Dr Kami Hoss Shares Insights on Oral Health and Orthodontics

Hello, I’m Alison Werner, Chief Editor of Orthodontic Products, and this is the Orthodontic Products Podcast on the MEDQOR Podcast Network. Recently, we did an article with Dr. Kami Hoss, an orthodontist in private practice at The Super Dentist, a multi-specialty pediatric dentistry and orthodontic practice in Southern California. Dr. Hoss has focused his career on the importance of pediatric oral care.

In an article he did for us recently, he spoke to us about the common myths, best practices and best ingredients to help orthodontic patients develop and maintain good oral health. For this podcast, we wanted to go a little more in depth with Dr. Hoss, who is the author of, If Your Mouth Could Talk, An In Depth Guide to Oral Health and Its Impact on Your Entire Life, and dive into what you need to know about adolescent oral healthcare and orthodontic treatment. So Dr. Hoss, thank you for joining me today.

Hey Alison, thank you so much for that nice introduction. I’m so happy to be here.

Great. Well, let’s get started. How long have you been practicing and how did your focus on oral healthcare come about?

Do I have to answer that question? Well, I graduated from dental school at UCLA 30 years ago, ’93. In fact, we have our 30th anniversary at the CDA Anaheim Convention. I’m on the board now there, on the board of counselors, and they just told me they’re going to celebrate all the years that end with three and eight. Yes, I’m one of those. So 30 years as a dentist, 27 years as an orthodontist. Then right after that I went to USC and I got my orthodontic degree and then I practiced… My wife is a pediatric dentist, I’m an orthodontist, and we started… I don’t know if I told you this story, but when I was graduating from USC, we had a practice consultant sat me down and she said, “I’m going to give you a few pieces of advice. This is your graduation present.” I’m like, “I’m all ears.”

So she said, “The two advices…” She gave me a couple, but the two of them that I want to share with you today is one, she said, “Don’t go to San Diego because I grew up in LA. I went to school there. My family lives there.” She said, “You’re a specialist. You’re going to be relying on general dentist and your friends and family to get your practice.” And I’m like, “Okay, that’s bad because I’m moving to San Diego the following week.” I said, “What is the second advice?” She said, “Don’t ever work with your wife.” Because of all the… Other than the obvious, you’re an orthodontist, she’s a pediatric dentist. People will refer you a patient. Then they would end up in her practice and that’s the last time you’re going to get a referral. So I didn’t follow any of those advices. I moved to San Diego the following week and I started a practice with my wife and we’ve never looked back. It’s been a wonderful relationship and wonderful practice.

Oh, excellent. So then how did you end up focusing in an oral healthcare? Because now you’ve written a book about it.

Yeah, first of all, when I was in college, I was an engineering major. I just love math and physics and when I think about it orthodontics is also a lot of physics and math, right? Factors and courses and direction and the other direction, all of that. I’m also a musician because, so I think art… A lot of dentists are artists. Right? We’ve [inaudible 00:03:14]-

Yeah, I’ve noticed that.

I’ve seen that as a common thing among a lot of the dentists and orthodontists especially. So how I got into more a general oral health, systemic health connection was, as you know Alison, we have a fairly large practice. We have dozens of pediatric dentists and orthodontists, general dentist, hygienists, and about many years ago, seven, eight years ago, I started had to really concentrate on running the practice more than I…

I used to do obviously clinical orthodontics every day, and then it went to four days a week, then went to three days a week, then two days a week and one days a week. And then we had so many offices and locations and team members that we had to manage. I took more on the role of the CEO of the company and then little by little, I started really getting more on the education side of it. It was really frustrating as an orthodontist, as a dentist, my wife and a lot of other doctors in our group, that when patients would discount or make oral health unimportant. They would say things like, “Dr. Hoss, isn’t that just the cavity or just some crooked teeth or aren’t those just baby teeth or isn’t my child too young?” In the beginning, I would have them sit down for 30 minutes, and I would have to explain how critical primary teeth are and why early treatment is so important for airway and for jaw corrections, these orthodontic stuff, or “Is fluoride safe?”

