# Why You Need to Pay Closer Attention to Your Teeth & Oral Health | Prof. Sue-Ching Yeoh

An episode of [Project 100 with Mark Bouris](https://invisiblenetwork.ai/podcast/1767053714), 18 Jan 2026, 1 h 33 min.

Audio: https://p.podderapp.com/2544644999/traffic.omny.fm/d/clips/2fb3740d-3436-44af-8cc0-a91900716aa5/05ac4e52-79fb-46b8-849c-b305000bd6d0/10decb37-1755-4b0e-84d7-b3d400798dd5/audio.mp3?utm_source=Podcast&in_playlist=ef13e652-7a19-41fd-9d0f-b305000bd6dc

In this episode, Mark sits down with Sue-Ching Yeoh, an AHPRA-registered Oral Medicine Specialist with clinical appointments at Royal Prince Alfred Hospital and Chris O’Brien Lifehouse, and an academic role at the University of Sydney. This conversation goes far beyond dentistry. A/Prof Yeoh explains how the mouth acts as an early warning system for systemic disease, including autoimmune conditions, cancer, HPV, and chronic inflammation. She breaks down what gum disease actually is, why bad breath is often a medical issue rather than a hygiene one, and how lifestyle, genetics, vaping, smoking, and even social media trends are quietly damaging oral health They also cover practical, no-nonsense advice most people never hear: • How to properly self-check your mouth • The truth about tongue cleaning, salt water rinses, whitening, and sensitivity • What tooth wear says about stress, nerve health, and aging • When cosmetic treatments help and when they mask deeper problems • Why early detection in oral health can be life-saving Eight Sleep’s newest generation, Pod 5. isn’t just another bed-frame add-on; it’s a high-tech mattress cover that actively adjusts to your body temperature throughout the night, cooling, warming, and even elevating your body when needed, all based on real-time data. The new Pod 5 introduces for the first time, a hydro-powered blanket system, utilising the same technology as the cover to extend temperature regulation across your entire body, not just the mattress surface. Clinically proven to increase quality sleep by up to one hour each night, it’s basically like having an AI-powered sleep coach, personal thermostat, and advanced health tracker working for you while you rest. Head on over to eightsleep.com/project100 and use the code PROJECT100 (that’s Project one-zero-zero) and get up to $550 off your very own Pod 5. Trust me, your body will thank you for this investment in better sleep. The all-new WHOOP is here — now 7% smaller with 14+ days of battery life. New features like Healthspan show how your daily habits are affecting your rate of aging — and now you can check your blood pressure straight from your wrist. If you’re serious about performance, longevity, and actual progress — this is it. Sign up for a one-month free trial at WHOOP.com — or visit join.whoop.com/mentored for one month off your annual membership fee. See omnystudio.com/listener for privacy information.

## Transcript

[0:00] Speaker 1: Professor sou jing Yo. How are you?
[0:02] Speaker 2: I'm really well, thank you? How about you?
[0:04] Speaker 1: I'm pretty good. You're a oral medicine specialist. I presume
[0:09] Speaker 1: that means you're a doctor of oral medicine, but you specialize.
[0:13] Speaker 1: You're a doctor and you specialize in oral medicine. Is
[0:15] Speaker 1: that how but that be the way to put it?
[0:16] Speaker 2: Yeah, so oural medicine is a funny thing. So it's
[0:19] Speaker 2: actually it's a dental specialty. So my primary degree, I guess,
[0:23] Speaker 2: is a dental degree, and then you go on to specialize.
[0:28] Speaker 2: You do it a couple of years of further training
[0:30] Speaker 2: particular to oral medicine. So lots of people actually don't
[0:33] Speaker 2: know what oral medicine is. Lots of dentists actually don't
[0:35] Speaker 2: know what oral medicine. Oh really, but yeah, yeah, it's
[0:37] Speaker 2: one of the lesser known dental specialties.
[0:40] Speaker 1: And maybe you could just give us a bit of
[0:42] Speaker 1: a run down. Then, So how do you become a
[0:45] Speaker 1: oral medicine specialist? I mean, so you start doing a
[0:49] Speaker 1: degree in medicine or degree stop the bit. You start
[0:53] Speaker 1: by doing a degree in dentistry. It has it worked?
[0:55] Speaker 1: What's the process and what are the specialties? Has it
[0:57] Speaker 1: all work.
[0:58] Speaker 2: Yeah. So basically you do your your basic dental degree
[1:01] Speaker 2: and you finish that, you come out as a qualified
[1:04] Speaker 2: general dentist. You'll usually work wherever, so in private practice
[1:08] Speaker 2: or wherever it is for a couple of years, and
[1:11] Speaker 2: then if you choose to specialize, you actually go back
[1:13] Speaker 2: into training, so you do a further three year degree
[1:16] Speaker 2: in your chosen specialty. So I chose oral medicine, and
[1:19] Speaker 2: so you complete that degree. Generally speaking, you would hang
[1:23] Speaker 2: around the hospital system with the university for a couple
[1:25] Speaker 2: of years and you find your feet after that and
[1:28] Speaker 2: then go wherever wherever it takes you.
[1:32] Speaker 1: And you ended up sitting up a clinic.
[1:34] Speaker 2: So you have a clinic, Yes, I do, so I
[1:35] Speaker 2: work part time in a private practice clinic here in Sydney.
[1:39] Speaker 2: I wear a number of different hats because you probably
[1:41] Speaker 2: know so there's.
[1:42] Speaker 1: Jami through them. So you run a clinic, Do you
[1:44] Speaker 1: run a clinic? Yep, in the city in Sydney.
[1:47] Speaker 2: It's in Sydney. And then I also work at the
[1:51] Speaker 2: University of Sydney, so I'm the program convenor for the
[1:54] Speaker 2: Romison training program. At the moment, I work at the
[1:57] Speaker 2: Chris O'Brien Lifehouse, which is the cancer hospital here in
[2:00] Speaker 2: Sydney and Rayal Prince Alfred Hospital as well.
[2:03] Speaker 1: So and where does cancer fit into oral medicine?
[2:07] Speaker 2: Yes, so cancer is actually quite a large part of
[2:09] Speaker 2: oral medicine. Oral medicine specialists deal with abnormalities of the
[2:13] Speaker 2: lining of the mouth, so obviously oral cancer falls into
[2:16] Speaker 2: that category. I guess. So we do see a lot
[2:19] Speaker 2: of people who have, you know, potential cancer or things
[2:23] Speaker 2: that could potentially become cancer, as well as cancer themselves,
[2:26] Speaker 2: and we're part of that sort of diagnostic step. I guess.
[2:30] Speaker 2: So you see something you think it may or may
[2:33] Speaker 2: not be something sinister, and we're responsible for the biopsy
[2:37] Speaker 2: and then obviously you know, facilitating treatment after that.
[2:41] Speaker 1: So would a dentist or a GP send someone to you, Yeah.
[2:45] Speaker 2: So very commonly patients are referred. Many patients will actually
[2:49] Speaker 2: go to their GP or even their general dentist initially
[2:53] Speaker 2: and get that initial assessment and then are usually referred
[2:56] Speaker 2: on to an oral medicine specialist after that.
[2:58] Speaker 1: And when we talk about industry, I think about teeth,
[3:02] Speaker 1: but oral medicine what we're talking about them and what
[3:05] Speaker 1: area does it cover? Does it cover your neck or
[3:07] Speaker 1: your tongue or what is it covering, because because it's
[3:10] Speaker 1: a bit confusing.
[3:11] Speaker 2: It is it is. It's mainly the inside of the mouth.
[3:14] Speaker 2: So we deal with the lining of the mouth or
[3:16] Speaker 2: the soft bits inside the mouth, as opposed to the
[3:19] Speaker 2: teeth themselves. So any abnormality on that area, we deal
[3:24] Speaker 2: with salivary gland issues. We deal with pain the in
[3:29] Speaker 2: the mouth or in the head and neck region that's
[3:31] Speaker 2: not related to teeth.
[3:33] Speaker 1: What do you mean a head and neck that's not
[3:35] Speaker 1: related to teeth.
[3:37] Speaker 2: So you can get pain on the lining of the
[3:39] Speaker 2: mouth that's not related to infection, not related to teeth.
[3:42] Speaker 2: You can get you can get pain in the muscles
[3:45] Speaker 2: of the face. You can get pain in the jaw,
[3:47] Speaker 2: joined or temperament dibblar disorders. So that all falls within
[3:51] Speaker 2: the scope of oral medicine as well.
[3:53] Speaker 1: But what about they think in the back of your
[3:55] Speaker 1: mouth or the thing they call the epiglottos that the
[3:57] Speaker 1: thing that hangs.
[3:58] Speaker 2: Down a dangles dangling things so that you light at
[4:00] Speaker 2: the back.
[4:00] Speaker 1: So that's what it called you, Yeah, that's I thought,
[4:03] Speaker 1: what's what the biglotts?
[4:04] Speaker 2: That's where'd I get that? It is? But the the
[4:08] Speaker 2: so from sort of you know, back where the tunsils are,
[4:11] Speaker 2: and there obviously it's really quite difficult for us to
[4:14] Speaker 2: see because it goes round a bend, and generally that's
[4:17] Speaker 2: the territory of you know, where we start to talk
[4:19] Speaker 2: about E and T so eve knows and throat specialists
[4:23] Speaker 2: because they've got the equipment to actually see back there
[4:25] Speaker 2: and do whatever they need to do.
[4:27] Speaker 1: So our shows about you know, longevity and health span
[4:32] Speaker 1: in other words, potentially identifying things that could kill us
[4:36] Speaker 1: early unfortunately, and or if we managed to get around
[4:42] Speaker 1: that part and live a good long life, how do
[4:46] Speaker 1: we live a good long life in other words, healthily
[4:49] Speaker 1: in other words, not always sick and and oral health
[4:55] Speaker 1: care comes into this area. I'm actually really particularly interested
[4:58] Speaker 1: in only for a reason. Why is that my mum,
[5:02] Speaker 1: my mom, when I was a kid, my mum for
[5:04] Speaker 1: some reason genetically inherited terrible teeth in her words, and
[5:09] Speaker 1: she was always back and forth to the dentist getting
[5:13] Speaker 1: herself you know, sorted out, and largely as a result
[5:18] Speaker 1: of you know, socioeconomic reasons is probably the rural reason
[5:21] Speaker 1: why that happened. And my mum was fanatical about teeth
[5:25] Speaker 1: and mouth and gums, and that type of stuff. And
[5:28] Speaker 1: I'm going back a long time when I was a
[5:30] Speaker 1: little kid, which was pretty unusual for people then, and
[5:33] Speaker 1: she was always big on making sure that we did
[5:37] Speaker 1: silly things. It seems sly to me when I think
[5:40] Speaker 1: about it, But after you clean your teeth, if you
[5:44] Speaker 1: don't get a bit for an hour or two after
[5:46] Speaker 1: rinch mouth that with salt water, warm salt water, just
[5:48] Speaker 1: gargle same in the morning, Mum was there weren't listenerines
[5:53] Speaker 1: and things like that in those days. But we'll ask
[5:56] Speaker 1: I'm going to ask about those those sorts of things anyway.
[5:58] Speaker 1: But Mum was always big on oral health, not because
[6:02] Speaker 1: of longevity, but aesthetics, and there's something that she never
[6:07] Speaker 1: got unfortunately. You know. I'm I think my teeth are
[6:12] Speaker 1: pretty good anyway. I'm not sure about the rest of it.
[6:14] Speaker 1: But I've become quite fascinated by it because I also
[6:17] Speaker 1: understand there's connections between the healthier mouth and other parts
[6:20] Speaker 1: of your body, your brain, your heart potentially, and it
[6:24] Speaker 1: can become an indicative of other areas. And I was
[6:27] Speaker 1: wondering if you could just maybe elaborate on that and
[6:30] Speaker 1: then maybe we can unpick a few of those.
[6:32] Speaker 2: Yeah, sure, So the mouth is very interesting. Obviously, the
[6:35] Speaker 2: mouth is you know, I think of it as a
[6:38] Speaker 2: little bit of a window into the body. It's obviously
[6:41] Speaker 2: the beginning of the gastro intestinal track, which runs right
[6:44] Speaker 2: through your body, and very commonly you can see signs
[6:47] Speaker 2: of you know, of things that might be occurring elsewhere
[6:51] Speaker 2: in the body is starting in the mouth, and you
[6:52] Speaker 2: can actually pick it up quite early. You make comments about,
[6:56] Speaker 2: you know, links between mouth disease and other systemic conditions.
[7:02] Speaker 2: So we don't know now that there is a very
[7:05] Speaker 2: well established association between paradontal disease or gum disease and
[7:10] Speaker 2: cardiovaspilal health. We know that there is an association between
[7:14] Speaker 2: peridontal disease and diabetes as well, and there's emerging evidence
[7:19] Speaker 2: to show a potential link between paradontal disease and Alzheimer's disease.
[7:25] Speaker 2: So there's certainly a lot of interplay between body systems.
[7:29] Speaker 2: The mouth is also sometimes the first you know things
[7:33] Speaker 2: are going wrong in the mouth. Sometimes it's the first
[7:35] Speaker 2: sign of other systemic conditions. Immune conditions, for instance, can
[7:41] Speaker 2: manifest in the mouth first before you see them in
[7:44] Speaker 2: other places of the body. So it is a very
[7:48] Speaker 2: very interesting place. It's a very small, dark whole, quite
[7:52] Speaker 2: difficult to see and to access, but it does give
[7:56] Speaker 2: us a lot of information about what else might be
[7:58] Speaker 2: going on in your body.
[8:00] Speaker 1: Maybe we just you just said I think I don't
[8:04] Speaker 1: know if you used the word, but it was more
[8:06] Speaker 1: correlation as opposed to necessarily causation. And you use the
[8:11] Speaker 1: word periodontal disease, And for me and probably are many others,
[8:16] Speaker 1: we don't know actually what periodontal disease means. Maybe you
[8:20] Speaker 1: could just unpack that a little bit. And how do
[8:23] Speaker 1: I know if I've got periodontal disease? And or if
[8:26] Speaker 1: I can't do it myself, how do I find out?
[8:29] Speaker 2: So I guess we generally talk about periodontal disease, and
[8:35] Speaker 2: I guess the lay term for that would be gum disease.
[8:37] Speaker 2: Gum disease, right, So inflammation. People are very aware of
[8:41] Speaker 2: the term called ginger vitis. So that's inflammation of the gum.
[8:44] Speaker 2: And there's different severities obviously, so very mild ginger vitis
[8:47] Speaker 2: compared to very severe gingervitis. And it can affect the
[8:50] Speaker 2: adjacent structures that actually hold the teeth in place, so
[8:54] Speaker 2: the gums and the bone underneath, so you can develop
[8:56] Speaker 2: things like loosening or mobility of the teeth, and they
[8:59] Speaker 2: can get quite bobbly, even to the point where they
[9:02] Speaker 2: can actually fall out on their own. And we're talking
[9:03] Speaker 2: about adult teeth which shouldn't really be falling out on
[9:06] Speaker 2: their own. And you can get infections obviously in the gum, inflammation,
[9:12] Speaker 2: bad breath, things like that. So I guess one of
[9:15] Speaker 2: the questions that you asked me was how how would
[9:17] Speaker 2: you know if you have.
[9:17] Speaker 1: Gum DISEASEAG every morning, clumage every night. I'm using whatever,
[9:22] Speaker 1: you know, whatever brain of toothpaste I use, and you
[9:25] Speaker 1: go to the dentist once every six months or once
[9:27] Speaker 1: every year, perhaps, Yeah, but how do I know if
[9:30] Speaker 1: I'm I've got it?
[9:31] Speaker 2: So your dentist would probably be the person to tell you, right,
[9:34] Speaker 2: And that's it's something that's quite readily assessed at the
[9:38] Speaker 2: at the dentist. So when they're cleaning their teeth, they
[9:40] Speaker 2: can look for signs of inflammation. They will have an
[9:44] Speaker 2: idea of the health of your gum tissue, and that's
[9:48] Speaker 2: usually related to how how you clean your teeth, how
[9:52] Speaker 2: frequently you clean the teeth. There are some genetic factors
[9:55] Speaker 2: obviously at play, and there are also some some factors
[9:58] Speaker 2: that predispose people to gum disease is in terms of
[10:01] Speaker 2: like immune immune factors, hormonal factors and what have you
[10:04] Speaker 2: as well. But your dentists would probably be the first
[10:07] Speaker 2: person to flag that with you.
[10:09] Speaker 1: So let's say, I don't know, I really don't know.
