Why Your Dentist Should Be Thinking About Your Brain, Sleep, and Nervous System

The process begins with an extensive 90-minute initial examination to gather records and understand the patient's current state. The second crucial step is to establish a solid foundation by ensuring gums and teeth are healthy, addressing any cavities or gum disease. Following this, an orthotic appliance (similar to a mouthpiece, not Invisalign) is worn, often at night. This appliance is designed to allow the jaw muscles and joints to find their most balanced state. This phase involves numerous adjustments until the system is stable, meaning the jaw closes consistently in the same spot, and forces are evenly distributed. Only once this stability is achieved, verified by measurements and lack of further adjustments, are teeth rebuilt to restore missing enamel and create a stable bite that correlates with the now-balanced joints and muscles. This meticulous approach aims to prevent the common issue of dental work being 'ground away' due to underlying biomechanical problems.

Myofunctional therapy focuses on retraining the tongue to its optimal resting position: suctioned against the entire roof of the mouth (palate), with lips closed and teeth slightly apart. This seemingly simple action is fundamental for correct swallowing, efficient chewing, and unobstructed breathing, impacting overall airway health. The therapy addresses underlying causes for improper tongue posture, such as weak tongue muscles (tonality) or restricted mobility due to a 'tongue tie' (frenum attachment). If a tongue tie is present, a frenectomy (laser procedure) may be performed to free the tongue, followed by guided exercises to ensure proper healing and increased range of motion. This practice is not new, with historical roots in midwifery, and is considered the natural form of oral function, exemplified by breastfeeding. The importance of this extends to the entire body, as the tongue is connected via deep fascia all the way to the toes, meaning tongue dysfunction can contribute to pain and restriction elsewhere in the body.

Proper chewing involves a clear division of labor: front teeth for tearing (like meat off a bone) and back teeth for grinding food into a liquid-like consistency. Many people, especially those with worn-down teeth, mash food rather than chew it effectively. The 'eye teeth' (canines) play a crucial role in guiding the jaw's motion, ensuring that when the jaw moves side-to-side, the back teeth disengage, preventing uneven wear. This guidance helps maintain a vertical chewing pattern rather than a damaging lateral one. Chewing food thoroughly is vital for digestion; undigested food can lead to digestive problems and nutrient malabsorption. Furthermore, consuming crunchy, hard foods provides necessary bone loading stimulation, which is essential for the proper growth and strength of facial muscles and jawbones, a concept highlighted in books like 'Jaws, the Hidden Epidemic' regarding the impact of soft modern diets on facial development.

Mindful brushing involves paying close attention to every part of the mouth for an adequate duration, ideally 2-4 minutes. A key aspect is the correct angle of the toothbrush: 45 degrees towards the gum line for most teeth, ensuring both the tooth surface and the gum margin are cleaned. For the inside surface of the lower (and upper) front six teeth, a 90-degree (straight up and down) angle is recommended. This specific technique targets an area particularly prone to plaque buildup due to the presence of salivary glands underneath the tongue, which can deposit calcium and phosphorus, leading to increased mineral accumulation on these teeth. The pH of saliva also plays a role; more basic saliva tends to correlate with more buildup, while acidic saliva is linked to more cavities. The goal is to prevent plaque accumulation and inflammation by effectively cleaning these specific areas.

C-shape flossing is a technique where the floss is wrapped around the side of each tooth, forming a 'C' shape, and then moved up and down, extending slightly below the gum line. This method is crucial because its primary purpose is not just to remove food particles, but to introduce oxygen into the subgingival (under the gum) area. The bacteria responsible for gum bleeding and disease are often anaerobic, meaning they thrive in oxygen-deprived environments. By introducing oxygen, flossing effectively kills these harmful bacteria. This technique also ensures thorough plaque removal from the tooth surfaces that a toothbrush cannot reach. While water picks can be beneficial for cleaning deep pockets or around implants, they do not fully replace the mechanical action and oxygen delivery of C-shape flossing.

Tongue scraping is recommended both morning and night to remove accumulated debris, bacteria, and 'amma' (toxic residue) from the tongue. According to Ayurvedic principles, the liver detoxifies overnight, depositing toxins into the gut, which can manifest as a coating on the tongue. This coating, which can vary in color (e.g., yellowish-green for sluggish liver, white for heavy toxins), is a breeding ground for bacteria. Scraping effectively removes this layer, reducing the overall bacterial load in the mouth and preventing these toxins from being re-ingested. It's more than just cleaning; it's a daily detoxification practice that can offer insights into gut health and digestive efficiency. Copper is a preferred material for scrapers due to its antibacterial properties. Proper storage of the scraper, away from potential toilet contamination, is also advised.

Bioesthetic dentistry is described as encompassing biological dentistry but extending further to analyze and restore the fundamental biomechanics of the mouth. It's not just about using natural materials or avoiding toxins, but about understanding how the bite connects with the jaw and muscles, and how this supports the entire body's posture. The goal is to restore natural function, with aesthetics being a secondary outcome. This approach aims to prevent dental work from failing prematurely due to underlying biomechanical imbalances, ensuring that investments in a 'beautiful smile' are sustainable.

Dr. Loud is in her second year of Ayurvedic studies, aiming to become a 'doctor of Ayurvedic medicine' (though the title is restricted in the US). She envisions this knowledge allowing her to provide truly individualized care, recommending specific herbs, practices, and food combinations tailored to each patient's constitution. This goes beyond typical dental advice, delving into the root causes of oral issues through a holistic lens. For example, she now advises against combining fruits with dairy or vegetables, and meat with dairy or potatoes, citing these as incompatible food combinations that can lead to digestive issues and contribute to systemic problems that manifest in oral health.

The speakers confirm that the bacteria in the mouth have qualitative links to various systemic diseases. They regularly see associations between oral bacteria and conditions like diabetes and Alzheimer's, citing ongoing research. They use specialized salivary DNA tests to identify specific oral bacteria related to gum disease, rather than general genetic tests like 23andMe. Based on these results, they recommend antimicrobial therapies and proper oral hygiene practices, including disinfecting toothbrushes and changing heads monthly, to reduce bacterial load. This highlights that oral health is not isolated but deeply intertwined with the body's overall well-being.

The experts confirm that dental work, if not done properly, can cause inflammation in the gums, raising inflammatory markers. More significantly, an imbalance in the musculoskeletal system of the jaw can disrupt the vagus nerve. This disruption can lead to issues with nervous system balance, manifesting as low Heart Rate Variability (HRV) and poor sleep quality. The constant muscle contraction in an imbalanced jaw can interfere with brain function and prevent deep sleep. Proper tongue posture, achieved through myofunctional therapy, is also highlighted as a way to stimulate the vagus nerve and calm the nervous system. This emphasizes that dental interventions have far-reaching effects beyond the mouth itself.