What Your Patient’s Gut Health is Telling You

Episode #561 with Dr. Uche Odiatu

There is more to gut health than probiotics, and it all starts in the mouth. Today, Kirk Behrendt brings back one of ACT’s favorite fitness gurus, Dr. Uche Odiatu, to talk about one of his favorite subjects: gut health. He passionately shares his knowledge about the microbiome, advice for engaging team members, and ways to talk to patients about this very important topic. A healthy mouth leads to a healthy gut! To learn how dentists and hygienists can help patients with whole-body health, listen to Episode 561 of The Best Practices Show! 

Episode Resources:

• Dr. Odiatu’s LinkedIn: https://ca.linkedin.com/in/druche
• Dr. Odiatu’s website: http://www.druche.com
• Dr. Odiatu’s Facebook: https://www.facebook.com/UcheOdiatu
• Dr. Odiatu’s social media: @fitspeakers
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Links Mentioned in This Episode:

Viome: https://www.viome.com

Main Takeaways:

Change your diet for better gut health.

Acknowledge the role of gut health on mental health.

Understand how antibiotic prescriptions affect gut health.

Learn how to engage your patients in gut health conversations.

Involve and empower your team so they learn more about gut health.

Quotes:

“If you want to be current, you've got to know about the microbiome because your patients are reading about it every night.” (3:49—3:54)

“The average Joe thinks, ‘Oh, I take a probiotic.’ There's much more to gut health than taking a probiotic, just like there's more to health than popping a vitamin pill.” (4:31—4:39)

“Gut health is elusive. It’s amorphous. You've got to think of how these gut florae became a part of us. When we’re born, basically, the womb is very sterile. When the baby comes through the birth canal, that's the first introduction to the microbiome, or the mother’s microbiome. However, if you were born by C-section, which is about one out of three kids, one out of three patients born now, they get more of a skin microbiome. They get more staph bacteria than lactobacillus and bifido. It takes about seven years for a C-section delivered baby to catch up to a vaginally delivered baby.” (4:40—5:18)

“Back 40 years ago, only one in 25 kids were born by C-section. Now, it’s one in three. So, when you talk about one in three, you're thinking about 30% of patients that are born without good, diverse, stable biome. And they do suffer from it. The Journal of Obstetrics and Gynecology has shown how they're more likely to have asthma, more likely to have metabolic syndrome, more likely to have food sensitivities. So, there are a lot of things going on. This all might sound, ‘Uche, as a dentist, how am I supposed to know these things?’ We know now that if people don't manage blood sugar well, guess what? They're also likely to have more bleeding upon probing, and loss of attachment. Diabetics lose teeth two to three times as much as a person who doesn't have diabetes. So, this is where the conversation goes. It’s really important to have a working knowledge, and you've got to read the books. You've got to listen to the podcasts. You can't be scared about it because these patients are Googling biome, gut, kombucha, and kimchi.” (5:19—6:16)

“In South Korea, the average adult eats 35 kilograms of kimchi a year. That's how much cheese the average North American eats a year, 35 kilograms of cheese in a year. So, kimchi, it’s very fermented. It’s got 20 times more probiotic qualities than other fermented foods like yogurt and fruit and vegetables. When you look at the obesity rate of South Korea, it’s about 10%. The obesity rate in North America is 35%. So, if you start looking at fermented foods and probiotic foods, you realize how it impacts metabolism, immunity, and how you look. So, I bring these things in eclectically when I talk. But ultimately, you've got to look current. You can't just think gut conversations just start with a probiotic. There's much more to it.” (6:21—7:12)

“The mouth is the gateway. And the number-one way to change and have a healthy gut is to change what you're eating. And who’s in charge of the eating apparatus? The dental industry. So, we are perfectly poised — there's never been a better time to talk gut health because we are in charge of the entrance to the GI tract. It all starts here.” (7:13—7:30)

“Hippocrates said, ‘Let food be your medicine, and medicine be your food.’ And Hippocrates also said, ‘All disease begins in the gut.’ He said that 2,300 years ago. And now, we realize the information about gut health, it’s true. (8:45—8:58)

