When the Mouth Speaks for the Body: Exploring Biologic Dentistry with Dr. Toni Engram

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Rachaele Carver (00:00):
Hello everybody, Welcome back to
another episode of the Root ofthe Matter.
I am your host, Dr RachelCarver, and we are very
privileged today to have anotherfellow biologic dentist who I
was just telling her off airthat I think we're the same
person.
We've had a lot of very similarexperiences, so I'm really
excited.
But we're gonna dive in alittle deeper on some of the

(00:21):
biologic techniques.
We'll talk a little bit aboutour sleep apnea.
She's a member of the BreathInstitute.
If you've been listening to mypodcast, that's one of the areas
I'm really interested inlearning more about the causes
of apnea and other oral issues.
We're going to talk a littlebit more about salivary testing

(00:43):
and all sorts of interestingthings that she's been up to.
So let me introduce Dr ToniEngram, who's an integrative
health coach.
She also did the IINcertification program, just like
I did.
She is smart, certifiedbiologic dentist and the founder
of Flourish Dental Boutique inTexas.
So she is fluoride free,mercury safe dental practice.

(01:05):
She brings unique,science-rooted perspective to
oral health, combining dentistry, functional wellness and
personal experience.
Healing from an autoimmunedisease those of you who know my
story right Sounds veryfamiliar and helping people
rethink the role the mouth playsin overall health.
Like I said, I think she's mysoul sister here, so why don't

(01:25):
you tell us a little bit ofmaybe your story right how you
got into?
Were you doing biologic fromthe very beginning, or did your
autoimmune condition, like me,lead you down this road?

Dr. Toni Engranm (01:39):
Yeah, I don't know about you, but I just
wanted to be a normal dentist.
I don't know about you, but Ijust wanted to be a normal
dentist.
And when I gosh, I'm not thatold, but when I graduated in
dental school being likeanything holistic, biological,
that was definitely warnedagainst we were told that those

(02:00):
people were perhaps unethical.
They were seen as the lesserthan dentists.
So I just wanted to be normal.

I had no idea there was this other aspect
even.

It wasn't talked about very much.
Thankfully, god had other plans, so I was working full time as
an associate.
I had a toddler at home, I wasopening my first practice from
scratch by myself, and where Iwas working it was in an area
where the food choices weren'tthat great and I wasn't making

(02:39):
good food choices.
Obviously, my stress level wasnot well controlled at all, and
so I just got super sick.
I started having GI issues,turns out I had symptoms before.
I just didn't know what theywere.
But right around that time in2010, 2011, it really got bad

(03:02):
and doctors blew me off forseveral months until I started
losing weight honestly and thisis TMI but until I started
losing weight and having bloodystools.
Then they finally listened anddid a colonoscopy and found out
I had Crohn's colitis.
And as I went I'm sure you'veshared your story on your

(03:25):
illness too but as I dove in andwent down those rabbit holes of
trying to figure out how toheal, I just really saw the
correlation between what I wastrying to heal in my own body,
which was Crohn's disease it'san inflammatory condition caused
at least in part by a dysbiosislike an imbalance in the

(03:47):
microbiome and what I wastreating in my patients every
day tooth decay, gum diseaseit's all about inflammation and
a dysbiosis and the bacteria ofthe very first part of your gut.
And so I knew, if I could figureout how to get well myself,
then I had to figure out how todo the same thing for my

(04:09):
patients.
And so that's what got mestarted in like oral systemic
health and learning about those,like the actual connections
that I had to learn that yourmouth is actually connected to
the rest of the body.
And then my patients reallyhelped nudge me the rest of the
way.
So I would start talking aboutnutrition and prevention and my

(04:33):
patients would say at this pointI'm starting to attract
patients who are morelike-minded.
And my patients would saythat's great, dr Tony, but why
are you still using fluoride, orthat's amazing, but are you
protecting yourself or yourassistant from all this mercury
that you're stirring around inthe office?
So it was really my patientsthat indirectly, very kindly

(04:58):
forced me to do the research andfigure out that there was
another way that was healthier.

Yeah, I think it's so interesting.
I credit so much of myeducation to my patients as well
because, yes, same exact timeperiod, right 2011,.
My second daughter was born.
That's when all my stuffstarted coming out, but it was
after I started looking at thesedifferent alternatives for my
healing.
It made me think, huh, maybe Icould be doing dentistry a

(05:27):
little bit differently too.
And then it was those patientsthat you were seeing and you're
really like why is thathappening?
I did the whole Dawsoncurriculum Cause I'm like why
has the bite messed up?
Like I don't, we don't reallylearn too much about that at
dental school.
And I was like you know, am.
And I was like you know, am Iscrewing something up when I
work on one side If it's notbalanced?
So I've always been that.
Why?

(05:47):
Why?
Type of person?
The same kind of thing.
My first introduction was viaozone, because I had been doing
these colon hydrotherapies.
I was like we got to clean out,clean everything out, right,
because my minor is eczema,right, which was the same kind
of thing.
The dysbiosis that's a littlebit farther up, higher in the
gut, which, in me, my liver notfunctioning great, so things

(06:10):
came up out through my skin,right, I couldn't get it through
my colon, so all those toxinswere coming out of my skin.
Yeah, ozone was my firstjumping off point too.
What was the first thing thatyou did?
Did you go right into the SMARTcertification and learning that
, or no, I really was resistantfor a long time.

