In this episode we welcome back our resident Biological Dentist, Dr John Roberts. We'll hear John talk about how the structure and shape of the mouth develops through childhood, and the potential impact on later life. We discuss how it can be affected by things such as breastfeeding, dummies and/or thumb sucking, the removal of teeth and the addition of braces.
Throughout this episode there is a key theme around mouth breathing. Listen to Dr John Roberts explain the negative effects of mouth breathing and how mouth taping can have a huge impact on your overall health.
Thanks for listening to our podcast and please feel free to get in touch:
We would love to hear from you!
In this episode we welcome back our resident Biological Dentist, Dr John Roberts. We'll hear John talk about how the structure and shape of the mouth develops through childhood, and the potential impact on later life. We discuss how it can be affected by things such as breastfeeding, dummies and/or thumb sucking, the removal of teeth and the addition of braces.
Throughout this episode there is a key theme around mouth breathing. Listen to Dr John Roberts explain the negative effects of mouth breathing and how mouth taping can have a huge impact on your overall health.
Thanks for listening to our podcast and please feel free to get in touch:
We would love to hear from you!
Welcome to functional medicine bite sized the podcast where Pete chats to experts in the field of functional medicine and health, giving you the listener pearls of wisdom to apply on a daily basis
Peter Williams:so everyone, welcome to this new episode of functional medicine bite sized. And as I said, right at the beginning, we are bringing our resident experts back in because they're so bloody knowledgeable. And of course, our resident dental expert, an integrative dental expert, what recognised around the world, Dr. John Roberts. And of course, he's a scouser. So he's got to be a good man. If that's the case, John, how you doing?
Dr John Roberts:I'm very well, thanks for doing that today. So we can watch the Darby tomorrow.
Peter Williams:Yeah, well, good. We'll see how we go on that one. I think it's a win for us, no doubt. wouldn't expect anything else. So John, we did our first episode, and I listened to actually about two hours ago, because I wanted to sort of scribble notes and come up with a script for today. And there's so much in there that it was, you know, we agreed, didn't we, just before we came, came on, and started recording is that there's so much I don't want to rush it. And, and obviously, bringing you back as a resident, I think is just a cool thing to do, because we get all your knowledge, and we don't rush areas. And so I was looking at my notes and scribbled right through them, because actually, I think what we're going to talk about is and I've entitled today bite, biomechanics and breathing because these, as I knew very little about in dentistry, wise, are really very important aspects of, again, not only what is the mouth and that dental care, but how that affects chemically many diseases want to talk about that. But also, I suppose, dentistry, what we do to our kids may have an impact in later years. So I've entitled it, John, as you say, bite biomechanics and breathing. What do you want to start pal? Because I know, as you say, we've got a big subject to cover here.
Dr John Roberts:I mean, thank you for the opportunity to talk again. And if as I grow older, and I'm 63. Now though, no plans to retire anytime soon. And the more I learn about mouth breathing, and the timing of treatments, then the more passionate I become about it, the mercury is something that I cut my teeth on, so to speak. And it's something that is now becoming well established with many, many dentists. But this whole essence of bite breathing, how your mouth, how your teeth fit together, what you do with your mouth, will affect everyone. And you know, the fact that tomorrow, I'll be doing one or two surgeries on babies to release lip ties and tongue ties that will affect that child until they're 100. And if you can get things right young, then you know, you're going to have a life changing experience. Now, within that we haven't got any studies or double blind clinical trials, but there's enough experienced practitioners, osteopath, chiropractors, body workers, speech therapists, who are all now acknowledging the importance of the mouth or the opening to your body, which is not only the mouth, but the nose plays an integral part for you, every day for the rest of your life. And if we can get it right, the way nature designed it the way animals use their mouths, then we have the great potential to give you the health. Or if we don't get it, right, we take from your health.
Peter Williams:Let me let me interject their pal. Because, obviously, we want to make sure every podcast is one where the man or woman in the street couldn't go, oh yeah I really get that. That's cool. So let's get let's keep this because these concepts that, you know, this tongue tie and, you know, bite and breathing and biomechanics, you know, for me, again, it's pretty new for me. And and so it's another wow movement with regards to I didn't even know that. So can we can we start with, as you say, you're seeing two babies tomorrow. So why don't we start with that? And, you know, what is it that we're trying to work to? Is that a sort of optimal state an optimal sort of bite an optimal position that the jaws should be and, you know, are there any things that we should and shouldn't be doing to children's mouths and what is tongue tie?
