How to Improve Oral Health & Its Critical Role in Brain & Body Health

如何改善口腔健康及其对大脑和身体健康的关键作用

2024-02-12 | 官方页面 YouTube 官方音频

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.

欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。

Today, we are discussing oral health.

今天，我们来讨论一下口腔健康。

Now, when most people hear oral health, they immediately think tooth health and appearance and presumably fresh breath or lack of bad breath as well.

现在，当大多数人听到口腔健康时，他们立即想到牙齿健康和外观，大概还有口气清新或没有口臭。

And while of course, tooth and breath freshness, whiteness, and health is a critical component of oral health, today you will learn that oral health, including the oral microbiome, the health of your palate, your tonsils, indeed the entire oral cavity, is an extremely important component of general bodily health.

当然，牙齿和口气的新鲜度、洁白度和健康是口腔健康的重要组成部分，但今天您将了解到，口腔健康，包括口腔微生物组、上颚、扁桃体乃至整个口腔的健康，是一般身体健康的极其重要的组成部分。

So much so that today we are going to add a seventh pillar to the so-called six pillars of mental health, physical health, and performance.

如此之多，以至于今天我们要在所谓的心理健康、身体健康和表现六大支柱的基础上添加第七大支柱。

This is not a trivial step to add a seventh pillar to these six pillars.

在这六大支柱的基础上添加第七根支柱并不是一件简单的事情。

If some of you have been listeners of this podcast for a while, you may recall that the six pillars of mental health, physical health, and performance, that is, the six things that everyone needs to invest specific protocols into each day are, in no particular order by the way, sleep, sunlight and light exposure generally, which by extension also includes dark exposure, nutrition, exercise, which we could also call movement, both cardiovascular exercise and resistance training, stress management, and relationships and social engagement, including relationship to self.

如果你们中的一些人已经听过这个播客一段时间了，你可能还记得心理健康、身体健康和表现的六大支柱，即每个人每天需要投入特定方案的六件事，通常是睡眠、阳光和光照，延伸出去还包括黑暗暴露、营养、锻炼（我们也可以称之为运动）、心血管锻炼和阻力训练、压力管理以及人际关系和社会参与，包括与自我的关系。

And today we are going to add oral health and microbiome health, and I suppose we could generally call this oral and gut health, because as you know if you think about it, your mouth, your oral cavity, and your gut are contiguous with one another.

今天我们要添加口腔健康和微生物组健康，我想我们通常可以称之为口腔和肠道健康，因为如果你仔细想想，你就会知道，你的嘴、你的口腔和你的肠道是彼此相连的。

We are going to add oral and gut health as the seventh pillar of mental health, physical health, and performance, because, as you will learn today, there are so many aspects of oral health and daily protocols for oral health that extend to cardiovascular health, to metabolic health, and indeed to brain health and to staving off diseases in all of those bodily compartments.

我们将把口腔和肠道健康作为心理健康、身体健康和表现的第七个支柱，因为正如您今天将了解到的，口腔健康和口腔健康日常方案有很多方面，延伸到心血管健康、代谢健康，甚至大脑健康，并避免所有这些身体部位的疾病。

I cannot overemphasize enough how much oral health influences your general bodily health.

我无论如何强调口腔健康对您的整体身体健康的影响程度都不为过。

So today you will learn about oral biology and health.

所以今天您将了解口腔生物学和健康。

We won't go too deep into the biology, but we will go deep enough into the biology that you will learn some incredible things, such as your teeth have the ability to literally fill back in cavities that have formed, provided those cavities haven't gone too deep into the teeth layers yet.

You will learn that saliva, while most people think of it as just spit, is an incredible substance, fluid, that contains all sorts of interesting and important things that allow you to rebuild the strength of your teeth and indeed to support the health of your oral cavity and gut microbiome and body generally.

您将了解到，虽然大多数人认为唾液只是唾液，但它是一种令人难以置信的物质——液体，其中含有各种有趣且重要的物质，可以让您重建牙齿的强度，并且确实支持口腔、肠道微生物组和身体的健康。

So saliva is super interesting and important, and today you're going to learn many protocols, including zero-cost protocols, protocols that will actually save you money, as well as some low-cost protocols to both restore, improve, and maintain oral health, and in doing so, maintain and improve your overall bodily health.

所以唾液是非常有趣和重要的，今天你将学习许多方案，包括零成本方案、实际上会帮你省钱的方案，以及一些恢复、改善和保持口腔健康的低成本方案，并在此过程中保持和改善你的整体身体健康。

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。

It is, however, part of my desire and effort to bring zero-cost to consumer information about science and science-related tools to the general public.

然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

为了与这个主题保持一致，我要感谢今天播客的赞助商。

There is so much NFL on ESPN right now.

ESPN 上现在有很多 NFL 节目。

Monday Night Football, plus pre-game and post-game.

周一橄榄球之夜，以及赛前和赛后。

NFL Live, NFL Prime Time.

NFL 直播，NFL 黄金时间。

Everything you need to stay on top of every game, every week.

每周掌握每场比赛所需的一切。

Unbelievable.

难以置信。

And now NFL Network is on the ESPN app.

现在 NFL Network 已登陆 ESPN 应用程序。

More football, more coverage, more ways to watch.

更多足球比赛、更多报道、更多观看方式。

Football's on all season long on ESPN and streaming on the ESPN app.

ESPN 提供整个赛季的足球赛事直播，并通过 ESPN 应用程序进行直播。

Okay, let's talk about oral health, this absolutely critical aspect of not just having fresh, bright teeth and no cavities and fresh breath, or at least lack of bad breath, one would hope, but also total body health.

As I mentioned a little bit earlier, oral health is inextricably linked to all aspects of brain and bodily health, both in the short term and in the long term, and it is perhaps the most overlooked aspect of mental health and physical health.

正如我之前提到的，无论是短期还是长期，口腔健康都与大脑和身体健康的各个方面有着千丝万缕的联系，而且它可能是心理健康和身体健康中最容易被忽视的方面。

So today I'd like to start off with a quiz.

所以今天我想从一个测验开始。

I'm going to ask you which of the following three categories you believe you best fall into.

我将问您您认为自己最适合以下三类中的哪一类。

Okay, the first category is those of you out there who brush and floss every day, probably twice a day, and who make some effort to try and keep your teeth clean, who like the feeling of your teeth being clean, and who pay a fair amount of attention to whether or not your teeth are getting whiter or not getting whiter, maybe whether or not your breath is fresh or not fresh.

Maybe, okay, these aren't requirements for being in this category, but maybe you're somebody who also uses a mouthwash or uses mints or gums in order to try and keep your mouth smelling and looking fresh and your mouth clean.

也许，好吧，这些并不是属于这一类别的要求，但也许您也使用漱口水或使用薄荷糖或口香糖，以尝试保持口腔气味清新、口腔清洁。

Okay, so this first category does not require that you do all of those things, but let's just make a basic requirement of participation in this category that you routinely brush at least twice a day and that you floss at least once a day.

好的，所以第一类并不要求您做所有这些事情，但我们只对参与此类别提出一个基本要求，即您每天至少刷牙两次，并且每天至少使用一次牙线。

Okay?

好的？

If you fall into that category, you are in category one.

如果您属于该类别，那么您就属于第一类。

And by the way, if you're in category one and you do those things and you do a bunch of other things like tooth whitening and maybe you go to the dentist especially often, more than the recommended twice per year, that still puts you in category one Okay.

顺便说一句，如果您属于第一类，并且您做了这些事情，并且做了很多其他事情，例如牙齿美白，也许您特别经常去看牙医，超过每年建议的两次，那么您仍然属于第一类。

Second category are those of you out there who are, let's say, a bit more blase about your oral and tooth care.

第二类是那些对口腔和牙齿护理更加厌倦的人。

Those of you that perhaps just brush your teeth in the morning so that your breath is fresh and you clean out that kind of sticky feeling in your mouth that's accumulated overnight, that sometimes brush and maybe floss at night, but a lot of times you fall asleep without doing that or you don't feel like doing it.

你们中的一些人也许只是在早上刷牙，这样你的口气清新，你就可以清除口腔中过夜积累的粘稠感，有时晚上刷牙，也许用牙线，但很多时候你不这样做或者你不想这样做就睡着了。

Or perhaps that don't really floss at all, okay?

或者也许这根本就不是牙线，好吗？

That perhaps go to the dentist once every six months, maybe a little less, maybe once a year, once every couple of years.

也许每六个月去看一次牙医，也许少一点，也许每年一次，每几年一次。

So while there's a bunch of different things that could put you into category two, let's make a basic requirement for belonging to category two, that you brush your teeth once a day, but not twice a day on a regular basis, or that you brush twice a day, but that you rarely floss, okay?

因此，虽然有很多不同的因素可以将您归入第二类，但让我们为属于第二类制定一个基本要求，即每天刷牙一次，但不要定期每天刷牙两次，或者每天刷牙两次，但很少使用牙线，好吗？

That would put you into what I'm calling category two.

这会让你进入我所说的第二类。

And then, of course, there's the third category that maybe some of you out there fall into, and this is the category of people who are extremely diligent, not just about tooth care, but also about oral health generally, about maintaining the microbiome of your mouth, about making sure that your gums are very healthy, about making sure that your soft palate and hard palate is very healthy, about making sure that, yes, your teeth are clean, that they're devoid of as much bacterial buildup and other stuff in there that can cause cavities, but also that you're paying careful attention to your oral microbiome and the overall milieu of your health in the mouth, and the fact that your mouth is linked to all these different aspects of brain and cardiac and metabolic health, okay?

当然，还有第三类人，也许你们中的一些人属于这一类人，这一类人非常勤奋，不仅关心牙齿护理，而且还关心一般口腔健康，维护口腔微生物群，确保牙龈非常健康，确保软腭和硬腭非常健康，确保牙齿清洁，没有太多细菌积聚和其他东西。 that can cause cavities, but also that you're paying careful attention to your oral microbiome and the overall milieu of your health in the mouth, and the fact that your mouth is linked to all these different aspects of brain and cardiac and metabolic health, okay?

If you fall into that third category, great, but let's be honest.

如果您属于第三类，那很好，但说实话。

Most people, I would argue 95%, maybe even 98% of people or more, fall into either category one or category two.

我认为，大多数人，95%，甚至 98% 或更多，都属于第一类或第二类。

So as you're hearing this, you're probably thinking, "Okay, well, if I'm in category one, I'm good, right?

所以当你听到这个时，你可能会想，“好吧，好吧，如果我属于第一类，我就很好，对吧？

I go to the dentist twice a year, I brush and floss, use some mouthwash, I even brighten my teeth.

我每年去看两次牙医，刷牙、使用牙线、使用一些漱口水，甚至美白牙齿。

I make sure that if I had a sugary meal, I'll rinse out my mouth.

我确保如果我吃了含糖的饭菜，我会漱口。

I try not to drink acidic foods," things that we'll discuss today as to whether or not they actually have relevance for cavity formation or not.

我尽量不喝酸性食物，”我们今天将讨论它们是否确实与蛀牙形成相关。

But guess what?

但你猜怎么着？

If you are in category one, as I described it, or category two, chances are you are doing things to really deplete and disrupt your oral health.

如果您属于第一类（正如我所描述的）或第二类，那么您所做的事情很可能会真正消耗和破坏您的口腔健康。

That's right.

这是正确的。

Even if you're paying a lot of attention to tooth health, chances are if you're like most people out there, simply because you don't have the latest information on what oral health really is and how to best support it, chances are you are doing things that, yes, might be keeping your teeth white and clean and you're not getting cavities, or you're not being told you have cavities that need to be filled when you go to the dentist twice a year or more, but that you are disrupting your oral health in ways that are depleting other aspects of your brain and bodily health.

Even if you're paying a lot of attention to tooth health, chances are if you're like most people out there, simply because you don't have the latest information on what oral health really is and how to best support it, chances are you are doing things that, yes, might be keeping your teeth white and clean and you're not getting cavities, or you're not being told you have cavities that need to be filled when you go to the dentist twice a year or more, but that you are disrupting your oral health in ways这会消耗你大脑和身体健康的其他方面。

And I'm not here to scare you.

I'm just here to tell you that if you're in category one, okay, you're clearly doing some things that are beneficial for you, but that there's some additional things that you can do and a few things to avoid doing that very likely will improve your overall bodily health very quickly.

And the good news is those things are also zero or low cost, or in some cases can save you substantial cost.

好消息是这些东西也是零成本或低成本的，或者在某些情况下可以为您节省大量成本。

Now, if you're in category two, chances are you are depleting both your oral health and your overall bodily health.

现在，如果您属于第二类，那么您的口腔健康和整体身体健康很可能都会受到损害。

But here's what's interesting.

但有趣的是。

Some of the folks in category two that are not doing as much for the, let's say, hygiene and freshening and whitening of their teeth, actually have a healthier overall oral microbiome.

That's not always the case, but often it can be the case.

情况并非总是如此，但经常可能是这样。

So what you're going to discover today is whether you're in category one or category two, there are some wonderful and easily accessible practices that are well-backed by science.

And by the way, in preparation for this episode, I also consulted with no fewer than five dentists, including a pediatric dentist.

顺便说一下，为了准备这一集，我还咨询了不少于五位牙医，其中包括一位儿科牙医。

I talked to a periodontist.

我和牙周病医生谈过。

I talked to people who fall into the functional dentist category.

我与属于功能性牙医类别的人进行了交谈。

I talked to people with a bunch of different orientations who are all heavily qualified to talk about and to make recommendations about oral health and tooth health, et cetera.

And what I'm going to deliver today is essentially the overlap in the Venn diagram of what they all agreed on.

我今天要传达的内容本质上是他们一致同意的维恩图中的重叠部分。

I'll highlight a few differences that they each had and that several of them had.

我将强调他们每个人以及其中几个人的一些差异。

They do fall into different camps, but I was positively surprised how much overlap or consensus there was in terms of best protocols for tooth and oral health.

And by the way, if you're in that third category of the person that's doing a lot for their tooth health and appearance and breath, et cetera, but also oral health and microbiome, I'm sure that today you'll also learn some new health practices and some things that will allow you to expand on your already terrific practices for oral health.

So let's get into the material about oral health, focusing first on tooth anatomy and health and a little bit about mouth anatomy.

因此，让我们深入了解有关口腔健康的材料，首先关注牙齿解剖结构和健康，然后再了解一些口腔解剖结构。

I promise to not go into this in too much depth, but we really need to have a firm basis, a foundation of understanding of what the mouth cavity really consists of.

And I'm not just going to throw a bunch of names out there for sake of nomenclature.

我不会只是为了命名而抛出一堆名字。

I don't need to cloud your hippocampus with that sort of information unless it's functional information.

我不需要用这类信息来掩盖你的海马体，除非它是功能性信息。

But it is critical functional information for the rest of our discussion, where we'll talk about ways that you can really build up the strength of your teeth, even if cavities have already started to form, and how to really get your saliva to be the best, healthiest saliva for your overall mouth and for your gut and for your brain, your heart, et cetera.

Okay, so let's talk just briefly, I promise, briefly about the anatomy and a little bit of the physiology of this stuff, okay?

好吧，我保证，让我们简单地谈谈这个东西的解剖学和一些生理学，好吗？

The teeth, we're all familiar with what teeth are, and the tongue, the tonsils in the back of the mouth.

牙齿，我们都熟悉牙齿是什么，还有舌头，口腔后部的扁桃体。

We have our soft palate, hard palate, gums.

Let's talk a little bit about how all that fits together, centering around the thing that most people think about when they think about oral health, and that's the teeth.

That's just a good jumping-off point for us.

Your teeth are layered structures, like pretty much every structure in your body is a layered structure.

您的牙齿是分层结构，就像您体内的几乎每个结构都是分层结构一样。

It's just the way those structures form.

Cells are born at one location, they migrate out and form stacks or layers.

细胞在一个位置诞生，然后迁移出去并形成堆叠或层。

Those different layers have different cell types, and your teeth are no exception.

这些不同的层有不同的细胞类型，你的牙齿也不例外。

So while there are different kinds of teeth in your mouth, teeth have an outer layer, which is the enamel.

因此，虽然嘴里有不同种类的牙齿，但牙齿有一个外层，即牙釉质。

The enamel, believe it or not, is not white.

It is translucent.

它是半透明的。

Light can make it through, but it's not transparent.

光可以透过，但它不透明。

It's not like a clear window.

It's translucent.

它是半透明的。

Light can make it through, but it's a bit opaque.

光可以透过，但有点不透明。

Okay?

好的？

Beneath the enamel is a structure called dentin.

Dentin is important for today's discussion because, as it turns out, cavities form, not surprisingly, from the outside of teeth inward, and cavities, as the name suggests, are holes that bacteria burrow down through the enamel and, if you're unlucky, make it down to the dentin.

Our goal, meaning your goal, is to engage in daily protocols, that's right, daily protocols that are simple and fast and zero or very low cost that allow you to avoid the formation of those cavities, yes, but also that can allow you to fill in those cavities.

我们的目标，也就是您的目标，是参与日常方案，没错，日常方案简单、快速、零或非常低的成本，可以让您避免这些空洞的形成，是的，但也可以让您填补这些空洞。

This is one of the most important things to understand about oral health, that frankly I didn't know until I started researching this episode and talking to all these experts in the field, which is that you can repair cavities that have started to form.

这是了解口腔健康最重要的事情之一，坦率地说，直到我开始研究这一集并与该领域的所有这些专家交谈时我才知道，那就是你可以修复已经开始形成的蛀牙。

That's right.

这是正确的。

Your mouth environment, based on its chemistry and some things that are mechanical, but mostly based on its chemistry, in particular how acidic it is or how basic it is, is always in a state of what's called either demineralization or remineralization.

您的口腔环境，基于其化学成分和一些机械因素，但主要基于其化学成分，特别是其酸性或碱性程度，始终处于所谓的脱矿质或再矿质化状态。

Now, those words are hard to say, and they're especially hard to say fast, so demineralization, remineralization, it's a little bit of a tongue twister.

Today, I'm going to use a shorthand that's a convention in the dentistry field, which is demin or remin to refer to demineralization or remineralization.

今天，我将使用牙科领域惯例的速记法，即 demin 或 remin 来指代脱矿或再矿化。

Remineralization is good.

It is the process by which within the enamel and to some extent in the deeper dentin layer of the tooth, but especially within the enamel, there can be the addition of new minerals that form very robust, essentially chains of crystals.

在这个过程中，在牙釉质内以及在某种程度上在牙齿的更深的牙本质层中，但特别是在牙釉质内，可以添加新的矿物质，形成非常坚固的、基本上是晶体链。

Okay?

好的？

If you've ever looked at a crystal of any kind under a microscope or you've seen a picture of it, they are incredibly well organized.

如果您曾经在显微镜下观察过任何类型的晶体或看过它的照片，就会发现它们的组织非常好。

They form a lattice of very strong often, although there are weaker crystals too, very strong bonds and structure.

尽管也有较弱的晶体，但它们通常形成非常坚固的晶格，但键和结构非常坚固。

It's like the structure of a really well-formed building.

这就像一栋结构良好的建筑物的结构。

Okay?

好的？

Remineralization is the process of putting minerals back into that crystal structure, and it's actually possible to fill back in those cavities that bacteria have started to form, especially when those cavities have burrowed down into the enamel but have not yet made it into the dentin layer of the tooth or teeth.

再矿化是将矿物质放回到晶体结构中的过程，实际上可以填充细菌已经开始形成的那些空洞，特别是当这些空洞已经钻入牙釉质但尚未进入牙齿的牙本质层时。

Okay?

好的？

This is very important to understand and it's especially important to understand the context of the fact that typically, not always, but typically, if you have a cavity formed at one tooth, and let's say it's just halfway or three-quarters of the way through the enamel layer, that if you have cavities elsewhere in your mouth, chances are that they are at the same depth or level.

理解这一点非常重要，并且了解以下事实的背景尤其重要：通常，并非总是，但通常，如果您的一颗牙齿上形成了蛀牙，假设它只是牙釉质层的一半或四分之三，那么如果您口腔中的其他地方有蛀牙，它们很可能处于相同的深度或水平。

Not always, but chances are, and that's great news if those cavities have not yet made it into the dentin layer.

并非总是如此，但很有可能，如果这些蛀牙还没有进入牙本质层，那就是个好消息。

Why is it great news?

为什么这是个好消息？

Well, I don't know about you, but I don't like having my teeth drilled.

嗯，我不了解你，但我不喜欢钻牙。

I don't like having cavities drilled and filled.

I had a very traumatic childhood with respect to dentistry and oral health.

在牙科和口腔健康方面，我有一个非常痛苦的童年。

I'll talk about it a little bit later in the episode.

我将在本集中稍后讨论它。

It's not that I had tons and tons of cavities.

I actually had this other issue where my adult teeth came in behind my baby teeth.

事实上，我还有另一个问题，我的恒牙位于乳牙后面。

I had to have all my baby teeth pulled.

I had to get a bunch of injections of Novocaine in my mouth.

我不得不在嘴里注射大量奴佛卡因。

I didn't like getting injections into my mouth, so I opted to have any cavities I had drilled without Novocaine.

我不喜欢在嘴里注射，所以我选择在不使用奴佛卡因的情况下钻孔。

It's not because I was a tough little kid, although that definitely toughened me up.

这并不是因为我是一个坚强的小孩，尽管这确实让我变得坚强。

It was because I hated having syringes in my mouth.

这是因为我讨厌把注射器含在嘴里。

I might have even bitten a dentist or two or three.

我什至可能咬过一两三个牙医。

I don't bite the dentist anymore.

I thank the dentist.

我感谢牙医。

By the way, I think dentists are wonderful.

Regular cleanings are wonderful.

We'll talk about frequency of cleanings, but here's the point.

我们将讨论清洁的频率，但这就是重点。

If you are somebody who enjoys getting your teeth drilled, well, then, I don't know what to say.

如果你是一个喜欢钻牙的人，那么，我不知道该说什么。

But if you're like most people out there with proper wiring of your neurology, well, then you don't like getting your teeth drilled, and you can avoid it in many cases by remineralizing that enamel layer of your teeth.

但是，如果您像大多数人一样，神经系统正常，那么您不喜欢给牙齿钻孔，并且在许多情况下，您可以通过使牙齿的釉质层再矿化来避免这种情况。

Now, if there's demineralization down to the deeper dentin layers of the tooth, then most often you're going to need it to be drilled.

现在，如果脱矿质深入到牙齿的更深的牙本质层，那么大多数情况下您将需要对其进行钻孔。

Drilled and filled, as they say, or as some people say, which is a bit more cynical, "Drill, fill, and bill," because you get charged for that, or your insurance gets charged for that.

正如他们所说，或者像有些人所说的那样，“钻孔，填充，然后开具账单”，这有点愤世嫉俗，因为你会为此付费，或者你的保险会为此付费。

Okay, back to some tooth anatomy and mouth anatomy.

好吧，回到牙齿解剖学和口腔解剖学。

We talked about the enamel layer of the tooth on the outside.

我们讨论了牙齿外面的牙釉质层。

I told you that it either can demineralize, demin, or remineralize, remin.

我告诉过你，它要么可以脱矿质，demin，要么可以再矿化，remin。

This is a key point.

这是一个关键点。

Your teeth are always in a state of either demin or remin.

您的牙齿始终处于 demin 或 remin 状态。

That's right, either demin or remin.

It's not both at the same time.

