Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1212 Pediatric Dentist Mark L. Cannon DDS, MS on Oral Dysbiosis : Dentistry Uncensored with Howard Farran

1212 Pediatric Dentist Mark L. Cannon DDS, MS on Oral Dysbiosis : Dentistry Uncensored with Howard Farran

6/21/2019 1:09:24 PM   |   Comments: 0   |   Views: 147

Mark L. Cannon received his Doctorate of Dental Surgery from the University of Nebraska and then attended Northwestern University for his Masters of Pediatric Dentistry. He completed his residency at Children’s Memorial Hospital and received his Diplomate status by the American Board of Pediatric Dentistry. He is a past president of the Illinois Society of Dentistry for Children, a Professor of Otolaryngology, Division of Dentistry at Northwestern University, Feinberg School of Medicine, an Attending Physician at Ann and Robert Lurie Children’s Hospital and a member of the International Association of Pediatric Dentistry. 


VIDEO - DUwHF #1212 - Mark Cannon



AUDIO - DUwHF #1212 - Mark Cannon



In addition to being the founder of Associated Dental Specialists of Long Grove (1981); he is the Research Coordinator of the Pediatric Dental residency program at Ann and Robert Lurie Children’s Hospital, Chicago, Illinois.  Dr. Cannon has 40 years of experience in pediatric dentistry and has presented lectures at the University of Athens, Greece, Sao Paulista State University, UNESP, Aracatuba, Brazil, University of Texas- Houston, University of Alabama-Birmingham, University of Southern California, University of California Los Angeles, Louisiana State University, and many other institutions world-wide. Dr. Cannon has lectured extensively on many oral health topics including evolutionary oral medicine, the gateway microbiomes, biologic and bioactive dental materials (patents owner), probiotics, and all aspects of everyday Pediatric oral health. Dr. Cannon has humbly accepted two invitations by the Karolinska Institutet, first to the Nobel Forum (2016) and secondly to the Nobel Assembly (2017). Most of all, Dr. Cannon is the proud father of five, all of whom are very accomplished. He is also a very proud grandfather!



Howard:  it is just a huge honor for me today to be podcast interviewing Dr. Mark L Cannon: DDS ms who received his doctorate of Dental Surgery from the University of Nebraska and then attended Northwestern University for his master's of pediatric dentistry he completed his residency at Children's Memorial Hospital and received his diplomat status by the American Board of pediatric dentist he is the past president the Illinois Society of dentistry for children a professor of Otero Larry ology division of dentistry at Northwestern University Feinberg School of Medicine an attending physician at Ann Robert Laurie Children's Hospital and a member of the International Association of pediatric dentists Terry in addition to being the founder of associated dental specialists of Long Grove in 1981 he is the research coordinator of pediatric dental residency program at an inn Robert lurie Children's Hospital in Chicago Illinois dr. Karen has 40 years of experience in pediatric dentistry and as presented lectures at the University of Athens Greece and Powell State University une SP eric ketubah Brazil University of Texas Houston University Alabama the list goes on and on and on forever dr. cannon has lectured extensively on many oral health topics including evolutionary oral medicine the Gateway microbiomes biologic and bioactive dental materials and he's a patent owner probiotics and all aspects of everyday pediatric oral health dr. cannon has humbly accepted two invitations by the Karolinska Institute first to the Nobel forum 2016 and secondly to the noble assembly in 2017 most of all dr. cannon is a proud father of five all of whom are very accomplished he is also a very proud grandfather while happy day after Father's Day how are you doing today

Dr. Mark L Cannon:  I am fine thank you so very much that was a great introduction well you're I mean you're an amazing guy 

Howard: there's so many things I want to talk to you about being a legend in pediatric dentistry but you're so fascinating in the the new thing which is the evolution or expansion of the understanding of the gut microbiome and how this is affecting oral medicine when did you get interested in the gut microbiome I mean we didn't hear about this in dental school 