I made changes really slowly, really slowly,
like I started by justeliminating fluoride varnish in
the practice and figuring outhow to make that viable for the
hygiene department.
And still, how are we treatingour patients and how do we make
up for that lost revenue?
Man, it was really slow and Ifound that the bulk of my

(07:00):
patients couldn't hang, didn'twant to hang.
It was a very insurance-basedpractice.
I was in network with everyinsurance under the sun and I
couldn't provide the care that Ineeded to care, the care that I
needed to give under thatsystem.
So probably the last thing thatI wanted to do was try to tell

(07:28):
my old school PPO patients that,hey, now I need to do this
whole protocol and we're goingto wear this spacesuit looking
thing to take out your silverfillings, even though six months
ago I took out this other oneand I didn't do that.
So it had a whole lot of moraldilemmas as I was transitioning
the practice.
So I actually happened,alongside of personal changes,

(07:52):
in the family too.
We had moved from the morerural town closer into the city
and so I actually sold thatpractice and knowing that, hey,
I really want to do thingsdifferently, but if I'm going to
do them differently, I need todo it from the start.
Yeah, I just wiped the slateclean, I sold that practice and

(08:17):
I started another one fromscratch, so that's how I did it.
It was really slow until I justset fire to the whole thing and
started over, and I wound updoing that in the middle of 2020
which was, in one way, I thinkit was.

that's good , because for me, so in 2011 was
when I started learning thesethings and, like you, so I think
this is good for any dentistsout there who are interested in
this but don't know how to getstarted.
There's not a lot of help.
The organizations IOMT, iabdmare great.
I'm trying to work with them tocreate more consulting type of

(08:54):
stuff, because how do you dothis?
But for me, I had a veryconventional practice when I
bought it in 2009.
And same thing it was likelittle by little, ended up
getting that smart certificationwhich stands for safe mercury
amalgam removal technique, andthe ibdm has something called
protect.
It's a pretty much identicaland I had just but I had been to

(09:18):
a dental conference I think itwas ibdm, it was maybe a
combined conference thebeginning of of March of 2020.
And I had bought the vacuum thelittle vacuum that we see and
it came in Dallas right, yes,yeah, yeah, I remember all of us
at that one.

That's my hometown, so I remember all of
us there wondering how the worldwas about to change and really
having it worked out though,because people assumed excuse me
that I was bringing all this inbecause of COVID.

So for me it was just like natural yes, we
can help protect you, but it'smore of that.
And I've found that when you'retalking to patients like
there's not a lot of dentalpractices or dentists in our
area, so trying to sell a preplike you did you're fortunate
that you were able to do thatNot so feasible in my areas.
I've just had that slow time.

(10:10):
I practice 16 years now.
It's just been that slow kindof transition and I still have
very traditional patients in thelist.
So it's a really interestingmix.
But I found that when I'mtalking to patients and you're
giving them the common senselike when you're explaining what
is acid reflux, for example,and you're explaining people
like that makes perfect sense.
So it's almost even moreexciting to work with somebody

(10:34):
who doesn't have any awarenessof holistic than somebody who
maybe knows too much, right.
So that's been really rewardingfor me, for people to start
thinking differently.
And then all of a suddenthey're referring their patients
to me for all sorts of medicalissues too, right?
Not just about the teeth, yeah.

I love them.

But those are really two really good
options.
And it can be very challengingin a practice like my, where
you're trying to convert.
It is easier in one way tostart over challenging and you
gotta, where are you gonna getthe patients from right?
Absolutely, but it is.
It's hard like it's.
You can't really be in the inbetween.
You either either do the floridor you don't.

(11:17):
You can't be wishy-washy aboutit.
So, depending on what, whateverpractice you have, you just
make that choice.
And so my patients will come in, even if they're not
necessarily holistic or lookingfor the biological.
Everybody gets treated this way, right.
So this is the way we do it inour practice.
When I do extractions, you getPRF right.
We draw your blood, we spindown your platelets and we put

(11:39):
it in.
That's just the way it's donein my practice.
If you don't really like it,there are other options.
But I think if you're going todo it, you got to be all in,
because when you're back andforth it's just a challenge.

And patients sniff that out.
I think what the generationsyounger than us are screaming at
the top of their lungs is that,hey, we need our authority
figures, which I think includehealthcare providers.
We need people to be authentic.
And so if you're wishy-washy,you're like I'll do fluoride for
some, not for others, or we'lldo all the mercury protocols for

(12:17):
some but not for others, thenpeople sniff that out and don't
particularly appreciate that.

Yeah, absolutely so.
Let's talk about some of thematerials, because that's one
big thing.
One thing I think about is okay, so we're taking out these
mercury amalgams, that's got allthese heavy metals, and we're
putting in basically plastics,right.
And then you think, ugh, yousee all the news about all these
microplastics, all these things.
Now there's a lot of researchabout BPA.
We know that's one of the worstplastics, right, and they think
they see all the news about allthese microplastics, all these

(12:44):
things.
Now there's a lot of researchabout bpa.
We know that's one of the worstplastics.
So obviously I think, maybebetter, maybe they don't last as
long.
Amalgams weren't good becausethey did last a long time.
Inevitably, they tend to crackthe teeth and we need crowns.
For the most part, it was adecent material.
However, we live in a verytoxic world.

(13:06):
Now I have I'm sure you did too.
In your other part you havepatients who are in their 70s
and 80s with a mouthful ofmildomas didn't really have any
health issues.
That's because they grew upbefore plastics were a thing.
Before we had 80,000environmental toxins right
Before glyphosate.
Before all this, their immunesystems developed strongly.
They didn't have 70 vaccinesbefore age 18.

(13:28):
So they're much healthieroverall compared to kids born
today.
We're seeing all the obesity,seeing our children with these
autoimmune conditions, diabetesit's just unheard of even just a
generation ago.
So talk to me about thematerials that you use that are

(13:51):
a better alternative to some ofthese other things.
Yeah.

