In this episode of Functional Medicine Research, I interview my friend and colleague Cass Nelson-Dooley, M.S. in a discussion on how to heal your oral microbiome. Cass recently published the book "Heal Your Oral Microbiome" and we discussed many important topics about this often overlooked health issue. We discussed what conditions may be connected to a dysbiotic oral microbiome, how oral microbiome dysbiosis affects your health, health sweeteners, strategies to heal the oral microbiome, testing, dental products and more. If you're struggling with healing your gut or have a health issue that won't resolve, your oral microbiome may be the missing link.

Full Transcript on How to Heal Your Oral Microbiome

Dr. Hedberg: Well, welcome, everyone, to "Functional Medicine Research." I'm Dr. Hedberg. And I'm very excited today to have my friend and colleague, Cass Nelson-Dooley, on the show. And Cass studied medicinal plants in the rainforests of Panama in 2003 as a Fulbright Scholar and then launched a career in science and natural medicine. She researched the pharmacology of medicinal plants at the University of Georgia and AptoTec, and then joined the innovators at MetaMetrics clinical laboratory and Genova. She enjoys teaching, presenting, writing, and researching how to address the underlying causes of disease, not just the symptoms.

She has over a decade of experience teaching doctors about integrative and functional laboratory results. In 2013, she started Health First Consulting, a medical communications company with a mission to improve human health using the written word. She created innovative videos and patient education handouts to improve practice efficiency and motivate patients. Miss Nelson-Dooley is the author of the book "Heal Your Oral Microbiome," which we'll be focusing on today. And has published case studies, book chapters, journal articles about natural medicine, nutrition, and laboratory testing. Her website is healthfirstconsulting.com. Cass, welcome to the show.

Cass: Thank you, Nick. So happy to be here.

Dr. Hedberg: Yes. It's been a while. We were just kind of reminiscing about the days at MetaMetrics and I read your new book, "Heal Your Oral Microbiome." So, I was excited to have you on about that because no one's really talking about it. So, why don't we talk about, kind of, the foundation of what we're talking about here, which is periodontal disease? And so can you just talk a little bit about what that is?

Cass: Sure. Sure. So, yeah, it's great talking with you after all these years and in the starting out, getting to know you in the functional lab industry. But, yeah. So, this book was a really fun book to write, especially from the jumping-off point of gut health, right, which is kind of a central tenet in functional medicine. And that's some of the testing that we used to talk about years ago. So, so much of what we know about the gut really just perfectly translates to the mouth. And periodontal disease, you know, I kind of like to just simply say that it is a dysbiosis. It's an oral dysbiosis that...and an aberrant or an over-reactive immune response to that dysbiosis.

So, one of the fascinating things, when I was writing this book, was realizing that so many of the things that plague our mouths are really just dysbiosis, you know, which we talk about all the time in regards to the gut. So, periodontal disease is an imbalance of oral bacteria that triggers an immune response that attacks and destroys bone and teeth. Cavities are a bacterial dysbiosis in the mouth. Root canal infections are bacterial imbalance in the pulp of the tooth. And then you can get cavities on the root of a tooth, which is, again, dysbiosis. So, it was pretty fun to realize, wow, all of these problems just go back to the oral microbiome and we just need to try to rein in that oral microbiome and make it healthier in order to prevent these diseases.

Dr. Hedberg: Yeah. And when you think of the microbiome, most people think of the gut, beginning with the stomach, but there's a microbiome almost everywhere. Like you point out in your book, the sinuses, the mouth, you know, everywhere and...

Cass: The skin.

Dr. Hedberg: ...the skin. Yeah. So many places. Anywhere there's a cavity. So, it's not just the gut. And, you know, really, people are not talking about the oral microbiome. They'll look at, you know, stool analysis results and just think about the intestine or the stomach, or they talk to the patient, and they're just thinking about their symptoms in relation to the gut. But the oral microbiome, I mean, it has just a significant impact on everything downstream going into the stomach, small intestine, and the colon. So, why do you think this isn't a bigger issue? Why aren't more people talking about it?