[10:12] Speaker 1: You may well may well be some studies on this
[10:15] Speaker 1: sort of stuff, but I don't know how what the
[10:18] Speaker 1: normal regularity of people checking with the dentists is. I
[10:20] Speaker 1: might be a little bit paranoid, So maybe I was
[10:22] Speaker 1: going a bit more often than most may because the
[10:26] Speaker 1: reason I told you right at the very beginning, because
[10:27] Speaker 1: I keep hearing my late mother talking to me about it.
[10:30] Speaker 1: You know, if you've been to the dentists, you've been
[10:31] Speaker 1: a dentist. But let's say, is there a do you
[10:35] Speaker 1: have a sense of what the normal cadence of an
[10:38] Speaker 1: average person's dental visitation is?
[10:41] Speaker 2: So I think there are multiple factors that sort of
[10:44] Speaker 2: play into that. Generally speaking, we'd say anywhere between six
[10:47] Speaker 2: to twelve months. Every six to twelve months, you should
[10:49] Speaker 2: be checking in with your dent.
[10:50] Speaker 1: That's what you should do.
[10:51] Speaker 2: What you should do. I think in reality most of
[10:54] Speaker 2: us would be going once a year, right, But you know,
[10:57] Speaker 2: I think increasingly we have We're more aware of our
[11:01] Speaker 2: oral health these days, and so people are starting to
[11:03] Speaker 2: go more frequently, which is fantastic. A lot of people
[11:07] Speaker 2: will check in with a dental hygienist somewhere, you know,
[11:09] Speaker 2: in that time point as well, so you might, for instance,
[11:12] Speaker 2: see your hygienis for a clean at the six month mark,
[11:14] Speaker 2: and then see your dentist for you know, a complete
[11:17] Speaker 2: checkup at the twelve month mark. I think that's probably
[11:21] Speaker 2: the norm here in Australia.
[11:22] Speaker 1: More than and our Australian's teeth generally speaking. You may
[11:26] Speaker 1: not know this more statistical thing, but are we known
[11:30] Speaker 1: as having quite healthy teeth as a nation?
[11:33] Speaker 2: I think we're doing quite well for a few reasons. Firstly,
[11:36] Speaker 2: I think dental awareness is reasonably high in Australia compared
[11:40] Speaker 2: to some other countries in the world. That's obviously related
[11:43] Speaker 2: to you know, the economics of the country I think,
[11:47] Speaker 2: and also the healthcare system and you know, what is
[11:50] Speaker 2: available to us here in Australia. The other big factor
[11:54] Speaker 2: I think is also that our water is mainly fluoridated
[11:58] Speaker 2: and that is protect did we know of teeth, So
[12:01] Speaker 2: particularly the young ones that are coming through now, it's
[12:04] Speaker 2: very common for them not to have any dental disease.
[12:07] Speaker 2: You know, back in the day, it would be quite
[12:08] Speaker 2: common for people to have lots of missing teeth or
[12:10] Speaker 2: fillings or broken teeth and what have you. And that's
[12:12] Speaker 2: probably a reflection of firstly the education around dental health,
[12:17] Speaker 2: but also about access to fluoridated water. And as we've come,
[12:21] Speaker 2: you know, as we've developed as a nation, I think
[12:23] Speaker 2: we're much more aware of those things now.
[12:25] Speaker 1: I'm old enough to remember when the water I'm old
[12:28] Speaker 1: enough to remember when they announced here in New South
[12:31] Speaker 1: Wales at least that the water was going to become fluoridated.
[12:34] Speaker 1: There wasn't when I was a kid, and you know what,
[12:36] Speaker 1: My mother used to make me take a very small
[12:40] Speaker 1: fluorid tablet once a week, Yes, before fluoridation.
[12:44] Speaker 2: Yeah, So that was common practice back in the day,
[12:46] Speaker 2: was it. Yeah, And there's probably still parts of the
[12:50] Speaker 2: country that don't have access to fluoridated water and those
[12:53] Speaker 2: people are probably supplementing as well a little bit, and
[12:56] Speaker 2: certainly in other countries that is reasonably common.
[13:00] Speaker 1: And so so now we've sort of covered the broader
[13:04] Speaker 1: sort of area, and as you said, the mouths of
[13:09] Speaker 1: funny thing. It's like we think we just clean our teeth,
[13:12] Speaker 1: it's all done, it's all sortied. But then we go
[13:15] Speaker 1: and drink coffee or we might have some other version
[13:18] Speaker 1: of warm beverage. We eat chocolate, we eat chips, we
[13:23] Speaker 1: eat fried foods, we drink alcohol, we may vape or smoke.
[13:30] Speaker 1: Then they hit it up without one hundred other things,
[13:33] Speaker 1: and then we also expose it to toxins I guess
[13:37] Speaker 1: to in terms of breathing in through our mouth, et cetera.
[13:43] Speaker 1: How do I know whether or not I mean, sort
[13:47] Speaker 1: of keeping my mouth closed all the time and only
[13:49] Speaker 1: eating certain things. How do I know if I'm exposing
[13:53] Speaker 1: myself as something that's sort of dangerous? I mean, what
[13:56] Speaker 1: would you say to me and or to a person
[13:59] Speaker 1: who's got a young kid, for example.
[14:01] Speaker 2: So I mean it's I think that's a really valid question,
[14:03] Speaker 2: and a lot of it is very much emerging research.
[14:08] Speaker 1: I'm talking as far as a mouth's concerned, by the way,
[14:10] Speaker 1: not I don't mean in terms of I shouldn't affect
[14:13] Speaker 1: my lungs or whatever it is.
[14:15] Speaker 2: So I think when we talk about mouth and you know,
[14:18] Speaker 2: possible sinister, you know, conditions that can affect a mouth.
[14:22] Speaker 2: At the end of the day, we're thinking mainly about
[14:25] Speaker 2: cancer and that sort of thing we know for oral cancer,
[14:29] Speaker 2: so that cancer affecting the lining of the mouth. There
[14:31] Speaker 2: are certain risk factors which are very much established. So
[14:34] Speaker 2: traditionally they're things like smoking, like tobacco, whether that's smoke, tobacco,
[14:41] Speaker 2: chewed tobacco, tobacco pouches, all that kind of stuff. We
[14:45] Speaker 2: know that alcohol exposure, and particularly alcohol and tobacco together,
[14:52] Speaker 2: they have a synergistic effect in terms of increasing risk
[14:56] Speaker 2: for developing mouth cancer. We know that in certain popular
[15:00] Speaker 2: res in Australia and internationally, people chew a reconnut or
[15:04] Speaker 2: beatle nut products and we know that that's very much
[15:07] Speaker 2: a risk factor for developing mouth cancer.
[15:08] Speaker 1: Could actually just stop there for one second, please, Is
[15:12] Speaker 1: that because those things you're chewing and or vaping or ingesting.
[15:20] Speaker 1: Is that because it changes the let's call it the
[15:24] Speaker 1: microbiomes or whatever is it that exists in your mouth,
[15:27] Speaker 1: you know, the bacteria and fungus or whatever, the good
[15:29] Speaker 1: stuff that exists. Is that because you're creating change?
[15:32] Speaker 2: Yeah, So it's probably two folds. So the first is, yes,
[15:35] Speaker 2: you are creating change, so the balance of all the
[15:38] Speaker 2: bugs that naturally occur in the mouth is probably off.
[15:42] Speaker 2: Sometimes you develop dryness of the mouth as a knock
[15:45] Speaker 2: on effect from some of the chemicals that are in
[15:47] Speaker 2: these products, and that also then contributes to the change
[15:51] Speaker 2: in the microbiome. So you get less of the protective
[15:55] Speaker 2: you know, bugs that are supposed to be there, and
[15:57] Speaker 2: you get an overgrowth of some other bugs which are
[16:00] Speaker 2: probably not so great for you know, the health of
[16:03] Speaker 2: the lining of the mouth. We also know that some
[16:06] Speaker 2: of the chemicals that are in those products are actually
[16:08] Speaker 2: carcinogenic in themselves, so they have the potential to cause
[16:14] Speaker 2: genes to mutate in the cells of the mouth, and
[16:18] Speaker 2: you only need a couple of small mutations and it's
[16:20] Speaker 2: a knock on effect, and that could potentially be the
[16:23] Speaker 2: beginning of a cancer forming there.
[16:25] Speaker 1: So, and then if I let's say that I'm okay,
[16:29] Speaker 1: but I've but I am concerned about things like diabetes
[16:34] Speaker 1: any top for metabolic disease, but as a result of diabetes,
[16:38] Speaker 1: heart disease, and or you know, Alzheimer's just move Alzhemer's
[16:44] Speaker 1: a little bit to the crosses across the park that
[16:46] Speaker 1: a little bit. Let's just look at look at diabetes first,
[16:50] Speaker 1: and any other immune type compromised compromising top disease. How
[16:56] Speaker 1: is that associated with the mouth?
[16:57] Speaker 2: Like?
[16:58] Speaker 1: Is it associated with with what I put in my mouth?
[17:00] Speaker 1: Or is associated with as a result of putting something
[17:02] Speaker 1: into my mouth has created some sort of change in
[17:04] Speaker 1: my mouth, which is therefore had an effect on whatever?
[17:09] Speaker 1: How what am we talking about here? What A'm I
[17:11] Speaker 1: worried about?
[17:12] Speaker 2: So I don't know that I'm the best person to
[17:14] Speaker 2: answer that question, but from my understanding, there's very much
[17:18] Speaker 2: a link or bidirectional relationship between pedadontal disease or gum
[17:23] Speaker 2: disease that we talked about previously, and say, for instance, diabetes,
[17:27] Speaker 2: we do know that the bacteria that are implement implicated
[17:33] Speaker 2: sorry in paradontal disease, So there's a bacterial page in javalis.
[17:37] Speaker 2: We know that that does have an effect on metabolism
[17:42] Speaker 2: of sugars and you know that whole diabetes scene. Yep. Similarly,
[17:48] Speaker 2: for say coronaryadi disease, we do know that that particular
[17:52] Speaker 2: bacteria and some of its toxins have been found in
[17:56] Speaker 2: athrosclorotic plaques for instance.
[17:59] Speaker 1: Actually, in other words, the plaques, the lipits that are
[18:03] Speaker 1: inside your heart, correct in your archies. Shouldn't that right?
[18:06] Speaker 1: That's right.
[18:07] Speaker 2: So there is that relationship there in terms of the
[18:10] Speaker 2: actual mechanics of it. Probably not the right person.
[18:13] Speaker 1: But but it is. It is that it is not
[18:16] Speaker 1: any correlated. It is sort of in existence that's detected.
[18:19] Speaker 2: Yes, it is. So this is established.
[18:21] Speaker 1: Research and the brain also appreciates also.
[18:23] Speaker 2: So there are studies that show that in autopsy specimens
[18:27] Speaker 2: of patients who have Alzheimer's or who had Alzheimer's disease,
[18:32] Speaker 2: that particular bacteria has been detected.
[18:34] Speaker 1: In the plaque in their brain.
[18:35] Speaker 2: In the brain.
[18:36] Speaker 1: Yeah. Wow. And so if i'm if I just now
[18:40] Speaker 1: wander back to period period peri periodontal disease, and let's
[18:48] Speaker 1: talk about is it ginger vitus or gingaviders gingervirus ginger vitis,
[18:53] Speaker 1: which is like, I mean, everyone's sort of heard of it,
[18:56] Speaker 1: but you think it's sort of complacement. We've heard of it,
[18:59] Speaker 1: but we don't have a clue what it is. I
[19:00] Speaker 1: haven't got the faintest idea what you're talking about, and
[19:04] Speaker 1: I may not. You did mention. I could go to
[19:06] Speaker 1: a dentis and Denis might be able to look at
[19:07] Speaker 1: it and tell me that I've got it. But let's say,
[19:09] Speaker 1: you know, I'm not going I've just been the DNIS
[19:11] Speaker 1: when a month ago and I just started to get
[19:13] Speaker 1: ginger vitis. If I'm not going to Dennis maybe for
[19:15] Speaker 1: another eight months, is there something I should be doing
[19:19] Speaker 1: or shouldn't be doing.
[19:21] Speaker 2: Yeah, So gingervirtis is basically inflammation of the gum, and
[19:25] Speaker 2: so you may be able to detect yourself. When you're
[19:27] Speaker 2: brushing your teeth. You might find that when you brush
[19:29] Speaker 2: along that gum line there's a bit of bleeding, or
[19:31] Speaker 2: when you split the toothpaste out, you can see that
[19:33] Speaker 2: it's tanged with blood. You might notice that your gums
[19:37] Speaker 2: look a bit swollen, or they look a little bit red,
[19:39] Speaker 2: they might be a little bit tender, And those are
[19:41] Speaker 2: some of the signs that you know, patients might be
[19:43] Speaker 2: able to detect in themselves that they.
[19:46] Speaker 1: May have, you know, just get from brushing too hardly.
[19:49] Speaker 2: Yeah, so, I mean that's true. You can easily traumatize
[19:52] Speaker 2: your gums. But if you're brushing, if you're brushing your
[19:57] Speaker 2: teeth and there's bleeding coming from multiple spots in the mouth,
[20:00] Speaker 2: it's likely that there is some inflammation there as opposed
[20:03] Speaker 2: to you really scrubbing and traumatizing your mouth to the
[20:07] Speaker 2: point of bleeding. So it's more likely that you have
[20:10] Speaker 2: some inflammation some ginger viders.
[20:12] Speaker 1: Yeah, so just let's talk about it from them and
[20:16] Speaker 1: I I'll position this carefully. But some of the mouthwashes
[20:23] Speaker 1: that get promoted by through the media say that they
[20:27] Speaker 1: will protect you from these things, but they also contain alcohol,
[20:31] Speaker 1: and there is a you know, there's a coul water.
[20:34] Speaker 1: People think that you shouldn't be putting these alcohol alcohol
[20:38] Speaker 1: based mouthwashes into your mouth, maybe because it changes the
[20:42] Speaker 1: floor of your mouth. Perhaps maybe I don't know what
[20:44] Speaker 1: the reason is. And or certainly with me, when I
[20:48] Speaker 1: use it, I feel dry after it. That's what happens
[20:52] Speaker 1: if I drank a whiskey, I don't feel dry too.
[20:57] Speaker 1: What should people be doing if they do have Jervis
[21:00] Speaker 1: aparering ovis the dentist, I mean, what should they be doing?
[21:03] Speaker 2: So there's lots of and and you're right, there's a
[21:05] Speaker 2: lot of research and a lot of media attention in
[21:08] Speaker 2: the last sort of ten years about this whole alcohol
[21:11] Speaker 2: containing mouthwashes. Some of the most you know, some of
[21:14] Speaker 2: the commercial brands that advertise quite heavily have alcohol percentage
[21:18] Speaker 2: in there. I think one of the things that has
[21:21] Speaker 2: come out of that whole hooha, I guess is the
[21:24] Speaker 2: fact that we now have a lot of alcohol free
[21:27] Speaker 2: mouthwashes that are equally good. They've got the active So
[21:30] Speaker 2: the active ingredient actually isn't the alcohol, right, alcohol, Yeah,
[21:34] Speaker 2: it's a preserve and you know so, and it gives
[21:38] Speaker 2: you that you know that that burst, you know, it
[21:41] Speaker 2: stings like crazy and then you feel, yeah, really clean
[21:43] Speaker 2: my mouth. So there's a lot of non alcohol containing
[21:48] Speaker 2: mathis mouthwashes now that are available, you know, at the
[21:51] Speaker 2: supermarket with different active ingredients. So a lot of them
[21:58] Speaker 2: are antibacterial ingredients. So there's ingredient called clorhexidy, which is
[22:01] Speaker 2: something that's in almost all of the commercial mouthwashes, and
[22:04] Speaker 2: that's antibacterial or antimicrobial. Generally speaking, people probably don't need
[22:11] Speaker 2: to be using a mouthwash regularly as part as.
[22:13] Speaker 1: The oral hygiene does regularly mean daily or.
[22:16] Speaker 2: Yea daily, They probably don't unless there's a specific problem
[22:19] Speaker 2: that your dentists identified and is targeting A lot of
[22:23] Speaker 2: people use mouthwash because of the feel of it, so
[22:25] Speaker 2: that it makes them feel that their mouth is fresh,
[22:28] Speaker 2: clean and fresh air. And that's probably the reason why
[22:31] Speaker 2: many Australians are actually using mouthwash on a regular basis.
[22:35] Speaker 2: But you know, I often tell my patients, unless there's
[22:38] Speaker 2: an indication to use it, you probably don't need to
[22:41] Speaker 2: be doing it.
[22:41] Speaker 1: So if you did have a little bit of bleeding
[22:44] Speaker 1: your gums, and it's not because you're cleaning your tooth
[22:46] Speaker 1: too vigorously, you might have chosen to have a soft
[22:50] Speaker 1: head toothbrush or something like that, and you are spinning
[22:54] Speaker 1: a bit of blood out when you finish cleaning your teeth,
[22:56] Speaker 1: and then you look at your gums. You know it
[22:58] Speaker 1: looks a bit red in there. You know it's a
[22:59] Speaker 1: bit tender. What would you say, as a professional to
[23:06] Speaker 1: your patient to do so?
