The Diary of a CEODr. Sampson: Why bleeding gums quietly drive disease risk
Sampson maps a 700-species microbiome living inside your mouth. She links gum bleeding to heart attacks, Alzheimer risk, and slower fertility.
EVERY SPOKEN WORD
150 min read · 30,045 words- 0:00 – 2:02
Intro
- SBSteven Bartlett
Is there a link between our oral health and our fertility?
- VSDr. Victoria Sampson
Yes. This is some of the newest research that's coming out. They found that over 90% of men who wasn't able to conceive with their partners had a oral disease. For those who got treated, there was a 70% improvement in pregnancy. Now, research has also found that if a woman has gum disease, it takes them two months longer to conceive. And I'm the only one who's talking about it.
- SBSteven Bartlett
And who are you?
- VSDr. Victoria Sampson
I am the Saliva Queen. Dr. Victoria Sampson is the trailblazing dentist...
- SBSteven Bartlett
Whose data-driven research has uncovered the shocking link between our mouths...
- VSDr. Victoria Sampson
And some of the world's most destructive conditions. More than 90% of diseases can be traced back to our microbiomes, and we now understand that having an imbalanced oral microbiome increases your risk of high blood pressure, heart disease, Alzheimer's, rheumatoid arthritis. And even men who have gum disease are 2.85 times more likely to have erectile dysfunction.
- SBSteven Bartlett
Really?
- VSDr. Victoria Sampson
Yeah. And then another study also showed there's oral bacteria that can make cancer more aggressive and harder to treat as well.
- SBSteven Bartlett
But what is it that causes all of this?
- VSDr. Victoria Sampson
Poor oral hygiene, sugar, stress, but also some of us genetically will have mutations which can cause disease. But there's ways to fix it. For example, I had a patient who had terrible arthritis and terrible gum disease, and when I treated the gum disease, her rheumatoid arthritis got better, to the point where she was actually able to walk again.
- SBSteven Bartlett
Wow.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
So let's talk about what we can do about it. Is there any time where I shouldn't brush my teeth? Do I spit or rinse after I brush my teeth? Chewing gum, coffee, mouthwash, good or bad for me?
- VSDr. Victoria Sampson
Let's go through all of that. So weirdly...
- SBSteven Bartlett
This has always blown my mind a little bit. 53% of you that listen to this show regularly haven't yet subscribed to the show. So could I ask you for a favor before we start? If you like the show, and you like what we do here, and you wanna support us, the free simple way that you can do just that is by hitting the subscribe button. And my commitment to you is, if you do that, then I'll do everything in my power, me and my team, to make sure that this show is better for you every single week. We'll listen to your feedback. We'll find the guests that you want me to speak to, and we'll continue to do what we do. Thank you so much. Dr. Victoria
- 2:02 – 3:22
The Oral Microbiome
- SBSteven Bartlett
Sampson, what is the mission that you're on?
- VSDr. Victoria Sampson
Um, my mission is to show people that the mouth is the gateway to the rest of the body. And if they really want to achieve full body health, it starts with the mouth first.
- SBSteven Bartlett
I've never heard of the term oral microbiome, really, until I met y- you and s- went through all of your work and your research. And I think many people listening to this now also probably aren't familiar with that term, or, a- and also the importance of that term. So if you had to make a case to someone like me who's really unfamiliar with this subject as to why it's so important, from a very top line perspective, what would you say?
- VSDr. Victoria Sampson
I think everyone knows that their gut has a microbiome. And for the past 10 years, we've always talked about how you can change your diet, probiotics, prebiotics for the gut microbiome. But what a lot of people don't understand is that the oral microbiome is the second largest and most diverse microbiome after the gut. It's also a lot easier to change, and actually, it's been shown to have a massive impact on general health. So uh, having an imbalanced oral microbiome increases your risk of oral diseases, like gum disease and decay, but also can increase your risk of other systemic diseases, like high blood pressure, heart disease, infertility, Alzheimer's. Um, and it's something that is so easy to manage and balance.
- SBSteven Bartlett
How many people does this impact?
- 3:22 – 4:01
What Impacts Our Oral Microbiome?
- SBSteven Bartlett
A- a- and how many people is it relevant to? So an understanding of my or- oral microbiome is gonna help me in a number of ways as it relates to my overall health, but how many people does it really, really have an impact on?
- VSDr. Victoria Sampson
I think it depends on what you're trying to get out of the oral microbiome testing. Um, I would argue that it benefits everyone. We all have teeth. We all have mouths. Um, and everything that we do, every time we breathe, we eat, we drink, we kiss, uh, we are impacting our oral microbiome every single time. And then every time we swallow or we breathe, that bacteria that is putting into our mouth will travel elsewhere to the rest of the body and cause problems elsewhere.
- SBSteven Bartlett
You said it's the second-biggest
- 4:01 – 5:14
2 Million Bacteria in Your Mouth
- SBSteven Bartlett
microbiome in the body.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
How many bacteria are in my oral microbiome?
- VSDr. Victoria Sampson
So you have 700, approximately, 700 different bacteria, which make up two billion bacteria overall. And what's also very weird about the oral microbiome compared to any of the other microbiomes is that you've got lots of different environments or niches within the same mouth. So if you think about the bacteria that would like to live under the gums or at the back of your throat or on your teeth, they're all very different environments. Some are hot, cold, you know, wet, and so you've got lots and lots of different parties of bacteria within the same microbiome in the mouth.
- SBSteven Bartlett
Okay. And y- you mentioned a second ago that things like kissing, breathing, swallowing have an impact on my oral microbiome-
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
... in a significant way that I need to know about.
- VSDr. Victoria Sampson
Uh, yes. So it's more about how often you're doing those certain habits. So, you know, for example, with kissing, the research has shown that you need to kiss more than 11 times a day for you to be sharing the same bacteria or microbiome as your partner. Um, but also even the habits that we have, um, the air quality that we have, everything will dictate the environment that our mouths are living in, and therefore what bacteria will live in our mouths.
- SBSteven Bartlett
And on the subject of
- 5:14 – 6:47
How Many People Have Oral Diseases?
- SBSteven Bartlett
oral diseases and things like tooth decay, how many people are impacted globally by oral diseases?
- VSDr. Victoria Sampson
So the World Health Organization has come out, um, saying that 3.5 billion people have some sort of oral disease. And they've also found that 10% of our world population are suffering from severe gum disease, which makes gum disease one of the most prevalent inflammatory conditions, um, in the whole body.
- SBSteven Bartlett
This conversation around the oral microbiome, have you seen it developing over the, over recent years? Have you seen it become more sort of pertinent to people in society?
- VSDr. Victoria Sampson
Massively. I think, I've been doing this for, for years. It's been something that I've loved. Um, and no one really knew what I was talking about most of the time. They all thought I was a bit of a dreamer. Even dentists, patients, they all thought, "Okay, well..."... doesn't really matter, does it? But in the last year or two, I've had people traveling from all around the world just to get their oral microbiome tested, to understand more about what's going on in their body. And I think we're seeing a shift in the generations, in terms of this new generation want to understand their health a lot more. So we're all sitting there wearing, you know, trackables, wearables, we're, you know, calculating how much sleep we have, how much we're eating. And for, uh, now, we're actually also wanting to understand our oral health. So that trust between a dentist and the patient is not necessary anymore. We want to actually understand what's going on in our mouths and actually, you know, be able to track things, see what bacteria we have, how much inflammation we have, our risk of diseases, and what we can do to change that.
- SBSteven Bartlett
Last question before I ask you a
- 6:47 – 8:33
Body Diseases Linked to Oral Microbiome
- SBSteven Bartlett
more sort of personal question about yourself. Um, what other diseases in my body, or sort of implications in my body, are linked and can be traced back to the oral microbiome?
- VSDr. Victoria Sampson
We now understand that more than 90% of diseases can be traced back to an imbalanced microbiome. Uh, if we zone into just the oral microbiome, it's got connections with infertility, heart disease, diabetes, Alzheimer's, rheumatoid arthritis, um, and the list goes on, erectile dysfunction. Um, and what's also very interesting, going back to your question about, you know, is there been a new interest in this, in the last few years, we've actually been able to show that there is a strong connection and causation between the oral microbiome and general diseases. Whereas prior to maybe five years ago, there was a lot of kind of, "Is this correlation? Is it just that, okay, there's the same risk factors with gum disease and with heart disease, for example, smoking?" And now we're actually seeing that no, it's not just correlation, there is strong c-causation between the two.
- SBSteven Bartlett
And who are you?
- VSDr. Victoria Sampson
Um, I am Victoria Samson, I'm a dentist, um, I do a lot on the oral microbiome. Um, people call me the saliva queen, that's my name on the streets (laughs) .
- SBSteven Bartlett
(laughs) and what's your sort of, what professional experiences and education have brought you here today, and how long have you been doing that? How many mouths and how much saliva have you seen? Give me a cl- a sort of a big view on the, uh, the wealth of experience you have on the subject.
- VSDr. Victoria Sampson
Um, so originally, I trained as a dentist, um, and that's six years of training. Um, I would say I was a pretty traditional, conventional dentist as I graduated. Um, I'd done some training, um, at the Karolinska Institutet during my university, and the, the Karolinska Institutet
- 8:33 – 10:46
Steven Adjusting Chair?
