Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered podcast. I'm Dr. Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. In today's episode, we're discussing how our oral health can have a ripple effect on everything from heart health to sleep quality. We'll explore how an inflamed mouth can set off chronic inflammation throughout our bodies, and what practical measures we can take in our oral health regimen to keep us comfortable in the dentist chair and beyond. We're going to take a slightly broader look at what oral health actually means. We're going to be talking about the health of our tongues, our oral microbiome, along with our gums and teeth, so that we can keep inflammation down in our mouths to protect the health of the rest of our body.

So whether you're anxious about your next dental appointment or looking for ways to prevent future problems, this conversation will show you how a holistic approach to oral care can make a surprising difference in the way you feel every day. First, let me introduce my guest, Dr. Nammy Patel. Patel is a functional and holistic dentist who's passionate about serving her patients’ health while running her dental practice based on values that are environmentally conscious. Dr. Patel is a leader in green dentistry—a holistic, functional, Ayurvedic approach to dentistry. Welcome to the WebMD Health Discovered podcast, Dr. Patel.

Nammy Patel, DDS: I'm so excited to be here today. I can't wait to share all this great information that we have. I feel like people don't really understand how important the mouth is to the rest of the body.

Pathak: So before we begin exploring our topic today, I want to ask you about your work in the area of holistic and functional dentistry. What does that mean, and how does it connect dentistry with our overall health?

Patel: I would say I am a dentist who helps you connect the connection between your mouth and your body. I provide data-driven care. I provide confidence in health, and I focus on longevity and disease prevention. So what I'm looking at is where you are in life right now, what the current condition is, how can I fix it? Then secondly, how can I help you prevent disease 20 years from now?

Pathak: And that's really interesting. So for many listeners, this might actually be the first time they're making the connection between overall health and their dental health. So let's take a step back. Why is it important for patients to learn how oral health influences the entire body? What is the connection there?

Patel: That is a great question. The number one thing about Western medicine is that dentistry has been a stepchild of medicine. We've always said, sure, the mouth is connected to the rest of the body, and sure they're connected somehow, but not really knowing the pathophysiology or not understanding exactly how the connection really exists. And it's been so nice that there's been great research that is out there that really looks at how the mouth is connected to the rest of the body. Two most important ways: number one, your saliva. Your saliva is very important. You swallow five gallons of saliva every single day. I'm gonna repeat that—five gallons. And in that saliva, there is bacteria. In our bodies, everywhere we go, there's good bacteria and bad bacteria. We want the good bacteria to live because that protects us. The bad bacteria actually causes heart attacks, diabetes, cancer, Alzheimer's, arthritis, and it causes this low-grade infection or this low-grade bacterial load over a long period of time. And what that does is it exhausts the body's resources. When our body's resources are too busy fighting an infection, it's not available to fight cancer. It's not available to prevent heart attacks. It's not available to fight arthritis, and that's really the problem with having bad bacteria in the mouth and the oral-systemic connection.

Pathak: So what I'm hearing you say is that the mouth is really a gateway to the rest of the body. So how do we connect that with what you're talking about in regard to the gut microbiome, bacteria, and inflammation? And if this is the first time someone's hearing about this connection, what symptoms would they notice? What does that look like?

Patel: If you're a patient and you're wondering, "Hey, do I have an oral-systemic problem?" the first thing somebody might notice—it's very basic—is you wake up in the morning and you put your hand in front of your mouth and you breathe. You exhale out and you smell that air, and a lot of times it will have a bad odor and it will smell funny. When you try flossing your teeth, they will bleed. That is a sign that the bacteria has invaded the gum tissue and is into your bloodstream at that point. So that's something you'll realize. When we talk about the oral microbiome, there are other things. When we start thinking systemically, the first things I hear a lot of patients say is, "I'm grinding my teeth," which you would think is a dental problem, but majority of the time that grinding is actually a clue to an airway problem.

Pathak: So on that note, if a patient comes to you and you're having a conversation about these symptoms, what are the next three steps? What happens in that consultation with you, and how does someone start to take care of their oral health as well as their overall health?

Patel: The first thing I would tell a patient when they come into my practice is, let's test it. Medical doctors are using biomarkers as the blood. In dentistry, we're going to use saliva. So we can actually test the specific bacteria that cause heart attack, diabetes, cancer, Alzheimer’s, arthritis, right? We can also test the red-light or bad bacteria that we find in patients with IBS or any sort of gut issue—H. pylori, right? That's a common one. The other thing we do is test the saliva for nitric oxide. We can actually test the saliva to see how much nitric oxide is present, because we will find that there’ll be low amounts of nitric oxide. Then I’ll do more research and do a sleep study and a CT scan and a posture analysis to really deep dive in and figure out what the problem is, so that we can get it down to the molecule level, get it down to the cellular function, and really fix it at its root.