[23:11] Speaker 2: I think the first thing is that you need to
[23:13] Speaker 2: check in with your dentist because it may be gingivitis,
[23:16] Speaker 2: but it may also possibly be a sign of something else.
[23:20] Speaker 2: I'm sorry tooth case not so much tooth decay, but
[23:23] Speaker 2: there are other conditions that affect the lining of the mouth,
[23:26] Speaker 2: including the gums that are not you know, infection related.
[23:31] Speaker 2: For instance, that there's some autoimmune conditions that can affect
[23:36] Speaker 2: the soft lining of the mouth, including the gums, and
[23:39] Speaker 2: that could be the reason why you're having bleeding or
[23:42] Speaker 2: pain or whatever it is from that area. So I
[23:44] Speaker 2: think it's important to not assume what's going on. You
[23:47] Speaker 2: need to check in with somebody who can actually look
[23:50] Speaker 2: and not what they're looking at or looking for, and
[23:53] Speaker 2: then if your general dentist is concerned, they may decide
[23:56] Speaker 2: to facilitate a referral on to somebody.
[23:58] Speaker 1: So an autoimmune disease, maybe just for the sake of
[24:01] Speaker 1: the audience, just cover off what you're talking about. There,
[24:04] Speaker 1: we all hear the word or immune, we will go yeah, yeah,
[24:07] Speaker 1: and I'm shaking my head furiously in agreement. I've got
[24:09] Speaker 1: no idea what you're talking about. When I thought about it,
[24:11] Speaker 1: What do you mean by it could be indicative of
[24:13] Speaker 1: an autoimmune disease?
[24:14] Speaker 2: Yeah, So autoimmune diseases are a funny thing. So generally,
[24:18] Speaker 2: you know, in general terms, we talk about the body's
[24:20] Speaker 2: immune system, and the immune system is designed to defend
[24:23] Speaker 2: our body, I guess against foreign things like infections and
[24:27] Speaker 2: what have you. Sometimes that immune system is a little
[24:30] Speaker 2: bit overactive, for lack of a better word, and instead
[24:34] Speaker 2: of just attacking foreign things, that starts to have a
[24:38] Speaker 2: response against your own tissue.
[24:40] Speaker 1: And that's an example of automata.
[24:42] Speaker 2: Yeah. So that's an example of an autoimmune disease. And
[24:44] Speaker 2: there are some of those that can present in the mouth,
[24:47] Speaker 2: on the lining of the mouth, as well as in
[24:49] Speaker 2: other areas of the body. So that's one of the
[24:52] Speaker 2: things that may possibly contribute to, you know, to bleeding
[24:56] Speaker 2: from the mouth.
[24:57] Speaker 1: So let's say an just so I can just unpick
[25:01] Speaker 1: this a little bit. So let's say I have an
[25:03] Speaker 1: autoimmune disease and as a result or that the autoimmune
[25:07] Speaker 1: disease for some reason is inflaming my gums and inflaming
[25:11] Speaker 1: them so much so that they bleed a bit. And
[25:14] Speaker 1: as a result of me cleaning my teeth just normally,
[25:17] Speaker 1: I spit out some you know, blood in my tooth,
[25:22] Speaker 1: rinsing my mouth, and I go to the dentists and
[25:26] Speaker 1: the dentist confirms those things. What am I supposed to do?
[25:30] Speaker 1: Then do they come see you?
[25:33] Speaker 2: Yeah, A lot of time the dentist will facilitate or referral.
[25:36] Speaker 2: So most of these conditions are diagnosed on a biopsy,
[25:39] Speaker 2: which means that you actually need a sample of the
[25:41] Speaker 2: tissue that gets sent off to the laboratory for testing
[25:44] Speaker 2: in further examination. So that process is usually facilitated by
[25:49] Speaker 2: somebody like me and or medicine specialists. So the dentist
[25:52] Speaker 2: will identify, Yep, you have an issue, let's send you
[25:54] Speaker 2: off to see so for instance, and the patient comes
[25:58] Speaker 2: in and I will usually do the biopsy in the chairs,
[26:02] Speaker 2: cut a chunk out, Yeah we do. I mean it's
[26:04] Speaker 2: not a big chunk. It's enough, it's enough for the
[26:07] Speaker 2: pathologists to have a look at. But it's not a
[26:09] Speaker 2: massive procedure.
[26:10] Speaker 1: Yeah.
[26:11] Speaker 2: But most of the time it is necessary to actually
[26:14] Speaker 2: submit some tissue because that's the way you can actually
[26:16] Speaker 2: firstly identify what's going on, but also we use that
[26:20] Speaker 2: to exclude you know, other conditions too. So very commonly
[26:24] Speaker 2: the pathologist will check all the cells, make sure they're
[26:26] Speaker 2: all looking good, all looking fine, there's no sign of
[26:29] Speaker 2: anything untoward happening, and the pathologist is usually able to
[26:34] Speaker 2: give us, you know, a lot of clues as to
[26:37] Speaker 2: what the disease is or what the condition is, and
[26:40] Speaker 2: then we know how to move forward from there.
[26:42] Speaker 1: Yeah. So in other words, it becomes an immune problem,
[26:46] Speaker 1: but expressing yourself in your gums in your mouth. Yeah,
[26:49] Speaker 1: So that's interesting because some like I would say, so
[26:53] Speaker 1: many people have occasions where when they're cleaning their teeth
[26:56] Speaker 1: they are spitting blood out.
[26:58] Speaker 2: Yep.
[26:58] Speaker 1: I mean I think it's happened to me. It's it
[27:00] Speaker 1: hasn't happened recently, but it's has happened to be in
[27:02] Speaker 1: the past. And I'll go, well, I've had that before.
[27:05] Speaker 1: Who cares. I'm not going to bother about that. So
[27:07] Speaker 1: do you think is that a in terms of longevity
[27:10] Speaker 1: and health span is one of the Is that one
[27:12] Speaker 1: of the signs that we should say, I haven't see
[27:14] Speaker 1: been Donas for six months, maybe I better make a
[27:16] Speaker 1: booking your move?
[27:17] Speaker 2: Yes? Yeah, yeah, so I have a I mean, in
[27:19] Speaker 2: my head, I have a number of things that I
[27:21] Speaker 2: call red flags. So these are things that should alert
[27:25] Speaker 2: you as as a patient to the fact that there
[27:30] Speaker 2: might be things happening in the mouth that shouldn't be
[27:32] Speaker 2: happening in the mouth. Not necessarily terrible, sinister things, but
[27:36] Speaker 2: it just means that you know, things are not quiet
[27:38] Speaker 2: as they should be. So you know, unexplained bleeding for instance.
[27:44] Speaker 1: And you shouldn't try to explain yourself.
[27:46] Speaker 2: Well, I think no, not you and me.
[27:49] Speaker 1: I mean I shouldn't. I shouldn't go all this because I.
[27:52] Speaker 2: Think there's I think it's something that's happen, if it's prolonged,
[27:57] Speaker 2: if it's occurring, you know, frequently. I think you should
[28:01] Speaker 2: always seek a professional's advice because it's very difficult to
[28:06] Speaker 2: self diagnose. I think very commonly when we do self diagnose,
[28:09] Speaker 2: we tend to get it wrong.
[28:10] Speaker 1: It's dangerous. It is not going to solve her for me.
[28:14] Speaker 2: Yeah, it's counterproductive, you know, and it can also cause
[28:17] Speaker 2: a lot of anxiety, I think. So it's always better
[28:20] Speaker 2: to ask somebody who you know is knowledgeable about it.
[28:23] Speaker 1: So that's one you mentioned it.
[28:25] Speaker 2: So unexplained pain, So pain that wasn't there before, and
[28:29] Speaker 2: it doesn't seem to be resolving, and you haven't sort
[28:31] Speaker 2: of you know, bitten your tongue or you haven't. You know,
[28:34] Speaker 2: there's no good reason why it saw And just on the.
[28:38] Speaker 1: Pain though, is we're talking at the mouth, so we're
[28:41] Speaker 1: talking about pain in my cheek or pain in my jaw, or.
[28:45] Speaker 2: Pain pain anywhere anyway. Yeah, it can be pain in
[28:48] Speaker 2: that zone. Yeah, So the most common reason for pain
[28:50] Speaker 2: in the mouth area is a toothache, you know, either
[28:54] Speaker 2: because there's a cavity or there's some sort of thing happening,
[28:56] Speaker 2: but the tooth and the dentists will be very very
[28:59] Speaker 2: easy z really able to identify if that is the cause.
[29:03] Speaker 2: But if it's not related to tooth, a tooth or
[29:05] Speaker 2: an infection, then if there's no clear cause, then it
[29:09] Speaker 2: should be investigated further. And that might be something that
[29:12] Speaker 2: a dentists might then refer on to an oral medicine
[29:14] Speaker 2: specialist or somebody like that. I always say that if
[29:18] Speaker 2: you've got if you've developed an abnormality on the lining
[29:21] Speaker 2: of your mouth, such as a lump that wasn't there before,
[29:23] Speaker 2: you notice something and it hasn't resolved itself, you can't
[29:26] Speaker 2: explain why it's there. It's been there for longer than
[29:28] Speaker 2: to keep biting it. Yeah, that's right. Yeah, then I
[29:32] Speaker 2: think you need to bring that to the attention of
[29:34] Speaker 2: your dentists. Ulcers, for instance, So the most common cause
[29:37] Speaker 2: of an ulcer is that we're chewing, we get a
[29:40] Speaker 2: bit excited and uncoordinated and we buy out or whatever.
[29:43] Speaker 2: You develop an ulcer, and that's very common.
[29:45] Speaker 1: Yeah, that's happened to me like if I, you know,
[29:48] Speaker 1: when I to box, if I got punch in the
[29:50] Speaker 1: mouth and car yeah, on the inside, it would turn
[29:55] Speaker 1: a bloody ulcer a day later.
[29:57] Speaker 2: Yeah yeah, and they can be quite painful. Look, you know,
[30:00] Speaker 2: they can look a bit weird. Yeah, yeah, but those
[30:02] Speaker 2: ones generally will heal themselves.
[30:05] Speaker 1: It takes about a week to heal.
[30:06] Speaker 2: Yeah, one to two weeks. So I say to people, look,
[30:08] Speaker 2: if there's something that's persisted longer than that time, and
[30:11] Speaker 2: I use two weeks as my sort of cut off,
[30:15] Speaker 2: then you need to bring that to the attention of
[30:17] Speaker 2: your dentist.
[30:18] Speaker 1: Yeah, because I have heard people say, you know, I
[30:22] Speaker 1: keep getting ulcers in my mouth, and I mean, I'm like,
[30:25] Speaker 1: I haven't, but I've heard people I used to think
[30:28] Speaker 1: that's a bit weird. So like, it's not a sort
[30:30] Speaker 1: of thing. I don't know why it is with us,
[30:32] Speaker 1: but we don't. We sort of persist with pain or discomfort, yes,
[30:38] Speaker 1: to solve itself. But do you get is that a thing?
[30:42] Speaker 1: I mean, we do it externally within a saw knee
[30:44] Speaker 1: or something like that, but is that a thing in
[30:46] Speaker 1: the in the mouth world and the health world.
[30:48] Speaker 2: It is a thing in the in the mouth world,
[30:50] Speaker 2: it's very common that you sort of think, oh, well,
[30:53] Speaker 2: you know, it's it's fine, it's not that bad. I'll
[30:54] Speaker 2: put up with it, and it might go away on
[30:56] Speaker 2: its own, and then that kind of, you know, it
[30:58] Speaker 2: might be a prolonged state that doing that. I think,
[31:02] Speaker 2: you know, I always on the side of caution, just
[31:04] Speaker 2: because you know, I know that these things potentially, hopefully
[31:09] Speaker 2: not but potentially could be something you know, sinister or naskety.
[31:12] Speaker 2: It might be an early sign of something that's going
[31:14] Speaker 2: for example, for example, cancer mouth, and that's probably the
[31:18] Speaker 2: most extreme example, but there's a number of other conditions
[31:21] Speaker 2: that can cause pain and what have you in the
[31:23] Speaker 2: mouth that won't resolve on its own. And I think
[31:26] Speaker 2: whatever it is that's going on needs to be investigated.
[31:30] Speaker 2: You need to know what's happening. And for the most part,
[31:32] Speaker 2: it's usually you know what, you know what it is,
[31:35] Speaker 2: you can treat it so you don't need to suffer
[31:38] Speaker 2: in silence. Should we.
[31:41] Speaker 1: Be sort of surveying our mouth once a day, once
[31:45] Speaker 1: a week, like actually looking in the mirror and opening
[31:48] Speaker 1: it up and having look around, and if so, what
[31:51] Speaker 1: should we be looking for? Because most people were just
[31:53] Speaker 1: cleaning through that's it's done, and then they go about
[31:56] Speaker 1: the day and then they clean it to before the
[31:58] Speaker 1: other a bit. Yes, that's our lot.
[32:00] Speaker 2: Yeah, look, it's a funny thing. I think you're right.
[32:03] Speaker 2: And the issue with the mouth is that it is
[32:06] Speaker 2: very small. Yeah, it's very dark, and when you look
[32:09] Speaker 2: in there, you think, I don't know what I'm looking at.
[32:11] Speaker 2: You know, is it supposed to look like that? So
[32:13] Speaker 2: that's always that always adds, you know, an element of doubt,
[32:16] Speaker 2: I think. And the other thing that you I think
[32:19] Speaker 2: it's good to be knowledgeable, you know, we talk about
[32:21] Speaker 2: it for other parts of the body, for instance, for women,
[32:23] Speaker 2: you know, to check your breasts and what have you.
[32:25] Speaker 2: So I think, you know, checking the lining of the
[32:28] Speaker 2: mouth once in a while is probably a good idea.
[32:30] Speaker 2: You need to have really good lighting, so you know
[32:33] Speaker 2: in the bathroom. In the bathroom light is pretty good,
[32:35] Speaker 2: and you need to sort of, you know, pull your
[32:36] Speaker 2: lip down and have a look at that, you know,
[32:38] Speaker 2: have look in your cheek, lift your tongue out, put
[32:40] Speaker 2: your tongue out and just have a bit of a peek.
[32:42] Speaker 2: The issue lies in well, if you see something you think, well,
[32:46] Speaker 2: is that supposed to be there? Or is that not
[32:48] Speaker 2: supposed to be there? And sometimes that leads to googling
[32:52] Speaker 2: or you know, chat juputeing, and people come up with
[32:55] Speaker 2: all sorts of things. I think that if you're you know,
[32:59] Speaker 2: if you're and you're having a look and you think
[33:01] Speaker 2: there might be something weird, you should be bringing that
[33:03] Speaker 2: to the attention of your dentist. Dentists are you know,
[33:07] Speaker 2: when they see you for your regular check up, they're
[33:09] Speaker 2: looking at not just your teeth but also the lining
[33:12] Speaker 2: of the mouth. So they're also in a very good
[33:13] Speaker 2: position and they actually, you know, know what it's supposed
[33:17] Speaker 2: to look like, so they're in a good position to
[33:19] Speaker 2: identify abnormalodies of the lining of the mouth. And a
[33:23] Speaker 2: lot of the time, some of these things, in the
[33:25] Speaker 2: early days, they're painless, so many patients don't realize there's
[33:28] Speaker 2: anything happening on the lining of their mouth until their
[33:30] Speaker 2: dentists actually says, hey, you know, I've noticed X, Y
[33:33] Speaker 2: and Z, and you know, so unless you're actually going
[33:39] Speaker 2: to seek a dental opinion on a regular basis, these
[33:44] Speaker 2: things will probably not be picked up until they're you know,
[33:48] Speaker 2: quite troublesome.
[33:49] Speaker 1: How should the lining of the mouth look like on
[33:51] Speaker 1: these so it should be like pink or red, or
[33:53] Speaker 1: moist or smooth or like is there something that you
[33:57] Speaker 1: guys in your world sort of use is a descriptor Yeah.
[34:02] Speaker 2: So it's different in different parts of the mouth, which
[34:04] Speaker 2: is what makes it tricky. So I do have a
[34:06] Speaker 2: lot of patients who do a self check and they
[34:08] Speaker 2: come across something and they're like, oh my gosh, it's
[34:10] Speaker 2: really bumpy, and is it supposed to be like that?
[34:12] Speaker 1: And I'm putting my tongue around my mouth there, I'm
[34:15] Speaker 1: right now, I'm feeling as I'm a mouth there to talk.
