How to Improve Oral Health & Its Critical Role in Brain & Body Health
Andrew Huberman discusses oral health as the seventh pillar of overall well-being. He explains how teeth can remineralize, the critical role of saliva, and science-backed protocols for strengthening teeth, gums, and the oral microbiome to impact metabolic, cardiac, and brain health.
Deep Dive Analysis
20 Topic Outline
Oral Health as the Seventh Pillar of Wellness
Self-Assessment: Your Current Oral Health Category
Teeth Biology and the Potential for Cavity Repair
The Critical Role of Mouth Anatomy, Gums, and Saliva
Understanding Cavity Formation: Bacteria, Sugar, and Acidity
Teeth Remineralization, Fluoride's Role, and Water
The 'Do Nots' of Oral Health: Alcohol, Stimulants, Mouth Breathing
Fasting, Nighttime Brushing, and Remineralization Opportunities
Proper Teeth Brushing Technique and Gum Health
Plaque, Tartar, and the Importance of Tooth Polishing
Effective Flossing Techniques and Waterpik Use
Xylitol: A Tool for Bacteria and Cavity Prevention
Toothpaste Options: Xylitol, Fluoride, Hydroxyapatite
Mouthwash Concerns: Alcohol, Antiseptics, and Nitric Oxide
Zero-Cost Oral Rinses: Baking Soda and Salt Water
Canker Sore Prevention, Gut Microbiome, and Sleep
Tongue Brushing and Toothbrush Care
Dental Procedures: Sealants, Fillings, and Root Canals
Dentist Visits and Daily Routines for Oral Health
Other Oral Health Practices: Oil Pulling and Vitamin D
7 Key Concepts
Seventh Pillar of Health
Oral and gut health is introduced as a new, critical addition to the existing six pillars (sleep, sunlight, nutrition, exercise, stress management, relationships) due to its profound influence on cardiovascular, metabolic, and brain health.
Demineralization (Demin) / Remineralization (Remin)
These are the two constant states of teeth. Demineralization is the process where acid degrades tooth minerals, forming cavities. Remineralization is the process of adding new minerals back into the tooth's crystal structure, which can repair cavities, especially in the enamel layer.
Streptococcus Mutans (Strep Mutans)
A specific type of bacteria, not something people are born with but communicable, that feeds on sugars (and other carbohydrates) in the mouth. When it consumes sugar, it produces acid, which is the direct cause of tooth demineralization and cavity formation.
Hydroxyapatite
The naturally occurring mineral responsible for forming the strong crystal bonds within the enamel and deeper layers of teeth. These bonds are crucial for tooth strength and are the basis of the remineralization process.
Fluoride
A substance that, when incorporated into tooth minerals, can replace some hydroxyapatite bonds, making them hyper-strong and increasing resistance to acid and chipping. It is not an essential nutrient but is added to water and toothpaste for this effect.
Oral Microbiome
The community of bacteria and other microorganisms living in the mouth. Its health is critical for overall oral health, preventing bad breath, supporting gum and tooth health, and acting as a barrier against harmful bacteria entering the body, influencing gut, cardiac, and brain health.
Nitric Oxide
A substance produced in the oral cavity that promotes vasodilation (widening of blood vessels) throughout the body, including the brain and heart. Alcohol-based mouthwashes are known to reduce its production, which can negatively impact cardiovascular health.
10 Questions Answered
Oral health, including the oral microbiome, is inextricably linked to cardiovascular, metabolic, and brain health, influencing both short-term and long-term well-being, making it a critical daily focus.
Yes, teeth can remineralize and fill back in cavities that have started to form, especially if they haven't penetrated too deeply into the dentin layer, through maintaining a healthy oral pH and mineral balance.
Cavities are not directly caused by sugar, but by specific bacteria (like Streptococcus mutans) that feed on sugars (and other carbohydrates) and then produce acid, which demineralizes the tooth enamel.
