. You know, they will catch up, I believe, with more awareness and, you know, companies like Super Teeth that are kind of leading the way into healthier oral health products.

Ben Greenfield [00:45:48]: Wow. By the way, BenGreenfieldLife.com/superteethpodcast is where the show notes will reside. And I'll link to everything we talk about at BenGreenfieldLife.com/superteethpodcast. What about gum? It seems to me like you're talking about like xylitol hydroxyapatite, maybe a little glycerin for texture. I don't know. CoQ10. Couldn't you do like a Super teeth gum? You ever thought about that?

Katherine Dahl [00:46:13]: Who's to say it's not coming real soon?

Ben Greenfield [00:46:17]: I love to chew gum. I would be all over that.

Katherine Dahl [00:46:19]: That is. Yeah. So we are, yeah, spilling the beans here, I guess. But yeah, that's, that's an R and D. That's cool.

Cass Nelson Dooley [00:46:25]: Good thinking, guys.

Ben Greenfield [00:46:28]: Great minds. What else is it that people should know about the biome that we haven't talked about yet?

Cass Nelson Dooley [00:46:32]: I just want to back up because there were a few times, Ben, where you asked questions and I just, you know, there was a nice flow going. I didn't want to interject. One of your questions I really liked was about strep throat and streptococcus and I wrote a blog on this. I have a, you know, evidence based blog that goes out every month. I would love for people to sign up. Hopefully we can give them the link to that e newsletter. But Streptococcus is the predominant bacteria in the mouth. In the, in the human mouth.

Cass Nelson Dooley [00:47:02]: And there's many, many species and most of them are friendly and do good things for us. Right. Strep throat is one specific strain of Streptococcus that can be harmful when the person is compromised. Right. When the rest of their oral microbiome is compromised. And that particular strain of Streptococcus can rise up and take over and create infections. So that's one of the reasons why I really like Streptococcus salivarius because that's, that's the type of bacteria that is found in the super teeth probiotic because it was discovered from, it came from a human, a human's mouth who had great oral health. And it was isolated and discovered that Streptococcus salivarius is the species naturally found in the human mouth that protects from oral disease and oral dysbiosis.

Cass Nelson Dooley [00:48:02]: So I really love that they use that one in a lot of probiotics, even the ones we swallow that are for gut health, we're not always using ones that are natural to the human body. Right, or come from the human body. Let me say that. So there's a probiotics that can do great things for us, but not all of them have been isolated from the human body. So the Streptococcus salivarius is unique in that. Another thing I wanted to kind of back up and define, because I think this is an important distinction, is that, you know, that we mentioned that the oral microbiome is all of the micro microbes in our, all of the microorganisms in the mouth. Well, the big player are bacteria, right? It's mostly bacteria. So when we talk about bacteria, they can be in the mouth, they can be in the gut.

Cass Nelson Dooley [00:48:50]: One particular one can overgrow and cause an infection. There's some that are pathogens, there's many that are good. So that's kind of the bacteria. Now when we're talking about probiotics, we're talking about specific bacteria that have been encapsulated and put into a supplement form. So probiotics are really supplements, they are bacteria, but they're really kind of packaged and ready to take. Whereas when we talk about bacteria, you know, that can be any number, you know, from the bacteria in your mouth, the bacteria in your dog's mouth, the bacteria, you know, on the surface of the kitchen counter, whatever.

Ben Greenfield [00:49:29]: And what about the idea of bacterial spores? Like some people will say that the bacteria doesn't need to be live because bacteria can create spores that have a similar effect. Are you familiar with that at all?

Cass Nelson Dooley [00:49:38]: I'm not as familiar with that. I have heard that you can get good effect from dead bacteria too. And I'm not shocked because I do think the immune system is incredibly wise and sharp. And it wouldn't surprise me that we can get benefits, health benefits from dead bacteria, just like we get benefits from dead viruses used in vaccines, for example. So I mean, the immune system catches on to what's going on and it can, you know, kind of pivot and figure out how to protect the body. So. But I can't say that I've read any research on that. Ben?

Ben Greenfield [00:50:14]: Yeah, I think that the dead bacteria actually release, or the bacteria, when they die, actually release spores. And those spores can go on and have little, little good zombie like effects still, even if they're not completely live. What flavors do you have for the toothpaste, I think the one I have is mint.

Katherine Dahl [00:50:30]: Yep. So we have a mint, which is. We've tried to be. Again, our approach is to be very mild. Nothing is too harsh in any way. And our mint has just a few essential oils in them. At small amounts, though, because essential oils do. They can be antimicrobial at high levels.

Ben Greenfield [00:50:53]: Yeah, like oil of oregano, for example. You take too much of that and nuke your biome.

Katherine Dahl [00:50:57]: Exactly. So we have been very mindful to keep our flavor profile low and the number of essential oils in it low. So that's our mint. And then the strawberry, though, is more of an extract, and it does have a little bit more of a flavoring to it. So that one's more geared towards kids. So we have our mint line and our strawberry line.

Ben Greenfield [00:51:22]: Okay, got it. So if I'm shopping and I get either the mint or the strawberry, both of them have the hydroxyapatite, the prebiotics, the glycerin, the xylitol, all of that in it.

Katherine Dahl [00:51:31]: Everything has the same active ingredients. It's just a different flavor for preference.

Ben Greenfield [00:51:36]: Okay, perfect. And there's one probiotic and one floss.

Katherine Dahl [00:51:40]: There's a mint probiotic and a strawberry probiotic.

Ben Greenfield [00:51:43]: This is fascinating. I don't think I've talked about toothpaste for this long before, but my listeners, if you're listening in, I'll throw a bunch of goodies in the show notes BenGreenfieldLife.com/superteethpodcast. Grab a little package for yourself. I obviously need to get on the probiotic bandwagon. I didn't know that about the tablets, so I need to get the turkey and cranberries of the teeth kingdom going here. And Cass and Katherine, thank you so much for coming on and for sharing all this stuff with us. Cas, if you email my team about your. Your newsletter, which you mentioned, I'll get that in the show notes as well, or somebody will.

Ben Greenfield [00:52:16]: And besides that, this has been incredible. Thank you so much.

Katherine Dahl [00:52:19]: Awesome. Thank you, Ben. We really, really appreciate it.

Cass Nelson Dooley [00:52:23]: Thank you.

Ben Greenfield [00:52:23]: All right, I'm Ben Greenfield, along with the team from Super Teeth, signing out from BenGreenfieldLife.com/superteethpodcast have an incredible week to discover even more tips, tricks, hacks, and content to become the most complete, boundless version of you, visit BenGreenfieldLife.com.

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