And, like you said, we do our best, we're
really intentional and I thinkthat's the difference between
biological dentists and maybeour more traditional colleagues
is that we're trying, we do ourbest.
We're very intentional with thematerials that we choose.
So I am careful to choosematerials that don't have

(14:16):
fluoride, that don't have BPA inthem, use more of the what they
say are the ceramic basedcomposites and porcelains where
we can, zirconia where we can,things that are more
biocompatible, that are at leastnot not containing heavy metals
anywhere possible and hopefullyaren't creating that galvanic

(14:40):
battery effect in the mouth.
But I still like sometimes mysuper crunchy patients, my
really holistically minded ones,we've got to tell them, remind
them that hey, it's stilldentistry, we're still putting
manmade materials in the mouth.
So nothing is going to be asnatural as what God put there in
the first place.

(15:00):
But we do the best we can tocreate the safest environment
possible with the safestmaterials we can possibly find.
And then if we can go upstreamand prevent new dentistry from
needing to be done, then we'rereally working some magic when
we can get your body to heal anddo what it needs to do on its

(15:24):
own so that you don't even haveto have the restorative material
, the filling the crown, the,whatever the case may be.

Yeah, and that's where we're on exactly
the same page.
I'm so big I am sure with yourbackground in health coaching
too, we're just so big on thatnutrition and prevention.
Once you cut into a tooth, wehaven't figured out how to grow
enamel back yet.
I'm sure it's coming, but Idon't know how soon.
So until we do that, we want totry to prevent that.
Once the tooth has got arestoration in it that's

(15:54):
lifelong, you're going to haveto have that replaced, probably
several times.
What do you talk to yourpatients about?
Let's say I find it interestingI have a lot of moms who are
holistically minded.
They come in and they're like Idon't understand, I'm doing
everything right and the kidstill has a mouthful of decay.
And they say they're not usingthe fluoride.
And then, of course, theconventional people think that's
why, because they feel likethey're feeding them the right

(16:16):
nutrition.
And I'm just curious your takeon that.
And how do you talk to parentsabout prevention?

I really try to approach it similar to a
functional medicine physician,so we're trying to go upstream
and look at those root causes.
So I ideally I really want tobe collaborating with the
pediatrician, with whoever themedical team is.
Hopefully they're moreintegrative and are looking at
these things more strategicallyalso.

(16:48):
But when it comes to a mouthfulof decay and we think the
diet's pretty on target, thenwe're looking at gut health.
So is the kiddo having normalpoops?
How often are we having poops?
We're looking at the acid levelin the mouth.
Is the pH too low and why mightthat be?
And we're looking at airway.
Are they breathing throughtheir mouth at night or are they

(17:11):
able to close and breathethrough their nose really well?
So that's when we really haveto rope in the healthcare team,
because if there are allergiesthat are or swollen tonsils that
are contributing that, we allneed to be on the same page to
get kiddos breathing better sothat they can close their mouths

(17:33):
, have an adequate level ofsaliva that's at the right pH
and go from there.
And then we're looking at atkids.
It's a little more transientthan microbiome.
It changes really quickly, butwe still want to know what
exactly does their microbiomelook like?
Are there imbalances that weneed to strategically correct in

(17:54):
the mouth so that they can havea healthy environment that's
more resistant to decay in thefirst place?

Absolutely so I'm exactly on that page.
Look at the gut Again.
Like you said, the gut startsin the first place.
Absolutely so I'm exactly onthat page, right, like.
Look at the gut, right Again.
Like you said, right, the gutstarts in the mouth.
So we can't forget this.
We think it's yes, it does havea different microbiome and
they're completely, they talk toeach other all the time too.
So I've also found, the more I'msitting and the more I know
myself as that kind of mom too,looking at the kids' nervous

(18:23):
systems.
Right, so if you're mouthbreathing, right, you're going
to be more in that sympatheticstate.
Absolutely.
When you are in sympathetic,naturally, like physiologically,
you shut down digestion.
Right, so you could be eatingthe healthiest diet.
But if you don't, I'm notproducing the stomach acid,
you're not producing theperistalsis to move things

(18:44):
through the GI tract, right,you're gonna get fermentation,
you're going to get a toxicoverload, you're gonna get that
dysbiosis.
So I see a lot of moms who, likeI, was so worrying and so
fearful I'm doing everythingright.
Why is my kids?
But kids, especially the firstsix years of life, their nervous

(19:04):
system really is developingbased on their primary
caregivers, right, and if we are.
I was this mom, so worried, butnow I have teenagers and they
just they buck everything.
I say because I came at it withthis fear-based mindset that if
you don't do this, such andsuch it's going to happen,
instead of being like, hey, it'sall good, let's you know, let's
try this or something.

(19:25):
So that nervous system piece, Ithink, is really important too.
So, again, that mouth breathingis so crucial to make sure
they're getting in thatparasympathetic Cause.
Like you said, why is the pHhigh right?
Why you know what's happening,why isn't digestion working
perfectly?
So, to go really far upstream,think what's happening at that
nervous system level.
So I think that's what I'veseen, experienced and visualized

(19:49):
in the last couple of years.
I've started putting the piecestogether.
I was like why, if they'redoing things right and you're
thinking nutrition, there has tobe something else.
So, thinking about the saliva,though, let's talk a little bit
about the salivary testing thatwe can do, because, speaking of
this, I just recently did twokids.
The mom asked me to do thesekids and I was like, oh, okay,
yeah, and you could see therewas some gut issues and the mom

(20:12):
is super educated.
It was like let's, I want todive into the gut testing more,
and I'm like yeah it'sfascinating.
So what kind of tests are youusing to look for these things?