Oh my God, I have to spend another hour explaining the pros and cons of fluoride, fluoride alternatives. When do we use it? What else do we use it? What else is in a toothpaste or mouthwash? So all these things led to me and the fact that dental schools and medical schools have been separate since these institutions were established over 200 years ago, and I don’t know if you know this story, but it wasn’t like a think tank got together and decided dental schools should be a separate entity. It was just more of a personality clash between the person who set up the first dental school in Baltimore and the medical school there. And so then all the other dental schools followed this terrible model of dental schools being a separate model. And so I think the public, not only the public, but I think even the profession, dentist and physician, we’ve forgotten that the mouth belongs in the body, is part of the body.

I know it sounds like a joke, but it’s true. I think we all have forgotten that we think the mouth is just, we have this entity that just works by itself and whatever happens to it has nothing to do with whatever happens in the body, and it couldn’t be further from the truth. In fact, literally everything that happens in the mouth is connected to the body. Your oral microbiome impacts many parts of the body. Almost everything that goes in your body goes through your mouth from air and toxic things, from microbes and all of that. It was just all these frustrations were building in me from a professional level, I’m usually easy going on, so I don’t get frustrated personal life, but professionally I was like, this is really terrible that we are… And on top of it, as you may know, Alison, the number one disease, non-communicable disease in the world according to WHO, World Health Organization is dental disease.

The most common chronic disease in kids is dental disease, dental [inaudible 00:06:31]. Other than public speaking, going to dentist is the biggest fear. So we literally are profession. We own the number one disease and the second most fearful thing. That’s a terrible position to be in. So because of all these reasons, I decided to write a book and really, that’s just part of it. Writing the book, I was part of it. I started becoming an advocate for oral health, systemic health connection, oral health pregnancy, health connection, oral health, airway and sleep connection meant oral health, mental health connection. And so with all of these, and then when Covid happened, I also was an advocate of oral health, the safety of dental offices during Covid, the importance of oral health during Covid as dental offices were closed. And even though in the beginning that was a good thing, but it’s at some point we needed, I think again, even the medical profession forgot that you cannot be healthy and you cannot fight an infection like Covid as effectively if you don’t have good oral health.

And by the way, all of that was proof later. There were many studies that showed that people with periodontal disease are significantly more likely to get complication of Covid. So anyway, so that’s how I really started doing that. When I wrote my book, then I always said to write a book, I had to research, and I spent a few years really digging up to 600 articles and books that I had to read and really collect all of this in a consumable way so parents can read it. I wrote it for parents, but later I found out a lot of dentists and physicians also love to read it and get a lot of things that the education that we all miss in dental school and medical school.

Well, building on that, our audience is orthodontists. What do you think they need to know about oral healthcare in the context of orthodontic treatments? What should they be keeping an eye on it? What should they be talking to patients about?

That’s a great question. Or I think I know my profession, obviously my colleagues, orthodontists, we know that what we do is a lot more than just straightened teeth, but that’s not the public’s perception. The public’s perception is that’s what we do. That’s why they wait until they’re 12 or 13 or until they have crooked teeth to come and see us. That’s why they skip orthodontists and go direct to consumer companies because they don’t understand the value that we provide, and that’s really a mistake. And it’s really terrible because they’re going to pay the price, the consumers, the moms and the dads and the kids and the individuals.

So I think as a profession, we really need to educate the public in any way we can from doing interviews and educating people around offices to forming groups and to providing mommy and me classes and writing books and blogs and everything we can collectively and partnering with our colleagues in the other specialties like pediatric dentist especially because I think those are such a unique, wonderful partnership, general dentist, hygienist and really put orthodontics back in the center of oral care. I’ll tell you why this is such an important thing.

So I think, again, I’m preaching to the choir because your audience are orthodontist, but I’ll just say that as if I was talking to more of a general public. So orthodontics literally can start in day one. For example, if a baby has a tongue tie and the baby can’t breastfeed, that can impact the oral development in significant ways because the tongue can’t rest against the palate other than just all the benefits of breastfeeding from a nutritional value, just from the oral development side of it. The baby will not get the right oral microbiomes, and then of course they won’t get the right mix of the seeding of the gut microbiome because a lot of those are just provided by the act of breastfeeding. The mouth muscles don’t develop correctly, the structures of the mouth, the nasal airway and breathing is taught to a baby because by the process of breastfeeding.

