Dr. Nammy Patel discusses the G in the AGES protocol: gums, gut, and glymphatic health. She explains how bacteria and biofilm in the mouth may influence inflammation throughout the body and why testing, laser therapy, ozone, and frequent cleanings can support a healthier oral microbiome.
John Maher: Hi, I’m John Maher and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole body health and author of the bestselling books, Age With Style: Guide to a Youthful Smile and Healthy Living and Total Wellness: Understanding the Link Between Your Teeth and Your Health. We’re talking about Dr. Nammy’s AGES Protocol, and today we’re talking about the G of AGES, which stands for Gums, Gut, and Glymphatic — how inflammation starts in the mouth. Welcome, Dr. Nammy.
Dr. Nammy Patel: Thank you for having me, John. I’m really excited to be here.
Reframing Gum Disease as Whole-Body Inflammation
John: Absolutely. Dr. Nammy, we hear a lot about gum disease.That’s one of the things that we see commercials about it on TV. When we think of a dentist, we think of, oh, we have gum disease and the dentist is going to fix that. We also think of it as more like bleeding gums and bad breath symptoms like that. But you treat it more as an inflammation problem that really affects the whole body, including the brain and the heart. Why is it so important that we reframe the way that we think about gum disease?
Nammy: One of the things about gum disease, people have always thought about brushing teeth or coming to the dentist because of a cosmetic thing or as a basic thing, they thought that’s just something that they should be doing. But we really forgot that one of the biggest ways to bio-optimize ourselves or feel better is really look at the mouth. Now, the mouth is really important because it’s the missing link. It’s the one thing people forget to look at, even regular dentists. They’re looking at just a cleaning and we’re going beyond that because we don’t want to just look at the cleaning. We want to look at how the mouth is related to the rest of the body. So what is that oral systemic connection? What is the mouth body connection? And that’s what we want to look at. And in my practice, I love the work I do because the part of the AGES protocol is the G.
And the G is really important because it talks about the gums, the gut and the glymph. And I say that because the most important thing that we always have heard about is the mouth gut connection, but we’ve always forget that the mouth is connected to the gut, but also the gut is connected to the brain. So we’ve heard of leaky gut, but we’ve heard of leaky brain, but we forget that it starts with the leaky mouth. And that’s what I’m portraying here when I look at the G of AGES protocol. When we’re looking at the gums, we can actually test out the bacteria and find the ones that are related to heart attack, diabetes, cancer, Alzheimer, arthritis. And we can discover these bacteria. 99% of the time, we find these bacteria in patients who snore, right? Or have sleep apnea.
We also find these bacteria in patients who have chronic illnesses, their toxic load in the body is just so much higher. Their immune system is so active that it’s not getting rid of the bacteria that’s inside their mouth. And many times, which is really surprising, John, is that many patients look fine. If they went to a regular dentist, they’d be like, “Oh my God, I’ll see you back in six months. There’s no worries.” But it’s not until we actually test the bacteria that we discover that there are some pathogenic snake-like bacteria that are sitting in the mouth that are problematic. And those are the specific bacteria that cause disease. And those are the specific bacteria that I am looking for and I want to treat yesterday or ASAP. And that’s what we’re talking about when we talk about the G.
Now, a lot of times patients will come in and say, “I just have this bad breath that doesn’t go away, or I wake up and I feel fine. I don’t bleed”, but we’ll discover that, hey, we’re finding these red light bacteria. Not do you only have this bacteria in your body, but what else are you not telling me? ” “Hey, how is your stress level? Are you super strict? Do you have brain fog? Do you have fatigue? Any arthritis? Are you on anxiety pills? “And that’s what we discovered from doing this oral microbiological. It’s just tests, just looking at the gums. It’s telling us a bigger story about the patient. It’s telling us what’s going on subclinically, things that are inside the body, unconsciously happening twenty four seven that we never really knew we should pay attention to. And so my life’s work in the past 20 years has been really focusing on the unconscious or the hidden infections. Things that we don’t normally see or feel, what’s really going on the root, let’s address it earlier.