Dr John Roberts:Okay, with a broad brush, a tongue tie, both a tongue tie and a lip tie where the where the tongue cannot have full range going around the mouth and if we, in an ideal world, have a mother breastfeed their child for perhaps a year 18 months, the simple action of the tongue going to the roof of the mouth, squeezing the nipple against the palate. And expressing the milk is not only good for the child on a psychological and a bonding system with the mum, but it actually is what grows the upper jaw, really interesting, we get this. And if you put a if you put your tongue to the roof of your mouth and push up, you get that forward motion, it grows the bones of the skull, we know children's bones are flexible, there's 22 pairs of bones. And if you're pumping forwards and forward and forwards, then you grow in one direction. Equally, if you put your thumb in your mouth and suck on it, like sucking your thumb or sucking a dummy, or dare I say sucking a bottle, you're using completely different muscles where you're pulling everything in, the tongue drops down, the palate drops down, the direction of growth of the face goes down. So by trying to dictate and control the growth of the skull, is one of the most important things we can do. There was a guy in 1840, I can't remember his name. He went and sought Red Indians when they were still not being fought at the cowboys and Indians. And then he went to South America. And he observed that the children were breastfed, they had beautiful faces. But the mothers at night would sit and deliberately keep their lips together to encourage breathing through their nose. And to get these beautiful faces these broad arches that we would like to aspire to. Because of many factors, hopefully we'll cover some of them, we're just not achieving that. And if we don't see a child breastfeeding long enough, and I'm talking in generic terms, we often see an upper or lower jaw that don't grow big enough. And in this modern dental world, we like these quick solutions or taking a few teeth out putting braces on for a short period of time. That narrows the size of the skull, it narrows the size of the dental arches, it cramps the tongue in and when you get to older people 50s and above. This is where you may start to have issues with snoring, sleep apnea, your blood pressure will go up your breathing through your mouth, and it has a knock on effect throughout your life. So getting children to breastfeed, tongue to the roof of the mouth is ideal. We're almost calling it biological dentistry. Now. That's how you were designed.
Peter Williams:Interesting. There are so many aspects that we could look at breast is best, of course, you know, you could take that back to simple things like vaginal delivery against against Caesarean section and you know how these fundamentals of basic human evolution and evolutionary process are so important. You know, the baby needs to come through mom's vaginal canal to pick up all the bacteria to start start their immune systems. And, you know, hopefully they get a bit of poop as well. And this is how it starts. And there's a huge difference between Caesarean section babies and vaginally delivered babies with regards to their microbiome and whether there's going to be a problem lifelong. And what you're saying there is that, you know, the importance of breastfeeding in a sense is, is developing the sort of physical architecture and structure hopefully in the most appropriate way. So there are not troubles going going as they age.
Dr John Roberts:Yeah. And, you know, even if you have children who are section born, and there's reasons why children are section born, that pumping mechanism of the tongue against the roof of the mouth, continues, the growth overcomes the fact that a child's head hasn't been squished, and then opened up again. So I work with a lot of cranial practitioners, cranial osteopath sacro-cranial therapists, who will send children to me because the child can't suckle because the tongue doesn't, doesn't get up to the roof of the mouth. So the skull doesn't quite grow and move. Remember that skull is opening and closing on a subtle level, 8 to 10 times a minute. We always thought that was rubbish. But now there is something called the glymphatic system, where we know the brain is bathed in a fluid called cerebral spinal fluid. And what pumps the cerebral spinal fluid is the act of chewing, swallowing and using your mouth. So again, we're getting lifelong benefits by swallowing, chewing correctly. Yeah, but you've got to give the child a chance. And now also, sometimes mothers can't breastfeed. I know busy lives, busy,what I don't like to see is dummies being put in because that really isn't just stop communicating with me, but the sucking of a dummy always bends the shape of the upper and lower jaws and I can often look at a two, three, five year old, 10 year old child, and say have you sucked the dummy or a thumb. And you can see you've changed. And I like your word architecture of the mouth. And what then happens is the teeth that come through in this bone, come through crooked, and we as dentists, then say, oops, you've got dads teeth, moms jaws, we're going to have to take teeth out, well, that's absolute rubbish. You don't have mums fingers and dads hands. Genetics doesn't work that way. What's happened is the jaw and the bone of your jaw hasn't grown sufficient. The teeth, which are preset in size anyway, come through. And if there's not enough room, they squeak through here, there and everywhere. So because we're not chewing food, because we're not, and it isn't eating a couple of carrots. You know, once we started eating white bread, and eating rice and everything, we don't chew, we don't function, we don't stimulate that bone growth. And so therefore, we get crowded teeth. And it is still a sad fact. And again, it's a generalisation. There are people who are doing great jobs with this, we'll see dentists wait till a child is 10, 12, 14, 15, take a few teeth out and make everything smaller. That is not the way the skull, the bite, the breathing is designed to work. We actually like a system where we actually don't look to do braces in a child. But we actually look to train the lips to come together, retrain the tongue to go to the roof of the mouth. So when you swallow, the tongue goes to the roof of your mouth, and you're putting this push against your mouth about to the roof of your mouth, two and a half, thousand times a day. If you've got your lips together, if you've got your tongue to the roof of your mouth, you're breathing through your nose, you are designed exclusively to breathe through your nose unless you're doing severe physical exercise. Now I know everyone said, Well, what about this Wim Hof breathing and everything, that's fantastic. But for the 99% of your life, you should be lips together, tongue to the roof of your mouth, breathing through your nose and swallowing with your tongue against your palate. And if I could give that to everyone I treat, I will have made a substantial change to the health of all the patients who I see.
Peter Williams:So John, again, I think maybe a lot of people listening to this will be brand new to this. And what we don't want to do is, ah target any groups because I can look, so just for everyone to know that that's not not what we're trying to do, but we are trying to point out where potentially some some of the evidence may be with the things that we do, unfortunately, and again, we do things that we don't know can I can think of, I can think of my eldest who sucked his thumb through his font teeth, and was almost obsessive with it until he was about the age of 7 or 8. And I'm sure that's created problems for him. And he seems to have a really wide jaw with his teeth quite far apart. And I don't know whether that is a good thing or a bad thing. Everyone is different. You see, all we can do is paint with a broad brush here, because I'll show you 70 year old people, 80 year old people with a tongue tie and a lip tie, beautiful dental arches, never any problems. And yet other people who we think have done the right thing, you know, they're breastfed for years, they've done this, and their children still have problems. So it's not the only thing. We can actively educate. And then if we need to intervene in Can we talk talk then about adults who we're trying to move towards what you would consider maybe an optimal bite? What does that look like? Is it the two jaws come together in a certain way? Or I mean, what would you be looking for? What would you see in in a dental chair?
