In this episode we cover:
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Chris Kresser: Hey, everybody, it’s Chris Kresser. Welcome to another episode of Revolution Health Radio. Today, I’m really excited to welcome Dr. Steven Lin as a guest on the show. He’s a dentist, and we’re going to talk about the connection between diet and dental health and the connection between dental health and overall health. I’ve come to believe over the years that dental health, and in particular the structure of our face and jaw, is one of the missing elements in the functional approach to health. We talk a lot about diet, exercise, stress, physical activity, sleep, etc., as mechanisms that can drive disease. We also talk about things like SIBO or infections or toxins or nutrient deficiencies as mechanisms that can drive disease. But dental problems and the misaligned structure of the jaw, malocclusion, etc., are also a significant driver of disease, and one of the primary areas of mismatch between our modern diet and lifestyle and our genes and our biology.
So we’re going to talk all about this and talk about some things that you can do about it. So it’s a whole other lever for intervention and improving our health. I’m really excited to be talking to Steven Lin about it. He’s a board-registered dentist, a TEDx speaker, and author of the new book The Dental Diet, which we’re going to talk about as well. Dr. Lin was trained at the University of Sydney with a background in biomedical science. He’s a passionate whole-health advocate, focusing on the functional link between nutrition and dental health. His mission is to prevent dental diseases, including orthodontic braces, and to reshape the model of dental practice. His book, The Dental Diet, is coming out today, so we’re really glad to have him. The book is a journey through ancestral medicine and the human microbiome; it models how crooked teeth are an epigenetic nutritional deficiency, and it presents a plan to heal your mouth, your body, and your mind. So, without further ado, let’s dive in.
Chris: All right. Dr. Lin, thanks so much for joining us.
Dr. Steven Lin: Hey, Chris, such a pleasure, thanks for having me.
Chris: Yeah. So we originally met at Paleo f(x), was that last year or maybe a couple of years ago?
Dr. Steven Lin: Yeah. Feels like a long time ago. No, it was last year and the time’s just absolutely flown. No, you’re right.
Chris: Right, yeah. I’m already planning for the next one. I just sent in my proposal for the talk next time. Are you gonna be back?
Dr. Steven Lin: Yeah, I’ll definitely be there. I really enjoyed seeing … That was such an inspiring time to actually see you work in person. And it really kind of … The stuff that’s happened since then, it’s just … It really kind of snowballs, it’s been such an amazing experience.
Chris: Cool. Yeah. You approached me, which I’m really glad you did, and chatted with me a little bit about the importance of dental health in overall health. And then, of course, the importance of food and diet in dental health, which, of course, [chuckle] most people who are listening to this show are like, “Yeah, that’s …” But that’s actually fairly controversial in your world, isn’t it, as a dentist?
Dr. Steven Lin: Yeah. It makes complete sense. You think the mouth and food, it just seems so silly that we would ever see those two things disconnected, but the two concepts do not link at all in what conventional dentists are taught, or how we look at the mouth and how we treat the mouth, or how we prevent disease, and that’s a big one. We are not preventing diseases because we are not understanding the nutritional mechanisms of dental disease.
Did you know there is a link between jaw development and ADHD?
Chris: Right. So the idea is if someone has dental problems, they’re just not keeping up with their dental hygiene, right?
Dr. Steven Lin: That’s exactly right, and it’s one of … The core piece of information that dentists give out is that we need to brush, floss, and use mouthwash or disinfect our mouth. And the way I kinda see that is like, “Do you take your car with an engine problem to the car wash?”
Chris: Right. Yeah. [chuckle]
Dr. Steven Lin: You’ve gotta get to the bottom of it, right?
Chris: Of course, there’s also the question of when we dig up archeological remains from 30,000 years ago, these people have perfect teeth, and we can be pretty sure that they weren’t using dental floss and toothbrushes at that point.
Dr. Steven Lin: Yeah. Dental floss and toothbrushes have only been around for decades. And this was really one of the waking moments for myself and to see how limited my training was, was that when you look at the archeological records of dental disease, it doesn’t exist in any biological system beyond when we hit the Agricultural Revolution, and then the Industrial Revolution. And so, animals, ancestral cultures, dental disease doesn’t exist, because in nature you have a problem with your teeth, you have a huge issue, you’re not gonna survive. And so we need those systems be working in order to be a biologically functional organism.
Chris: This is why I love the evolutionary perspective, of course, it’s just absolutely common sense for the reason that you said—if an animal doesn’t have a functional dental architecture and teeth, they’re not gonna survive in the natural world. So it makes no sense at all that a human being would depend entirely … I’m not saying there isn’t a role for brushing teeth and flossing, I imagine you’re not either, but to depend entirely on that for dental health makes no sense from an evolutionary perspective. And even now I think the only animals that experience dental problems are our pets, because we’re feeding them the wrong thing too.