- VSDr. Victoria Sampson
is the best dental school in the world. Um, but they're very focused on the mouth-body connection, on testing saliva. Um, and what they thought was that, you know, you go to your doctor and you have a blood test, why don't you go to your dentist and get a saliva test? So from even dental school, I had this in the back of my mind, but I still didn't have the training, and so I just became a dentist. Um, I was working half NHS, half private, and then as time evolved, I then, um, shifted to fully private. Um, and then when COVID happened, um, I started doing a lot of research, and all the dental practices were closed across the country. Um, and I thought that was crazy, because basically the government was saying dental practices, uh, or dentistry is not a necessity. So, uh, I thought that was insane, and so I decided to do a lot of research, and I wrote a paper which was connecting, um, oral health with poor, with COVID complications. So what we found was that patients who had poor oral health or gum disease were at a much higher risk of COVID complications. Um, and then that evolved into me doing some studies with universities and hospitals. But the issue was that we couldn't go into, um, hospitals and check people's teeth and gums because they had COVID. So instead what we did was we would collect their saliva, and we would take it to the lab, and we had this beautiful snapshot of what was going on in a patient's mouth at that moment in time just from their saliva. So we did a lot of research, and we found that, uh, COVID sufferers or patients who had gum disease were nine times more likely to have COVID complications. But also what I took from that was that, why aren't we using saliva, you know, more regularly? Why don't we use this in a more commercial aspect and for our patients? So after that, I devoted a lot of time into developing oral microbiome testing. We had gut microbiome testing, you've got urinary microbiome, you've got every single microbiome has a test, but the oral microbiome didn't really have one. So I built one of the first oral microbiome tests in Europe, um, and that was a couple of years ago, and then now have come out and, uh, kind of left and created my own one, um, about a couple of weeks ago.
- SBSteven Bartlett
That research you
- 10:46 – 13:06
Research Linking COVID-19 and Oral Hygiene
- SBSteven Bartlett
mentioned, specifically the research paper which was titled, "Could there be a link between oral hygiene and severity of COVID infections?" was the first research paper to link gum disease with worse COVID complications, and I was reading that it was the most cited research paper by the, one of the sort of dentistry publications?
- VSDr. Victoria Sampson
Yeah. Yeah. So the British Dental Journal is one of the most cited and viewed articles. Um, and what it also helped do was, um, the World Health Organization and SAGE picked that up, and they said, "Oh, wait a second, I think that oral health is really important for general health, and also we should reopen dental practices." So this also paved the way for dental practices reopening later on.
- SBSteven Bartlett
W- what's going on there? Can you explain that to me like a 10-year-old? So if I have a bad or a unhealthy oral microbiome, I'm nine times more likely to end up in ICU with COVID complications. What- what's the link?
- VSDr. Victoria Sampson
So there's a few. So the first one is inflammation. So COVID, we know, um, it releases a lot of inflammatory markers, so it's what we call the cytokine storm. So it's essentially the storm of lots and lots of inflammatory markers. And gum disease, separately, um, is essentially inflammation of the gums. And so, what gum disease does is it releases lots of inflammatory markers from the mouth elsewhere to the rest of the body. So then when you add those together, and you have your cytokine storm from COVID, and you've got your inflammatory markers from gum disease, it's just adding petrol to the fire, so you're just making that cytokine storm even worse.
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
Um, but then on a separate side, it's also bacteria. So if you look at the, um, autopsies and the research of COVID, uh, patients, um, most of them didn't die from the virus itself. You... No one really died from COVID-19. They died from complications. So the number one complication was actually a bacterial infection. So imagine your body... You've got COVID. You are really unwell, and your immune system is on absolute overdrive. This is the primetime for bacteria to come into your body and to cause what we call a bacterial superinfection. And so actually, when you look to the autopsies of a lot of these patients, they had oral bacteria from their mouth traveling to their lungs and causing bacterial superinfections which would result in things like pneumonia, and that's actually the cause of death for most patients.
- SBSteven Bartlett
You don't really
- 13:06 – 13:55
Can Your Oral Microbiome Kill You?
- SBSteven Bartlett
think that your oral microbiome can be fatal, it can kill you?
- VSDr. Victoria Sampson
No, and even, I think as a dentist, we weren't really taught how important bacteria was or how important the mouth was for the rest of the body. Uh, the number... The only one that we ever learnt, um, and a lot of people would know this one, is that if you, um, have heart surgery, you can't actually have a hygiene for about six months after the heart surgery.
- SBSteven Bartlett
A dental hygiene?
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
Hmm.
- VSDr. Victoria Sampson
And the reason for that is because you're at a very high res- risk of something called infective endocarditis. So this is oral bacteria which travels down to a faulty heart valve, um, and can actually cause death. Um, so we know that, but we never really look at it for other diseases or other problems.
- SBSteven Bartlett
I wanna, um, I wanna take a step back
- 13:55 – 17:03
How Food Shapes Your Mouth
- SBSteven Bartlett
before we go through the links between our or- oral microbiome and all of these diseases, but also, I really wanna also talk about h- what we can do about it, 'cause I've got so many questions around it. I've got all of these products down below my chair, from mouthwashes to toothpaste to all these kinds of things which I wanna talk about as well. But just taking a step back to something that one of my guests previously was telling me about, I think it was James Nestor. He was telling me that the, the mouth itself and the jaw, because of processed foods, is an abnormal shape. And when I say abnormal, I mean, um, in relation to how it was supposed to develop, because we're eating so many processed foods which aren't, you know, which are designed to be easy to chew, the mouth itself and the jaw have changed. Is there any truth in that?
- VSDr. Victoria Sampson
Yeah, 100%. So there was a man called Weston Price, um, and he was a dentist, and he basically suspected that, and he was like, "This is strange. Why is it that, um, people who are more industrialized in westernized areas have higher levels of decay and they have loads of crowding?" So they had basically lots of crowding of the teeth, um, and smaller jaws. And so he basically traveled around the world, and he looked at lots and... different, um, tribes, villages, countries, and he compared the teeth of, uh, for example, twins. One twin would be in a very industrialized, westernized area, and the other one was not. And what he found was that in the twins who were in these non-industrialized areas, they were eating harder foods, uh, they were having less sugar, and actually their jaws developed a lot better. So they didn't have crowding. They had perfect teeth actually, and they had no decay compared to the children or the, the twins who were in more industrialized areas. And it is because our food now has become so processed. A lot of children are not having hard foods, um, and so we don't develop the jaws and the muscles at an early age. And so the teeth haven't changed size, the teeth are exactly the same size as they were previously, but what we're seeing is that those teeth, um, don't have any space to grow anymore, and that's when we're getting crowding.
- SBSteven Bartlett
And can you see that in any of those models?
- VSDr. Victoria Sampson
So, uh, yeah, in this model, you can actually see at the very back, so a lot of people will have wisdom teeth, um, and, uh, one of the biggest issues at the moment is that a lot of people have impacted wisdom teeth. So this is basically, imagine your teeth are all upright. Your wisdom tooth is coming out at a completely horizontal angle, and it's pushing on the rest of the teeth.
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
It's an absolute nightmare as a dentist to take out. It's even more of a nightmare for a patient to have to endure, but also we're seeing that there are a lot more impacted wisdom teeth, um, in the last 30, 40 years than there were previously.
- SBSteven Bartlett
Ah, because the diets have changed.
- VSDr. Victoria Sampson
Because the diets have changed. A lot more children are needing orthodontic treatment now as well, just because they have crowded teeth, teeth are overlapping, um, and so they need braces to straighten those teeth out. If you think about cavemen, cavemen didn't have dentists, they didn't have braces, they didn't even use toothpaste, but they didn't die from gum disease or decay or crowded teeth. So it's been something in our industrialized or more, kind of, westernized diet that has changed that.
- SBSteven Bartlett
My wisdom tooth
- 17:03 – 18:22
What’s a Wisdom Tooth?
- SBSteven Bartlett
is coming through on my left side at the moment, and I think actually also my right side at the same time, and I'm 32 years old now. So I'm like, "W- why the hell am I growing teeth at 32 years old?" I thought I was on my way out or something.
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
Um, so I got two questions just before we crack on, which is, what the hell is a wisdom tooth, why is it called a wisdom tooth, and why is it coming through at 32 years old?
- VSDr. Victoria Sampson
(laughs) Um, so we have teeth erupting at different s- kind of times of our lives. So usually you have your baby teeth. They will erupt up to the age of about six or seven years old, um, and then you have your adult teeth coming through, and usually they will stop erupting around 12 years old. Um, and then you have nothing, you're chilling, you have nothing, nothing, nothing, nothing until about maybe-... mm, 18, 19 years old, and that's where you start to get your wisdom teeth. The name behind wisdom teeth, from what I understand, is because it's, it erupts when you're older. It's when you have more wisdom and you're-
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
... more wise.
- SBSteven Bartlett
Oh, so I'm wise now.
- VSDr. Victoria Sampson
So you're just very wise.