Fluoride can make tooth enamel hyper-strong by forming super physiologically strong bonds, increasing resistance to acid and chipping. However, concerns exist regarding potential negative impacts on thyroid and brain health, and the oral microbiome, leading to a polarized debate.
Avoid excessive alcohol consumption, stimulants (which dry the mouth and increase acidity), smoking/vaping/dipping tobacco (which disrupt the microbiome and can be pro-cancerous), prolonged exposure to sugar, and mouth breathing.
The most essential time to brush and floss is at night before going to sleep because saliva production is dramatically reduced during sleep, leaving teeth more vulnerable to acid-producing bacteria.
No, most alcohol-based mouthwashes are detrimental to oral health because they deplete the mucosal lining, disrupt the healthy oral microbiome, and reduce nitric oxide production, which is important for cardiovascular health.
Xylitol is a sweetener that Streptococcus mutans bacteria feed on, but when they consume it, they cannot produce acid and are killed off. This inhibits cavity formation and reduces the total amount of cavity-causing bacteria.
A soft toothbrush should be used with gentle, circular motions on the fronts and backs of all teeth to break up biofilm without disrupting the gum-tooth interface. Vigorous brushing with medium or hard bristles is not recommended.
The general recommendation is twice a year for routine cleanings and checkups. These visits are crucial for removing plaque and tartar that cannot be removed at home, identifying deep cavities, and establishing a baseline of oral health, though daily diligence can reduce the need for extensive interventions.
17 Actionable Insights
1. Prioritize Nighttime Oral Hygiene
Brush and floss your teeth thoroughly every night before going to sleep. This is the most critical time for oral hygiene because saliva production dramatically decreases during sleep, making your mouth more susceptible to acid-producing bacteria and cavity formation.
2. Practice Nasal Breathing
Breathe through your nose as much as possible, especially at night. Mouth breathing dries out the oral cavity, which is a leading cause of tooth decay and disrupts the healthy oral microbiome.
3. Use a Soft Toothbrush Gently
Brush your teeth with a soft-bristled toothbrush using gentle, circular motions on all tooth surfaces. Avoid vigorous brushing with medium or hard toothbrushes, as this can damage the gum-tooth interface and lead to gum recession.
4. Floss Correctly and Consistently
Floss by gliding the floss down the side of each tooth, slightly under the gum line, using a circular motion before lifting it out. If your gums bleed, floss at least twice daily; if only once, prioritize nighttime flossing to remove food particles and plaque.
5. Minimize Mouth Acidity Throughout Day
Reduce the amount of time your mouth is in an acidic state to promote remineralization. Rinse your mouth with plain water after meals or consuming acidic foods/drinks, and consider creating stretches of 2-6 hours or more during the day without eating or sipping acidic beverages.
6. Avoid Alcohol and Stimulants
Limit or avoid alcohol and prescription/illicit stimulants (e.g., Adderall, Vyvanse, Welbutrin, Modafinil, excessive coffee) as they make saliva more acidic, disrupt the oral microbiome, and encourage mouth breathing, all of which are detrimental to oral health.
7. Cease Smoking, Vaping, and Dipping Tobacco
Completely avoid smoking, vaping, and dipping tobacco products. These substances severely deplete oral health, degrade gum tissue, and significantly increase the risk of oral cancers.
8. Avoid Most Commercial Mouthwashes
Refrain from using alcohol-based or strong antiseptic mouthwashes for routine use, as they deplete the mucosal lining, disrupt the healthy oral microbiome, and reduce beneficial nitric oxide production. If you desire a rinse, opt for a non-alcohol, non-strong antiseptic alternative or a high-salt solution.
9. Utilize Xylitol After Meals
Chew xylitol-containing gum or mints after meals. Xylitol is a sugar substitute that prevents cavity-causing bacteria (strep mutans) from producing acid, kills these bacteria, and reduces gum inflammation, while also increasing beneficial saliva production.