So if an orthodontist or a pediatric and or a pediatric dentist, ideally a team, as you know, I just love this whole orthoped… I just can’t imagine any orthodontist practicing individually. If any orthodontist wants my advice, my first advice is partner up with the pediatric dentist because it’s like I just can’t imagine practicing without pediatric dentist partners in our practice. But let’s just say again, a baby’s born literally from day one of that baby’s birth an orthodontist can be involved with the oral development, make sure that there is no tongue-tied, make sure the breathing is correct with a nasal area. Make sure obviously if there’s deformities and everything, of course, orthodontists we’re the experts of not just teeth, but the whole facial structures and of the mouth and the jaw and the facial development. And then as the baby gets a little older, then again we can be involved in speech and habits and thumb sucking and tongue postures and pacifier use and how that impacts the oral development.

These are dramatic things. If your mouth doesn’t develop correctly, you can’t get enough oxygen in your brain. The first five years of a child’s brain development is critical. As you probably know, their brain grows to 90% of its sizes by age five. So obviously oxygen is the most important nutrient, it’s like the number one thing that we need. So it needs to go to every cell. It required for every cell, especially the brain. So it will impact their intellectual development and their personalities, their intention, how they sleep. If the babies have airway issues and they have sleep apnea or other sleep disorders, they’re snoring, and that’s because of their oral development that an orthodontist could have intervened and recommend something or do some minor intervention or treatments at that time. The path of the growth of that child could be set in completely different ways.

And so again, of course, as the children, they have jaw development, they have an underbite, well, we want to start them early. If they have an overbite or a crossbite, all the skeletal developments, that’s when orthodontists gets involved. Then later on, then the teeth is really the last thing, but this is reverse right now. Everybody just thinks about teeth, and I think as a profession, I think our role is to make sure that we educate the public and the profession, the other colleagues in our profession, like pediatric dentist, general dentist, hygienist, that we are so much more than just teeth straighteners. We are really overall health development experts.

Okay, so once you have that patient in the chair and they’re undergoing orthodontic treatment or even at the start of orthodontic treatment, what should orthodontists be talking to their patients about their oral healthcare?

Okay, that’s a great question. It surprises me when I tell this to people, but it’s true. We, meaning dentists and hygienists, my profession, hygienists, dentist, orthodontist, pediatric dentist, general dentist, we get little to no education in dental school or our residency programs about oral care products. It’s shocking, but it’s true. Our general knowledge of what’s in a toothpaste is almost the same as the general public. Our biases, for example for or against fluoride is just like the general public. We have very little knowledge about what else, is there an alternative to fluoride? What is the fluoride pros and cons?

There’s a two-year old that never gets a cavity and an eight-year old that doesn’t brushes their teeth and a 13-year old who just got braces and a mom, 25-year-old mom or a 30-year-old mom that has gingivitis, do they get the same toothpaste? Do they get the same mouthwash? Are they all fluoride toothpaste are the same? What is even a non fluoride toothpaste. It’s fascinating when people say it’s non fluoride. I’m like, “What does that mean? What else is in there?”

Is there an alternative to fluoride like hydroxyapatite or nano hydroxyapatite? Because these are really the only two ingredients that remineralize teeth, fluoride or hydroxyapatite ingredients. But what else is there? Our mouths are not just enamel. First of all, our teeth are very much alive on the inside, especially since our specialty deals with growth and development of the mouth. Well, obviously children’s mouths need nutrients. They need calcium. They need vitamin A, they need vitamin D3, they need vitamin K2 for this calcium to be absorbed in their teeth and their mouth, so their mouth and their jaws grow correctly.

So as advice to your listeners is that we need to give more than just brush your teeth twice a day when you get home because today just got your braces up. We need to educate ourselves about what oral care products specifically we need to recommend because our patients are begging us or they’re asking us for those recommendations and why we don’t do it. Because we don’t know. We don’t know the difference between Crest and Colgate and Oral B and supermarket, whatever the products are, we just basically say whatever the rep brought it to our, they left the samples in our practice, we give it, but our patients are… And the reason this is important, because not only we will help them develop healthier habits, because at the end of the day, we’re healthcare professionals. We want these children and parents and adults, we don’t want to just straighten your teeth.