Dr. Steven Lin: That’s exactly right. And there are studies, actually, that in zoo animals, for instance, in cheetahs, they’ve noticed palatal dysfunction. And so the only time you see malocclusion and crooked teeth is when we feed them the processed diet, go figure. Exactly, and so the ancestral perspective was just such a waking moment, plugging that back in. Because I was always kind of an evolutionary biology nerd before I went into dental school. And I expected that I … I remember actually from my dental interview, I wanted to talk about impacted wisdom teeth, and is that a sign that we’re evolving away from … Are we seeing that we will eventually lose our wisdom teeth? But that was never covered in my training at all. We never talked about jaw development or what ancestrally we’ve seen in terms of our dental health. But wisdom teeth impactions, it’s almost … We see it is absolute common sense now that we go and rip these teeth out of our jaws because they don’t grow properly, and no one’s questioned that. There’s no attempt to say why wisdom teeth impactions are so common today.
Chris: Yeah. The ancestral evolutionary perspective is lacking across the board in medicine, but it does seem to me that dentistry is one of the areas where it’s most needed and also most lacking. There’s virtually no discussion of it, I think, in conventional dentistry. Whereas in conventional medicine, there is some discussion of evolutionary medicine. There’s even that term, “evolutionary medicine,” and I’m seeing articles in the New York Times about the Tsimané in Bolivia and questions about, “Why don’t they have heart disease at the same rates that we do? Why don’t they get Alzheimer’s?” So I see that a little bit with health. Is there any discussion of that at all in dentistry at this point in the conventional world?
Dr. Steven Lin: In the conventional world, it is still quite disconnected, but in the early 20th century, a lot of the literature was based around, for instance, the orthodontic industry, the early textbooks… Edward Angle and whatnot. They talked about craniofacial growth and they looked, and they spoke to anthropologists. And so Robert Corruccini is one of the most prominent dental anthropologists. And he’s done hundreds of studies looking at teeth across all kinds of different situations, and his sum-up of what his life’s work showed him is that malocclusion is the malady of civilization. You talk to any anthropologist about dental health … And the funny thing is too, is that the records we have about our human ancestors are all based in jaws and teeth. So how it all connected … We give them a dental exam. It’s so crazy it’s been disconnected. Anthropologists will laugh at you when you ask them about dental health in societies of years gone by. It just doesn’t happen.
Chris: Right. Yeah. It seems like the most obvious question that anyone would ask, if they’re digging up these remains, like, “Oh, wow. These people all have perfect teeth. How is that possible in a lack of all modern dental hygiene?” Of course, there’s Weston A. Price, who did ask that question. He was working in the 1920s, ’30s, and wondered why people in the industrialized world all seem to have screwed up crooked teeth and took off on a worldwide journey to answer that question. So tell us … I’ve talked about Weston Price and written about him extensively, but I think some of my newer listeners may not be familiar with his story, and it’s really revealing, I think.
Dr. Steven Lin: Yeah. And this was actually revealing for me, it was actually kind of the catalyst to start this whole journey, is that I was in dental practice seeing very sick kids coming, whose jaws weren’t developing, who have this host of chronic diseases that I could not explain. All I could do was fix their teeth, and I was becoming disillusioned with my work. So I actually took time away from my practice, and I was actually in Europe, taking some backpacking time, and I was in a hostel in Istanbul and on the shelf was a … It was a shared reading shelf where you leave your book and go on your way. And there was this book called Nutrition and Physical Degeneration. And so I didn’t know what that was. In my seven years of practice, I had not heard of Weston A. Price. And so I picked it up and I was like, “What is this?” You don’t normally see dental books on any shelf, right?
Chris: Yeah. [chuckle]
Dr. Steven Lin: But I opened it and it was a completely different language to me. I did not understand or comprehend what this book was about from a very casual perusing. So I looked at it and I kind of … It’s got 15,000 photographs, and I kind of discounted it. But I came back to it probably a few years later and went into a deep dive, and the story of Weston A. Price is just fascinating. He was a dentist from Cleveland, Ohio, who practiced in the early 20th century and he thought that his patients were looking much sicker than what he’d seen in his previous years of practice. So he had a theory that the modern diet was the cause. And so, as you said, he went all around the world to 14 cultures, and he studied this intersection between the modern and the traditional diet. So he found the cultures that were living on the traditional diet and also were living close to people that had access to modern foods like refined sugars, flours, and vegetable oils. And so what he did is he compared the dental health of both of these populations in all of these places, took photographs, looked at the ancestral records, and he showed that in every time when the modern diet intersects, that’s when modern dental disease appeared. And this is in the 1930s, so we’re only talking about less than a hundred years ago.
