The Melanie Avalon Biohacking Podcast
The Melanie Avalon Biohacking Podcast

Episode 1 · 2 months ago

#162 - Danny Grannick (Bristle): The Oral Microbiome, Bristle Testing, Oral Vs. Gut Microbiome, Probiotics For Your Mouth , Fluoride Efficacy & Safety, Flossing & Electric Toothbrushes, Reversing Cavities, And More!



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2:45 - IF Biohackers: Intermittent Fasting + Real Foods + Life: Join Melanie's Facebook Group At For A Weekly Episode GIVEAWAY, And To Discuss And Learn About All Things Biohacking! All Conversations Welcome!

3:00 - Follow Melanie On Instagram To See The Latest Moments, Products, And #AllTheThings! @MelanieAvalon

Check Out My Blog On Bristle And The Oral Microbiome At!

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7:05 - FOOD SENSE GUIDE: Get Melanie's App At To Tackle Your Food Sensitivities! Food Sense Includes A Searchable Catalogue Of 300+ Foods, Revealing Their Gluten, FODMAP, Lectin, Histamine, Amine, Glutamate, Oxalate, Salicylate, Sulfite, And Thiol Status. Food Sense Also Includes Compound Overviews, Reactions To Look For, Lists Of Foods High And Low In Them, The Ability To Create Your Own Personal Lists, And More!

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13:00 - Danny's Background

16:50 - Danny's Personal Oral Hygiene Habits

18:55 - The History And Research In Oral Health

21:30 - Red & Orange Complex

23:45 - Bacteria And Its Relationship To Oral Disease

29:00 - What Bristle Tests For

31:10 - Publishing Clinical Literature

32:30 - The Range Of Results

35:20 - Implications Of Diversity In The Biome

37:55 - Is There Overlap In Species In Oral And Gut Microbiomes?

40:00 - How Many Species Are In The Gut?

40:20 - What Types Of Organisms Inhabit Our Oral Microbiome?

41:00 - What Determines Our Biome Make Up?

43:05 - How Quickly Can It Change?

48:30 - Transient And Colonized Bacteria

51:10 - What Is The Method Of Transit?

52:55 - Can You Reset The Oral Microbiome? What Happens?

56:55 - Fermented Foods

57:40 - Dental Carries

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1:06:40 - Do Cavities Always Indicate Disease?

1:12:45 - How Fast Does Bacteria Begin To Effect The Teeth?

1:13:40 - Should You Brush Immediately After Eating?

1:15:25 - Nitrates, Nitrites, Nitrosamine

1:17:10 - The Bristle Program

1:19:10 - The Importance Of Flossing 

1:22:05 - Electric Toothbrushes

1:25:00 - How Often Should We Replace Our Toothbrushes?

1:27:30 -The Bristle Results

1:31:30 - Is There Any Downsides To Getting Fillings?

1:33:00 - The Bristle Recommendations

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1:37:15 - Fluoride Efficacy And Safety

1:43:15 - One On One Consultations With Bristle Experts

1:45:00 - What Is The Future Of Bristle?

1:48:00 - HSA And FSA Eligibility

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We continue to do research into the oral microbiome and our understooding between oral health as kind of a category and overall health has for rest at our technology sequences everything in this slab. As a person, you will have some combination of any of those sublattered species. Our metals are like the only other place that you can mechanically remove bacteria from the environment. Most people think that brushing right after mules or anything to do, but you should actually wait like thirte bits to a dollar. Welcome to the Melanie avalon bio hacking podcasts, where we meet the world's top experience to explore the secrets of health, mindset, longevity and so much more. Are you ready to take charge of your existence and bio hack your life? This show it is really please keep in mind we're not dispensing medical advice and are not responsible for any outcomes, and we experience from implementing the tactics line hearing. Are you ready? Let's do this. Welcome back to the Melanie Avalon biohacking podcast friends, I am thrilled about today's episode. I have been wanting to look into the workings and implications of the oral microbiome for so so long. So when the founders of Bristol came to me to discuss collaboration, I was so thrilled, but I also didn't want to get my hopes up because, as you guys know, I am all about diving deep into the science making sure everything is truly valuable. Bristol has lived up to everything and especially interviewing Danny grannick today blew my mind with his knowledge. We get into so many cool topics in today's episode. I mean, if you thought the GUT microbiome was important, wait until you hear all of this information about the oral microbiome. I really think this is one of the biggest new frontiers that we will be seeing more and more research on. We get into so many fun topics today, like the differences between the oral and the GUT microbiome, how the oral microbiome affects your health, how it relates to health conditions, how you can optimize it for the better, what sort of toothbrushes you should use, the implications of flossing, whether or not you should use fluoride. I cannot recommend enough getting a bristle kit, a s a p. You will learn so, so much about yourself and they were so kind to give me a cupon code for fent off for you guys, and not only fiercent off normal orders, but fifteen percent off subscriptions, which are already discounted. This is unique, by the way. They don't normally do this, but I asked them if they would do it for you guys and they said yes. So thank you so much, Bristle, for that. So to get that incredible discount, just go to Melanie avalon DOT COM, slash Bristle B R I s t l e, and you see Coupon Code Melanie Avalon for fifteen percent off, and yes, that includes subscriptions. Definitely, definitely. Let me know what you guys think. Share with me on my facebook group. I have bio hackers, intermittent fasting, plus real foods plus life. Find the pinned announcement post about this episode and comment your thoughts there. That will also enter you into a giveaway to win a free product from me, so it's totally win win. You can also enter to win on my instagram. Find the Friday announcement posts there and again comment to enter to win something that I love and also just to share your thoughts, because I would love to hear them. The show notes for today's episode will be at Melanie Avalon dot com slash oral microbiome. Those show notes will have a full transcript, so definitely check that out. I also did a very extensive blog post on the oral microbiome, as well as Bristle. That is at Melanie avalon dot com slash Bristle Science, B R I, S T L E, S C I e N C E. I really, really can't wait to hear you guys think of this episode, so definitely let me know. 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Why did I make magnesium as my first nutrition supplement? That's because magnesium is so, so important. It is involved in over six hundred in somatic processes in the body. Basically everything that you do requires magnesium and most people are deficient. That's because historically we got our magnesium from the soil and our soils are depleted a magnesium today. On top of that, pesticides in the soil can key late magnesium, making the magnesium that is they're not available to our bodies and potentially toxic. On top of that, it is so, so important to get your magnesium levels up. That will help with sleep, with stress, with muscle recovery, cardiac health, even blood sugar control, so many things. And I made my magnesium eight to be the best magnesium on the market. I'll just read a random review from the website at avalon x dot us. I'm just picking a random one. So this one is from Karen. Subject line best magnesium I have ever used. She says I cannot rave enough about this product. I'm sleeping deeply, my moodist calm and my muscle recovery has been amazing. It is something that I have noticed within days, and I've been taking a top magnesium supplement for years. This one is far superior. Thank you so much, Karen. I'm so so happy that you noticed that. I really did formulate it to be the most superior magnesium on the market. It contains eight forms of magnesium and their most bioavailable forms, with the CO factor methylated basics to help with absorption, as well as key related manganese, because magnesium can displace manganese. It is free of all problematic fillers, including rice, which is very, very common, and a lot of supplements. If you see NEWMAG for example, as a Filler, that's not magnesium. It's actually a blend of a lot of things, including seed oils and Rice brand. 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After you place your first order to get text updates with all of the latest sales and specials from me, text beauty counter to eight seven, seven, eight, six, one eight, three, one eight and you can get all my clean beauty email list at Melanie avalon dot com slash clean beauty. I give away a lot of free things on that list, including samples, so definitely check it out, and you can join me on my facebook group clean beauty and safe skincare with Melanie Avalon. People share product reviews and I do a giveaway every single week in that group as well. And lastly, if you're thinking of making clean beauty and safe skincare a part of your future, like I have, I definitely recommend becoming a band of beauty member. It's sort of like the Amazon prime for clean beauty. You get tim percent back and product credit, free shipping on qualifying orders and a welcome gift that is worth way more than the price of the year long membership. It is totally completely worth it and I'll put all this information in the show notes. All right, without further ado, please enjoy this wonderful conversation with Danny grannick. Hi, friends, welcome back to the show. I am so incredibly excited about the conversation that I'm about to have. Okay, so the backstory on this conversation. There is a topic that we talk about a lot on this show, and that is the micro buy home. That said, I think when...

...people hear microbiome they think the gut microbiome, and historically that's what all the episodes on this show concerning the microbiome have been about. That said, I have been very intrigued at the implications of the oral microbiome. Maybe we can touch on this later in the episode, especially when I well, I had been just in general thinking there probably is something there, especially since it took us so long to finally understand the implications of the GUT microbiome. And then, on top of that, I remember I read a study a few months ago talking about how maybe some of the G I issues that we thought were due to Gut microbiome and balances, particularly Cebow, being caused by the microbiome from the colon migrating up, that actually it might be due to the oral microbiome migrating down, which blew my mind. And when I heard that I was there's a lot going on in the oral microbiome and nobody's talking about it. So I've been wanting to do an episode on it and, as the way things often happen, the perfect person to do this interview just came to me. There's a new ish company called Bristle friends. This is the coolest thing ever. So they provide a super easy at home oral microbiome test. Super Easy, just require some saliva, you send it off and then you get personalized results that show information about your oral microbiome, as well as recommendations and a care plan. And they're even setting up a system where you can do a one on one call to learn about your results, and I did that and was blown away by the information and that on top of that, and I was just telling the CO founder before we started recording their log that they have associated with their website is next level. I know you guys often like my blog, for example, because of how it goes into the science and the detail and has studies. This is like that times ten. They have posts about all of these topics and it is so incredibly nuanced and so enlightening. So this whole process has just been absolutely amazing. I've been looking forward to this for so long. I am here with the CEO and Co founder, Danny Grant. I have so many questions. Danny, thank you so much for being care no, thank you for having me. I'm super excited. Let's do it. And on top of that, Danny gets all of the awards because I put him through the wringer before recording with getting a better Mike and he literally drove to have a better set up. So I thank you so much, Danny, for your patients and your time. All of the awards are none of the awards because I also didn't have the microphone for for the session at the beginning. I'll take I'll take that one. Well, here we are now. So I'm just so excited about this. So, like I said, so so many questions. But to start things off, I am so curious about you. What led you to co found this company, because that is no small FIEF, Co founding a company, especially one that is so incredibly interactive, like you're not just creating a product, you're creating an interactive experience and education, and I mean there's a lot that goes into this. So what led to that? Also, were you always interested in the oral microbiome or when did that interest start? What is your story? Yeah, I get asked that a lot. I think even my friends are are still kind of surprised when I'm talking about the company, to hear that it's in oral health. I never imagined that I would end up here. My background is in biochemistry and then coming out of college I was making the decision that a lot of people have, which is do I go pursue my PhD and something very specific in science, or do I kind of branch off and do something else? That's something ended up being a career in genote, mixed on the commercial side actually, and I worked for a sequencing company called a lumina. So they make the platform technology that other companies used to do genetic sequencing and it was it was a really exciting time to join. Genomics had largely been more on the research side and when I came on it was this transition into the clinical side. So sequencing was being adopted into companies, into care systems, was being applied across oncology non invasively old testing and we were seeing this really exciting seat of improved health outcomes on the other side, shifting to this more precision based and preventive standard of care. So you know, I was blown away. It was it was awesome to see the application of advanced technology touching all of these different areas of health and I had always been entrepreneurial kind of looking for the next opportunity where where I...