Dr John Roberts:Well, again, if everyone goes up to the mirror and has a look, there's three main ways your teeth fit together. And when you bite together, the upper front teeth should just overlap about a quarter of the lower teeth. So when you bite together, you have front teeth in front of lower teeth, and there's about a millimetre between the top teeth and the bottom teeth if you're looking towards the back of the neck. Now, if the front teeth are too far forwards, and generally they're not too far forward, the lower jaws too far back, that would be described as a class two occlusion and you can look this up on Google. If the lower jaw is in front of the upper teeth. That's generally described as a class three occlusion. But how your teeth are designed to meet is when you bite together, and you have that wonderful clunk sound, all the back teeth touched together, not on the sides or the tip, not on the sides or the cusps, the pointy bits. They all fit together, top to bottom. But when you push your jaw forwards, you only push forwards on the front teeth and the back teeth don't touch. And when you go side to side, you go on the canines the big pointy ones. And if everything is balanced, you'll often see someone Who is 60, 70 with not a lot of wear on their teeth because they all fit together the way nature intended. And years ago, 30 years ago, we would do courses on the ideal way teeth should meet. Now we just move teeth so they look straight, but they keep banging into each other. Which is why when people have retainers, ah wear braces, they then have to wear retainers. Because the teeth move well, that's because when you bite together, and you move the teeth top on bottom, then the teeth get pushed out the way by the bottom teeth. So if you get the muscles right, if you get how the teeth fit together right, those teeth will last much, much longer than if you just move them into a place that looks straight, but doesn't fit the body. And going back to if you get the lips together, and they're not pushing too far on the upper and lower teeth backwards, if you get the tongue to the roof of your mouth, so it's not pushing on the teeth, just on the pink stuff behind the teeth and you're breathing through your nose. When you swallow, you don't actually see any facial motion. Now obviously, this is a podcast, you can't see this. But you can Google what is an ideal swallow, many people will swallow and the tongue will push against the teeth, that they'll suck in their cheeks. And you'll see a lot of wrinkling and creasing in the face. That is putting undue stress on the teeth, undue stress on the muscles. And usually it's pushing the jaw back. And it can then lead to jaw joint problems. But going back, what is an ideal bite? It is back teeth touching front teeth don't push forwards or side to side, front teeth touching back teeth and the muscles not exerting any pressure on the teeth.
Peter Williams:John, can you can you go back to the conversation about the jaw muscles. What I took from that is that potentially, we have changed our diet so much that we don't get the ability to chew anywhere near as much as we should we should be doing and that potentially has consequences almost like muscles are too weak to be able to do their job. And that may have implications with regards to the way we chew our food or the way we eat our food or the way our jaw is set up. Is that correct?
Dr John Roberts:I think it's more the fact that because the jaws haven't grown sufficient and the teeth come in wherever they can, your number one priority is to get your teeth to fit together. So you then have to overuse or misuse the muscles to get the teeth to fit together the best you can. And then if you look at the jaw joint, everyone calls it the temporomandibular joint, we prefer to call it teeth, muscles and jaw. If the teeth aren't fitting together this ideal bite concept, then the muscles have to overwork to get the teeth to fit together. And then the jaw joint gets pushed out of place. And then you can start to get pain in the jaw joint or pain in the muscles, headaches, head, neck, shoulder pain, eye pain. Yeah, so what happens is, it's not that we haven't over exercised or under exercised the muscles, the muscles are abused, to try and get the teeth to fit together the same as if you wear high heels all the time. Strong leg muscles, but the muscles are being overused and misused. So you can walk in high heels. And that's what we do with our mouths. We overuse and misuse our muscles.
Peter Williams:Interesting and increasingly a favourite subject of mine now because I was invited to quite a big international conference. And one of the questions this was only about three years ago, and one of the questions was, would you tape your mouth, and I will hold my hands up and said that I didn't believe that that was a smart thing to do. Because I didn't believe that that would be something that would be done naturally, I have to say, I've changed my mind on this view. I think it's going to be done in a very specific way. But I'm definitely coming to and that and again, we can talk about some patients, they're definitely coming around to the idea of the sleep apnea side, and the implications for many chronic diseases of having problems with with breathing and particularly at night. So can we address all of that on a basic level, the complications with breathing and then of course, we can get into the implications. And I can think of two chronic diseases where it's really pretty important. And we've got a couple of patients currently that we are working with to help them on that side.