If you look at Price’s work, a quick Google search will show all these faces and black and white photos and you see these amazing, wide dental arches. Now when I saw that, my mind said, “That doesn’t happen. I don’t see that in practice today. Kids do not develop dental arches like that anymore.” And so I thought this must be some kind of old book, it’s obviously outdated. But I realized then that there is something missing here and that Price was speaking about something vitally, vitally important. And that all of a sudden it woke me, “We are in an epidemic of crooked teeth and malocclusion.” And so the orthodontia today, four million kids have braces in the US, no one has tried to find out why that is. And so, all we’re doing is straightening teeth without trying to find the cause of this, and we’ve walked ourselves into a craniofacial structure that is not developing anymore. This is what Price was talking about. I think it’s one of the most important health books that has been completely misunderstood, and you’ve really helped to bring his work to a better understanding.
But I think the problem is the dental industry really has misunderstood what Price’s message was. And, kind of, Price was a bit of a victim of his time, which most scientific innovators are. He didn’t have the … He couldn’t identify Activator X, so he was identifying three factors in the diet: vitamin A, vitamin D, and Activator X, that when … Every traditional side made sure they had that 10 to 20 times as much in their foods. He said, “When they eat these three vitamins, their faces grow well.” And that’s as simple as he put it. But now, we’ve got the science to plug in exactly what’s happening there. We know craniofacial growth is related to our facial structures and why that relates to, for instance, airways and what happened since. And we can now intervene in that process. But the nutritional plugging in and the K2 story I think is really kind of … So he called Activator X that other key factor. He died before he identified it, vitamin K2, and I think that was probably one of the key factors that resulted in his work being lost for 60 to 70 years.
Chris: Yeah. Yeah, I agree. The amazing thing about his work in that book is that you don’t see these changes happening over 100 years when people switch from a traditional diet to a modern diet; you see them in a single generation. And he even has pictures of people living, following their traditional diet and lifestyle, and then the next generation that has moved and started to adopt a Western diet, and you can see their facial structure is different. They have a nice wide dental arch and straight teeth and a lower jaw that’s not totally recessed. And then, in one generation, after the modern diet, the face has narrowed, dental arch has narrowed, the jaws recessed, and the teeth are crooked, and there’s tons of gaps and space. It’s really remarkable that it happens that quickly.
Dr. Steven Lin: Absolutely. It’s quite frightening, really, but the fact that we’ve lost … It speaks to we’re kind of a species with amnesia that’s forgotten how to eat, in terms … How to develop a dental arch is such a fundamental part of our physiology, but how could we have forgotten this, such important information?
Chris: Yeah. And it’s really something … What’s interesting to me is that still to this day, even as you say we understand that vitamin K2 is Activator X. We understand the role of fat-soluble vitamins in growth and development of the jaw and other skeletal structures. It’s still not on the radar for most people. We have a six-year-old daughter, and she was in a musical theater performance this weekend, and I went to the performance and I’m watching the performance, but me being me, I’m also just [chuckle] watching other stuff. And I happened to notice, I would say at least 50 percent of the kids just had totally crooked teeth, narrow faces, recessed lower jaw. It was such clear evidence of malocclusion and impaired development of the facial structure. I’d like to get into what that means from a health perspective because it’s more than just crooked teeth.
But I would venture to say that if we asked those parents, number one, “Do you see anything unusual here, or abnormal?” Often times the answer is gonna be, “No.” They’re not even aware that that is unusual or abnormal. It’s not unusual, it is abnormal, right? [chuckle] They’re not aware that that’s not a normal part of human development because so many kids have that. We’ve just come to accept it as normal. And number two, if we asked them, “Is there anything you could do differently?” And this, of course, is a little more challenging or difficult of a question because it implies some guilt or blame sometimes on the parents, which I don’t … it’s just lack of awareness. But, is there anything that actually contributed to this? Ninety percent of them, 95 percent of them are not gonna say that it’s diet or lifestyle related. They’ll probably assume it’s genetic or something like that.
Dr. Steven Lin: That’s completely the problem at hand. This was happening … This happens in the dental practice every day, that we see kids come in with these craniofacial structures. And the way I would describe it is that my training did not allow me to identify that this was a problem with craniofacial growth. We would identify the teeth, so we would just look at the teeth, their relation in the jaws, so there’s three classes of malocclusion: class one, class two, class three—angles, classes. That’s what we learned about. The kid would come and sit down, open up, and look at the relation of the teeth and the bite, and we’d say, “Well, you’ve got a bit of crowding there. You might need braces in the future.” And a really uncomfortable moment in the dental practice was when parents would ask me, “Why is this happening? Why does this child need braces, and maybe this one, maybe not?” And I’d always kinda be like, “Well, it’s genetic.”
Chris: Luck of the draw.
Dr. Steven Lin: Yeah, [chuckle] exactly. That’s what I was taught, but there is no genetic evidence, that line of thinking has not played out in the literature whatsoever. We cannot explain craniofacial growth as a genetic problem, and the vast epidemic that we’re in today. But these kids are showing far more symptoms than just jaw growth. They show a very fundamental pattern of how they look as a person. And the face is a very powerful aspect of who we are. And so they’re coming into the surgery, they’re slumped over, their shoulders are slumped forward, their head’s postured forward. They have dark circles under their eyes, their mouth is open, their tongue’s hanging out of their mouth. Their mother says they don’t sleep very well, they don’t perform very well at school, they act up. They often have digestive issues.