Yes, that’s one of the things we do, but we want them to live a happier, healthier, more successful lives and by providing these tools, and we can’t do that until we are educated on it. So I really encourage everybody, our profession, especially that we really learn this because manufacturers have done a terrible job. As I said in the beginning, the number one disease is dental disease. So if they were doing their job, we wouldn’t been in this situation. So we need to take control. We need to be owners of oral care products and help not just those two or three days that people come and see us out of the year or maybe orthodontist a little bit more, but the other 363 days we’re the experts, we need to play that role through throughout the year, 365 days a year for our patients.

Are there any good resources you can recommend for orthodontists who want to learn more about which products they can recommend or just how do they education themselves?

That’s a great question. Obviously. Again, not to self promote at all. I’m just here just to talk to you casually and the audience, but I do have my book I go over. In my book there are two things that I write in my book that I always say it’s sadly, but it’s an education we didn’t have in dental school. And what are those two things? One is oral health, systemic health connection. So I go through all the details in depth about all sorts of chronic diseases. And then I have another chapter on mental health one. I have another chapter on airway and sleep. I have one on pregnancy health and then another one that I really explain how the oral microbiome evolves in what is genetics and epigenetics and what are all roles of all these things in our health and happiness and success and confidence and prosperity in our lives and longevity, all that stuff.

So that’s one source. Again, full disclosure, we do have our own Oracle Care product company called Super Mouth, and we have actually a product line for orthodontists, it’s called Super Med Pro. So you can go to supermarket.com, supermedpro.com. Again, full disclosure, I am the founder and CEO of those companies, but really, today I’m not here to sell anything. I’m just really here to advocate for oral health and to advocate for our profession and really get the message out that as a profession, we need to own this. We need to own not just what people do in our offices and how we take care of them in our offices while they’re within our doors and in our buildings, but what happens to them when they leave our offices. Right now, they’re on their own. They have to make this decisions, nobody’s educating them, and we need to take that role.

In the article, you you go in depth about the routine you recommend that orthodontists give their patients in terms of oral healthcare during treatment. Can you go over the fundamentals of what that routine should look like during orthodontic treatment?

Absolutely. So as you probably know, I think it’s a nightmare for all us orthodontists who’ve been practicing a while, and we know there are two things that we really, really get sad when we see. One is root resorption. Let’s just say we’ve done this treatment, or in the middle of it, we take an extra mic, oh my God, we have some… That’s when you don’t sleep at night. And then the other one is when we see decalcification on teeth, and the reason I think they’re both irreversible, I mean usually in orthodontics, I always joke around with my other specialty colleagues at pediatric dentist, general dentist and or oral surgeon, I’m like, “You guys, your job, they has a lot more responsibility. You could really damage something really badly.”

For us, a tooth move is a little bit too much, we just move it the other way a little bit. I obviously exaggerated, but those couple of things like root resorption or decalcification are permanent, cavities that they get because they didn’t take care of their braces or retainers or expanders, whatever it was. So I think, again, this is why it’s important for us to take that role so it’s not just go brush your teeth twice a day. If that would work, then we wouldn’t have this classifications and these cavities and everything. So this is how I would recommend that. This is how we recommend it to our patients. First of all, we need the right tools. As orthodontists, we love tools. The patients also need to have the right tools. So what are the right tools in? There’s a morning routine, there’s an evening routine, and then there’s a daily routine.

So in the morning routine, this is what a routine should be. We wake up, you use an alkaline mouthwash, and then the first thing you use in the morning, and the last thing you do before bedtime is your mouthwash, but not any mouthwash. Almost all over the counter mouth washes are terrible. Those glow the dark colors, neon and fluorescent green and neon pink, think about it. That’s obviously artificial color. Anything, artificial colors, preservatives, acidic. So another thing that’s very, very common is because to extend shelf lives, a lot of the manufacturers make their mouth washes incredibly acidic. There was this doctor who actually went, there’s an online article, I think his name is Dr. Steven Nelson, if I’m not mistaken. He went and bought every mouthwash on the market, nearly in the grocery store next to him, and he did a pH test, and 95 or 98% of the mouth washes, the pH is below 5.5 where all the disease happens.