Dr John Roberts:I cannot say anything wrong about mouth taping, other than it should be done perhaps with the guidance of a practitioner, because it is such a departure from someone who perhaps has breathed through their mouth for 20 30, 40 years to suddenly take their mouth close will bring in panic and anxiety and you pop them off the treatment from day one. Whereas if you perhaps practice taping your mouth during the day when you're driving the car knowing you can always break the seal and breathe. But the whole point of mouth taping is you've lost the tone in the lips, and often in your tongue so your mouth hangs open, you breathe through your mouth. As I said before, you're designed to breathe through your nose. Now the question is, if you put your lips together, bite together, if you've been extracted into with orthodontics, there's no room for your tongue. There's absolutely a fantastic book written called six foot tiger in a three foot cage. And it's dealing with all the people who have been had orthodontics or extractions, the tongue has stayed the same size, the mouth has become smaller, often because of inappropriate orthodontics. So when you bite together and put your lips together, there's only one place for the tongue to go and that's back. So it blocks off the nasal passage for you breathing, so you reflexively, open your mouth. So if you tape your mouth, and you've not got consideration of this, this is why people panic. But the average Joe Bloggs with good teeth like you have, lip taping, and doing this every night will improve the quality of your health. And everyone thinks it's about oxygen. And it's not about oxygen, it is about carbon dioxide. Because we live in an atmosphere of 22, 24% Oxygen. So your blood if you get a P O T metre, and you put it on your finger, most people who are enjoying good health it's between 98 and 100, your body has more than enough oxygen, so much so it doesn't even store oxygen, it sticks it to the red blood cells transports it to where it's needed and let go of it. But what makes it stick to the red blood cells in the lung, what makes it let go where it's needed is carbon dioxide. And very simply, if you breathe through your mouth, you breathe out too much carbon dioxide. So instead of having a level which we would like at 40, we won't talk about units, it goes down to 28. So all of a sudden, you can have a load of oxygen in your blood all glued to your red blood cells and the haemoglobin, which we all know about, it gets to the muscles. And because the pH of the outside of the body, the muscles, the fluid that surrounds the muscles is wrong, it doesn't let go is a bit like the carriage doors don't open, the red blood cells come in, they don't let go of the oxygen and they go again. And all of a sudden the body is cramping and fatiguing. Not because you're low in oxygen, but because you're not letting go of the oxygen when you need to. And it's a concept that people just haven't got, breathing through your nose increases to a physiological biological safe level, that the body works better. And it changes the acid alkaline balance to the body. That's how elegant and beautiful the body is read through your mouth, you breathe out carbon dioxide, you then get muscles going into spasm, which is why it is recognised, men start to have heart attacks in the middle of the night. Because they're breathe out so much carbon dioxide, smooth muscle goes into spasm, which is why we wake up in the middle of the night needing at pee once or twice or three times a night. Now, I can't tell you categorically tape your moutha and that won't happen. But you will see changes because your body is working the way it was designed to work. Now again, people will come and say, oh, well, I can't do that. Well, it can be because of inappropriate dentistry because your mouth hasn't grown sufficient to fit your tongue. Everyone looks at the teeth. But it's the tongue that grows the mouth. And if the mouth hasn't grown, then the tongue doesn't fit. And there's only one place for it to go and that's backwards, or sit with your mouth open and hang. You can think of kids we call it Nintendo mouth where they've just got their mouth open and tongue hanging forwards playing Nintendo. They've also got poor posture and other things. And we have kids now who do online gaming, and you know what? They're taping their mouth? Because their concentration is better. I mean, the world is full of statistics, one that's challenging for some, a child who breathes through the mouth will have 10 points lower on their IQ. I say that because I can quote the research on it isn't being nasty. A child is designed to breathe through their nose exclusively, when they're asleep and when they're awake. And if you look up websites, children who are asleep with their mouth open, it's a sign of health issues. And although there's an epidemic for whatever reason of autism, ADHD and all these issues that we seem to have with children, there is a common theme of not breathing properly, breathing through their mouth at night snoring not getting the good nourishing eight hours sleep. So how your mouth is, how your muscles work. And I'll keep coming back to this lips together tongue to the roof of your mouth, breathe through your nose. That is a recipe for health, at any age. And so taping for an adult, you've got to be careful with kids, I think we won't go below the age of eight. And we'll spend a long time building them up. But if you can tape your mouth at night, I have a bit difficulty because I have facial hair. But if you can tape your mouth at night, you will notice improvements, you just got to do it. I think most people would benefit from looking up a Buteyko practitioner, b-u-t-e-y-k-o, for those who are making notes. And one of the best people and a teacher and educator worldwide is a guy called Patrick McKeown. And I think it's M little c, k-e-o-w-n but he's based in Galway in Ireland, and he does podcasts, free podcasts, he does so much to educate people all over the world. And then if you're on his website and find practitioners, you need to be trained, not just tape my lips together and breathe through my nose, it is a whole process because your body adapts. But once you then start breathing through your nose, oh my goodness. And again, we talk about the growth and development of the face. If you could see my face, I have a narrower nose when I breathe in my nose collapses inward. So it is difficult forcing breathing. So I actually wear something when I'm walking every day, when I'm sleeping to keep my nose open so I can breathe through my nose. And we're covering a lot again, in a short space of time, look up mute M.U.T.E. You can get them from boots and other places, put them in your nose and you only go oh my god, I can breathe. And if you can keep your lips together and put your mutes in, you will perform better, you will sleep better. And what you're doing is you're compensating for perhaps dentistry that wasn't as ideal as you would like for your body when you were younger, which is why I care passionately about treating kids young. So they don't have the problems that we see in people who have had inappropriate orthodontics or are older and just we haven't paid the attention that we should have done 40, 50 years ago. Does that make sense?