- SBSteven Bartlett
Oh, that actually makes sense.
- VSDr. Victoria Sampson
(laughs) Um, and so some people will get it at 18. Some people don't have any wisdom teeth. Some people have wisdom teeth which erupt perfectly and are all completely fine, and others will have their wisdom tooth erupt at 32 years old and maybe be a little bit impacted or cause problems. So they're also very strange teeth. Um, they're very unpredictable the way that they are.
- SBSteven Bartlett
Is there any
- 18:22 – 19:07
Do Wisdom Teeth Need Removal?
- SBSteven Bartlett
evolutionary basis for why we need them? There must be some kind of evolutionary reason for them.
- VSDr. Victoria Sampson
Not that I understand. What th- ha- is also happening is that, um, apparently, and this is some research, is that less people are having wisdom teeth because more children or y- or adults are getting their wisdom teeth taken out. And as evolution goes, um, eventually some people are actually not having wisdom teeth at all, because their ancestors haven't had wisdom teeth, so why would they have wisdom teeth? Um, but overall, no, there's no real need for wisdom teeth. I never like to take them out unless needed, because I mean, more teeth-
- SBSteven Bartlett
The better.
- VSDr. Victoria Sampson
... the better. And you never know if you have to have something taken out, then we can use your wisdom tooth for something.
- SBSteven Bartlett
If I were to look
- 19:07 – 20:33
Why Do We Need Dentists If Ancestors Had Good Teeth?
- SBSteven Bartlett
at my ancestors from 500 years ago, you said they don't have dentists, they don't have toothpaste and all those kinds of things, but you also said they don't have too- tooth decay.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
Does that not therefore mean that I shouldn't need a dentist and I shouldn't need toothpaste or mouthwash or floss?
- VSDr. Victoria Sampson
If you had a caveman diet, then potentially you might not need toothpaste, floss, or even a toothbrush. Um, and there's a lot of argument as to, you know, there's a lot of people out there saying, "No, you don't need to use any toothpaste. You don't need floss, anything like that." And fine, go ahead, do that, but only if you are going to be eating, you know, meat, uh, raw meat sometimes, and you're only drinking water and you're not having anything in your diet which has any sugar or carbohydrates in it.
- SBSteven Bartlett
I mean, doesn't that speak to what the perfect diet is supposed to be? Can't we tell what the perfect diet is supposed to be by looking at the mouth?
- VSDr. Victoria Sampson
Yeah. So, uh, another issue is that with a lot of the food that we eat now, um, they have a lot more sugar in them, and that will impact the acidity of your saliva. And essentially what decay is, is, uh, you have sugar or you have some sort of carbohydrates, and you've got this bacteria in your mouth, and they feed on that sugar. And as they feed on that sugar, they release acid. Um, and if that acid is left there, then it can cause demineralization of your teeth, and that demineralization will end up with decay.
- SBSteven Bartlett
Okay. So let's talk
- 20:33 – 22:22
Is Everyone’s Microbiome Massively Different?
- SBSteven Bartlett
about the personal m- oral microbiome. Um, is my oral microbiome different from, say, Jack's over there and from my girlfriend's?
- VSDr. Victoria Sampson
Yes. Massively.
- SBSteven Bartlett
H- h- massively different?
- VSDr. Victoria Sampson
Yes. Uh, maybe, uh, massively, I would say. Um, so one of the issues that I used to have was I was doing lots of oral microbiome testing, um, and I would have, you know, let's say you and your girlfriend do an oral microbiome test, and both of you, I would see your results, and they would come out pretty much the same, because we're only looking at certain bacteria. We can't look at all 700. So we would look at the top 20 bacteria that cause problems. So I would look at both of them, and then I would look inside your mouths, and one of you, I don't know (laughs) who in this case, had raging gum disease and terrib- terrible oral health, and the other person would be completely fine. So then I realized that actually it's not just bacteria that causes disease or problems, it's how your body responds to that bacteria and the strains of bacteria that you have as well. So for every bacteria, um, there'll be multiple strains, and some of those strains can be really aggressive and really horrible for your mouth, and other strains are completely fine and are not gonna cause you any problems. So when I developed my test, what we did is we looked at strains. So we looked at the strains of certain bacteria, um, and we would be able to differentiate between patients who had the really bad strains and the really good strains. But then also we looked at the ratio of good and bad bacteria in someone's mouth, so their diversity, as well as their genetic mutations and also their inflammation. So when you put all of it together and you, it's like a puzzle piece, then you can actually have a better insight into someone's oral health. So I guess my answer is that everyone's oral microbiome is a little bit different, but it's also how your body responds to that microbiome and bacteria that really dictates whether or not you're going to have disease or problems.
- SBSteven Bartlett
So you could
- 22:22 – 24:22
How Oral Health Improves Overall Health
- SBSteven Bartlett
be someone who takes care of their teeth really, really well, but still have a bad oral microbiome relationship with the rest of your body, effectively?
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
And I see it every day, and we have a lot of patients who suffer from terrible gum disease, and they come to me and they brush three times a day. They've never touched a cigarette. They have immaculate oral hygiene. They eat very well. But they have terrible gum disease. And for those patients, they might have genetic mutations that predispose them to gum disease and to inflammation. So even the smallest amount of bacteria, their body responds in a very aggressive and inflammatory, destructive way, which can cause disease.
- SBSteven Bartlett
When I was speaking to, I think it was Tim Spector about the gut microbiome, he was telling me that the gut microbiome turns over, i.e. the bacteria d- dies every couple of days or weeks or something. How often does the oral microbiome die, turn over, and why does that matter?
- VSDr. Victoria Sampson
So what's interesting or different between the oral and gut microbiome, the oral microbiome, if someone doesn't go in there and mechanically disrupt the bacteria and the plaque in your mouth, then that bacteria can stay forever. So the gut, what happens is you've got something called peristalsis, you've got movement, so the bacteria moves, it, it changes, it regenerates, there's turnover. In the mouth, so the teeth are the only non-shedding surfaces in the whole body, so that means-
- SBSteven Bartlett
Non-shedding surfaces?
- VSDr. Victoria Sampson
So imagine if you, if you never had a shower-... uh, in your life. Uh, you would still self-wash because the skin cells would shed.
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
But if you never brushed your teeth, then your teeth are not shedding. They're gonna stay like that. So that bacteria will just keep on growing and growing and growing and growing, and you'll get this really thick plaque. So that's why actually the oral microbiome, you need to mechanically remove that bacteria, and that's why brushing your teeth is super important or, um, using the correct toothpaste, or et cetera, going and seeing your hygienist because you need to mechanically remove that bacteria quite regularly.
- SBSteven Bartlett
Okay.
- 24:22 – 26:16
Can Swallowing Saliva Make You Sick?
- SBSteven Bartlett
And the, the two ways ... I was reading in your work, it said that the two ways that oral health impacts overall health are by the spreading of bacteria, and the other sort of central issue is it causes inflammation. So on this point of spreading bacteria, I'm always concerned, this is a bit of a superstitious thing, but ev- any time that I'm sick, I'm always like, "Don't s-" ... uh, part of me is like, "Don't swallow."
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
Because in my head, I think if I'm sick in my mouth or if I've got, um, like a sore throat or something, I'm like, "If I swallow it, the rest of my body's gonna get sick." It's super, super s- superstitious, but is there any truth to any of this?
- VSDr. Victoria Sampson
Um, so not from just being sick like a common cold. And it's actually really interesting, I had a patient yesterday, and bless him, he's very young, seven years old, um, and he had exactly that same mindset. He just randomly woke up one day and he said, "This is kind of gross. Why am I swallowing my saliva? There's all these bad bugs and gross things in my saliva, and I'm swallowing it every day, and it's traveling to the rest of my body," at seven. And so what he ended up doing was refusing to swallow his own saliva, and so he would basically just dribble, and he would just wipe his, uh, the saliva off with a sleeve or he'd carry a towel with him and just wipe it. So bless him, he had a big rash around his, his, um, his face. Um, and it, it was a bit of a weird moment for me because I was like, "S- you're kinda right." Like, I mean, it is a bit weird, especially as a child to sit there and think like, yeah, you've got 700 dif- different bacteria, two billion bacteria overall, and then you're swallowing it, and it can travel elsewhere to the rest of the body. So yes, in, in short, yes, bacteria from your mouth when you swallow it, it can travel elsewhere to the rest of the body. However, a lot of the bacteria, um, dies, so the acid in the stomach can kill a lot of the bacteria. So it's only the really, really bad bacteria that are able to survive and cause problems, and that's why it's so important that you have a good oral microbiome and you balance it well.
- SBSteven Bartlett
And the other central way that
- 26:16 – 28:18
Inflammation and the Oral Microbiome Link
- SBSteven Bartlett
it can cause negative impacts to your overall health is by inflammation. What is the link between inflammation and my, my oral microbiome?