“Right now, if your bacteria were fermenting fiber, which they love, and you were eating about 30 grams a day, as a man, 35 grams a day, your body is pumping out short-chain fatty acids. And they are the most anti-inflammatory agent your body makes. And every hygienist knows inflammation is key. Back in 2009, JADA said a lot of the destruction of periodontal disease comes from a hyper-inflamed host, a host that goes overboard, a weak immune system, burning out and causing bleeding and creating a lot of osteoclasts that are breaking down bone. Well, if your body has enough fiber and you're fermenting and making short-chain fatty acids, you now have a big bucket of water, anti-inflammation, and you can douse the flames easier. So, anyone who is eating fiber, anyone who is eating 30 grams a day for men and 25 grams a day for women, they can actually douse the flames of inflammation. They have a less likely chance of almost every modern disease, including gingivitis and periodontal disease.” (9:05—10:02)

“Right now, they're saying that 90% to 95% of North Americans aren't eating enough fiber. They literally have all these fires in their body, and they cannot douse the flames. So, if your bacteria aren't getting fermenting fiber, what happens if they can't ferment? They can't douse the flames of inflammation. So, the joints hurt, hair hurts, cognitive irritation, gut inflammation, psoriasis, eczema, ankylosing spondylitis, gingivitis, periodontal disease, all because the body is unable to make short-chain fatty acids. And this body is incredible. It has its own pharmacy. But you've got to give it the fuel, and that's where food comes in. Let food be your medicine, and medicine be your food.” (10:06—10:44)

“Dr. Paul [Tennenbauer], PhD in immunology, said if you are going to eat a meal that’s debauchery, if you have a cheat meal — again, pizza once a week, there are 21 meals a week. It’s basically one of the 21. So, it’s not so bad, one out of 21. If you give your bacteria what they want, they’ll let you have your cheat meal. But if you have a big meat meal with a lot of saturated fat and processed food, and you don't give them what they want, they will slow down digestion. You'll have gas. You'll have constipation. You'll have inflammation. But if you have a salad with your big steak, you have two sides, broccolini and asparagus or mushrooms, now you make your bacteria happy.” (11:20—12:00)

“Give your body a couple of fermented foods a day, and now you're giving them what they want. Now, they’ll let you digest that [not-as-healthy] food. They won't give you as much gas. They’ll douse the flames of inflammation around your joints. So, it’s like a tag team, back and forth”. (12:16—12:28)

“If you want to make your own pizza, you can have gluten-free bread. You can have whole grain bread. You can put real cheese on, feta cheese, goat cheese, instead of that spray-on orange cheese. You could put hormone-free meat. You can get free-range chicken. You can put broccoli on pizza, mushroom and broccoli on pizza, [if it isn’t] taboo for you. You can put peppers. You can put olives. You can make a pizza healthy. It’s not debauchery if you make your own.” (12:29—12:58)

“Only one out of 100 people are celiac. There are some people who are gluten-intolerant, but they're not gluten-allergic. Celiacs are definitely allergic to gluten. A lot of people eat poor-quality bread. Some people say, ‘Oh, I don't do gluten.’ Eat better quality bread, whole grain, sprouted bread. Sourdough bread is very much gut-friendly. Sourdough is a different kind of yeast. It’s a different way that bread is made. Sourdough is gut-friendly. Rye bread is gut-friendly. One-hundred percent whole grain bread is gut-friendly. White bread, the white bread that you can make into a snowball, not very gut-friendly. But for most Americans, guess what? That snowball, that white bread, is two to four grams a day for the average American. But again, very heavily processed.” (13:11—13:52)