Dr. Mark L Cannon: well actually I got interested in the microbiome in the 1970s I worked as a microbiology lab assistant working with all the periodontal pathogens and trying to understand how they influenced our auto immune system how they influenced our ability to defend ourselves this becomes so important later on it's this dis the most fascinating journey here I am 1974-75 I present a paper I think it was late 75 it was the role of Bacteroides men and legenda cos 250 261 the role of the phagocytosis of that my macrophage is an influence on our immune system and we were postulating all these things about pro-inflammatory cytokines so you fast-forward I've become very involved in probiotics you know I published a couple papers on probiotics we did the big probiotic studies showing that in reality if you want to control dental disease probiotics are a wonderful way to go because the commensals defend the host this all merged into evolution because you can't know where you're going without knowing where you have been in the past and there are so many Howard you know this every other day there's this amazing publication that comes out showing how the microbiome affects our behavior how you know it affects us epigenetically how it turns on cancer genes all these amazing articles like for instance breast cancer that the breast has a specific microbiome which we'll talk a little bit more about later let's go back to three so I am in down school and I'm doing all this research and I get recruited into pediatric dentistry and I get over to Northwestern where I start working a lot with biological materials got to work with some of the best people and in dentistry Evan green or to bill and Sally Marshall very famous people Jack Farrah cane so I can't emerged into that I continue to teach into research and then I started to go back to my roots I was probably about 15 years ago and I started to lecture more and more in the microbiome so let's  go back to what we're talking about the Gateway microbiome C as we've evolved we have evolved protective microbiome and we have these gateway micro biomes the oral microbiome is a gateway microbiome the nasal cavity has a gateway microbiome and the placental microbiome and amazingly enough these micro biomes this group of bacteria wishes 97% commensals these are the guys that protect you from dying they protect your health that's why we survived as a species so as time has gone on starting about like seven million years ago there was a divergence of the hominids which were part of and we had to break off the hominids about three million years ago and our gut bacteria and our all bacteria all diversified but specific every species has a specific microbiome and our bacteria in the mouth are bacteria in the gut all produce extremely valuable things and I don't mind digress real quick but for pediatric dentistry one of our biggest thing is early childhood caries well kids who get early childhood caries they're missing in their nitrate reducing bacteria the bacteria that break down your green stuff that turn it into nitrites and when you swallow the night try it becomes nitric oxide in your stomach you probably have heard about this urea zorb it back it's a very strong basal dilator it's a very strong cardioprotective in fact there's great articles published in cardiology journals like this all published I can show you tons of references on this that nitric oxide is essential for health for your heart health well we have an epidemic of people low in nitric oxide this is why there's epidemic and erectile dysfunction and this is directly related to the oral cavity and an oral bacteria because you're missing your nitrate reducing ones and that's why we again have a blub upward burst of decay and young kids all this is interrelated you know I mentioned before we got on how I'm a member of the American Academy oral systemic health but everything's connected so this Gateway microbiome in the mouth protects you with all these positive bacteria stripped or olestra uber us kills strep mutants so you don't get decay stirrup salivary a' skills strep pyogenes so you don't get strep throat so all of dental disease is a dysbiosis is not enough of the good commensal bacteria and too many of the pathogens and everything we've been doing which is shocking to me is we've been killing the good guys most the mouth rinses on the market they're antiseptic to kill the good guys they actually make you sicker that here's this is a shocker but there's a good seven published articles on this if you use a chlorhexidine mouth rinse your blood pressure goes up significantly within one day if you do want if you use a chlorhexidine mouth rinse your blood pressure goes up significantly in one day Wow because you kill the bacteria that are producing the nitrites from the nitrates and you don't have a good enough level of nitric oxide which leads to erectile dysfunction periodontal disease more decay cardiac issues in  issues with airway now we've got to get back to understanding the value of the Gateway microbiomes and the fascinating to me is that there's a placental microbiome dr. Kirstie our guards published a number of work on this and translational journals and translational research journals and there's a very specific microbiome to the placenta you know babies are not born sterile they're born with about 10,000 different strains a bacteria that we now know because of taking cord blood and looking at the bacteria floating around in the core blood and of course now they've got these great studies on caesarian babies and there was some brilliant research on like in 2004 where they actually and this is really fascinating I get to the point real quick they gave a bacteria from the human breast to mice a commensal bacteria from the human breast to mice fed it to mice in in their food and these were pregnant mice and they went in and they checked the amniotic fluid on those pregnant mice and the bacteria was in there floating alive because there's maternal imprinting the mom will pick up bacteria from her gut from other sources transmitted through the bloodstream this is published in Pediatrics in 2007 and they they're kept alive in the monocytes of the cells and they're delivered to the baby via the placenta placenta builds it up they come from the placenta into the amniotic fluid the baby swallows a ma like fluid they get their gut prime to get their immune system Prime by all the commensals what destroys a system of the pathogens if the mom has periodontal disease and if they have poor families gingivalis by levels or as you well know that famous research that's been done by many people like you've been with the fuser back to nucleate um that bacteria breaks down your tight junctions you get a flood of pathogens that go from the Mamas Prairie Donnell issue into the blood and it ends up in a placenta and so that gets to the baby yes when the leading reasons they found four miscarriages so again oral health even determines if the baby is born Kirsti our guard did that great clinical study in Malawi where they had these pregnant moms big study choose silence all calm and from what I understand just like the studies that were done in Japan and elsewhere much better birth rates on the baby they did study that in the UK to lower rate of miscarriage so we as dentists Howard we're standing on something that's amazing we're the guardians of the oral gateway microbiome we're also the guardians of the airway because we're the ones controlling the width of the maxilla we're the ones in charge of whether a person actually will have obstructed you know sleep apnea and that's because you know a lot of times it's consul's adenoids specially the kids are involved but otherwise we're really the ones who set the stage so when we'll talk about that more later but let's go ahead now first with a microbiome so if we've got to in our practices understand that our main mission is preventing dysbiosis our main mission is to prevent disease great study came out of Japan and looking at Japanese children and there's four main types of hormonal change of Alice there's type 1 type 2 type 3 type 4 based on the thin Bria is called you know for  most injure Valis phim a type 2 is the main pathogen Howard what keeps you from getting poor from Onis gingivalis VMA type 2 having poor for most gingivalis phimai type 1 or type 4 because it's just like fusible infused bacterium nucleate them if you have the protective strains they colonize it he don't have the bad guys so you don't get the periodontal disease and you don't get something else and this is something I think is the most important thing in dentistry today there's a disease out there Howard now I call Nags neural arterial gingival simplex let's think about this this is something where all the listeners have to start going like wait we got we pull off the road here think about this we have a disease organism or famos gingivalis specifically film 8 type 2 that has been directly linked to gingival disease periodontal disease atherosclerosis the work done in UCLA and elsewhere when they went into the atheroma x' and they found or for most gingivalis heavily the initiator of the arteritis it causes atherosclerosis I'm sure you've seen those studies they've done like the piggie study where they gave pigs high cholesterol and they had another group they had normal diet and then they also did bacteremia for the poor fellows gingivalis and those that had the PG got the Ovilus grossest Athletica roses as a result of a bacterial invasion of your coronary arteries and your aorta so that's part two we have the gingival and we have the neural because as you know the last couple months all the articles come out showing that the main organism cause of organism with inflammatory alzheimer's is poor for most gingivalis so you see Howard we don't have periodontal disease it doesn't exist it's all a symptom one disease called neural arterial gingival simplex we have three symptoms from one causative organism and you can trace this all the way back like Lance said about five years ago had that publication on mummies and they looked at mummies from forty three hundred years ago and they did CDs and they found a flaw cirrhosis okay they go oh and their conclusion there's about twenty authors on this bus oh there must be quote a basic predisposition to this disease Howard if you look the CDs they obviously didn't have a dentist on that author list they all had periodontal disease when the first norm bridges was done about 4,500 years ago on a mummy because if you look at all those mummies are like missing their lower incisors they've had remodelling of bone because the teeth have had to been removed because of severe periodontal disease hormones gingivalis became a pathogen from being a commensal in the Mesolithic period and exploded about 10 to 12 thousand years ago during the neolithic and the late happy Paleolithic period so there was a big explosion in periodontal disease and long before strep mutans exploded which started in the neolithic period about 10,000 years ago because of change in diet we started eating a lot more carbs 10,000 years ago our diet change and that's in the cavity rate skyrocketed and continues to skyrocket taking off hugely in the industrial revolution in the 1840s because then sugar became very commonplace often it was actually subsidized taxes were reduced on it you know after all we had the sugar wars in the 1700s between france and england all that and then we had this next revolution which i call a fast food revolution which has caused so many issues but all these carbs are feeding all these pathogens and these pathogens are creating this huge systemic health issue and in dentistry we're looking at the dead canary because we're like the coal miners carrying around canary in a cage and all this in the canary drops dead and we go like Ellis let's put a fake canary on so we put a wooden canary and that's our that's our dentures those are our crowns that's our fillings because we got to make that canary looks like it's alive Howard those those are all dead I mean that's the beginning of the end for the individual the host because it's like if you came down with rotavirus you wouldn't say oh I have headache disease chill disease fever disease diarrhea disease you would say I have a rotavirus infection so using the same logic with all our patients and periodontal disease they don't have just periodontal disease they have negs neural arterial gingival simplex and the sooner we can convince our profession and insurance and governmental agencies that we're looking at a national health crisis that is a hundred percent preventable you can block for from on gingivalis you can block fuser back to nucleate him they're both very sensitive to Polly halls are very sensitive to erythritol and to xylitol and so there's many other pathogens do for instance you had mentioned Nobel and the the invite by the Nobel Committee on medicine and physiology came because of research we had done polyols at Northwestern University and Children's Hospital and supposedly I've been told this and I can't find anything to the contrary I was a first dentist ever invited by the Nobel Committee on medicine in physiology and it was because of work we had done polyols showing that erythritol and xylitol which are used in many dental products are capable of blocking the microorganisms that are involved with autism and autistic spectrum disorder and there's a lot of gut microbiome stuff with autism which you know I do a lot of research in and the we got a great study going on right now with the microbiome the oral microbiome and autism so we have all this going on and one of the things we tested was not just the class dirty involved with autism but the clostridia that involved with CF CF to the cluster d difficile and we had two strains a seed if there are the two biggest killers in Chicagoland and they're extremely sensitive to xylitol so you can have a 10% xylitol drink and you have to remember your toothpaste is 20% some old toilet all your mouth rinses your the xylitol mouth rinses use your over 20 percent xylitol they're extremely sensitive to it I went lecturing I lectured some up in Canada some other places they got really excited so many parts the world now not so much the United States isn't that always the case so our dad you're nodding your head yes I can see that right now that's always the case so here's a scenario we it was a suggestion but by one the guys and special infectious disease at at Children's Hospital that we put in these two very strong controls two strains have c-diff that antibiotics have been ineffective against and are the two biggest killers in Chicagoland and c-diff kills a lot of people okay and they were both both strains were very very susceptible to the polyols at a low concentration easily done and any type of drink you know he can add that much erythritol to a monster zero for instance and it just hammered the c-diff well that got me an invite to the Nobel forum and the next year I got an invite to the Nobel assembly so I got to be part of the assembly for that year and it's just a year it's not it's I don't want to over overstate it at all over bloah it was interesting being the first dentist to be part of the Nobel assembly and all that and but the thing that was interesting is in discussion with people at the Nobel and I said to a few of them I feel awkward feel like him I'm beyond my capability being here having lunch with Nobel Prize winners gonna have a beer a couple Nobel Prize winners and medicine and I said because I'm only a dentist and they all looked at me and said no I mean because he says you the the type of research you've done and your contributions are enough that if you and in fact they used my research as an example of how we could come up with something that is so simple and inexpensive and could save so many lives you know almost as many people die from seed if the United States as has will die on the highways it's almost the same number so it's an amazingly simple thing to do and so safe so I'm really kind of excited to be part of that so we've been using that very same principle now looking at the effects of xylitol erythritol we know very small amounts of it well actually have effect in the biofilm in the mouth so far we've seen no negative effects whatsoever from it just reduces decay and of course we're hoping we can use it to fight neck is that neural arterial gingival simplex which is one of the biggest things we have to do we have to convince everyone that when you see your dentist you're working hard to prevent heart disease they're working hard to prevent diabetes they're working hard to prevent inflammatory Alzheimer's and those visits are extremely important so anyway Howard that's that's the beginning of the evolutionary oral medicine phase we have seen these changes go on in mankind we have all these environmental influences on our microbiome really sets up the placental microbiome which sets up the fetal microbiome which sets up the development of the human and during every stage every fetal the developmental stage from embryo on up from my 24 days on of development bacteria influence the development of that baby and it's very important so I'd strongly encourage that people would really work hard especially with women of childbearing age and make sure that they have the appropriate oral microbiome and that you use a good amount of polyols to prevent these issues that we run into with a passive adjuncts 