Right now my hygienists are getting a
microscope for use chair side.
We don't have one yet, but, man, they are chomping at the bit
to get it.
So right now we use a whole lotof like an outside lab.
I use Bristle because I likethe diversity of the species
that they test for, and Bristleis really cool because you can

(20:44):
actually patients can order thatthemselves and they've got a
ton of educational materials ontheir website.
Obviously, if we're running thetest, then it's more targeted
and we're going to set upspecific protocols based on
their test results.
But that's really been myfavorite so far and I like to do

(21:04):
those tests at the beginning ofa treatment protocol and then
again a few months later so thatwe can objectively see okay,
did this do what we needed it todo or do we need to do some
more tweaking?

I'm telling you we're the same person.
I also love bristle and I'mlike, okay, my microscope is
being ordered for the fall.

Stop it, I'm serious.

But I also really love the bristle.
We've had the owner on thepodcast because the big one used
to be the oral DNA, but it onlylooked for the bad or
pathogenic.
Yeah, it's giving the wholeshot because we all have those,
even in health, right?
Yeah, bristle test for 700different species so you can see
not only do you have that, buthow much good do you have,

(21:46):
because that's the thing thatwe're really looking for.
If you're so importantdifferent treatments, I feel I
used.
If you don't have, if you havetoo much bad, not enough good,
we need to treat that.
But there's also treatment likehow do you get more good, how
do we diminish the bad, but alsohow do we grow the good?
So, yeah, I'm a big fan of thattesting too and love all the

(22:08):
bristle protocol because theyare.
It is built for moreconventional dentists, which is
amazing.
If you don't really knowanything, it's.
They do have awesome education.
But again, but and now theyhave you can customize your trip
, which is very nice.
I was talking to them a lotabout them, like I don't love
all these things, can we?
So that's really nice.
But I had a patient who had apretty good saliva test and then

(22:30):
and I was like okay, don'tfollow this, do this.
But she decided to take it onher own and started using I
don't know if you've ever seenthis, but the biocide and
toothpaste.
And she is my third patientI've seen now using the biocide,
not only like the drops for guthealth, but the toothpaste too.
It's all natural, but it is tookilling and her first test was

(22:53):
pretty good.
Keep doing it Again.
I had two people refer to mefrom a functional medicine doc
and now her as my patient.
She used it completelydecimated everything, like all
of her beneficial bacteria thatshe'd had three months prior
gone.
And I saw this in my functionalmedicine patients.
They were sent to me becausethe doctor was like I don't
understand, we're doing a guthealing protocol, why is the

(23:16):
oral pathogen, why are theyhigher?
And so we combined it with astool test.
You could see that thesecretory IgA, which is an
antibody that kind of, creates abarrier in the mucous membranes
.
It prevents toxins and thingsfrom getting into circulation
and that had been decimated, sogone.
So now there's no more barrierto prevent those things from

(23:39):
getting in and out.
Yes, biocidin is a very naturalproduct, but even natural things
can be too killing.
You know we use that forkilling, but ooh, it might be
peppermint even.
That's why some of the Robitinis one of my favorite toothpaste
.
They don't use a lot of pepper.
They only had citrus for a longtime until finally people were

(24:00):
like we don't like the flavor.
So now they have a mint one,but it's very specially
formulated.
So not to have too much,because too much peppermint is
killing and right.
That's not the goal.
The goal is to create a healthybalance.
But anyway, I think salivatesting is really good.
I love that We'll give ourpatients pH tape also too,
because here's something you cantrack daily.

(24:21):
It's not very expensive.
You can buy pH tape, comes inlike a roll in a little plastic
container.
You can test that throughoutthe day and that is a really
good.
I was talking to a friend ofmine who is a functional
medicine doc and his son washaving all this decay and I said
you got to look at the gut.
He's like I don't know, thatdoesn't resonate with me and I'm
like if you tell me that allthe time, I'm like, yes, I see

(24:44):
this daily.
This is why I'm telling youhave him monitor your pH.
If you have neutral pH for theaverage of the day, obviously it
becomes acidic right after youeat and hopefully you have
enough good buffering capacityin your saliva that within 30 to
60 minutes you'll get back tothat neutral pH.
But if you consistently haveacidic saliva you're going to be

(25:07):
more prone to those things.
So then you got it.
We got to think deeper, likeyou said, what's the cause?
What's the upstream cause ofthat pH and again I think it's
mostly due to that digestion.
Things are not happy very wellgoing on there.

So let's know what's.
Funny though that reminds me ofthat, it reminds me that
sometimes I have to remindmyself that even functional
medicine practitioner familiesare not always perfect.
And what?
Who's a very well-knownfunctional medicine doctor in my
area and her teenager keptstruggling with tooth decay.

(25:44):
It turns out she's drinkingsoda every day every time she's
out of the house away from mom.

Oh yeah, there's lots of teenagers.

So even in our holistic families, sometimes
it's just hey, we got to cut theDr Pepper.

Yes, I know it's unbelievable With my kids.
They come out and even I gointo the rooms and I'm like
where did you get all thisperfume?
I'm like this is killing yourhormones and I had to let go a
little bit because, talkingabout nervousness, I have to
stop because that stresses themout.
So I had to be like you knowwhat.
I've tried to give them thebasis, but I can't control them

(26:24):
as much anymore, so I just hopethat someday they will come back
and they will say hey, mom, canyou help me get better?
You know, and again, I preventthese things.
This is the things I keeptrying to teach them.
We got to prevent, we got.
Prevent these things, this isthe things I keep trying to
teach them.
We got to prevent, we got.
Again, I had to chill out alittle bit, just be like, just
let it be, because, again, like,the more I stress about it, the

(26:45):
more I'm going to manifestthose things that I don't want
to happen.
So, yeah, like I just I got todo the best I can.
I have to just keep doing,trying to model right the right
behaviors and stuff and justhope they'll come around once.
I'm not this crazy weird personanymore, so let's talk a little

(27:06):
bit more about like the breath.
Tell me a little bit about whatthe breath institute is and why
that matters and how we talkabout that with sleep apnea and
stuff and different treatmentsfor that.