“This is from Justin [Senebaugh]. Justin [Senebaugh] is a microbiologist out of California. Processed food is our downfall. The more processed food we eat, the more processed food the patient eats, the higher likelihood they're going to have an inflamed gut and chronic levels of inflammation, things that don't heal well. Peri-implantitis. We’re so good at putting out the fire and having good integration around the implant. But we don't talk to patients about — you do an implant on a shift worker, you do an implant on a sedentary person, you do an implant on a person who is depressed — one of the periodontists I heard lecture at the Dental Economics Conference last year in Nashville with Dr. Pam, he was saying that he was surprised how people who take antidepressants have a six percent higher chance of not accepting that implant than a person who doesn't take antidepressants, just because depression is an inflammatory condition. They have higher levels of C-reactive protein. So, start looking at the bigger picture. Start thinking A and B and C. There's much more to the body than one plus two. There are many ways of looking at it. The body is always synergistic in how it responds to what we do.” (13:54—14:59)

“Ninety-eight percent of bacteria in us are good. There are bacteria, archaea, eukaryotes. Everyone knows about H. pylori. But not all the H. pylori are bad. There are about three different strains. Only one causes a problem. The other two don't always cause a problem. E. coli, there are about 20 or more different strains of E. coli. They all live inside us. C. difficile is always hanging out. It’s like the Hell’s Angels in the parking lot called our gut. But guess what? If you don't have a lot of good, beneficial flora, now they get more parking spots. As soon as C. difficile gets more parking spots, guess what? Now, you've got quite the party. So, what happens is you've got to really feed the good ones and starve the bad ones.” (15:09—15:48)

“There are 42 trillion single-celled organisms in us, the same amount of cells of human origin in the body. But 85% of our human cells don't have a nucleus, and they don't have bacteria. So, that's why the gut bacteria actually outnumber the human origin ten to one. But species wise is sheer dominance. So, we have 21,000 human coding genes. You and I are 21,000 genes. But the sheer collective genetic footprint of the 10,000 to 20,000 species inside you is up to 100 million genes. So, who runs the show?” (15:58—16:32)

“The earth is 4.6 billion years old. There was zero life for a billion years. About 3.5 billion years ago, bacteria formed. These same bacteria are living inside us. A lot of immunologists and microbiologists joke around, we could just be the walking vehicles of bacteria to survive. Because when you're living, they're your friends. But when you die, within three days, your body decomposes by the same bacteria that helps you live. So, when the body decomposes, that's your bacteria now chowing down on you. So, think about it. They're ruthless. Most of us treat our bacteria bad our whole lives, starving our bacteria, not getting good sleep, not being physically active, poorly managed stress. So, now, you die. Three days later, the decomposing started. And it’s the same bacteria that — people always think the bacteria comes from the flies. No, it comes from the bacteria inside us. They're our friend, but now they're your foe.” (16:44—17:36)

“We think of the GI tract as it starts here and ends at the butt. So, there's up to about 26, 28 feet of it. So, that makes sense. The gut flora starts here. There are about 700 species in the mouth. Again, most of them, beneficial. Most bacteria in the mouth are part of your friends. So many dentists, though, don't know what's going on inside. We kind of know the bacteria that often produces or ferments and breaks down sugar and causes decay. We know that. But the other bacteria, we haven't analyzed them yet. They're so amorphous it’s hard to fully understand. So, that's why when people get an imbalance, all of a sudden, you get Candida, or you get thrush. You get a white tongue. So, if I get someone coming in at 50, 55, 60 with oral thrush, I know that Candida albicans is overgrowing. But we have it in our mouths all the time. When your beneficial flora is high and there's good sleep and a good immune system, the body can keep Candida at bay. But when someone has gone through a recent bout of antibiotics, or multiple bouts of antibiotics, if someone has stress, or if someone has dry mouth, or someone doesn't sleep very well, now they have Candida. And it manifests as millions, if not trillions, of bacteria multiplying and you get this white coating, which is basically Candida setting up condos on your tongue. It means that that's the body out of balance, and dry mouth sets that up.” (17:50—19:08)