[34:17] Speaker 2: It's really difficult. So the color is going to change
[34:20] Speaker 2: depending on which part of the mounts something. Some areas
[34:22] Speaker 2: are quite red, others are pale pink, for instance, And
[34:25] Speaker 2: it's just dependent on the type of lining in that
[34:28] Speaker 2: particular era of the mouth and the function of that.
[34:31] Speaker 2: Some areas are us and soft, some areas are quite
[34:34] Speaker 2: hard or firm bumpy, you know. So it is it's
[34:37] Speaker 2: a mind field in there, to be honest with you,
[34:38] Speaker 2: and for you to self check without any kind of
[34:40] Speaker 2: dental background is actually really tricky. So I say to
[34:44] Speaker 2: people the best thing to do is to check in
[34:47] Speaker 2: with the dentists every six to twelve months, because then
[34:49] Speaker 2: you know you're having it looked at by a professional
[34:52] Speaker 2: every six to twelve months.
[34:53] Speaker 1: And they're having a good look. And let's talk about
[34:56] Speaker 1: just this. The the saliva glands, which I think sit
[35:01] Speaker 1: under your tongue. How many you have to so we
[35:04] Speaker 1: have heaps.
[35:05] Speaker 2: Yeah, we have three what we call major glands. They're
[35:08] Speaker 2: pairds on both sides, so we're the glands here the product.
[35:10] Speaker 2: They're the ones that swell up when you have mumps,
[35:12] Speaker 2: for instance, and there's there's a set of like two
[35:15] Speaker 2: pairs under your tongue, right, So those are the major
[35:18] Speaker 2: glands under here. Yeah, yeah, so they're the major glands.
[35:20] Speaker 2: There's three paired glands, and then there's hundreds of very
[35:24] Speaker 2: small minor glands speckled throughout your mouth, so in the
[35:28] Speaker 2: under the surface of your lip for instance, on the inside,
[35:31] Speaker 2: on the roof of your mouth, underneath your tongue, so
[35:34] Speaker 2: they're everywhere. So they produce a significant amount of saliva
[35:37] Speaker 2: as well.
[35:38] Speaker 1: And the importance of us having enough saliva, And how
[35:41] Speaker 1: do we know if we don't have enough saliva? I mean,
[35:43] Speaker 1: assuming we're not dehydrated, Like what is what is the
[35:47] Speaker 1: function of saliva in our mouth anyway, Well, what is
[35:50] Speaker 1: it there for?
[35:50] Speaker 2: Yeah, so saliva is one of these things that we
[35:52] Speaker 2: don't really know the value of until we don't have it,
[35:56] Speaker 2: I guess. So dry mouth is quite common. One of
[35:59] Speaker 2: the most common causes of dry mouth in Australia is
[36:02] Speaker 2: actually medication. So many medications that people are prescribed and
[36:06] Speaker 2: also non prescribed over the countermedications have a side effect of,
[36:10] Speaker 2: you know, potentially causing dry mouth. And you know, in
[36:13] Speaker 2: Australia now with you know, our healthcare system being what
[36:17] Speaker 2: it is and people are living for longer, a lot
[36:20] Speaker 2: of patients are actually taking a number of medications at
[36:23] Speaker 2: the same time, so we call that polypharmacy and that
[36:26] Speaker 2: can contribute to that cumulative oral dryness. In terms of
[36:30] Speaker 2: the function of saliva, lots of different functions. Firstly, it
[36:33] Speaker 2: keeps in mouth nice and moist, which is important because
[36:36] Speaker 2: the lining of the mouth is happiest when it's moist constantly.
[36:40] Speaker 2: The teeth are protected with saliva. There's lots of goodies
[36:43] Speaker 2: in there that actually, you know, protect the teeth from
[36:46] Speaker 2: becoming proned or vulnerable I guess to decay. There's some
[36:53] Speaker 2: enzymes in saliva that you know, try and keep the
[36:56] Speaker 2: balance of all the you know, we talked about the
[36:58] Speaker 2: microbiome previous, So when you don't have enough saliva, you
[37:03] Speaker 2: tend to have overgrowth of some of the you know,
[37:06] Speaker 2: more suppressed I guess fungal in fungus, for instance, fungus
[37:12] Speaker 2: called Canada can overgrow and cause an infection. So there's
[37:15] Speaker 2: lots of different things that saliva does. You know, It's
[37:19] Speaker 2: something that we don't know much about until we don't
[37:23] Speaker 2: have it, and then your math becomes very uncomfortable. You know,
[37:26] Speaker 2: people find it difficult to speak, they trip over.
[37:30] Speaker 1: Their words, that kind of steeks at the top of
[37:32] Speaker 1: their mouth exactly.
[37:33] Speaker 2: You know, they can't swallow, they can't eat the food
[37:36] Speaker 2: without having a sip of water, things like that. But
[37:39] Speaker 2: also you might find at the dentists the dentist says,
[37:43] Speaker 2: all your math is a bit dry. You're developing new
[37:48] Speaker 2: areas of decay, for instance, in quite a short time frame,
[37:51] Speaker 2: or there's signs of wear on the teeth that's sort
[37:53] Speaker 2: of accelerated. So there's a lot of effects of saliva
[37:57] Speaker 2: that we don't necessarily know beyond the fact that your
[37:59] Speaker 2: mouth feels dry.
[38:00] Speaker 1: So they so a sign. One of the other signs
[38:03] Speaker 1: on your list probably is the amount of saliva in
[38:06] Speaker 1: your mouth or any change.
[38:09] Speaker 2: Yeah, yeah, definitely. So I do have a number of
[38:11] Speaker 2: patients to come to see me because of dry mouth
[38:15] Speaker 2: and the effects of that. So that's sif something.
[38:18] Speaker 1: What about things like things that might stimulate saliva, like,
[38:23] Speaker 1: for example, chewing gum. Yeah, I mean, you know, that's
[38:27] Speaker 1: everywhere we've been chewing chewing them forever. Is that a
[38:31] Speaker 1: thing should be? Is it a good idea that you
[38:33] Speaker 1: have chewing them?
[38:34] Speaker 2: Yeah? Look, sugar free gum I think is the way
[38:35] Speaker 2: to go. So yeah, so that mechanically sort of, you know,
[38:40] Speaker 2: causes the salivary glands to work a bit harder, and
[38:43] Speaker 2: that's a good way, and it's quick and easy and
[38:45] Speaker 2: very accessible. So there's that You need to make sure
[38:48] Speaker 2: that you're firstly drinking enough water so you're not dehydrated,
[38:52] Speaker 2: but also then you can sip water throughout the day
[38:54] Speaker 2: and that just provides that long lasting lubrication if you
[38:58] Speaker 2: go to the chemist's. Lots of over the counter products
[39:00] Speaker 2: now that have developed for people that have dried mout.
[39:03] Speaker 2: Oh really, yeah, So either salavery substitutes or you know wow. Yeah, yeah,
[39:07] Speaker 2: there's a whole heap of stuff.
[39:08] Speaker 1: What do you drink it?
[39:10] Speaker 2: Well, you swish it. You can use it as a rinse.
[39:11] Speaker 2: You can swish it around you, right, there's gels and
[39:14] Speaker 2: it just alleviates that discomfort and you can get on
[39:16] Speaker 2: with your day. And there are certain medications that you know,
[39:20] Speaker 2: some doctors or almost some specialist might prescribe that can
[39:24] Speaker 2: actually stimulate your salivary glands to produce more saliva if
[39:27] Speaker 2: it's if it's indicated.
[39:29] Speaker 1: Can I just talk about we haven't talked about the
[39:31] Speaker 1: tongue that much. And I see, like I know, on
[39:34] Speaker 1: some tooth brushes that got these like ridgi thing at
[39:36] Speaker 1: the back on the on the flip side of the
[39:39] Speaker 1: brush part. And I've always presumed that's for scraping your tongue.
[39:43] Speaker 1: And there are a lot of people who believe in
[39:46] Speaker 1: this are scrabing your tongue. What's that about? Tell me
[39:50] Speaker 1: about that? Is that is that a good practice?
[39:52] Speaker 2: Yeah? So the tongue, the top surface of the tongue
[39:54] Speaker 2: isn't smooth, as you know, there's heaps of you know, bumps,
[39:57] Speaker 2: take little yeah things that into the mouth, yes, and
[40:02] Speaker 2: so that collects debris, so it collects you know, saliva, food,
[40:07] Speaker 2: all that kind of stuff can collect on there and
[40:09] Speaker 2: accumulate and that can cause a coating on the on
[40:11] Speaker 2: the surface of the tongue.
[40:12] Speaker 1: And what would that look like.
[40:14] Speaker 2: Usually it's usually a white coating and if you scrape
[40:17] Speaker 2: it usually will lessen or will come off. Sometimes if
[40:20] Speaker 2: it's disgusting, yeah, it's not, it's not. It's not fantastic.
[40:24] Speaker 2: You know, sometimes if you have a cup of you know,
[40:26] Speaker 2: black coffee or you know, a glass of red wine,
[40:28] Speaker 2: that might discolored a lovely brown color which is even
[40:32] Speaker 2: more attractive. But you know, but so the potential is
[40:36] Speaker 2: that you're collecting it's not clean, and so you you
[40:40] Speaker 2: do need to mechanical you need to do this. Yeah,
[40:42] Speaker 2: you should be doing it as part of your routine
[40:45] Speaker 2: dental hygiene practice. So when you brush your teeth, you
[40:48] Speaker 2: brush your tongue. So whether you use yeah, so whether
[40:51] Speaker 2: you use the actual toothbrush like the bristle part or
[40:53] Speaker 2: the back of it. Some people using as you mentioned before,
[40:56] Speaker 2: tongue scrapers or what have you. You don't have to
[40:59] Speaker 2: be it. It doesn't need to be rigorous, like you
[41:01] Speaker 2: don't need to apply force to it. You just need
[41:03] Speaker 2: to be frequently to briding your tongue or you know,
[41:06] Speaker 2: just yeah, just getting all that.
[41:09] Speaker 1: How far back do you have to go?
[41:10] Speaker 2: Yeah, it's a tricky one because it.
[41:11] Speaker 1: Makes you feeling on a vomit.
[41:12] Speaker 2: You're going to gag.
[41:14] Speaker 1: I've tried. It doesn't mean if you're going on a gag.
[41:16] Speaker 2: I think you just do the best you can realistically.
[41:18] Speaker 2: I mean, you know, it's not no point doing it
[41:20] Speaker 2: and vomiting every time you're doing it. Yeah. I do
[41:23] Speaker 2: tend to tell people that we tend to feel a
[41:25] Speaker 2: bit more gaggy in the morning, first thing in the morning.
[41:27] Speaker 2: So some people say, okay, that's fine, I will brush
[41:30] Speaker 2: my tongue in the evening when I brush my teeth
[41:32] Speaker 2: in and they tend to cope a little bit better
[41:34] Speaker 2: that way. So you do what you can.
[41:36] Speaker 1: The tongue goes a fair way back, though, it does
[41:40] Speaker 1: goes down and so there's no way you can reach
[41:43] Speaker 1: back there.
[41:43] Speaker 2: But I think you just go as far back as
[41:45] Speaker 2: you possibly can in terms of being you know, comfortable
[41:48] Speaker 2: doing it, and you do it gently. But it's about frequency.
[41:52] Speaker 2: So there's no point sort of giving a good scrub
[41:53] Speaker 2: once a year, you're probably better off doing a you know,
[41:57] Speaker 2: a little bit less vigorous, I guess, but doing it daily.
[42:01] Speaker 1: And is this all part of so like if you're
[42:04] Speaker 1: getting rid of the debris, let's call it, that's accumulating
[42:07] Speaker 1: you do it. You're doing it with your teeth as well.
[42:10] Speaker 1: Is this all part of sort of like spring cleaning
[42:15] Speaker 1: your room in your mouth? I mean, that's sort of
[42:17] Speaker 1: what it sounds like to me.
[42:18] Speaker 2: Yeah, yeah, well I think it's like it's like taking
[42:21] Speaker 2: a shower, isn't it like a shower of day? Some
[42:22] Speaker 2: people do it multiple times a day to make sure
[42:25] Speaker 2: that you're clean, clean all the gun coffee, your hair
[42:28] Speaker 2: and what have you because you've been out. Yeah, And
[42:30] Speaker 2: so it's similar with the mouth. You're using your mouth
[42:32] Speaker 2: all the time. You're chucking all sorts of stuff in
[42:34] Speaker 2: your mouth and you need to make sure that it's clean.
[42:37] Speaker 2: So it's the same sort of thing.
[42:39] Speaker 1: But do you think that you know, whilst Australians have
[42:43] Speaker 1: pretty good teeth, generally speaking, we have fluoridation in the
[42:45] Speaker 1: waters in most states I think, or access to most
[42:49] Speaker 1: Austrainans get that anyway, But do you think that Australians
[42:52] Speaker 1: in terms of dental careless. I don't mean going to
[42:55] Speaker 1: the sea of the dentists, but just dental care day
[42:57] Speaker 1: to day are good at looking after all these aspects
[42:59] Speaker 1: of them.
[43:00] Speaker 2: Else, I think Australians are probably most aware about looking
[43:04] Speaker 2: after their teeth, so making sure that they're you know,
[43:08] Speaker 2: brushing their teeth. I think Australians are less aware about
[43:13] Speaker 2: the other structures in the mouth, so the lining of
[43:16] Speaker 2: the mouth that gumes, you know, all that kind of business.
[43:19] Speaker 2: I think it's something that as a dental profession we're
[43:23] Speaker 2: working to I guess educate our patients of because that's
[43:27] Speaker 2: probably something that we've not done previously or as well
[43:31] Speaker 2: as we possibly could. So I think that's probably where
[43:34] Speaker 2: we're at.
[43:36] Speaker 1: Is it a nice to do thing or is it
[43:39] Speaker 1: you should be doing it?
[43:40] Speaker 2: I think you should be doing it.
[43:42] Speaker 1: And if you don't, what risks are you introducing into
[43:47] Speaker 1: your system? So the first I mean teething is obvious
[43:53] Speaker 1: tooth okay, yes, but with other stuff like maybe screaming
[43:56] Speaker 1: your tongue whatever it is. In case, I'll be what
[44:00] Speaker 1: are the other risks? Like what are we talking about
[44:02] Speaker 1: outside two decay?
[44:03] Speaker 2: Yeah, So I mean obviously tooth decay is the main
[44:06] Speaker 2: thing in terms of the lining of the mouth there,
[44:09] Speaker 2: it's also about I think, being knowledgeable. So if you're
[44:11] Speaker 2: actually being systematic about cleaning your mouth and checking your
[44:15] Speaker 2: mouth and what have you, that if there is something
[44:16] Speaker 2: that's going on there, you're aware of it, you pick
[44:18] Speaker 2: it up quite early, and therefore it's it's much easier
[44:22] Speaker 2: to manage and the outcome is generally better. So I
[44:27] Speaker 2: think it's it's about us being knowledgeable about our health
[44:31] Speaker 2: and our oral health and you know, actioning anything early.
[44:35] Speaker 2: I think that's probably one of the main points to
[44:37] Speaker 2: take away from that. There are conditions that can affect
[44:41] Speaker 2: you know, the lining of the mouth that don't affect
[44:44] Speaker 2: teeth obviously, and then you know you'd want to be
[44:46] Speaker 2: picking those things up. So I think it's actually about
[44:50] Speaker 2: you know about that sort of aspect of it, rather
[44:53] Speaker 2: than you know, am I by not doing this? Am
[44:57] Speaker 2: I causing something bad?
[44:58] Speaker 1: Yeah? And then I think and I think I'm starting
[45:02] Speaker 1: to understand a little bit more now. Sorry, I'm starting
[45:04] Speaker 1: understand a bit more now.
[45:05] Speaker 2: So, like.
[45:06] Speaker 1: In terms of I think what you're saying is that
[45:12] Speaker 1: if you are caring for your dental hygiene, mouth hygiene
[45:19] Speaker 1: generally speaking, which includes your teeth, and you are checking
[45:24] Speaker 1: doing all the things that you're talked about, and are
[45:27] Speaker 1: you going to see the dentist every period of time
[45:30] Speaker 1: whatever it is, in a regular sense and making sure
[45:33] Speaker 1: that there's you know, they're baselining something or rather through
[45:36] Speaker 1: X rays or whatever, they're getting a baseline at least
[45:39] Speaker 1: they know a little bit about your mounteam photographs and
[45:41] Speaker 1: stuff like that that if they detect a change, it
[45:45] Speaker 1: may not necessarily be something wrong with the mouth. That
[45:47] Speaker 1: it might might be that it is indicative for something
[45:50] Speaker 1: else that's going on in your system. So your mouth
[45:52] Speaker 1: may become an indicator if you're doing everything right, your
[45:55] Speaker 1: mouth may be but there is something wrong, your mouth
[45:58] Speaker 1: may be an indicator with something else is going on
[46:00] Speaker 1: in your body being first expressed in your mouth. That's right.