10. Choose Hydroxyapatite Toothpaste (Fluoride-Free Option)
If concerned about fluoride, select toothpaste containing hydroxyapatite, a natural mineral that promotes remineralization of tooth enamel and can help fill in early cavities. Look for toothpastes that also include xylitol and a mild abrasive.
11. Use Baking Soda as Toothpaste Alternative
For a zero-cost option, brush your teeth with a mixture of baking soda and water. Baking soda is a mild abrasive that effectively disrupts biofilm and cleans teeth without harming enamel, especially when used with a soft toothbrush.
12. Employ a High Salt Solution Rinse
Create a high salt solution by dissolving salt in water until it’s nearly saturated, then swish it around your mouth and spit it out (do not swallow). Follow with a plain water rinse to improve mouth pH and foster healthy oral microbiota.
13. Support Gut Microbiome Health
Consume 1-4 servings of low-sugar fermented foods daily, ensure adequate prebiotic fiber intake, and get 6-8 hours of quality sleep each night. A healthy gut microbiome indirectly supports the oral microbiome, helping to prevent and heal issues like canker sores.
14. Brush Tongue with Separate Toothbrush
Lightly brush your tongue with a separate, soft toothbrush to remove unhealthy bacteria and improve breath. Using a separate toothbrush prevents cross-contamination with bacteria from your teeth and avoids damaging fragile tongue tissue.
15. Consult Dentist on Cavity Remineralization
If your dentist identifies cavities, ask about their depth and whether there’s an opportunity to remineralize the teeth through daily protocols before opting for drilling and filling, especially if the cavities are still in the enamel layer.
16. Maintain Regular Dental Checkups
Continue to visit the dentist for routine checkups, typically twice a year. These visits provide professional cleanings, allow for monitoring of your oral health, and help identify any deeper issues or genetic predispositions that require intervention.
17. Avoid Disrupting Mercury Fillings
If you have metal fillings that contain or might contain mercury, avoid chewing on hard substances like mastic gum or hard candies. Such actions can disrupt the fillings and potentially liberate mercury into the bloodstream, which can be harmful.
6 Key Quotes
Your teeth have the ability to literally fill back in cavities that have formed, provided those cavities haven't gone too deep into the teeth layers yet.
Andrew Huberman
Your mouth environment, based on its chemistry and some things that are mechanical, but mostly based on its chemistry, in particular how acidic it is or how basic it is, is always in a state of what's called either demineralization or remineralization.
Andrew Huberman
Cavities are not caused by sugar. Cavities are caused by bacteria that feed on sugar.
Andrew Huberman
If you are in category one, as I described it, or category two, chances are you are doing things to really deplete and disrupt your oral health.
Andrew Huberman
If there is a most critical time of day or night to brush your teeth and floss and clean your teeth, it's at night time.
Andrew Huberman
Most all mouthwashes, especially those containing alcohol, are terrible for oral health.
Andrew Huberman
5 Protocols
Nighttime Oral Hygiene Protocol
Andrew Huberman- Brush teeth with a soft toothbrush using gentle, circular motions.
- Floss between all teeth, gliding down the side of the tooth, getting slightly under the gum, and using a circular motion before lifting up.
Xylitol Use Protocol for Cavity Prevention
Andrew Huberman- Consume xylitol in gum or mint form immediately after meals.
Low-Cost Toothpaste Alternative Protocol
Andrew Huberman- Mix baking soda with water to create a paste.
- Gently brush teeth with this mixture using a soft toothbrush.
Low-Cost Mouthwash Alternative Protocol
Andrew Huberman- Dissolve salt in water to create a high saline solution (until it won't quite dissolve).
- Swish the solution around the mouth thoroughly and then spit it out.
- Follow with a swish and spit of plain, clean water (no salt).
Tongue Cleaning Protocol
Andrew Huberman- Use a separate, soft toothbrush (distinct from the one used for teeth).
- Lightly brush the tongue to remove unhealthy bacteria buildup.