And what we see is that we have these tiny, tiny, long, underdeveloped maxilla, which is the upper jaw bone. And so the way you see that is that that’s the palate, so the roof of your mouth, should be flat and wide and U-shaped. In these kids that today I’m seeing, it’s V-shaped and very, very high. So you can nearly barely fit your finger up to touch the palate, and that should be flat. And so that’s a sign of a skinny and underdeveloped maxilla. And so what’s happening in that, when that palate is underdeveloped, that high palate is actually impinging on the nasal airways. So their nasal airways are completely deformed. Now, that was never taught to us in dental school, that the maxilla also actually houses the nasal airways.
Dr. Steven Lin: And so crooked upper teeth are a direct sign that we have a decreased volume in the airway system. And so that goes to explain why, for instance, when they sleep, they have to sleep with their mouth open. It increases the pressure and they’re actually going through forms of sleep apnea and breathing issues when they’re asleep. And so they’re having very, very dysfunctional and non-restful sleep, very unlikely getting into the late stages of REM. And that’s why we’re seeing the deep connection between these kids with breathing issues and ADHD, which we know 10 percent of kids are now on ADHD medicines, and a lot of the time it is a breathing issue. And so there are a plethora of problems here that we’re missing.
Chris: So let me just stop and reiterate some of this because I think it’s really important, and I think awareness of this is very low, even in a world of people who are listening to the show, Functional Medicine, integrative medicine. Dental health is about much more than how your teeth look cosmetically, or even things like the health of your gums and your oral microbiome and how that contributes to other health issues, which we’ve talked a little bit about before. You’re saying that the structure of your jaw and how your jaw develops can affect everything from your sleep, which as we know then affects everything else, is you don’t sleep. Poor sleep is one of the primary drivers of all chronic diseases. It can affect your nervous system, it can affect your immune system, it can affect … And I’m putting some words in your mouth here, but you summarized a lot of different conditions, your endocrine system and hormone production. It sounds like it virtually affects every system of the body. Would you agree with that?
Dr. Steven Lin: Absolutely, and this is what we’ve vastly missed, is that crooked teeth are a sign that these fundamental processes aren’t developing properly, when we don’t develop a craniofacial structure. So the maxilla and the mandible, which is the upper and lower jaw, they form the structure, and so the bite, so how our teeth come together will actually impact our spinal posture. So how the maxilla and mandible posture together, the entire spine will have to adjust. And so, for instance, a lot of kids have that forward head posture. And the reason why they’re tipping their heads forward is because they need to open their airways. So this is a purely survival instinct, is that we have lost these wide, open nasal sinuses that we need to breathe through. And then so we have the skeletal structure that’s adjusted. So malocclusion is just adjustment to the environment. And so we’re using the input that we have to create a structure with the resources that we have, but so …
Chris: It’s a maladaptation?
Dr. Steven Lin: Exactly, and you’ve summarized it perfectly there. It rolls exactly onto all these different structures, it’s at the root cause of all of these issues. If your breathing and craniofacial structure and brain are in a system that’s kind of cramped, and there’s one description of it, a tiger being stuck in a cage, we’re basically stuck in these airway structures that are just causing us extreme, extreme, deep autonomic problems. And so the breathing connection is something that we were never connected to. But also the intervention of how, for instance, the tongue drives facial development. So the maxilla is the centerpiece of jaw growth, and so how the tongue and oral posture and breathing all come into this lovely interplay of functional craniofacial growth.
Chris: I have some personal experiences with all of this that I wanna talk a little bit about, just to bring this to life for people. So my wife had chronic intractable upper back, neck, and shoulder pain for probably 20 years. And she is a long-time meditator, and when she would do meditation retreats, it would just be pure agony, because she’d be sitting there in the meditation posture for 14 hours a day, in a position that was just agonizing for her to be in. And she is someone who has a very high level of body awareness. She’s a Feldenkrais practitioner. She’s trained in somatic experiencing. She’s a dancer. She’s someone who has spent many, many years cultivating body awareness. So this pain was not something that was unexplored. She had tried everything that you could possibly imagine to resolve the pain. And then we began to learn about this connection between the structure of the jaw and all of the rest of the systems of the body several years ago. And she went to work with a dentist who does what he calls “dental orthopedics.” I think you call it “functional orthodontics,” Steven; we’ll talk about this in a little bit. But basically, he works with patients to realign their jaw in a way that’s more consistent with our evolutionary template, the norm. And so, he gave her a dental appliance that did this, and immediately, overnight, her 20 years of intractable neck and shoulder pain disappeared, was just gone.