Peter Williams:It does make sense, Jonn? And obviously the taping, as you say it didn't make sense to me several years ago. But obviously we've done quite a bit of investigation on me, haven't we and we've done some rather specialised X rays or you've had a look in my mouth. And what is clear is that it looks like maybe I am mouth breathing at night. And that potentially has implications with regards to as you say, I mean, it is still I think, fundamentally creating a low oxygen state because we can't use the oxygen. I think that's what you were you were saying. And that really does have implications from a point of view of chronic fatigue from a point of view of diabetes. And you also mentioned the glymphatic system, which one of the systems that I'm incredibly interested in because it is a little bit like the binman coming in cleaning, cleaning things out every night. And of course, it only works really well when you when you get a good night's sleep.
Dr John Roberts:Yeah, and if you look at the phases of sleeping, it, you know, every 90 minutes, your brain cells literally shrink by 60% squeeze out all the toxins that they've created during the day, and they get washed away. You know, like you and I are talking now and concentrating. Our brain is buzzing, and we're just holding on to the waist. And then unless you can every night, relax, have that good sleep with correct oxygen levels. And I'm going to say swallow correctly because if you swallow with your tongue to the roof of your mouth, and lightly squeeze your teeth together, that's what actually pumps your cranial system. That's what actually moves the fluid around. And this is what cranial osteopaths have been talking for 30, 40, 50 years, I think Sutherland was 100 years ago. Yeah, if the skull is nice and round, the teeth fit together and the muscles work well. That's ideal skull mechanism thats skull mechanics. No one talks about skull mechanics how your skull moves, how you teach it together, how the muscles work, but our bodies are designed to work that way. And it's how far off that 100% design that will dictate our health levels. So, swallowing, breathing through your nose every night is actually helping drain your brain every night, which is a lot of thought now that whether Alzheimer's is a type three diabetes, but if you can flush your brain through every night, rehydrate it with all the good stuff, the vitamins, minerals that we all know about. How much will that allow us longevity. And you see the good primitive tribes, they sleep in simple beds and cool areas. And we can talk about sleep hygiene. Yeah, lips together tounge to the roof of your mouth, breathing through your nose and swallowing right
Peter Williams:I think what we've got to do, John, obviously, as resident dentist, is we probably need to do as an individual podcast on dentistry and its links with Alzheimer's because it incorporates all of this, doesn't it?
Dr John Roberts:It does with the mercury with the gum disease.
Peter Williams:So I think what we should do is a separate podcast, because as I say, we've got quite a lot of information that I think is going to be really helpful on, on on risk. And I think sometimes, you know, even even in this practice, I mean, you must have this, you just think, Oh, God, you know, there is so much for us that, to understand that we didn't understand, I think I asked you this question in the first episode. Why is it that most of dentistry or maybe I'm wrong, maybe dentistry is approaching all these aspects? Is it because it's just too difficult to do? And, and, you know, I get it, you know, some people just want to take teeth out, they don't want to worry about anything else. People just want to do, you know, root canals. And that, you know, I get that it's, it's not, that's not for me to judge, but there's so much information out, and so much information where we're bringing dentistry into the sort of bigger picture of systemic health. Why is it John, that, and maybe you can tell me here, because obviously, you're in the industry? Why is it that this is not sort of standard of care? Or, you know, I mean, there's a lot of stuff that we that I had no idea about two or three years ago. So why is that?
Dr John Roberts:I cannot comment for what my other colleagues think, I've got to be very careful not to criticise colleagues, we all (absolutely) embrace differences of opinion. But when there is an ever increasing body of science, saying, Actually, guys, we should be looking at this, we've missed it, then we should at least be having an open debate. But it's still very much closed door, we've always done it that way. We're always going to do it this way. And none of us like to be challenged on something we've been doing for the past 10,20, 30. Dare I say, 40 years, I have not gone and become a professor or a consultant, because I've been in general dentistry, but I'm an experienced general dentist. So you know, when I first went mercury free to go back to the last one, you know, I was vilified and everyone told me I was crazy or whatever. But you know what the science now says, I was probably right. And the science now says children can grow and develop their jaws to fit all their teeth. So we can get that ideal bite. But we have to take a lot longer. And it costs more. And there's efforts and if the child has to do exercises every night, you know, me as a kid, the only way I learned to play the piano is exercising every night, the only way you're going to learn how to tongue to move your mouth lips together and breathe, is to do the exercises. And we have a fantastic programme for kids to do all those exercises. And when they do it, and where their little what are called myobraces, you will see the jaws growing not because of pushing on the teeth, but because of changing the muscles. And the key to this is when we see adults whose jaws perhaps haven't grown big enough, who perhaps have had teeth taken out. And we see people who are clenching and grinding their teeth. Or that's the biggest thing because if you're an adult, and you start to see wear on your upper and lower front teeth, if you bite those teeth together, and those were facets, those teeth that match up, I know you've got a sleep problem, because your lying on your back, your jaw falls back, your tongue falls back, it gets in the way of your airway. So you're either going to open your mouth and breathe through your nose, ah breathe through your mouth. Or you're going to push your jaw forwards put your teeth together so you can breathe through your nose. So everyone who's clenching and grinding their teeth. Now, we always talked about it as stress and I have evolved with this over 30 plus years. People clenching/grinding, you're stressed, have a glass of wine, have a warm bath, have a shower, leave all the troubles of the day. But if every time you fall asleep and you go into that REM sleep and your jaw falls back or there's not enough room for your tongue and you can't breathe, no wonder you wake up and you can't get back to sleep, because it's like you've been strangling yourself from the inside. And the up and coming new dentists and the new people dealing with TMD is all about airway dentistry. You need to give that child or that adult as much space as you can. You need to exercise the tongue to come forward so it doesn't fall back and recognise signs on the teeth, cracking teeth chipping teeth, front teeth wearing down. And I'm going to say guys not putting fancy veneers and drowning everything. So you've got bright white teeth, recognise that as a pathology and deal with the problems of not breathing, right. And then when you fix the teeth, it looks better and it works better. I do very little damage to teeth, I don't drill, and do crowns and veneers, I try and put the jaws where they want to be, give more room for the tongue, teach them how to breathe through their nose. And you know what, they stay healthy. And they don't need the fancy dentistry to look good. They just want to be well. So anyone who is clenching and grinding and the dentist says you're stressed and wear this, the dentist is doing half a good job. But recognising that it's a sleep issue. And the effect that poor sleep is having on people is enormous. And again, don't believe me? Just go and google it. There's the British Dental Society for sleep medicine. There's amazing societies in America on all of this. And you're right. Oh, my goodness. Why did I look at this sooner? So I can't quite remember what you asked me now. But why aren't we doing it? Because we've always done it this way. Why have we done amalgams. It's quick, cheap and easy. And you can teach anyone to do it. Doing good white fillings, or proper, harder white fillings is costly, and time consuming. And when you have a system that rewards you, whether you do one filling or 10 fillings, you just do them quickly, why would you spend 3, 4, 5 years doing braces to grow and develop the jaws to retrain the muscles when you can, when they're 14, take 4 teeth out, Put a brace on, pull it all back, make the tongue the prisoner in this cage, and then let them go away for 30 years and then come back with sleep, snore, breathing problems. And with the breathing problems, you can bring in anxiety, depression, and the list is endless. It's more than Mercury.