Yeah, so it's Zaroosh Zoghi who came up with
that.
He's an ENT physician out inCalifornia I think he's in the
Los Angeles area and he reallydeveloped these protocols around
how to properly revise lip andtongue ties, specifically tongue

(27:39):
ties in older kids and adults,because we know that impacts
breathing so much when you canhave a tongue that's functioning
the way that it should and whenit can naturally rest against
the roof of the mouth for themajority of the day.
And so that was.

(27:59):
It was a fun training to do,and I actually do.
I wind up doing tongue tierevisions on infants more than I
do the big kids and the adults,but I still do the older kids.
The procedure's a little bitdifferent and the protocols, the
prep work before and after, isa little bit different depending
on the age.

(28:20):
But, man, we can impact so muchby just helping patients be
able to have functioning tonguethat helps develop the jaws and
the airway the way that itshould, which then in turn helps
them breathe and sleep the waythat they should.
It's just all so much moreimportant than we were able to

(28:46):
appreciate when we were indental school a couple of
decades ago I didn't know any ofthis.

It's obvious when you have a tongue
tie on the tip of your tongueright, and often at birth that
physician will see that and theymight clip it or something.
But it's these what we callposterior tongue ties that often
aren't caught and then create aproblem.
Because I'm always telling mypatients, your tongue is
connected by a fascia all theway to your toes.
So if you have tight pulling onthat tongue, that affects all

(29:17):
of your posture, your movements.
The body is amazing and veryadaptable.
The thing about if you have hippain, knee pain, is that related
to your bite being off, andpeople were like, what does that
have to do with anything as anathlete you have?
If you get certain injuries orcertain feet pattern, like
bunions, right, that's a weirdfoot pattern and that's related

(29:38):
to how everything you know.
Yes, it can have a geneticcomponent too, but again, that's
all structure related and again, since we've cut the head off
from the rest of the body rightIn medicine you never think
about those things.
But what do you notice?
Like when you do a tongue tieon, say, a teenager or an adult,
what are the responses?

(30:00):
It's there.
That's what they feel right.

Yeah, that's right.
A lot of times it's, and we'lltake pictures before and after
and it's really cool becausewhen you take a picture from the
side, most of the time whenthey're starting, they have this
super common forward headposture like we all tend to get
over time tech neck, staring ata computer too long, hunching
over for too long and you cansee that if they've got the

(30:26):
right body work, if they've donetheir myofunctional therapy, if
they've done their body work,then on procedure day, literally
that day, they are able tostraighten their head and neck
posture and reverse that forwardhead posture as soon as the
procedure is complete, which isinsane to me.

(30:48):
It's like a weird magic partytrick and they do.
They get this parasympatheticlike automatically stimulates
the vagus nerve and they reallycan open their chest bigger,
they can breathe better.
A lot of times they'll feellike a rush of energy.
So, depending on how sensitivethe patient is sometimes they're

(31:10):
aware of it, sometimes they'renot but all number of things
We'll have reducing of head andneck tension, an easing of some
of their shoulder tensionAnybody who gets tense kind of
in their traps a lot of timesthat will finally relax when
they get the tongue tie releasedand then obviously a lot of

(31:31):
times they're breathing betterand they're sleeping better,
which means overall their healthtends to get better over time.

Yeah, it's amazing, and if we think about
temporal mandibular jointdisorders, so much of that can
be muscle related, and so wealways ask that TMD, do they
have a tongue guy?
Is there all this tension inthese areas, and could part of
the picture be that that tongue?
We tend to make splints andthis is what we learn right in

(32:02):
dental school maybe a littlemake all these splints and
through all these things, but tome it's a band-aid because
you're addressing the symptomyou're not really addressing.
Well, why is that joint likethat in the first place?
I think as biologic dentists,we're always asking that
question why, what?
What is the cause?
Let's think upstream because wewant to be able to solve stuff

(32:24):
and, like you said, we're sointerested in prevention and so
we think a little bit deeperversus just you know, because in
conventional dentistry yourtoolbox is about this big.
Maybe you have a few things inyour toolbox.
As biologic dentists, ourtoolbox is enormous because
we're just thinking outside ofthe box, literally.
What are these other modalitiesthat we need to look at or

(32:47):
think about?
And also really thinking abouthow the entire body is connected
right, and so we need to thinkbeyond the head and the neck and
how these things are impactingall of us.
So tell us about sleep apnea.
You use the Fotona laser, likeI do, for a procedure called
night laze.
So again, how do you go aboutdeciding whether they might be a

(33:14):
good candidate for the lasertreatment, or is there breath
work involved?
Exp expansion Tell me a littlebit about your process and how
you might diagnose a sleep issue.

So on all of my new patients I'm doing a CBCT
to look at the airway, seeanatomically, does it look like
they're breathing through a nicebig pipe or does it look like
they're breathing through acoffee straw?
And when we're looking if theyare having sleep issues we're
always questioning.
That's on our intake forms.

(33:45):
So we're screening everyone forsymptoms and if they are having
symptoms of poor sleep, wakingup in the middle of the night,
snoring, anything like that, andwe can tell that they have
excess soft tissue that'simpeding the airway.
If it looks like their airwayis restricted, then a lot of
times they're great candidatesfor nightlays.

(34:08):
I always want to do a sleepstudy just to see where they are
, if they've got actual apnea ordon't have actual apnea,
because we want to see the fullstory.
And nightlays can be used foras a treatment for mild to
moderate sleep apnea or it canbe used as a treatment just for
snoring and so it can have agreat impact.