So, then later on, my … I think a couple years ago I was starting to get sick a lot during the winter, and at first I thought, “What’s going on here? Is this because I have a daughter who’s in preschool and just bringing home all these germs?” But it was beyond what seemed normal, even considering that. And I have a very narrow face. I’m a classic poster child for this maladaptation and the mismatch between our modern diet and lifestyle and what our genes and biology require for proper facial development and jaw development. I have a very narrow face, a narrow dental arch. I actually had four adult teeth extracted, which was horrible. I can’t believe they were doing that still. But that made my jaw even narrower, it narrowed the space in my dental cavity. I don’t have that wide roof of the mouth that you’re talking about. I have a narrow one, which creates even less space inside my mouth. My tongue, frenulum was very tight. So I didn’t have that. I was just … You’d just go down the list, and I had all the things wrong.
And I started to work with a dental appliance, and as soon as I put it in, it made my bite tip to tip, which is what Price observed in all of the people that he studied. And that next winter, I didn’t get sick once. And since then, I haven’t really even been sick. It starts to come on and I take my herbs and stuff and it goes away generally within a day. And I haven’t really even been fully sick with a cold or a flu since I had this appliance.
And now our daughter, Sylvie, she has straight teeth. She doesn’t have a lot of dental problems like many kids do, probably because of her diet. But that wasn’t able to overcome both my wife and my issues which we, of course, passed on to her. So she’s starting to work with a dentist who is very skilled with the functional orthodontics, or dental orthopedics. And it’s having quite a big impact on her nervous system, on behavioral patterns that most parents would assume are just part of personality or maybe even related to diet, but that in many kids’ cases, I think are directly related to the structure of their jaw.
That’s just to give you an idea of the breadth of conditions, people who are listening, that correcting these problems can address. And that this is really a whole other avenue of approaching health problems from the functional perspective. We talk about diet, we talk about sleep, we talk about mechanisms like SIBO or nutrient deficiency or infections or toxins like mercury or mold, but I would say that the structure of the jaw, and dental health certainly in general, but more specifically the structure of the jaw, is another core fundamental mechanism that we can use as practitioners or as people to address chronic health problems.
Dr. Steven Lin: Chris, it’s so true. And you’ve actually summarized it amazingly well there in terms of the potential out there. And the big thing here is that for most people what we see is the conventional orthodontic approach, is that when a child goes to the orthodontist they’ll be told, “Well, we’re gonna wait until his adult teeth set in, and then we’ll put braces on.” And so that approach is completely disregarding that there is a developmental process that we can intervene in. And what they’re often doing is use … I think your experience is that they’re extracting teeth when there’s not enough space. So you’ve got a malformed system, they’re taking the teeth out, and then they’re straightening the teeth in the malformed system.
Now, the way I would describe it … A professor that I work with I think describes it very well is, when you build a house, you don’t put the furniture down and then build the walls and the roof and the tiling all around it. First, you put the foundation, and you build the walls and the roof, and then you put the furniture in. So, using braces to straighten teeth is like putting the furniture in. The teeth are the last adaptation to a whole system that has grown and developed in a certain way. And all the other are issues are gonna be underlying if we don’t address that. So, we’ve been veneering over this … A completely poorly … and basically a system screaming out for both function and the nutrients it needs to grow and develop properly.
And the amazing thing, as you’ve said too, is that I wasn’t taught in dental school that in the palate that we have stem cells up across the midline of our palate, so the two sides of the maxilla fuse. That was never taught. We were told it fuses roughly in your teenage years and that’s it, you’re done. But, so when you send physical messages via these expansion devices, these stem cells wake up epigenetically and then suddenly they begin to build bones. So you can expand … It’s very slow in adults, but the clinical applications of this are really, really exciting and I’ve seen … For instance we’ve used brain surgery software to track how a six-month expansion process will impact the whole system. And so what you see is you see remodeling on the underdeveloped area of the maxilla, but even when you don’t expand the other bones, the mandible also remodels on its own. So it’s taking messages from the muscles that are readjusting. But then you see the eyes level up, so they’ll actually, the orbits will actually develop and level out because the maxilla has expanded.
But the really amazing things, what we’re seeing is that the sphenoid bone which sits right under, behind, and which is the base of the brain is remodeling as well. So that expansion is having profound, profound impact. And I think this is one of the most important things we need to do is to understand this system and get this very, very simple … Like you said, you put the device in and you felt it straight away. This is such a simple intervention, but once you understand how important this is and that we can actually have an impact on this, the implications are potentially enormous.
Chris: It’s amazing the changes you can see just with your own eyes with kids who wear these devices that correct these problems. You actually see their faces widen, you see their teeth change, you see the whole structure of their face change. It’s very visible. I’ve seen before and after pictures in many kids who’ve done this. And even in adults, you can see adults’ faces change too. As you said it’s slower than it is with kids, but I’ve seen pictures, before and after pictures of adults that in some cases where… Certainly you can still recognize them but it’s extremely notable especially when you put their pictures side by side.