...would make an impact, and that was kind of where it stopped for a while. I mean, I think I was so swept up in in the innovation in the industry that that I wasn't really focused on starting anything. And it wasn't until a couple of years in when I was living in San Francisco, that my now co founder, Brian, and I were just watching a pitch competition at UCSF, to University of California San Francisco, and there were a couple of companies that were presenting on the Gut Microbib, which we all know has exploded over the last couple of years, and we were sitting in the crowd and you know, we had worked with almost every company in that space and Brian, by chance, had a dental appointment the next day. Probably like a lot of people listening right now, Brian is this like cliche patient who is religious about oral hygiene and always would get cavities. Every time he would go to the dentist, they would find a cavity, you'd be back in for a couple of weeks or a filling. So he was, you know, lamenting about this impending dental appointment and I think it was just this really serendipitous context of listening to the pitches and talking about Ryan stental appointment that we started really asking ourselves like why we hadn't seen any companies in the space tackling oral health with with something other than x rays and observational screenings, and that led us on a journey of research and interviews and cold emails to two researchers at universities for about a year and a half just trying to understand how the oral microbiome was connected to oral health and then doing a really deep dive into the standard of Care and how we think about oral health and whether or not leveraging the oral microbiome could bring the improvements to the standard of care that we wanted to see. Wow, I feel like I could have a whole episode just on the entrepreneurial side of this because I am so fascinated by it. For the journey for you through this whole experience, have you changed your oral habits? So I in probably another cliche and and probably like a lot of other people that are listening to the call. When I was five or six I was diagnosed. I think it was six or seven cavities at the same time and they all needed fillings. You can imagine that that kind of appointment and that kind of procedure for a five or six year old it was a pretty traumatizing experience. So I have hated going to the dentist ever since. Like to me, it just the experience makes my skin crawl, the smells, the sound of the drill, the fear that you know, I'm going to go and find out the same stuff that Brian always does, which is I have a cavity and I need a filling. So I had you know, I was diligent about my oral hygiene. I think unlike Brian, I fell into this luckier group, which was I did the basics and I was lucky to never have oral disease since that event. But you know, for me it was it was kind of the opposite story. Like I think my oral hygiene was just the bare basics and and I was fortunate because I never had toothaches or pains or anything to really drive me to the dentist beyond the typical checkups. Since starting Bristle, like I think that there's this change in perspective as as we were researching the company and uncovering the connections between the oral microbiome and oral health and oral and overall health. It all of a sudden became apparent that this aspect of my health that I overlooked for so many years and kind of written off is just a set of chores that I had to do, was actually a really important component of maintaining and improving my health. So since then, you know, obviously, using Bristle, I've been able to implement new steps in my hygiene routine and I've switched the products that I'm using and I've been able to track the impact of that on my oral microbiome ever since I do have a really granular question about the cavities. But before that, I guess, just stepping back, when you it started going through that process that you spoke about with gathering research and cold calling and just, you know, learning about this in the scientific literature. How many studies are there? Like what did you find when you sat down to research? Yeah, the history of research around and I kind of attempt to separated almost into two categories of research around oral health and research around the world microbiome. Obviously there's overlap, but it's a really interesting history. So we could actually go back to I want to say the mid sixteen hundreds and there's this guy, and and I'm going to totally butcher this, but it's Anthony Van Leewin Hook and he was an early, early scientist. He's deemed the father of microbiology and and he had changed his career to focus on creating lenses and and eventually, obviously, you know, started creating the early versions of what we know as a microscope and he would basically go around and he was starting to look get different objects under under these lenses and he wrote a foundational paper...

...where he described some of the earliest, if not the first, descriptions of microbes and it was called concerning it's translated, but it's called concerning little animals. So he called them animal fuels. And you know, you can imagine this guy is going around his house, Er's apartment or whatever and he's looking at all of these different things and seeing all these different organisms kind of moving around and I believe the first biological sample that he looked at was actually a sample of dental plaque from his mouth. So when you look at those early pictures, there is a drawing of the microbes that he saw having taken dental plaque off of his teeth and and put it under the microscope. So just kind of like a you know, when we think about microbiology, I think a lot of people probably defer to environmental microbiology and obviously, you know, gut microbiology and all of that kind of stuff, but it really is rooted in the oral microbiome, which is kind of an interesting little tidbit. But obviously, going off of that, you know, over well for the next couple of centuries we continue to do research into the oral microbiome and some of the earliest expansions on our understanding concerned very specific bacteria and their association to gun disease. So there is something that's taught in a lot of dental schools. It's called the red and orange complex and it's twelve or thirteen species of bacteria that had been identified in very early research as being costly related to the onset and progression of gun disease. Most of the research since that kind of criteria, that kind of category was established, has really been limited to those bacteria. So when we look at a lot of the research in oral health, in the oral microbiome. It's contextualized to those twelve or thirteen bacteria and that that was it for a really long time. And the same thing was done with carries, where cavities causing bacteria. You know, there were five, maybe six that we've identified and all of the research just looked at those bacteria in the context of Health and disease. So it's a very kind of like narrow understanding and for context, since then we've identified over seven bacterial species as being part of the oral microbiome and a lot of that work was done by a research group out of Harvard called the forsythe institute and in the NIH who created the human oral microbiome database. So they were able to expand the catalog and our understanding of the oral microbiome and its rule in oral health. And since then it's it's still kind of just remained in this very narrow scope. A lot of the research papers that have been released have not gone past that read and Orange Complex. They've only looked at one or two species of bacteria. But you know, I think the exciting thing is that our understanding between oral health as kind of a category and overall health has progressed a lot. There's been a history of associations between poor or declining oral health and systemic conditions, some of the major ones including cardiovascular disease, Alzheimer's diabetes, and for a long time it was really only shown at the clinical or symptomatic level where we could correlate, you know, somebody with declining oral health would also have some kind of systemic disease associated with it. But we're now able to look at that in this very empirical and objective Lens by looking at the comprehensive oral microbiome, and we're starting to uncover more concrete connections between those indications. I just want to say how much I am enjoying this conversation. Okay, some questions about that. This is something I was thinking about when I was reviewing a lot of the literature on like the Bristol blog and also looking at my results, and it would say that it would talk about how these different strains, you know, has shown connections to different oral mouth issues and, like you just spoke about, like they would study, you know, related to dental caries or gum disease or whatever it may be, when they say that like a certain strain have been found to be beneficial for like bad breath or gum inflammation or something like that. Out of those twelve or so main strains, have they done tests on all of them for all of the conditions or is it more like some of them they've tested for some things and some for others? And the reason I'm asking is it can make it seem like, oh, this is the strain that's good for bad breath, but is it just because that's the strain they tested for bad breath and they didn't actually test all the other strains for bad breath? Does that make sense? Yeah, yeah, you're hitting on a really good so there's two pieces there. When we think about the progression and research. There's breadth. So the idea of expanding what you know. Like to your point, when we have done research in the past and tested for bacteria, we've really only tested for those twelve thirteen and you don't know what you don't know. So if you're only testing...

...for twelve or thirteen but there's a hundred different species of bacteria in somebody's mouth, you're you're missing the complete picture. You're making assumptions based on what your test is saying. Is there isn't there, and you're also limiting your understanding of what bacteria causes diseases to what you're testing for. It's a very narrow kind of shielded horse blinders way of looking at biology. And then we have the other concept, or the other piece, which is depth. And for a long time, including the red and orange complex, we only looked at microbs at the species level, but advances in sequencing technology allow us to look at the strain levels. So multiple strains of bacteria can make up a single species and not related to oral health. But I think a really good example is equal I. So everybody is really familiar with the coal I as as a species of bacteria, but the reality is is that there's dozens, more than ten, different kinds of strains of the coal I and only a few of those strains are pathogenic, you know, the ones that kind of migrate their way into I won't mention specific companies, but food that you would get from a restaurant. That leads to some pretty unwanted side effects. But it's important to understand what strains are present and that requires higher resolution technologies because you would want to know as a consumer. You know if you're about to eat a salad and you're only testing for the species of the coal, I it may come up positive, but the strains of equal and that are in that salad may not be the ones that lead to those symptoms that nobody wants to deal with. They may be unharmful or even prob commensal species of beneficial species. And and that's been a really big turning point in the oral and Gut microbiome, in our understanding of the role of those those microbes and health, because we're we're able to deconvolute the presence of not only a species of bacteria but specific strains and the role that they play. So it's kind of two levels of resolution that we've been able to develop. And then we've also been able to just test for more species at the same time, so now we can look at all of the microbes and a given sample instead of only limiting research to detecting whether or not those twelve or thirteen predetermined targets are there or not. So with those twelve or thirteen initial ones, did you find that the majority of them were tested for all of the different conditions, or was it lacking in that area? You know, I think the twelve or thirteen that in the red and orange complex associated with periodontal disease are very much associated with periodontal disease. I don't know if, outside of Bristle they've been compared against other conditions. I do know that systemically they have been. So, to name another example, pigeon Chablis is a notorious oral pathogen. It's in the red complex of the really, really bad section of Pyramid of bacteria. That species of bacteria is causally related to the onset of periodontal disease and there have also been research studies looking at that species of bacteria in the context of Alzheimer's manifestation and progression. You know, we have found. We have found that certain species of bacteria do overlap in indications. We see, for example, that a lot of the species that cause periodontal disease are also implicated in plotosis or chronic bad breath. But again, you know, when you're only looking at twelve or thirteen species for all of your research, you're missing the role of the other species that are present in somebody's mouth. So you may be making assumptions, are seeing correlations that aren't actually true. Signals that that may appear stronger than they actually are, and vice versa. So we're finding new species that are associated with periodontal disease and with carries and with Halotosis, and we're also able to develop new insights about new bacteria that may be associated with overall health and disease, including Gut Tos biosis. So with Bristle do you test over seven hundred weight strains or species strains? So yeah, so that's a that's a good question. We use a method called Shotgun metagenomics and the name isn't important. The idea is. You know, let's let's actually back up. A lot of people are now familiar with Q PCR because of covid obviously, and the way that Q PCR works is you predetermined targets, genomic targets of, in this case bacteria that you want to test for. So I could say, okay, I want to test this sample for this these ten species of bacteria, and what that test will tell me is whether or not they're there and, if they are there, what their relative abundance is within that sample. But there could be a hundred, fifty species that are actually on the sample, but I won't know because I'm only testing for those ten and that is going back to that red and orange complex and a...