Pathak: I really appreciate you giving us that overview. So now let me ask you, what are the dental health red flags for any person? So by red flags, I mean a cause for concern that would indicate that someone should book an appointment with their dentist immediately. Tell us some of those red flags.

Patel: The first red flag that I would say you need to come on in is do that breath test as soon as you wake up in the morning. Exhale. Smell your breath. Is it stinky? Do you have sulfur-causing bacteria? That's the number one thing, and you can do that easily, and you can do it periodically because some patients need to come in every three months, some people six months, some people even sooner than that. So that's a great test you can do at home every single day, or once a month—whatever you want to do.

The second is when you're trying to floss and you notice bleeding gums, make an appointment right away because that is gum disease. That means that there’s bacteria that are overgrowing. So come on in.

Now, the third thing is if you look in the mouth and you look at your teeth and there’s redness around the gums, there’s redness and swelling. So as soon as you see redness and swelling, make an appointment. Come on in. Let's figure out why that's happening because that is a clue there is something wrong.

And then the last thing I would say is pay attention to grinding. People are thinking, “Oh, I'm grinding ‘cause I'm stressed out.” It's not that. You may be grinding for a short period of time, like you have a week of stress—makes sense. But if you're grinding consistently and chronically, and all the time, your tongue is the problem. We need to get you to come on in because you could have sleep apnea, you could have upper airway resistance. And you can check for these things really easily. You can just open your mouth and look. Look in the mirror—you’ll see holes in your teeth. There’ll be little small holes, like yellow spots on the tops of your teeth. That’s what's telling you you're grinding chronically for a long period of time.

Pathak: Thank you so much for walking us through that because it answers a lot of people's questions about when to make an appointment and can help them really tie together some of these symptoms. Now I want to explore some of the most effective things that we can do to improve our dental health. Can you describe the perfect day for a dental health and wellness routine? How should we start and end our day?

Patel: That is a great question. I'd love to share my dental morning ritual and my dental evening ritual. So the first thing for me in the morning is, I like to wake up and make sure that I am flossing my teeth first, brushing my teeth, and scraping my tongue. The mornings—I’m kind of in a rush, so I don't have as much time as I'd like to. So I floss, brush my teeth, and I'm out the door.

In the evenings, what I like to do is from an oral-systemic health perspective: the first thing I always do is shower. I open my sinuses—all the toxins from the day. Make sure that they're out of your system and out of your sinuses so that you're making your body more open for that nitric oxide we talked about. After I shower, the first thing is I floss my teeth. Then I brush my teeth. I scrape my tongue. I like to use coconut oil to swish—swish, swish, swish, swish, swish.

Twenty minutes is ideal. Make sure that you spit it out in the garbage can and not in your drain. The coconut oil is a great binder for mold, for viruses, for bacteria, for metal. So that oil pulling will help pull that stuff out on a daily basis.

Pathak: Thanks so much for describing that routine. And you mentioned some things that listeners might find surprising, or this might be the first time they've heard it. Can you give a brief overview of tongue scraping and why it's beneficial, and when is it beneficial?

Patel: Sure. So tongue scraping is fantastic. One of the biggest things with our tongue is that they’re highly vascularized, which means that there's a lot of blood vessels—which is really good because when we have blood flow, we have good things that come in and bad things that come out, and vice versa. So our tongue is really good at getting rid of the junk that our body needs to get rid of. You can pee it out. You can poop it out. You know, you can sweat it out. Tongue scraping is another way we can get all the toxins out.

So what we can do is scrape our tongue and get rid of all the coating. It's almost like dead skin cells. You know, when we exfoliate our skin, it feels really good and fresh. It's kind of like that. So you just tongue scrape and remove all the bacteria that's stuck on your tongue. And it gives you really fresh breath too.

Pathak: So, speaking of fresh breath, let's talk about smoking and dental health. I wanna talk about the intersection between smoking, oral infections, inflammation, and dental health. What are some things that people need to know?

Patel: The number one thing you need to know about smoking is that it causes cancer. The types of cancers that it causes are difficult to treat. And it's not just cancers of the mouth — it's cancers of the lung, it's cancers of the liver, it's cancers of the brain. Oral cancer is huge, and it's on the rise — 40% per year. Now smoking is really, really, really, really bad.

Not just smoking, but also vaping. Our society is thinking, "Hey, I'm not smoking, I'm vaping." It's actually 10 times worse, actually. So we really don't wanna smoke or vape because there are carcinogenic compounds in there. So there are things that will tell our cells and our body to overgrow, and that's what cancer is. Cancer is uncontrolled growth.