[46:03] Speaker 2: It's very interesting. There's actually quite a number of conditions
[46:05] Speaker 2: that can affect like other body sites that actually can
[46:09] Speaker 2: present in the mouth quite early only so even before
[46:13] Speaker 2: you know you've got anything else going on. So I
[46:15] Speaker 2: guess one example might be gastrointestinal disease. So some people
[46:18] Speaker 2: have inflammatory bow disease for instance, like Crohn's disease, ulster
[46:22] Speaker 2: of collidis and what have you. And before they even
[46:24] Speaker 2: get any of those gastro symptoms, you can actually detect
[46:28] Speaker 2: some signs in the mouth because it is one big
[46:31] Speaker 2: tube I guess that runs through your body that you
[46:34] Speaker 2: know that there's something going on, there's something not quite right.
[46:37] Speaker 2: So you know, that's probably one of the examples. And
[46:39] Speaker 2: I do see that, you know, reasonably frequently.
[46:42] Speaker 1: But what would you see like would you?
[46:45] Speaker 2: Yeah, So some some of those patients come in with
[46:48] Speaker 2: swellings in their mouth. They have an alteration in the
[46:51] Speaker 2: texture of the lining of the mouth sometimes as you know,
[46:55] Speaker 2: some redness and ulceration the appearance of the lining, so
[46:59] Speaker 2: not the tea, but the soft areas in the mouth
[47:03] Speaker 2: are altered, and that would commonly lead us to perform
[47:06] Speaker 2: a tissue biopsies and that tissue off to the pathologist.
[47:10] Speaker 2: The pathologists would usually see some very classic features under
[47:14] Speaker 2: the microscope that would point in the direction of these
[47:18] Speaker 2: types of conditions, and that whole process then sort of,
[47:21] Speaker 2: you know, it starts you down this pathway of further
[47:24] Speaker 2: investigations and eventually you probably end up at a gastro entrologist,
[47:29] Speaker 2: for instance, to have a look at the rest of
[47:30] Speaker 2: the gun, but it is certainly a reasonably common scenario
[47:36] Speaker 2: that you would see signs of these types of things
[47:38] Speaker 2: in the mouth.
[47:39] Speaker 1: First, So are you someone like at your stage in
[47:44] Speaker 1: your stage dentist, then they're coming along to see Professor Sue.
[47:50] Speaker 1: So like, are you a frequent referral of patients off
[47:54] Speaker 1: to gastrionrologists?
[47:55] Speaker 2: Yes?
[47:56] Speaker 1: Or is it the other way they don't refer back
[47:58] Speaker 1: to you?
[47:59] Speaker 2: We do. Both works both ways because sometimes patients have
[48:03] Speaker 2: that you know, it depends on their referral pathway as well.
[48:07] Speaker 2: But we certainly, yeah, it works both ways.
[48:09] Speaker 1: So where it works from the other way because one
[48:11] Speaker 1: of the things I want to talk to about is
[48:12] Speaker 1: asked to reflex so you know, like as we get older,
[48:15] Speaker 1: like that's the thing, and you know, the valve doesn't
[48:19] Speaker 1: close as well as it should do down there and
[48:21] Speaker 1: whatever it's called, that valve between your stomach and your esophagus,
[48:24] Speaker 1: and in a few eat at the wrong time before
[48:28] Speaker 1: you go to bed sort of thing, it starts coming
[48:30] Speaker 1: back up the other direction. It's never pleasant and it
[48:35] Speaker 1: can sort of do things to your mouth, can't it.
[48:37] Speaker 1: What are we looking at there?
[48:39] Speaker 2: So we so the acid that comes from the stomach
[48:42] Speaker 2: is very very acidic, and that's why you get that
[48:45] Speaker 2: burning sensation, that heartburn, you know, because it comes up
[48:47] Speaker 2: and it kind of burns. It can come up into your.
[48:51] Speaker 1: Mouth, so especially while you're asleep, Yeah, that's right, and you're.
[48:56] Speaker 2: Lying down, it's all sort of flowing up. So that
[49:00] Speaker 2: because it's so acidic there, it changes the environment in
[49:02] Speaker 2: your mouth. So we talked about the microbiome, but it
[49:05] Speaker 2: can actually erode your teeth. So you can actually see
[49:08] Speaker 2: signs of erosion acid erosion on the tooth structure itself,
[49:12] Speaker 2: so you can get some thinning of the teeth. The
[49:14] Speaker 2: teeth can become quite sensitive, so you know hot and cold,
[49:17] Speaker 2: and you know when you buy into an ice cream
[49:19] Speaker 2: and you go, well, you know, that sort of thing
[49:20] Speaker 2: can occur and that can be a sign of reflux, yeah.
[49:26] Speaker 1: Or even worse. But because and reflex in itself is
[49:31] Speaker 1: quite damaging to esophagus because you know, as I understand
[49:34] Speaker 1: from one of our podcasts I recall as it, reflex
[49:37] Speaker 1: can actually affect the lining of your esophagus which is
[49:42] Speaker 1: not meant to be hit with acid. And as a
[49:47] Speaker 1: result of you know, change the structure, you can get
[49:50] Speaker 1: a think all barases, which is pretty deadly. So if
[49:55] Speaker 1: someone is listening to this and they're saying, well, I
[49:58] Speaker 1: do get that acidic feeling in my mouth and my teeth,
[50:01] Speaker 1: and maybe that's important for them to part from seeing
[50:06] Speaker 1: their dentists and something like yourself. It could be indicative
[50:09] Speaker 1: of something worse that's happening, much more sinister potentially, right.
[50:14] Speaker 2: Yeah, So I think if somebody is experiencing those symptoms,
[50:16] Speaker 2: they need to firstly speak to their GP about it,
[50:19] Speaker 2: because the GP is quite knowledgeable and there's steps that
[50:22] Speaker 2: you can take, you know, certain medications and what have
[50:25] Speaker 2: you that you can try initially. But if it persists,
[50:29] Speaker 2: then certainly the GP will probably instigate a referral to
[50:32] Speaker 2: a gastroentrologist and they might decide to do an endoscopy.
[50:34] Speaker 2: So put a camera down and have a look down,
[50:37] Speaker 2: you know, the bits that you can't see, and yeah,
[50:40] Speaker 2: and just check on what's going.
[50:42] Speaker 1: On there, checking lining of our sophagus and going right
[50:44] Speaker 1: into our timing and seeing what's going on, what's going
[50:46] Speaker 1: on down there. Something that's always fascinated me and a
[50:51] Speaker 1: lot of people in India do this. It's called well
[50:55] Speaker 1: oil pulling. Is that a thing?
[51:00] Speaker 2: So it is a thing. I don't know much about it, yeah,
[51:03] Speaker 2: but increasingly I know a lot of people. Do it
[51:05] Speaker 2: become a thing? Yeah, it's become a thing. Yeah. I
[51:08] Speaker 2: don't know much about it.
[51:09] Speaker 1: Yeah, but fair enough. Well what I heard about you
[51:12] Speaker 1: you get coconut oil and you put in your mouth
[51:16] Speaker 1: and you sort of sort of circulate around the mouth,
[51:20] Speaker 1: swishing and around your mouth for twenty I think it's
[51:23] Speaker 1: like twenty minutes. And as I understand it, and I
[51:26] Speaker 1: learned this from a yoga person and she told me this.
[51:28] Speaker 1: But the yoga person told me that the the result
[51:33] Speaker 1: of this, somehow the oil grabs hold of all the
[51:36] Speaker 1: bacteria that shouldn't be there, and then when you spit
[51:39] Speaker 1: it out, whatever's in there they shouldn't be in there,
[51:41] Speaker 1: it goes out with the oil. But it's pretty I've
[51:46] Speaker 1: tried it once. It's pretty sickly sensation, like you've got
[51:50] Speaker 1: this oil in your male you're sort of swishing bay
[51:52] Speaker 1: around it. And the other thing I want to ask you,
[51:54] Speaker 1: which is, is sleeping at night with our mouth open,
[52:00] Speaker 1: like mouth breathing. Yeah, mouth breathing, what they call mouth breathing.
[52:04] Speaker 1: And there's now we see stuff on social media a lot,
[52:07] Speaker 1: but you know, taping the mouth, is there any credit
[52:12] Speaker 1: around that in terms of what you guys do, like
[52:15] Speaker 1: in terms of oral health, is that a thing that
[52:18] Speaker 1: we should try to maintain breath through a nose if
[52:21] Speaker 1: we can.
[52:21] Speaker 2: Yeah, So breathing, like when you're asleep, it's very difficult
[52:24] Speaker 2: to do, to consciously do anything, which is I guess
[52:27] Speaker 2: why people resort to actually mechanically taking their mouthshoed. So
[52:31] Speaker 2: I guess one of the things with math breathing is
[52:33] Speaker 2: that if you're doing it first a six seven hours
[52:35] Speaker 2: of a night, your mouth tends to dry out. So
[52:39] Speaker 2: then we have that whole dry math discussion that we
[52:41] Speaker 2: talked about previously, where you know, the lining of the
[52:43] Speaker 2: mouth that's not that's supposed to be constantly wet, is
[52:46] Speaker 2: not wet even when you sleep. Even when you sleep,
[52:49] Speaker 2: so the saliva production fluctuates, the amount of saliva your
[52:52] Speaker 2: body produces fluctuates during the day. So there's a you know,
[52:56] Speaker 2: dienal pattern as in like so during the the waking hours,
[53:01] Speaker 2: it tends to produce more. When you're thinking about food,
[53:03] Speaker 2: it tends to produce more. When you're asleep, it tends
[53:06] Speaker 2: to you know, to you're still producing it, but just
[53:08] Speaker 2: less of it. And that's normal. So everybody has that pattern.
[53:13] Speaker 2: So your mouth is naturally dryer at night than it
[53:16] Speaker 2: is during your waking hours anyway, is the rhythm it is, Yeah,
[53:21] Speaker 2: it is right. And so then when you are mouth
[53:24] Speaker 2: breathing for six or seven hours of a night, you
[53:26] Speaker 2: are adding to that to that dryness. So sometimes that's
[53:30] Speaker 2: enough to sort of you know, tip you over and
[53:31] Speaker 2: you can sort of develop Then, you know, some of
[53:34] Speaker 2: those bugs that are you know, living in harmony with
[53:38] Speaker 2: everything else, say, they tend to overgrow and cause what
[53:41] Speaker 2: we call opportunistic infections in the mouth. You can get
[53:45] Speaker 2: inflammation because the lining of the mouth is dry, you
[53:48] Speaker 2: can you know, develop over you know, over time, predisposition
[53:52] Speaker 2: to getting dental decay and what have you because your
[53:54] Speaker 2: mouth is dry. So it's about the dryness of the
[53:57] Speaker 2: mouth realistically. So I think that's probably one of the
[53:59] Speaker 2: reasons why people do try and tape their mouth shut.
[54:03] Speaker 2: I've never tried it, but I suspect it might be
[54:05] Speaker 2: quite uncomfortable. I don't know how, you know, if you
[54:08] Speaker 2: intentionally with your mouth open to have to you know,
[54:11] Speaker 2: sleep with the shut. I don't know. If it's you know,
[54:16] Speaker 2: a long term solution, if it can be tolerated or not.
[54:18] Speaker 2: But you know, I have no objection to people doing it.
[54:21] Speaker 1: Yeah, Well, can we just talk about bad breath? Where's
[54:24] Speaker 1: bad breath fit into all this? So if someone has
[54:29] Speaker 1: a I'd imagine there's different types of bad breath too,
[54:36] Speaker 1: different There are as I remember, I don't know if
[54:39] Speaker 1: I'm this is correct, but I think there are places
[54:42] Speaker 1: where you can go and breathe into a jew or
[54:44] Speaker 1: a box or a bottle or something like that and
[54:46] Speaker 1: they diagnose things from it. Is that right or am
[54:49] Speaker 1: I wrong?
[54:49] Speaker 2: No? No, you're right, You're right. So there are these
[54:52] Speaker 2: devices where they can sort of analyze capture the gas. Yeah, exactly.
[54:58] Speaker 2: I've never used one, but certainly exist. So bad breath
[55:02] Speaker 2: is one of these things where there's I guess there's
[55:05] Speaker 2: a few. When we talk about brad breath, the term
[55:08] Speaker 2: we use is halotosis, So that's you know, that objective
[55:12] Speaker 2: smell the first.
[55:13] Speaker 1: Thing in the morning. Yeah, and when you see them
[55:14] Speaker 1: in the movies, and they in the movies they kissing
[55:16] Speaker 1: first in the morning, think, what the fuck, come on,
[55:20] Speaker 1: give us a break, fair ega, Like anybody's doing that
[55:23] Speaker 1: first thing in the morning. Something weird, They like, you
[55:26] Speaker 1: know what I mean? So what is what is it?
[55:30] Speaker 1: Bacteria accumulating in our mouth all night? Is that what
[55:33] Speaker 1: we're talking about?
[55:33] Speaker 2: And the dryness of the mouth, so there's no saliva
[55:35] Speaker 2: that's sort of washing over the lining and clearing out
[55:38] Speaker 2: any bacteria or whatever it is. Right, So when we
[55:41] Speaker 2: talk about bad breath, there is there's a couple of
[55:43] Speaker 2: things that we always need to exclude in terms of causes.
[55:47] Speaker 2: So the first is any kind of infection in the
[55:51] Speaker 2: mouth that can cause bad breath. So that includes gum
[55:54] Speaker 2: disease or ginger vitis, these gingervitis, all that kind of business,
[55:57] Speaker 2: but also other kinds of infections that you can get.
[55:59] Speaker 2: So if you've got an infected tooth for insance and
[56:01] Speaker 2: what have you, that can alter your breath. The second
[56:06] Speaker 2: is you want to make sure that you know things
[56:09] Speaker 2: are generally healthy in there, so there's no growths or
[56:12] Speaker 2: tumors or whatever that could be contributing. And that was
[56:15] Speaker 2: probably you know down the other end of causes. Dryness
[56:21] Speaker 2: of the mouth is one of the contributors to bad breath,
[56:24] Speaker 2: just because you don't have that lubrication in that one.
[56:27] Speaker 1: Not just for sea morning.
[56:28] Speaker 2: Generally generally generally speak because this.
[56:30] Speaker 1: Slave is sort of basically rinsing your mouth at the
[56:33] Speaker 1: whole time. Yeah, it is, and you swallow it.
[56:34] Speaker 2: It's like a self cleansing mechanism.
[56:36] Speaker 1: Really yeah yeah, okay, cool.
[56:38] Speaker 2: Yeah. So if you don't have that happening, then you
[56:39] Speaker 2: you know, stuff collects and it can start to smell.
[56:43] Speaker 2: So so there's that oral hygiene. So if you don't
[56:47] Speaker 2: have optimal oral hygiene, you tend to develop stale as
[56:51] Speaker 2: in plaque, as in plak accumulation, or food debris hanging
[56:54] Speaker 2: around and what happens. So those are the types of
[56:57] Speaker 2: things that we look for from a from a dental perspective,
[57:00] Speaker 2: you can also get other contributors to bad breath. So
[57:04] Speaker 2: some people have, for instance, sinus infections and they have
[57:08] Speaker 2: what we call it post nasal drips that they've got
[57:10] Speaker 2: mucus stripping down the back of their throat and that
[57:12] Speaker 2: can commonly contribute to bad breath. And gastro intestinal things
[57:16] Speaker 2: that we talked about reflex before and gases coming up
[57:19] Speaker 2: from the stomach and coming out the mouth, and that
[57:21] Speaker 2: can also contribute to bad breath. So there's you know,
[57:24] Speaker 2: generally I think of it in three groups, where we've
[57:26] Speaker 2: got the you know, obviously my group, which is the
[57:28] Speaker 2: dental group, or the mouth group that you need to exclude,
[57:31] Speaker 2: and if you can't find any good reason for it,
[57:33] Speaker 2: then you need to start looking at the other body
[57:35] Speaker 2: systems to see whether there's another potential contributor.
[57:38] Speaker 1: In which case you would send them off to say
[57:40] Speaker 1: gastrins or yes, that's for example, to so what's going
[57:42] Speaker 1: on in the stomach, because there's maybe there's something they've
[57:45] Speaker 1: ingested or they're eating or something. Because sometimes people get
[57:48] Speaker 1: a strong sulfur smell. Yes, you know they get and
[57:51] Speaker 1: that to me, like my senses, is coming from their gut.
[57:54] Speaker 2: But I don't know the yeah looks. I certainly think
[57:57] Speaker 2: if there's nothing obvious from the mouth, and I would
[58:01] Speaker 2: be sending the patient off just to exclude, you know,
[58:05] Speaker 2: just just to be complete about it.