It's one or the other, and it is largely dependent on the pH, that is the acidity of your mouth, which is largely dependent on how much saliva you're producing and the mineral content of that saliva.

两者择其一，很大程度上取决于 pH 值，即口腔的酸度，而 pH 值很大程度上取决于您产生的唾液量以及唾液中的矿物质含量。

Keep that in mind.

请记住这一点。

I think it's a very important point.

Now, another key point is that next to your teeth, right, you have your gums, the gingiva, as it's called.

现在，另一个关键点是，在你的牙齿旁边，对吧，你有牙龈，俗称牙龈。

Now, the gingiva provides a really important role in keeping the teeth stable.

现在，牙龈在保持牙齿稳定方面发挥着非常重要的作用。

We don't often think of it like that, but even though that stuff seems gummy and soft, it is soft tissue, it is very important for fixing the teeth to the bone.

我们通常不这么认为，但尽管那东西看起来又粘又软，但它是软组织，对于将牙齿固定在骨头上非常重要。

It's not just about the roots that extend down into the jawbone below.

这不仅仅是延伸到下面的颌骨的根部。

The gums are very important for keeping the teeth where they are.

牙龈对于保持牙齿的位置非常重要。

There's actually a little ligament, too, between gums and the teeth that resides a little bit deeper.

实际上，牙龈和牙齿之间也有一条稍微深一点的韧带。

But the gums form a critical barrier Between the oral cavity and the deeper layers of what eventually is bone and into the general blood flow or bloodstream of the body.

但牙龈在口腔和最终形成骨骼的深层之间以及进入身体的一般血流或血流之间形成了重要的屏障。

Now, this is so important to understand that the gums are a seal around the tooth.

现在，了解牙龈是牙齿周围的密封件非常重要。

This is why when you go to the dentist, they're paying attention with that little pick.

这就是为什么当你去看牙医时，他们会注意那个小镐。

They're paying attention to how high or hopefully low the tenting is, the little recesses or pockets of gums along the...

他们正在关注帐篷的高度或希望有多低，沿着牙龈的小凹处或口袋。

Here I go, yes, I have my tooth in my mouth.

Yes, I'll try not to do that during today's episode, point to my teeth so much so that you can't understand what I'm saying.

是的，在今天的节目中我会尽量不这样做，经常指着我的牙齿，这样你就听不懂我在说什么。

That the gums are providing a seal between the oral cavity and essentially the bone and the general bloodstream.

牙龈在口腔和骨骼以及一般血流之间提供密封。

Now, this is so critical because let's just take a step back and think about the oral cavity and what a remarkable place it is.

现在，这非常重要，因为让我们退一步想想口腔，它是一个多么了不起的地方。

Think about it.

想一想。

This is a gaping hole in our body.

Okay?

好的？

We have some other gaping holes in our body, but those tend to be sphincter-based holes.

我们的身体上还有一些其他的大洞，但这些洞往往是基于括约肌的洞。

Yes, I realize there are probably some chuckles as soon as you say sphincter.

是的，我意识到当你提到括约肌时可能会有一些笑声。

Like yes, the anal sphincter, okay, we're anatomists, we're biologists, we can talk about that, stays shut.

就像是的，肛门括约肌，好吧，我们是解剖学家，我们是生物学家，我们可以谈论这个，保持关闭。

Stuff is generally not going up there, and if it is, not very often.

一般情况下，那里不会有东西，即使有，也不会很频繁。

Okay?

好的？

Your nasal passages.

你的鼻腔。

Yeah, those are holes, but there's a lot of stuff there.

是的，这些都是洞，但里面有很多东西。

There's mucus to catch stuff.

There's a cribriform plate, there's a bone.

There's a bunch of things that act as barriers between the nasal cavities and the brain, which sits right behind it, the olfactory bulb.

有很多东西充当鼻腔和大脑（位于鼻腔后面的嗅球）之间的屏障。

And yes, we have eyes and then we have the outside of the eyes, and there's a susceptibility there, but we have our blink reflex.

是的，我们有眼睛，还有眼睛的外部，那里有敏感性，但我们有眨眼反射。

There's also an ocular microbiome.

There's a bunch of things there, but think about just this gaping hole in the front of our face that we use to eat and speak and breathe.

那里有很多东西，但想想我们脸上的这个大洞，我们用它来吃饭、说话和呼吸。

Okay?

好的？

It's a huge hole, and as a consequence, it's filled with bacteria from our outside environment all day long.

这是一个巨大的洞，因此，它整天都充满了来自我们外部环境的细菌。

All day long, sometimes at night, although we're going to talk later about the critical, critical need to be a nasal breather at night and not a mouth breather, not just for sake of staving off sleep apnea, but also because it turns out the dryness of the mouth is one of the ways that you really can throw off your oral health in major ways.

一整天，有时在晚上，尽管我们稍后会讨论晚上用鼻呼吸而不是用嘴呼吸的关键，这不仅仅是为了避免睡眠呼吸暂停，而且还因为事实证明，口腔干燥是真正会在很大程度上破坏口腔健康的原因之一。

In fact, it's one of the leading causes of tooth decay in people like methamphetamine addicts, or if you see people that are mouth breathers, their oral health and their teeth generally, but certainly their oral health is severely depleted.

事实上，它是甲基苯丙胺成瘾者等人蛀牙的主要原因之一，或者如果你看到那些用嘴呼吸的人，他们的口腔健康和牙齿总体而言，但可以肯定的是，他们的口腔健康状况严重恶化。

So you've got this big hole in your front of your face and you're talking and eating and moving about during the day, even if you're a nasal breather, when you're not talking or eating, and all this bacteria's getting in, and it's a really moist environment, and it's really warm.

所以你的脸上有一个大洞，白天你说话、吃饭、走动时，即使你用鼻呼吸，当你不说话或吃饭时，所有这些细菌都会进入，这是一个非常潮湿的环境，而且非常温暖。

So the combination of bacteria, moist, and warm means that this thing is like a Petri dish for growing stuff that could potentially be really bad for us.

因此，细菌、潮湿和温暖的结合意味着这个东西就像一个培养皿，用来种植可能对我们有害的物质。

But it has this incredible feature, which is that if the pH is right, then the bad stuff is killed off, doesn't make it into our system, doesn't disrupt our oral health or our bodily health.

但它有一个令人难以置信的功能，那就是如果 pH 值合适，那么有害物质就会被杀死，不会进入我们的系统，不会破坏我们的口腔健康或身体健康。

It also has a critical feature, which is that the bacteria that are good for us proliferate and supports the sealing process of the gums against the teeth and tooth health and tongue health and palate health, et cetera.

它还具有一个关键功能，即对我们有益的细菌会增殖并支持牙龈对牙齿和牙齿健康、舌头健康和上颚健康等的密封过程。

Okay?

好的？

So the oral cavity is amazing by virtue of how vulnerable it is, but also how robust it is, and the way it stays robust is by keeping the saliva healthy.

因此，口腔的神奇之处不仅在于它的脆弱性，还在于它的坚固性，而口腔保持坚固的方法就是保持唾液健康。

Now, there are other ways too, but that's one of the main ones, and it's a huge portal into the rest of the body.

现在，还有其他方法，但这是主要方法之一，它是进入身体其他部位的巨大门户。

And if the oral cavity isn't amazing to you already based on what you've heard thus far, think about this.

如果根据您迄今为止所听到的内容，口腔对您来说并不令人惊奇，请考虑一下。

If you get a cut on your arm or your hand or your shin, unless you're one of these remarkable people that always heals up without a scar, as long as you're about 25 years or older, typically you'll form a little bit of scar.

如果你的手臂、手或胫骨被割伤，除非你是那些总是能痊愈而没有疤痕的杰出人士之一，否则只要你大约 25 岁或以上，通常都会形成一点疤痕。

There'll be something noticeable there.

那里会有一些值得注意的东西。

The oral cavity also can take cuts and burns and things like that, unfortunately, those things occur, but with rare exception, heals up with nearly zero scarring.

口腔也会遭受割伤和烧伤之类的事情，不幸的是，这些事情会发生，但除了极少数例外，愈合后疤痕几乎为零。

Sometimes there's a scar, but nearly zero scarring, which is remarkable.

有时会有疤痕，但几乎为零疤痕，这是很了不起的。

Why?

为什么？

Well, it's basically an open wound with a bunch of bacteria in it and it's warm and it's moist.

嗯，它基本上是一个开放性伤口，里面有一堆细菌，而且又热又湿。

So clearly there's something special going on in this thing that we call the oral cavity, and indeed there is.

很明显，我们称之为口腔的东西正在发生一些特殊的事情，而且确实存在。

And it's anchored in the fact that if we treat it right, you can encourage remineralization.

它基于这样一个事实：如果我们正确对待它，就可以促进再矿化。

How do you do that?

你是怎么做到的？

By keeping the saliva healthy.

通过保持唾液健康。

How do you do that?

你是怎么做到的？

By supporting the proper bacteria within the mouth and making sure that you're eliminating the bacteria that you don't want, or at least limiting those bacteria, and today we're going to talk about how to do that.

通过支持口腔内适当的细菌并确保消除不需要的细菌，或者至少限制这些细菌，今天我们将讨论如何做到这一点。

And by virtue of doing all the things that support tooth health, you're also going to support gum health.

通过采取所有支持牙齿健康的措施，您也将支持牙龈健康。

Okay?

好的？

Those gums are critical because they form that barrier that if it gets too big, if those pockets, those recesses get too big and you're not taking care of the bacteria in your mouth, meaning you're not getting rid of the bad bacteria, those bacteria worm their way down into the deeper recesses near the roots of the tooth, sometimes into the tooth, we'll talk about that, and can get down into the bone and then can cause serious, serious issues.

这些牙龈很重要，因为它们形成了屏障，如果它变得太大，如果那些口袋、那些凹处变得太大，而你没有照顾到口腔中的细菌，这意味着你没有清除坏细菌，这些细菌会蠕动到牙根附近的更深的凹处，有时进入牙齿，我们会谈论这个，并且可以深入到骨头，然后可能导致严重的问题。

This is so-called periodontal disease, and periodontal disease is associated with all sorts of really bad stuff, including Alzheimer's.

这就是所谓的牙周病，牙周病与各种非常糟糕的疾病有关，包括阿尔茨海默病。

Okay?

好的？

This is not just some wellness culture, woo-science leap to Alzheimer's.

这不仅仅是一些健康文化，也是对阿尔茨海默氏症的科学飞跃。

There's literally evidence that the specific bacterias that cause recession of the gums can cross the blood-brain barrier if they make it into the general circulation and potentially cause plaques and tangles, some of the hallmark features of neural degeneration in Alzheimer's, okay?

确实有证据表明，导致牙龈萎缩的特定细菌如果进入全身循环，就可以穿过血脑屏障，并可能导致斑块和缠结，这是阿尔茨海默氏症神经退化的一些标志性特征，好吗？

Probably not the only cause of Alzheimer's, but potentially one of the major causes.

可能不是阿尔茨海默病的唯一原因，但可能是主要原因之一。

This is a new theory, but it's one that a lot of people are starting to pay attention to, and it's also very clear that bacteria make it down into these deeper recesses near the roots and into the bone that you can end up with issues related to cardiac health and certainly metabolic health.

这是一个新理论，但很多人都开始关注这一理论，而且很明显，细菌会进入根部附近的更深的凹处并进入骨骼，最终可能会导致与心脏健康和新陈代谢健康相关的问题。

Okay?

好的？

So again, the goal today is not to scare you.

再说一遍，今天的目标不是吓唬你。

It's not to spend too much time on all the terrible things that can happen, but rather to emphasize the positive, which is that if you do the right things at the right times, especially if you do them on a regular basis, that you can really improve the health of your total oral cavity and your teeth and your breath and all the other stuff that people care about for aesthetics and interpersonal interactions will flourish as well.

这并不是要花太多时间在所有可能发生的可怕事情上，而是要强调积极的一面，那就是，如果你在正确的时间做正确的事情，特别是如果你定期这样做，你就可以真正改善整个口腔、牙齿和呼吸的健康，以及人们关心的美学和人际互动的所有其他东西也会蓬勃发展。

There is so much NFL on ESPN right now Monday Night Football, plus pre-game and post-game.

ESPN 上现在有很多 NFL 周一橄榄球之夜节目，以及赛前和赛后节目。

NFL Live, NFL Prime Time.

NFL 直播，NFL 黄金时间。

Everything you need to stay on top of every game, every week.

每周掌握每场比赛所需的一切。

Unbelievable.

难以置信。

And now NFL Network is on the ESPN app.

现在 NFL Network 已登陆 ESPN 应用程序。

More football, more coverage, more ways to watch.

更多足球比赛、更多报道、更多观看方式。

Football's on all season long on ESPN and streaming on the ESPN app.

ESPN 提供整个赛季的足球赛事直播，并通过 ESPN 应用程序进行直播。

Well, okay.

好吧，好吧。

Let's talk about how cavities form, because I think this is the major question that people ask when asking about or thinking about oral health.

让我们谈谈蛀牙是如何形成的，因为我认为这是人们在询问或思考口腔健康时提出的主要问题。

As I mentioned before, cavities are literally holes.

正如我之前提到的，空腔实际上就是孔。

They're fenestrations, as the nerds call them, nerds like me call them.

它们是开窗，书呆子们这样称呼它们，像我这样的书呆子这样称呼它们。

Little fenestrations, little holes down into the enamel that if they make it down to the dentin layer of the tooth, most likely do need to be drilled and filled and presumably build.

牙釉质上的小窗、小孔，如果它们深入到牙齿的牙本质层，很可能需要钻孔、填充，并且可能需要建造。

Okay?

好的？

But your goal, I think all of our goal, is to try and keep our teeth in a state of remineralization by keeping the pH, that is the relative acid-alkaline balance of the mouth, such that the saliva supports remineralization.

但你的目标，我认为我们所有的目标，都是通过保持 pH 值（即口腔的相对酸碱平衡）来尝试使我们的牙齿保持在再矿化状态，以便唾液支持再矿化。

Now, let's think about how a cavity actually forms.

现在，让我们考虑一下空腔实际上是如何形成的。

Turns out that no specific food, not even sugar, causes cavities.

事实证明，没有任何特定的食物，甚至糖，都会导致蛀牙。

Cavities are not caused by sugar.

蛀牙不是由糖引起的。

Cavities are caused by bacteria that feed on sugar.

蛀牙是由以糖为食的细菌引起的。

And now that's not just a little bit of a twist in the mechanism, that's a critical point.

现在这不仅仅是机制上的一点点扭曲，这是一个关键点。

There's no specific food, not even pure sugar, not even like a hard candy, like a delicious Jolly Rancher, I used to like those when I was a kid, that gets stuck in your tooth that causes cavities.

没有特定的食物，甚至没有纯糖，甚至不像硬糖，比如美味的 Jolly Rancher，我小时候曾经喜欢那些，它会卡在你的牙齿上，导致蛀牙。

No. It's the bacteria that feed on sugar, that then produce acid, that burrows down through, that degrades, that demineralizes the tooth in this very focal area that we call a cavity.

不是。细菌以糖为食，然后产生酸，向下钻入，降解牙齿，使牙齿在这个我们称为蛀牙的非常集中的区域脱矿质。

Okay?

好的？

Now, if that isn't surprising enough, get this.

现在，如果这还不够令人惊讶，那就看这个。

The bacteria that causes cavities by eating sugar and releasing this acid, while there are several of them, the major one is called Streptococcus mutans, or what I'll call Strep mutans for short.

通过吃糖并释放这种酸而引起蛀牙的细菌，虽然有几种，但主要的一种称为变形链球菌，或者我简称为变形链球菌。

Strep mutans is not something you're born with.

变形链球菌并不是与生俱来的。

It's actually a communicable bacteria.

它实际上是一种传染性细菌。

That's right, you give it to one another.

没错，你就给了对方。

Through how?

通过什么方式？

Sharing of glasses, sharing of bottles, kissing on the mouth, et cetera.

共用玻璃杯、共用瓶子、亲吻嘴等等。

Now, I am not here to tell you not to do any of those things.

现在，我来这里并不是要告诉你不要做任何这些事情。

I'm certainly not here to tell you that.

我当然不是来告诉你这些的。

However, and by the way, in researching this episode, I did learn that there is a specific category of person out there, typically they are a dentist or married to a dentist, that have opted, believe it or not, to never kiss their children near or on the mouth so as to help their children not get Streptococcus mutans, because almost all adults carry it.

然而，顺便说一句，在研究这一集的过程中，我确实了解到有一类特定的人，通常是牙医或与牙医结婚的人，不管你信不信，他们选择永远不会亲吻孩子的嘴附近或嘴上，以帮助他们的孩子不感染变形链球菌，因为几乎所有成年人都携带这种病毒。

Not all, but it's communicable, like a STI or like a flu or like a cold.

不是全部，但它是传染性的，就像性传播感染、流感或感冒一样。

It's communicated between individuals.

它是在个人之间进行交流的。

We are not born with it.

我们并非与生俱来。

Now, that's a whole area of, let's just call it biosocial ethics decision-making that I think most people are not going to be too concerned with, or at least act on, because let's face it, most people are not going to change their overall behavior of kissing or usage of bottles or glasses in order to avoid getting Strep mutans.

现在，这就是生物社会伦理决策的整个领域，我认为大多数人不会太关心，或者至少不会采取行动，因为让我们面对现实，大多数人不会为了避免感染变形链球菌而改变他们接吻或使用瓶子或玻璃杯的整体行为。

Most people in the world have Strep mutans or will get Strep mutans, and it lives in the mouth.

世界上大多数人都患有或将会感染变形链球菌，并且它生活在口腔中。

Okay?

好的？

It just resides there.

它就驻留在那儿。

Strep mutans is there, and it's hungry.

变形链球菌就在那里，而且它很饿。

What's it hungry for?

它饿什么？

Sugar.

糖。

When there's sugar present, it eats it, it produces acid, the acid produces cavities.

当有糖存在时，它会吃掉糖，产生酸，酸会产生蛀牙。

Taking teeth from a state of remineralization to demineralization, or, and by the way, this is really important, if your mouth is already in a state that's more demineralization mode, so to speak, well, then it will capitalize on that, and it will cause cavities much faster.

将牙齿从再矿化状态转变为脱矿质状态，或者，顺便说一句，这非常重要，如果您的口腔已经处于脱矿质模式的状态，那么可以说，那么它将利用这一点，并且会更快地导致蛀牙。

Okay?

好的？

So keep in mind that acidity is bad for the mouth.

因此请记住，酸性对口腔有害。

Does that mean that you should never consume a lemon or, and by the way, yes, I'm guilty of every once in a while I'll chew a lemon slice, or drinking water with lemon in it, or carbonated drinks, or sodas, or tea, or anything that has acidic flavor?

这是否意味着你永远不应该吃柠檬，或者，顺便说一句，是的，我时不时地咀嚼柠檬片，或者喝含柠檬的水，或者碳酸饮料，或者苏打水，或者茶，或者任何有酸性味道的东西，我感到内疚？

No. Likewise, should you completely avoid ingesting any kind of sugar because Strep mutans love sugar?

不。同样，您是否应该完全避免摄入任何类型的糖，因为变形链球菌喜欢糖？

No. Turns out Strep mutans like sugars in the form of complex carbohydrate sugars, too.

事实证明，变形链球菌也喜欢复合碳水化合物形式的糖。

So if you eat pasta or rice or oatmeal and some bread every once in a while, as I do, I'm an omnivore.

因此，如果你像我一样偶尔吃意大利面、米饭或燕麦片和一些面包，那么我就是杂食动物。

I eat meat and fish and eggs and also starches and vegetables and fruits.

我吃肉、鱼、蛋、淀粉、蔬菜和水果。

I'm an omnivore, as most people are.

我和大多数人一样是杂食动物。

Well, then Strep mutans has an opportunity to eat the sugars that come from those other carbohydrates.

那么，变形链球菌就有机会吃掉来自其他碳水化合物的糖。

Does that mean that if you were to have a zero carbohydrate diet, no sugars, no starches, et cetera, you would reduce the opportunity for Strep mutans to consume sugar and release acid?

这是否意味着，如果您实行零碳水化合物饮食，不含糖、不含淀粉等，就会减少变形链球菌消耗糖和释放酸的机会？

Maybe.

或许。

Maybe.

或许。

However, most people won't do that, and Strep mutans is a very clever, maybe even diabolical bacteria.

然而，大多数人不会这样做，而变形链球菌是一种非常聪明，甚至可能是邪恶的细菌。

And if you are on a zero carbohydrate, zero sugar diet, there's some evidence that Strep mutans will figure out ways to feed on other components of food in order to create this acid to then create cavities in your teeth.

如果您采用零碳水化合物、零糖饮食，有一些证据表明变形链球菌会找到以食物的其他成分为食的方法，以产生这种酸，然后在您的牙齿上产生蛀牙。

So the key thing to understand here is that cavities form not from foods, not from sugars per se, but from Strep mutans and other bacteria that eat those sugars and create acid.

因此，这里要理解的关键是，蛀牙不是由食物形成的，也不是由糖本身形成的，而是由变形链球菌和其他吃掉这些糖并产生酸的细菌形成的。

Hence, the critical need to keep your mouth as alkaline as possible, which does not mean that you can never drink some lemon water or coffee or tea.

因此，保持口腔尽可能呈碱性至关重要，但这并不意味着您永远不能喝柠檬水、咖啡或茶。

Here's the key point that everyone needs to remember because this dovetails beautifully into how often you should brush and floss, and when you should brush and floss specifically.

这是每个人都需要记住的关键点，因为这与您应该刷牙和使用牙线的频率以及具体何时刷牙和使用牙线完美吻合。

The key point is the degree to which your mouth is in a demin state or a remin state, and the degree to which cavities have the opportunity to form is dependent on the amount of time, the amount of time in which your mouth is net acidic or net alkaline.

The amount of time that you are in a demineralization mode or remineralization mode.

您处于脱矿质模式或再矿化模式的时间。

Okay, so it's the amount of time.

好吧，那就是时间了。

No one can avoid having their mouth be acidic every once in a while or ingesting a sugar or a food that Strep mutans can feed on and produce acid.

没有人能够避免口腔时不时地呈酸性，或者摄入一种糖或一种变形链球菌可以进食并产生酸的食物。

The key is to try and reduce the amount of Strep mutans and reduce the amount of acid in the mouth.

关键是要设法减少变形链球菌的数量并减少口腔中的酸量。

That's the best way to reduce cavities and even reverse cavities that have started to form.

这是减少蛀牙甚至逆转已经开始形成的蛀牙的最佳方法。

Now, in a moment, I'm going to tell you about fluoride, because I know there are a lot of questions about fluoride.

现在，稍后我将向您介绍氟化物，因为我知道有很多关于氟化物的问题。

But in order for you to understand what I say about fluoride and to make the best decision about fluoride, both in drinking water and toothpaste, et cetera, for you, you have to understand the remineralization process just a little bit.

So a little bit of chemistry here, a little bit of structural biology, and this will be fun.

所以这里有一点化学，一点结构生物学，这会很有趣。

I promise, even if you know no biology, no structural biology, no chemistry, you're going to like this part, and it's very simple.

我保证，即使你不懂生物学、结构生物学、化学，你也会喜欢这一部分，而且它非常简单。

Those minerals that form the crystals within the enamel and some of the deeper layers of your tooth, or teeth rather, those crystals form through a specific type of bond, and those bonds are very strong.