...lot of the research that's been done to date. Our technology sequences everything in this live but we don't we don't predetermined targets, we don't make assumptions about what's there are or not. We we sequence everything and we get the whole genome information and then we map it to this massive database of potential species and in some cases we're actually assembling new species ourselves and doing discovery in that sense. Yeah, and that allows us to pick up on anything that's in there. I feel like that's a big deal. I feel like that's a really big deal. Yeah, it's it's really important and I think you know the other microbiome industries and other other tests that are on the market. They can be really effective in confirming the presence or absence of species that we already know. But a big part of Bristle is progressing our understanding of the world microbiomes. So we wanted to invest in a technology that would produce as much data as possible. Whether or not we know that those vcs of bacteria at this moment in time our associated with health and disease. We want to be the ones to make those associations and make those discoveries and then present them to our users. Are you guys publishing clinical literature on your findings? We have had an ongoing clinical research collaboration with the University of the Pacific in San Francisco, the dental school there, and they were actually some of the earliest supporters of Bristol when before it was ever a company, when Brian and I were just emailing random researchers. So I do want to give them a very sincere thank you in a shout out on the podcast. So we've been doing a clinical research study and that was how we kicked off the company. And that study takes patients that go to the dental clinic and we obtain a saliva sample before their check up and then we get the full record of that dental check up as well as their electronic medical records, so we can look back and start to tease out associations between the oral microbio status of given patient cohorts and not only the dental symptoms that they had that day but also, you know, other aspects of their health, including overall health as well as previous oral health conditions. Wow, that is super, super cool if you are testing for literally everything, because when people get the results they get like a summary and then with a lot of really helpful information kind of grouping the bacteria into how it relates to different conditions that people might experience, and but then you also get your raw results. So, like I pulled up my my raw results, which actually list the genius and the species and the relative abundance. So for that list, because I looked at mine and there's around like sixty species listed. Does that mean they're potentially could have been up to like seven hundred? And what is the range that you see with people? Like you said, people have like one? Yeah. So so that list, I guess. Going to the report, you know, having looked at the genomics industry and worked with companies for a wile, one thing that we wanted to bring to the product was just when when people take the test, it's generally I have a problem and I want to understand what's causing it and start improving and we wanted to make that understanding as easy as possible. So we want to boil down the complex data into very readable, easy to understand scores. But there is this really exciting research and discovery aspect and I think that a lot of our users want to leverage the data to do their their own digging and and start to read up on various research papers and new discoveries, because obviously we're a small team and we can't even keep up with everything ourselves. So we've had different users kind of email us new research studies and that's always nice to get. But with regards to the raw results, so there are over seven hundred species associated with the oral microbiome. That that generally means that and again that is always expanding, but that generally means that as a person, you will have some combination of any of those seven hundred species. It doesn't mean that you have all of them. On an average we usually find somewhere between, I would say, you know, sixty, seventy five to a d twenty different species in somebody's oral microbiome. But there are certainly exceptions to that standard. We have users that take the test and they only have a handful of microbes and and that's really been an exciting piece of research internally because having that low of of a diversity in your oral microbiome in some cases hasn't manifested in any symptoms and it's been a surprise to the person who took the test. In other cases it has come from a user who has had chronic oral disease for a really long time. They've gone through the gambit of interventions and nothing has worked. So we we do have these outliers that that take the test in you know, for us it's an opportunity to start to understand at a community level how the oral microbiome connects to health and disease and also...

...start to work on more effective interventions and care paths for these patients to repopulate and restructure the oral microbiome into a healthy state. Okay, that is so fascinating because it's really analogous to the the gut microbiome in a way, because I feel like with the gut microbiome now the thing everybody talks about is diversity and how that correlates to all of these beneficial health effects. But then or and I've seen a lot of studies on the GUT microbiome in patients with low diversity who actually experience, you know, less symptoms and it's kind of, like you said, like this outlier situation, although I might have made an assumption. So in general, is more diversity in the oral microbiome correlated to better health in general oral health? Yeah, so that has yeah, that's that's one example of a piece of research that hasn't really been looked at because the technologies that have been used for the most part have been those kind of narrow pieces that you can't understand diversity of an environment if you're only looking at, you know, five species of bacteria and that's it. So we've been able to build a new understanding of the world that diversity plays in oral health. It's it's ongoing. I think you know, early signs kind of tell us, like you would expect, that it's a bit of a bell curve where you want to land somewhere in the middle and too high of an oral microbiome diversity is potentially associated with adverse outcomes. Same thing with low diversity. We we actually have a blog article that we we published with some internal research and data for what we've seen with with regards to diversity. I would highly recommend anybody listening go checking out. Oh, I will put a link to that in the show notes and, by the way, the show notes will be at Melanie Avalon DOT com. Slash oral microbiome. I just want to clarify. So you have seen with some of few results that people with high diversity actually is correlates to issues. That's really interesting. Yeah, so it's it's kind of a combination. I mean, you know, I don't think it's ever going to just be diversity that affects somebody's oral health or overall health status. We have to look at the identity of the Micros that make up that environment. So you could have, you know, having an ultra high diversity of all commensal species of bacteria is probably great, but having an ultra high diversity of a lot of pathogenic species obviously wouldn't be. And and part of it is understanding what the balances between those two. So, you know, somebody may have a very, very high diversity and if they have more commence a species or strains as part of their oral microbiome, it may actually help mitigate the risk that the pathogenic strains in their oral microbiome convey. So they could have relatively high abundances and in a few different varieties of pathogenic bacteria. But there is kind of this community, community level effect, where the negative effects of those pathogenic bacteria are, I don't want to say canceled help but combated. Is there overlap itsing pick up microbiome and the oral microbiome with any of the straints, or do they tend to be too completely separate communities? I mentioned at the beginning. I've read that study about CEBO potentially being related to oral microbiome migrating downwards. Yeah, so what is the comparison there? Yeah, I think it always comes back to you know, for a long time, and we still continue to think like this sometimes, but we have traditionally looked at the body as this very compartmentalized, modular organism where our mental health is its own thing and our cardiovascular health is its own kind of self contained box metabolic health, and that's not how our bodies work. It's it's an ecosystem and everything influences something else. So, you know, the gut in the oral microbiome is obviously physically connected by our digestive tract, but for a long time there there weren't known associations between those two. What has has been uncovered over the last couple of years, I think, through research, has been that certain oral bacteria can migrate to the Gut and cause dispiosis or adverse effects there. There are even cases where commensal species of bacteria, so species in our oral microbiomes that are beneficial to our oral health can migrate to our gut and when you change the environment they become pathogenic to that environment, so they can actually end up causing damage. You know, specific strains have been I'm going to say peage and Devlis a lot because it is kind of the most notorious and one of the most well studied, but f Nucleotum as well has been tied to Gut dispiosis, so IBS ID krones disease, colorectal cancer as well, and I think that will continue to uncover the relationship between oral health and gut health and vice versa. We also see that gut dis biosis can manifest as oral disease in the same way that that we've seen with diabetes in some other chronic diseases. Do you know how many general this... something I should know. How many species in the gut they now think that there are? I don't know off the top of my head. I'll look it up and put it in the show notes. I should probably know that. Another question looking at the gut some more. You know there's bacteria, but then there's also yeast and parasites and I don't I always say it wrong archaea. Is the mouth pretty much just bacteria or are there other organisms as well? You know, so there's the full breadth of organisms that you find in other environments. Viruses, Fun guy bacteria typically the main three. That's another advantage of our test. So because we shocking metagenomics, we we actually detect and can identify all kinds of microbes, I think, different from the gut. That our understanding of the rule of those other microbes in oral health and overall health is still early. So we're doing a lot of research there, but we do plan to release that kind of data as part of the raw results so that people can start digging in on their own. Okay, awesome. Do you know or how as there's been studies on what determines a person's oral microbiome. So are we born with it? Is it affected by birth? Is it inherited? What? What creates it? Yeah, so the research is still early, but there's there's a couple of factors. I mean the biggest one is behavior and environment. So the emergence of pathogenic bacteria, the prevalence of oral disease is largely a byproduct of pooral oral hygiene, for dietary choices, things like that. But there have been some studies that have shown, you know, when we're born, there have been studies that show more similarities than a children's oral microbiome with their mothers. There have been studies that have shown actually that the oral microbiome and the placental microbiome are more similar than I think it was the oral microbiome and the GUT microbiome, or the placental microbiome and the Gut microbiome, one of those two. So there is this idea that parents can confer oral my acrobiome signatures to their children and then that in combination, you know, I think, with with behavior and hygiene habits, which are also conferred from parents to children. So any parents out there and make sure you're brushing your teeth in front of your kids all the time. You know, I think it's kind of it's similar to Ards, you notice, right like you get some some blueprints from your parents, but a lot of what happens later in life and a lot of the things that you may be at risk for materialized based on other factors that that influence the expression of those genes and the oral microbiomes. Similar we also find that oral microbiomes can be influenced by our partners, so a lot of spit being exchanged between romantic individuals. For the record, cavities has been, I think, labeled noncommunicable, but I would argue with that. I think that it is a communicable mission. So we do see some similarities in couples that that lived together and and again, parents and children. And how fast do you changes tend to happen? One of the blog posts that you had was fascinating and it was I think it might have been was the effects of Philostan or one of okay, one of your blog posts, Dr was talking about the oral microbiome and it was talking about having different strains and what they affected, and it was saying in some of the studies that maybe in order for these oral probiotics to be taken and have an effect, that you had to first wipe out your microbiome with an antiseptic for it to have a full effect, which was a really fascinating concept to me. So how fast do changes happen in the oral microbiome in the mouth if you use an antiseptic? Do you just wipe out everything, like like, what's happening there? Yeah, yeah, there's a yeah, I have a lot to there's a lot of unpacks. So I think the blog article was on oral probiotics. I would highly recommend people read it. We have a lot of information about probiotics and I think that there's also a lot of misinformation out there that we touch on. But we are finding that there are dependencies on how quickly you may be susceptible or can recover from oral microbiome DIS biosis or oral health conditions based on the oral microbiome profile that you have. So we're starting to understand loosely these buckets of oral microbiome profiles and that can help us predict somebody's risk for progressing to oral disease, as well as stratifying the efficacy of different interventions. So you know, like everything else, that the rate of progression kind of depends on the environment, your behavior as well as your specific oral microbiome. But you know, we know that people go from healthy to disease between dental visits like Brian. So it is a pretty rapid progression from health these day to...