[58:07] Speaker 1: I think, yeah, because they know there's a horrible thing
[58:10] Speaker 1: to say. But when I not horrible. When my dad
[58:14] Speaker 1: was my fat passed away last but when he was
[58:16] Speaker 1: getting older he is ninety, but as he was getting
[58:18] Speaker 1: older and older, this old person's breath thing. And my
[58:25] Speaker 1: dad had pretty good teeth and unfortunately I errd his seed,
[58:29] Speaker 1: not mums. But but Dad had good teeth and he
[58:33] Speaker 1: used to go Dennist all the time and get check
[58:34] Speaker 1: checks and stuff. But I just maybe a year before
[58:38] Speaker 1: he passed away. Of course, he died from cancer, but
[58:41] Speaker 1: you know, we didn't know until like about eight weeks
[58:44] Speaker 1: before he died. But not you know, but there was
[58:49] Speaker 1: a smell about him. Yeah, and I often wonder to myself,
[58:54] Speaker 1: I wish I had said something between him maybe well,
[58:59] Speaker 1: and truly a year or so before when I started
[59:01] Speaker 1: noticing it. Apop, you better go and get this checked checked.
[59:05] Speaker 1: Is that a thing?
[59:06] Speaker 2: Yeah, I think it is a thing. I think it
[59:08] Speaker 2: is a thing. I think there's lots of contributing factors.
[59:10] Speaker 2: It's difficult to pinpoint a you know, a single thing.
[59:13] Speaker 2: But you know, if there's no clear reason for it,
[59:16] Speaker 2: you should get it investigated.
[59:17] Speaker 1: Yeah, because I mean, is there is a term where
[59:21] Speaker 1: old people's breath. We can coin the term, but you
[59:25] Speaker 1: haven't heard it because because a lot of older people
[59:27] Speaker 1: do have that strong smell about them.
[59:30] Speaker 2: Yeah, yeah, I know what you mean, but yeah, I'm
[59:32] Speaker 2: not familiar.
[59:33] Speaker 1: And I mean because because I mean, I come from
[59:37] Speaker 1: a part of European background and a lot of mere
[59:41] Speaker 1: garlic all the time, and you get that soult for smell.
[59:43] Speaker 2: Yes, that's right, Yeah, that's related to garlic and onions.
[59:47] Speaker 1: Yeah yeah, yeah yeah. And are there any foods that
[59:51] Speaker 1: we that were shotributing that are good for our oral health?
[59:56] Speaker 1: Is it? Or is that not a thing that you
[59:59] Speaker 1: would think about. We'll talk about talk to your patients
[1:00:01] Speaker 1: about in terms of sort of like general general health
[1:00:06] Speaker 1: for our mouth.
[1:00:07] Speaker 2: So I think the biggest thing from a dental perspective
[1:00:10] Speaker 2: is the sugar, because it's firstly it's not good for
[1:00:14] Speaker 2: our health in general, but also you know, the the sugar,
[1:00:20] Speaker 2: if it hangs around your mouth, can potentially put your
[1:00:22] Speaker 2: high risk of developing dental decay in it.
[1:00:25] Speaker 1: Why is that? Why does sugar do that?
[1:00:27] Speaker 2: So the bacteria in the mouth like sugar. They ingest sugar,
[1:00:32] Speaker 2: and so when they're feeding on that, there's a lot
[1:00:34] Speaker 2: of acid that's produced. When the environment becomes a cidic
[1:00:38] Speaker 2: in the mouth, you do develop decay of the teeth.
[1:00:42] Speaker 1: And therefore, once you develop decay, you're sorry, once the
[1:00:45] Speaker 1: tooth wears down, Sorry, you developed decay. Yes, that's what
[1:00:49] Speaker 1: it is. Your an animal gets less.
[1:00:51] Speaker 2: Correct, you end up with a hole in your tooth essentially,
[1:00:53] Speaker 2: which is for the most part and irreversible process.
[1:00:57] Speaker 1: So sugar is not a matter of what you should
[1:01:00] Speaker 1: be eating, but it's a matter of what you probably
[1:01:02] Speaker 1: you shouldn't be eating, is what you're saying. Yeah, so sugar.
[1:01:05] Speaker 1: Let's say we love chocolate and we'd like to have it.
[1:01:08] Speaker 1: Everyone loves chocolate, well not every but most people do.
[1:01:10] Speaker 1: But are you suggesting then we should go on to
[1:01:12] Speaker 1: clean it too straight away?
[1:01:14] Speaker 2: So I think there's I mean, that's not always practical,
[1:01:18] Speaker 2: but I think if you limit your sugar intake to
[1:01:21] Speaker 2: meal times. So it's also about frequency, right, So if
[1:01:23] Speaker 2: you've got like a chocolate bar that you take a
[1:01:24] Speaker 2: bite dot of every twenty minutes throughout the day, you're
[1:01:27] Speaker 2: probably more at risk than if you're eating a chocolate
[1:01:30] Speaker 2: bar at you know, lunchtime and then one at dinner time.
[1:01:34] Speaker 2: So it's about frequency in the prolonged exposure of it.
[1:01:38] Speaker 2: Lots of people these days are actually bringing a toothbrush
[1:01:41] Speaker 2: to work and cleaning that in the middle of the day,
[1:01:42] Speaker 2: and that's that's okay, you know. So the other thing,
[1:01:47] Speaker 2: as well as maybe just rinsing your mouth out or
[1:01:49] Speaker 2: having some water afterwards just to sort of clear that
[1:01:52] Speaker 2: from the actual mouth and sticking to the teeth. So
[1:01:56] Speaker 2: that might be something that's easier to do well.
[1:01:58] Speaker 1: Ex Bacteria, Like why does it?
[1:02:01] Speaker 2: Oh, it feeds on sugar, But.
[1:02:03] Speaker 1: What is a feeder on if you're not eating chocolate
[1:02:05] Speaker 1: or if you're not eating something with sugar on it.
[1:02:07] Speaker 2: Yeah, so there's a lot. I mean, it feeds on
[1:02:09] Speaker 2: lots of things to be honest, right, but sugar tends
[1:02:11] Speaker 2: to be you know, the one that we talk about
[1:02:13] Speaker 2: when we when we're talking about teeth, dental you know,
[1:02:16] Speaker 2: dental disease.
[1:02:17] Speaker 1: So like if we ate no sugar, would we not
[1:02:21] Speaker 1: Is it is it fair to say that we might
[1:02:23] Speaker 1: not get dental disease?
[1:02:25] Speaker 2: I think the risk is less just just a risk factor, Yeah,
[1:02:29] Speaker 2: I think so. I think it's very difficult to talk
[1:02:32] Speaker 2: in absolutes because there's lots of other factors that can
[1:02:36] Speaker 2: cause dental disease or that can contribute to the risk.
[1:02:41] Speaker 2: But I think a low sugar diet would be compared
[1:02:44] Speaker 2: to a high sugar diet would lessen the risk.
[1:02:48] Speaker 1: So you're talking more from.
[1:02:49] Speaker 2: A like formentable carbohydrate types of Shue.
[1:02:52] Speaker 1: Yeah, yeah, yeah, So let's take someone like me. Not
[1:02:55] Speaker 1: that I'm asking you to diagnose me, that would be
[1:02:58] Speaker 1: unfair for both of us, but say something on me.
[1:03:01] Speaker 1: I'm sort of getting on in years and but you know,
[1:03:08] Speaker 1: I've eaten sugar, but as a kid ate very rarely
[1:03:11] Speaker 1: a sugars like we wasn't accessible that we didn't have
[1:03:13] Speaker 1: a shopping center near us or anything like that, so
[1:03:15] Speaker 1: I couldn't get off the bus and go to the
[1:03:18] Speaker 1: shopping center and by myself at chocolate barring. Plus about
[1:03:20] Speaker 1: no money, so I never any mane in my pocket,
[1:03:22] Speaker 1: so I don't know how it would have bought it.
[1:03:23] Speaker 1: And there was no credit cards, just access was heavily limited.
[1:03:31] Speaker 1: My mother gave me Florid tablets, but I think we're
[1:03:34] Speaker 1: on about I was about ten and floridation sort of
[1:03:36] Speaker 1: came into the system, so I guess so I took
[1:03:39] Speaker 1: advantage of that. We didn't have any of the sorts
[1:03:42] Speaker 1: of foods that are around today, take away foods. Everything
[1:03:45] Speaker 1: was made at home. You took lunch from home, ate
[1:03:50] Speaker 1: dinner home, you ate everything at home. I don't have
[1:03:53] Speaker 1: one filling and I've never had a tooth removed. And
[1:03:56] Speaker 1: I go down as regularly is that genetics.
[1:04:02] Speaker 2: Look, I think there's genetics in lots of things.
[1:04:05] Speaker 1: When we talk about much as lucky.
[1:04:06] Speaker 2: Yeah, well there's probably a little bit of that as well.
[1:04:09] Speaker 2: But I think, you know, it's to be completely honest
[1:04:13] Speaker 2: with you, I don't know what the science is behind that,
[1:04:15] Speaker 2: the genetic component, but I'm sure there is a genetic component.
[1:04:20] Speaker 2: You know, there are certainly cases where people inherit well
[1:04:23] Speaker 2: not inherent, but you know, they have developmental defects of
[1:04:26] Speaker 2: their teeth that you know, weaken the structure of the teeth, for.
[1:04:29] Speaker 1: Instance, developmental overlapping each other or something.
[1:04:34] Speaker 2: No, so for instance, like the structure of the actual
[1:04:36] Speaker 2: tooth itself.
[1:04:37] Speaker 1: Right is like as an enamel and something like that.
[1:04:40] Speaker 2: That's right, So as it's formed, it doesn't form properly
[1:04:43] Speaker 2: for whatever reason, and those teeth are then prone to
[1:04:46] Speaker 2: well they're not as strong as they should be, so
[1:04:48] Speaker 2: they're any kind of insult then is you know, significant
[1:04:51] Speaker 2: to the tooth. So so that's you know, so there
[1:04:54] Speaker 2: is that sort of basis for some of it. But
[1:04:56] Speaker 2: in terms of you know, your particular case, you know
[1:04:59] Speaker 2: where you've got good genet for teeth, you know, I
[1:05:01] Speaker 2: think that probably is a thing, but like I said,
[1:05:04] Speaker 2: I'm not sure about the actual you know, science, I
[1:05:06] Speaker 2: guess behind that.
[1:05:07] Speaker 1: Yeah, So because you know, he got my mother had
[1:05:10] Speaker 1: once sat teeth, which my brother's more inherited. My younger
[1:05:13] Speaker 1: brother and my sister, my youngest younger sister and I
[1:05:18] Speaker 1: have more got dad's shape teeth. Everything's sort of very
[1:05:21] Speaker 1: similar and equally as a result, we tend to have
[1:05:26] Speaker 1: better teeth health than say, my brother, and I noticed
[1:05:31] Speaker 1: his is wearing down really quickly. So if our teeth
[1:05:36] Speaker 1: are wearing down, unless my brother's sixty something, So is
[1:05:42] Speaker 1: it a thing that he should go then and say
[1:05:44] Speaker 1: to his dentist look, or would his dendist say to him,
[1:05:48] Speaker 1: maybe we should build these up a bit or put
[1:05:51] Speaker 1: caps on on whatever the case may be, apart from
[1:05:53] Speaker 1: the sets, Ye, is that something that people should start
[1:05:56] Speaker 1: to consider? Those things so those that they're they're available
[1:05:59] Speaker 1: readily by don't assume you're in a socioeconomic environm where
[1:06:02] Speaker 1: you can actually afford it. But is that something that's
[1:06:04] Speaker 1: important in terms of having future better oral health, having
[1:06:08] Speaker 1: bigger teeth, bigger teeth, but you know what I mean,
[1:06:10] Speaker 1: like your tooth being bigger.
[1:06:12] Speaker 2: Yeah, look, I think it's certainly something that if you
[1:06:15] Speaker 2: have observed that's occurring, that you should have that conversation
[1:06:18] Speaker 2: with your dentist. The first thing, I guess is to
[1:06:20] Speaker 2: figure out why it's happening, so you know what the
[1:06:23] Speaker 2: deal is. If you're safe, for instance, grinding your teeth,
[1:06:25] Speaker 2: or you're having a lot of like acidity in your diet,
[1:06:28] Speaker 2: that's actually wearing down the tooth surface and that's what's
[1:06:31] Speaker 2: causing it.
[1:06:32] Speaker 1: But let's say to the front ones here. Yeah. Yeah.
[1:06:35] Speaker 2: The other thing as well is that you know when
[1:06:36] Speaker 2: your tooth, when you're when the tooth is getting smaller
[1:06:41] Speaker 2: in terms of its size, there's a nerve that sits
[1:06:44] Speaker 2: inside each tooth, and so you know, we want to
[1:06:47] Speaker 2: know what the health of that nerve is. You know,
[1:06:51] Speaker 2: if the tooth wears down too quickly, the nerve gets
[1:06:53] Speaker 2: inflamed and you can have all sorts of problems toothache
[1:06:55] Speaker 2: and what have you. So so I think you know,
[1:06:59] Speaker 2: if that's sort of thing is occurring in your you're
[1:07:02] Speaker 2: observing that, then something that you need to have a
[1:07:04] Speaker 2: chat with your dentist about in terms of whether you
[1:07:07] Speaker 2: know you should have those teeth built up to their
[1:07:10] Speaker 2: original size for instance. I think it really depends on
[1:07:14] Speaker 2: the severity and what impact it's having on the rest
[1:07:16] Speaker 2: of your mouth or your ability to function, your ability
[1:07:20] Speaker 2: to eat properly, to chew properly, to speak clearly, you know,
[1:07:24] Speaker 2: articulate your words and what have you. Also the impact
[1:07:28] Speaker 2: it has on like the way you bite your teeth
[1:07:31] Speaker 2: together and the other structures of your face. So that's
[1:07:33] Speaker 2: something you close your jaw, you close your draw so
[1:07:37] Speaker 2: you know the draws you know, closes to the point
[1:07:39] Speaker 2: where the teeth they meet here, and if the teeth
[1:07:43] Speaker 2: are very short, then your jaw actually has to close
[1:07:45] Speaker 2: further to meet the teeth together. So you know there
[1:07:48] Speaker 2: are implications for the musculature and the draw into and
[1:07:50] Speaker 2: what have you. So you know, for the most part
[1:07:52] Speaker 2: it's not an issue, but there will be some severe
[1:07:56] Speaker 2: cases where you know where it isn't you know, it
[1:08:00] Speaker 2: does impact your daily function, and that's something that your
[1:08:03] Speaker 2: dentists will probably need to have a thorough look at
[1:08:05] Speaker 2: and have a chat to you about what may or
[1:08:08] Speaker 2: may not be possible.
[1:08:09] Speaker 1: Because people getting your toeth capped today is it's a
[1:08:13] Speaker 1: regular event. Like I reckon every guy I know who's
[1:08:16] Speaker 1: over sixty who can afford it, And all of a
[1:08:19] Speaker 1: sudden one day I see them and they've got like
[1:08:22] Speaker 1: perfect teeth, Like it's crazy, you know, I think, I think,
[1:08:25] Speaker 1: what the fuck's happened here? And they look great? They
[1:08:29] Speaker 1: look great. And I often wondered, is if it's the aesthetics.
[1:08:33] Speaker 1: Is that's a personal issue that depends on whether someone
[1:08:35] Speaker 1: wants to do that. It's completely up to them. But
[1:08:37] Speaker 1: I'm thinking more in an oral health sense that you're
[1:08:41] Speaker 1: saying that there could be circumstances where it is good
[1:08:45] Speaker 1: for your oral health to get them rebuilt, so to speak.
[1:08:48] Speaker 2: Yeah, look, it's it's possible. It really depends the case
[1:08:51] Speaker 2: by case thing, and you need to speak to your
[1:08:53] Speaker 2: dentist about it. There's lots of reasons to cap a
[1:08:56] Speaker 2: truth apart from the aesthetics. So if the tooth, if
[1:08:59] Speaker 2: the natural tooth structure is eroded and it's not robust,
[1:09:03] Speaker 2: then you can actually, you know, put a cap over
[1:09:05] Speaker 2: the top of it and make it robust.
[1:09:06] Speaker 1: Which you want. My mother did for her lower front teeth.
[1:09:10] Speaker 2: Yeah, and it just means that you get to keep
[1:09:11] Speaker 2: that tooth in place for longer, potentially than if it
[1:09:15] Speaker 2: was to chip away. To the point where it's not
[1:09:17] Speaker 2: salvaigible and you end up losing the tooth, for instance.