- VSDr. Victoria Sampson
So it's, uh, something that we call low-grade chronic inflammation. And imagine, so you've got this delicate balance of bacteria in your mouth, which is your microbiome, and we all have bad bacteria in our mouths, but most of us hopefully have better levels or higher levels of the good bacteria. So there's always that balance, and what happens in an imbalanced oral microbiome is that shift changes, so you get higher levels of bad bacteria, and you don't have enough good bacteria. These bad bacteria, firstly, yes, they can travel elsewhere to the rest of your body, as you discussed. The second is that they can release inflammatory markers. So they basically release inflammation, and this inflammation can travel from your mouth to the rest of your body and contribute to inflammation elsewhere. So for example, if you had rheumatoid arthritis and then you had inflammation from your gums, that inflammation from your gums is making your arthritis in your wrists worse. So it's contributing to it. Now, what's also interesting, and that's why it's called low-grade chronic inflammation, is often you wouldn't even know that you have it. I have so many patients who say, "Oh, you know, my gums bleed," but that's normal. If your eye bled or if your foot was bleeding every day, you would be worried and you would think, "Actually, there's inflammation here. There's a problem here." But so many people have bleeding gums, and they don't understand that bleeding gums is a sign. It's your gums screaming to you saying that, "I have inflammation," and that inflammation can travel. And then the third mechanism as well, so there's one more, is, um, it's damage to your blood vessels. So again, the same bad bacteria in your mouth, it releases these enzymes, these toxic enzymes, and they can travel through the rest of your body through your blood vessels, and they can actually damage your blood vessels. So these blood vessels are not able to dilate and constrict as well as they used to.
- SBSteven Bartlett
On that point of arthritis, I read a stat which, um, I believe is true. I think it actually came
- 28:18 – 30:43
Rheumatoid Arthritis Strongly Linked to Oral Health
- SBSteven Bartlett
from some of your research that said people with rheumatoid arthritis are eight times more likely to develop gum disease than patients without rheumatoid arthritis.
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
Which is shocking.
- VSDr. Victoria Sampson
Yeah. So there's a really strong, um, bidirectional relationship between rheumatoid arthritis and gum disease. So that means that if you have really bad rheumatoid arthritis, you will have pretty bad gum disease, and if you treat your rheumatoid arthritis, your gum disease will get better, and vice versa. If you have, if you treat the gum disease, your rheumatoid arthritis will get better. And that was actually one of the, um, first patients that really got me on my journey of the mouth-body connection. So like, yeah, I was doing the saliva testing, I got it. You know, I was like, "Okay, cool. We are quantifying oral health. We're tracking things." But even me, I wasn't really fully sold on this whole mouth-body connection, how our mouth is connected to the rest of the body. So I had a patient who was sent to me by, um, her functional medicine practitioner, and she had been seen by, uh, four or five different practitioners. She had terrible rheumatoid arthritis, and she, um, went to this final guy, and he was the first guy to ever ask her, "Have you ever had your teeth checked? What's happened?" And she said, "Oh, I've had a few teeth taken out in the last year or two, about six teeth, but, you know, it's just, it, it is what it is." And he was like, "I, I don't think that's normal." So he sent her to me, and he was like, "Can you do your saliva stuff that you do and see if there's anything up, uh, d- going on there?" And we did do a saliva test. We saw that she had super high levels of inflammation, of collagen breakdown, um, high levels of bad bacteria, and what was the most important was that when I treated her gum disease, she had terrible gum disease, and that's why she was losing her teeth. When I treated the gum disease properly and aggressively, um, yes, her gums healed, but more importantly, her rheumatoid arthritis got better to the point where she was actually able to get off steroids and medication and be able to walk again.
- SBSteven Bartlett
Wow.
- VSDr. Victoria Sampson
Yeah. (laughs)
- SBSteven Bartlett
By treating her gum disease?
- VSDr. Victoria Sampson
Yeah. And I think that, you know, sometimes as a dentist, we treat a lot of gum disease, and we treat a lot of things, and we don't necessarily see the systemic consequences, because the patient doesn't come back or, you know... Um, or it's such a small impact that you don't necessarily see it. But this was the one time where I was like, "Wow, like, what we do is actually really, really insightful and really important."
- SBSteven Bartlett
And you mentioned alongside
- 30:43 – 33:30
Heart Disease and the Oral Microbiome
- SBSteven Bartlett
that, um, inflammation also has an impact on cardiovascular functioning and health. Uh, I believe it's the case that cardiovascular disease is the biggest killer in the world, from what I understand. Um, so I was wondering if, if you knew any of the stats that show the impact or the l- the increased likelihood of me having a heart attack or a stroke or something, based on my oral microbiome?
- VSDr. Victoria Sampson
So, um, the research has shown that if you have gum disease, you are at a 20% higher chance of high blood pressure. Um, but also, they are now saying that up to 30 to 40% of cardiac, um, issues in hospital can be traced back to an oral bacteria, um, causing problems in the heart valve. Um, so the reason for this connection, so yes, inflammation, but also going back to that third mechanism I told you, which was about the vasoconstriction, so the blood vessels constricting and dilating. So, these toxic enzymes which are being released by the bacteria, they travel through the blood, um, and they basically stop the blood vessels from being able to widen and lots of blood to travel to the heart, and also to constrict, and that also is, um, one of the biggest connections with, uh, heart disease.
- SBSteven Bartlett
I found this stat, which might well be from your work or someone else's. It's from the study called The Association Between Periodontitis and Blood Pressure Highlighted in Systemic- Systemically Healthy Individuals.
- VSDr. Victoria Sampson
Not mine, but... (laughs)
- SBSteven Bartlett
Okay. And it found that people with gum disease were twice as likely to have a heart attack and three times as likely to have a stroke than those without inflammatory gum disease, which is absolutely staggering.
- VSDr. Victoria Sampson
Yeah, and then another study also showed that when you treated someone's gum disease, their levels of CRP... And CRP is an inflammatory marker that you can check in your blood. The levels of CRP significantly reduced, and for a lot of patients who suffer from heart conditions, they will get their CRP quite regularly checked through blood testing.
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
And so this is a way of reducing their inflammation, is just by having a, a simple hygiene. And I've even seen, um, particularly in America, there's a lot of, um, uh, cardiac surgeons and, um, doctors related to, to heart health, um, who are now actually working with dentists, because they understand that if they work together, then they're going to have far better results for their patients.
- SBSteven Bartlett
And this is, this is that swallowing thing we were talking about. This is because you're swallowing that bad bacteria.
- VSDr. Victoria Sampson
Yeah, and your heart valve, um, imagine if it's be- it's faulty, imagine you just had surgery. I always think of it like it's sticky. It's like Velcro, so it's really prone to infection and problems. It's just like if you fell over and you had a scab, and you were rolling around in mud all the time, you would get bacteria going into that scab and causing problems. This is the same thing with your heart valves.
- SBSteven Bartlett
Doesn't the bacteria just
- 33:30 – 33:48
How Oral Bacteria Filters Through Your Body
- SBSteven Bartlett
travel on its own anyway? 'Cause I feel like it's in my mouth, so I feel like it... I don't know, these are living organisms. Don't they just, like, find their way down, even if I don't swallow?
- VSDr. Victoria Sampson
Yeah. Even through your blood, um, and also through your gums as well. So you can swallow your bacteria, breathe it, or it can go through your blood.
- SBSteven Bartlett
At the start of this conversation,
- 33:48 – 35:56
Erectile Dysfunction Linked to Oral Hygiene
- SBSteven Bartlett
we were talking, you mentioned the sort of implications for your cardiovascular system, and one of the things you said was erectile dysfunction, and that was slightly alarming to me-
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
... as a man-
- VSDr. Victoria Sampson
Yep. (laughs)
- SBSteven Bartlett
... um, who's trying to stay away from erectile dysfunction.
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
What is, what is the research that supports this idea that my oral microbiome can have an impact on my erectile functioning?
- VSDr. Victoria Sampson
So, men who have periodontal disease are 2.85 times more likely to suffer from erectile dysfunction.
- SBSteven Bartlett
2.8 times?
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
Is... I'm pretty sure that's 280%, isn't it?
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
Okay, so what is this periodontal disease?
- VSDr. Victoria Sampson
Gum disease.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
So, uh, it's kind of, I would say it's a bit of a spectrum. So, the early stages of periodontal disease, or gum disease, is just gum inflammation. So that's that patient who is brushing their teeth, spits in the basin and sees blood. So that's the origin- you know, the early inflammation. If they don't get that checked out and sorted, that will just continue and continue and continue to what we call gum disease. Um, and that's where, yes, you've got inflammation, but actually, you have really high levels of bad bacteria now, and this bacteria is essentially eating away at the gums and also your bone. And, uh, it's, it's now become irreversible.
- SBSteven Bartlett
I'm just gonna have a swig of this.
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
(laughs)
- VSDr. Victoria Sampson
For your erectile dysfunction? (laughs)
- SBSteven Bartlett
Yeah. (laughs) Fucking hell. Okay.
- VSDr. Victoria Sampson
Um... (laughs) And then at the very end of the spectrum is people who are losing their teeth, having really terrible gum infections, and all of these kind of mouth-body connections that we're talking about.
- SBSteven Bartlett
Okay, and then, uh, can you just explain, as, again, as, as if I'm 10, the, how my, how that gum disease, that periodontitis, is it called?
- VSDr. Victoria Sampson
Mm-hmm.