...a disbiotic one in the majority of people. As far as the use of probiotics. So probiotics, it's not a great comparison, but I always talk about vitamins as as kind of an analogy to to probiotics. You know, if you meet your daily intake of vitamin C every day taking a vitamin C supplement, that's at two. You're not you're not retaining of your daily intake of vitamin C and becoming like a superhero. Your bodies flushing out a lot of the excess vitamin C and our microbiomes and the use of probiotics works similarly. So the efficacy and the potential that you're a good candidate for a probiotic does depend on the oral microbiome that you have. There are one probiotic is called K twelve and it's an s sl of various strange sorts of beneficial strain of bacteria that's in the oral microbiome or was found in the oral microbiome of healthy individuals. There's a bunch of research on it being effective. But if you already have a higher binments so that that species or strain in your oral microbiome, introducing more of it is not going to or reduces the chances of a significant shift in your oral microbiome makeup and therefore your oral health status. So we're finding that the best candidates for certain probiotics are the ones that have the lowest abundance of that species to begin with them then we kind of reintroduce that species to increase its abundance. The other really cool thing about the mouth, I think, and talking about antiseptics, you know one way to, I guess, artificially decrease the abundance of either beneficial microbes that you want to reintroduce or pathogenic bacteria that you want to further eliminate is just by kind of wiping the slate clean, and traditionally that has been done with antibiotics, antiseptics. They are they're definitely effective in wiping everything out. Our ability to rebuild the microbiomes in a predictable and intentional way, I think, is still some ways off, which is why you see a lot of patients, I think especially on the Gut microbiome side, that have kind of bombarded there and they're got microbimee with antibiotics and then have resulted in more severe symptoms than they had to start and now they're they're kind of at a dead end and they're going through the full ringer of trying different probiotics and different medications. The cool thing about the mouth, something that makes me really excited about the potential, is it's one of the only parts of our bodies that we can physically manipulate. So like, outside of like our skin that you can rub soap on or something on or, you know, scrub, our metals are like the only other place that you can mechanically use a toothbrush, a tongue scraper or floss to physically remove bacteria from the environment, and that, in combination with more controlled use of the antiseptics and antibiotics, I think is the best and most effective path to wiping the slate clean and giving yourself the best chance to have a high response to the reintroduction of probiotics, and those are the kind of care paths that we're developing for our users. So, like in the gut, they often talk about how there's basically, and maybe there's some overlap, but basically two broad types of probiotics and the microbiomes. So the ones that that are there, that are like colonized, and then the ones that are transient, when we take probiotics and they kind of passed through and when you stop taking the probiotic they go away. So in the mouth, are they all transient or are there some that are kind of like similar to in the Gut microbiome, where they're there and they stay there? Yeah, we're still looking into the transient aspect, but I think a lot of the research in the probiotic used today points to the the end goal being to recall aize a microbiome environment by, you know, eliminating the pathogenic species of bacteria and replacing them with probiotic or beneficial species, and that's what we're trying to do with the oral microbiome. First, like you said, I think there may be some some efficacy and transient probiotics, but that also ends up I think it's a band aid and and it also causes a dependency on taking them all the time and we also don't completely understand whether or not they're working. Like I think that one of the problems with probiotics is unless you're really diligent about testing. There's no way to actually know whether or not you're shifting your you know, insert whatever microbiome you want into the state or the the makeup that you're...

...trying to go for. And there's a lot of companies on the market that that are just selling probiotics and all of these probiotics have the same strains or some combination of the same strains, and there's no way to one. I mean there are ways. There's got microbiome tests on the market, but I think only a fraction of people really use them. But it's important to understand where you're starting from and also map and kind of track, like, where you're trying to end up, because you can take probiotics for six months, but if you test between you know, if you do it before and after test and you don't see a shift in your microbiome, you might be feeling better, but it probably isn't because you're taking the probiotics it. It might be a placebo effect, it might be some other kind of intervention that's been introduced. So you know, I think the probiotics are available, but in terms of really being able to quantify their efficacy and landing and expanding in the microbiome that you're tar getting. There's still a ton of research that has to be done and major question about this and I have wondered about this for so long and it's really important for the conversation we're having right now. So the method of if you are taking those probiotics, because they're often sold as a hill, like a capsule. So if you're doing that, do you take it? It goes down to your GI tract and then they they work their way back up to your mouth and or how does that compare to like a Lozenge, because I was looking at some of the studies and they would use lozenges and or like a probiotic toothpaste. So the actual method of how they get to the mouth. The method definitely matters. I don't think that there's been enough research and swallowing probiotics and showing a true shift in the oral microbiome profile. We have seen with stronger studies with lawsenges. There's I think there's maybe a few toothpastes on the market. Mouth Rensto is something else that I'm really keen on looking at. Obviously, like not with alcohol and antiseptics and all that stuff. But there's a lot more ways to introduce probiotics to the oral microbiome than they are with the Gut microbiome, and that provides almost this like targeted methodology. I think it would be really cool to see one day like a floss and that floss is coated in a very specific probiotic bacteria right and you're introducing it exactly where it needs to go. The same thing with mouth rents in your tongue or a tongue scraper, and then you can imagine a toothpaste with kinds of probiotic bacteria that mitigate the growth of SMUTANS, one of the kind of key players and cavities formation. There's all of this potential because you can literally like open up your mouth and it acts as it oh my goodness, if you ever want to collaborate on something in the future, I would so be down. That's amazing. I would sow be down for this. Okay, and some other questions. While we're still talking about the oral probiotics, one of the most fascinating findings sort of recent ish on the Gut microbiome was a study where they were looking at wiping out the gut microbiome. I think it was all for colonoscopy prep. So it wasn't antibiotic wiping out, but it was wiping out, I guess, physically, and they found that the person's Gut microbiome returned to their quote, normal microbiome better if they didn't take probiotic. So it was like a natural process to just let it happen. So in the mouth, do you think there's a difference and say you, quote, wipe the slate clean, like we keep talking about like the effects of that, like well, it kind of go back to what it was before, compared to if you do integrate some sort of probiotic, are you changing what it becomes? I know you touched on this a lot already, but I'm just curious if the mouth kind of naturally gravitates to the state it was at before and health factors might affect that. So I think I mean full disclosed, like I would love to see the study. So this is all conjecture for the record. My my guess is that. Okay. So we we have used the term wiping the slate clean and I think that that can mean different things to different people, just like you know, if you're living with roommates. Like my standard of clean might be different than my roommates standard of clean, where when I wipe down a counter, I am like it's bleach and I'm putting elbow grease into it and I'm spending an hour, whereas somebody else's definition of like wiping the slate clean or cleaning the counter might be taking a dirty rag with some water on it and, you know, just kind of wiping it down a little bit. So with that Gut microbiome study, I mean I'm interested to look at it because my first response is whatever method that they used to remove that got microbiome may have been more effective than other methods that have been done in the past where you're truly kind of like wiping out that got microbiome. The the problem with antibiotics and antiseptics is that they do kill bacteria, but what ends up happening,...

...or what can end up happening, is that the most resistant and sometimes the most pathogenic strains are still present, just in smaller amounts. So they end up growing back, and we see that with oral health and the use of the antibiotics there, where a lot of patients are prescribed something like a chlorhexidine mouth rents to treat oral thrush and they'll take it for a few weeks, their symptoms subside and then a few weeks later it flares back up because you haven't completely wiped out that pathogenic bacteria. So if you're not making other changes, like of course it's going to grow back. I would need to look at the study, but that would be right, I guess where you know our our definition of like wiping the slate clean is it's a spectrum and I think that there is potential if you truly are starting from baseline and rebuilding from there, where probiotics and other interventions might be more effective, or you might actually be able to rebuild it if there's some behavioral changes alongside it. But I also think that there's a lot of danger where you can wipe the slate clean and if you don't make any actual changes, like you're giving a chance for those pathogenic bacteria to be reintroduced and grow or you're not wiping the slate entire late clean, so you're kind of already starting from a bad state. Okay, Gotcha. Yeah, I will track down those studies and put them in the show notes and also send it to you. I I briefly just googled it and one did come up, but I don't think this was it, because the title of this is post antibiotic Gutmucoastal microbiome reconstitution is impaired by probiotics and improved by fecal transplant. I don't think the one I read was talking about fecal transplants. So all it might have been. In any case, I will find out. I will read it. Yeah, when I read it later I'll know if it was the one I was thinking of. Another huge question that I have is are there oral probiotics or oral strains? Are they in our food at all? Like when we fermented, for example, we know we some of those, you know, appear in the Gut. Does that happen with the mouth or is it not related to the food? So there are over labs. But like, first of all, there's overlaps between the probiotics that you find in in a lot of fermented foods um I can't remember the names of the specific companies, but you know there's like that yogurty drink that has probiotics to night. So there's some overlap in in the species and strains and those products that are beneficial to both the gut and the mouth. Other probiotics may be different, so it really depends on on what you're eating. Okay, Gotcha, and trying to start which direction to go, because I do have questions about diet in general. But maybe before that. I mentioned earlier that I had a question about cavities. So before that broad question, you've mentioned a lot of mouth issues. So bad breath, cavities, periodontist. How do these all relate? And what mean by that is, are some of them actual, quote, diseases? Are some of them just a state created by bacteria that's not necessarily a disease per se, like bad breath? Is that? Is that always something wrong, or is that maybe just just a side effect that's benign from a health perspective? Yeah, that's a really good question. There's no one answer. So I'll start with this. I think this has been an evolution in medical care and I think it will be coming to dental care and oral health. But the way that we have traditionally characterized and classified diseases has been based on the presence and the severity of associated physical symptoms. So you know, in oncology like breast cancer, was diagnosed as breast cancer because you had cancer in your breast and it wasn't until we had a good molecular understanding of what was going on that we were now able to define disease by the mutations that drove the formation of that tumor, and that opened up this whole world of precision diagnostics and precision therapeutics that could be applied to specifically treat those targets. So when we think about the diagnosis of a cavity, like a cavity, the literal diagnosis of a cavity is like the decay in your tooth. So it is purely the presence and severity of that physical symptom. But we need to shift the way that we diagnose conditions to focus on root cause, because a cavity can emerge from pathogenic bacteria that produce acid and the acid erodes the animel around the tooth and eventually makes our yeah, eventually makes its way to the tooth itself and then you get an ex Er and you find out you have a cavity. Cavities can also be spurred by mechanical mechanisms. So you know, grinding...

