Oral Microbiome with Bristle Health

Kamaldeep Singh -

Episode Transcript

Nicole Carter00:00

I'm Excited to talk about this topic today because it's in all the work that we've been doing around gut health. I don't think I've come across this at all yet. And I think there's an awareness, but not nearly enough. So we're going to learn some really cool things today. I see how we can help you integrate it into your gut health protocols.

So with that, I'm going to welcome Danny Grannick. He is the CEO and co-founder of Bristle, and which is an oral microbiome testing company, which focuses on helping people measure, understand and improve their oral health. Danny earned a bachelor's in biochemistry at the university of San Diego before moving into a variety of commercial roles in genomics sequencing sequencing, working at companies, including aluminum.

And Oxford Nanopore. Wow. You'll have to tell us more about that. During his time, he worked with companies leveraging genomics across consumer health oncology and synthetic biology. And Danny is looking at your meeting in San Diego, California. So really excited to have you and your company Bristle.

Very cool. Let me just let our viewers know what the Bristle company is all about. Bristle is actually the first comprehensive home oral microbiome test to help people measure, understand and improve their oral health. So our test identifies and quantifies all 100 or more unique bacterial species in the saliva sample, both beneficial and pathogenic, and it provides scores that are related to cavities gum disease, halitosis, gut inflammation, and more so based on the test results.

Right prevention based information or diet and hygiene and oral healthcare product recommendations to help people to improve their health. So each person that does the testing gets a one-on-one coaching session with one of their oral health hygiene experts. To redo and help understand the results.

So this is really amazing. I mean, this is pretty ground breaking in the microbiome world. When you say Danny.

Danny Grannick02:03

Yeah, I think so. I actually, I mean, I loved Erica your term pull by them. I think you said no, I think it's such a good representation because when we talk about the microbiome. I think a lot of the focus has been in rightfully so they kind of back her behind, but the last couple of years, but the reality is is that, you know, the body is a complex dynamic space and we have a robotic different microbiomes for different parts of our body.

We have a skin microbiome is an actual microbiome, an ear canal microbiomes, and just like all those, but we have not well microbiome. And, you know, I think the really exciting thing. Is the technology that's been developed. That's allowed us to start measuring. You're not understanding exactly how these microbes interact with our bodies and how they influence health and disease, because it's another kind of angle that we can take when, when we try to improve our health.

And for us. You know, the oral decorative behind is just been just completely unexplored territory. And I think oral health is its own category. It's been overlooked when, when we typically think about.

Nicole Carter03:14

Hmm. You know, it's interesting about this that comes to mind for me is a lot of people are familiar with the Western aid price foundation.

And I don't know if anybody knows the story behind that, but Weston a price actually had a son who died after receiving a root canal by him. So he gave his son a root canal and an infection began and his son died from it. And he began this school crusade. Health starting from, you know, basically the knowledge around what happened to this root canal.

So there's no question that the, that the mouth and what, you know, your words are oral microbiome, but there's a strong connection to the overall body. And I think people are just starting to learn that. You know, everyone is familiar with that word microbiome now, but I don't know that everyone really knows what that means. Do you want to talk about that?

Danny Grannick04:04

Yeah. So, so the microbiome broadly is kind of a make-up of bacteria and viruses that. On or within our bodies. And, and like I said, there's a lot of different environments within our bodies and each has a unique oral microbiome or a unique microbiome that performs different functions.

So in a typical microbiome, You know, as I'm sure a lot of people aren't familiar with, like there certain bacteria that are pathogenic. And what, when you think of business like infectious microbes that can calm this, where it progressed different kinds of diseases and something that a lot of people aren't aware of is that we also don't have beneficial microbes.

So. The, the microbes that you would find in a probiotic or a really good example of a bacteria that confer benefits to our health. And it's the balance of the pathogenic and beneficial microbes that kind of predisposes us for certain health conditions. And, you know, in the case of. An unbalanced microbiome, which was called dysbiosis your but you basically have an overlap in some of those pathogenic or harmful microbes and they've caused damage to different parts of our body.