[1:09:20] Speaker 2: So there's you know, there are some indications where a
[1:09:24] Speaker 2: cap would be or a crown would be appropriate. They're
[1:09:28] Speaker 2: called crowns or caps Yeah, we call them crowns in
[1:09:30] Speaker 2: the dental world.
[1:09:31] Speaker 1: Is the difference between capsule crowds? No, it's the same thing, okay,
[1:09:33] Speaker 1: because Mum was used to call it a crown and
[1:09:35] Speaker 1: all of a sudden people call it capsu. Yes, the
[1:09:38] Speaker 1: same thing, okay.
[1:09:40] Speaker 2: So so yeah, there' certainly lots of reasons why somebody
[1:09:43] Speaker 2: might or might not decide to have a crown.
[1:09:45] Speaker 1: But what about And there's also another really big trending
[1:09:49] Speaker 1: thing is especially when watching TV and I'll see TV presenters,
[1:09:52] Speaker 1: everyone's got the whitest teeth, so widest, crazy and I've
[1:09:55] Speaker 1: got my god and look, lit are fantastic, that will
[1:09:58] Speaker 1: look perfect. What about teeth whitening? Is there any downside
[1:10:04] Speaker 1: of getting your teeth whitened or any upside apart from esthetics?
[1:10:08] Speaker 2: Yeah, so it's it's certainly a trendy thing to do.
[1:10:10] Speaker 2: There's lots of different ways that you can whiten your teeth,
[1:10:13] Speaker 2: as in you know that you can. You can go
[1:10:16] Speaker 2: to your dentists and get them whitened at the dentists
[1:10:18] Speaker 2: so or your dentists can make mouthguards essentially custom fit matter.
[1:10:23] Speaker 1: I tried that one. I didn't do anything because my
[1:10:29] Speaker 1: teeth got my teeth hurt. I was quite uncomfortable.
[1:10:33] Speaker 2: No, I think that's one of the most common downsides
[1:10:36] Speaker 2: to having bleach bleaching your teeth is that sensitivity that
[1:10:40] Speaker 2: you develop in the teeth, and it can be actually
[1:10:42] Speaker 2: quite severe, the sensitivity and not you know, hot and cold,
[1:10:46] Speaker 2: and it stops it from eating and breathing and talking
[1:10:47] Speaker 2: and all that kind of business. So that's probably the
[1:10:51] Speaker 2: most common, you know, downside to it. The other thing
[1:10:57] Speaker 2: as well, is for most of the time it doesn't
[1:10:59] Speaker 2: just last. You've got to top it up, right, So
[1:11:02] Speaker 2: you might sort of get to the point we think
[1:11:04] Speaker 2: I quite like that you know whiteness or that shade,
[1:11:07] Speaker 2: and then you stop bleaching it, and over time it goes,
[1:11:13] Speaker 2: it starts to regress and you need to top it up.
[1:11:15] Speaker 2: So it's not necessarily a once off process. Many people
[1:11:19] Speaker 2: end up doing it, you know, for quite a long
[1:11:21] Speaker 2: period of time, throughout many years.
[1:11:24] Speaker 1: It's mostly hydroperoxide that they're putting potentially, yes, and hydrogen
[1:11:28] Speaker 1: peroxide is it's a poison, So does it does it
[1:11:35] Speaker 1: does do any damage to what's going on inside of
[1:11:38] Speaker 1: your mouth? And if it does, does your mouth sort
[1:11:41] Speaker 1: of somehow recover really miraculously because you know, we just
[1:11:44] Speaker 1: build that weight, like in other words, we regenerate all
[1:11:47] Speaker 1: the good bacterias and all the other stuff we want
[1:11:50] Speaker 1: to have floating around our mouth. So the way, but
[1:11:54] Speaker 1: I'm bad to grink some drinks of MACHOs green, so
[1:11:57] Speaker 1: I'm getting really self conscious in here in front of you.
[1:12:00] Speaker 2: So for the most part, when we talk about bleaching teeth,
[1:12:03] Speaker 2: it is something like hydrogen peroxide and different concentrations generally speaking,
[1:12:09] Speaker 2: And I guess this is one of the important points
[1:12:11] Speaker 2: is that if you are going to go down this pathway,
[1:12:13] Speaker 2: it's important to get either your dentist to do it
[1:12:15] Speaker 2: in the chair while yeah, the dental practice, or you
[1:12:19] Speaker 2: get the custom made mouth guards as you did saying Mark,
[1:12:23] Speaker 2: because what that does is it make sure that the
[1:12:25] Speaker 2: amount of bleach that you need to use is minimal.
[1:12:28] Speaker 2: You're not getting bleach that's like spilling out and sort
[1:12:31] Speaker 2: of you know, coding your mouth. You can actually go
[1:12:34] Speaker 2: to the chemist and get these. It's like you know
[1:12:36] Speaker 2: those soccer mouth guards that you used to be, or
[1:12:38] Speaker 2: you just chuck it in some hot water and more in. Yeah,
[1:12:41] Speaker 2: you can do that kind of thing. I wouldn't advise
[1:12:43] Speaker 2: doing that just because it doesn't actually fit, doesn't fit
[1:12:46] Speaker 2: your mouth, like it's a one size fit all thing,
[1:12:49] Speaker 2: and the amount of bleach that you end up using,
[1:12:51] Speaker 2: it just spills out all over the shop and it
[1:12:53] Speaker 2: coats the lining of your mouth. It's not supposed to
[1:12:55] Speaker 2: be there, and you can develop you know, reactions on
[1:12:58] Speaker 2: the lining of your math because too much bleach in there.
[1:13:01] Speaker 2: Garm yeah actually, yeah, yeah. So when they do it,
[1:13:04] Speaker 2: when they give you the custom made ones, it's it's
[1:13:07] Speaker 2: fabricated to fit your mouth. It fits very well, and
[1:13:11] Speaker 2: it's fabricated to only allow the bleach to be in
[1:13:14] Speaker 2: certain areas of the mouth or on the teeth themselves,
[1:13:17] Speaker 2: so you're not supposed to have bleach spilling out all
[1:13:20] Speaker 2: over the place, so it's more controlled. And yeah, if
[1:13:25] Speaker 2: you're going to do it, that's the way I would recommend.
[1:13:27] Speaker 1: Because I was just thinking when you were speaking then
[1:13:31] Speaker 1: the name with your teeth is pretty tough. It's spilled
[1:13:34] Speaker 1: that way, and it can whilst it's going to absorb
[1:13:37] Speaker 1: the hydrogen peroxide and might some way into the tooth
[1:13:43] Speaker 1: but effectively lightens the color. But I guess what you're
[1:13:48] Speaker 1: saying is that it's definitely not meant to be getting
[1:13:51] Speaker 1: on your gums.
[1:13:52] Speaker 2: Yes, nightly so so most people use these things, you know,
[1:13:58] Speaker 2: nightly overnight for instance. So if you've got chemicals in there,
[1:14:02] Speaker 2: touching of gums for a prolonged period, burn it. Yeah, yeah,
[1:14:05] Speaker 2: you can develop like chemical burns.
[1:14:07] Speaker 1: Yeah, yeah, I can imagine that because if you just
[1:14:11] Speaker 1: put a hydroen broxil on your hand.
[1:14:13] Speaker 2: It's depending on the concentration of it obviously, but yeah,
[1:14:17] Speaker 2: you're right. Absolutely you can have a reaction of the
[1:14:19] Speaker 2: lining of the mouth of the gums because of this
[1:14:21] Speaker 2: chemical that's sitting there for a prolonged period of time
[1:14:24] Speaker 2: quite frequently.
[1:14:25] Speaker 1: How do you someone like you as an oral specialist,
[1:14:29] Speaker 1: oral health specialists, how do you what do you think
[1:14:33] Speaker 1: of the whole ascetic world around our teeth today? And
[1:14:42] Speaker 1: you know, what do you think about that? Do you
[1:14:44] Speaker 1: think we've gone too far or there's things we should
[1:14:46] Speaker 1: be careful of because we seem to be more worried
[1:14:50] Speaker 1: about what we particularly the younger cohort tend to be
[1:14:54] Speaker 1: really conscious of how bright and showing the teeth are.
[1:15:00] Speaker 1: Is that potentially an issue for us or is it
[1:15:02] Speaker 1: a good thing?
[1:15:04] Speaker 2: So I think it's it's a difficult one. So I
[1:15:09] Speaker 2: agree with you. I think we are becoming more conscious
[1:15:11] Speaker 2: about not just our teeth, but our appearance in general,
[1:15:14] Speaker 2: particularly the young people. I don't know if that's a
[1:15:16] Speaker 2: result of you know, social media and exposure to things
[1:15:19] Speaker 2: that you know, celebrities and what have you that we
[1:15:21] Speaker 2: didn't have, you know, when I was growing up, because
[1:15:24] Speaker 2: I'm also old.
[1:15:26] Speaker 1: You don't look it.
[1:15:28] Speaker 2: It's the hairdart, so you know. So there's a lot
[1:15:32] Speaker 2: of that happening. I think I see it in my
[1:15:33] Speaker 2: own children, for instance. So we're just much more aware
[1:15:36] Speaker 2: of these types of things. I think there's there's two
[1:15:43] Speaker 2: things to be said. The first is about the person's
[1:15:47] Speaker 2: self confidence and their self image. So some people feel
[1:15:50] Speaker 2: the need to do it because of how they want
[1:15:52] Speaker 2: to project themselves or what have you, and that's that's
[1:15:54] Speaker 2: a personal thing. In terms of the actual gentle or
[1:15:58] Speaker 2: oral side of things, I think there are some easy
[1:16:02] Speaker 2: things that can be done that are quite easy. So
[1:16:04] Speaker 2: you know, some sometimes the bleaching, if it's done in
[1:16:06] Speaker 2: a controlled environment, you know, with well defined like baseline
[1:16:10] Speaker 2: and time points and what have you, that's not it's
[1:16:12] Speaker 2: not terrible. But we have gotten to a point now
[1:16:16] Speaker 2: where people are doing drastic you know, dental makeovers, people
[1:16:21] Speaker 2: are flying overseas and doing holiday you know overseas, dentustry
[1:16:24] Speaker 2: and what have you can potentially land them into some
[1:16:27] Speaker 2: hot water. There's lots of complications that may or may
[1:16:30] Speaker 2: not arise out of those types of types of things.
[1:16:33] Speaker 2: So you know, I think it's you know, there's always
[1:16:37] Speaker 2: the extremes, isn't there And finding the balance is what's tricky.
[1:16:40] Speaker 1: Yeah, I find it a little worrisome because social media
[1:16:47] Speaker 1: is a big push of all this sort of stuff. Yes,
[1:16:50] Speaker 1: and there's now it's and I have noticed, I don't
[1:16:52] Speaker 1: know whether it's because I've started to look at things
[1:16:57] Speaker 1: like oral health more recently in the last FORMATH that
[1:17:01] Speaker 1: the algorithm has worked out and sending me more stuff.
[1:17:04] Speaker 1: Potentially that is the case. But right down to and
[1:17:07] Speaker 1: I said it right at the beginning of the show,
[1:17:10] Speaker 1: you know, there are there's I see an American doctor
[1:17:14] Speaker 1: get on there and talk about you know, one oral
[1:17:17] Speaker 1: health hack is that every day you should have a
[1:17:22] Speaker 1: glass of warm water with salt, you know. And he
[1:17:26] Speaker 1: mentioned where the salt should come from, the Barges Sea,
[1:17:28] Speaker 1: which is like this at the bottom of North America
[1:17:32] Speaker 1: between North and South America and with a squeeze lemon
[1:17:37] Speaker 1: juice in it. Like, is there any sides around that?
[1:17:43] Speaker 1: Or is this just is that some sort of weird
[1:17:46] Speaker 1: health hack that you know, our grandparents are talking about
[1:17:48] Speaker 1: or I don't know if it's real or not real.
[1:17:51] Speaker 1: I don't know whether. And one of the things I
[1:17:52] Speaker 1: want to ask you, like, is that something I should
[1:17:54] Speaker 1: be doing? I thought, well, that makes sense. So the
[1:17:56] Speaker 1: salt lemon, you know, I'm Greek, so lemon and salt
[1:18:00] Speaker 1: we have we have that and everything and water like
[1:18:04] Speaker 1: and it's a mouth, you know, swallow of course you
[1:18:05] Speaker 1: just reach mouth out of it after meal.
[1:18:08] Speaker 2: Yeah, So I think it's probably about the cleansing of
[1:18:12] Speaker 2: the cleansing action of the rinse itself rather than what's
[1:18:15] Speaker 2: in it. So salt water is one of these funny things, right,
[1:18:18] Speaker 2: Like our grandmother's used to always talk about salt, you know,
[1:18:20] Speaker 2: salt water like rinse with salt water, rub salt on
[1:18:22] Speaker 2: it or whatever, because it had some sort of magic
[1:18:25] Speaker 2: power and and I'm sure it probably does some some
[1:18:29] Speaker 2: anti inflammatory or antibacterial or something properties, but nobody really
[1:18:34] Speaker 2: knows why it works. Well, I certainly don't know why
[1:18:36] Speaker 2: it works.
[1:18:37] Speaker 1: There's no science around it. There's no not that I
[1:18:39] Speaker 1: not that I know of.
[1:18:40] Speaker 2: But it's not to say that it's not there.
[1:18:42] Speaker 1: Yeah, just not for me. You haven't done a literature
[1:18:44] Speaker 1: review on that.
[1:18:45] Speaker 2: Might have to do a quick doctor. But but yeah,
[1:18:48] Speaker 2: so so you know, so there's that in terms of
[1:18:52] Speaker 2: salt salt water rinces. I don't have a problem with that.
[1:18:55] Speaker 2: You know, if that's something that you want to do
[1:18:57] Speaker 2: and you want to you know, feel that your mouth
[1:18:59] Speaker 2: is fresh and clean and what have you, that's fine.
[1:19:01] Speaker 2: The lemon, I mean, you can take that to the extreme.
[1:19:04] Speaker 2: Some people, you know, end up sucking on lemons and
[1:19:06] Speaker 2: what have you. When they end up you know that
[1:19:08] Speaker 2: it's the acidity really of the lemon that can cause
[1:19:11] Speaker 2: damage to the mouth, to the teeth and too the
[1:19:13] Speaker 2: learning of the mouth. So i'd be you know, you'd
[1:19:15] Speaker 2: want to moderate that. I think it's not to say
[1:19:17] Speaker 2: that you shouldn't have lemon at all in your diet,
[1:19:19] Speaker 2: but it's just about the concentration of it. Yeah, that's right,
[1:19:22] Speaker 2: that's right. But I suspect that whole thing of you know,
[1:19:25] Speaker 2: getting up in the morning and having this rinse is
[1:19:27] Speaker 2: probably about cleansing your mouth out ready to start the day.
[1:19:30] Speaker 1: Yeah, and that sort of makes sense. And there's nothing
[1:19:33] Speaker 1: better than having that fresh feeling too. By the way,
[1:19:35] Speaker 1: I I mean, I was quite enamored towards that concept
[1:19:44] Speaker 1: when I read about it. I actually came up on
[1:19:47] Speaker 1: this morning when I was just opened my phone up
[1:19:51] Speaker 1: professors who could just tell me or maybe would you
[1:19:54] Speaker 1: like to finish this off as are there is there
[1:19:56] Speaker 1: anything that we haven't touched on that you think you've
[1:19:59] Speaker 1: been professional that we should be touching on in relation
[1:20:02] Speaker 1: to oral health generally, I.
[1:20:07] Speaker 2: Guess take home message realistically, and we have talked about
[1:20:10] Speaker 2: this quite extensively. Realistically is about about being knowledgeable about
[1:20:16] Speaker 2: your mouth, so not just your teeth, but the lightning
[1:20:18] Speaker 2: of your mouth. If there's anything that you're concerned about
[1:20:21] Speaker 2: you think that's a bit weird, a bit of normal,
[1:20:23] Speaker 2: or you know, pain bleeding, what have you, that's ulcers
[1:20:27] Speaker 2: that are there that's lasting more than that two week mark.
[1:20:30] Speaker 2: Please please bring that to the attention of your dentist.
[1:20:34] Speaker 2: I guess one of the things we didn't talk about,
[1:20:37] Speaker 2: and I don't want us to go down a dark
[1:20:40] Speaker 2: hole realistically with cancers. But you know, oral cancer in
[1:20:45] Speaker 2: the initial stages is actually painless.
[1:20:48] Speaker 1: Oh really, So.
[1:20:50] Speaker 2: It's really important that why do we know we've got it? Well,
[1:20:53] Speaker 2: many people don't. Many people don't until somebody looks and goes, well,
[1:20:57] Speaker 2: what's going on there? What's you know, what's happening?
[1:20:59] Speaker 1: But is there something that like you're a profession but
[1:21:02] Speaker 1: you you would see.