Cass: Well, I think it's coming. I think we're just at the front edge of it. I mean, the gut has been in the spotlight. The gut microbiome has really gotten a lot of attention over the last decade or two, at least, if not more. So, I really just think it's a matter of time. I mean, this book, "Heal Your Oral Microbiome," is the first one on the topic. So, I mean, people certainly know about the oral microbiome and talk about it. And I would argue that this is what dentists are working with on a daily basis is the oral microbiome. But no one had written a book about it before. And that was kind of neat that the publisher saw that opportunity, you know, that the time was right for this topic.

The oral microbiome is second in biodiversity only to the gut. So, I mean, it really is time to talk about it. It's time to talk about the oral microbiome. And I think for anyone who has been interested in functional medicine or practicing functional medicine, it's just kind of a natural next step. It just kind of needs to be folded in, like, instead of thinking of the gut as, you know, the stomach and downward, we need to think of it as starting at the mouth.

Dr. Hedberg: Right. Right. Many years ago, I was reading an interview with the gastroenterologist who wrote the book "The Second Brain." I'm blanking on his name now, but they asked him what he thought of the idea of leaky gut and he said leaky gut is garbage. That's just quackery. And now we have, you know, so many published papers on leaky gut. And so it's a real thing now. And you talk about leaky mouth, which I thought, you know, is really interesting. So, can you expand on that?

Cass: Sure. And this is something that, you know, I have written about and mentioned and other dentists, I know Dr. Mary Ellen Chalmers had mentioned it, kind of, in passing years ago. This is just, kind of, an idea and I think it's something that various of us have come to on our own because it's just an extension of the leaky gut idea. But the lining of the mouth is very similar to the lining of the gut. And we know that, actually, it's a little bit more porous, a little bit more porous than the gut lining. And we do know that just even in a healthy person when they chew or brush their teeth or get a dental cleaning, of course, anything like that, when they eat a meal, they develop some bacteremia from that, you know, kind of, action, that disruption in the oral microbiome. So, the bacteria from the mouth go through the oral lining and the mucosal lining and get right into the bloodstream, so, even in a healthy person. So, you know, it's like, okay, we've got that barrier there.

So, what about someone with gingivitis? What about someone with cavities or a root canal infection that hasn't been addressed or periodontal disease? What happens when they brush their teeth or eat or get a dental cleaning? That's dysbiotic flora going right into their bloodstream. So, I think the concept of a leaky mouth, you know, when there is oral disease, I think this is a really big thing we need to consider. I mean, we know that oral bacteria flood into the bloodstream. We know that we can find oral bacteria in the joints or in the heart or in arteries or, you know, in various distant sites from the mouth. So, I mean, we really want to have a healthy microbiome in the mouth because that barrier is not...even in a healthy person, it's not a watertight barrier. Things pass through it.

Dr. Hedberg: And, you know, cavities and gum disease and things like that is basically what you're talking about in the book is dysbiosis in the mouth. So, if someone has one of those or it's happening all the time, why don't we get into what they can do to begin to shift their microbiome in the right direction?

Cass: Sure.

Dr. Hedberg: What would you say is the biggest way to begin that shift?

Cass: Yeah. So, I mean, for me, it's diet every time, you know, kind of we are what we eat, right? And our microbiome is what we eat. And this is, again, such an easy jump to make from integrative and functional medicine because we already know how critical the diet is to the whole body health. So, it's, you know, going into a healthy diet, meaning, you know, no sugar, no refined carbs, no packaged foods like breads and cookies and, you know, pasta and things like that and, really, working toward a whole foods, plant-based diet with plenty of fiber if a person can tolerate that if there isn't a gut dysbiosis they're managing. But, yeah. So, a healthy diet, I think, is one of the best ways to shift the oral microbiome and even things like, you know, in greens, you know, leafy greens and beets. I mean, it's so interesting the foods that our oral microbiome really likes, you know, and thrives off of. So, lots of veggies and fiber. That's really, you know, how the microbiome evolved with us, we would be on that type of a diet.

But that's not all. There's a lot of other things to do to improve the oral microbiome. I mean, since writing the book, I'm a big fan of oral probiotics, especially...Hold on one sec. Oh, yeah. Excuse me. Oral probiotics are really great.