So it doesn’t lead to chronic conditions like heart attack, diabetes, cancer, Alzheimer, arthritis. The most common one, John, I see is that patients come in and say,” I have high cholesterol. I’ve been working with my medical doctor, but my cholesterol is high. And yes, I’m stressed out, but my cholesterol is high. “And so we will do the oral microbiome test. 99% of the time we find TDTF. These are specific pathogenic strains or bacteria that you cannot clean off and they actually need to be lasered off or they need to be killed with antibiotics. We find them 99.9% of the time. And it’s very interesting because patients wouldn’t normally think high cholesterol, maybe I should go check the dentist too. There’s something that’s connected here. There’s something that’s missing. There’s something that I should pay attention to. And that’s why dentistry is a missing link. And the gums are a key driver.
They tell us so much about what’s going on in the body and we must address it.
The Glymphatic System and Oral Bacteria
John: One of the Gs that we’re talking about here is the glymph or glymphatic system. Tell me what that is and how that relates to oral health.
Nammy: So the reason I talk about the glymphatic system is the glymph is your body’s or your brain’s detoxification system. Just like we poop on a regular basis, our brains need to poop as well. Our brains are going through cellular changes, right? Because anytime that our body is regenerating, there’s toxins that happen and they need to get taken out of the system. So the system that does that in our body is called the lymph system. The system that does it in our brain is called the glymph system. And that glymph system is very important because it helps take away toxicity out of our brains so that we can have more focus. We’re able to think better and we don’t have different diseases. We don’t forget things or anything like that. So the glymph is really important because through the mouth, I talked about testing, there’s these specific bacteria, PG in particular that is causative for Alzheimer’s and dementia.
What happens with these bacteria is that they’re so small. They’re so small that there is actually a barrier between the brain and the body, making sure that the toxins don’t get in. And so these PG bacteria, they’re so small, they break down the barrier and they get into the brain. These are all snake-like bacteria that when researchers have opened the brain up in Alzheimer’s patients, they’ve actually seen these snake-like bacteria in the brain. These bacteria, when they’re in the brain, what they do is your body is like, ” You should not be here. “So it’ll attack it. As your body attacks it, what it does, it gets rid of bacteria, but it also gets rid of good tissue because it has to. It’s a proper inflammatory response. And so when that happens over a period of time and consistently is when there are problems associated with memory, we see the glymph system not being able to get rid of all the bacteria and we’re not able to … Because there’s so much of them, right?
We have a certain amount of flow. If there’s too much inflammation in the brain, there’s so much bacteria in the brain that the body has to get cleared out. These bacteria become a problem and the GLM system gets backed up. And that’s why we want to look at the glymph system. We want to make sure that the mouth is clean, the body is clean, but also the brain is clean. We want to make sure there’s none of that PG sitting around. We want to make sure that the blood brain barrier is intact. We’re making sure your immune system is working better because if you’ve got PG, most likely you’ve got a couple others that are in the body as well. So we want to get rid of all of the pathogenic bacteria that we’re looking for.
Laser and Ozone Therapy for Pathogenic Oral Bacteria
John: And so how do you go about doing that? I know you mentioned lasers. I think you’ve talked about ozone treatments. How does that work and what does that look like for a patient in the chair?
Nammy: So one of the things that we look at is first we test the specific bacteria. We want to know exactly what we’re dealing with and how much of it do you have. And then also, what is your immune system like? Is your immune system going to clear this on its own or is it something that it’s going to need some assistance with? For somebody who may be chronically ill, we’re going to find that their immune system’s going to need some help. So we want to look at some supplements that would be very helpful with that. So the first thing we would do is test. We test the bacteria, the amounts, also their immune system and their genetic predisposition to inflammation. Then the second thing we look at, depending on what we find, we do deep cleanings. We do deep cleanings with lasers, which is really awesome because it gets rid of the specific bacteria you can’t scrape off, and that’s what we want to do.
We also use ozonated water, ozonated oils, and ozone in many forms. The reason we like ozone is ozone is extra oxygen. Now, these pathogenic bacteria cannot survive in oxygen. So we love putting extra oxygen into the body so that it can eliminate these bacteria without toxins and also without antibiotics. So it’s a first mode of attack that we actually go to. We use laser therapy to be able to remove them locally. We also do that to heal disease tissue so that when there is an infection, there’s swelling, there is redness. We take out the dead tissue so that way there is better tighter junction. So the gum tissue is nice and healthy around the tooth and that more bacteria can’t get in there again. We also have different modalities. There’s sometimes we use vitamin C. There is zinc that we utilize. Boron that we utilize in many cases to be able to help eliminate these bacteria and also keep the gums super healthy so that we can keep the mouth, the gums, the gut, the glimph, very healthy.