Howard: you know there was out in in md magazine there was an article dentist to blame for increasing spread of c-diff because of use of overuse of antibiotics and they got a lot of quotes in there with a lot of really smart people do you think dentists are still over prescribing antibiotics and wreaking havoc on the gut microbiome

Dr. Mark L Cannon: well there are some people I am very upset about that we have had patients who've been referred in because they have cavities little kids and then come in with a script that was written for amoxicillin and there is absolutely no value in doing that whatsoever unless you see a big roaring infection there's no reason to use antibiotic and again we mentioned an autism in the research on autism the big studies they've done the Danish Hospital revenge industry studies they've shown there was an increased risk of autism and kids whose moms have been prescribed antibiotics even up to five years prior to the pregnancy it takes about five years for you to regrow your oxalobacter former genies bacteria oxford actor former genius is the only bacterial species that breaks down oxalate for you humans don't break down oxalate just like humans don't break down gluten glutens digested by your oral bacteria he's really interesting Harvard de la research in 2014 where they found 150 strains of bacteria to break down gluten into non immunogenic 16 17 and 33 mer peptides and it's really funny that people think because that's those developed after we started eating grain we got those baby after about twelve thousand years ago blunted to feein started to harvest grain and and he howard houses for a fun fact why did the Natufian because they have good evidence for this why did that those people twelve thousand five hundred years ago now in the area of syria they were they have a big Dam and Lake Lake Syed's there why did they start stay in an area for rye and barley there was too many reasons one was climate change climate change significantly back that time Syria was a forested area it turned into a desert and meanwhile Europe that was covered with glaciers a glaciers all melted full of Dion dirt all's you know on the Endor Thals actually will disappear before that but then the inter Thals love living up north because they could their Airways did a good job they're well suited for living north the climate change they had to go into a wases which means they had to go from little tiny little tribes into building themselves into a sheet little cities of like five thousand but it was to make beer so beer created civilization about twelve thousand five hundred years ago I mean 

Howard: I want to back up to something you said earlier about the nitrous oxide producing bacteria and how it's that affects cardiovascular disease I think it's very interesting that when I was taking snoring classes that when you're coaching professional athletes you always got to get him to quit mouth breathing and breathe through the nose because when you breathe through the nose you form nitrous oxide and ever since I learned that when you're watching like the NBA Finals are the most elite athletes have their mouth closed at all time and then I noticed that people that are marathon runners around here in Phoenix some of them to train will put the electrical tape the big old met just tape over their mouth until they just gives it and they said that they totally after a minute they can tell

Dr. Mark L Cannon:  I want to ask you one before ESI drug we're going back to that real quick yeah the trick on that is people put they take a sip of water and they put the water in the mouth they also and they run with that water in their mouth until they get like down past the top of a hill then they swallow it and that way they're forced to nasal breathes and that keeps your mouth nice and moist inside that's another trick that's used by marathon runners and you're right nitric oxide is production you get more of it by breathing through your nose they've done great Studies on that where they put tubes in your nose they check how much nitric oxide is produced and they check against mouth breathing the other thing going back to those top athletes every type a fleet has a very specific microbiome versus long distance runners will have a different gut microbiome that contains 22 completely different phyla from a sedentary individual hey Howard guess what those bacteria do in the gut they're in the lower into a large intestine lower part of the the gastrointestinal tract they break down what we would call indigestible carbohydrates so when you eat something that's full of fiber they'll be breaking it down many hours later for additional energy okay you know who else has that hunter-gatherers if you go to Africa and look at the microbiome of like the Hudson tribe they're got they have the same gut type bacteria that break down or they did some famous stuff in burkina faso showing that the people in that african village have a gut bacteria they can break down quote complex carbs and digestible carbs they break it down so you could you were getting energy from Ilia eight eight hours earlier man isn't amazing 

Howard: I'm going to run I'm all IRA I had my gut microbiome tested it can only break down potatoes and Jameson whiskey so that's I'm limited to that diet hey what do you think happened to the Neanderthals that's a big debate going around and the Dinos events do you think they'd just be genetically we just married them orb them or do you think it was a violent encounter and it was war