Peter Williams:So, it's a really good question. Because, you know, I think about the fundamentals of just I can I can think about type two diabetics, but also sort of when people start to become significantly overweight, just the physical musculature, and the architecture of the mouth just gets bigger as well. So I'm assuming if we've got someone whose jaw didn't develop, to the extent that it should have, and over time they get overweight, the tongue gets larger, the fat mass gets larger, you know, you're probably looking at someone who's who's really increasing their risk of of breathing problems at night. You know, and in particular, you know, classical sleep apnea from that.
Dr John Roberts:Yeah, 100%.
Peter Williams:So, John, let me ask you another question. Is there anything in mouth breathing, as opposed to breathing through the nose where that alters the bacterial balance in the mouth?
Dr John Roberts:Well, there's a couple of things there. And if I digressed the other way, one of the best things you get when you breathe through your nose, your sinuses, if they're blocked, un opened, and believe it or not, sinuses are an organ, they have blood supply, nerve supply, they have sensory supply, your sinuses produce nitric oxide, and I think it was 2015, the Nobel Prize was given to nitric oxide and it accumulates in the back of your nose. And if you breathe through your nose, the nitric oxide is used to clean and sterilise the air. And there are now novel COVID testing, putting nitric oxide at the back of the nose. And I don't think it's any, it's any coincidence that that's where they swab to find the COVID virus. But if you're breathing through your nose, flooding the area with nitric oxide, which your body automatically makes, then maybe this is one reason why some people get COVID and other people don't. But you asked What about breathing through your mouth. When you dry out the mouth, you change the population because the mouth is drier.
Peter Williams:And I'm assuming what what we're looking at there is our inability to consistently secrete saliva which has many protective molecules in it from antibacterial to to immune aspects. I'm assuming that would be the predominant reason why we may start to see increased levels of oral pathogens in people who you know, tend to wake up in the morning with dry mouth.
Dr John Roberts:Yeah, but also if you think about your teeth as a joint, your upper teeth, lower teeth and in the middle is your saliva, which is the same as a joint with sinovial fluid. And so if you've got fluid between your teeth, you'll hear of people saying, oh, I heard someone clenching grinding their teeth at night and it was making an awful racket, or my kid does it. You can't do it during the day because the teeth are all wet. If you dry your mouth, you're drying the food and the staining on so if someone comes along and has staining on their upper and lower front teeth it's because they're breathing through their mouth and imagine licking a mirror, and then you let it dry, you'll have that film of cells. and whatever else is in your saliva on the mirror, you then breathe through your mouth, you dry this film on, and then it absorbs stain, and people are going to the dentist all the time getting it cleaned off. And that's great, we make money off that. But it's telling you you're a mouth breather, it's telling you you're changing the pH in your mouth, you're not producing enough saliva to protect the teeth. Because saliva is a brilliant thing at buffering your teeth, the chemicals in saliva mean that your teeth shouldn't go bad. And I think there's a lot of research now saying that changes to the pH of your mouth will actually encourage decay.
Peter Williams:Yeah. And obviously, I think the patients who come to us who are on a whole host of medications and many medications, you know, I can think about beta blockers and blood pressure and medications, or the diuretics where you know, you are trying to reduce the amount of fluid in the body have a direct effect on drying off, because they are reducing saliva. So, let's assume you've got a mouth breather, and you've got someone on some of these medications, then you would expect, wouldn't you and I think it would be good preventative medicine, defensive dentistry, to at least have an indication of what's going on there, whether that's an oral bacterial test to see whether as it changes over time, but they would be the patients for us that we pick out from a point of view of it's really important that you probably you know, you're in contact with your dentist, based on based on the scenarios that we're seeing, because the risk is great.