(34:29):
It can be done as a standalone,we do a few sessions and that
gives them enough excessexpansion in their airway that
they're able to breathe betterand feel better and have better
sleep.
Or it might need to be done inconjunction with some other
things.
If they've got diagnosed truesleep apnea and maybe they're in

(34:55):
a bad state, then they may needto do some other more
traditional sleep apneatreatments first and then I'll
have some patients.
I don't know about you, but I'm.
I personally don't do any ofthe adult expansion like the
Vivos appliances or anythinglike that for expansion, but I
have some friends in the areawho do those and don't do night

(35:17):
lays.
So sometimes we'll sharepatients because I think the
night lays is really goodbecause it's semi-permanent,
it's not permanent, permanentand so sometimes we'll do night
lays to help open things up asthey're starting their vivos
expansion protocols with theother provider, so it gives them
some immediate relief while mycolleague is literally trying to

(35:42):
open up their airway and widentheir airway.
Some, so lots and lots of uses.
I think it's really versatileand it's an expensive machine,
but I'm sure I'm glad I have it.
I wish more people had it, yeah.

No, it is amazing.
And, as we were talking aboutbefore we started recording, I
started to notice with my CBCTsthe 3D x-rays that some patients
had large airways, but yet theystill had sleep apnea.
So I started to think okay, sothere's more than just the
anatomy right.
And so a lot of it also had tobe breathing.
The nightly is great.
It's laser, it does not hurt.

(36:16):
It's a little bit of a tediousprocedure, it can be challenging
those daggers, but it's everysingle one of my patients we've
done, I said.
They immediately feel likethey're sleeping better, and I
think it's important to knowthat this is not going to cure
necessarily sleep apnea.
Right, and, like you, we do thesleep first, because if you

(36:37):
have that severe, like you, wedo the sleep study first,
because if you have that severelike, you have to see the sleep
physician.
I'm not going to tell you I'mgoing to do this laser procedure
and then your sleep apnea isgone, because there again,
there's more to it than just thestructure, and some people have
apnea, but they're the.
If you look at the back oftheir throat, everything looks
good, but there are some peoplewhere it's really stretched out.
The uvula, the taking down, isreally stretching.

(36:58):
You're like, okay, we can helpthat, because what the laser
does is it stimulates thecollagen, and it stimulates the
collagen to plump back up and goback to where it is, but that
and that again helps open theairway.
But we still got to think.
Why, though is that happeningSometimes?
It's structural right.
So I like to do the openingdevices.

(37:21):
I think they're absolutelyamazing.
So it's again it's like inconjunction, because when you're
opening it with an appliance,you're getting at the root cause
of it, right.
So you're opening that A lot ofpeople.
I started noticing even bettersuccess with nightlays when I
started giving a homeopathicsanguinaria, because that's
known for snoring and sleepapnea and having them do

(37:44):
myofunctional exercise.
So there's my favorite websiteit's on YouTube Six exercises
for snoring and sleep apnea.
So when they and then theperson has to be compliant,
obviously.
But again, it's not just aboutthe laser, just about the
appliance, right, we got tothink holistically and
three-dimensionally about allthese issues when they start

(38:06):
doing the tongue exercises,because we said, just like with
the tongue tie, we can't just goin and cut your tongue tie.
You've got to prepare thetongue.
You got it.
Especially if you're older,right, with a baby doesn't
matter, they don't haven'tlearned too many bad habits yet,
but as an adult you've beenusing the tone in a certain way
for decades.
Perhaps you have to retrainthat.
So, again, a lot of it issnoring, because I started

(38:27):
snoring a decade ago and I waslike what's happening there, my
collagen starting to droop alittle bit, my airway didn't
necessarily change, but stressand breathing patterns and all
these things.
So I had to really teach mytongue where it's supposed to be
.
Like you said, it's supposed tobe on the roof of the mouth and
my mouth would fall open.
So when I first started doinglike mouth taping, I was like

(38:51):
ripping it off in the middle ofthe night because I was like, oh
my gosh, I'm not used tobreathing through my nose.
And so again, like you, retrainyour nervous system.
I think a lot of we knowcentral sleep apnea is due to
brain activity, but even some ofthe other, all breathing
pattern is related to thenervous system.
So we've got to retrain thatnervous system if we want to get

(39:11):
total resolution.
So the patient kind of has tobuy in.
There's some homework that hasto be done.
That's why I talk to my teamall the time about being
partners, like I can help you,but you got to meet me halfway.

And what's interesting too, especially the
age range where we usually startseeing symptoms of this is for
women it's right around the timeof perimenopause, leading into
menopause.
So we can't discount the factthat a lot of times there's a

(39:46):
huge hormone component to this.
And so we've got to be looking,and I think as dentists we,
like any profession when you'rea hammer, all you see is a nail
Like it I have to remind myselfthat, hey, we've got to.
Even as cool as our tools are,we have to look again, go

(40:11):
upstream.
Is the cause the small airway,the excess tissue?
Or is the cause a drop inprogesterone and an increase in
cortisol?
Because we're all in that agerange where our stress levels
are higher, and not only ourstress levels are higher.
We've got less of theprogesterone and estrogen to

(40:33):
combat the cortisol and helpkeep things in balance, and that
can play a huge role.
So, yeah, sometimes doing nightlays and expanding the airway
if there's tongue tie, if theairway is super small, then yeah
, I think doing the dentistryfirst makes a ton of sense.

(40:53):
But then there are some caseslike you were mentioning.
If the airway looks okay, thenprobably doing some airway work
from the dental office is notthe first best option that we
should look into.
It's getting that patient tothe functional medicine doctor,
to their gynecologist if theyhave one, who understands

(41:16):
hormones which is not always agiven and making sure that part
is balanced and in check so thatthey have the ability to be
able to breathe, even if they doneed some help mentally down
the road.