Dr. Mark L Cannon:  no the  most recent research shows that their genes were weeded out and what happened was there's a lot of intermarrying in fact they found even from like 45,000 years ago they found an individual I still had up to 9% DNA from Neanderthals my I have about a little bit over 4% of my DNA is neanderthal here I have what I have about 277 variants that are Neanderthal based thank God I got a couple good things from my Neanderthal origins good white jaws never need any orthodontics I have a great airway the Neanderthal airway was over double as efficient as homo sapiens and the and earth all air away was set up to be very good for quote cold climates and as a climate kept warming going north Homo sapiens could move up and that's how we got our start because don't forget Caucasians here's how about being Irish we're only about eight thousand eighty five hundred to eighty eight hundred years old and that's when they first started to see those mutations the SLC forty five eighty two gene pop up and then about eight thousand years ago you had the oak the herc2 gene oco-2 gene which of the genes for blue eyes and blonde hair those popped up and they were sexually preferred by northerners now the reason these mutations occurred or because when you move north and there wasn't enough sunlight and he had to start wearing a lot more furs to keep warm vitamin D deficiency and to this day everyone who lives in Chicago is vitamin D deficient we all have to take our vitamin D every day it's just absolutely crazy and that gave the another mutation which is the mutation for the keep the LC D gene alive the lactose gene - which will produce lactase rather and break down lactose X about 4,300 years ago the reason we had to do that with step volume a D and vitamin D is directly related to a periodontal disease and also to decay - which is really fascinating how well your teeth are built to begin with makes a big difference so we've always been had a little bit of a disadvantage being the pioneers and we just did that following Hertz your hundred gathers he kept following herds going up and they kept following the grass going up they kept going up and to further further north and we mutated so hey that brings us to airway because that's the biggest thing - I know you're gonna go that way is Airways getting progressively worse and our Airways are the demonstrable it was a great publication American Journal of orthodontics done at the dental school in Vienna and the Medical School in Vienna where they looked at ninety force calls from the 19th century compared him to a hundred some-odd from 20th century did a succesfull metric analysis and did some little bit of PARs analysis and they found that the jaws were getting more and more narrow even the stuff from the plague hits even the stuff from the great Oslo Norway studies where they looked at children and looked at developing children that enter canine with significantly just decrease from the 1500s to mm or jaws are getting much more narrow and at the same time our pharynx is getting longer and our nose has to get longer and the reason the nose has to get longer everyone's get a little bit longer pointing our noses is because the nose is essential for warming the air so you can omit if I it otherwise we having brain freeze because we're all moved up to these northern climates which we can live in because we have heating 

Howard: I want to digress for a minute because this is a issue where I live in Phoenix Arizona all my patients who are dermatologists tell everyone to stay out of the Sun then all my patients that are nutritionists and physical trainers and anything everything else to say no you need to go get it ten minutes a day and it's not enough even if you eat outside for lunch and I got a bald head and in my forearms are showing they say that's not enough raw skin you need ten minutes you know five minutes on each side of you just lay in there at noon and flip over and I tell that some dermatologist may go insane but so so the public is hearing - exactly opposite piece of advice so is this Sun or sunscreen for vitamin D

Dr. Mark L Cannon:  but here's the problem you have a dermatologist that thinks that your skin's not part of the body they're only looking at the skin itself and of course you're out in the Sun you're gonna increase your chance of having things even just a couple sunburns increase your chance of no skin cancer and of course you're gonna age your skin because of all those extra you know reactive oxidative species you have going on so here is the answer you take some NAC and acetylcysteine an acetal cysteine is a precursor to glutathione so you take that's what I do I if I have to be out in the Sun I still want to get my vitamin D I don't want to burn so I take some in situ Assisting and it reduces a chance of burning now you'll have people argue that if you overdo your glutathione you'll increase your chance of cancer because you need to have those reactive oxidative species that kill those rapidly producing cancer cells I think that's extremely unlikely I personally I think if you are inflammatory type individual like being Irish we're prone to inflammation that we're prone to inflammation because we're not on up the good Irish diet we should have which is Guinness soda bread and corned beef and cabbage every day

Howard:  so let's bring it back home to dentistry so on dental town one of the most popular threads under health is the oral systemic health connection so how do you start changing the gut microbiome I mean I  just I it's too much information but Sunday I was at a party then this guy was talking about a study where all the oral probiotics you buy at walgreens would be better mixed with water and uses an in a to get right to the gut microbiome site better how  do you how do you change the gut microbiome 

Dr. Mark L Cannon: oh boy that is such a wonderful question thank you for asking that I really love that because you see everything affects that if you exercise your gut microbiome changes just by that diet changes our gut microbiome quite a bit probiotics can change your gut microbiome the problem with the probiotics and a lecture on those extensively is the majority on the market are worthless the strain is wrong you don't need that strain you already have that strain you're missing something else vastly more important you're missing bacillus subtilis you're missing class Tritiya genus you're missing something you're just not getting because you know you're talking about tens of thousands of strains of bacteria most of them are not the right strain there might be the right species but they're not the right strain you know you have the species let's say lactobacilli root or I and there are several known good strains but there's some that probably do nothing the gut microbiome can be a little bit resistant to change too so you may have to do all three to get to where you want to be now have you guys had done the American gut project yourself Howard the American no

Howard:  I did the 23andme and by the way by the way yeah by the way I was like four point five percent Neanderthal busines ender Tull is Caucasian is that term kind of loss now because it makes more sense to go to DNA and say the the you and I are partner and just type rights yeah no you know

Dr. Mark L Cannon:  it doesn't really matter because there's they found the Neanderthal genes from Asiatics too so in Asia so the they basically they've done some computer modeling on this the Neanderthal genes where they were strong they made the human the Homo Sapien hybrid weaker like slower because Homo sapiens could run my faster than Deandra tall and running is very important in escaping being a prey or being a predator is very important Neanderthals could not throw a spear as well as Homo sapiens so basically there was also this homo sapien men were felt to prefer Neanderthal women but homo sapien women did not and did not prefer Neanderthal men and that's a very important gateway for an extinction of a species right there so you know the Homo sapiens were off chasing Neanderthal women at the same time homo sapien women whereas homo sapien women just did not like the Neanderthal men and so that was a gateway stopper right there that's another postulation I don't think they'll ever be able to prove that but that's just one of the things they think so the airway thing was interesting too because like thank God you know you and I we probably got a little bit better airway from that the end I hope so Dean and with all it may be short that's one of the things that 23 means y'all the American gut project that's when you senior a fecal sample and they tell you what back there you have I'm very very proud to tell you I don't have an American got money was not looking at American at all and that's because when I travel I eat local I always try to eat fresh local you know everything is not processed and you really want to change your gut microbiome stay away from the processed food stay away from the GMOs and so on and now we have even better technology we're doing something called vie ohm and that's not looking at the DNA Howard s looking at the RNA so you're actually looking at what genes are have been expressed making proteins because like for humans only eight to 12 percent of our DNA is actually expressing for a protein so that kind of means that lava is just sitting there that's why we share so many genes with yeast and mold and fruit flies you name we share these genes it doesn't mean that you're part fruit fly either you know so those you're part of the are the human mind my own project is that through the NIH know the that's different from the American gut project I think that American gut project is through the University San Diego the NIH I probably did run the human microbiome project that was to determine what the human microbiome looks like but the human microbiome would look different in let's say Cambodia than it does in San Diego than it does in New Jersey it's gonna be a little bit different for it because it differs when you move if you moved into our country it's going to change a little bit if I went and looked in Central Africa for three or four years and ate tubers and ate fresh kill off the rough the steps my gut microbiome would change and that's what's supposed to happen it's supposed to that's why there's gateway microbiomes are supposed to respond to the environment and protect you when we go in and we do these crazy things like I say to our patients you know use this anti microbial mouth rinse three times a day and you're saying yourself I'm killing three percent pathogens in the other 97% I'm killing or the gluten metabolizers to break down the gluten I'm raising the blood pressure I'm increasing the chance of erectile dysfunction periodontal disease you have to kind of in the long term and route carries you have to kind of want to step back and say hey I gotta be more specific and that's one of the big clarion calls coming from the oral systemic health people like the American Academy of oral systemic health we had a board meeting yesterday it was Saturday like 1 to 10 and we ate dinner and went over stuff and then also from 7:00 to 4:00 and and the big mission is to get out there and tell people that the mouth is part of the body and we're finding all these cardiologists who are agreeing saying like dr. Lloyd Rudi saying every time his heart team removed an infected heart valve every time I was infected by oral bacteria the stroke stuff that came out like two weeks ago right that when they looked at the clots from strokes 70 was at seventy nine percent of them had strep viridans as being the initiator so you see that the oral bacteria can cause a ton of disease and that's why they knew about oral systemic health going back all the way to ramses ii and after the Battle of Kadesh there was a wall mural you can see in Egypt where all these Hittite prisoners are on their knees and her hands up in their mouth was wide open and the Egyptian soldiers are behind him with their spears forcing to open their mouths and they're being inspected to see how their teeth are and you can look at Tacitus his Roman historian the Roman Forum it slave market they the second thing they looked at with us the oral cavity there's famous Renaissance paintings of the middle of the eastern slave markets showing everyone opening their mouths and having their teeth inspected there's lifted graphs from the American South they would look at the mouth as an indication of health and even at Ellis Island they do the same thing there's great stuff I'm GV black about that so let's get back to the wisdom that our forefathers had to know the mouth is part of the body just like the skins part of the body you need to have these nutrients you need to have good probiotics but to know which probe I can use you have to know which one you're menacing you have to know which back to you're missing it could be oxalobacter forming genies it could be the bacillus how do you get bacillus bacillus p.m. ulis bacillus subtilis but every time you buy chicken now they've been giving him lots of bacillus subtilis because that's how they're raising him without antibiotics and makes the chickens healthier you don't they don't need to have antibiotics and we eat that chicken you're getting some bill bacillus subtilis because that is a ground organism that the chickens used to get from pecking at the ground to get the bacillus subtilis and that is the famous probiotic that the germans used in world war ii in north africa to save their med this is 1941 Germany Nazi Germany gave the Africa Corps bacillus subtilis is a famous bacillus tell a story to save their men's live from dysentery in World War II - and I keep saying if we've known this like menikoff in 1907 saying there's many positive bacteria in 1908 who wins Nobel Prize for phagocytosis research if we have known this for well over a century Howard why aren't we adopting this why aren't we realizing that there's a strong oral systemic health we aren't reutilized in the probiotics and nepali halls to maintain the health of our patients you know I mentioned that study we did with probiotics that was the most effective way we had 60 kids that we started off with there were extremely caries prone three years later we got like fifty three of them back and only four remain caries prone the rest of them have been turned around with probiotics and we published that and you know people are still going like well probiotics it has to be a good probiotic now those are two very good probiotics by the way they weren't the junk stuff you see yeah this stuff is unregulated there's a lot of stuff that's not real probiotics at all and that's what's giving everything a bad name so it's it's like this one study I'm probiotics and yogurt our just it's funny people quote that all the time saying look these people who use this yogurt they actually gain weight and they had other issues and then you look at the the yogurt they use it wasn't a real yogurt at all it was when these artificial things and it was full of high fructose corn syrup and everything he go like I wonder why they gained weight they're adding all these extra calories per day well I was 