...your teeth at night and you can physically wear down the enamel on your tooth and and cause decay. And you know, if you combine that with highly acidic foods or other kind of factors, then of course you're gonna end up with a cavity. periodontal diseases the same thing. It's been diagnosed and characterized based on a couple of different factories, like bleeding on probing as one pocket depth is another, but it all boils down to again physical symptoms, when in reality at least, what we find is there's a very big difference between it's it's a bit more complex than I'm making it, but there's a difference between periodontal disease that is rooted in an overabundance of Pigeon Gvelas then periodontal disease that's rooted in an overabundance of Eth nucleon and and you know it's not one species causes one disease. There's a lot of other things going on there. But you know, we need to shift away that we we diagnosed and characterized disease to focus on root cause instead of that outcome of that root cause, and I think that that's been a huge miss in oral care, because if we treat all periodontal disease the same, then we're only going to use, we're gonna WE'RE gonna use the same interventions, the same procedures to treat it, which is what we've been doing. But the reality is is that, like those procedures are probably like somewhat effective for everybody, but they're not really effective for anybody. And and that's what we have to shift to as this idea of personalized diagnosis and precision care, and and that's what we're trying to do it, bristle. I don't know if that answered your question. It does, and with periodontal disease, just to actually add a definition to it. So what do people experience when they have periodontal disease? Yes, so, traditionally it's uh, you know, early periodontal disease, kind of the condition associated with it and and maybe touching on your holotosis face, you know, Ginger Babis is technically an early sign or a symptom of periodontal disease, and then you go through various stages where stage one and two, you know, have varying levels of pocket depth. I think you get up to pocket depth, for background, is defined as the gap, the size of the gap between your tooth and your gumline, and it's measured in millimeters and may be off on the specific numbers, but the idea is that like level one and two. So just going up from Gingivitas, those are the early stages of periodontal disease and maybe your pocket depth is like two to four millimeters or something like that, and then you go to stage three and stage four and there's obviously more severe conditions associated with it where you know, you may have bone loss in a pocket depth of of six millimeters, and that's how we've been diagnosing the various stages of periodontal disease up until now. Is the pocket gap related to receding gums or is that different? Yeah, yeah, so it has to do with gun inflammation and the gun recession. Okay, it's kind of the outcome. Yeah, the outcome of those mechanisms and those stages. Is it reversible up into a certain point and then not, or how does that work? Yes, yes, so for periodontal disease, I believe again, up until stage two it's generally reversible, or you can at least stop progression and then at Stage three, in stage four, I believe it becomes a permanent and chronic condition. A lot of our users are in Stage three in stage four, and that is where you have to go into the periodontist every three months to again get well. I won't get you in depth, but very invasive and very expensive recurring procedures. Oh Wow, hi friends, I'm about to tell you how you can get my favorite electrolytes for free. Yes, completely free, and the feedback we have received about element electrolytes from our audience is overwhelming. You guys love element and I'm so excited because our new offer allows new and returning customers to get free element and, on top of that, through super popular grape fruit flavor is back. If you've been having issues with intermittion fasting, electrolytes may just be the thing that you need. And or have you heard of something called the Keto flu? Here's the thing. The keto flu is not actually a condition. 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And this offer is exclusively available only through V I P element partners. You won't find this offer publicly anywhere else. So again, the link is drink L M and T DOT COM forward slash Melanie Avalon, and we'll put all this information in the show notes. All right. Now back to the show. So the reason I was thinking about the cavities and was asking that question this is something that's haunted me for a very long time, which is that I don't remember having a lot of cavities growing up. I'm sure I did, but I don't remember it being a big part of my life. And then when I did a low carb diet for quite a while, I had great teeth, like it was great. Then I switched to and this was a whole foods based diet, and then I switched to a very high carb, low fat whole foods diet. So I was eating eight and still I am eating high protein ton of fruit, like a ton of fruit, and every night, in a one meal a day type situation. And when I made that switch, so metabolically health wise, everything was great, stayed the same, something's probably even improved. But I started getting cavities, like so many cavities, and I grind my teeth really bad, and so I started getting I mean it was bad with my my teeth as far as grinding my teeth away, and so I've been fascinated by the whole concept because I got a lot of cavities and but it's a situation where I'm like, I don't know if it's because I have a root caused health issue or if it's just because I eat a lot of fruit, and then that's just like what's going to happen with that. So so I guess the question in there is do cavities, and maybe you are to answer this as well, but do they always indicate a health issue? Like vegans, I feel like, often have problems with their teeth. Yeah, I would say most of the time it indicates a health issue, like it is the downstream effect of some kind of biological root cause, but other times it is purely like a physical issue, like teeth grinding, where, the way, you know you're not going to you wouldn't take a probiotic if what's actually causing your decay is a physical habit right, like the problem. I mean maybe you get some other health benefits, but like, theoretically there's no s vutans that you have to eliminate that's going to reduce the incidents of cavities. Of what's actually causing it is you grinding your teeth at night. What would really be effective is a mouth guard. So you know there are and I think that that's where, you know, we need to stop thinking of the way that we diagnosed disease today is actually disease. We need to actually think about it as symptoms and and diagnosed disease based down the root cause. So your your cavities shouldn't just be called cavities as this umbrella condition. It should be, you know, as an example, like bacterially driven cavities, are mechanically driven cavities, and there should be a very specific care path that's associated with either one of those outcomes that that you can implement. I think in your case, you know, maybe a combination of the two, where maybe the fruits that you're eating are introducing sugar into your mouth and you may have some carries causing bacteria that are learning the Ph creating a morrishetic environment, so that, in combination with with grinding your teeth, is kind of worsening the effect. But again, it's it's important to understand, like as important as it is to identify the bacteria that that are causing the cavities, it's equally insightful to find out that you don't have the bacteria that are causing cavities, because that points you in the right direction of what's causing it and it also points you in the right direction of like what changes you should make to address that. So here's a clarifying question... that. So, for example, could one person be eating a ton of fruit but for whatever reason they don't get the type of bacteria that would eat the sugars and create the acid and create the cavities, and then another person would eat a lot of fruit and and would experience that. Or is it if you're eating a lot of fruit, you're probably going to encourage that type of bacteria? If the bacteria is there and you're eating a lot of fruit, like if you have two people and they both have the same abundance of the same kind of carries causing bacteria and they're eating the same amount of fruit, then the same, I mean theoretically the same amount of acid is going to be produced in their mouths. There are some differences in terms of you know, maybe one person is more diligent about oral hygiene or they use some kind of supplement that comes offset the low ph so they're lowering their own risk. But at the end of the day, if the bacteria are there, they all function basically the same way and there may be some genetic differences where, you know, maybe one person has stronger enamel than the other person, which mitigates the again, the progression and severity of the symptoms associated with that bacteria. But it's so important to get rid of the bacteria themselves. So I guess what I'm wondering is, and maybe this is being too black and white, but is it that there are certain strains that would create cavities if they, you know, had the right medium, so like a high fruit diet, for example, and maybe you if you had just like a little bit of that, but you're not eating a lot of fruit, would they like kind of stay dormant and then if you eat a lot of fruit, like could you bring out populations that might have been smaller and then once they get whatever they eat, they get bigger? Yeah, yeah, so it's, yes, like weeds in a garden. Well, maybe, I don't know. I've never really had to deal with weeds in a garden, but the idea is, like you may have a very low abundance of pathogenic bacteria related to carries and that population can theoretically be kept in check if you have, you know, a bunch of probiotic species of bacteria in your mouth and you're not introducing a lot of sugar. But if you start eating a lot of sugar, those bacteria produce more acid. The acid will shift the PH in your mouth and a more acidic environment is more preferential to carries causing bacteria. So you would end up actually decreasing the abundance of some of your commensal species, which would give those pathogenic species a chance to expand and replicate. And it's kind of this virtuous cycle of eating sugar, you know, shifting the Ph, causing an increase in abundance of carries causing bacteria. That in turn produced more acid, that lowers a PH further. That results in damage to your tooth. How fast do these bacteria start eating and producing the asset? So, like if you have a meal fruit or, let's even say like a processed sugary meal, while you're eating, are they eating and producing acid? Or if you eat and then immediately, although I know we have probably talked about this, like if you should brush or not right after eating certain foods, can you stop that before it even happens? Is there a time delay? Yes, so I think it's it's probably a bit of both, where I would almost think of it as like a a graph, where as you're eating, like some of that is being converted by the back here in your mouth. But at least the research that I've seen kind of shows that it doesn't pick up until after your meal. So I was talking to somebody in their their advice early on in the company was, you know, there was a research stud you don't have to dig it up, but it was basically most people think that brushing right after a meal is or anything to do, but you should actually wait like thirty minutes to an hour and then brush your teeth because that's the most effective time to to do it and mitigate the effects of the bacteria metabolizing whatever food is left in your mouth. Is that because of the danger of the Ph from the food or is it something else? With waiting, I think it's so while you're eating there's an influx of saliva in your mouth and I think that that helps to mitigate like the the speed at which they start metabolizing the food. And then, obviously, when you're done eating, your solidarity production goes down and the food is kind of sticking around and it gives the bacteria a chance to start chomping down on it. And then I think the other pieces, you know again like especially cheese. It's is like a great example and one of our advisors, Mark Burgina, with you know, he he is uh more against cheese it's and anybody I've ever met, but for good reasons. So cheese it's you know it's it's a carbohydrate rich food and it's also really sticky, where we can think about like gummy bears is another good example where, after you're done eating, like anybody who's eating cheese, it's, you know that there's still remnants. I don't want to get too graphic here. If cheese it's in your mouth and those cheese it's happened to stick to places where a lot of...