So, you know, to kind of pull it back into a real world example, when we think about the oral microbiome, there are specific bacteria that produce acid and the acid indicates the, an analog, my teeth, and eventually that can get so severe that it causes a hole in the tooth. And that's kind of what we noticed that cavity today.

And so for people with really bad cavities, it's really an over-plan it's those bacteria that produces a lot of acids and causes that damage. And I understanding which bacteria somebody has in their world microbiome and how much they have. Kind of get an idea of their risk for certain conditions and also start tracking and working on reducing the abundance of that pathogenic bacteria while increasing the abundance of those beneficial microbes that help fight off disease causing microbes.

They help us produce. You know, they help us digest certain foods and perform really important functions that improve our oral health, but also improve our overall.

Nicole Carter06:20

Yeah. So when someone is working on, you know, their, their gut microbiome, they know this well, or Erica and I have talked about. Ad nauseum really about how to improve the oral microbiome.

So they have a good understanding of that in terms of, you know variety of foods and, and avoiding things that kill the microbiome. What does, what, what types of things affect the oral

microbiome?

Danny Grannick06:44

Yeah. So that's been a really big question that we've been at the forefront of answering. I think, you know, when we think about dental care, which I view as kind of a separate category from oral health, dental care is all about removing disease or removing the damage of disease.

So poverty addresses the very latest stages of the disease and the results in damage. If those pathogenic microbes. When we talk about ways to shift the oral microbiome into the state of health, there's a lot of interventions that I think we've talked about brushing and flossing, and we hear from the dentist all the time, we don't fully understand like the impact of these practices on, at the microbiome level.

And that's really what our company's focused on identifying. So we've been able to start stratifying different people's oral microbiomes. You know, you have two people and they're both prone to gum disease, but it's being passed by different specific bacteria. One person may actually be a better responder to your increased freshing frequency.

Whereas another person they respond to one frequent fast. Part of our goal is understanding somebody who's world microbiome profile to the hygiene regimen and diet recommendations, according to best fit. I'm covering a lot of these discoveries kind of from the ground up. I think there's the typical freshing loss thing of what the sugar that we've known for a really long time, but we're actually finding that there's really state differences in the impacts that those interventions have based on the microbiome that somebody has.

Nicole Carter08:25

Yeah. That's interesting about the sugar and when someone. You know, when we look at their microbiome, you know, that we're learning a lot more about that, what their microbiomes tells them in terms of their quality of health and any diseases that they have inflammation, what is the connection? Like? What can we learn from the oral microbiome about her?

Danny Grannick08:49

Yeah. So we, I always refer to that. The mouth is the gateway to the body and the beer. So it kind of serves two purposes. I think something we very rarely talk about is just how connected our mouth is to the rest of our bodies and how much stuff like enters our mouth on a daily basis.

So in that sense, There are situations where pathogenic bacteria in your mouth or bacteria that you're introducing through your mouth can migrate to other parts of your body. And we've seen that affect gut health. We've seen it influenced diabetes progression. There've been a lot of studies investigating the role of certain world bacteria in Alzheimer's disease.

We know that a lot of the bacteria in the mouse eventually make their way to other parts of our body and they can cause. And then I think on the other side of the morning, we have this idea of the mouth actually reflecting on ones that might be going on in other parts of our bodies and similar. You know, a lot of diabetic patients experience a periodontal disease.

So we think that shifts in the world microbiomes and shifts in the world, health actually indicate potentially early diabetes or pre-diabetes. We know that you know, cognitive women have much aggravate, so changing. So there's four on reflection there as well. And in that sense, you know, we're seeing that the oral microbiome definitely has this, like bi-directional relationship with the rest of our bodies.

And again, we're just starting to understand the relationship there, but it's been really exciting to see, I think another really good example that we've been looking at. There's a certain function in our body when we eat nitrate rich foods. So things like spinach and our body would use is not to nitric oxide, nitric oxide.

It's this really important compound that's related to controlling blood pressure. So the more nitric oxide you produce, the lower your blood pressure is, and it's used in a of blood pressure medication. And a lot of that activity actually happens in the oral microbiome is returning those foods. So what we've found.