Howard: I was very surprised just recently right here in my backyard in Phoenix and Scott sells Mayo Clinic and they started doing fecal matter transplants so this is this is really a thing where people are so serious about you know you say change it with a diet exercise and probiotics and a big probiotic now is fecal matter transplants do you call it yeah you consider that a probiotic or is that

Dr. Mark L Cannon: well yeah because you're actually you're giving them probiotics for someone else now that there's two great studies we talked about on that one it was done at the Medical Center in Amsterdam and what they did is they called out for volunteers they had people come in they classified them as to being diabetic pre-diabetic now the Baloch syndrome overweight underweight normal weight and they collected their fecal matter and then you came back and you received someone else's it was random everything was randomized she came back as a volunteer they're amazed how many volunteers came and if you were in metabolic syndrome or a pre-diabetic and you got a fecal transplant from someone who was normal a normal blood sugar and everything normal insulin sensitivity you know what you got cured it's a great study you got yours in fact you lost weight which is one of the other things they've shown in many many probiotic studies that's a fascinating one to read up on and everyone who reads that goes like holy cow now if you were overweight had diabetes he received fecal transplant from someone else who was overweight had diabetes guess what nothing happened you know so that's really how and they've done this many many times with mice by the way and rats I mean that's been done so many times well he could find dozens of published studies on that with animals the other big one is that the Karolinska Institute under Tom ed that they've done all these great studies human studies and they have this capsule that has 200 strain of positive bacteria that they've been giving to people who have all sorts of issues from depression anxiety everything everything gets better everything gets better neurological symptoms go down it helps everything because it's a booster into our immune system and again it's they've done all these clinical trials you cannot get their capsule in the United States they cannot produce enough of it for all the clinical trials going on and I have to tell you that that came from the eve project Howard where they went in and this is what they've been doing in these other countries because they can they have national health service they have these huge data banks so they data mined everyone in Sweden had never been sick then they contacted them and they check to make sure all their visits were well visits only they never came insect they found a whole group of people who'd never been sick no cancer nothing not even a cold and they found these people always lived in a rural area on the sea or up toward a mountain someplace and they always ate fresh food and they always say a ton about her but it was fresh butter everything and they took their fecal samples they kept kept them alive and then they kept checking it for any changes and they kept checking the patients to see if they ever got cancer anything and how their health could be maintained and from that great project brilliant research a tremendous amount of work they have their fecal sample which is just awesome so that's the route we're going 

Howard: so so you were saying though that in order to change you're in order to talk about probiotics you first need to know what's in your gut microbiome so are you recommending to dentists listening this that they should send their poop into the the American gut project to find out what it looks like yeah yeah they can do that or even better do biome biome be IOM II is the one that uses the RNA technology and the RNA technology tells you everything that's being expressed now we've done that for myself I have for my poop you get back tons of information just amazing what you get back because it includes the viruses and everything the yeast the mold the viruses you get all the information with a virus you have in your gut but we're doing oral veeram biome and mitochondrial swabs on my patients with autism we have IRB approved study where we're testing the patients we have with autistic spectrum disorder because they have a completely unique microbiome oral and gut of course the world determines the gut and so much so you can diagnose autism with an accuracy of over 96% by just taking a sample of their saliva and checking the microbiome in the food you said use biome is that biome makers in and Sacramento California is that by August by VIOME as a bio I i already up the vias in victory i and Irene o is an Omar M as in Mary e is an English okay so you can contact them at biome they have some specials where he can get a like over Father's Day it was like $149 for having a complete gut thing and in the future for dentists every patient will be doing oral one in the future very very soon and we'll be doing the cheek swabs and look at mitochondrial health because you can look at that mitochondrial DNA and see if they have the novel biomarkers for periodontal disease and for Atlas Roses which by the way Howard they're the same twelve novel biomarkers Atlas corrosive and periodontal disease has exact same twelve novel biomarkers 

Howard:  how much how much do you think of this is arm or is dentistry I mean there's two million dentists around the world there's two hundred thousand United States what percent of the dentist are buying into this and what percent of the dentist you think I think this is bleeding edge not leading edge this is a hokey-pokey it's gonna need another decade or so to the jury's still out weirdy done is set with this 