So just quickly tell you what happens is your mouth saliva, the pH is normally seven. Just about every time you put food in your mouth because of the foods and the digestive enzymes, the mouth becomes acidic for about 30 to 60 minutes. And by the way, that’s why you should never ever brush your teeth for at least 30 to 60 minutes after any meal or drinks. Let me repeat that because this is something, even dentists and orthodontists get wrong, and I’ve seen wrong information on people’s websites. You should never brush your teeth for at least 30 to 60 minutes after any meals or drinks. Why? Because when you do that, when you eat those foods, your mouth becomes acidic. It goes below 5.5, the pH for about 30 to 60 minutes. And so imagine that’s when you get a cavity, that’s when the demineralization of teeth happen.

That’s when the “bad bacteria” thrive, as basically oral diseases happen 5.5 pH or below. And so this doctor went and bought every mouthwash and he tested a pH of it. Almost all of them were the pH was below 5.5, somewhere as terrible as three or four. So that’s another thing you want to check. Make sure it’s an alkaline mouthwash. Make sure it’s got no artificial nothing. Basically, it doesn’t have antibiotics. That’s another thing I see a lot of companies proudly say they kill 99% of their germs. If I told you, Alison, “Hey, I just had an epiphany. Why don’t we all take on a daily basis as a society, two antibiotics on a daily basis that kills 99.99% of our germs to stay healthy?” You’ll probably end the podcast say, this guy is crazy. So what we do that with our mouth, we don’t even think about it.

So no, we should not be killing our oral microbes on a daily basis. We should promote a healthy balance of our oral microbiomes, which what we have those, by the way, ingredients, they’re called prebiotics instead of antibiotics. So prebiotics, or I’ll give you some example like xylitol, I know people think of that as a sweetener and which it is, but it’s actually, there was a beautiful systemic article that reviewed over 200 articles that were done on xylitol as a prebiotic effect. In other words, it promotes healthy microbes while selectively reducing the harmful ones or any line. I mean, there are many, many of these prebiotics, so no antibiotics, again, mouth, which we’re still on the mouthwash. So then use a mouthwash that’s he healthy, alkaline, no antibiotics, prebiotics, healthy ingredients. The first thing, to loosen the plaque, loosen the food particles overnight.

Then the second is you want to clean your tongue. You want to use a tongue cleanser or scraper. You never want to use a toothbrush because the toothbrush bristles were made for the enamel, which is the hardest substance in your body, but your tongue is obviously a different structure. So you want to use a tongue brush or tongue scraper or tongue cleansers that are specific for tongue. Then you want to floss your teeth. And of course, with orthodontic patients, we need ortho flosses, the ones that you could get in the wires, and I love these. I really don’t like those threaders because they can really injure the gums and all of that. And when you injure the gums, you’re introducing oral microbes to the bloodstream. So I don’t know if you’ve seen these ortho flosses that are great, that have floss, and then at the end of it has a little bit of a thicker end-

Yes.

That you can basically thread it as one piece. And then you brush your teeth with a soft or also soft to toothbrush. And that’s another thing. The reason we develop our own system for orthodontics is because really you need, because especially you’ve got braces, and aligners obviously is easy, you just pop it up, but with braces, you need these bristles that go around the brackets. That’s why we had to develop systems that goes specifically compensate for that space of the brackets. Anyways, and so ultimate, at least soft or ultra soft, there’s never a good reason to use high abrasive bristles. And again, toothpaste. Toothpaste, you want to make sure they either have fluoride, especially during braces because we have a high risk or prescription fluoride and or hydroxyapatite, or I prefer nano hydroxyapatite with those vitamins, vitamin K2 and vitamin D3 again.