- SBSteven Bartlett
... has an impact on my penis? I don't understand.
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
Like, I don't understand the link. It makes all of my blood vessels-
- VSDr. Victoria Sampson
Exactly.
- SBSteven Bartlett
... dot... li- Uh, okay.
- VSDr. Victoria Sampson
Yes, so it essentially stops your blood vessels from dilating-
- 35:56 – 39:53
Emerging Research: Breast Cancer and Oral Microbiome
- SBSteven Bartlett
true, but also, the other thing that I, I read in your research which I found really, really, um, shocking is the link between my oral health, my oral microbiome, and cancer.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
I was reading specifically about female breast cancer-
- VSDr. Victoria Sampson
Mm-hmm.
- SBSteven Bartlett
... um, which I know is, affects a lot of women. Um, what is the link there between breast cancer, cancer generally, and our oral microbiome?
- VSDr. Victoria Sampson
So this is, um, I would say some of the newest emerging research that's coming out. So with breast cancer, um, I didn't know this before this research came out, but your breast has, uh, its own microbiome. So that tissue within the breast, um, different bacteria are able to grow. And what they found was that in women who had breast cancer, they had high levels of certain oral bacteria in their breast microbiome. So the oral bacteria is called fusobacterium nucleatum, and they compared the breast microbiomes of patients who didn't have breast cancer versus those who had breast cancer.
- SBSteven Bartlett
Sorry, what's an oral, uh, what's a breast microbiome?
- VSDr. Victoria Sampson
Just the collection of bacteria in your breast.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
Yeah. Um, I didn't even know there was a microbiome in your breast either, but (laughs) apparently so.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
And, um, so when they compared a healthy, um, woman, uh, her breasts to a woman who had breast cancer, the woman who had breast cancer had very high levels of the specific oral bacteria called fusobacterium nucleatum in their breast. Um, there's also been research on colorectal cancer. Um, and actually Apple News came out with something couple of months ago, which was nice to see them kind of just spreading the word. But what they found was that in patients who had colorectal cancer, um, more than 50% of them had the, the exact same oral bacteria from the breast cancer study, that fusobacterium nucleatum, in the colons. And what they found was that oral bacteria, uh, made the cancer more aggressive and harder to treat as well.
- SBSteven Bartlett
I was reading about a study in mice, um, that linked that oral bacteria to tumor growth.
- VSDr. Victoria Sampson
Mm-hmm.
- SBSteven Bartlett
Are you familiar with that study?
- VSDr. Victoria Sampson
Yes. And it's that specific oral bacteria, so the fusobacterium nucleatum, which has been shown to accelerate tumor growth, um, within mice, but also, um, for colorectal cancer and breast cancer as well.
- SBSteven Bartlett
And what's your belief there? I know this research is fairly new, but do you think there is a, a causal relationship, a significant causal relationship between the health of our oral microbiome and our probability of developing some form of cancer?
- VSDr. Victoria Sampson
I wouldn't yet say causal. I think that for most cancers, it is multifactorial and there are a lot of things that can impact whether or not you get the cancer and how aggressive the cancer is. Um, I do think that oral health and some specific oral bacteria, um, are risk factors and can definitely increase the, um, aggression of those cancers or even the initiation of them. Um, there's also been research, and I think I'm waiting for the research to be published, on what they're doing is they've created a antibiotic which only kills that oral bacteria that I was talking about, so fusobacterium nucleatum. And they are going to be issuing that, uh, antibiotic to those patients who have the colorectal cancer which has the oral bacteria to see whether or not it slows down their progression or improves their, their prognosis. So if I see those results and it shows it, then there's for sure a strong causative link between the two. But for now, I would say that it's multifactorial and it's definitely a risk factor.
- SBSteven Bartlett
That oral bacteria that you're describing, that you called it fusobacterium?
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
What is it that causes that? Is it something that I'm eating? Is it a lifestyle choice I'm making?
- VSDr. Victoria Sampson
Uh, multiple things. Poor oral hygiene. Um, some of us genetically will have higher levels of it. Um, it's what we eat, it's who we're kissing, it's what we're breathing in.
- SBSteven Bartlett
Does my girlfriend have it?
- VSDr. Victoria Sampson
(laughs)
- 39:53 – 41:12
Green Tea Benefits for Oral Health
- VSDr. Victoria Sampson
So we would have to see.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
But it's, uh... And that's the thing, that's the beauty of being able to test these things now is that you can actually see, and also what's is strange is that green tea, um, you know, something so simple is extremely effective at killing fusobacterium nucleatum. So it's just knowing those types of things, being able to do the test, knowing the right treatment plans and recommendations based from that. We know green tea is good for us, and now we can really understand why.
- SBSteven Bartlett
Okay, that's interesting. You, you have actually tested Jack over there, right? And you said to me before we started recording that he's got a ton of that fusobacterium.
- VSDr. Victoria Sampson
Uh, yes, he does. Yeah.
- SBSteven Bartlett
And it's really getting out of control, that's what you said.
- VSDr. Victoria Sampson
It's really badly out of control, yeah.
- SBSteven Bartlett
Thanks, Sylvester.
- VSDr. Victoria Sampson
So I've, um... (laughs)
- SBSteven Bartlett
(laughs)
- VSDr. Victoria Sampson
I've given him a, a big vat of green tea as a gift.
- SBSteven Bartlett
Green tea?
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
Green tea. (laughs) This guy's gonna edit that out, this is the problem. (laughs)
- VSDr. Victoria Sampson
(laughs) Definitely. Cut it out.
- SBSteven Bartlett
Green tea?
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
That's good for my oral microbiome?
- VSDr. Victoria Sampson
Yeah, really good.
- SBSteven Bartlett
How?
- VSDr. Victoria Sampson
Stains, but really good. Um, it's anti-inflammatory, um, it helps with what we call oxidative stress. So this is, um, basically stress for the body. Um, and it's antibacterial, so it actually is very effective at killing fusobacterium nucleatum.
- SBSteven Bartlett
What is your opinion of
- 41:12 – 42:14
Impact of Coffee on Oral Health
- SBSteven Bartlett
the impact that coffee has on my oral microbiome?
- VSDr. Victoria Sampson
I'm slightly biased because I love coffee.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
(laughs) Um, but there is no negative impact of coffee on the oral microbiome directly. Um, coffee does dry your mouth out, um, and so you have reduced saliva, and that can actually cause problems for the oral microbiome. So the saliva is super important in your mouth. It provides all of the food, the proteins, everything for the bacteria in your mouth. So it's kind of like this delivery service, your delivery, it's traveling around providing all the food and bacteria, um, sorry, food to the bacteria, and that's what keeps the good bacteria alive and happy. So when you have a dry mouth, let's say you're drinking lots of coffee or you're very nervous or you are on antidepressants, for example, um, which are a big one, then you just don't have as much saliva. So you, those bacteria don't have as much food, and those bacteria die, and then you get bad bacteria growing in replacement.
- SBSteven Bartlett
What about tea? We're a nation
- 42:14 – 44:02
Effects of Hot Drinks & Sugar on Teeth
- SBSteven Bartlett
of tea drinkers in the UK.
- VSDr. Victoria Sampson
Um, similar. So it also does dry your mouth, not as bad as coffee, but otherwise no problems other than staining.
- SBSteven Bartlett
What about if I put loads of sugar in it? 'Cause a lot of people put a lot of sugar in it.
- VSDr. Victoria Sampson
Ah, okay, yeah. No, no, no. You never... No, no. So actually, sugar in your tea is even worse than you having a biscuit, for example. Um, so because the sugar dissolves in your hot tea, and the tea is hot when you drink it, um, it can actually cause more problems. Uh, another thing with sugar is, um, I have a sweet tooth, I love sugar, but it's about how you eat your sugar. So let's say if you have your hot tea with five lumps of sugar in there, and you're sipping it over an hour or two, that's where you start to see a lot of problems. So actually, you need to be having a sugar attack, so just all the sugar in one go. And that way, your mouth has all the sugar in one go, and it's able to neutralize the saliva and get back to a good state as quickly as possible. Every time you sip your, your tea with sugar, what happens is that the saliva has to go from acidic, back to neutral, acidic, back to neutral, acidic, and then it starts to just not work properly, and the saliva just stays acidic. And that's where you start to see decay.
- SBSteven Bartlett
So you wanna just down the tea.
- VSDr. Victoria Sampson
Down the tea, or, I don't know if you're a M&M guy, have all your M&Ms in one go. Don't snack on M&Ms every 10 minutes.
- SBSteven Bartlett
What about other drinks, like, I don't know, you know, Coca-Colas and these other sort of fizzy drinks that might have artificial sweeteners in, things like that?
- VSDr. Victoria Sampson
So they're not as bad as your natural sugars, um, but for example, something like your Coke or, or Fanta or whatever, it's also, um, very acidic, um, and it can actually cause erosion as well. So this is essentially where the outer layer of your tooth, so the enamel, is just worn away from having lots and lots of these fizzy drinks.