那些在牙釉质和牙齿或牙齿更深层内形成晶体的矿物质，这些晶体通过特定类型的键形成，并且这些键非常牢固。

Think of them like Lego chains.

把它们想象成乐高链条。

But these are not just conventional Lego chains.

但这些不仅仅是传统的乐高连锁店。

These are Lego chains that when they stick, when two pieces come together, things are tough to pull apart.

这些是乐高链条，当它们粘在一起时，当两块拼在一起时，很难分开。

They're not indestructible, but they're tough to pull apart.

它们并非坚不可摧，但很难拆开。

And they're also special because unlike a string of Legos, like a single string of Legos, these bonds that form during remineralization of the teeth are interdigitated with one another, or rather, are at angles with one another that make those bonds especially strong.

Any architect or somebody that understands structural biology will understand that bonds can be weak or strong, depending on whether or not they're linear, whether or not they're crossed, whether or not they're in lattices.

There's a whole bunch of interesting angled forces stuff that the architects will understand and the construction workers will understand at a very intuitive and concrete level, no pun intended, and on and on.

有一大堆有趣的角度力的东西，建筑师会理解，建筑工人也会在非常直观和具体的层面上理解，没有双关语，等等。

But just think about it.

但想想吧。

A bond is only as strong as the number of different points at which it can resist shearing and pressure.

粘合的强度取决于其能够抵抗剪切和压力的不同点的数量。

So the way that these remineralization bonds form is through the addition of specific minerals at specific angles, and the naturally occurring mineral that's responsible for the majority of these bonds in the enamel and teeth is called hydroxyapatite.

因此，这些再矿化键的形成方式是通过以特定角度添加特定矿物质，而在牙釉质和牙齿中形成大部分这些键的天然矿物质称为羟基磷灰石。

What a great name if you're talking about oral health, right?

如果你谈论的是口腔健康，这个名字多棒啊，对吧？

Because we use the mouth for a lot of things.

因为我们用嘴来做很多事情。

You can think of the small list or long list of those things.

你可以想出这些事情的小清单或长清单。

There are many of them, depending on who you are and what you like to do with your mouth.

它们有很多，取决于你是谁以及你喜欢用嘴做什么。

But the point being that we do indeed eat with our mouth.

但重点是我们确实是用嘴吃饭的。

Appetite is part of eating, so you just remember hydroxyapatite bonds, and they are very strong, but they're not indestructible.

食欲是饮食的一部分，所以你只要记住羟基磷灰石键，它们非常坚固，但它们并不是坚不可摧的。

Acid can actually break those bonds.

酸实际上可以破坏这些键。

Okay?

好的？

That's the demineralization process.

这就是脱矿质过程。

Now, fluoride is a substance that is not a vitamin, it's not a mineral, it is not an essential nutrient, but that in the last century, it was discovered, can actually replace some of the hydroxyapatite bonds in teeth and actually make those bonds hyper strong, super physiologically strong.

Now, we'll talk about the safety considerations with fluoride in a little bit because there are some safety considerations.

现在，我们将稍微讨论一下氟化物的安全注意事项，因为有一些安全注意事项。

But it was decided en masse in the United States and Europe that the addition of fluoride to the drinking water and to many toothpastes or tooth powders would be useful because it creates these super physiologically strong bonds within the minerals of the teeth.

但美国和欧洲一致认为，在饮用水和许多牙膏或牙粉中添加氟化物是有用的，因为它可以在牙齿的矿物质中产生超强的生理结合。

And indeed, it does.

确实如此。

Fluoride gets between those Lego pieces and makes them extra, extra strong, and this is why fluoride is added to the drinking water.

氟化物进入这些乐高积木之间，使它们变得非常非常坚固，这就是饮用水中添加氟化物的原因。

But, and this is very important to emphasize, but nowadays, there's a really polarized debate about fluoride because some people out there believe that fluoride can disrupt thyroid health, might even be disruptive for brain health.

Certainly, if fluoride levels are too high in drinking water or any substance, it can be very dangerous.

当然，如果饮用水或任何物质中的氟化物含量过高，则可能非常危险。

It can be a poison, but of course, the dose makes the poison, right?

它可能是一种毒药，但当然，剂量就是毒药，对吗？

Fluoride itself may not be poisonous at very low levels, but there are really two camps now that have formed, and I'll just illustrate those two camps by virtue of what's happening right now.

氟化物本身在很低的水平下可能没有毒，但现在确实已经形成了两个阵营，我将通过现在发生的事情来说明这两个阵营。

Right now in the state of California, there is a major lawsuit against the government because people want fluoride removed from the drinking water because of the long list of bad things that excessive, I want to highlight excessive fluoride can do for bodily and brain health, especially in kids, but also in adults.

At the very same time, meaning right now, there is also a major lawsuit, this one in Buffalo, New York, from mostly parents who are suing the city of Buffalo, saying that there was not enough, maybe even zero fluoride in the drinking water for some period of time, and as a consequence, their children's teeth or oral health or both is depleted, and they are suing for damages.

Okay, so this is a really polarized camp.

好吧，这是一个两极分化的阵营。

Now, I did a full episode of "The Huberman Lab Podcast" all about water, and I talked about fluoride levels, which levels are thought by the CDC to be safe, which levels are not thought to be safe.

现在，我做了一整集关于水的“胡伯曼实验室播客”，我谈到了氟化物水平，疾病预防控制中心认为哪个水平是安全的，哪个水平被认为是不安全的。

I talked about some of the theories as to how fluoride might disrupt function of the thyroid and some considerations there.

我谈到了一些关于氟化物如何破坏甲状腺功能的理论以及一些注意事项。

Please check out the timestamp in that episode.

请查看该集的时间戳。

I linked to that timestamp in the caption for this episode.

我在本集的标题中链接到了该时间戳。

But the important point here is that if you are at all concerned about fluoride in the drinking water, the simple answer is to just filter the water that comes out of the tap.

If you're concerned about fluoride, then I suppose you'd probably want to avoid toothpastes that have fluoride.

如果您担心氟化物，那么我想您可能会想要避免使用含有氟化物的牙膏。

Indeed, there are some.

确实，有一些。

I will provide links to some of those in the show note captions for this episode.

我将在本集的节目注释标题中提供其中一些内容的链接。

There are a variety of these zero fluoride toothpastes that have started to accumulate.

有各种各样的零氟牙膏已经开始积累。

But keep in mind that when fluoride is introduced into the bonds of the minerals of the teeth, they do make the teeth really, really strong.

但请记住，当氟化物被引入牙齿矿物质的结合中时，它们确实会使牙齿变得非常非常坚固。

But, and all the dentists I spoke to emphasize this point, the bonds that form are not the natural bonds.

但是，我采访过的所有牙医都强调这一点，形成的纽带并不是天然的纽带。

Now, the fact that they're not the natural bonds doesn't necessarily mean that they aren't good for us or that they're bad for us, but the bonds that form when viewed under what's called electron microscopy look different.

They look wavy.

它们看起来呈波浪状。

They're not smooth bonds, and they do increase the So resistance to different forces, including cavities or acid that would create cavities, to be specific.

They make the teeth stronger structurally, so resistance to chipping, et cetera.

它们使牙齿结构更坚固，从而抵抗碎裂等。

But there is a growing concern about excessive fluoride, which by the way, if you drink a lot of tap water, you're going to be exposed to more fluoride than if you drink less tap water.

That just kind of stands to reason, but people don't really talk about this, right?

这是有道理的，但人们并没有真正谈论这个，对吗？

When you talk about X amount of fluoride by concentration in a given liter of water or gallon of water, you also have to ask, well, how much tap water are you drinking every day?

Okay, you have to ask that question, right?

好吧，你一定要问这个问题，对吧？

It's not simply the concentration, it's how much you're ingesting overall.

这不仅仅是浓度，而是您整体摄入的量。

And that's something that's much harder to control for.

这是更难控制的事情。

Again, in the water episode, I talk about ways to eliminate or reduce fluoride in the drinking water if that's a concern of yours.

再次，在水这一集中，如果您担心的话，我将讨论消除或减少饮用水中氟化物的方法。

But if you want to know why there's fluoride in drinking water, it's because governments figured out, hey, well, if we want to reduce tooth decay, what's the simplest low-cost method to do that?

Well, it's to put fluoride in the drinking water.

嗯，就是在饮用水中添加氟化物。

And you now also now know why there's fluoride in a lot of toothpaste.

现在您也知道为什么很多牙膏中都含有氟化物了。

But given the concerns about thyroid health, potential concerns about brain health, now you also know why many people, including some dentists that I spoke to, are not big fans of fluoride, both for children and for adults.

但考虑到对甲状腺健康的担忧，对大脑健康的潜在担忧，现在你也知道为什么很多人，包括我采访过的一些牙医，都不热衷于氟化物，无论是对于儿童还是成人。

So you just have to make a decision for you.

所以你只需要为你做出决定。

I'm not here to tell you what to do.

我来这里不是为了告诉你该怎么做。

You just have to decide, are you pro, neutral, or against fluoride in your drinking water?

您只需决定，您是支持、中立还是反对饮用水中添加氟化物？

And if so, are you going to filter?

如果是这样，你会过滤吗？

Are you going to completely avoid drinking any water, maybe even cooking with any water from the tap?

您是否打算完全避免喝任何水，甚至不使用水龙头里的水做饭？

And on and on.

不断地。

But now you know why fluoride is in drinking water and fluoride is in toothpaste.

但现在您知道为什么饮用水中含有氟化物、牙膏中含有氟化物了。

If you're somebody who's concerned about fluoride in either or both of those sources, well then what you really want to think about, and what most of us probably should be thinking about anyway, is trying to increase the remineralization state of our teeth and mouth in ways that don't create the opportunity for any other health hazard.

And I will say this as well, which is that there's some data, not a lot, but some data that fluoride might not be so great for our oral microbiome.

And as we'll soon learn, the oral microbiome is critical for our oral and overall health.

我们很快就会了解到，口腔微生物组对于我们的口腔和整体健康至关重要。

So in a moment, we are going to get into what to do, the to-dos, the behavioral to-dos, and some of the other to-dos for trying to keep your mouth in the best possible remineralization state, the best pH for tooth health, for gum health, for avoiding periodontal disease, maybe even for reversing some aspects of tooth and periodontal sickness, because indeed, you can do that if you shift your mouth to the correct pH, if you're putting it into that remineralization mode.

因此，一会儿，我们将讨论要做什么、待办事项、行为待办事项以及其他一些待办事项，以努力使您的口腔保持在最佳的再矿化状态，牙齿健康、牙龈健康、避免牙周病的最佳 pH 值，甚至可能扭转牙齿和牙周病的某些方面，因为事实上，如果您将口腔调整到正确的 pH 值，如果您将其置于再矿化状态，您就可以做到这一点模式。

Okay?

好的？

However, before we get into the to-dos, I think it's very important to discuss the do nots that every dentist and periodontist I spoke to agreed on.

然而，在我们讨论待办事项之前，我认为讨论与我交谈过的每位牙医和牙周病医生都同意的不该做的事情非常重要。

The quick list, as I'll call it, of bad for your teeth, bad for your mouth, and therefore bad for your brain and body, are, not surprisingly perhaps, alcohol.

正如我所说，对牙齿、口腔、大脑和身体有害的快速清单，毫无疑问就是酒精。

Which, by the way, I did an entire episode about alcohol.

顺便说一下，我制作了一整集关于酒精的内容。

It's one of our more popular episodes.

这是我们最受欢迎的剧集之一。

I'm not here to tell you to never drink if you're an adult who's non-alcoholic, but the cutoff seems to be two alcohol-based drinks per week, beyond which you run into trouble.

我并不是在这里告诉你，如果你是一个不酗酒的成年人，就永远不要喝酒，但界限似乎是每周喝两杯含酒精的饮料，超过这个限度你就会遇到麻烦。

And yes, zero is better than any.

是的，零比任何都好。

But here when we say alcohol is not good for oral health and for tooth health, what we're talking about is the disruption that alcohol creates to the microbiome and the way that it alters the pH of your saliva and places the mouth and the teeth into a demineralization state.

但在这里，当我们说酒精对口腔健康和牙齿健康不利时，我们谈论的是酒精对微生物群造成的破坏，以及它改变唾液 pH 值并使口腔和牙齿进入脱矿质状态的方式。

That's very clear.

这非常清楚。

It also kills certain cells of the mouth.

它还会杀死口腔的某些细胞。

Some people, I remember this in college, would say, "Oh, if you've got a scratch in the back of your throat, you're getting sick, you should drink."

我记得在大学时，有些人会说：“哦，如果你喉咙后面有划痕，那么你生病了，你应该喝酒。”

Right?

正确的？

And that's what they said.

他们就是这么说的。

"You should drink.

“你应该喝酒。

It's going to kill that thing off." Well, guess what?

它会杀死那个东西。”嗯，你猜怎么着？

It does the exact opposite.

它的作用恰恰相反。

It kills off a bunch of things that you want, like the cells in and around the mucosal layer of the mouth that are actually going to provide immune support and eliminate those bacteria or viruses that are making you sick, et cetera.

它会杀死一些你想要的东西，比如口腔粘膜层内部和周围的细胞，这些细胞实际上会提供免疫支持并消除那些让你生病的细菌或病毒，等等。

So alcohol is bad.

所以酒精是不好的。

I'm not saying you shouldn't drink at all.

我并不是说你根本不应该喝酒。

If you're a non-alcoholic adult, you have to decide for you.

如果您是一个不酗酒的成年人，您必须为自己做出决定。

But just understand that if you're drinking alcohol, that you want to pay extra attention to your oral health and your tooth care practices, especially on the days around that alcohol consumption.

但只要明白，如果您正在喝酒，您需要格外注意您的口腔健康和牙齿护理习惯，尤其是在饮酒前后的日子。

And if you're somebody who doesn't want to drink alcohol, now you have yet another reason to not drink alcohol.

如果你是一个不想喝酒的人，现在你又有了一个不喝酒的理由。

The second thing on the no-fly list or the not good for us list for sake of oral health are stimulants.

出于口腔健康考虑，禁飞清单或对我们不利清单上的第二件事是兴奋剂。

Now, of course, things like methamphetamine, which are severely deleterious, addictive drugs for all sorts of reasons.

现在，当然，像甲基苯丙胺这样的东西，由于各种原因，它们是严重有害的、令人上瘾的药物。

They kill dopaminergic and other brain neurons.

它们杀死多巴胺能神经元和其他脑神经元。

They are highly addictive, and on and on.

它们非常容易上瘾，而且会不断上瘾。

But also stimulants like Adderall, Vyvanse, et cetera.

还有兴奋剂，如 Adderall、Vyvanse 等。

Those stimulants, basically any drug that increases epinephrine and norepinephrine, so-called adrenaline and noradrenaline are the other names for those, are going to have a negative effect on oral health.

这些兴奋剂，基本上是任何增加肾上腺素和去甲肾上腺素的药物，所谓的肾上腺素和去甲肾上腺素是这些药物的别称，都会对口腔健康产生负面影响。

Does that mean you should stop those medications if you've been prescribed them?

这是否意味着如果您服用了这些药物，您应该停止服用这些药物？

No. It means that you should do some other things to try and offset the negative consequence of stimulants.

不。这意味着您应该做一些其他事情来尝试抵消兴奋剂的负面后果。

Why would stimulants cause such disruption in oral health?

为什么兴奋剂会对口腔健康造成如此大的破坏？

Well, there are really two reasons.

嗯，确实有两个原因。

There's a chemical reason and there's a mechanical reason.

有化学原因，也有机械原因。

The chemical reason is that stimulants change the pH of your saliva, making the mouth more acidic, which makes strep mutans and other bacteria more capable of creating cavities down into the teeth.

化学原因是兴奋剂会改变唾液的 pH 值，使口腔变得更加酸性，从而使变形链球菌和其他细菌更容易在牙齿中产生蛀牙。

They take your mouth and your teeth from that remineralization state, or as I've been referring to it, mode, to that demineralization, demin mode.

它们使你的口腔和牙齿脱离再矿化状态，或者正如我所说的，脱矿质模式。

Demon mode.

恶魔模式。

That's a way to remember it's bad.

这是一种记住它很糟糕的方式。

Demon mode.

恶魔模式。

Demon mode, not good.

恶魔模式，不好。

Maybe in a video game demon mode is good.

也许在电子游戏中恶魔模式是好的。

Demon mode not good for the mouth.

恶魔模式对嘴不好。

Demin mode, demineralization mode.

Demin 模式，脱矿质模式。

So there's a chemical reason why stimulants disrupt the oral health milieu and cause disruption in tooth health and degradation, demin, of the enamel of the teeth and deeper layers of the teeth.

因此，兴奋剂会破坏口腔健康环境，导致牙齿健康受损，并导致牙釉质和牙齿深层退化、脱釉，这是有化学原因的。

And this is Profoundly evident in meth addicts.

这在冰毒成瘾者身上表现得非常明显。

But the other reason, and this was a reason that was shared with me by a physician, an MD from University of California, San Francisco, who interacts by virtue of his profession with a lot of methamphetamine addicts who have terrible teeth, is that stimulants encourage mouth breathing.

但另一个原因是，兴奋剂会促进口呼吸，这是一位来自旧金山加利福尼亚大学的医学博士与我接触的原因，他凭借自己的职业与许多牙齿很糟糕的甲基苯丙胺成瘾者进行了互动。

Watch a meth addict or watch somebody who's on a high dose of stimulants, and they tend to mouth breathe because of the shifts in autonomic nervous system function, they tend to be mouth breathers.

观察冰毒成瘾者或服用高剂量兴奋剂的人，由于自主神经系统功能的变化，他们往往会用嘴呼吸，他们往往会用嘴呼吸。

So it's the drying of the mouth that also shifts the mouth from that remineralization mode to demineralization mode.

因此，口腔干燥也会将口腔从再矿化模式转变为脱矿质模式。

So if you do take stimulants by prescription, I would hope not methamphetamine or illicit drugs, but if you take prescription stimulants, and by the way, things like Wellbutrin, modafinil, they do qualify as stimulants, even though modafinil is a little bit of a special case.

因此，如果您确实通过处方服用兴奋剂，我希望不是甲基苯丙胺或非法药物，但如果您服用处方兴奋剂，顺便说一下，像维布特林、莫达非尼这样的东西，它们确实符合兴奋剂的资格，尽管莫达非尼有点特殊。

Any drug that increases norepinephrine, epinephrine, any stimulant, and yes, indeed, coffee, we'll talk about coffee as well, and tea, will make the saliva more acidic and make your oral health potentially less good.

任何增加去甲肾上腺素、肾上腺素、任何兴奋剂的药物，是的，确实还有咖啡，我们也会谈论咖啡和茶，都会使唾液变得更酸，使您的口腔健康可能变得不太好。

Mouth breathing, bad for oral health, bad for teeth, bad, bad, bad.

用嘴呼吸，对口腔健康不利，对牙齿不利，不好，不好，不好。

There's just no question about it.

毫无疑问。

So today's discussion, I'm calling oral health, but that includes oral airway health.

所以今天的讨论，我称之为口腔健康，但这包括口腔气道健康。

And I've talked before on this podcast about the fact that if you can be a nasal breather, be a nasal breather, please.

我之前在这个播客上谈到过这样一个事实：如果你可以用鼻呼吸，那就请用鼻呼吸。

As long as you're not speaking, as long as you're not eating, try and breathe through your nose.

只要你不说话，只要你不吃东西，就尝试用鼻子呼吸。

If you're exercising and exercising really hard, like you're running really hard, fine, mouth breathe.

如果你正在锻炼并且非常努力地锻炼，就像你非常努力地跑步一样，好吧，用嘴呼吸。

I don't think there's any evidence that staying in nasal breathing mode all the time while exercising is best for performance.

我认为没有任何证据表明锻炼时始终保持鼻呼吸模式对表现最好。

In fact, to the contrary, there are times when you need to mouth breathe, and there are sports where you need to exhale through the mouth, specifically certain martial arts, for instance.

事实上，恰恰相反，有时你需要用嘴呼吸，有些运动需要用嘴呼气，例如某些武术。

So not saying don't ever breathe through your mouth, but as much as possible, try and keep the oral cavity moist and closed.

因此，并不是说不要用嘴呼吸，而是尽可能保持口腔湿润和封闭。

This is critical.

这很关键。

So stimulants dry out the mouth, they increase the acidity of the saliva.

因此，兴奋剂会使口腔干燥，并增加唾液的酸度。

That's bad.

那很糟糕。

Smoking cigarettes and yes, also cannabis, and yes, vaping does this, too.

抽烟，是的，还有大麻，是的，电子烟也有这个作用。

It's so funny, anytime I talk about smoking being bad, people are like, "Well, what about cannabis?"

这太有趣了，每当我谈论吸烟不好时，人们都会说，“那么，大麻呢？”

Well, I did an episode about cannabis.

嗯，我做了一集关于大麻的节目。

Cannabis does have certain medical uses that are very interesting and there's good evidence for those.

大麻确实具有某些非常有趣的医疗用途，并且有充分的证据证明这些用途。

But for many people, cannabis is not a good idea.

但对于许多人来说，大麻并不是一个好主意。

You can check out that episode to decide for you.

您可以查看该集来为您做出决定。

Then people ask, "Well, what about vaping?

然后人们会问：“那么，抽电子烟怎么样？

Vaping's not as bad as smoking, right?" That's what they say.

吸电子烟并不像吸烟那么糟糕，对吧？”他们就是这么说的。

Or they're sort of asking, saying, hoping, wishing, fantasizing.

或者他们在问、说、希望、愿望、幻想。

And the truth is that vaping is terrible for your oral health as well.

事实是，电子烟对您的口腔健康也很糟糕。

Is it as bad as smoking?

它和吸烟一样有害吗？

Probably not, but it's bad for a bunch of other reasons that offset any gain or gains you would get from vaping instead of smoking.

可能不会，但由于其他一些原因，这很糟糕，这些原因抵消了您从电子烟而不是吸烟中获得的任何收益。

So just know that if you're a smoker or a vaper, or if you vape rather, that you're going to want to pay extra attention to some of the other protocols discussed and that we will discuss going forward in order to try and support your oral and therefore your whole body health.

因此，只要知道，如果您是吸烟者或电子烟爱好者，或者如果您吸电子烟，您将需要额外注意所讨论的其他一些方案，我们将继续讨论，以尝试支持您的口腔健康，从而支持您的整个身体健康。

Okay, so we've got alcohol, stimulants, smoking/vaping, and by extension, dipping tobacco, frankly, not good for oral health or tooth health.

好吧，我们有酒精、兴奋剂、吸烟/电子烟，坦率地说，沾烟对口腔健康或牙齿健康不利。

In fact, they can be pro-cancerous to the gum tissue.

事实上，它们可能会导致牙龈组织癌变。

It's well established, and they can also cause degradation of the gum tissue and even some of the underlying bone if you tend to do it on the same side all the time or often at all.

这是众所周知的，如果您总是或经常在同一侧这样做，它们还会导致牙龈组织甚至一些下面的骨骼退化。

So that's not good.

所以这不好。

We already discussed that sugar is not good for oral health.

我们已经讨论过糖不利于口腔健康。

Does that mean you can never ingest sugar?

这是否意味着你永远不能摄入糖？

No, of course not.

不，当然不是。

Enjoy the sweets you enjoy every once in a while.