That certain people in a low abundance of the bacteria that perform that function actually correlates to higher blood pressure stocks. And I think it's a perfect example of kind of direct relationship between oral health, the makeup of our oral microbiome and sort of these systemic conditions. Risk floor or experience later in life.

Nicole Carter11:15

So if someone has inflammation in their body, are they going to even see signs of inflammation in their, in their mouth?

Danny Grannick11:23

Yeah, I think in a lot of cases, it's definitely true. Like if you have inflammation or if you have dysbiosis in other parts of your body, you're certainly going to see either the signature or the.

Some kind of sign of it in your ear or on microbiome. And I think in that way, a lot of moral health conditions are really kind of symptoms of other things that are going wrong. And it's kind of like a check engine light,

Nicole Carter11:44

right? Oh, that's a good way to look at it. You know, what's funny. When Erica and I started this podcast over a year ago, one of the first things that we decided we wanted to both do.

Was a stool test because we said, ah, let's both do a stool test and compare it and you know, review it on the show. And so we did that and it was totally not a big deal, but a lot of people are really afraid of that. They're really put off by anything, you know, stool related for information. They're just not going to want to do that.

So would you say that the Bristle test is maybe a more user-friendly way of diagnostics around microbio?

Danny Grannick12:22

Yeah. I mean, I think that it serves two major purposes. The first is clearly there's a direct relationship between the world microbiome and oil health status. So you get those insights right away.

And then I think when we talk about the oral microbiome in the context of systemic council, third, maybe even more specifically gut health, it can get you some of the. Some of those low hanging answers or at least point you in the right direction as to what might be going on in other parts of your body and kind of thing.

So for anybody that might be experiencing conditions related to gut dysbiosis, potentially, I get first snap.

Thinking taking that step to do the stool test. Cause I do know that that's kind of a big barrier for a lot of people. Yeah,

Nicole Carter13:14

definitely. Yeah. And I did actually the Bristle test I received a personal task and I got the experience firsthand and I, it was incredibly simple. It was literally spitting in a little tube, no mess, no hassle whatsoever.

It took me about five minutes and then I put it in the. And it was just so simple, but can you walk us through the process from the user end and then, you know, what happens on your end and what does the information come back to

tell us? Yeah, so as a user you know, you would go to our website, wrestle health.com.

You get your kid in the mail. Kind of looks like a 23andme kit or something that you would get from that even DNA testing company, like you said, it's pretty simple. You have an online form that people fill out where we ask some questions around hygiene and health history. Just to get a context of you as a person.

Okay. You supply your saliva sample and literally just fitting in it too. You've been sending me back. I think one of the most common kind of customer support inquiries we get is people double checking that they did it. Right. Because it just seems so it seems almost too easy. So that's been kind of an interesting challenge, but you send your saliva sample back and modality.

It arrives at our lab and retake it through to details around this. But we take it through a series of kind of chemical processing steps, where we extract all of the genomic material from the sample, and then we use genetic sequencing. But instead of looking at your DNA, we're actually from a data of the DNA of all the microbes in your saliva.

And what that allows us to do is to identify who's in there and how much of each there are. And we take that data. Classify it, and we start to bucket it into the related indication. So, you know, depending on the makeup of your oral microbiome, you'll see which microbes you have that are related to tooth decay and have inflammation.

In fact, grass got dysbiosis and we also pull out all of the beneficial. And we'll tell you the ratios of, of all of those microbes and that rolls up into kind of your overall score. And based on your score, we're able to offer you a different recommendations around a hygiene recommendations that are intended to shift your microbiome into a more balanced state and negate your risk for those conditions in the future.

Yeah. And like you touched on. The last part is the coaching with our, our kind of oral health experts. And that really helps people close the loop between kind of getting the information on not gonna really implement to get into their lives. Yeah. I think that

people oftentimes, you know, they love this ice, this idea of doing some sort of testing, but it's the use of the information where people often get.

And I see that often and where people are just like, okay, I have some information. I don't really know what to do with it. But it sounds like the the coaching session is really where someone is kind of gets that translation of like, okay, here's your information, here's where you are now. And here's the things that you should work on.