- SBSteven Bartlett
Ah, okay. So it, it's not gonna
- 44:02 – 50:39
Link Between Brain Health & Alzheimer’s
- SBSteven Bartlett
cause decay in the same way, but it might change the acidic balance, which then decays my tooth, which makes me more susceptible to when I eat sugar-
- VSDr. Victoria Sampson
Exactly.
- SBSteven Bartlett
... to having a problem. Okay, got you.
- VSDr. Victoria Sampson
Exactly.
- SBSteven Bartlett
So going back to what we were talking about, the, uh, the implications of an oral microbiome in the rest of my body, brain health is one thing that I was really curious about. Um, we've had lots of conversations on this show about Alzheimer's and dementia, and just general sort of optimal cognitive performance as I age. It's something I'm thinking a lot about. I wanna have a sharp brain. It's quite important because of what I do. Um, so is there a link between my oral microbiome and my cognitive and brain health?
- VSDr. Victoria Sampson
Yes. Um, so if we look at actually just the, the occurrence of Alzheimer's, um, and gum disease or, or oral health, a lot of research has shown that, um, if you have gum disease for more than 10 years, you have a 70% increased chance of developing Alzheimer's. So that was a study that was done on over 20,000 people, and they followed them for 20 years, and they saw, okay, if you had gum disease, um, at baseline, whether or not you get Alzheimer's at 10 years or 20 years. So a 70% increased chance of it. Um, they've also done a lot of research where, uh, they've been looking at oral bacteria, and what they found was that there are certain oral bacteria, so, uh, one called P. gingivalis, and that's one of the worst oral bacteria, I would say, out of all of them. So this P. gingivalis is able to travel from your mouth to your brain, I mean, it's only quite close by anyway, and what's unique about this bacteria is it's able to cross the barrier between, uh, in your brain, so the blood-brain barrier, um, and it releases these toxic enzymes. So these enzymes are called gingipains, and they're imagined as these, like, horrible firefighter things, and they can break down neurons, they can break down, um, a lot of brain tissue. And so when they looked at the cerebrospinal fluid and the brain fluid or tissue of Alzheimer's sufferers, they found that 97% of them had these toxic enzymes, these gingipains, in their brains, compared to zero for the patients who did not have Alzheimer's. So this is, you know, the first study shows, yes, there's some sort of correlation, but there's a lot of other risk factors. The second one, which was looking at your gingipains, is showing that there's definitely a strong causative factor, um, between the two. And then, another study which was very interesting was, um, looking at cognitive, cognitive decline. So okay, fine, you have Alzheimer's, unfortunately. Um, is it, is it too late? Should you stop brushing your teeth, or what's the point? And so what they did was they had, uh, patients, um, who had Alzheimer's, and they checked their cognitive function, and they also checked their oral health. And then, uh, six months later, they reviewed them, and they found that the patients who had gum disease had a much more rapid cognitive decline than those patients who didn't have gum disease. So again, it is still important if you do get Alzheimer's that you maintain your oral health, that you have someone help you brush your teeth, because your cognitive decline, um, will be faster.
- SBSteven Bartlett
How do they unpick that from other causal factors that might be going on, like bad food choices? Because in my head I was thinking, well, if someone's drinking sugary fizzy drinks every day, they're more likely to have gum disease, but maybe also that the chemicals within that fizzy drink are impacting their chances of dementia. Maybe they're also someone that has an unhealthy lifestyle. Maybe they're more sedentary. If they're eating bad things, maybe they're more sedentary, and maybe it's that that's causing the rapid cognitive decline versus the gum disease itself. Is it possible to untangle all of this?
- VSDr. Victoria Sampson
I mean, it is very difficult. I think that for those types of things, you either... You're right, diet, lifestyle is super important. And we know that Alzheimer's is, again, multifactorial. Um, I think it's really about the quantity of patients that they check. So they need to be looking at a huge number of patients, and they did, um, to check whether or not there is a strong correlation between them. Um, also, going back to the gingipain study, so the one about the bacteria, that shows it doesn't, it's not diet or lifestyle or, or nutrition. It is a specific oral bacteria that has traveled to the brain and released these enzymes, which are then breaking down neurons. So there, there's definitely a strong causative, um, effect.
- SBSteven Bartlett
That is, um, fascinating. It's really, really fascinating because dementia and Alzheimer's still seem to be a bit of a mystery.
- VSDr. Victoria Sampson
It is. And, and I work, um, with a, a team for Alzheimer's, and what they've done, similar to what you were saying, is that they've kind of separated all of the, the causes of Alzheimer's that we know, um, or the risk factors. And thankfully, they've put oral health as one of them as well. And I think from all of the other risk factors, so, uh, you know, for example, if you have, uh, the genetic mutations, you got the APOE4, or any of those mutations, that's, you can't change that unfortunately. Some of us have mutations which means that we are at a much higher risk of suff- of getting Alzheimer's in the future. But something like that oral bacteria, P. gingivalis, and those gingi pains, you can get rid of P. gingivalis really easily, again, if you tested it. You can even test for gingi pains, um, and then you can get rid of the bacteria before it starts causing problems.
- SBSteven Bartlett
The test that you offer, does it test for gingi pains?
- VSDr. Victoria Sampson
It does, yeah. So we're the only ones, um, on the market who do, because that was something that I thought was super important. What's the point in us telling you that you have a bacteria if we can't tell you that that bacteria is being really bad in your mouth and causing a lot of problems?
- SBSteven Bartlett
And people think I'm joking, but you have actually tested several members of my team, including myself, so w- I am actually gonna find out the results today.
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
Um, on the subject matter of the brain, uh, is there a link between my mental health, depression, anxiety, and my oral microbiome?
- VSDr. Victoria Sampson
So again, there's been a lot of research. Um, I think it's difficult for something like mental health and, um, and gum disease, which, you know, the chicken and the egg, which one came first. Um, because-
- SBSteven Bartlett
Oh.
- VSDr. Victoria Sampson
... one of the issues is, if you have a decline in your mental health, you are less likely to take care of your oral health-
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
... um, and therefore, that can exacerbate issues. So, there has been a lot of research to show that, you know, uh, there's a correlation between-
- SBSteven Bartlett
Mm-hmm.
- VSDr. Victoria Sampson
... poor mental health and poor oral health, but in my personal opinion, that causative connection is not there yet. Um, there's also been some research with things like schizophrenia, but again, it's the jury's still out, in my opinion.
- SBSteven Bartlett
Are you able to tell the state
- 50:39 – 51:40
Can Mental Health Be Seen in the Mouth?
- SBSteven Bartlett
of someone's mental health by looking at their oral microbiome, in your view?
- VSDr. Victoria Sampson
Um, you can know if something's up. Like for example, I, I had a patient relatively recently, I've been treating her for five, six years now, and I know that she takes good care of her, her teeth, she, she takes good care of herself. And a few weeks ago, she came in, and she was not taking care of her gums or her teeth at all. Everything was an absolute mess in there. And, um, so I did pull her aside, and I was like, "What's wrong? Like, something's happened here." And I think it is quite a big, um, sign for a lot of people, it's the first thing that they kind of let go of is their oral health.
- SBSteven Bartlett
And is that because of, you know, they start certain self-soothing behaviors because they're stressed in other parts of their life? So if they're having a bad time in their relationship or work, and they're stressed, they might start eating sugar more or-
- VSDr. Victoria Sampson
Or just not brushing their teeth.
- SBSteven Bartlett
... smoking or drinking more?
- VSDr. Victoria Sampson
Yeah, yeah.
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
Or just not brushing. Like with this woman, she just wasn't brushing her teeth anymore. Another thing that we can also see, I mean, it's kind of a bit on a tangent, but
- 51:40 – 52:18
Spotting Eating Disorders Through Oral Health
- VSDr. Victoria Sampson
also, um, eating disorders as well. So things like bulimia, um, or even sometimes anorexia, you can see in the mouth. So there's a lot of times where we'll see young teenagers, um, and I'll know that they are bulimic because they have certain issues in their mouth which they shouldn't have. And that, again, is a telltale sign.
- SBSteven Bartlett
Is that because the stomach acid is coming through their mouth?
- VSDr. Victoria Sampson
Yeah. So they get a lot of erosion on the, on their teeth, and then in some cases, you can also get these marks on the roof of your mouth. So if they're trying to force themselves to-
- SBSteven Bartlett
Ah.
- VSDr. Victoria Sampson
... to vomit, then you can see that. Um, and that's something that, you know, you have to pull the patient aside or tell their mother and explain that to them as well.
- SBSteven Bartlett
And is there a
- 52:18 – 53:54
How Stress Affects Your Oral Health
- SBSteven Bartlett
relationship between stress and my oral health? So if I'm more stressed, and my cortisol levels are higher, is that gonna make everything in my mouth worse?
- VSDr. Victoria Sampson
Yes, it will.
- SBSteven Bartlett
E- even outside of the lifestyle choi- choices I might make in such a state?
