Today I interviewed Brian Mauer from the company Bristle Health and we’re going to talk about saliva testing and what their company does. In my opinion it is an amazing company.

 I have a couple of patients that have done this. I have tested myself. I have not gotten my results. Back. But we’ll talk about that in another blog. 

Bristle is an at-home oral Health test, where from small saliva samples, we profile the oral microbiome,  the community of bacteria, both good and bad, that are present in the mouth. The reason we do this is it can help us understand the root cause of oral conditions. So things like caries, cavities, gum disease, bad breath even all stem from an imbalance of these bacteria in the mouth, bacteria and fungi. And by analyzing them, we can really start to understand how healthy our oral community is and help patients understand where I am getting a real quantitative measurement of how we recommend which treatments or interventions are going to be most effective for me. 

So my story, starting to bristle , was that I was really a frustrated patient. So not a dentist. We aren’t dentists on the team but we came from the genetics and genomics industry. And we were using this technology to help with cancer research with heart disease research, liver research, basically all across the healthcare landscape, including gut microbiome skin microbiome, and I’m somebody who had always struggled with cavities throughout my life and with different issues despite doing what I thought I was supposed to be doing. And you know, I would ask, Why am I getting this when my friends aren’t or when other people aren’t.

At one point I had just been told I had bad teeth. And you know, that’s a terrible answer. Me and my co-founder Guinea, have  seen all these gut microbiome companies, helping people really understand what’s imbalanced in their gut and how to improve it. 

But we noticed nobody’s looking at the oral microbiome. There was no way as a consumer that I could go and really understand, you know, do I have an imbalance of bacteria? Is that what’s driving my condition? So we decided to make one and that was the genesis of Bristle.

We weren’t we set out to start bristle really around this idea of we would look at the oral microbiome to get insight into oral health with the goal of developing more personalized care plans and more effective treatments because, as you know, as most people know what works for someone in one thing isn’t going to work for everyone else. So we want to be able to get those effects. But as we dug in, we really realized this is such a larger problem. No oral disease on its own is a massive problem in the United States in the world. Over half of US adults will have some form of gum disease. 90% will have a cavity in a permanent tooth, but as you mentioned, it really continues throughout the body. Got conditions like IBS and IBD. You know, the mouth is constantly seeding the gut with oral bacteria. And these, these anaerobic gum line bacteria are the same that cause gum disease have been found to cause conditions or worsen conditions in the gut. Very similarly with pregnancy and adverse pregnancy outcomes, or heart disease or diabetes. And we just kept going more and more and it felt like an imperative mission to start to understand this more and start to help improve our overall health through the mouth.

As a dental hygienist 64 million people have gum disease. Heart disease is the leading cause of death in the United States when you’re brushing your teeth and you have gingivitis and periodontal disease. You’re all that bacteria is entering your bloodstream. So it’s accumulating in your arteries, which is shrinking your arteries, then your heart has to pump harder. There’s such a huge correlation.

Heart disease is  such a complex relationship as well with the mouth where one of the things we had learned was the gum line has direct access to your bloodstream.  When you are flossing and your gums are bleeding, you know that’s letting these bacteria into your bloodstream where they like to go around and wreak havoc, but also on the flip side, oral bacteria, some beneficial species actually played a key role in reducing our blood pressure.

 There are bacteria that help extract nitrate from our diet and convert it into nitric oxide, which we’ve learned has huge implications in our vascular health, brain health, and heart health. So it’s really you know, one of the things I love that you preach is it’s not just let’s take out the bad it’s really let’s create a healthy community in the mouth because these beneficial bacteria help with our heart health help with digestion.

We’ve seen this data. If you have 100 bacteria, it can be tough to know what to do now? And so it’s always that so what have, you know, what can you recommend? And we really want to take it beyond this idea of just brushing and flossing. What are these other interventions you can implement for yourself or your family throughout the day to improve your health?

A spray here that contains Xylitol and some pH neutralization, constantly trying to maintain a healthy pH balance in the community, diet, eating whole foods, so much of it actually stems from diet. A lot of times it gets boiled down to sugar but you know, simple carbs and carbohydrates can really lead to this acidity that creates an unhealthy community. On the flip side, again, there’s positive things you can be doing: eating more nitrate in your diet, feeds those good bacteria and helps produce more nitric oxide or incorporating things like arginine that help remove the sticky plaque from your teeth.