But that’s just on the remodelization of teeth, which is so important for orthodontists because we don’t want our patients to get declassification throughout the treatment. But of course, ideally our toothpaste should also have good cleansers. Again, nothing artificial in it as much as possible. And then again, a pH should be good. That’s the routine in the morning before breakfast. So hopefully don’t use peppermint oil. That’s going to overwhelm the mouth for that breakfast as you’re going to have. I love to use if an adult, you like mint, spearmint, I prefer over peppermint by far. But you can also use any flavor you like. So that’s be before. So again, mouthwash, tongue scraper, floss, and then you brush your teeth with a safe and effective toothpaste before breakfast, you grab your breakfast throughout the day. I would use a mouth spray because you can’t brush your teeth after meals, mouth spray.

That’s again, a safe and effective mouth spray. The same rules, high pH, alkaline pH and prebiotics and all that. You put it in your pocket, you take it around, you rinse your, because you want to reverse the pH quicker and you want it balance, okay, the microbiome better. And then before bedtime is your evening routine. So you reverse it a little bit. You do the mouthwash at the end. You can floss again if you want. The flossing is optional. You do the tongue scraper, you brush and floss, and then you do the mouthwash for the overnight protection because you want to make sure the fluoride and or nano hydroxyapatite and the prebiotics stay in your mouth throughout the night.

Okay. Is there any difference, because a lot of what we talked about has been focused on adolescent oral healthcare, and that’s what the article was focused on. Is there any difference between the needs of the adolescent and an adult who is an orthodontic treatment?

That’s a really good question. So I think it really has to do more with their oral hygiene than it has to do with their age. Sometimes, as we get older, our habits become better sometimes, but generally speaking, I hate to generalize things, but generally in my own experience, teens are the worst. I had to say it, but they’re the ones that get, and again, I hate to say, but boys are the worst than girls. These are generalizations. I’m a boy, so I guess I could say boys usually have, but so I’ve noticed it’s more, again, some kids are just perfect. They’re really take care of their oil hygiene. So for kids, I think there is the one difference though is you want to make it more fun. So I think everybody, me too, if I want to use something, I wanted to look good at least, be elegant and be nice and fun and creative and beautiful to look at.

That’s why I use my iPhone. I don’t know if you’re Apple person, but I like Apple because not just the quality of what, but it just looks beautiful and it feels good. So this is how we should be thinking as a profession too. We want our oral care products to feel good and to taste good. And for kids, they need to be playful. And it’s like the way we develop it is with superheroes and villains, and we make movies, augmented reality and music. Well, you’re like, what does all of this have to do with oral care is because then we go from something that the kids think it’s a chore, from there to play at a place that the kids think they’re playing, right? Course every kid wants to play, but they don’t want to brush their teeth. So if they think they’re playing with a toothbrush, I have patients or parents send me pictures of their kids sleeping with our toothbrushes or they take them to school.

They’re not thinking they’re sleeping with the toothbrush, because it’s based on the superheroes and villains and characters and the storytelling we do through comic books and music and all of that. That really builds positive associations with their oral care. And that’s really ultimately our goal as a profession, right, as orthodontists, a general dentist, hygienist, is that we want our patients to build positive association. So especially with orthodontists, because we’re limited amount of time that we see our patients. It’s not like we see orthodontic patients forever. They usually come for a few years and then they leave us. So hopefully what we’ve left them with is our good habits that they can carry through other lives.

Well, you mentioned the fact that orthodontists only see patients for a defined period of time, even in that time that they’re seeing them, they don’t see them given the way treatment modalities have changed, they don’t necessarily see them as often or need to see them as often. Now, what are your thoughts on using tools, remote monitoring or anything like that to kind of monitor that oral healthcare, that oral hygiene? Yeah,

I love it. I think when I was practicing, we started using self ligating brackets 25 years ago, so I was always a proponent of as much as possible, let’s use technologies to make it easier, less appointments, because we all have busy lives. Imagine every time that a patient has to sit in your chair, especially a kid, the kid has to take off from school, their parents have to take on board, they have to get a babysitter, whatever it is, it puts a huge burden. We think it’s just the six or $7,000 that they’re going to pay us, but it’s really all this additional burden that we’re putting on this family. So whatever. So I’m all for extending intervals between appointment times or maximizing technology. So how do we do that? Well, we do that with just the things you just mentioned.