偶尔享受一下您喜欢的甜点。

Enjoy a nice pastry.

享用美味的糕点。

Do as you will.

随你所愿吧。

If you're somebody who never eats those things, great, but then understand that any carbohydrate, any starch provides a sugar that strep mutans can eat and create acid and demineralize your teeth, create cavities, that is.

如果你是一个从不吃这些东西的人，那很好，但你要明白，任何碳水化合物、任何淀粉都会提供一种糖，变形链球菌可以吃掉这些糖，并产生酸，使你的牙齿脱矿质，产生蛀牙，就是这样。

So avoid sugar in excess, and if you eat sugar, try and rinse your mouth after, and ideally you would brush, maybe even floss after.

因此，避免摄入过量的糖，如果您吃糖，请尝试在吃完糖后漱口，最好先刷牙，甚至用牙线洁牙。

Okay, I do know those people that after every meal, even in the middle of the day, they run to the bathroom and brush their teeth and floss, and that's great, but most people don't do that.

好吧，我确实知道有些人每顿饭后，甚至在中午，他们都会跑到浴室刷牙和使用牙线，这很好，但大多数人不这样做。

So swishing water, rinsing your mouth out, again, plain water, maybe with a little bit of salt in it, is going to be beneficial.

因此，再次漱口、漱口，白开水（也许加一点盐）会很有帮助。

We'll talk about mouthwashes later, just to give you a little window into where we're headed with that.

我们稍后会讨论漱口水，只是为了让您了解我们的发展方向。

Most mouthwashes, terrible for your oral health, especially alcohol-based or antiseptic-based mouthwashes, except under certain conditions, prescribed or otherwise.

大多数漱口水对您的口腔健康有害，尤其是含酒精或防腐剂的漱口水，除非在某些情况下、处方或其他情况下。

Okay, so if you eat any sugar, and frankly, after you eat anything, it's a good idea to try and clear as much of that food product from your mouth.

好吧，如果你吃了任何糖，坦率地说，吃完任何东西后，最好尝试从嘴里清除尽可能多的食品。

You may not think you still have food in your mouth and teeth, but try to swish some water, maybe spit it out, maybe swallow it.

你可能不认为你的嘴里和牙齿里还有食物，但试着漱口一些水，也许吐出来，也许吞下去。

That's up to you.

这取决于你。

Are you a spit or swallow?

你是吞口水还是吞口水？

Not my business.

不关我的事。

Don't want to know.

不想知道。

Don't tell me.

别告诉我。

Don't put it in the comments.

不要把它放在评论里。

Just decide for you.

只为你做决定。

But sugar and other food products residing in the mouth for long periods of time, not good.

但糖等食品长时间驻留在口腔中，就不好了。

And similarly, acidity, foods that are acidic.

同样，酸度，酸性食物。

So certain things like citrus fruits, which I love.

有些东西，比如我喜欢的柑橘类水果。

I love oranges.

我喜欢橙子。

I have an orange tree in my backyard now, and I absolutely love it.

我的后院现在有一棵橘子树，我非常喜欢它。

I love oranges, grapefruit.

我喜欢橙子、柚子。

I love the peel.

我喜欢果皮。

I even eat the peel sometimes.

有时我什至吃果皮。

It's so delicious.

真是太好吃了。

And no one's telling you not to eat acidic foods or to avoid acidic drinks like lemon water or carbonated lemon water.

没有人告诉您不要吃酸性食物或避免喝柠檬水或碳酸柠檬水等酸性饮料。

Some people are really extreme and they decide to just use a straw when they drink those things.

有些人真的很极端，他们决定在喝这些东西时只用吸管。

In fact, the dentist I spoke to said, "Yes, could you ask people, please, if they're going to drink acidic drinks to try and use a straw?"

事实上，我采访过的牙医说：“是的，你能问问人们是否要喝酸性饮料，尝试使用吸管吗？”

But then I said, "Well, you know, a lot of straws, they disrupt the environment.

但后来我说：“嗯，你知道，很多吸管会破坏环境。

Most people aren't carrying around metal straws or, you know, and what about the turtles?" This kind of thing.

大多数人不会随身携带金属吸管，或者，你知道，那么海龟呢？”这种事。

And they said, "Well, okay, here's the real truth.

他们说：“好吧，这就是事实真相。

The real truth is, it's the amount of time that the mouth is exposed to that acid." So if they're going to drink it, drink it over the course of five, 10, 15, maybe 20, 30 minutes, and then be done with it.

真正的事实是，这是口腔接触酸的时间。”因此，如果他们要喝它，请在 5 分钟、10 分钟、15 分钟、也许 20 分钟、30 分钟内喝完，然后就喝完。

Rinse out the mouth with a little bit of water and try and clear out that acidity.

用少量水冲洗口腔，并尝试清除酸性物质。

It's not about completely avoiding acid foods or sugary foods or acidic drinks.

这并不是要完全避免酸性食物或含糖食物或酸性饮料。

It's about, again, limiting the amount of time that the overall milieu of the mouth is acidic because of this whole demin, remin thing, strep mutans and the acid created by strep mutans that can erode the teeth, and the fact that if your mouth is kept acidic for long periods of time, you're going to provide the opportunity for faster and deeper development of those cavities.

这又是关于限制口腔整体环境呈酸性的时间，因为所有的去菌、雷菌、变形链球菌和变形链球菌产生的酸都会腐蚀牙齿，而且如果你的口腔长时间保持酸性，你就会为这些蛀牙提供更快、更深发展的机会。

And keep this in mind, again, anytime we talk about demineralization, the formation of cavities, remember, it's like a seesaw.

再次记住这一点，每当我们谈论脱矿质、蛀牙的形成时，记住，这就像跷跷板一样。

It's either demin or remin, but not both.

它要么是 demin，要么是 remin，但不能两者兼而有之。

So anytime you're demineralizing your teeth, you're also not remineralizing your teeth.

因此，每当您对牙齿进行脱矿质时，您也不会再对牙齿进行再矿化。

Okay, so really avoid alcohol, stimulants, smoking, vaping, sugar, mouth breathing, acidic foods, acidic drinks.

好吧，所以真的要避免酒精、兴奋剂、吸烟、电子烟、糖、口呼吸、酸性食物、酸性饮料。

But many of us, most of us can't avoid any sugars, any acidic foods.

但我们中的许多人无法避免任何糖、任何酸性食物。

The other things can be avoided, but some of us are prescribed these drugs and need these drugs.

其他事情是可以避免的，但我们中的一些人开了这些药物并且需要这些药物。

Some people like a drink with alcohol in every once in a while, and it's perfectly fine for them, or they've deemed it perfectly fine for them.

有些人喜欢偶尔喝点酒精饮料，这对他们来说非常好，或者他们认为这对他们来说非常好。

In that case, try and rinse the mouth.

在这种情况下，请尝试漱口。

Try and keep the milieu of the mouth as moist and as basic, or alkaline rather, less acidic as possible.

尝试保持口腔环境湿润和碱性，或者碱性而不是酸性，尽可能少。

So to translate this a bit more to the real world, if you're somebody like me who loves tea, I drink cold brew, zero-sugar yerba mate.

因此，为了将这一点更多地转化为现实世界，如果你像我一样喜欢喝茶，我会喝冷萃、零糖的马黛茶。

That's my favorite source of caffeine.

这是我最喜欢的咖啡因来源。

I also like a nice black double espresso or coffee every once in a while.

我也喜欢偶尔喝一杯美味的黑双份浓缩咖啡或咖啡。

It's fine to drink that, but you don't want to sip on those sorts of things all day, and you don't want to sip on them for hours and hours.

喝它很好，但你不想整天喝这些东西，你也不想几个小时都喝它们。

And if you're going to combine those things with some acidic foods or with any kind of food, try and get your meals done, wrap them up, and rinse your mouth and move to the next part of your day.

如果您打算将这些东西与一些酸性食物或任何种类的食物结合起来，请尝试将饭菜吃完，包好，漱口，然后开始一天的下一部分。

And that actually segues into a really important point that came about when researching this episode, that if I had to highlight, boldface, underline, and light up one particular protocol that I think most everybody is not thinking about, is that there are certain times in the 24-hour circadian period in which your mouth makes the maximum amount of saliva, okay?

这实际上引出了研究这一集时出现的一个非常重要的观点，如果我必须强调、粗体、下划线和点亮一个我认为大多数人都没有想到的特定协议，那就是在 24 小时昼夜节律中，有某些时候你的嘴会产生最大量的唾液，好吗？

And that the saliva has an opportunity to be the optimal pH, that is chemistry, for encouraging remineralization of your teeth.

唾液有机会达到最佳 pH 值，即化学作用，以促进牙齿的再矿化。

And that's during the daytime and especially through the middle of the day.

那是在白天，尤其是中午。

Now, there are a couple of things that can disrupt that.

现在，有一些事情可以破坏这一点。

For instance, eating.

比如说吃饭。

Anything, I don't care if you're carnivore or vegan, whatever, omnivore.

任何事情，我不在乎你是肉食动物还是素食主义者，无论如何，杂食动物。

When you eat, you change the pH of your saliva, and you're introducing those sugars that the bacteria can feed on.

当你吃东西时，你会改变唾液的pH值，并引入细菌可以赖以生存的糖分。

So one thing that became very clear to me when researching this episode, talking to experts, reading manuscripts, and also reading some really interesting books about remineralization opportunities for the teeth, is that having a stretch of time of maybe two, four, six hours or more where you're not eating anything or ingesting anything that's acidic in terms of liquids can be very beneficial.

因此，当我研究这一集、与专家交谈、阅读手稿以及阅读一些关于牙齿再矿化机会的非常有趣的书籍时，我变得非常清楚的一件事是，有一段可能两个、四个、六个小时或更长时间不吃任何东西或摄入任何酸性液体的时间是非常有益的。

Now, this is a vote in support of so-called intermittent fasting.

现在，这是一次支持所谓间歇性禁食的投票。

This is something that I practice, typically by eating my first meal somewhere around 11:00 a.m.

这是我练习的方法，通常是在上午 11:00 左右吃第一顿饭。

every morning, sometimes earlier.

每天早上，有时更早。

I'll sometimes have a little breakfast at 9:00 if I'm particularly hungry.

如果我特别饿的话，有时我会在 9:00 吃一点早餐。

But typically, I eat my first meal around 11:00 a.m.

但通常情况下，我会在上午 11:00 左右吃第一顿饭。

or noon, and then I eat my last bite of food by about 8:00 p.m.

或中午，然后我会在晚上 8:00 左右吃完最后一口食物。

Not everyone likes to do intermittent fasting, and I realize for sake of weight loss, it's probably interchangeable with caloric restriction generally.

并不是每个人都喜欢间歇性禁食，我意识到为了减肥，它通常可以与热量限制互换。

And there's a lot of debate as to whether or not intermittent fasting is going to extend lifespan, whether or not it's better for metabolic health than simple caloric restriction.

关于间歇性禁食是否会延长寿命，是否比简单的热量限制更有利于代谢健康，存在很多争论。

I don't want to get into that debate.

我不想卷入这场辩论。

Frankly, it's a barbed wire debate that's been carried out on this podcast and elsewhere before, and I think is ongoing, I think is the best way to couch that debate.

坦率地说，这是一场铁丝网辩论，之前在这个播客和其他地方进行过，我认为正在进行中，我认为这是表达这场辩论的最佳方式。

But in researching this episode, it became very clear that we have an amazing opportunity during the day, especially in the morning and throughout the day, to create a lot of saliva that's the right pH to support remineralization of the teeth, provided that there isn't a lot of food or acidic liquids in the mouth at that time.

但在研究这一事件时，我们发现，我们在白天有一个绝佳的机会，特别是在早上和一整天，可以产生大量唾液，其 pH 值适合支持牙齿的再矿化，前提是当时口腔中没有大量食物或酸性液体。

So at least to my mind, this is an interesting opportunity to place intermittent fasting, which again, or even just gaps between meals, not constantly snacking or sipping on acidic beverages throughout the day, as an opportunity to create that healthy milieu during which the teeth can remineralize and the overall oral health can improve.

因此，至少在我看来，这是一个有趣的机会，可以进行间歇性禁食，甚至只是两餐之间的间隙，而不是全天不断地吃零食或喝酸性饮料，以此作为创造健康环境的机会，在此期间牙齿可以重新矿化，整体口腔健康也可以得到改善。

Now, does that mean you should never eat or drink anything during the middle of the day?

那么，这是否意味着您不应该在中午吃或喝任何东西？

No, I'm not saying that.

不，我不是这么说的。

I'm saying that if you're going to do those things, try and clear them from your mouth as I described before.

我是说，如果你要做这些事情，请尝试将它们从你的嘴里清除，就像我之前描述的那样。

Now, many of you will probably say, "Hey, during the middle of the night, I'm not eating or drinking anything." For some of you, that might be the only time that you're not eating or drinking anything because you're asleep.

现在，你们中的许多人可能会说：“嘿，在半夜，我没有吃或喝任何东西。”对于某些人来说，这可能是唯一一次因为睡着而不吃不喝任何东西。

One would hope you're asleep.

有人希望你睡着了。

But here's the interesting thing.

但这是有趣的事情。

Every cell, tissue, and organ in our body is on a 24-hour circadian clock.

我们体内的每个细胞、组织和器官都遵循 24 小时生物钟。

I think many of you have heard me say that in the context of viewing morning sunlight and other protocols that I suggest on the Huberman Lab podcast.

But here's the interesting and important point.

但这是有趣且重要的一点。

In the middle of the night, indeed, you're not ingesting any food or fluids, presumably, but your saliva production is dramatically reduced.

事实上，在半夜，你可能不会摄入任何食物或液体，但你的唾液分泌会急剧减少。

Again, dramatically reduced.

再次大幅减少。

And as a consequence, if there's food, or rather food opportunity for strep mutans and other bacteria to feed on and create acid to erode your teeth, the saliva necessary to offset that, to combat that, is simply not present, or at least not present at the same levels that it is during the day.

结果，如果有食物，或者更确切地说，有食物机会让变形链球菌和其他细菌以食物为食并产生酸来腐蚀你的牙齿，那么抵消它、对抗它所必需的唾液就根本不存在，或者至少不存在与白天相同的水平。

So this is a sort of two-pronged protocol.

所以这是一种双管齐下的协议。

On the one hand, I'm saying you might consider trying to introduce maybe an hour or a two-hour or longer stretches during the day in which you're not ingesting any food, and if you're drinking anything, it's not acidic, or if you are, to try and rinse away that acid as much as possible.

一方面，我想说的是，你可能会考虑尝试在一天中进行一小时、两小时或更长时间的休息，在这段时间里你不摄入任何食物，如果你喝了任何东西，它不是酸性的，或者如果你是酸性的，请尝试尽可能多地冲洗掉酸性物质。

So plain water would be great.

所以白开水就很好了。

Avoiding carbonated lemon water would be great.

避免碳酸柠檬水会很好。

But if you like those things, and indeed I love those things, I love carbonated lemon water, I love things like yerba mate.

但如果你喜欢这些东西，我确实喜欢那些东西，我喜欢碳酸柠檬水，我喜欢马黛茶之类的东西。

Indeed, the yerba mate I like is cold brew, zero sugar, but has some lemon and ginger in it.

确实，我喜欢的马黛茶是冷萃的，零糖，但里面有一些柠檬和生姜。

Okay, that's fairly acidic.

好吧，那是相当酸的。

But then drinking it down either pretty quickly or if you're going to sip on it, then rinsing it away with some water and not doing that throughout the entire day.

但是，然后很快地喝掉它，或者如果你要小口喝它，然后用一些水冲洗掉它，而不是一整天都这样做。

And indeed, I tend to drink my caffeine early in the day and not so much throughout the day.

事实上，我倾向于在一天的早些时候喝咖啡因，而不是全天喝那么多。

Maybe a little bit of mate in the afternoon sometimes.

有时下午可能会有点伴侣。

Okay, so that's one aspect of maintaining or encouraging the correct pH of saliva to remineralize your teeth.

好的，这是维持或促进唾液正确 pH 值以使牙齿再矿化的一方面。

Right?

正确的？

Create these windows of opportunity where there's a lot of saliva for long stretches of time during the day, as long as possible, while still making it compatible with your nutrition needs and your hydration needs, of course.

The other prong, or the other aspect of this protocol is that at night when you go to sleep, you need to know you're not producing very much saliva, and that's the critical time to make sure that there is as little opportunity as possible for strep mutans and other bacteria to feed on sugars or other food products, and thereby to create acid that creates cavities.

该协议的另一个方面或另一个方面是，在晚上睡觉时，您需要知道自己没有产生太多唾液，这是确保变形链球菌和其他细菌以糖或其他食品为食的机会尽可能少的关键时刻，从而产生产生蛀牙的酸。

And so this is a very important protocol that every single dental and oral healthcare professional I spoke to supported and indeed champions, which is if there is a most critical time of day or night to brush your teeth and floss and clean your teeth, it's at nighttime.

Why am I saying this with such whispered importance?

为什么我要这么低声强调这一点？

Well, I think there are many people out there, in particular people that fall into that second category that I mentioned at the beginning of today's episode, that wake up in the morning and brush their teeth, maybe even use mouthwash, maybe floss, and do a bunch of things to try and get their mouth clean and fresh, especially if they're going to interact with other people during the day and to get rid of all the kind of stickiness and morning breath, that kind of thing, but that at night they're finishing dinner, maybe having some dessert, doing some work, and passing out without brushing their teeth or flossing, or simply getting too lazy to brush or floss.

嗯，我认为有很多人，特别是属于我在今天节目开始时提到的第二类的人，他们早上醒来刷牙，甚至可能使用漱口水，可能是牙线，并做很多事情来尝试让口腔保持清洁和新鲜，特别是如果他们要在白天与其他人互动并摆脱所有粘稠和早上口气之类的东西，但晚上他们会吃完晚饭，也许会吃一些东西吃甜点、做一些工作、没有刷牙或使用牙线就昏倒了，或者只是懒得刷牙或使用牙线。

And by the way, I'm going to raise my hand and just say for many years I was in that category.

顺便说一句，我要举手说，多年来我一直属于这一类别。

I know, ew, gross.

我知道，呃，太恶心了。

But I was in that category.

但我属于这一类。

I had high motivation to brush and floss, or at least to brush in the morning.

我有很高的动力去刷牙和使用牙线，或者至少在早上刷牙。

Very little motivation to do it in the evening.

晚上做这件事的动力很少。

Every professional said, if you're going to brush and floss just once per 24 hours, and that is not what they recommend, by the way, but if you were going to do it just once, the critical time, the most essential time to brush and floss and clean the mouth and get the milieu of the mouth correct for tooth care and mouth overall oral health is at night before you go to sleep, because you already know the mechanistic backbone for this argument.

Because at night you're producing far less saliva, and if there's any food product there that the bacteria can feed on, the saliva isn't there to combat that because it's a constant battle between acidity and alkalinity.

Your saliva's coming in and trying to save everything, and the strep mutans is trying to destroy your teeth, and the acid is the weaponry they use and what fuels that weaponry, what provides them more ammo to destroy your teeth, are sugars and acidity.

你的唾液涌进来，试图拯救一切，而变形链球菌则试图摧毁你的牙齿，而酸是他们使用的武器，而这些武器的燃料，为他们提供更多的弹药来摧毁你的牙齿，就是糖和酸。

So if you were going to brush or floss, and ideally you do both only once per 24 hours, it would be at night before going to sleep.

因此，如果您要刷牙或使用牙线，而且最好每 24 小时只刷一次，那么应该是在晚上睡觉前。

Indeed, so much so that I would say that nighttime brushing and flossing is perhaps one of the most important things that we could do for overall oral health care.

事实上，我想说，夜间刷牙和使用牙线可能是我们为整体口腔保健所能做的最重要的事情之一。

We'll talk about what to do, what to use for brushing and flossing in a few minutes, but that's absolutely essential.

我们将在几分钟内讨论该怎么做，用什么刷牙和使用牙线，但这绝对是必要的。

I do not want that to be translated into you only need to brush or brush and floss once per 24 hours.

我不希望这被翻译成您只需每 24 小时刷一次或刷牙并使用牙线一次。

Every professional I spoke to and all of the data point to the fact that doing it twice per 24 hours is best, or perhaps even three times per 24 hours.

我采访过的每一位专业人士以及所有数据都表明，每 24 小时做两次是最好的，甚至每 24 小时做 3 次是最好的。

But let's be honest, most people are not going to brush and floss three times every 24 hours.

但说实话，大多数人不会每 24 小时刷牙和使用牙线 3 次。

Some will, but most won't.

有些会，但大多数不会。

And now, of course, I've been saying brushing and flossing, but I haven't talked about the incredibly extensive landscape of how to brush and floss.

当然，现在我一直在说刷牙和使用牙线，但我还没有谈论如何刷牙和使用牙线的极其广泛的领域。

So now let's take ourselves back to being little kids, right?

那么现在让我们回到小时候吧？

When we were taught to brush our teeth in a particular way.

当我们被教导以特定方式刷牙时。

You're supposed to spend a certain number of minutes, set a timer, supposed to floss in a certain way.

你应该花一定的时间，设定一个计时器，并以某种方式使用牙线。

Every time we go to the dentist, they tell us to floss in a certain way.

每次我们去看牙医时，他们都会告诉我们以某种方式使用牙线。

Do this, not this.

做这个，不做这个。

What do the data really say?

数据到底说明了什么？

What are the modern health professionals in dental and oral health really suggesting we do when it comes to brushing and flossing?

在刷牙和使用牙线时，现代牙科和口腔健康专业人士真正建议我们做什么？

And fortunately here, there's a near uniform consensus.

幸运的是，这里几乎达成了一致的共识。

There's always that outlier, that person that says to do things a little bit differently or no.

总有一些离群者，那个人说要以稍微不同的方式做事，或者不做。

There's in fact one person very prominent in the dental health space that is not a fan of flossing, but they are really the outlier.

事实上，在牙齿健康领域，有一个非常知名的人并不喜欢使用牙线，但他们确实是个异类。

The vast majority of dentists out there all say the same thing.

绝大多数牙医都说同样的话。

You need to brush, you need to floss, you need to do it twice a day or more, and you need to do it correctly.

你需要刷牙，你需要用牙线，你需要每天刷两次或更多次，而且你需要正确地刷牙。

So now let's talk about what correct brushing and flossing really is.

现在让我们来谈谈什么是正确的刷牙和使用牙线。

Okay, so I'm not going to demonstrate how to brush your teeth, but one very actionable protocol that was told to me by all the dental professionals I spoke to was use a soft toothbrush.

好吧，我不打算演示如何刷牙，但我采访过的所有牙科专业人士告诉我的一个非常可行的方案是使用软牙刷。

Now, this one hurts, or I suppose hurts less.

现在，这个很疼，或者我想疼得更轻了。

Anyway, it hurts my heart a little bit because I enjoy very much using a medium or hard toothbrush and really like scrubbing back there, especially in the teeth in the back.

不管怎样，这有点伤我的心，因为我非常喜欢使用中号或硬质牙刷，并且非常喜欢擦洗后面的地方，尤其是后面的牙齿。

It just feels good.

感觉很好。

I feel like I'm doing something good.

我感觉我正在做一件好事。

I get into the backs of the teeth, the fronts of the teeth.

我进入牙齿的后面，牙齿的前面。

I don't know, I actually enjoy brushing my teeth, especially lately.