The statistics are 50% of the people that even have dental disease. Don’t go to the dentist for whatever reason for fear of copay, they still have to pay. They don’t want to hear what’s happening and in your mouth. It’s funny because our teeth are the only part of our skeleton that we clean. Right and it’s also the only part of her body that doesn’t heal itself and regenerate so you can heal it if the cavity is just in the enamel surface but once it goes through the dentin, there’s nothing you can do.  You  now have to see a dentist to repair that or it will just progress and so that’s where that bacteria and getting that bacteria is really important and like you talked about,

 I think a lot of people don’t understand that. When they have cavities and gum disease. It’s a pH issue. Brushing, flossing, going to the dentist, will help prevent it but  what is the root cause?

Dental disease is silent. It  is more common to try not to kiss your kids on the mouth. When they’re babies because they’re not born with these bacteria. They’re transmitted when you’re feeding them or kissing them. And as you mentioned, they found transmission of both gum disease causing and cavity causing bacteria to children from their parents. You don’t give you child the disease, you give them the bacteria  and teach them the same habits you have. 

So it really does start with the household. And I think the other piece you had mentioned of people not going to the dentist, even if they have disease, is again an education problem of oral disease progressing silently. 

You can have cavities progressing or you could be progressing to really actually pretty advanced stages of gum disease without knowing because there aren’t painful symptoms. Bleeding gums shouldn’t be normal. Could you imagine if you ran a piece of string across your hand, and it started bleeding, that would be an area of concern. We would stop the bleeding but we just accept bleeding gums as normal for some reason. That’s got to change.

The mouth is like the check engine light for the body. It does get complex if most mothers will encounter pregnancy gingivitis during their pregnancy. And I know for moms I’ve spoken to that’s something that most people aren’t aware of that the hormonal changes can make you more sensitive to these bacteria that may have not been causing issues before but because of the increased blood flow to your mouth and because of different changes, the whole environment changes and so there’s different things you should be doing. 

You know, a mother’s intuition is often talked about that a patient’s intuition of knowing what is happening we ignore it! This should not be the case.

I think a lot of people go the traditional route until the traditional route stops working for them, and they look for how can I take this into my own hands and those are my favorite stories of patients who sought us out found us implemented those changes like the patient you had described, and really took ownership of their health and had a care team around them with their hygienist their dentist and other care providers that really bought in that that’s what gets me really excited for the future of healthcare.

Even like diabetes, it’s cyclical. If your gums have gum disease, your sugar is going to be out of whack and your sugar is out of whack your gums are going to be bleeding.  They both need to be in balance. In order for everything to be healthy. You really can’t have gum disease and not have issues. If you’re a diabetic struggling with sugar, you probably have some gum disease and then your protocol and learning the bacteria has helped. I’ve seen it. So and that’s I guess that’s why I’m so excited about your company versus some of the other saliva testing companies. It’s just because you really guide the patient’s information that they’re not hearing other places.

I know how frustrating the world of disease can be. We know like our team has experienced it. It can feel shameful, it can feel like you don’t know where to go. And that was just what we wanted to be able to give patients, a quantitative readout actually being able to measure what is going on. How am I changing? 

I wear an Apple Watch and it motivates me to go outside. I know I’m supposed to do it but it is helpful to stick to adding and motivating when your scores improve. It’s the best thing when you go in and ace your next dental appointment or start to feel more comfortable in a social setting because you know your back bad breath symptoms or whatever you were struggling with. And it’s not a patient problem. I think a lot of times it feels like it’s, I’m doing something wrong, or I’m the one to blame for this. When really it can be we just haven’t had the right tools or we haven’t had the right education.

These are all pieces of a bigger puzzle.

Be your own health advocate. Take control of your health and if you want to learn more about your oral health, that’s what bristles is for the tandem of people to help educate patients. Together we make the change in how we practice health care instead of sick care.

It truly is up to you!

A healthy mouth is a healthy body and a happy healthy life!

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