I think that's such a major point.
That is really important to meas a biologist is, as you
mentioned earlier, right, it'sthat team.
Right, I've learned so muchbecause I didn't have a lot of
people in my area that werelike-minded, so I was just, I
was learning and that's why Iwent and did the health coaching
certificate and learned allthose kinds of things, but

(41:53):
you're so much better off as apatient, not one person.
So it's I know a lot, a littlebit about a lot of things, right
, but in some cases, like youneed that specialist, right,
like it's sometimes it's hard,it's very disconnected when we
have all these subspecialties.
But that's why creating thatteam, I think, is so valuable,
because there are things thatyou know, as knowledgeable as we

(42:15):
may be.
Like you said, the hammer andthe nail.
We're thinking more of dentally.
Yes, we have a more holisticview, but sometimes we just get
in that route and then acolleague will be like well, did
you ever think about this?
And it's like that makes somuch sense, and so I think it's
nice to have those differentperspectives.
That's how we become betterdoctors when we're being taught.

(42:37):
That's like what you said aboutyour patients.
I love it when my patients cometo me and teach me something
that I never thought about it.
Or just because we have allthese expertise and all these
letters after a name, we're notthe patient and I'll leave
letters after a name, we're notthe patient.
So I also love it whensometimes I'm like I have no
idea what's going on and thepatient and I'm gonna say what
do you think's wrong?

(42:57):
To the patient right, they knowtheir body the best and that is
where I think so much valuableinformation.
I'm like that's when I startedusing biofeedback, because I'm
like there's some of these casesand I'm like I have no idea and
so I love using these energytools.
I had a really fascinating casea couple of weeks ago where
somebody drove all the way fromCalifornia.

(43:18):
She had a crown that she'd hadbeen redone four times and then
they were talking root canal andshe said she'd listened to the
podcast.
She's like I just don't want tohave a root canal.
And I said she didn't reallyhave any inflammation, tooth
nerve symptoms.
So I was like it's just weird,but I don't know, because the
crown looked good.
I took a 3D x-ray.
Everything looked fine.
Pulled out the biofeedbackmachine and what we were talking

(43:41):
about earlier about materials,ceramics and dental cement came
up as allergens for her and Iwas like what, like I never ever
would have saw it, and so,having that laser, I was like
what, like I never ever wouldhave thought, and so having that
laser.
I was so fortunate that I wasable to take the crown off whole
, so it was a zirconia because Iwas like, oh, I hate that.
Like the crown looks good, Ihate having to charge this

(44:02):
patient all this money.
Yeah, took it off, got rid ofthe smadges, the ozone, cleaned
up the tooth and then I muscletested her.
I had her hold the crackbecause it's a zirconia crown.
I've never heard of somebodyhaving sensitivity to zirconia.
So she held that.
She was very strong.
So I was like, okay, it's notthe crown.
But and then I had a fewdifferent cements and she did

(44:23):
not test for the resin cement.
I still do have a glass ionomercement and the mineral-based
ceramere.
She tested terribly for theresin and the glass ionomer and
very strong for the mineralcement.
So like, and when I took it offit looked like she maybe had a
glass ionomer cement in there.
So I was like, interesting, sowe were able to put that back on

(44:43):
without having heard to have arook and hopefully I haven't
heard back if it was bad or notbut I was like how fast.
And I never would have knownthat without that tool, cement
would never have, never, everhave crossed my mind.
So it was just fascinating whenyou think about.
And then, and she had said, andI had asked her, I was like,
when you had the temporary on,did it bother you, because we

(45:05):
use different materials fortemporary crowns and temporary
cement and she said, oh,actually it wasn't that bad.
And so then I was like, okay,maybe it is the cement or the
material.
So again, it's just fascinatingwhen you and again, is the
patient's experience right?
She's like I just want to takeit off out of my mouth and I was
like that sounds like anallergen, right, like an itchy

(45:27):
weird.
So, yeah, just this fascinating,all these different things that
we can do.
Tell me about, like, speakingabout a root canal.
This is my biggest cross, likeI'm always thinking how can I
prevent that?
What, what in my powers, andI've used so many different like
modalities between ozone andcertain herbs and nutrition and
red light.

(45:47):
Do you have a protocol?
Maybe when somebody comes in,they're on that fence of
reversible versus irreversible.

Yeah, same, I'm usually hitting it hard and
heavy with the ozone If we're onthe border and it's still
technically reversible, because,man, we're trying to avoid that
root canal.
We're trying to avoid thatdiscussion about a root canal
versus pulling the tooth, if atall possible.

Yeah.

It's usually and sometimes we'll do if they
live close enough that they canget to me.
Then we'll do ozone injectionsonce a week for a month or two
to see if we can get it to feelbetter.

And I'm always thinking I think that's
the best way.
But again it's like, how oftenis the patient?
If they're not super close, arethey going to be able to come
in every week?
So I'm always like, okay, whatare the at-home modalities?
Not everybody has an ozonemachine.
They're relatively affordablenowadays, so it's not a question
.
But not everybody feelscomfortable injecting themselves

(46:48):
, right?

Yeah, have you had much luck with people doing
red light?
At home I've had people thathave red light, but not enough
to really be able to test it.

No, we do sell those and they're nice, the
little, the intracoral so Ithink that's my next best step.
This is something you can takehome and use all the time.
So I think that's great,because when I think of the
nerve dye, I'm thinking, oh,there's less energy.
How do we pump more?
And that's why ozone is amazing, because you're like pumping
electrons and energy directlyinto the system.
So I use a lot of the ozonatedolive oil, right, but again,

(47:25):
it's the same as the gas, so wegive that to patients.
There's a little herbalcombination which I think I
first found out about that inthat conference in 2020 in
Dallas called Oral Health.
It's a bunch of Chinese herbsand you're supposed to put it
against the tooth.
But again, that's what I'mthinking.
How do we increase the energyin that area?