我不知道，我其实很喜欢刷牙，尤其是最近。

Don't ask me why, but I do.

别问我为什么，但我就是这么做的。

But every single one of them said that that very vigorous brushing with medium or hard, as they're called, bristles really disrupts the interface between the teeth and the gums in ways that's not healthy for the gums and actually makes tenting of the gums and those pockets, those recesses, as they're called, far more likely to form.

但他们每个人都表示，用中度或硬质刷毛（所谓的硬毛）非常用力地刷牙确实会破坏牙齿和牙龈之间的界面，这对牙龈不健康，而且实际上更容易形成牙龈和那些凹处，也就是所谓的凹陷。

And every single one of them said, if you are regular with your brushing, and especially if you're brushing and flossing regularly, that a soft toothbrush, that is one that's moved in a circular motion on the fronts and backs of your teeth for all your teeth, and that is gentle, that you're not providing a lot of pressure, is going to be the best way to break up that biofilm layer each and every time and promote the best tooth and overall oral health.

他们每个人都说，如果你经常刷牙，特别是如果你经常刷牙和使用牙线，那么一把软牙刷，即在你所有牙齿的前牙和后牙上以圆周运动移动的牙刷，而且很温和，不会提供很大的压力，将是每次打破生物膜层并促进最佳牙齿和整体口腔健康的最佳方法。

So I suppose manufacturers who are making medium and hard toothbrushes maybe give us some rationale for that, because the dental professionals that I spoke to, and again, I spoke to a fair number of them, all said the same thing.

因此，我认为生产中硬牙刷的制造商可能会给我们一些理由，因为我采访过的牙科专业人士，以及我再次采访过的相当多的牙科专业人士，都说了同样的话。

Soft toothbrush, not just better, soft toothbrush best Likewise, if you use an electric toothbrush, which I now do, sometimes I switch back and forth, but if you use an electric toothbrush, it was recommended that you not provide too much pressure, that you really try and keep the tips of the bristles on the teeth and gums.

软牙刷，不仅仅是更好，软牙刷最好同样，如果你使用电动牙刷，我现在就是这样，有时我会来回切换，但如果你使用电动牙刷，建议你不要施加太大的压力，要尽量让刷毛尖端保持在牙齿和牙龈上。

And yes, it was also suggested that people brush their gums.

是的，也有人建议人们刷牙龈。

This is interesting.

这很有趣。

For people out there who have tooth sensitivity, one of the major suggestions from people in the dental and periodontal field, at least the ones I spoke to, was to actually brush your gums lightly to increase circulation of blood and other nutrients to the deeper portions of the tooth that actually extend into the bone.

对于牙齿敏感的人来说，牙科和牙周领域的人（至少是我采访过的人）的主要建议之一是轻轻刷牙，以增加血液和其他营养物质的循环，到达牙齿更深的部分，这些部分实际上延伸到骨头中。

Now, there is a tremendous amount of blood flow to the gums.

现在，有大量的血液流向牙龈。

Anyone who's sort of nicked their gum while flossing or with a toothpick can tell you it bleeds very readily.

任何在使用牙线或用牙签时割伤牙龈的人都会告诉你，牙龈很容易流血。

And that's not a good thing, right?

这不是什么好事，对吧？

You don't want to create bleeding of the gums.

您不想造成牙龈出血。

We'll talk about bleeding of the gums during flossing in a moment, by the way, so don't jump the gun just yet.

顺便说一下，我们稍后会讨论使用牙线时牙龈出血的问题，所以先别操之过急。

I said jump the gun, not jump the gum, by the way.

顺便说一句，我说的是跳枪，而不是跳口香糖。

If you are brushing your gums, make sure you're using a soft toothbrush.

如果您刷牙龈，请确保使用软牙刷。

If you're using an electric toothbrush, make sure you're going very lightly on the gums.

如果您使用电动牙刷，请确保轻轻刷动牙龈。

And because there's so much blood flow to the gums, it does encourage a lot of circulation to some of the deeper cavities of the tooth, as it turns out.

事实证明，由于流向牙龈的血液太多，它确实促进了牙齿某些较深空腔的大量血液循环。

I don't want to revert to tooth anatomy in any kind of detailed way now, but of course, within the tooth, you have, again, enamel, you have the dentin, you've got what's called the pulp or the center.

我现在不想以任何详细的方式回到牙齿解剖学，但是当然，在牙齿内部，你有牙釉质，你有牙本质，你有所谓的牙髓或中心。

There's a lot of nerves innervating the center of the tooth.

牙齿的中心有很多神经支配。

There's a bunch of other tissues, and the bone around it, and layers, et cetera.

还有一堆其他组织，周围有骨头，还有层，等等。

And when you massage or lightly brush the gums around there, you're encouraging a lot of blood flow to those deeper components of the tooth, which are really the live and active components of the tooth that require blood flow and nutrients.

当您按摩或轻轻刷牙周围的牙龈时，您会鼓励大量血液流向牙齿的深层成分，这些成分实际上是牙齿的活体和活性成分，需要血液流动和营养。

So, this is a good thing.

所以，这是一件好事。

In fact, it's probably such a good thing that most people, perhaps all of us should do it, but most people probably won't take the time to also brush their gums.

事实上，这可能是一件好事，大多数人，也许我们所有人都应该这样做，但大多数人可能不会花时间刷牙龈。

But if you have a little bit of time, it can be beneficial, especially if you have sensitive teeth.

但如果您有一点时间，这可能会有所帮助，特别是如果您的牙齿敏感。

The idea that's sort of emerging now in the dental field is that it can help promote resilience or less sensitivity of the teeth to things like hot and cold, and maybe even to pressure.

现在在牙科领域出现的想法是，它可以帮助提高牙齿的弹性或降低牙齿对冷热甚至压力等因素的敏感性。

So before we talk about flossing, I just want to reemphasize that the reason to brush your teeth and the reason to brush your teeth lightly or without too much pressure, that is, is that if you're regular with your toothbrushing and flossing, the main goal of brushing is to break up the biofilm layer that provides a substrate for Strep mutans and other bacteria to layer on thicker layers of bacteria, so-called plaque, that will eventually turn to tartar.

因此，在我们谈论使用牙线之前，我想再次强调一下，刷牙的原因以及轻轻刷牙或没有太大压力的原因是，如果您经常刷牙和使用牙线，那么刷牙的主要目标是破坏生物膜层，该生物膜层为变形链球菌和其他细菌提供了基质，从而形成更厚的细菌层，即所谓的牙菌斑，最终会变成牙垢。

Okay?

好的？

If we really want to gross ourselves out and really motivate brushing and flossing, maybe we should describe that what happens with Strep mutans is it forms these strand-like bacteria.

如果我们真的想让自己感到恶心并真正激励刷牙和使用牙线，也许我们应该描述变形链球菌所发生的情况是它形成了这些链状细菌。

So these are like little cilia, so they're attached to the tooth as the biofilm layer, so like little strands of strings.

所以它们就像小纤毛，所以它们作为生物膜层附着在牙齿上，就像小绳子一样。

But if enough of it accumulates, then it gets thicker and kind of mossy, and it's kind of thicker and looks kind of spongiform, and that's the plaque.

但如果积累得足够多，那么它就会变得更厚，有点苔藓，而且更厚，看起来有点海绵状，这就是斑块。

And then if enough of it forms and there's enough acidity in the mouth, then it forms tartar, which is the hard caked-on stuff that requires scraping off by the dentist.

然后，如果形成了足够多的牙垢，并且口腔中有足够的酸度，就会形成牙垢，牙垢是一种坚硬的结块物质，需要牙医刮掉。

And some people get a lot of tartar, some people have less tartar buildup, depending on how diligent they are at removing the biofilm with brushing.

有些人牙垢堆积较多，有些人牙垢堆积较少，这取决于他们刷牙去除生物膜的勤奋程度。

Now, you can remove biofilm and plaque with brushing, but once it starts to form tartar, that is, once it's layered on, sometimes it has a yellowish tint to it, then you really start to run into trouble because brushing and flossing will not remove that tartar.

现在，您可以通过刷牙去除生物膜和牙菌斑，但是一旦它开始形成牙垢，也就是说，一旦它分层，有时它会呈淡黄色，那么您就真的开始遇到麻烦了，因为刷牙和使用牙线无法去除牙垢。

And that's why the dentist needs to get in there and scrape it away.

这就是为什么牙医需要进去把它刮掉。

So it's ideal to be diligent about removing the bacteria while it's still in that strand or plaque form, ideally when it's still in that strand form, removing that biofilm.

因此，理想的做法是在细菌仍处于链状或菌斑形式时勤于去除细菌，理想情况下当细菌仍处于链状形式时，去除生物膜。

If you've ever been to the dentist, you may recall they'll do this tooth polishing.

如果您曾经看过牙医，您可能还记得他们会做牙齿抛光。

They'll do that thing with the kind of gritty stuff on your teeth, and you wonder, "Is this to make my teeth whiter?" And indeed, it can create a bit more shine or sheen to your teeth.

他们会用你牙齿上的那种砂质东西做这种事，你会想，“这是为了让我的牙齿更白吗？”事实上，它可以让你的牙齿更有光泽。

But the main reason for doing that, it turns out, is to make the surfaces of your teeth smooth.

但事实证明，这样做的主要原因是为了让牙齿表面光滑。

After all, they do it on the backs of your teeth, too.

毕竟，它们也会在你的牙齿背面做这件事。

Right?

正确的？

If they're good dentists, they do it on the backs of your teeth as well.

如果他们是优秀的牙医，他们也会在你的牙齿背面做这种手术。

Why would they do it there?

他们为什么要在那里这么做？

It can't be for cosmetic purposes.

它不能用于美容目的。

Well, they do that because the smooth surface makes it harder for those strands, that biofilm, to stick and form, and certainly for the more dense plaque and tartar layers to build up on top of it.

嗯，他们这样做是因为光滑的表面使得这些线、生物膜更难粘附和形成，当然也更难在其上面积聚更致密的牙菌斑和牙垢层。

So they're making your teeth smooth so that the bacteria can't adhere to it as readily.

因此，它们可以使您的牙齿变得光滑，从而使细菌不易粘附在牙齿上。

But it's the daily protocols of tooth and oral health that are really critical.

但真正重要的是牙齿和口腔健康的日常习惯。

We'll talk about dental visits and frequency of dental visits and what a dental visit is really about.

我们将讨论牙科就诊和牙科就诊的频率以及牙科就诊的真正含义。

Is it always about cleaning or filling, et cetera?

总是与清洁或填充等有关吗？

But in the meantime, brushing and brushing often enough such that you don't get any buildup of biofilm for very long periods of time, eliminating or reducing the amount of plaque and tartar that builds up is going to be your best strategy for improving tooth health.

但与此同时，经常刷牙，这样你就不会在很长一段时间内积聚任何生物膜，消除或减少积聚的牙菌斑和牙垢的数量将是改善牙齿健康的最佳策略。

Now, what about flossing?

现在，使用牙线怎么样？

There's a little bit of debate about flossing in the dentistry field.

在牙科领域，关于使用牙线存在一些争议。

Some people say if your gums bleed when you floss, you need to floss more.

有人说，如果用牙线洁牙时牙龈出血，就需要多用牙线洁牙。

In fact, most dentists I spoke to said that.

事实上，我采访过的大多数牙医都这么说。

But they also emphasized that you need to floss correctly.

但他们也强调，你需要正确使用牙线。

You can't just pull the floss down onto the gum in between the tooth.

您不能只是将牙线拉到牙齿之间的牙龈上。

You need to glide down the side of the tooth, get a little bit underneath the gum, and use a circular motion, and then lift up from between the two teeth, which frankly is a lot easier if your teeth aren't very close together.

您需要沿着牙齿的一侧滑行，到达牙龈下方一点，然后进行圆周运动，然后从两颗牙齿之间向上提起，坦率地说，如果您的牙齿不是很靠近，这会容易得多。

Right?

正确的？

Some of us have teeth that are very close together, and when you try and bring it up through the teeth, it's more of an effort.

我们中有些人的牙齿非常靠近，当您尝试将其从牙齿中拔出时，需要付出更多的努力。

Okay?

好的？

But they really all emphasize trying to not drop this rather sharp floss, and here we could also be talking about the toothpick-based floss, where there's a little arc with a little bit of floss across from it, the ones that you can buy.

但他们确实都强调尽量不要掉落这种相当锋利的牙线，在这里我们也可以谈论基于牙签的牙线，那里有一个小弧线，其对面有一点牙线，你可以购买。

Some people actually use toothpicks, an old-fashioned method.

有些人实际上使用牙签，这是一种老式的方法。

Frankly, most dentists I spoke to don't want people jabbing their mouth and gums with toothpicks You can decide for yourself, but almost all of them, except for one, felt that flossing is a great idea for tooth health, and that if your gums bleed when you floss correctly, as I just described what correct flossing is, that your best strategy is to floss at least twice a day between all of your teeth.

坦率地说，我采访过的大多数牙医都不希望人们用牙签刺破口腔和牙龈。你可以自己决定，但几乎所有人（除了一位）都认为使用牙线对牙齿健康是一个好主意，并且如果你在正确使用牙线时牙龈出血（正如我刚刚描述的正确使用牙线是什么），那么你最好的策略是每天至少在所有牙齿之间使用牙线两次。

And if you're not going to floss twice a day, for whatever reason, in protest or for lack of time, at least once a day.

如果您不打算每天使用牙线两次，无论出于何种原因，出于抗议或缺乏时间，至少每天一次。

And when would that once a day be?

每天一次是什么时候？

It would be at night before going to sleep for the reasons we talked about earlier.

由于我们之前讨论过的原因，这会是在晚上睡觉前。

And several dentists I spoke to said that using a waterpik is going to be better than using more typical floss or using those toothpick-based floss approaches, because it's gentler on the teeth.

我采访过的几位牙医表示，使用水牙线比使用更典型的牙线或使用牙签牙线的方法更好，因为它对牙齿更温和。

I personally have not used a waterpik, but I'm sort of intrigued by the concept, because it sounds like it's much harder to damage the gums and teeth by doing it, and that it is at least as efficient as standard flossing.

我个人没有使用过水牙棒，但我对这个概念有点感兴趣，因为听起来这样做更难损坏牙龈和牙齿，而且它至少与标准牙线一样有效。

So for those of you that have the disposable income and the interest in using a waterpik, sounds like it could be a really good idea.

因此，对于那些有可支配收入并且对使用水笔感兴趣的人来说，听起来这可能是一个非常好的主意。

For the vast majority of us, like me, just getting some traditional floss and using dental floss at least once a day at night, and ideally also in the morning after brushing, that seems like the most direct and low-cost strategy.

对于像我这样的绝大多数人来说，只需使用一些传统的牙线，每天晚上至少使用一次牙线，最好是在早上刷牙后，这似乎是最直接和低成本的策略。

I should just mention that the pediatric dentist that I spoke to mentioned that flossing is really about removing food product from between the teeth, and therefore, children younger than six, who typically have big spaces between their baby teeth, and their adult teeth have not yet come in.

我只想提一下，我采访过的儿科牙医提到，使用牙线实际上是为了清除牙齿之间的食物残渣，因此，六岁以下的儿童通常乳牙之间的空间很大，而恒牙尚未长出。

In fact, that's what those spaces are about, by the way, unless you're me, and when you were a kid, your teeth were too close together and all your adult teeth came in behind those teeth.

事实上，顺便说一句，这就是这些空间的意义，除非你是我，当你还是个孩子的时候，你的牙齿靠得太近，你所有的恒牙都长在这些牙齿后面。

It was a really miserable experience for me.

这对我来说真是一次痛苦的经历。

Most kids, their baby teeth are spaced out a bit in order to allow the adult teeth to come in, to erupt, as it's called.

大多数孩子的乳牙都会稍微间隔一些，以便让恒牙长出来，也就是所谓的萌出。

Such a dramatic word.

这是多么戏剧化的一句话啊。

I just love reading this literature.

我就是喜欢阅读这些文学作品。

When the molars erupt, it's like, whoa .

当臼齿长出时，就像，哇。

No, they just come up through the gums.

不，它们只是从牙龈中出来。

Those spaces are really there for the adult teeth to come up through the gums.

这些空间确实是供恒牙从牙龈中长出来的。

And so it was suggested that children who have those spaces between their teeth, and the spaces are big, don't need to floss between those teeth because it could cause some damage to the gums.

因此，有人建议，牙齿之间有间隙且间隙较大的儿童不需要在牙齿之间使用牙线，因为这可能会对牙龈造成一些损害。

Rather, they should just focus on their brushing.

相反，他们应该只专注于刷牙。

Now let's talk about some protocols that involve changing the chemistry of your mouth, not just immediately after meals or during brushing or flossing, but really around the clock.

现在让我们谈谈一些涉及改变口腔化学成分的方案，不仅仅是饭后或刷牙或使用牙线时，而是全天候进行。

And one of the key protocols that I'd like to discuss is the use of an artificial sugar called xylitol.

我想讨论的关键协议之一是使用一种称为木糖醇的人造糖。

Xylitol is a very low-calorie sweetener.

木糖醇是一种热量非常低的甜味剂。

I can place it among the other low-calorie sweeteners like aspartame, sucralose, stevia, et cetera.

我可以将它与其他低热量甜味剂（如阿斯巴甜、三氯蔗糖、甜叶菊等）放在一起。

But what's unique about xylitol is that very much like standard sugar or any kind of carbohydrate sugar, the bacteria Streptococcus mutans loves to eat xylitol.

但木糖醇的独特之处在于，与标准糖或任何种类的碳水化合物糖非常相似，变形链球菌喜欢吃木糖醇。

But when Streptococcus mutans eats xylitol, it doesn't, meaning it cannot produce the acid that normally would demineralize the teeth and create cavities.

但当变形链球菌吃掉木糖醇时，它就不会产生这种酸，这意味着它不能产生通常会使牙齿脱矿质并产生蛀牙的酸。

In addition to that, when Streptococcus mutans eats xylitol, it kills Streptococcus mutans.

除此之外，当变形链球菌食用木糖醇时，它会杀死变形链球菌。

So what this means is that if xylitol is present in the oral cavity after a meal, say in the minutes and hours after a meal, then any strep mutans that happens to be there is going to preferentially feed on the xylitol, not other sugars, and it won't be able to release acid.

因此，这意味着，如果饭后口腔中存在木糖醇，例如饭后几分钟或几小时内，那么恰好存在的任何变形链球菌都会优先以木糖醇为食，而不是其他糖，并且它无法释放酸。

And because xylitol can actually inhibit the growth, and that is the proliferation of more strep mutans, we've got a twofer.

因为木糖醇实际上可以抑制生长，即更多变形链球菌的增殖，所以我们有一个双重选择。

We've got a situation where strep mutans can't release acid to demineralize the teeth and potentially cause cavities, and the total amount of strep mutans that can grow, that can proliferate in what are called colonies, literally the bacteria colonizes on the teeth, forming that biofilm.

我们遇到的情况是，变形链球菌无法释放酸使牙齿脱矿质，并可能导致蛀牙，而变形链球菌的总量可以生长，可以在所谓的菌落中增殖，实际上细菌在牙齿上定植，形成生物膜。

Well, then that can't happen.

好吧，那么这不可能发生。

So xylitol is a very potent tool for improving oral health in this way.

因此，木糖醇是通过这种方式改善口腔健康的非常有效的工具。

In addition, xylitol reduces inflammation of the gum tissue and other soft tissues of the mouth.

此外，木糖醇还可减少牙龈组织和口腔其他软组织的炎症。

And so xylitol is providing an array of positive benefits, especially when it's present in the mouth immediately after meals.

因此，木糖醇提供了一系列积极的好处，尤其是当它在饭后立即存在于口腔中时。

And for that reason, there are a number of different dentists that have created xylitol products in the form of gums or in the form of mints, specifically to be used after meals.

出于这个原因，有许多不同的牙医创造了口香糖或薄荷糖形式的木糖醇产品，专门用于饭后使用。

So by chewing a few of these xylitol mints or by chewing a xylitol-based gum immediately after a meal, you're taking substantial steps towards improving the chemical milieu of your mouth and inhibiting the proliferation of cavity-forming Streptococcus mutans.

因此，通过在饭后立即咀嚼一些木糖醇薄荷糖或咀嚼木糖醇口香糖，您就可以在改善口腔化学环境和抑制形成空洞的变形链球菌的增殖方面迈出实质性的一步。

Now, you can also find some literature on other proposed benefits of xylitol, such as improving overall microbiome, such as reducing inflammation in other tissues besides the gums and within the mouth.

现在，您还可以找到一些关于木糖醇其他拟议益处的文献，例如改善整体微生物组，例如减少牙龈和口腔内其他组织的炎症。

There is some evidence that it can support the gut microbiome, because, of course, the oral microbiome and the gut microbiome are contiguous.

有一些证据表明它可以支持肠道微生物组，因为口腔微生物组和肠道微生物组当然是相邻的。

They have different compartments.

他们有不同的隔间。

You might even be surprised to learn that within your mouth, there are different niches, as they're called.

您甚至可能会惊讶地发现，在您的嘴里，有不同的“壁龛”，正如它们的名称一样。

For instance, there's different microbiota that live on the gums versus the hard palate versus the soft palate, back in the throat, and then as you descend into the gut, et cetera.

例如，牙龈、硬腭、软腭、喉咙后面以及肠道等处都有不同的微生物群。

And it does appear that xylitol has certain positive benefits for all of those different gut microbiome niches.

木糖醇似乎确实对所有不同的肠道微生物群具有一定的积极益处。

But the literature on that is less well substantiated than, for instance, the literature showing that if xylitol is put in as a surrogate sugar substrate for strep mutans, that it disables strep mutans and can prevent the formation of cavities.

但关于这一点的文献没有得到充分证实，例如，有文献表明，如果将木糖醇作为变形链球菌的替代糖底物，它可以使变形链球菌失效并防止蛀牙的形成。

Now, as far as I know, when consumed in mint form or gum form, I'm not aware of any specific side effects or bad effects of xylitol, provided that it's not consumed in excess.

现在，据我所知，当以薄荷形式或口香糖形式食用时，我不知道木糖醇有任何特定的副作用或不良影响，只要不过量食用即可。

But as with everything, dosage matters.

但与所有事情一样，剂量很重要。

So if you're somebody who wants to explore the use of xylitol gum or xylitol mints after a meal, I wouldn't suggest going from consuming zero xylitol mints to consuming 50 a day or something like that, or even 10 a day.

因此，如果您想尝试饭后使用木糖醇口香糖或木糖醇薄荷糖，我不建议从零食用木糖醇薄荷糖到每天食用 50 颗或类似的东西，甚至每天 10 颗。

You might start off slowly and just consume one or two after a meal, maybe just your morning meal, maybe just your evening meal.

您可能会慢慢开始，饭后只吃一两粒，也许只是早上的饭菜，也许只是晚上的饭菜。

Something of that sort, rather than chewing xylitol gum all day long, et cetera.

类似的东西，而不是整天咀嚼木糖醇口香糖，等等。

I'll just mention one other positive benefit of xylitol gum, which is if you use xylitol gum after, say, your noon meal or your early day meal, it further increases the production of saliva, which, as we talked about before, is a great thing because one of the best ways to support oral health and tooth health is to have a long stretch of time in the middle of the day where you're producing a lot of healthy saliva in large amounts, because again, saliva is this incredible stuff that's supporting remineralization of the teeth.