And here's the steps that you should take to work on. So,

Danny Grannick16:26

yeah, the recommendations we give a lot of recommendations around what people can do, but I think that there's a gap between what you can do and what you're willing to do or what, what you want to implement first stage. Right? So maybe some of the dietary recommendations, I think a great example is.

It's easy for us to sit here and say, you know, cut out sugar to reduce your risk for cavities. But what if you're a diabetic patient like that recommendation doesn't necessarily apply to you? So we need to be able to kind of construct a regimen. Exploits that recommendation, but still against them into a state of moral health.

And that's really the goal of poetry. It's, it's closing the gap between the recommendations that we provide and the reality of somebody in an individual.

Nicole Carter17:19

Yeah, this is really cool. I am really looking forward to recommending this for my clients as a starting point. Almost none of them want to do a stool test, but they all are interested in the information, you know, it's like, should I get labs done?

Well, you know, it's not going to tell you so much about your microbiome and that's really the cornerstone of your health. Everything comes from the microbiome. So I think this is a really important shift that will help people. Erica what are your thoughts? Are you, do you ever get people that ask about oral microbiome?

Erika Smith17:49

You know, interestingly enough, I was just meeting with a client earlier this morning and he was asking me he was deejaying and he wanted to know, you know,

or anything like that, the program, he was concerned about it breath. And I said, you know, do you, are you experiencing some college assistant? He said, yes. And I was like, oh, well, we're going to have to look into. But definitely not something that, you know, a lot of my clients know enough about just a microbiome.

They do forget to associate that there we have different ones. Like Danny mentioned, you know, the whole environment is completely even beyond what we can even understand. And then beyond that, The pH in her mouth and south the same pH in the bottom. So the microbiomes are called micro

Danny Grannick18:39

because they depend on their environment.

We have one, like you mentioned, in all of those

Erika Smith18:44

spaces in our brain, even as one now. And so I think it is important to look out that's and it would be so fun to just test all of them, right? No, who's there. This is amazing. I actually worked in the dental field for a very long time. And so.

Danny Grannick19:00

It took me a while to give up a regular

Erika Smith19:04

toothpaste and you know, like the mouthwash, like, I, I don't use my brush.

They got ones that was really odd. So, and my, my mental health has been much better since I've stopped doing all of those things. So I would be

Danny Grannick19:18

really interested in doing

Erika Smith19:20

this test. So is it something that you guys recommend macula pays? What do you guys

Danny Grannick19:25

feel in your recommendations? Yes, I think that's kind of the beauty of the test.

It's, it's going to be different depending on some of these, I might think there's also, there's kind of two components. I think it's, it's what we recommend, but it's also the specific ingredients that would make a certain recommendation. So now flash is a very good example as a typical kind of patient or consumer, you know, you walk into a grocery store.

And of course your tour, you know, brush floss, mouthwash trait, the three things that you probably want to have in your bathroom cabinet, but a lot of the mouthwash that isn't on the shelves, it's actually a pretty harsh antibacterial agent. And on the surface, it sounds sprayer, right? It's like when you use pure owl and they made a claim of it kills 99.99, whatever percent churns, but that sounds great.

A lot of people don't understand is that showing 99.99% of the terms is also telling a lot of the beneficial

those, you, you may actually be predicting something greater, so disease in the future because those pathogenic bacteria, if they're sticking in that space too. So I think there's a lot of misunderstandings about what. What traditional recommendations are actually beneficial to oral health debate. and then there's also a lot of misinformation around the aids crisis, and we're starting to stratify how effective those ingredients are based on impact.

So a lot of debating about the fluoride versus the appetite versus immediates and. There's a lot of.

For as much as we do know, I think the craziest thing to me to say, nobody has ever been late

and we'll never really understand

Erika Smith21:40

Yeah. And I think it's, it it's worth mentioning to our listeners that fluoride was initially

Danny Grannick21:45

introduced to strengthen that the cheese, because they were noticing a lot in theories,

Erika Smith21:50

right? In theory, they say, if you eliminate actual sugar from your diet and technically don't need it before.