...athogenic bacteria like to resign. So you know if you don't brush your teeth and that food is just sitting there, the bacteria going to continue to get it and probably replicate and growing abundance. And then, if you wait a little bit, you know as you're eating it, there's food moving through your mouth. I think there's a lot of stuff going on with the saliva. But if you wait a little bit, I think you can dislodge a lot of that food you know when it's had a chance to settle. And while we're in the Diet Sphere, I've been so fascinated hearing about the role of nitrates and nitrosen means and nitrites and how the ore microbiome interacts with that. Is that something that you've studied? Yeah, so we're we're actively looking into that, along with a few other things that the idea is, and I don't quote me on this, you might know actually, but I think I was reading this paper and the paper was saying that the human body doesn't naturally reduce nitrate into nitric oxide. It's it's a microbial mechanism. But the idea is that, you know, trick oxide is associated with lower blood pressure status and a lot of the bacteria that performed this mechanism of reducing nitrate to nitric oxide are in the oral microviom er, at least they should be, and there have been studies showing the association, again, between poor oral health status and increased risk for cardiovascular disease. So we've been looking at the connections between the relative abundance of those species and the incidents of high and low blood blood pressure. Yeah, I'm really fascinated and I'm really excited to see the growing information on that, because people talk about it a lot and foods for it and, like I mentioned, beats. But the connection between how, like you mentioned, it's actually the microbes that make that conversion and I think it's also what determines if it becomes like nitrosamine, which is actually not beneficial for health. Firstus nitric oxide. So I'll be really curious to see what what gets developed there with research. When people sign up for Bristle and do the whole program do you ask about dietary habits anywhere? Are you guys looking at that? Yeah, we do and we're we're constantly expanding the questions that we ask. We're making a bunch of updates in the product right now. I think you know it's been a lot of it is discovery and and a lot of the research is early around the role of Diet and the oral microbiome. It's been obviously a lot. There's been extensive research in the got microbib but for for oral health it's kind of been the same stuff for a really long time, which is sugar causes cavities and that's pretty much like where it's stopped. So you know, the way that our team works is we basically go and carry a bunch of research for a topic that we're interested in. In this case we can use diet as an example. We get a bunch of papers together and we start sifting through everything and maybe we start categorizing it according to dietary interventions, where you might have a stack of research that's associated with introducing foods that are really high and nitrate, and then you may have another stack of papers that has to do with order and carbohydrates and so on and so forth. And you know, we want to go through and make sure that we're making calculated decisions around what we're pursuing next, and we also want to make sure that we're not just bombarding our users with like five questions, which it would be ideal for us, but like nobody wants to go through that. And then we'll start to pick kind of the most likely candidates and we'll introduce those into into the surveys that we provide. And that's going to be a constantly evolving piece where, if you're on a subscription, you will see like new questions being introduced, you know, when you register your next bar code, and and that's because we have new research questions that we're starting to investigate. And the same thing is true with your health history of different kind of behaviors and hygiene interventions. The whole the whole gambit. Have you thought about incentivizing it, like, you know, having this massive long survey and if people fill it out they get a code for a discount off their next order? I haven't, but that is a fantastic idea. Is then people will be reordering and you'll be getting information. Yeah, so you will probably see that in a few weeks. Yes, I'm excited. While we're talking about the studies that you guys have done with the user data that you got, I mentioned earlier just how incredibly impressed I am with the research that you have on your site and one of the really, really impressive articles was one of the articles that you had on flossing and it talks about how, surprisingly, the literature to date isn't overwhelmingly supportive of the connection between flossing and benefits to oral health. But then you guys went and actually, you know, looked at your data and you have all of the results of what you guys found. So just flossing in general, do you think it's beneficial for oral health, and also, what is that experience like and how do you go about it when you want to test something and you're looking at user data and you know, which is what is all of that like? Yeah, so first I would say like I think flossing is probably one of them most...

...effective interventions that you can do to improve your oral health. All of our data points to a reduction almost across the board of pathogenic bacteria and actually an increase in incommensals. And you know, I think the this kind of goes back to the recurring theme in Oral Health, which is there's a lot of research looking at interventions in oral health status, but there's very little research looking at interventions in oral microbiomes status. So I think a lot of the early research with regards to philosophy and and some other things, as well as the symptoms, may not have shifted as quickly as the researchers thought, or they shifted as quickly as the control or some other thing, but they kind of missed the boat on on the bacterial and oral microbiome piece and that that's really important for short term and long term oral health. So that was really exciting for us and it is kind of this idea that, you know, I hate to use, oh my God, I hate to use the term like contrarian, but I think there is this idea of like challenging the status quo where in a good and a bad way, like we are able to to really ask some simple questions and provide new insights to our users, where it is as simple. As you know, we have a blog that looked at whether electric toothbrushes are more effective than manual ones, and again, it's kind of something I think a lot of people make assumptions about or they don't really think about other than what their dentists might say, but nobody's really looked at it at the oral microbiome level and we were able to uncover some really cool insights there. And the same thing goes for flossing your your dentist tells you to floss. I think most people hate it, but there's never there's very little information that's conveyed to patients about why it's important and like what the real impact is, let alone a way for them to actually see the improvement over time, and that's that's been really exciting for us. What did you find when you looked at the electric toothbrushes? Did you find they were more beneficial, so that one was actually a little bit more nuanced? We I can't remember exactly what all of the conclusions were, but we did find distinct differences in the advocacy of electric toothbrushes in age groups. I think that we found differences in the efficacy and Inter an indication. So don't quote me on this, but I think we found that it was more effective in reducing Holotosis, but we found that it wasn't as effective in reducing some of the species associated with carries or vice versa. So there were a couple of factors that that kind of indicated whether or not an electric toothbrush would be more effective, not generally, but like for you as a person, whereas flassing, there were some nuanced differences, but it was a lot more kind of like universal with electric toothbrushes. If I had to guess, I would hypothesize that they would be more beneficial in young kids. Did you look at that? No, we haven't. I mean, I don't know, but because kids are the ones that are not going to be putting in a for effort for brushing, so I feel like they might benefit more from a little help compared to like an adult who might put more effort into their brushing. Yeah, so I'm looking at I'm looking at the yeah, no, we definitely want to. I mean children's oral health is kind of this whole other world that we haven't been able to do as much work as we want to in, but we certainly intend to. I'm looking at the blog article and it looks like people under thirty had higher commensal scores when using an electric toothbrush versus those using a manual one. We also looked at brushing frequency with them. So, you know, it's one if you use an electric toothbrush, that's great, but are you actually brushing like two or three times a day, or are you only doing it once? So we found that, let's see, people using either manual and electric toothbrushes had similar commensal scores, but people who brushed twice per day and used an electric toothbrush had significantly better commensal scores than those using a manual one. And what you have to wonder though, also is causation correlation, like are the people who are going that intense with their habits, like, are they also doing all of these other oral help habits? Yeah, that's why it's important to look at you know, that's why data is like the big piece. It's the same reason why we did the shotgun metagenomics approach versus something else, because you can make a lot of assumptions where, yeah, I would imagine that somebody who invests three dollars in their oral be electric toothbrush is probably a bit more diligent than somebody who's buying like the one dollar toothbrush at right aid, or somebody who's replacing their toothbrush every three months like it's probably has better habits than somebody who who doesn't for years. So that's why it's important to not only just look at the surface level but start to tease out, you know, the assumptions that people might start making where somebody who has an electric toothbrush invested more, so we would expect them to brush more times per Tay because they're better about oral hygiene. So we really want to try to get as close to base truth as possible. Speaking of the replacing, how often do you recommend replacing your toothbrush? That's something I've...

...had a big change in, because I used to replace it I don't even know, maybe once a month, but then I had a moment, and this is not this is not super sustainable for the planet, but I realized I was like toothbrushes aren't that expensive. I could be replacing it a lot and feel cleaner, but I don't know if that's just in my head, like I don't know if I actually need to be replacing it as much as I do. Do you have thoughts on replacing toothbrushes? Definitely do it. So there's a whole host of reasons. I would say at a minimum replace it every three months. We're doing some research there as well. One, I mean, for one, like your toothbrush is just kind of sitting there and in the bathroom where you're like flushing the toilet. I don't know. Yeah, so, for one, like your toothbrush is just kind of sitting out there and it's wet and like you can imagine that. Like you wouldn't leave Your Cup with water in it for a day and just keep refilling the same cup without ever washing it. So I don't know why we do that with our toothbrush, but the other pieces. Yeah, it's in your bathroom and your bathroom isn't exactly known for being the most sterile place on the planet. There was a study done a while back that had showed they were this is gonna be graphic, but they were looking at flushing and the dispersion of fecal particles and they I think they found. Yeah, I think they found that if you leave your toilet open, your toilet seat open, any flush, that fecal particles dispersed. I think it was something like six FT, you know, around your toilet. So you can I'll let the audience kind of draw their own implications from that. But yes, I would replace your toothbrush. I saw something about that forever ago, like years and years ago, and it has stuck with me to this day. And I mean I'm crazy, like I mentioned, replacing a lot, like I replaced my toothbrush probably every two weeks, but I just feel cleaner. Yeah, and I mean I think feel more often the better. Yeah, I should probably that's something else I should create, like a toothbrush that's really sustainable, and I know there are some sustainable options, but I haven't found one that I super love. So question about the recommendations and actually I guess I can look at so my results so listeners can get it an idea of what happens when they do the whole process. So I got back my results and what's super cool is it gives you results and then you get your own score and then you get it how you compare to healthy people. So beneficial bacteria, I got moderate. I got five point five out of ten. So it's so like the ideal healthy people is ten. I got five point five, which was not super exciting. But then you get more information about it, like it says how it relates and the strange that might be related to that. Out of curiosity, I don't know if you can, if this is information that you can give, how many people have done Bristol? If you can't say that, that's fine. I'm just wondering, like, how many people you're comparing to? Yeah, unfortunately, I can't. I can't, but I can't. I can't say that the data that we're comparing to in those graphs isn't actually consumers were. We are launching a feature for that, but we wanted to be as again, as closed to ground truth as possible. So the data that you're looking at is actually from the clinical research study and it's all de identified, of course, and an aggregate. But when we talk about healthy patients, those are healthy people. Like those were patients that were diagnosed as being healthy and the dental clinic and and same thing for the gun gun inflammations, for like those patients who are comparing you to or patients who are diagnosed with periodontal disease. Okay, yeah, so for gun inflammation, for example, I also got moderate. I got four point four. So people have gun inflam nation, it says our tin. And then healthy people without gum information, it compares to two point two. Interestingly well, for Haltosis, bad breath, I got low, so that made me happy. For to decay, I got undetected. How common is that that you have undetected bacteria? Yeah, it's it's Um more common than I thought it would be. The bacteria that cause cavities are, by the nature, if we're looking at the oral microbiome as like a pie chart, even people with a high score is still contextually like a very small abundance of carries causing bacteria. They just the the effects of those bacteria, I think, are just more severe. So we we do get undetected quite a bit, like more often than I thought we would, which is interesting, but it also kind of suggests that the mechanical piece of cavities is more prevalent than we would have thought. And you know, generally like, for I think Mike carries war is...