“Dry mouth sets up the mouth out of balance. If the mouth is dry, someone is not going to digest food as well. So, when you think about digestion, people always think it starts in the stomach. But if someone has a dry mouth — think about it. Two-thirds of all prescription and over-the-counter medication causes dry mouth — two-thirds. As we get older, 55, 60-plus, dry mouth. People who mouth breathe, dry mouth. People who are anxious — think of all this post-pandemic stress — dry mouth. So, if you're chewing food with a dry mouth because of stress, age, anxiety, and side effects of maybe three, four, or five medications, now, I'm not even going to start the breakdown process. Digestion starts in the mouth. Actually, I should really say it starts when you're thinking about the food. But if you have a dry mouth, you start swallowing that food without it being touched with all the saliva to bring it into a liquid form. You don't have all the enzymes. And now, the stomach has to work harder to digest the food and absorb it. (19:08—19:58)

“You can eat a great diet with dry mouth, and now you're going to have nutritional deficiencies. That's what a lot of doctors don't understand. ‘Hey, your diet looks good. I wonder why you're lacking B-12 or you're lacking this nutrient.’ Well, what happens is, you're chewing your food too fast in a dry mouth because you're anxious, and you're sleep deprived, or you're mouth-breathing. Now, you're sending down food only partially broken down. The body is a miracle, but it can't work magic. And now, you become nutritionally deficient, simply because of a dry mouth. And that's why when I see a patient with dry mouth, I call that the sign of accelerated aging. I want to get their attention. ‘Accelerated aging.’ ‘What can I do?’ ‘Well, we’ve got to start getting you nose-breathing. How are you sleeping?’ So, all these conversations start with the dentist and hygienist.” (19:58—20:38)

“You've got to start talking the talk of total-body health. And now, as a dentist, I can talk dry mouth, and digestion, and absorption, and slowing down the aging process. ‘Just by having a fully functioning, fully restored mouth, I can actually help slow down aging. You know why? Because when you have a fully restored mouth with good saliva and good TMJ, now you can break down food. And literally, you have healthier lungs, heart, liver, and brain.’ So, it starts with us. This is where dentists have to start taking ownership. We are oral physicians. We are physicians of the mouth. I don't just do veneers. I'm a physician of the mouth. I'm looking at the big picture. ‘Let's see your meds. Let's talk about shift work,’ that kind of thing.” (20:38—21:17)

“People think of burnout as stress, ‘I'm not managing stress well.’ People are taking antidepressants. However, when you think of the gut, think of the bacteria as your — they're traveling with us from birth to grave. They don't have a brain, but they have a consciousness. So, when someone is stressed, mouth-breathing, when someone is stressed, poor sleep, when someone is stressed, eating comfort foods, when someone is stressed, muscular tension, your bacteria, they don't have a brain, have a consciousness. They sense you not moving. They sense your dry mouth. They sense the lack of nitric oxide. They sense the lack of rest. So, what happens when your bacteria senses it? Digestion slows. Any time you're in fight-or-flight, or angry, or upset, or frustrated, or irritated looking at the news, the body puts all the energy into the present moment because there is no gradient to stress. It's all or nothing. So, when you're angry, looking back at the guy honking the horn, you're watching the news on CNN, looking at FOX and all this stuff, what happens is your body goes into high alert into the present moment. It puts digestion on hold, so digestion slows. Any time you're anxious, digestion slows down. The minute digestion slows down, your body can no longer repair, recover, and grow. That's why stress can literally make you shorter.” (21:49—23:05)

“They talk about there are three reasons why kids will often not be as tall as other kids. So, 80% is genetic, family. But three negative impacts on childhood health is stress, infection, and food quality. So, 20% of your kids’ height is the amount of stress they had in that childhood home, how much immune system challenges, how sick they were, and the quality of the food. Twenty percent is a big impact. It’s one or two inches. And again, it’s the bacteria. Bacteria have a part to play.” (23:05—23:37)

“Your bacteria, they don’t know light or dark. But they do know when you’re horizontal. And some bacteria are most awake when you're dreaming. Many bacteria are very awake when you're dreaming. And dreaming is what sleep scientists have said now is when your body processes emotion or processes memory. So, if people are stressed, they literally grab the emotional dirt from today and drag it into...