HoldsUp

DavidPerlmutterMD · 2023-04-17 · David Perlmutter (host), Mark Burhenne

Oral Bacteria And Your Health - with Dr. Mark Burhenne | The Empowering Neurologist EP. 162

40 research-tied claims examined: 1 contradicted 8 overstated 2 context 24 supported 5 unverified

8

Overstated

0:12:55Mark Burhenneoverstatedmoderate

Periodontitis affects approximately 50% of people under age 40 and up to 75% of people over age 65.

"This is one of the most prevalent diseases in the world right now. Under age 40, 50% of us in this country, for example, but all over the world. Even in this country with good dentistry, 50% of us have that. Over age 65, it's up to 75%." (said at 0:12:55)

Nationally representative surveillance data from the US National Health and Nutrition Examination Survey (NHANES) report that periodontitis affects roughly 42% to 47% of all adults aged 30 and older, not individuals under age 40. In younger age brackets (e.g., ages 30–44), prevalence is approximately 34%, so claiming that 50% of people under 40 have periodontitis is an overstatement resulting from conflating the overall adult average with younger age groups. For adults aged 65 and older, NHANES data report periodontitis rates of roughly 64% to 70%, which is reasonably aligned with 'up to 75%'.

0:23:40David Perlmutter (host)overstatedlow

Herpes simplex virus type 1 (HSV-1) cold sores are associated with an increased risk of developing Alzheimer's disease.

"as it relates to herpes simplex type 1, i.e., cold sores, which we know are dramatically associated with Alzheimer's risk." (said at 0:23:40)

Observational evidence supports a modest statistical association between herpes simplex virus type 1 (HSV-1) infection and Alzheimer's disease risk, but characterizing this relationship as "dramatically associated" significantly overstates the magnitude of effect. Systematic reviews and meta-analyses of cohort and case-control studies report modest pooled effect sizes: cohort studies find approximately a 20% increased risk (HR 1.20, 95% CI 1.10–1.31) and case-control studies report pooled odds ratios between 1.32 and 1.46. Furthermore, these associations are derived from observational data where causality remains unproven, and high seroprevalence across the general population makes the absolute risk increase modest.

0:31:05Mark Burhenneoverstatedlow

Tongue scraping decreases blood pressure by promoting nitric oxide production from the oral microbiome.

"tongue scraping actually decreases your blood pressure, which is kind of conversely to it's the converse of killing the bugs. But if you can, you know, manage that biofilm on the back of your tongue, which is one of by the way, one of the niches of the oral microbiome, there are several, then you can actually promote NO production by keeping those bugs happy" (said at 0:31:05)

Commensal bacteria on the dorsal surface of the tongue play a key role in the enterosalivary nitrate–nitrite–nitric oxide (NO) pathway, which contributes to systemic vasodilation and blood pressure regulation. An observational study by Tribble et al. (2019) found that self-reported tongue cleaning frequency influenced tongue microbiome composition and blood pressure responses during chlorhexidine mouthwash exposure and recovery, and that individuals with higher levels of bacterial nitrite reductases had lower resting systolic blood pressure. However, stating definitively that tongue scraping decreases blood pressure overstates the evidence: direct randomized controlled trials isolating tongue scraping as an intervention to lower blood pressure are lacking, and current findings remain preliminary and observational.

0:34:33Mark Burhenneoverstatedmoderate

Sleeping with the mouth open causes intraoral pH to drop to 2.8 to 3.0.

"If you sleep with your mouth open all night long, you are disrupting your oral microbiome. The pH will drop to three, 2.8, which is quite low." (said at 0:34:33)

While mouth breathing during sleep does lead to a statistically significant decrease in intraoral pH, the claimed drop to pH 2.8–3.0 vastly overstates the magnitude of acidification. In a crossover trial measuring continuous intraoral pH during sleep with forced mouth breathing (via nose clips) versus normal nasal breathing, mean intraoral pH during sleep decreased from 7.0 (± 0.5) during normal breathing to 6.6 (± 0.5) during mouth breathing (PMID: 26666708). A pH of 2.8 to 3.0 represents extreme acidity (comparable to vinegar or gastric contents) and does not reflect typical intraoral conditions resulting from mouth breathing.