我只想提一下木糖醇口香糖的另一个积极好处，那就是，如果您在午餐或早饭后使用木糖醇口香糖，它会进一步增加唾液的产生，正如我们之前谈到的，这是一件好事，因为支持口腔健康和牙齿健康的最佳方法之一就是在一天中的很长一段时间内大量产生大量健康的唾液，因为唾液是一种令人难以置信的物质，可以支持口腔健康和牙齿健康。牙齿的再矿化。

So lots and lots of reasons to think about, maybe consider using xylitol gum or xylitol mints.

所以有很多很多的理由需要考虑，也许可以考虑使用木糖醇口香糖或木糖醇薄荷糖。

There are a number of different ones available out there.

有许多不同的可用。

I have zero, again, zero financial relationship to any of those mint or gum companies.

我与这些薄荷糖或口香糖公司的财务关系为零，再次，零。

I'll provide a link in the show note captions to one source.

我将在节目注释标题中提供一个来源的链接。

The company and the products were developed by a dentist, Dr. Ellie Phillips, who is quite prominent in the public health education space around dental health.

该公司和产品是由牙医艾莉·菲利普斯博士开发的，她在牙齿健康的公共健康教育领域非常有名。

Some of her views are a little bit controversial, like her views on flossing.

她的一些观点有点争议，比如她对使用牙线的观点。

Other of her views I find, frankly, quite ahead of their time in that she's been talking about a number of these things like promoting the health of the oral microbiome and the potential value of xylitol gums and mints, et cetera, for some period of time.

坦率地说，我发现她的其他观点相当超前，因为她在一段时间内一直在谈论许多这样的事情，比如促进口腔微生物组的健康以及木糖醇口香糖和薄荷糖的潜在价值等等。

I think most of the information that she puts out there is supported by other dentists, and she still suggests regular dental visits, so nothing renegade out there or heretical.

我认为她在那里发布的大部分信息都得到了其他牙医的支持，而且她仍然建议定期看牙医，所以没有任何叛逆或异端的信息。

Again, there are other sources of xylitol gums and mints that you could consider.

同样，您可以考虑木糖醇口香糖和薄荷糖的其他来源。

I'm just simply putting a link to the one that I use because I happen to use them and like them.

我只是简单地添加一个指向我使用的链接，因为我碰巧使用它们并且喜欢它们。

So I'd like to use the discussion about xylitol as a segue into a discussion about toothpaste because there is a lot of controversy out there about which toothpaste are better for us, maybe even bad for us, and best for us.

所以我想用关于木糖醇的讨论来作为关于牙膏的讨论的延续，因为关于哪种牙膏对我们更好，甚至可能对我们有害，以及对我们最好，存在很多争议。

I think it's fair to say, based on what we all now know about xylitol, that if you can find a toothpaste that contains xylitol as a sweetener, that can only be a good thing.

我认为可以公平地说，根据我们现在对木糖醇的了解，如果你能找到一种含有木糖醇作为甜味剂的牙膏，那只能是一件好事。

And indeed, there are a number of them out there.

事实上，这样的人有很多。

We'll talk about specific sources in a little bit, but let's just put xylitol on the short to not so short list of things that would be great to have in a toothpaste for all the reasons that you now understand.

我们将稍微讨论一下具体的来源，但我们只是将木糖醇列入简短或不那么简短的清单中，出于您现在了解的所有原因，木糖醇在牙膏中会很棒。

The real big question with toothpaste is always, should I use a toothpaste that has fluoride or avoid toothpastes that have fluoride?

关于牙膏的真正大问题始终是，我应该使用含氟化物的牙膏还是避免使用含氟化物的牙膏？

And in order to answer that, we have to go back to our earlier discussion about fluoride.

为了回答这个问题，我们必须回到之前关于氟化物的讨论。

It really depends on whether or not you're somebody that thinks that fluoride is great because it creates these super physiologically strong bonds within our teeth.

这实际上取决于您是否认为氟化物很棒，因为它在我们的牙齿内产生了这些超强的生理联系。

The crystal structures are that much stronger than when formed by hydroxyapatite, or whether or not you're somebody who is wary of fluoride, that you're concerned about potential brain health issues or thyroid issues.

晶体结构比羟基磷灰石形成的晶体结构要坚固得多，或者无论您是否对氟化物保持警惕，是否担心潜在的大脑健康问题或甲状腺问题。

And here, I think people really do fall into either camp or the camp, frankly, of, "I don't know.

在这里，我认为人们确实会陷入“我不知道”的阵营或阵营，坦率地说。

Should I be worried?

我应该担心吗？

I don't know if I should be worried." I personally grew up using fluoride toothpaste.

我不知道我是否应该担心。”我个人是使用含氟牙膏长大的。

We had the standard name brand fluoride toothpaste in our bathroom, and I brushed my teeth with those for years.

我们的浴室里有标准的名牌含氟牙膏，多年来我一直用这些牙膏刷牙。

Whether or not that negatively impacted my health or not, I don't know.

我不知道这是否对我的健康产生负面影响。

Get my blood work done, my thyroid hormones are normal.

做完血液检查，我的甲状腺激素正常。

My brain, well, it works at least reasonably well.

我的大脑，嗯，至少运转得相当好。

But I do realize that some people are very concerned about fluoride, and they just don't want it anywhere near their kids.

但我确实意识到有些人非常担心氟化物，他们只是不希望它靠近他们的孩子。

They don't want it anywhere near themselves.

他们不希望它靠近自己。

So if you're somebody who's going to err on the side of caution with fluoride and you are seeking a non-fluoride-containing toothpaste, there are such toothpastes out there, and most of those, if not all of them, contain, you guessed it, hydroxyapatite.

因此，如果您对氟化物持谨慎态度，并且您正在寻找不含氟化物的牙膏，那么市面上就有这样的牙膏，而且您猜对了，其中大多数（如果不是全部）都含有羟基磷灰石。

They contain the minerals that naturally form the bonds that create that additional enamel that can potentially fill in cavities and by remineralization of the enamel and some of the deeper layers of the tooth.

它们含有天然形成键的矿物质，这些键形成额外的牙釉质，可以填充蛀牙，并通过牙釉质和牙齿深层的再矿化。

So if one is seeking toothpaste and you want to avoid fluoride, you'd want to find something that ideally had hydroxyapatite and something that had xylitol.

因此，如果您正在寻找牙膏并且您想避免氟化物，那么您会想要找到最好含有羟基磷灰石和木糖醇的牙膏。

And they often also contain some sort of mild abrasive.

它们通常还含有某种温和的磨料。

Okay?

好的？

Not a really scratchy, abrasive substance, but a mild abrasive that can really allow for breaking up of the biofilm that we talked about earlier.

不是一种真正的刮擦性研磨物质，而是一种温和的研磨剂，可以真正打破我们之前讨论过的生物膜。

Now, I've provided links to a couple of sources for such toothpastes and also for these little toothpaste tablets that I've been using lately as well.

现在，我提供了此类牙膏以及我最近使用的这些小牙膏片的一些来源的链接。

I sometimes switch back and forth between the two.

我有时会在两者之间来回切换。

These are tablets that you chew up, and then you brush your teeth immediately after with your wet toothbrush.

这些药片是您咀嚼后立即用湿牙刷刷牙的药片。

Both of them work quite well.

他们两个都工作得很好。

Again, I want to be clear that the companies that I've provided links to in the show note captions are companies for which I have absolutely zero financial relationship.

再次，我想澄清的是，我在节目说明标题中提供的链接的公司是我与之完全零财务关系的公司。

I do know some of the people that started these companies.

我确实认识一些创办这些公司的人。

I actually discovered these companies because these people are dentists or periodontists or other people in the oral health field.

我实际上发现这些公司是因为这些人是牙医或牙周病医生或口腔健康领域的其他人。

But I also want to be very clear that there was no exchange of promotion of their products for information or otherwise.

但我也想非常清楚地表明，他们的产品促销并没有以信息或其他方式进行交换。

I simply tried and liked the products, and I just so happened to have learned some things about oral health care from these people separate and away from anything about toothpaste or xylitols, et cetera.

我只是尝试并喜欢这些产品，而且我碰巧从这些人那里学到了一些关于口腔保健的知识，远离牙膏或木糖醇等。

Okay?

好的？

So I want to be very clear that I do believe these are quality sources.

所以我想非常明确地表明，我确实相信这些都是优质来源。

These are the toothpastes and tooth tablets that I happen to use, gums and mints that I happen to use, in large part as a consequence of researching this episode.

这些是我碰巧使用的牙膏和牙片，我碰巧使用的口香糖和薄荷糖，很大程度上是我研究这一集的结果。

But I pay full price for them.

但我为它们支付全价。

I'm certainly not suggesting that anyone else has to use them.

我当然不是建议其他人必须使用它们。

They just represent one option if you're looking for non-fluoride-containing toothpaste and some other things to promote oral health.

如果您正在寻找不含氟化物的牙膏和其他一些促进口腔健康的东西，它们只是代表一种选择。

And I'm sure there are other sources out there, and if you'd like to refer the various viewers and listeners of this podcast to those sources because you feel very strongly about those other sources, just put those in the comment section on YouTube.

我确信还有其他来源，如果您想将此播客的各种观众和听众推荐给这些来源，因为您对这些其他来源有强烈的感觉，只需将它们放在 YouTube 的评论部分即可。

Okay, let's talk about mouthwash or mouthwashes, plural.

好吧，我们来谈谈漱口水或漱口水，复数。

At the beginning of today's episode, I said, "Let's determine what category of oral health you are in." Are you somebody who pays a lot of attention to oral health?

在今天节目的开头，我说：“让我们确定一下您属于哪一类口腔健康。”您是一个非常注重口腔健康的人吗？

You brush and floss at least twice a day.

您每天至少刷牙和使用牙线两次。

You're using mouthwashes, tooth whiteners perhaps as well, or are you in category two or three?

您可能也在使用漱口水、牙齿美白剂，或者您属于第二类或第三类？

Well, here's the deal.

好吧，事情就是这样。

Most all, not all, but most all mouthwashes, especially those containing alcohol are terrible for oral health.

大多数，不是全部，但大多数漱口水，尤其是含有酒精的漱口水对口腔健康都有害。

Simply put, they deplete certain components of the mucosal lining of the mouth, and they disrupt the healthy components of the oral microbiome.

简而言之，它们会消耗口腔粘膜内层的某些成分，并破坏口腔微生物群的健康成分。

So for those of you that rely on such mouthwashes, I would really encourage you to learn more about them, you're about to do that now, you're already doing that now, and to really consider whether or not they are helping or harming your oral health.

因此，对于那些依赖此类漱口水的人，我真的鼓励您更多地了解它们，您现在即将这样做，您现在已经这样做了，并真正考虑它们是否有助于或损害您的口腔健康。

Now, I'm not suggesting that you create a scenario where your breath is causing other people to dissolve into a puddle of tears or back away from you quickly.

现在，我并不是建议你创造一个场景，让你的呼吸导致其他人溶解成一滩泪水或迅速远离你。

That's not what you want, that's not what I want, that's not what anyone wants.

这不是你想要的，这不是我想要的，这不是任何人想要的。

But I think it's important to realize that these alcohol-based mouthwashes are not good for us.

但我认为重要的是要认识到这些含酒精的漱口水对我们没有好处。

In addition, there are antiseptic mouthwashes, some of which contain alcohol, some of which don't, which sometimes are prescribed for very serious bacterial overgrowth and infections of the oral cavity.

此外，还有抗菌漱口水，其中一些含有酒精，一些不含酒精，有时用于治疗非常严重的细菌过度生长和口腔感染。

If your dentist or physician or periodontist prescribes those, I certainly am not going to try and get in the way of that prescription.

如果您的牙医、医生或牙周病医生开了这些处方，我当然不会试图妨碍该处方。

That's between you and your healthcare professional.

这是您和您的医疗保健专业人员之间的事情。

But you would be wise to ask them whether or not these chlorhexidine-type mouthwashes, et cetera, are potentially bad for other components of oral health or microbiota in the gut generally, because in some cases, they have been shown to be not good for us.

但你应该明智地询问他们，这些氯己定型漱口水等是否可能对口腔健康的其他成分或肠道微生物群有害，因为在某些情况下，它们已被证明对我们不利。

At the same time, we don't want overproliferation of really bad bacteria in the mouth, so we don't want infections to run wild either.

与此同时，我们不希望口腔中真正有害的细菌过度增殖，因此我们也不希望感染疯狂蔓延。

Most people, however, are using mouthwashes to freshen their breath and to kill off additional bacteria in the mouth that they might believe they couldn't get with brushing or flossing.

然而，大多数人都使用漱口水来清新口气，并杀死口腔中的其他细菌，而他们可能认为刷牙或使用牙线无法清除这些细菌。

If you are somebody who really wants to use a mouthwash for that reason, I encourage you to try and find a mouthwash that is not alcohol-based and that is not a strong antiseptic, or that if it is an antiseptic, that it's not alcohol-based.

如果您确实出于这个原因想要使用漱口水，我鼓励您尝试找到一种不含酒精且不是强效防腐剂的漱口水，或者如果它是防腐剂，则它不含酒精。

Okay?

好的？

And such mouthwashes exist out there.

这种漱口水是存在的。

They're a little bit hard to find.

它们有点难找。

I'll provide a link to at least a couple of them in the show note captions.

我将在节目注释标题中提供至少其中几个的链接。

Here, I have to say I have not tried those mouthwashes yet.

在这里，我不得不说我还没有尝试过那些漱口水。

They do come from sources in which they were developed by licensed dental healthcare professionals, but as is always the case when somebody's selling something, it's worthwhile to due diligence.

它们确实来自有执照的牙科保健专业人士开发的来源，但就像有人销售东西时的情况一样，值得进行尽职调查。

Now, as we talk about toothpaste and mints and gums and mouthwashes, I think it's worth taking a step back and also asking the question, are there any zero or very, very low cost or even cost-saving alternatives to any of this?

现在，当我们谈论牙膏、薄荷糖、口香糖和漱口水时，我认为值得退后一步并提出一个问题，是否有任何零成本或非常、非常低成本甚至节省成本的替代品？

And the great answer is yes.

最好的答案是肯定的。

There are actually a number of things that you can do with basic over-the-counter stuff from the grocery store that all the dentists I spoke to said, "Yeah, that's a pretty good option.

实际上，你可以用杂货店里的基本非处方药做很多事情，我采访过的所有牙医都说：“是的，这是一个非常好的选择。

It's not the best option available perhaps, but it's a pretty good option, and in many cases, it's better than the typical commercially available toothpaste or mouthwash." For instance, I would imagine, based on everything I now know about the structure of teeth, that using something like baking soda to brush the teeth would indeed scrape off the biofilm, perhaps even whiten the teeth a little bit, although as we talked about earlier, you're not really whitening the teeth, you're actually just changing the reflectiveness and some of the composition of that enamel, which is translucent, so that you can see the underlying components better.

这也许不是最好的选择，但它是一个相当不错的选择，在许多情况下，它比典型的市售牙膏或漱口水更好。”例如，我可以想象，根据我现在对牙齿结构的了解，使用小苏打之类的东西刷牙确实会刮掉生物膜，甚至可能稍微美白牙齿，尽管正如我们之前谈到的，你并没有真正美白牙齿，你实际上只是改变了反射率和牙釉质的一些成分，牙釉质是半透明的，这样你就可以更好地看到下面的成分。

Well, I talked to several dentists, and they told me that baking soda actually is fairly low on the abrasiveness rating scale.

嗯，我和几位牙医交谈过，他们告诉我，小苏打的磨蚀性等级实际上相当低。

They have a specific rating scale for this that we don't have to go into, but it's actually considered quite safe for the enamel of the teeth, especially if you're brushing with a soft toothbrush and you're not really grinding the stuff against your teeth at maximum intensity or even near maximum intensity.

他们对此有一个具体的评级标准，我们不必讨论，但实际上它被认为对牙釉质相当安全，特别是如果你用软牙刷刷牙，并且你并没有真正以最大强度甚至接近最大强度磨牙。

So it turns out that baking soda and water is actually a pretty good toothpaste if you're not going to go buy a toothpaste.

所以事实证明，如果你不打算去买牙膏的话，小苏打和水实际上是一种非常好的牙膏。

So that's good news.

这是个好消息。

Now, you may have heard that you can make a sort of mouthwash or mouth rinse with baking soda, water, and a little bit of hydrogen peroxide.

现在，您可能听说过可以用小苏打、水和一点过氧化氢制作一种漱口水或漱口水。

I want to emphasize a little bit, but I'm also going to emphasize I don't think this is a good idea at all.

我想强调一点，但我还要强调我认为这根本不是一个好主意。

Why is it not a good idea at all?

为什么这根本不是一个好主意？

Well, first of all, when we were kids, we used to take baking soda and hydrogen peroxide and put them together to simulate volcanoes, so that tells you right there the kind of chemical reaction that you're going to get.

嗯，首先，当我们还是孩子的时候，我们常常把小苏打和过氧化氢放在一起来模拟火山，这样就可以告诉你将会发生什么样的化学反应。

But in addition to that, it's pretty clear that hydrogen peroxide, unless there's a specific medical recommendation to do so, is not something you want to introduce to the oral cavity.

但除此之外，很明显，除非有特定的医学建议，否则您不应该将过氧化氢引入口腔。

Now, this is something that I'm very familiar with because when I was a postdoc, so this is in the 2005 to 2010 stretch, I started to get some pretty bad canker sores.

现在，这是我非常熟悉的事情，因为当我还是一名博士后时，也就是 2005 年到 2010 年期间，我开始出现一些非常严重的口腔溃疡。

I don't know about you, but canker sores feel awful to me.

我不了解你，但口腔溃疡让我感觉很糟糕。

I hate them.

我讨厌他们。

When you eat, they hurt.

当你吃东西时，它们会受伤。

When you swallow, they hurt.

当你吞咽时，它们会受伤。

When you do anything, they pretty much hurt.

当你做任何事情时，他们都会很受伤。

And someone gave me the recommendation to use a little bit of baking soda dissolved in some water and a little bit of hydrogen peroxide, and to use that as a oral rinse and of course then to spit it out.

有人建议我使用一点点小苏打溶解在一些水和一点点过氧化氢中，然后用它作为口腔冲洗剂，当然然后把它吐出来。

And I did that, and actually what happened to me is I got almost quarter-size ulcers on the roof of my mouth and on the sides of my mouth.

我这样做了，实际上发生在我身上的是，我的上颚和嘴两侧出现了几乎四分之一大小的溃疡。

It took those little canker sores, which were annoying and kind of painful, and turned them into full-blown ulcers.

它把那些令人烦恼和痛苦的小溃疡变成了全面的溃疡。

I know this because when I stopped using it, those healed up almost immediately.

我知道这一点是因为当我停止使用它时，那些症状几乎立即痊愈。

And then when I spoke to some dentists and periodontists, they said, "Oh, yeah, yeah, hydrogen peroxide is just far too abrasive for the mouth cavity." And the reason I raise this is because I don't think I'm alone in that if you kind of venture into some of the, let's call it alternative recommendation space for oral health, you may hear that things like hydrogen peroxide can be useful for gargling with or swishing with if you are starting to get a little bit of a throat tickle, maybe an infection.

然后当我与一些牙医和牙周病医生交谈时，他们说，“哦，是的，是的，过氧化氢对口腔来说太磨蚀了。”我提出这个问题的原因是，我认为我并不孤单，如果你冒险进入一些口腔健康的替代推荐空间，你可能会听说，如果你开始感到喉咙有点痒，可能是感染，过氧化氢之类的东西可以用来漱口或漱口。

It turns out it's a really bad idea.

事实证明这是一个非常糟糕的主意。

Now, if there are physicians or oral health experts out there that strongly believe in the use of hydrogen peroxide rinses or gargling with it to promote oral health for any reason, let me know in the show note captions.

现在，如果有医生或口腔健康专家出于任何原因坚信使用过氧化氢冲洗或漱口来促进口腔健康，请在节目说明标题中告诉我。

I don't want to go against any of those recommendations.

我不想反对任何这些建议。

But this now considered kind of old school recommendation of creating one's own mouthwash with a little bit of baking soda, some hydrogen peroxide, and water does not seem like a good idea, not just based on my experience, but every one of the dental professionals that I spoke to.

但现在，这种用一点小苏打、一些过氧化氢和水自制漱口水的老派建议似乎并不是一个好主意，不仅根据我的经验，而且根据我采访过的每一位牙科专业人士的经验。

That said, it does seem that creating a high salt solution Okay, so taking some salt, putting it into water, dissolving it, and then finding the point at which it won't quite dissolve because the concentration of sodium is just high enough and using that as, of course, not something to swallow, but rather as a dental rinse.

也就是说，似乎确实可以制造高盐溶液好吧，所以取一些盐，将其放入水中，溶解它，然后找到它不会完全溶解的点，因为钠的浓度足够高，当然，不要将其用作吞咽的东西，而是用作牙科冲洗剂。

So putting it in your mouth and swishing it around, and then spitting it out, and it's going to taste very salty.

所以放进嘴里晃一晃，然后吐出来，味道会很咸。

And then taking a swig of water, just plain water, and then swishing it around and then spitting it out.

然后喝一大口水，只是白开水，然后漱口，然后吐出来。

That actually provides a really nice milieu for the production of healthy mouth bacteria.

这实际上为健康口腔细菌的产生提供了一个非常好的环境。

It's near zero cost.

成本几乎为零。

I suppose you need a little bit of salt, a little water, and a glass to put it in, but it's basically zero cost.

我想你需要一点盐、一点水和一个玻璃杯才能放进去，但这基本上是零成本。

And if you think about it, that high saline or high salinity solution is a lot like the sort of brines and the liquid that comes from these low-sugar probiotic foods that earlier I was suggesting, and in other episodes I've suggested, could be really healthy for swallowing for the gut microbiota.

如果你仔细想想，这种高盐度或高盐度溶液很像我之前建议的、以及我在其他剧集中建议的低糖益生菌食品中产生的盐水和液体，对于肠道微生物群来说，吞咽可能非常健康。

But again, I want to be very clear, do not swallow high salt concentration fluid.

但再次强调，我要非常明确的是，不要吞咽高盐浓度的液体。

We're talking about a swish and then a spitting it out as a way to improve the overall milieu of the mouth, to get the pH right, to promote the proliferation of healthy microbiota components.

我们谈论的是漱口然后吐出来，作为改善口腔整体环境、调整 pH 值、促进健康微生物群成分增殖的一种方法。

Okay, so we've talked about some commercially available gums and mints containing xylitol.

好的，我们已经讨论了一些市售的含有木糖醇的口香糖和薄荷糖。

We've talked about some commercially available toothpaste.

我们已经讨论过一些市售牙膏。

Indeed, some toothpastes that almost fall into the very boutique category because they have all these things that are known by dentists and periodontists to be great for oral health.

事实上，有些牙膏几乎属于精品类别，因为它们拥有牙医和牙周病医生所知的所有这些对口腔健康有益的东西。

But those can run some cost, right?

但这些可能会产生一些成本，对吗？

And so I do think it's important that we also talked about the use of just baking soda with a soft toothbrush and some water and gently brushing the teeth as a great way to disrupt the biofilm and clean your teeth.