Testing the Oral Microbiome
John: In terms of the gut and the oral microbiome, what are you really testing for when you test the oral microbiome? And what does the sort of balance look like and what can throw that off?
Nammy: A lot of things that we test for in the oral microbiome is actually very comprehensive. The oral microbiome test is very comprehensive and I like to test for three things. One is your genetic risk for inflammation. This is what mom and dad gave you. I can’t change it. So I want to know, is your immune system super active, middle active, or like low active? Because what that tells me is what are the likelihood of these chronic conditions? Heart attack, diabetes, cancer, Alzheimer, arthritis, and chronic illnesses. So that’s the first thing I want to do is look at how does your body work? The second thing I want to look at is what is the bacteria that you have? What specific? Do you have green light, yellow light, red light and purple? I want to know which ones you have and how much of them do you have?
I want to see the pattern of what you have. I also want to see how much you have because based upon those three conditions is how I will customize a treatment plan and I will figure out how to get rid of them because sometimes we have to use probiotics, prebiotics that will help create that healthy microbiome. And the microbiome is pretty tricky because I like to think of it like a pond. A pond is not just plants. A pond has koifish, has plants, it has algae, it has a lot of different things. It has fresh water and it’s healthy water. It has microbacteria inside as well, but they’re healthy bacteria. So it’s a fine balance that needs to be maintained. And that’s a thing for the mouth. It has to be a spine balance. Now, things that throw that off are going to be dryness.
If there is dryness of the mouth from snoring, anti-anxiety medications is a common one. If there’s anybody taking Lexapro, anything like that, a beta blocker, high blood pressure medication, those things are all going to cause a dry mouth. We also have patients on cancer chemotherapy or radiation therapy that’ll kill the salivary glands and that’ll create dryness of the mouth. There’s women going through hormonal changes and that creates dryness. A lot of time food tastes funny. Pregnancy is another one because there’s hormonal imbalance that will cause an imbalance in the microbiome. There’s also age that does that because as we get in our 60s and 70s and 80s, the salivary glands just don’t work as hard as they used to. They used to be able to output so much. Just like when I was 16, I believe I ran a mile in four minutes. Now it takes me a good like eight to 10 to run a mile.
So it is just the way our body works. And what happens as we get older in life, the salivary gland zone output. So it’s a natural phenomenon to have dry mouth. And my personal opinion is that a lot of chronic conditions that we see on the elderly, as we get into 60, 70, 80, 90 kind of all start in the mouth because the dryness starts, the bacteria starts developing, they go into the body to the rest of the system and they start disseminating everywhere else. That’s why we look at the root, which is the mouth, the missing link, the connection that is going to give you maximum output, the area where we can help prevent diseases. There’s
Biofilm and Inflammatory Markers
John: A word called biofilm that most patients have probably never heard of. Tell me what that is and why managing it can change everything from a patient’s breath to inflammatory markers.
Nammy: That is a great question, John. So the biofilm is bacteria that develops. And so we have bacteria everywhere in our body and we want the bacteria because there’s good bacteria and there’s bad bacteria. The good bacteria is what we want. So when we get a biofilm, each person’s biofilm is very different. So the biofilm is what we actually test for to see if there’s not any bad ones inside. So biofilm is bacteria that just naturally occur in your mouth and it’s a layer of bacteria that you are always going to have. And that’s why we always brush and floss our teeth every single day. We want to remove that biofilm. Now, when that biofilm hardens, which starts at seven days to 21 days, we start calling that calculus because that is biofilm, a lot of bacteria that’s clustered up together and we call that calculus.
And that’s what gets scraped off when you come in for your routine cleanings. And so the reason we like to control the biofilm, and we focus so much on oral hygiene at home and coming into the office every three months to remove the bacteria is because if we can stop the bacteria at its source, which is the biofilm, we’re going to stop that cascade of chronic illnesses and chronic diseases. Because when there’s a little bit of bacteria, our immune system can work with it. It can remove it and the bacteria doesn’t get control over our immune system. We’re able to keep the infection at bay. We’re able to then focus our energies on regeneration because we’re not fighting bacteria, we’re putting more energy into regeneration. So the biofilm is at the root. We want to get that biofilm off consistently. And for my patients, I always say, come in for cleanings every three months because at that time there will be calculus that’s build up, bacteria that’s built up that needs to get removed.