...that like opening up my results, but something like point too, because usually there is some some ebundance of carriers causing bacteria, but we do get plenty of people that that get Zeros. That's so interesting, especially given, like I mentioned, my history. I've had a lot of dental work done because of how much I ground my teeth and also I've had veneers. So it's really interesting to see that effect. Yeah, so one of the other pieces, and we were kind of talking about this earlier, is the way that we diagnosed cavities. So you can you can have a lot of cavities, but it doesn't necessarily mean that they were brought on by pathogenic bacteria. And in certain cases there's something called incipient carries and it's basically like you had a cavity and they were able to stop the progression of that cavity. But sometimes, like whether or not that cavity is diagnosed is up to the dentist. So sometimes you'll get very conservative dentists that that are mitigating or early risk or they recognize like hey, this is an incipient cavity and we should do a filling just to make sure that it's all good, even though it's not. It's not progressing, it's not getting worse and you may not even have bacteria that are contributing to it, whereas other dentists may be a bit more liberal and don't formally diagnose it as a cavity yet until it continues to progress. So sometimes, you know, the Lens that people are looking at your mouth through can influence, like, your diagnosis. That is something I've wondered. So getting a filling. Are there any downsize to that? Is that only helpful? Kind of have a negative effect on your mouth? I don't think it will have. Well, there are some downstream correlations that people are looking into with regards to cavity fillings and re canals and things like that, but in terms of treating the decay that is present right like again, if we if we ignore kind of the microbial aspect and we just looked at look at it as a physical symptom that's present, then doing a cavity filing makes sense because you literally have a hole in your tooth and that whole needs to get filled. You know, I think there's other situations that fall into shades of gray where early carries is preventable and it is reversible, and some dentists will instead defer to a cavity filling rather than implementing behavioral change and vice versa. So you know there are gray areas for whether or not those procedures are harm metically necessary. Yeah, it's interesting. When I was really experiencing issues with my mouth, but the dinners that I saw said was that it was probably mechanical because all of my issues were at the bottom of my mouth and like nothing on the top. And she was saying that if it was related to a bacteria issue, then I probably would have seen it all throughout my mouth, not just on my bottom, but probably was from grinding. So very, very fascinating. Okay, and then I keep mentioning the recommendations. So when you do the bristle program you get recommendations and first question. So I was given seven recommendations and I can talk a little bit about them. But before that, how many total recommendations are you pulling from and how customized is it to the individual? Yeah, so right now the recommendations are mainly around products. In the next couple of weeks you'll see that expanded to diet and hygiene recommendations as well, so you'll have even more stuff to sift through. We also right now include alternatives, and I think this will probably open up another conversation, but you might see like fluoride and Hydrox the appetite listed. Those ingredients aren't normally both found in the same toothpaste. Usually you can find fluoride based tooth based or you can find a hydroxy appetite based toothpaste. So we're building in logic as you take your survey. That includes like preferences for what kinds of ingredients you may or may not want, and that will become there will be more recommend nations, but they'll be more targeted recommendations and we're constantly evolving the logic between the products and hygiene recommendations that we make. In your oral microbiome right now it is connected to your actual results. So there are products a little show based on specific bacteria that are in high abundance or low abundance or present or not present, as well as your high level scores. So if listeners are curious, you get like the name. So I actually didn't get either of those. I didn't get fluoride or the I never know how to say it. It's that hijoxy. What is it? That other one? Nano hydroxy appetite. You know, it's a mouthful. I guess that's a good fun I have to use that more. Well, it's funny because it's like a thing that people are looking for. Is An ingredient, but it's such a long word, but I never remember what it is. So like an example I got is, what's one that I can pronounce? Chlorine dioxide, and then you click on it and it says what it does and how it works and it and then it gives you names of specific brands that it's in. One of them might use before the closest and then it gives you reference is. So it's very, very helpful. Hi Friends,... finally happened. I have a very limited time or ring discount for a very limited time. It is happening. You know, I love my Orr ring. What is the Orr ring? It's pretty much the coolest ring ever. You wear it on your finger and it measures your heart rate and heart rate variability, your body temperature, your activity, your respiration and they even recently added your blood oxygen. When it comes to sleep, you can see how long you spent in each individual sleep stage. Ladies, you can even use it to help track your cycle. Every single day I wake up and it gives me a readiness score which tells me, based on how I slept, based on my heart rate variability, my stress levels, how I should tackle the day. It is the coolest thing ever. You get so much data, so many metrics, and what I really love about aura is it it's very motivating. I never feel overly obsessive, which I was worried about before getting it. It really is just utterly enlightening. When I had covid and January it totally knew. It was so cool to track my covid progression. On the or ring, I cannot recommend enough getting an or ring now. Aura very rarely does discounts. They're just not big on the discounts. I have been trying so hard for years to get a discount for you guys, and so now I am thrilled to let you know that for a very limited time. Yes, this ends Thursday September two, you can get thirty dollars off in or ring. If you've been thinking of getting one, now is the time. I promise. They do not do discounts very often. So to get that discount, very very limited time, go to or a ring dot com slash Melanie avalon. That's o. YOU ARE A R I N G DOT COM forward slash M E L A N I E A V A L O N or ring dot com slash Melanie Avalon, you will get thirty dollars off, very very limited time. Jump on it now. This ends Thursday. After that you can keep using that link for whatever current offer I have with them, but if you want this substantial discount, now is the time. Or Ring Dot com slash Melanie Avalon. I'm just so, so excited that this moment is finally here and I can't wait to hear what you guys think and I'll put all this information in the show notes. All right. Now back to the show. My listeners, I know, will be really upset with me if I don't ask you the question. You mentioned fluoride. What do you guys think about Floride, because I know that can be very polarizing, especially in the more holistic health world. Like thinking about myself, two and a half years ago, before we started the company, never imagined that I would be having as many conversations about Florida, as I have today. My most objective opinion is we need more evidence, and that, I guess what I'm saying is there is clear research that shows that fluoride is an effective intervention for the prevention of Carrie's. So if we're talking about just cavities and and protecting yourself, for mitigating risk for cavities, Florida has been shown to be effective. There's obviously been a lot of research showing that it is also implied in some neurological conditions. What I think we're really lacking is like a full scale study, Longitudinal study, with with an adequate sample size and very rigid criteria, that that looks at the effect of Florid long term. And again, like I don't fall necessarily on either side of the debate and neither does bristle because again, we are trying to be as evidence based as possible. And you know, right now we make the recommendation for two reasons. One, we are constantly looking at the evidence behind it and as soon as we find the right kind of data and the right kind of evidence that truly indicates that it is harmful, of course, where we would remove it as a recommendation and we've probably actively done that with other ingredients in the past, like Lore hexadine. We also include it because for a lot of people flooride is an accessible intervention. You know, right now, I think Nanto hydroxy appetite tends to be this higher end ingredient that's included in a lot of premium brands, and that's not that's not to say that it's it's not more effective, it's it has been shown to be equally effective in the prevention of carries as fluoride. So that's why we listed as an alternative. But at the same time, you know, not everybody can afford premium brands and some people really only have access to a walmart or CVs or something that limits their selection. So we do want to make sure that people are adopting changes that they can actually implement, and that's one reason that we include fluoride. Yeah, it's very debated. I think one nuance in a lot of the research is that the data showing the neurological effects has largely been attributed to the continuous and on the continuous and acute ingestion Florid. So you know,...

...there's what's this saying like everything's okay in moderation or something like that. Right now, we live in a society where our our water is flooridated, our toothpaste flooridated everything, and a dental office is flooridated. Like it's a lot of fluoride that we're in taking, especially if you're drinking water straight out of the top and you're using a floride based toothpaste and you're, you know, to some degree like ingesting all of that. There have been studies that have shown that topical flooride use does not produce the same effect. So you know, again, just using a fluoride toothpaste to brush your teeth and spit it out into the sink may not be as as damaging as as ingesting flooride continuously for years. All that to say, like I I think that there's more research that has to be done and we're certainly looking into it as a company, but we don't want to close that off as an option for anybody right now until we know more. Well, yeah, it's interesting because so I have not used fluoride product, I have drink fluorinated water and I have not used Florida at my toothpaste for probably like a decade and every time I would go into the dentist with these cavities that I started getting after the high fruit diet, every time I would get schooled about how I needed to be using fluoride in my toothpaste. And I do wonder. I wonder a few things. One, I wonder if I had been doing that, if maybe I wouldn't have had all the issues that I had, if it would have been protective. Two, I also wonder, so the effects of fluoride. Is it from the fluoride literally touching your teeth or systemically do to have the benefits? So when we're drinking the water, is it just from the fluorinated water touching the teeth, or do we get it because we're drinking it and it's in our system and then it also goes back to our teeth from drinking it later? I'm not I mean I know that part of it is the introduction of flooride directly to the oral environment, which is why we have florid and toothpaste. I believe that there is a mechanism for just increasing systemic Florida and having that reintroduced through your saliva into the oral cavity. But you know, I think the other piece here that that a lot of people are missing is fluoride is a it is a preventive intervention, but I think it's also quite reactive. Like it's you can, you can eliminate fluoride from everything that you use if you're also changing your behavior and changing your diet right. You can brush with water because you're still removing a lot of those pathogenic bacteria and the plaque from your teeth. The fluoride does help remineralize enamel and protects the tooth from the effects of acid, but decreasing the production of acid by addressing the bacteria that produce it is a totally viable and non fluoridated path that that anybody can take as well. Okay, I think that's a very measured answer. I guess. Just for me personally, I wonder like maybe I should have been doing like just topical fluoride and maybe you know would have happened official effects? Yeah, you know how to Droxy opicide has been to be as effective, so I would you can use either. The problem with that when I was looking it up was I wasn't able to find a brand I liked, where I liked the ingredients that had that but I should do another look for it. So which speaking of I ran my entire routine by one of your experts even. Is that her name? Amen? Amen, I should know this. I follow her on instagram and she was fabulous. But something that's so, so cool about Bristle is you have the opportunity to actually have a call, like on the phone call, with an expert who helps go over your results and can give you thoughts on your personal routine. And she even sent me like a recap of recommendations and I was I was really blown away by that personal touch and what I learned from it, especially because I think it's so incredible just in the entirety of health, the advances that we're making and so much data that the every day you user can get regarding their health. So be at blood tests, be at the Gut microbiome, now the oral microbiome. But it can also be a little bit of overwhelmed with data and it's also trusting that the consumer has the knowledge base to, you know, form the correct conclusions from all of that. So it can be very overwhelming and so you guys have done a really, I mean a really amazing job and making the results that the individual user gets, making it user friendly, making it very clear and at the same time making it very detailed. So basically you can get your results and you can learn as much as you want to learn or if you just want surface level like basic recommendations, you can just look at that. But then, on top of that, to have that one on one interaction was really amazing. So I applaud you for that and I really really encourage listeners to try this out because it is so eye opening. And I know we talked about this before how you're changing and enhancing that whole program but what does the future look like for Bristol like? What do you to achieve an accomplish and see and what the user experience?...