Dr. Mark L Cannon: well there's like over 26,000 published articles on probiotics right now if you go look at PubMed there's over 2500 clinical trials and the vast vast vast majority and the high ninety percentiles are positive you have to look hard to find a negative one and when you do you in finding all sorts of errors and their methodology which is really fascinating and how can you not when they have known for thousands of years the connection between oral health and systemic health how it's just like denying that the world is round is it's like a that has to be based on some type of strange belief or it's driven by economics because they sink I don't get paid for this stuff but the reality is if you have practice and you believe in total health care for your patients the patient's know it and they are loyal to you because you don't try to sell them anything you just tell them this is what you should do I tell these kids all the time that that come in with their little ones I said what are you doing for your own health are you drinking kefir because here's a classic study that came out of Finland the moms microbiome determines what type of breast milk she produces for the baby and if the breast milk the moms microbiomes are on the breast milk is wrong the baby has a hard time feeding and they get ecology so hey you want your baby asleep you have a good probiotic I recommend for a lot of people to use like life way kefir you have that down right wasn't that why is that kefir taking off so much everybody down here is talking about it well because it has 12 very positive strains of bacteria there are very high amounts you get about 20 billion CF views with about a cup of it every morning and it's it's there live bacteria and you want to make sure that you keep the kefir for a while so it has the bacteria have the chance to digest all the sugars that are in there and by the time you drink it everything's broken down it means basically lactose free and everything and it's just a healthy way of doing what they've been doing and in the Bulgaria and other parts of world Greece for like two three thousand years and it's always positive to have good bacteria that are there they lactobacilli that many of them like lactobacilli Reuter I have been just there's like hundreds of studies elective sale I wrote her I literally hundreds and that's why it's taking off that's an easy one and you know what you got I mean a life way is out skokie of Illinois and they have done a really great job of making sure they're giving you the right strains so that's why it's taken off Howard so this is the dimension listening that should stop eating processed food any whole you know biological diaper bacteria food yeah they should exercise more

Howard:  but back to but back to you know let's uh talk about some dentists and he's older he's uh wants to aggressively change his gut microbiome you probiotics you said was a great question the diets obvious the exercise obvious but back to the gut microbiome would you go to Mayo Clinic and do fecal transplants would you recommend that they first do this volume where they send a poop sample to buy yes that that'd be my first a she that violent yeah yeah biome

Dr. Mark L Cannon:  I actually give you the recommendations and died and everything and you know from your 23andme did you do the found my fitness Howard um 23andme you did that so there's something called found my fitness with dr. Rhonda Patrick and they make recommendations off of your 23andme as what you should do for health oh you know I do not see that so is that your is that a biome are DNA sampling place you like the most 23 me is I think that's good as far as why like so much they gave it as gifts to people yeah I I did - I did I didn't tell ya I think it was one number one gifted things because to me this godly somewhat accurate because I have a family history that my family has kept going back unbelievably far you wouldn't believe have I told you how far back that was handwritten and passed down from great-great-great grandparents and so on and photos to photos that go way back to the Civil War the early photos like Matthew Brady type photos so the  funny thing is what 23andme said match 100% the family history 100% right down to every date was exactly correct now

Howard:  I thought that was fascinating huh that is and then you also talked about a dental decay and some of these um sugar-free substitutes trying to reduce the K but are you a fan of that or not 

Dr. Mark L Cannon: oh yeah huge fan of xylitol and Revitol you can as many anti inflammatory thing and erythritol in silence all both are very strong inhibitors have not just strep mutans but more importantly of the biofilm formation it breaks up how much the plaque changes the type of block - it changes a type of byproducts in the black well-proven many articles on that and then inhibits the periodontal pathogens - or for most gingivalis use of bacteria nucleate them so it goes right down the line and it barely inhibits the lactobacilli and most of lactobacilli it pretty much leaves alone and those guys the way it leaves alone or the who's who's of probiotics so you we finally have something that's a smart kill on what we want to get rid of and it leaves alone that lactobacilli para case yeah i prevent cavities because you want to make sure you leave those guys alone you want to leave alone the ROO dry and the Ramos's and all the other good ones

Howard:  well I think a lot of dentists are listening this podcast that our pediatric dentists because I mean you're gloriously recognized that a pediatric dentist for 40 years what do you think about your profession and pediatric dentistry for decades after you walked out of Northwestern

Dr. Mark L Cannon:  well I got recruited by one of the founders of pediatric dentistry dr. Ralph Ireland who told me he took me his office is much be a pediatric dentist because we have three obligations to practice so we know what we're doing so we can number to teach because everyone had an obligation to teach at the time we were told we had to teach and practice and three do research he called the three Horsemen of pediatric dentistry you have to do all three I took it to heart back in what was at 74 75 1974 1975 and I've been doing that ever since and that was before we had all this economic pressure from insurance companies and PPOs and demos and DSOs and you name all the alphabet out there and of course I've seen the government assistance programs from Ashley paying for procedures of paying for absolutely nothing and then we were in Illinois so we're the we're the state were last year for a patient we might receive a check for 12 cents 

Howard: so you're in Chicago there  was another pediatric dentist legendary Fred Margolis we had him on the show 107 and then he passed away he was kind of really introducing lasers to pediatric dentistry in your backyard did you know Fred and what did you think of that oh I knew very bright very very well

Dr. Mark L Cannon:  I knew Fred very  well and we use lasers go ahead we use lasers a lot for soft tissue I actually did the research on that and in biomaterials and I actually prefer using ultrasonic dentistry for that it gives a better bond it's more precise using ultrasonic dentistry for the exact same thing he was using the laser for and so that's where I stand on it and I know Fred did sadly pass away and he is someone I would see all the time at meetings and

Howard:  you're also in the same city as Lynn Margulis who was that an American evolutionary theorist and biologist I mean she was a legendary and everything you're talking about Marie familiar with Lynn Margulis and her work in Chicago 

Dr. Mark L Cannon: no I really did not ever meet her no I did not ever meet her and my stuff all Augusta art being driven by the microbiome because as you know in some very very top journals and including the Journal of microbiology they've had these great articles about the hollow biome that the host the human in our case and our bacteria are a symbiotic bacteria form one giant genome which they call a hollow genome and that bacterial genetics drives our evolution and it does so first by having epigenetic effects so my way went the other way I went from microbiome into more genetics because the epigenetic effect and then that influences us genetically by the constant turning off and on of change changes our evolution 

Howard: I'm gonna go to the oral biome in your profession the most controversial thing that's came to it is the silver diamine fluoride and some people say you're you're tipping the  oral microbiome to where it's slowing down the rate of infection so slow that the pulp is layin secondary dentin and the baby teeth and it's not causing an abscess and other people say no you need to do a pulpotomy a chrome so crown then the pediatric dentist sale of it are saying yeah but this two-year-old would require to be go to an O R with an anesthesiologist and that's a high risk dangerous procedure and then and then when they start fighting bloody on dental town then it comes down to will mark you're just saying that because Delta will pay you so much money more for apple bottom in a chrome still crown or Medicaid or whatever and they're not paying me anything hardly to paint on this silver diamine fluoride it's so complex but it's so emotional it's the only thing I've seen that a dinner party at a bar where you can lead to profanity and I've seen that a few times between pediatric dentists where do you sit on this whole that rant where if you have a couple of beers how would you try men