Nicole Carter21:59

The

Erika Smith21:59

sugar is actually

Danny Grannick22:00

feeding the bacteria that's causing that change

Erika Smith22:02

in pH and therefore causing the cabins.

Danny Grannick22:04

If food explain in the beginning of the

Erika Smith22:07

episode. So, you know, if you have a low

Danny Grannick22:10

sugar diet, technically shouldn't have. There that we think probably not shouldn't

Erika Smith22:17

require the fluoride before

Danny Grannick22:19

it to a certain degree, other block issues. There

Erika Smith22:22

is a lot of evidence for that, but yeah, I think that we haven't put enough thought and process into it all, but also you talked about dysbiosis as the packaging and all of those things.

And I wanted to circle back on that

Danny Grannick22:37

and maybe can write it down for the people listening that the.

Erika Smith22:42

It's all about, about, so we, we know we don't only, but you also sort of need the fact that it says dysbiosis. We don't want to eliminate everything. And that's why we

Danny Grannick22:55

don't want to hear about that.

Erika Smith22:57

That's why we don't

Nicole Carter22:58

want to just blend their

Erika Smith23:00

napalm with all things, because we're repeating the good of

Danny Grannick23:04

returns.

We don't know who survived, who going to take over after we do this. So it's major at a super important for that you talked about. That's a really good point. I mean, I think going off of that, you know, there's two ideas that are important for the balance of diversity that you have. So while you want to maximize this with the official ones, you can post to take a break from sciences because they all have their unique functions and you may be missing.

You don't have material.

Erika Smith23:45

And we talked about probiotic prebiotic often we're doing our podcast talking about the actual gut microbiome.

Nicole Carter23:54

So what

Erika Smith23:55

are the things that we can do as a probiotic prebiotic for

Nicole Carter24:01

our microbiome? I know myself,

Erika Smith24:03

I take the MK prince of K-12 and 18 probiotics that are actually.

Overall probiotics, you can't take it and you just kind of chew them and just leave them in your mouth and then not rinse them off. And they are known

Danny Grannick24:18

to help immunologically. And

Erika Smith24:22

I don't know if you know enough about it.

Danny Grannick24:24

Maybe helps even more. Yeah. So the probiotic space is really exciting for us. I mean, I think the other really cool thing about.

It's it's physically accessible. So when we think about probiotics the idea is you're introducing a concentrated amount of beneficial bacteria into in this case, your mammals, right? And the idea is if I think of a better word, like napalm my mouth, but beneficial microbes, it'll display some of those pathogenic blinds and get the back to balance.

You know, there's, there's kind of levels.

Is there room for probiotic, bacteria in whatever environment you want. And then another one is, you know, depending on what your oral microbiome looks like now, K-12 or mat may be more or less effective for you. It's kind of, I think of it like a vitamin, right? If you're already getting your daily, just see every day, you know, taking a vitamin, someone ended up with like 2000% of your day.

Your body is not going to retain all 2000%. And if somewhere with a profile. So, what we're able to do is based on your moral microbiome, you know, there's very distinct factors where if you're low in bacteria, a and high in bacteria, B that makes you a really good candidate for probiotics C versus in maybe high in a lung B.

And that makes you a better candidate for probiotic deep. So we're getting to the. Personalized precision medicine approach with probiotics, where we're able to say with confidence that one's going to be more effective than the other. And the other exciting part about the mouth is that we can introduce.

Hygiene changes that kind of displaced those microbes and create a better environment for those probiotics. Be more effective. As an example, is tongue scraping as, as kind of like a hygiene regimen where you can physically start to remove some of those bacteria and create the space that the probiotic needs to do.

Its job. I

Erika Smith26:31

love that. I really, really love that. I think that the way you're speaking is how I. Almost always can get my clients to do

Danny Grannick26:38

the

Erika Smith26:39

gut microbiome tests because it's like, you know, right now we're shooting in the dark, right. So we can do all of these days and then take your lab work, which I agree with Nicole.