0:43:16Mark Burhenneoverstatedmoderate

Studies over the past 20 years show that sodium lauryl sulfate (SLS) is a major cause of oral canker sores.

"And by the way, SLS, we've had studies for the last 20 years showing that SLS is one of the major causes of oral canker sores. And again, that goes back to that breakdown of the oral mucosa. SLS breaks it down and predisposes you to these very painful uh canker sores uh traumas." (said at 0:43:16)

While clinical studies and systematic reviews indicate that sodium lauryl sulfate (SLS) can irritate the oral mucosa and that switching to SLS-free toothpaste may reduce the frequency, duration, or pain of recurrent aphthous stomatitis (canker sores) in susceptible individuals, calling SLS a "major cause" overstates the evidence. Recurrent aphthous stomatitis has a complex, multifactorial etiology involving genetic, immunological, nutritional, and microbial factors. Systematic reviews emphasize that the evidence base showing benefit from SLS avoidance consists of relatively small randomized trials and characterizes SLS as a potential aggravating factor or trigger rather than a primary cause.

0:53:46Mark Burhenneoverstatedmoderate

Fluoride from professional fluoride varnish enters the bloodstream within 10 minutes of application.

"and by the way, the amount of fluoride in that varnish is way more than what's in your toothpaste, way more. And it it literally is in your blood supply, in your bloodstream uh, within 10 minutes and hitting the brain." (said at 0:53:46)

While 5% sodium fluoride dental varnish contains a higher concentration of fluoride (~22,600 ppm) than standard toothpaste (~1,000–1,500 ppm), the actual amount applied is very small (typically 0.1–0.5 mL), and it adheres to tooth surfaces to slowly release fluoride. Pharmacokinetic studies show that systemic absorption of fluoride from varnish results in low, transient increases in plasma fluoride levels that remain far below toxic thresholds and within normal physiological variations, rather than causing rapid, harmful accumulation in the brain.

0:58:55Mark Burhenneoverstatedhigh

Approximately 80% of the United States population receives fluoridated municipal water, adding more fluoride to water than the rest of the world combined.

"It is probably 80% of the country. We are the most fluoridated uh, country in the world. In fact, we add more fluoride to more water for for people that are drinking from the water supply than than the world combined." (said at 0:58:55)

The claim overstates the percentage of the United States population receiving fluoridated municipal water and exaggerates U.S. coverage relative to global practices. CDC surveillance data demonstrate that 69.2% of the U.S. population served by community water systems received optimally fluoridated water as of 2006 (and the Healthy People target was set to reach 75%). As a proportion of the total U.S. population (which includes those on private wells), the percentage is lower. Furthermore, water fluoridation is practiced across approximately 25 countries worldwide, alongside other systemic fluoridation initiatives such as salt and milk fluoridation.

0:50:46Mark Burhenneoverstatedmoderate

The National Toxicology Program (NTP) reviewed 55 studies on fluoride and concluded that exposure poses neurodevelopmental risks with no safe level.

"even the NTP, National Toxic uh, toxicology program in the US... they agree with the quality of 55 of the studies and they agree with the results and they now are saying that there is no safe level of fluoride if if we want to play it safe." (said at 0:50:46)

The National Toxicology Program (NTP) Monograph (2024) systematically evaluated the evidence linking fluoride exposure to neurodevelopmental and cognitive outcomes and concluded, with moderate confidence, that higher fluoride exposure (primarily drinking water concentrations exceeding 1.5 mg/L) is associated with lower IQ in children. However, the speaker misrepresents the report's conclusions and study quality tallies. The NTP evaluated 72 studies on children's IQ, categorizing only 19 as high quality (18 of which found inverse associations) and 53 as low quality. Crucially, the NTP did not conclude that 'there is no safe level of fluoride'; rather, its primary conclusion of hazard was based on higher exposure levels (≥1.5 mg/L), and it did not establish a no-effect threshold or declare any level unsafe.

Unverified means no publication matching the claim was located; it does not prove the claim false. Spotted an error? See the corrections policy - disputes from the people quoted are prioritized.