Chris: So, Steven, there are a lot of different ways that people go about doing this kind of work, and I know now that people listening to us are gonna be curious, and they’re gonna wanna know, “How do I find someone who does this kind of work? What should I be looking for?”
And we’re still talking about the functional orthodontics, dental orthopedics here, but I wanna come back to some of the other topics regarding dental health. But there’s ALF, is one way that people, dentists … One kind of methodology for correcting the problems with the jaw, and there are a bunch of other techniques. It seems like the Wild West to me still that there’s not really any standard [chuckle] technique. And you have dentists who have their own kind of personal approach to it and it makes it hard for me at least as a practitioner to refer people to somebody because it’s hard to know who’s doing good work.
Dr. Steven Lin: That’s the challenge at the moment. We have so many dentists, and I visit them all over the world, that are doing such great work in this area and, like you say, it’s a very individualized. People have taken their own spin on things and used different research and created different devices, but so there’s a … The ALF is one expansion device, so that’s a non-plate bonded upper maxilla device that you wear that expands. So that’s one system, so all that does is it expands in the way that we’ve spoken about. It’s very simple, you get good results with that. There are other systems, the DNA appliance [now called Vivos], the Biobloc Orthotropics [now called Myobrace], which is the UK system by Mike and John Mew, so they use what’s called orthotro … And it’s kind of … There’s a lot of different names, like you said, orthopedics, it’s called all these different names so …
Chris: Yeah, the DNA appliance specifically claims to promote stem cell generation in the mouth, I think.
Dr. Steven Lin: Exactly, exactly. They’ve actually got TGA approval as a therapeutic treatment for sleep apnea as well, so this stuff is starting to come forth. And another system is the Myobrace system which is from Australia, but I hear in the US too. And that’s a more kids-focused one, so it’s myofunctional orthodontics, where we retrain the kids to breathe with the dental appliance. So they’re basically taught to breathe through their nose and then, lo and behold, their jaw develops naturally. It’s fascinating. But some kids will also need some expansion as well. So it is a very pieced-together model. I would look for a dentist, one, that works in airway and sleep, so they’ll have that branding on their websites, airway and sleep. They will talk about myofunctional therapy, which is basically like Pilates for the face, which is reprogramming the tongue, the lips, nasal breathing, so that should always be incorporated, understanding the facial and muscle structures of jaw growth development.
Dr. Steven Lin: And then the devices they can use are ALF, the DNA, there’s the Homeoblock, there’s the Biobloc, which is the orthopedics. So there’s a lot of names out there, but if they are talking about these titles, then it means they’re trained. What dentists do is they’ll go and train for a certain amount of time to understand the research and these clinical protocols and then put it into their practice in a certain way. So they’ll usually explain on their websites, so check that. Make sure that they talk about sleep and airways, that’s the most fundamental, that’s the most basic one, and it’s probably the most common too. If a dentist understands that, they’re gonna know that you want this kind of approach. And so from there … And there’s a big approach in terms of working with ENTs, with sleep physicians, even osteopaths.
Chris: Yeah. The dentist I work with uses the ALF. She works directly with an osteopath, so when you go in and get an ALF adjustment, the osteopath is there to work … Who works closely with the dentist to determine what adjustment is necessary and how it’s working. We do our tongue exercises [chuckle] as a family now. The way I found her was just through word of mouth, and then we interviewed some of her patients and talked to them about the results they’d had and how it was to work with her, which is a good way to do it. If you find someone that you like, ask them to speak with some of their patients. If they don’t let you do that, that’s kind of a red flag. [chuckle] But if they do, you can ask the patients what their experience has been like and what benefits they’ve got, anything you should know about treatment and just their thoughts in general about working with the dentist. That can really be helpful.
Chris: I think there are people doing this kind of work in most major metropolitan areas in the US now. It may be harder to find, if you’re in a smaller town or something like that, but sometimes people will travel because the nature of the work is you often don’t need … Depending on the phases of work you’re in, the adjustments could be as sporadic as every two or three months. It could be maybe monthly, but for some people, this can be such a game-changer that it’s actually worth traveling for even of you don’t have someone in your local place.
Dr. Steven Lin: Absolutely. I actually get a lot of inquiries on my website about trying to find a practitioner. So next year we’re gonna look together to have a complete directory of practitioners and how they can find them. And there’s also stuff they can do online a lot as well. So there is going to be access to this, coming very, very soon. We’re on the cusp of some big changes, so keep your eyes out and make sure you just keep looking, don’t lose hope, there are practitioners out there that do this.
Chris: Yeah, and we’ll provide some links in the show notes to some of the technologies that we’ve discussed like the ALF and the DNA appliance so you can learn more about them, and maybe you use that to start Googling for people in your local area.