Pathak: So let's just take a pause for a moment and put ourselves in the position of the person who's listening — who's a smoker — and who wasn't really, before this conversation, making the connection between their smoking, their dental health, and oral health. And they may have assumed that yes, there might be health consequences in other parts of the body, but they weren't really that concerned about how it might be impacting their oral health. What are some things you're seeing when you're treating people who are smokers, and what are some warning signs that someone who's smoking should start paying attention to?

Patel: The first thing that I notice in patients who smoke is that, number one, their breath smells. And you also feel it, 'cause the mouth feels really ashy. It feels dehydrated and dry and leathery. But more importantly, it's cancer-causing, and that's the most important thing about smoking and vaping that we need to be mindful of as a society.

The other things I notice is that there is so much black tartar on the teeth, and they look diseased — you know, like something is wrong. The other things are that gum tissue becomes really white because there's not enough blood supply. Because the smoking is sucking up all the blood, it's really a dry environment, and the gum tissues look white. And when we see white, we get really concerned because those are precancerous signs.

So those are the things that we want to look at in the mouth. And you could go do that in the mirror. If you're a smoker, go — just look around the mouth. Does it feel dry? Are there white spots? Are the teeth looking black? Are there black areas on the teeth? They should be nice and white. If they're yellow and dingy and looking like there's black stains on them — let's take a look and see what's going on.

Pathak: That's super helpful. Now let's pivot a bit and talk about pregnancy, hormonal changes, and the impact on a woman's oral health. Can you walk us through some of the changes that happen in our mouths that women might experience at different stages of pregnancy?

I think sometimes it can be a little alarming for some of us. So what should we expect, and what's a red flag?

Patel: For women who are pregnant, in a dentist’s office, the first things I notice are gonna be, um, acid reflux, and that nausea causes cavities. So that's the first thing we notice, especially on the back molars. As the pregnancy continues too, we also see bleeding gums. There are so many bleeding gums because progesterone is a hormone that tells you you're pregnant. But in the mouth, it makes specific bacteria overgrow.

Women will notice sometimes a gag reflex. They can't eat certain kinds of foods. They can't brush their teeth really well. The toothbrush is hard to get back there. Now, the biggest thing I get really concerned about is the bleeding gums — because the bleeding gums, we never know what type of bacteria are on there. What happens is that there's specific bacteria that overgrow. And I always say, let's just test the kind of bacteria that you have so we can know with confidence that there's not gonna be any problems during pregnancy and you're gonna have a healthy baby.

So those are some things that I would recommend for my pregnant women. Most importantly, make sure you're checking those bleeding gums. Those bleeding gums are really, really, really important. And then secondly, making sure you're taking your prenatal vitamins — especially vitamin D3 and K2. Because if you're not taking those vitamins, what'll happen is the pregnancy will be done and you will end up with like eight cavities, and you don't know how that happened.

You might not get bleeding gums, you might not have any gagging, or you might not have any acid reflux — but all of a sudden, pregnancy’s done and you have all these cavities — it's because you're vitamin deficient. So really making sure that you're really taking those D3 and K2.

Pathak: So let's build on what you just said and talk about some other dental issues that come up throughout our lifespan.

What should we expect as we age, and what are some of those indicators, again, of those red flags that a listener can look out for? And what do you see in your own patients?

Patel: So now what I see in my office — certain things happen to certain patients at certain points in their lives, and it's because there's physiological changes that are happening. So usually by the 40 mark is really when I start seeing a lot of these concerns — and men and women both.

The first thing I start noticing is really a lot of gum disease, because most people start mouth breathing during that time, creating a dry environment. The reason why that occurs is because just like we get wrinkles on our face, the tongue starts getting wrinkles. When the tongue starts getting wrinkles, we start snoring. That's creating the dry environment that makes the bacteria overgrow.

So I will find gum disease. By 45 or 50, I really start seeing sinus issues. I really start seeing different issues with sleep that really magnify now.

Your body does two things as we get older. One is it decreases the amount of vitamin D it converts. So getting out in the sun is really important. But what naturally just happens as we get older is our body just stops converting vitamin D3. So when D3 is really low, we find there's more cavities. We also find that sleep is a huge problem. And D3 is really important because it's your precursor to your testosterone, your estrogen — which is all welcome to menopause. Those are all changing. So 40s, 50s — that's what I see.

By 60, I see a lot of patients with dry mouth. The reason for that is our saliva naturally stops producing as much saliva as it did before. So it's time to start adding a substitute saliva into our regimen.

By 65, pretty much everyone's getting sleep apnea or upper airway resistance. Remember that tongue muscle that I talked about that starts at the 40s? Now it keeps unraveling, unraveling, unraveling. And then 20 years later, we're seeing that to be sleep apnea. And then once sleep apnea comes into play, we're seeing hypertension, diabetes, and all of those diseases that happen — 60s, 70s, 80s.