- VSDr. Victoria Sampson
Yes. Um, just that stress will increase your inflammatory markers, your inflammation. Um, it also will dry your mouth out. And all of those things will be linked. Um, uh, we do a lot of testing at my clinic, and so one of the tests that we look at is collagen breakdown. So, um, we have lots of different types of collagen all over our bodies, and our gums are made up of a certain collagen. So we look at an enzyme called AMMP8, and this enzyme is responsible for breaking down that specific collagen. Um, so we test the colli- that enzyme all the time with our patients. It's a really nice way of knowing, like, um, whether or not someone's about to have gum disease, um, how much collagen breakdown is happening from a biomolecular level. So I had a woman, very healthy, always been fine, um, and then she had her collagen breakdown tested, and her levels were through the roof. Her gums looked fine. She didn't look like she had any problems, but I've never seen such a high level in my life. And so, you know, I'm trying to think of what could be causing it, all of that. And she had lost her baby a couple of days before. And that type of intense stress on someone's body can have so many res- effects and impacts on the rest of your body. Um, and that was one of them. When we retested her six months later, she was back to normal again. But you can see even your mouth c- you know, stress can really impact you.
- SBSteven Bartlett
On this subje- uh, I was thinking about,
- 53:54 – 57:36
Mouth vs. Nose Breathing: Health Impacts
- SBSteven Bartlett
I just mentioned Jame- James Nestor earlier, who was telling me about the research of, um, how the, the mouth has changed shape because of the foods we're eating and how that, that's caused a bunch of downstream implications for us. One of the also, uh, o- one of the other things he also mentioned was about mouth breathing and nose breathing.
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
And there's a lot of people that have become incredibly interested in whether we should be breathing through our mouths or our nose, and I was wondering if you had a perspective on that. Um, and also the other thing that he mentioned to me was that there's a link between mouth breathing and things like ADHD.... what is your point of view?
- VSDr. Victoria Sampson
I completely agree with all of that. So, actually, my sister, she is an orthodontist. Um, so she works at our clinic, a- and, um, you know, we run it together with our mother. And, um, she is very, very hot on, um, mouth breathing. And what she, um, mainly does is she basically tries to stop children in particular from breathing with their mouths open. And what she has found is that most of her patients, uh, who come to her, um, are mouth breathers. They often have some sort of, um, ADHD. They have, or some sort of attention deficit. Um, they are, uh, bed wetters. They grind their teeth a lot of the time, um, and they have a whole cascade of other problems, and, uh, she can treat it then, and it's relatively easy. She would argue that it's very difficult, but to me, I think it's easy. (laughs) I'm like, "Yeah, there we go, you can do what you do." Um, and because the, the jaws of a child are very malleable, so they haven't fully solidified, so you can still move things, you can, um, get the teeth to meet. So if you get the teeth to meet correctly, then, uh, the child won't want to breathe with their mouth open. The annoying thing is, is that, uh, a lot of adults are mouth breathers because their teeth do not meet correctly, or their jaws are in the incorrect position, and, uh, at that point, it is quite difficult to move the jaws into the correct position, or to get the teeth to close in a way so that the lips are at rest and you breathe with your nose instead of your mouth. But again, I see those types of patients because they all come to me with a lot of other problems, so again, same thing. A lot of them have, uh, a lot of them have suffered from long COVID. A lot of them have inflammatory conditions, um, h- are always tired, they, a lot of them, chronic fatigue. It, you know, there's a lot of connections now, uh, between mouth breathing and those types of issues as well.
- SBSteven Bartlett
Is there a, a link between the health of my oral microbiome and whether I breathe through my nose or mouth?
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
'Cause James was explaining to me that the nose is effectively like a, a filter system.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
There's a certain temperature in there.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
Um, there's, like, sinuses and stuff which are, have some kind of mucus which helps to catch bacteria. So if I'm breathing through my mouth, am I more likely to have a, a unhealthy oral microbiome?
- VSDr. Victoria Sampson
100%. So exactly the same thing. You're, you're, you've got a filter in your nose, and so it will stop a lot of bad things from coming through. But the mouth, uh, there is no filter. I mean, you breathe it in, it goes straight into your lungs, so there's no way of stopping anything. A lot of people now are starting to mouth tape, um, and that's become kind of trendy and cool. Um, it's not the easiest thing to do. It, it seems a bit weird to tape your mouth a- at nighttime. Um, but for anyone who's worried that they breathe with their mouth open, mouth taping, in my opinion, is a really nice way of just, like, testing it out and seeing whether or not you do breathe with your mouth open. Because you'll do some mouth taping, and you can see whether or not you sleep better, so if you have a wearable, you can see, "Oh, wow, my oxygen levels are so much better. I had such a deep sleep." And if that's the case, you might be more inclined to straighten your teeth or sort out the reason that you're breathing with your mouth open.
- SBSteven Bartlett
And I,
- 57:36 – 58:31
Higher ADHD Risk in Mouth-Breathing Children
- SBSteven Bartlett
I, uh, took notes of a study which kind of is interconnected to the point we're making about mouth breathe- breathing, which said, "In a six-year study of 11,000 children, it was found that children who suffered from sleep-disordered breathing were 50% to 90% more likely to develop ADHD-like symptoms than were normal breathers who breathe through their nose correctly," which is absolutely staggering. 50% to 90% more likely to suffer from ADHD-like symptoms just because they breathe through their mouth at night-
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
... and have disordered breathing.
- VSDr. Victoria Sampson
And it's, and it's mainly to do with also oxygen being delivered to your brain.
- SBSteven Bartlett
Right, yeah.
- VSDr. Victoria Sampson
So there's not as much good oxygen, um, like, real, rich oxygen, filtered oxygen, traveling to the brain, and so that's basically not allowing your brain to function as well.
- SBSteven Bartlett
You mentioned kissing earlier on.
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
Um, I'm still supposed to kiss my partner, right?
- VSDr. Victoria Sampson
Yes. I hope you do, many times.
- SBSteven Bartlett
You s- you said if I kiss her
- 58:31 – 59:32
Kissing and Bacteria Transmission
- SBSteven Bartlett
more than 11 times a day or something, then our oral microbiomes synchronize in some way?
- VSDr. Victoria Sampson
Yeah, so there is, um, passage of bacteria from you to her and her to you. Um, they have also shown that, uh, for example, they did a study where one, uh, partner chewed lots and lots of probiotics, so like good bacteria, and then had a super long smooch with their partner, and actually was able to transfer nearly 60% or 70% of that good bacteria into their partner. So it's not necessarily long-lasting. I wouldn't say that, um, you know, if you kiss someone once on a night out that you are going to terribly impact your microbiome. It's fine, you can go and kiss, but it's more for long-term partners. If you're kissing regularly and for a long time, then yes, your microbiomes will start to, um, be quite similar. Um, another factor as well is that obviously your lifestyles are probably pretty similar. You're probably using the same toothpaste, eating the same food, so it's difficult to fully put it on just kissing, but yeah.
- SBSteven Bartlett
What about oral sex
- 59:32 – 1:01:55
Oral Sex and the Oral Microbiome
- SBSteven Bartlett
and the implications that will have? So if we're, if me and my partner are doing oral sex with each other, is that gonna impact our oral microbiome?
- VSDr. Victoria Sampson
Yes. So actually, there's been a few case reports which have shown, um, uh, there's one in particular, and, uh, I had a patient as well (laughs) who had this. A woman who, um, had a new partner, and she liked to perform oral sex on him, and then she came to me because she was complaining of very inflamed gums and she was getting gingivitis-
- SBSteven Bartlett
Ugh.
- VSDr. Victoria Sampson
... and, you know, it's not something I really ask. Like, I'm not gonna be like, "How's your, how's your sex life going these days?" Like, so I didn't ask it, but she kept on coming back to me, "No, my gums are still inflamed. No, my gums are still inflamed." And then she asked, she was like, "Is it maybe because I have a new partner?" And I was like, "Okay, maybe you guys are kissing a lot." And she was like, "No, no, no, no," and, and then she explained to me. Um, and then I was like, "Okay, fine, why don't you go and test and, uh, ask him, eh, whether or not he has any issues?" Um, and it turns out that he was having recurrent urinary infections, and so actually, they were transferring bacteria, and she was having inflammation in her gums because she was...... yeah, performing her oral sex. So yeah, there is transfer. Again, I wouldn't be scared and say never do it. Um, I once made an ex-boyfriend do an oral microbiome test, uh, (laughs) just to check and just to make sure everything was okay. (laughs)
- SBSteven Bartlett
You made him do it?
- VSDr. Victoria Sampson
Yeah. (laughs) I don't, it's not a, it's not a, um, a prerequisite anymore, but it was at the time. I was like, "Uh, let me see, let me just make sure."
- SBSteven Bartlett
Of course it is, of course it is. You must, you must think that when you meet people. You must think, "God, I wonder what their oral microbiome is saying," like, in a romantic context, 'cause you know the significance of it.
- VSDr. Victoria Sampson
Yeah, I think it's a... You know, I spend a lot of time and energy making sure my oral microbiome is very nice and balanced, so I wouldn't want anyone messing that up for me.
- SBSteven Bartlett
Hmm.
- VSDr. Victoria Sampson
It's important.
- SBSteven Bartlett
Are you in a relationship now?
- VSDr. Victoria Sampson
Yes, I am.
- SBSteven Bartlett
Have you tested their oral m- microbiome?