Like we can do lab work, but that doesn't tell us the face. It's just tell us how your body is responding to all of this stuff. So instead of waiting and seeing how your body responds and knowing what's in there and actually. Eating the right things or supplying yourself with the right probiotics. It's just, it's lead gears.

Like you're taking away so much time and guess we're I love how you're saying that. Not to do this for the Sarah. Do you think that the oral microbiome is related to.

ER rates or location where you're at? Like, does it change when you change any of those?

Danny Grannick27:41

I missed, I missed the first part of your question, but I think I got the gist of it when maybe the world Acrobat is related to certain kind of demographic. And I do, I mean, I think that it's, it's, you know, as we build out our database, we're starting to find more and more patterns and commonalities between.

Different kinds of groups into in down our oral microbiome. But I think you can look at it just the rates of oral disease across the population. And it also gets some insight. I think socioeconomic factors, you know, the, the prevalence of oral disease and lower socioeconomic groups. Much higher than that and socioeconomically and higher groups.

And I think that we're going to find really distinct oral microbiome patterns, air, and I think the real opportunity that we have this oral. If we can rebalance oral microbiome is life's like preventable. So for those kinds of groups, like we can provide this massive benefit in an industry or an area of care where people pay thousands of dollars out of pocket every year to treat disease.

I think ethnically where we're still looking into it. It's a really interesting question. I know that we see patterns in gut microbiome. Profiles like across the globe. And I'm sure that we would see the same thing. And I would also imagine that it's largely influenced by diet as well. So we're starting to collect a lot of the data around, you know, what kinds of diets people are intaking and how that relates to the whole microbiome profile.

This is all fascinating. I could probably sit here and talk to you for days

Erika Smith29:14

about this in all

Danny Grannick29:15

honesty, for sure. So thank you so much for answering my questions.

Nicole Carter29:22

I think it's going to be a really a part of the future of health. You know, when we, as people start to expand and more interested in knowledge is microbiome and what really that needs.

So I think you're on the right track. You guys strictly trailblazing with. Oral microbiome. What my last question is just how did you get into this?

Danny Grannick29:44

Yeah, so, you know, I think part of that was like coming from the genomics industry, you know, I came at a really exciting time where sequencing. Kind of moving from this experimental, like research focus technology to clinical applications, and we saw it.

And I think oncology is a really great example where, you know, for a really long time, the way that we approach cancer was we were characterizing it based on where the cancer was. How big the tumor was. So breast cancer like cancer

technology allowed us to do is get a lot more precise around what was driving cancer. So we've moved from characterizing it based on location to the mutations that led to the formation of the tumor. And. At knowledge allowed us to create therapeutics that bypass the need for chemotherapy, which we can kind of relate to are antibacterials that we use.

I can announce today to precision insulin, right? That we're targeting the specific drivers of cancer. And we've been using genetic technology to start detecting the earliest indications of those kinds of cancer from a blood sample. So there's been this massive transition. And all of these different fields, cancer's one example, but we've seen the same thing in cardiovascular disease.

Non-invasive prenatal testing, the gut microbiome space. And, you know, I think for a long time, I was always kind of looking for an area of health care that could be innovated using the technology that existed today. And to me, you know, oral health really just stood out as this system of care. And, and I think.

Yeah, just the system of care that has been ingrained in the status quo for decades. And hasn't really caught up to the rest of healthcare and the way that we approach health and disease and the technologies that we use. So, you know, the idea of applying it to all of the cameras, I think obvious once we recognize that that was an area where we can make a relevant, big.

I think you certainly will. So we're really excited for you. And thank you so much for your time today and coming on and telling us all about this fascinating field, looking more forward to learning more about it. So what can people do to get started?

Yeah. So does it, our website, bristle health.com. We have tons of educational blog articles, lots of content.

If you want to get caught up on the world itself you can also get the kit directly from us share that there's, there's a discount code that we found that your followers to leverage. I can't remember what it is, but we'll be sure to share it and then get your kid in the mail and we'll get you started on the attorney to improve your oral health.

Nicole Carter32:37

Awesome. Love it. Okay. We will include those links below for you all to get yourself get started. So thank you again for tuning in.

Erika Smith32:49

See you next time.

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