Steven, I wanna talk about a couple of other things before we finish up. One is standard orthodontics. A lot of parents are facing the decision about whether to get braces for their children and they’ve been told that they need them by the orthodontists that they’ve seen. What would you say to those parents?
Dr. Steven Lin: I would say if your orthodontist isn’t talking about early intervention, so if they’re talking about waiting or they haven’t even talked to you about any kind of breathing or functional issues, I would be looking for a second opinion.
Dr. Steven Lin: Now, what we are seeing there is the preventative orthodontic model, which is one where we’re getting much, much earlier. The first dental check should happen straight after the child is born. And what this actually talks to is that midwives used to have a nail, a sharp nail on their pinky finger and they used to check the tongue of the child, so the first dental check and if there was a tie, a tongue-tie under the tongue, they would cut it with their sharp nail. Now, tongue ties, which are a flap of skin that is left over when craniofacial development is incomplete, can lead to many, many problems, and it’s been linked in the literature to … It slows down jaw growth, so you increase your risk of crooked teeth.
That’s the first check that every parent should be able … It’s the simplest. You are your own orthodontist. The things that you’re watching your child do every day is far more important than what an orthodontist can do when you go to them later on when the problem’s already occurred. If there is a tongue-tie… Breastfeeding is then the real … the first catalyst of how you begin that jaw growth. So the child breastfeeding is this amazing synergy of craniofacial growth. The child has to push the nipple to the roof of their pallet, which is soft like wax in those early months. And that pressure expands out the maxilla, but it also teaches them to breathe through the nose and then the tongue is activated. The tongue actually in a way sits and actually connects to the base of the skull, the higher bone, the mandible. It’s holding the airways open. And we need to learn to posture, to hold those … That’s why your tongue exercises are so important because you’re learning to hold your airways open. And actually, interesting the studies on indigenous Australians, with the Australian didgeridoo, that we can improve sleep apnea and have positive results on sleep apnea when we use the airways and exercise the airway.
Breastfeeding is the first step of this craniofacial growth, and what that is showing us now is that every meal your child is having is developing its jaw. And so you should be thinking this way that what you’re feeding your child to help this process happen. And so from there as the child gets its deciduous teeth or its kids’ teeth, often we don’t see crooked teeth in those early stages, but you can spot the signs that things are going wrong. So look at the palate, see is their palate high? Do they breathe through their nose? When they’re watching television is their mouth open? Kids should never breathe through their mouth; we need to teach them to breathe through their nose. Their tongue posture, all of these things we can be looking at every day, it’s so important for parents to know this, and you’re influencing craniofacial growth.
And then so as the child reaches six and then we’re starting to go into the next stages of development and so we’re starting to lose teeth then, then we’re starting to get where we need to make sure that the jaws are going towards a good trajectory for the adult dentition to come in. So all of these factors will come into play. And so one thing that I’ve really hammered in the book and also in my practice is that vitamin D is crucial; they should be checking their child’s vitamin D levels religiously through these processes just because it’s such a fundamental sign of all these things and developmental processes happening well.
Chris: And would you say that if a kid is a teenager, or a pre-teen, and they’re facing braces, that working with a device like the ALF or the DNA appliance can in some cases avert the need for braces? Or are they complementary processes?
Dr. Steven Lin: So braces are like the finish. So sometimes… So I worked with John and Mike Mew in the UK, they really don’t … They say, “We don’t even really look at the teeth, we’re looking at the jaw.” But so braces, they’re a nice … Once you do the extension, once you get the foundations of the house right, you can bring the nice furniture in, put the braces on, that’s fine. But as long as we know that there’s no breathing issue, that the sleep’s fine, their function’s fine, then you can pull the teeth into line then, that’s okay. And so what these new systems are doing is that it’s testing all the sleep parameters and making sure that their growth and function is properly developed, or functioning as best as it can, and then you can put the braces on, that’s fine. But as long as we see the braces as that last real superficial aspect of the dental arch development, that’s where we’re gonna go with braces; it will not be the first step, it will be the last if we do want that cosmetic change in the teeth. Because there will be more space, for instance, when you expand the maxilla, sometimes you have to align it; it doesn’t happen the same in everyone, so there are different ways and systems you can do. You can do it with invisible braces, for instance, but it should be very much seen as the last step. So for parents, you should try and get in much, much earlier.
Chris: It’s like taking a drug for diabetes before you make diet changes.
Dr. Steven Lin: Yes, absolutely. [chuckle] That doesn’t make any sense, does it?
Chris: No, not all. And not to say that if you make the diet changes and the blood sugar is still really high, there can be a role for medication if you’re not able to manage it completely. So it’s just definitely something to think about and consider, and like Steven said, get a second opinion if your orthodontist isn’t looking at things from this perspective. ‘Cause you’re gonna spend a ton of money on braces and orthodontics, and if that ends up causing more problems than it solves, that’s of course unfortunate.