And when we remove that continuously, we continuously lower the bacterial load in your body. When we lower the bacterial load in your body, your immune system has to work less to fight bacteria. So it focuses more energy on regeneration and keeping young and healthy and essentially biohacking your bio optimizing you.
A Patient Story: Gum Health and Arthritis Symptoms
John: Can you give me an example of a patient who came to you and they’re having issues with their gums, their gut, their glimph, and you’ve treated them. Tell me a little bit about how you treated them and what a difference that it made for them.
Nammy: Oh my gosh, you can’t wait. So I’m going to talk about Carolina, wonderful lady, only speaks Spanish and my staff was so wonderful to be able to help us communicate really well. And she comes in and she’s like, Dr. Patel, I have arthritis and I am 42 years old and this is really hard. I’ve been going to the doctors regularly and they are telling me I must go on medications and I really don’t want to. And she’s like, “I’ve gone to the dentist. I had this beautiful braces I just completed and I’ve been in braces for five years and now my knuckles are really swelling up. Could you help me out? ” And so ding, ding, ding, the first thing I noticed her airway is going to be off, right? She just had braces so that there’s some structural changes. The second is you hadn’t been a dentist in a little bit of time, so let’s test the bacteria that’s in your mouth.
We tested the bacteria, we found so many bacteria in the mouth and we found so much of them, and especially the pathogenic one, the 13 species that we look for. We also saw that her immune response was high. That means her immune … The fact that her body is going to work in a way to get, it’s going to have more chronic illnesses. And so when I saw that, I knew I needed to be super aggressive in addressing her gums. So we did, we had her come in, we did a deep cleaning with laser ozone, and we use erythrotol, we use vitamin C. We really worked on this and we got her on vitamin D, D3K2 to help her bone healing, getting rid of the infection, helping her bone heal, getting rid of the infection, letting her bone heal, getting rid of the infection, letting her bone heal.
And we did this in a way, not just with the gums, we also used a product or a machine that actually does steam sauna and detoxifies her. So we detoxify the mouth, we detoxified her body, and in six weeks, we retested her. We could see the bacterial levels have gone down. And I want to share this story because of course, as a clinician, I care about the clinical results. Most important, I was seeing her every week because I knew I needed to be barely aggressive. So when I saw her the next week and she said, “Dr. Patel, can I tell you? ” When I got home that night, I went to sleep. It was a long session. I was tired and she’s like, “I woke up and the swelling in my knuckles went away.” She was like, “I would struggle first thing in the morning to open my pill box and it would hurt so much.” And I would cry because it was so hard.
And she’s like, “I woke up and my knuckles had no pain just from your first session,” which is huge. I had to see her six more times. So that first session was amazing, just getting that result. And I mean, just you
Could see the smile on her face. She was so happy, feeling relieved, knowing that everything is working and it was just delightful to be able to see that. So
Key Takeaways for Gums, Gut, and Glymph Health
John: What do you want people to take away from this conversation about the gums and gut and glymph systems? What’s the main thing that people should take away and what should they do to address this if this sounds familiar to them, something that they’re dealing with?
Nammy: Absolutely. The first thing I would say, the three things I would want you to take away today would be, we’ve always heard about the leaky gut and we’ve been focusing on that for such a long time. Let’s go deeper and understand where does that leaky gut come from, comes from the leaky mouth and now what else is it connected to, which is the leaky brain. So we’ve got the leaky gut, the leaky mouth, the leaky brain, and we want to make sure all of those leaks are fixed. That’s number one when it comes to that. The second thing is number two is test your mouth, test what kind of bacteria in there so you can personalize and customize your protocols. That is the key is to be able to do that. Number three, remove the biofilm more frequently. Go for cleanings every three months. Just because insurance pays for it six months doesn’t mean it’s the best for you because the insurance will pay for surgery for a heart attack, but isn’t really going to be focused on helping you prevent it.
So number one thing I would say is focus on the biofilm, remove that biofilm more frequently so that you can make sure that you are investing into your own health, keeping the bacterial load down and helping your body heal really well. All right.
John: Well, that’s really great information, Dr. Nammy, thanks again for speaking with me today.
Nammy: Absolutely.
John: And for more information about Green Dentistry, you can visit the website at sfgreendentist.com or call 415-433-0119.