Dr. Mark L Cannon:  I tell them the research that we've done and we've done actually a good amount in fact we developed a new cytotoxicity testing method just to look at the cytotoxicity as silver diamine fluoride so here's the important thing silver diamine fluoride is very valuable but it must be used by someone who knows how to use it so a pediatric does please look at this kid and they have these lesions and they can't get them into the ORF for any reason I mean it might be a reason where it's not just the cost it might be your operating rooms or backed up for six months or your if you use mobile anesthesia and maybe they can't come to your office or three or four months the silver diamond fluoride will buy you time but we've seen use where people have placed it on the chronic teeth  are already necrotic and then the kid gets a big abscess because it was already irreversible pulpitis they needed to have apple pata me in a stainless steel Brown the worst issue we have with it is safe as directed and we see pediatricians placing silver diamine fluoride we hear about school nurses placing silver diamine fluoride they don't have the lights they don't have the suction they don't have the isolation if you put silver diamine fluoride on soft tissue that is a big big no-no we showed significant damage to fresh dermal fibroblasts and we have actually presented this at meetings saying okay it's like anything else you wouldn't let a pediatrician do a pulpotomy you wouldn't let a pediatrician place a Circo neum crown pediatricians should not be using silver diamine fluoride they don't have the training they don't have the expertise if you can't handle or two or a three-year-old child you shouldn't be using it but having said that if I can my practice if we have someone that we need to delay decay that's what you're doing is you're delaying decay that's what flurry basically does right delays decay there's all these great studies showing that fluoride takes decay that would have happened from zero to ten years of aah and pushes at ten to twenty years of age the key that would happen from zero to 20 pushes at 22:40 that's why by age 65 ninety-eight percent of Americans have fillings as it pushes it back which is fine if you all died in 65 but I'm beat I know you're under 65 powered by I'm over 65 so see I I break the mold there so the thing with silver timing fluoride is you do have to reapply every six months so it should be done by qualified dentists and yeah I can see everyone's point of view because yes I've had kids come in with abscessed teeth and the teeth have silver diamond fluoride on it there was poor choice that was poor case selection or use the material it'd be just like if I had tried to play go foil in their front tooth of a two-year-old that's just not what you're supposed to do 

Howard: so what advice would you give to the young you did pediatric dentistry for four decades and we just had a whole graduating class walk out last month a pediatric dentist um what would you tell them what would you tell the young kids I tell them I was i

Dr. Mark L Cannon:  I had lectured on this about what 12 14 years ago I gave a presentation at the American Academy of pediatric dentistry meeting and I called that standing at the crossroads and it was a picture of the crossroads I said we can go one way or the other way you can either go on like the pediatric dentist of lore where you do the three horsemen he tried to develop new materials as you know I've been involved with a lot of dowel material developments to one of the three Horseman research teaching and practice yeah and so you know it's it's a tough schedule but you know that's what you do research teaching practice and or you could become one of those people who shows up at the office and you just do procedures you're not treating a patient but you're doing lots of procedures see how many stainless steel crowns are we doing this morning and how many composites are we doing this morning how many sealants are we doing where as basically for a lot of us I think that's why there's many people going into oral systemic health they can't look at themselves as being a healer you know not just a provider of services where healer we're here to teach we're here to educate remember that doctor means educator means teacher so by being a doctor we're a teacher and we're supposed to teach health and that means they come in there on bad diet you talk to them about diet they come in they're using the wrong toothpaste who talked to them about toothpaste you make sure that they're using something that is going to be very valuable for them for the rest of their lives 

Howard: what do you see in pediatric dentistry right now that bothers you the most when you're looking at people are dentistry at 30,000 feet what would 

Dr. Mark L Cannon: I want the young people to be as enthused is I have been in my profession I want the young people to spend the time to look at new ways in better ways of serving their patients and to not just accept the status quo you know Howard you probably have heard that a lot of times I will come out with something that has a contrarian but because I feel strongly that just because everyone thinks a certain way is not correct right and I've always been pushing the envelope and trying to say hey you know we need to change what we're doing so we can provide the best care I want every young person here I can do this I love this luxury good do you want to finish that her let me ask another one last thing I'm okay I was lecturing in Wisconsin and one of my former students came up and said you know I graduate from northwestern in 1982 I want to introduce dr. cannon he says there's several things I'll never forget I learned from him first he said what I teach you today will be wrong tomorrow I always told that because it's true but yet teacher did they'll be wrong tomorrow and the second thing he said is don't believe everything you read especially not next textbook because those people write books and don't do dentistry and 

Howard: it also takes some five years to write a textbook and then it takes a year or two to get it published then they sell it for ten years so you're this kid walking into a private dental school two hundred thousand dollars a year reading a history book ten years old but I want to go back to specific says when I'm talking to pediatric dentists online at dental town with the worst nightmare in the world is you take a kid to the OR are and he doesn't wake up and you're in Chicago and right in your backyard dr. Charles J coat MD professor of anesthesiology and pediatrics at Northwestern University I'm just just published a guideline that he recommends at least two individuals with specific training credentials should be present with a pediatric patient undergoing deep general anesthesia for dental treatment in a dental facility or a hospital surgicenter that that should have been I mean what person today is gonna be one person what would you guess

Dr. Mark L Cannon:  well I hope not very many because there's always supposed to be two and we do office base anesthesia but there's always two experienced people and you might call me the third because I did do my anesthesia training at Northwestern had you know it's just my rotation of course at Children's Hospital but I have intubated large number of people myself and I can maintain the airway I can do all that stuff my fear is that there are people who take it lightly and you should never take it lightly so I used to do that at Northwestern  children's I was in the or all day Monday and Wednesday 

Howard: so I don't know I mean hundreds of cases I've done I mean I but I'm talking about what percent of pediatric dentists are doing the anesthesiology and doing the dentistry on general sedation 

Dr. Mark L Cannon: I hope they're not doing it you cannot do that I mean I don't think that's going on in the United States right now today it probably is I'd rather it not you know but you know it is yeah I just don't know if the presentation right it's the same thing with antibiotics the old guys I mean 

Howard: I have so many adorable dental friends that are grandpas and you they still every single root canal ten BK 500 milligram 28 tabs twenty-eight tab 16 tabs vicodin and they're not gonna change so these younger kids are come out of school and the most stressful is when you come out of school and you're going in to work with your beloved mom who's a dentist or dad who's a dentist and they're doing these things like the general sedation while they're pulling the wisdom teeth on a teenager or a two-year-old you know and they're giving around antibody and by kitten after every root canal or extraction and it's just so so looking at that data I'd want to see are we talking about a young millennial are we talking about old grandpa who needs to be retired off to the golf course as soon as possible but you know Charleston you you agree with all of his work

 Dr. Mark L Cannon: well I have to tell you two things on that number one I'm a grandpa okay I had two grandchildren and there are elderly people and we're young yet Howard you know we're both very young we can't we  keep up to date I mean I keep up very  up to date and I I'm sometimes I'm shocked I'm talking to a young graduate who doesn't know anything in this new or modern like you said they're sometimes they're being taught by faculty who or should retired years ago to the second thing on that is oral surgeons are probably the biggest number of people doing deep sedation without some one experience with them besides them and they have been doing that for decades so I don't think that's going to change

Howard:  I want to ask you another dentistry uncensored controversial do I just I know there's a lot of pediatric dentists listen still because I'm gonna call you out as a pediatric dentist first two words of the the podcast so I know they're gonna listen to it and the other big stressor having is this vaccination bill some pediatric dentists want to have a sign that says we do not accept your unvaccinated child in my office because they don't want any thing going on what would you think if a young pediatric dentist in Chicago said I'm gonna put a sign on my door and we do not want unpacks kids in our office how does that say