Dr John Roberts:And I had a lady from north Wales today. So she's travelled about 100 miles. And she's had an oral microbiome test. And it's showing nasty bugs living in a mouth. But she had a mouthful of amalgam, she was 60 years old. And unless you change the environment,
Peter Williams:Sure
Dr John Roberts:then you've got to get rid of the mercury, because the mercury is polluting the saliva, and it won't allow good bugs to live. She was a mouth breather, she knows she's a chronic mouth breather. She's had teeth out when she was young. And she she knows she sort of understood well if I breathe through my mouth, I dry my mouth out, I don't have the normal bugs living in because the environment of the mouth is different. Yeah, and together with the Mercury. And so the treatment is a mixture of everything and it included lips together and breathing through your nose, as well as taking out the amalgam and showing a better way to clean the teeth.
Peter Williams:Isn't it interesting that something as simple as spit, saliva becomes one of your major protectors. And, and you're just not told this, or you're just not told how important that is? You're not told how important the risk of a dry mouth is. You're not told that the drugs that you may have to take for another condition are actually causing a bit of a catch 22?
Dr John Roberts:Yeah, one of the most dangerous things, and I'm using the word advisedly here is people use mouthwashes, I'm not going to mention brands. But there's a couple of studies where people use mouthwashes to kill all the bacteria in your mouth. And that's never a good idea. If you burn and scorch, everything, you'll only end up with the bad things left. But if you use these commercially available mouthwashes that dentists use, it will show they kill the good bacteria that produced the nitric oxide that I've just been saying is protective, and your blood pressure will go up by five points. The studies are there. You don't have to believe me. Yeah, use of mouthwashes and blood pressure increase? I'm sure you'll find it.
Peter Williams:I think the main study on that was, was actually a British study. And the active ingredient in these mouthwashes is something called Chlorahexadine. Yeah. And what's really interesting about this as it seems to target, so the back of the tongue is where we have these bacterial species that take your food and take their nitrates out of your food and help your body start the conversion into nitric oxide. And of course, of course, nitric oxide is a gas which predominantly, I mean it's all over the body, but on the cardiovascular perspective it sort of lives on the outside of the arterial walls. And it's a bit like as you say, it keeps everything clean. It keeps everything from stopping being secreted on there. And it also has a really wonderful ability to relax things arterially, you know particularly arterial walls. So as you're right again, and again, here's a, now John, just just confirm on that. That doesn't mean to say in certain circumstances, you wouldn't, you wouldn't use a mouthwash that maybe has a lot of these anti-microbials in there because, you know, I think about would it make sense straight after a dental extraction or some dental surgery, there would be an argument there for either antibiotics or certain mouthwashes wouldn't there, that would theoretically would make sense in that situation.
Dr John Roberts:Yeah, I mean, I'll never say I'm not dogmatic enough to say you should never do this. And antibiotics have a role and a place. But there's a lot of mouthwashes. Now, more based on essential oils, but again, not the most commercial ones, which, as you know, bacteria live in communities, and they produce a slime, a biofilm, where they all live. And then they just jump out and go to another biofilm. They're like living in houses, and they move from one to the other. So instead of just blasting everything, you use mouth washes that dissolve the biofilm away. That's what your toothpastes do. That's what some of your ultrasonic machines do. They break the biofilm, they break the houses, the bugs are in, the bugs are then free floating, and they get washed away. Yeah, you knock down the houses So they've got nowhere to live, rather than trying to kill them. But you're never getting rid of where they're actually hiding deep down.
Peter Williams:Yeah, I think we need to give bacteria so much credit, because obviously, they've been around for billions of years. So they've had plenty of time to be super smart. And the term that they used in the scientific literature that I love is this what we call quorum sensing. And you're right, they like to live in communities like humans. And so different bacterial species will start going, Hey, come over here, I'm building a really nice house. And if you come in and join us, we'll make it even bigger. And it'll be absolutely more difficult to get rid of. And, you know, in a sense, this is the tartar isn't this is the plaque buildup. And this is why it's so bloody difficult to get rid rid of because these bacteria build these really, really, tough houses. And that's why I think they're sort of you need to be going to a hygienists regularly because I suppose one of the key methods of trying to control bacteria is that physical removal?
Dr John Roberts:Yeah, you have to do that physical removal. There's not many people who understand fully how to keep their mouth clean. But if you want to keep your health, if you want to keep your mouth clean and want to keep your teeth forever, visit the hygienist regularly. And it's not very good for dentists because we get less work to do. But again, again and again, hygiene work and you will keep your teeth a lifetime. But the hygienists are also talking because they'll recognise people who are mouth breathing, or who've got dry mouths, there are prescriptions for artificial saliva, we don't generally ask people to chew sugar free gum and stuff like that. But getting the saliva flowing, get this protective nature out there. The lady I saw today is taking good bacteria to try and re inoculate the mouth with the good bugs is what we're looking to do. You've got to get that environment right, which in her case is going to be removing mercury fillings and all the places that she couldn't get to clean because of poor fillings, it fundamentally keep your mouth moist lips together and breathe through your nose, which is what we've been talking about.