因此，我确实认为重要的是，我们还讨论了使用小苏打和软牙刷和一些水并轻轻刷牙，这是破坏生物膜和清洁牙齿的好方法。

And a high salt solution as a swish and spit followed by a swish and spit with clear water, clean water, no salt in it, as a essentially very low cost or zero cost mouthwash.

高盐溶液作为漱口和吐口，然后用清水漱口和吐口，干净的水，不含盐，作为本质上非常低成本或零成本的漱口水。

Far and away different from the heavily scented alcohol-based antiseptic mouthwashes that are commercially available and that we know are basically not good for our oral microbiome.

与市售的香味浓郁的酒精抗菌漱口水截然不同，我们知道这些漱口水基本上对我们的口腔微生物群不利。

In addition, I'd like to point out that those alcohol-based mouthwashes that many people in the world use are also known to reduce the amount of nitric oxide that's produced in the oral cavity, and that's very important for the production of nitric oxide elsewhere in the body.

此外，我想指出的是，世界上许多人使用的含酒精漱口水也可以减少口腔中产生的一氧化氮的量，这对于身体其他部位产生一氧化氮非常重要。

Why is that important?

为什么这很重要？

Well, nitric oxide promotes vasodilation, not just within the blood vessels that line and feed the oral cavity, but also the throat, also in the nose, also in the brain, also in the heart.

一氧化氮不仅促进口腔内的血管舒张，而且还促进喉咙、鼻子、大脑和心脏的血管舒张。

So what we're talking about here is a substance that is indeed increased when we, for instance, nasal breathe.

所以我们在这里讨论的是一种物质，当我们用鼻子呼吸时，这种物质确实会增加。

We know that dramatically increases nitric oxide.

我们知道这会显着增加一氧化氮。

We're talking about a substance that when the oral microbiome is preserved in its healthy state, tends to increase in production.

我们谈论的是一种物质，当口腔微生物组保持健康状态时，其产量往往会增加。

And we're talking about a substance that's really good for small capillary vein and arterial health because it allows for the passage of blood, both for the delivery of oxygen and other nutrients to tissues, but also the removal of waste products from tissues.

我们谈论的是一种对小毛细血管和动脉健康非常有益的物质，因为它允许血液通过，既可以将氧气和其他营养物质输送到组织，又可以清除组织中的废物。

So we don't want to do anything that reduces nitric oxide unless there's some specific medical condition that leads us to want to do that.

因此，我们不想做任何减少一氧化氮的事情，除非有某种特定的医疗状况导致我们想要这样做。

So for most people, increasing nitric oxide or keeping nitric oxide levels stable is the state that we want to seek.

所以对于大多数人来说，增加一氧化氮或者保持一氧化氮水平稳定才是我们想要寻求的状态。

And these alcohol-based mouthwashes are known to deplete the production of nitric oxide.

众所周知，这些含酒精的漱口水会消耗一氧化氮的产生。

So there's yet another reason to avoid the use of these alcohol-based, more typical over-the-counter mouthwashes.

因此，还有另一个理由避免使用这些含酒精的、更典型的非处方漱口水。

By the way, this is not a scare tactic against mouthwashes.

顺便说一句，这并不是针对漱口水的恐吓策略。

I'm sure that if you use mouthwashes, you're still producing some nitric oxide, but I think nowadays many, hopefully all of you, are interested in doing whatever you can to improve your mental health, physical health, and performance.

我确信，如果您使用漱口水，您仍然会产生一些一氧化氮，但我认为现在许多人，希望是你们所有人，都有兴趣尽一切努力来改善您的心理健康、身体健康和表现。

And if there are things that you are doing that are inhibiting those in any way, that you'd potentially want to at least think about those, maybe remove them from your protocols, especially if there's a cost to them that you can remove.

如果你正在做的事情以任何方式抑制了这些，你可能至少要考虑一下这些，也许将它们从你的协议中删除，特别是如果你可以删除它们的成本的话。

In other words, you can save on costs.

换句话说，您可以节省成本。

So again, lots of reasons to move away from the alcohol-based standard antiseptic mouthwashes.

再说一遍，有很多理由放弃使用含酒精的标准抗菌漱口水。

Aside from the improvement in your breath, that, by the way, can be better achieved by supporting the oral microbiome other ways that we've discussed, there's really no clear advantage as to why one would use one, and there apparently are a number of disadvantages.

顺便说一句，除了改善呼吸之外，可以通过我们讨论过的其他方式支持口腔微生物组来更好地实现这一点，但对于为什么人们会使用它确实没有明显的优势，而且显然有很多缺点。

Now, earlier we talked briefly about canker sores.

现在，早些时候我们简要讨论了口腔溃疡。

They are really uncomfortable.

他们真的很不舒服。

There are a lot of theories as to why canker sores form, and there are a lot of products and theories as to how to get rid of canker sores.

关于口腔溃疡形成的原因有很多理论，关于如何消除口腔溃疡也有很多产品和理论。

Well, indeed, there are some ways that we can prevent the formation of canker sores and accelerate their healing, and that actually has to do with promoting the health of the gut microbiome.

嗯，确实，我们可以通过一些方法来预防口腔溃疡的形成并加速其愈合，这实际上与促进肠道微生物组的健康有关。

So there's a clear link between gut microbiome and oral microbiome in a way that can either promote or reduce the formation of canker sores and can actually help heal canker sores.

因此，肠道微生物组和口腔微生物组之间存在明显的联系，可以促进或减少口腔溃疡的形成，并且实际上可以帮助治愈口腔溃疡。

And to my knowledge, the best way to support a "healthy gut microbiome" is to consume at least one to four servings of low-sugar fermented foods per day.

据我所知，支持“健康肠道微生物组”的最佳方法是每天至少食用一到四份低糖发酵食品。

I mentioned what some of those are a little bit earlier.

我之前提到过其中一些内容。

I also did an entire episode about gut microbiome.

我还制作了一整集关于肠道微生物组的节目。

We've hosted expert guests on the microbiome, including Justin Sonnenburg from Stanford School of Medicine.

我们接待了微生物组方面的专家嘉宾，其中包括斯坦福大学医学院的贾斯汀·索南伯格 (Justin Sonnenburg)。

And for sake of time, I can just briefly list off the things that are known to promote a healthy gut microbiome and that would indirectly support the healing and prevention of canker sores.

为了节省时间，我可以简单地列出已知的可促进健康肠道微生物组并间接支持口腔溃疡愈合和预防的物质。

And those are consuming one to four servings of low-sugar fermented foods per day.

这些人每天食用一到四份低糖发酵食品。

For instance, consuming enough prebiotic fiber, so consuming enough fiber in the diet through fruits and vegetables, or perhaps supplementing prebiotic or probiotic fiber.

例如，摄入足够的益生元纤维，通过水果和蔬菜在饮食中摄入足够的纤维，或者补充益生元或益生菌纤维。

And in some cases, if somebody is really dysbiotic or if you've been taking antibiotics, actually taking a pill form or capsule form probiotic.

在某些情况下，如果某人确实存在菌群失调，或者您一直在服用抗生素，那么实际上会服用药丸或胶囊形式的益生菌。

But it's not something that I recommend people take consistently, and I certainly don't.

但这并不是我建议人们始终如一地采取的措施，我当然也不会这样做。

I think by ingesting those low-sugar fermented foods on a regular basis By trying to make sure that you're getting enough sleep each night.

我认为通过定期摄入那些低糖发酵食品来确保你每晚都有足够的睡眠。

This is key.

这是关键。

Probably should've mentioned this earlier in the episode, but one of the folks who I have great respect for in the public health discussion around dental health is Dr. Mark Burhenne.

也许应该在本集早些时候提到这一点，但在有关牙齿健康的公共卫生讨论中我非常尊敬的人之一是马克·伯亨博士 (Mark Burhenne)。

He goes by AsktheDentist on Instagram.

他在 Instagram 上的昵称是 AsktheDentist。

He's actually a retired dentist, but he's been deeply involved in the kind of evaluation of the consumer product space as it relates to dental and oral healthcare for a number of years.

他实际上是一名退休牙医，但多年来他一直深入参与与牙科和口腔保健相关的消费品领域的评估。

And Mark Burhenne, in addition to discussing all the various topics that we've talked about today, such as xylitol and fluoride yes or fluoride no, et cetera, has also been a big proponent of people paying attention to that first pillar of mental health, physical health, and performance, which is sleep, and pointing out that when people get fewer than their necessary allotment of sleep each night, so typically most people need six to eight hours, some people need more, some people need a little less, but getting at least six to eight hours of quality sleep per night, which supports the health of the gut microbiome and oral microbiome, and thereby indirectly supports the health of the entire brain and body.

马克·伯亨尼（Mark Burhenne）除了讨论我们今天讨论的所有各种主题（例如木糖醇和氟化物是或氟化物否等）之外，还大力支持人们关注心理健康、身体健康和表现的第一支柱，即睡眠，并指出，当人们每晚的睡眠时间少于其必要的睡眠分配时，通常大多数人需要六到八个小时，有些人需要更多，有些人需要少一点，但是每晚至少获得六到八小时的优质睡眠，这有助于肠道微生物组和口腔微生物组的健康，从而间接支持整个大脑和身体的健康。

So, Dr. Burhenne and others have talked about this, but I really appreciate that he's championed the importance of sleep, among other things, but certainly sleep as a way to support the oral microbiome.

Burhenne 博士和其他人已经讨论过这个问题，但我真的很欣赏他对睡眠等重要性的倡导，但睡眠无疑是支持口腔微生物组的一种方式。

So we've talked quite a bit about teeth and gums, a little bit about mucosal lining and throat.

我们已经讨论了很多关于牙齿和牙龈的问题，也讨论了一些关于粘膜内层和喉咙的问题。

One thing that we haven't talked very much about is the tongue.

我们还没有谈论太多的一件事是舌头。

Your tongue is obviously a very important component of your mouth.

舌头显然是口腔的一个非常重要的组成部分。

And as I mentioned earlier, different niches, different locations within the mouth have different microbiota living on them, both good and "bad," meaning ones that we'd like to promote the proliferation of because they reduce bad breath and promote oral health and all that good stuff, and "bad" bacteria because they make our breath smell bad and because they deteriorate the various tissues of the mouth.

正如我之前提到的，口腔内不同的生态位、不同的位置上生活着不同的微生物群，有好的微生物群，也有“坏的”微生物群，这些微生物群是我们希望促进增殖的微生物群，因为它们可以减少口臭，促进口腔健康和所有这些好东西，而“坏”的细菌是因为它们使我们的口气闻起来难闻，并且会恶化口腔的各种组织。

I looked pretty extensively into this issue of tongue scraping, and it's an interesting one.

我对刮舌这个问题进行了相当广泛的研究，这是一个有趣的问题。

And every licensed dental healthcare professional I spoke to in preparing for this episode agreed that, yes, it can be a good idea to scrape the tongue.

在准备这一集时，我采访过的每一位有执照的牙科保健专业人士都同意，是的，刮舌头可能是个好主意。

And each one of them cited the fact that a number of unhealthy bacteria can build up on the tongue across the course of the day and throughout the night, much in the same way that biofilm can build up on teeth, although through a different process, different bacteria, and that scraping the tongue or brushing the tongue can be advantageous for removing that bacteria.

他们每个人都提到了这样一个事实，即许多不健康的细菌会在白天和整个晚上在舌头上积聚，就像生物膜在牙齿上积聚一样，尽管通过不同的过程，产生不同的细菌，而刮舌头或刷舌头可能有利于去除这些细菌。

What was interesting is that several of them pointed out that lightly brushing the tongue may in fact be better than scraping the tongue because they argue that, especially when people use those steel tongue scrapers, that few people know how to use them with sufficient force to remove the bacteria, but not so much force that they don't damage the tongue tissue, and the tongue is a very fragile soft tissue.

有趣的是，他们中的一些人指出，轻轻刷舌头实际上可能比刮舌头更好，因为他们认为，特别是当人们使用那些钢制刮舌器时，很少有人知道如何使用它们以足够的力来去除细菌，但不要用力过大，以免损坏舌头组织，而舌头是非常脆弱的软组织。

So the recommendation that they relayed to me was to suggest once or twice a day brushing of the tongue.

因此，他们向我传达的建议是建议每天刷一到两次舌头。

But here's an important point.

但这里有一个重要的点。

They all suggested that you use a separate toothbrush to brush your tongue than you would to brush your teeth.

他们都建议您使用单独的牙刷来刷舌头，而不是刷牙。

Okay?

好的？

So if things weren't complicated enough already, talking about using a separate toothbrush.

因此，如果事情还不够复杂，可以考虑使用单独的牙刷。

Why?

为什么？

Well, they gave two reasons.

好吧，他们给出了两个理由。

One is they want to prevent crossover of the bacteria between those two different tissues, especially if one is brushing the tongue too vigorously.

一是他们想防止细菌在这两种不同的组织之间交叉，特别是当人们刷舌头的力度太大时。

You don't want to introduce bacteria from your toothbrushing onto your tongue.

您不想将刷牙时产生的细菌带入舌头。

Of course, you can rinse it in between, but the ideal situation is to use a separate toothbrush for the purpose of brushing the tongue.

当然，您可以在中间冲洗，但理想的情况是使用单独的牙刷来刷舌头。

Now that opened up a whole exploration and discussion about toothbrush care.

这就开启了关于牙刷护理的整体探索和讨论。

We could probably do a whole episode all about toothbrush care, but we won't.

我们也许可以制作一整集都是关于牙刷护理的，但我们不会。

Suffice to say that when you brush bacteria off your teeth or tongue, and presumably the toothbrush gets moist if by no other means, certainly by means of your saliva being on it, then you rinse it off, and then even if you were to dry it off with some sort of clean towel or something like that, and you set it out, a lot of bacteria are going to proliferate on that toothbrush.

可以这么说，当你刷掉牙齿或舌头上的细菌时，如果没有其他方式，当然是通过你的唾液在上面，牙刷可能会变得潮湿，然后你把它冲洗掉，然后即使你用某种干净的毛巾或类似的东西把它擦干，然后把它拿出来，很多细菌也会在牙刷上繁殖。

So this opened up a whole discussion about should you cover your toothbrush or let it dry out in the air?

因此，这引发了一场关于你应该盖住牙刷还是让它在空气中风干的讨论。

Should you use UV irradiation to sterilize your toothbrush?

应该使用紫外线照射来给牙刷消毒吗？

And frankly, it took us, me, down the rabbit hole of toothbrush care so far that at one point I just screamed, "Uncle," like enough.

坦率地说，到目前为止，我们，我，已经陷入了牙刷护理的兔子洞，以至于有一次我只是尖叫，“叔叔”，就像足够了。

I think one has to decide how much bacteria they are willing to tolerate living on their toothbrush in between toothbrushings.

我认为人们必须决定在刷牙之间他们愿意忍受多少细菌生活在牙刷上。

Anywhere from zero, where you use a new toothbrush or toothbrush head every single time you brush, that seems unreasonable, or at least economically unreasonable for most people, versus replacing it once a week versus once every two weeks.

从零开始，每次刷牙时都使用新的牙刷或牙刷头，这似乎不合理，或者至少对大多数人来说在经济上不合理，而不是每周更换一次或每两周更换一次。

Really there's no specific recommendation I can make.

确实我无法提出具体的建议。

All I can say is be aware that bacteria are growing on the toothbrush head.

我只能说，要注意细菌在牙刷头上生长。

Try and avoid contact between the toothbrush head and any unsanitary surfaces.

尽量避免牙刷头与任何不卫生的表面接触。

Try and rinse and dry off the toothbrush head.

尝试冲洗并擦干牙刷头。

All these things are recommendations that were relayed to me and that just make good common sense.

所有这些都是我转达给我的建议，而且都是很好的常识。

Now prior to this episode, I put the call out on social media for questions about oral health, and one of the questions that came back from many hundreds of people was what about fillings?

在这一集之前，我在社交媒体上呼吁人们询问有关口腔健康的问题，数百人提出的问题之一是补牙怎么样？

What about metal fillings?

金属填充物怎么样？

What about sealants?

密封剂呢？

Are they safe?

他们安全吗？

Well, most dentists will tell you that sealants are safe.

大多数牙医都会告诉您密封剂是安全的。

They are now made from compounds that are generally not thought to cause any major issues.

它们现在由通常被认为不会引起任何重大问题的化合物制成。

To be honest, I did not do a deep dive into the chemical composition of different sealants because it turns out that different dental practices use different sealants.

老实说，我没有深入研究不同密封剂的化学成分，因为事实证明不同的牙科诊所使用不同的密封剂。

I'm sure that if I looked hard enough, I could find some really bad stuff in sealants.

我确信，如果我足够仔细地观察，我会在密封剂中发现一些非常糟糕的东西。

I'm sure I could also find some reassurance that at the concentrations and conditions that they're introduced to teeth, that they are a better alternative to having deep cavities into the teeth.

我确信我还可以找到一些保证，即在将它们引入牙齿的浓度和条件下，它们是比在牙齿上形成深洞更好的替代方案。

And that actually gives me an opportunity to raise something that I perhaps said earlier but I want to reemphasize, which is I've been talking about how you can remineralize the teeth and how that's ...

这实际上让我有机会提出一些我之前说过但我想再次强调的事情，那就是我一直在谈论如何使牙齿重新矿化以及这是如何......

critical if you want to maintain and build up your tooth and oral health.

如果您想保持和增强牙齿和口腔健康，这一点至关重要。

But it's very clear that if the cavities get down into the dentine layers of the tooth, that in most cases, there is no remaining opportunity to remineralize the teeth using the sorts of practices we're talking about today, and that indeed, it's very likely that those cavities need to be drilled and filled.

但很明显，如果蛀牙深入到牙齿的牙本质层，在大多数情况下，就没有机会使用我们今天讨论的各种做法对牙齿进行再矿化，而且实际上，这些蛀牙很可能需要钻孔和填充。

Now, that's not always the case, and this is one reason why I highly recommend that if you've listened to this episode, and if you're here at this point in the episode, then you've listened to the episode, that you talk to your dentist.

现在，情况并非总是如此，这就是为什么我强烈建议您如果听过这一集，并且如果您在这一集中的这一点，那么您已经听过这一集，并且与您的牙医交谈。

Ask them if they say you have a cavity, "How deep are these cavities?

询问他们是否说您有蛀牙，“这些蛀牙有多深？

Do you think there's an opportunity for me to remineralize the teeth if I do the following things?" And if they tell you, "Look, you have a cavity or cavities, and they're simply too deep into the tooth that you can't remineralize your teeth and fill those in," well, then you should trust them.

您认为如果我做以下事情，我有机会重新矿化牙齿吗？”如果他们告诉你，“看，你有一个或多个蛀牙，而且它们在牙齿中太深了，你无法再矿化你的牙齿并填补它们，”那么你应该相信他们。

They're the dental professional.

他们是牙科专家。

If you don't, then you should find a different dentist.

如果你不这样做，那么你应该找一位不同的牙医。

However, they may be surprised, and who knows, pleasantly surprised for you to say, "Hey, I heard that you can actually remineralize teeth, and if I've got a cavity but it's still not through the enamel layer, if I'm really diligent and use some xylitol and maybe some hydroxyapatite and avoid certain things and do certain things discussed in this episode, that I could remineralize and fill in those cavities." That said, there, of course, will be situations where you need to get those cavities drilled and filled, especially if they make it into the deep layers of the tooth.

然而，他们可能会感到惊讶，谁知道呢，你会惊喜地说，“嘿，我听说你实际上可以使牙齿再矿化，如果我有蛀牙，但它仍然没有穿过牙釉质层，如果我真的很勤奋，使用一些木糖醇，也许还有一些羟基磷灰石，避免某些事情，做本集中讨论的某些事情，我就可以再矿化并填充这些蛀牙。”也就是说，当然，在某些情况下您需要钻孔和填充这些蛀牙，特别是当它们进入牙齿深层时。

And you do not want those cavities to persist and for bacteria to proliferate in those deeper layers of the teeth and down into the bone.

而且您不希望这些蛀牙持续存在，也不希望细菌在牙齿的深层繁殖并深入骨骼。

That is so bad for reasons we talked about earlier, not just for your mouth and your teeth, but for your general health and brain health included.

由于我们之前讨论过的原因，这非常糟糕，不仅对您的口腔和牙齿，而且对您的整体健康和大脑健康也包括在内。

So for that reason, and also because the history of dentistry was such that in the early part of the last century, if you had a toothache and a cavity, what did they do?

因此，出于这个原因，也因为牙科的历史是这样的，在上世纪初，如果你牙痛和蛀牙，他们会怎么做？

They pulled the teeth.

他们拔掉了牙齿。

They extracted the teeth.

他们拔掉了牙齿。

Then at some point, this business of filling teeth became industry standard, so people would get metal fillings.

然后在某个时候，这种填充牙齿的业务成为行业标准，因此人们会得到金属填充物。

Now, the types of metal fillings that people had and have depend on when they got those fillings.

现在，人们拥有和拥有的金属填充物的类型取决于他们何时获得这些填充物。

There were, believe it or not, lead fillings.

不管你信不信，里面有铅填充物。

This is not good.

这不好。

You don't want lead in your body for all sorts of reasons.

出于各种原因，您不希望体内含有铅。

It is terrible for brain health.

这对大脑健康来说是可怕的。

That's why it's now illegal to contain in paints and many household goods.

这就是为什么现在油漆和许多家庭用品中含有这种物质是非法的。

You don't want lead fillings.

你不需要铅填充物。

But some people had lead fillings or silver fillings or a combination of lead, silver, and other things.

但有些人有铅填充物或银填充物或铅、银和其他物质的组合。

And many metal fillings that were given, and sometimes are still given, depending on where you live in the world and country, and the kind of healthcare and costs that you have available to you, contain mercury.

许多金属填充物（有时仍在使用）都含有汞，具体取决于您居住在世界上的哪个地方和国家/地区，以及您可以获得的医疗保健类型和费用。

Now, I asked several dentists about this and said, "Well, if somebody has a metal filling that likely has mercury in it, do they need to have that metal filling removed?" And all of the dentists I spoke to said it depends, but generally, the practice is to leave those fillings in and try not to disrupt them.

现在，我问了几位牙医，并说：“好吧，如果有人的金属填充物中可能含有汞，他们是否需要去除金属填充物？”我采访过的所有牙医都说这要看情况，但一般来说，做法是保留这些填充物并尽量不要破坏它们。

Now, they also provided an important recommendation, which is if you have metal fillings that contain mercury or that you think might contain mercury, to avoid disrupting those fillings through the use of things like mastic gum.

现在，他们还提供了一个重要的建议，即如果您有含有汞或您认为可能含有汞的金属填充物，请避免使用乳香胶等物质来破坏这些填充物。

We haven't talked too much about mastic gum.

我们还没有过多谈论乳香。

I've used mastic gum before, not for long periods of time.

我以前用过乳香胶，但时间不长。

It's a very thick gum.

这是一种很厚的口香糖。

The original use of mastic gum and the origins of mastic gum are like a tree sap kind of substance that you chew on.

乳香胶的最初用途和乳香胶的起源就像是一种可供咀嚼的树汁物质。

It's supposed to strengthen your jaw, et cetera.

它应该可以增强你的下巴等等。

I don't use it any longer.

我不再使用它了。

I used it for a short while.

我用了很短一段时间。

It doesn't taste like much of anything.

它尝起来没什么味道。

Some people believe there are certain anti-inflammatory and other health benefits of mastic gum.