Dr. Mark L Cannon:  well that here's the problem I have with us is that that decision was not made by the child that decision was made by the parent not the child you can never punish ethically a child for bad decisions of the parent so and every parent does have a right to determine what their child has so if I raise five kids and I would feel really be put upon because I'm naturally a libertarian if someone told me I had to for instance take my child to do a certain procedure I felt that was not an American Way of life we've got to be Americans first we have to really respect and honor the freedom and the sacrifices people have made to give us a freedom to have freedom of choice and not live in the gulag atmosphere so what I do is I do advise and that's what we're supposed to do we're supposed to teach and educate allowed them to make their decision the best educated decision they can make but if that meant turning away a child in pain turning away a child with an infection I would not do it because now you're punishing the child for a decision made by the pairing feel the sense

Howard:  but they always say it's the same thing where you see all these school districts now from New Zealand Australia all around the world saying your kid can't come to school if it's not vaccinated so that's kind of a backdoor approach of government forced vaccination against your libertarian views where do you stand on that do you think that do you think well school sissies you can do that shir schools that say that for instance and

Dr. Mark L Cannon: there are states have different laws every state in the United States that different laws dealing with it freedom of choice and so on but the school is optional you can opt out of the school you can say I'm not taking my kids that school I'm gonna do the homes girl or I'm gonna put him in a parochial school and that is your right and I defend people right to do that because there's many many a parent who's been a bad school district where the kids just don't get a decent education and they've said hey I'm gonna pay our pocket to take my child to a parochial school that is their right so when one must also have the right to say no we won't take you but that's fine you have the right to say that's fine I'm not going there 

Howard: oh my god my redneck dentist friends from Texas Oklahoma in Kansas in Arizona when you start time a government forced vaccination they're there ready to line up and start shooting a and their dentist would ask another very specific question the questions get very important as they get more expensive and a lot of these young pho dentists I'm gonna go back to lasers with Fred Margolis they're saying like like states Alea some young kid was opening up his pediatric dentist office in Chicago today would you recommend the use of any of these lasers because they're usually a hundred thousand dollars so you're talking I'd be like twenty five-year-old scared kid so your answer to lasers is no 

Dr. Mark L Cannon: no I would I would get a soft tissue laser definitely absolutely positively have to have a good diode laser like for frenectomy Xand and I find you're like Tamizh I do a lot of laser procedures isn't a brand I mean what there was one name bro i use i use the KO diode laser you can't buy it now at the 980 of course AMD has lasers - those are like four thousand dollars the AMD ones but first soft for heart tissue when you're starting off you can get a good handpiece as you know on ebay for 20 bucks so when you're starting off i that that you you can i'm be very practical yeah I want I want you to be and the other thing is you know buy good ultrasonic unit use ultrasonic dentistry I mean that just cuts preps are very  nicely the small pits the small buccal pits and all the preventative restorations and was ultrasonic would you recommend oh my god you get a Chinese one called C's guy for like what 90 bucks hundred bucks you know the funny thing about this is we're in age where dental equipment if you shop can be extremely reasonable contrary to education what was the name of that laser the  altars oh no no they thought experiment sky sea sky and just just see - sky or just see not just s II a cane Chinese SC bullion s II s K Y K is just ultrasonic that you use for scale link and also using for cutting small perhaps extremely comfortable they sell all these little diamond points for it so I can cut little preventive restorations buckle pets and small close all's you know is that

Howard:  last dentistry uncensored question another debate I'm going from you know death and destruction to splinter non-event there's a lot of dentists to a lot of pediatric dentists who tell me they do not believe in sealants anymore you're taking technology to ass attach and bond to detonate enamel but your asset at scene pits and fissures fill with Oreo cookies and they see that so much research shows that half the sealants fail the first year they all fail the second year and they would rather just do a preventative resin restoration and clean out the pit and fissure and basically you're doing an occlusal composite which they say in five years ninety percent of them are still there so our tub sealants gone extinct and replaced with preventative resin restorations aka and includes a composite 

Dr. Mark L Cannon: well what they're basically doing is what I do anyway I I take that ultrasonic and I use the very fine point to it and I clean out all the pits and fissures and then when you do the sealant you'll last much much longer and the other thing is I hate to say it but I have lectured on sealants and I've had people come up to me afterwards saying we have a hi-8 sealant failure rate they're all done by my dental assistants and one person said hey I actually timed how long they were itching it was seven seconds you cannot edge enamel in seven seconds and this is part of the big they average the edge time the biggest issue the other thing is there's many different types of sealants you know a few years on patients who are young patients a hydrophobic sealant material now this is throwout from altered and ultra seal it's very hydrophobic then you would have to use their primer beforehand because there's always moisture in the pits and grooves good research on that so when I did a sealant study back like 15 years ago and we used a flowable composite and we cleaned the pits and grooves and we etch for the full 30 seconds and rinsed for 20 seconds and cured for 40 seconds we had 96% stay the first year and after even 3 years so it is very technique sensitive now the at will is not very realistic how we did it so what we use in the office is we use a hydrophilic sealant material which is from pulp then called embrace as a hydrophilic resin if there is moisture so we guess secondary touch so it it's not repelled from the moisture deep in the pits and grooves they actually soaks into it and does the secondary edge in that because it's a self etching type material because it is a very acidic hydrophilic material you like your that and you make sure you do it for 40 seconds not 20 there's a reason why I won't it takes too long to talk about it but then you'll find we have a very high sealant retention rate ours is much much higher than what they have but they're used in the wrong materials and they're not watching the etch time we actually had to independent observer come in to watch us do sealants and when the things they commented on is you guys catch for the full 30 seconds you also agitated the etchant so you got a good edge whereas if you don't do that if you don't agitate the etchant for the 30 seconds they're gonna pop off dude so you have anywhere is I hear 

Howard: where is sky soon we're is not located were they making all these guys did you say sky skiers seats guy sees guy okay it's it's I hate to tell you this it's eBay I'm have every dealer call me I only babies eBay Sona but where are they making a sea sky China also played in China everything you buy is made in China huh so is it the SIS that group no that's off right it's a Chinese name that's just their name they call it they have other things like woodpecker they they make Ronald would Peck so on yeah you know everything you buy is made China anyway to me it's just pants how many middleman you want to pay so is there anything my god we went an hour and a half we were supposed to an hour they're sitting there listening to me right now saying when is when are they gonna stop is there anything that I am should have asked you about pediatric dentistry for these young pediatric dentists graduates 

Dr. Mark L Cannon: well I would say there's about dozen things but that would take us the rest of the day so we should probably for those board people who are sitting in their car saying I want to go park my car right now I'm still listening this podcast well we call it quits for today hey you know I wish you'd make us an online singing course um we they're just an hour long they're all ABA approved we put up 400 courses and they're coming up on a million views these Millennials you know it's it's low-cost it's it's only an hour you would raise the profile of our prestige by having a course on from the legendary you do you think you'd ever make it online course for dental town sure on sure let's do it alright well hey it was a I knew it was gonna be fun when I woke up this morning I was so excited you know Monday's podcasting day and you're my first one 

Dr. Mark L Cannon: iIwas so excited I'm a big fan I've been following you for so long and I just want to tell you that it was just an honor and a privilege to podcast you well thank you it's honor to be on your program it was a lot of fun and good luck with everybody and everything enjoy Arizona because it's chilly up here in Chicago.

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