(47:47):
And again, the red light isreally good for circulation.
So we talk about, like bvitamins again, good circulation
.
How do we get more energy,trying to avoid the energy
disruptors?
But still, I've never, Ihaven't found the magic bullet
right again, unless you didweekly for a long time.
That can be good, but and itcan be good for a while but but

(48:10):
again, what made it?
Do that first, like, how do youhave to always do that?
I'm still searching for the badpeople out there.

I know, and what I hope that more of my
patients understand anyway, isthat sometimes they expect us
because we're biological deaths,because we're more holistic,
they expect us to never say thatyou need a root canal to save a
tooth and it's not a funconversation, but sometimes that

(48:40):
is the conversation of it's oneor the other.
You don't have to do the rootcanal, but if you don't do the
root canal then that tooth needsto go.
And I hope that peopleunderstand that biological
dentistry is not the same thingas supervised neglect.
You're not the same, because Ithink sometimes that's what our

(49:03):
patients prefer At least some ofmine do anyway, it's fine I can
just leave it.

I'm like, no, that's the hard conversation
, right, because a lot of peoplehave these abscesses and we
might not find them without a 3dx-ray and they don't, and so it
doesn't hurt, I don't want totake it out and so having to try
to explain, okay, but that is.
I was like if you have aninfection on your arm, right,

(49:29):
you wouldn't really necessarilyignore it.
If there's pus in it, youwouldn't ignore it, you would
treat it, but if it's in yourmouth and your jawbone, you
can't see it, you can't feel it.
It's hard and I get it.
It's a very hard conversation.
People are coming toBiologenics because they want us
to save everything, and Ireally liked that you made that
comment, because that's true.
They do think we're going tofix everything and everything's

(49:51):
going to be magic, and while wewant that to be true and while
we're always educating ourselvesand learning, it's not always
possible, and that's why you andI are both so big on prevention
, right, let's not get to thepoint where it gets.
And again, don't make me havethese hard conversations.
Yeah, stop it.
The body is so complex andthat's the value of going to the

(50:16):
dentist more frequently, and soa lot of my holistic peers.
I don't want x-rays and I'm likeI understand, but digital
x-rays now have very littleradiation.
You get more from the sunlightbut I can't treat you.
I'm not going to take themevery every six months or
whenever we every person.
We look at them as anindividual, but I don't

(50:38):
necessarily like to go longerthan three years because a lot
of things can happen.
Right.
But I need to have a baselineand I need to know like it's on
me.
If I don't take the x-ray andsomething happens to you, I'm at
fault.
Even if you signed somethingthat refused, I am still at
fault in the legal system.
It is still my fault because Iam the expert and I have to know

(50:58):
better.
So that's a frustratingconversation with me.
With patients, I get it.
We use homeopathics and beforean x-ray you want to minimize
the radiation or you want tohelp your body clear, take a lot
of antioxidants ahead of time,right.
Take some high dose like C,drink some pomegranate juice,
take some glutathione if youhave it, like those kind of

(51:21):
things, and then, like I said,in our office we offer a
homeopathic low remedy rightafter and that again can help
the body remove.
The acid doesn't get stuck inthe body and cause problems.
So again, nothing.
If you go on an airplane ride,you get more radiation there.
So there's risk everywhere inlife and we want to help you
mitigate it.
But we also want to catch thoseinfections and those problems
super early, and x-rays are theonly way we can do that.

Yeah, absolutely.

For just about an hour.
This has been an awesomeconversation.
Anything else you want tomention or you think that's
really relevant, that ourpatients would be eager to hear?

I will leave them with an encouragement.
My encouragement is that and Iknow that you share this view as
well is that our bodies aredesigned to heal.
So, if nothing else, like wesaid, we don't want to overtreat
, we don't want to undertreat,but know that we're just here to

(52:20):
help.
Your bodies are designed toheal on their own, and so I
think you and I both just wantpeople to.
We want to support people alongtheir own journey to health and
walk alongside them and partnerwith them.

I love it.
That's a perfect ending andexactly how I feel too.
And, yes, we want to give youencouragement and optimism there
that, yes, like you said, wewill walk alongside you, we will
help you get there and, as wecontinue to learn and evolve, we
will bring to you, hopefully,the newest and greatest
treatments and prevention.
So thank you so much, dr Tony.

(53:00):
And if there are people who'dlove to reach out to you, can
you, and we'll also puteverything in the show notes.
But if you wanted people tocontact you, how would they find
out more about you and yourpractice?

Yeah, absolutely so.
Our practice website isflourishdental, and probably our
most busy platform is onInstagram, and so you can find
me personally on Instagram.
It's at Dr Tony.
Ingram Tony with an.
I Ingram with an E Great.

And that'll all be in the show notes for
you guys.
So I hope you really enjoyedthis conversation as we dove
deep into the ins and outs ofbiologic dentistry how to be
your own best dentist here andfind the right provider for you.
So until next time, everyone, Ihope you have a wonderful day
and we'll see you then.
Huge thanks to you, our amazinglisteners, for helping us climb

(53:56):
into the top 5% of podcasts inthe oral health space, With all
the love and support.
We've been getting manyrequests for one-on-one
consultations, so we made ithappen.
Are you ready to take your oralhealth to the next level?
Click the link in the shownotes to book your personalized
consultation and let's kickstartyour journey to a healthier,
brighter smile, starting today.

(54:16):
We'll see you then.

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