有些人认为乳香具有一定的抗炎和其他健康益处。

I haven't really explored mastic gum in enough depth or detail to comment on any of that.

我还没有真正深入或详细地探索乳香，无法对此发表评论。

But a number of dentists said, "Well, if you have metal fillings, chewing on things like mastic gum or hard candies where you're really chewing on that hard candy," which by the way, you're supposed to suck the hard candy, the Jolly Rancher, you're not supposed to chew on them, but that some people will do that.

但一些牙医说，“好吧，如果你有金属填充物，咀嚼乳香或硬糖之类的东西，你实际上是在咀嚼硬糖，”顺便说一句，你应该吮吸硬糖，快乐牧场主，你不应该咀嚼它们，但有些人会这样做。

They'll just naturally chew on those, can actually disrupt and liberate some of that mercury, and that would be bad.

它们会自然地咀嚼这些物质，实际上会破坏并释放出一些汞，这会很糟糕。

And keep in mind also that when mercury is contained in a metal filling, it's not really bioactive in that mode, but if it's liberated, then it can get into the bloodstream and potentially cause other issues.

还要记住，当金属填充物中含有汞时，它在这种模式下并不具有真正的生物活性，但如果它被释放，那么它可能会进入血液并可能导致其他问题。

So this is a somewhat controversial topic, so much so that in certain countries, and I believe in the EU, somebody check me on this, but I believe that in the not-too-distant future, metal fillings will no longer be used in the European Union, perhaps elsewhere in the world.

所以这是一个有点争议的话题，以至于在某些国家，我相信在欧盟，有人在这方面检查我，但我相信在不久的将来，金属填充物将不再在欧盟使用，也许在世界其他地方。

They're sometimes still used in the United States.

它们有时仍在美国使用。

There's a lot that's changing in this landscape around fluoride, around metal fillings, et cetera, so it's a very dynamic landscape right now.

围绕氟化物、金属填充物等的景观正在发生很多变化，所以现在是一个非常动态的景观。

I think suffice to say that if you have metal fillings currently, try not to disrupt them in a way that could liberate that mercury.

我认为只要说一下，如果您目前有金属填充物，请尽量不要以可能释放汞的方式破坏它们。

However, if you have them and you're really concerned about them, talk to your dentist, ask what the various options are, see whether or not they could be replaced with something safer, and if the process for replacing them is really worth the trouble.

然而，如果你有它们并且你真的很担心它们，请咨询你的牙医，询问有哪些不同的选择，看看是否可以用更安全的东西代替它们，以及更换它们的过程是否真的值得麻烦。

And again, to just go back to the larger point of whether or not you should get cavities filled, whether or not you need that root canal, that was a very common question.

再说一次，回到更重要的问题，是否应该填充蛀牙，是否需要根管治疗，这是一个非常常见的问题。

A lot of people said, "Do we really need root canals?

很多人问：“我们真的需要根管治疗吗？

Do we really need to drill cavities?" My observation, based on now having talked to a number of different practitioners in this space who really pay a lot of attention to the peer-reviewed research, the old school practices, the new practices, and where everything is headed, is that there are indeed instances where people need root canals.

我们真的需要钻洞吗？”根据我与该领域许多不同从业者的交谈，我的观察是，确实存在人们需要根管治疗的情况，他们确实非常关注同行评审的研究、旧式实践、新实践以及一切的发展方向。

There are many cavities that are just too deep into the teeth that remineralization of the teeth through the sorts of protocols that we're talking about today is not going to cut it, that they really need to be drilled and filled.

有许多蛀牙距离牙齿太深，通过我们今天讨论的各种方案对牙齿进行再矿化并不能消除蛀牙，它们确实需要钻孔和填充。

And of course, we hope those dentists are doing that as little as is required to maintain dental health.

当然，我们希望这些牙医在保持牙齿健康所需的范围内尽可能少地这样做。

I also would hope that dentists are talking to their patients about ways that they can improve their oral health.

我还希望牙医能够与患者讨论改善口腔健康的方法。

And indeed, there are a lot of cases reported online where people will go in, get X-rays and an exam, they'll talk about all these cavities that they have, and then they go home and they do a bunch of practices, and they are able to remineralize their teeth and to essentially reverse those cavities.

事实上，网上有很多报道的案例，人们会去医院接受 X 光检查和检查，他们会谈论他们所拥有的所有这些蛀牙，然后他们回家并进行一系列练习，他们能够使牙齿重新矿化并从根本上扭转这些蛀牙。

And I certainly don't doubt those stories, but it's simply not always the case that we can remineralize our teeth and fill back in our cavities if those cavity recesses are too deep into the teeth, they need to be drilled and filled.

我当然不怀疑这些故事，但情况并不总是如此，如果这些空洞凹进牙齿太深，我们需要钻孔和填充，我们就可以重新矿化我们的牙齿并填充我们的空洞。

Now, that raises a final set of questions and points, which is, do we really need to go to the dentist twice a year, every six months?

现在，这就提出了最后一组问题和要点，那就是，我们真的需要每年去看牙医两次，每六个月一次吗？

That's the general recommendation.

这是一般建议。

And this was a tricky one to ask dentists because, of course, dentists are highly incentivized to see their patients, and I'm not somebody that believes that everything is an attempt to make money.

向牙医询问这是一个棘手的问题，因为当然，牙医非常有动力去看他们的病人，而且我不是一个相信一切都是为了赚钱的人。

But look, when money's involved, things can get complicated.

但你看，当涉及到金钱时，事情就会变得复杂。

Now, what was really great is that the feedback I got from dentists was very balanced.

现在，真正很棒的是我从牙医那里得到的反馈非常平衡。

I must say that the community of dentists seems like a really wonderful community.

我必须说，牙医社区似乎是一个非常棒的社区。

I don't know how they treat each other, but they were very kind, very generous with information with me.

我不知道他们如何对待彼此，但他们非常友善，非常慷慨地向我提供信息。

And at the end of this episode, just before wrapping, I'll refer you to a couple online oral health and dentist educators that I think are providing some really useful content on a consistent basis.

在本集结束时，就在结束之前，我将向您推荐几位在线口腔健康和牙医教育工作者，我认为他们正在持续提供一些真正有用的内容。

And I'll provide links to those in the show note captions.

我将提供节目注释标题中的链接。

But here's what the consensus was.

但这就是共识。

This business of going to the dentist twice a year makes sense.

每年去看两次牙医是有道理的。

It makes sense from the perspective of, quote-unquote, "routine cleanings," but everyone acknowledged that those routine cleanings, while they can remove tartar that's built up, that would be very, very difficult for people to reverse or eliminate at home, and while they can identify cavities and tell you how far a cavity has developed into the tooth, et cetera, every one of those dentists agreed that those routine cleanings are not actually going to help remineralize your teeth except to the extent that they remove existing bacteria, plaque, and tartar.

从“例行清洁”的角度来看，这是有道理的，但每个人都承认，这些例行清洁虽然可以去除积聚的牙垢，但人们在家里逆转或消除牙垢是非常非常困难的，虽然他们可以识别蛀牙并告诉你蛀牙已经发展到牙齿的程度等等，但每一位牙医都同意，这些例行清洁实际上不会帮助你的牙齿再矿化，除非它们去除了现有的牙垢。细菌、牙菌斑和牙垢。

And so all of them said that they wish for and that they really strive in their own practices to promote more oral health daily protocols of the sort that we've talked about today, which I think is just great.

因此，他们所有人都表示，他们希望并且确实在自己的实践中努力促进更多的口腔健康日常方案，就像我们今天讨论的那样，我认为这非常棒。

I think, obviously, I believe in medical professionals providing routine care.

我认为，显然，我相信医疗专业人员提供日常护理。

I also believe in each and all of us doing things for our health, not just oral health, but sleep health, mental health, physical health, et cetera, to try and not just maintain, but really bolster our brain and body against disease, and also to bolster our vitality to feel really great, energetic, focused, sleeping better, et cetera.

我也相信我们每个人都应该为自己的健康做一些事情，不仅仅是口腔健康，还有睡眠健康、心理健康、身体健康等等，不仅要努力维持，而且要真正增强我们的大脑和身体对抗疾病，并增强我们的活力，让我们感觉很棒、精力充沛、注意力集中、睡得更好等等。

So it was refreshing to hear that they feel that way as well.

所以听到他们也有这样的感觉真是令人耳目一新。

And in addition to that, all the dentists I spoke to said that setting aside situations of reconstructive surgery for the mouth or periodontal surgery, which often is needed if those recesses into the gums and gingivitis and worse have started to really develop and proliferate, all of them emphasized that the twice-a-year dental visit is not just about getting the cleaning.

除此之外，我采访过的所有牙医都表示，抛开口腔重建手术或牙周手术的情况不谈，如果牙龈凹陷和牙龈炎或更严重的情况开始真正发展和扩散，通常需要进行口腔重建手术或牙周手术，他们都强调一年两次的牙科检查不仅仅是为了清洁。

It's really the checkup to evaluate how those daily practices are emerging.

这实际上是评估这些日常实践如何形成的检查。

So it's sort of like going to the doctor for a checkup on your BMI, on your blood pressure, but also things like blood tests, things that typically we don't do at home unless we're accessing those through particular sources.

所以这有点像去看医生检查你的体重指数、血压，还有验血之类的事情，这些事情我们通常不会在家做，除非我们通过特定来源获取这些信息。

But all of them emphasized that going to the dentist twice a year is not just about those cleanings.

但他们都强调，每年去看两次牙医不仅仅是为了清洁牙齿。

It's also about establishing what the baseline level of health is in one's mouth and teeth, and having that on record and in a very detailed way so that one can check back routinely twice a year and discover whether or not, in fact, they could get away with perhaps one cleaning a year because you're so diligent about your brushing, flossing, xylitol, not being a mouth breather, and on and on.

它还涉及确定一个人的口腔和牙齿健康的基线水平，并以非常详细的方式记录下来，以便人们可以每年两次定期检查，并发现他们是否实际上可以每年进行一次清洁，因为你非常勤于刷牙、使用牙线、木糖醇，而不是张口呼吸等等。

Or perhaps if you're not being very good about those protocols, or, and this is important, if you have some of the genetic variants that create an overproliferation of certain bacteria that predispose you to gingivitis or that predispose you to excessive buildup of tartar.

或者，如果您对这些方案不太了解，或者，这一点很重要，如果您有一些基因变异，这些变异会导致某些细菌过度增殖，从而使您容易患牙龈炎或导致牙石过度堆积。

This is the reality that some people have genetic variations that create a susceptibility to certain things, both bacteria and other conditions in the mouth, that make it such that those people perhaps need to go to the dentist not just twice a year, but perhaps four times a year or six times a year.

现实是，有些人的基因变异会对某些东西（包括细菌和口腔中的其他状况）产生敏感性，这使得这些人可能不仅需要每年去看牙医两次，而且可能每年看四次或六次。

Indeed, there are some individuals for whom either because of lack of diligence to protocol and/or genetic issues actually need to go to the dentist every single month for major cleanings.

事实上，有些人由于缺乏遵守协议和/或遗传问题实际上需要每个月去看牙医进行大清洁。

But fortunately, if we are diligent about these daily protocols, nighttime protocols, and we really are paying attention to the components that can create healthy saliva and remineralize the teeth, and that can fill in any cavities that begin to form, and we're staving off the production of strep mutans, and we're scraping away that biofilm on a regular basis, that we are going to prevent the need for so many routine cleanings.

但幸运的是，如果我们认真执行这些日常方案、夜间方案，并且我们真正关注可以产生健康唾液和使牙齿再矿化的成分，并且可以填充任何开始形成的蛀牙，并且我们正在避免变形链球菌的产生，并且我们正在定期刮除生物膜，那么我们将不需要如此多的例行清洁。

And even if we are still getting those two-year routine cleanings, for those out there that are fortunate enough to have that covered by insurance or can afford it, well then, all the better.

即使我们仍然进行两年的例行清洁，对于那些有幸拥有保险或负担得起的人来说，那就更好了。

Because as I mentioned at the beginning of today's episode, oral health is not just about having clean, straight, white teeth and fresh breath.

因为正如我在今天节目开头提到的，口腔健康不仅仅是拥有干净、整齐、洁白的牙齿和清新的口气。

It's not just about that.

不仅仅是这个。

All of those things are great to have, but oral health is about all of that, and it's also about reducing cardiovascular disease.

所有这些都很棒，但口腔健康不仅与这些有关，而且还与减少心血管疾病有关。

It's about reducing irritable bowel syndrome.

这是关于减少肠易激综合症。

Yes, I know that we haven't done an episode about this yet, but I get, oh, so many requests to do episodes about irritable bowel syndrome and other colitis-type bowel and gut issues that people have.

是的，我知道我们还没有制作关于此的剧集，但是我收到了很多要求制作有关肠易激综合症和人们患有的其他结肠炎型肠道问题的剧集。

And it's so clear that oral health and promoting oral health has been linked to promoting positive gut health as well, maybe even reducing and possibly eliminating some of the symptoms of irritable bowel disease.

很明显，口腔健康和促进口腔健康也与促进积极的肠道健康有关，甚至可能减少甚至消除肠易激病的一些症状。

Because again, the mouth and the gut are contiguous with one another.

因为，嘴和肠道是相连的。

They're related, and a lot of the bacteria that can cause things like gut issues are making their way into the body, not directly through the gut, but through the oral cavity because of the richness of blood flow to that region.

它们是相关的，许多可能导致肠道问题等问题的细菌正在进入人体，不是直接通过肠道，而是通过口腔，因为流向该区域的血液丰富。

So again, today we've talked about a lot of different protocols, ranging from cost-saving to zero cost to low cost to, let's just be frank, higher cost products and protocols such as water picks, et cetera.

再说一次，今天我们讨论了很多不同的协议，从节省成本到零成本到低成本，坦率地说，更高成本的产品和协议，例如水镐等。

The point of today's discussion was essentially threefold.

今天讨论的要点主要有三个。

First of all, to really tamp down in our minds the importance of oral health, not just tooth health, but oral health on the whole because of its relationship to brain and body health on the whole.

首先，要真正认识到口腔健康的重要性，不仅仅是牙齿健康，而是整个口腔健康，因为它与整个大脑和身体健康有关。

So much so that I'm placing it right up there next to the other six pillars of sleep, nutrition, movement, stress modulation, relationships, and light as the seventh pillar of Critical to attend to on a daily basis in order to promote our mental health, physical health, and performance.

以至于我把它放在睡眠、营养、运动、压力调节、人际关系和光线等其他六大支柱旁边，作为每天需要注意的第七大支柱，以促进我们的心理健康、身体健康和表现。

The second point is that there are many things that we are probably doing currently that we could do differently, either by doing them more or perhaps less, or eliminating them altogether.

第二点是，我们目前可能正在做的许多事情我们可以采取不同的做法，要么多做一些，要么少做一些，或者完全消除它们。

Things like considering whether or not these antiseptic alcohol-based mouthwashes are good for you or not.

比如考虑这些含酒精的抗菌漱口水是否对你有好处。

They're not.

他们不是。

They're bad for you, in my opinion, but you can decide for you.

在我看来，它们对你不利，但你可以为自己做决定。

How often do you brush, when you brush, whether or not you decide to use xylitol, et cetera, as ways to improve your oral health, and of course, in doing so, the strength of your teeth, the brightness of your teeth, the freshness of your breath, et cetera, but through some means that I think for most people, they weren't aware of.

你多久刷一次牙，什么时候刷牙，你是否决定使用木糖醇等等，作为改善口腔健康的方法，当然，在这样做的过程中，你的牙齿的强度，你的牙齿的亮度，你的呼吸的清新等等，但通过一些我认为对大多数人来说，他们没有意识到的方式。

I certainly wasn't aware that we could re-mineralize our teeth at any moment by changing the acidity, the chemical milieu of our mouth, and that there are very straightforward cost-saving, zero-cost, and low-cost ways to do that.

我当然不知道我们可以随时通过改变口腔的酸度和化学环境来重新矿化我们的牙齿，并且有非常简单的节省成本、零成本和低成本的方法来做到这一点。

And then the third point is that today's discussion by no means was exhaustive.

第三点是，今天的讨论绝非详尽无遗。

You may be exhausted, but it was by no means exhaustive, meaning we simply don't have time to go down the rabbit hole of all these other promoted health practices, such as, for instance, oil pulling.

您可能会精疲力尽，但这绝不是详尽无遗的，这意味着我们根本没有时间深入了解所有其他提倡的健康做法（例如油拔）的兔子洞。

A lot of people out there believe that if you take olive oil and swish it around your mouth and spit it out, that that's good for your mouth.

很多人相信，如果你拿橄榄油在嘴里漱口然后吐掉，这对你的口腔有好处。

And indeed, some dental healthcare professionals, I should say licensed dental healthcare professionals, said, "Yeah, I think there's some benefit to that." There's the whole story about vitamin D and whether or not we're getting enough vitamin D can indeed impact our tooth health, so make sure your vitamin D levels are sufficient.

事实上，一些牙科保健专业人员，我应该说有执照的牙科保健专业人员说，“是的，我认为这样做有一些好处。”这是关于维生素 D 的完整故事，我们是否摄入足够的维生素 D 确实会影响我们的牙齿健康，因此请确保您的维生素 D 水平充足。

Make sure you're getting some sunlight.

确保你得到一些阳光。

Again, this ties into some of the other six pillars.

同样，这与其他六大支柱中的一些相关。

Am I suggesting that everyone do oil pulling?

我是否建议每个人都做油拔？

No. I don't think the peer-reviewed evidence on oil pulling is sufficient to suggest that people do that, but as a practice, considering that it's essentially near zero cost, taking a little bit of olive oil and swishing it around in your mouth and spitting it out, couple cents maybe.

不。我不认为有关抽油的同行评审证据足以表明人们这样做，但作为一种做法，考虑到它基本上接近于零成本，取一点橄榄油，在嘴里漱口，然后吐出来，也许几美分。

If that's something that you feel benefits you, great.

如果您觉得这对您有益，那就太好了。

If you are aware of some terrific peer-reviewed research on that and you want to put a link to that in the comments on YouTube, great.

如果您知道一些有关这方面的出色的同行评审研究，并且您想在 YouTube 的评论中添加该研究的链接，那就太好了。

Please send them my way.

请按我的方式发送它们。

I'd love to review them.

我很想回顾一下它们。

But my point is that there are a lot of different practices that have been promoted, including oil pulling and a bunch of other things that start to get pretty far into the esoteric, which doesn't necessarily mean that they don't have merit, but today, I've really tried to focus on the major ones, the ones that relate to what most everybody could and should be doing, like brushing and flossing, rinsing, getting the oral microbiome healthy, reducing the amount of strep mutans and the opportunity of strep mutans to create that acid that's going to deplete the enamel of your teeth and lead to tooth decay, trying to limit the amount of recessing of the gums and periodontal disease, and for all the reasons that we talked about before.

但我的观点是，有很多不同的做法得到了推广，包括油拔和其他一些开始变得深奥的做法，这并不一定意味着它们没有优点，但今天，我真的试图把重点放在主要的做法上，那些与大多数人可以和应该做的事情相关的做法，比如刷牙和使用牙线、漱口、保持口腔微生物组健康、减少变形链球菌的数量和感染机会。变形链球菌产生的酸会消耗牙齿的珐琅质并导致蛀牙，试图限制牙龈萎缩和牙周病的程度，以及我们之前讨论过的所有原因。

Keeping a healthy mouth, including healthy teeth, healthy tongue, healthy gums, healthy palate, and all the rest is oh so important, not just for your mouth, not just for speaking and smiling and looking the way you want to look, but also for your heart, also for your gut, also for your, believe it or not, your skin.

保持口腔健康，包括健康的牙齿、健康的舌头、健康的牙龈、健康的上颚等等，都非常重要，不仅对你的嘴、说话、微笑和看起来像你想要的样子，而且对你的心脏、你的肠道、还有你的皮肤（不管你信不信）。

Didn't have time to go into this, but it directly relates to skin health, and for your brain health.

没有时间详细讨论这一点，但它与皮肤健康和大脑健康直接相关。

So I strongly suggest that all of us take a look at what we are currently doing for our tooth and oral health and consider what modifications are best for us.

因此，我强烈建议我们所有人看看我们目前正在为牙齿和口腔健康所做的事情，并考虑哪些修改最适合我们。

If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel.

如果您正在学习和/或喜欢此播客，请订阅我们的 YouTube 频道。

That's a terrific zero-cost way to support us.

这是支持我们的绝佳零成本方式。

In addition, please subscribe to the podcast on both Spotify and Apple.

此外，请在 Spotify 和 Apple 上订阅该播客。

And on both Spotify and Apple, you can leave us up to a five-star review.

在 Spotify 和 Apple 上，您都可以给我们五星级的评价。

Please check out the sponsors mentioned at the beginning and throughout today's episode.

请查看今天节目开头和整个节目中提到的赞助商。

That's the best way to support this podcast.

这是支持这个播客的最佳方式。

If you have questions or comments about the podcast or topics or guests that you'd like to suggest for the Huberman Lab podcast, please put those in the comments section on YouTube.

如果您对播客有任何疑问或意见，或者您想向 Huberman Lab 播客推荐的主题或嘉宾，请将这些问题或意见放入 YouTube 的评论部分。

I do read all the comments.

我确实阅读了所有评论。

If you're not already following me on social media, I am hubermanlab on all social media platforms.

如果您还没有在社交媒体上关注我，我是所有社交媒体平台上的 hubermanlab。

So that's Instagram, Twitter, now called X, LinkedIn, Facebook, and Threads.

这就是 Instagram、Twitter（现在称为 X）、LinkedIn、Facebook 和 Threads。

And on all those platforms, I discuss science and science-related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the content covered on the Huberman Lab podcast.

在所有这些平台上，我讨论科学和科学相关工具，其中一些与胡伯曼实验室播客的内容重叠，但其中大部分与胡伯曼实验室播客涵盖的内容不同。

Again, that's hubermanlab on all social media platforms.

再说一次，这就是所有社交媒体平台上的 hubermanlab。

If you haven't already subscribed to our monthly Neural Network Newsletter, our Neural Network Newsletter is a zero-cost newsletter that includes podcast summaries and protocols as short one to three-page PDFs.

如果您还没有订阅我们的每月神经网络新闻通讯，我们的神经网络新闻通讯是一份零成本新闻通讯，其中包括一到三页 PDF 格式的播客摘要和协议。

For instance, we have zero-cost protocols for improving sleep, for improving dopamine function, for deliberate cold exposure, for fitness, for learning and neuroplasticity, and much more.

例如，我们有零成本方案来改善睡眠、改善多巴胺功能、刻意冷暴露、健身、学习和神经可塑性等等。

To sign up for the newsletter, simply go to hubermanlab.com, go to the Menu tab, scroll down to Newsletter, and supply your email.

要注册新闻通讯，只需访问 hubermanlab.com，转到“菜单”选项卡，向下滚动到新闻通讯，然后提供您的电子邮件。

Again, the newsletter is completely zero cost, and I want to emphasize that we do not share your email with anybody.

再次强调，时事通讯完全是零成本，我想强调的是，我们不会与任何人分享您的电子邮件。

Thank you once again for joining me for today's discussion all about oral health, and last but certainly not least, thank you for your interest in science.

再次感谢您参加今天有关口腔健康的讨论，最后但同样重要的是，感谢您对科学的兴趣。