- VSDr. Victoria Sampson
I've been trying to, but he won't let me. (laughs)
- SBSteven Bartlett
(laughs) You- you've asked him?
- VSDr. Victoria Sampson
Yeah, of course I have.
- SBSteven Bartlett
And what did he say?
- VSDr. Victoria Sampson
Um-
- SBSteven Bartlett
Mind your own business?
- VSDr. Victoria Sampson
But I did give him an oral microbiome test, so hopefully he will just use it. I said, "You can even use a fake name, I don't care. I don't, I'm not going to test it. I'm not gonna check it."
- SBSteven Bartlett
Ah, okay.
- VSDr. Victoria Sampson
"I just want you to do the test for me." (laughs)
- SBSteven Bartlett
For- for you?
- VSDr. Victoria Sampson
For me, yeah. (laughs)
- SBSteven Bartlett
And what's his, what's his rebuttal? He's like, "I don't..."
- VSDr. Victoria Sampson
He was like, "What happens if you break up with me if I have a really imbalanced oral microbiome?" And I was like, "I hope that our relationship is stronger than just your oral microbiome, but there's ways to fix it." And that's the beauty of the oral microbiome is that it's actually pretty easy to, to fix and to change.
- SBSteven Bartlett
If his results
- 1:01:55 – 1:02:35
Switching to Steven - Transition
- SBSteven Bartlett
came back and he had a terrible oral microbiome, one of the worst you've ever seen-
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
... are you less likely to kiss him that day?
- VSDr. Victoria Sampson
That day, yes. (laughs)
- SBSteven Bartlett
There you go. Don't do the test, my friend.
- VSDr. Victoria Sampson
No, no, no, that day-
- SBSteven Bartlett
Don't do the test.
- VSDr. Victoria Sampson
That day, yes, and then-
- SBSteven Bartlett
There's no upside to him doing this test. I completely understand.
- VSDr. Victoria Sampson
And then I would go and creep into his bathroom and change all of his oral products and-
- SBSteven Bartlett
This is what he's scared about.
- VSDr. Victoria Sampson
... personalize everything for him, and then-
- SBSteven Bartlett
You've done that already?
- VSDr. Victoria Sampson
(laughs) I already have, yes.
- SBSteven Bartlett
Yeah. (laughs)
- VSDr. Victoria Sampson
He tests everything out for me as well, 'cause I get a lot of products sent to me, so I'm always getting him to s- to try things out for me as well.
- SBSteven Bartlett
Okay, so no blow jobs if they've got, um, issues down there?
- VSDr. Victoria Sampson
Yeah, yeah.
- SBSteven Bartlett
Okay. And we don't really know if they've got issues down there unless they admit it or do
- 1:02:35 – 1:07:01
Oral Health and Fertility
- SBSteven Bartlett
some kinda test?
- VSDr. Victoria Sampson
Yeah, yeah.
- SBSteven Bartlett
Okay. What about fertility? Is there a link between our oral health and our fertility?
- VSDr. Victoria Sampson
Yes. Um, so if we look at men to start with, um, there was a study done, and they found ... So they looked at a group of subfertile men, so men who, um, weren't able to conceive with their partners, and they checked all of their mouths, and they found that over 90% of these men had some sort of oral infection or dental disease of some sort going on. They split the group into two. Half the group had the, uh, treatment that was needed, so I don't know if they had gum disease or decay, they- they got it fixed, and the other half were left to their own devices. Um, after eight months, there was a 70% improvement, um, in their success for pregnancy, the men who'd had their oral infections sorted, um, and they had a much better improvement in their sperm quality and motility as well.
- SBSteven Bartlett
And what did they do to those men in that group where they saw the significant improvement?
- VSDr. Victoria Sampson
So y- for example, if the man had, um, gum disease, they would treat it with, uh, hygiene, or if they had an infected tooth, maybe they would take it out or do a root canal or et cetera. They would just have to treat that infection. So, I speak a lot about gum disease all the time, but actually, there are so many other oral diseases, like decay, um, or toothache, or all those types of things, that can also contribute inflammation and problems.
- SBSteven Bartlett
In that study, six months after, th- their sperm had improved by 20%, and after eight months, 50% of their wives were pregnant.
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
That is staggering.
- VSDr. Victoria Sampson
Yeah.
- SBSteven Bartlett
What about women, though? Is- is there a- a similar sort of result as it relates to women's fertility?
- VSDr. Victoria Sampson
Yes. So, um, research has also found that if a woman has gum disease, um, she is less likely to ovulate, um, and also she's going to have, uh, issues with conception. So, they've found that women with gum disease, it takes them two months longer to conceive versus a woman who doesn't have gum disease. Um, but once the woman has conceived, um, the issue is still not over. She still has to maintain her gums. So firstly, a lot of women will have, um, pregnancy gingivitis. So this is basically super inflamed, puffy gums because of all the hormones, um, and so they should be going very regularly to see their hygienist. Um, but also what the research has found is that women who are pregnant and have gum disease are at a much higher risk of preterm birth, so premature, uh, babies, low birth weight, um, and also preeclampsia as well. So, they did a study in Malawi. Um, it was on 10,000 women. So Malawi has the highest rate of preterm birth in the world, at just about, I think it's n- just under 20%. Um, and preterm birth is, uh, a big issue for- for governments, for hospitals. It's really expensive. You need to keep the woman and the child in the hospital for a lot longer, but also that child will have a whole myriad of problems afterwards as well. So weirdly, Wrigley's, um, the sugar- the chewing gum company, sponsored this, uh, study. They went to Malawi. They had these 10,000 women. They split them up into two. 5,000 of those women, uh, were given sugar-free chewing gum, toothbrush, and some toothpaste, and the other half were left alone. And they found that there was a 20% improvement, um, or 20%, sorry, reduction in preterm birth in the woman who'd had the sugar-free chewing gum compared to the woman who hadn't had it. So something so cheap and so easy like chewing gum was able to actually reduce the risk of preterm birth for these women.
- SBSteven Bartlett
How and why?
- VSDr. Victoria Sampson
So, if you look into the research a little bit more ... Um, you going to get your chewing gum now? (laughs)
- SBSteven Bartlett
Yes.
- VSDr. Victoria Sampson
Um, so sugar-free (laughs) chewing gum, um, has been shown to, um, stimulate your saliva, so it helps with what we were talking about earlier. Saliva's super important, um, when it provides all the good food for, uh, your bacteria. Um, but then also if it's sugar-free, um, let's say it's using xylitol, that's naturally antibacterial, so it's killing a lot of the bacteria in the mouth. And what they found is that there are certain oral bacteria that can travel down to the placenta, um, and can also, uh, cause problems there and essentially, um, increase the chance of preterm birth.
- SBSteven Bartlett
You sufficiently convinced me that saliva is an important thing, and I actually did one of your tests.
- VSDr. Victoria Sampson
Okay.
- SBSteven Bartlett
Let me go grab the results.
- VSDr. Victoria Sampson
Okay.
- SBSteven Bartlett
Every
- 1:07:01 – 1:08:00
Ad Break
- SBSteven Bartlett
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- 1:08:00 – 1:16:59
Study Results on Oral Health
- SBSteven Bartlett
And here are the results.
- VSDr. Victoria Sampson
Okay.
- SBSteven Bartlett
I've not actually seen them yet.
- VSDr. Victoria Sampson
No.
- SBSteven Bartlett
So this is exciting. Um, I'll give them to you so you can explain them to me.
- VSDr. Victoria Sampson
Okay.
- SBSteven Bartlett
Is that okay? So this is the test that I did, right?
- VSDr. Victoria Sampson
Yes, you did. Yeah.
- SBSteven Bartlett
Okay. Uh, um, the test I did contains this little kit that-
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
... basically in the middle of the office one day, someone came up to me and said-
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
... "Steve, can you spit in this?"
- VSDr. Victoria Sampson
(laughs)
- SBSteven Bartlett
And I said, "Sure."
- VSDr. Victoria Sampson
Yep.
- SBSteven Bartlett
And then they took my spit away.
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
Um, and it turns out it was upon request from you.
- VSDr. Victoria Sampson
Yes, exactly. I wanted your saliva.
- SBSteven Bartlett
Yeah, which is-
- VSDr. Victoria Sampson
Just to check to make sure if I could do this interview as well, so. (laughs)
- SBSteven Bartlett
Oh, right. Okay. So this is the test that I did. I spat in this little thing.
- VSDr. Victoria Sampson
Yes.
- SBSteven Bartlett
Sent it off back to you, you ran the test, how long does it take to do this test?
- VSDr. Victoria Sampson
Uh, it would probably take you about two minutes to do sp- uh, yourself, and then you get the results three to four weeks later.
- SBSteven Bartlett
What did you find out from doing my test?
- VSDr. Victoria Sampson
(clicks tongue) Well...
- SBSteven Bartlett
Okay.
- VSDr. Victoria Sampson
Let's go through your results. So, um, we found that you have quite a diverse microbiome, so that means that you have a nice ratio of good bacteria versus bad bacteria. And this has been compared to healthy and diseased subjects, so you are really right on the top of the bell curve, so very good with that, so happy. Um, then we predict your-
Episode duration: 1:33:57
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