[1:21:03] Speaker 2: So if you're if you are trained to look, there
[1:21:07] Speaker 2: are certain signs that would alert you to the fact
[1:21:09] Speaker 2: that there's something abnormal happening. There certain suspicious features that
[1:21:13] Speaker 2: would then trigger you to perform a biopsy in and
[1:21:16] Speaker 2: you know, secure a diagnosis. So the only way it
[1:21:18] Speaker 2: can be diagnosed realistically is with a biopsy. But lots
[1:21:21] Speaker 2: of people don't actually realize that it's actually painless at
[1:21:24] Speaker 2: the beginning. Wow, people assume that oh, cancers, you know,
[1:21:27] Speaker 2: it's obviously a bad thing and it's you know, probably
[1:21:30] Speaker 2: going to be painful and what have you. That's not
[1:21:32] Speaker 2: necessarily the case. So you know, there are cases of
[1:21:37] Speaker 2: what I call delayed diagnosis because it's not painful and
[1:21:40] Speaker 2: nobody is really you know, looking for it. That you know,
[1:21:44] Speaker 2: people end up with a cancer that's diagnosed, you know,
[1:21:48] Speaker 2: later than it could have could have been.
[1:21:51] Speaker 1: And the only you get diagnosed, the more likelihood to
[1:21:54] Speaker 1: get cure.
[1:21:55] Speaker 2: Yeah, absolutely, prognosis or the outcome is significantly better if
[1:21:59] Speaker 2: it's diagnosed early.
[1:22:01] Speaker 1: And is mouth cancer becoming more common.
[1:22:05] Speaker 2: It's certainly so. In Australia, I think there's probably roughly
[1:22:08] Speaker 2: you know, four thousand ish new cases diagnosed every year
[1:22:14] Speaker 2: head and neck cancer. So if you look at cancer statistics,
[1:22:16] Speaker 2: we often group the head and neck cancers together, which
[1:22:19] Speaker 2: is a bit unfair because there's whole bunch of different
[1:22:21] Speaker 2: cancers that can occur in that part of your body.
[1:22:24] Speaker 2: But it's you know, ranked is about the seventh most
[1:22:27] Speaker 2: common cancer site, so you know, mouth cancer is certainly
[1:22:31] Speaker 2: one of those. Mouth cancer. So the mouth is a
[1:22:33] Speaker 2: funny thing because if you had a mouth problem and
[1:22:35] Speaker 2: you went to your GP, A lot of the gps
[1:22:38] Speaker 2: firstly are not trained to inspect the mouth, you know,
[1:22:43] Speaker 2: to the degree that a dentist is, for instance, So
[1:22:46] Speaker 2: I say to people going to GPS, fine, but you
[1:22:48] Speaker 2: should also touch base with your dentist because they've got
[1:22:51] Speaker 2: the equipment, they've got the light, they've got the magnification
[1:22:53] Speaker 2: and the training to actually have a really good look.
[1:22:56] Speaker 2: So so that's one of the things. The other thing
[1:22:59] Speaker 2: I guess that we haven't talked about in relation to
[1:23:01] Speaker 2: Mauth cancer is this emerging demographic of human papillomavirus related that. Yeah,
[1:23:08] Speaker 2: so HPV human papillomavirus. It's it's a virus. There's many
[1:23:14] Speaker 2: different strains of this particular virus, but there are a
[1:23:17] Speaker 2: number that are what we call oncogenic or they have
[1:23:19] Speaker 2: the ability to to you know, to start or to
[1:23:25] Speaker 2: be associated with the cancer. So the most common HPV
[1:23:28] Speaker 2: cancers in women a cervical cancer, but increasingly there is
[1:23:34] Speaker 2: a population of patients and these are younger patients who
[1:23:38] Speaker 2: are developing oroferones like oroforn dual cancer. So the back
[1:23:42] Speaker 2: of the you know that juvule area where the ts
[1:23:44] Speaker 2: are related to HPV infection, how do they catch that
[1:23:48] Speaker 2: like a virus? Yeah, so HPVs and STIs are sexually
[1:23:52] Speaker 2: transmitted infection. And the beauty well and the other thing
[1:23:57] Speaker 2: I guess about this demographic is that they don't have
[1:24:00] Speaker 2: any of those traditional risk factors for math cancer. So
[1:24:03] Speaker 2: we talked about the smoking and the drinking and the
[1:24:05] Speaker 2: you know, older age group and what have you. These
[1:24:07] Speaker 2: these people are not in that classic demographic and so
[1:24:11] Speaker 2: we are seeing this rising trend in HPV positive oro
[1:24:15] Speaker 2: fair est.
[1:24:16] Speaker 1: So they catch they catch the HPV from another person
[1:24:19] Speaker 1: I presume y orally transmit or some transmit like that,
[1:24:25] Speaker 1: and they is there something that they would notice in
[1:24:29] Speaker 1: their mouth or.
[1:24:30] Speaker 2: So you can develop like mal oral cancer usually towards
[1:24:35] Speaker 2: the back related to HPV, but it tends to also
[1:24:38] Speaker 2: be sort of in that tonsular region or further back
[1:24:42] Speaker 2: with relation to that. The beauty in Australia is that
[1:24:45] Speaker 2: we've now got this vaccination program which was rolled out
[1:24:48] Speaker 2: in a number of years ago. So we're for this virus, yeah,
[1:24:52] Speaker 2: for the HPV virus. So we're getting these you know,
[1:24:55] Speaker 2: young teens, so people that are you know, in school
[1:24:57] Speaker 2: in year seven for instance, there's an immunos program where
[1:25:01] Speaker 2: all the kids get lined up and you know, yeah,
[1:25:04] Speaker 2: yeah consent get get vaccinated. So we know that that
[1:25:08] Speaker 2: vaccine is very effective in preventing HPV infictions, and so
[1:25:13] Speaker 2: we are starting to see now because the vaccination program
[1:25:16] Speaker 2: has been out for a while, we're starting to see
[1:25:18] Speaker 2: the effect that it's having on HPV related disease. So
[1:25:23] Speaker 2: things like O referrangeal cancer and other you know, things
[1:25:26] Speaker 2: like genital wartz and what have you, can be related
[1:25:29] Speaker 2: to such PV as.
[1:25:30] Speaker 1: Well, given that this cancer caused by this virus or
[1:25:36] Speaker 1: is it cause or correlated of course caused by the virus.
[1:25:40] Speaker 1: You're saying that a lot of these are sort of
[1:25:43] Speaker 1: like asymptomatic. You don't get any symptoms. And let's say
[1:25:47] Speaker 1: that the person's is thirty years of age. In other words,
[1:25:52] Speaker 1: they weren't around when the vaccine was available. And let's
[1:25:57] Speaker 1: say that particularly individual has been inactive person male or female,
[1:26:01] Speaker 1: what should they be doing? I mean, Dan, it's not
[1:26:05] Speaker 1: going to be able to tell them what's going where
[1:26:06] Speaker 1: they should be seen the dentist or what should they do.
[1:26:08] Speaker 2: So I think the tests, Yeah, so it probably is
[1:26:11] Speaker 2: not going to show in the blood test. So if
[1:26:12] Speaker 2: they're developing lumps in the neck for instance, that you
[1:26:15] Speaker 2: know sometimes you get these lymph nos that pop up
[1:26:17] Speaker 2: in the neck and what have you. So things that
[1:26:19] Speaker 2: are not related to a sore throat or an infection
[1:26:22] Speaker 2: or what have. You need to get that checked out.
[1:26:24] Speaker 2: If you're developing you know, pain when you're swallowing for
[1:26:28] Speaker 2: no good reason and it's persistent, or changing your voice
[1:26:32] Speaker 2: or you know, just things that are not quite right.
[1:26:35] Speaker 2: You need to be bringing that to the attention.
[1:26:36] Speaker 1: Of somebody, you GP or whatever.
[1:26:39] Speaker 2: I think.
[1:26:39] Speaker 1: So it's interesting and just just finally, another thing is
[1:26:42] Speaker 1: really trainy big time is vapes. Where does that sit
[1:26:47] Speaker 1: in the oral health world?
[1:26:50] Speaker 2: Yeah, so vaping is my thing. I mean, vaping is
[1:26:53] Speaker 2: not my thing.
[1:26:53] Speaker 1: But it's it's you can pull it out how if
[1:26:55] Speaker 1: you like that.
[1:26:57] Speaker 2: So it's a topic that I talk a lot about vape.
[1:27:00] Speaker 2: So it's very interesting. Vacans really only come about in
[1:27:04] Speaker 2: the last you know, ten fifteen years before. When I
[1:27:07] Speaker 2: was growing up, it wasn't the thing. And the landscape
[1:27:11] Speaker 2: of vaping in Australia is changing because there is recent
[1:27:15] Speaker 2: legislation which is sort of trying to cut down on
[1:27:18] Speaker 2: these black market vapes which are unregulated and you know
[1:27:21] Speaker 2: and all of that. The thing with vaping, I guess,
[1:27:24] Speaker 2: is that at the moment you need to so in
[1:27:29] Speaker 2: Australia anyway, in order to access vaping for smoking cessation.
[1:27:35] Speaker 2: As a smoking cessation tool, you need to actually go
[1:27:39] Speaker 2: to the chemist to purchase it. You need to it
[1:27:42] Speaker 2: sits behind the counter at the chemist. You need to
[1:27:44] Speaker 2: talk to the chemist and have that conversation. If you're
[1:27:47] Speaker 2: under eighteen and you need to access a vape for
[1:27:49] Speaker 2: that purpose, you need to go to your GP and
[1:27:51] Speaker 2: get a prescription. The black market vapes that used to
[1:27:55] Speaker 2: get at the corner store are now illegal. The thing
[1:27:58] Speaker 2: with those, I guess was that they were firstly unregulated. Secondly,
[1:28:04] Speaker 2: the lots of constituents in the vapes that weren't advertised.
[1:28:07] Speaker 2: So yeah, nicotine is probably the biggest one, and a
[1:28:11] Speaker 2: lot of the marketing around those is targeting quite young
[1:28:16] Speaker 2: adolescents who are not necessarily aware of what's going on
[1:28:19] Speaker 2: and what's in it, and it was kind of like
[1:28:21] Speaker 2: a hip, you know, social activity for a period of time.
[1:28:28] Speaker 2: I think the landscape is slowly changing, so I think
[1:28:30] Speaker 2: that's sort of taking it. The legislation is sort of
[1:28:34] Speaker 2: helping us with that. But there's lots of health risk
[1:28:37] Speaker 2: associated with vaping. You know, certainly nicotine, we know is
[1:28:43] Speaker 2: a chemical that can cause lots of issues with general
[1:28:46] Speaker 2: health and oral health as well. And then not just
[1:28:49] Speaker 2: the nicotine, but there's whole heap of other chemicals that
[1:28:51] Speaker 2: you're inhaling, Yeah, heaps. And we know that there are carcinogens,
[1:28:56] Speaker 2: so cancer causing chemicals that's that's in that aerosol that
[1:29:03] Speaker 2: you inhale, that can you know, cause of obviously cancers
[1:29:07] Speaker 2: in the lungs and other areas of the of the body.
[1:29:10] Speaker 2: So it's a minefield.
[1:29:12] Speaker 1: So while so it seems like you know to perhaps
[1:29:15] Speaker 1: you and I certainly a survey too, but ridiculous that
[1:29:22] Speaker 1: we would inhaler vape. It is much more prevalent than
[1:29:28] Speaker 1: everybody gives it credit for because a you can't see it,
[1:29:32] Speaker 1: no one can see it. They can hold it here
[1:29:34] Speaker 1: and there's no smoke, there's no cigarette, there's no match,
[1:29:37] Speaker 1: there's not a box. It's they can hide and they
[1:29:40] Speaker 1: can use it all the time. I'm excuse me, my
[1:29:43] Speaker 1: my head office in the main city, in the city,
[1:29:46] Speaker 1: i should say, and walking around everywhere doing it literally everywhere.
[1:29:51] Speaker 1: And so you're saying an oral health point of view,
[1:29:58] Speaker 1: it's just no girl.
[1:29:59] Speaker 2: Yeah, absolutely, And I'm pretty straight up with my patients,
[1:30:02] Speaker 2: so I will tell them, Yeah, I think there's probably
[1:30:06] Speaker 2: you know, a proportion of people that are using vaping
[1:30:09] Speaker 2: for smoking cessation and they've possibly exhausted the other methods
[1:30:16] Speaker 2: that are tried and true and what have you, like
[1:30:17] Speaker 2: the patches and the gums and that kind of business,
[1:30:20] Speaker 2: and so they're doing it. There's a lot of literature
[1:30:23] Speaker 2: to show that people that start vaping for smoking cessation
[1:30:29] Speaker 2: many of them actually end up doing both. So they
[1:30:32] Speaker 2: end up doing vaping and smoking.
[1:30:34] Speaker 1: Wow.
[1:30:34] Speaker 2: The other thing about vaping is that there's lots of
[1:30:37] Speaker 2: data to show that it can be a gateway to smoking,
[1:30:40] Speaker 2: So particularly for the younger individuals who've never smoked in
[1:30:43] Speaker 2: their vaping they started, yeah, they end up then smoking
[1:30:46] Speaker 2: as well. So it's a bit of a double you know.
[1:30:47] Speaker 1: It's mad about that too. By the way, I was
[1:30:49] Speaker 1: looking at some stats from the ABS the other day
[1:30:51] Speaker 1: and that the amount of cigarette smoking in Australia has
[1:30:58] Speaker 1: reduced significantly. Yes, But equally I was talking to some
[1:31:01] Speaker 1: friends of mine who were in the police and they
[1:31:04] Speaker 1: say that the amount of illegal cigarettes have increased more
[1:31:09] Speaker 1: significantly than the ABS would have us believe as the
[1:31:12] Speaker 1: amount of smoking that exists in Australia. So you know,
[1:31:15] Speaker 1: the ABS stats on smoking is incorrect because it doesn't
[1:31:18] Speaker 1: take account of what's illegal.
[1:31:19] Speaker 2: Yes, yeah, and I think it's very difficult to quantify
[1:31:22] Speaker 2: that and that was one of the issues with vapes
[1:31:24] Speaker 2: as well. So certainly during the COVID lockdown, people were
[1:31:28] Speaker 2: actssing vapes through Uber you know, or social media, and
[1:31:31] Speaker 2: you could just auder your vapes or uber driver pull
[1:31:33] Speaker 2: up and you've got some bapes.
[1:31:34] Speaker 1: So it's sort of crazy that we sort of self destruct. Yes,
[1:31:41] Speaker 1: we do this sort of stuff, and only as we
[1:31:43] Speaker 1: sort of get older do we tend to work these
[1:31:45] Speaker 1: things out, because it's unfortunate bit of a younger head
[1:31:49] Speaker 1: on our shoulders type mentality that puts us into this territory.
[1:31:53] Speaker 1: I mean, by the way, you know, I was young
[1:31:54] Speaker 1: ones and I just remember I remember it. I remember it.
[1:31:57] Speaker 1: I remember, you know, the sort of stuff we'd mad
[1:32:00] Speaker 1: shit I did. And you know, part of this show
[1:32:03] Speaker 1: was about having people like you were experts to about
[1:32:06] Speaker 1: me sort of sound like a parent, but getting experts
[1:32:09] Speaker 1: on there who can actually tell the story about these
[1:32:12] Speaker 1: things like around vapes, oral health generally, you know, making
[1:32:15] Speaker 1: sure that we talk to our dentists, make sure we
[1:32:17] Speaker 1: talk our GP about any changes or anything that's bothering us,
[1:32:22] Speaker 1: and make sure we build good habits, healthy habits in
[1:32:25] Speaker 1: terms of our you know, our teeth, and we'd just
[1:32:28] Speaker 1: stop thinking about you know, it's you're right, like we
[1:32:32] Speaker 1: tend to as we grow up. Just that's something I do.
[1:32:36] Speaker 1: So putting a seatbelt on my climber teeth put that's it.
[1:32:40] Speaker 1: I don't think any more about it. But I think
[1:32:41] Speaker 1: that I'm going to drive fast because I'm safe. I
[1:32:45] Speaker 1: have clema teeth that I can do whatever I want.
[1:32:48] Speaker 1: And I guess it's the seatbelt mentality. If there's such
[1:32:51] Speaker 1: a phrase, we just invented. That's if there isn't. We
[1:32:55] Speaker 1: just made it up. But I really appreciate you coming
[1:32:57] Speaker 1: on that was That was really awesome and it actually
[1:33:00] Speaker 1: cleared up a lot of things in my mind too,
[1:33:02] Speaker 1: by the way, appreciate it.
[1:33:03] Speaker 2: Thanks for so much for having me. That was great, awesome,

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