Chris: Your book that’s coming out today actually, congratulations on that, is called The Dental Diet. So we started the conversation off by talking about the contribution of food and diet to dental health, and why that’s so obvious but often overlooked, and how that impacts the rest of the body. So let’s finish up by talking a little bit about how changeable is this stuff? If a kid is born with poor dental health, poor teeth, maybe the parents weren’t aware of this stuff, they weren’t making the right decisions about it, how can The Dental Diet help? Is it too late? Can it actually make a difference? Can it make a difference as they grow up in terms of the structure of their jaw and their general health and well-being? What have you seen in your practice? If you start working with a child and his or her family and they start to implement this nutrient-dense diet, what’s possible? What are you seeing in your patients?
Dr. Steven Lin: Yeah. The implications for the growth factors that we’ve talked about are profound because the reason why fat-soluble vitamins grow straight teeth is because they send deep hormonal and bone homeostasis signals through the body. Vitamins A, D, and K2 all have this beautiful synergy to make sure bone is mineralizing properly. And that’s so obvious in terms of we know how they can stunt jaw growth. But it also connects to the growth hormone, insulin-like growth factor, so they stream through the body. So when you correct these things, the growth hormone factors are corrected in the child as well.
But the other thing is the sex hormones, and their hormonal signals are changing as well. Testosterone is known to connect to jaw growth, but it’s also connected to levels of fat-soluble vitamins, so vitamins D and K2 are linked obviously to testosterone release in the testes. And so we have kids now that have these hormonal and thyroid issues. But at the base of it, their bones aren’t growing well because we don’t have enough of these nutrients. So we see this amazing change in how their bodies are starting to balance out.
But one thing that I really missed in dental school is that each tooth has an immune system. We have osteo-immune cells inside our tooth in the dental pulp called “odontoblasts” that are hungry for fat-soluble nutrients. And so vitamin A and vitamin D activate these odontoblasts, but they actually release proteins that are activated by vitamin K2. And so that stimulates an immune response inside your teeth, making you immune to tooth decay. And these are the systems that were ancestrally always treasured because it made sure that our dental health was in line, so kids are then not having the rate of tooth decay that they’re having.
But then on the other side of it, the mouth and the oral microbiome, which the immune system is protecting them against, is translating straight to the gut, which is forming thousands of bacteria every day, and all of a sudden their digestive system is starting to balance out. All of these factors are all happening in the mouth, but all reverberate right throughout the body. And so once you manage and once you simply set the diet so that they are eating for these nutrient-dense, fat-soluble vitamins, then everything else comes into play. It’s a beautiful way to see the health change of a child. But also right throughout life, all of these processes are happening every moment of every day. It’s quite remarkable.
Chris: Well, Steven, this has been fantastic. I wanted to discuss this on my show for some time, so it was really serendipitous that we connected at Paleo f(x) and that you’ve written this really important book. It’s called The Dental Diet. It is available today in the US, the UK, Australia, and Germany. I think this has been, quite frankly, a missing piece in the functional approach to health and wellness. It, for some people, can be that thing that is preventing progress from occurring, and I’ve certainly seen that to be true in some of my patients. We do the whole Functional Medicine thing, and we run all the tests, we treat, and they’re not responding, and then I refer them out for dental orthopedics or functional orthodontics, and that then is the linchpin, so to speak. It’s the thing that then allows everything else to work the way it was supposed to work.
Establishing the connection between diet and dental health is absolutely crucial, and your book does a fantastic job of that. And I love how it ties the health of the mouth to the health in the jaw and the structure of the face to the health of the body in a really clear and accessible way. I think it’s an important book, and I really highly recommend everybody to go pick up a copy of it because it’s … And especially if you have kids, it’s absolutely mandatory information for parents to have. Steven, thanks for joining us, again. And where can people find out more about your work and follow what you’re up to?
Dr. Steven Lin: Yeah. So they can jump on my website at drstevenlin.com and on social media @doctorstevenlin. And so yeah, we cover a lot of functional oral health topics on there, like the oral microbiome, the mouth-body connection, sleep. But Chris, I really have to thank you for all the work you’ve done, because during my process of waking up from my conventional dentist hat, finding people like you that were actually getting to the root cause and thinking ancestrally was crucial. It was a crucial piece of the puzzle, so I really have to send out my gratitude for that.
I really agree that the Functional Medicine … The progress we’re seeing really needs to take the next step, and that the functional dental … This whole perspective of seeing the whole body … The mouth is part of the body after all, and that it all comes together in this beautiful synergy. When we eat for dental health, when we understand the function of the mouth, it all comes together in this beautiful synergy. So I’m really excited for what we’re gonna see in the next years.
Chris: Absolutely. Well, thanks again. And I’m sure I’ll see you in Austin in April.
Dr. Steven Lin: Amazing. Looking forward to it, Chris.
Chris: All right, take care.
Dr. Steven Lin: You too.
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