We can hopefully use either better technologies, so they do more auto movement of the teeth, or they’re just more self adjusting, or we have to use telehealth and video. This is so common that we now look at each other on a phone or a Zoom. Yeah, why don’t we just do that as part of our treatment? We do such great service for our patients. They don’t have to leave work or school. We can do it at their convenient time. We can just do a quick check. They can take pictures, and there’s so many technologies, as you know, for us to monitor our patients, but that even makes it even more important for their oral hygiene to be good at home because we’re not seeing them in the office and visually see if they’re getting a cavity or decalcification. Then that becomes the oral care products that they use at home and how they use it becomes even that much more important.

So that’s why, again, goes back to our original discussion of we can’t just say this is in the dentist hand. At the end of the day when the people remove their braces, and if we have those unfortunate declassification of their teeth, you know who they’re going to blame, they’re going to blame us. The parent is not going to blame the kid because he or she didn’t brush their teeth, which is really where the blame should lie on, but they’re going to blame the orthodontist. Everybody’s going to blame the orthodontist. So why do we want that beautiful work at the end? We did two or three years or a year, whatever the length term, all of our skills and passion and art, and we made this beautiful smile and this child, remember, this child is going to live with this smile for the rest of their life. So our obligation and our responsibilities to make sure that they do the right things at home so they get end up with the beautiful smile and a healthy smile.

Well, to close out, what excites you about the future of oral healthcare?

Well, so I’ve been attending a lot of meetings lately that this whole oral health, systemic health is coming back. So I don’t know if you know about the history, but this was a topic 120 years ago. 120 years ago in the early 20th century, started in Europe, and then it came to US, and really all over the world, the physicians started to think that almost every chronic disease is linked to oral health. They went extreme. They said syphilis and even stupidity, which back then was a actual medical diagnosis, they linked it to oral health really, from chronic diseases, digestion, brain abscesses. And because there were this adversary relationship between medicine and dentistry, even back then, they started recommending total extractions of teeth. With anything that they couldn’t fix they would say, “Oh, it’s the dentist’s fault. They put a crown or a bridge over these abscesses, and now this is what’s causing it.”

Because it made sense, if you have an infection in your body and you’re just covering it up. And so at least, it made sense from their point of view. Obviously we later found out that we can actually be so correct, that was terrible. Like my grandmother, I actually start my chapter five with this story. It’s a true story that my grandmother has dentures, and she had them started in her twenties. My mom was a young mom when she had me. So I have a relatively young grandmother, and when I realized, wait a minute, my grandmother’s younger than all these other grandmothers when I was a kid. And so I asked her, I’m like, “What has it that you have dentures?” And she kind of started with some tears in her eyes, she told me the story that when she was in her young youth, she was one of this whole generation of toothless people around the world that physicians in that generation they were recommending total extractions of teeth to cure all source of ailments.

So in other words, that pendulum went from that extreme to the late 20th century that we didn’t connect the oral health to anything. But I feel like now, finally, the last 20, 30 years, based on really, really fantastic research, awesome clinical data, we’re now finding out exactly how oral health is connected to pregnancy health, exactly how oral health is connected to Alzheimer’s, exactly how oral health is connected to respiratory diseases and to all sorts of, how oral microbiome… Many things are not exactly. I mean, the oral microbiome, the gut microbiome, we’re still learning a lot. So we’re not there, but we’re learning more and more every day. So this is what excites me. I feel like we’re finally putting that mouth back in the body, and hopefully as a society, we’re going to see as the most important organ in our bodies.

Yeah. Well, if our audience wants to read more about your book, where can they find it?

Everywhere. So anywhere that books are sold online, Amazon, Barnes and Noble, it’s sold in US, in Canada, in all Australia, Great Britain, all the English-speaking languages is getting translated into Chinese and Hungarian and other languages, and it’s available both hard copy, digital and audiobook.

Great. Well, Dr. Hoss, thank you so much for joining me today. It’s been a pleasure and really informative. So thank you.

Likewise. Thanks so much for having me.

Great. And to our audience, thanks for taking the time to listen. Don’t forget to subscribe to the MEDQOR Podcast Network to get the latest episodes of the Orthodontic Products Podcast, and be sure to visit orthodonticproductsonline.com for the latest orthodontic industry news. Until next time, take care.