How might it be changing? What are you looking for now? Yeah, so, I mean I think at the highest level, like we as a company, we think that oral health has been this overlooked but critical component of overall health and in our goal as a company is to help people improve their oral health to improve their overall health. Our Bet is, you know, by by helping people rebalance our oral microbiome, will not only decrease or eliminate the prevalence of oral disease, but we'll see a reduction or an impact in the prevalence of diabetes, card vascular disease cognitive decline. So that's kind of the big vision for the company. But in terms of what we want to do on the product side, you know, I think oral health is just such a black box right now. We we never know what our oral health status is. We only find out that we have disease when it's progressed to the point where we need an expensive or an invasive intervention, and we want bristles up a more effective and more accessible standard of care for people. More effective in the sense of detecting disease earlier, being more precise about the way we characterize it, implementing behavioral preventive recommendations across the Diet, hygiene and the right products to use for the bacteria that you have in the oral health status that you're at, and accessible in the sense of you know, one of the statistics that really stood out to me is when we were doing initial research around Bristle was eighty million US adults skip dental checkups every year, which isn't I guess it's not that surprising probably for a lot of people, but the three most commonly cited reasons were inconvenience, cost and fear. And what we want to deliver is a more approachable, accessible, easy to use experience and and that was a big factor in US going direct to consumer, because we didn't want to limit the availability of our technology to people who already saw a dentist or who had access to see the dentists. We want everybody to be able to take whether it's your zero to one, like first step in oral health and you're going from like eight to ten. We want to open the door to everybody. So you know, in terms of the product we want to we want to be the source of truth, I think, for people to understand their oral health status and to implement really effective changes to improve their oral health, and we want to direct them to the best in class products that will have the biggest impact. And we right now work with a variety of companies and obviously make referrals to brands that aren't bristle and I I want to maintain that. I think you know, one of the things I'm most proud of as a company is that we are objective. We we aren't trying to just sell people products, because we make them and it's adding to our revenue. We're trying to point people to product because they're they're the most effective options that those people can adopt. So, you know, we want to continue working with other oral care product companies to get their products into our recommendations, to to test them and understand the effects that certain ingredients have and work with them to to create better versions of their products for people. You know, we think that there's probably some opportunities for us to introduce products or at least work with companies to introduce new formulations and new ingredients, and we also want this to be adopted into the standard of care because, you know, right now it is a purely reactive process and more than anything like I would love to see dentists and and hygenis leveraging Bristle as part of the practice to really shift from pure reactive treatment of disease to proactively managing health and more consultative standard of care with with their patients. That is amazing and that was one of my initial thoughts when I experienced Bristle, which was because I work and I have interacted with and engaged with a lot of not oral microbiome but brands like this, where there's a test and then there, you know, you learn something and then there's product recommendations and so often it does feel like oftentimes it is very helpful, but it also feels like the purpose is to be a funnel towards a product run by the company. And when I saw Bristle, which I know right now, you guys you don't have any products right now right. So I would anticipate and I would hope that you guys would, hopefully in the future, because then we would mean, especially after talking to you now, I just really trust where you're coming from with any products that you would create. But, like I mentioned, it's very cool that in the recommendations you list out, you know, all of these different brands and it comes off it's just completely unbiased, which is really refreshing. It's kind of like the best of both worlds. Because I I didn't realize this, but it is hs a F S A eligible. So does that mean that we can, it was our h s a account card, to...

...purchase the kids? Yes. How often do you recommend, because it's cheaper the the more you test per year? How often do you recommend people be testing and re testing? Yeah, I mean, I think for most people, like every six months is is kind of the baseline that we've seen. We're starting to do more testing, with more frequent tests, but I would say, you know, the majority of people in the six month testing plan are probably in the right place. Of course, you can always start with the single kit just to get like a snapshot of Your Oral Health Status and then determine things from there. The three months, I think is is very effective, especially if you're really invested in your health and and, like we talked about, the oral microbiome is really dynamic. Your oral health does shift in the recommendations that we make change as your oral microbiome changes. So it's it's just another way to kind of stay on top of things and make the changes that you need to make to address whatever risk you have it at any given time. Hi Friends, so what I'm a about to say may include some disturbing content, so if young ones are listening, you may want to skip ahead. On Valentine's Day two I experienced sexual battery by a man at a massage parlor. I felt so helpless and so scared while it was happening and afterwards I was really, really scared to tell anybody. I'm so glad that my friends encouraged me to tell the police and I'm so glad that the police believed me and that the man is now in jail. And ever since sharing my story, you guys have been so supportive. So many people have applauded me for telling the police, saying that something like that had happened to them too, and they never told anybody. I started looking into the statistics and they are pretty shocking. So sexual assaults are most likely the most prevalent crime in the US and they are also the most underreported. Every sixty eight seconds, an American is sexually assaulted, so I was one of those. Every nine minutes that victim is a child. Meanwhile, only twenty five out of every one thousand perpetrators will end up in prison, and only five percent of sexual assault reports filed have ever been proven false. Of all juvenile sexual assault victims are female. Adult rape victims are female and in two thousand nineteen over six hundred and fifty six hundred and seventy six women were raped and nearly one million women were victims of sexual assault. I believe this is a huge, huge problem happening in our society. It's one of the crimes where there's not usually evidence. It's not like a physical object was stolen or somebody outwardly injured or killed. It's basically your word against the perpetrator, and so it can be really, really scary to tell somebody and stand up for yourself, but I want to encourage you that we can change this. We can speak up. So if something happens to you, I encourage you. Please, please, tell somebody. I promise you you're not crazy. The thing that really convinced me to go to the police was it wasn't so much about me, but about stopping this man from doing this to somebody else. If you feel like someone crossed the boundary, they probably did. People don't usually question things that are appropriate and normal, and as parents, I encourage you to have these conversations with your children in whatever time and way you feel comfortable. I think we can make change here. It's just about spreading awareness and taking a stand and speaking out. So thank you, everybody so much for the support. I love you all. You are amazing and let's change this. So, like I always say, you got this. Okay, back to the show. Awesome. Well, we do have a code for listeners. So thank you so much for this. And I've curiosity is, do you know if my code is good on subscriptions or is it just the one time purchase for the initial if it's, won't make it good for the subscriptions. So let's if it's not. All you know somebody after the calling and make it so. Thank you. That's amazing. So if you go to Melanie avalon dot com, slash Bristle, that's B R I s t l e, that will redirect to their ending page for me on their website and you can use see coupon code Melanie Avalon to get off. So I am so, so grateful. Thank you for that. I am I'm really excited. I mean I just had such an amazing time doing this. Like I said, it was something I thought was really important and it's thrilling to see a company actually tackling this in such a broad way. I mean with the research, with the empowerment of consumers to actually learn about their health and then all of the information that you provide. It's just so cool so important. I cannot recommend it enough. I can't wait to hear from listeners what they experience. So yes, well, we covered so much information. The last question I always ask every single guest on this show and it's just because I realized more and more each day how important mindset is. What is something that you're grateful for? Yeah, I mean, I think you know, I want to say obvious leave the team and the company and our users have all been...

...great. I think that's a really unique situation for me to be in. Honestly, we I started the company in San Francisco and San Francisco is an amazing city. I I moved back to San Diego, where I'm originally from, ten or eleven months ago and a big component of that was was the mental health piece. I think you know, there's been a lot of advantages from a mental health perspective of just being in a place that's a bit slower paced, not being kind of surrounded by, you know, the quote unquote scene of tech and startups and investors. It's allowed me to focus on the mission a lot more and connect with our users. And then, you know, I think that maybe on the other end of the spectrum, I grew up surfing and that's always been like my personal outlet and I would say I'm just grateful. It's so rare and I don't think about it enough. So I'm glad that you brought the question of but, like, it's such a cool opportunity for me and I feel so grateful to be able to build a company that I believe in and do it in a place that I enjoy being and still having time in my life to do the things, I mean, the other things that I love, you know, being having having access to the ocean and like being able to serve. It's another thing that like, very few people get to experience and you know, I think a lot of the time I take a lot of these things for granted or you just get so granular and in the day to day of running the company and building things. But yeah, I'm really grateful for for where I live right now and the fact that I do have time to go do those things. I'm I'm grateful for my my girlfriend, who has been incredibly supportive and was there from the beginning of the company, or names Nicole. I got a puppy a few months ago. Her name is Lola, so that's been kind of the light of my life for for in the last couple of months and she's been great. I'm grateful that she's been an easy puppy because that could have made my life a lot more difficult. Yeah, well, that is amazing. And not to end on a crazy rabbit hole, but my interview tomorrow is actually it's with Dr Karen Becker, who wrote a book called the forever dog. So it's all about the longevity and dogs and all about their health and how it correlates to human health. I don't think she talks at all about the oral microbiome of dogs. That might have to be something you look into in the future. Yeah, there's some really interesting there's a lot of research into the oral microbion of dogs and cats. Actually some interesting indications. Oh Really, oh, hey, wow, okay, see, see, there's just so much here. Well, thank you again. This, this conversation has been amazing. I am so, so grateful for what you're doing. I mean literally you're changing the world because, I mean I don't know anybody else doing this and I really think this is the beginning of a huge frontier that hopefully will be more and more explored and become more and more accessible, which is something you're doing with bristols. So thank you so much. We'll have to stay in touch and I'm really excited to see the future of everything. Thank you so much for listening to the Melanie avalon bio hacking podcast. For more information, you can check out my book what when wine? Lose weight and feel great with Paleo style meals, intermittent fasting and wine, as well as my blog, MELANIE AVALON DOT COM. Feel free to contact me at podcast at Melanie Avalon Dot Com and always remember you got this.

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