Pathak: And that leads me to the topic of myths and misinformation, which we always like to address on this podcast. There's so much misinformation out there about healthcare in general, and a lot I'm sure that you see when it comes to dental health.

So we're just gonna go rapid fire through some of the most common myths and misconceptions, and you can set us straight. So the first myth is that inflammation in the gums is isolated to the mouth and doesn't really affect the rest of the body.

Patel: So that is a false statement. When there is bleeding in the gums, that means that the problem has become systemic at this point. And that's why I encourage you, if you have any bleeding in the gums, come on in right away.

Your blood vessels are interconnected. The mouth is related to the rest of the body. And so science has already proven that our veins, our blood vessels, our nerves — are all connected. Now, when there is bleeding in the gums, it actually means that the bacteria has invaded the blood vessels. It's not just in the root, it's not just in the tooth. It now becomes a systemic problem — that bacteria has now gone into the bloodstream.

Pathak: Myth number two: If your teeth don't hurt, your oral health must be fine.

Patel: Wow, that is actually the opposite. A lot of times, you can have zero pain and there could be lots of stuff happening in the mouth. One could be gum disease. A second could be a rotted tooth — because it's dead, you are not gonna feel anything. So I would say that is absolutely false. If you don't feel anything, it does not mean you are safe.

The only way we know we're safe — just like our blood work tells us we're doing okay — we need to go seek a professional opinion and have it looked at in the mouth. We need digital imaging to see the x-rays. We need to look at the gum depths and see how your gums are looking. And we could take it a whole different step higher by doing an oral microbiome test and really deep diving and seeing what bacteria are present in the gums.

Pathak: Okay, final myth: Bleeding gums when brushing or flossing is actually normal and not a concern.

Patel: Absolutely not. If you have any bleeding gums, let's get you in. We have to figure out why you're bleeding.

Now, it could be you're brushing too hard and we need you to stop so you don't cause more damage. Or it could be that you have some of these really bad bacteria that cause systemic infections. Or it could be hormonal changes, as many women do. It could be men and women going through these changes.

If you have bleeding gums, come on in — let's check it out.

Pathak: Another topic we often talk about on this podcast is health disparities, and I'd like for you to talk about what that looks like in relation to dental care, whether it's financial impact, barriers to care, or even perception of need. Is there anything you'd like to say to listeners who are struggling with issues around cost or access to care?

Patel: Sure. You know, we're in a society where health is a privilege. We like to think that it's something that, uh, we all have. Health is... it's expensive.
And in dentistry, on top of that—because if we're looking at prevention, if we're looking at the things that I'm talking about—insurance companies don't want to pay for it because they're not prevention-focused. You're not gonna die, so it's not like they want to help prevent that.

Now, my goal with it is—I know this for dental offices 'cause I am a part of a network of dentists—we always look at how we can help our patients. There are financing options. Let's figure out a way, customize the plan so that it's affordable for you, and really make sure that—what can you do at home that can actually lift you up?

If there's therapy that's needed, that's tens of thousands of dollars. It doesn't mean you're not doing anything. It could mean we're just taking you to the first step, which is gonna be awareness, which is learning how to brush and floss and do certain things. And then maybe the year after we do like a deep cleaning, you know what I mean? And then maybe the year after we start looking at your airway and we're gonna start incrementally helping you to become better.

And I understand that cost is a concern—as it should be—but, you know, it doesn't mean you have to go all in.
You can start with one thing that's actually gonna improve your life by 1%. And if you change your trajectory by 1%, where you're gonna be in 2, 3, 4, 5 years is completely different.

For example, my smokers—if you are smoking and you cut down from a pack a day to maybe one cigarette a day—that's huge. The amount, the impact that you have made on yourself? Enormous. You have changed the trajectory of your life. You have reduced your cancer risk by so much.

And that's what I say with healthcare and with dentistry: start with one bite. Start with one thing. Complete that. Then go to the next step. Learn about brushing, flossing, how you can do things at home. Vitamins, nutrition—there's so many aspects and so many layers to your dental health and your overall health. So start with one thing and then build upon it.

Pathak: Thank you so much for joining us for this discussion about how caring for our teeth and gums can have an impact far beyond our oral health.

We learned that our mouth hosts a bustling microbiome—one you swallow up to five gallons of every single day—making it a key to everything from digestive health to preventing chronic inflammation.

The message? Oral care is about more than just brushing and flossing. It's about viewing the entire mouth, thinking about our airway, and the rest of our body as one connected system.

Your mouth is more than just your smile. It's a mirror for your overall health. Taking care of it means taking care of you.

To find out more information about Dr. Patel, make sure to check out our show notes.

Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at [email protected].

This is Dr. Neha Pathak for the WebMD Health Discovered podcast.