Peter Williams:Which brings us back to I think it's probably a good place to try and summarise this one. You know, I mean, I'm fascinated by dentistry. And I mean personally, as you say, because obviously, for someone who's supposed to be super fit and super healthy, you know, got told at 45 which is God, seven years ago now that actually Mr. Williams, you've got periodontal disease, how what the hell does this mean? So it's been a pretty intense seven years of really digging into into the data and getting getting an understanding and, and also getting an understanding of, I suppose, a bit like medicine, I spoke to Doctor Pat hanaway. And I think I've discussed this on the other podcast, you know, the science is there, the answers are there. And it's like so, so why don't we do it. And, you know, unfortunately, do you bring it back to naivety and ignorance. And, you know, I suppose if you do decide to step out, you are making significant changes to your practice as a business as well. And, you know, for many people, I get it, I get it, why we don't go any further. You know, I'm gonna do this, this is what I'm happy. I don't have enough time to, you know, to get into the other stuff. And so I get that, but I also find it quite interesting that the information is there. And as you say, I think the mercury situation was a really interesting one that you said is that you were poo-pooed 25 years ago, but the science has consistently consistently shown that this is a this is a toxic heavy metal, that again for those canaries in the in the minefield and we're trying to find that out. It's going to be really toxic for them. And not only are we talking about toxicity in their mouth, we're going to talk about systemically you know, toxicity and in particular is me and you know, your risk for dementia and Alzheimer's.
Dr John Roberts:Yeah, and I think having talking about Alzheimer's because you can bring in that material, You can bring in the bacteria in your mouth due to gum disease. Absolutely, you can bring in the breathing. Yeah, and but we also need practitioners like you. And let's not forget, you know, we are just mechanics in the mouth. And we know how the mouth works. But we need to hand over the mouth, which is attached to the rest of the body, to people like you to make sure the body works. And we probably need good body workers as well to keep the body moving, which is why yoga and walking, you know, it's no good having good functional medicine, doctors, good dentists, if you don't use your body properly. So it's that integrative approach to everything that is so exciting.
Peter Williams:It is so exciting. I think for a lot of people, though, it's so difficult, from a point of view of when you've been indoctrinated in, here's the condition, and here's how we deal with it. And it's like a one on one exchange, when you suddenly get to the point where here's what we're dealing with. But there are mechanisms over multiple systems, there could be 1000s of interventions that we need to think about over time, and you're going to have to make a lot of changes you're going to have to do it on a daily basis. That's a big jump for a lot of people. It really is and so, you know, it is interesting that, you know, there's always going to be, it's always going to be harder to push, because it's difficult to do. John, I'm not gonna make any bones to say that what we do, you know, is dependent on having a highly motivated patient, and who needs to do things on a daily basis. And unfortunately, he's probably going to have to spend quite a bit of money to try and correct these things going forward.
Dr John Roberts:Absolutely. And that's why these podcasts like you're doing you, all you can do is empower people with information and let them make the choices. And if I was to have an ask of you, because I think you're Bredesen trained, aren't you with the Alzheimers? You know, that is a perfect harmony of dentistry and functional medicine and physical medicine. And if there was ever a time for it to attract other people in indeed in this epidemic of Alzheimer's that we're seeing and when you've got some guy now writing books on, well, here's the stories of my first seven survivors. Yeah. Why wouldn't we want to start that journey now? Which is what you do, which is what I'm doing, and slowing down this process of ageing? Yeah. So as I said, I think there is a there's a big podcast on dentistry and alzheimers. And I say that because the research is actually really quite frightening. Just the statistics on it. So we definitely do that. We'll do that on the next one, John, because you know, it's vitally important. It is a, it is a disease that me and you are both interested in. And I've actually done quite a lot of work in that area as well. So I think we're reasonably well informed. And definitely more informed than most on the sort of oral alzheimers connection side that I want to summarise tonight, because tonight was really about getting an understanding that bite and biomechanics and the way that the jaw is, and the breathing is important, John, if you were trying to give the person on the street, the sort of three to five things to think about, and to take away to apply the next day with regards to this, what would you recommend to them. Breath through your nose for the rest of your life. And that means lips together and tongue to the roof of your mouth. That's how your body was always ever designed to work. And apart from perhaps Bulldogs who were bred with misshaped jaws, all animals breathe through their mouth, they use their tongue, if it's hanging out to cool down, they don't open their mouth to breath. Humans are the only animals that breathe through the mouth, because we have messed up the oral musculature, the oral structure, the dental arches. So my only take home for tonight is please for the rest of your life. Breathe through your nose, lips together, tongue to the roof, your mouth, and maybe again, we could, you know not wanting to offer but you have to do we have to show the exercises, you can do it there are other people putting exercises out. I think they're all going in the right direction. But please tape your mouth if you're comfortable. But work with a Buteyko practitioner, if you can, yeah, tongue to the roof of your mouth. And when you swallow, the tongue stays there, which is going to feel strange and maybe we can train people on that. Please, please please you and all your family breathe through your nose for the rest of your life.
Peter Williams:That's a really good way to end that and John I think what we should also do is is get a little bit more almost have a roundtable podcast and you know, I can think about some of the muscular skeletal therapists that you you also know the oral dental hygienists as well.
Dr John Roberts:Absolutely brilliant.
Peter Williams:Yeah, I think it might be good for us to get a few of us on the podcast to be able to expand, expand this a little bit more on that side. Right buddy.
Dr John Roberts:Thank you very much mate.
Peter Williams:Thanks mate. So big match tomorrow so I'll be texting the blue side of Liverpool and and just let them know who's gonna win tomorrow and mate this I really appreciate it. This is just as you say, we would like to see you as our dentist who is not only looking at what is happening locally, but importantly how that affects systemically and I really appreciate your time pal. So until next time, that would be great, buddy.
Dr John Roberts:Thank you Very much, Peter. Good night.